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The.Pitt.S02E07.540p.X265.AAC [Full Movie] [Long Version]Full EP - Full
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00:25Oh, okay.
00:27Where are we now?
00:29Got the VRI for a deaf patient in Central 12, still waiting on Pete's for baby Jane
00:33Doe.
00:34Central 6 is sitting pretty with his insulin drip and the Westbridge Diversions are kindly
00:37waiting their turn to sip for ours in our lovely halls.
00:40You are some kind of savant.
00:42Worthy of a race?
00:43Just more of my love.
00:45But enough of that, I have a sexual assault victim in triage I call par, so an advocate
00:50is on the way.
00:51Okay.
00:51We'll take care of it.
00:53Uh, Dr. McKay, what's going on with your patient in Central 9, isn't she good to go?
00:57Oh, she was, but she decided she wanted to stay in the hospital now because she's in
01:01too much pain.
01:02In our loud and overcrowded ED with more Westbridge cases arriving every moment, she would be
01:06more comfortable at home.
01:08But deep breath is lovely.
01:13Would you mind helping Dana with a sexual assault victim who just came in?
01:16Of course, sure.
01:17Why don't you and I go see if we can't convince your patient to leave?
01:20All right.
01:21I need to take care of a sexual assault victim in triage.
01:23One of you needs to hold down the fort.
01:25We can call for a saint.
01:26On a holiday?
01:27It'd be ours.
01:28We're not going to make this patient wait.
01:29And since I'm the only saint on staff...
01:31Princess, look over.
01:33Hey!
01:34Hey!
01:35You two better not be teaching any bad habits.
01:37Come on.
01:38You ready, dog?
01:39Sure.
01:39A saint is a sexual assault nurse examiner.
01:43We do forensic exams, collect the evidence, and hand it over to the police if a report
01:47is made.
01:48We also provide resources, support, sometimes even testimony.
01:51You go to court?
01:52Saints are very valuable in a hospital, especially in the ED.
01:55More nurses should train for it.
01:57It's a not-so-subtle hint.
02:07Looks like this is the new hotspot, huh?
02:09And only getting hotter.
02:10Any word on what's going on with Westbridge?
02:12I got 20 on lanternflies.
02:14Nope.
02:15Nothing.
02:16These patient passports have an interesting alternative use.
02:19Where's the sexual assault victim?
02:21She's in triage tier two.
02:22Thanks, Lupe.
02:24Here's her intake.
02:25Got it.
02:34Hi, Miss Miller.
02:35I'm Dana.
02:37How are you doing?
02:39Been better.
02:40Been better.
02:40Yeah.
02:41You're in a safe place now.
02:42I'm the charge nurse in the ED and a sexual assault nurse examiner.
02:46This is Emma.
02:47I'll be assisting.
02:49And I'm Dr. Al Hashimi.
02:50I'll be checking you for any injuries that need immediate attention.
02:54You can just call me Alana.
02:55Um, I don't have any injuries.
02:58Okay.
02:58That's good.
02:59We're gonna get a room ready for you.
03:00Meanwhile, Dr. Alashimi's gonna ask you a few questions.
03:03How long is this gonna take?
03:05I can't promise an exact time, but we'll try to be as fast as you need.
03:10Yeah.
03:15Okay, Alana.
03:16Do you take any prescription medications?
03:18Just Synthroid.
03:19One tab a day.
03:20Okay.
03:21And any allergies to medications?
03:23No.
03:24Okay.
03:24Dana will come get you when the room is ready, and I'll be back to finish your exam.
03:35Come find me when she's in a gown.
03:37Will do.
03:38We're gonna use triage exam rooms one and two for this.
03:41It's the most private space we have away from the ED.
03:44All right.
03:44This can be a lot.
03:45You up for it?
03:47Yeah.
03:49Yes.
03:49I'm good.
03:50All right.
03:50Let me know if you need to step out.
03:54Oh.
04:04Dr. Ellis.
04:05Oh, no.
04:06Oh, yes.
04:07Dr. Ellis.
04:08Need the room.
04:09Find another place to lay your head.
04:11Not even a 20-minute power nap?
04:13No, my double's at 1.30.
04:15I'm too high.
04:15No.
04:15We're getting Westbridge diversions.
04:17And chairs is insane.
04:18Didn't you see out there?
04:19No.
04:20I do not come in through that mess.
04:21Okay.
04:23Yeah.
04:25People sleep in here?
04:25Yeah.
04:26No, I chipped off.
04:27Just need rest.
04:28Especially if they have to come in during the day.
04:30But today we can't waste the space.
04:32I need you to get me a stool on wheels and Esme for a turnover.
04:40So you're having a headache and abdominal pain?
04:47Yeah, that's right.
04:48Okay.
04:49And which would you say is worse?
04:55My headache was terrible last week, but now...
05:00Hey, you're breaking up.
05:01Can you run that back again?
05:03Sure.
05:07My headache was terrible last week, but now my abdominal pain...
05:13Oh my god, come on, you piece of shit.
05:16Fuck.
05:21Um...
05:35Um...
05:45I'll...
05:46I'll be right back.
05:48Sorry.
05:56Um...
05:56Dr. Al-Hashimi?
05:57Jackson's parents are here.
05:59Okay.
06:00Take that.
06:01Um, Mr. and Mrs. Davis, this is one of my attendings, Dr. Al-Hashimi.
06:05Hi.
06:06Nice to meet you.
06:07Demi.
06:07Charles.
06:08What the hell's going on?
06:10He's barely conscious.
06:12Jackson's just a little tired due to the sedative he was given.
06:15You sedated him.
06:16Oh, your son was brought in extremely agitated.
06:18You'd be too if you were chased.
06:20And why the fuck did they do that?
06:22This is bullshit.
06:24We're taking him home.
06:25Why don't we step out for a second?
06:35Right now, Jackson is on an involuntary psych hold.
06:38What?
06:39That's not necessary.
06:41He just needs some rest.
06:42He's been studying for the bar exam.
06:44We can watch him at home.
06:45So far, all of his tests look good, but Jackson has reported hearing voices.
06:50This could be serious.
06:51Dr. Jefferson will come back and speak with you.
06:54He can explain more of what may be going on with Jackson.
06:57And who is Dr. Jefferson?
06:58He's from psychiatry, and he's excellent.
07:00He can explain next steps and answer all of your questions.
07:02Javati, why don't you take the Davises to the family room?
07:05Sure.
07:05Excuse me.
07:06It's just this way.
07:29You have reached the Pittsburgh Neuroscience Group.
07:33If this is a medical emergency, please hang up and dial 911.
07:37For our address and office hours, press 1.
07:40To refill a prescription, press 2.
07:43To leave a message for the doctor on call...
07:47Hi, this is Dr. Baran Al-Hashimi.
07:50I'm a patient of Dr. Fairgraves.
07:51I need to speak to him if he's on call.
07:56If he's not, I'll take his next available appointment.
07:59And please call me if he has a cancellation.
08:04Like I said, you're more than welcome to stay down here until an inpatient bed opens up upstairs.
08:09But that can take a while.
08:11Sometimes days, even longer.
08:14It's gonna be really noisy here and you won't get any rest.
08:17At home, you'll be surrounded by your family and be more comfortable.
08:22It's your choice, Roxy.
08:27It's not that I don't want to go home, but...
08:30Hi, Mom.
08:31Mom.
08:32Lena texted me to come back.
08:33I figured I'd bring the boys.
08:36What's going on?
08:37Is everything okay?
08:38Robbie.
08:39Police officer.
08:40Incoming trauma.
08:41Yeah.
08:42Coming.
08:43I'll be right back.
08:44We'll give you a chance to talk.
08:48Okay.
08:49You can have a seat.
08:58Do you need anything before we begin?
09:06You are in control now, Alana.
09:09We're here to help and support you.
09:11Once I open this kit, I cannot leave the room.
09:15But if you need a break or some air, just let us know.
09:18Okay?
09:19Emma can go with you if you like.
09:22An advocate from Pittsburgh Action Against Rapists been called and they should arrive soon.
09:26Can we start?
09:27Sure.
09:28I'm gonna put my face shield on so it don't contaminate anything.
09:32Emma's already done the same.
09:35Now, in order for the doctor to do her exam, I need you in a gown, but I need to
09:40collect your clothing first.
09:41Is that okay?
09:47I'm gonna need you to undress on top of these pads.
09:50Put each item of clothing on the pads, okay?
09:54Then we'll package each piece in a separate bag.
09:57We'll get you new clothes.
09:58Don't worry.
09:59All right.
10:00Emma's gonna be behind this curtain and I'll be in here with you.
10:04Take off your shoes first.
10:07When you're done, I want you to put on your gown, open in the back.
10:15Okay.
10:28Okay.
10:32Okay.
10:39What if the mom doesn't want to leave?
10:41Well, then she's gonna have to put up with us
10:45I can't imagine
10:48Her boys. Oh, don't go there. I'm gonna see if I can grease the wheels get her room upstairs soon.
10:53Good luck
10:54What is that? I've had a plan for a hall space filling up fast police officer should be here any
10:59minute
10:59Yeah, well as soon as you can please I need you to fix the VRI
11:03Thanks
11:04Santos I need you to pick up some more of these Westbridge diversions. Sure you want my firstborn to maybe
11:09well they know how to suture
11:11Intubated neck wounds. That's not great. We were diverted here. Is there a trauma room open trauma one?
11:16What's the story my buddy officer hero high-velocity GSW. He's getting harder to bag warehouse robbery gone sideways
11:23One two three you guys wait here. We'll take care of him. I promise
11:27I thought you left us already for the open road. I miss seeing you in uniform
11:31You should see me as a flight attendant. Do you do this intubation under active fire? Yeah, are you serious?
11:36I go in with the team in case there's an injury. That's badass. Dr. Santos
11:40Let's make sure these lungs are up. Can you see the course?
11:42Yeah, it was a great view, but it's hard to pass after I cleared him. Yes, that's only 85
11:46Dr. Santos what could cause respiratory failure in an intubated patient? There are a lot of possibilities
11:52I think dope
11:53Displacement, obstruction, pneumothorax, equipment failure, good lung sliding, no pneumo
11:59It is displacement. Okay, that is a transjected trachea
12:05Pulling out
12:07Bag
12:08But if you intubate again, won't it just come straight out the wound?
12:11Yep, exactly. So we need another plan
12:14Okay, fast down to 83
12:15Yeah, he's not moving in the air. Okay, I need a neonatal mask
12:18Neonatal? Yep
12:21I'm just going to finish my initial exam. Let me know if you feel any pain, okay?
12:29My legs are fine
12:32Well, it looks good
12:34No need for x-rays or advanced imaging
12:36Got it
12:37Two areas of ecchymosis
12:39That means breathing
12:40Over the shoulders bilaterally
12:41I'll document my photos
12:43Okay
12:44Dana will finish up her work and I will be in the ER if you have any questions
12:47You're in great hands
12:49Thank you
12:51Alright, a lot of
12:53I read your intake
12:56Why don't you give me your description of exactly what happened?
13:01I was at a 4th of July barbecue
13:06With a bunch of friends
13:09I helped set up
13:19Where does it hurt?
13:21Like here, under my belly button
13:24Okay, do you have any fever, vomiting, diarrhea?
13:29No, it's just a stomach ache
13:31Okay, let's still go see the nurse and have her call me
13:33Okay, but I'm still having ice cream tonight
13:37Let's just see how you feel later
13:39It's not bad, you don't have to get so sad
13:42I'm not sad, I'm good
13:44Your face doesn't look good
13:47Um, well, do you still want to watch the fireworks tonight? I have our headphones
13:54I'm not being rude
13:55Sorry, Becca, I gotta go
13:56I'm not being rude, I'm not being rude
14:00I'm not being rude
14:00Sorry
14:00Sorry
14:02Elliott Green, 17, syncopal episode of football practice
14:05Look, I just got dizzy, okay?
14:07It's hell week, I need to get back
14:09Yeah, okay, tough guy
14:10A&O, systolic of 95, tacky at 122, no meds, no allergies
14:14How long were you at practice?
14:16Started at 9, so like 4 hours
14:194 hours in this heat with all that gear?
14:21No pain, no gain
14:26God, I'm hungry
14:29Hey, when's our break?
14:32There's no breaks down here
14:33Always make sure you pack a protein bar, something quick
14:36Ogilvy, Joy
14:38Jump in on this
14:40Syncope at football practice
14:41I just, I just need it to hydrate
14:44Possible heatstroke?
14:46Well, with heatstroke
14:47You would have an altered mental status
14:48And they're usually dry, not sweaty
14:49Mortality is 50%, especially in the elderly
14:51In an extreme heat like this
14:55Landon, can you cover this?
14:57No problem
14:57Mr. Diaz?
14:58Orlando
14:59Orlando
15:00Where are you going?
15:01Home
15:01You take these out?
15:02Uh, no
15:03It takes 48 hours for you to get out of DKA
15:05Your blood is still full of acid
15:06Look, I can add thousands of dollars to the 100 grand I already owe
15:09I'm, I'm sorry, 100 grand?
15:11The medical debt
15:12My wife doesn't even know
15:14I'll never be able to pay it off as it is
15:16Where are your wife and daughter? Maybe we can all talk
15:18I told them to go back to work a couple hours ago
15:20The hospital is giving you a big discount
15:21And Mr. Diaz, I know it's not ideal
15:23But can you stay for at least 12 hours? It will get you out of the danger zone
15:27No
15:28I really can't
15:29Every minute I stay is a meal
15:31Shoes, school supplies
15:33Plus, I have a second job I have to get to by 4
15:35You need fluids
15:37I drink plenty of water
15:38And potassium, and insulin
15:40How about this?
15:41You stay and I'll get together everything you'll need at home
15:44Also, a referral to Northside Christian Health Center
15:48Come on
15:49You don't work until 4, it'll keep you from passing out on the job again
15:53Or worse
15:58Okay, I guess
16:00Great
16:00Thank you
16:01Please
16:06That's up to 98
16:08Neonatal mask is working
16:09Santos, finish the test
16:10What are you injecting?
16:12Bido with Epi
16:13It'll clamp off any little bleeders, some skin hooks
16:15For Shiley
16:17I don't like the curve of it, Shiley
16:18I didn't know you were so picky
16:20Santos, take a break
16:21Help me cut down a 6-O-E-T tube
16:23What is going on here?
16:24You have a field medic assisting you?
16:26Dr. Abbott is an attending and he's also a SWAT physician
16:29My buddy Hiro here is in bad need of an airway
16:32I cut it right here
16:33We can do this
16:34No, no, I got it
16:34You must be Gloria's new hire
16:36Yes, Dr. Al-Hashimi
16:37Well, I'd shake your hand, but my tube is ready
16:40And if I could find and secure the distant trachea, we have a shot at this
16:42Okay, keeping an eye on the stats
16:46Slow, smooth, smooth as fast
16:47You know, you can call me just to say hi sometimes
16:50What's up now?
16:51GSW with tracheal transection
16:53Very retracted, but I think I can get it
16:56Both lungs are up
16:58Stats down
16:59Standing the belly now
17:00Okay, just
17:03I got it, I got it
17:08Gently, gently, or we're gonna lose it
17:10Down to 89
17:13I'm in, balloon up
17:17End title, excellent waveform
17:19Good breath sounds
17:22Also the tracheal to the skin, 2-0 silk
17:25Zats are coming up
17:27Not bad, Abbott
17:30While you were playing him with that airway, you missed a big bruise in the left upper quadrant
17:33He was wearing body armor
17:35High-velocity projectile doesn't have to penetrate to do damage
17:38There's no fluid in the suprasplenic space
17:40Let me look
17:43Okay, right there
17:46Looks like a subcapsular hematoma of the spleen
17:49Must have been a big impact
17:50AR-15 muzzle velocity is 3,000 feet per second
17:53CT angio of the neck ASAP along with CT chest, abdomen, pelvis
17:57Yep
17:58Just as soon as we secure this tube
18:04Burst leaders in
18:05Mucous membranes dry
18:07Peeples, 4 millimeters reactive
18:09Did you get tackled today?
18:11No, just running drills
18:12Any chest pain, palpitations?
18:14No
18:14Hands off please, running the 12 lead
18:16How we looking?
18:18Good, healthy kid, no history, no trauma
18:21Differential for syncope in an adolescent
18:24Cardiac arrhythmia from drugs
18:26Long QT, WPW, or Brugada
18:30Brugada is more common in Asian males
18:31That still should be considered
18:33Long odds though, Brugada prevalence is 1 in 20,000 in North America as high as 1 in 300 in
18:38Asia and the Middle East
18:39And?
18:40First described in 1992, has a high incidence of sudden death among young patients with otherwise structurally normal hearts
18:46Wait, did you just say sudden death?
18:48Temp is 1 in 2.5
18:50Sorry, our student doctors are discussing a rare condition you don't have
18:54I just didn't drink enough water
18:57I overheated
19:00Not my type, bud
19:02Other than standard labs, what else to order?
19:08CK, to rule out rhabdo
19:10To make sure you don't have any muscle breakdown from the heat
19:13Let's set up a cooling room for Elliot here in the other heat exhaustions we will inevitably get today
19:22Last photo
19:27Okay, I take the SD card
19:30And I seal it in an evidence envelope with everything else
19:34Okay
19:35Next, I'm just gonna turn off the light
19:39And I'll run a blue light over your skin
19:43Anything glows
19:44I'll swab it with a wet
19:46Then dry Q-tip
19:48Is that okay?
19:49Yeah, sure
19:50Yep
19:53Alright
19:54Take off your gown on the left side
19:56And turn a little bit towards me, just to the left
19:59There you go
20:01Yep, there you go
20:02You can be with us
20:26There's something on the left wrist
20:28swab
20:37sorry
20:37don't be
20:38it's just cold
20:40yeah
20:41let me stop
20:49thanks Antoine
20:50no problem
20:51keep your head down
20:52out there
20:52what's the story
20:54neck angio is negative
20:55missed the carotids
20:56he's lucky
20:57what about the belly
20:58small splenic injury
20:59no free fluid
21:00in the abdomen
21:01that should heal
21:01on its own
21:02what's the plan
21:03head and neck
21:03we'll have an OR
21:04ready with thoracic
21:05standing by
21:05how soon can they
21:06take him
21:07we're a little
21:07backed up with
21:08Westbridge patients
21:09but let's bring him
21:09up
21:09we'll get him
21:10taking care of
21:10for you
21:13hey
21:14you're gonna be
21:15okay here
21:15we're getting
21:15you to surgery
21:17I'll write the
21:18procedure note
21:18thank you
21:25swat
21:25really
21:26I suck at golf
21:27you spend time
21:29in the middle east
21:30more than I would
21:31have liked
21:31I worked in
21:33Kabul with
21:33Médecins Sans Frontières
21:34and in 2020
21:35at the maternity
21:36hospital
21:37I met
21:38the most incredible
21:39bravest doctors
21:40there
21:41dashed
21:42e-barchi
21:43tragedy
21:46we should grab a beer
21:47sometime
21:47share war stories
21:49I'd like that
21:54she seems cool
21:55yep
21:56maybe
21:57I think I'll be around
21:58long enough to find out
22:00oh there she is
22:01Vic
22:03dad
22:04Victoria
22:05this is Dr. Amy June
22:07Dr. June is the
22:08smartest person I know
22:09don't tell your mother
22:10just kidding
22:12seriously don't
22:13hello
22:14hi
22:14are you here to
22:15see a patient
22:16no we're here to see you
22:17Dr. June is chief of dermatology
22:19in Victoria's
22:20first shift in the ER
22:21was on the day of the
22:22pit fest shooting
22:23I heard all the
22:25incredible stories
22:26including your own
22:27acts of
22:28med student prowess
22:29wow
22:30med student prowess
22:32that's
22:33I'm pretty sure
22:34I was just trying to
22:34stay out of the way
22:35she's modest
22:36like her dad
22:37and her mother
22:37oh
22:39sorry
22:40Dr. June
22:42yep
22:43coming
22:44I'm doing a favor
22:45for someone at the
22:46mayor's office
22:47who needs
22:47Mohs surgery
22:48on a basal cell carcinoma
22:49and then I am
22:50grilling for 30
22:52oh my god
22:53happy fourth all
22:53happy fourth
22:55thanks for coming down
22:56my pleasure
22:56let's grab a coffee
22:58sometime
22:58absolutely
22:59yes
22:59thank you
23:01you know
23:02mom really wants me
23:03to go into surgery
23:04your mom
23:05wants me to
23:06stop drinking
23:06and join a pickleball league
23:07oh that's the same
23:08yeah
23:09exact same
23:09I will risk an achilles tear
23:11before I give up scotch
23:13hey
23:13I hope I didn't embarrass you
23:14coming down here
23:15no
23:15I'm just trying to present you
23:17with some options
23:18for your residency
23:19I
23:20I really appreciate it dad
23:21I do
23:22I just
23:23I'm still not sure
23:25well either way
23:26you'll do what's right
23:27you always do
23:28Radia
23:30talk to Javadi
23:31you are a man of many talents
23:33you don't know the half of it
23:35your daughter has some high standards
23:37to live up to
23:37no you don't know the half of it
23:43Mr. and Mrs. Davis
23:44this is Dr. Jefferson
23:45from psychiatry
23:46please call me Caleb
23:48can you tell us
23:49what's going on with our son
23:51all of his labs
23:53and x-rays
23:53came back normal
23:54given his age
23:56and his hearing voices
23:58do either of you
24:00have a family history
24:01of mental illness
24:03not mine
24:11my brother took his own life
24:13wait what
24:15Uncle Ken
24:18you said he drank himself to death
24:19ma
24:20he did that too
24:21was he ever formally diagnosed
24:23with a mental health issue
24:24no
24:24he was depressed
24:25had mood swings
24:28but he didn't want to see anyone
24:30oh my god
24:30okay why am I just now
24:31hearing about this
24:32Jada please
24:33please what
24:33mom
24:34why would you not tell Jackson
24:36or me
24:38I can't believe this
24:39Jada
24:40excuse me
24:46Jada
24:47what happens next
24:51we keep your son here
24:53for the next three days
24:54for observation
24:54and therapy
24:55and that'll help us
24:57to understand
24:57what is going on
24:58Jada should really hear this
24:59let me see if I can find her
25:01bring her back
25:05okay
25:06we're gonna swab your mouth now
25:08my mouth
25:09two dry swabs
25:11along the inside of your cheek
25:13and then along the gum line
25:19how are you feeling
25:23I wish this day never happened
25:25would you like some medicine
25:26to help you relax
25:27you've experienced
25:28horrific trauma
25:32you've been doing this a while
25:33let's just say
25:34Florence Nightingale
25:35and I were roommates
25:37who
25:39I rest my case
25:41she was the founder
25:42of modern nursing
25:45okay
25:46we can have something
25:47to eat a drink now
25:48I'm fine
25:48you sure
25:49I'll just keep going
25:52okay
26:00we now have
26:01a heat exhaustion
26:02treatment area
26:03in North Park
26:05evaporated cooling
26:06great plan
26:07yeah
26:08what is
26:09Dr. Langdon's idea
26:12he figured we'd be seeing
26:14a lot more patients
26:14in this heat
26:16he's right
26:18how are you feeling
26:20it's a loaded question
26:21it wasn't meant to be
26:24you have a deposition
26:25in a couple hours
26:26yes
26:26how are you feeling about it
26:28um
26:29trying to think positively
26:30but feeling
26:31um
26:31less so
26:32you know
26:33this job's really important
26:34to me
26:35and my sister
26:36you know I support
26:36both of us
26:37it's gonna go great
26:38just tell them what happened
26:40you're not at fault
26:40your job's not in jeopardy
26:42I mean
26:42the lawyer said that I
26:44the lawyer's job is to try
26:45and shake your confidence
26:46so don't let them
26:46you're a very good doctor
26:48I have been training
26:49residents for years
26:50you are one of the very best
26:53him?
26:54no we need to stick to the plan
26:56promise
26:56thanks
26:57she's not thinking
26:58okay
26:59it's gonna be great
27:01then I'm taking her home
27:03that's it
27:03we have to honor
27:04your wife's wishes
27:06even if she's loaded up
27:07with morphine
27:07and can't think straight
27:08especially then
27:09hello
27:09Paul Hamler
27:11this is my attending
27:11Dr. Rubinovich
27:13hi
27:13uh
27:14my wife is not
27:15thinking clearly
27:16what is it that
27:18she's asking for
27:19it's that she wants
27:20to stay here
27:21why don't we all
27:22go in and talk
27:24Brian Jenkins
27:25is allowed to hunt
27:26with a .22
27:27on his grandpa's farm
27:28sounds like an accident
27:29just waiting to happen
27:30mm-hmm
27:30and you're not
27:31Brian Jenkins
27:32how are we doing
27:33in here Roxy
27:35been better
27:36rumor has it
27:37you're still interested
27:38in booking a room
27:39with us
27:41I don't want to
27:42go back home yet
27:43it's all set up
27:45Roxy
27:45you're gonna be
27:45more comfortable
27:46at home
27:47Paul
27:47I changed my mind
27:49it is our home
27:52I don't
27:54I don't want you
27:55living with my ghost
27:56I will happily
27:57live with your ghost
27:58can we just
27:59all stop
28:00talking about ghosts
28:01please
28:01yes I'm sorry
28:03sorry sweetie
28:04you're right
28:05got trauma
28:06flying in
28:07each day of five minutes
28:07okay
28:08um
28:09I'm very sorry
28:10I will be right back
28:11excuse me
28:13it's a boating accident
28:15swimmer versus propeller
28:16ouch
28:17what body parts involved
28:18they didn't say
28:19how old
28:20nope
28:20anything
28:21all I got was
28:22boating accident
28:23swimmer versus propeller
28:24propeller
28:24got it
28:29two
28:29hear one trauma
28:30needless
28:30two minutes
28:31hear one trauma
28:32needless
28:33two minutes
28:56Picked a hell of a day to come back, huh?
28:59How's Jake?
29:02He's good.
29:04Better.
29:05He's coping.
29:06Gonna be a senior this fall.
29:09That's great.
29:11There's a lot for him to go through.
29:14A lot for all of us to go through.
29:16Yeah.
29:19Okay, I'm just gonna say it.
29:21I'm sorry.
29:23I betrayed your trust.
29:24I betrayed our patient's trust.
29:26And I'm really fucking sorry.
29:28It'll never happen again, I swear.
29:34I'm really glad that you got the help that you need.
29:40But I don't know if I want you working in my ER.
29:52Why'd you intubate?
29:53He was splitting from the pain.
29:55Barely moving air with sats in the 80s.
29:56How do you get sliced up in the propeller?
29:58He was in the Allegheny trying to untangle a water ski tow line when his buddies started
30:01the engine.
30:02Drunk buddy, I assume?
30:03It's 4th of July, you tell me.
30:05Focus on the patient, please.
30:06Sophie, take over bagging.
30:10Okay, 1, 2, 3.
30:12Watch that buckle.
30:15You need me in here?
30:16Nope.
30:16We have a senior resident and an attending.
30:19Mel, can we start with a...
30:20The E-Fast, sure.
30:22Yes, please.
30:23Why?
30:23To check and make sure there's no pneumothorax, otherwise it could become a tension.
30:27Exactly.
30:28Oh.
30:30You want oneg?
30:31No, that'd be pee first.
30:33108 over 64, pulse is 102, sats are good.
30:36Okay, let's have oneg ready, but don't get it just yet.
30:39Anything else?
30:43How about a emo cube?
30:44Uh, yeah.
30:45Yeah, yeah, of course.
30:54Next step is fingernails.
30:58We'll go into each nail.
31:00First with the wet swab, then with the driver.
31:05Do you want to take a break, honey?
31:07No.
31:14How much longer?
31:15After these, we'll get to external and internal vaginal collection.
31:23It's the advocate from PAR.
31:26Okay.
31:27They've been doing this longer than I have.
31:29They provide resources, assistance, and support for sexual assault survivors.
31:35Hey.
31:38This will not define you, okay?
31:40You don't have to talk to them, but I recommend you do.
31:44You're available 24-7.
31:47Okay.
31:49Okay.
31:53Okay.
31:56Okay.
31:57Okay.
31:57I'm Paulette Sanderson from Pittsburgh Action Against Rape.
32:00Hi, Paulette.
32:02I'm the same thing, and this is Alana.
32:04Hello.
32:05I'm sorry to meet you under these circumstances, but I and my organization are here to help
32:09you navigate everything that comes next.
32:11I brought you some clothes and basic necessities.
32:14I can even stay with you through the rest of your examination if you'd like.
32:20I don't think that's necessary.
32:22Okay.
32:23Okay.
32:24That's fine.
32:25Would it be okay if I asked you a few questions?
32:38Sure.
32:41Our VRI isn't working.
32:44Video relay interpreter?
32:47Yeah, of course I rebooted it.
32:49Wait, how are you going to fix it if you don't know what the hell it is?
32:53Yeah.
32:53Okay.
32:54Whatever.
32:55I want to do a head and belly scan on Harlow.
32:57Can you try telling her why?
32:58What about the VRI?
32:59It's DOA.
33:02I'm charting every free minute I get.
33:04I wasn't coming over for that.
33:06Good job in the trauma earlier.
33:11What's this?
33:12Daniel Scott, 32.
33:14Weekend dizzy while washing his car.
33:15Tacky at 106.
33:16BP 90 over 60.
33:18Tempts too high to register.
33:19We have the coolie room set up in North 5.
33:21Okay, how are you feeling, Mr. Scott?
33:23Thirsty.
33:23Let's see if we can't fix that.
33:24He's going to need a core temp, a CMP.
33:26Whoa.
33:27Oh, hey, we need a trauma room.
33:28What's open?
33:29Two.
33:29I'll grab the Ativan.
33:31Any past medical history?
33:32No.
33:32Wife says he's healthy.
33:33No meds, no allergies.
33:35He needs a core temp.
33:36Okay.
33:41Ready to transfer?
33:43Let's give two of Ativan.
33:44Don't want him seasoned again.
33:46I got to get back to my patients.
33:47Okay.
33:47One, two, three.
33:49Eat.
33:51Orders?
33:52Second IV with saline open, sepsis panel, UA, urine drug screen, EKG, and CK.
33:57I don't see any apparent trauma.
34:01People's reactive.
34:02Mr. Scott?
34:03Daniel, can you talk to me?
34:04Mm-hmm.
34:04Post-dictal, but moving all extremities.
34:07Pulse 137, BP 88 over 60.
34:09What are you thinking, Dr. Santos?
34:11A heat stroke, but consider sepsis or drugs.
34:17Rectal temp is?
34:19104.6.
34:20Okay.
34:21Let's start with four ice packs on the groin and axilla.
34:24Should we do a full-body ice bath?
34:26That'll take too long.
34:27You have an arctic sun?
34:28Yeah, we do.
34:28Get pads on the chest, abdomen, and both legs.
34:30I'll check back in.
34:34Cephtazidine is up, and first hemoglobin 8.2.
34:38Eight's pretty low.
34:38He must have bled down from 14.
34:40Anything I want to do about that?
34:42Um, young, healthy guy, we transfuse at seven.
34:45Do we?
34:46We'd be in real trouble if he equilibrates from acute blood loss.
34:49Am I interrupting something?
34:50Motive lacerations.
34:56Jesus, this looks like some Jurassic Park shit.
34:58Is that your official surgical diagnosis?
35:00He is hemodynamically stable.
35:02What else do we know?
35:05Intubated in the field due to poor tidal volume.
35:08E-fast was negative for pneumothorax, so no need to do a chest tube.
35:13And no free fluid in the abdomen.
35:16Good hemostasis inside the wounds.
35:17Nothing arterial.
35:18At first, he had a hemoglobin of 8.2.
35:20We'll follow that closely.
35:22With no active bleeding, I wouldn't transfuse just yet.
35:27Dr. Langdon agrees with you.
35:29Let's get him to CT.
35:31Jason Stills, 62, was gathering the makings of a salad when he started feeling dizzy and nauseated.
35:37Vomited once.
35:37How you feeling, Mr. Stills?
35:39I'm feeling good, I'd die.
35:40Well, you came to the right place to prevent that.
35:43Uh, do you mind if I touch your abdomen?
35:45Yeah, sure.
35:47Does this hurt at all?
35:48No.
35:49He's tachycardic at 124 with a temp of 102.4.
35:52Hey, Joy, what's your suggestion?
35:54Keep hydrating, check electrolytes, and move him to the cooling room.
35:57Precisely.
35:58Good luck finding a parking spot.
35:59North 5.
36:00What?
36:01No valet?
36:06Jada.
36:07Hey.
36:09I've been looking all over for you.
36:10I just went for a walk.
36:12I wanted to talk to you.
36:14That's okay?
36:17Um, so does Dr. Jefferson.
36:19It's important that you get to hear what he has to say.
36:21Why?
36:22Because I'm gonna go crazy like my brother?
36:24Or kill myself like my uncle?
36:27Of course not.
36:28Um, but we still have no idea what caused Jackson's episode.
36:34Episode.
36:35Right.
36:37Look, I know this must be so scary for you.
36:41And you probably feel betrayed by your parents.
36:45But they had no way of knowing about Jackson.
36:48You know, and some families just have a difficult time talking about mental health.
36:54Now you can help us take the first steps to finding out what we can do to help your brother.
37:04Mr. Diaz, I have a surprise for you.
37:08Shh.
37:09Oh.
37:11Sorry.
37:13It's okay.
37:14Have you, have you seen my patient?
37:16Orlando.
37:17Mr. Diaz?
37:18Room is empty.
37:21Seriously?
37:22Yeah.
37:29What happened to you?
37:30Oh.
37:32Well, it grazed my vest.
37:34You were shot?
37:35Shot at.
37:36Geniuses thought today was the day to rob a goods warehouse.
37:40Didn't think about how long it would take to load the appliances.
37:42They panicked.
37:44All hell broke loose.
37:45Jesus.
37:49Why do you do this?
37:51My therapist said I needed a hobby.
37:53Funny.
37:57Shit, this...
37:57This sucks.
37:59Oh, it's nothing.
38:00No, I...
38:01No, don't worry about me.
38:02I'm fine.
38:02Seriously.
38:03My patient, he didn't have any insurance, and he was already in a mountain of medical debt.
38:10He couldn't afford any of his meds.
38:12Hmm.
38:14What's in the bag?
38:16Insulin, test strips, electrolyte powder.
38:21I got him everything he needed for home care.
38:24So Ubered to his house.
38:26Is the hospital going to pay for that?
38:28I'll pay for it.
38:40What are you doing?
38:42Well, you clearly can't.
38:45Did you make a chart?
38:47No.
38:48This can stay off the books.
38:50Don't need the paperwork from the hospital or the police department.
38:54Okay.
38:56We're a little secret.
39:01How's he doing?
39:02Any more seizures?
39:04Nope.
39:0510.02.9.
39:06Lab spec?
39:07Mostly signs of dehydration, tad hypernatremic, mild BUN, and creatinine, bub.
39:13CK400-something.
39:14Nothing worse than that.
39:15Okay, good.
39:16Keep cooling.
39:17I'll monitor him.
39:18Great.
39:18That'll give Dr. Santos a chance to get caught up.
39:22Okay.
39:25Your R2 year can be challenging.
39:28You just have to keep grinding.
39:31What's your dyspo plan for Mr. Scott?
39:33ICU admission.
39:35You should call neurology to consult.
39:37Yeah, done.
39:38Since it was exertional heat illness in a young person, the mortality is low.
39:42But non-exertional heat stroke in an elderly person, you need to worry.
39:47I'll put in orders for repeat labs.
39:50Good work in there.
40:05This 49-year-old woman presents to the emergency department.
40:13The chief complaint of right ear pain.
40:17Hey, Donnie, can you do something about that?
40:20What?
40:22Seriously?
40:23That's not driving you nuts?
40:25The baby.
40:26It won't stop crying.
40:27Oh, that music's my ears now.
40:29I think Jesse's the nurse.
40:30Okay, you...
40:46What the hell is going on?
40:48With what?
40:50With her.
40:51Can you make her stop crying?
40:53She's been fed and changed.
40:55She's cranky from rhinovirus.
40:58There's no something you can do.
41:00She's due for her next time, I'll...
41:03Give me a minute.
41:04I'll be right back.
41:04Wait, no, no, no.
41:05I'm not going to stay here.
41:09What is your problem?
41:14That's precisely why I didn't go into Peds.
41:18Okay, hey, hey, hey, little Miss Sunshine.
41:24Oh, it's time for you to take a little nap.
41:28That would be so fucking nice.
41:30Yes, it would.
41:34Starting to understand why you got left here.
41:54Oh, it's time for you to take a little nap.
42:27What's more from, C.C.?
42:28Nothing intrathoracic, nothing intra-abdominal.
42:31The killer just missed gutting him.
42:33Very fortunate.
42:34Repeat, hemoglobin is eight.
42:36we're holding off on transfusion plan i'll have mel and langdon suture up the lacerations
42:42wait what that could take days i i calm down sadness i'm kidding this is one for my skilled
42:49surgical residents upstairs not you boy scout butchers boy i missed you yo yo can't say the same
42:56okay let's take up this art project so about back to it good talk how we doing princess
43:06all right a little bloated i want too many hot dogs from the truck
43:11you meant the board huh gus our incarcerated patient got a spot upstairs looking for our
43:17unhoused patient digby and of course we have whitaker donahue and the med students on these
43:23diversion intakes but they just keep coming yeah we may need to start just sending people up and ask
43:28for forgiveness it's their permission hello oh okay yes i will be right there c-suite wants to see me
43:37upstairs oh called to the principal's office on your first day not a good sign i think i'm a baby
43:44whisperer hey great we'll add baby jando to your patient load forget i said anything where are we
43:49with your deaf patient harlow uh the vri was a bust but the interpreter's on the way uh figured i'd
43:55just
43:55give her a head and belly scan and go from there no wait for the interpreter no need to give
43:59the
43:59patient unnecessary radiation and you're charting catching up and checking it twice good hey have you
44:06a chance to speak to langdon today uh no why did he say something no just curious how is everything
44:14at home with you and whitaker he's weirder than you'd expect yeah but uh i don't see him all that
44:23much
44:23he spends a lot of time at amy's his girlfriend i don't know what to call it the the farmer
44:32who got
44:32burned last year the day of the mass cash his widow amy oh he died yeah he had burns on
44:3890 of
44:39his body his chance of survival wasn't very slim okay so i'm an optimist the sun doesn't always come
44:43out tomorrow annie wait wasn't she pregnant no she was a young orphan no not annie amy yes yes very
44:54pregnant and young and whitaker's now seeing this amy and her baby he got really close to the family
45:02when the husband was dying he really believed that the guy would pull through he helped her
45:06through the loss of her husband and then again when she had the kid and now he spends almost every
45:11weekend at the farm huh plus he's on the street team and he just wants to help everybody and i
45:18just
45:19don't want to see him taken advantage of you know he's just a fucking huckleberry yeah he's our
45:24fucking huckleberry i'll talk to him hey your call strong deflection well played you're the boss
45:31or you are until end of shift today still the boss when you see me in here still the boss
45:36copy that boss
45:39dr robbie can can i grab you for a second yeah sure what's up um can't you
45:48order my wife to go home i'm sorry my life's dying and you're telling me there's nothing i can get
45:59mr hamler that's not no no there's got to be something please it may not seem like much but right
46:09now you being here for her and respecting her wishes is the best thing that you can do for her
46:15supporting her and her choices is the most remarkable gift that you can give her at this time
46:22the meds we have her on will help her pain and she may get to a point where she feels
46:27well enough to go
46:46give me one second
46:53okay i'm gonna let you guys get acquainted i will be right back oh excuse me i'm waiting
46:59for dr mohan is she available i will try and find her for you sir
47:07whether you choose to report or not we're here for you call me any time it could be a month
47:13or a
47:14year from now i'll follow up with you too thank you thanks
47:23you got a pap smear before yeah every few years good same position but i'll start with swabs on the
47:31outside external genitalia then i'll use the speculum to get internal swabs you ready all right
47:38help you get your feet in the stirrups okay all right now slide your bottom down
47:49yeah a little bit more a little more sorry i i can't okay it's okay we can take a break
47:57no
47:57problem i don't want to break i want to stop okay is this about reporting because you can do this
48:04collection without a police report for now and none of it goes in your permanent medical record
48:09i don't want to do this anymore tell me why you want to stop
48:15he's my friend he knows all my friends
48:20it was just a dumb
48:26he was drunk he didn't mean it didn't mean anything okay okay
48:33it's okay it's okay i understand you too
48:38a lot this is a difficult process to say the least
48:43why don't you take a breather and come back and whatever you want to do we'll do
48:56let's go let's go find the good snacks
49:21jesus christ
49:23Sorry, giving new meaning to the nickname Crash, huh?
49:28I've been trying to get to the bathroom for over an hour now.
49:31Yeah, you and me both, sister.
49:43Uh-oh, this can't be good.
49:46Who's this?
49:47That is hospital CEO Trent Norris.
49:49He's the big boss.
49:51Hmm, nice outfit.
49:53Hey, Rockstar, gather your staff, please.
49:55Sure, anything you want to tell me first?
49:57No.
49:59Hey, everybody, can you, uh, gather around, listen up for a moment, please?
50:04And have your attention, everyone.
50:07The internal disaster at Westbridge has been identified as a cyberattack.
50:15And now Good Dominion Hospital has been hit as well.
50:18Their ambulances are being diverted over to St. Mary's, but we can expect more walk-ins and Westbridge diversions.
50:24Uh, for how long?
50:26We don't know how long.
50:27If the ransom is paid.
50:29Ransom?
50:30What?
50:31Are we next?
50:31Our IT protection system has blocked thousands of intrusion attempts in the hours since Westbridge was hit this morning.
50:39But IT believes we're still vulnerable.
50:42So we're going to preemptively shut down all the computer systems.
50:46Oh, jeez.
50:50Patient registration, electronic health records, lab and radiology interfaces, email, internet.
50:56Want to talk to me first? Do you want to consult my department?
50:58I consulted your fellow attending.
51:03When are we going down?
51:06Soon.
51:07Very soon.
51:09Okay.
51:09Hey, somebody get a picture of the board.
51:11Quickly.
51:12Quickly.
51:13We're about to go analog.
51:15Okay.
51:20Do the phones work?
51:22They don't work.
51:23Oh my gosh.
51:24Did you get the photo?
51:25Yeah.
51:25Yeah, I got it.
51:28This is going to be fun.
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