- 3 hours ago
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⚡ EP 8: The tension escalates as new threats emerge. 😨 Every step forward reveals deeper complications.
⚡ EP 8: The tension escalates as new threats emerge. 😨 Every step forward reveals deeper complications.
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TVTranscript
00:28You
00:39Oh
01:0216 is open
01:03How come nobody's been
01:05My bad
01:06It's taken
01:07Sorry
01:08Mr. Louie was found unresponsive
01:10And on the sidewalk
01:11Next to fine wine
01:12And good spirits
01:13Decent vitals
01:14No head trauma
01:14Didn't we just discharge him
01:16A couple hours ago
01:16Yep
01:17Stone cold sober
01:18At 7 a.m
01:19Oh god
01:20Don't light any matches
01:21Hey doc
01:22How you doing?
01:23Not as good as you Louie
01:24Hey you know that doctor
01:26What did you have to drink Louie?
01:27Uh
01:27Just a couple of shots of vodka
01:29So like a half gallon?
01:31Oh hell no
01:32Just a quart
01:33If you over exaggerate your questions
01:35You usually get a truthful answer
01:36Learn from the best
01:38He's got Librium from this morning
01:39That's what I prescribed him
01:41Alright Louie
01:41Let's scoot it on over
01:44You want to guess the blood alcohol level?
01:46Why would I want to do that?
01:48I don't know
01:48Because it's fun
01:49You prescribed 20 Librium
01:51There's only 10 left
01:52See you next time
01:54Shouldn't we be concerned
01:56About an overdose?
01:56Oh no
01:57Vodka is Louie's drug of choice
01:59Quickest way to kill the shakes
02:00True that
02:01Where'd the other 10 pills go?
02:03I don't know
02:04Maybe uh
02:04Lost
02:05Stolen
02:06Maybe sold them to buy the vodka
02:07What'd you do with the other pills Louie?
02:09They're in my pocket
02:10I didn't need them
02:11I was like
02:11Ah
02:12Come on
02:13Give it a rest
02:22Is everybody okay with comms?
02:23She seems fine to me
02:24Unlike our patient board
02:26How's it cracking?
02:28Sleeping like a baby
02:28What's the story of beds upstairs?
02:30Waterfall took the last ICU bed
02:32One telebed's open
02:33No med search
02:33No Pete's
02:34So which one of our 21 boards
02:35Is going to win the lottery?
02:37CHF's masturbation's been with us for two days
02:39Sounds like a winner
02:40Right
02:40The rest will receive our lovely consolation prize packet
02:43Tell them what they want
02:44Dana
02:44Stop
02:45It's another 24 hours of bright light
02:47Screaming trauma patients
02:48Hard gurneys and sleep deprivation
02:49All while you wait for a bed upstairs
02:51Hey uh
02:52Nandi
02:52The influencer in Central 8
02:54Still waiting for Psych?
02:55Nope
02:55She's a keeper
02:55Her mercury level is sky high from that face cream
02:58I ordered chelation
02:59TID
03:0010 per kilo of DMSL
03:01Make sure it comes up from pharmacy
03:03Great pickup
03:05Hey
03:05Okay
03:06Excuse me
03:08I'm sorry
03:09Dr. Rabinovich
03:10Yes that is me
03:10Father McGill
03:11Here to see John and Lily Bradley
03:13Ah yes
03:13Thank you for coming
03:14No problem
03:15I will take you to the family room
03:17Dana I need some help
03:19What's up?
03:20Been trying to check the nursing notes on Louis from 7am this morning
03:24Langdon ordered lorazepam but I don't think it was given
03:26Yeah lorazepam ordered dispense and then returned unused to the PDS
03:30Per Dr. Langdon as patient's tremor had resolved
03:33Is that unusual?
03:34No, haven't told the time
03:35You think that could be the vial I couldn't open on our seizure patient?
03:38Possibly
03:40Can we check the other vials in the PDS and make sure they're okay?
03:43You really want to
03:44I do
03:44Alright, come on
03:45This area on North 2 has been waiting a long time
03:48I'll take it
03:48Yep
03:49Oh, Dr. King
03:51Rita
03:52We were so worried
03:53Oh, I'm so sorry
03:54My phone was on silent
03:55I missed 10 calls from the hospital
03:57Is my mom okay?
03:58Oh yeah, she's fine
04:02I went to move my car and it was so peaceful and quiet when I parked in the garage
04:08I toast off
04:10I'm just really glad you're back
04:12Oh, your mom is going to be so happy
04:13She's waiting in the hall
04:14Okay
04:15So if I order lorazepam for Louie
04:18The log shows me we have five vials left
04:24Take one out
04:25And now we have four left
04:27But if I click
04:28I don't want to return one
04:29Unused
04:30You put it back
04:33And the computer count goes back up to five
04:36Yeah
04:37Same lot numbers, everything looks good
04:39No way of knowing which file was returned by Dr. Langdon
04:42Yeah
04:43I guess
04:44Thanks
04:45Yeah
04:45Old man coming in with a heart rate of 30
04:47Sounds like pacemaker failure
04:49Could be a good case
04:51Putting an amputation in 15
04:52Ooh, that one sounds even better
04:54Yeah
04:58Braco DiGiulio
04:59Amputation of the fourth fingertip at the base of the nail
05:02Bone exposed
05:03Uh, how'd this happen?
05:05I, uh, I crushed under
05:07Air-conditioned unit we were installing
05:09We'll numb up your finger
05:11One shot will help with the pain
05:13Amazing
05:14Digital block, three cc's of Marcane
05:17Pulse 110, BP 135 over 88 in triage
05:20Any drug allergies, sir?
05:22Uh-uh
05:22Two grams of cefazolin?
05:24Uh-huh
05:27Ooh, wow
05:31Go with the block
05:33You ready?
05:34Mm-hmm
05:36Pinprick and some burning
05:38Uh, where's the missing piece of skin?
05:40It's, um
05:42Under a thousand pound unit
05:44It's flat as a pancake
05:46Well, then we have nothing reattached
05:48Plan, Dr. McKay?
05:50Bone ranger of VY flap
05:52Exactly
05:53Awesome, I picked the right case
05:57Can somebody translate?
05:59To close the wound, we're gonna trim down the bone
06:01Then use a plastic surgery trick so the skin will cover everything
06:04Okay
06:05Your finger's gonna be a little shorter
06:07No nail
06:09Great
06:1010% off manicures
06:12Looks like they found you guys a new rig
06:17Nah, we Ubered
06:18Willie Alexander, 81, near syncope from the membrane day center
06:21They said he's more altered than usual
06:22Pulse is 30, BP's 80 over 40
06:25No change with a mig of atropine
06:27He's got a pacer in his chest, but there's no capture
06:29How you feeling, Mr. Alexander?
06:30Call me Willie
06:31I'm fine, I'm fine
06:33Any chest pain?
06:35No, ma'am
06:35Do you take beta blockers?
06:37I take walks every day
06:39Only med is an amenda
06:40On my count, one, two, three
06:45Pacemaker patient with dementia
06:47Heart rate at 30
06:48Little altered with a systolic at 80
06:50What you plan, Dr. Lang?
06:52Second mig of atropine
06:54Now push dose
06:55Epi 0.1 milligram
06:57Putable chest
06:5831 on the monitor
06:59Dr. Javadi, what do you think of that heart rate?
07:01It's not beta blockers, so junctional escape for them
07:03Exactly, common with a non-functioning pacemaker
07:06Ideology, Dr. Mohan?
07:07Dead battery or lead failure?
07:09Indeed
07:10Good squeeze, even if it is slow
07:13Atropine and epi on board
07:14What's next, Dr. Lang?
07:15We can try percutaneous pacing, but eventually you'll need transvenous
07:19Agreed
07:19Systolic's up to 95 with epi
07:21It's too low
07:22Let's start a drip, two mics per minute
07:25Check the mental status
07:26He knows his name
07:27Sir, do you know what year it is?
07:29Uh, it's 20-something
07:32Do you know where you are?
07:34It looks like a hospital to me
07:36Pittsburgh Trauma Medical Center
07:37Yep, yep, I know this place
07:40This Dr. Adamson's place
07:43Where's he at?
07:44He working today?
07:47Are you feeling any pain?
07:49No, that shot worked great
07:50Okay
07:51Like this
07:56How far down?
07:57Just so the sub-Q will cover
07:59You'll need to take a few days off work, sir
08:01Good, more time to study
08:03For what?
08:04A master's degree, psychology
08:07No good
08:08Yeah
08:09HVAC's just my day job
08:10I went to trade school
08:11Because I couldn't afford college
08:13Now I can
08:15Good honor, Roger
08:17Working the surgical borders
08:19Two incisions
08:23Advance the triangle to cover the tip
08:26Until the V becomes a Y
08:27Exactly
08:31I guess you're the boss here?
08:33Something like that
08:34Very good at teaching
08:38Seriously
08:38You step back
08:39And with a few words
08:40You impart wisdom
08:43If you say so
08:45Do you mind if I ask what you do
08:46When you don't work?
08:49Sleep
08:50Now blunt dissect
08:52To undermine the tissue
08:56What do you think, Dr. Jabadi?
08:58Third degree
08:59Complete heart block
09:00Because?
09:01Give you dissociation
09:02No relationship between the P waves
09:04And the QRS complexes
09:05Clear
09:05Heart rate is 30
09:07Those low BP's gonna make him
09:08A lot more confused
09:09Could cause a heart attack
09:10Or a stroke
09:11If we don't fix it
09:12Oh
09:13Well, mystery solved
09:14The wires aren't even touching
09:15I'm totally disconnected
09:17Shit happens
09:17Heart rate still in low 30s
09:19No change with atropine
09:20Pacing pads are on
09:21We can try
09:22Willie
09:24Your pacemaker isn't working
09:26We're gonna fix it
09:27We're gonna try to pace your heart
09:28From the outside
09:29You might feel it in your chest
09:30Let's start at 10 milliamps
09:32Rate at 16
09:32Pacing pads are on
09:36Touch it
09:38No capture
09:39Increase to 20 milliamps
09:41That's more like a shock
09:42Still no capture
09:43Up to 30
09:45Up to 30
09:46Y'all trying to let you
09:48Kiss her off
09:48Can't tolerate it
09:49You're in a shed
09:49Dr. Langdon?
09:51One of Versed
09:52Can we set up for transvenus?
09:53I was set up before you got here
09:58Versed's on board
09:59Willie
10:00We need to float a temporary pacemaker
10:02From your neck into your heart
10:04Where is that?
10:05Because your heart rate is only 30
10:07And I hit me with a
10:09With a shot at me
10:11You've already had three
10:13Wait, wait, are you a doctor?
10:18He's out
10:22Ginger, what do you think about having some help at home?
10:27I think Rita could use a little break
10:31Every now and then
10:35We can't afford it
10:36Oh, um, Kiara told me about DHS Senior Phone Line
10:40It's part of AAA, the area agency on aging
10:45They make referrals for in-home services
10:48Uh, what's that going to cost?
10:50Medicare will cover short-term home care at least 10 hours a week
10:55Ginger, have you ever been to a senior center?
10:57I went once
10:58Nothing but old people
11:00AAA also has senior companions for a few hours a day
11:04And if Rita needs to be away at lunchtime
11:05The options program can deliver a meal
11:13Um, is everything alright?
11:16Yeah
11:18Did I say something that upset you?
11:21No
11:21It's all good
11:23It's just
11:26This is way more than I expected
11:37Bam
11:38Internal jugular accessed
11:41Pulse hocks 99 and 5 liters
11:42Systolics 9 and 5 on Epi
11:44That's good enough to perfuse the brain
11:45Good, where?
11:47You doing okay under there, Wooly?
11:49I guess
11:50So this is just like a triple lumen?
11:52Except you need a big 7 French introducer to fit the pacing wire
12:00I could use some air
12:02Is that any better?
12:05What y'all doing?
12:07We're putting a temporary wire into an external pacemaker
12:10Until you can have surgery to repair the one in your chest
12:14Heart rate's still 31
12:16Bradycordia
12:19Are you a doctor, really?
12:24Yeah, right
12:25No mention of any medical career in his past records
12:29Just mild dementia
12:31Are you a doctor?
12:33That was a good one
12:36Okay, last one
12:37How does it look?
12:40Perfect
12:42Zero for my tube goss
12:44What's up, party people?
12:46Ah, VY flap
12:47Nicely done
12:48Can I borrow Dr. Santos?
12:50As long as Dr. McKay can finish the dressing
12:52Uh, sure
13:00I can't stop thinking about your foot
13:03I
13:04You know what I mean
13:05I'm sorry
13:06But I know
13:07Move on
13:08I already did
13:08Okay
13:10There's a high maintenance surgery clinic patient down here
13:13As in
13:14Total pain in the ass
13:15I could use your help distracting her
13:17So we're
13:19We're good
13:19Every hero needs a sidekick
13:22I need to find a tube goss cage
13:24I'll be right back
13:26You'll need to elevate
13:28Antibiotics three times a day for a week
13:31A couple of painkiller tablets
13:33But try to get by on Tylenol and ibuprofen
13:35Are you okay?
13:38Is today a bad day?
13:39Drowning victim ETA three minutes
13:43Sorry, I gotta go
13:4720 centimeters clears the cordis
13:49Pacing box rate of 80
13:525 milliamps
13:53Confirmed
13:54On ventricular setting
13:55Passing to 30
13:57Just outside the heart
13:58Why do we inflate the balloon now?
14:00So it'll float into the right ventricle
14:01Exactly
14:02We're looking for
14:03An injury pattern
14:04Since it's below the AV node
14:05Looking good
14:07Check the pulse
14:10Strong radio
14:11Really strong
14:11Man, I feel like I just woke up
14:13Nice work, Dr. Langdon
14:15It's a stall
14:15It's up to 130
14:16How do you feel?
14:18They're like a million bucks
14:21Widen QRS on the scope
14:23Willie, did you used to work at this hospital?
14:25Hell no
14:26I just brought the mail
14:27Can we still Javadi?
14:30Absolutely
14:31Time to shine, Crash
14:33Do you have time to write the procedure note?
14:35No problem
14:36I'll be at Central if you need me
14:38Oh, jeez, I still need to tell Nandi about her mercury level
14:42The average emergency doctor gets pulled from task A to task B every three to five minutes
14:46Remind me again why we picked this specialty
14:48Because we all have ADHD and anything else would be boring as hell
15:00We may have another ICU admission
15:02I'll call to confirm
15:04Okay
15:04Dr. Collins, do you think that we might be able to
15:06Browning victim here
15:07Not right now
15:10Amber Phillips, six years old
15:12Found at the bottom of a home pool with an unknown downtime
15:14ASIS, tell you on the monitor
15:16Intubated with a cuff 4.5, 22 gauge left AC
15:190.25 epi three minutes ago
15:21One, two, three
15:24We're going to take over compressions
15:29Any family coming in?
15:30Grandma and little sister
15:31Fast and deep
15:34Ready?
15:35Yeah
15:35Go
15:38She's really cold
15:39Okay, you're going to get a core temp
15:44Good breath sounds bilaterally
15:45Should we use the Lucas?
15:47No, she's way too smart for that
15:48Bractal temp only 85?
15:50What do you think, Mel?
15:51Uh, she's cold, moderate hypothermia
15:53We need to get her up to 90 if we have any chance of restarting her heart
15:55250 cc's heated saline
15:57Set up the Arctic sun, continuous core temp monitoring
16:00And prep another epi 0.25
16:02Yep
16:06Preemptive order's done, let's go
16:08I just, I don't understand why you need me
16:09Crohn's disease status post colectomy 10 years ago now with severe abdominal pain
16:14Could be perforation, fistula, obstruction
16:16Great teaching case
16:18Someone give me something for the pain!
16:22Good afternoon, Ms. Walker, I'm Dr. Garcia from surgery
16:25This is Dr. Santos and Javadi
16:26It's like you're in a lot of pain
16:28No shit!
16:29We ordered you some morphine
16:30Did you read my chart? I'm allergic to morphine
16:33I'll puke my guts out
16:34That's a side effect, not an allergy
16:37Give me some Dilaudid
16:39Okay, one milligram Dilaudid
16:40I'll grab it from the PDS
16:41Money's never enough, I need two, sometimes four
16:43Got it
16:44Pertinent history, Javadi
16:47Have you had any fever or vomiting?
16:48Oh, shut up with your questions!
16:51Ma'am, we can't help you
16:52If you want to help me, give me my doctor
16:54Dr. Shamsi
16:55Ten years, no one knows me better
16:57I don't want to talk to anybody else
16:59I'm very sorry, but she's in surgery right now
17:01Ella
17:02Unknown
17:03Oh
17:04But ma'am, right here we have Dr. Shamsi's daughter, Victoria
17:09She's the next best thing
17:15Time for another epi
17:19Dr. Robbie
17:20We are back
17:27My wife and I decided
17:29We're on board with organ donation
17:30Oh, I'm really glad to hear it
17:33The church supports their decision
17:35The OPO is sending an ambulance
17:37I'll be staying with the family
17:43How's it going in there?
17:44Oh, not good
17:46Robbie
17:47For the little girl in trauma one
17:49This is Grandmother Francis
17:51And Sister Bella
17:52Hi, I'm Dr. Rabinovich
17:54How is she?
17:57Bella, would you like to color?
17:58Maybe get a snack?
18:00Yes, please
18:01My name's Kiara
18:02Let's find you some crayons
18:04I like to draw
18:05Let's do it
18:06Come on
18:10They are still doing say PR
18:12Can I please see her?
18:14Yes, of course
18:15Got Grandma coming in
18:17Let's sit right by the bedside
18:18Ready to switch
18:20Go
18:22Here you go, ma'am
18:26You can hold her hand
18:27She wasn't breathing
18:28So the medics put a tube in her throat
18:30She's so cold
18:31We're warming her up
18:32That way she'll have a better chance
18:33To respond to the medicines
18:36They moved a bench
18:38Next to the pool fence
18:39So they could go over
18:42Because their soccer ball
18:43Went in the water
18:45Amber couldn't make it out the deep end
18:46The gate was locked
18:48I was vacuuming
18:49I didn't hear them
18:55My mercury level is 94?
18:58That's high enough to cause all your symptoms
18:59Insomnia, tremors, imbalance, psychosis
19:03From a stupid face cream
19:05We're going to start chelation therapy
19:08It's a medication that binds with the mercury
19:10And helps your body excrete it
19:11And then I'll be back to normal?
19:14I don't know
19:15Are any of us normal?
19:17Where's my phone?
19:19They locked it away with all your valuables
19:21I need my phone
19:22Okay, but when you post
19:24You have to tell everyone not to use the cream
19:26Definitely
19:26Can I borrow your phone?
19:28Just the camera
19:29I was wearing a wig when I left my apartment
19:31I had a wig when I came in, right?
19:33Not when you came in
19:36Oh my god
19:40I look like shit
19:48How is he doing?
19:49Stable
19:49Scheduled for a new pacer tomorrow with cardiology
19:52Great
19:53Robbie
19:53Here it's a T1
19:56This is Dr. Robbie
19:57We're saying, are she okay?
19:59What, have you heard?
20:00She got pulled from the pool
20:02She wasn't breathing
20:03So we're doing that for her now
20:04And we're trying to get our hearts tired again
20:06Wait, her heart stopped?
20:08I have to be with her
20:09Of course
20:11There are a lot of people in here right now
20:12Trying to help her
20:13You understand
20:16Amber
20:16Oh my god, Amber
20:19I love you
20:20I love you so much
20:21I am so sorry
20:23Where's Bella?
20:24She's with our social worker
20:25Oh, I should be with her
20:27I'll go with you, Mom
20:28I'll be right back
20:30Come on, she's still
20:31She's still in the hall a bit
20:33Hang on
20:33We got it
20:34Oh
20:40Rhythm check
20:41Hold compressions
20:46Asystole
20:46Resume compressions
20:49Three minutes since the last epi
20:50Push another
20:52Did you shock the heart?
20:53Uh, no
20:54Why didn't you shock the heart?
20:56We've got to say
20:56You've got to shock the heart
20:57Your heart rhythm right now is flatline
20:58And that's not treatable with a shock
21:00We're trying to get the rhythm to change
21:01To something you can shock
21:02By warming her up
21:04Okay, so we got to warm up
21:06We got to get some warm blankets in here
21:07We're giving her warm IV fluids
21:08And you can feel these blue pads
21:10They have warm water running through them
21:11Like a hot tub
21:17Are you sure you're doing everything?
21:20Yes, we are
21:25Amber
21:27Honey, I'm here
21:29It's gonna be okay, I promise you
21:31Everything's gonna be okay
21:34I can't take it much longer
21:36I got Dr. Shamsi on speakerphone from the OR
21:39Eileen, how soon can you get here?
21:41I'm finishing a lab
21:42Coley, shouldn't be long
21:43Your daughter's here
21:44Hi, honey
21:47Minimal relief with two of Dilaudid
21:49She needs four
21:50That's what I've been telling them
21:51We're titrating
21:53We didn't want her to stop breathing
21:54Is Dr. Garcia with you?
21:56Right here
21:56How's the exam?
21:57Rigidity with guarding
21:59Sounds like peridonitis
22:00Two sets of blood cultures
22:02And 3.375 of Zosyn
22:03Make sure she's next in line for a CT scan
22:05And bump everyone else
22:06Do you understand?
22:08Victoria?
22:08Got it
22:09See you soon
22:10Thank you, Eileen
22:12Ready for some more Dilaudid?
22:14God, yes
22:14Victoria, we'll make sure
22:16All of Dr. Shamsi's orders are followed
22:17Call if you need us
22:18Yeah
22:21Great move bringing in Javadi
22:24Is this patient payback
22:26For dropping the scalpel?
22:27Look at the bright side
22:28If she goes to the OR for perf
22:30You can scrub in
22:30I'll coach you
22:31You'll make a brilliant first impression
22:33On Dr. Shamsi
22:34Really? You do that?
22:35Mm-hmm
22:36Thanks
22:38I, um
22:41I have something unusual to ask
22:43Okay
22:46I've been on two cases with Langdon
22:48And there have been irregularities with benzos
22:52Lorazepam with a seizure
22:53Librium with an alcoholic
22:54And?
22:56And I'm concerned
22:58Concerned about what?
23:01That he could be stealing?
23:04Whoa, whoa, whoa
23:05I insult the shit out of Langdon
23:07But he's a great doctor
23:08I've never seen him impaired
23:11What do I do?
23:12You've been here for what?
23:14Seven hours?
23:14Just do your job
23:30Kind of a weird vibe out here
23:33Yeah, pediatric drowning will do that
23:36Thought I didn't end up in there
23:38Yeah, you and me both
23:42What's with the scarf?
23:43Oh, it's from the lost and found
23:45From my patient in Central League
23:46Cool
23:47I'm off to North to dysuria
23:51What happened to two visitors a patient?
23:54It's the fentanyl overdose
23:56It's going to be an honor walk
23:59He's an organ donor
24:01I'll see you later
24:02See you
24:12Myrna?
24:16Myrna?
24:19No, no, no
24:19Not today
24:21Myrna!
24:22What the fuck?
24:24What do you think you're doing?
24:26I
24:27I was just checking on you, ma'am
24:29You can't even take a nap in this hellhole
24:32Fuck off
24:33Sorry
24:37Hi
24:37I'm Dr. McKay
24:39Uh, Piper
24:40Laura
24:41And you guys are?
24:43She's my boss
24:44Oh, what can I work?
24:46I'm an accountant and she's my assistant
24:48Oh, cool
24:49Um, Piper, are you okay with your boss being here while we talk?
24:54Yeah, I'm good
24:55Are you sure?
24:56I'm going to be asking you some pretty personal questions
24:58She doesn't mind
24:59We have no secrets
25:04Okay
25:06So, burning with urination
25:07When did that start?
25:09About two days ago
25:11Why don't we let Piper answer the questions?
25:13I'm sorry, it's just
25:14We've been waiting so long
25:18About two days ago
25:19Any blood in the urine?
25:21I don't think so
25:23No, she would have definitely noticed that
25:25Do you need me to pull something out?
25:27Okay
25:28I'm going to get you a gown
25:29And I'll bear it back
25:30Okay?
25:31Okay
25:37Any change with the extra dilaudid?
25:39Not really
25:40The pain is still there
25:45Sorry
25:48Sorry, just to review
25:49No fever
25:50No vomiting
25:52No diarrhea
25:53No constipation
25:54Correct
25:56When exactly did the pain start?
25:5910.15 this morning
26:01All of a sudden
26:03That's very strange
26:05I agree
26:08Will you tell me everything you did this morning?
26:10Took a shower
26:11Had breakfast
26:13Some coffee
26:15Toast with jam
26:17Yard work
26:18Moved some firewood
26:20Did the pain start before or after the firewood?
26:23A little bit after
26:25I might have got a splinter in my foot
26:27I wasn't wearing socks
26:31The other one
26:40Two small punctures
26:41One millimeter apart
26:44Two splinters
26:47Whoa
26:50What?
26:53There's a dead black widow spider in your shoe
26:55You're shitting me
26:56Red hourglass marking
26:58We need IV diazepam
27:00Start with five
27:00Might need ten
27:06What does a spider bite have to do with my Crohn's disease?
27:10Oh, nothing
27:10Black widow venom can cause muscle spasms in the belly
27:13People have had surgery thinking it was appendicitis
27:16Hi, Dolores
27:18Why didn't you get her to CT yet?
27:20I don't think she needs it
27:21The abdomen is rigid
27:22She's perfed
27:23Maybe not
27:24What are you giving?
27:26Diazepam
27:26I didn't order that
27:27I did
27:28She has a rigid abdomen
27:29But no other GI signs or symptoms
27:31Didn't make any sense
27:32There's a black widow spider
27:33And a bite mark on the foot
27:34The venom is causing spasm
27:36Of the abdominal wall musculature
27:38Whatever you guys gave me
27:40It's working
27:41Possibly
27:42No
27:43Definitely
27:46I'm much better
27:53Take a deep breath
27:59Good
28:00Good
28:00You from Pittsburgh?
28:03Two hours north
28:04Like Mill Village
28:06Okay
28:06Do you have any family you want to call?
28:09I don't have a phone
28:10She can use mine if she needs to
28:15Okay
28:17Lay down
28:22I've never heard of Mill Village
28:25Yeah, nobody has
28:27Population 400
28:27You have that small
28:29Tell me about it
28:30After high school I had to get out of there
28:33Well you're lucky you found a job
28:36Any pain around here?
28:37Mm-hmm
28:38A little
28:40Okay
28:40Sit up for me
28:44You gave us a urine specimen
28:46Hours ago in the waiting room
28:48Okay
28:49Well, I'll find the results
28:50And then you might need a pelvic exam
28:52Is that really necessary?
28:55It could be
28:56If there's no bladder infection
28:58It's important to check
28:59Okay
29:01And if we do a pelvic, Laura
29:02We'll have you step outside for a minute
29:03I prefer to stay with her
29:05For support
29:10Piper, do you want some privacy?
29:14No, it's cool
29:15She
29:15She can stay
29:18Okay
29:22I'll be back
29:26Core temp is 88
29:29Is that good?
29:31It's up from 85 on her arrival
29:34So
29:35We're headed in the right direction
29:37You hear that, Amber?
29:39Is it better?
29:41You're getting better
29:45I need to step out for a second
29:47You're in good hands
29:49Come find me when it's over 90
29:59Paris are gonna need the family room
30:01It's available now
30:05Less rights for Nick
30:08Just one of those days
30:09Yeah
30:10Anyone else dying?
30:12Not at the moment
30:15What the hell is that?
30:20Ask for better patient satisfaction scores
30:23What do you want, man?
30:26Excuse me, Dr. Robbie
30:27This is Eli, son of Willie Alexander
30:29Hey, nice to meet you
30:29Likewise
30:30How's he doing?
30:31He's doing better
30:31He's gonna need to stay with us, though
30:33For a new pacemaker
30:34He got a new one at Presby
30:35About, uh, a year ago
30:37They said it'd be good for 10 years
30:39Yes, but the wires
30:40Separated from the box
30:41It happens sometimes
30:42Yeah
30:43Can he have a visitor?
30:44Of course
30:45Right this way
30:47Hey, Eli, what did your dad do for a living?
30:49A postal worker of 40 years
30:52Did he ever do any volunteer work at the hospital?
30:55No, but when he was a kid
30:57He was a medic for the Freedom House Ambulance Service
31:02That's incredible
31:03Uh, I will be in as soon as I can
31:05Thank you
31:06You guys are a legend
31:08I know
31:10Sorry, can I get your help with something?
31:12Um, 18-year-old woman with Desiria
31:14Moved here two months ago
31:16From rural Pennsylvania
31:17She's with her female boss
31:19Who's very controlling
31:20And answers questions for her
31:22Won't leave her side for anything
31:24Even a pelvic exam
31:25And you're thinking?
31:28Red flags for trafficking
31:29Sounds like it
31:30We need to take a sexual history
31:32And do a pelvic in private
31:33She's not gonna talk
31:35Unless we separate them
31:36That we can do
31:37Come on
31:41It looks like ST elevation
31:44That could be bad
31:46Oh, no, that's just because
31:47We're pacing your right ventricle
31:50Willie, I'm impressed
31:51After all these years
31:52You still remember your medical training
31:54Well, he couldn't tell you
31:55What he had for breakfast
31:57It's all right
31:58I remember what's important
32:00Like the Freedom House
32:02What's that?
32:03Damn shame
32:04That's your history
32:06Dad, they're busy
32:07Back in the 60s
32:08No 911
32:09No ambulances
32:11All we had was
32:12Police paddy wagons
32:13That took you to the hospital
32:15If you were lucky
32:16Then this doc in pit
32:18Dr. Saffer
32:20He got some money
32:21And trained us up
32:22Well, you must have been
32:24A good student
32:24Hell no
32:25I was a knucklehead
32:29Smoked a lot of weed
32:30Dropped out of high school
32:31But Freedom House
32:33Trained me up
32:34Saved my life
32:36What are you doing there, Willie?
32:39Nothing
32:39You're moving your old pacemaker
32:42Diagnosis made
32:43What?
32:44Twiddler syndrome
32:46Spinning that thing around
32:47Caused the wires to break off
32:48Dad
32:49I didn't mean to
32:51That's okay
32:51We'll put the new one in
32:52A little deeper
32:53Won't happen again
32:56Some of your tests
32:57Are concerning for a kidney stone
32:59Wouldn't that give more pain?
33:01Not always
33:02If it's a urine infection
33:03With a stone
33:03You'll need to stay in the hospital
33:04For some IV antibiotics
33:07What do we have to do?
33:08A CT scan of your kidneys
33:10How long is that going to take?
33:12They can do it right now
33:13Great, let's go
33:14I'm sorry there's radiation
33:16You won't be able to stay with her
33:17But we'll be back
33:18As soon as the scan's done
33:21You're good with this, right?
33:22Yeah, I'll be fine
33:25We'll see you in a minute
33:27So, Laura's an accountant?
33:30Uh-huh
33:30Hmm, how'd you get the job?
33:33Online ad
33:34Yeah
33:34Zoom interview
33:35You must be good at math
33:37Not really
33:40So, what do you do for work?
33:42I answer the phones
33:43I make appointments
33:45I bring deposits to the bank
33:48You work with spreadsheets?
33:51She hasn't taught me that yet
33:54This is where you do the CT?
33:56Uh, no
33:58We wanted to give you some privacy
34:00For your pelvic exam
34:02Laura's gonna be so pissed
34:04Why would she be mad?
34:06Piper, you have any concerns
34:07You want to talk about?
34:10No, just the pain when I pee
34:13Anything you need to tell us
34:14About your job or your boss?
34:17No
34:17No, no
34:18It's all
34:19Really great
34:25Okay
34:27Temp is up to 91
34:29She's so much warmer
34:30It's working
34:32Can you shock the heart now?
34:3591 is warm enough
34:36For her heart to respond
34:37Oh, compressions
34:41Resistly
34:42Resuming compressions
34:45Got the potassium level back
34:4612.2
35:03No one has ever survived a cardiac arrest
35:06With a potassium over 11
35:10There is absolutely no chance of recovery
35:14I am so sorry
35:18Amber has died
35:21No, no, no
35:22No, no, no
35:23It's not happening
35:24No, no, no
35:27No
35:27No
35:28No
35:29No
35:32Before we stop
35:35Do you think her sister would like a chance to say goodbye?
35:39No, Bella shouldn't see her like this.
35:43Okay.
35:45You can stay in here for as long as you like.
35:48It's okay, it's okay.
35:50We are going to stop now.
35:58Resuscitation efforts discontinued, 1451.
36:01Oh, my baby.
36:04Oh, sweetheart, I'm sorry.
36:13Okay, that's it.
36:14We're done.
36:16Let me get the gurney up.
36:23Is everything okay?
36:25Yeah.
36:26There's no infection in your uterus or ovaries.
36:28Okay, that's good.
36:31But your urine test was positive for chlamydia.
36:34Shit.
36:35It's a sexually transmitted infection.
36:38Any idea how that happened?
36:41Yeah, my cheating piece of shit ex-boyfriend back home.
36:46But we broke up before I moved.
36:48You need antibiotics twice a day for ten days.
36:51That'll clear it up.
36:52And he'll need treatment too.
36:54If I don't tell him, is there a chance his dick will fall off?
36:57If you don't tell him, a public health nurse will.
37:00You should also test for HIV, syphilis, gonorrhea, and hepatitis.
37:04Okay.
37:05Any other sexual partners in the last few months?
37:09Not really.
37:11Use condoms?
37:12Most of the time.
37:13It's important to use them all the time.
37:15Yeah, but if I forget, you can just give me a shot, right?
37:17Not for some infections.
37:18This is serious.
37:20Birth control?
37:21Norplant.
37:21Yeah.
37:21It's good for five years.
37:25Piper, we have a question that we ask everyone.
37:30Sometimes people are pressured to have sex when they don't want to.
37:33Has that ever happened to you?
37:38No.
37:39Never.
37:40And when you signed in, you put down Laura as your emergency contact?
37:44Yeah.
37:46You have the same address as Laura?
37:49Yeah, she's letting me use her guest room until I can save up for a place of my own.
37:55Okay.
37:57Why don't we have you lie down again?
37:59What for?
38:00Uh, ultrasound.
38:01We're gonna check your kidneys.
38:03You got bumped from CT by a couple emergency cases.
38:22Bella?
38:23Dr. King and Dr. Collins are here.
38:27Hi.
38:28I'm coloring.
38:30You're a very good artist.
38:32Thanks.
38:37Um, Bella?
38:40Yeah?
38:41What have you heard about Amber?
38:43She's really sick, but the doctor and the nurse is trying to make her better.
38:51What spank you said?
38:54You know, I have a sister too, and I don't like it when she's sick.
38:59She saved me.
39:03She did.
39:05I fell in the pool.
39:07She helped me get out, but then she couldn't get out.
39:13I'm making her a card.
39:27Freedom House took us in and trained us for 300 hours.
39:32They turned out the very first medics in the United States.
39:35We started IVs, defibrillated, intubated in the field.
39:42They were the heroes of Hill District.
39:44Bunch of young black dudes saving lives every day.
39:48Why'd you quit?
39:49I didn't.
39:50The city saw how successful it was, took over the program.
39:53Trained new medics.
39:55All white.
39:56Everything that Willie and his friends did set the EMS standard for the entire country.
40:01Their program created the 911 system.
40:04It wasn't just us.
40:06We had the best teachers.
40:08And Dr. Saffer invented CPR.
40:12And Dr. Adamson, math student when I arrived.
40:16But I'm telling you, boy, that guy could teach like there was no tomorrow.
40:23You ever him give a lecture?
40:25Many times.
40:26Every time I say he's patient.
40:29It's like he's standing right here, whispering in my ear, telling me what to do.
40:33Me too.
40:35Hmm.
40:36Where is he working now?
40:39Dr. Adamson died a few years ago during COVID.
40:42Oh.
40:44Hard to believe.
40:46He was so young, so full of life.
40:49Force of nature.
40:51Yes, he was.
40:57We're back.
40:58I should be out there for the honor walk.
41:01Right.
41:03Hey, Mrs. Phillips.
41:05Your son would like to speak with you.
41:07Dr. King can stay here.
41:09Bella?
41:09Be right back.
41:25I've finished my card.
41:30Oh, no.
41:34It's beautiful. I love it.
41:36Thanks.
41:38Can I see Amber now?
41:41Um, no.
41:43Not quite yet.
41:45What is that?
41:47Oh, uh, it's from the gift shop.
41:49For Amber?
41:51For you and for Amber.
41:54But you get to name it.
41:57I think her name will be Bear.
42:00Bear. All right.
42:02Um, since you can't see Amber right now, but I bet you got a lot of things to tell her.
42:08Bear's gonna help.
42:10How?
42:11Well, um, if you tell Bear everything you want to tell Amber, then I'll take Bear and sit her on
42:18Amber's pillow and then she'll tell her everything you said.
42:21What do you think of that plan?
42:23I like it.
42:23Yeah?
42:24Okay.
42:25Do you want to give it a try?
42:26Here you go.
42:30Hi, Amber.
42:32It's me, Bella.
42:33Thank you for saving me.
42:36When you come home, I promise I won't touch your toys without asking.
42:44And I try not to fight because you're my best friend in the whole entire world.
42:50I love you.
42:56Amber's gonna be so happy with that.
43:03Hey.
43:04Hi.
43:07Uh, how long have you been working here?
43:1132 years.
43:12All in the ER?
43:14Yeah.
43:14Oh, man.
43:17How do you do it?
43:19I like taking care of everyone.
43:20Especially the ones who fall through the cracks. They got nowhere else to go.
43:24Well, you deserve a medal.
43:29I'd settle for a raise.
43:42Thank you for opening.
43:47Uh...
43:51I wish I could do the surgery here.
43:53Surgical teams are flying in from all over the country to meet Nick at the Center for Organ Recovery.
43:59We have a car and driver waiting so John and Lily can follow right behind the ambulance.
44:05So we won't be seeing you again?
44:08No.
44:10If it's alright, I think a lot of us here would like to attend Nick's funeral.
44:22Yeah, of course.
44:24Shh.
44:52Thank you very much.
44:57Okay.
44:58Let's go.
45:31Let's go.
46:05Let's go.
46:28Let's go.
46:59Let's go.
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