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The.Pitt.S01E09.540p.x265.AAC [Full Movie] [Full Episodes]Full EP - Full
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02:02M.K.
06:06İzlediğiniz için teşekkür ederim.
06:26Almond milk and your soy lattes.
06:29That doesn't even make sense.
06:30You know, most commercial almond and soy milks are fortified with calcium,
06:34so they end up having a higher percentage of calcium than cow's milk.
06:37Uh, prepped with betadine and rates.
06:39Very nice.
06:41Let's have a closer look.
06:42Dr. King, can you please grab me a 10cc syringe, a 20-gauge needle, and some sterile saline?
06:48Pluck it out, stitch me up, and send me home.
06:50I've got to get back out there to my kid.
06:51We're still waiting to be seen, by the way.
06:53Fred, it's a little more complicated than that.
06:55You got yourself a fight bite, which means a couple things.
06:58First, we need to determine if the bite extended into the joint space.
07:01If it did, you're going to need IV antibiotics on a trip to the OR to see a hand surgeon.
07:06Pinprick and a little Bernie.
07:07An operation?
07:08Well, you're just shouting a minute ago about infection.
07:11And with good reason.
07:12And while I am sure you are in the clear for rabies and HIV, human mouths are filthy.
07:18Some more than others.
07:19How can you tell if it's bad?
07:21Great question, Dr. King.
07:24I'm sorry?
07:25I am going to inject some sterile saline into your knuckle joint, which you won't feel because of the anesthetic.
07:31If it comes spraying back out of the bite wound, we'll know.
07:33Ready?
07:34I guess.
07:37There she blows.
07:39Oh, shit.
07:40Are you serious?
07:41You hear that, you fucking bitch?
07:43I've got to have surgery thanks to you.
07:46Good.
07:47You assaulted me.
07:49Damn right.
07:49And I'll bet next time you'll keep your masks and opinions to yourself.
07:54You okay?
07:55Yes.
07:57Three grams, unison IV.
07:59Call the OR.
08:00Tell them we have a fight bite that needs to be washed out.
08:02Then go take 20 minutes in the lounge.
08:04I'll come find you if I need you.
08:05Well, I don't need a break.
08:06Yes, you do.
08:09Okay.
08:10Oh, uh, did you want me to tell the surgeons to go no mask for surgery?
08:16What?
08:16Well, those of us who save lives for living believe strongly that masks minimize risk when
08:21it comes to spreading disease and infection.
08:23But I want to respect your beliefs.
08:25So, what do you think?
08:27With or without for surgery?
08:28Without?
08:30Um, I want with.
08:33Good call.
08:35Hello, cop.
08:36Just here at cafeteria send the ice?
08:37Yeah, everything they got.
08:39Hey, I hear they're going to start you working on the Middle East peace plan.
08:42Not since the Dalai Lama or Gandhi.
08:44Baby, fucking I right there.
08:45You should have seen me.
08:46It was inspiring.
08:47Also terrifying.
08:48A little bit shaming.
08:49Holy trinity of crowd control.
08:51Hey, can we pick it up in here, please?
08:52Overdose is here.
08:56Pitfest OD.
08:56Keely Ralston brought to the first day tent at Pitfest with alternatial status and fever.
09:01Tempt too high for a field thermometer.
09:02Intubated en route.
09:03We got to cool this lady down.
09:04Get some ice packs.
09:06Head, neck, groin, scent off a rainbow.
09:07On it.
09:09Heart rate 132.
09:10BP 210 over 120.
09:11Jesus, that's high.
09:12Four of Ativan in the field.
09:14Pupils are dilated.
09:15Definitely MDMA overdosed.
09:16Dr. Mohan, how do you want to treat the BP?
09:18Uh, beta blockers?
09:19No, unopposed to alpha can kill her.
09:20Four more of Ativan, please.
09:22Seriously?
09:22She might need another 40.
09:24Hypertension and tachycardia from MDMA is centrally mediated.
09:27Ativan is the drug of choice.
09:29Damn.
09:29Core temp 107.3.
09:31Okay, can we get another hose in here before she fries her brain, please?
09:34Let's go.
09:34Come on.
09:39I'll be right back.
09:41Hi.
09:42You look lost.
09:43No, it's my assistant who actually seems to have been misplaced.
09:46I mean, how long does a CT take?
09:48Certainly not this long.
09:49You can get pretty backed up.
09:50Can I get you a cup of bag of coffee, dry sandwich?
09:53No, thank you.
09:54How about a cola koi for my secret session?
09:55I'm allowed to go for it myself.
09:56I'm freaking addicted.
09:57I'm good on drinks.
09:58Can you take me to radiology?
10:00Yeah, right this way.
10:07Piper, while we still have a few minutes, there's some things I want to say.
10:10Yeah, it means protection.
10:12I know.
10:13I'm sorry.
10:14Totally.
10:14It's a mistake.
10:15Totally.
10:17I'm a part of the street team here.
10:19It's a group of doctors and nurses who go out in the community and help.
10:23People who can't or won't ask for help.
10:28Addicts, unhoused, runaways.
10:30And I'll be honest with you, Piper.
10:32I think you need some help.
10:35What are you talking about?
10:37If you're in trouble, we can help you.
10:40I'm not.
10:41Okay?
10:43And if we're done here, I think I'd like to go.
10:46Will you at least take a look at this?
10:51There's a list of resources on the back.
10:53I don't need that.
10:55I know you don't have a phone.
10:57But if you could just take my number, okay?
11:02You never know.
11:04We're at risk, Laura.
11:06How about taking the pen?
11:08If you ever feel unsafe or in danger, call this number.
11:11It's the national hotline.
11:13There's somebody on the other end, 24-7.
11:15A trained professional looking out with anything.
11:17I have all the help I need.
11:18I want to go.
11:20Now.
11:21Okay, I'm going to count.
11:21One, two, three.
11:23Gentle, gentle, gentle.
11:24You said we have splashed down.
11:27Good luck.
11:27See you on the next one.
11:28Tense down to 107.1.
11:30How long does she need to stay in the ice, Dr. Santos?
11:32Why would she be in the ice?
11:33It's 13 minutes.
11:33Dr. Santos.
11:34Until her temp is normal.
11:35Wrong.
11:36You pull her out at 102.
11:37Otherwise, we could overshoot and cause hypothermia.
11:39Heart rate 120.
11:40Pressure 198 over 116.
11:42More Ativan?
11:43Another four, please.
11:44Why is she on the ice, Dr. Santos?
11:45To bring her temp down.
11:47Wow.
11:47State the obvious yet.
11:48Still won't answer the question.
11:49The quicker we bring it down,
11:50the less of a chance for permanent damage
11:51to the brain and the liver of kidneys.
11:53Exactly.
11:53Was she sweating?
11:54Profusely.
11:55What if she wasn't, Dr. Santos?
11:56What if she was dry as a bone?
11:57Then we'd have to think anticholinergic overdose,
12:00not sympathetic.
12:04Very good.
12:09Yeah, three.
12:12Hey.
12:14I found you scrubs that should fit.
12:17Oh.
12:18Thank you.
12:19That's great.
12:20I appreciate that.
12:21But they come with a catch.
12:23Mr. Krakosha's asking to see you.
12:25The guy who peed on me?
12:27Why me?
12:28I didn't ask,
12:30but maybe you should wait
12:31to put these scrubs on
12:32until after you...
12:33That's a good idea.
12:35Oh, God.
12:38Oh, man.
12:39We get a load of the...
12:40Oh, my God.
12:40Come on, man.
12:42Whoa.
12:43Oh, man.
12:45Well, you know what?
12:46I got it.
12:47I got it.
12:48Yeah, I see you.
12:49Yeah, I can be happy.
12:52There's a number, buddy.
12:53Trauma tier two, ECA now.
12:55That's another for a Vativan.
12:56Rectal temps down to 105.
12:58Okay, moving in the right direction.
12:59We might get lucky here.
13:00Double trauma at the back door.
13:02Auto versus pedestrian
13:03before getting a telephone pole.
13:04You got this?
13:05Yep.
13:06Dr. Robbie,
13:07I finished with Dr. Rezeki,
13:09the therapist downstairs.
13:09Yes, yes, yes.
13:10How'd that go?
13:11Well.
13:12Excellent.
13:16Have you heard from David?
13:17No.
13:18That's David's the therapist.
13:26Do you think that he's still
13:27going to pick you up today?
13:28I think so.
13:29Okay, well...
13:29Robbie, here they come.
13:31Okay, well, you're medically cleared,
13:33so why don't you stay here
13:33for a little while longer
13:34in the hopes that he does?
13:36I still would like him
13:37to talk to somebody.
13:38Perla, this is Teresa.
13:38She's a friend of mine,
13:39so I expect concierge service, yes?
13:42VIP treatment.
13:43Thank you.
13:43You're in good hands.
13:44Just let me know
13:44if David shows up
13:45or if he calls.
13:46Good boy.
13:47Good boy.
13:48Walter Purnell, 52,
13:50walking his dog
13:51in the crosswalk,
13:51got struck by a Chevy Impala
13:53at low velocity.
13:54Ambulatory on scene,
13:55no KO,
13:56no neck, chest,
13:56or belly pain.
13:57Good vitals.
13:58Whoa, major road rash.
13:59Yeah, the car didn't hit me
14:01so much as throw me,
14:02but I slid for a good 10 feet.
14:04Of course,
14:05this is the first day
14:05I've worn shorts
14:06I'll left in here.
14:07No deformity at the knee
14:08or ankle.
14:09Distal pulses intact.
14:11Four of morphine so far.
14:12Yeah, feel free
14:12to be more generous.
14:13Don't worry,
14:14we will patch you up.
14:15We will get you right.
14:15Who's your friend?
14:16Oh, this is Crosby,
14:17who thankfully barked
14:19and warned me
14:19so I had half a second
14:20to try and move out of the way.
14:21Crosby, you're a hero.
14:23Donnie,
14:23you think you can find
14:24a milk bone
14:24for our little lifesaver
14:25here in the doctor's lounge?
14:26Absolutely.
14:27I'll take good care of you.
14:28Uh, can he stay with me?
14:29He's a very good boy.
14:30No doubt.
14:30Let's get you settled first.
14:31You're going to South 20.
14:32Got it.
14:33Is that the driver?
14:3328-year-old lady
14:34had her seatbelt on,
14:36clipped the guy with the dog
14:37and went straight
14:37into a telephone pole.
14:38Bloods from a scalp lap.
14:40Also completed chest pain.
14:41Sleepy but arousable.
14:42What's your name?
14:43Paula.
14:44Heart rate's a bit tacky.
14:45112.
14:46BP's fine.
14:46Paula,
14:47are you in any pain right now?
14:48Yeah, I can't go hurt.
14:50What else to say?
14:51She was driving erratically
14:52before the crash.
14:53No ETOH on her breath.
14:54Maybe drugs?
14:55Core tab's 100, 4.2.
14:57Heart rate, 116.
14:58BP, 180 over 110.
15:00Better, but still too high.
15:01Another four at Ativan.
15:03That'll make 20.
15:04Good counting.
15:05Pedestrian in South 20
15:06needs a doctor.
15:07You got this?
15:08Yep, keep chilling.
15:09All hands on deck.
15:10You ready?
15:10Ready.
15:11Okay, here we go.
15:12One, two, three.
15:17I heard motor vehicle collision
15:19with chest pain
15:19and altered mental status.
15:20Me, Paula.
15:22Restrained driver
15:23versus telephone pole.
15:24altered before the crash.
15:25Good BP, but tacky.
15:26Second line
15:27and run a liter of LR wide open.
15:28Still tacky at 115.
15:30BP's 180 over 72.
15:31Airways patent.
15:32Good breath sounds bilaterally.
15:34Equals are equal and reactive.
15:36Paula, do you know
15:36what today's date is?
15:40Sats, 94%.
15:40How about the city we're in?
15:42It's, well...
15:43Bruising on the chest.
15:45Possible sternal fracture.
15:47Pericardium's clear.
15:48Good, good.
15:49No marked tenderness.
15:50Nothing in Morrison's pouch.
15:52She's a little tachypneic.
15:54I don't think she needs intubation.
15:55Might just be concussed.
15:57I'd worry about her
15:57crumping in the scanner.
15:58She's protecting her airway.
16:00I see lungs sliding.
16:01No pneumo.
16:01With a head injury?
16:02You guys are supposed
16:03to be the airway experts.
16:04Stop fighting.
16:05Make a decision.
16:06Call me when she goes to CT.
16:07Paula, can you raise
16:08your right arm for me?
16:10Good sign.
16:11Follows commands.
16:12You want to intubate
16:13with a GC as of 13?
16:14Okay.
16:15We can hold off and monitor.
16:16What's your plan?
16:16Pan scan, head to pelvis,
16:18EKG, troponin,
16:20straight cath urine
16:20for UA and tox screen.
16:22Agreed.
16:22I'm on it.
16:24Gotta bend those knees.
16:26I quit showing off.
16:27Is that what you were doing?
16:28Always.
16:30It's a 10-day course
16:32of doxycycline.
16:33One pill twice a day.
16:35I'll make sure she takes it
16:36on a full stomach.
16:38I can give you
16:39your first dose now, Piper,
16:40if you like.
16:41Get you started.
16:42That'd be great.
16:43Actually, I need Piper
16:44to answer that one.
16:46You sure?
16:46That'd be great.
16:48Okay.
16:50Hello, everyone.
16:52Looks like we're
16:52finishing up here.
16:53I come bearing gifts,
16:55everything you always
16:55wanted to know about STIs
16:57but never wanted to read.
16:58No gross pictures,
16:59I promise.
17:00I think we're good.
17:01You sure?
17:02Mm-hmm.
17:03Yeah, I learned my lesson
17:05and it won't happen again.
17:09I guess that's it, then.
17:13Well, if you change your mind,
17:15it comes with a free pen.
17:17Thank you both so much
17:19for your help.
17:19Yeah.
17:20Thanks.
17:23Okay.
17:25Good luck to you both.
17:31Fuck.
17:35That sums it up.
17:38She'll be back.
17:39Only she'll have slipped
17:40a little further.
17:41Sometimes it takes
17:42a few visits.
17:44How can I keep her here?
17:45You got anything?
17:47Maybe Kiara has
17:47a social services card
17:49to play.
17:49She was by trauma
17:50one last I saw her.
17:51Brilliant.
17:52Brilliant.
17:53Thank you.
17:53That's why I'm here.
17:55To be brilliant.
17:56And bring peace.
17:58Heart rate's 84.
18:00BP 126 over 78.
18:02Pulse ox 99 on room air.
18:03Good news, Mr. Purnell.
18:05Your heart, lungs,
18:06and belly all look good.
18:07Yeah.
18:08Just the leg.
18:10Ooh.
18:10This might be a road rash record.
18:12We might have to
18:12bust out the tape.
18:13I'm getting a little
18:14worried about Crosby.
18:15Who's Crosby?
18:16His dog.
18:16My dog.
18:17Where's Crosby?
18:18He's in a break room.
18:20I think.
18:21I'm sure he's fine.
18:22We got a lot of dog lovers
18:23around here.
18:24I'm the new owner
18:25of a nine-week-old golden doodle.
18:26Oh, nice.
18:28Crosby's a terrier.
18:30Great dogs.
18:31Determined, courageous,
18:32love to dig.
18:33Who's he named for?
18:34Sidney or David?
18:35David.
18:36Still my Sunday morning soundtrack.
18:38Oh, sorry.
18:39Yeah, anyways.
18:40Great name.
18:41So the knee looks stable.
18:43There's no laxity
18:44to suggest a torn ligament.
18:45I think the pain's
18:46probably just from the road rash,
18:47but let's get an x-ray
18:48just to be sure.
18:49Some more morphine?
18:50You're a wonderful human being.
18:51Let's start with lead.
18:52No more than 30 cc's.
18:53We're going to try
18:55a topical anesthetic
18:56to numb the raw skin
18:57before we start
18:58picking out all the gravel.
18:59Well, my morning horoscope
19:00didn't mention any of this.
19:02Well, hey,
19:03look on the bright side.
19:04Now you can tell people
19:05that you got hit by a car.
19:06Not a lot of people
19:06can live to say that.
19:07Yeah, I hope whoever hit me
19:08is rich and well-insured.
19:11I'll let him do it.
19:14Flag on the play.
19:16Positive pregnancy test.
19:17Still on a scan?
19:19Maybe she's bleeding
19:19from an ectopic.
19:21No, she delivered
19:23a healthy baby here
19:23ten days ago.
19:24Normal vaginal delivery,
19:26no complications.
19:28Pregnancy tests
19:29stay positive
19:29for a few weeks.
19:30So we good to go?
19:31Good to go.
19:32We'll let the tech know.
19:38Oh, man.
19:40She was seen here
19:40this morning
19:41by Dr. McKay.
19:42For what?
19:43Urinary tract infection.
19:45Discharged
19:45with oral antibiotics.
19:47Think it has something
19:48to do with the crash?
19:49Yes, no, maybe.
19:51Ask me again
19:52after I've had
19:53the scans, labs,
19:54and talk screen.
19:56Wow.
19:58No.
19:59Okay.
19:59Um, so...
20:01I need to talk
20:02to you about something.
20:03About what?
20:04Do me a favor.
20:05Look at me
20:06and don't turn around
20:07and just watch the other things.
20:09I told you not
20:09to turn around!
20:15I wish there was
20:16a way to keep it,
20:16but there just isn't.
20:18Well, then fuck it.
20:19We'll just say
20:20that we need
20:20another urine sample.
20:21that the lab
20:22left the last one
20:23out too long
20:23and couldn't culture it.
20:25Okay, then what?
20:26I'll give Piper
20:27the sample cup
20:27and send it down
20:28the hall to the bathroom.
20:29I'll stay with Laura
20:30in the room
20:30with some bullshit.
20:31You wait for Piper
20:32by the bathroom.
20:33To say what exactly?
20:34I don't know.
20:36It'd just be
20:36another voice saying
20:38I see you're in danger?
20:39There are limits
20:40to what we can legally do,
20:41but I can try
20:42to talk to her.
20:43Thank you.
20:46Hi, it's Dr. McKay again.
20:48Can I come in?
20:52Sorry.
20:54Yeah.
20:56Well,
20:57it was a long shot anyway.
21:00Hi.
21:01I think Piper took a pen.
21:04Yeah.
21:11Temp is 103.2.
21:13Nice, almost there.
21:15Oh, my God.
21:16There are literally
21:17hundreds of different
21:18MDMA pills.
21:19And the milligram
21:20dosage ring
21:21is all over the place.
21:22These names.
21:23BMW 5,
21:25Jurassic Park,
21:26Red Superman.
21:27Well,
21:28why is she seizing?
21:29Uh, febrile seizure?
21:30No, her temp is down.
21:31Maybe she needs
21:32more Ativan.
21:32No, she's had 20 already
21:33and the vitals
21:34will stabilize it.
21:35Another four of Ativan
21:36and Pipergram pepper.
21:37I don't think
21:37this is a CNS problem.
21:40She needs saline.
21:42We don't have
21:42that yet.
21:43At festivals,
21:44you dance for hours,
21:45you sweat,
21:46you drink gallons of water,
21:47but nobody thinks
21:48to replenish their salts.
21:49It's low sodium,
21:50hypernatremia.
21:51She needs 100 cc's
21:52of hot saline.
21:52We don't know
21:53her sodium levels.
21:54Just drop 100 cc's
21:55of 3% and have it ready,
21:57okay?
21:58Do it.
21:58And Pipergram pepper,
22:00now.
22:14Start the cap row,
22:15please.
22:15It's not gonna help.
22:17Problem one.
22:18What are you doing?
22:20Got it.
22:21Thanks.
22:22It's hypernatremia.
22:23Serum sodium is critical,
22:24only 112.
22:25Knew it.
22:26Okay, I'll push
22:27the other 50 cc's.
22:28What the hell?
22:30She's seizing.
22:31You think?
22:31How long?
22:32About three minutes.
22:33Why did you not
22:34come get me?
22:34Hello?
22:35I was across the hall.
22:36I was 30 feet away.
22:37What did she have already?
22:40It's hypernatremia.
22:42We pushed 100 cc's
22:43of 3% saline.
22:44That did the trick.
22:44Again, why did you
22:45not come get me?
22:47It was my fault.
22:49Yeah, I wanted to keep
22:51going with Ativan and Keppra,
22:52but Dr. Mohan had
22:53an excellent idea
22:54to treat for hypernatremia
22:56even before her labs
22:56came back.
22:58Temps down to 102.4.
23:00Good call, Dr. Mohan.
23:02Another minute
23:03more de-eyes her.
23:04I am going to take
23:05that minute to try
23:06to instill in Dr. Santos
23:08a very clear understanding
23:09of what her role is here
23:11and how she's expected
23:12to function.
23:13Dr. Langdon.
23:14Dr. Santos.
23:16When I say doctor
23:17in such a fashion,
23:18to draw attention
23:19to the ridiculous fact
23:20that you have enjoyed
23:22that title for, what,
23:2390 days?
23:24So, yeah, I'm confused.
23:26Is it hubris or ignorance
23:29that makes you think
23:29that you know more
23:30than other residents
23:31that have two to three
23:33years more experience
23:34and have helped
23:34thousands more patients
23:36in the emergency department
23:37than you have?
23:38Not to mention
23:38the over 500 hours
23:40of advanced training
23:42with lectures
23:43in simulation labs
23:44with senior faculty
23:45instruction.
23:45It doesn't matter!
23:47Stupid or arrogant,
23:48you need to realize
23:49that you are a beginner,
23:50which means your job
23:52is to shut up,
23:53listen, and learn
23:53because so far today
23:54the only thing
23:55you have been successful at
23:56is proving repeatedly
23:57that you know nothing.
23:58Dr. Langdon?
24:01is the patient stable?
24:05Temps one and two,
24:05just about to take her
24:06out of the ice.
24:07Proceed.
24:07Dr. Langdon,
24:08a word, please.
24:16Look, I know that
24:17sounded rough,
24:18but you only caught the tail.
24:19I can give you a list
24:20of my...
24:21Stop talking!
24:21She was giving you
24:21unsupervised...
24:22Knock it off!
24:23Shut the fuck up!
24:25Where does it say
24:26that shaming, belittling,
24:27and insulting
24:28are effective teaching tools?
24:30Let me just tell you,
24:31harassment has zero
24:32educational value.
24:33You feeling upset?
24:34She's getting under your skin?
24:35Check yourself.
24:36Take a break.
24:36I've been watching you ride her.
24:38this kind of behavior
24:39will not be tolerated.
24:41I don't want to see it.
24:43I'm sorry.
24:44It won't happen again.
24:45Where's your other one?
24:46Where's Mel?
24:47She's taking a break.
24:48Yeah, well,
24:49maybe go find her
24:49and see if you can
24:50get her back in the game.
24:51You are senior leadership here.
24:54Step up and act like it.
25:06Wow, you came prepared.
25:09Uh, better safe than sorry.
25:12Uh, sorry I took off like that.
25:14I have a thing about rats
25:15and cows.
25:16Totally freaked me out.
25:17Really?
25:19Oh, there's plenty of both
25:21where I come from.
25:22They're, um,
25:22you know, pretty harmless.
25:24Let's hope, Mr. Coco.
25:25does now, too.
25:26Yeah, no kidding.
25:28Okay.
25:37Is this the guy?
25:38Yes.
25:40Hey, man.
25:41It's Dennis Whitaker.
25:43I just wanted to say sorry
25:44for earlier.
25:46I heard I got you pretty good.
25:48Yeah.
25:49I kind of go out of my head
25:51when I'm off my meds.
25:53Then I guess I piss on
25:54people.
25:56I'm pretty sure the meth
25:57doesn't help.
25:59I'm not using it anymore.
26:01I take Gansai psychotics
26:02for the schizophrenia
26:03I got from doing meth,
26:05but I've been
26:07clean a year.
26:10Why aren't you taking your meds?
26:11Why don't I take my meds?
26:13Well, Doc,
26:14I'm kind of in between houses
26:15right now,
26:16living in an encampment
26:17on Liberty Avenue.
26:19It costs money.
26:20I don't have insurance.
26:23Should I go on?
26:24No, no, no.
26:24That's fine.
26:26I'm sorry.
26:31Life
26:33isn't always easy.
26:37Have you talked
26:37to a social worker yet?
26:39No.
26:39Do you think you
26:41could go grab
26:42Chiara in here?
26:47I really am sorry.
26:49It's okay.
26:50Honestly,
26:51really,
26:51it's okay.
26:53I appreciate the apology.
27:02This must be Crosby.
27:05I've read a lot
27:06about you, buddy.
27:08I was my least
27:09problematic trainee.
27:11Well, technically,
27:12you're all pretty green,
27:14but you're growing on me.
27:15Thank you.
27:16So,
27:17how are you doing?
27:20Um,
27:21good.
27:22Better.
27:23Yeah?
27:25It's,
27:26I mean,
27:27it's just,
27:28it's the,
27:29um,
27:29the little girl
27:30and the sister
27:30is just
27:32too close to home.
27:34The things we do
27:35are hard.
27:36Yeah.
27:38You're,
27:38uh,
27:40sitting here
27:42feeling like,
27:43like maybe
27:44you're not up to it.
27:46Yeah.
27:48Been there.
27:50We all been there.
27:53Mel,
27:53you're a sensitive person.
27:57This,
27:58this is,
27:59uh,
27:59a tough place
28:01for sensitive people,
28:02but we need them
28:03badly.
28:07Now,
28:09if you're ready,
28:11I need you.
28:12It's a perfect job.
28:14It's practically
28:15a zen exercise.
28:16I've got
28:17a thousand pieces
28:18of gravel
28:19that need to be plucked
28:20out of a two-foot-long
28:21road rash.
28:23A thousand?
28:24Yeah.
28:25Give or take a hundred.
28:27South 20.
28:29Make sure you close
28:30the door behind you.
28:31Don't want Crosby
28:32to get now.
28:33Yeah,
28:33no,
28:34thank you.
28:34No problem.
28:35I'll,
28:35I'll be right there.
28:38That's a lot of gravel.
28:40It looks clean to me.
28:42You feel that,
28:42Earl?
28:43Feel what?
28:44That's a no.
28:45All right,
28:45now I just apply
28:46the dermal bond.
28:47Cool.
28:48Um,
28:50can I ask you something?
28:52That's why I'm here.
28:53Um,
28:54yeah,
28:54I was just wondering
28:55what the nurses do
28:56after their shifts.
28:58In terms of what?
28:59Um,
29:00you and I
29:00never,
29:00like,
29:00go out together.
29:02like hanging out
29:03to decompress
29:03after a shift,
29:04you think?
29:05Yeah,
29:06sometimes.
29:07I mean,
29:07most of us
29:08are just happy
29:08to get the hell
29:09out of here.
29:10Personally,
29:11I'm all about
29:12a long,
29:13long hot shower,
29:15comfy sweats,
29:16eating some takeout
29:17in front of the TV,
29:18ideally watching something
29:19that makes me laugh.
29:21Yeah,
29:22I can see that.
29:24I'm not imagining it
29:25in my mind,
29:25of course,
29:25I just mean that
29:26I can,
29:26I can see the appeal.
29:28Um,
29:29I was just asking
29:30because,
29:31you know,
29:31since we worked together,
29:34maybe we could
29:35grab a coffee together
29:36sometime
29:36and could,
29:37like,
29:37help me get the lay
29:38of the land,
29:39so to speak.
29:42You asking him out?
29:43No,
29:44what?
29:44No,
29:45no,
29:45it's just that
29:46I'm,
29:46I'm,
29:46I'm new here,
29:47so I just thought,
29:48I don't date people
29:49in the workplace.
29:50It's nothing personal,
29:52just,
29:52it's never a good idea.
29:54No,
29:55no,
29:55of course not,
29:56no,
29:56no,
29:57I just,
29:57no,
29:58it's not a good idea.
29:58No,
29:59of course,
29:59I just thought that
30:00since you,
30:00you know how
30:01everything operates here
30:02and you,
30:02like,
30:02have everything
30:02so dialed in
30:03that you would be,
30:04like,
30:04a valuable resource,
30:04but,
30:05um,
30:05no,
30:06no,
30:06I just figured it out
30:09on my own.
30:12No shortcuts here.
30:14How do I train you,
30:15Earl?
30:17Huh?
30:17So you rang it yourself
30:18and had a sandwich?
30:19Feel like I'm
30:20washing around,
30:21come.
30:23Just came by
30:23to see if I could
30:24take Dr. Javadi
30:25on a reconnaissance
30:25through chairs?
30:26Yes.
30:27I mean,
30:28sorry if you think
30:29that's...
30:29Of course.
30:30Of course,
30:30I can finish up
30:31my man years.
30:32Great.
30:40You okay?
30:41I feel ridiculous.
30:44Spoken like
30:46two complete sentences
30:48in the last half hour
30:48and both of them
30:49have made me sound
30:50even more imbecile
30:51than the incomplete ones.
30:53You attribute that, too.
30:56It's like my parents
30:57once took me skiing
30:58for Christmas in Utah
30:59and from the moment
31:00I got off the plane
31:00I just,
31:01I could not
31:02catch my breath.
31:03No matter how hard
31:04I tried to see altitude
31:05it made me feel
31:05just, like,
31:06awkward
31:07and uncoordinated.
31:08I couldn't concentrate.
31:09I couldn't get my bearings.
31:11And I'm a very good skier
31:12but I spent the whole vacation
31:13just, like,
31:13on my butt.
31:14Dizzy
31:15and panting.
31:18But I was like
31:18a human, Utah.
31:20Ha!
31:22Oh, I mean,
31:23I've worked
31:24with a few Utahs.
31:25I wish you
31:26many, many Utahs
31:27in your life.
31:30Jesse,
31:31where are you going?
31:32Trauma 2.
31:32Stop, stop, stop, stop.
31:33I'm not back in there.
31:35I'm not even
31:36going to tell you why.
31:37How's she doing?
31:38Still with some
31:39thoracic pain.
31:40Oh, hey, Paula.
31:41I'm Dr. Collins.
31:42Your CT shows
31:43that you have
31:43a broken sternum.
31:44That's your breastbone
31:45right here.
31:46Probably from the shoulder
31:47belt when you
31:48crashed your car.
31:50and hit your head.
31:51With a concussion,
31:52sometimes you
31:53don't remember,
31:53but your head CT
31:54doesn't show
31:55anything serious.
31:57So, I saw
31:58on your chart
31:59you're a new mom.
32:00How's your baby doing?
32:02He's good.
32:03He's with my mom.
32:05South 15's open.
32:07Oh, hey,
32:07Dr. McKay?
32:08Just get the bed
32:08out of 15.
32:09A patient you saw
32:10this morning
32:10came back as an MVC,
32:11sternum fracture,
32:12slightly concussed.
32:13Oh, no.
32:14Paula,
32:14do you remember me?
32:15You look familiar.
32:16I was your doctor
32:17this morning
32:17for your bladder infection.
32:19Sorry,
32:20I'm a little out of here.
32:21Still tachycardic
32:22115,
32:23VPs 124 over 78.
32:25No bleeding anywhere
32:26on the CT.
32:27Chest and abdomen
32:28clear apart
32:29from the sternum fracture.
32:30He'll probably still
32:30attack you
32:31from the fracture pain.
32:33Let's try four of morphine.
32:35Paula,
32:36we're gonna give you
32:36some pain meds.
32:37Let me know
32:37if it helps,
32:38okay?
32:40Mr. Pernell,
32:41you are in luck.
32:42If I had to have
32:43gravel meticulously
32:44picked out of my leg,
32:45this is the person
32:46I'd call,
32:46Dr. Mel King,
32:47detail specialist.
32:48Hello.
32:49I love your dog.
32:50Crosby?
32:51How is he?
32:52Oh, he's great.
32:52Here,
32:53something helps you up close.
32:54Hey,
32:55I don't want to be
32:56one of those people
32:57who say they need
32:57an emotional support animal,
32:59but is it possible
33:00he could be with me?
33:01We could tie his leash
33:02to the bed.
33:03He wouldn't be
33:03in any trouble,
33:04I swear.
33:04What do you think?
33:05I'm happy to go get him.
33:07Any pain here?
33:08No.
33:09Okay.
33:09You go get the dog.
33:11You get to work.
33:12I am gonna get
33:12some more gauze
33:13from triage.
33:14And just in case,
33:15if anybody asks,
33:16just say you need him
33:16for anxiety.
33:18Okay.
33:19Thanks.
33:21I know you hear me.
33:23You can pretend you don't,
33:24but I know you do.
33:27This glass might be bulletproof,
33:29but it ain't soundproof,
33:30huh?
33:31Hello?
33:32Can you hear me now?
33:33Huh?
33:34Hello?
33:35Whoa, whoa, whoa.
33:35Sir, sir,
33:36what is the issue?
33:37Same issue.
33:38I've been here all day,
33:39and you people
33:40have done nothing
33:41to fucking help me.
33:42We're still waiting
33:42on your second troponin.
33:43We can't clear you medically
33:45until it comes back.
33:46For instance,
33:46if it comes back elevated,
33:47that could indicate
33:48a silent heart attack,
33:49and you'd need to be admitted
33:50from monitoring
33:51in a cardiology consult.
33:52That's all I'm asking for.
33:54I'm afraid I've had
33:55a silent heart attack.
33:56I just want someone
33:57who knows something
33:58about hearts
33:59to tell me
33:59what's happening to me.
34:00You know,
34:01unlike most of these losers,
34:02I have insurance,
34:03good insurance,
34:04and I pay my taxes,
34:06which pays for them
34:06to not have any insurance.
34:08Sir, you've got
34:08about five seconds
34:09to change your whole attitude
34:10before security
34:11and the police
34:11get involved.
34:13Fuck it.
34:14I'm leaving.
34:17Hey!
34:18Hey!
34:19You are absolutely
34:20free to go,
34:21but if you do,
34:22you will be leaving AMA
34:23against medical advice.
34:25This form states
34:26that I have advised you
34:27to stay and complete
34:28your evaluation,
34:29but you are choosing
34:30to leave,
34:31understanding,
34:31and accepting all risks
34:33of heart attack,
34:33stroke, disability,
34:34and death.
34:40Sounds like a CYA form
34:42in case I drop dead
34:42on the curb.
34:43That's exactly what it is.
34:46I just want to be
34:47treated fairly.
34:49I assure you
34:50that is our intention.
34:52We are not back here
34:53playing go fish.
34:54We're doing our best
34:54to help some very sick people.
34:56You will be seen, okay?
35:04Robbie's going to love
35:04that patient satisfaction score.
35:07Crazy people.
35:13What's going on?
35:14Car crash
35:15because Paula
35:15just went south.
35:16BP's crashing
35:1784 over 62,
35:18much less responsive.
35:19Leader of LR wide open?
35:20Putting her on a 100%
35:21hour brainer.
35:22Paula, open your eyes.
35:23Paula.
35:24This is the morphine?
35:25She only got a small dose.
35:27Both socks is down to 89.
35:28Set up for intubation
35:30and...
35:30McCaite, get Robbie in here.
35:33I'll call ICU
35:34and get her bumped
35:35ahead of Joyce
35:35or Sickler.
35:36She should get the next bed.
35:38Between the hypothermia
35:39and the seizure,
35:40she's going to be out of it
35:40for a while.
35:41A similar thing
35:42happened to a friend of mine.
35:43Is that what made you
35:44think of hyponatremia?
35:45Look, I know you value
35:46evidence-based medicine,
35:48but sometimes experience
35:50counts for something.
35:54May I ask why you did that?
35:56What?
35:57Took the blame
35:58for a delay in care
36:00which didn't belong to you.
36:02and gave me credit
36:03for a safe that did
36:04belong to you.
36:05You know, I've been on
36:06Langdon's shit list all day.
36:08Seemed like he was
36:09going to be more upset
36:09about us not calling him in
36:11than glad that we
36:11stopped the seizure,
36:13so no reason for him
36:15to be pissed at both of us.
36:16Why have you been
36:17on his shit list?
36:18Well, I think he made it
36:20very clear that he thinks
36:21I don't have what it takes
36:22to make it here.
36:24Whether you do or do not,
36:25it was completely
36:26inappropriate for him
36:26to speak to you that way.
36:28Meh.
36:29I've heard worse.
36:30Well, for what it's worse,
36:31he's wrong,
36:33You're very good at this.
36:36Thank you.
36:38It's actually worth a lot.
36:41I thought the CTs were normal.
36:43They were.
36:44Systolic's down to 70,
36:44heart rate's up to 130.
36:46100 of ketamine,
36:46100 of rock.
36:47Does she have delayed bleeding?
36:48It's not the chest.
36:49Pericardium's still clear.
36:50No tamponade,
36:51good EF,
36:51lungs are up.
36:53She feels warm.
36:54Well, check her tent.
36:55Ned's on board.
36:56Belly is clear,
36:57no bleeding here.
36:58She's loose.
36:58Okay, go for it.
37:03I see cords.
37:04Looks good.
37:06I'm in.
37:07Connect the bag.
37:08Nice.
37:10Good breath sounds bilaterally.
37:12Temp is 102.4.
37:13What?
37:13Is this septic shock?
37:14Okay, we need to assume
37:15the worst here.
37:16Code sepsis,
37:17two sets of blood cultures,
37:18lactate,
37:1830 per kilo of LRN4,
37:20antibiotics of triaxone?
37:22No, no,
37:22she was just in the hospital.
37:23Peptazo and Beko.
37:24Got it.
37:24If this is sepsis,
37:26where is it coming from?
37:27What's the source?
37:27Friginary tract infection.
37:29She doesn't have one.
37:29She did when I saw her.
37:30It's not a UTI.
37:31We catheterized a year
37:32and a half an hour ago.
37:32There's no nitrates,
37:33zero WBCs.
37:35Your specimen
37:36could have been
37:36contaminated this morning.
37:37Is it pneumonia?
37:38Chest CT negative.
37:40Abdominal CT negative
37:41for an infectious source.
37:43She was altered meningitis.
37:44She's postpartum.
37:45Ugh, endometritis.
37:47Yes, the CT of the uterus
37:49shows a thickened endometrium,
37:51but that's normal postpartum.
37:52No retained POCs.
37:53It still could be the source.
37:54We'll do a pelvic
37:55after she's stable.
37:57Mr. Krakosha,
37:58here's my obvious concern.
38:00I write you a script
38:01for 30 days worth of pills.
38:05Then what?
38:06What do you mean?
38:06I'll take them.
38:07Well, you come back
38:09for 30 more, right?
38:10I mean, that's the question.
38:12Even if I could give you
38:13your dose in a once-a-month shot,
38:15you still have to come back.
38:16when the month is over.
38:18What if he didn't have to?
38:20Oh, no, he has to.
38:21If he doesn't, he...
38:22Well, he pees.
38:24We have a street team here.
38:25Mr. Krakosha,
38:26are you pretty much
38:27in one spot these days?
38:29Yeah, well, we're on liberty.
38:30There's Ben and Dumb.
38:31The alley?
38:32I know it well.
38:33So we could bring
38:35the meds to him?
38:36Absolutely.
38:37The once-a-month injection
38:38sounds like the easier option.
38:40We could just put you
38:40on our schedule.
38:41Uh, I'd be interested
38:44in joining that.
38:45And maybe I can bring out
38:46the medicine myself.
38:47That'd be amazing.
38:48We could use all the help
38:49we can get.
38:50Thanks, Doc.
38:54Yeah.
38:54Burulent drainage
38:56from the cervix.
38:58Got the culture?
38:59Oh, looks like
39:00we have our sores.
39:02The positive urine
39:03this morning
39:04was contaminated.
39:05Maybe.
39:06Definitely.
39:08Not-so-clean-catch specimen.
39:11This infection's
39:12been brewing for a while.
39:13So the car crash
39:14was a coincidence?
39:15Not necessarily.
39:17She was probably
39:17already septic
39:18as the disease progressed.
39:19Dropped her BP
39:20and passed out while driving.
39:21And she wasn't hypotensive
39:22when she arrived.
39:22Adrenaline rush
39:23from the car crash
39:24and the sternal fracture
39:25raised your BP
39:25but not for a while.
39:26No.
39:27No history of fever.
39:29Bet she was taking
39:30Tylenol for the pain.
39:31Let's call ICU
39:31for an admit.
39:32Also one guy
39:33to see her.
39:36I mean,
39:37she had mild
39:39lower abdominal pain
39:40and a positive urine dip.
39:41No fever,
39:43no back pain
39:43to indicate
39:44pyelonephritis.
39:45She was alert,
39:46walking, talking.
39:48It just seemed
39:48like a simple UTI.
39:50I saw no reason
39:50to have her wait
39:51eight hours
39:52for a bed
39:52for a pelvic exam.
39:58Okay.
40:04Every postpartum patient
40:05needs a pelvic exam
40:06to rule out
40:07endometritis.
40:08Wait,
40:09you're saying that
40:10with 20-20 hindsight.
40:12Did you ask
40:12about Tylenol
40:13or ibuprofen use?
40:15Because that
40:15could mask a fever.
40:17There was no fever.
40:18Did you do
40:18a careful abdominal exam?
40:20It was a quick chair exam
40:22and there was only
40:22mild tenderness
40:23over the bladder.
40:24Perhaps
40:26there was something
40:27about the patient
40:27that made you
40:28overlove proper treatment.
40:32Like what?
40:34Other than the obvious
40:35health risk factors.
40:37Her size doesn't
40:38inherently make her
40:39unhealthy.
40:40Are you saying
40:41I was biased
40:42against the patient
40:42because of her weight?
40:43I raise it
40:44as a possibility
40:45not as an accusation.
40:47Wow.
40:48I mean,
40:49I really don't think
40:50that's the case here
40:52but I will look out
40:53for it.
40:55Yeah.
40:57You were good with him.
40:59Do you get a lot
41:00of homeless in Pittsburgh?
41:01We call them unhoused.
41:02It's not as bad
41:03as Philly or D.C.
41:04but it's still pretty bad.
41:05Yeah.
41:05It really is great
41:06that you want to help out.
41:08The street team
41:08get cool jackets.
41:10Yeah?
41:10Come find me
41:11in the shift
41:11and I'll give you
41:12more information.
41:13I will do.
41:15You made it out
41:16unscathed this time.
41:17Yeah.
41:18I'm joining the street team.
41:20Even got a jacket.
41:22So...
41:22Well...
41:25Yeah.
41:26It is cool.
41:27Very cool.
41:33Who's Boach?
41:34Ralph Twenties.
41:35I'm taking him
41:36for a visit.
41:37This is Crosby.
41:38Hello.
41:39I'm going for a smoke
41:40if anyone asks.
41:41He's an emotional...
41:42Support animal.
41:43I know.
41:44I got it.
41:47Oh!
41:50Crosby!
41:51Hey, heads up.
41:52Crosby!
41:52Oh!
41:54Drop it!
41:55Drop it!
41:57Whoa.
41:58Is it good?
41:59Yeah, that's it.
42:05Gotcha.
42:06Come on.
42:08Crosby!
42:09Crosby!
42:09Come here, buddy.
42:10Come here.
42:11There you go.
42:12Shit.
42:13Shit.
42:16Oh!
42:18Good work.
42:19There you go.
42:20Good work.
42:21Good work.
42:21Good work.
42:22Good work.
42:22Good work.
42:28You got a rat, didn't you?
42:30Yeah.
42:31He does that.
42:32Yeah.
42:34When do those cops get in?
42:35Uh, I don't know.
42:37Who called them?
42:37I don't know.
42:38Where's Dana?
42:39Again, I don't know.
42:40Thank you.
42:41Anytime.
42:49Hard at work.
42:51Hard at work?
42:53I'll take my chances.
42:55Jesus.
42:55Just go.
42:59Oh.
43:01Oh.
43:04Oh.
43:06Oh.
43:07Oh.
43:08Oh.
43:09Oh.
43:09Oh.
43:10Oh.
43:11Oh.
43:11Oh.
43:12Oh.
43:12Oh.
43:13Oh.
43:14Oh.
43:15Dude.
43:24E storm.
43:32MÜZİK
44:07MÜZİK
44:34MÜZİK
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