1
00:00:06,666 --> 00:00:08,186
They've installed cameras.
2
00:00:08,187 --> 00:00:09,859
They're all over the C.C.U.
3
00:00:09,860 --> 00:00:12,621
Next they'll be in the O.R.s,
the hallways,
4
00:00:13,189 --> 00:00:14,677
the on-call rooms.
5
00:00:15,556 --> 00:00:17,273
We're being spied on, Mer.
6
00:00:17,907 --> 00:00:19,201
Who knows what evil lurks
7
00:00:19,202 --> 00:00:21,589
behind that electronic eye?
8
00:00:21,759 --> 00:00:23,252
Morning, Dr. Yang.
9
00:00:24,229 --> 00:00:25,800
Big Brother knows my name.
10
00:00:28,731 --> 00:00:30,710
Big Brother can see your name tag.
11
00:00:30,711 --> 00:00:31,915
Excuse me.
12
00:00:31,916 --> 00:00:33,531
The cameras are not here to spy on you.
13
00:00:33,532 --> 00:00:35,122
They are here to supplement you.
14
00:00:35,123 --> 00:00:37,675
On the other side of
the camera is a remote physician,
15
00:00:37,676 --> 00:00:40,823
an extra set of eyes to
help reduce mistakes,
16
00:00:40,824 --> 00:00:43,859
improve patient care,
and maximize physician hours...
17
00:00:43,860 --> 00:00:45,945
- We've all heard the buzz words...
- Now the initial program...
18
00:00:45,946 --> 00:00:48,373
"Streamline, optimize,"
19
00:00:48,374 --> 00:00:50,697
integrate, adapt."
20
00:00:50,823 --> 00:00:54,223
Every day someone comes up
with a new strategy or tool
21
00:00:54,224 --> 00:00:57,991
or technology to increase our efficiency.
22
00:00:57,992 --> 00:01:00,637
The idea is to make our lives easier.
23
00:01:00,638 --> 00:01:02,894
But the question is, does it?
24
00:01:02,894 --> 00:01:06,000
And of course, ultimately
reduce costly litigation.
25
00:01:06,050 --> 00:01:07,933
So does that answer your questions?
26
00:01:07,934 --> 00:01:09,834
With disturbing clarity.
27
00:01:09,879 --> 00:01:12,218
All right. Let's move on then.
28
00:01:12,243 --> 00:01:15,271
As you can see,
this O.R. has been arranged
29
00:01:15,272 --> 00:01:16,897
with maximum efficiency,
30
00:01:16,898 --> 00:01:18,776
specifically for O.R. turnover.
31
00:01:18,777 --> 00:01:21,621
Now what are the main
causes for bottleneck?
32
00:01:22,064 --> 00:01:24,150
The layout of O.R. supplies,
33
00:01:24,151 --> 00:01:26,144
equipment, and instruments.
34
00:01:26,145 --> 00:01:28,602
- So what we have done here...
- What did we miss?
35
00:01:28,603 --> 00:01:30,073
O.R.s are sloppy.
36
00:01:30,074 --> 00:01:32,152
There are doctors in the ceilings.
37
00:01:32,153 --> 00:01:33,882
What? What do... what does that even mean?
38
00:01:33,883 --> 00:01:36,393
We'd know if you'd just put
her stupid tights on her.
39
00:01:36,394 --> 00:01:37,624
I was talking her into it, okay?
40
00:01:37,625 --> 00:01:39,374
- She was getting on board.
- Um, she's 2. At a certain point,
41
00:01:39,375 --> 00:01:40,133
she doesn't have to get on board.
42
00:01:40,134 --> 00:01:40,989
She has to be in day care.
43
00:01:40,990 --> 00:01:42,441
So you pick her up and you
yank her tights on her.
44
00:01:42,442 --> 00:01:44,100
That's what you do. And then she cries.
45
00:01:44,101 --> 00:01:45,433
Yeah, because you wasted
all that time cajoling her,
46
00:01:45,434 --> 00:01:46,450
so now I have to be the bad cop.
47
00:01:46,451 --> 00:01:47,806
If you just made it
clear in the first place
48
00:01:47,807 --> 00:01:48,876
that she has no choice...
49
00:01:48,877 --> 00:01:50,193
Because when every second counts,
50
00:01:50,194 --> 00:01:52,536
you need the most efficient approach.
51
00:01:52,537 --> 00:01:54,335
- Mm.
- What she said.
52
00:01:56,135 --> 00:01:57,786
It's about new hospital procedures,
53
00:01:57,787 --> 00:01:58,937
and we weren't invited.
54
00:01:58,938 --> 00:02:00,395
Thank god. It looks boring.
55
00:02:00,396 --> 00:02:01,860
Don't you guys get what's going on?
56
00:02:01,861 --> 00:02:04,431
Yeah, they're closing the E.R.
and streamlining the place.
57
00:02:04,432 --> 00:02:05,206
It sucks, but...
58
00:02:05,207 --> 00:02:06,465
They're gonna fire us.
59
00:02:06,466 --> 00:02:07,901
Why bother teaching us the new protocols
60
00:02:07,902 --> 00:02:09,116
if we're gonna be gone anyway?
61
00:02:09,117 --> 00:02:11,563
- You're crazy.
- It's not that bad.
62
00:02:11,634 --> 00:02:12,253
Is it?
63
00:02:12,254 --> 00:02:13,357
Look at this.
64
00:02:15,901 --> 00:02:17,891
Nurses are stockpiling.
65
00:02:18,073 --> 00:02:19,316
The end is coming.
66
00:02:21,234 --> 00:02:23,207
Your average time between surgeries
67
00:02:23,208 --> 00:02:24,899
is 37 minutes.
68
00:02:24,900 --> 00:02:26,989
With these new O.R. procedures,
69
00:02:26,990 --> 00:02:28,904
I'd like to see that cut in half.
70
00:02:29,129 --> 00:02:30,300
Thank you, everyone.
71
00:02:33,248 --> 00:02:35,021
Closing the E.R. should cut down on time.
72
00:02:35,022 --> 00:02:36,303
We won't have any patients.
73
00:02:36,304 --> 00:02:37,370
How's Hunt feel about that?
74
00:02:37,371 --> 00:02:38,866
Oh, he says he's not gonna
do anything about it
75
00:02:38,867 --> 00:02:40,339
until it actually happens.
76
00:02:40,340 --> 00:02:41,044
Oh, it's happening.
77
00:02:41,045 --> 00:02:43,699
And he can't be a trauma
surgeon without an E.R.
78
00:02:43,700 --> 00:02:44,466
Is he gonna leave town?
79
00:02:44,467 --> 00:02:45,863
'Cause if you go with him, I'm screwed.
80
00:02:45,864 --> 00:02:47,451
I'm kind of depending on your rent check.
81
00:02:47,452 --> 00:02:48,545
Way to make this all about you.
82
00:02:48,546 --> 00:02:50,158
The E.R. is not going to close.
83
00:02:50,159 --> 00:02:51,591
Derek has a plan.
84
00:02:51,592 --> 00:02:52,319
Where is Derek?
85
00:02:52,320 --> 00:02:54,074
He spent the night with Kepner.
86
00:02:54,671 --> 00:02:55,408
It's gonna work, right?
87
00:02:55,409 --> 00:02:57,075
Of course. See, 'cause derm cuts a fellow,
88
00:02:57,076 --> 00:02:59,453
and then cardio skips the TED conference,
89
00:02:59,454 --> 00:03:01,843
plastic/ortho shares, uh, lab facilities,
90
00:03:01,844 --> 00:03:03,258
we'll get a little bit here,
a little bit there.
91
00:03:03,259 --> 00:03:05,168
And we'll have enough saved
to keep the E.R. alive.
92
00:03:05,169 --> 00:03:07,180
Oh, there gonna be mad
about the TED conference.
93
00:03:07,181 --> 00:03:08,139
Oh, they're gonna be
pissed about everything,
94
00:03:08,140 --> 00:03:09,658
but that's okay. It's gonna work.
95
00:03:09,659 --> 00:03:10,815
Do we have a reply yet?
96
00:03:10,816 --> 00:03:13,055
Uh, no, not yet.
97
00:03:13,368 --> 00:03:14,773
That was the subject line?
98
00:03:14,774 --> 00:03:16,139
Wh-wh-wh, is that bad?
99
00:03:16,140 --> 00:03:18,706
Well, would you open
any that said "Proposed budget cuts"?
100
00:03:18,706 --> 00:03:20,465
Oh, no. Did I just kill our proposal?
101
00:03:20,466 --> 00:03:22,431
No. We're just gonna have
to pitch it in person.
102
00:03:22,432 --> 00:03:24,237
Go door to door, which is better anyway.
103
00:03:24,579 --> 00:03:25,879
It's hard to say no to someone's face.
104
00:03:25,880 --> 00:03:27,388
Oh. No offense, sir.
105
00:03:27,389 --> 00:03:29,209
You have an unusually
appealing face, but...
106
00:03:29,210 --> 00:03:30,158
I have to brush my tee.
107
00:03:30,159 --> 00:03:31,824
- I know. You do, too.
- Oh.
108
00:03:31,825 --> 00:03:34,315
Standardizing an O.R. is one thing,
109
00:03:34,316 --> 00:03:36,433
but that's not going
to make much difference
110
00:03:36,434 --> 00:03:39,958
if we don't standardize
what happens in the O.R.
111
00:03:39,959 --> 00:03:42,557
To that end, I have brought in
Dr. Darrell Nesbaum
112
00:03:42,558 --> 00:03:44,160
to show us how it can be done.
113
00:03:45,734 --> 00:03:46,856
Everything will be scanned...
114
00:03:46,857 --> 00:03:48,879
When did you become such a kiss-ass?
115
00:03:49,344 --> 00:03:52,091
The last five hospitals whose
efficiency she improved
116
00:03:52,092 --> 00:03:54,329
ended up cutting their staff by 30%.
117
00:03:54,330 --> 00:03:56,837
I'll learn to rope cattle
if it means keeping my job.
118
00:03:56,838 --> 00:03:59,942
Well, I'm safe because they
can't fire the pregnant lady.
119
00:04:01,544 --> 00:04:02,294
Can they?
120
00:04:02,295 --> 00:04:04,580
Uh, Dr. Nesbaum,
you can take it from here.
121
00:04:04,581 --> 00:04:05,549
Of course.
122
00:04:06,634 --> 00:04:08,027
Good morning, everybody.
123
00:04:08,196 --> 00:04:11,461
Now I have just one
question before we begin.
124
00:04:11,709 --> 00:04:14,933
Are you ready to rock some hernias?
125
00:04:15,185 --> 00:04:16,915
That's what I'm talkin' about.
126
00:04:23,948 --> 00:04:25,040
Has she moved yet?
127
00:04:25,041 --> 00:04:26,384
What do you think?
128
00:04:26,385 --> 00:04:27,254
Is her mom here?
129
00:04:27,255 --> 00:04:28,854
'Cause she's nicer when her mom's here.
130
00:04:28,855 --> 00:04:29,908
No, she had to leave for work.
131
00:04:29,909 --> 00:04:31,599
You sure the kid didn't eat her?
132
00:04:32,150 --> 00:04:33,258
You guys, stop.
133
00:04:33,259 --> 00:04:35,734
She's angry. She's 13 and she
had a double hip replacement.
134
00:04:35,735 --> 00:04:36,683
You'd be angry, too.
135
00:04:36,684 --> 00:04:37,653
She's mean.
136
00:04:37,654 --> 00:04:38,379
Like a badger.
137
00:04:38,380 --> 00:04:40,984
She's three days post-op now. Okay?
138
00:04:40,985 --> 00:04:42,867
If she doesn't move her hips,
we're looking at clots,
139
00:04:42,868 --> 00:04:44,691
contractures, poor recovery.
140
00:04:44,692 --> 00:04:46,565
We just have to make her
do it for her own good.
141
00:04:46,977 --> 00:04:49,591
Oh. Look who I'm talking to.
142
00:04:49,999 --> 00:04:51,911
Can't even put a toddler in tights.
143
00:04:53,914 --> 00:04:55,081
Gr... well, then you just...
144
00:04:55,082 --> 00:04:57,099
you show me how a bad cop does it.
145
00:04:59,819 --> 00:05:01,556
Karev, get in there.
146
00:05:01,557 --> 00:05:02,335
Why me?
147
00:05:02,336 --> 00:05:03,424
We're attendings. You're a fellow.
148
00:05:03,425 --> 00:05:04,478
It's an order.
149
00:05:07,373 --> 00:05:08,976
That's how a bad cop does it.
150
00:05:08,977 --> 00:05:12,440
Dr. Hunt, I sent contractors
to measure the E.R. space.
151
00:05:12,441 --> 00:05:13,747
Yeah, and I told them to get lost.
152
00:05:13,748 --> 00:05:15,276
I know. That's why we're talking.
153
00:05:15,277 --> 00:05:17,756
The E.R. is open for one more day.
154
00:05:17,757 --> 00:05:18,980
Uh, Dr. Hunt,
155
00:05:18,981 --> 00:05:20,508
the E.R. is closing.
156
00:05:20,509 --> 00:05:21,654
I know you don't want it to,
157
00:05:21,655 --> 00:05:23,107
but you're gonna need to let that go.
158
00:05:23,108 --> 00:05:24,670
While we are treating patients,
159
00:05:24,671 --> 00:05:27,107
I don't want your workmen in the way.
160
00:05:27,357 --> 00:05:29,542
We are on a tight schedule
with the renovation.
161
00:05:29,543 --> 00:05:31,346
I was hoping that you would cooperate.
162
00:05:31,347 --> 00:05:33,027
Yeah, well, you're gonna
need to let that go.
163
00:05:33,159 --> 00:05:34,449
Well...
164
00:05:36,084 --> 00:05:37,539
I'd just like to hear you name one thing
165
00:05:37,540 --> 00:05:39,972
that you can put in there
that's more useful than an E.R.
166
00:05:39,973 --> 00:05:41,384
It's still under review, but...
167
00:05:41,385 --> 00:05:43,673
In the army, the guys at the
front get the most saves.
168
00:05:43,674 --> 00:05:45,853
Why? Because the closer
you are to the moment of injury,
169
00:05:45,854 --> 00:05:47,441
the better chance you have to help.
170
00:05:47,442 --> 00:05:48,833
That is what an E.R. is.
171
00:05:48,834 --> 00:05:49,670
Where are we going?
172
00:05:49,671 --> 00:05:51,230
Roof. Medevac's coming.
173
00:05:51,342 --> 00:05:53,358
Uh, I-I-I shouldn't.
174
00:05:53,359 --> 00:05:54,408
I should hop off now...
175
00:05:54,409 --> 00:05:56,321
Emergency medicine is the front line.
176
00:05:56,322 --> 00:05:58,241
We're the first responder. We're closest.
177
00:05:58,242 --> 00:06:00,266
It's the most important
thing that a hospital does.
178
00:06:00,267 --> 00:06:00,949
It's arguably...
179
00:06:00,950 --> 00:06:02,371
So name me one thing
180
00:06:02,372 --> 00:06:04,704
that you would replace it
with that matters more.
181
00:06:05,515 --> 00:06:06,670
You've made your point.
182
00:06:06,671 --> 00:06:08,913
Now if you don't mind,
I have a big day, and I...
183
00:06:08,914 --> 00:06:11,853
40-year-old male logger versus chain saw.
184
00:06:11,854 --> 00:06:14,208
Deep neck laceration affecting
most of the major blood vessels
185
00:06:14,209 --> 00:06:15,620
and extending into the chest.
186
00:06:15,621 --> 00:06:17,605
He's hypotensive and tachycardic.
187
00:06:17,606 --> 00:06:19,535
Oh, and his nose is
pretty much sliced off.
188
00:06:19,536 --> 00:06:20,359
How's his airway?
189
00:06:20,360 --> 00:06:21,710
Intact. It was never stridorous.
190
00:06:21,711 --> 00:06:23,649
Did not appear to involve the trachea.
191
00:06:25,020 --> 00:06:26,594
Oh! I got it. I got it.
192
00:06:26,595 --> 00:06:28,631
It's the carotid. I have it.
193
00:06:29,441 --> 00:06:30,448
I got it.
194
00:06:31,585 --> 00:06:33,096
I was closest.
195
00:06:51,178 --> 00:06:52,103
Okay, everything appears stable.
196
00:06:52,104 --> 00:06:54,090
Let's redress the nose. Page plastics.
197
00:06:54,091 --> 00:06:55,477
- Right away.
- Gown me.
198
00:06:55,518 --> 00:06:56,799
Work around Dr. Cahill.
199
00:06:56,800 --> 00:06:58,057
And see who else is available.
200
00:06:58,058 --> 00:06:59,654
- I'll check.
- Keep holding pressure.
201
00:06:59,655 --> 00:07:01,363
As soon as I find another surgeon,
202
00:07:01,364 --> 00:07:02,377
I'll take over and I'll
get you out of there.
203
00:07:02,378 --> 00:07:03,445
No, I got it.
204
00:07:03,689 --> 00:07:05,277
Having one person control the carotid
205
00:07:05,278 --> 00:07:07,198
limits his chance of stroking out.
206
00:07:08,940 --> 00:07:10,722
All right. Gown her, too.
207
00:07:10,723 --> 00:07:11,705
Right away.
208
00:07:12,283 --> 00:07:13,234
Start with Russell.
209
00:07:13,235 --> 00:07:14,457
You want to do the opener or me?
210
00:07:14,458 --> 00:07:15,626
Well, the numbers are so compelling.
211
00:07:15,627 --> 00:07:16,687
I think I'd start with how much
212
00:07:16,688 --> 00:07:18,266
his department's cuts
will save the hospital.
213
00:07:18,267 --> 00:07:19,271
And then I would...
214
00:07:19,272 --> 00:07:20,411
I'll-I'll do the opener.
215
00:07:20,412 --> 00:07:22,317
Sorry. I get a little
excited about statistics.
216
00:07:22,318 --> 00:07:24,464
- Not everybody shares that passion.
- Not everybody.
217
00:07:24,465 --> 00:07:25,329
Okay, so you do the talking,
218
00:07:25,330 --> 00:07:26,950
and I'll hold up the chart
when you give me the signal?
219
00:07:26,951 --> 00:07:28,527
Perfect. Oh, damn it.
220
00:07:28,528 --> 00:07:29,881
Hunt needs me in the O.R.
221
00:07:29,882 --> 00:07:30,868
You're gonna have to start without me.
222
00:07:30,869 --> 00:07:32,004
No. P-people don't like me.
223
00:07:32,005 --> 00:07:32,899
Talk from your heart,
224
00:07:32,900 --> 00:07:34,833
not about the charts or the numbers.
225
00:07:34,918 --> 00:07:36,081
You can do this.
226
00:07:41,536 --> 00:07:42,692
And there you have it.
227
00:07:42,693 --> 00:07:44,493
A technique I have developed through years
228
00:07:44,494 --> 00:07:46,067
of highly focused research.
229
00:07:46,068 --> 00:07:48,878
I eat, sleep, and breathe hernias, folks.
230
00:07:48,958 --> 00:07:51,052
After today, something
tells me you will, too.
231
00:07:51,053 --> 00:07:51,736
Gross.
232
00:07:51,737 --> 00:07:52,972
Dr. Nesbaum.
233
00:07:53,460 --> 00:07:56,198
Over the years,
I've developed my own technique
234
00:07:56,199 --> 00:07:57,596
for a hernia repair.
235
00:07:57,597 --> 00:08:00,267
So if it's all the same to you,
I'll stick to that.
236
00:08:00,268 --> 00:08:02,193
I'm sure it's lovely, but the point here
237
00:08:02,194 --> 00:08:04,939
is to standardize the way
Seattle Grace Mercy West
238
00:08:04,940 --> 00:08:05,965
approaches the hernia
239
00:08:05,966 --> 00:08:08,143
so every O.R. can be prepped the same way.
240
00:08:08,144 --> 00:08:11,210
It's quick, clean, efficient.
241
00:08:11,211 --> 00:08:12,530
I suppose.
242
00:08:13,295 --> 00:08:14,799
Listen to old man Webber,
243
00:08:14,800 --> 00:08:16,665
"My ways are the best ways."
244
00:08:16,666 --> 00:08:20,359
"Ooh, it's drafty in here.
Somebody bring me a blanket."
245
00:08:20,512 --> 00:08:23,828
Now what do you say to a little
friendly competition, hmm?
246
00:08:23,829 --> 00:08:26,430
The first surgeon who can
perform 20 hernia repairs
247
00:08:26,431 --> 00:08:28,953
using my exact tension-free mesh technique
248
00:08:28,954 --> 00:08:32,928
will win bragging rights,
the respect of their peers,
249
00:08:32,929 --> 00:08:34,525
and aha...
250
00:08:37,246 --> 00:08:38,662
this sweet baby.
251
00:08:39,495 --> 00:08:40,826
Oh. I've seen those in the gift shop.
252
00:08:40,827 --> 00:08:41,748
They're not cheap.
253
00:08:41,749 --> 00:08:44,083
I knew it. They're making
us fight to survive.
254
00:08:44,084 --> 00:08:45,189
First prize is a fleece.
255
00:08:45,190 --> 00:08:47,867
Second prize is a one-way
ticket to the curb.
256
00:08:48,111 --> 00:08:49,337
Shall we begin?
257
00:08:50,513 --> 00:08:51,456
Tributes,
258
00:08:51,457 --> 00:08:53,904
may the odds be ever in your favor.
259
00:09:00,451 --> 00:09:01,839
Take 'em off.
260
00:09:03,957 --> 00:09:04,911
What?
261
00:09:05,473 --> 00:09:07,869
Well, we gotta get you up and moving.
262
00:09:07,870 --> 00:09:08,631
Today's the day.
263
00:09:08,632 --> 00:09:09,709
Maybe tomorrow's the day.
264
00:09:09,710 --> 00:09:11,406
Look, if you don't get up,
265
00:09:11,407 --> 00:09:12,981
your hips aren't gonna heal right.
266
00:09:12,982 --> 00:09:14,028
I don't care.
267
00:09:14,029 --> 00:09:15,221
I know it's hard.
268
00:09:15,222 --> 00:09:16,392
But you're only 13.
269
00:09:16,393 --> 00:09:17,976
You talk like your whole life is over.
270
00:09:17,977 --> 00:09:19,941
Like you even know what my life was.
271
00:09:19,942 --> 00:09:23,082
I know that you were into gymnastics.
272
00:09:23,756 --> 00:09:25,949
I wasn't "Into gymnastics," stupid.
273
00:09:25,950 --> 00:09:27,399
It was my career.
274
00:09:27,502 --> 00:09:28,683
Ever since I was 4 years old,
275
00:09:28,684 --> 00:09:30,787
it's all I've ever wanted to do.
276
00:09:30,983 --> 00:09:32,617
My mom worked double shifts
277
00:09:32,618 --> 00:09:34,832
so I could be in the gym five hours a day.
278
00:09:34,833 --> 00:09:36,095
More on the weekends.
279
00:09:36,096 --> 00:09:38,232
And I knew that if I worked really hard,
280
00:09:38,233 --> 00:09:40,267
someday she wouldn't have to anymore.
281
00:09:41,517 --> 00:09:42,844
I ranked number one
282
00:09:42,845 --> 00:09:45,088
at the future stars nationals last year.
283
00:09:45,089 --> 00:09:47,065
I was going to the Rio Olympics.
284
00:09:47,066 --> 00:09:48,536
I was next.
285
00:09:48,537 --> 00:09:50,367
When my hips started to hurt,
286
00:09:50,588 --> 00:09:51,660
I thought that I pulled a muscle,
287
00:09:51,661 --> 00:09:53,181
so I trained through it.
288
00:09:54,188 --> 00:09:56,307
I'm not next anymore.
289
00:09:56,308 --> 00:09:58,493
I'm nothing. I'm number zero.
290
00:09:58,494 --> 00:10:00,652
Hey. No, you're not.
291
00:10:00,968 --> 00:10:02,840
Maybe this part might be over,
292
00:10:02,841 --> 00:10:05,888
but you got time to do
all sorts of things.
293
00:10:05,889 --> 00:10:08,503
They said that
if the surgery was successful,
294
00:10:08,689 --> 00:10:10,680
I might be able to ride a bike,
295
00:10:10,681 --> 00:10:13,892
'cause that's as good as having
your face on a slurpee cup, right?
296
00:10:15,394 --> 00:10:17,587
You might understand if...
297
00:10:17,943 --> 00:10:19,926
you've ever been great at something...
298
00:10:21,085 --> 00:10:23,245
been best at something.
299
00:10:24,243 --> 00:10:28,376
So, yeah, my life is over at 13.
300
00:10:28,649 --> 00:10:31,239
I get to ride a bike and go to school
301
00:10:32,199 --> 00:10:33,789
and wait to die.
302
00:10:41,861 --> 00:10:43,603
Cardio tech to the E.R.
303
00:10:43,703 --> 00:10:45,466
Cardio tech to the E.R.
304
00:10:46,462 --> 00:10:49,859
Dr. Yang, about the I.V.
heparin you ordered for room three.
305
00:10:52,012 --> 00:10:53,496
Is there a problem?
306
00:10:53,618 --> 00:10:56,182
No. It's just Dr. Richardson insists
307
00:10:56,183 --> 00:10:58,298
I give Sub-Q Enoxaparin.
308
00:11:00,168 --> 00:11:02,181
Who the hell is Dr. Richardson?
309
00:11:05,091 --> 00:11:07,646
Oh, yeah. Ignore it.
310
00:11:07,924 --> 00:11:08,905
I tried.
311
00:11:08,906 --> 00:11:09,854
He keeps insisting,
312
00:11:09,855 --> 00:11:11,894
and it's really upsetting the patient.
313
00:11:21,374 --> 00:11:23,439
Open the pod bay doors, Hal.
314
00:11:23,440 --> 00:11:26,284
It's Bob Richardson. Dr. Richardson.
315
00:11:26,285 --> 00:11:28,634
I have a little problem, Bob.
316
00:11:28,635 --> 00:11:29,850
I'm here to help.
317
00:11:29,851 --> 00:11:32,210
You're supposed to be our
eyes in the sky, correct?
318
00:11:32,211 --> 00:11:32,864
Yes.
319
00:11:32,865 --> 00:11:35,286
Then how about you just do that?
320
00:11:35,287 --> 00:11:35,991
I'm sorry?
321
00:11:35,992 --> 00:11:37,747
Don't question my medical decisions.
322
00:11:37,748 --> 00:11:39,596
If I order my intern to give I.V. Heparin,
323
00:11:39,597 --> 00:11:40,925
I want I.V. Heparin.
324
00:11:40,926 --> 00:11:42,918
Uh, I guess you haven't read the results
325
00:11:42,919 --> 00:11:44,487
from the SYNERGY trial,
326
00:11:44,488 --> 00:11:47,975
which showed Enoxaparin reduced
the need for monitoring.
327
00:11:47,976 --> 00:11:51,114
Oh. Got a lot of time to read, Bob,
328
00:11:51,132 --> 00:11:52,425
hanging out in your underwear,
329
00:11:52,426 --> 00:11:54,518
watching your wall of monitors?
330
00:11:54,534 --> 00:11:55,616
'Cause that same trial
331
00:11:55,617 --> 00:11:57,218
- found that there was more bleeding...
- Dr. Yang.
332
00:11:57,219 --> 00:11:59,435
The pit's calling with a possible
cardiac trauma in the field.
333
00:11:59,436 --> 00:12:00,571
Five minutes away.
334
00:12:02,651 --> 00:12:04,140
Don't try and be a doctor, Bob.
335
00:12:04,141 --> 00:12:06,842
Just make sure my idiot
interns don't screw up.
336
00:12:07,133 --> 00:12:08,515
Give the I.V. Heparin.
337
00:12:08,625 --> 00:12:09,693
Don't butt in.
338
00:12:09,972 --> 00:12:10,845
Let's go.
339
00:12:17,216 --> 00:12:20,029
Dr. Russell. Dr. Kepner, trauma.
340
00:12:20,030 --> 00:12:22,537
Trauma, of sainted memory.
341
00:12:22,538 --> 00:12:24,945
Actually, um, we're trying
to save the department,
342
00:12:24,946 --> 00:12:26,808
I was wondering if could
talk to you about some ideas.
343
00:12:26,809 --> 00:12:29,591
Got your e-mail. "Proposed budget cuts."
344
00:12:29,596 --> 00:12:30,699
Nice try.
345
00:12:30,742 --> 00:12:32,600
Well, I think you'll see that a 2%...
346
00:12:32,988 --> 00:12:35,068
Okay, uh, numbers don't
really matter. I, um...
347
00:12:35,069 --> 00:12:37,019
Ever been to a TED conference?
348
00:12:37,020 --> 00:12:37,587
I haven't.
349
00:12:37,588 --> 00:12:38,613
Inspiring.
350
00:12:38,614 --> 00:12:41,063
Finest minds of our
generation under one roof,
351
00:12:41,064 --> 00:12:43,504
sharing stories of
mind-bending innovation.
352
00:12:43,505 --> 00:12:44,540
That sounds great but...
353
00:12:44,541 --> 00:12:47,668
Innovation is what's gonna
save this hospital...
354
00:12:47,669 --> 00:12:50,343
- Okay.
- Not this penny saved, penny earned crap.
355
00:12:50,344 --> 00:12:51,655
Okay, but, um...
356
00:12:51,656 --> 00:12:53,462
Good to meet you, Dr. Kepler.
357
00:12:53,463 --> 00:12:54,937
Kepner.
358
00:12:58,564 --> 00:12:59,393
This is a mess.
359
00:12:59,394 --> 00:13:00,994
I don't think we can fix this primarily.
360
00:13:00,995 --> 00:13:02,642
Can you check for back bleeding?
361
00:13:04,501 --> 00:13:05,479
Cahill?
362
00:13:05,655 --> 00:13:06,327
Me?
363
00:13:06,328 --> 00:13:07,642
Yeah, you're holding the clamp.
364
00:13:07,643 --> 00:13:09,563
- If you can't do it, then...
- Okay.
365
00:13:13,449 --> 00:13:14,435
He doesn't have any.
366
00:13:14,436 --> 00:13:16,063
Okay. Which means he has
poor collateral flow.
367
00:13:16,064 --> 00:13:17,035
We're gonna need a shunt.
368
00:13:17,036 --> 00:13:19,663
I can put it in if someone will
get me a rummel tourniquet.
369
00:13:22,417 --> 00:13:23,357
Thank you.
370
00:13:35,150 --> 00:13:35,819
Sorry.
371
00:13:35,820 --> 00:13:37,511
I-I used to do that.
372
00:13:37,601 --> 00:13:38,570
It's like riding a bike, huh?
373
00:13:38,571 --> 00:13:40,634
Yeah, if the bike's
going 200 miles an hour.
374
00:13:40,635 --> 00:13:41,639
That's what makes it fun.
375
00:13:41,640 --> 00:13:43,337
Yeah, damn right, it does.
376
00:13:43,338 --> 00:13:45,528
So why did you stop in the first place?
377
00:13:46,827 --> 00:13:47,832
Yeah, Hunt, I got your page.
378
00:13:47,833 --> 00:13:49,119
You're worried about a brain bleed?
379
00:13:49,120 --> 00:13:50,601
Yeah, we didn't get a
chance to do the scan.
380
00:13:50,602 --> 00:13:51,820
His carotid blew.
381
00:13:51,889 --> 00:13:52,744
Is that Kepner?
382
00:13:52,745 --> 00:13:55,037
Cahill. Dr. Shepherd, hi.
383
00:13:55,541 --> 00:13:56,992
So instead of telling
us how to do our jobs,
384
00:13:56,993 --> 00:13:57,935
now you're just doing them?
385
00:13:57,936 --> 00:13:59,105
That would be more efficient.
386
00:13:59,106 --> 00:14:01,446
No, she was in the right
place at the right time.
387
00:14:01,497 --> 00:14:02,649
She probably saved his life.
388
00:14:02,650 --> 00:14:03,941
I got lucky.
389
00:14:03,943 --> 00:14:06,422
Lucky for this guy his
chain saw slipped today.
390
00:14:06,423 --> 00:14:08,136
Tomorrow he'd be dead already.
391
00:14:11,632 --> 00:14:12,196
What do you got?
392
00:14:12,197 --> 00:14:13,662
Skateboarder versus car.
393
00:14:13,663 --> 00:14:15,063
Late teens. Didn't have I.D.
394
00:14:15,064 --> 00:14:16,977
The kid was slaloming hills with a buddy.
395
00:14:16,978 --> 00:14:18,335
Was nonresponsive in the field.
396
00:14:18,336 --> 00:14:19,886
His last systolic was 70.
397
00:14:19,887 --> 00:14:21,850
Heart rate tacking along in the 130s.
398
00:14:21,851 --> 00:14:24,429
E.K.G. shows some changes,
so I suspect cardiac trauma.
399
00:14:24,430 --> 00:14:26,689
Okay, I need a portable
X-ray up here, stat.
400
00:14:26,690 --> 00:14:29,592
I need a 12-lead, and, uh,
let's get a T.E.E. bedside.
401
00:14:29,593 --> 00:14:31,634
- Right away.
- Ready on three. One, two, three.
402
00:14:32,677 --> 00:14:34,458
- Murphy, set up the T.E.E.
- Got it.
403
00:14:34,459 --> 00:14:35,804
Type and cross for six units.
404
00:14:35,805 --> 00:14:38,103
Hang two units of O-neg
as soon as possible.
405
00:14:38,104 --> 00:14:39,326
Hey, what's your buddy's name?
406
00:14:39,327 --> 00:14:40,865
Um, Rich. Rich Campion.
407
00:14:40,866 --> 00:14:42,068
Does he have any allergies
that you know of?
408
00:14:42,069 --> 00:14:43,254
Is he on any medications?
409
00:14:43,255 --> 00:14:44,723
I-I-I don't know.
410
00:14:45,227 --> 00:14:46,490
Look, is he going to be okay?
411
00:14:46,491 --> 00:14:48,688
We're doing everything we can.
412
00:14:49,578 --> 00:14:51,814
No breath sounds on the right.
Someone set up a chest tube.
413
00:14:51,815 --> 00:14:52,791
On it.
414
00:14:53,238 --> 00:14:55,280
It looks like a mediastinal hematoma.
415
00:14:55,281 --> 00:14:56,520
Could be an aortic transection.
416
00:14:56,521 --> 00:14:58,676
Uh, we need to move fast, people.
417
00:14:59,233 --> 00:15:00,683
B.P.'s still dropping. Scissors.
418
00:15:00,684 --> 00:15:02,559
Yeah, he's crashing. Where is that blood?
419
00:15:02,560 --> 00:15:03,804
Right here, doctor.
420
00:15:04,732 --> 00:15:06,433
Oh, he has a medical I.D.
It must have broken off.
421
00:15:06,434 --> 00:15:07,836
Okay. What's it say?
What's he allergic to?
422
00:15:07,837 --> 00:15:08,859
Oh, god.
423
00:15:08,860 --> 00:15:10,169
What is he allergic to?
424
00:15:11,834 --> 00:15:12,903
Okay, stop.
425
00:15:14,037 --> 00:15:16,512
He's a Jehovah's witness.
We can't give him blood.
426
00:15:24,970 --> 00:15:26,688
They're prepping the O.R.
for a bloodless surgery
427
00:15:26,689 --> 00:15:28,246
so we'll need to recirculate his blood.
428
00:15:28,247 --> 00:15:29,695
So we'll put him on a cell saver machine,
429
00:15:29,696 --> 00:15:31,607
and then continue the hypertonic saline,
430
00:15:31,671 --> 00:15:34,686
colloids, and factor VII to pump
up his intravascular volume.
431
00:15:34,687 --> 00:15:36,558
We're seriously repairing
an aortic transection
432
00:15:36,559 --> 00:15:37,579
without blood?
433
00:15:37,580 --> 00:15:39,728
- Yeah, we have no choice.
- We could use blood.
434
00:15:39,729 --> 00:15:42,051
Oh, we could also be arrested
for assault and battery.
435
00:15:42,052 --> 00:15:42,764
Very funny.
436
00:15:42,765 --> 00:15:43,608
I'm not joking.
437
00:15:43,609 --> 00:15:45,685
There are protocols in
place for people who won't
438
00:15:45,686 --> 00:15:47,552
or can't accept supplemental blood.
439
00:15:47,579 --> 00:15:49,111
We do bloodless surgeries
here all the time.
440
00:15:49,112 --> 00:15:52,059
Have you ever done this...
a bloodless aortic transection?
441
00:15:52,227 --> 00:15:53,077
No.
442
00:15:53,770 --> 00:15:55,798
Dr. Radnor to labor and delivery...
443
00:15:55,799 --> 00:15:57,737
I-I hear you. I did.
444
00:15:57,738 --> 00:15:58,848
And...
445
00:15:59,244 --> 00:16:00,535
- Alex.
- Oh.
446
00:16:00,536 --> 00:16:01,570
You don't have her walking yet?
447
00:16:01,571 --> 00:16:03,588
Oh, there's no talking to that girl.
448
00:16:03,589 --> 00:16:04,776
It's dark in there.
449
00:16:04,777 --> 00:16:05,592
Really dark.
450
00:16:05,593 --> 00:16:06,703
- Karev...
- I'm serious.
451
00:16:06,704 --> 00:16:08,913
That girl turned me into a suicide risk.
452
00:16:09,496 --> 00:16:10,787
I'm gonna move her myself then.
453
00:16:10,788 --> 00:16:13,423
Mm. Excessive force...
bad cop's go-to move.
454
00:16:15,102 --> 00:16:16,530
You know what makes a bad cop bad?
455
00:16:16,531 --> 00:16:19,034
When the good cop's namby-pamby
approach gets us nowhere.
456
00:16:19,035 --> 00:16:20,434
Then bad cop has to set a limit
457
00:16:20,434 --> 00:16:21,940
and ends up looking like a big meanie.
458
00:16:21,941 --> 00:16:24,359
A good cop's approach takes time
459
00:16:24,360 --> 00:16:25,444
and patience.
460
00:16:25,445 --> 00:16:26,896
Bad cop is a notorious hothead.
461
00:16:26,897 --> 00:16:28,955
If she's going to insist
on wearing dresses,
462
00:16:28,956 --> 00:16:29,865
she has to wear tights.
463
00:16:29,866 --> 00:16:31,290
I'm gonna go lie down.
464
00:16:34,996 --> 00:16:36,076
His vitals are worse.
465
00:16:36,077 --> 00:16:38,078
- How's the cell saver coming?
- Almost ready.
466
00:16:38,079 --> 00:16:39,728
- Do we have surgical glue?
- Yes.
467
00:16:39,729 --> 00:16:41,219
- Avitene?
- Yes.
468
00:16:41,220 --> 00:16:42,906
Okay, I want two bovies set up.
469
00:16:42,907 --> 00:16:44,841
- I'm on it.
- Joy, get my headlamp ready.
470
00:16:44,842 --> 00:16:47,172
Here it is. Wait a minute. Wait a minute.
471
00:16:47,173 --> 00:16:49,160
Where is my gel foam and thrombin?
472
00:16:49,161 --> 00:16:50,671
We're trying to keep
blood loss to a minimum.
473
00:16:50,672 --> 00:16:52,248
We need a whole bunch more.
474
00:16:52,663 --> 00:16:54,393
- Okay, hypertonic saline?
- Check.
475
00:16:54,394 --> 00:16:55,800
- Factor VII?
- Check.
476
00:16:55,801 --> 00:16:57,246
- Cell saver ready?
- Check.
477
00:16:57,247 --> 00:16:59,063
Okay, let's go before he bleeds out.
478
00:17:05,013 --> 00:17:07,291
I can't cut. He'll lose too much blood.
479
00:17:07,292 --> 00:17:08,312
What do we do?
480
00:17:08,868 --> 00:17:10,095
We'll go in percutaneously.
481
00:17:10,096 --> 00:17:12,681
Get the O.R. ready for
an endovascular repair.
482
00:17:12,682 --> 00:17:13,735
Let's move.
483
00:17:22,183 --> 00:17:23,935
Excellent, Dr. Grey.
484
00:17:24,629 --> 00:17:26,005
19 more to go.
485
00:17:26,811 --> 00:17:28,029
You're gonna choke, Grey.
486
00:17:28,030 --> 00:17:30,463
You'll choke and die,
and I will dance and sing.
487
00:17:31,024 --> 00:17:33,107
Damn it. Damn it!
488
00:17:34,291 --> 00:17:36,798
The mesh is bunching up
at the pubic tubercle.
489
00:17:37,463 --> 00:17:39,326
You know, I still feel that you do not...
490
00:17:39,327 --> 00:17:41,288
I understand this can be tricky at first,
491
00:17:41,289 --> 00:17:42,674
but once you get the hang of it,
492
00:17:42,675 --> 00:17:44,513
you'll see why a dozen
hospitals around the country
493
00:17:44,514 --> 00:17:45,897
have already adopted this approach,
494
00:17:45,898 --> 00:17:47,689
and I've already had
inquiries from a dozen more.
495
00:17:47,690 --> 00:17:49,273
- Check!
- Excuse me.
496
00:17:53,645 --> 00:17:55,997
Okay. All right. That's the right idea.
497
00:17:56,019 --> 00:17:57,556
- But, um...
- But-but what?
498
00:17:57,557 --> 00:17:58,823
- Well...
- Check.
499
00:17:58,824 --> 00:17:59,922
- Check!
- Check!
500
00:17:59,923 --> 00:18:00,906
Hey, don't beat around the bush.
501
00:18:00,907 --> 00:18:03,198
Tell me what you don't like,
'cause it looks perfect to me.
502
00:18:03,199 --> 00:18:04,322
O-okay.
503
00:18:04,490 --> 00:18:06,725
Take a look at what
Dr. Grey is doing over here.
504
00:18:06,812 --> 00:18:08,012
You see how she doesn't rush,
505
00:18:08,013 --> 00:18:09,276
cut the mesh just right?
506
00:18:09,277 --> 00:18:12,477
See, now when done properly,
the mesh will fit perfectly
507
00:18:12,478 --> 00:18:14,473
and not require extra sutures to hold it,
508
00:18:14,474 --> 00:18:17,829
thereby reducing the risk
of future complications.
509
00:18:17,884 --> 00:18:20,927
So do this over,
pay attention to the details,
510
00:18:20,928 --> 00:18:22,453
and take your time.
511
00:18:24,008 --> 00:18:25,051
I would be happy
512
00:18:25,052 --> 00:18:27,075
to give you some pointers if you'd like.
513
00:18:27,076 --> 00:18:29,902
That bun in the oven may give
you job security, Meredith Grey,
514
00:18:29,903 --> 00:18:31,102
but it does not make you immune
515
00:18:31,103 --> 00:18:32,726
from a smack in the mouth.
516
00:18:40,746 --> 00:18:42,005
Rich is still in surgery.
517
00:18:42,006 --> 00:18:44,028
Uh, Dr. Yang sent me down
to talk to his family.
518
00:18:44,029 --> 00:18:45,078
Well, how-how's he doing?
519
00:18:45,079 --> 00:18:46,700
It's touch and go.
520
00:18:46,701 --> 00:18:48,821
They're gonna take him
back up to the C.C.U.
521
00:18:48,918 --> 00:18:50,089
Is his family here?
522
00:18:50,563 --> 00:18:51,840
Dude, like...
523
00:18:52,253 --> 00:18:54,307
- dozens of them.
- Lord...
524
00:18:54,354 --> 00:18:56,868
You know, I swear,
we hung out practically every day.
525
00:18:56,869 --> 00:18:59,269
We have the same shift at the skate shop.
526
00:19:00,013 --> 00:19:01,722
And he never once mentioned to me
527
00:19:01,723 --> 00:19:03,558
that he was a Jehovah's witness.
528
00:19:03,641 --> 00:19:05,222
He never talked about it.
529
00:19:05,615 --> 00:19:06,669
Father of all mercy...
530
00:19:06,670 --> 00:19:08,389
I kind of don't think he is.
531
00:19:08,980 --> 00:19:10,652
Well, maybe it was just a personal thing.
532
00:19:10,653 --> 00:19:12,373
Maybe, but I mean, if you...
533
00:19:13,033 --> 00:19:14,610
if you believed in something so hard
534
00:19:14,611 --> 00:19:16,713
that you would die for it...
535
00:19:18,985 --> 00:19:19,769
Would you keep it a secret?
536
00:19:19,770 --> 00:19:21,781
Wouldn't you at least tell your friends?
537
00:19:22,556 --> 00:19:24,846
Yeah. Yeah, I guess.
538
00:19:24,847 --> 00:19:26,714
I should... look, I gotta...
I gotta get out of here.
539
00:19:26,715 --> 00:19:29,009
Will you... will you call me when he's out?
540
00:19:29,010 --> 00:19:30,666
Sure. No problem.
541
00:19:31,567 --> 00:19:34,554
With which we ourselves are
being comforted by now.
542
00:19:34,994 --> 00:19:38,830
Blessed be the god and father
of our lord Jesus Christ.
543
00:19:39,341 --> 00:19:41,356
We can't repair the carotid under tension.
544
00:19:41,357 --> 00:19:42,263
It'll pull apart.
545
00:19:42,264 --> 00:19:43,870
Or clot. It's tricky.
546
00:19:43,871 --> 00:19:45,790
We can't use one of these
vessels to patch it.
547
00:19:45,791 --> 00:19:48,325
The chain saw chewed
everything up pretty good.
548
00:19:48,927 --> 00:19:51,455
I could take a piece of
saphenous vein from the leg...
549
00:19:51,456 --> 00:19:52,694
Yes. Good.
550
00:19:52,695 --> 00:19:54,820
Good. Go ahead. Prep the leg.
551
00:19:54,821 --> 00:19:56,629
All right. Scissors and betadine, please.
552
00:19:56,630 --> 00:19:57,788
Right away, doctor.
553
00:19:58,276 --> 00:20:00,139
So I hear somebody's nose came off?
554
00:20:00,169 --> 00:20:01,136
Can I have a headlamp, please?
555
00:20:01,137 --> 00:20:02,405
Almost. Take a look.
556
00:20:02,406 --> 00:20:04,110
Well, I would if we could find out
557
00:20:04,111 --> 00:20:06,343
Where we're keeping
the headlamps these days.
558
00:20:06,843 --> 00:20:08,706
And what should've
shaved off half a second
559
00:20:08,707 --> 00:20:10,516
has now added five.
560
00:20:11,308 --> 00:20:12,247
Thank you.
561
00:20:12,298 --> 00:20:13,254
Gauze, please.
562
00:20:13,255 --> 00:20:16,265
Oh, sorry. Meant to just say "Gauze."
563
00:20:16,662 --> 00:20:18,448
That "Please" just cost
me a tenth of second.
564
00:20:18,449 --> 00:20:19,569
All right, Avery. That's enough.
565
00:20:19,570 --> 00:20:21,017
Chief, you know this is all about
566
00:20:21,018 --> 00:20:22,687
turning over the tables for her.
567
00:20:22,842 --> 00:20:24,475
I mean, I feel like I'm
working the dinner shift
568
00:20:24,476 --> 00:20:26,443
- at a jumbo burger in here.
- Dr. Avery...
569
00:20:26,444 --> 00:20:28,608
She should just replace us
with surgical robots, really.
570
00:20:28,609 --> 00:20:30,992
I mean, that's essentially
what she's asking us to be.
571
00:20:31,097 --> 00:20:32,878
Bless you. You don't tell
us how to run an O.R.
572
00:20:32,879 --> 00:20:34,671
if you don't actually work in one.
That's all I'm saying.
573
00:20:34,678 --> 00:20:37,179
You can tell Dr. Pantsuit
hasn't been in one in years.
574
00:20:37,180 --> 00:20:38,457
Until today.
575
00:20:44,840 --> 00:20:45,888
Well...
576
00:20:46,093 --> 00:20:48,348
I can repair this post-op.
577
00:20:48,349 --> 00:20:51,341
So just give me a shout when you're done.
578
00:20:52,055 --> 00:20:53,022
Thank you...
579
00:20:53,084 --> 00:20:54,138
doctors.
580
00:20:55,474 --> 00:20:56,699
Best of luck.
581
00:20:57,776 --> 00:20:59,611
I thought I was gonna be fired.
582
00:21:02,644 --> 00:21:03,616
Sorry about that.
583
00:21:03,617 --> 00:21:04,746
Oh, it's fine.
584
00:21:04,835 --> 00:21:07,251
It's easier if there's a bad guy.
585
00:21:09,039 --> 00:21:10,733
My people just care about this place.
586
00:21:10,734 --> 00:21:11,688
I know.
587
00:21:11,689 --> 00:21:13,843
I know you're all upset, especially you,
588
00:21:13,844 --> 00:21:15,398
losing your E.R.
589
00:21:15,482 --> 00:21:17,121
But I also know that without me,
590
00:21:17,122 --> 00:21:19,164
you'd lose this entire hospital.
591
00:21:19,311 --> 00:21:21,829
So if you need to blame
me instead of thank me,
592
00:21:21,830 --> 00:21:23,185
I'm fine with that,
593
00:21:23,654 --> 00:21:25,657
because I will know who saved it.
594
00:21:26,335 --> 00:21:28,993
I've saved a dozen before
just like this one,
595
00:21:30,015 --> 00:21:32,045
and no one thanked me for those either.
596
00:21:41,126 --> 00:21:43,545
Let's add a C.P.K. to his next blood draw.
597
00:21:43,554 --> 00:21:45,013
What was his last hemoglobin?
598
00:21:45,091 --> 00:21:45,718
4.
599
00:21:46,397 --> 00:21:47,975
The guy's on fumes.
600
00:21:48,798 --> 00:21:50,023
Try and stimulate blood production
601
00:21:50,024 --> 00:21:51,920
by giving E.P.O.
602
00:21:51,921 --> 00:21:53,725
Or we could... give him blood
603
00:21:53,726 --> 00:21:55,077
and cut out the middle man.
604
00:21:55,078 --> 00:21:57,677
We can also give I.V. Iron-dextran.
605
00:21:57,678 --> 00:21:58,694
Thanks, Bob.
606
00:21:59,076 --> 00:22:01,740
We can give him iron? How is that logical?
607
00:22:01,741 --> 00:22:03,193
We can give him the components of blood,
608
00:22:03,194 --> 00:22:03,961
just not blood?
609
00:22:03,962 --> 00:22:05,312
We have to respect his wishes.
610
00:22:05,313 --> 00:22:07,474
What wishes? He can't tell us anything.
611
00:22:07,554 --> 00:22:08,548
His friend didn't even know
612
00:22:08,549 --> 00:22:09,714
that he was a Jehovah's witness.
613
00:22:09,715 --> 00:22:10,683
Yeah, it's not the kind of thing
614
00:22:10,684 --> 00:22:12,373
you talk about at the skate park.
615
00:22:12,374 --> 00:22:14,287
I'm just saying, he's 19.
616
00:22:14,472 --> 00:22:16,185
How can he even know what he believes?
617
00:22:16,186 --> 00:22:17,065
When I was 19,
618
00:22:17,066 --> 00:22:19,826
I was a completely different
person than I am now.
619
00:22:19,827 --> 00:22:21,369
I wanted to be a radiologist.
620
00:22:21,370 --> 00:22:24,473
Wow. I feel like
I'm seeing a whole new you.
621
00:22:24,488 --> 00:22:25,637
Uh, start his E.P.O.
622
00:22:25,638 --> 00:22:26,715
and keep a close eye on his crit.
623
00:22:26,716 --> 00:22:27,938
Right away, doctor.
624
00:22:29,090 --> 00:22:30,633
So you're fine with this?
625
00:22:30,634 --> 00:22:32,138
Even though he could die,
you're fine with just...
626
00:22:32,139 --> 00:22:33,880
It doesn't matter what I think.
627
00:22:33,893 --> 00:22:36,465
He had an alert.
It was very clear... no blood.
628
00:22:36,468 --> 00:22:37,997
I don't get to have an opinion about it,
629
00:22:37,998 --> 00:22:39,253
and neither do you.
630
00:22:44,983 --> 00:22:46,411
So there's nothing we can do?
631
00:22:46,458 --> 00:22:47,702
Yeah, there is.
632
00:22:48,056 --> 00:22:49,726
We can talk to the family.
633
00:22:49,938 --> 00:22:50,845
Good luck.
634
00:22:54,061 --> 00:22:55,955
Simmi, I need you to take my hand.
635
00:22:55,956 --> 00:22:56,997
I'm gonna help you sit up.
636
00:22:56,998 --> 00:22:59,014
You're gonna swing your legs to the side
637
00:22:59,148 --> 00:23:00,600
and you're gonna stand up.
638
00:23:01,516 --> 00:23:02,380
Now.
639
00:23:02,422 --> 00:23:04,407
I don't give you permission to touch me...
640
00:23:04,885 --> 00:23:06,359
like, bodily.
641
00:23:06,453 --> 00:23:07,505
I'll scream.
642
00:23:10,434 --> 00:23:11,822
Simmi, if you don't move,
I'm gonna have to say
643
00:23:11,823 --> 00:23:13,340
that you're acting against medical advice.
644
00:23:13,341 --> 00:23:15,353
We will discharge you, you will go home,
645
00:23:15,354 --> 00:23:17,448
and you will rot, okay?
646
00:23:17,449 --> 00:23:18,905
The muscles around
your new hips will atrophy,
647
00:23:18,906 --> 00:23:21,111
and you will probably never walk again.
648
00:23:21,287 --> 00:23:22,727
Why do you care?
649
00:23:23,578 --> 00:23:24,971
Because I'm your doctor
650
00:23:25,635 --> 00:23:27,609
and I worked very hard to help you.
651
00:23:30,835 --> 00:23:32,896
Wouldn't it suck if you didn't help me?
652
00:23:33,395 --> 00:23:34,894
If you went through all of that training
653
00:23:34,895 --> 00:23:36,394
to become a big doctor,
654
00:23:36,466 --> 00:23:37,851
you came up with a plan,
655
00:23:38,349 --> 00:23:40,239
you did my operation,
you did it just right,
656
00:23:40,240 --> 00:23:41,612
just perfect,
657
00:23:42,176 --> 00:23:44,114
you made me so I could walk again,
658
00:23:44,156 --> 00:23:45,342
but I didn't,
659
00:23:46,129 --> 00:23:48,069
wouldn't you feel helpless,
660
00:23:48,770 --> 00:23:50,720
like nothing matters?
661
00:23:51,417 --> 00:23:53,261
No matter how much you care,
662
00:23:53,443 --> 00:23:55,104
how hard you try,
663
00:23:56,371 --> 00:23:58,645
how badly you want something,
664
00:23:59,313 --> 00:24:00,999
you will never have it...
665
00:24:02,655 --> 00:24:05,640
because everything is
totally out of your control.
666
00:24:11,667 --> 00:24:12,615
Feel that?
667
00:24:20,131 --> 00:24:21,457
Couldn't have done it better myself.
668
00:24:21,458 --> 00:24:22,092
Yes!
669
00:24:22,093 --> 00:24:23,568
Yes, indeed.
670
00:24:23,574 --> 00:24:25,628
Okay, all right, people often ask me
671
00:24:25,629 --> 00:24:28,922
how I can focus so much time on hernias
672
00:24:28,923 --> 00:24:30,732
and maintain this level of excitement.
673
00:24:30,733 --> 00:24:31,847
Well, now you see...
674
00:24:31,908 --> 00:24:34,152
perfection is exciting.
675
00:24:35,039 --> 00:24:36,007
Yeah.
676
00:24:36,565 --> 00:24:37,442
Hear that, Grey?
677
00:24:37,443 --> 00:24:38,595
I'm perfect.
678
00:24:39,760 --> 00:24:41,731
Oh, look at miss slow
and steady over there.
679
00:24:41,732 --> 00:24:43,739
Can't even bother to participate.
680
00:24:46,679 --> 00:24:48,074
No, seriously, Grey, you okay?
681
00:24:48,075 --> 00:24:50,355
Um, yeah, yeah. I just need to...
682
00:24:56,213 --> 00:24:57,187
Darn it.
683
00:25:01,559 --> 00:25:02,688
Something's wrong.
684
00:25:03,756 --> 00:25:04,850
Something's wrong.
685
00:25:05,532 --> 00:25:07,016
You're right. I got comfortable and flip,
686
00:25:07,017 --> 00:25:08,850
and the universe is
smacking me down for it.
687
00:25:08,851 --> 00:25:10,637
I-I'm not immune. I'm not safe.
688
00:25:10,638 --> 00:25:12,022
Wait, wait. Grey, stop.
689
00:25:12,023 --> 00:25:13,050
What is going on?
690
00:25:13,051 --> 00:25:16,217
There-there's a flutter.
I-it's... it can't be right.
691
00:25:20,940 --> 00:25:23,123
Oh, sweetie. This is not a bad thing.
692
00:25:23,124 --> 00:25:24,764
What? It's not?
693
00:25:24,862 --> 00:25:26,723
Oh, no, it's good.
694
00:25:27,252 --> 00:25:28,577
It's so good.
695
00:25:30,640 --> 00:25:32,475
Your baby's kicking.
696
00:25:35,018 --> 00:25:36,167
Oh.
697
00:25:38,338 --> 00:25:40,021
He's lost a lot of blood.
698
00:25:40,022 --> 00:25:41,940
I'd say more than half his volume.
699
00:25:41,948 --> 00:25:43,467
He'll make new blood.
700
00:25:44,169 --> 00:25:46,914
It takes about four days
to make new blood cells.
701
00:25:46,915 --> 00:25:48,821
He may not have that much time.
702
00:25:49,000 --> 00:25:49,970
What would really help
703
00:25:49,971 --> 00:25:51,155
is a blood transfusion.
704
00:25:51,156 --> 00:25:53,442
No. No blood.
705
00:25:53,491 --> 00:25:55,504
If you're worried about
disease transmission,
706
00:25:55,505 --> 00:25:57,349
I can assure you that all of our blood
707
00:25:57,350 --> 00:25:58,802
is meticulously screened.
708
00:25:58,803 --> 00:26:00,614
It's not that we don't trust your blood.
709
00:26:00,615 --> 00:26:01,453
We just...
710
00:26:01,454 --> 00:26:03,758
We believe that life is a gift from god
711
00:26:03,868 --> 00:26:06,282
and we don't try to sustain it
by taking in blood.
712
00:26:08,368 --> 00:26:10,071
Let me be perfectly clear,
713
00:26:10,664 --> 00:26:12,793
your son's condition is critical.
714
00:26:12,863 --> 00:26:15,787
Without blood, his organs
will start shutting down.
715
00:26:15,975 --> 00:26:17,524
And once he starts that spiral,
716
00:26:17,695 --> 00:26:19,184
there is nothing we can do.
717
00:26:19,185 --> 00:26:20,233
Oh, dear god.
718
00:26:20,234 --> 00:26:23,142
We are juggling all kinds
of substitute measures,
719
00:26:23,143 --> 00:26:25,845
but nothing is as good as blood.
720
00:26:25,942 --> 00:26:27,947
As his surgeon, I urge you
721
00:26:27,948 --> 00:26:30,358
to let us give him the best chance we can.
722
00:26:30,359 --> 00:26:31,771
Let us give him blood.
723
00:26:34,371 --> 00:26:37,714
We have seen amazing
miracles through prayer.
724
00:26:38,240 --> 00:26:40,185
If it's god's will...
725
00:26:40,887 --> 00:26:41,911
So you won't allow blood,
726
00:26:41,912 --> 00:26:43,444
even if it's gonna save his life?
727
00:26:43,445 --> 00:26:44,944
- 'Cause prayer...
- Murphy.
728
00:26:45,297 --> 00:26:48,480
We appreciate all
you're doing for our boy.
729
00:26:48,856 --> 00:26:50,147
But your blood wouldn't save his life.
730
00:26:50,148 --> 00:26:51,505
It would condemn him.
731
00:26:54,907 --> 00:26:56,734
Living with it would be
so much worse for him
732
00:26:56,735 --> 00:26:58,179
than dying without it.
733
00:27:00,491 --> 00:27:01,640
We understand.
734
00:27:01,817 --> 00:27:03,578
We will do everything in our power
735
00:27:03,579 --> 00:27:05,191
to keep your son alive.
736
00:27:05,802 --> 00:27:06,854
Thank you.
737
00:27:11,014 --> 00:27:14,185
Colvin said I was insulting him
and everyone in his field.
738
00:27:14,235 --> 00:27:16,357
B** said she doesn't talk to fundraisers.
739
00:27:16,395 --> 00:27:19,158
And-and Springfield basically
had me agreeing to give him money.
740
00:27:19,159 --> 00:27:21,127
- And then Russell...
- You talked about the numbers?
741
00:27:21,708 --> 00:27:22,344
No.
742
00:27:22,345 --> 00:27:22,961
April.
743
00:27:22,962 --> 00:27:25,312
I... didn't. I mean, just... a ti...
744
00:27:25,313 --> 00:27:26,561
like barely at all.
745
00:27:26,562 --> 00:27:28,778
We don't have a lot of time,
but I'll see what I can do.
746
00:27:28,848 --> 00:27:30,046
Oh, there's Redmond.
747
00:27:30,047 --> 00:27:31,493
Hey, hey, Tim.
748
00:27:31,616 --> 00:27:32,917
I saw your little Howie today
749
00:27:32,918 --> 00:27:34,532
when I was dropping Zola off at day care.
750
00:27:34,533 --> 00:27:35,093
Man, he's cute.
751
00:27:35,094 --> 00:27:36,577
Ah, thanks. Yeah, he's a kick.
752
00:27:36,578 --> 00:27:37,423
Yeah, Zola's at that age
753
00:27:37,424 --> 00:27:39,003
where she's just putting
everything in her mouth.
754
00:27:39,004 --> 00:27:40,125
Yeah, we're not quite there yet.
755
00:27:40,126 --> 00:27:42,267
Oh, just you wait.
It's like, legos, magnets.
756
00:27:42,268 --> 00:27:42,658
Really?
757
00:27:42,658 --> 00:27:44,959
Anything that is a choking hazard,
they find it.
758
00:27:44,961 --> 00:27:46,444
- Jeez.
- Yeah, well, lucky for us,
759
00:27:46,445 --> 00:27:48,397
the E.R. is right downstairs
from the, uh, day care.
760
00:27:48,398 --> 00:27:49,799
Yeah, that's for sure.
761
00:27:50,275 --> 00:27:51,248
Wait, isn't that closing?
762
00:27:51,249 --> 00:27:52,746
Yeah, that's what I wanted
to talk to you about.
763
00:27:52,747 --> 00:27:54,274
Dermatology has two fellows.
764
00:27:54,275 --> 00:27:56,932
Now if we could just cut one of them...
765
00:27:57,115 --> 00:27:59,121
maybe we could possibly...
766
00:28:08,342 --> 00:28:09,600
I hate her.
767
00:28:09,931 --> 00:28:10,723
Who?
768
00:28:10,724 --> 00:28:12,790
- My intern.
- Why?
769
00:28:13,055 --> 00:28:14,113
Look at her, all mopey-faced
770
00:28:14,114 --> 00:28:15,788
just 'cause she didn't get her way.
771
00:28:16,111 --> 00:28:18,924
We were never mopey-faced.
We sucked it up.
772
00:28:19,826 --> 00:28:20,804
Why aren't you in your skills lab?
773
00:28:20,805 --> 00:28:22,272
Oh, because the baby kicked.
774
00:28:22,273 --> 00:28:23,744
Wouldn't stop kicking, actually.
775
00:28:23,745 --> 00:28:24,474
Jerk.
776
00:28:24,475 --> 00:28:26,996
No, it's good. It's great.
Kicking is a good thing.
777
00:28:27,393 --> 00:28:29,025
Maybe I should kick my intern.
778
00:28:29,068 --> 00:28:31,949
Maybe my baby's kicking because
it wants a granola bar.
779
00:28:32,915 --> 00:28:34,652
That's possible.
780
00:29:11,760 --> 00:29:13,579
You want to stop right there.
781
00:29:23,485 --> 00:29:25,802
You tried to give blood instead of fluids?
782
00:29:25,889 --> 00:29:27,374
He's not stupid, you know, the eyeball?
783
00:29:27,375 --> 00:29:29,653
- He has eyes.
- And a zoom lens.
784
00:29:29,654 --> 00:29:30,995
Rich is circling the drain,
785
00:29:30,996 --> 00:29:32,228
and he doesn't have to be.
786
00:29:32,229 --> 00:29:33,884
We are giving him everything we have,
787
00:29:33,885 --> 00:29:35,191
just like the family requested.
788
00:29:35,192 --> 00:29:37,444
Yeah, I know. And they're
praying. Awesome.
789
00:29:37,445 --> 00:29:40,368
You never administer anything
to a patient without my orders.
790
00:29:40,369 --> 00:29:42,062
You think that because
you've been here all of,
791
00:29:42,063 --> 00:29:43,700
what, six months, you know everything?
792
00:29:43,701 --> 00:29:44,835
You know nothing.
793
00:29:44,848 --> 00:29:46,911
On the timeline of doctoring,
you are an amoeba.
794
00:29:46,912 --> 00:29:48,769
I thought that he deserved a chance.
795
00:29:48,770 --> 00:29:50,735
You have passion. I get it.
796
00:29:50,990 --> 00:29:52,364
You still have to do what I say.
797
00:29:52,365 --> 00:29:55,191
I am your boss and I am trying
to save this patient's life.
798
00:29:55,192 --> 00:29:57,193
Now get out of here.
You're off my service.
799
00:29:57,194 --> 00:29:58,579
- I just...
- Now.
800
00:30:02,610 --> 00:30:03,772
I'm sorry.
801
00:30:08,420 --> 00:30:10,910
What are you gonna do, get her fired?
802
00:30:11,293 --> 00:30:12,744
She didn't do anything.
803
00:30:13,634 --> 00:30:15,122
There's nothing to tell.
804
00:30:16,277 --> 00:30:17,577
She's right, you know?
805
00:30:17,782 --> 00:30:19,126
He's circling the drain.
806
00:30:19,127 --> 00:30:21,264
Yeah, I know.
807
00:30:24,116 --> 00:30:25,219
Okay.
808
00:30:26,782 --> 00:30:27,654
Ready?
809
00:30:29,047 --> 00:30:30,399
Fingers crossed.
810
00:30:30,400 --> 00:30:31,533
Yes.
811
00:30:32,089 --> 00:30:33,433
The sutures will hold.
812
00:30:34,744 --> 00:30:36,419
There will be no bloodbath.
813
00:30:36,438 --> 00:30:37,837
Okay, let's go, doctor.
814
00:30:38,188 --> 00:30:39,516
Remove your clamps.
815
00:30:40,581 --> 00:30:41,979
Dr. Cahill?
816
00:30:55,175 --> 00:30:56,178
Okay.
817
00:30:56,306 --> 00:30:57,498
Okay, good.
818
00:30:57,599 --> 00:30:59,980
I-I-I totally wasn't sure
that was gonna work.
819
00:31:00,342 --> 00:31:01,128
I get it. I get it.
820
00:31:01,129 --> 00:31:02,250
But you did great.
821
00:31:02,260 --> 00:31:02,899
I'd never have thought
822
00:31:02,900 --> 00:31:04,624
you'd spent a day outside of an O.R.
823
00:31:04,625 --> 00:31:07,187
Oh, thank you very much.
824
00:31:07,922 --> 00:31:10,130
Oh, good god. I have to go.
825
00:31:10,131 --> 00:31:11,951
I-I've-I've lost a whole day.
826
00:31:11,952 --> 00:31:13,770
You're all right if I...
827
00:31:13,771 --> 00:31:15,047
No, no, we're not done.
828
00:31:15,048 --> 00:31:15,866
But it's pretty straightforward...
829
00:31:15,867 --> 00:31:17,687
No, we need to finish debriding.
830
00:31:17,688 --> 00:31:19,037
We need to put in drains, close,
831
00:31:19,038 --> 00:31:22,639
then you get to tell
the family that you saved him,
832
00:31:23,485 --> 00:31:25,165
he's alive because of you.
833
00:31:25,485 --> 00:31:27,900
And then they get to thank you.
834
00:31:29,417 --> 00:31:30,919
And that's the best part.
835
00:31:34,649 --> 00:31:36,035
10-blade, please.
836
00:31:40,362 --> 00:31:41,576
I'm saying, they always cut
837
00:31:41,577 --> 00:31:43,909
the lowest on the totem pole first.
838
00:31:43,910 --> 00:31:45,169
And we're below that.
839
00:31:45,170 --> 00:31:46,999
I've been emptying urine bags all morning.
840
00:31:47,000 --> 00:31:48,252
You gotta stop.
841
00:31:48,829 --> 00:31:51,025
All these cuts, the reconfiguring,
842
00:31:51,168 --> 00:31:52,501
this is designed to make the hospital run
843
00:31:52,502 --> 00:31:53,846
more efficiently in the future.
844
00:31:53,847 --> 00:31:54,445
So?
845
00:31:54,446 --> 00:31:55,268
That means Cahill
846
00:31:55,269 --> 00:31:57,343
is planning for
the hospital to have a future.
847
00:31:57,344 --> 00:31:58,095
If you're gonna have a hospital,
848
00:31:58,096 --> 00:32:00,583
- there's one thing you can't cut.
- Doctors.
849
00:32:01,633 --> 00:32:03,567
Crap. My patient's coding.
850
00:32:03,747 --> 00:32:04,761
See that?
851
00:32:04,853 --> 00:32:06,001
We save lives, people.
852
00:32:06,002 --> 00:32:08,652
We are smart, young,
853
00:32:08,957 --> 00:32:10,210
vital doctors.
854
00:32:10,211 --> 00:32:11,167
You're right.
855
00:32:11,168 --> 00:32:13,645
If she's planning for the future...
856
00:32:13,646 --> 00:32:15,176
We are that future.
857
00:32:20,249 --> 00:32:21,798
Oh, you hope.
858
00:32:22,758 --> 00:32:24,699
'Cause you can talk all you want
859
00:32:24,726 --> 00:32:26,559
and work hard, hustle,
860
00:32:26,990 --> 00:32:29,182
you can empty more urine
bags than the next guy.
861
00:32:29,600 --> 00:32:30,851
The future, kids,
862
00:32:31,182 --> 00:32:33,126
is completely out of your control.
863
00:32:49,913 --> 00:32:50,884
Jeff.
864
00:32:51,426 --> 00:32:52,396
How's the research coming?
865
00:32:52,397 --> 00:32:54,520
Save it. Your sidekick
already made the pitch.
866
00:32:54,521 --> 00:32:55,293
Not gonna happen.
867
00:32:55,294 --> 00:32:56,108
Oh, come on.
868
00:32:56,109 --> 00:32:57,965
Your team can watch the TED talks online.
869
00:32:57,966 --> 00:33:00,234
It's not about the talks.
It's about the networking.
870
00:33:00,235 --> 00:33:01,666
- The real conf...
- This isn't about me.
871
00:33:01,667 --> 00:33:02,901
This is what's good for the hospital.
872
00:33:02,902 --> 00:33:04,832
Everyone can benefit from the E.R.,
873
00:33:04,873 --> 00:33:06,792
- the patients especially.
- Mm.
874
00:33:06,793 --> 00:33:09,621
You know what might open
my heart to your cause?
875
00:33:10,036 --> 00:33:11,622
Your parking space.
876
00:33:13,639 --> 00:33:15,298
My space is right next to yours.
877
00:33:15,299 --> 00:33:16,924
Uh, it's not even an advantage.
878
00:33:16,925 --> 00:33:18,599
In fact, you're 5 feet
further from the door.
879
00:33:18,600 --> 00:33:20,145
I don't want to swap. I want 'em both.
880
00:33:20,146 --> 00:33:22,174
I don't want you dinging my doors.
881
00:33:22,775 --> 00:33:24,024
- What?
- I want both spots
882
00:33:24,025 --> 00:33:26,246
So I can park in the middle.
883
00:33:33,711 --> 00:33:35,077
How's your sister, Jeff?
884
00:33:35,960 --> 00:33:37,078
Really?
885
00:33:37,516 --> 00:33:39,885
Really? You're really gonna go there?
886
00:33:39,886 --> 00:33:41,644
Well, I'll never forget
how grateful you were
887
00:33:41,645 --> 00:33:43,441
when I clipped her aneurysm.
888
00:33:43,763 --> 00:33:44,443
And you said,
889
00:33:44,444 --> 00:33:46,560
"If there's anything I
can ever do for you"...
890
00:33:48,032 --> 00:33:49,130
This is just plain bullying.
891
00:33:49,131 --> 00:33:50,895
Say good-bye to TED, Jeff.
892
00:33:59,254 --> 00:34:01,161
I still want your parking space.
893
00:34:03,343 --> 00:34:05,975
May as well swallow
your poison berries now, Webber,
894
00:34:05,976 --> 00:34:08,822
because I am the girl... who's on fire.
895
00:34:08,823 --> 00:34:09,987
Check.
896
00:34:10,525 --> 00:34:12,350
Very good, Dr. Webber.
897
00:34:12,515 --> 00:34:14,371
Oh, let's just, um...
898
00:34:15,021 --> 00:34:16,548
I'm-I'm confused.
Where-where's the mesh?
899
00:34:16,549 --> 00:34:17,546
Oh, I didn't use any.
900
00:34:17,547 --> 00:34:19,904
I wanted to give you
a look at the Webber method
901
00:34:19,905 --> 00:34:21,881
so you can see just what you're missing.
902
00:34:22,957 --> 00:34:23,696
It's lovely, but...
903
00:34:23,697 --> 00:34:24,294
Isn't it?
904
00:34:24,323 --> 00:34:26,870
See, when I use the relaxing incision
905
00:34:26,871 --> 00:34:29,345
to oppose the tissue without tension,
906
00:34:29,368 --> 00:34:32,019
I achieve the same result
without the use of mesh.
907
00:34:32,440 --> 00:34:34,739
But this method will
no longer be performed
908
00:34:34,740 --> 00:34:36,004
at Seattle Grace.
909
00:34:36,762 --> 00:34:39,569
The method we learned today
is the accepted method
910
00:34:39,570 --> 00:34:42,195
for open primary repairs hospital-wide.
911
00:34:42,506 --> 00:34:44,950
Because we're cogs in an assembly line,
912
00:34:45,200 --> 00:34:47,650
churning out product over and over,
913
00:34:47,787 --> 00:34:49,067
standardized across the country.
914
00:34:49,068 --> 00:34:49,789
Don't you think every patient
915
00:34:49,790 --> 00:34:51,198
deserves the same standard of care?
916
00:34:51,199 --> 00:34:52,418
And how good can that care be
917
00:34:52,419 --> 00:34:54,271
when we see 50 patients in a day?
918
00:34:54,272 --> 00:34:56,040
What are their names?
Who are their families?
919
00:34:56,041 --> 00:34:57,954
With that kind of volume,
who in the hell knows?
920
00:34:57,955 --> 00:35:00,081
As long as you can slap
a sign on the door that says,
921
00:35:00,082 --> 00:35:01,630
"Over ten million served,"
who the hell cares?
922
00:35:01,631 --> 00:35:03,870
You're missing the point.
The patients don't matter.
923
00:35:03,871 --> 00:35:05,128
What matters is...
924
00:35:05,129 --> 00:35:06,806
Mm. I didn't...
925
00:35:07,040 --> 00:35:09,139
Obviously, I didn't mean that. Okay?
926
00:35:09,140 --> 00:35:11,072
We are only concerned about hernias,
927
00:35:11,073 --> 00:35:12,895
right now, I mean.
928
00:35:14,307 --> 00:35:15,956
See, that... that is really quite good.
929
00:35:15,957 --> 00:35:16,849
I-in the months to come,
930
00:35:16,850 --> 00:35:19,179
I think everyone should
follow your lead, okay?
931
00:35:19,180 --> 00:35:20,827
Okay. Keep it up.
932
00:35:27,614 --> 00:35:28,605
Still in V-fib.
933
00:35:28,606 --> 00:35:30,321
- How long has it been?
- 26 minutes.
934
00:35:30,322 --> 00:35:32,708
Push another epi and, uh,
charge again to 200.
935
00:35:32,709 --> 00:35:33,872
Charging.
936
00:35:34,921 --> 00:35:36,026
Clear.
937
00:35:38,154 --> 00:35:38,906
Still nothing.
938
00:35:38,907 --> 00:35:39,839
Damn it.
939
00:35:39,840 --> 00:35:42,468
Uh... charge to 200 again.
940
00:35:42,473 --> 00:35:43,602
Clear.
941
00:36:10,517 --> 00:36:11,824
Okay, I'm calling it.
942
00:36:12,510 --> 00:36:14,823
Time of death... 6:42.
943
00:36:24,836 --> 00:36:26,363
He didn't have to die.
944
00:36:26,667 --> 00:36:28,457
All they had to do was
let us give him blood.
945
00:36:28,458 --> 00:36:30,169
And he still could've died.
946
00:36:30,467 --> 00:36:32,898
The C.C.U. is full of people
we pump full of blood,
947
00:36:32,899 --> 00:36:34,255
and they still die.
948
00:36:35,122 --> 00:36:36,032
People die.
949
00:36:36,033 --> 00:36:37,648
You know, what you did was wrong
950
00:36:37,649 --> 00:36:39,147
in about a hundred different ways.
951
00:36:39,148 --> 00:36:40,792
And I plan on telling you all of them,
952
00:36:40,793 --> 00:36:42,641
just not right now.
953
00:36:43,681 --> 00:36:46,612
'Cause right now,
I have to go talk to the family.
954
00:36:47,935 --> 00:36:49,587
Hey, show's over, Bob.
955
00:36:49,588 --> 00:36:50,953
You can change the channel.
956
00:36:59,968 --> 00:37:01,837
Oh, hey.
957
00:37:02,864 --> 00:37:04,042
How'd it go?
958
00:37:06,316 --> 00:37:07,856
Oh, for god sakes.
959
00:37:07,857 --> 00:37:10,657
I mean, s... okay, see, officer hard-ass?
960
00:37:10,658 --> 00:37:12,779
Your approach doesn't always work either.
961
00:37:18,074 --> 00:37:19,139
Hey.
962
00:37:20,049 --> 00:37:21,914
You need to get up now.
963
00:37:22,083 --> 00:37:23,318
You need to take a few steps
964
00:37:23,319 --> 00:37:24,757
and remember how it feels.
965
00:37:24,758 --> 00:37:26,751
And I know... I know how hard this is.
966
00:37:26,752 --> 00:37:28,300
But you want this. You do.
967
00:37:28,301 --> 00:37:30,024
You don't know what I want.
968
00:37:31,542 --> 00:37:32,859
No? Okay.
969
00:37:42,208 --> 00:37:43,964
I lost my leg...
970
00:37:44,484 --> 00:37:46,096
less than a year ago.
971
00:37:46,349 --> 00:37:49,601
And I was scared and in pain
972
00:37:49,602 --> 00:37:51,899
and I thought that
I would never be able to do
973
00:37:51,900 --> 00:37:54,692
the things that I like to do anymore.
974
00:37:54,884 --> 00:37:56,105
But I did.
975
00:37:57,607 --> 00:37:58,852
I operated on you.
976
00:38:00,893 --> 00:38:02,072
Wow.
977
00:38:02,372 --> 00:38:05,210
They send the cripple in to
teach me how to live my life.
978
00:38:07,652 --> 00:38:09,178
Okay. Okay.
979
00:38:09,179 --> 00:38:10,149
You know what?
980
00:38:10,154 --> 00:38:11,721
You can be scared and you can be pissed
981
00:38:11,722 --> 00:38:13,864
and you can lie here like a garden slug
982
00:38:13,865 --> 00:38:15,500
till you die for all I care.
983
00:38:15,501 --> 00:38:18,093
But you will not, not, become a monster
984
00:38:18,094 --> 00:38:20,154
that takes everyone else down with them.
985
00:38:20,205 --> 00:38:23,014
You will treat people
with kindness and respect.
986
00:38:23,050 --> 00:38:25,467
Ooh. And you will start with yourself.
987
00:38:25,468 --> 00:38:27,956
And you will start by standing up.
988
00:38:27,957 --> 00:38:30,141
And you will do so by the
time I count to three,
989
00:38:30,142 --> 00:38:32,272
or I will drag your ass out of this bed.
990
00:38:32,273 --> 00:38:33,629
So one...
991
00:38:34,189 --> 00:38:35,199
two...
992
00:38:37,883 --> 00:38:39,754
three. Okay. You got it.
You got it.You got it.
993
00:38:39,754 --> 00:38:40,943
Okay. Okay, I got you. I got you.
994
00:38:40,943 --> 00:38:42,407
All right. Good. Good.
995
00:38:42,407 --> 00:38:43,993
Good. Good.
996
00:38:44,772 --> 00:38:45,822
Wow.
997
00:38:45,963 --> 00:38:47,047
Take a step.
998
00:38:49,111 --> 00:38:50,871
- Great.
- Look at that. You got it.
999
00:38:52,779 --> 00:38:53,707
Good.
1000
00:38:53,772 --> 00:38:56,916
Good job. All right. Look at you.
1001
00:38:58,786 --> 00:39:01,483
Oh, my... he's gonna live?
1002
00:39:02,500 --> 00:39:03,409
Thank you.
1003
00:39:03,410 --> 00:39:06,100
This is who you really should be thanking.
1004
00:39:06,101 --> 00:39:06,928
If it wasn't for her...
1005
00:39:06,929 --> 00:39:09,296
Thank you. Thank you so much!
1006
00:39:09,297 --> 00:39:11,788
God bless you. Thank you.
1007
00:39:20,175 --> 00:39:21,896
Hold the elevator, please!
1008
00:39:26,101 --> 00:39:27,079
Oh.
1009
00:39:27,321 --> 00:39:28,826
Oh. Off to celebrate, are we?
1010
00:39:32,572 --> 00:39:34,183
Ah. I get it.
1011
00:39:34,750 --> 00:39:36,114
Well, change can be rough.
1012
00:39:36,115 --> 00:39:37,817
But once you get used to it,
1013
00:39:37,818 --> 00:39:40,744
you'll never believe you did
a hernia repair any other way.
1014
00:39:42,128 --> 00:39:43,047
And if I may say,
1015
00:39:43,048 --> 00:39:45,708
that sweatshirt is quite becoming on you.
1016
00:39:45,745 --> 00:39:47,093
It's itchy.
1017
00:39:52,510 --> 00:39:54,207
I did forget what a rush it is.
1018
00:39:54,208 --> 00:39:56,162
Uh, yeah. What, saving someone's life?
1019
00:39:56,163 --> 00:39:56,830
Yeah, it's not bad.
1020
00:39:56,831 --> 00:39:58,088
You know, we could do that again tomorrow
1021
00:39:58,089 --> 00:39:59,810
if we had an E.R.
1022
00:39:59,965 --> 00:40:01,294
We figured it out.
1023
00:40:01,335 --> 00:40:02,312
We can save the E.R.
1024
00:40:02,313 --> 00:40:03,903
We got each department to make some cuts,
1025
00:40:03,904 --> 00:40:05,602
and I'm gonna have to park in Tacoma,
1026
00:40:05,603 --> 00:40:06,979
but it is going to work.
1027
00:40:06,980 --> 00:40:08,426
I'm sorry.
1028
00:40:08,724 --> 00:40:10,360
You misunderstood.
1029
00:40:10,599 --> 00:40:13,111
No amount of budget cutting or shuffling
1030
00:40:13,112 --> 00:40:14,198
is gonna save your E.R.
1031
00:40:14,199 --> 00:40:16,311
or your hospital, for that matter.
1032
00:40:19,589 --> 00:40:21,231
You're getting us ready to sell.
1033
00:40:21,232 --> 00:40:22,423
What?
1034
00:40:23,391 --> 00:40:26,624
A buyer is going to save your hospital.
1035
00:40:27,090 --> 00:40:29,405
I just need to make it presentable.
1036
00:40:29,406 --> 00:40:31,611
I'm sorry. Wh-what? It's...
1037
00:40:31,612 --> 00:40:33,634
You're staging it, like a house.
1038
00:40:33,689 --> 00:40:34,624
Exactly.
1039
00:40:34,625 --> 00:40:37,690
And the E.R. is like the shag carpet.
1040
00:40:38,151 --> 00:40:39,323
It's gotta go.
1041
00:40:41,227 --> 00:40:42,275
Sorry.
1042
00:40:44,343 --> 00:40:45,844
I had a wonderful time today.
1043
00:40:59,418 --> 00:41:01,056
To really be efficient...
1044
00:41:02,607 --> 00:41:04,777
you have to eliminate what doesn't work.
1045
00:41:17,151 --> 00:41:19,384
You have to figure out what's important...
1046
00:41:35,393 --> 00:41:36,865
What are you gonna do?
1047
00:41:37,927 --> 00:41:39,558
You mean right now or...
1048
00:41:41,480 --> 00:41:43,456
Or both. Whichever.
1049
00:41:46,802 --> 00:41:50,200
Right now I am going to drink a lot.
1050
00:41:52,582 --> 00:41:53,750
That's all I know.
1051
00:41:55,900 --> 00:41:57,682
Can I buy the first one?
1052
00:41:58,615 --> 00:41:59,807
Yeah.
1053
00:42:02,535 --> 00:42:03,223
And hold on tight...
1054
00:42:05,653 --> 00:42:07,906
to the things that matter most.
1055
00:42:19,355 --> 00:42:20,238
Wow.
1056
00:42:20,440 --> 00:42:21,659
Oh, I felt that.
1057
00:42:26,034 --> 00:42:27,430
Uh-huh. Wait.
1058
00:42:28,315 --> 00:42:29,436
Oh!
1059
00:42:30,090 --> 00:42:31,121
Ooh.
1060
00:42:31,478 --> 00:42:33,570
Oh, you got a soccer player,
I think, right there.
1061
00:42:33,570 --> 00:42:38,651
Sync by YYeTs
Corrected by MystEre
www.addic7ed.com
9999
00:00:0,500 --> 00:00:2,00
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