- 8 hours ago
The Pitt - Season 2 - Episode 15: 9:00 P.M.
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00:13Bharan, is this you?
00:20It began after a bad case of viral meningitis when I was five.
00:24They tried every anti-seizure medication, but I still had episodes every few months or so.
00:31No one's ever noticed before. They just think I'm thoughtful.
00:35Are you driving?
00:37I couldn't until laser ablation to my left temporal lobe 12 years ago.
00:44Between that and the Keppra, I've been seizure-free.
00:46Cleared by neurology to drive and to work as an attending.
00:52How long between the seizure you had today and the last one?
00:56It's been well over a year.
01:01But I had two today.
01:07I don't know why. It could be sleep deprivation, new job stress.
01:12I haven't had to deal with peds cases since Afghanistan.
01:17What are your options now?
01:21Up my Keppra, or maybe try one of the newer anti-seizure meds.
01:26But if that doesn't work, I'm left with two choices.
01:29A temporal lobectomy, which could impair my speech,
01:33or get a neuromodulation device, which can sense and stop the seizures almost immediately.
01:39You need to disclose this.
01:41I know. I have a plan.
01:43Hey, Robbie. Dana's looking for you. She's in peds.
01:46Yeah, okay. I'll be right there.
01:48Sounds like you needed in peds, and I have patients to see.
01:52Robbie, a pregnant woman with severe headache on her way and by ambulance.
01:55Find Abbott or a nicer president.
02:13I need you to turn out your pockets.
02:21Hey, show me your hands.
02:50Come here often?
03:01What's going on?
03:02Oh, sorry, false alarm. I thought she sparked a fever.
03:06But it was the wrong chart for my analog hell.
03:09You know anybody who might consider kinship adoption doctors and nurses qualified?
03:13Oh, look at me.
03:15Hey, can your staff keep an eye on Dr. Alishimi until she leaves?
03:18Why?
03:21Um, because I think she's tired and I don't want her to make any mistakes.
03:24Oh, great advice. Maybe you should take it.
03:27Yeah, I'm gonna go get some fresh air.
03:29Grab some for me while you're out there.
03:30Your lungs wouldn't know what to do with it.
03:31Screw you.
03:33In front of the baby, nice.
03:39We are the night crawlers.
03:41We deal with the weirdest and the wildest because...
03:44We are the weirdest and the wildest of them all.
03:46That is right, and tonight they are really gonna be crawling.
03:49Now go get some.
03:50Hooah!
03:56Sorry to wake you.
03:57I was thinking.
04:02I doubt BTX.
04:04You're supposed to be leaving.
04:06I am.
04:09You know, this spirit quest of yours has a lot of people up in arms around here.
04:13Everyone's gonna be fine without me.
04:15It's hardly a spirit quest.
04:16Whatever it is, it seems you've given people the impression you might not be coming back.
04:19Well, who knows what the future has to store for any of us.
04:22Yeah, saying shit like that right there isn't helping.
04:24People are worried about you.
04:26Dr. Abbott, the patient at South 21, Digby, he's missing again.
04:29Sounds like a day shift problem.
04:30Not if he was handed off already.
04:37Best I can do under the circumstances.
04:39Hey, don't leave before I get back, yeah?
04:41Well, I feel like I live here now.
04:46Your friend fixing your bike?
04:48Ambulance clipped it while I was just parked here today.
04:51Jesus Christ.
04:53It's a sign if I've ever seen one.
04:56Yeah, here's the thing.
04:57When people worry about you, it makes me think that I should be worried about you.
05:00And I don't like worrying about things.
05:01Ooh, now you're a shrink.
05:03No, I'm trying to be your friend.
05:04You got Dana convinced that you're gonna hurt yourself.
05:06Dana's got her own issues.
05:07That sounds like projection.
05:08Are you seriously trying to have this fucking conversation with me right now, man?
05:11I...
05:12I'm not the one who spends his free time getting shot at.
05:15Hoo-wah!
05:17Hey, Dr. Robbie.
05:18This is Judith Estrada.
05:1936 weeks pregnant with two days of headache.
05:21Now a 10 out of 10 with blurred vision.
05:24BP 174 over 120.
05:26Heart rate 92.
05:27No relief with fentanyl.
05:28Judith, I'm Dr. Abbott.
05:29Any weakness in your arms or legs?
05:31No, no.
05:32Is this a stroke?
05:32We need to check for everything.
05:33Pitting edema, that's severe preeclampsia.
05:36Where are you doing your prenatal care?
05:38Nowhere.
05:39It's a wild pregnancy.
05:41I want a free birth.
05:45This 81-year-old nun presents with red itchy eyes with secretions for the past two days.
05:52The patient complains of no URI symptoms, no contact with any chemical aids or non-none exposures.
05:57Hey.
05:57Want half a monster?
05:59Oh, no, thanks.
06:01I don't really want to stay awake any longer than I have to.
06:03Yeah.
06:04Yeah, I hear you.
06:07Did you find your ID badge?
06:09No.
06:10You're any closer to deciding what's next for you?
06:13Uh, yeah, I'm seriously considering law school.
06:15What?
06:15What are you talking about?
06:16You're gonna be a great doctor.
06:18Okay.
06:19I mean, no offense, but look at what this place does to you.
06:23LinkedIn's an addict.
06:24He's a person with a substance use disorder.
06:27McKay was on house arrest.
06:29Dana's a time bomb.
06:31Santos is one of the angriest people you were ever going to meet.
06:34Sarcastic, yes.
06:35Cynical, definitely.
06:36I don't know if she's...
06:37You know.
06:37Mel?
06:40Samira has no life.
06:42Abbott's an adrenaline junkie who gets shot at for fun.
06:46Robbie's got like PTSD or something way fucking worse.
06:49I mean, I'd hate to know what you think about me.
06:53I don't know.
06:54I just...
06:55The more time I spend here, the more I realize the importance of mental health.
07:04Just for patients and for us.
07:05And this is...
07:08Yeah.
07:09Well, you know, maybe that's what you should focus on.
07:14What?
07:15Mental health.
07:16Clearly you have a passion for it, right?
07:19I mean, that's great.
07:20I wouldn't call it a passion.
07:21I would call it like a...
07:26Oh, my God.
07:30You might be right.
07:33Oh, you're a genius, Whitaker.
07:35Oh, okay.
07:38CTG is on.
07:40CTG?
07:42Cardiotachography.
07:42Measures the baby's heart rate and checks for contractions.
07:46Feel heart rate 128.
07:47Normal range, nasally?
07:49110 to 160.
07:51So the baby's okay?
07:52Right now, yes.
07:54128 is reassuring.
07:55BP's 170 over 119.
07:58Six grams of magnesium running in.
07:59Your next move, Cruz?
08:0120 of labetalol IV push over two minutes.
08:03What's happening?
08:05Do you have a condition called preeclampsia?
08:07And how did that happen?
08:08Uh, nobody really knows, actually.
08:10It affects about 10% of the pregnancies.
08:13High blood pressure, headaches, protein in the urine, and swollen ankles.
08:17Well, it's a wild pregnancy.
08:19So that means no medical care.
08:21Then why are you here?
08:25I just need to get rid of this headache.
08:29Well, if we don't lower your blood pressure and treat with magnesium, there can be problems.
08:35Like what?
08:36Seizures.
08:37Bleeding.
08:38Even death.
08:39For you and the baby.
08:40Oh, my God.
08:42Robbie, your VIP's ready to go.
08:44Okay, I'll be right there.
08:46You good?
08:46Yeah, I'm good.
08:47I got it.
08:48My eye's closed.
08:50But I won't.
08:51Maybe one eye.
08:53Hey.
08:57Hey, Becca.
08:58How are you feeling?
08:59I'm better, thanks.
09:02Where are you?
09:04I'm at Adam's house.
09:06Can I call you later?
09:07We're watching a movie.
09:08Oh, sure.
09:08I thought you were going to see the fireworks.
09:10Nope.
09:11We decided to watch Elf instead.
09:13Ah.
09:14Of course you did.
09:16Okay, I'll call you tomorrow.
09:17Tomorrow?
09:17Wait.
09:18Are you spending the night?
09:20Um, yes.
09:22His parents invited me.
09:24They need to ask me that.
09:25Are you staying here too?
09:28No, they needed to ask if it's okay if you stayed.
09:32Why?
09:34Because, uh, it's polite.
09:38It's the right thing to do.
09:40Um, I need to talk to them.
09:43Um, they're not here.
09:44They're at a barbecue.
09:46Okay, um, can you have them call me as soon as they get home?
09:49Yes.
09:50You promise?
09:51I promise.
09:52Okay, bye now.
09:53Bye.
09:54Have fun.
09:56Thanks for fixing my bike.
09:57If you keep me running, I'll keep her going.
10:01You know the Cree don't have a word for goodbye?
10:05You know a lot of Cree?
10:07A bit.
10:08I got around, man.
10:09I don't doubt it.
10:13Look, I'll come back for all this other shit.
10:16Great.
10:17If you promise to come back and let me take the Bonnie for a ride.
10:20Uh, I don't know.
10:21I've seen you ride, old man.
10:23Fuck you.
10:24I mean it.
10:26We got a deal?
10:30I'll think about it.
10:46This looks like an ambush.
10:48We got a slight hiccup in chairs.
10:49Ice is back.
10:50No.
10:51We got a dead body.
10:53Tell me he died out there?
10:54Yeah.
10:54Poor devil checked in at five this morning.
10:56He was a DNR.
10:56What was his chief complaint?
10:58Emeralds and constipation.
10:59No shit.
11:00Hence the constipation.
11:02You throw me a slow one, I'm gonna hit it.
11:04Tell the night shift.
11:05I'm saying that's when he died.
11:06We all in agreement on that?
11:07To the grave.
11:08Just like poor Jasper.
11:10You're on fire.
11:11Just give him a second whim.
11:15How's the headache?
11:16Still a 10.
11:17More fentanyl?
11:18Yep.
11:19BP's good.
11:20Another 50.
11:21Hey Abbott.
11:22A tending and president are stuck in the OR.
11:24Oh, you're the next best thing.
11:26Better.
11:27Some would say.
11:28Hmm.
11:29What do you got?
11:30This is Judith.
11:31G1P0 with no prenatal care.
11:33Preeclampsia with severe hypertension.
11:35Hey Judith.
11:36Nurse Garvin from OB.
11:37Some jelly on the belly.
11:39Gonna take a quick look with ultrasound.
11:40No, no, no.
11:41Ultrasound can harm the baby.
11:42Not true.
11:43Not doing the ultrasound could end up harming you and the baby.
11:48Okay.
11:49Just do it as fast as you can.
11:52Why no prenatal care, Judith?
11:54Yeah.
11:55I wanted a free birth.
11:57No doctors, no hospital, no medicine.
12:00You have a midwife?
12:02A birth doula?
12:03No.
12:04I don't need one.
12:06Women have been having children on their own for thousands of years.
12:08Yeah, with an infant mortality rate of 30% for most of those thousands of years.
12:13Female length, 7 centimeters.
12:1437 weeks.
12:15They'll probably induce.
12:17What?
12:17What?
12:18No.
12:19No, no, no, no.
12:20Absolutely not.
12:21At 37 weeks, the cure for preeclampsia is to deliver the baby.
12:24We need to get you upstairs so the OB doctors can induce labor to save you and your baby.
12:29No.
12:29No, no, no, no, no.
12:30Mm-mm.
12:33Yeah, that's definitely Jasper.
12:35He was alive and kicking when I shift into this morning.
12:38This is definitely a day shift patient.
12:39He's not a patient.
12:40He's a DB that we gotta deal with.
12:44Is this dude dead?
12:46Nope.
12:46Nope.
12:47All right, Mr. Reed, time to take you back and get you checked out, okay?
12:50He sure looks dead.
12:51Are you a doctor?
12:52No.
12:52But he has hypernarcolepsy.
12:54It's no joke.
12:55Mm-hmm.
12:56Excuse me.
12:58Oh, sometimes I hate guides.
13:01Ugh.
13:12Wow.
13:14Crazy how muggy it still is out here.
13:17You, uh, you seen Robbie?
13:20Uh, not for a bit.
13:22You catch up on your charts from the beginning of the shift?
13:25Yeah.
13:26What are you still doing here?
13:27Uh, just gonna...
13:29You staying for the fireworks?
13:32Yeah.
13:32I was supposed to see them with Becca, but...
13:35She is at her boyfriend Adam's family's house instead.
13:44Your sister seems like she's, uh, pretty put together.
13:50Yeah.
13:52Uh, a lot more than I realized.
13:56How was your day?
14:00I've had better.
14:02You?
14:06Yeah.
14:09Then again, I've had a lot worse.
14:12Hell, I did a closed cervical reduction like an hour ago.
14:15Oh, I heard.
14:15That must have been so intense.
14:18My hands are still shaking.
14:21Hey, um, do you think you could teach me how to do that sometime?
14:25Uh, yeah.
14:26Yeah?
14:27Yeah, sure.
14:27I mean, I hope you never have to use it.
14:29I could have paralyzed that guy.
14:31Yeah, but you didn't.
14:34Nope.
14:35I didn't.
14:39By the way, for talking me down earlier, I'm sorry I snapped.
14:48It's okay.
14:57Dr. Mohan, you ever heard of Kentia Foster, and it's where a nurse or doctor can become an emergency foster?
15:03No.
15:03I don't need any kids.
15:05I need to find a job first.
15:07Candace O'Grady is an 82-year-old female brought in by her son for intractable vomiting.
15:12He's gonna kill Donald Trump.
15:17Oh, I've already got one I can barely keep up with.
15:21What about Sleeping Beauty over here?
15:23She's already babysitting Whitaker.
15:25Well, if you know anyone who'd like to help us out with baby Jane Doe, have them call the main
15:29desk.
15:29Sure thing.
15:31I've taken myself, but did you kill me?
15:41Is her sky-high?
15:47Help syndrome.
15:48Hemolytic anemia, elevated liver enzymes, and low platelets.
15:51They're cleaning a room.
15:52We can bring her up in ten minutes.
15:54How you doing, Judith?
15:58Hey...
15:59Hey.
16:00Oh, she's seizing.
16:02Oh, shit.
16:03Ten of IV diazepam have another ten ready.
16:06With all the movement, we can't get a fetal heartbeat.
16:08Putting on 15 liters by mask.
16:09Should we intubate?
16:10Hold intubation.
16:11Let's try to break this.
16:12We don't want to mask seizures with paralysis unless we have to.
16:16Okay?
16:20Crew CTG isn't reading.
16:22Check with ultrasound.
16:23On it.
16:23Nazely, what's the diagnosis?
16:25With a seizure, now with the clampsia.
16:29Fetal heart rate is about 90.
16:30Way too low.
16:31Mom, stats are going down.
16:32Found a tuber.
16:33Set up four foot weight.
16:35Another ten of diazepam.
16:37Push four grams of Kefra.
16:47Hey, how are you guys making it up?
16:51We're getting there.
16:51Have you seen Dr. Alashimi?
16:53No.
16:54Can I talk to you for a sec?
17:01So, I just wanted to let you let you let up and check it out some of your online posts.
17:04Look, I was just trying to help get some health messages out there especially.
17:06I think they're great.
17:08Really good.
17:10You do?
17:10Yeah.
17:12Yeah.
17:13Keep it up.
17:14Okay.
17:15As long as you follow the HIPAA laws.
17:18I do.
17:19And wait until you're done charting.
17:21Sure.
17:24Actually, Dr. Robbie, sorry.
17:26Um, can I ask you a question?
17:29Two.
17:30Um, I may be considering emergency psychiatry.
17:35Very cool.
17:37Think I could do it?
17:42I think that you could do anything that you put your mind to, Victoria.
17:50Okay.
17:51Pulse locks is 88.
17:54Dr. Abbott?
17:56Intubate?
17:57Let's do it.
17:59Nazely, what do you suggest for rapid sequence induction?
18:02Atomidate and rock.
18:03Not quite.
18:04120 of propofol 60, it's succinylcholine.
18:07Why is that, Cruz?
18:08Propofol for the anti-seizure effect.
18:09Sucks to avoid prolonged paralysis, so we can check a neuro exam.
18:13Exactly.
18:13Pushing the propofol.
18:15Once she's flat for intubation, we need to displace the uterus to the left.
18:18Nazely, that's you.
18:18Big hug.
18:19Both arms.
18:19Get the baby off the vina cava.
18:21Sucks is on board.
18:22But after she's paralyzed, the seizing stops, right?
18:24It might look like that, but an ongoing seizure will still fry the brain.
18:28We monitor the EEG.
18:30Is there time for that?
18:30Wait and see.
18:33Paralytics kicked in.
18:34Let's go.
18:34Roll her to her back.
18:37Intubate, then EEG to see if her brain is still seizing.
18:41I need first-pass success.
18:42You and me both.
18:52Have you seen Dr. Alashimi?
18:54No.
18:55Have you seen Dr. Alashimi?
18:58Alashimi?
18:59I thought this day's going.
19:00She'll probably quit.
19:02Last day, sir, she's in peds with baby Jane Doe.
19:05Nope.
19:06I was just in there.
19:07Want me to page her?
19:09Uh, no, that's okay.
19:10I will find her.
19:16Hello.
19:17Hello.
19:20Hey, how did our people do with the deposition?
19:23Dr. Ellis is a pit bull.
19:25Dr. King is a petunia.
19:27They were pretty brutal with her.
19:29She's sensitive.
19:29Very.
19:30I'm afraid it isn't over.
19:32They want to call her back.
19:33Oh, that's unfortunate.
19:35Maybe I should go with you to break that news to her, actually.
19:38Missouri Lowe's coming, eh?
19:39Hey, while I have you, can I pose a hypothetical to you?
19:42If a doctor suspects another physician of having a medical condition that could negatively affect the way they would treat
19:48a patient,
19:49where would disclosing that fall on the HIPO violation scale?
19:54First, do no harm.
19:58Dr. King, do you have a second?
20:03Okay.
20:08Good lung sliding bilaterally.
20:10Fetal heart rate borderline at 98.
20:13Roll to the left again.
20:14That can help.
20:15One, two, three.
20:19Okay.
20:21All set here.
20:22EEG monitor's good to go.
20:24That was fast.
20:25Still seizing while paralyzed.
20:27It's non-compulsive status.
20:29What's she had so far?
20:31A 30 of diazepam full load of Mag-Keprin pro football.
20:33Damn, what's your next step?
20:35Any ideas?
20:37Hmm?
20:37Nazely?
20:39Dilantin?
20:40Valproate?
20:40Mmm, infusion is too long, so is onset of action.
20:43Push 100 of ketamine.
20:45That's had results with refractory status.
20:47She also has HELP syndrome.
20:48Hemoglobin only 7.
20:50Platelets down to 30.
20:51Two units whole blood.
20:52Oneg is going up on the rapid infuser as we speak.
20:55Uh, put the AP pads on just in case.
20:57And 10 of Decadron IV pushed for the inflammatory storm.
21:00Fetal heart rate up to 104.
21:01A little better?
21:02No, she should be upstairs where they'll be.
21:05She will be.
21:07After we break the seizure.
21:09There was a delay in history taking due to a malfunctioning VRI interpretation device.
21:15During this time, there was a normal CBC and comprehensive metabolic panel that came back from the lab.
21:23What's wrong with you malfeasance?
21:25I have to do another deposition.
21:28Oh, that sucks.
21:30You must really mess up.
21:33Dude, I'm joking.
21:34You gotta lighten up.
21:36It's all just bullshit.
21:40God, you know how to fuck all this.
21:41Do you want to go get a drink?
21:44Me?
21:45Yes, you.
21:46You do go out, don't you?
21:49Well, I'm usually with Becca.
21:50Well, bring her along.
21:52Can she drive?
21:54No.
21:54She's with her boyfriend.
21:57Okay, Becca.
22:00So it's just you and me.
22:04Do you like karaoke?
22:06You do karaoke?
22:08Well, what I do is more like primal scream therapy.
22:13There's nothing like getting wasted and just absolutely wailing to shake off a shitshow like today.
22:19I could use a fun night.
22:22You and me both, sister.
22:24There has been no improvement.
22:26Still season on the EG.
22:27Neurology's been called.
22:28Okay, got it.
22:29OB says send up to have an O already.
22:31Without time.
22:32Baby's been braiding down a bit more.
22:34This thing looks like a second term for the worse.
22:35Clampsia, refractory seizures, help syndrome with anemia, and thrombocytopenia.
22:40Yeah, about as bad as it gets.
22:42V-feb.
22:44Chest compressions, nasally.
22:46Charged at 200.
22:48Prep the belly.
22:50Get a baby warmer.
22:51Call the NICU.
22:52Start a timer.
22:53Charged.
22:55Clear.
22:58Continue compressions.
22:59We'll check a rhythm in a minute.
23:01Get on up.
23:03Robbie, it's you and me.
23:04Nasally, what's the four-minute rule?
23:06I'm not sure.
23:09Pregnant patient with a viable fetus.
23:10You have four minutes after cardiac arrest to save the baby.
23:13And the mom.
23:14We don't call it a post-mortem C-section anymore.
23:16It's a resuscitative hysterotomy to try to save them both.
23:19But she doesn't want any medical intervention.
23:21That doesn't matter.
23:21Mom and baby are both dead if we do nothing.
23:24Okay.
23:24Charge at 200.
23:25One more rhythm check, and then Abbott and I are going to cut.
23:29Alice, you and Cruz on mom resuscitation, Shen.
23:31You and Nasally take the baby.
23:32Okay, hold compressions.
23:36Still V-fib.
23:37Clear.
23:39No change.
23:40Resume compression.
23:41Ampivapi.
23:42Okay, showtime.
23:43We need to get this baby out right now.
23:44Take a break.
23:48Okay.
23:49Tembleed.
23:50Good.
23:51First incision is from the xiphoid to the pubic symphysis,
23:55through the skin to the linea alba.
23:58Units three and four on the infuser.
24:00Second incision goes through the peritoneum, exposing the uterus.
24:05Where do you need me?
24:07You're with the baby.
24:08Nasally's got the bag mask.
24:09You're on suction.
24:10Stand by for intubation.
24:11Bladder retractors.
24:12Neonatal monitor and pulse hox ready to go.
24:14Alice gentle traction.
24:17Okay, making a small vertical incision through the lower uterus so as not to cut the baby.
24:24Got it?
24:25Yep, I got it.
24:26Okay.
24:27Okay, using scissors to extend superiorly.
24:32Let's hand retract the uterus with me.
24:34Amniotic fluid looks good.
24:37Give me some fundal pressure.
24:39Reach position.
24:43Okay.
24:45Baby's out.
24:46It's a girl.
24:47All right.
24:50Milking the cord.
24:53Clamping.
24:55Cutting.
24:57Okay, blue and flaccid.
24:58Coming to you, Shen.
24:59You ready?
24:59Yeah.
25:00You got her?
25:00Yeah.
25:02Okay.
25:07Poor tone.
25:08No movement.
25:09Keep the blow by closer.
25:12She's really blue.
25:13Some blue is normal, but not this much.
25:16Do we need to intubate?
25:18Not yet.
25:18They usually pink up with stimulation and blow by.
25:21Okay.
25:22Removing the placenta.
25:23Sweeping to the left, trying to get it in one piece.
25:27Looks intact.
25:28Yeah.
25:28Nicely done.
25:3010 of IV, Pitocin to contract the uterus.
25:32And lots of massage.
25:35Heart rate 76.
25:36Less than 100 means we need a bag.
25:38Suction first.
25:39All right.
25:42Hey, Jordan, charge at 200.
25:44Stand by for the next rhythm check.
25:47She grimaced.
25:48Good sign.
25:48Bagging.
25:49Her socks 45%.
25:51I've never seen it that low.
25:53It's not as bad as it sounds.
25:55I'm more worried about the heart rate.
25:57Okay.
25:57Get ready with an IO in case we need happy.
25:59Okay.
26:02Rhythm check.
26:03Hold compressions.
26:05Still V-fib.
26:06Okay, shock it.
26:07Clear.
26:09Resume compressions.
26:10Shen, how's she doing over there?
26:11Heart rate's up to 104.
26:12At one minute, she's zero for color.
26:15Two for heart rate.
26:16One for reflex tone.
26:17Breathing up.
26:18Gar at five.
26:19Five out of ten.
26:20Not great.
26:21Pulse socks 58% intubation.
26:24Not yet.
26:25O2 sat in the 60s is normal at one minute.
26:27Heart rate of pulse socks are trending higher.
26:29Let's keep doing what we're doing.
26:31A little tincture of time.
26:32All compressions.
26:34Looks like sinus.
26:37Can't feel carotid.
26:38No.
26:39Heart's barely pumping.
26:40It's PEA.
26:42Backlight compressions.
26:43Transfuse.
26:44Two more units.
26:44She needs more red cells and platelets.
26:46I'm going blood loss in the uterus.
26:47Give me all the lap heads we got, please.
26:56Yeah.
26:58Okay, yeah.
26:58Thanks.
26:59I appreciate it, honey.
27:00Oh, gotta go.
27:02Whoa, whoa, whoa.
27:04Hold up.
27:04Is there a problem here?
27:06Yeah.
27:06You two aren't leaving empty-handed.
27:08What?
27:10When are you following me?
27:13Rape kits are supposed to be picked up within 72 hours of collecting them.
27:18This one's been here for over two weeks.
27:21That's not on us.
27:23Well, it's on somebody.
27:24It's not bad enough these poor women go through an assault,
27:27plus the indignity of the whole collection process,
27:29but nobody from the police department even has the human decency
27:32to come get these things.
27:33Like, nobody there gives a flying fuck?
27:35Okay, we got it.
27:36We'll see that these get put into evidence properly.
27:41How hard was that?
27:46Units five and six are in.
27:48Down to a slow ooze here.
27:49Hold compressions.
27:54Looks like sinus.
27:56And I got a weak carotid.
27:57Okay, cycle to BP.
27:59Better filling.
28:00Better squeeze.
28:01No seizure activity on the EEG.
28:03That's progress.
28:03That's progress.
28:04We're at five minutes.
28:06Heart rate is 132.
28:08Pulse ox, 79%.
28:09Nazely, the apgar?
28:12One off for color, one off for tone,
28:15one off for respiration with hypoxia total of seven.
28:17Respiration scores for observed breathing, not pulse ox.
28:19Sat of 80 is normal.
28:20At five minutes, with no crying, she still gets one off.
28:27Oh, she just scored the winning point.
28:30Apgar of eight is pretty normal.
28:35Holy shit.
28:36What did I miss?
28:38Ecclampsia with status, health syndrome,
28:41cardiac arrest, resuscitative hysterotomy.
28:43Better see the OR with a septic twin C-section.
28:46Got your text 12 minutes ago.
28:47Shit happens fast out here.
28:49Resuscitative hysterotomy in 36 seconds.
28:51Impressive.
28:52BP's 102 over 64.
28:54Hemoglobin's up to nine.
28:55That'll do.
28:57Nick, you're sending a team down.
28:58We can take Mom.
28:59You guys are rockstar.
29:06If you're not careful,
29:07you're going to get stuck here all night.
29:09No.
29:10He said she'd be in 30 minutes.
29:12How's Mom and Baby?
29:13Whew.
29:14They're both going to go upstairs.
29:16Good.
29:17You leaving now?
29:18Yeah.
29:19Pretty soon.
29:20I've got to find Whitaker.
29:21I've got to find Alashimi.
29:23I've got to find Langdon before I leave.
29:25You miss Langdon.
29:26He just checked out.
29:31Shit.
29:56Can I help you?
29:57Uh, yeah.
29:58I'm Dr. Langdon from the ED.
30:01I was just, uh, checking in on the status of someone we sent up here earlier.
30:06Patient's name is, uh, Cohen?
30:09Let me check.
30:10What was she up here for?
30:11Uh, clean out a nasty neck fashion.
30:16Oh, yeah.
30:17She's good.
30:18She's in 4202, recovering nicely.
30:21Great.
30:22Great.
30:23I mean, she was, she was in not great shape earlier.
30:26It was a good catch.
30:28Saved her life, even if we couldn't save her leg.
30:34Uh, was it below the knee?
30:36Unfortunately, it was above.
30:54My cell phone and the building managers.
30:57He can help if there's any emergencies.
30:59Yeah, what kind of emergencies?
31:02Whatever.
31:02And follow up with Duke in a couple days, yeah?
31:05Yeah.
31:06Are you, um, you sure about this?
31:08I trust you, Whitaker.
31:10Great.
31:12Any questions?
31:13Uh, when are you back, exactly?
31:16You know, I'll text you.
31:18I'm trying to keep my dates kind of fluid.
31:21I think this is your ride.
31:23Yeah, uh, yes.
31:25I promise I'll check in on your house tomorrow.
31:28Sounds good.
31:30Hey.
31:32Okay, hey, Theo.
31:35You're up late, huh?
31:37What you got there?
31:39Come.
31:41Okay.
31:43He's been fussy all day.
31:45I think he's got another tooth coming in.
31:47All right on, big guy.
31:49Are you ready to get funky?
31:52Yeah?
32:13Hey.
32:14Any luck picking an elective?
32:18I don't know.
32:21Maybe I will go into geriatrics.
32:25It's a smart choice.
32:30I know that life can be challenging, especially when it doesn't work out the way you expected.
32:34Okay.
32:41I thought I would be married with two kids in college by now.
32:46Maybe have some property with a pond.
32:49We could play hockey on it in the wintertime.
32:53And yet, look at me now.
32:54No wife, no kids, no pond.
33:01It's never too late.
33:04Do you really believe that?
33:06Yeah.
33:08Only for me or for you two?
33:10Okay.
33:11See what you did there.
33:14Is that true or something you just said to make a point?
33:23Have you worked things out with your mom?
33:28We're not talking.
33:32I am sorry that, um, I let it distract me.
33:38She was treating me like a child, and I was letting her.
33:46Have a good trip.
33:49Please be safe.
33:52We need you here.
33:55Even if you can be a dick sometimes.
34:00Good luck.
34:02You too.
34:12Hey, I didn't think you were still here.
34:15I was just talking to the neurologist on call.
34:19And?
34:21We had a nice chat.
34:24She agrees I can work with double coverage.
34:27That's not her call to make.
34:29You can't do anything critical where a five-second lapse in consciousness could potentially kill a patient.
34:35I agree.
34:40But 90% of our patients don't require critical procedures.
34:43And the ones that do?
34:45Will be handled by whomever's working with me.
34:47Unless they're also tied up with a critical patient.
34:49What if it's a double or triple triple?
34:51Robbie, I can handle it.
34:52No, you can't, and I can't let you.
34:54I am fully capable of handling this.
34:56No, you are not fully capable, and you know it.
35:02What do you want from me?
35:04I want what's best for this department, patients and staff.
35:06Best case scenario, you get a handle on this.
35:09You're seizure-free for six months.
35:10You get your driver's license back.
35:11You are cleared to work.
35:12I am cleared for my driver's license.
35:15You shouldn't be driving at all like this.
35:17If you were a patient, we would have to report you.
35:20I am not your fucking patient.
35:21No, but I cannot let you work in my emergency department
35:23until you are fully capable of doing so.
35:25That is not your fucking call.
35:27You fucking ain't right, that's my call.
35:29I'm trying to protect you and my patients, and...
35:36You didn't rat out Langdon for stealing fucking drugs.
35:39No, but I kicked him out of this department
35:40until he got the appropriate help that he needs.
35:42And the same goes for you.
35:44You've got until Monday to let the administration know,
35:47or I will.
35:54I am finished.
35:56Last chart.
35:59With me both.
36:00Is this a thing?
36:01I finished a while ago.
36:03I never want to hear that fucking bell again.
36:10Where's Dana?
36:11Not sure.
36:12Bunch of days shift just headed to the roof
36:13to watch the fireworks.
36:15You want me to call them?
36:16No, that's okay.
36:19Yo.
36:20Thanks for your help in there.
36:24Almost out?
36:25Yep, just about.
36:28Is this where you're trying to talk me out of going?
36:30Me?
36:31No, not a chance.
36:33Why, are you having second thoughts?
36:34Nope.
36:35No?
36:35Nope.
36:37Not to convince me.
36:39I mean, it is a little strange.
36:40The only place you talked about going
36:41is somewhere they used to drive Buffalo off a cliff to die.
36:44I looked it up, and as far as summer vacations go,
36:46it's not exactly a holiday hotspot.
36:48I mean, what's in the fucking gift shop, man?
36:51It's just one place I'm going.
36:52As long as it's not the last.
36:54Don't be pulling a thumb on Louise out there.
36:56I am minutes from taking a three-month vacation.
36:58When was the last time you took any thumb off, Jack?
37:00Yeah, but I've dealt with my demons.
37:03It's a process.
37:05You want to know why I never killed myself?
37:08After what I saw lived through, losing my leg, losing my wife.
37:17Because it comes for all of us, man.
37:19You and I know it more than most.
37:20We see it every shift, but we can't let ourselves succumb to it.
37:25Yes, life can suck.
37:28It can be unbearable and brutal and ugly and heartbreaking,
37:34but it's also beautiful and hilarious.
37:38And that woman today.
37:44Her baby, they'd both be in the morgue if you hadn't been here.
37:48That's us.
37:49That's you and me.
37:49That's what we're here for.
37:52The most important things I've ever done in my life
37:55have been in this hospital.
37:58Nothing will ever matter more than what I've done in this hospital.
38:01But it is killing me.
38:05You know how they say that a part of you dies
38:07when you lose someone you love?
38:08I'm not convinced that a part of you doesn't die
38:11every time you see a fellow human pass.
38:13And I've seen so many people die
38:17that I feel like it's leeching something for my soul.
38:22Go on a cruise, man.
38:27Knock off this helmet-less motorcycle shit.
38:29Yeah.
38:31People talk.
38:32That's death wish behavior.
38:33I'm tired of being a role model.
38:35I'm tired of feeling like you can't get ahead.
38:36I'm tired of feeling like I'm drowning every day.
38:38I'm tired of all of it.
38:39You need to get away for a while,
38:41and you need to get some help.
38:42You need this place as much as it needs you.
38:50Am I fucked up?
38:53100%.
38:57But nobody works here
38:58as long as you and me and doesn't get screwed up.
39:00You gotta find somebody to help you
39:04dance through the darkness.
39:10Did you just make that up?
39:14Maybe it's a song lyric.
39:16Maybe my therapist said it.
39:17I don't know.
39:22Some dude just pulled up.
39:24Looks like he blew half his face off.
39:28How can you not love this place?
39:33Look, don't make me look stupid.
39:36You come back to us in one piece.
39:42I'm still your emergency contact,
39:43and I do not want to be contacted.
39:48All right, Nightcrawlers,
39:49what the hell's going on out here?
39:51Okay.
39:51We'll just keep going.
39:52It's off the line.
39:53No.
39:5625-year-old man.
39:58History.
39:59No men.
39:59No alley.
40:00No.
40:00No.
40:01No.
40:02No.
40:06No ì„¤ì •.
40:07No.
40:36I'm running non-stop.
40:56I'm running non-stop.
41:26More than 2,000 years ago, the Chinese were throwing bamboo into fire to make explosions.
41:32They went on to invent gunpowder, and boom, the rest is history.
41:38They had chemicals to get the different colors, you know?
41:41Sodium gives you yellow, strontium gives you red, and barium is green.
41:47Who knew chemistry could be so damn pretty?
41:49Let's go.
41:52Let's go.
41:57Let's go.
41:58Let's go.
42:02Let's go.
42:10Let's go.
42:16Let's go.
42:17Let's go.
42:17Let's go.
42:29Let's go.
42:44I don't know.
43:00Hey.
43:00Hey.
43:01Thought you'd left already.
43:02On my way out.
43:04Hey, I'm sorry that I didn't find the time today
43:08to have that conversation.
43:09Yeah, that's all right.
43:10Seems like you didn't really want to.
43:12I didn't.
43:16Did you?
43:19Uh, yeah, actually.
43:23Look, I'm doing the work.
43:26I've been sober 186 days.
43:28I'm going to meetings.
43:29I'm taking the drug tests.
43:31That's good.
43:31And you're still riding me.
43:36What would have happened if I paralyzed that guy?
43:40I don't know.
43:41What would have happened if I hadn't been here today?
43:43You'd still be questioning yourself.
43:44Now you know you can do it.
43:45You're welcome.
43:46Also, that's how you teach now?
43:48Sometimes.
43:49You know who I saw in rehab?
43:52I saw a bunch of guys just like you.
43:54The only difference is they've accepted that they need help.
43:59I think you're afraid to admit that the mighty Dr. Rabinovich isn't perfect.
44:04Oh, I never claimed to be perfect.
44:06No.
44:07But you expect it of yourself, and it's not realistic, man.
44:11How can any of us live up to your standards if you can't even do it?
44:17You need help, Robby.
44:20You need help.
44:24Finished?
44:27You don't gotta be honest with me, man.
44:29At least be honest with yourself.
44:47She is due for a new bottle.
44:49I was hoping to get her some formula before I clocked out.
44:54I'll stay with her.
44:56Thanks.
44:59Why are you...
45:00Will you hit those lights on your way out?
45:02Yep.
45:02Why are you crying?
45:04Why are you crying, little one?
45:07You're okay.
45:08You're safe.
45:10Yeah, you're not alone.
45:19Yeah.
45:20You're okay.
45:22Do you need to be swaddled again?
45:24Is that it?
45:26Did that look?
45:30I wish somebody would swaddle me.
45:34Yes, I do.
45:37Oh.
45:42You got off to kind of a rough start.
45:45Didn't you, little one?
45:48Yeah, you did.
45:52Well, that makes two of us.
45:58I got abandoned too.
46:04When I was eight.
46:10But I got through all of that, and so will you.
46:15I got a good feeling that you're gonna be just fine.
46:20Everything's gonna be just fine.
46:23You got so many wonderful things to see.
46:26And so many people to love ahead of you.
46:31And so many wonderful things to see.
46:36People to love ahead of you.
46:46It's okay.
46:48It's gonna be okay.
46:51It's okay.
46:54But I was impressed.
46:57But I just want to miss.
46:59And so many people to miss.
46:59Will it be this way?
47:02For I don't know where I won't go?
47:19I want you to know
47:23I'm happy for you
47:27I wish nothing but
47:32The best for you both
47:37An older version of me
47:39Is she perverted like me?
47:42Would she go down on you in a theater?
47:46Does she speak eloquently?
47:48And would she have your baby?
47:51I'm sure she'd make a really excellent mother
47:55Cause the love that she gave
47:57Doesn't mean to her neighbor
47:58Is able to make it up
48:00Then you're open wide
48:02No
48:05And every time you speak her name
48:07Does she know how you told me it would be
48:09Until you die
48:11Until you die
48:12But you're dead alive
48:13And I am
48:15To remind you
48:17Of the first job that
48:20When you went away
48:22It's not fair
48:24To deny me
48:27Of the cross I bid
48:30That you gave to me
48:31You, you, you
48:33I don't know
48:35You, you, you, you, you, you
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