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The.Pitt.S02E01.540p.X265.AAC [Full Movie] [Ranked]Full EP - Full
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00:23You are close to me
00:30And I'm thinking of the time we spent together
00:34Now it's in my backyard
00:40Sometimes I sit and wonder
00:45If I'll ever tell your number
00:51Cause I'm having fun
00:53Looking out when I'm on
00:56Doing all the things I like to do
01:02I'm having fun
01:04Cause I knew it all along
01:07Would be better off without you
01:11I used my cast off
01:16As soon as you parked that outside
01:18Morning doc
01:18Olsen
01:19Happy 4th
01:20See you guys
01:21Sorry
01:50Hey how's it going dad
01:52I'm so sleep deprived
01:53My house is starting to feel like a CIA black site
01:55If you consider hiring a night nurse
01:57You're looking at him
01:58You got a ripe one coming in
01:59You're going to have to deal with
02:00Before everybody out there starts puking
02:01Lovely
02:02Your replacement came in early
02:04She brought in a full bagel spread
02:05I'm just saying
02:06She's not my replacement
02:07She's just covering his chief
02:08While I go on my little sabbatical
02:09Three months
02:10I'll be back before your daughter
02:11Sips in the night
02:12Hey dude
02:12That's cold
02:13Morning
02:14Morning
02:30Morning
02:30Morning John
02:30I could have sworn it was still around 4am
02:33Did you guys have an easy night last night?
02:35The waiting room actually looks manageable
02:36I wouldn't call it easy
02:38But not too bad
02:39I figured we'd have hands and burns down here a bunch
02:41But so far nobody's blown off any fingers
02:43Oh you know you just jinxed
02:45You guys and your jinxes
02:46Please Jesus please
02:47Hail Mary again
02:49In the sanctified flesh
02:50Don't let me die alone
02:51Just try to relax Margaret
02:52I need a priest
02:54Hey hey Dr. Robbie
02:55What's the good word Perla?
02:57All your results came back normal Mrs. Walker
02:59I'm dying
03:00You're not dying Mrs. Walker I promise
03:01Jesus is coming for me
03:03If he is he hasn't checked the net registration yet
03:05Please don't let me die a sinner
03:06Don't worry Margaret
03:07We're going to have the hospital chaplain
03:09Come and see you in a moment
03:10I'm not going to last that long
03:11Yes you will
03:12Because we're going to give you a shot
03:13To keep you alive until they get here
03:15What are you thinking Dr. Abinovich?
03:17500 mics of cyanocobalamin?
03:18In her condition I push a full thousand
03:20Woo
03:21You heard the man Perla
03:23God bless you
03:24God bless all of you
03:26Amen to that
03:29Nothing like the miracle healing powers
03:31Of a good old B12 shot
03:32She hold down a job
03:34She doesn't
03:35She's wearing a waitress uniform
03:37Yeah from a diner that closed 20 years ago
03:41And so it begins
03:43My husband is still waiting to see a doctor
03:46I apologize for the wait
03:47But here are two doctors just for you
03:49Mr. Burgess has been complaining of leg cramps for a day
03:52Slightly tacky at 110
03:54BP 128 over 75
03:56Afebrile
03:57Good stats
03:57I'm Dr. Shen
03:59But I'm going off shift
04:00Dr. Abinovich will be one of the doctors looking after you
04:02What other medications are you currently taking Mr. Burgess?
04:05I brought his meds
04:08Thank you
04:09These are his supplements
04:11Mostly all natural and organic where possible
04:13And these are his homeopathic prescriptions
04:15I also have a list of his refrigerated probiotics
04:19Thank you
04:23Where the hell is everybody?
04:25Our new attending is torturing our intern and med students in trauma one
04:29She came in early to meet the night shift and took things over
04:33Okay
04:33That takes giant balls of disrespect
04:35Giant balls of disrespect was the name of my band in high school
04:38And my nickname for my ex-husband
04:41Hey
04:42Hey, uh
04:42Is this your last shift?
04:43For a while, yeah
04:44Oh, I'm so jealous
04:47Hey, I'll pay you a grand if you take my second husband
04:50Tempting
04:51So
04:52Tell me about this new attending
04:53Uh, she's pretty
04:55Divorced
04:56One kid can already tell she is a strict rule follower
04:59I'm probably going to grow to hate her
05:01What's her name again?
05:02Dr. Buran Al-Hashimi
05:04Al-Hashimi?
05:06What is that?
05:08Irish
05:10She's some sort of clinical informatics expert
05:12When she started talking about AI
05:14I started thinking about robots
05:16And kind of stopped listening
05:18Clear
05:19Off the chest, Ogilvy
05:21Get ready to step up here, Joy
05:22Ogilvy, off the chest
05:24Clear
05:26Still VTAC, but it looks weird
05:28Agreed
05:28No pulse
05:29No effusion
05:30Good lung sliding
05:31Hey, start compressions, Joy
05:32We haven't considered all of the T's
05:34I checked for tamponade and tension pneumo
05:36What if it's thrombosis?
05:36If it's a pulmonary or a cardiac clock
05:38T and K could save it
05:39We are sticking with the algorithm for now
05:41Algorithm's not working
05:42Faster and deeper, please
05:43Uh, you need a break, Joy?
05:45No, I need an attending
05:46I'm right here
05:49Stop compressions
05:50We're calling it
05:52Sorry
05:52The patient's dead
05:57All right
05:58Who can tell me what went well?
05:59We followed the VTAC algorithm
06:01We checked for reversible causes
06:02We limited our rhythm in pulse checks
06:04To ten seconds
06:05Excellent
06:05Should we have given thrombolytics?
06:07No
06:07You should have recognized
06:08That the cardiac rhythm on the monitor
06:09Was polymorphic
06:11Not just VTAC
06:12It was torsade de point
06:14That's French
06:15Twisting up the points
06:16From prolonged QT
06:17Anti-arrhythmic electrolyte disorders
06:19Your patient would have lived
06:21If you pushed magnesium sulfate
06:22Good news is
06:23He's an organ donor
06:24Parts of him we're gonna get used
06:26To make frisbees
06:27Water bottles
06:27End up as microplastics
06:29In our brains
06:29And reproductive organs
06:30Thank you for the words of encouragement boss
06:32Dr. Alashimi
06:32Dr. Michael Rabinovich
06:33Everybody calls me Rami
06:34Pardon please
06:35Welcome to the pit
06:37Yeah
06:37Tom is a minute up
06:38Ooh
06:39Who wants to treat a real patient?
06:40Yes please
06:41Things gonna give me nightmares
06:45I hope you don't mind me
06:46Jumping right into things
06:47I find that a mock code
06:49Is a great way to assess
06:50The students capabilities
06:51Well
06:52It might have been nice
06:53If we'd had a little time
06:54To go over how we do things
06:55Did you not get a packet
06:56From Dr. Underwood
06:57Gloria
06:58It outlined the quality improvement changes
07:01I instituted at the VA
07:02We're adopting the program
07:03At all of the university hospitals
07:05You didn't read it?
07:06No I did
07:07I mean I will
07:08I'm going to
07:08I want to
07:09I thought I had a little bit more time
07:11Before you came in today
07:12We've already distributed
07:13Patient passports
07:14To everyone at registration
07:16What is a patient passport?
07:18So glad you asked
07:21Samira
07:21Dr. Al
07:22We worked together at the VA
07:24A few years ago
07:25And now you're in R4
07:26Yes
07:27And I'm so excited
07:28You're joining us
07:29Dr. Mel King is here too
07:30I think you worked with her as well
07:32I did indeed
07:33John Doe
07:34Dishwasher penetrating trauma
07:36From a kitchen knife
07:36To the right chest
07:37Salter accident?
07:38Unclear
07:39Initially had a pulse
07:40Lost it two blocks away
07:44What do we got party people?
07:46Dr. Yolanda Garcia
07:48Trauma surgery fellow
07:49Meet Dr. Baran Alashimi
07:51New ED attending
07:52She's going to be covering for me
07:53While I'm gone
07:54So nice to meet you
07:55That time they replaced you
07:56Rabbit bitch
07:57I'm going to miss you too
07:58YOLO
07:59Dr. Garcia has a hard time
08:00Expressing your feelings
08:01Not all of them
08:02One
08:03Two
08:04Three
08:06Prefer a laparocotomy
08:07I'm on it
08:09What's up boy chocolate?
08:11Did you know
08:12Our farm boy here
08:14Is a vintage funk freak?
08:16Unfortunately
08:16He also likes to use
08:18Other people's toothbrushes
08:19There's one time
08:19They were the same color
08:21What's your plan Samira
08:24Chest tube to the right
08:25Standby with master
08:26Transfusion protocol
08:27I put two units on the infuser
08:28Stare web six and a half
08:29Here we let the fellows
08:30And the residents
08:31Kind of take charge
08:32I'll hold on to them
08:33Just in case
08:34Is the VA even a trauma stand?
08:37Not for medic runs
08:39But they walk in
08:41Falls
08:41Major MBCs
08:43GSWs
08:45Stab wounds on the right
08:46Why are we opening
08:47The left chest?
08:48Better access if it's tamponade
08:49And you can cross clamp
08:51The aorta
08:52Giovanni, Whitaker
08:53Stare gloves
08:54Can I glove that?
08:54That's best if you
08:55Watch the first one
08:57This guy's dead anyway
09:01Sunblade
09:0228 French on a long pillie
09:05Giovanni, you're on section
09:06Whitaker, get ready
09:07For internal compressions
09:11Sorry, that's my phone
09:15Finished out of a tractor?
09:16Whitaker, give me a little room
09:18I need to get to his heart
09:19I'm in
09:19Hook up the thoracic seal
09:22Tommy, you get that for you?
09:23Not right now
09:34Good tamponade
09:35Pretty dry in here
09:38Heart's empty
09:39Somebody start cardiac massage
09:40I'll cross clamp
09:41Yeah, I got it
09:41You do these one-handed
09:43Pushing up against the breastbone
09:44Four fingers
09:45Very good
09:46Not much blood to suction
09:47Okay, team
09:48I can really
09:48Next steps
09:50Keep transfusing
09:51Open the right chest
09:51That is correct
09:52Booties on kids
09:53There will be blood
09:56Frank
10:00Landis
10:03Frank
10:12You should be good
10:13You should be good to go now, hon
10:14Thanks, Lupe
10:15Of course
10:16Hey, go get them
10:21Hey, dog
10:23It's been a while
10:27I got a bad toothache today
10:31We'll take care of that, Lord
10:33All right
11:00Yes, I see
11:01You got a couple fingers
11:02Right, huh?
11:07there's too much blood suction uh we're tracking the lung try to identify the source
11:13could be the right ventricle or more likely the hilum fresh law pads
11:19siri turn on silent mode
11:45siri turn on silent mode
12:14good morning it was a good morning i'd still be in bed so what are you doing here
12:18ventricle's mom is visiting for the holiday she's still alive what was to me to die plus who else
12:23is going to get this place to the fourth of july weekend sure as hell ain't gonna be me i
12:27rest my
12:28case what am i walking into nothing too bad yet uh these are the ones i keep an eye on
12:35the prodigal son returns too soon no i guess not you're back it took some time like an old trail
12:45horse always follow way back out you look good get how you feeling oh yeah great you know it's been
12:53uh
12:54it's been a journey i bet thanks rob you're on uh he's in with the trauma but if you hurry
13:01back you
13:01can catch some of the pass-ons there in north uh thanks i'll keep an eye on him
13:11i think we have a lost little lamb uh excuse me hon can we help you i'm looking for the
13:17charge nurse
13:18oh well you found two of them i'm lena this is dana i'm night shift going home but dana is
13:23queen of
13:24the day shift emma nolan nice to meet you both i'm a new grad rn here to shadow welcome to
13:30the pit
13:30emma nolan here let me put some of your stuff behind the desk and i'll give you a quick tour
13:34okay where from sweetheart to st marie it's in upper michigan tactically canada my great-grandmother
13:43was from up that way nice area a lot of bugs how about a cup of coffee can't locate the
13:52source
13:52proximal high home is under the sternum along with most of the right ventricle you need better
13:57exposure convert to a clamshell exactly trauma shears might have been nice to let them come
14:03up with that plan no heart's gonna need double compressions just like this squeeze from the apex
14:08to the aorta
14:12right ventricle looks good massive hemorrhage from the highland second mtp packs going additional four
14:18units hyaluranger looks very proximal maybe pulmonary artery and vein clamps on nope no good
14:26still bleeding like a stuffed pig i can give it a talk conversely is a very skilled surgeon if she
14:30can't get it we need to think of something else like what
14:36hyalur flip you're gonna rotate the lung 180 degrees like putting a king in the garden hose
14:41it'll stop the bleeding that could possibly work or he'll die when you rip the entire lung off the
14:46hyaluron gently very very gently very recently
14:53yeah
15:06that's a good sign hyalur looks dry but the heart feels empty okay we fixed the leak now let's fill
15:12the
15:13tank. You are very popular today. Sorry, I'll turn it off when I can. Nine-year-old Kylie
15:25Connors, riding by her dad's girlfriend, Gina. Kylie took a tumble on the stairs this morning.
15:31We submitted a chin-lack and a chipped front incisor. She's got lead on a pressure dressing.
15:36Bleeding pretty good on a rival. Dermabond should do the trick. Any questions? Dr. King?
15:44Mel. Oh, um, I didn't say anything.
15:51How you feeling, Kylie? Tired? We've been here since 5.30. Oh, that makes two of us. But don't
15:57worry, we'll patch you up good as new and we will get you out of here as soon as we
16:01can.
16:02Any questions? No, I'm just her dad's girlfriend, so I'm new to all this. No worries. We got you.
16:07Next.
16:1026-year-old Liam Sanders. Took a fall from his bicycle. No LLC, non-focal neural. Lower leg
16:17lack with no bony tenderness.
16:18Were you wearing a helmet, Liam?
16:20No, I was just writing in my neighborhood.
16:22You should always wear a helmet.
16:24Hey, nice of you to join us.
16:25Hey.
16:26Dr. Langdon!
16:30Sol, it's Dr. Langdon.
16:33Candice O'Grady, 82. Brought a virus on Richard for intractable vomiting.
16:41Heartly and a hemorrhage on the right.
16:42Looks like the flip works.
16:43As a heartbreaker.
16:44Feels full of blood. First time since we started.
16:46Hold compressions.
16:50Quivering bag of worms.
16:52Resume compressions.
16:53When the heart quivers like that, it's obvious if you fit.
16:56Okay, internal paddles ready?
16:58Charge, tail.
16:5925 joules.
17:0050 gets it right the first time.
17:04Charge!
17:04Okay, Whitaker, when you're ready.
17:05Clear!
17:10That's what normal sinus looks like.
17:14Strong carotid.
17:15Salient lap pads and up to the OR.
17:19How the way to start the day?
17:21Unconventional, but a decent outcome.
17:25Why don't we split up for efficiency?
17:27Residents present to either one of us, but not both?
17:31We can certainly discuss that.
17:37Were you feeling weak or dizzy?
17:40No.
17:41I got up to pee and I tripped over a laundry basket that I couldn't see in the dark.
17:44Did you hit your head?
17:46Does my chart say that I hit my head?
17:47No, we just want to be thorough to make sure you don't miss anything.
17:52Yeah, how about we focus on patching me up?
17:55Ah.
17:56All right, Mr. Williams, we're going to check an x-ray of your wrist and try to get you out
18:01of here as quickly as possible.
18:02Great.
18:03And let's keep the bullshit extra charges to a minimum, huh?
18:06My deductible is already a bitch.
18:11Sure.
18:16Sure.
18:16Sure.
18:36My mother is trying to destroy my life.
18:38Well, yeah, they seem to take pleasure in that.
18:41I committed to a partnership track position next year at a hospital back in Jersey so
18:44I could be close and support her.
18:46But now she's getting married and selling our house to go on a year-long cruise around
18:51the world.
18:52Wow.
18:53I mean, that's a...
18:54Pretty fucking stupid idea, if you ask me.
18:57She's known this guy less than a year.
18:58What if he's a player?
19:00What if she disappears at sea?
19:02I mean, what if they're in love?
19:03Lust is more like it.
19:05That is even better.
19:08Man, it has been a while, and I'm solo this weekend.
19:15I need to get laid.
19:21It's a little much before 8 a.m., right?
19:24Yeah.
19:27Forever.
19:34How's it going, Esby?
19:35Oh, just another day in paradise.
19:55Where's your going on a trip?
19:58Taking a sabbatical.
19:59Leave tonight.
20:00Where are you going?
20:02Um, head smashed in buffalo jump.
20:06Captain Crunch flying squirrel socks.
20:08Are we talking in code or you have a stroke?
20:12It's an aboriginal UNESCO heritage site in Alberta.
20:15I've never seen the Badlands.
20:17What is this, like, uh, some sort of spirit quest?
20:20Uh, yeah.
20:22Something like that.
20:24Look, I, uh, I guess we should talk.
20:26I've got a lot of things I need to...
20:28At some point, not right now.
20:29Right now, I've got to hit the head, and I would like you to go help Donnie out in triage.
20:32Triage?
20:34No.
20:35No, I already picked up a patient in North, too.
20:37A bicycle led by somebody.
20:38Pretty sure we can cover for you.
20:39We've been doing it for months.
20:43Right.
20:44No, and I am, I am very, uh, both very sorry and appreciative of that.
20:49I just would hate to think this is some kind of a punishment for...
20:53Uh, yeah.
20:54Yeah, no, for sure.
20:55We'll talk later.
20:56Before you go.
20:59Like I said, not right now.
21:01Donnie just passed his DP certification.
21:03He can help you if you get in over your head.
21:09Hey, Mel.
21:11Can you take over a bike fall leg lack in North 2 from Langdon while he's out in triage?
21:15Um, you know, I, I can work in triage.
21:17No, I want to keep Langdon out in triage, and I want to keep you back here.
21:21You okay with that?
21:22Sure.
21:23Great.
21:24Absolutely.
21:33So, who should I pick up?
21:35We're about to get the morning rush.
21:37What do you mean?
21:38Every morning around this time, the nursing homes and assisted living facilities do their
21:43morning bed checks.
21:44Uh-huh.
21:48It looks pretty quiet to me.
21:54Uh-huh.
21:56Incoming!
21:58Oh, like I said, come on.
22:01Ethan Bostick, 79.
22:02Found altered this morning at assisted living.
22:04No history of dementia.
22:06Has a pulse.
22:07What's a pulse?
22:08Position orders for life-sustaining treatment.
22:10No CPR, no intubation.
22:13Then there's, there's nothing for us to do.
22:15South 15 is open.
22:16Uh, well, do not resuscitate does not mean do not treat.
22:20He may perk up with fluids, HIV antibiotics.
22:28What's the good word, Crash?
22:30You save that ventriloquist dummy?
22:32Yeah.
22:33Really?
22:34No.
22:36Wait, tell me you're not actually charging about losing a mannequin.
22:39It's part of the exercise.
22:40Don't do it unless you may ask us to do it.
22:42Who's his next of kin, Barbie?
22:44Okay.
22:44Bye.
22:46What's your, uh, take on the new attending?
22:50Not too soon to tell.
22:53You?
22:55She's already bugging me about being behind on my charting.
22:57Now I know why everyone says being a second-year resident sucks.
23:00Yes, it does.
23:01I must have sat through the part of med school where they tell you 90% of your time will
23:05be spent typing.
23:05Which is just one more reason surgery is a better lifestyle choice.
23:10Hey, Dr. Shamsi.
23:11Dr. Trinity Santos.
23:13Oh, yes.
23:14The ER intern who's interested in my surgery program.
23:16Well, it's me.
23:17But I'm an R2 now, and thinking of double boarding in surgery and emergency medicine.
23:22Which I know would sound ridiculously ambitious if I didn't have the talent to back it up.
23:26Again, a required attitude.
23:29Are you here to see a patient?
23:31I was.
23:32I did.
23:33And now I'm here to learn why you aren't returning my calls or texts.
23:37Okay, I'm out.
23:39Nice seeing you again, Dr. Shamsi.
23:41As soon as I get a little free time, I will make plans for all of us to do something
23:44together.
23:45What about Tuesday?
23:46I'm working.
23:46On your birthday?
23:48I will call you and Dad tomorrow, and we will come out this night to do it together.
23:51I promise, but right now, I just have a bunch of night shift handoffs.
24:03We have schedules.
24:04You have chaos.
24:07You know she's wasting her talents down here.
24:09Victoria is a big girl.
24:11She can make her own decisions.
24:12She's also a young girl who's still very impressionable.
24:15And you can be very...
24:17Impressionable?
24:21Yes.
24:22Who?
24:24Who?
24:25Oh, for God's sake.
24:27I'll be right there.
24:28We need to talk.
24:31How about same time tomorrow?
24:36Next Tuesday is your birthday?
24:37No?
24:40Yes?
24:41Your 21st birthday.
24:42Please don't say anything.
24:43Okay, I get a little anxious about...
24:45Dr. Shamsi's little girl with her chin legs getting to a gown.
24:47Don't worry, but you don't want.
24:51Nothing.
24:53Have a good day.
24:54You too.
24:59Hey, Duke, I'm just calling to remind you that this is my last shift for a while, so I need
25:06you to come in before 3 o'clock in case we need to run some tests.
25:11Okay, we had a deal, brother.
25:16Oh, hello.
25:17Hi.
25:18I know you're crazy busy.
25:20Always.
25:20But I figured we should really go over a few things before you're gone.
25:23Sure.
25:23Where would you like to start?
25:26Well, one little thing that I think would have a big impact with staff and patients alike is if we
25:30launched a campaign to eradicate referring to this wonderful department as the patient.
25:37Really?
25:37I know you think it's silly and petty.
25:39No, I think it's just kind of endearing, pretty damn accurate.
25:43I would argue the opposite.
25:45I think subconsciously it affects those who work here.
25:48It also lowers expectations, which in turn lowers patient satisfaction.
25:52Well, you've been talking to Gloria.
25:53Yes, and she agrees with me.
25:55Don't doubt that for a moment.
25:57You have to see the man who will do it right now.
25:59We see people in order of severity, ma'am.
26:02You have to ask for others to teach everybody.
26:04What would you plot?
26:05I don't know what you're saying.
26:07I can taste the shit in the back of my throat.
26:09Actually, the ladies' rights are going to make all of us six.
26:11Yes, please.
26:20Alright, we'll get them back.
26:23Tell Dana we're bringing the funk.
26:28Lisa, when did your eyes start bothering you, Miss Matthews?
26:31Sister Grace, please.
26:33I'm only married to God.
26:34Of course.
26:35I'm sorry.
26:36A few days ago, I thought it was pink eye.
26:40Or maybe I scratched it while gardening.
26:42It's a very bad case of conjunctivitis.
26:44We should send a sample to the lab to direct her treatment.
26:48Look up for me.
26:54I'll put a numbing drop in your eye
26:56and check for a scratch with a special lamp.
27:01And I'll get you to look up for me again.
27:05Have you ever considered serving God?
27:08Which one?
27:09Excuse me?
27:12My family's Hindu.
27:13So we have like 33 different kinds of deities.
27:16Oh, we have the one.
27:18Some people only need one, right?
27:21Okay.
27:25Most important rule around here, be smart, be safe.
27:28Can't warn you enough about protecting yourself and your fellow nurses.
27:31We use the STAMP acronym to assess patients.
27:34You know it?
27:35S is for staring or refusal to make eye contact.
27:38If they're staring, they're scaring.
27:39T?
27:40Tone of voice.
27:40Often the threat level rises with their voice.
27:43A is for anxiety.
27:45You can also think aggression.
27:47M is mumbling.
27:48If you're listening closely enough, it's often the same.
27:50What they're thinking of doing is to talk themselves up to it.
27:52And P?
27:53Pacing.
27:54Good.
27:54We also have a safe word.
27:56Hula hoop.
27:57I guess technically it's two words, but whatever.
27:59If there's a threat, say hula hoop and we'll all respond.
28:04Yeah?
28:06Lovely.
28:07Okay.
28:08I'll be right there with reinforcements.
28:12Dirty calls.
28:13We're headed for triage.
28:20I'm going to get your cash off.
28:22Just leave it.
28:41The antibiotics should clear everything up, but you should try to stay off it for a few days.
28:47I have to work.
28:49I'm late as it is.
28:51Well, take breaks and elevate when you can.
28:54Tie it on Advil for the pain.
28:56If the pain persists or feel like it's getting worse, come on back.
29:00We'll get you fixed up.
29:01Thanks.
29:02Listen, give this to the doctor.
29:06What the hell is it?
29:07Patient passport.
29:09Let's patients know what they're waiting for and how long it'll take.
29:11You check off if he needs labs, x-rays, CT.
29:14No, and the above.
29:15When do we start this?
29:16Today.
29:17The new attending.
29:20What's up with your tooth, Louie?
29:23It's been going on for a while, but it got bad last night.
29:28Lower left side.
29:30Okay.
29:35It could be an infection at the root.
29:37We can drain it, but then you're breathing kind of fast.
29:44Yeah, I've been walking more, trying to get in shape.
29:50Sometimes I get a little short of breath.
29:52Yeah, you need to walk past the liquor store, not into it.
29:56What shape you're getting in is for a liver transplant.
29:58I don't need a new liver.
29:59Just get rid of this toothache.
30:01Deep breath.
30:06One more.
30:08Is my heart still ticking?
30:09Like a jackrabbit.
30:11How long you been sitting down?
30:12Oh, just for a few minutes.
30:14Not that long.
30:15Um, Louie.
30:19There's something I need to tell you.
30:23Last time I saw you, about 10 months ago,
30:27I treated you, and I took some of your medicine.
30:31I'm not sure I follow.
30:34I have an addiction to benzos,
30:36and I helped myself to some of the Librium I prescribed you for your withdrawal.
30:42You stole my pills?
30:46Yeah.
30:47You stole my pills?
30:48Um, I'm sorry.
30:51It was, uh, it was not only wrong and utterly unprofessional,
30:56but it was a betrayal of my Hippocratic oath,
30:58and it was a fucking crime.
31:02That's where I've been.
31:04Rehab and counseling.
31:08Huh.
31:09I'm sorry.
31:10I-I understand if you prefer a different doctor.
31:14Hey, Doc.
31:14We have a situation.
31:17Excuse me.
31:19What kind of situation?
31:20Someone left the little baby in the restroom.
31:31Okay.
31:33Let's think about reversible causes of confusion in the elderly.
31:37Uh, hypo or hypernatremia.
31:39Infection, but he's afebrile,
31:40good or two sats, and urine dip was negative.
31:42Yeah, great.
31:43Joy, anything to add?
31:46Nah.
31:49V-Tac, can I?
31:50Yeah.
31:53No pulse.
31:54Should we call for a code blue?
31:55No CPR.
31:56No shock.
31:57We honor his pulse and his wishes.
32:00So, what does that leave us?
32:02Making sure he's comfortable.
32:05Palsuction.
32:07Altered mental in the elderly can also be toxicity from anticholinergic,
32:10sedative hypnotics, opioids.
32:15Am I missing something?
32:17Social skills?
32:23You look so peaceful.
32:25Should we maybe go find a new patient?
32:26No, stay here.
32:31A systole.
32:42Quick and painless.
32:44We should all be so lucky.
32:45I'll try to contact some family.
32:50Yeah, one of the things we like to do here,
32:56when we have the time,
32:58is to take a moment of silence when we lose a patient,
33:01to respect their humanity.
33:03He was someone's son,
33:05perhaps a father himself,
33:08brother or friend.
33:13Oh, just make sure your phones are on silent.
33:20Great, great, great.
33:21Okay.
33:23Is anyone missing a baby?
33:26Did anyone leave their child in the restroom?
33:31You, uh, remember seeing a woman enter with a baby,
33:34believe without one?
33:36No, sorry.
33:38Might be on the security tapes.
33:40I'll have them all check it out.
33:42Please.
33:42Yeah.
33:43Harlow Graham to window one.
33:46Harlow Graham to window one.
33:50Harlow Graham to window one, please.
33:58Donnie, Donnie, you're a nurse practitioner,
34:00and this is Emma, a new grad nurse.
34:01Hey.
34:02Nice to meet you.
34:02What's going on?
34:03Somebody dumped their kid.
34:05Well, maybe Mom just stepped out for a smoke or something.
34:07What?
34:08I'm being hopeful.
34:09Sometimes I just need a little break,
34:10and then they come back.
34:13At least I didn't leave her in a suitcase at the bus station.
34:16Did that happen?
34:17If that's a true story, I don't want to know about it.
34:19Get the worst of scenes.
34:20Please, please, don't tell me.
34:21I'm a new dad.
34:22Remember?
34:31I'll get Robbie.
34:32Should I come with?
34:33No, stay here.
34:34Donnie, Jesse, teach her something.
34:39You know how to check a rectal temp on an infant?
34:42Uh, theoretically.
34:52Mr. Williams, how's the pain?
34:55Nothing I can't manage with some Vicodin and a little scotch.
34:59Well, it's best not to mix the two.
35:01James here is going to take you to get an x-ray of your wrist.
35:04I'm going to be fine.
35:06Well, it'll tell us if you need a cast.
35:08I doubt it.
35:09I should probably go home, keep some ice on it.
35:12I know you guys always need the beds.
35:15Well, it'll only take a minute, and then we'll know for sure.
35:19Yeah, I really don't think it's necessary, and I have a busy day.
35:21But I appreciate your concern.
35:27I'd really like to observe you for a little bit, in case you did hit your head.
35:31My head?
35:33I have my schnoz on my arm, I think.
35:35Nothing more.
35:36You think you don't remember?
35:38No.
35:38Yes.
35:41I'm going to be fine, really.
35:44Thank you for your concern.
35:50Okay.
35:52Ha!
35:54How about we take that x-ray just to be safe?
35:58Yeah.
36:00Yeah, okay.
36:01Okay, good idea.
36:04Somebody found a baby?
36:06Yeah.
36:07Not the first time it's happened.
36:09So, about those pills I took.
36:12Don't worry about it, Doc.
36:14If the pills helped you, great.
36:17I never really liked taking them.
36:21I appreciate that, Louie.
36:23That's not really the point, but...
36:25I need to lift up your shirt for a second.
36:28Okay.
36:34How long has your belly been hard like that?
36:36I don't know.
36:37I figured I could wait another week.
36:39You need, uh, some lab tests and a procedure to drain off some of this fluid.
36:44Yeah, I know the drill.
36:46I've been tapped a few times before.
36:49Three times in the last six months.
36:52You need to give your liver a break, Louie.
36:55Yeah, I know.
37:00I just heard somebody dumped a baby in the waiting room bathroom.
37:04How sad is that?
37:05Huh?
37:07What's up with you today, Mel?
37:09Lynn, call ya?
37:11What makes you think there's something up with me?
37:13You're moping around here all day like somebody gunned down your favorite K-pop band.
37:17I don't really have a favorite K-pop band.
37:19Not that I don't like the genre.
37:21Forget K-pop.
37:22What's going on with you?
37:23You usually ride in here on your unicorn tossing wildflowers.
37:28Unicorn?
37:28Never mind.
37:30Is everything okay with your sister?
37:33Oh, yeah, she's great.
37:34It's just this...
37:38Spill, girl.
37:40Um, well, a couple of months ago I got named in a malpractice lawsuit.
37:47And so today is the deposition.
37:52That's it?
37:53Every emergency medicine doc gets sued sooner or later.
37:56Seriously.
37:57Don't sweat it.
37:58You're still a resident.
37:59We're protected by the hospital.
38:00You could cut somebody's head off and get away with it.
38:04You know, like, don't.
38:07You won't want to become known as the one who put Mel in malpractice.
38:11Hey, Santos, our little girl Kylie has been in the West Bend emergency department a couple times.
38:18I'm not saying this isn't necessarily the case here, but recent studies have linked bullying behavior to different personality disorders.
38:26On the other hand, though, I am known to be a bit overly sensitive sometimes.
38:31Mel.
38:31Yes?
38:31Talk to yourself again.
38:33You need something?
38:34Uh, do I have a good lawyer?
38:35I don't know.
38:36I'm kidding.
38:37I'm not...
38:40Yo, Rabinovich.
38:41Somebody ditched a bundle of joy in chairs.
38:43How old?
38:44A couple months.
38:44Maybe Donahue's got her in peds.
38:46No one saw who left her?
38:47Apparently not.
38:48It's so sad.
38:50Tell me about it.
38:50Who throws away a perfectly good baby?
38:53Make a leg.
38:54Ah!
38:55Sweet baby Jesus, Antoine.
38:57Right to the outdoor shower.
38:58I just drive him.
38:59I'm not a washing detail service.
39:00Yeah, yeah.
39:01God forbid you prove useful.
39:03Ah, good time, Emma-sama.
39:04Time for you and me to do the Lord's work this way.
39:07Oh, God.
39:08What is that?
39:09Okay.
39:10Big breath.
39:13All right.
39:13Lungs sound great.
39:15Can you lean forward for me?
39:22Uh, did you hit your back when you fell down the stairs?
39:26No.
39:27Okay, there's a pretty good bruise here.
39:29I got knocked down in soccer.
39:33Oh, no.
39:34You broke your wrist last year, too, huh?
39:36I fell with my skateboard.
39:37Got a purple cast.
39:39Cool color.
39:40And you were treated at West Penn.
39:42Is that your closest hospital?
39:45I guess that would make sense.
39:46I've only been dating your dad a few months.
39:49He lived in Garfield before the divorce.
39:51And what about these?
39:53Soccer.
39:54Do you wear shin guards?
39:55My dad ordered them.
39:58What does your dad do for work?
40:00He draws buildings, but he's not an architect.
40:03He's a draftsman for a firm in Newcastle.
40:07Um, Kylie, any chance you can pee?
40:11Mm, maybe.
40:12Okay.
40:13Well, uh, with the bruise on your back, we need to check your urine.
40:16Okay.
40:17Okay.
40:21Did you eat anything out of the ordinary recently?
40:23No.
40:24Sorry, but we went through this a bunch.
40:27Don't you people communicate?
40:29You're the third nurse we've told her story to.
40:30I'm a doctor.
40:32Richard.
40:33Would you go to the cafeteria and get me a large chamomile tea?
40:37What can we get you, my dear?
40:39I'm fine.
40:43Yeah, I'll be right back.
40:49Please excuse my son.
40:52Ever since my husband died, he's been a little overprotective.
40:56I think it's sweet.
40:58You're very lucky to have him.
41:00I am.
41:02Are you still taking your loperamide and cholestyramine?
41:07Um, not so much.
41:09No?
41:10Well, that may be why you're experiencing the abdominal pain and vomiting.
41:15When did you stop taking your meds?
41:17Last winter or so.
41:21My neighbor Helen and I bingo in Wintersville.
41:25There's a dispensary next door.
41:28And we got some marijuana.
41:30And I swear, it cleared everything up.
41:34A few cookies every few hours.
41:38And no more pain.
41:40A few cookies?
41:43How many are you eating in a day?
41:45Oh, uh, I don't know.
41:50Probably a dozen or so.
41:52But they're not very big.
41:55There have been some studies that show an added dementia risk with marijuana use in older adults.
42:04Kylie, there are some questions that we ask every kid who comes in with an injury.
42:13Like what?
42:14Like, sometimes the people that you live with can get so mad that they hit you or hurt you, maybe
42:24without even meaning to.
42:26Does that ever happen?
42:27No, not to me.
42:29Or sometimes kids can get punished for doing something wrong with maybe a spanking or a belt.
42:37I get timeouts.
42:40How about at school, Kylie?
42:42You know, is anybody being, you know, mean or bullying you?
42:45No, I have lots of friends.
43:02You know, I have lots of friends.
43:08yo Whittaker dr. Langdon you meet Louie here yeah yeah many times good morning
43:18mr. Cloverfield what's up doc where's your new resident badge buddy buddy oh
43:23yeah they didn't give me a new one yet bummer you and your ducklings got time
43:29to tap a six-pack off our friend here Louie needs a paracentesis yeah sure
43:33it's good to see you again Louie not in this condition of course how you feeling
43:38feeling like I need a drink pretty soon okay well first things first we are gonna
43:45make you more comfortable by draining some fluid you're gonna take off a big
43:49volume start with 60 grams of 25% albumin IV you tapped him before no that's okay
43:55doc I'll talk him through it that's 99 on room air normal BP
44:07well hydrated no obvious source of infection could be a benign virus but
44:12can't assume that it's the abandoned baby mm-hmm how old how do you think she is
44:18month month and a half it's tricky under 28 days is a safe haven drop-off no
44:24questions asked but over 28 days is a crime child abandonment how should we
44:30assess under 28 days gets everything including an LP but over 28 days you can
44:37follow PCORN or step-by-step determine risk of invasive bacterial infection this
44:41baby looks great we know nothing about the birth history did mom have group B
44:46strep active HSV lesions we should assume the worst put in your words that
44:51you want in CBC what culture camp panel chest x-ray UA and culture respiratory virus panel
45:02check inflammatory markers procalcitonin and CRP then take it from there that
45:09sounds like a plan dr. Robbie Santos needs you north one okay I'll be right there feel
45:15excuse me feel excuse you mind if I join with uh no at this it will help me get a
45:25better sense of how you like to do things by seeing you in action with the
45:28residents be my guest I will be right back
45:42nine-year-old Kylie Connors took a tumble running up the stairs this morning chin lack
45:46and fractured tooth brought in by her dad's girlfriend Gina supposedly the dad had to leave
45:51early for work Kylie has a lot of bruising on her body some old some new are you concerned about
45:58non-accidental trauma or worse her urine sample shows gross hematuria which could be renal injury or
46:06vaginal bleeding from trauma could have contaminated the specimen lots to consider what's your plan
46:13labs ultrasound social work consult then decide if this is reportable
46:22let me know if you can feel this no am I supposed to no
46:32your hair is such a pretty color thank you reminds me of my mom she died when I was nine
46:38um sorry about that she wore glasses like you too weird what do you like to do when you're not
46:47working
46:48um spend some time with my sister read do you drink coffee uh no I avoid caffeine
46:56caffeine me too what about boba I love boba
47:10I don't know if he's some gum but it's laced with nicotine trying to quit smoking
47:16that's good birdie's still out getting all those nooks and crannies Mr. Digby your skin will thank you
47:23we all will I could stay in here all day a miracle with a little soap water and human decency
47:32can do
47:32sometimes don't forget the ears pal don't want anything growing in there either okay okay so what's
47:39your story Emma what do your parents do got siblings boyfriend ever kill a man in a bar fight
47:57so mr. Williams sometimes a fracture of the scaphoid bone doesn't show up on day one
48:03so my advice to be safe is we're split for two weeks and then come back for repeat x-ray
48:09and we'll
48:09see if it's really there my knee hurts oh did you hurt your knee I must have
48:27what is this that's um for your wrist I need this
48:36well um if it's a uh John can you yeah if it's a fracture and we don't immobilize the bone
48:43might not
48:44heal properly
48:48how long is this gonna take just a few minutes to fit you
48:56is this place new mr. Williams do you know what day it is
49:09it's taco tuesday do you know where you are
49:15yeah I'm in the slowest medical clinic in the west
49:19do you know what year it is how about you just fix my wrist and you stop with all the
49:25questions
49:28I am not here to be profiled
49:35yeah of course
49:38I'll be back okay
49:51all right mr. digby looking better already certainly smell a little better
49:55do you have any conditioner
49:56let's get you dried off and back inside
49:58get him downed up and put him in south 21 and cross from the old nun
50:01maybe some of her to find grace will wear off on him
50:05who do we have here
50:07Evelyn Bostick 81 with Alzheimer's we brought her husband in about 30 minutes ago
50:11she was supposed to get a ride in but they found her wandering in traffic
50:14where are we
50:15you're at the hospital dear
50:16I'm not sick
50:18we brought you to see your husband
50:19oh no is he's in okay
50:22be in to chat with you mrs. Bostick
50:25he died
50:27what you got am boy
50:28Alan Billings had a pallet fall into his outstretched arm
50:32looks like an open dislocation
50:34yeah that's gotta hurt
50:35don't worry sir we got you
50:43how's she doing
50:43seems happy enough
50:46yeah
50:47I just got a quick point of care CBC
50:57is there a problem
51:02did I miss something
51:04Dr. Al
51:06Dr. Al
51:14I'm in hurt
51:17but I refuse to cry
51:22I'm in hurt baby
51:24but I refuse to cry
51:29it's no true
51:30you know you know you know you know you know
51:33I can't lie
51:34and I said
51:36Yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah,
51:49yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah,
51:51yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah,
51:51yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah,
51:51yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah,
51:51yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah, yeah
52:00You know I won't cry
52:03You know, you know I won't cry, baby
52:06I'm telling you, I won't cry
52:10Oh, I don't lie
52:13Oh, but I refuse to cry
52:16And I say sometimes, darling
52:21Your friends, they treat you so cold
52:24But baby, you know they act better, yeah, yeah
52:28When you have that goal
52:31But I won't lie
52:34You know, you know, you know
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