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The Pitt - Season 1 - Episode 10: 4:00 P.M.
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00:10you
00:11You know your son is now
00:12No, but he hasn't done anything
00:15Officer, why are you here? We received the call that her son David has created a list of girls you
00:20would like to eliminate
00:22Who called you?
00:23You know anything about this list? Somebody called you who somebody from my hospital?
00:27uh
00:29Dr. McKay
00:32Who is that?
00:35I'll be right back
00:41Teddy 28 years old burned in a gas tank explosion paramedics estimate 90% BSA trauma ones open
00:48We managed to get a 20 gauge in the right AC first leader of LR running wide open
00:52Vitals are good pulse ox 97. Teddy are you in a lot of pain right now?
00:55Not as much as I should be
00:58Okay
01:01Mainly third degree
01:03Singed nasal hairs, soot and oropharynx
01:06Do you have family on the way?
01:08Amy, my wife
01:09What happened?
01:11Please transfer gas from a 200 gallon field tank to my tractor
01:16Let's set up for intubation, Whitaker run the parkland formula
01:19Okay, titrate morphing page, Garcia
01:21And I will be back for the intubation
01:22On it boss
01:26Don't touch me
01:27I'm fine
01:29Jesus fucking Christ
01:35It's okay
01:36Okay, okay, okay
01:38Holy shit
01:39Grab an ice pass
01:40I got the cart
01:42What happened?
01:43Just got punched
01:44Just took a pull
01:46Oh my
01:47Who punched you?
01:48Just an unhappy patient
01:50A patient hit you?
01:51Happens all the time
01:52Got my cheek broken
01:53I lost it too
01:54Oh
01:55We've all been assaulted
01:56Go get our mod
01:58Did you use your hands?
01:59Ah, yep
01:59Probably
02:00But
02:02No LSCs
02:03Just a bloody nose
02:04I'll give pressure
02:05Okay, okay, okay
02:06Any trouble seeing any double vision?
02:08No
02:09I'll grab you a few scrubs
02:11What about headache?
02:12Hello
02:13You need to find her a room
02:14I do not need a room
02:15Dave, move north one of the hall
02:16Found my finger
02:18Right
02:19Left
02:20Up
02:21Down
02:22Hey
02:22New arm was intact
02:24Who did this?
02:26He's a pissed off patient, but he splits
02:28It's just forget
02:28Forget?
02:29Hell no
02:30Look, I want a name
02:33Doug Driscoll
02:34Doug Driscoll
02:35The asshole on chairs
02:37Yeah
02:37Let me
02:38Call in the cops
02:39I'll get a wheelchair
02:41Peebles are equally reactive
02:45No septal hematoma
02:47Should someone call your husband?
02:49Absolutely not
02:50Okay
02:52Tell me when it's sore
02:57Tendered to nasal CT head maxillofacial
02:59I'll give them a heads up
03:00Is that really necessary?
03:02You have at least one facial fracture
03:04With the headache and the fall
03:05I won't let anything train you
03:08Okay, who can step up for Dana while she's getting checked out?
03:11Her left
03:12Thank you
03:16Okay guys, we've got about three hours left in this shift
03:19And I need everybody to step up, is that clear?
03:21Yeah, yeah
03:21Yeah, yeah
03:23I can't believe they allow you around med students, Langdon
03:27Don't pick up any of his bad habits
03:28You know the difference between surgeons and serial killers?
03:31Serial killers don't build their victims
03:32Do it
03:33You guys staying ahead with his flutes?
03:34Uh, per the parkland
03:35Four per kilo times 90% burned
03:37Wow
03:3827 liters over 24 hours
03:40He's had two so far
03:42Lactated ringers
03:421.785 liters per hour for the next seven hours
03:45I'll program the pump
03:46We got a second IV
03:48Hello sir, I'm Dr. Garcia
03:50Need to peek under these dressings
03:51Are we ready to intubate?
03:53Wife should be here intubate
03:55Whittaker
03:56Earlier you said third degree
03:58We refer to burns as either being full thickness or partial thickness
04:01Looks like 60 to 70% full, 20 to 30% partial
04:04Intubation meds
04:05120 rock uranium, 100 ketamine
04:07Got it
04:07Draw them up and hold them
04:08Vitals are good, but gonna need a pan scan after intubation
04:12Oh my god
04:14Oh my god
04:15No, no, no
04:15Teddy
04:18I'm Amy, I'm Teddy's wife
04:19How is he?
04:20He's stable for now
04:21I'm okay, honey
04:22Okay
04:23Teddy, you've got severe burns covering most of your body
04:26You've also burned the inside of your throat
04:28Just to be safe
04:29I need to put in a breathing tube and you won't be able to speak
04:32We need to do this now before his throat swells and it becomes difficult for him to breathe
04:36So if there's anything you two want to say to each other, this is the time to do it
04:41It's okay
04:41I think I'll be okay
04:46Can I kiss him?
04:47Yes, of course
04:56Okay
04:57Ready to intubate
04:57Push ketamine then rock
04:58Get right here
04:59Coach Stroke, emergency department
05:01Coach Stroke, emergency department
05:03Coach Stroke, emergency department
05:03Ketamine's going in
05:04Okay, I will be right back
05:09Jane Doe, looks like you're in her twenties
05:11Obvious aphasia, right side of hemiparesis and facial drip
05:14Hi, what's your name?
05:16Nod your head if you understand
05:18Receptive and expressive aphasia?
05:20No motor strength in the right arm
05:21Open your mouth
05:25Gag reflex present?
05:27Left motor intact
05:29BP is 150 over 88
05:31Where should we go?
05:32Accu check is 73
05:33Straight to radiology
05:34CT brain without contrast
05:36Perfusion scan
05:37CT angio head and neck
05:38Hey Crow, anybody?
05:39Yeah
05:40So you didn't get a name on her?
05:42Uh, we looked
05:43Couldn't find a wallet or an ID
05:44But we had to jam out of there
05:45Because it was a code stroke
05:46Who called 911?
05:47Well, apparently our Jane Doe is a professional gamer
05:49She was a no-show for some big tournaments
05:51So her teammate in Dubai calls another teammate in Houston
05:54Who called 911 here?
05:55Who gets a stroke in their twenties?
05:57That's what you get to figure out
05:59Okay, come find me after the scan results are back
06:06You called the cops on David Saunders?
06:08I did
06:09Mom!
06:12Harrison?
06:13Hey!
06:14Hey!
06:15Are you okay?
06:17How'd you get here?
06:18With Dad
06:19Chad Ashcroft, 39, skateboarding accident
06:22Deformity of the right ankle
06:24No LOC, good vitals
06:26Got four of morphine en route
06:28Skateboarding, really?
06:30I'm fine, by the way
06:31You know this guy?
06:33You know this guy?
06:35Mmm, looks trimaleler
06:38What are you doing for this location?
06:40You think I want to be in this shithole?
06:41I told them to take me to Presby
06:42You were the closest hospital, so here we are
06:45Where should we put him?
06:47On the curb?
06:48Are you two family?
06:50Are you two family?
06:50X
06:50This is Chad, Harrison's dad
06:56Nice to finally put a face to a name
06:59What's open?
07:01McKay, stay with your kid
07:02Let's take this half-pipe Prince to South 19
07:11Hey, what's the golden rule?
07:13No hospitals
07:14Okay, let's add
07:15No skating without a helmet ever again
07:18You hear me?
07:19Yes, Mom
07:24When was the last time you took a bath?
07:28Where's Robbie?
07:30Intubating the burn patient
07:33Ma'am, can you close your eyes for me?
07:37Robbie, it's Amira
07:38The endo CT came back
07:40No bleed
07:41But there's a carotid artery dissection left neck
07:44With a thrombocythero clot to the left middle cerebral artery
07:49Okay, got it, we'll wait
07:52With no intracranial hemorrhage, she might be a TNK candidate
07:55But couldn't TNK cause a brain bleeding killer?
07:58TNK is still the best clot-busting possibility
08:00Um, shouldn't we do endovascular therapy?
08:04I mean, it's the safest option to
08:06What do you call a Tyrannosaurus under stress?
08:11What?
08:12Mervous Rex
08:13Dr. King, meet Dr. Mehta
08:15One of our esteemed stroke neurologists
08:18How's the patient?
08:19An eye stroke scale of 27
08:21No last known well time
08:24Dr. Mehta, should we take her to EVT?
08:27Not yet
08:28Take first spin in the MRI
08:29Check for irreversible damage first
08:31There's a diffusion flare mismatch
08:33She's still in the window for thrombolittings
08:35And she still gets AVT
08:36Two for one special
08:40What type of person is best suited to work with an MRI machine?
08:44A trained technician
08:45Someone with a magnetic personality
08:49That one's new
08:53Somebody punched her?
08:55A patient
08:55Broke her nose
08:56Is she okay?
08:58Robbie checked her out
08:59Sent her to CT
08:59Sorry to interrupt the hot goss
09:01But what about me?
09:03Uh, you got some pretty good cuts here, sir
09:06We're working on closing them up to prevent infection
09:09Can you call in a plastic surgeon?
09:11Uh, the lacerations aren't that deep
09:15Medical glue should do the trick
09:16If you have any extra, do you want to maybe apply some to his lips?
09:20Your son was worried about you
09:22Wanted to make sure you were okay
09:24Are you okay?
09:25Yeah, totally
09:26Just a few battle wounds
09:28Uh, did you hear?
09:29Dana got assaulted
09:30What?
09:31A patient broke her nose
09:32When can I get out of here, please?
09:34We're waiting for radiology to come down with a portable x-ray machine
09:39So we can take a better look at your leg
09:42You'll need a splint and eventually a cast
09:44Oh, I hear that
09:45Your dad's gonna have a cool cast
09:48Big Harry in the house, up top
09:49Lataya!
09:52I told my dad that we were skateboarding last weekend
09:54Ah
09:55So he took me today
09:57And then he fell and broke his leg
10:00Yeah, I can see that
10:02Hey man, Mateo
10:03Hey
10:05Ugh
10:07Wanna go raid the break room with me?
10:09I hear there's a bag of Takis with your name on it
10:12Sure, yeah, yeah
10:14But not too much sugar
10:15Says that my name is Captain Crunch for breakfast
10:17No, not anymore
10:18Chloe makes me an acai bowl every morning
10:21Oh, Chloe
10:23A gift that keeps on giving
10:25I already apologize for that
10:28How are those last coming, Dr. Santos?
10:31Good, all done
10:32Mm-hmm, would go check on radiology
10:34I'll come with you
10:35Sooner we get you in, sooner we get you out
10:37Thank you
10:47No
10:48Dr. McKay
10:50Somebody hit Dana?
10:51I specifically told you to leave Teresa Saunders alone and call the cops on her son
10:55We talked about it
10:56A decision
10:57A decision was not made
10:58So I made it
11:00It was not yours to make
11:01No, it was yours and you didn't do it
11:03I didn't do it because it wasn't warranted
11:06Wasn't it?
11:07If Teresa left, how are we gonna get David assessed for his risk to others?
11:11I couldn't live with myself if something terrible happened
11:13Yeah, well, now the police are involved so you may ruin this kid's life forever
11:17And what about the girls on this list?
11:20Are you telling me their safety, their lives are worth less than his?
11:25I can live with this one, and now you can too
11:30Uh, distal tibia and fibula with an unstable mortis
11:44Hold on, show us the lateral, please
11:47Here you go
11:51Not two, three breaks
11:53Jesus
11:55Wait, so now I gotta cast?
11:56Uh, no, a splint
11:58And then surgery to stabilize the bones with plates and screws so they can heal properly
12:02How long am I gonna be stuck here?
12:04That is above my pay grade
12:07Gabriel
12:08You may want to cancel any dinner reservations you may have
12:12Set up for a double splint, posterior leg, and sugar tongue
12:17Well, is that gonna be painful?
12:19There may be some discomfort
12:20I assure you, we will prescribe proper pain medication to provide you with adequate relief
12:26Drop a hundred of propofol, fifty of foot
12:28Whatever, just knock me out
12:31With pleasure
12:36Perla
12:37Which of our patients can we send on their merry way?
12:41Right, um, Barry, yoga split lip, move from north one to the hall, um, Walter, road rash with the rat
12:47killing dog, south twenty, and Vince, uh, basketball elbow fracture, outside central two
12:52Okay, you can run another set of vitals on Crosby's Papa and discharge
12:55You can tell Ortho to get their head out of their ass and take Joel Embiid with them
12:58And you can release Yoga Barry, but tell him to refrain from doing any handstands for at least forty-eight
13:03hours
13:03Copy that
13:04Go, go, you heard the man
13:08I do not know how Dana does this every day
13:10Uh-huh, running the ER is a Sisyphean task
13:14So this is a punishment?
13:15No
13:16Sisyphus
13:17Sisyphus pissed off the gods, so they punished him by making him push this massive boulder up a hill for
13:22eternity
13:24One must imagine Sisyphus
13:26Happy
13:28You're doing great
13:29Hey, Ahmad
13:32Is Theresa still out in Cheers talking to those cops?
13:34Yeah
13:34Do me a favor, just kind of keep an eye on it
13:36Don't let her leave without talking to me
13:38Okay
13:38Any word on Driscoll?
13:40I issued an alert throughout PTMC security and called the cops with his home address from Ms. Char
13:45They want a statement from Dana
13:46She's in CT, let's...
13:49Let's, um, clear her medically and then she can decide when she wants to talk to them
13:53What about other hospitals? You let them know?
13:56Notify
13:57Everyone's on the lookout for this guy, Driscoll
13:58Thanks, Ahmad
13:59Got it
14:01Glad to know the authorities are looking for this cycle, but...
14:03What are you gonna do to protect the rest of us?
14:06Violence against healthcare workers is a national problem
14:08And it's only getting worse
14:09No surprise, there's a nursing shortage everywhere
14:11I hear you, I hear you, I hear you, I hear you, and it is unacceptable
14:14What the hell kind of circus are you running now?
14:16Oh my god, you're like a bad penny
14:18Where is Dana? Where is she?
14:19She's alright, we sent her to CT to make sure
14:21Did you fill out an incident report?
14:24I don't know, I was more concerned with her having a skull fracture than with your liability
14:28The guy from the waiting room get back here without anyone noticing
14:30Wow, Gloria, what a great question
14:32Our hard working nurses were just asking me what steps the hospital plans to take to ensure their safety in
14:36the future
14:37Maybe you would like to explain to them why you've denied my request for additional security measures three times in
14:42the last four months
14:42If nurses don't feel safe, they're not gonna come to work
14:48First off, the safety of all our employees
14:52Do you remember the last nursing strike?
14:54Yeah, that was a real shit show
14:55Maybe this is something our union reps should know about
14:57Okay, let's take a beat and remember that PTMC is a family
15:01Come on
15:02Bysfunctional family
15:03You should be worried about the nurse's satisfaction and the safety of that
15:07Yeah, about everyone
15:08Rob
15:11Robby
15:13Dr. Robby, I've got a question for you
15:14Sure
15:15We're working on Chad and my team is McKay's ex, he's a nightmare
15:43Here's your driver's license and insurance card, Mr. Buclisi
15:46Have a seat and the triage nurse will call you back soon
15:48Thank you
15:50Hello, my son, he needs help, his eye
15:52Let me ask you about your eye
15:54Do you see the line you just cut?
15:55No, please, it's an emergency
15:57You think everybody's waiting for manicures?
15:59He caught a line drive to the eye
16:00We're so sorry, ma'am
16:01We thought this was the line for pediatrics
16:03I'm 16
16:06I'm doing this because you're a minor and you have manners
16:08Thank you so much
16:10Name and date of birth?
16:11Everett Young, December 7th, 2008
16:13I'll get your insurance information from your father, take a seat
16:15What? No, we're not waiting
16:17Show her
16:18Show her
16:19Show her
16:23Okay, then
16:23Come around to the double door
16:28Is your next to place on deck?
16:29All set
16:30She's 62 kilos, 0.25 per kilo is 15.5 millimeters
16:33Push over 10 seconds
16:35What's the status?
16:36Diffusion flare mismatch means she's less than four hours into it
16:38Getting TNK now
16:39Sounds great
16:39Would you mind hanging down here for a bit? I could use your expertise on this
16:42Can't believe you have the nerve to ask
16:44Good one
16:45Okay, keep me posted
16:4950 on board
16:50Anything I can do to help in here?
16:52No, I'm pretty good
16:54How are you doing?
16:57Not as good as you, apparently
16:59Push another 25
17:00Wet the splints now, please
17:02You can help lift his leg for the splints
17:06And we're at 75
17:08Mm-hmm
17:10When we lift his leg, it's really gonna hurt him
17:12But he won't remember benefits of propofol
17:15Hall socks, 99, good end tidal CO2
17:20Hey, Chad?
17:22Chad
17:26Perfect
17:26Let's do this
17:33Do you feel sad?
17:36Uh, don't worry
17:38We'll have you fixed up good as new
17:41What does he have that I don't have?
17:45I mean, sure he's younger
17:47And that hair
17:51Who?
17:54Mateo
17:57What's his story, anyone?
18:00Is she having sex with him?
18:04Well, if she isn't, she probably should
18:11Who do we have the pleasure of meeting this afternoon?
18:13Everett Young, 16, took a line drive to the left eye
18:16Taki at 118
18:18Four of morphine, four of Zofran
18:19Excuse me
18:23Uh, it was easily 100 miles per hour
18:25Oof, did she pass out?
18:26Uh, no, ma'am
18:28Baseball's a fun activity, you any good?
18:30Any good?
18:31He's got a 95 mile an hour fastball
18:33A 12-6 slider
18:34A .94 ERA
18:36And he's a southpaw
18:37What's that?
18:39That's a future Cy Young
18:42I didn't know what that is either
18:43Ms. Giovatti is a student doctor
18:45She's a bit of a prodigy herself, actually
18:47Do you mind if she helps out?
18:49No, ma'am
18:50Okay
18:52Tell me how many fingers I'm holding up
18:54Um...
18:56I can't tell
18:57Oh my god, oh my god
18:59Okay, can you tell me when the light turns on?
19:04Um...
19:04Now?
19:05Light perception only
19:07Do you want a portable slit lamp?
19:09Definitely, yeah
19:10Giovatti, what do you think of the anterior chamber?
19:12Hyphema
19:12Exactly, grade four
19:14You have meaning?
19:17Giovatti
19:17Meaning blood is filling up the front eye chamber
19:19He'll need an emergency evaluation by ophthalmology
19:22Is that why he can't see?
19:23That's part of it, yeah
19:24You see how the eye is pushing out?
19:26There seems to be a collection of blood behind the eyeball
19:29The eye pressure's too high, we have to act quickly
19:31Okay, well check the pressure
19:32We're going to right now
19:33Yeah
19:34Can you look at Robbie?
19:36Yeah
19:41Looked like you were having a pretty intense conversation with Robbie earlier
19:46Everything okay?
19:49Um...
19:49There's nothing
19:50Nothing?
19:52Okay, well not nothing, but nothing for you to be concerned about
19:56An intern has a problem around here
19:58They come to the senior resident, not the attending
20:03He's my attending and I wanted his input on a patient
20:06Is that not okay with you?
20:09Just, um...
20:12Come to me first, next time
20:15Got it?
20:17Yeah, got it
20:25You a junior?
20:27Yeah
20:28You thinking about college?
20:29I have some D1 interest
20:32Where'd you go to college?
20:33Uh, Pitt
20:34For undergrad, now med school
20:36You want to leave town?
20:37Look up at the ceiling for some dumbing drops
20:40It's not exactly an option to live anywhere but home when you go to college at 13
20:45Wow
20:45Add some drops of the fluorescein strip
20:47I was thinking about California
20:50Maybe UCLA or USC
20:52Still?
20:53Hey, maybe you go straight to the majors, huh?
20:54College can wait
20:56I don't know
20:57I do
20:58Ev's got a God-given gift
20:59That's why we spent every weekend doing travel ball when he was young
21:02Pro camps, showcases
21:04He's not throwing away his shot at the majors
21:06Uh, we have to check for the puncture before we can measure the pressure
21:10Look straight ahead and try not to move your eyes, okay?
21:13Yes, ma'am
21:13Lights going out
21:15Hello, I'm Dr. Rabinovich
21:17Everybody calls me Dr. Robby
21:19Hey, Greg Young, this is my boy Everett
21:21Nice to meet you both
21:22Okay, I will take that slit lamp and you can calibrate for telemetry
21:25Okay
21:26They're holding CT for him
21:27Let's take a look
21:29Negative side down
21:31No globe rupture
21:33Okay, go with the tonkin
21:35Hold still
21:36Okay
21:42Left eye pressure 58
21:44Is that high?
21:45Yes, it is
21:461% lighter with epi
21:47Push 1%
21:48Open a lateral canthotomy tray
21:49Excuse me
21:49What?
21:50Without a CT?
21:51Isn't that-
21:52Exactly what the patient needs?
21:53Yes, it is, Dr. McKinney
21:57Okay, uh, we're gonna lie you back, little Everett, okay?
22:00We need to do a little minor surgery to relieve the pressure behind your eye, so we're gonna cut a
22:06small opening on the side of your eye, not in your eye, got it?
22:09Yeah
22:09You wanna watch?
22:12No, I'll sit down
22:14Your body, step up so you can see
22:17Dr. McKinney
22:18Dr. McKinney
22:18Chad is splinted and is awaiting ortho for surgery taken
22:21Thanks for the appetite
22:22Thank you
22:23Brissette's on board
22:25Numbing medicine here, okay?
22:28Okay
22:28Pinprick and some bunny
22:32Ouch
22:33What, is Dana gonna be okay?
22:35It's gonna take more than a punch to the face to keep that mama down, she's tough
22:39Yeah
22:41Um, I'm sorry to bother you
22:45Um, I, I just wanna make sure that Teddy's not in any pain
22:51Oh, he's heavily sedated, he can't feel a thing
22:55Right, it's just that when I look at him, I just, I just feel so helpless
23:02Look, his, uh, CT scans came back negative for internal injuries, he's on IV therapy to replace any lost fluids
23:10I assure you, we are doing everything we can to give him the best treatment possible
23:14Thank you
23:15Yeah
23:16Yeah, Teddy's ring
23:21Um, I had to cut it off because of the swelling
23:26Hopefully you can find a good jeweler to fix it, I don't know how it works
23:39Um, do you have a best friend, doctor?
23:43Oh, it's, uh, another year to go till you can call me doctor
23:48Uh, you can just call me Whitaker though
23:50Um, do you have a best friend, Whitaker?
23:54Um, I have three older brothers, I guess they're kinda my best friends
24:02They kinda tortured me growing up, so maybe not, but, yeah
24:08Teddy's been my best friend since we were fifteen
24:11High school sweethearts?
24:13We were just a couple of nerdy Aggies who, uh, we met in 4-H and we fell in love
24:21I'm sorry
24:22No, it's fine
24:23I'm a third generation Nebraska farm kid myself
24:27Get out
24:28Well, if you're ever homesick, you should, uh, you should come by our farm sometime
24:36That's very kind
24:37I need some help in here
24:42What's going on?
24:43Respiratory distress, SATs are dropping 87%
24:46Uh, lung injury from the fire?
24:48It's not just the low SATs, the vent's showing high peak pressure, low tidal volume
24:51Uh, restrictive pattern?
24:53Most likely
24:54I'll grab Ravi and LinkedIn
24:55Wait, wait, wait, wait, what's that? What's going on?
24:58Ventilator is having trouble pumping air into Teddy's lungs
25:00Uh, burnt skin loses elasticity, now his chest walls too tight
25:03Well, what can you do?
25:04We're gonna have to cut the burnt skin
25:06Um, release pressure on the chest wall, help Teddy breathe
25:10So, after you cut his eye, see you again?
25:13This will give us our best shot at preserving his vision, yes
25:16Dr. McKay, are you ready to do the honors?
25:19Who, me?
25:21We are a teaching hospital, are you still here to learn?
25:25Yes, yeah
25:32Okay
25:32Okay
25:32Okay
25:34You can release that tidal stat now
25:40I have scissors
25:44The length of the crushed area is gonna be your guide for the length of your cut
25:50Good
25:51Tooth forceps
25:59Feeling for the inferior
26:03Feeling for the inferior
26:04And superior Cruz
26:07How can you see with all that blood?
26:09You can't, it's all tactile
26:11Feels like two guitar strings
26:14Okay
26:14That's in balm
26:23Inferior
26:23Yeah
26:27And...
26:28Superior
26:29Nice, good
26:33That's a lot of blood
26:34Okay, let's get a repeat pressure
26:35It's getting a lot brighter
26:40Pressure of 18?
26:43Perfect
26:43CT can take him as soon as we dress the wound
26:45Page ophthalmology and tell him to prep for surgery
26:48Doc, thank you
26:49Thank you
26:50My pleasure, my pleasure
26:51Good luck to you, Everett
26:53Hey
26:55Thanks for letting me do that
26:57You sound surprised
26:59Yeah, I figured after the whole Theresa thing you might bench me
27:03Am I still pissed that you won't be on my back?
27:06Absolutely
27:06And if you ever do it again, you can bet your ass that I will bench you
27:09But this is a teaching hospital
27:11And teachers can still learn stuff
27:15I...
27:15Saw a sad, confused boy
27:18And...
27:18That's all I thought about it
27:20I did not think enough about those girls
27:25Any word on Dana?
27:26She should be coming back from CT soon
27:28Burnt victims tanking, we need you
27:30Oh my god, I can't wait for this shift to be over
27:37Hey
27:39Bud, you doing okay?
27:40Yeah
27:41I'd say you hooked me up
27:43I can see that
27:46How's dad?
27:49He's gonna need surgery
27:50But he's gonna be okay
27:54You know, I was thinking
27:56Since your dad's gonna be laid up for a while
27:58Maybe you'd want to stay with me until he gets better
28:02For real?
28:04Real
28:05What do you think?
28:12That is yes
28:15This procedure is called mescarotomy
28:17We need to cut the skin so that the chest wall can expand
28:20That sounds painful
28:21Whitaker?
28:23Uh, he's still heavily sedated
28:25He won't feel a thing
28:27This is gonna help Teddy breathe
28:30Sot's 83
28:31Peak pressure's 40
28:33Title volume's only 300
28:34I want you to watch Dr. Langdon as he makes this vertical incision
28:37Then you're gonna do the exact same thing on your side and follow your instructions
28:40I'm sorry, I just, I don't think I can watch it
28:42Jordan, would you...
28:46Start at lateral clavicle
28:53Down
28:55Interior axillary
28:58And lower rib margin
29:01The tissue's really popping out
29:03Which illustrates what?
29:04The pressure underneath
29:06Your turn
29:09Here goes
29:14A little more pressure
29:16Yeah
29:16You make a decisive incision to get through the S-garn
29:18Into sub-Q
29:20Go back a little deeper on that first section
29:22Okay
29:25Yep
29:27Yep, good
29:28Looking good
29:31Okay
29:31Now the horizontal incision, Dr. Langdon
29:36And...
29:38Connecting the two incisions
29:45That oughta do it
29:46Peak pressure's already down to the 30s
29:48And title volume is coming up
29:50Sot's 91
29:51That was wild
29:54We'll stress these wounds and send off a blood gas
29:56Well done
29:56And very well taught, Dr. Langdon
29:59Thank you
30:12You think Coley's will still be open by the time we get off?
30:16No
30:16No, no, no
30:17Damn
30:17I was hoping to surprise Abby and the kids, grilled some salmon for dinner
30:21Mmm, such an adrenaline junkie
30:24What'd you call me?
30:26Your ice plunges
30:27Marathon man
30:28Surprise, here's a dog
30:29Surprise, here's some salmon
30:33Pissed in your corn place
30:35Oh, oh
30:36What, I touch a nerve?
30:37You're regretting buying that dog, aren't you?
30:40Poggy-poggy
30:41That's why I'm so scared
30:42Oh
30:42See, Iwasan mo yung ganyan
30:45Sayang lang ang oras mo
30:47Thinkin mo nag-sex sila?
30:49Ew, naku, hindi
30:50Oh, Robbie
30:51Dana's CT results, you're back
30:52No intercranial hemorrhage
30:54No skull fracture
30:55Non-displaced nasal fracture
30:57But the rest of the facial bones look intact
30:59Oh, oh, oh
31:00Any hemorrhaging into the sinuses?
31:02Nada
31:02Great, we could really use her back on the floor
31:06What? I'm just sayin'
31:09Mind if I give her the good news?
31:11No, go for it
31:11And anything else she needs
31:13I got it
31:21About the whole thing with Santos and the seizure patient
31:26What about it?
31:28I'm sorry for laying into her so hard
31:34Why do I feel there's a butt coming?
31:36But I don't think she's a team player
31:39How so?
31:40She's cherry-picking cases
31:42She gave Whitaker a shitty nickname after his patient died this morning
31:46She's even harassing Jabadi to get a rent from her mom for surgery
31:50If she wants to be in surgery, what's she doing in the ER?
31:53That's a great question, why don't you ask her new BFF, Garcia?
31:56I know that you've seen those two
31:58I'm the only one calling her out so she has an axe to grind
32:02You've always said that being in the pit is like playing a team sport
32:07A team has to be able to trust each other
32:09If we have one weak link, this whole place goes to shit
32:15Good meeting
32:23Call Zosie and Family Med, they open up their urgent care of five
32:25Let them never send it up to two honky kids
32:27Yep, Zosie and Family Med
32:29Okay, copy that
32:31Anna, please check in on Earl
32:33Poor thing got caught in the crosshairs of that mom fighting me
32:35We bring him another sandwich
32:36Yeah, okay
32:37Good
32:38No egg salad
32:39Dana, I got you, okay? Rest up, bud
32:42Ugh
32:43Can take the girl out of the ER
32:44But you can't take the ER out of the girl
32:47Old habits die hard
32:48Let me take a look
32:53Oh, she's a real beauty, alright
32:55But your CT came back clean
32:58Nothing Mother Nature can't heal on her own
32:59Too bad, it's open for a free nose job
33:03Probably get hazard bad
33:04Two for one
33:18You know, you're clear to go back to work if you want
33:22Or home
33:25Already, yep
33:28You?
33:28No
33:30Got a lot to think about
33:33Yeah
33:35A pretty fucked out day
33:39What do you call a group of brains who form a singing group?
33:43What?
33:44A glia club
33:45Oh
33:47Good one
33:48Keep me posted if there are any changes
33:52Um
33:53What's with Dr. Meta and the...
33:55The jokes
33:58You know why they say laughter is the best medicine?
34:01Because it's true
34:02Laughter releases endorphins, endorphins help relieve pain
34:08Um, so...
34:09What...
34:10Dr. Meta thinks that if a joke helps raise spirits and makes people feel better, then he's all for it
34:16It's his special sauce
34:18Um, do you have a special sauce?
34:20I'm pretty data-driven, but I really like to talk to my patients about their lives
34:26Makes them feel important
34:30She's waking up
34:33How are you feeling?
34:35Okay
34:36Are you trying to say okay?
34:40Yes! The thrombolytics are working
34:43Um, can you, uh, lift your right leg for me?
34:47It's okay, um, try moving it from side to side
34:51Can you tell us your name?
34:56Uh...
34:57Oh, um, maybe you can type it out on the screen
35:02Here
35:07Vera?
35:10Okay, uh, what's your last name?
35:15Malahi?
35:18Well, hello, Vera Malahi
35:23Hey
35:23Oh, Chad's a little piece of work
35:27I appreciate you dealing with him
35:29You know, it was actually kind of fun
35:34I did not have that on my bingo card
35:36Well, you know, patients under propofol are always a good time
35:40Hmm
35:42Oh, yeah?
35:43What did he say?
35:45Nothing
35:46Nothing to worry about unless
35:48You're concerned he still has a thing for you
35:52Oh, please euthanize me if I ever even consider it
35:58But you know, if I could go back, I wouldn't change a thing
36:01Without Chad, I wouldn't have Harrison
36:03You're very lucky
36:06You know, right?
36:09All right, thanks again
36:12I was getting ready to take her up when she developed angioedema and her fats dropped
36:17A little bit of stridor
36:20Swollen lips, swollen tongue
36:21Vera, is this a side effect of the medication we gave you?
36:24Sats her up with high flow nasal
36:25It's anaphylaxis, get Robbie
36:28Angioedema is not always anaphylaxis
36:29I know, but it can progress to it and cause an obstruction
36:32If it's just angioedema, I can reverse the swelling fast with IV epi
36:35BP is 165 over 85
36:37Prep ketamine and rock for intubation
36:39Wait, wait, Dr. Mohan, you just said
36:41We're not intubating yet
36:43She's gonna rest
36:44What happened?
36:46Angioedema with stridor, a respiratory's on their way, we should intubate, right?
36:50Good BP and O2 sats, epinephrine can reverse the swelling right away
36:53I pushed 10 mics of IV epi, starting her drip at 5 cc's, 5 mics per minute
36:57Sats are holding at 95 on high flow, BP is good
37:00Vera, we're gonna sedate you so that we can help you breathe better
37:03Or not, let's just wait a minute
37:05How'd you get that epi drip hung so fast?
37:06Bedside drip, I mix one milligram with a liter
37:09Nice
37:10Are we intubating, are we not intubating?
37:12Not
37:13Stridor is improving
37:15Is it getting easier to breathe?
37:18Speech is coming back
37:2050-difanhydramine 125 solimedrol
37:24Do you think Dr. Mehta will want her intubated for the thrombectomy?
37:27Not necessarily, if she can talk and move during the procedure then they can monitor any changes in the neural
37:32exam
37:34Slow-mo, no-mo
37:36Sorry, I think Dr. Mehta's rubbing off on me
37:40We're taking him up to our burn unit, he'll be in great hands, they've had lots of experience with cases
37:45like Teddy's
37:45What now?
37:48We will continue with IV fluids and pain meds
37:52We'll support his breathing with the ventilator and we'll keep his wounds clean, look for any signs of infection
37:57Then later the plastic surgeons can do skin grafts
38:01He's gonna be okay
38:03Teddy's condition is very critical, so no promises, but our team is gonna do everything they can to give him
38:07the best chance possible
38:10I'll make sure to stop by the ICU, check in on both of you
38:14I can't begin to thank you enough, Dr. Whittaker
38:16Oh, uh, student doctor
38:22Oh, uh, don't forget about dinner at the farm
38:26And, uh, make sure to brush up on your diaper changing skills
38:29With seven nieces and nephews, I'm a diaper genie, so...
38:36You know you just called yourself a trashcan, right?
38:39Before you grab her next patient, um, call Chiara, have somebody go upstairs and talk to the wife
38:46Amy? Why?
38:47We wanted to give her hope, but the reality is her husband's not gonna make it
38:51He's stable
38:52His chance of dying in the next week is over 90%
38:56He's young, he's strong, maybe he's the 10%
38:59Maybe, but he's a lot more likely to die of sepsis before his kid is born
39:03Call Chiara
39:12The CT shows a hairline orbital floor fracture
39:15But thanks to the kinthotomy, the hematoma isn't pushing on his eyeball
39:19Will I be able to see?
39:22That's why you need surgery
39:24The ophthalmologist will drain the blood inside the front of your eye
39:27And replace it with the clear fluid you need to see
39:30Okay? We're ready for you now
39:32Hey, hey, hey, don't worry, bud
39:34Alright?
39:38So, so he has the surgery, stays overnight, he goes home tomorrow?
39:43It depends on how the surgery goes and what his post-op results are like
39:47Give or take?
39:48He could be as soon as tomorrow, yeah
39:51Okay
39:53So we could be, could be game ready by Thursday
39:56Yeah?
39:58Sarah, your son is freaking out because he may never see out of his left eye again
40:02Yeah, that's...
40:03No, no, forget baseball
40:05And just be his dad
40:07Gotta keep with that fucking heart
40:11Uh, there's a waiting room up by surgery
40:14Sixth floor, right off the elevator, you can't miss it
40:17And your edema responded to epi, diaphanhydramine, and steroids
40:21Excellent
40:25Thank you
40:27You're very welcome
40:31Which neurotransmitter makes the best adhesive?
40:34I don't know
40:35Glue to me!
40:37Glue to me, am I right?
40:39Nicely done, Dr. King
40:44You know this really quick thinking back there?
40:46I'm really sorry if it seemed like I doubted you, I didn't, I just...
40:50Honestly...
40:51I surprised myself a bit
40:53We entrusted your gut
40:55Maybe that's your special sauce
40:58Maybe
40:59Um, Dr. Mohan
41:02What if I don't have special sauce?
41:05Of course you do
41:06Of course you do
41:07Just be yourself
41:08We'll come
41:18So...
41:19Now might be a good time to go through some doctor, patient, or action guidelines
41:23I'm sorry that I was just such...
41:24So overbearing
41:27Sorry
41:29Look, do I think you needed to chill out a little bit?
41:31Yes
41:32But he's a parent, and this might be his way of coping with the stress of a very frightening situation
41:38I'm sorry, I don't know what came over me
41:41No, I do
41:42You and that baseball kid are two pressure cooker prodigies in a pod
41:48Just...
41:48As physicians, we gotta learn to keep our emotions in check
41:51And not let our personal experiences interfere with our professional responsibilities
41:56How long did it take you to learn that?
41:59I'm still learning
42:00And I also learned to never get on your bad side
42:04Yo, yo, yo
42:06Hey
42:07Almost quitting time
42:08I so appreciate you helping me out with Harrison
42:10No
42:11And my douchebag ex
42:12Yeah, we all have him
42:13Yeah
42:14Oh
42:16Totally
42:16Me too
42:17Me too, yeah
42:20Always happy to help
42:22Yeah
42:23So I get off in a couple hours
42:24Do you mind just doing a loop every once in a while to make sure he's not bringing the place
42:27down?
42:27Can do
42:28And, you know, a new foot massage place just opened in the Strip District
42:31Do you wanna go on Sunday?
42:33For sure
42:33Okay, cool
42:34I'm free Sunday
42:36Um, to help or just do whatever, wherever
42:40Oh my God
42:41I mean, Harrison would love a sitter closer to his own age
42:46I'll get your number and text through the address, that's awesome
42:48Thank you
42:49Oh, sure
42:50Dr. Santos, a moment, please
43:01So, how's your first day going?
43:04So far, so good
43:05Getting along with everyone?
43:06Yeah, pretty much
43:08Except Langdon?
43:11So, in the CR, we all need to work together as a single, unified entity
43:15And if two people on my team can't work together, it kinda throws the rhythm of the place off
43:20Understood
43:21My duty, regardless of personal relationships, is to make sure everybody on my team is doing okay
43:29So, are you doing okay?
43:33Uh, it's not a big deal, I can handle it
43:39Handle what?
43:43Nothing, it's fine, I...
43:47I don't wanna get anyone in trouble
43:53Okay, if there's anything, anything that could affect my ER, I need to know about it, and you have a
43:59responsibility to tell me
44:11Hey
44:11Hey
44:12Hey!
44:12Did they catch the bastard who sucker punched you?
44:15I haven't heard
44:16Well, when they do, just send them to me
44:20I can make it look like an accident
44:24Let me just take you up on that
44:26Mm-hmm
44:26Gotcha
44:30You've been paroled
44:33Are you sure?
44:34Yep
44:35Okay
44:36Yeah, okay
44:37Yep
44:38All right
44:38Go check on Werner
44:40Got a sec?
44:41Bless you
44:42For you, boss, I got two
44:43What's up?
45:01I heard there's been some inconsistencies with meds intended for your patients
45:06What?
45:10Frank
45:11Frank
45:11Have you been helping yourself to benzos from the ER?
45:15Yeah, I've been stealing blood, too
45:21I asked you a question
45:23Wait, are you serious?
45:25What are you doing?
45:28Really?
45:30Santos
45:32Whatever the hell she told you is bullshit
45:36I didn't mention Santos
45:38You didn't have to
45:40I told you
45:41She is trouble
45:43Have you ever taken a patient's medication?
45:46This is insane
45:46This is completely fucking insane
45:48I need you to open your locker
45:49Yeah, right
45:50Open your locker
45:50You're gonna...
45:52Open your fucking locker
45:53Or I will have security smash it open
46:16Is the imprint code on these pills gonna match Louie's liberium?
46:28Go home, Frank
46:29No, no, it's not like you think
46:31You remember whenever I helped my parents move
46:33I was too cheap to pay for movers
46:35I hurt my back
46:36I told you that
46:37You teased me about it
46:38Remember?
46:38Well, our own Dr. Hagen prescribed me some pain meds and muscle relaxes
46:42I was just weaning myself off
46:44It was just for maintenance
46:44I'm done, Robbie, come on
46:46You know me, Robbie
46:47You know me, man
46:48I'm sorry
46:49I fucked up
46:50I just...
46:50I was trying to...
46:52No, it's not like you don't understand
46:54I don't fucking understand
46:55It's not like you think
46:56I'm not high
46:57I'm not high
46:58You've seen what I do, Robbie
47:00Could a drug addict do what I do?
47:05Apparently
47:08I just fucking let him
47:12You're done
47:14Leave now or I will have a ma to escort you out
47:16Robbie
47:17Please
47:19You are done
47:25What?
47:47Thankfully
47:57With you
47:57Greetings
48:01I didn't give up
48:02This man
48:02Is no brother
48:02Told me
48:04I
48:04The
48:11Who
48:12He
48:12Looks
48:12How?
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