- 16 hours ago
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🔥 EP 4: The situation escalates as new challenges arise. 😱 Every decision now carries serious consequences.
🔥 EP 4: The situation escalates as new challenges arise. 😱 Every decision now carries serious consequences.
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TVTranscript
00:13What the hell is going on out there?
00:15Somebody stole the reg.
00:17Again?
00:18Hey, where do you think you're going?
00:19We'll be back in two minutes, Max.
00:21Anton's going to show us his new motorcycle.
00:23Great.
00:23We always need organ donors.
00:25Ah, someone stole your reg.
00:26Yeah, you weren't watching the screens.
00:27How'd you miss it?
00:28Oh, I saw it pull out.
00:29But I figured you were in it.
00:31Why'd you leave the keys in it?
00:32It's a protocol.
00:33No, it's not.
00:33That's what I said.
00:35Yes, it is.
00:37And who steals a fucking ambulance at 10 a.m.?
00:40Easy.
00:40Junkies, meth heads thinking they just stole a candy store.
00:43Or a psych patient kicked loose last night.
00:44Y'all don't know.
00:45That thing is getting stripped, chopped, and shit.
00:46Hey, shut the fuck up.
00:50Maybe another job it took.
00:51Did you call your dispatch?
00:52Of course we called our dispatch.
00:53Did you call the cops?
00:54I can't.
00:55But the two having breakfast in the cafeteria.
00:57Help you sell.
00:58Hey.
01:00I'm good.
01:00Thanks.
01:01Oracle.
01:02Come on.
01:04Lock with $20 on the psych patient.
01:05Oh.
01:05I'll take that action.
01:06Yeah.
01:07Hey, do we have crutches?
01:09Yeah, ortho locker just restocked.
01:10Okay, great.
01:11Can you bring back Sherry Davis next?
01:13Oh, sternum mom with the handburn?
01:14Hmm?
01:14Oh, she split.
01:16Shit, when?
01:17I gave the kids two breakfasts each off the borders card, and they left.
01:20In school, probably.
01:21Did she say anything about coming back for wound care?
01:24Not to me.
01:26Fuck.
01:27I need rooms cleared and clean, so I'm shuffling the deck.
01:29Yeah, but why are you moving him into Peds?
01:31I'm just about to extubate him.
01:33There's no kids in there at the moment.
01:34The family can have some privacy.
01:36There's nice pictures on the wall.
01:38What's the problem?
01:38There's no problem.
01:39There's no problem.
01:41Mrs. Smith does not need a cardiac monitor.
01:43She can get her vanco in the hall.
01:44We've got one telebed available.
01:46Let's give it to Otis before someone else snags it.
01:48Yep.
01:48Leave the family in Central 7 alone until nuclear medicine's ready to take the kid.
01:52There's no sense in moving them twice.
01:54Aye, aye, Cap.
01:56Hey, Robbie.
01:59You're going to extubate.
02:00Yes.
02:01Good.
02:01You shouldn't have intubated.
02:02Yeah, I remember you saying it just like it was this morning.
02:05Want me to do it?
02:06No.
02:07Why?
02:09Adamson.
02:10Jesus!
02:11Okay.
02:12There's something moving in there!
02:13Ma'am, hold still!
02:14I can't help you if you keep moving your head!
02:16Get it fucking out!
02:18I can feel it!
02:19Arthropod in the EAC.
02:21Oh, my God!
02:24I better get in there.
02:25Yeah.
02:31How long will he live without the oxygen?
02:34It's difficult to say.
02:35Hey, once the tube comes out, it could be anywhere from 30 minutes to several hours.
02:42When I extubate, we're going to suction the back of his throat.
02:44We're going to give him some glycopyrrolate drops, which will cut down on his secretions.
02:48He'll get morphine for any pain.
02:51And we'll give him some oxygen in his nose as a comfort measure.
02:58Jesus.
02:59I don't think that I can go through this.
03:02I mean, this is happening, like now, like today.
03:08We just decided that Dad is going to die in this room, in a room with cartoon forest animals
03:15all over it.
03:18God, if you think about it, it's kind of perfect.
03:25Our dad worked on Mr. Rogers' Neighborhood the whole time that we were growing up.
03:29Oh, no kidding.
03:30That's very cool.
03:30Mr. Rogers, the television program?
03:32That's right.
03:33Here in Pittsburgh?
03:34At WQED on Fifth F for 33 years.
03:38Dad worked with Jack Guest, the art director, so he helped paint and build all those sets.
03:46I mean, I don't think that I can do this.
04:00Okay.
04:01Just to be clear, your father's dying, and you're choosing to allow that to occur naturally,
04:08rather than subject him to a torturous amount of procedures which would only delay the inevitable.
04:13I just thought that it would be different.
04:15And I thought that we'd have more time.
04:18Is your family religious?
04:20Oh, God, no.
04:22No God.
04:27I had a teacher, a mentor, who told me about a Hawaiian ritual called Ho'oponopono,
04:38or The Four Things That Matter Most.
04:41It's basically just a few key things that we can say when we're saying goodbye to a loved one
04:45that can really help at the early stages of loss.
04:50What are they?
04:51They're going to sound really simple, but I swear I've seen them work.
04:55Okay.
04:56I love you.
05:01I forgive you.
05:03Please forgive me.
05:06That's it?
05:08Yep.
05:09I told you it was simple.
05:13Okay.
05:16Mr. Spencer, I'm going to take this tube out of your throat now.
05:21Now, what I want you to do is take a very deep breath, breathe in, and now blow it out.
05:29There we go.
05:31There we go.
05:40Okay.
05:41Okay.
05:44Give me some oxygen in your nose.
05:48A couple drops under your tongue.
05:55Okay?
05:56I'm tired.
05:56You can rest.
05:58Close your eyes if you want.
06:00You're chilling right here.
06:03Yeah, Dad.
06:04You just rest, okay?
06:07We're right here.
06:09I'm right here.
06:23Come find me.
06:24Can you take a deep breath for me?
06:27Jesus, everybody's going to this concert tonight.
06:29I wonder if there's any decent passes left.
06:32Another deep breath.
06:34Oh, my God, Jenna.
06:36You're never going to believe who DM'd me.
06:38I fucking told you this would happen.
06:39I'm sure Jenna's happy you're here to support her, but perhaps you could wait outside until
06:43we finished.
06:43Excuse me?
06:44Excuse me, I'm in the middle of an examination.
06:46Yeah, and I'm going to stay with my friend for as long as she needs me.
06:49I'm the one who brought her here.
06:50Gold star for you.
06:52Okay.
06:53It's fine.
06:54I'm fine.
06:55You sure?
06:56Yeah.
06:57Come on, Mark.
06:57Mr. Kirsten.
07:01Oh.
07:05I wanted her to leave.
07:08How are you doing?
07:10Um, I called Nick's dad an asshole, told him to go ask his son.
07:18Why would I say that?
07:22Why don't you tell me about school?
07:24What are you studying?
07:26What?
07:26Do you do any sports?
07:29Are you into any extracurricular activities?
07:31I don't know why you're asking me that.
07:35It's important that you focus on the good things in your life right now.
07:39How?
07:41A boy, a very sweet boy that I barely even knew is dead, and I just fucking made it worse.
07:47You just need to-
07:48I mean, his father thinks I killed him, and you're asking me if I play sports?
07:52Jenna.
07:53Jenna, I can tell how upset you are right now.
07:55I see how painful this is.
07:57We don't even do drugs.
08:00We were studying.
08:01You know, how does that happen?
08:03I can't imagine how hard this must be for you.
08:07I just really want to go home.
08:11Well, your vitals are excellent.
08:14When your parents arrive, they can take you.
08:20Here, if you need anything.
08:26Oh, well, that works out.
08:28A couple of observations?
08:30Please.
08:31Authorize your skin.
08:32Rhino.
08:33Good.
08:34Distraction is a terrible strategy.
08:35When a patient says I'm hurting, we don't respond.
08:37What's your major?
08:38I wasn't trying to-
08:40Additionally, I statements work better than you statements.
08:43I can see how painful this is, acknowledges the reality of the situation, and invites further
08:46examination, you need to move on has the opposite effect.
08:50Understood, but in my personal experience-
08:52Your personal experience isn't germane here.
08:54Germane?
08:55Relevant, pertinent, appropriate.
08:58Well, I respectfully disagree.
09:00My life gives me a perspective that-
09:02Are you where you have an aggressive energy, Trinity?
09:05Even this conversation feels confrontational.
09:08You bring our education to the job, not our baggage.
09:11Got it.
09:13Will do.
09:16Good news or bad news first?
09:18What's the good news?
09:19Your canal is numb.
09:20Simple flush with saline will fix the problem.
09:23What's the bad news?
09:24You've got a dead bug in your ear.
09:29A cockroach.
09:33We were in here for maybe 35, 40 minutes tops.
09:36I go outside, it's gone.
09:37Seriously, there's nothing on the radio?
09:39Not yet.
09:40The keys are inside?
09:41Yes, I leave them in there in case somebody needs to move it.
09:44Not supposed to leave the keys.
09:45That's what I said.
09:46You take the keys, so nobody steals.
09:48So what the fuck is security for?
09:50I'm about to show you.
09:51Oh, yeah.
09:51Hey, guys, we can congregate somewhere else.
09:53Get a little room.
09:54We've got a new guest checking in.
09:55Guys, Ahmad, we've got to keep this area clear.
09:57Everybody, please.
09:58Hey, five bucks on Chop Chop.
09:59Wendell Stone, 52, chief rigger from Pit Fest.
10:02Isolated shawm to the left chest when a speaker tower came down on him.
10:05Looks like multiple rib fractures.
10:07Pulse 110, BP 130 over 85.
10:09Decent sats at 96.
10:1150 event in the field.
10:12Got it?
10:13How we doing, Mr. Stone?
10:14Mr. Stone's my dad.
10:16Just Stone.
10:18Damn.
10:19They woke the Kraken.
10:21What's he do for his next round?
10:25Forty minutes ago.
10:28Perfect.
10:30Mr. Driscoll?
10:31Mr. Doug Driscoll?
10:33About fucking time.
10:35See you later, suckers.
10:38Excuse me.
10:39Sorry.
10:41Jiayi Chin?
10:42I have some time to offer Jiayi Chin.
10:44Yes, please.
10:45Over here.
10:48Jiayi.
10:48Jiayi Chin.
10:49Yeah, good.
10:49How much longer is it so we can see the doctor?
10:51Uh, we have to wait for a bed to open up.
10:53Might be a little while.
10:54Pretty popular today.
10:56The medicine should help.
10:59Thoromorphine.
11:00No abdominal tenderness.
11:02What do we got?
11:03Thanks, you owe me a Coke.
11:04Isolated chest trauma with...
11:05I want to hear from Dr. Santos.
11:07Isolated chest trauma with obvious flail chest.
11:10No human pneumo on POCUS.
11:11Good sats and vitals.
11:13Excellent presentation.
11:14Sir, I'm Dr. Garcia from surgery.
11:16I need surgery?
11:17Not necessarily.
11:19No blood in the belly.
11:19I'm fast.
11:20Okay, you got this?
11:22Abdomen's benign.
11:23CT chest, abdomen, pelvis with contrast.
11:26Intertrust weigh more than your ultrasound skills.
11:28Exus!
11:29And more morphine, for God's sake.
11:32No, no, no.
11:32Don't knock me out.
11:33I gotta stand on top of the crew doing the pudding.
11:35The what?
11:36The festival.
11:37We'll block all the nerves going to the broken ribs.
11:41Roll to the right.
11:42You'll be awake and pain-free.
11:44Yeah, that's what I'm talking about.
11:46That's a ton of intercostal blocks.
11:48Nope, one shot.
11:49Cerratus interior blocks down to T9.
11:51You kids and your crazy regional blocks.
11:53Dr. Santos, call me with the CT results.
11:55Extension 1121.
12:00Gabe's the same age that I was when we made our first layout.
12:03You remember that, Dad?
12:04The two-level track in the basement of the Clovis house?
12:07Oh.
12:08That's right.
12:09Yeah, it was an O gauge.
12:10It limited the cars we could use, but that layout was a beauty.
12:16Doctor?
12:17Does that sound he's making mean it could be any minute?
12:22No.
12:23No, it just means that he's having trouble handling his secretions.
12:34Mr. Spencer, this should help.
12:46I'm also going to give you a scopolamine patch behind your ear.
12:51That will cut down on his secretions for the next 24 hours.
12:54You think he has 24 hours?
12:56There's really no way to know.
12:58Let's give him another two or more fever PPRN.
13:01We're going to give him something to keep him comfortable.
13:03Doctor, what were those four things again?
13:08I love you.
13:09I forgive you.
13:11Please forgive me.
13:12It's easy.
13:14I love you, Dad.
13:16I've loved every minute we've gotten to spend together.
13:22You're the best dad a boy could have wanted.
13:25You never missed a game.
13:26You always made time for me, whether to play catch or to build models or help me with my homework.
13:36Or when we would wake up before everybody else and make sandwiches.
14:03Let's go to the right back.
14:04Great.
14:54they spotted it Easton 376 oh oh let's go it is all in there 15 on crash from another five
15:03on
15:03junkies give me eight dollars on catch with another uh-uh multiples of five only I'm not
15:07touching no stripper bills what's that shit hey you want to keep it down this is a hospital
15:13not rivers casino keep talking I'm gonna find Robbie
15:20psych wanted to transition him to oral meds there's an order for an olanzapine tablet at 9 30 a.m
15:25yeah
15:26that's on us I've been with criticals all morning he needs to go upstairs to behavioral health we're
15:31too busy down here to dispense psych meds on the schedule understood what options are we left with
15:36either we let him tire himself out or we go in and stick him I'm worried he's gonna hurt himself
15:42he's in partial soft restraints what we really need is a pavulin blow dart
15:50hold it you caught me and I was almost over the wall go easy on me warden I need an
15:56order for an
15:56magistrated psych patient been here for days methamphetamine induced psychosis the kraken
16:01really should call him that how about a b52 no no no that would take way too long type the
16:06staff
16:06qtc normal five of bedazzolam five of haldol and mr.
16:11kakosia you're joking no kakosia will be out like a light in under a minute
16:16it hardly seems as offensive to call him kraken if his name is actually
16:19irritable five month old clearly I'll be right there
16:22um I need more coffee
16:26you doing okay cap yeah why can't I be going over the wall
16:47yes
16:48cordera it's actually tasha cordera and miss okay you want to come on back go through those doors
16:58you cut your arm yes okay no problem
17:06hi I'm dr. mckay this is victoria javadi student doctor hello tasha
17:12hi um sorry for the long wait tasha do you mind if I take a quick peek yeah okay
17:20all right not too bad definitely gonna need a few stitches though when you come on back we'll get
17:27you patched up okay okay how big is the pneumothorax got it thanks what's the pneumothorax uh just a
17:39little air leaking from the big bruise in your lung getting short of breath here pain no all
17:46that's gone good the block worked sats are down to 85 on five liters his lung contusions need some
17:53help start by pap 10 over 5 that'll open up the bruised parts of your lung thanks uh good news
18:01is you
18:01don't need surgery but i'll uh let dr garcia know about the ct uh she likes you
18:08i've met her two hours ago must have made a strong first impression
18:16any fever vomiting or cough none of that uh good feedings was she full term at birth
18:22a normal delivery travel vaccines i get two months and four months to get an what's your
18:29differential diagnosis i need to check with a rectal thermometer is that really necessary it's
18:34really important oh i need it oh we gotta rule out any serious bacterial infection sepsis
18:44pneumonia phylo appendicitis meningitis you think she has meningitis no we're just discussing
18:51hypothetical possibilities temp 99.2 making meningitis extremely unlikely heart rate 164
19:01stats 99 this is dr robbie our senior physician hi nice to meet you
19:11afebrile alert good vitals doctors mohan and king were just about to start their physical
19:16why don't you go check on our students and i'll handle this
19:26why are you sticking me again came in an hour after the chest pain
19:30it's a heart attack it can take more time for the heart damage to show up in the blood
19:33put your finger on that even with the normal ekg that's why i repeat the test
19:40lift on up thank you
19:45all right let's get you back to the weight room what no no all i've been doing is waiting
19:50i'm supposed to see a doctor now soon i'll let you know
19:57this is a fucking joke yeah it's good to laugh
20:03laughing our way to being a third world country
20:08remind you of home
20:12okay no we're not supposed to pick favorites here
20:14i'm gonna keep my eye on you yeah
20:21you do that oh yeah
20:29so tasha it was a decanter a beautiful baccarat carafe i was uh showing a colleague how to
20:36polish it and the neck broke with my arm still inside so not my finest
20:42did it shatter no no it cracked cleanly in two but as a reflex i jerked my arm back
20:49that's what did it reflexes i have regretted a few of my own good now i inject to the other
20:56side single layer straight edges about as straightforward as it gets good it's a relief
21:06what's going on hypoxic to 78 bps crashing systolic's 82 pulse is ready i should intubate
21:13does he need a massive transfusion protocol no absent breath sounds on the left
21:17tracheal deviation to the right 14 gauge angiocath now put him on a non-rebreather
21:23what are you doing tension pneumothorax from the bipap's positive pressure
21:32you hear that who the hell ordered bipap garcia no his his stats were down that i didn't you did
21:40without running it by me can i put in a chest tube he doesn't need a chest tube he needs
21:45a
21:45pigtail catheter and i'll be doing it stats and pressure both coming up draw up 75 of ketamine
22:00why is she still crying fontanella soft and flat people's equal and reactive tracking across midline
22:06dr mohan keep it focused please mucous membranes nice and moist
22:12hard to hear over the crying but ones are clear heart rate's tacky but normal soft abdomen no obvious
22:21signs of tenderness so basically a normal exam and what's wrong give us a little time to finish
22:26our exam i know what am i looking for dr king uh cellulitis edema from the spottic syndrome
22:37diagnosis made what is it hair tourniquet uh mothers with hair can wrap around the toe multiple times
22:42when it dries it tightens and cuts off circulation my hair i i showered before nursing that easy to
22:49miss mom but we caught it early so there won't be any permanent damage to the toe
22:54it's too tight for scissors do we have an air we do indeed an air like from the drugstore 10
22:59minutes
23:00should dissolve it right off and stop the time
23:05hey you're okay what's up we're gonna give the wild one a shot have the order meds on the way
23:10but we
23:11need bodies i call the head i got kicked last time right arm left arm right lady need one more
23:17got two more i'm just here to observe and speak with the patient once he's under control oh
23:21hey robbie can can you help us with mr cracosia nope coward whitaker just the man we need come
23:30over here please whoa what did i miss a little drama from attention pneumo you could have called
23:35me you got under control good and dr santos learned what can happen when you put a patient
23:42with a small pneumothorax on bipap ah thumb scalpel he was hypoxic i thought it would help but
23:49you didn't discuss it with me and he almost died dilator you need to run every order by a senior
23:55resident or attending that's why it's a four-year program now when you do this procedure you want
24:00to make sure to never ever lose this guide wire that gets sucked in the chest you're screwed
24:06now ready for the paint deal
24:10what the hell are you doing pneumo is tiny it'll resolve spontaneously yeah it was tiny until the
24:15patient went on bipap are you fucking kidding me guide wire out his sats were down i i gave the
24:21order
24:21without clearing it with me honest mistake from the rookie that's how we learn
24:31if she knew everything she'd be your attending not an intern
24:36that is very true besides it could have happened on its own without the bipap
24:41wow beautiful moment a lot of love in the room if you'll excuse me i save
24:51it's wheeler dr abbott said to come back at 6 30 and he'd still be here but we overslept
24:58i forgot to charge my phone i'm really sorry okay let's see wheeler kristin it's christy and
25:06and i'm her mom dr abbott went off duty at 7 but that's no problem we'll get you back
25:12have a seat until we call your name okay thank you so much you're welcome next
25:24how you guys doing thanks you missed our appointment but otherwise we're fine oh no
25:32have you been here long i've been here about four hours
25:36oh we were here two nights ago we waited seven hours
25:40it's all bullshit can't believe somebody hasn't died out here
25:52how we doing no change i've been doing all the talking do you want to say some things
26:06what is there to say i'm sad i'm angry i don't want him to go
26:13there's so much that i wish for different it's not fair
26:22tell it i am telling him i'm telling both of you it's not fair
26:31i wanted what you had
26:37i love you dad and i'm thankful for everything you did to provide for us
26:46you weren't the dad i wanted because i didn't i didn't play baseball or build models or fish
26:56my friends dads all had grown-up jobs
26:59they didn't tell silly jokes or talk in character voices or make up stories
27:08i was embarrassed and i didn't want my friends to meet you
27:14it's true
27:18i'm ashamed to admit it but it's true
27:23i left for college and i i stayed away
27:32i could have gone fishing
27:35i should have gone fishing
27:40and i'm i'm curious now
27:50i forgive you dad for not being the man that i wanted you to be
27:54but i am i am so grateful that you weren't
27:58the world needed you to be exactly as you are
28:03it got it got serious and and it turned ugly
28:06and you and your friends built the neighborhood of make-believe
28:15what an incredible gift
28:25daddy i'm so sorry please please forgive me
28:52no news chopper coverage no eye in the sky not even a damn drone no mystery here
28:57the cops head east on 376 they're headed to swissville yeah the cousin in swissville
29:01he says he's crazy fellas they are not going to swissville
29:04they're crossing the line canada baby that's the other way genius see i'm taking all your money
29:09no you're not you're taking his money i think so i'm breaking up this someone's circle antoine
29:13you're supposed to be in triage dennison needs a knee immobilizer and crutches go on
29:16paulo take postural vitals on thorpe and north five and a repeat for cassium draw on
29:20fontaine and south 18. larry you're coming with me okay we have a quorum meds finally here
29:26yep guys got some energy let's do this donahue right leg larry left leg kim right
29:31arm i call left arm perla takes ahead and our young man here will inject clear yeah pull socks
29:36right here good luck i am injection to the mid anterior left thigh everybody ready yo whitaker
29:44you play any ball well football no dodgeball of course football yeah some peewee you know i was
29:52actually a pretty good kicker not helpful look larry and i gonna block for you come in right behind us
29:57when we split and go for his legs you go right up the middle in zone baby okay yeah got
30:02it okay
30:03okay you ready one two three okay mr krakosia we're here to help you we're here to help you oh
30:13god
30:14what do i do
30:24congrats kid you just earned your yellow wings okay midazolam we'll take him down in a minute we'll
30:29monitor him for 20 after that the haldol will have kicked in yeah he's settling down now do
30:33i really need to be here for 20 minutes why you got a date i mean i'm covered i'm kidding
30:37thanks for
30:38your help go get cleaned up okay thanks everyone good work i know i don't need to say it but
30:42let's try to
30:43stay on top of mr krakosia med schedule sorry yeah thanks can i help you get any scrubs oh no
30:48it's
30:49good i'm gonna uh thank you for the offer though so tasha you work in a restaurant no take it
31:01in two
31:01bites okay rotate your wrist follow the curve of the needle exit at 90 degrees same distance from the wound
31:10good yes i'm the sommelier at altius no altius is supposed to be amazing sorry what is it you do
31:16i'm the sommelier the wine steward we have the best seller in the city i don't mind bragging that
31:24sounds like a great gig you have to go to school for that oh my yeah yeah i have a
31:28degree cool okay
31:30how's that uh really good first tie is a surgeon's knot wrap the suture twice grab the short end pull
31:37with
31:38just enough tension bring the wound edges together not too tight or shoulder railroad tracks so tasha
31:44what's your favorite wine you've ever tasted or most expensive same answer for both uh 2011 the man
31:54uh three more instrumentized great square knot single wrap around the needle driver is that french
32:01as french as it gets a burgundy and how much does that cost i sold that bottle for 18 000
32:10not here that was in new york are you kidding 18 grand for a bottle of wine
32:16i mean was it really that good life changing and i know something about life changing maybe one day
32:24i'm still not old enough to drink legally that's a little scary and i'm about 18 grand short in front
32:33of bills so i'll have to take your word for it too uh my only extravagance these days is moisturizer
32:40i hear you jenna got some people here to see you oh my god oh my god oh my god
32:49oh my god you're
32:50okay so sorry i have no idea how this happened i swear is she um yes she's cleared medically you
32:55may
32:55take her home here are some discharge instructions but no more pills unless they're from a doctor or
33:00pharmacy i won't we're giving you some fentanyl test strips these work on pills and liquids and this is
33:07a narcan spray please just keep it in your purse just in case if you're at a party someone's out
33:12of
33:12it yeah thank you you realize how lucky you are yes hi i do mr mrs bradley i just spoke
33:24to nuclear
33:24medicine and they are ready to take nick for the cerebral perfusion study test in a few minutes
33:28can we stay with him absolutely the test itself involves radiation imaging so you'll have to wait
33:34just outside the door but dave will take you down i'll show you where you can be he'll also bring
33:38you back here the results take about an hour or so and i will come find you when i get
33:43them and we'll
33:44take you from there thank you doctor okay
33:52so sorry to keep you waiting i'm dr heather collins you must be christy and lynette wheeler yes yes we
34:01were supposed to see dr abbott yes dr abbott is an amazing physician but even he needs sleep
34:06occasionally i guess i just got tired and i forgot to charge my phone and we overslept i use an
34:12old
34:12fashion alarm clock since med school never fails that's what i have at home i just forgot to bring it
34:19okay i see we're doing a medication abortion today correct yep well since i didn't initially assess you do
34:27mind if i ask a few questions get up to speed no thanks is this your first pregnancy yes and
34:37you're 17
34:38when did your last menstrual cycle start um not exactly sure end of june 23rd maybe
34:48any allergies to medication no any surgeries in the past no
34:54i need to do another quick ultrasound to make sure everything's okay for the medication
34:58do you want to put on a gown to make sure you don't get gel all over your clothes okay
35:05i'll be right back thank you
35:08joyce our sickler's doing well in the exchange transfusion awaiting a telemetry bed
35:13quinn the midnight vapor still in sinus after cardioversion uh four hours of cardiac monitoring
35:18starting now and you can discharge good samaritans hanging in stable vitals and neurocheck yeah i
35:23want to get a repeat head ct in an hour rule at any increased bleeding and mr gold was still
35:27positive for camphalobacter has gone home on azithromycin well i hope he loads up on water
35:32electrolytes the guy filled up half a dozen bedpans must be a record without sounding like a broken
35:37record everything okay with you it's your third cup before 11 a.m yeah i'm not sleeping great if i
35:41can
35:42with me a little bit but i've got four days off next week i think i'm gonna get out of
35:45dodge and head
35:45of the hills i wish you would what shakespeare say tradition heal myself what you've been talking
35:50to collins not shakespeare luke the disciple you've probably heard it from paul the apostle
35:56but what do i know i'm jewish it's not my book shakespeare had nothing to do with it though
35:59yeah we have a little time when we begin oh you have everything yeah i think so
36:17is that yeah let's go sweetheart wait um mr bradley
36:26i just wanted to apologize uh for the way i spoke to you wait please no excuse um i was
36:32gonna ask a
36:32nurse to give you this but uh it's my number and email if i can ever be of any help
36:38in any way
36:40please i don't know who you are oh i'm sorry i'm jenna uh
36:48i met nick at orientation and he was really sweet um
36:55we were in the same econ class and we had this really big test coming up so some of us
37:00made this
37:00kind of study group and um stay up way too late drinking coffee and then have a really hard time
37:05falling asleep and one girl said she knew how to get xanax um but was too afraid to go pick
37:14it up
37:16nick was just being nice when he said he'd do it
37:22i'm so sorry um i really hope he pulls through this i'm i'm praying he pulls through this he will
37:33uh yeah thank you
37:37you should go i'm sure your parents want to take you home
37:48hi
37:53sorry about earlier i think i still have a lot to learn
37:59you do
38:02looks good nice job doc thank you for the trust now keep it clean and dry and we'll see you
38:09for
38:09a wound check in two days you did great didn't feel a thing suture's out in a week but come
38:14back
38:14sooner for any redness fever or drainage okay okay thank you um i couldn't help but notice there's
38:21a misgendering error on your chart i'm really sorry about that i've gone ahead and fixed it here and
38:26on your insurance data file but it shouldn't happen again wow i am
38:34thank you truly thank you both yeah of course
38:42that was cool i didn't think to check that good catch
38:47oh any other medications uh the only medicine is tylenol and she has no allergies
38:53hi i'm dr mahan hello nice to meet you uh let me catch her up jia yi is a 12
38:59year old with six
39:00weeks of constant pain in the suprapubic area there's no fever no dysuria no nausea vomiting
39:06diarrhea no vaginal discharge and the urine pregnancy test is negative a pregnancy test of course it's
39:13negative she has a stomachache tell me a little bit more about your pain can you give me a number
39:18from
39:19one to ten ten being the worst it was like a two the first few weeks then it went up
39:23to a five now
39:24it's worse like a seven and when was your last menstrual period i haven't had it this month no
39:31never a few of my friends got theirs i'm still waiting she's only 12. okay we'll be back for an
39:38exam
39:38why don't you change into a gown open in the back
39:44it's weird i mean no period but she has early secondary sexual characteristics you know breast
39:52development widening hips yeah it's primary amenorrhea what are you thinking could be a
39:59pituitary dysfunction okay how are we doing are we moving anybody out of here we're trying
40:03asthma cleared after two nubs went home with steroids and albuterol i like that who else uh
40:09higher scabs don't know zip ties from airline cable walk around and find out come monday that
40:15promoter's gonna have my lawyer's shoe so far up his ass he's gonna be flossing with the laces
40:19how we doing in here vitals are perfect setting 98 on four liters nice i could go back to work
40:26now
40:26with six rib fractures a bruised lung and a catheter in your chest not the best idea but i do
40:31respect the
40:31work ethic richie get cecil on facetime again i need to see the ship myself do me a favor call
40:38dr gregorian and thoracic and see if you'll take stone as a personal favor to me and make sure he
40:42knows he doesn't need any real babysitting stay but we just need a bit copy that projectile vomiting
40:46is better with ondanzatron labs normal weight and pio challenge what about maneuver the falling
40:51any buttocks on board pain free on the or schedule at 3 pm we park you in the hall for
40:55a few hours okay
40:56good a little jelly on the belly sorry it's cold
41:04and just to be sure you're not being treated for any blood clots taking any anti-coagulants
41:09no i don't take any medicines
41:24is everything okay
41:28yeah there it is there it is top of seven i knew you wouldn't let me down here we go
41:33wait where is it yeah well it sure as shit ain't swizzville they're out in monroe baby
41:37trailing ppd what are they doing out there they're driving till the wheels fall off and it's almost
41:42outside i catch i got ten dollars that say they don't make it to the county line they coming back
41:46i don't know yeah yeah yeah i'll take that they're westmoreland's problem now
41:52it's on the news uh yes ma'am where are they they're headed east toward monrovo let me see
42:06give me twenty dollars on junkies caught outside our zone well damn all right
42:18soft non-tender okay jay we're gonna check below the waist you'll be all covered up would you like
42:24dad to say yes please don't go okay i'm here i'm here all right knees up but keep your feet
42:31on the bed
42:33and let the knees flop apart we're just gonna take a quick look
42:41you'll feel me touch your upper leg so we can see where you pee
42:44any pain no it's okay
42:51okay you can put your legs back down you did great and we know how we can help you
42:56thank you dad can we step out for a minute
43:03good job
43:07what's what's wrong with her her mother died of colon cancer is it no that has nothing to do with
43:14this do you know what a hymen is but not really when the baby is developing in the womb there's
43:23a
43:23membrane called the hymen which blocks the vaginal passage before birth most of it goes away but
43:28sometimes it doesn't is that dangerous no not at all the good news is that your daughter has an
43:34imperforate hymen totally blocking the vagina we saw what looks to be about three months of
43:40violacious menstrual blood bulging from behind it oh my god it's totally curable and an easy fix
43:47your daughter needs minor surgery best done under anesthesia in an operating room by a gynecologist
43:52then she'll be okay yes totally back to normal thank you the uh we lost jai's mother
44:04when jai was six and i do my best to fill her place but as she gets older
44:15her mother her mother would have known what to do i'm sure you do great she's going to be fine
44:22thank you
44:28you should let her know i'll do the talking this time
44:35housekeeping is turning over south 20. damn we're good what's it like when i'm not here i hate to
44:40break it to you but i run a tight ship with it with that more fun with me though right
44:43jokes are
44:43better always but your tell is the hairier it gets the funnier you get and you are on fire today
44:51dr robbie it's time
45:01hey
45:12is he's still with us those are called diagonal respirations close to the end
45:21he said our mother's name a few minutes ago marge
45:27did he like she was here in the room with us and then he he smiled and just closed his
45:36eyes
45:40how are you both holding on i'm exhausted yeah uh i i'm i think i'm doing okay
45:48jeremy i am so glad that you were here same i i couldn't go through this by myself
45:55you don't have to and sarah and i are here i know thank you i need you
46:04it's good that your families live close
46:08this becomes a primary relationship now
46:13you're the last witnesses to each other's lives you hold the memories
46:19scary thought the way my memory's going
46:23i just had the craziest idea you know what we should think about doing why don't we take
46:29the boat out like this weekend
46:33so
46:34oh
46:34oh
46:34oh
46:35oh
46:37oh
46:38oh
46:38Ugh.
47:13Oh, no.
47:18Oh, no.
47:29Oh, no.
47:31Oh, daddy.
47:56Back from twice a day, warm soaks, and we'll see you here again in two days for a wound check.
48:02Got any questions?
48:02Oh, hey, hey, hey, hey, hey.
48:03I need a gurney here.
48:05Now.
48:06Gurney!
48:46I need a gurney here.
48:47I need a gurney here.
48:48I need a gurney here.
48:51I need a gurney here.
48:55I need a gurney here.
48:56I need a gurney here.
48:57I need a gurney here.
48:59I need a gurney here.
49:00I need a gurney here.
49:04I need a gurney here.
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