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00:08PARAHAN
00:08Buran! Is this you?
00:16It began after a bad case of viral meningitis when I was five
00:20They tried every anti-seizure medication, but I still had episodes every few months or so
00:27No one's ever noticed before, they just think I'm thoughtful
00:31Are you driving?
00:33I couldn't until laser ablation to my left temporal lobe 12 years ago.
00:39Between that and the Keppra, I've been seizure-free,
00:42cleared by neurology to drive and to work as an attending.
00:48How long between the seizure you had today and the last one?
00:52It's been well over a year.
00:57But I had two today.
01:03I don't know why.
01:05It could be sleep deprivation, new job stress.
01:08I haven't had to deal with peds cases since Afghanistan.
01:13What are your options now?
01:17Up my Keppra or maybe try one of the newer anti-seizure meds.
01:22But if that doesn't work, I'm left with two choices.
01:26A temporal lobectomy, which could impair my speech,
01:29or get a neuromodulation device, which can sense and stop the seizures almost immediately.
01:35You need to disclose this.
01:37I know. I have a plan.
01:39Hey, Robbie. Dana's looking for you. She's in peds.
01:42Yeah, okay. I'll be right there.
01:44Sounds like you needed in peds, and I have patients to see.
01:48Robbie, a pregnant woman with severe headache on her way and by ambulance.
01:51Find Abbott or a nightship resident.
02:09Need you to turn out your pockets.
02:17Hey, show me your hands.
02:46Come here often?
02:57What's going on?
02:59Oh, sorry, false alarm. I thought she spiked a fever, but it was the wrong chart for my analog hell.
03:05You know anybody who might consider kinship adoption doctors and nurses qualified?
03:09Don't look at me.
03:11Hey, can your staff keep an eye on Dr. Alice and me until she leaves?
03:14Why?
03:16Uh, because I think she's tired and I don't want her to make any mistakes.
03:20Oh, great advice. Maybe you should take it.
03:23Yeah, I'm gonna go get some fresh air.
03:24Grab some for me while you're out there.
03:26Your lungs wouldn't know what to do with it.
03:28Screw you!
03:29In front of the baby, nice.
03:35We are the night crawlers.
03:37We deal with the weirdest and the wildest because...
03:40We are the weirdest and the wildest of them all.
03:42That is right, and tonight they are really gonna be crawling.
03:45Now go get some!
03:46Hooah!
03:51Sorry to wake you.
03:53I was thinking.
03:58I doubt BTX.
04:00You're supposed to be leaving.
04:02I am.
04:05You know, this spirit quest of yours has a lot of people up in arms around you.
04:09Everyone's gonna be fine without me, and it's hardly a spirit quest.
04:12Whatever it is, it seems you've given people the impression you might not be coming back.
04:15Well, who knows what the future has to store for any of us.
04:18Yeah, saying shit like that right there isn't helping.
04:20People are worried about you.
04:22Dr. Abbott, the patient at South 21, Digby, he's missing again.
04:25Sounds like a day shift problem.
04:26Not if he was handed off already.
04:33Best I can do under the circumstances.
04:35Hey, don't leave before I get back, yeah?
04:37Hell, I feel like I live here now.
04:42Your friend fixing your bike?
04:44Ambulance clipped it while I was just parked here today.
04:47Jesus Christ.
04:49It's a sign if I've ever seen one.
04:52Yeah, here's the thing.
04:53When people worry about you, it makes me think that I should be worried about you.
04:56And I don't like worrying about things.
04:57Ooh, now you're a shrink.
04:59No, I'm trying to be your friend.
05:00You got Dana convinced that you're gonna hurt yourself.
05:02Dana's got her own issues.
05:03That sounds like projection.
05:04Are you seriously trying to have this fucking conversation with me right now, man?
05:08I'm not the one who spends his free time getting shot at.
05:11Ooh-wah!
05:13Hey, Dr. Robbie.
05:14This is Judith Lestrade, 36 weeks pregnant with two days of headache.
05:17Now a 10 out of 10 with blurred vision.
05:20BP 174 over 120.
05:22Heart rate 92.
05:23No relief with fentanyl.
05:24Judith, I'm Dr. Abbott.
05:25Do you have any weakness in your arms or legs?
05:27No.
05:27No.
05:27Is this a stroke?
05:28We need to check for everything.
05:29Pitting edema of severe preeclampsia.
05:32Where are you doing your prenatal care?
05:34Nowhere.
05:35It's a wild pregnancy.
05:37I want a free birth.
05:41This 81-year-old nun presents with red itchy eyes with secretions for the past two days.
05:47The patient complains of no URI symptoms.
05:50No contact with any chemical aids.
05:52Hey.
05:53What, half a monster?
05:55Oh, no, thanks.
05:57I don't really want to stay awake any longer than I have to.
06:00Yeah, I hear you.
06:03Did you find your ID badge?
06:05No.
06:06You're any closer to deciding what's next for you?
06:09Uh, yeah, I'm seriously considering law school.
06:11What?
06:11What are you talking about?
06:12You're gonna be a great doctor.
06:15I mean, no offense, but look how this place does to you.
06:19LinkedIn's an addict.
06:20He's a person with a substance use disorder.
06:23McKay was on house arrest.
06:25Dana's a time bomb.
06:27Santos is one of the angriest people you were ever going to meet.
06:30Sarcastic, yes.
06:31Cynical, definitely.
06:32I don't know if she's, you know.
06:33Mel?
06:36Samira has no life.
06:38Abby's an adrenaline junkie who gets shot at for fun.
06:42Robbie's got, like, PTSD or something way fucking worse.
06:45I mean, I'd hate to know what you think about me.
06:49I don't, no, I just...
06:51The more time I spend here,
06:53the more I realize the importance of, like, mental health.
07:00Just for patients and for us.
07:01And this is...
07:03Yeah.
07:04Well, you know, maybe that's what you should focus on.
07:10What?
07:11Mental health.
07:12Clearly you have a passion for it, right?
07:15I mean, it's great.
07:16I wouldn't call it a passion.
07:17I would call it, like, a...
07:22Oh, my God.
07:25You might be right.
07:29Oh, you're a genius, Whitaker.
07:31Oh, okay.
07:34CTG is on.
07:36CTG?
07:37Cardiotachography.
07:38Measures the baby's heart rate and checks for contractions.
07:42Feel heart rate 128.
07:43Normal range, Nazely?
07:45110 to 160.
07:47So the baby's okay?
07:48Right now, yes.
07:50128 is reassuring.
07:51BP's 170 over 119.
07:53Six grams of magnesium running in.
07:55Your next move, Cruz?
07:5720 of labetalol IV push over two minutes.
07:59What's happening?
08:01You have a condition called preeclampsia.
08:03And how did that happen?
08:04Uh, nobody really knows, actually.
08:06It affects about 10% of the pregnancies.
08:08High blood pressure, headaches, protein in the urine, and swollen ankles.
08:13Well, it's a wild pregnancy, so that means no medical care.
08:17Then why are you here?
08:20I just need to get rid of this headache.
08:25Well, if we don't lower your blood pressure and treat with magnesium, there can be problems.
08:31Like what?
08:32Seizures.
08:33Bleeding.
08:34Even death.
08:35For you and the baby.
08:36Oh, my God.
08:38Robbie, your VIP's ready to go.
08:40Okay, I'll be right there.
08:41You good?
08:42Yeah, I'm good.
08:43I got it.
08:44My eye's closed.
08:46But I will.
08:47Maybe one eye.
08:48Hey.
08:53Hey, Becca.
08:54How are you feeling?
08:55I'm better, thanks.
08:58Where are you?
09:00I'm at Adam's house.
09:01Can I call you later?
09:03We're watching a movie.
09:04Oh, sure.
09:04I thought you were going to see the fireworks.
09:06Nope.
09:07We decided to watch Elf instead.
09:09Ah.
09:10Of course you did.
09:12Okay.
09:12I'll call you tomorrow.
09:13What?
09:13Wait.
09:14Are you spending the night?
09:16Um.
09:17Yes.
09:18His parents invited me.
09:20They need to ask me that.
09:21Are you staying here too?
09:23No.
09:24They needed to ask if it's okay if you stayed.
09:28Why?
09:31Because it's polite.
09:34It's the right thing to do.
09:38I need to talk to them.
09:39Um.
09:39They're not here.
09:40They're at a barbecue.
09:42Okay.
09:43Um.
09:43Can you have them call me as soon as they get home?
09:45Yes.
09:46Can you promise?
09:47I promise.
09:48Uh.
09:48Okay.
09:49Bye ma'am.
09:49Bye.
09:50Have fun.
09:51Thanks for fixing my bike.
09:53All right.
09:53Keep me running.
09:54I'll keep her going.
09:57You know the Cree don't have a word for goodbye?
10:01You know a lot of Cree?
10:03A bit.
10:04I got around man.
10:05I don't doubt it.
10:09Look, I'll come back for all this other shit.
10:12Great.
10:13If you promise to come back and let me take the Bonnie for a ride.
10:16Uh.
10:17I don't know.
10:17I've seen you ride old man.
10:19Fuck you.
10:20I mean it.
10:22We got a deal?
10:26I'll think about it.
10:42This looks like an ambush.
10:44We got a slight hiccup in chairs.
10:45Ice is back.
10:46No.
10:47We got a dead body.
10:49Tell me he died out there?
10:50Yeah.
10:50Poor devil checked in at five this morning.
10:52He was a DNR.
10:52Uh.
10:53What was his chief complaint?
10:54Hemorrhoids and constipation.
10:55No shit.
10:56Hence the constipation.
10:58You throw me a slow one on my head.
11:00Tell the night shift.
11:01I'm saying that's when he died.
11:02We all in agreement on that?
11:03To the grave.
11:04Just like poor Jasper.
11:06You're on fire.
11:07Just give my second whim.
11:11How's the headache?
11:11Still a 10.
11:13More fentanyl?
11:14Yep.
11:15BP's good.
11:16Another 50.
11:17Hey Abbott.
11:18Attending and resident are stuck in the OR.
11:20Oh, you're the next best thing.
11:22Better, some would say.
11:24Hmm.
11:25What do you got?
11:26This is Judith.
11:27G1P0 with no prenatal care.
11:29Preeclampsia with severe hypertension.
11:31Hey Judith.
11:32Nurse Garvin from OB.
11:33Some jelly on the belly.
11:35Gonna take a quick look with ultrasound.
11:36No, no, no.
11:37Ultrasound can harm the baby.
11:38Not true.
11:39Not doing the ultrasound could end up harming you and the baby.
11:44Okay, just do it as fast as you can.
11:48Why no prenatal care, Judith?
11:51I wanted a free birth.
11:53No doctors, no hospital, no medicine.
11:56You have a midwife?
11:58A birth doula?
11:59No.
12:00I don't need one.
12:02Women have been having children on their own for thousands of years.
12:04Yeah, with an infant mortality rate of 30% for most of those thousands of years.
12:09Femur length, seven centimeters.
12:1037 weeks.
12:11They'll probably induce.
12:13What?
12:14No.
12:15No, no, no, no.
12:16Absolutely not.
12:16At 37 weeks, the cure for preeclampsia is to deliver the baby.
12:20We need to get you upstairs so the OB doctors can induce labor to save you and your baby.
12:25No, no, no, no.
12:26Uh-uh.
12:29Yeah, that's definitely Jasper.
12:31He was alive and kicking when I shift into this morning.
12:34This is definitely a day shift patient.
12:35John's not a patient.
12:36He's a DB that we gotta deal with.
12:40Is this dude dead?
12:42Nope.
12:43All right, Mr. Reed, time to take you back and get you checked out, okay?
12:46He sure looks dead.
12:47Are you a doctor?
12:48No, but he has hyper narcolepsy.
12:50It's no joke.
12:55Sometimes I hate guides.
13:08Wow.
13:10Crazy how muggy it still is out here.
13:13You, uh, you seen Robbie?
13:16Uh, not for a bit.
13:18You catch up on your charts from the beginning of the shift?
13:21Yeah.
13:22What are you still doing here?
13:23Uh, just gonna...
13:25You staying for the fireworks?
13:27Yeah.
13:28I was supposed to see them with Becca, but...
13:30She is at her boyfriend Adam's family's house instead.
13:40Your sister seems like she's, uh, pretty put together.
13:46Yeah.
13:48Uh, a lot more than I realized.
13:52How's your day?
13:55I've had better.
13:58You?
14:02Yeah.
14:04But then again, I've had a lot worse.
14:08Hell, I did a closed cervical reduction like an hour ago.
14:10Oh, I heard. That must have been so intense.
14:14My hands are still shaking.
14:17Hey, um, do you think you could teach me how to do that sometime?
14:21Uh, yeah.
14:22Yeah?
14:23Yeah, sure. I mean, I hope you never have to use it.
14:25I could have paralyzed that guy.
14:27Yeah, but you didn't?
14:29No, I didn't.
14:35By the way, for...
14:37talking me down earlier.
14:40I'm sorry I snapped.
14:44It's okay.
14:53Dr. Mohan, you ever heard of Kentia Foster, and it's where a nurse or doctor can become an emergency foster?
14:58No, I don't need any kids. I need to find a job first.
15:03Candace O'Grady is an 82-year-old female brought in by her son for intractable vomiting.
15:08No, it's a psych comp.
15:12Beep.
15:14Oh, I've already got one I can barely keep up with.
15:17What about Sleeping Beauty over here?
15:19She's already babysitting Whitaker.
15:21Well, if you know anyone who'd like to help us out with baby Jane Doe, have them call the main
15:24desk.
15:25Sure thing.
15:26I've taken myself, but did you kill me?
15:32...1.2.
15:33Another 40 of them.
15:35Magbulus is in now.
15:36Two burns an hour.
15:37Bob's are coming back.
15:38Hemoglobin 7.5.
15:40Plate looks 40.
15:41These are sky-high.
15:42Help syndrome.
15:44Hemolytic anemia.
15:45Elevated liver enzymes and low platelets.
15:47They're cleaning a room.
15:48We can bring her up in 10 minutes.
15:50How you doing, Judith?
15:54I...
15:56Oh, she's seizing.
15:58Oh, shit.
15:5910 of IV diazepam.
16:01Have another 10 ready?
16:02With all the movement, we can't get a fetal heartbeat.
16:04Putting on 15 liters by mask.
16:05Should we intubate?
16:06Hold intubation.
16:07Let's try to break this.
16:08We don't want to mask seizures with paralysis unless we have to.
16:12Okay?
16:16Crew CTG isn't reading.
16:18Check with ultrasound.
16:18On it.
16:19Nazely.
16:19What's the diagnosis?
16:21Um...
16:21With a seizure.
16:22Now it's eclampsia.
16:25Fetal heart rate is about 90.
16:26Way too low.
16:27Mom's sats are going down.
16:28Found a tuber?
16:29Set up for it, but wait.
16:31Another 10 of diazepam pushed 4 grams of Keppra.
16:43Hey, how are you guys making up?
16:47Yeah, we're getting there.
16:47Have you seen Dr. Alashimi?
16:49No.
16:50Can I talk to you for a sec?
16:57So, I just wanted to let you know that I've been checking out some of your online posts.
16:59Look, I was just trying to help get some health messages out there especially.
17:02I think they're great.
17:03Really good.
17:05Really good.
17:05You do?
17:06Yeah.
17:08Yeah.
17:08Um...
17:09Keep it up.
17:10Okay.
17:11As long as you follow the HIPAA laws.
17:14I do.
17:15And wait until you're done charting.
17:17Sure.
17:20Actually, Dr. Robbie.
17:21Sorry.
17:23Um...
17:23Can I ask you a question?
17:25Sure.
17:26Um...
17:26I...
17:27I may be considering emergency psychiatry.
17:31Very cool.
17:34Think I could do it?
17:38I think that you could do anything that you put your mind to, Victoria.
17:46Okay.
17:47Okay.
17:48Pulse locks is 88.
17:50Dr. Abbott?
17:52Intubate?
17:53Let's do it.
17:54Nazely, what do you suggest for rapid sequence induction?
17:58Etomidate and rock.
17:59Not quite.
18:00120 of propofol 60.
18:02It sucks in all choline.
18:03Why is that, Cruz?
18:03Propofol for the anti-seizure effect.
18:06Sucks to avoid prolonged paralysis so we can check a neuro exam.
18:08Exactly.
18:09Pushing the propofol.
18:11Once she's flat for intubation, we need to displace the uterus to the left.
18:14Nazely, that's you.
18:14Big hug.
18:15Both arms.
18:15Get the baby off the vena cava.
18:16Sucks is on board.
18:18But after she's paralyzed, the seizing stops, right?
18:20It might look like that, but an ongoing seizure will still fry the brain.
18:24Monitor.
18:25EEG.
18:25Is there time for that?
18:26Wait and see.
18:29Paralytics kicked in.
18:30Let's go.
18:30Roll her to her back.
18:33Intubate.
18:33Then EEG to see if her brain is still seizing.
18:37I need first pass success.
18:38You and me both.
18:48Have you seen Dr. Alashimi?
18:50No.
18:51Have you seen Dr. Alashimi?
18:53Alashimi?
18:55I thought this day's going.
18:56She'll probably quit.
18:58Last day, sir, she's in peds with baby Jane Doe.
19:01Nope.
19:01I was just in there.
19:03Want me to page it?
19:05Uh...
19:05No, that's okay.
19:06I will find her.
19:12Hello.
19:16Hey, how did our people do with the deposition?
19:19Dr. Ellis is a pit bull.
19:21Dr. King is a petunia.
19:23They were pretty brutal with her.
19:25She's sensitive.
19:25Very.
19:26I'm afraid it isn't over.
19:28They want to call her back.
19:29Oh, that's unfortunate.
19:31Maybe I should go with you to break that news to her, actually.
19:34It was your last company.
19:35Hey, while I have you, can I pose a hypothetical to you?
19:38If a doctor suspects another physician of having a medical condition that could negatively affect the way they would treat
19:44a patient,
19:45where would disclosing that fall on the HIPAA violation scale?
19:50First, do no harm.
19:54Dr. King, do you have a second?
20:04Good. Lung sliding bilaterally.
20:05Fetal heart rate borderline at 98.
20:09Roll to the left again.
20:10That can help.
20:11One, two, three.
20:14Okay.
20:17All set here.
20:18EEG monitor's good to go.
20:20That was fast.
20:21Still seizing while paralyzed.
20:23It's non-compulsive status.
20:25What's she had so far?
20:2730 of diazepam full load of Mag-Keprin pro football.
20:30Damn.
20:30What's your next step?
20:31Any ideas?
20:32Hmm?
20:33Nazely?
20:35Dilantin?
20:36Valproate?
20:36Mmm, infusion is too long, so is onset of action.
20:39Push 100 of ketamine.
20:41That's had results with refractory status.
20:43She also has HELP syndrome.
20:44Hemoglobin only seven, platelets down to 30.
20:47Two units whole blood.
20:48Oneg is going up on the rapid infuser as we speak.
20:51Uh, put the AP pads on just in case.
20:53And 10 of Decadron IV push for the inflammatory storm.
20:55Um, fetal heart rate up to 104.
20:57Yeah.
20:58A little better.
20:59Yeah.
20:59She should be upstairs where they'll be.
21:01She will be.
21:03After we break the seizure.
21:05There was a delay in history taking due to a malfunctioning VRI interpretation device.
21:11During this time there was a normal CBC and comprehensive metabolic panel that came back from the lab.
21:19What's wrong with you malfeasance?
21:21I have to do another deposition.
21:24Oh, that sucks.
21:26You must really mess up.
21:29Dude, I'm joking.
21:30You're not lighting up.
21:32It's all just bullshit.
21:36How do you know the fuck all this?
21:37Do you want to go get a drink?
21:40Me?
21:41Yes.
21:41You.
21:43You do go out, don't you?
21:45Well, I'm usually with Becca.
21:47Well, bring her along.
21:48Can she drive?
21:50No.
21:50She's with her boyfriend.
21:53Okay, Becca.
21:56So it's just you and me.
22:00Do you like karaoke?
22:02You do karaoke?
22:04Well, what I do is more like primal scream therapy.
22:09There's nothing like getting wasted and just absolutely wailing to shake off a shit show like today.
22:15I could use a fun night.
22:18You and me both, sister.
22:20There's been no improvement.
22:22Still seizing on the EEG.
22:23Neurology's been called.
22:24Okay, got it.
22:25OB says send us to have an O already.
22:27About time.
22:28Maybe he's been braiding down a bit more.
22:30This one looks like a second term for the worse.
22:32Clampsia, refractory seizures, help syndrome with anemia and thrombocytopenia.
22:36About as bad as it gets.
22:37V-feb.
22:40Chest compressions, nasally.
22:42Charged at 200.
22:44Prep the belly.
22:45Get a baby warmer.
22:47Call the NICU.
22:48Start a timer.
22:49Charged.
22:50Clear.
22:53Continue compressions.
22:55We'll check a rhythm in a minute.
22:57Going up.
22:59Robbie, it's you and me.
23:00Nasally, what's the four minute rule?
23:02I'm not sure.
23:04Pregnant patient with a viable fetus.
23:06You have four minutes after cardiac arrest to save the baby.
23:09And the mom.
23:10We don't call it a post-mortem c-section anymore.
23:12It's a resuscitative hysterotomy to try to save them both.
23:15But she doesn't want any medical intervention.
23:17That doesn't matter.
23:17Mom and baby are both dead if we do nothing.
23:20Okay.
23:20Charge at 200.
23:21One more rhythm check and then Abbott and I are going to cut.
23:25Ellis, you and Cruz on mom resuscitation, Shen.
23:27You and Nas will take the baby.
23:29Okay, hold compressions.
23:32Still V-fib.
23:33Clear.
23:35No change.
23:36Resume compression.
23:37Ampivepi.
23:38Okay, showtime.
23:39We need to get this baby out right now.
23:40Take a break.
23:43Okay.
23:44Tembleed.
23:46Good.
23:47First incision is from the xiphoid to the pubic symphysis.
23:51Through the skin to the linea alba.
23:54Units three and four on the infuser.
23:56Second incision goes through the peritoneum, exposing the uterus.
24:01Where do you need me?
24:02Here with the baby.
24:04Nazely's got the bag mask.
24:05You're on suction.
24:06Stand by for intubation.
24:07Bladder retractors.
24:08Neonatal monitor and pulse hox ready to go.
24:10Ellis, gentle traction.
24:13Okay, making a small vertical incision through the lower uterus
24:16so as not to cut the baby.
24:18Mm-hmm.
24:20Got it?
24:21Yep, I got it.
24:22Okay.
24:22Okay, using scissors to extend superiorly.
24:27Oh, let's hand retract the uterus with me.
24:30Amniotic fluid looks good.
24:33Give me some fundal pressure.
24:35Breach position.
24:39Okay.
24:40Baby's out.
24:42It's a girl.
24:43All right.
24:46Milking the cord.
24:49Clamping.
24:51Cutting.
24:53Okay.
24:54Blue and flaccid.
24:54Coming to you, Shen.
24:55You ready?
24:55Yeah, I got it.
24:56Yeah.
24:58Okay.
25:03Poor tone.
25:04No movement.
25:05Keep the blow-by closer.
25:08She's really blue.
25:09Some blue is normal, but not this much.
25:12Do we need to intubate?
25:13Not yet.
25:14No.
25:14They usually pink up with stimulation and blow-by.
25:17Okay.
25:18Removing the placenta.
25:19Sweeping to the left, trying to get it in one piece.
25:23Looks intact.
25:24Yeah.
25:24Nicely done.
25:2610 of IV, Pitocin to contract the uterus.
25:28And lots of massage.
25:31Heart rate, 76.
25:32Less than 100 means we need a bag.
25:34Suction first.
25:35Okay.
25:38Hey, Jordan, charge at 200.
25:40Stand by for the next rhythm check.
25:43She grimaced.
25:43Good sign.
25:44Bagging.
25:45Full sock's 45%.
25:47I've never seen it that low.
25:49It's not as bad as it sounds.
25:51I'm more worried about the heart rate.
25:53Okay.
25:53Get ready with an IO in case we need Abby.
25:55Okay.
25:58Rhythm check.
25:59Hold compressions.
26:01Still V-fib.
26:02Okay.
26:02Shock it.
26:02Clear.
26:05Resume compressions.
26:06Shan, how's she doing over there?
26:07Heart rate's up to 104.
26:09At one minute, she's zero for color.
26:11Two for heart rate.
26:12One for reflex tone.
26:13Breathing up.
26:14Garth five.
26:15Five out of ten.
26:16Not great.
26:17Pulse socks 58%.
26:19Intubation?
26:20Not yet.
26:21O2 sat in the 60s is normal at one minute.
26:23Heart rate of pulse socks are trending higher.
26:25Let's keep doing what we're doing.
26:27A little tincture of time.
26:28All compressions.
26:30Looks like sinus.
26:32Can't feel carotid?
26:34No.
26:35Heart's barely pumping.
26:36It's PEA.
26:38Backlight compressions.
26:39Transfuse.
26:39Two more units.
26:40She needs more red cells and platelets.
26:41It's only going blood loss in the uterus.
26:43Give me all the lap heads we got, please.
26:52Yeah.
26:54Okay, yeah.
26:54Thanks.
26:55I appreciate it, honey.
26:56Oh.
26:57Gotta go.
26:58Whoa, whoa, whoa.
26:59Hold up.
27:00Is there a problem here?
27:02Yeah.
27:02You two aren't leaving empty handed.
27:04What?
27:06When are you following me?
27:09Rape kits are supposed to be picked up within 72 hours of collecting them.
27:13Yeah.
27:14This one's been here for over two weeks.
27:17That's not on us.
27:19Well, it's on somebody.
27:20It's not bad enough these poor women go through an assault, plus the indignity of the whole
27:24collection process.
27:25But nobody from the police department even has the human decency to come get these things?
27:29Like, nobody there gives a flying fuck?
27:31Okay.
27:31We got it.
27:32We'll see that these get put into evidence properly.
27:37How hard was that?
27:42Units five and six are in.
27:44Down to a slow ooze here.
27:45Hold compressions.
27:50Looks like sinus.
27:52And I got a weak carotid.
27:53Okay.
27:54Cycle to BP.
27:55Better filling.
27:56Better squeeze.
27:57No seizure activity on the EEG.
27:59That's progress.
27:59That's progress.
28:00We're at five minutes.
28:01Uh, heart rate is 132.
28:03Uh, pulse ox 79%.
28:05Nasally the Apgar.
28:08One offer color, one offer tone, one offer respiration with hypoxia total of seven.
28:13Respiration scores for observed breathing, not pulse ox.
28:15Asset of 80 is normal at five minutes.
28:17With no crying, she still gets one off.
28:23Oh, she just scored the winning point.
28:26Apgar of 80 is pretty normal.
28:31Holy shit.
28:32What did I miss?
28:34Ecclampsia with status.
28:35Help syndrome.
28:36Cardiac arrest.
28:38Resuscitative hysterotomy.
28:39I'm just in the OR with a septic twin C-section.
28:42That's your text 12 minutes ago.
28:43Shit happens fast out here.
28:44Resuscitative hysterotomy in 36 seconds.
28:47Impressive.
28:48BP's 102 over 64.
28:50Hemoglobin's up to nine.
28:51That'll do.
28:53Nick, you're sending a team down.
28:54We can take Mom.
28:55You guys are right there.
28:57Right here.
28:57If you're not careful, you're gonna get stuck here all night.
29:05No.
29:05Now he said she'd be in 30 minutes.
29:07How's Mom and Baby?
29:09Whew.
29:10They're both gonna go upstairs.
29:12Good.
29:13You leaving now?
29:14Yeah.
29:15Pretty soon.
29:16I gotta find Whitaker.
29:17I gotta find Alashimi.
29:19And I gotta find Langdon before I leave.
29:21You miss Langdon.
29:22And he just checked out.
29:27Shit.
29:52Can I help you?
29:53Uh, yeah.
29:54I'm Dr. Langdon from the ED.
29:56I was just, uh, checking in on the status of someone we sent up here earlier.
30:02Patient's name is, uh, Cohen.
30:05Let me check.
30:06What was she up here for?
30:07Uh, clean out a nasty neck fashion.
30:12Oh, yeah.
30:13She's good.
30:14She's in 4202, recovering nicely.
30:17Great.
30:18Great.
30:19I mean, she was, she was in not great shape earlier.
30:22It was a good catch.
30:24Saved her life, even if we couldn't save her leg.
30:29Uh, was it below the knee?
30:31Unfortunately, it was above.
30:50My cell phone and the building managers.
30:53He can help if there's any emergencies.
30:55Yeah, what kind of emergencies?
30:58Whatever.
30:58And follow up with Duke in a couple days, yeah.
31:01Yeah?
31:02You, um, you sure about this?
31:04I trust you, Whitaker.
31:06Great.
31:07Any questions?
31:09Uh, when are you back, exactly?
31:12You know, I'll text you.
31:14I'm trying to keep my dates kind of fluid.
31:17I think this is your ride.
31:19Yeah.
31:20Uh, yes.
31:21I, uh, I promise I'll check in on your house tomorrow.
31:24Sounds good.
31:26Hey.
31:28Okay.
31:29Hey, Theo.
31:31You're up late, huh?
31:33What you got there?
31:35Yeah.
31:37Okay.
31:39He's been fussy all day.
31:41I think he's got another tube coming in.
31:43All right on, big guy.
31:45Are you ready to get funky?
31:48Yeah?
32:09Hey.
32:10Any luck picking an elective?
32:13I don't know.
32:17Maybe I will go into geriatrics.
32:21It's a smart choice.
32:26I know that life can be challenging, especially when it doesn't work out the way you expected.
32:31Okay.
32:37I thought I would be married with two kids in college by now.
32:42Maybe have some property with a pond.
32:45We could play hockey on it in the wintertime.
32:49And yet look at me now.
32:50No wife.
32:51No kids.
32:52No pond.
32:57It's never too late.
32:59Do you really believe that?
33:02Yeah.
33:04Only for me or for YouTube?
33:06Okay.
33:07I see what you did there.
33:10Was that true or something you just said to make a point?
33:19Have you worked things out with your mom?
33:23We're not talking.
33:28I am sorry that I let it distract me.
33:34She was treating me like a child and I was letting her.
33:42Have a good trip.
33:45Please be safe.
33:48We need you here.
33:51Even if you can be a dick sometimes.
33:56Good luck.
33:58You too.
34:08Hey, I didn't think you were still here.
34:11I was just talking to the neurologist on call.
34:15And?
34:17We had a nice chat.
34:20She agrees I can work with double coverage.
34:23That's not her call to make.
34:25You can't do anything critical where a five-second lapse of conscious desk could potentially kill a patient.
34:31I agree.
34:36But 90% of our patients don't require critical procedures.
34:39And the ones that do?
34:41Will be handled by whomever's working with me.
34:43Unless they're also tied up with a critical patient.
34:45What if it's a double or triple triple?
34:47Ravi, I can handle it.
34:48No, you can't.
34:49And I can't let you.
34:50I am fully capable of handling this.
34:52No, you are not fully capable.
34:53And you know it.
34:58What do you want from me?
34:59I want what's best for this department.
35:01Patients and staff.
35:02Best case scenario.
35:03You get a handle on this.
35:05You're seizure free for six months.
35:06You get your driver's license back.
35:07You are cleared to work.
35:08I am cleared for my driver's license.
35:11You shouldn't be driving at all like this.
35:13If you were a patient, we would have to report you.
35:16I am not your fucking patient.
35:17No, but I cannot let you work in my emergency department until you are fully capable of doing so.
35:21That is not your fucking call.
35:23You fucking ain't right that's my call.
35:25I'm trying to protect you and my patients.
35:32You didn't rat out Langdon for stealing fucking drugs.
35:35No, but I kicked him out of this department until he got the appropriate help that he needs.
35:38And the same goes for you.
35:40You've got until Monday to let the administration know I will.
35:50I am finished.
35:52Last chart.
35:55Give me both.
35:56Is this a thing?
35:57I finished a while ago.
35:59I never want to hear that fucking bell again.
36:06Where's Dana?
36:07Not sure.
36:08Bunch of day shift just headed to the roof to watch the fireworks.
36:10You want me to call them?
36:12No, that's okay.
36:15Yo.
36:16Thanks for your help in there.
36:20Almost out?
36:21Yep, just about.
36:24Is this where you're trying to talk me out of going?
36:26Me?
36:27No.
36:28Not a chance.
36:29Why, are you having second thoughts?
36:30Nope.
36:31No?
36:31Nope.
36:33You don't have to convince me.
36:35I mean, it is a little strange.
36:36The only place you talked about going is somewhere they used to drive Buffalo off a cliff to die.
36:40And I looked it up.
36:40And as far as summer vacations go, it's not exactly a holiday hotspot.
36:44I mean, what's in the fucking gift shop, man?
36:47It's just one place I'm going.
36:48As long as it's not the last.
36:50Don't be pulling a Thelma and Louise out there.
36:52I am minutes from taking a three month vacation.
36:54When was the last time you took any time off, Jack?
36:56Yeah, but I've dealt with my demons.
36:59It's a process.
37:01You want to know why I never killed myself?
37:04After what I saw lived through.
37:08Losing my leg.
37:09Losing my wife.
37:12Because it comes for all of us, man.
37:15You and I know it more than most.
37:16We see it every shift, but we can't let ourselves succumb to it.
37:21Yes, life can suck.
37:24It can be unbearable and brutal and ugly and heartbreaking.
37:30But it's also beautiful.
37:33And hilarious.
37:35And that woman today.
37:40Her baby, they'd both be in the morgue if you hadn't been here.
37:44That's us. That's you and me.
37:45That's what we're here for.
37:48The most important things I've ever done in my life
37:51have been in this hospital.
37:54Nothing will ever matter more than what I've done in this hospital.
37:57But it is killing me.
38:01You know how they say that a part of you dies
38:03when you lose someone you love?
38:04I'm not convinced that a part of you doesn't die
38:07every time you see a fellow human pass.
38:09And I've seen so many people die
38:13that I feel like it's leeching something for my soul.
38:18Go on a cruise, man.
38:22Knock off this helmetless motorcycle shit.
38:25Yeah.
38:26People talk.
38:28That's death wish behavior.
38:29I'm tired of being a role model.
38:30I'm tired of feeling like you can't get ahead.
38:32I'm tired of feeling like I'm drowning every day.
38:34I'm tired of all of it.
38:35You need to get away for a while and you need to get some help.
38:38You need this place as much as it needs you.
38:46Am I fucked up?
38:48One hundred percent.
38:53But nobody works here as long as you and me and doesn't get screwed up.
38:56You gotta find somebody to help you dance through the darkness.
39:06Did you just make that up?
39:10Maybe it's a song lyric.
39:12Maybe my therapist said it.
39:14I don't know.
39:18Some dude just pulled up.
39:19Looks like he blew half his face off.
39:24How can you not love this place?
39:29Look.
39:29Don't make me look stupid.
39:32You come back to us in one piece.
39:38I'm still your emergency contact and I do not want to be contacted.
39:44All right, Nightcrawlers.
39:45What the hell's going on out here?
39:47Okay.
39:47We should.
39:48He's already in front of one.
39:49No.
39:5235 year old man.
39:54History.
39:55No men.
39:55No allies.
39:56No.
39:57No.
39:59No.
40:00No.
40:03No.
40:09I'm running nonstop.
40:55I'm running nonstop.
41:22More than 2,000 years ago, the Chinese were throwing bamboo into fire to make explosions.
41:28They went on to invent gunpowder, and boom!
41:31The rest is history.
41:34They had chemicals to get the different colors, you know?
41:37Sodium gives you yellow, strontium gives you red, and barium is green.
41:43Who knew chemistry could be so damn pretty?
42:15They never used to be.
42:25Let's go.
42:55Hey.
42:56Hey.
42:57Thought you'd left already.
42:58On my way out.
42:59Hey, I'm sorry that I didn't find the time today to have that conversation.
43:05Yeah, that's all right.
43:06Seems like you didn't really want to.
43:08I didn't.
43:12Did you?
43:15Uh, yeah, actually.
43:19Look, I'm doing the work.
43:22I've been sober 186 days.
43:24I'm going to meetings.
43:25I'm taking the drug tests.
43:26That's good.
43:27And you're still riding me.
43:31What would have happened if I paralyzed that guy?
43:35I don't know.
43:37What would have happened if I hadn't been here today?
43:39You'd still be questioning yourself.
43:40Now you know you can do it.
43:41You're welcome.
43:42Oh, so that's how you teach now?
43:44Sometimes.
43:45You know who I saw in rehab?
43:48I saw a bunch of guys just like you.
43:50The only difference is they've accepted that they need help.
43:55I think you're afraid to admit that the mighty Dr. Rabinovich isn't perfect.
44:00Oh, I never claimed to be perfect.
44:01No.
44:03But you expect it of yourself, and it's not realistic, man.
44:07How can any of us live up to your standards if you can't even do it?
44:13You need help, Robby.
44:16You need help.
44:20Finished?
44:23You don't got to be honest with me, man.
44:25At least be honest with yourself.
44:42She is due for a new bottle.
44:45I was hoping to get her some formula before I clocked out.
44:49I'll stay with her.
44:52Thanks.
44:55Why are you...
44:56Will you hit those lights on your way out?
44:58Yep.
44:58Why are you crying?
45:00Why are you crying, little one?
45:03You're okay.
45:04You're safe.
45:05Yeah, you're not alone.
45:15Yeah.
45:16You're okay.
45:18Do you need to be swaddled again?
45:20Is that it?
45:26I wish somebody would swaddle me.
45:30Yes, I do.
45:37You got off to kind of a rough start.
45:41Didn't you, little one?
45:44Yeah, you did.
45:48Well, that makes two of us.
45:54I got abandoned, too.
46:00When I was eight.
46:06But I got through all of that.
46:08And so will you.
46:11I got a good feeling that you're gonna be just fine.
46:15Everything's gonna be just fine.
46:18You got...
46:19You got so many wonderful things to see.
46:22And so many people to love ahead of you.
46:28So many...
46:29Wonderful things to see.
46:32People to love ahead of you.
46:34You helped me.
46:39Shhh.
46:42Shhh.
46:43It's okay.
46:44Shhh.
46:44It's okay.
46:59It's the reason the...
47:15I want you to know that I'm happy for you.
47:24I wish nothing but the best for you both.
47:33An older version of me, is she perverted like me?
47:37Would she go down on you in a theater?
47:42Does she speak eloquently?
47:44And would she have your baby?
47:47I'm sure she'd make a really excellent mother.
47:51Cause the love that she gave was amazing.
47:54The neighbors is able to make it an open wide.
47:58No.
48:01And every time you speak her name, just tell me.
48:04You told me it's okay until you die.
48:07Until you die.
48:08But you're still alive.
48:09And I'm here to remind you of the first you felt when you went away.
48:18It's nothing to deny me of the cross I've been that you gave to me.
48:27You.
48:28You.
48:28You.
48:29You.
48:31You.
48:32You.
48:33You.
48:34You.
48:34You.
48:47You.
48:50You.
48:50You.
49:03You.
49:04You.
49:06You.
49:07You.
49:08You.
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