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💥 EP 10: Tension explodes as conflicts reach their peak. 😨 Every decision now has serious consequences.
💥 EP 10: Tension explodes as conflicts reach their peak. 😨 Every decision now has serious consequences.
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TVTranscript
00:10You know where your son is now?
00:12No, but he hasn't done anything.
00:15Officer, why are you here?
00:17We received a call that her son David has created a list of girls he would like to eliminate.
00:22Who called you?
00:23Do you know anything about this list?
00:25Somebody called you. Who? Somebody from my hospital?
00:28Uh, Dr. McKay?
00:32Who is that?
00:35I'll be right back.
00:41Teddy, 28 years old. Burned in a gas tank explosion. Paramedics estimate 90% BSA.
00:47Trauma 1's open.
00:48We managed to get a 20 gauge in the right AC. First liter of LR running wide open.
00:52Minals are good. Pulse ox 97.
00:54Teddy, are you in a lot of pain right now?
00:56Not as much as I should be.
00:59Okay.
01:01Mainly third degree.
01:04Singed nasal hairs, soot and oropharynx.
01:06Do you have family on the way?
01:08Amy, my wife.
01:10What happened?
01:11Was transferring gas from a 200 gallon field tank to my tractor.
01:16Come on.
01:16Let's set up for intubation. Whitaker, run the Parkland formula.
01:19Okay, titrate morphine, Paige Garcia.
01:21Yeah, and I will be back for the intubation.
01:22All right, boss.
01:26Don't touch me.
01:28I'm fine.
01:29Jesus fucking Christ.
01:35It's okay.
01:36Okay, okay, okay, come on.
01:39Holy shit.
01:40Grab an ice bath.
01:40I got the cart.
01:42What happened?
01:43Just got punched.
01:44Just took a pull.
01:46Who punched you?
01:48Just an unhappy patient.
01:50A patient hit you?
01:51Happens all the time.
01:52Got my cheek broken.
01:53I lost it too.
01:55We've all been assaulted.
01:56Go get our mod.
01:58Did you use your hands?
01:59Aye.
02:00Probably, but no LSDs.
02:03Just a bloody nose.
02:04I'll give pressure.
02:05Okay, okay, okay.
02:07Any trouble seeing your double vision?
02:09No.
02:10I'll grab you a new scrubs.
02:11What about a headache?
02:12A little.
02:13You need to find her a room?
02:14I do not need a room.
02:15Dave, move north one of the hall.
02:17On my finger?
02:18Right?
02:19Left?
02:20Up?
02:21Down?
02:22Hey.
02:23Your arm was intact?
02:24Who did this?
02:26He's a pissed off patient, but he splits.
02:28It's just forget.
02:29Forget?
02:29Hell no.
02:30Look, I want a name.
02:34Doug Driscoll.
02:35Doug Driscoll.
02:36The asshole in the chairs?
02:37Yeah.
02:38Calling the cops.
02:39I'll get a wheelchair.
02:42Pubos are equally reactive.
02:45No septal hematoma?
02:47Should someone call your husband?
02:49Absolutely not.
02:51Okay.
02:52Tell me when it's sore.
02:54Ah!
02:56Okay.
02:57Tendered to nasal CT head maxillofacial.
02:59I'll give them a heads up.
03:01Is that really necessary?
03:02You have at least one facial fracture with the headache and the fall.
03:05I won't let anything into front of you.
03:08Okay.
03:08Who can step up for Dana while she's getting checked out?
03:11Her left.
03:13Are you okay, man?
03:13So would they talk as a phone, no?
03:15Yeah.
03:16Okay, guys.
03:17We've got about three hours left in this shift, and I need everybody to step up.
03:20Is that clear?
03:21Yeah.
03:21Yeah.
03:24I can't believe they allow you around med students, Langdon.
03:27He didn't pick up any of his bad habits.
03:29You know the difference between surgeons and serial killers?
03:31Serial killers don't build their victims.
03:33You guys staying ahead with his flutes?
03:34Per the Parkland, four per kilo times 90% burned.
03:38Wow.
03:3827 liters over 24 hours.
03:40He's had two so far.
03:42Lactated ringers, 1.785 liters per hour for the next seven hours.
03:45I'll program the pump.
03:46We got a second IV.
03:48Hello, sir.
03:49I'm Dr. Garcia.
03:50I need to peek under these dressings.
03:52Are we ready to intubate?
03:53Wife should be here in a minute.
03:56Whitaker, earlier you said third degree.
03:58We refer to burns as either being full thickness or partial thickness.
04:01Looks like 60 to 70% full, 20 to 30% partial.
04:04Intubation meds?
04:05120 rock, uronium, 100 ketamine.
04:07Got it.
04:08Draw them up and hold them.
04:09Vitals are good, but I'm going to need a pan scan after intubation.
04:12Oh, my God.
04:14Oh, my God.
04:15No, no, Mom.
04:16No, Teddy.
04:17I mean, I'm Teddy's wife.
04:19How is he?
04:20He's stable for now.
04:21I'm okay, honey.
04:22Okay.
04:23Teddy, you've got severe burns covering most of your body.
04:27You've also burned the inside of your throat.
04:29Just to be safe, I need to put in a breathing tube and you won't be able to speak.
04:32We need to do this now before his throat swells and it becomes difficult for him to breathe,
04:36so if there's anything you two want to say to each other, this is the time to do it.
04:41It's okay.
04:42I think I'll be okay.
04:46Can I kiss him?
04:47Yes, of course.
04:56Ready to intubate.
04:57Push ketamine, then rock.
04:59Right now.
05:00Coach Stroke, emergency department.
05:02Coach Stroke, emergency department.
05:03Ketamine's gone in.
05:04Okay, I will be right back.
05:09Jane Doe, looks like you're in her 20s.
05:11I'll be with aphasia, right-sided hemiparesis, and facial drip.
05:14Hi, what's your name?
05:16Nod your head if you understand.
05:18Receptive and expressive aphasia.
05:20No motor strength in the right arm.
05:21Open your mouth.
05:25Gag reflex present?
05:27Left motor intact.
05:29BP is 150 over 88.
05:31Where should we go?
05:32Accu check is 73.
05:33Straight to radiology.
05:34CT brain without contrast.
05:36Perfusion scan.
05:37CT angio head and neck.
05:38Hey, Crow?
05:39Anybody?
05:39Yeah.
05:40So you didn't get a name on her?
05:43We looked.
05:43Couldn't find a wallet or an ID, but we had to jam out of there because it was a code
05:46stroke.
05:46Who called 911?
05:47Well, apparently, our Jane Doe is a professional gamer.
05:49She was a no-show for some big tournament, so her teammate in Dubai calls another teammate
05:53in Houston who called 911 here.
05:56Who gets a stroke in their 20s?
05:57That's what you get to figure out.
05:59Okay, come find me after the scan results are back.
06:06You called the cops on David Saunders?
06:08I did.
06:10Mom!
06:12Harrison?
06:13Hey!
06:14Hey!
06:15Are you okay?
06:17How'd you get here?
06:18With Dad.
06:20Chad Ashcroft.
06:2139.
06:21Skateboarding accident.
06:23Deformity of the right ankle.
06:24No LOC.
06:25Good vitals.
06:26Got four morphine on route.
06:28Skateboarding, really?
06:29I'm fine, by the way.
06:31You know this guy?
06:33Unfortunately.
06:36Looks trimalular.
06:38We're going to go to the hospital.
06:39You think I want to be in this shithole?
06:41I told him to take me to Presby.
06:42You were the closest hospital, so here we are.
06:45Where should we put him?
06:46On the curb?
06:48Are you two family?
06:50X.
06:50X.
06:52This is Chad, Harrison's dad.
06:55Oh, nice to finally put a face to a name.
06:59What's open?
07:01McKay, stay with your kid.
07:02Let's take this half-pipe Prince to South 19.
07:11Hey, what's the golden rule?
07:13No hospitals.
07:14Okay, let's add.
07:16No skating without a helmet ever again.
07:18You hear me?
07:19Yes, Mom.
07:24Where's the last time you took a bath?
07:28Where's Robbie?
07:29Intubating the burn patient.
07:33Ma'am, can you close your eyes for me?
07:37Robbie, it's Amira.
07:39The endo-CT came back.
07:40No bleed.
07:41But there's a carotid artery dissection left neck
07:44with a thrombocytoro clot to the left middle cerebral artery.
07:49Okay, got it.
07:50We'll wait.
07:52With no intracranial hemorrhage,
07:53she might be a TNK candidate.
07:55But couldn't TNK cause a brain bleed and kill her?
07:58TNK's still the best clot-busting possibility.
08:01Um, shouldn't we do endovascular therapy?
08:04I mean, it's the safest option.
08:06What do you call a Tyrannosaurus under stress?
08:11What?
08:12Mervis Rex.
08:13Dr. King, me.
08:14Dr. Mehta, one of our esteemed stroke neurologists.
08:18How's the patient?
08:19NIH stroke scale of 27.
08:21No last known well time.
08:24Dr. Mehta, should we take her to EVT?
08:27Not yet.
08:28Take first spin in the MRI.
08:30Check for irreversible damage first.
08:31There's a diffusion flare mismatch.
08:33She's still in the window for thromboletings.
08:35And she still gets EVT.
08:36Two for one special.
08:40What type of person is best suited to work with an MRI machine?
08:44A trained technician.
08:45Someone with a magnetic personality.
08:49That one's new.
08:53Somebody punched her?
08:55A patient.
08:55Broke her nose.
08:56Is she okay?
08:58Robbie checked her out.
08:59Sent her to CT.
09:00Sorry to interrupt the hot goss, but what about me?
09:03Uh, you got some pretty good cuts here, sir.
09:06We're working on closing them up to prevent infection.
09:09Yeah, can you call in a plastic surgeon?
09:11Uh, the lacerations aren't that deep.
09:15Medical glue should do the trick.
09:16If you have any extra, do you want to maybe apply some to his lips?
09:20Your son was worried about you.
09:22I wanted to make sure you were okay.
09:24Are you okay?
09:25Yeah, totally.
09:26Just a few battle wounds.
09:28Uh, did you hear?
09:29Dana got assaulted.
09:31What?
09:31A patient broke her nose.
09:33When can I get out of here, please?
09:34We're waiting for radiology to come down with a portable x-ray machine so we can take a better look
09:40at your leg.
09:41Okay, you'll need a splint and eventually a cast.
09:45Ah, you hear that?
09:46Your dad's gonna have a cool cast.
09:47Big Harry in the house, up top.
09:50Mateo!
09:52I told my dad that we were skateboarding last weekend.
09:55Ah.
09:55So he took me today and then he fell and broke his leg.
10:00Yeah, I can see that.
10:02Hey, man.
10:02Mateo.
10:04Hey.
10:05Ugh.
10:07Want to go raid the break room with me?
10:09I hear there's a bag of talkies with your name on it.
10:12Sure, yeah, yeah.
10:14But not too much sugar.
10:16Says the man who eats Captain Crunch for breakfast.
10:18No, not anymore.
10:19Chloe makes me an acai bowl every morning.
10:21Oh, Chloe.
10:23A gift that keeps on giving.
10:25I already apologize for that.
10:28How are those lots coming, Dr. Santos?
10:30Good.
10:31All done.
10:32Mm-hmm.
10:33Would go check on radiology.
10:34I'll come with you.
10:35Sooner we get you in, sooner we get you out.
10:48Dr. McKay.
10:50Somebody hit Dana?
10:51I specifically told you to leave Teresa Saunders alone and then call the cops on her son.
10:55We talked about it.
10:56A decision was not made.
10:59So I made it.
11:00It was not yours to make.
11:01No, it was yours and you didn't do it.
11:03I didn't do it because it wasn't warranted.
11:06Wasn't it?
11:07If Teresa left, how are we going to get David assessed for his risk to others?
11:11I couldn't live with myself if something terrible happened.
11:14Yeah, well, now the police are involved, so you may ruin this kid's life forever.
11:18And what about the girls on this list?
11:20Are you telling me their safety, their lives are worth less than his?
11:25I can live with this one.
11:27And now you can, too.
11:40Uh, distal tibia and fibula with an unstable mortis.
11:44Hold on, show us the lateral, please.
11:47Here you go.
11:50Okay.
11:52Not two.
11:52Three breaks.
11:53Jesus.
11:55What, so now I got a cast?
11:56Uh, no, a splint and surgery to stabilize the bones with plates and screws so they can heal properly.
12:02How long am I going to be stuck here?
12:04That is above my pay grade.
12:07Gabriel.
12:08You may want to cancel any dinner reservations you may have.
12:12Set up for a double splint, posterior leg, and sugar tongue.
12:17Well, is that going to be painful?
12:19There may be some discomfort.
12:20I assure you we will prescribe proper pain medication to provide you with adequate relief.
12:26Drop 100 of propofol, 50 of fudge.
12:29Whatever, just knock me out.
12:31With pleasure.
12:37Perla, which of our patients can we send on their merry way?
12:41Right.
12:42Um, Barry, yoga split lip, move from north one to the hall.
12:45Um, Walter, road rash with the rat killing dog, sock 20, and Vince, uh, basketball elbow fracture, outside central two.
12:52Okay, you can run another set of vitals on Crosby's papa and discharge.
12:55You can tell Ortho to get their head out of their ass and take Joel Embiid with them.
12:58And you can release Yoga Berry, but tell him to refrain from doing any handstands for at least 48 hours.
13:03Copy that.
13:04Go, go.
13:05You heard the man.
13:08I do not know how Dana does this every day.
13:10Aha, running the ER is a Sisyphean task.
13:13So this is a punishment?
13:15No.
13:16Sisyphus.
13:17Sisyphus pissed off the gods, so they punished him by making him push this massive boulder up a hill for
13:22eternity.
13:24One must imagine Sisyphus.
13:26Happy.
13:28You're doing great.
13:29Hey, Ahmad.
13:32Is Teresa still out in cheers talking to those cops?
13:34Yeah.
13:34Do me a favor, just kind of keep an eye on it.
13:36Don't let her leave without talking to me.
13:38Okay.
13:39Any word on Driscoll?
13:40I issued an alert throughout PTMC security and called the cops with his home address from his char.
13:45They want a statement from Dana.
13:46She's in CT.
13:49Let's clear her medically and then she can decide when she wants to talk to them.
13:54What about other hospitals?
13:55You let them know?
13:56Notify.
13:57Everyone's on the lookout for this guy, Driscoll.
13:58Thanks, Ahmad.
13:59Got it.
14:01Glad you know the authorities are looking for this cycle, but what are you going to do to protect the
14:05rest of us?
14:06Violence against healthcare workers is a national problem.
14:08And it's only getting worse.
14:09No surprise.
14:10There's a nursing shortage everywhere.
14:11I hear you.
14:12I hear you.
14:12I hear you.
14:13I hear you.
14:13And it is unacceptable.
14:14What the hell kind of circus are you running now?
14:16God, you're like a bad penny.
14:18Where is Dana?
14:19Where is she?
14:19She's all right.
14:20We sent her to CT to make sure.
14:22Did you fill out an incident report?
14:24I don't know.
14:25I was more concerned with her having a skull fracture than with your liability.
14:28Did the guy from the waiting room get back here without anyone noticing?
14:30Wow, Gloria, what a great question.
14:32Our hardworking nurses were just asking me what steps the hospital plans to take to ensure their safety in the
14:36future.
14:37Maybe you'd like to explain to them why you've denied my request for additional security measures three times in the
14:42last four months.
14:43If nurses don't feel safe, they're not going to come to work.
14:49First off, the safety of all our employees.
14:53Do you remember the last nursing strike?
14:54Yeah, that was a real shit show.
14:55Maybe this is something our union reps should know about?
14:57Okay, well, just take a beat and remember that PTMC is a family.
15:02Come on.
15:02It's functional family.
15:03You should be worried about the nurse's satisfaction and the safety.
15:07Yeah, I'm worried about everyone.
15:09Rob.
15:11Robby.
15:13Dr. Robby, I've got a question for you.
15:15We're working on Chad and my team.
15:17McKay's ex.
15:18He's a nightmare.
15:24Me and me, thanks.
15:43Here's your driver's license and insurance card, Mr. Buclisi.
15:46Have a seat and the triage nurse will call you back soon.
15:50Hello.
15:51My son, he needs help, his eye.
15:52Let me ask you about your eye.
15:54Do you see the line you just cut?
15:55No, please.
15:56It's an emergency.
15:57You think everybody's waiting for manicures?
15:59He caught a line drive to the eye.
16:00We're so sorry, ma'am.
16:01We thought this was the line for pediatrics.
16:03I'm 16.
16:06I'm doing this because you're a minor and you have manners.
16:09Thank you so much.
16:10Name and date of birth?
16:11Everett Young, December 7th, 2008.
16:13I'll get your insurance information from your father.
16:15Take a seat.
16:16What?
16:16No, we're not waiting.
16:17Show her.
16:18Show her.
16:23Okay, then.
16:24Come around to the double door.
16:28Connected place on deck?
16:29All set.
16:30She's 62 kilos, .25 per kilo.
16:32It was 15.5 million.
16:34Push over 10 seconds.
16:35Status?
16:36Diffusion flare mismatch means she's less than four hours into it.
16:38Getting TNK now.
16:39Sounds great.
16:40Would you mind hanging down here for a bit?
16:41I could use your expertise on this.
16:43Can't believe you have the nerve to ask.
16:44Good one.
16:45Okay, keep me posted.
16:4950 on board.
16:50Anything I can do to help in here?
16:52Yeah, I'm pretty good.
16:54How are you doing?
16:57Not as good as you, apparently.
16:59Push another 25.
17:01Wet the splints now, please.
17:02You can help lift his leg for the splint.
17:06And we're at 75.
17:10When we lift his leg, it's really going to hurt him.
17:13But he won't remember benefits of propofol.
17:16Hall socks, 99.
17:17Good end tidal CO2.
17:20Hey, Chad.
17:22Chad.
17:26Perfect.
17:27Let's do this.
17:33Do you feel sad?
17:36Uh, don't worry.
17:38We'll have you fixed up good as new.
17:41What does he have that I don't have?
17:45I mean, sure, he's younger than that hair.
17:51Who?
17:53Mateo.
17:55Oh.
17:57What's his story, anyone?
18:00Is she having sex with him?
18:04Well, if she isn't, she probably should.
18:11Who do we have the pleasure of meeting this afternoon?
18:13Everett Young, 16.
18:15Took a line drive to the left eye.
18:16Taki at 118.
18:18Oof.
18:18Four of morphine, four of Zofran.
18:20Excuse me.
18:23It was easily 100 miles per hour.
18:25Oof.
18:25Did she pass out?
18:26Uh, no, ma'am.
18:28Baseball's a fun activity.
18:29You any good?
18:30Any good?
18:31He's got a 95 mile an hour fastball, a 12-6 slider, a .94 ERA, and he's a southpaw.
18:37What's that?
18:39That's a future Cy Young.
18:42I don't know what that is either.
18:43Miss Javadi is a student doctor.
18:46Miss Javadi is a student doctor.
18:46She's a bit of a prodigy herself, actually.
18:48Do you mind if she helps out?
18:50No, ma'am.
18:50Okay.
18:52Tell me how many fingers I'm holding up.
18:54Um...
18:56I can't tell.
18:57Oh, my God.
18:58Oh, my God.
18:59Okay.
19:00Tell me when the light turns on?
19:04Um...
19:04Now?
19:05Light perception only.
19:07Mm-hmm.
19:07Do you want a portable slit lamp?
19:09Definitely, yeah.
19:10Javadi, what do you think of the anterior chamber?
19:12Hyphema.
19:13Exactly.
19:13Grade four.
19:14You have meaning?
19:17Javadi.
19:17Meaning blood is filling up the front eye chamber.
19:20He'll need an emergency evaluation by ophthalmology.
19:22Is that why he can't see?
19:23That's part of it, yeah.
19:24You see how the eye is pushing out?
19:26There seems to be a collection of blood behind the eyeball.
19:29The eye pressure's too high, we have to act quickly.
19:31Okay, well, check the pressure.
19:32We're going to, right now.
19:34Can you look at Robbie?
19:41It looked like you were having a pretty intense conversation with Robbie earlier.
19:46Everything okay?
19:48Um, there's nothing.
19:51Nothing?
19:52Okay, well, not nothing, but nothing for you to be concerned about.
19:56An intern has a problem around here.
19:58They come to the senior resident, not in the attending.
20:03He's my attending, and I wanted his input on a patient.
20:06Is that not okay with you?
20:09Just, um, come to me first, next time.
20:15Got it?
20:16Yeah.
20:17Got it.
20:25You a junior?
20:27Yeah.
20:28You thinking about college?
20:29I have some D1 interests, but...
20:32Where'd you go to college?
20:33Uh, Pitt, for undergrad, now med school.
20:36You want to leave town?
20:37Look up at the ceiling for some dumbing drops.
20:40It's not exactly an option to live anywhere but home when you go to college at 13.
20:45Oh.
20:45Add some drops of the fluorescein strip.
20:48I was thinking about California.
20:50Maybe UCLA or USC.
20:52Still?
20:53Hey, maybe you go straight to the majors, huh?
20:54College can wait.
20:56I don't know.
20:57I do.
20:58Ev's got a God-given gift.
20:59That's why we spent every weekend doing travel ball when he was young.
21:03Pro camps, showcases.
21:04He's not throwing away his shot at the majors.
21:06Uh, we have to check for the puncture before we can measure the pressure.
21:10Look straight ahead and try not to move your eyes, okay?
21:13Yes, ma'am.
21:13Lights going out.
21:15Hello.
21:16Hello.
21:16I'm Dr. Rabinovich.
21:17Everybody calls me Dr. Robbie.
21:19Hey, Greg Young.
21:20This is my boy Everett.
21:21Nice to meet you both.
21:22Okay.
21:22I will take that slit lamp and you can calibrate for telemetry.
21:26Okay.
21:26They're holding CT for him.
21:27Let's take a look.
21:29Negative side delt.
21:32No globe rupture.
21:33Okay, go with the tonkin.
21:35Hold still.
21:36Okay.
21:42Left eye pressure, 58.
21:44Is that high?
21:45Yes, it is.
21:46One percent lighter with epi.
21:47Push one over his head and open a lateral canthotomy tray.
21:49Excuse me.
21:50What?
21:50Well, without a CT?
21:52Isn't that...
21:52Exactly what the patient needs?
21:53Yes, it is, Dr. McKinney.
21:57Okay.
21:58Uh, we're gonna lie you back, little Everett, okay?
22:00We need to do a little minor surgery to relieve the pressure.
22:04We need to do a little minor surgery to relieve the pressure of the pain.
22:04Behind your eye, so we're gonna cut a small opening on the side of your eye.
22:07Not in your eye.
22:08Got it?
22:09Yeah.
22:09You wanna watch?
22:12No, I'll sit down.
22:14Your body, step up so you can see.
22:17Dr. McKay, Chad is splinted and is awaiting ortho for surgery.
22:20Take him.
22:21Thanks for the update.
22:23First head's on board.
22:25Numbing medicine here, okay?
22:28Okay.
22:28Pinprick and some bunny.
22:32Ouch.
22:33What?
22:34Is Dana gonna be okay?
22:35It's gonna take more than a punch to the face to keep that mama down.
22:38She's tough.
22:39Yeah.
22:42Um, I'm sorry to bother you.
22:45Um, I just wanna make sure that Teddy's not in any pain.
22:51Oh, he's heavily sedated.
22:54He can't feel a thing.
22:55Right.
22:56It's just that when I look at him, I just, I just feel so helpless.
23:02Look, his, uh, CT scans came back negative for internal injuries.
23:06He's on IV therapy to replace any lost fluids.
23:10I assure you, we are doing everything we can to give him the best treatment possible.
23:15Yeah.
23:16Teddy's ring.
23:19Um, I had to cut it off because of the swelling.
23:26Hopefully you can find a good jeweler to fix it.
23:29I don't know how it works.
23:39Um, do you have a best friend, Doctor?
23:43Oh, it's, uh, another year to go till you can call me Doctor.
23:48Uh, you can just call me Whitaker though.
23:50Do you have a best friend, Whitaker?
23:54Um, I have three older brothers.
23:59Guess they're kind of my best friends.
24:02They kind of tortured me growing up, so maybe not.
24:05But, yeah.
24:08Teddy's been my best friend since we were 15.
24:11High school sweethearts?
24:13We were just a couple of nerdy Aggies who, uh, we met in 4-H and we fell in love.
24:21I'm sorry.
24:22No, it's fine.
24:23I'm a third generation Nebraska farm kid myself.
24:27Get out.
24:29Well, if you're ever homesick, you should, uh, you should come by our farm sometime.
24:35That's very kind.
24:38I need some help in here.
24:42What's going on?
24:43Respiratory distress.
24:44Sats are dropping 87%.
24:46Uh, lung injury from the fire?
24:48It's not just the low sats.
24:49Events showing high peak pressure, low tidal volume.
24:51Uh, restrictive pattern?
24:53Most likely.
24:54I'll grab Ravi and Langdon.
24:56Wait, wait, wait, wait.
24:56What's that?
24:57What's going on?
24:58Ventilator is having trouble pumping air into Teddy's lungs.
25:00Uh, burnt skin loses elasticity.
25:02Now his chest wall's too tight.
25:03Well, what can you do?
25:04We're gonna have to cut the burnt skin.
25:06Um, release pressure on the chest wall.
25:09Help Teddy breathe.
25:10So after you cut his eye, see you again?
25:13This will give us our best shot at preserving his vision, yes.
25:16Dr. McKay, are you ready to do the honors?
25:19Who, me?
25:21We are a teaching hospital.
25:23Are you still here to learn?
25:25Yes.
25:32Okay.
25:34You can release that hemostat now.
25:38Yeah.
25:41I was scissors.
25:44The length of the crushed area is gonna be your guide for the length of your cut.
25:47You're welcome.
25:50Good.
25:51Tooth forceps.
25:59Feeling for the inferior.
26:05And superior, Kruse.
26:07How can you see with all that blood?
26:09You can't. It's all tactile.
26:11Feels like two guitar strings.
26:14Metzenbaum.
26:23Inferior.
26:24Inferior.
26:27And...
26:29Superior.
26:30Nice. Good.
26:33That's a lot of blood.
26:34Okay, let's get a repeat pressure.
26:36It's getting a lot brighter.
26:40Pressure of 18?
26:43Perfect.
26:44CT can take him as soon as we dress the wound.
26:45Page ophthalmology and tell him to prep for surgery.
26:48Doc, thank you.
26:50My pleasure, my pleasure.
26:51Good luck to you, Everett.
26:53Hey.
26:55Thanks for letting me do that.
26:57You sound surprised.
26:59Yeah, I figured after the whole Teresa thing, you might bench me.
27:03Am I still pissed that you won't be on my back?
27:06Absolutely.
27:06And if you ever do it again, you can bet your ass that I will bench you.
27:09But this is a teaching hospital, and teachers can still learn stuff.
27:15I saw a sad, confused boy, and that's all I thought about.
27:20I did not think enough about those girls.
27:25Any word on Dana?
27:26She should be coming back from CT soon.
27:28Burnt victim's taken.
27:29We need you.
27:30Oh, my God.
27:30I can't wait for this shift to be over.
27:37Hey.
27:39Bud, you doing okay?
27:40Yeah.
27:41I'd say you hooked me up.
27:42Mm-hmm.
27:43Yeah, I can see that.
27:46How's Dad?
27:49He's gonna need surgery, but he's gonna be okay.
27:54You know, I was thinking, since your dad's gonna be laid up for a while,
27:58maybe you'd want to stay with me until he gets better.
28:02For real?
28:04For real.
28:05What do you think?
28:12I think that is yes.
28:15This procedure is called mescarotomy.
28:17We need to cut the skin so that the chest wall can expand.
28:20That sounds painful.
28:22Whitaker?
28:23Uh, he's still heavily sedated.
28:25He won't feel a thing.
28:27This is gonna help Teddy breathe.
28:30So, that's 83.
28:31Peak pressure's 40.
28:33Title volume's only 300.
28:35I want you to watch Dr. Langdon as he makes this vertical incision,
28:37then you're gonna do the exact same thing on your side and follow his construction.
28:40I'm sorry, I just, I don't think I can watch it.
28:42What do you want me to do?
28:46Start at lateral clavicle.
28:54Down, interior axillary, and lower rib margin.
29:01The tissue's really popping out.
29:03Which illustrates what?
29:04The pressure underneath.
29:07Your turn.
29:10Here goes.
29:14A little more pressure.
29:16Yeah.
29:16You make a decisive incision and get through the S gun into sub-Q.
29:21Go back a little deeper on that first section.
29:23Okay.
29:25Yep.
29:27Yep.
29:28Good. Looking good.
29:31Okay.
29:32Now the horizontal incision, Dr. Langdon.
29:37And connecting the two incisions.
29:45That ought to do it.
29:47Peak pressure's already down to the 30s.
29:48And tidal volume is coming up.
29:50So that's 91.
29:51That was wild.
29:54We'll stress these wounds and send off a blood gas.
29:56Well done.
29:57And very well taught, Dr. Langdon.
30:12You think Coley's will still be open by the time we get off?
30:16No.
30:17Damn.
30:18I was hoping to surprise Abby and the kids.
30:20Grilled some salmon for dinner.
30:21Such an adrenaline junkie.
30:24What'd you call me?
30:26They're ice plunges.
30:27Marathon man.
30:28Surprise!
30:29Here's a dog.
30:30Surprise!
30:30Here's some salmon.
30:33I'm pissed in your cornflakes.
30:35Oh.
30:37What, did I touch a nerve?
30:38You're regretting buying that dog, aren't you?
30:40Bogey-bogey.
30:41I'm so scared.
30:42Oh.
30:43If you don't know what you're doing,
30:45it's just a long time.
30:47They're going to be sexy.
30:49Oh, I'm not.
30:50Oh, Robbie.
30:51Dana's CT results are back.
30:53You want your cranial hemorrhage,
30:55no skull fracture,
30:56non-displaced nasal fracture,
30:57but the rest of the facial bones look intact.
31:00Any hemorrhaging into the sinuses?
31:02Nada.
31:03Great.
31:03We could really use her back on the floor.
31:07What?
31:07I'm just saying.
31:09Mind if I give her the good news?
31:11No.
31:11Go for it.
31:12And anything else she needs.
31:13I got it.
31:21About the whole thing with Santos and the seizure patient?
31:26What about it?
31:28I'm sorry for laying into her so hard.
31:34Why do I feel there's a butt coming?
31:36But I don't think she's a team player.
31:39How so?
31:40She's cherry picking cases.
31:42She gave Whitaker a shitty nickname after his patient died this morning.
31:46She's even harassing Javadi to get a rep from her mom for surgery.
31:50If she wants to be in surgery, what's she doing in the ER?
31:52That's a great question.
31:54Why don't you ask your new BFF, Garcia?
31:56I know that you've seen those two.
31:58I'm the only one calling her out so she has an ax to grind.
32:03You've always said that being in the pit is like playing a team sport.
32:08A team has to be able to trust each other.
32:09If we have one weak link, this whole place goes to shit.
32:15Good.
32:16Good meeting.
32:23Call Zosie and family med.
32:24They open up the urgent care of five.
32:26Let them never send it up to two honky kids.
32:27Yep.
32:28Zosie and family med.
32:29Okay.
32:30Copy that.
32:31Anna, please check in on Earl.
32:33Poor thing got caught in the crosshairs of that mom fighting.
32:35We'd bring him another sandwich.
32:36Yeah.
32:37Okay.
32:38No egg salad.
32:40Dana, I got you.
32:41Okay.
32:41Rest up, bud.
32:42Ugh.
32:43Can take the girl out of the ER, but you can't take the ER out of the girl.
32:47Old dad was die hard.
32:49Let me take a look.
32:52Whoa.
32:53She's a real beauty, all right.
32:56Bet your CT came back clean.
32:58Nothing Mother Nature can't heal on her own.
33:00Too bad.
33:01It's open for a free nose job.
33:03Probably get hazard bad.
33:05Two for one.
33:18You know, you're clear to go back to work if you want.
33:22Or home.
33:25I'm not ready yet.
33:27You?
33:28No.
33:30Got a lot to think about.
33:33Yeah.
33:35A pretty fucked out day.
33:39What do you call a group of brains who form a singing group?
33:43What?
33:44The glia club.
33:46Oh.
33:47Good one.
33:48Keep me posted if there are any changes.
33:53What's with Dr. Mehta and the jokes?
33:58You know why they say laughter is the best medicine?
34:01Um.
34:02Because it's true.
34:03Laughter releases endorphins.
34:04Endorphins help relieve pain.
34:08Um.
34:09So.
34:10Dr. Mehta thinks that if a joke helps raise spirits and makes people feel better, then
34:15he's all for it.
34:16It's his special sauce.
34:18Um.
34:19Do you have a special sauce?
34:20I'm pretty data-driven, but I really like to talk to my patients about their lives.
34:26Makes them feel important.
34:30She's waking up.
34:33How are you feeling?
34:35Okay.
34:37Are you trying to say okay?
34:40Yes.
34:41The thrombolytics are working.
34:43Um.
34:44Can you lift your right leg for me?
34:47It's okay.
34:48Um.
34:48Try moving it from side to side.
34:51Can you tell us your name?
34:55Yeah.
34:57Oh.
34:58Um.
34:59Maybe you can type it out on the screen.
35:02Here.
35:07Vera?
35:09Uh.
35:10Uh.
35:10What's your last name?
35:14Malahi?
35:18Well, hello, Vera Malahi.
35:23Hey.
35:24Oh.
35:25Chad's a little piece of work.
35:27Appreciate you dealing with him.
35:28You know?
35:30It was actually kind of fun.
35:34I did not have that on my bingo card.
35:36Well.
35:36You know.
35:37Patients under propofol are always a good time.
35:42Yeah?
35:43What did you say?
35:45Nothing.
35:46Nothing to worry about unless you're concerned he still has a thing for you.
35:52No.
35:53Please euthanize me if I ever even consider it.
35:58But you know if I could go back I wouldn't change a thing.
36:01Without Chad I wouldn't have Harrison.
36:04You're very lucky.
36:06You know, right?
36:06Fine.
36:09Alright.
36:09Thanks again.
36:12I was getting ready to take her up when she developed angioedema and her fat's dropped.
36:17A little bit of stridor.
36:20Swollen lips, swollen tongue.
36:21Vera, this is a side effect of the medication we gave you.
36:24Sats are up with high flow nasal.
36:26It's anaphylaxis, get Robbie.
36:28Angioedema is not always anaphylaxis.
36:29I know but it can regress to it and cause an obstruction.
36:32If it's just angioedema, I can reverse the swelling fast with IV epi.
36:36BP is 165 over 85.
36:38Prep ketamine and rock for intubation.
36:39Wait, wait, wait.
36:40Dr. Mohan, you just said-
36:41We're not intubating yet.
36:43But she's gonna rest.
36:44What happened?
36:46Angioedema with stridor.
36:48Respiratory's on their way.
36:49We should intubate, right?
36:50Good BP and O2 sats.
36:51Epinephrine can reverse the swelling right away.
36:53I pushed 10 mics of IV epi, starting her drip at 5 cc's, 5 mics per minute.
36:57Sats are holding at 95 on high flow.
36:59BP is good.
37:00Vera, we're gonna sedate you so that we can help you breathe better.
37:03Or not.
37:04Let's just wait a minute.
37:05How'd you get that epi drip hung so fast?
37:06Bedside drip.
37:07I mix one milligram with a liter.
37:09Nice.
37:10Are we intubating?
37:11Are we not intubating?
37:12Not.
37:13Stridor is improving.
37:15Is it getting easier to breathe?
37:17Mm-hmm.
37:18Speech is coming back.
37:2050-difanhydramine 125 solimedrol.
37:24Do you think Dr. Mehta will want her intubated for the thrombectomy?
37:27Not necessarily.
37:28If she can talk and move during the procedure, then they can monitor any changes in the neural
37:32exam.
37:34Slow-mo, no-mo!
37:36Sorry, I think Dr. Mehta's rubbing off on me.
37:40We're taking him up to our burn unit.
37:42He'll be in great hands.
37:43They've had lots of experience with cases like Teddy's.
37:46What now?
37:48We will continue with IV fluids and pain meds.
37:52We'll support his breathing with the ventilator, and we'll keep his wounds clean, look for
37:56any signs of infection.
37:57Then later the plastic surgeons can do skin grafts.
38:01He's gonna be okay.
38:03Teddy's condition is very critical, so no promises, but our team's gonna do everything
38:07they can to give him the best chance possible.
38:10I'll make sure to stop by the ICU, check in on both of you.
38:14I can't begin to thank you enough, Dr. Whitaker.
38:17Oh, uh, student doctor.
38:22Oh, uh, don't forget about dinner at the farm.
38:26And, uh, make sure to brush up on your diaper changing skills.
38:30Oh, with seven nieces and nephews, I'm a diaper genie.
38:33So...
38:36You know you just called yourself a trash can, right?
38:39Before you grab her next patient, um, call Kiara.
38:43Have somebody go upstairs and talk to the wife.
38:46Amy? Why?
38:47We wanted to give her hope, but the reality is her husband's not gonna make it.
38:51He's stable.
38:52His chance of dying in the next week is over 90%.
38:55He's-he's young, he's strong.
38:57Maybe he's the 10%.
38:59Maybe.
39:00But he's a lot more likely to die of sepsis before his kid is born.
39:03Call Kiara.
39:12The CT shows a hairline orbital floor fracture.
39:15But thanks to the kinthotomy, the hematomas, I'm pushing on his eyeball.
39:19Uh, will I be able to see?
39:22That's why you need surgery.
39:24The ophthalmologist will drain the blood inside the front of your eye and replace it with the clear fluid you
39:29need to see.
39:30Okay?
39:31We're ready for you now.
39:32Hey, hey, hey.
39:33Don't worry, bud.
39:34Alright?
39:38So-so he has the surgery, stays overnight, he goes home tomorrow?
39:43It depends on how the surgery goes and what his post-op results are like.
39:47Give or take.
39:48He could be as soon as tomorrow, yeah.
39:51Okay.
39:53So he could be, could be game ready by Thursday.
39:56Hmm?
39:58Sarah, your son is freaking out because he may never see out of his left eye again.
40:02Yeah, I don't-
40:03No, no, forget baseball.
40:05And just be his dad.
40:07It's gotta keep it that fucking hard.
40:11Uh, there's a waiting room up by surgery.
40:14Sixth floor.
40:15Uh, right off the elevator, you can't miss it.
40:17Angioedema responded to epi, diaphanhydramine, and steroids.
40:21Excellent.
40:27You're very welcome.
40:31Which neurotransmitter makes the best adhesive?
40:34I don't know.
40:35Glutamate!
40:37Glutamate.
40:38Am I right?
40:40Nicely done, Dr. King.
40:44You know this really quick thinking back there?
40:45I-I'm really sorry if it seemed like I doubted you.
40:48I didn't.
40:49I-I just-
40:50Honestly?
40:51I surprised myself a bit.
40:52Yeah?
40:54We trusted your gut.
40:55Maybe that's your special sauce.
40:58Maybe.
40:59Um, Dr. Mohan?
41:02What if I don't have special sauce?
41:05Of course you do.
41:07Just be yourself.
41:08We'll come.
41:19So...
41:19Now might be a good time to go through some doctor-patient interaction guidelines.
41:23I'm sorry that that was just such an asshole.
41:24So overbearing.
41:26I'm sorry.
41:29Look, do I think you needed to chill out a little bit?
41:31Yes.
41:32But he's a parent.
41:34And this might be his way of coping with the stress of a very frightening situation.
41:38I'm sorry. I don't know what came over me.
41:41No, I do.
41:42You and that baseball kid are two pressure cooker prodigies in a pod.
41:48Just...
41:48As physicians, we gotta learn to keep our emotions in check.
41:51And not let our personal experiences interfere with our professional responsibilities.
41:56How long did it take you to learn that?
41:59I'm still learning.
42:00And I also learned to never get on your bad side.
42:04Yo, yo, yo.
42:06Hey.
42:07Almost quitting time.
42:08I so appreciate you helping me out with Harrison.
42:11No.
42:11And my douchebag ex.
42:13Yeah, we all have him.
42:14Yeah.
42:14Oh.
42:16Totally.
42:16Me too.
42:17Me too, yeah.
42:20Always happy to help.
42:22Yeah.
42:23So I get off in a couple hours.
42:24Do you mind just doing a loop every once in a while to make sure he's not burning the place
42:27down?
42:27Can do.
42:28And, you know, a new foot massage place just opened in the Strip District.
42:31Do you wanna go on Sunday?
42:33For sure.
42:33Okay, cool.
42:34I'm free Sunday.
42:36Um, to help or just to...
42:39Yeah, whatever.
42:39Wherever.
42:40Oh, my God.
42:42I mean, Harrison would love a sitter closer to his own age.
42:45I...
42:46I'll get your number and text you the address.
42:48That's awesome.
42:50We'll share.
42:50Dr. Santos, a moment, please.
42:52Thank you, sir.
42:55Thank you, sir.
42:57Thank you, sir.
43:00So, how's your first day going?
43:04So far, so good.
43:05Getting along with everyone?
43:06Yeah, pretty much.
43:08Except Langdon.
43:11So, in the CR, we all need to work together as a single unified entity.
43:15And if two people on my team can't work together, it kind of throws the rhythm of the place off.
43:20Understood.
43:21My duty, regardless of personal relationships,
43:25is to make sure everybody on my team is doing okay.
43:29So, are you doing okay?
43:33Uh, it's not a big deal. I can handle it.
43:39Handle what?
43:43Nothing. It's fine. I...
43:47I don't want to get anyone in trouble.
43:53Okay, if there's anything, anything that could affect my ER,
43:58I need to know about it, and you have a responsibility to tell me.
44:11Hey. Hey.
44:12Did they catch the bastard who sucker-punched you?
44:15I haven't heard.
44:16Well, when they do, just send them to me.
44:20I could make it look like an accident.
44:24Let me just take you up on that.
44:27Gotcha.
44:30You've been paroled.
44:33Are you sure?
44:34Yep.
44:35Okay.
44:37Okay.
44:38Yep.
44:38Go check on Marner.
44:40Got a sec?
44:41Bless you.
44:42For you, boss, I got two.
44:43What's up?
45:01I heard there's been some inconsistencies with meds intended for your patients.
45:06What?
45:11Frank, have you been helping yourself to benzos from the ER?
45:15Yeah, I've been stealing blood, too.
45:20I asked you a question.
45:23Wait, are you serious?
45:25What are you doing?
45:28Really?
45:30Santos.
45:32Whatever the hell she told you is bullshit.
45:36I didn't mention Santos.
45:38You didn't have to.
45:39I told you.
45:41She is trouble.
45:43Have you ever taken a patient's medication?
45:46This is insane.
45:47This is completely fucking insane.
45:48I need you to open your locker.
45:49Yeah, right.
45:50Open your locker.
45:50You're going to remove it from your fucking locker, or I will have security smash it open.
46:17Is the imprint code on these pills going to match Louis Librium?
46:28Go home, Frank.
46:29No, no.
46:30It's not like you think.
46:31You remember, whenever I helped my parents move, I was too cheap to pay for movers.
46:35I hurt my back.
46:36I told you that you teased me about it.
46:38Remember?
46:38Well, our own Dr. Hagan prescribed me some pain meds and muscle relaxes.
46:43I was just weaning myself off.
46:44It was just for maintenance.
46:45I'm done.
46:45Robbie, come on.
46:46You know me, Robbie.
46:48You know me, man.
46:48I'm sorry.
46:49I fucked up.
46:50I just, I was trying to...
46:52I don't know what, still pills?
46:52No, it's not like you don't understand.
46:54I don't fucking understand.
46:55It's not like you think.
46:56I'm not high.
46:57I'm not high.
46:58You've seen what I do, Robbie.
47:00Could a drug addict do what I do?
47:05Apparently.
47:08And I just fucking let him.
47:12You're done.
47:14Leave now, or I will have Mahat to escort you out.
47:17Robbie, please.
47:19You are done.
47:26What?
47:27I'm not.
47:28I'm not.
47:53I'm not.
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