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The.Pitt.S01E02.540p.x265.AAC [Full Movie] [High Quality]Full EP - Full
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00:00рдЪреАрдЬрд╝рд┐рдП рдпрдЪрд┐рдП рдПрдХ рдЕрд╡рд┐рдП рдЬрд╛рдУреЛ рдЖрдЧ рдЬрд╛рдУ рдСрдл рдмреЛрдЧ рдСрдЧ рдЬрд╛рдУреЛ рдкреЗ рдирд╛рдУрдЧреА рдПрдХ рдЕрд╡рд┐рдП рдПрдХ рдмреЗрдВрдЧреНрдпрд╛рдУ рдЕрд╡рд┐рдП рдПрдХ рдЕрд╡рд┐рдП
00:21рдирд╛рдУреЛрдбрд╝ рд╣реИ
00:30рдХреЛрд░реЗ рдХрд┐ рдПрдВрдЧ
01:00рдПрд░ рд░рд╛рд░рд┐рд╡рд▓ рдХрд┐ рдореЗрд╢ рдмрд╛рд░реА рдХрд╛ рдкрд┐рд▓реНрд╕рдХ рдмрд╛рд░рд┐рдХрд░реНрдЯ рдХрд░ рдард╛рд░реАрдЦ рдкреНрд░реАрд╢ рдкреНрд░реАрдкрд╛рд░ рдХреЗ рд╣реНрд░реАрдЦ рдЗрдЬ рдореЗрдВ рдкреАрдбрд╝рдХрд░ рдерд╛рдЗрд╡ рдЯреБрдмреНрд╕ рдПрдХ
01:08рдкреНрд▓реА рджреВрдм рджреВрдм
01:29рдЧреНрд╕рдХреНрд╕рд╛рдкрди, GCS3.
01:31рдХрд┐ рдирдХреЗ рдлрд┐рд░ рдлрдЪреЗрдХреЗ рдЗрддреНрд╕редрдЪрд░реВрдо рдХрд╛ рдЕрдкрди division?
01:33рдпреЗ рдкрд┐рд░ рд╕рднрд╝реЛрдЬ рдЕрдзрди рд╣рдореЗ ╨Р╨╗╨╡╨║╤БуБиуБДуБЖуБУуБи ikke happy, рдФрд░ рдЙрд╕ рдХрд░ рджреЛ,рд╛рд▓реЗрдзреЗ рд╡рд┐рд╣рд╛рд▓рд╛тАж
01:50рдЕрдмрдзрддреА с╜ЙрдЧрд╛рдЪ, рдЙрд╕ рднреАрд╡рд╛рд▓ рдкреНрд░рд╛рд╖реНрддреНрдпрд╛ рд╢реНрд░рд╣рд▓рд╛ред
01:53рдХрд┐ рдореЗрдВ рдкреНрд░ рдкреНрд░редbar рд╣реИ рдХреЗ рд▓рд╕ред Patr
01:5984 over 58.
02:01Okay.
02:02What's your plan, Dr. Collins?
02:04Push-dose epi, 0.1 milligram,
02:07fully for urine, stabilized for CT,
02:10and throw a wide net.
02:17Where are we going now?
02:19We need the room for someone else,
02:20but you can rest in the hall
02:22till we get your labs back.
02:25Your parents must be proud
02:27having a son who's a doctor
02:30yeah I guess
02:33you know I was the first one in my family to go to college
02:36and now they sacrificed a lot to get me here
02:42how's your pain Mr. Milton
02:43uh I'm fine
02:45you could use a latte though
02:47that could bring back the gallstone pain
02:49how about a bourbon
02:50it's barely 8 o'clock
02:53how about some ice chips
02:55no thanks
02:56I prefer my whiskey neat
02:58yeah that's not happening
03:05systolic back down to 90
03:07another 0.1 of epi
03:09flaccid paralysis of all four extremities
03:14no eye movement with ice water
03:16so no brainstem function
03:17due to
03:18hypoxic injury, massive hemorrhage
03:21Samira, escort him to CT
03:23take the drug box with you
03:25call me if you need me
03:27hey are you okay?
03:30yep
03:30you sure?
03:31have you ever had to worry about me?
03:34no, but never hurts to check in
03:36it's part of my job
03:38consider yourself checked in
03:40okay
03:45got something?
03:46oh I had a case for Dr. Collins
03:48may I see it?
03:50yeah
03:5168 year old male, history of hypertension
03:53one hour of right upper quadrant pain
03:55after eating a fatty meal now resolved
03:57a febrile, non-tender
03:59there was a gallstone present on POCUS
04:01EKG shows no acute ischemic changes
04:03but I'm still waiting on LFTs and lipase
04:06why did you order the EKG?
04:08the nurse suggested it to rule out any cardiac issues
04:11well good call on both your parts
04:14nurses know what they're doing
04:15never hesitate to listen to them
04:17come find me when those labs are back
04:18hey how's that finger?
04:19oh it's nothing
04:20Dr. Robbie
04:20yep
04:21the son and daughter of Mr. Spencer
04:23from assisted living
04:24they're here
04:24okay
04:25I'll be right there
04:33your father has pneumonia
04:34and a condition called sepsis
04:37what is that exactly?
04:38it means that the bacteria has spread
04:40from his lung to his bloodstream
04:42so far he's been responding well to treatment
04:45hey pop
04:47it's Helen and Jeremy
04:51Jeremy
04:54Hillary
04:56boom
04:57bud
05:01it's the nowhere man from yellow submarine
05:04it's what he used to call me when I didn't do my homework
05:05is this his baseline?
05:08he has good days and bad days
05:11why don't we step out for one more second
05:18so your father came in with low blood pressure
05:20which is improving
05:22can he go back to assisted living?
05:23eventually we hope so
05:25your dad has an advanced directive
05:27expressing his wishes
05:28which says that IV fluids and medications are okay
05:31but no artificial life support
05:33no CPU
05:33he doesn't want a bunch of machines keeping him alive
05:36okay
05:38then we will continue with oxygen
05:40and IV fluids
05:41and antibiotics
05:42but if his lungs stop working
05:44we're not going to place a tube in his windpipe
05:46for a breathing machine
05:46but pneumonia is treatable?
05:49most of the time it is
05:52but if he can get better in a week
05:53then put him on a machine
05:54that's not what he wanted
05:56do either of you have durable power of attorney for healthcare?
05:59yes
06:00we both do
06:00okay
06:02well this is a decision
06:03that does not need to be made right now
06:05why don't you think about it
06:06talk about it
06:09if things get worse
06:11sometimes allowing for a comfortable natural death
06:13can be the most humane path
06:18no routine cases
06:19until we assess the tier one
06:21thanks
06:22dr langdon
06:25so uh
06:25how's the
06:27VA?
06:28yeah
06:28it was uh
06:29good
06:29uh
06:29you know
06:30challenging
06:30I learned a ton
06:32I just think it
06:33maybe it should be mandatory
06:34that all doctors spend time there
06:36like on a regular basis
06:37because of all they've sacrificed for us
06:39that's a nice thought
06:40how'd you choose the pit?
06:42oh
06:42I have a sister with special needs
06:43and she got into this really great facility here in Pittsburgh
06:46and PTMC has such a great reputation
06:48I thought
06:49you know
06:49I'd be a good
06:50can I present my headache to you?
06:51uh
06:51yeah
06:51what do you got?
06:52uh
06:5236 year old woman with severe headache
06:54due to paracervical trigger point
06:56her pain went from 11 to 0
06:58after 2 cc's of IMR cane
07:00wait wait wait
07:00you did a trigger point injection
07:01before presenting the case?
07:03yeah
07:03interns always present first
07:05I spent a month at the pain clinic
07:07no it's not okay
07:08I'm very comfortable
07:09it's definitely not okay
07:1023 year old Ben Kemper
07:12no helmet got doored riding an e-scooter
07:14neck versus handlebar
07:15then face planted to the pavement
07:16obvious facial fractures
07:17but alert and oriented with good vitals
07:22here we go
07:25one
07:26two
07:26three
07:29how we doing Ben?
07:31come on
07:32I'm back in my throat
07:33that's probably from the nose bleed
07:35short rapid rhino please
07:37tacky at 120
07:38pull socks borderline at 90
07:40we'll buy it 15 liters for now
07:42neck contusion
07:43larynx shifted to the right
07:44no crepidance
07:45four morphine
07:46I'm gonna stick something in your nose
07:49to stop the bleeding
07:51no hemotimpanum
07:53inflate the balloon
07:55how about now Ben?
07:58better
07:59what's up?
08:01good vitals
08:02A and O
08:03let's have a look
08:08ouch
08:09floating face
08:10before three fracture
08:11you don't see that every day
08:13okay let's prep for an airway
08:14double setup just in case
08:30nice work
08:31thanks
08:34all right Mr. Chagari
08:35you are good to go
08:36oh thank you
08:37remember
08:3810% off for doctors and nurses
08:42I'm a student doctor
08:43all right sorry
08:44I hit my head remember
08:46well my son loves pizza
08:48so I will take you up on it for sure
08:49thank you
08:50thank you
08:50wait for a nurse
08:51okay
08:52thanks
08:54I just realized it sounds like
08:55I always feed my kid junk food
08:57oh
08:57no
08:58pizza
08:59s'mores
08:59no no please
09:00I like pizza and s'mores
09:02who doesn't?
09:04thanks
09:05how many kids do you have?
09:07just one
09:08Harrison
09:08he's 11 now
09:11what does your husband do?
09:13no husband
09:13just being my son
09:14I take it you don't have kids?
09:16I don't mean on account of your age
09:18or
09:19I don't know
09:20maybe I do
09:20I mean most medical students don't have kids
09:22yeah
09:23no
09:23no
09:24no kids
09:25just
09:26I'm not even a boyfriend
09:27it's just school
09:28for now
09:29yeah
09:29that'll keep you pretty busy
09:31I do not miss it
09:33must have been difficult as a young mother
09:35it had its moments
09:37but my life has been full of challenges
09:38med school was not one of the hardest by far
09:42it was one of the most rewarding though
09:44other than having my son
09:47hey
09:48facial act with a possible foreign object in the eye
09:51which is always a solid 7 on the WMMB scale
09:54what makes my tail vomit
09:59you okay?
10:00yeah
10:01yeah
10:02um
10:03he's funny
10:04the
10:05the nurse
10:06oh
10:06Mateo
10:07you can say his name
10:09um
10:10yeah
10:10uh
10:12foreign object in the eye
10:13could be really serious
10:22hey fruitcake
10:25hey I'm talking to you fruitcake
10:27Myrna
10:27I've told you a hundred times
10:29my name is Dr. Robbie
10:30you want to see my vagina
10:32I have already seen it
10:35and once was enough
10:37thank you
10:38Robbie
10:38parents of Nick Bradley
10:40the ODT are here
10:41okay park him in trauma one
10:43he's not back from CT yet
10:44but I'll be right there in a minute
10:45behaving yourself Myrna?
10:47oh yes ma'am
10:53how we doing?
10:54catamini sucks on board
10:55pulse ox holding at 94
10:56prepping the neck just in case
10:58let's have a look
11:01a little deeper
11:03lots of swelling
11:04I can't see the cords
11:05to the right
11:06the left
11:07yeah really distorted from the trauma
11:09and the demon's only going to get worse
11:10which is why we should crike
11:11you don't crike a laryngeal fracture
11:13don't listen to Edwina scissorhands here
11:15if they can't cut it
11:15surgery doesn't want to fix it
11:16the contusion is high
11:17at the thyroid cartilage
11:18so you just stand there
11:20looking pretty ER Ken
11:21and let me fix this
11:23we're down to 85
11:24alright pull out
11:25eye gel
11:25bag and crike
11:26eye gel please
11:27turn off the alarm
11:28I've never done a crike before
11:29no Mel will do the crike
11:31you've already had a busy morning
11:32glove up Mel
11:32no I'm doing the crike
11:34doctor
11:34you would be doing it doctor
11:36if it wasn't an odd day
11:37surgery gets even days
11:38ED gets odd days
11:39you know this
11:39for crike's sake
11:40it's because you're all
11:41fucking odd down here
11:42okay teamwork please
11:43let's focus on the patient
11:44I so appreciate your
11:45gracious understanding
11:45I'll assist in case
11:47she screws up
11:47you're longer
11:48plain nice
11:49stats are up with the eye gel
11:51you ready
11:52hello
11:53oh uh hello
11:55you've done this
11:57yes
11:57in the cadaver lab
12:00let's hope that's not
12:01where this poor soul ends up
12:03we'll do an open technique
12:04since we have a minute
12:05okay
12:07okay
12:08okay you're gonna be making a vertical incision
12:09to avoid the jugulars and the carotids
12:14good
12:15if this was a crike that needed to happen in seconds
12:16you could use a 10 blade
12:18your finger and a bougie
12:23this is called a wheat laner
12:24and this is your tracook
12:27C-spine
12:28head CT
12:29OMF
12:30start a propofol drip
12:31okay now we're gonna make a horizontal incision
12:33across the crick with the thyroid membrane
12:394-0 Shiley next
12:41get ready to bag the crick
12:45yeah yeah yeah
12:46good
12:54excuse me
12:55no worries
12:57end tidal CO2 is yellow
12:58yellow is yes
12:59nicely done
13:00sew it in
13:00okay
13:01I will be next door
13:04does your resident know how to suture
13:06or do I need to teach
13:07you're all class yo-yo
13:09I know
13:09thanks
13:10that means a lot of nothing coming from you
13:13Mel you okay
13:14if you're done fighting
13:15we're not fighting
13:16this is playing
13:17Langdon's too soft to fight
13:18oh yeah
13:19I have nothing but respect for Dr. Garcia
13:21in fact
13:21I think she would make a wonderful hostess at Applebee's
13:24later odds
13:28let's go
13:30okay
13:30okay thanks
13:31just received a word
13:32your son's head CT is normal
13:34and he's maintaining a good heart rate
13:35you got him back
13:36blood pressure
13:37thank you thank God
13:38right now he's unconscious
13:39with a tube in his throat for oxygen
13:42why don't we step out for a minute
13:44while they get him settled
13:45and then you can come back
13:45you can sit with him as long as you want
13:48Nikki it's mama
13:49I'm here babe
13:50you're doing great son
13:53boom
13:56okay let's step outside
13:59okay
14:05so
14:06we don't know how long he was at home without breathing
14:09he's breathing now
14:11not on his own
14:13but he's gonna wake up
14:14we certainly hope so
14:16we're gonna know better after we get some more test results back
14:18are you sure that he didn't take anything that could have caused this
14:22no
14:23no he's a good kid
14:24he's in college
14:25he has a part-time job
14:26he even chose to live at home so he can focus on school
14:29Dr. Robbie from the urine
14:31what's that?
14:34it's a drug test
14:35and it is positive for fentanyl
14:38no that is impossible
14:39Nick doesn't do drugs
14:40there are a lot of pills that are sold illegally that have fentanyl
14:44not just painkillers
14:45Xanax
14:46out of van
14:47no not our son
14:49well maybe he didn't know that he took something with fentanyl
14:52I don't know
14:53the hows and the whys don't really matter
14:55what matters is spending time with Nick
14:56we've got some more tests to run
14:58we'll know our options after that
14:59but in the meantime
15:00why don't you take a seat
15:01talk to him
15:05can he hear us?
15:06you know we're never really sure
15:08so you should just assume that he can
15:09and we'll come find you as soon as we know more
15:12okay
15:12see
15:19can we move Nick Bradley to a private room?
15:22like you're gonna make it?
15:24didn't he respond to Narcan?
15:26I think his pinpoint pupils just grew into blown pupils from brainstem deaths
15:30shit
15:32yeah
15:32not much older than Jake
15:35don't go there
15:38hard not to sometimes
15:41Mr. Spencer's room
15:44hey Robbie
15:44Teresa
15:45the mother of the young man David who bolted
15:47she's asking for her son
15:48okay
15:49I'll be there in a minute
15:50what is happening?
15:51uh
15:52his oxygen levels are dropping
15:54Mr. Spencer
15:55how are you feeling?
15:57I don't remember where I parked
15:59Mr. Spencer
16:00do you know where you are?
16:01it's so loud in here
16:04dad
16:04do you know where you are?
16:06dad
16:06look at me
16:07what's my name?
16:08I don't know where my car is
16:12I-PAP 15 over 5
16:14can you step out?
16:20what's I-PAP?
16:21it is a pressurized air mask that can improve his oxygen
16:24either his pneumonia is getting worse
16:27or his heart couldn't handle the fluids that we gave him to treat the sepsis
16:30his lungs are filling up with fluid
16:32can't you take the fluid away?
16:33not without his blood pressure crashing with very bad consequences
16:37so let's just hope the BiPAP works
16:39and if it doesn't?
16:41then I would need to know your decision about using a breathing machine
16:44we're still talking about it
16:46well we know he expressed his wishes
16:48in writing
16:49do not intubate
16:51we're thinking try it for a week
16:54that would be a very painful week
16:57he wouldn't get a lot of rest
16:58with all the monitors and all the blood tests
17:01he might need to be sedated
17:02he might need to be restrained
17:04because he'd be in an unfamiliar place
17:05with a very uncomfortable tube down his throat
17:08and he wouldn't really know what was happening
17:11elderly patients can often develop psychosis
17:14but he might get better
17:15or he might get worse
17:18what would you do?
17:20I really can't answer that for you
17:21this is your father
17:22that's your decision to make
17:23I can guarantee you
17:24that we will keep him as comfortable as possible
17:27if a natural death is what you choose
17:28but he's not your father
17:30and he can recover from us
17:32what my sister means is that
17:34we're still deciding the best thing to do
17:38well the sooner you decide the better
17:41I'm really sorry
17:42I wish there was more that I could do
17:44I'm not sure that he has that much time left
17:53Dr. Robby?
18:01you were right
18:03she can't say whether she was bumped by accident
18:05or shoved on purpose
18:06no other witnesses?
18:07no
18:07not really
18:08we'll pull security footage
18:10maybe we'll find something
18:11hopefully she tripped
18:13I don't mean I hope she tripped
18:14I mean I hope she wasn't pushed on purpose
18:17that would make this a hate crime
18:19yes ma'am
18:22ma'am
18:23doctor
18:24sorry
18:24I'm sorry
18:26no harm no foul
18:28will you let me know
18:29if she says anything else?
18:34will do
18:38at the risk of seeing me
18:40then you probably shouldn't
18:41and I just
18:41no
18:42trust me
18:43how do you know
18:44I just know
18:45I just wanted
18:46I know
18:48look
18:49I'll let you know
18:50if she says anything else
18:51that could be important
18:52to your investigation
18:57thank you
18:59you know for the record
19:00nope
19:12any luck getting our seg borders upstairs
19:15yeah right
19:16at least the kraken's still sleeping
19:20is it me or was that opposite
19:21no
19:22what
19:23you don't even know what I
19:24what you were gonna say
19:26maybe you do
19:27maybe you do
19:29you seem nice
19:30absolutely not
19:31mm-mm
19:33there's no possible scenario
19:35in which you and I
19:36have this conversation
19:37you of all people
19:38should know better
19:39I was
19:40new
19:42just walk away
19:43best possible scenario
19:45just keep on walking
19:47mm-hmm
19:48you gotta lay off mixing
19:50Adderall and energy drinks
19:51trust me
19:52I will
19:53all right
19:54thanks
19:56that's the thing about
19:57emergency medicine
19:58you never know what
19:58you're gonna get
19:59and we get everything
20:01is that why you chose it
20:03maybe a little
20:04I also get to pick my shifts
20:05which for a single mother
20:06is amazing
20:08but mostly
20:09I just like the people
20:10you know
20:10they're always there
20:11when you need them
20:12you wouldn't want to be
20:13a part of that
20:14you know
20:25this is the monitoring center
20:27we see that you're not
20:28in your inclusion zone
20:29do you have permission
20:30to be outside this area
20:31yes
20:32I am at work
20:33just like last time
20:35and the time before that
20:38I'll be right back
20:42what is the point
20:43of this fucking thing
20:44if it doesn't even work
20:54sorry
20:54you're doing great
20:56take your time
20:57you okay
20:58I am
20:59I get frustrated
21:00when I can't do things
21:01or at least it looks like it
21:02yeah
21:03you and me both
21:05thanks
21:05but um
21:06my frustration
21:06manifests itself emotionally
21:08and then
21:09I get upset
21:10and then
21:11it looks like
21:11I can't handle things
21:12and you know
21:13then I can't cry
21:14in front of the patient
21:14because no one wants
21:15to see their doctor cry
21:16that's just a big red flag
21:17you just did a perfect crike
21:19you're doing great
21:23hey
21:24you
21:24pasty white
21:25how about a sandwich
21:27uh
21:28what brings you here today sir
21:30I'm here for a fucking sandwich
21:33okay
21:35okay
21:36uh
21:36excuse me
21:38Perla
21:39can this patient
21:40get a sandwich
21:40I already gave you
21:42a sandwich
21:42I ain't ate this
21:44all week
21:46sure
21:47give him another sandwich
21:48they're on the food cart
21:49just make sure
21:49it's not egg salad
21:50or he'll throw it
21:51on the floor
21:51okay
21:52good to know
21:53thanks
21:53thanks
21:57okay
21:59okay
22:08any quick ones up here
22:10it's only 830
22:11and Robbie's already on my case
22:12for being too slow
22:13I can usually at least make it a lunch
22:15before he starts hounding me
22:16cut a little slack today
22:17okay
22:18it's the anniversary of Dr. Adamson's death
22:21that's sad
22:23there's still no reason to take it out on me
22:26I'm just saying
22:28Dr. Mohan
22:29Samira
22:29please
22:30I just wanted to apologize
22:32when my phone went off earlier
22:34that was really unprofessional
22:35don't sweat it
22:36trust me
22:37we'd need to laugh
22:38otherwise we'd never stop crying
22:40thank you
22:41besides
22:42with all the craziness
22:42that comes through here every hour
22:43nobody cares and notices
22:45got an unresponsive unhoused man coming in
22:48might be a good teaching case
22:49funky music
22:54let's go
22:56Caucasian male
22:56approximately 60 to 70 years old
22:58found unresponsive
22:59no signs of trauma
23:00no ID
23:03on three
23:05one
23:05two
23:06three
23:10did you take anything
23:12smell the alcohol from here
23:13this guy's wearing the spring
23:14summer and fall collection
23:17oh
23:17jeez
23:18whoa
23:18whoa
23:19whoa
23:20whoa
23:20what's wrong
23:23what's wrong
23:24what's going on
23:25patient tested positive for rats
23:27no
23:30if it matters I only counted three
23:33oh there goes one
23:38because your son tested positive for THC
23:41the psychoactive ingredient in cannabis
23:43we're gonna have to admit him for overnight observation and monitoring
23:47what about his brain
23:49is there a chance that much pot is going to do some damage and he's only four
23:53the honest answer is we don't know there haven't been any long-term studies but the fact that this is
23:57a one-time occurrence suggests that there should be no long-term effects
24:00like you don't know
24:01so my son could end up with learning disabilities psychiatric problems or even autism because there's no evidence to suggest
24:08any of that
24:09hello i'm chiara alfaro i'm the department social worker
24:13chiara will help you navigate the next steps
24:16what steps
24:17well a case like this requires mandatory reporting to child services and sometimes law enforcement
24:23no
24:24why do you have to involve the police
24:25it's a controlled substance
24:26they're not taking my kid away
24:28no one's suggesting that
24:29well fuck your suggestions
24:30no one is touching my child
24:32in fact we're leaving
24:33well you know you can't take your son
24:35he can stop breathing
24:35he can't have a seat
24:36serve him at home
24:37amanda
24:38fuck off drew
24:39get security
24:40if you can't cooperate i'm gonna have to ask you to leave
24:42amanda please he needs to stay here
24:44and you need to get a fucking hotel
24:46your son can't leave the hospital but i can have you removed
24:48don't you dare touch me get out of you
24:51mrs johnson i know this is scary and stressful
24:54oh fuck you fuck you this is my son my son and nobody is touching him
24:58whoa whoa whoa what's going on
24:59i was worried about a CY
25:00amanda
25:03this is a hospital
25:05sitting in the Jerry Springer show
25:06ma'am
25:07nobody's trying to take your child
25:09so why don't you stay here with him
25:11while your husband talks to our social worker outside
25:13and straightens all this out
25:14well i don't want him
25:15speaking for me and my son
25:17well it is either you or him
25:19your son is not leaving
25:20but you can be escorted out
25:22and even arrested if you refuse to cooperate
25:24nobody wants that
25:25so you tell us
25:26what do you want to do
25:30i'm staying with my son
25:31okay great
25:33you do that
25:35we all on the same page here
25:37thank you olsen
25:38you okay
25:39yeah we got this
25:41all good
25:42it's all yours
25:43so mrs joe's
25:48is everything all right out there
25:50yeah just another day in paradise
25:52how are you feeling
25:53better
25:54where's the unit
25:55he left
25:56he said he had to
25:58get back to school
25:59what
26:00um
26:01maybe you could try calling him
26:02get him to come back
26:07what's gonna happen to him if i do
26:10hopefully he'll be willing to talk to somebody
26:12will you talk to him
26:13i can try
26:14i don't think he wanted to talk to me
26:18have you shared with anyone about
26:20the writings of his you found
26:22no
26:23i didn't know who to tell
26:25i just don't want to see him get hurt
26:28neither do we
26:38no
26:38he's just going straight to voicemail
26:40see maybe if you can text him
26:54he's not texting back
26:55he's
26:56oh i'm sorry about all this
26:58it's okay
26:59what you're doing for david is very brave
27:03i'm his mother
27:03i'll do anything to protect him
27:08do you think he would hurt anyone
27:09no
27:12but
27:17i'm sure a lot of parents felt that way
27:20before their children did unspeakable things
27:26does he have any history of violence
27:28has he ever been in any trouble
27:29no
27:29never
27:30he's very quiet
27:33and he takes great care of me
27:35he
27:36he's
27:38struggled
27:38with his father's death
28:10we both have
28:38in the ed
28:40i'll be here all week
28:41well maybe not
28:47drug-seeking woman kicked off a city bus for disrupting and disturbing passengers
28:51you've been screaming for narcotics non-stop
28:53we found an empty purchasing bottle
28:55what the hell are you doing
28:56what are you doing
28:57what are you calling
28:57he's been uncooperative and combative since we picked him
28:59take the offer
29:00let's go
29:01stop fighting
29:02come the fuck down or i'm finding the cops
29:04my meds at home aren't working
29:06please i have sickle cell pain
29:08okay stop everybody stop
29:10stop
29:13what's your name
29:14it's joyce
29:15it's joyce
29:16joyce is this your sickle cell pain
29:19yes
29:1910 milligrams of ivy morphine
29:21you really want 10
29:22yes repeat it in five minutes if needed
29:23and she needs a dilatidrib
29:24this is a vaso-occlusive crisis
29:26i'm so sorry this happened
29:27we're gonna be okay now
29:28we're safe here
29:29come on
29:31we're gonna be safe here
29:32i promise
29:32just breathe
29:33okay
30:00live wire hit his left
30:02four off
30:02shocked him once for v-pip
30:03was there a power pole down
30:04no abandoned factory
30:05he found both cutters head aside
30:07got electrocuted
30:07did you try to steal copper
30:09most likely
30:09power line fried his arm
30:11and the current through his whole body
30:12stopped his life
30:14ready
30:18steady lift
30:21add a myoglobin and a ck to the labs
30:23two liters normal saline wide open
30:26dr santos what are we worried about
30:27uh
30:29rhabdomyolysis from tissue damage
30:31can kill the kidneys
30:31ongoing risk of cardiac irritability
30:34excellent
30:34ap pad in place
30:35guy fell off a telephone pole
30:36no he was on a platform
30:38boring
30:39cut into a live wire
30:42tense ventral compartment
30:43set up the stick pressure monitor
30:46v-fib
30:46charge the 300
30:47am i running this or are you
30:49sorry reflex response
30:50clear
30:52ah fuck
30:53sorry
30:55sorry
30:56so what what happened
30:58i bought it for my girlfriend's dog
31:01i work nights and he yaps all day long
31:06and when i woke up i was wearing it
31:09stupid bitch
31:12i think she must have used crazy glue
31:17yeah it um it looks that way
31:20have you tried removing the batteries
31:22of course
31:24we should close the case shut
31:26all right i think we have a couple options gary
31:29um we can try to find a solvent that will dissolve or at least soften the glue enough
31:34for you to peel it off without taking your skin with it
31:37or um
31:39that's your buddy
31:40um
31:41i i guess
31:42and your skin cells on your neck will naturally slough off
31:45and you should just be able to remove it in time
31:48how much time
31:49um
31:50couple weeks maybe
31:51couple weeks
31:52i think this guy's got scurvy
31:54what is he a pirate
31:55no he's an unhoused man
31:57lives almost exclusively on dollar store ramen
31:59uh there's parapollicular hemorrhage
32:01gingivitis
32:02bleeding gums
32:03and um
32:04yeah
32:04no fruit or vegetables in his diet
32:06i suppose that could do it
32:07as long as you've ruled out piracy
32:08no parrot no peg leg
32:10doesn't reek of sweat and rum
32:12well i think you mentioned it
32:13there was a smell
32:14probably a pirate
32:17tell him to pick up some vitamin c
32:18next time he ducks at a dollar store
32:22i can't tell if you're joking
32:24no captain scurvy's got a vitamin c deficiency
32:26cheapest way to fix it is with a daily supplement
32:29captain scurvy's another joke
32:31i'd like to think so
32:32that's a good one
32:32dr langdon dr king
32:34this is arthur carlson
32:35from children youth and families
32:36he'd like to speak to the parents of tyler jones
32:38right
32:39right
32:40uh mel would you mind showing him to kiara and the family
32:43yeah right this way
32:49beto
32:50hello doctor
32:51what are you doing here
32:52i'm working day shifts now
32:54didn't you retire a couple years ago
32:56no
32:57i have to work today
32:59right
33:00right just stay right here okay
33:02i have a lot of cleaning to do
33:04yeah no i'll just i'll be just one second
33:06hey doc doc
33:08how about a sandwich
33:09sure earl turkey no egg salad
33:10i got you just give me one minute
33:15so beto said he's working here
33:16yeah he just started wandering
33:18fortunately always winds up back here
33:20thinks he still works in the ed
33:22i called his family
33:23they usually pick him up after a few hours
33:25really
33:26yeah give some a break and look at him
33:28he's talking to people
33:29feeling useful
33:30getting some exercise
33:31hell i wish i was that happy
33:33think he's any good at catching rats
33:35stop
33:36oh earl wants a sandwich
33:37earl always wants a sandwich
33:39hey check it out
33:40i got mckinsey puppy
33:42cute
33:43hope that wasn't your idea
33:44why
33:45seriously
33:46you really think your wife needs anything else to take care of
33:49abby loves dogs
33:50i love penguins doesn't mean i want to take care of one
33:52well i'm pretty sure it's illegal to own a penguin
33:54pretty sure you're missing the point
33:55the point is tanner promised you to take care of it
33:58a four-year-old
34:00yeah
34:00okay
34:07how's she doing
34:09still breathing after 20 of morphine
34:14how's the pain joyce
34:15oh
34:16a little better
34:18you've ordered an exchange transfusion
34:20figured i needed that
34:22what's your normal regimen at home
34:2590 of extended release morphine every 12 hours
34:29and oxycodone for breakthrough pain
34:31but
34:31it wasn't working
34:33starting iv dilaudid up for an hour
34:36you can press this button
34:38if you need a little extra
34:39uh that only works once an hour though
34:41so don't go crazy
34:42could i confer with you
34:44yeah
34:54you seem surprised by the opiate dosage
34:57seemed a little high
34:58so was her pain
35:00how do you know she's not drug seeking
35:01you can't fake a hemoglobin of six
35:02do you know what sickle cell crisis does to the body
35:05blood cells get caught and plug up your capillaries
35:07and deprive all your cells of oxygen
35:08it's been described as an electrical stabbing pain
35:11that feels like it's breaking your bones
35:13and flushing glass through your body
35:15i never thought of it like that
35:17little empathy goes a long way
35:18with those suffering in real pain
35:23yeah
35:23don't worry you'll get good at spotting the fakers
35:25and half the time all those people need
35:26is someone to really listen to them
35:28and hear their story
35:33interior compartment pressure is
35:3649
35:36burn caused massive swelling
35:38what does he need dr santos
35:40uh fasciotomy
35:41but he still has a radial pulse
35:43pressure'd have to be over a hundred
35:45to lose the pulse
35:45and at that point he'd lose the arm
35:4749's enough to destroy all the nerves
35:49and muscles in a matter of hours
35:51compartment pressure is 49
35:52yeah i'm gonna make the initial incision down here
35:55ortho can finish up in the OR
35:56good plan
35:57i'll let him know
35:58hey robbie
35:59always good to see you friend
35:59hey like my rock star
36:00she's pretty good
36:01she has a great teacher
36:04sterile gloves for dr santos
36:06oh
36:06we don't teach forearm fasciotomies to our residents
36:09what if she's all alone
36:10somewhere someday with no backup
36:15this is the path to avoid the median nerve
36:18and all major vessels
36:20maybe just watch the first time
36:22she'll hold the blade
36:24i'll cut
36:2410 blade of dr santos
36:30let's start proximal
36:33how much pressure
36:34just about this much
36:45through the skin
36:46and sub-q
36:53good
36:58how are they making out
37:00they're still talking
37:03you okay
37:04yeah for sure
37:05i just hate seeing families torn apart
37:07oh they'll be fine
37:09how can you be sure
37:10they're white
37:12probably get off with a slap on the wrist
37:13if they weren't
37:15she'd probably lose her child
37:17and he'd end up going to jail
37:18but
37:20sorry i did a fellowship in cynicism
37:23you sure you okay
37:24100%
37:25i'm just gonna get some air
37:32i am a savage
37:34classy
37:34bougie
37:35ratchet
37:36sassy
37:37moving
37:37nasty
37:39i am a savage
37:41how do you know
37:43i got stuff
37:43can you guys help
37:46what's your name
37:47alice
37:48okay alice
37:49let me take a look
37:51what the fuck
37:51it hurts
37:52oh i know
37:53all right
37:54we're gonna take good care of you
37:55you guys got us up here
37:56alice
38:00i have an abdominal gsw
38:02in the ambulance bay
38:03code trauma now
38:05gsw just got dumped
38:06by homeboy ambulance
38:07okay you got this
38:08yeah go
38:10two grams of ansep
38:11orthos on their way
38:18systolic's only 80 14 gauge
38:20left ac
38:20we got two units of whole blood
38:22going on the rapid diffuser
38:23call the or we'll be right up
38:24lungs up
38:25do you take medications every day
38:26any allergies
38:27no
38:29morrison's a full of blood
38:30see that
38:30yeah
38:30torp is liver
38:32what's his name
38:33alex
38:33alex you've lost a lot of blood
38:35you need to go to surgery right away
38:36are we gonna die
38:37not now that i'm here
38:38spoken with humility in the surge
38:40oh it's ready how's he doing
38:41you see it's coming up a bit
38:42let's go
38:42are you coming mom
38:43just ice them up
38:44of course of course
38:47so he didn't have to wait for or
38:50nope
38:50we're a trauma center
38:52we always keep one or
38:53we're stocked and ready to go
38:54well that's awesome
38:58what happens if there are multiple
39:00traumas needing or
39:01we get a lot busier
39:04mr milton
39:05i'm sorry we had to move you
39:07into the hall
39:07i know it gets pretty chaotic
39:08and noisy out here
39:10mr milton
39:12hey
39:12hey bennett
39:13wake up for me
39:17oh shit shit shit
39:18um i need a little help here
39:21help
39:22when did you check on him last
39:23i don't know around
39:25half an hour ago almost
39:26i was waiting on labs
39:26what's going on
39:27it's my gallstone guy
39:28you saw zk g
39:29unknown downtime
39:29he was sleeping in the hall
39:31crash guard let's go
39:37i got it
39:41hold compressions
39:45assistively
39:46resume compressions
39:47amp of epi
39:50slow tempo
39:51slow tempo
39:51should i intubate
39:52no drop it down on the
39:53we don't want to hold
39:54compressions
39:56pupils are fixed and dilated
39:58he's been down a long time
40:11how we doing in here
40:13so much better
40:14dr mohan
40:15this is my wife
40:16undeen
40:17dr samira mohan
40:18nice to meet you
40:19undeen
40:19thank you for helping her
40:21of course
40:21and again
40:23i'm so sorry
40:24about how you were treated
40:25when you first arrived
40:26not everyone who works here
40:28is accustomed to dealing
40:28with sickle cell
40:29we will be doing
40:30everything possible
40:31from here on in
40:32to manage choices crisis
40:33in the meantime
40:34can i get you anything
40:35i'm fine
40:36undeen
40:37no thank you
40:38okay well
40:39have the nurses come find me
40:40if you need anything
40:43take slow deep breaths
40:45for me ian
40:46loaded a neb
40:475-albuterol
40:47and 5-solimedrol
40:50keep an eye on him
40:51and present to dr langton
40:52okay
40:52okay great
40:54i'll see you back in triage
40:55once he settles down
40:56yeah
40:58let's take this off
40:59hang in there ian
41:00this should really help
41:01with your asthma
41:12how can i help you hun
41:13um i'm looking for dr langton
41:15yeah
41:15let me see where he is
41:21dr langton
41:21we have a med student
41:22at central looking for you
41:25copy that
41:26he's headed this way
41:27thanks
41:29hey crash
41:30you missed a pretty cool
41:32fasciotomy
41:33i'm not sure i'd be
41:34describing a fasciotomy
41:35as cool
41:36you would if you were
41:37the one who did it
41:39how's it going out
41:40in a rival's lounge
41:44do you know anything
41:45about dr mckay
41:47i've been here for
41:48less than two hours
41:49i don't know anybody
41:51including you
41:53i thought you were
41:53some kind of kid genius
41:55i'm like any other
41:56third year med student
41:57clearly
42:01hey i'm just trying
42:02to break the ice
42:02i'm not trying to annoy you
42:04and yet
42:05you're still calling me crash
42:06when i asked you not to
42:07really you're still on that
42:09still on that
42:12yeah
42:13okay
42:14sorry
42:15i had no idea genius
42:17was so sensitive
42:20but i get it
42:21big brain
42:22big feelings
42:23makes total sense
42:25i'll try to be softer
42:29рдХрд░ рджреЛ рджреЛ рдкреЙрд╕ рдЯрд╛рд╣рди рддрд╛рдпреЛрдВ рдирдВрдЯреНрдЯрд┐рдВ рдмрд╛рдХреНрд╕
42:32рдореИрдВ рдорд╕рд╛рд╕ рдЕрдВрдкрд▓ рдЗрд╕рд╛ рд╕рдХ рдЕрдирд▓рд╛ рдмрд╛рдЧрдЧ рдЙрдбрд╝рд╛ рдЙрдбрд╝рд╛ рдмрд╛рдЧрдм рд╕рд╛рде
42:37рд╕рджреНрджрд┐рдВрдЧ рдХреЛ рдорд╕ рдмрд╛рд╣рди рд╢реБрдЯ рдФрд░ рдЧрдЬреЗ рд▓рдЧрдЯ рд╕рд╛рде
42:44рдореБрдкрдиреА рдЕрд╡рдбрд╝ рд░реБрдЯ рдЕрдкрд░ рдеред
42:50рдпрде рд╣рд┐рдВрдж рдПрдХ рдЕрдм рджреВрдВрдЯ рд░рд╡рд╛ рд╣реИ
42:53I'm fine
42:53All compressions
42:57Still in asystole
42:59Resume compressions
43:01Well, should we shock him?
43:02You don't shock asystole
43:03Well, it could be fine V-fib
43:05Not a chance
43:07Okay, uh, when was his last epi?
43:09Three minutes ago
43:10Okay, well, ACLS says every three to five minutes, right?
43:12So let's push another round
43:14Fine
43:14Robbie, Mr. Spencer's adult children are asking for you
43:18And the parents of Nick Bradley, the fentanyl overdose, also want to speak with you
43:21Okay
43:22Three rounds of epi and then call it
43:26Mr. Spencer's maxed out on BiPAP, 25 on 10
43:28Sats?
43:29Not great, high 80s
43:34Hi, I heard you wanted to talk to me
43:36Yeah, that alarm kept going off
43:37Yeah, why don't we step outside?
43:41The alarm is for low oxygen
43:43Does he need more of that BiPAP?
43:45I'm afraid that's as high as we go
43:47So the decision at this point
43:49We want you to put our father on the breathing machine
43:54Even though that goes against his desires to not be intubated?
43:58We're not ready to let go yet
44:01And if your father is?
44:05He was a stubborn son of a bitch
44:07He would never have given up on either of us
44:09We're not giving up on him
44:12You're absolutely certain you want to put your father through this after everything I've told you?
44:20I may have to honor his advance directive
44:25No, you have to honor our durable power for healthcare
44:29If not, we can talk to your hospital attorney
44:35Jeremy, you're on board with this?
44:37Yeah, I guess so
44:41Okay, you can sit with him until we're ready
44:44When will that be?
44:45Momentarily
44:57Please don't tell me you're going to intubate that poor man
45:00It's what the family wants
45:02So what?
45:02They want to torture him?
45:04I explained all that
45:06If I co-sign
45:07We can override their durable power
45:10They're threatening to go to the hospital attorney
45:12Let them
45:12Call the ethics committee
45:13They'll agree with us
45:15No, you're probably right
45:16But we don't have that kind of time
45:17We are stuck
45:19What are you talking about?
45:21Shit
45:24What?
45:26I gotta go tell those parents
45:27Their 18-year-old son is brain dead
45:30You want me to come with you?
45:31Nope
45:31It's okay
45:32What are you going to say?
45:34I'm going to say that it's likely
45:35But we still need to do an apnea test
45:37And a cerebral perfusion study
45:40There's no cranial nerve activity
45:42Those people need some hope
45:44False hope
45:45Hope is hope
45:46Is it?
45:47What are we praying for miracles today?
45:51They need time to process
45:53Before they can accept what's happening
45:55You ever
45:56Consider taking that advice?
45:59Physician heal thyself?
46:02Don't you have patience?
46:25No, no, no, no
46:26No, no, no, no, no
46:27People wake up from COVID
46:28You can wake them up
46:31You can do that
46:32You can talk
46:34You can talk
46:35You can talk
46:35You can talk
46:36You can talk
46:52You can talk
46:53You can talkRL
46:56-RL-RL-RL-RL-RL-RL-RL-RL-RL- gems stressing
47:01are
47:07рдХрд░ рджреЛ
47:24рдЭрд╛рд▓ рдЭрд╛рд▓
47:40рдХрдкрдХрд╛рди рдЬрд╛рдЬрд┐рддрд╛ рд╣реИ
47:50рдХрд░ рджреЛ рдХрд░ рджреЛ рдХрд░ рджреЛ
48:17рд▓рдЪреНрдЫрд╛рдкреНрдкрд┐рдЬрдорд╛ рдЧреНрд░реАрдХрд╛рд▓рд╢рд┐рдорд╛ рдпреЙрдм рдПрдХ рд╕рдХрддрд╛рдпреВрди рдиреЙрдм рдХрд░ рджреЛ, рд░рд╛рдбрд╝реА рдХреЛ рдЪреБрдЫрд╛рд╢рд┐рд╕ рдЕрдм рдФрд░ рд░рд╛рдмрднреА рд╢реАрдбрд┐рдд рдерд╛ рд░рд╛рдмрд╕реЗ рдЬреБрдЫрд╛рд╡рдирд╛рдкреНрдЯ рдереЗрдВрд░рд╛рдмреНрд╕рд╛рдм рдПрдл
48:27рдЗрд╕ рдПрдХ рддреБрдЫрд╛рджрд┐рд╕реНрдЯ рдХреЛ рджреЛ рдЗрди рд╣реИ
49:13рдЭрд╛рд▓ рдЭрд╛рд▓
49:16рдЭрд╛рд▓ рдЭрд╛рд▓
49:51рдЭрд╛рд▓
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