1 00:00:06,090 --> 00:00:08,330 [ Indistinct chatter ] 2 00:00:16,430 --> 00:00:18,390 I'm confused. 3 00:00:18,400 --> 00:00:20,360 Why am I cleaning up the mess from last shift? 4 00:00:20,370 --> 00:00:22,340 Because, Dr. Savetti, you're a resident, and your mama said so. 5 00:00:22,340 --> 00:00:25,140 Dr. Pineda, tell him what else I say. 6 00:00:25,140 --> 00:00:27,140 If you want to be part of a team... 7 00:00:27,140 --> 00:00:29,570 No job is too big, no job is too small. 8 00:00:29,580 --> 00:00:33,820 Being an emergency-room physician requires humility. 9 00:00:33,820 --> 00:00:36,720 And like a firefighter cleans his rig, you clean yours. 10 00:00:36,720 --> 00:00:38,090 This is center stage. 11 00:00:38,090 --> 00:00:40,730 It demands your respect. 12 00:00:42,190 --> 00:00:45,250 Sorry, Dr. Lorenson, but did you want to lay down? 13 00:00:45,260 --> 00:00:47,390 No. Uh, no. I didn't... I don't want to lay down. 14 00:00:47,400 --> 00:00:48,570 Because if you're tired, 15 00:00:48,570 --> 00:00:50,600 your mama could read you a bedtime story. 16 00:00:50,600 --> 00:00:53,105 No. Just there's a lot of blood on these sheets. 17 00:00:53,106 --> 00:00:54,660 You know, the Buddhists, 18 00:00:54,670 --> 00:00:57,500 they use manual labor as a way to meditate, 19 00:00:57,510 --> 00:00:59,750 to bring them closer to the world they inhabit. 20 00:00:59,750 --> 00:01:04,240 Or, as Mr. Miyagi said, "wax on, wax off." 21 00:01:04,250 --> 00:01:05,520 Who's Mr. Miyagi? 22 00:01:05,520 --> 00:01:06,680 "The karate kid"? 23 00:01:06,680 --> 00:01:08,680 It's from the '80s. Right, Christa? 24 00:01:08,690 --> 00:01:10,670 Funny. 25 00:01:10,670 --> 00:01:12,660 Okay, little serious talk before our shift starts. 26 00:01:12,660 --> 00:01:14,740 It's Saturday night, 27 00:01:14,740 --> 00:01:16,820 which means we're gonna see some things before the sun comes up. 28 00:01:16,830 --> 00:01:19,260 For you first-year residents especially, 29 00:01:19,260 --> 00:01:22,490 remember, the first pulse you check is always your own. 30 00:01:22,500 --> 00:01:26,800 When it gets rough, make sure to breathe. 31 00:01:26,800 --> 00:01:31,230 Remember, oxygen is the first drug we give our patients. 32 00:01:31,240 --> 00:01:32,530 Same for you. 33 00:01:32,540 --> 00:01:36,310 Lean on each other. That's what siblings are for. 34 00:01:36,310 --> 00:01:38,640 Lean on me. That's what your mama's for. 35 00:01:38,650 --> 00:01:39,850 Leanne: [ Chuckles ] 36 00:01:39,850 --> 00:01:41,820 Evening, Dr. Rorish. Evening, mama. 37 00:01:41,820 --> 00:01:44,490 We've got two incoming, five minutes out. 38 00:01:44,490 --> 00:01:46,490 Let's clean it up, glove it up, and go. 39 00:01:46,490 --> 00:01:47,725 Meet me at the bay doors. 40 00:01:47,726 --> 00:01:48,850 You heard your daddy. 41 00:01:48,860 --> 00:01:50,760 Let's go save the people of Los Angeles. 42 00:01:50,760 --> 00:01:53,465 I am making a formal complaint about this. 43 00:01:53,466 --> 00:01:55,320 Are you sure you want to do that, Mario? 44 00:01:55,330 --> 00:01:56,260 Angus is right. 45 00:01:56,270 --> 00:01:57,330 Last couple years, 46 00:01:57,330 --> 00:01:58,390 half the residents didn't make it. 47 00:01:58,400 --> 00:02:00,130 How do you know so much? 48 00:02:00,140 --> 00:02:01,770 How do you not know this? 49 00:02:01,770 --> 00:02:04,730 Malaya was here for medical school and her internship. 50 00:02:04,740 --> 00:02:06,540 Be nice. 51 00:02:06,540 --> 00:02:08,200 Dr. Rorish likes her. 52 00:02:08,210 --> 00:02:10,740 Oh. Then you were here for Dr. Rorish's accident. 53 00:02:10,750 --> 00:02:12,850 Her family. That's none of our business. 54 00:02:12,850 --> 00:02:14,550 Wait, wait, wait, wait. What... What are you talking about? 55 00:02:14,550 --> 00:02:15,710 Car accident. Bad one. 56 00:02:15,720 --> 00:02:17,320 Minivan rolled down an embankment. 57 00:02:17,320 --> 00:02:18,490 Oh, my God. 58 00:02:18,490 --> 00:02:19,730 Whole family. [ Clicks tongue ] 59 00:02:19,730 --> 00:02:21,480 Man: Plenty of o-neg. 60 00:02:21,490 --> 00:02:23,290 [ Indistinct conversations ] 61 00:02:26,300 --> 00:02:27,900 You get any sleep today? 62 00:02:27,900 --> 00:02:29,930 Yeah. 63 00:02:29,930 --> 00:02:32,690 I know when you're lying. No, you don't. 64 00:02:32,700 --> 00:02:33,630 You have a tell. 65 00:02:33,640 --> 00:02:35,710 Yeah? What's my tell? 66 00:02:35,710 --> 00:02:37,310 I'm not giving that up. 67 00:02:37,310 --> 00:02:39,680 Then you'll stop doing it, i won't know when you're lying. 68 00:02:39,680 --> 00:02:41,850 You think you're so smart. You're so dumb. 69 00:02:41,850 --> 00:02:45,180 You're the dumbest person i ever known. 70 00:02:45,180 --> 00:02:46,810 [ Sirens wailing ] 71 00:02:46,820 --> 00:02:48,820 Stop talking. This isn't gossip. 72 00:02:48,820 --> 00:02:50,150 I'm sorry. 73 00:02:50,150 --> 00:02:51,480 I didn't know you two were besties now. 74 00:02:51,490 --> 00:02:52,690 Malaya: I'm with Christa. 75 00:02:52,690 --> 00:02:54,190 I don't think we should talk about it. 76 00:02:54,190 --> 00:02:56,820 You four, you're gonna continue 77 00:02:56,830 --> 00:02:59,900 to shadow and assist me and Dr. Hudson 78 00:02:59,900 --> 00:03:01,870 until that board gets to code black, 79 00:03:01,870 --> 00:03:03,740 and then we're freeballing it. 80 00:03:03,740 --> 00:03:05,560 I'll take the first one. 81 00:03:05,570 --> 00:03:07,940 Dr. Lorenson, Dr. Savetti, go with Dr. Hudson. 82 00:03:07,940 --> 00:03:09,410 And you two, you're with me. 83 00:03:09,410 --> 00:03:10,940 [ Indistinct radio chatter ] 84 00:03:10,940 --> 00:03:13,800 Medic: All right. Let's go. We got it. 85 00:03:13,810 --> 00:03:15,650 All right. Set her down easy. 86 00:03:15,650 --> 00:03:16,715 What have you got? 87 00:03:16,716 --> 00:03:17,940 Car versus car, head-on. 88 00:03:17,950 --> 00:03:20,250 27-year-old female, multiple neck lacerations. 89 00:03:20,250 --> 00:03:23,290 One 6-centimeter in zone three, probable arterial source there. 90 00:03:23,290 --> 00:03:24,290 Ebl 400 cc. 91 00:03:24,290 --> 00:03:25,920 What's her name? Laura halloran. 92 00:03:25,920 --> 00:03:27,300 She's in and out. 93 00:03:27,310 --> 00:03:28,690 Laura, can you hear me? I'm Dr. Hudson. 94 00:03:28,690 --> 00:03:30,790 I'm gonna help you. 95 00:03:30,790 --> 00:03:32,350 Woman: Coming in now. 96 00:03:32,360 --> 00:03:33,920 Risa, monitor, O2, lac tray with a yankauer. 97 00:03:33,930 --> 00:03:35,700 Start two liters of n.S. Wide open. Risa: Copy that. 98 00:03:35,700 --> 00:03:38,700 Leanne: High-speed mvc with a positive psi, unrestrained. 99 00:03:38,700 --> 00:03:40,930 Significant crepitus throughout the chest and neck. 100 00:03:40,940 --> 00:03:43,440 On my count. One, and two, three. 101 00:03:43,440 --> 00:03:45,740 Two, three. [ Grunts ] 102 00:03:45,740 --> 00:03:48,540 Mid-80s on 25 meters, gcs 13. 103 00:03:48,550 --> 00:03:50,610 Please. I can't die. 104 00:03:50,610 --> 00:03:51,840 What's your name, sir? 105 00:03:51,850 --> 00:03:53,670 J-j-Jake. Jake Willis. 106 00:03:53,670 --> 00:03:55,490 Jake, Jake, I need you to calm down for me, okay? 107 00:03:55,490 --> 00:03:56,650 Please! 108 00:03:56,650 --> 00:03:58,910 My family, they cannot get by without me. 109 00:03:58,920 --> 00:04:02,380 My wife, Becca, she takes care of my daughter. 110 00:04:02,390 --> 00:04:04,690 She doesn't... She doesn't w... 111 00:04:04,690 --> 00:04:06,890 He's out. 112 00:04:06,900 --> 00:04:08,000 All right. Dr. Pineda, intubate, please. 113 00:04:08,000 --> 00:04:08,930 On it. 114 00:04:08,930 --> 00:04:10,460 Ah. 115 00:04:10,470 --> 00:04:11,670 God, I'm surprised he was conscious at all. 116 00:04:11,670 --> 00:04:13,340 Look at this. 117 00:04:13,340 --> 00:04:15,010 Okay, I'll need bilateral chest tube, 118 00:04:15,010 --> 00:04:16,740 large bore in case there's blood. 119 00:04:16,740 --> 00:04:18,340 32 French. Let's get ready to roll him. 120 00:04:18,340 --> 00:04:20,000 Christa: Brisk facial bleeding. And on my count. 121 00:04:20,010 --> 00:04:21,680 One, two, three, roll. Glass embedded pretty much everywhere. 122 00:04:21,680 --> 00:04:23,020 Okay. We're gonna need to roll her off the board. 123 00:04:23,020 --> 00:04:24,940 Carefully, she might have a c-spine injury. 124 00:04:24,950 --> 00:04:26,550 Dr. Lorenson, i need you to hold that neck 125 00:04:26,550 --> 00:04:27,650 like it's disconnected. 126 00:04:27,650 --> 00:04:29,540 It might be. On my count, everybody. 127 00:04:29,550 --> 00:04:31,880 Neal and Christa: One, two, three. 128 00:04:31,890 --> 00:04:32,860 Easy. Easy. 129 00:04:32,860 --> 00:04:34,620 You got it? Yeah. Got... 130 00:04:34,620 --> 00:04:36,520 Whoa, whoa. Whoa, whoa. Let's go. Slowly. Slowly. 131 00:04:36,530 --> 00:04:38,600 Thank you. 132 00:04:38,600 --> 00:04:39,560 Spine's good. 133 00:04:39,560 --> 00:04:40,960 Okay. Down we go. 134 00:04:40,960 --> 00:04:42,730 Dr. Savetti, what's your next move? 135 00:04:42,730 --> 00:04:44,490 Ultrasound the abdomen, see if there's any fluid. Very good. 136 00:04:44,500 --> 00:04:45,560 Dr. Lorenson, we're gonna find the artery up here 137 00:04:45,570 --> 00:04:47,790 and tie it off. 138 00:04:47,790 --> 00:04:50,010 Grab a Kelly, forceps, and some 3-0 prolene. 139 00:04:50,010 --> 00:04:52,010 You know what I asked for? Yes or no? 140 00:04:52,010 --> 00:04:53,980 Yes. Yes, I just... 141 00:04:53,980 --> 00:04:55,780 The Kelly. It's on the tray second from the right. Yes. Yes. I... yes. 142 00:04:55,780 --> 00:04:57,310 Can't hesitate. Not ever. 143 00:04:57,310 --> 00:04:58,840 Abdomen's clear. No fluid. Very good. 144 00:04:58,850 --> 00:05:00,590 Dr. Rorish will need that at the next table. 145 00:05:00,590 --> 00:05:02,910 Suction, please. Let's clear the field. 146 00:05:02,920 --> 00:05:04,850 Malaya: And... I'm in. 147 00:05:04,850 --> 00:05:06,050 All right. Okay, bag it up. 148 00:05:06,060 --> 00:05:08,660 Dr. Pineda, hand off to Dr. Leighton. 149 00:05:08,660 --> 00:05:09,820 I need you down here, please. 150 00:05:11,090 --> 00:05:12,450 [ Gasps ] He's awake. 151 00:05:12,460 --> 00:05:14,520 He's not awake. Look at his vitals. 152 00:05:14,530 --> 00:05:15,660 It's just a reflex. 153 00:05:15,670 --> 00:05:17,830 We got you, Jake. 154 00:05:17,830 --> 00:05:19,860 You hear me now? Stay with us. 155 00:05:19,870 --> 00:05:21,605 Hey, uh, Jesse, let's make sure he's down. 156 00:05:21,606 --> 00:05:23,970 Push another 10 of etomidate, please. 157 00:05:23,970 --> 00:05:26,340 He's not coming up over 80%. His chest is hardly rising. 158 00:05:26,340 --> 00:05:27,400 All right. 159 00:05:27,410 --> 00:05:29,010 Positive for pericardial fluid. 160 00:05:29,010 --> 00:05:30,010 Plenty of it. 161 00:05:30,010 --> 00:05:32,110 Dr. Leighton, stop. 162 00:05:32,120 --> 00:05:33,650 Put the bag down. Okay? 163 00:05:33,650 --> 00:05:35,420 You're decreasing his icp by hyperventilating him. 164 00:05:35,420 --> 00:05:36,920 Six breaths a minute, that's all he needs. 165 00:05:36,920 --> 00:05:38,090 Jesse: It's okay. Just hold it there. 166 00:05:38,090 --> 00:05:39,590 It's okay. Just slow down. 167 00:05:39,590 --> 00:05:41,090 Uh, we need to get him upstairs. 168 00:05:41,090 --> 00:05:43,020 Jesse, notify the O.R. Jesse: Okay. 169 00:05:43,030 --> 00:05:44,030 See that? 170 00:05:44,030 --> 00:05:45,530 Christa: The artery. 171 00:05:45,530 --> 00:05:47,730 The maxillary artery, to be precise. 172 00:05:47,730 --> 00:05:50,030 It branches out from the external carotid. 173 00:05:50,030 --> 00:05:52,730 It's a real bitch. But in a couple of seconds... 174 00:05:52,740 --> 00:05:54,740 It's our bitch. Precisely. 175 00:05:54,740 --> 00:05:56,040 More dependant fluid in the lungs, 176 00:05:56,040 --> 00:05:57,010 left worse than right. 177 00:05:57,010 --> 00:05:58,540 He's gonna die on the elevator. 178 00:05:58,540 --> 00:05:59,530 Likely, yes. 179 00:05:59,540 --> 00:06:01,000 I need a thoracotomy tray. 180 00:06:01,010 --> 00:06:02,980 You're gonna open up his chest? 181 00:06:02,980 --> 00:06:04,950 You got a better idea? I could use the assist. 182 00:06:04,950 --> 00:06:07,090 Dr. Savetti, get back here. You and Dr. Lorenson close. 183 00:06:07,090 --> 00:06:09,110 Who can tell me what we're doing? 184 00:06:09,120 --> 00:06:10,720 Dr. Pineda? 185 00:06:10,720 --> 00:06:12,990 A thoracotomy... a clamshell, right and left chest open. 186 00:06:12,990 --> 00:06:13,990 That's right. 187 00:06:13,990 --> 00:06:15,390 Why? Dr. Leighton? 188 00:06:15,390 --> 00:06:16,790 Uh, only way to stop the internal bleeding 189 00:06:16,790 --> 00:06:18,990 is to go in now. That's right. 190 00:06:19,000 --> 00:06:22,100 Guys, the thoracotomy is the mother of all E.R. procedures. 191 00:06:22,100 --> 00:06:24,400 Only 5% success rate in e.R.S nationwide. 192 00:06:24,400 --> 00:06:25,930 Don't need all the facts, Malaya. 193 00:06:25,940 --> 00:06:27,410 We are the statistical anomaly. 194 00:06:27,410 --> 00:06:30,830 Jesse, I need, uh, six units of o-neg, please, 195 00:06:30,840 --> 00:06:32,140 through the level-one. Already here. 196 00:06:32,140 --> 00:06:34,840 All right. Push it through both 18s, please. 197 00:06:34,840 --> 00:06:36,140 All right. Scalpel. 198 00:06:36,150 --> 00:06:38,120 Okay. 199 00:06:39,750 --> 00:06:41,080 All right. 200 00:06:41,080 --> 00:06:42,010 Jesse. 201 00:06:42,020 --> 00:06:43,750 Okay. 202 00:06:43,750 --> 00:06:45,480 We're gonna spread the ribs now. 203 00:06:45,490 --> 00:06:46,790 Whoa. 204 00:06:46,790 --> 00:06:49,660 Then... Then push the lungs aside. 205 00:06:49,660 --> 00:06:51,000 Dr. Leighton, take the other side, please. 206 00:06:51,000 --> 00:06:53,790 10 blade, please. 207 00:06:53,800 --> 00:06:55,130 Okay. Now, watch Dr. Hudson. 208 00:06:55,130 --> 00:06:56,760 He's about to reveal the pericardium, 209 00:06:56,770 --> 00:06:58,540 the sac around the heart. 210 00:06:58,540 --> 00:07:00,110 You've done a lot of these? 211 00:07:00,110 --> 00:07:01,130 No. First one. 212 00:07:01,140 --> 00:07:03,670 That's comforting. 213 00:07:03,670 --> 00:07:05,430 Dr. Hudson has done more than most. 214 00:07:05,440 --> 00:07:07,940 He did a surgical residency before he moved to E.R. 215 00:07:07,940 --> 00:07:10,140 Opening the pericardium now. 216 00:07:10,150 --> 00:07:11,520 Now, the... wait, there it is. There it is. 217 00:07:11,510 --> 00:07:12,610 For those of you who can see, 218 00:07:12,620 --> 00:07:14,190 look, see that laceration right there 219 00:07:14,190 --> 00:07:15,860 above the proximal aorta? 220 00:07:15,860 --> 00:07:17,540 Cross clamp, please. Okay, we're cross-clamping it. 221 00:07:17,540 --> 00:07:19,210 It'll divert the blood above the opening to the brain, 222 00:07:19,220 --> 00:07:20,880 which needs perfusion the most right now. 223 00:07:22,090 --> 00:07:24,050 No cardiac activity. 224 00:07:24,060 --> 00:07:25,700 Dr. Leighton, can you inject 225 00:07:25,700 --> 00:07:28,570 with intracardiac epinephrine, please? 226 00:07:32,070 --> 00:07:33,070 Go ahead. 227 00:07:33,070 --> 00:07:34,070 Dr. Pineda, get your hands in here. 228 00:07:34,070 --> 00:07:35,710 Really? Yeah, get your hands in. 229 00:07:35,710 --> 00:07:37,540 Put them around the heart really gently, 230 00:07:37,540 --> 00:07:39,480 and you're gonna massage it. 231 00:07:39,480 --> 00:07:41,110 Oh, my God. I feel it. 232 00:07:41,110 --> 00:07:43,110 It's beating now. 233 00:07:43,110 --> 00:07:44,110 It's beating without me. 234 00:07:44,110 --> 00:07:46,170 Okay, you got a rhythm there. 235 00:07:57,560 --> 00:07:59,130 Lab results for your mva head injury. 236 00:07:59,130 --> 00:08:00,630 Thanks. Mm-hmm. 237 00:08:00,630 --> 00:08:02,820 That's odd. 238 00:08:02,820 --> 00:08:05,000 Wait, did she say those are Laura halloran's labs? Yeah. 239 00:08:05,000 --> 00:08:06,030 What's wrong? 240 00:08:06,040 --> 00:08:07,740 She has a lactate of 4. 241 00:08:07,740 --> 00:08:09,070 Maybe she had too much wine last night. 242 00:08:09,070 --> 00:08:11,030 Or it's an early sign of organ death. 243 00:08:11,040 --> 00:08:12,810 But, uh, question is which organ? 244 00:08:12,810 --> 00:08:15,880 Excuse me, why is this patient still in trauma one? 245 00:08:15,880 --> 00:08:17,180 Evening, Dr. Taylor. 246 00:08:17,180 --> 00:08:18,920 Oh, sorry, i forgot my salutation. 247 00:08:18,920 --> 00:08:20,450 How you doing? 248 00:08:20,450 --> 00:08:21,990 Now, why hasn't she been admitted yet? 249 00:08:21,990 --> 00:08:23,820 'Cause, uh, something's bothering me. 250 00:08:23,820 --> 00:08:25,120 Well, something's bothering me, too. 251 00:08:25,120 --> 00:08:27,020 Hemorrhoids. My ass is on fire. 252 00:08:27,020 --> 00:08:28,580 Do I get a bed in trauma one for that? 253 00:08:28,590 --> 00:08:30,120 I can't send the patient upstairs 254 00:08:30,130 --> 00:08:31,560 till I know what's wrong. 255 00:08:31,560 --> 00:08:33,790 Well, what is it that Dr. Rorish always says? 256 00:08:33,800 --> 00:08:35,930 We're the first 10 minutes. 257 00:08:35,930 --> 00:08:38,090 Well, this one is in minute 11. 258 00:08:38,100 --> 00:08:39,160 So let's ship her out. 259 00:08:40,140 --> 00:08:42,040 Hang on. 260 00:08:42,040 --> 00:08:44,070 Something in her isn't getting enough blood. 261 00:08:44,070 --> 00:08:45,730 You heard Taylor. He's the director of the E.R. 262 00:08:45,740 --> 00:08:47,270 Yeah. And this is our patient. 263 00:08:48,750 --> 00:08:50,480 Let's, uh, get her to ct. 264 00:08:50,480 --> 00:08:52,220 I want a pan scan... Head, neck, chest, ab/pelvis. 265 00:08:52,220 --> 00:08:53,980 You got it. 266 00:08:53,980 --> 00:08:55,040 [ Indistinct chatter ] 267 00:08:55,050 --> 00:08:57,010 Mario, you're with me. 268 00:08:57,020 --> 00:08:58,590 Whoa. That's Brian wellborn. 269 00:08:58,590 --> 00:08:59,620 Friend of yours? 270 00:08:59,620 --> 00:09:00,820 Hockey player. L.A. rays. 271 00:09:00,820 --> 00:09:03,890 Well, in here, he's just a patient. 272 00:09:03,890 --> 00:09:06,790 26-year-old male was found unconscious at the gym. 273 00:09:06,800 --> 00:09:08,065 He was awake when we arrived, 274 00:09:08,066 --> 00:09:10,030 but initially lethargic and confused. 275 00:09:10,030 --> 00:09:12,630 Gcs 13, fgs 110. 276 00:09:12,640 --> 00:09:13,970 I wasn't unconscious. 277 00:09:13,970 --> 00:09:15,040 I laid down for a few minutes, 278 00:09:15,040 --> 00:09:16,640 I woke up in a freaking ambulance. 279 00:09:16,640 --> 00:09:17,910 Has this happened to you before? 280 00:09:17,910 --> 00:09:19,080 Nothing happened to me. Were you listening? 281 00:09:19,080 --> 00:09:20,780 I was. 282 00:09:20,780 --> 00:09:22,340 But given how upset you are, 283 00:09:22,340 --> 00:09:23,900 I'm surprised that you even got into the ambulance, 284 00:09:23,910 --> 00:09:26,040 unless you weren't completely lucid at the time. 285 00:09:26,050 --> 00:09:27,620 I've been working out like crazy, dieting, 286 00:09:27,620 --> 00:09:29,090 getting ready for the new season. 287 00:09:29,090 --> 00:09:30,160 I overdid it. End of story. 288 00:09:30,150 --> 00:09:31,350 What do you want to do, doctor? 289 00:09:31,350 --> 00:09:32,780 Take a history, examine him. 290 00:09:32,790 --> 00:09:34,225 Good. You're not serious. 291 00:09:34,226 --> 00:09:35,320 If your car broke down, 292 00:09:35,330 --> 00:09:36,960 you want to look under the hood, right? 293 00:09:36,960 --> 00:09:38,230 Mr. wellborn, you're here now. 294 00:09:38,230 --> 00:09:39,530 We can't let you leave 295 00:09:39,530 --> 00:09:40,830 until we've at least done a basic exam. 296 00:09:40,830 --> 00:09:42,200 What do you mean you can't let me leave? 297 00:09:42,200 --> 00:09:43,270 It's the law. 298 00:09:43,270 --> 00:09:44,340 We need to make sure you're not a danger 299 00:09:44,340 --> 00:09:45,590 to yourself or to others. 300 00:09:45,600 --> 00:09:46,770 It's routine. 301 00:09:46,780 --> 00:09:47,960 I need to call my team doctor. 302 00:09:47,960 --> 00:09:49,140 I left my phone back in the locker room at the gym. 303 00:09:49,140 --> 00:09:50,870 We'll hook you up with a phone, buddy. 304 00:09:50,870 --> 00:09:52,900 Evaluate and get back to me. And remember what I said. 305 00:09:52,910 --> 00:09:56,310 Totally. Go. 306 00:09:56,310 --> 00:09:58,110 You take care of her at the nursing home? 307 00:09:58,110 --> 00:10:01,840 She's a nice lady, but she is confused and very willful. 308 00:10:01,850 --> 00:10:03,610 You have a nice face. 309 00:10:03,620 --> 00:10:05,260 So do you. 310 00:10:06,620 --> 00:10:08,020 Alzheimer's? Dementia. 311 00:10:08,020 --> 00:10:09,420 She have a good heart, 312 00:10:09,430 --> 00:10:10,830 but she wanted to go out for the day, 313 00:10:10,830 --> 00:10:11,860 like a field trip, 314 00:10:11,860 --> 00:10:12,990 and we don't do that. 315 00:10:13,000 --> 00:10:15,030 But she don't take no for an answer, 316 00:10:15,030 --> 00:10:16,120 so she swallowed the money. 317 00:10:16,130 --> 00:10:18,660 What do you mean she swallowed the money? 318 00:10:18,670 --> 00:10:20,870 She took a bunch of coins and swallowed them. 319 00:10:20,870 --> 00:10:22,240 They're inside her right now. 320 00:10:22,240 --> 00:10:24,410 She ate them so she'd get out for the day? 321 00:10:24,410 --> 00:10:26,410 $3.80. 322 00:10:28,280 --> 00:10:29,350 We do what we got to do, right? 323 00:10:29,350 --> 00:10:31,150 Right as rain. 324 00:10:31,150 --> 00:10:33,180 Why didn't you just give her a laxative and wait it out? 325 00:10:33,180 --> 00:10:36,180 Now that she's here, she's here until she passes them. 326 00:10:36,190 --> 00:10:38,220 The rules say we can't discharge any patient 327 00:10:38,220 --> 00:10:41,050 with a foreign object inside of them. 328 00:10:41,060 --> 00:10:42,290 But you already knew that, didn't you? 329 00:10:42,290 --> 00:10:45,150 We have so many patients and not enough staff. 330 00:10:45,160 --> 00:10:47,160 I can't be taking her to the toilet every five minutes. 331 00:10:47,160 --> 00:10:48,790 You think we can? 332 00:10:48,800 --> 00:10:51,070 Call us when she's ready to get picked up, hmm? 333 00:10:52,070 --> 00:10:53,710 [ Indistinct radio chatter ] 334 00:10:57,670 --> 00:10:58,900 [ Telephone rings ] 335 00:10:58,910 --> 00:11:01,740 Woman: Mrs. Perez. Mrs. Perez, please. 336 00:11:01,740 --> 00:11:04,070 Excuse me. Can I help you? 337 00:11:04,080 --> 00:11:06,250 I got a call my husband was in, uh, an accident? 338 00:11:06,250 --> 00:11:08,720 Jake Willis. Is he okay? 339 00:11:09,750 --> 00:11:10,950 Let me get his doctor for you. 340 00:11:10,950 --> 00:11:12,600 Oh, God, is he... 341 00:11:12,600 --> 00:11:14,250 Mrs. Willis, please don't read into anything I say. 342 00:11:14,260 --> 00:11:16,060 I'm not directly familiar with the case. 343 00:11:16,060 --> 00:11:17,560 I simply don't know. 344 00:11:17,560 --> 00:11:19,060 If you'll wait, I'll get Dr. Rorish. 345 00:11:21,160 --> 00:11:22,260 Mario: I was at the Edmonton game. 346 00:11:22,270 --> 00:11:24,270 Brian: Which one? 347 00:11:24,270 --> 00:11:25,400 Which one? The no-look backhander. 348 00:11:25,400 --> 00:11:26,390 It was unbelievable. 349 00:11:26,400 --> 00:11:27,730 Are we almost done here? 350 00:11:27,740 --> 00:11:29,000 Open your mouth for me. 351 00:11:29,000 --> 00:11:30,260 What's my mouth got to do with anything? 352 00:11:30,270 --> 00:11:31,700 I'm a resident, okay? I don't check everything out... 353 00:11:31,710 --> 00:11:33,710 Yeah, fine, you want to look at my mouth? 354 00:11:34,440 --> 00:11:36,070 Here. 355 00:11:37,780 --> 00:11:40,250 Occupational hazard. 356 00:11:41,120 --> 00:11:43,820 Tongue out. 357 00:11:45,490 --> 00:11:46,720 Ah. 358 00:11:46,720 --> 00:11:47,950 You're right. You didn't pass out. 359 00:11:47,960 --> 00:11:49,190 Told ya. 360 00:11:49,190 --> 00:11:50,290 [ Grunts ] Done here? 361 00:11:50,290 --> 00:11:51,350 You had a seizure. 362 00:11:51,360 --> 00:11:52,460 Whoa, whoa, whoa, whoa. 363 00:11:52,460 --> 00:11:54,090 How'd you come up with seizure, huh? 364 00:11:54,100 --> 00:11:55,230 Looking in my mouth? You believe this guy? 365 00:11:55,230 --> 00:11:57,830 You bit your tongue. 366 00:11:57,830 --> 00:11:59,290 And it looks like it's happened before. 367 00:11:59,300 --> 00:12:00,400 Am I right? 368 00:12:02,270 --> 00:12:04,070 Becca: So, he's alive? 369 00:12:04,070 --> 00:12:05,200 Leanne: He's alive. 370 00:12:05,210 --> 00:12:08,080 Oh, thank God. 371 00:12:08,080 --> 00:12:10,361 I don't know what we would do if anything happened to him. 372 00:12:12,220 --> 00:12:14,180 Would you rather speak privately? 373 00:12:14,180 --> 00:12:15,340 I can have a nurse come watch your daughter. We'll... 374 00:12:15,350 --> 00:12:18,250 No, no, no, no. Tara needs me around. 375 00:12:18,250 --> 00:12:19,910 She's calm now, but... 376 00:12:19,920 --> 00:12:22,420 Is Jake gonna be okay? 377 00:12:22,430 --> 00:12:24,400 The truth is we don't know yet. 378 00:12:24,400 --> 00:12:26,220 But you said you fixed him. 379 00:12:26,230 --> 00:12:29,030 I said we stabilized him. 380 00:12:29,030 --> 00:12:35,430 Unfortunately, now we... Just... Have to wait. 381 00:12:40,240 --> 00:12:43,270 Tara's father left just after she was diagnosed. 382 00:12:43,280 --> 00:12:44,980 He said it wasn't what he signed up for. 383 00:12:44,980 --> 00:12:46,910 Can you believe that? 384 00:12:46,920 --> 00:12:49,250 I didn't know what to do. 385 00:12:49,250 --> 00:12:52,110 I tried to work, but she needed me. 386 00:12:52,120 --> 00:12:54,420 Honestly, I... 387 00:12:54,420 --> 00:12:56,250 [ voice breaking ] I didn't know if we would make it. 388 00:12:56,260 --> 00:12:59,400 And that's when i met Jake. 389 00:12:59,400 --> 00:13:03,200 Do you know where he was going tonight? 390 00:13:03,200 --> 00:13:06,300 He was gonna sign them up to take dance classes together. 391 00:13:06,300 --> 00:13:08,400 I told him he didn't have to do that. 392 00:13:08,400 --> 00:13:10,100 I think I insulted him. [ Sobs ] 393 00:13:10,110 --> 00:13:15,810 And he said, "no, she's my daughter. 394 00:13:15,810 --> 00:13:19,240 It's what I signed up for." [ Sobs ] 395 00:13:19,250 --> 00:13:21,090 "It's what I signed up for." 396 00:13:24,190 --> 00:13:26,260 [ Crying ] 397 00:13:26,260 --> 00:13:29,060 ♪♪ 398 00:13:32,400 --> 00:13:34,600 I'll let you know when he's out of surgery. 399 00:13:41,500 --> 00:13:43,570 [ Door opens ] 400 00:13:47,080 --> 00:13:48,610 She swallowed them? 401 00:13:48,610 --> 00:13:51,310 How else would they get there? 402 00:13:51,310 --> 00:13:53,510 [ Indistinct chatter ] 403 00:13:54,580 --> 00:13:58,210 All right, gang. She leaves when she's empty. 404 00:13:58,220 --> 00:14:01,380 Dr. Leighton, you'll go first. 405 00:14:01,390 --> 00:14:03,460 First for what? 406 00:14:03,460 --> 00:14:06,200 I gave her a mild laxative about 30 minutes ago. 407 00:14:06,200 --> 00:14:08,810 Mark: Eugh. 408 00:14:08,810 --> 00:14:11,430 Looks like the slot machine's ready to start paying off. 409 00:14:13,500 --> 00:14:16,400 Nothing. Maybe you were right. 410 00:14:16,410 --> 00:14:18,140 I trust your hunches more than mine. 411 00:14:18,140 --> 00:14:19,480 Well, we can all be wrong. 412 00:14:19,480 --> 00:14:22,080 Leanne, do you have a moment? 413 00:14:22,080 --> 00:14:23,480 Oh, don't look. 414 00:14:23,480 --> 00:14:24,980 Gangrenous toe. 415 00:14:26,150 --> 00:14:27,390 Gangrene is my jam. 416 00:14:27,390 --> 00:14:28,580 Is that so? 417 00:14:30,420 --> 00:14:31,990 You needed something? 418 00:14:31,990 --> 00:14:33,490 Sorry. 419 00:14:33,490 --> 00:14:36,160 Yeah, that, uh, female mvc has a lactate of 4. 420 00:14:36,160 --> 00:14:38,195 What are you thinking? Organ ischemia? 421 00:14:38,196 --> 00:14:40,020 Yeah, but the pan scan is negative. 422 00:14:40,030 --> 00:14:41,470 Wouldn't ischemia show up? 423 00:14:41,470 --> 00:14:43,240 Not necessarily. 424 00:14:43,250 --> 00:14:45,040 Any evidence of abdominal trauma from the accident? 425 00:14:45,040 --> 00:14:46,430 No. Huh. 426 00:14:46,440 --> 00:14:49,410 Then what could've caused it? 427 00:14:49,410 --> 00:14:50,610 Unless... 428 00:14:50,610 --> 00:14:53,240 It wasn't caused by the accident. 429 00:14:54,610 --> 00:14:55,580 Ohh. 430 00:14:55,580 --> 00:14:57,550 I was on my way here. 431 00:14:57,550 --> 00:14:59,350 You were on your way to the hospital? 432 00:14:59,350 --> 00:15:02,090 The pain was sudden, and... And so intense, I threw up. 433 00:15:02,090 --> 00:15:03,410 Appendix? 434 00:15:03,420 --> 00:15:04,740 No, I don't think so. 435 00:15:04,740 --> 00:15:06,060 Risa, i need the ultrasound. Flying in. 436 00:15:06,060 --> 00:15:07,190 You think it's internal bleeding? 437 00:15:07,190 --> 00:15:08,290 Gp won't show up on ultrasound. 438 00:15:08,290 --> 00:15:09,520 Very good. 439 00:15:09,530 --> 00:15:11,260 But no. We're not looking for blood. 440 00:15:11,260 --> 00:15:13,300 I have a hunch. 441 00:15:16,030 --> 00:15:17,260 Oh, that's interesting. 442 00:15:17,270 --> 00:15:19,240 You... you don't have a right ovary. 443 00:15:19,240 --> 00:15:21,440 No, just... just a left. 444 00:15:21,440 --> 00:15:22,970 Why? Is something wrong with it? 445 00:15:22,970 --> 00:15:24,430 Look. 446 00:15:24,440 --> 00:15:25,710 There should be a rainbow 447 00:15:25,710 --> 00:15:26,980 of flashing colors here on the left, 448 00:15:26,980 --> 00:15:28,340 coursing through her left ovary. 449 00:15:28,340 --> 00:15:29,940 But there's nothing. It's just darkness. 450 00:15:29,950 --> 00:15:32,530 Torsion? 451 00:15:32,530 --> 00:15:35,110 Laura, your ovary is twisted, cutting off the blood flow. 452 00:15:35,120 --> 00:15:36,490 It's called a torsion. 453 00:15:36,490 --> 00:15:38,320 Is it dangerous? 454 00:15:38,320 --> 00:15:39,710 I need to know when the pain started... exactly when. 455 00:15:39,720 --> 00:15:42,620 Um... I was... I was moving 456 00:15:42,630 --> 00:15:44,460 some... some boxes from my basement. 457 00:15:44,460 --> 00:15:45,460 It was around 9:00. 458 00:15:45,460 --> 00:15:46,960 I came straight from there. 459 00:15:48,600 --> 00:15:51,370 An ovary has about six hours it can survive without oxygen. 460 00:15:51,370 --> 00:15:52,730 That means, if we're lucky, 461 00:15:52,730 --> 00:15:54,090 we have about three hours to detorse it, or... 462 00:15:54,100 --> 00:15:55,260 I'll lose it? 463 00:15:56,670 --> 00:15:58,470 I'm afraid so, yeah. 464 00:15:58,470 --> 00:16:00,030 Can I ask you what happened to your other ovary? 465 00:16:00,040 --> 00:16:02,600 [ Sighs ] They said it was a-a teratoma. 466 00:16:02,610 --> 00:16:03,640 Happened a few years ago. 467 00:16:03,650 --> 00:16:05,080 My late husband and I 468 00:16:05,080 --> 00:16:08,140 had been having some fertility problems, and... 469 00:16:08,150 --> 00:16:10,050 Nobody available right now from o.B. 470 00:16:10,050 --> 00:16:12,280 Laura, we're gonna need to contact your obstetrician, okay? 471 00:16:12,290 --> 00:16:14,690 Um, I've been going to a clinic in San Francisco. 472 00:16:14,690 --> 00:16:16,130 I fly out once a month. 473 00:16:16,130 --> 00:16:17,330 For fertility? 474 00:16:17,330 --> 00:16:18,530 You said it was your late husband? 475 00:16:18,530 --> 00:16:21,610 It is. 476 00:16:21,610 --> 00:16:24,690 It's where we froze Noah's sperm before he got sick. 477 00:16:24,700 --> 00:16:28,610 I can't lose this ovary. Please. 478 00:16:32,740 --> 00:16:34,600 I would like to see his chart, 479 00:16:34,610 --> 00:16:36,110 and please let the E.R. director know 480 00:16:36,110 --> 00:16:37,540 I'm here and would like to see him. 481 00:16:37,550 --> 00:16:38,550 Who the hell are you? 482 00:16:38,550 --> 00:16:41,080 Who are you? A resident. 483 00:16:41,080 --> 00:16:42,510 So, are you the genius 484 00:16:42,520 --> 00:16:44,455 who diagnosed this man with seizures? 485 00:16:44,456 --> 00:16:45,580 Again, who are you? 486 00:16:45,590 --> 00:16:46,590 I'm his team doctor. 487 00:16:46,590 --> 00:16:48,690 Oh, I get it. 488 00:16:48,690 --> 00:16:50,590 You get what? Seizures mean he can't play. 489 00:16:50,590 --> 00:16:52,150 I didn't have a damn seizure. 490 00:16:52,160 --> 00:16:53,550 Correct. 491 00:16:53,560 --> 00:16:55,290 In fact, I want it stricken from his chart right now. 492 00:16:55,300 --> 00:16:57,540 That's against the law, and a real doctor would know that. 493 00:16:57,530 --> 00:16:58,630 Who do you think you're talking to? 494 00:16:58,630 --> 00:17:00,290 Edward: Brian, settle down. 495 00:17:00,300 --> 00:17:02,730 I'm Jesse sallander, senior E.R. nurse. 496 00:17:02,740 --> 00:17:04,410 Can I help you? Yes. 497 00:17:04,410 --> 00:17:05,860 I'm checking my patient out, 498 00:17:05,860 --> 00:17:07,310 but I would like a chart revision first. 499 00:17:07,310 --> 00:17:08,580 Chart revision? Yeah, a chart revision. 500 00:17:08,580 --> 00:17:10,450 Hey, man, we're trying to help you. 501 00:17:10,450 --> 00:17:12,320 Help me? Oh, you think I need your help? 502 00:17:13,650 --> 00:17:15,650 Dr. Savetti, you don't want to do this. 503 00:17:15,650 --> 00:17:16,910 Believe me. 504 00:17:16,920 --> 00:17:18,190 Enough. Savetti, step out, please. 505 00:17:18,190 --> 00:17:20,190 Come on, me? Now, son. 506 00:17:22,220 --> 00:17:24,650 Are you the attending? I'm Dr. Edward Darius. I'm... 507 00:17:24,660 --> 00:17:26,630 Whoever you think you are, you have zero authority in here. 508 00:17:26,630 --> 00:17:29,170 I play racquetball 509 00:17:29,170 --> 00:17:32,500 with ed harbert, c.E.O. Of this hospital. 510 00:17:32,500 --> 00:17:36,360 Did you know only 1% of all males can perform auto-fellatio? 511 00:17:36,370 --> 00:17:38,630 You, sir, have a serious medical issue, 512 00:17:38,640 --> 00:17:40,100 and it does need to be addressed, 513 00:17:40,110 --> 00:17:41,330 but this isn't a jail, 514 00:17:41,330 --> 00:17:42,550 and we can't keep you here... Ah, he's seizing. 515 00:17:42,550 --> 00:17:45,180 He's seizing. I got him. 516 00:17:45,180 --> 00:17:46,540 Ohh. 517 00:17:46,550 --> 00:17:48,520 Easy. Easy. I need a face mask at 25 liters. 518 00:17:48,520 --> 00:17:50,650 2 mgs of ativan, please. 519 00:17:50,650 --> 00:17:51,750 There it is. 520 00:17:51,750 --> 00:17:53,820 Put it on. Put it on, please. 521 00:18:01,300 --> 00:18:03,370 ♪♪ 522 00:18:08,270 --> 00:18:10,270 [ indistinct conversations ] 523 00:18:10,270 --> 00:18:12,270 [ Door opens ] 524 00:18:12,270 --> 00:18:13,730 [ Gurney rattling ] 525 00:18:13,740 --> 00:18:17,410 [ Indistinct radio chatter ] 526 00:18:17,410 --> 00:18:19,510 Interested in knowing how your patient is doing, 527 00:18:19,520 --> 00:18:20,450 the hockey player? 528 00:18:20,450 --> 00:18:22,350 Sure. 529 00:18:22,350 --> 00:18:24,310 Had a pretty rough seizure, 530 00:18:24,320 --> 00:18:28,220 but it's over now, and he's resting. 531 00:18:28,220 --> 00:18:30,490 And Dr. Darius? 532 00:18:30,490 --> 00:18:33,320 Taylor and Rorish kicked him out. 533 00:18:33,330 --> 00:18:35,470 Glad I'm not the only one that got booted. 534 00:18:36,370 --> 00:18:38,440 You ever see "an officer and a gentleman"? 535 00:18:38,440 --> 00:18:40,410 What? 536 00:18:40,420 --> 00:18:42,410 The movie "an officer and a gentleman"? 537 00:18:42,410 --> 00:18:44,070 No. 538 00:18:44,070 --> 00:18:45,730 Richard gere plays this guy named mayonnaise. 539 00:18:45,740 --> 00:18:47,770 Mayonnaise? 540 00:18:47,780 --> 00:18:49,810 Yeah, 'cause his last name is Mayo, and he's white. 541 00:18:49,810 --> 00:18:53,710 Now, mayonnaise joins the Navy to fly jets. 542 00:18:53,720 --> 00:18:55,790 See, he's good at almost everything. 543 00:18:55,790 --> 00:18:59,550 Fastest runner, best fighter, smart, and fearless. 544 00:18:59,560 --> 00:19:03,490 Now, if the movie were just called "an officer," 545 00:19:03,490 --> 00:19:04,550 he'd be just fine. 546 00:19:04,560 --> 00:19:06,750 But it's not. 547 00:19:06,750 --> 00:19:08,930 It's called "an officer and a gentleman," 548 00:19:08,930 --> 00:19:13,790 which means you have some things to learn. 549 00:19:13,800 --> 00:19:15,230 Like what? 550 00:19:15,240 --> 00:19:19,610 Humility, Patience, kindness, charity. 551 00:19:19,610 --> 00:19:20,780 You know, the big ones. 552 00:19:20,780 --> 00:19:23,410 You saying I'm mayonnaise? 553 00:19:23,410 --> 00:19:24,670 Well, you ain't Lou gossett. 554 00:19:24,680 --> 00:19:27,650 I know the neighborhood you come from, bro. 555 00:19:27,650 --> 00:19:30,250 Only thing that gets through those walls is a bullet, 556 00:19:30,250 --> 00:19:32,380 which means the only way out is to become a bullet. 557 00:19:32,390 --> 00:19:33,960 You got out. 558 00:19:33,960 --> 00:19:36,490 And you're here now. 559 00:19:36,490 --> 00:19:38,950 You can't be a bullet anymore, you understand? 560 00:19:41,730 --> 00:19:43,770 I'm out. 561 00:19:44,500 --> 00:19:48,570 [ Indistinct chatter ] 562 00:19:48,570 --> 00:19:50,260 Hey. Person. 563 00:19:51,610 --> 00:19:52,610 Christa. 564 00:19:52,610 --> 00:19:53,910 Really? I'd have thought Susan. 565 00:19:53,910 --> 00:19:56,480 Uh, o.B. Called. There's an open O.R. 566 00:19:56,480 --> 00:19:57,620 That's great. That's great news. 567 00:19:57,620 --> 00:19:59,470 Hold your water. 568 00:19:59,480 --> 00:20:00,710 There's no available surgeons. 569 00:20:00,720 --> 00:20:02,290 But that doesn't help me. 570 00:20:02,290 --> 00:20:04,550 I'm not here to help you. 571 00:20:08,820 --> 00:20:11,650 Woman: Yeah, was in a diabetic coma when he came in. 572 00:20:11,660 --> 00:20:13,830 25 cents. You got off easy. 573 00:20:13,830 --> 00:20:15,560 It was all nickels. 574 00:20:15,560 --> 00:20:17,560 [ Coins clink ] 575 00:20:17,570 --> 00:20:19,570 Cough for me? ¿puede toser, por favor? 576 00:20:19,570 --> 00:20:20,870 [ Coughs ] An O.R. opened up. 577 00:20:20,870 --> 00:20:22,810 But there are no available surgeons. 578 00:20:22,810 --> 00:20:24,510 For Laura halloran. 579 00:20:24,510 --> 00:20:25,870 The torsion? 580 00:20:25,870 --> 00:20:28,270 How much time do we have? 581 00:20:28,280 --> 00:20:29,680 Uh, perdón. No... no English. 582 00:20:29,680 --> 00:20:32,015 We have about 90 minutes till she loses the ovary. 583 00:20:32,016 --> 00:20:33,910 Do you know how long she and her husband 584 00:20:33,920 --> 00:20:35,250 wanted to have children together? 585 00:20:35,250 --> 00:20:36,480 20 years. 586 00:20:36,490 --> 00:20:37,720 How is that possible? She's only 27. 587 00:20:37,720 --> 00:20:39,490 They met in the third grade. 588 00:20:39,490 --> 00:20:40,630 Third grade. Yeah. 589 00:20:40,630 --> 00:20:42,580 Grab a tissue. I'm not done. 590 00:20:42,590 --> 00:20:44,650 Dr. Hudson, laceration right leg. 591 00:20:44,660 --> 00:20:45,760 Sides east 2. 592 00:20:45,760 --> 00:20:47,720 You think you can handle that one? 593 00:20:47,730 --> 00:20:49,850 It's a fairy tale, right? 594 00:20:49,850 --> 00:20:51,970 Until he gets diagnosed with stage iv lymphoma two years ago. 595 00:20:51,970 --> 00:20:55,440 Dislocated shoulder, sides south 1. Seriously? 596 00:20:55,440 --> 00:20:56,970 We're in code red. Buckle up. 597 00:20:56,970 --> 00:21:01,940 [ Speaking Spanish ] 598 00:21:01,940 --> 00:21:05,340 He froze his sperm before chemo and radiation. 599 00:21:05,350 --> 00:21:07,050 He died last year, and it's all she has left of him. 600 00:21:07,050 --> 00:21:09,320 Christa, I sympathize, but with no one to perform surgery... 601 00:21:09,320 --> 00:21:10,350 That's the thing. You can do it. 602 00:21:10,350 --> 00:21:11,610 Me? Yes. 603 00:21:11,620 --> 00:21:13,170 You did a surgical residency. 604 00:21:13,170 --> 00:21:14,720 You must have done an o.B. Rotation. 605 00:21:14,720 --> 00:21:16,130 I'm not a surgeon. 606 00:21:16,140 --> 00:21:17,560 I don't have surgical privileges. 607 00:21:17,560 --> 00:21:19,260 Look, I'm sorry. 608 00:21:19,260 --> 00:21:20,960 But there's really nothing we can do for her right now. 609 00:21:20,960 --> 00:21:22,320 You have patients. 610 00:21:25,670 --> 00:21:26,900 Mario. 611 00:21:26,900 --> 00:21:28,630 Dr. Rorish, listen, sorry about before... 612 00:21:28,640 --> 00:21:29,640 Here. What's this? 613 00:21:29,640 --> 00:21:31,910 It's wellborn's ct results. 614 00:21:31,910 --> 00:21:34,380 Parenchymal hemorrhages? 615 00:21:34,380 --> 00:21:36,610 Go tell him. Me? 616 00:21:36,610 --> 00:21:38,810 Can you be professional? 617 00:21:38,810 --> 00:21:40,570 Yes, of course. Thank you. 618 00:21:40,580 --> 00:21:41,640 Don't thank me. This isn't a gesture. 619 00:21:41,650 --> 00:21:42,790 We're about to be in code black. 620 00:21:42,790 --> 00:21:44,360 He's your patient, your responsibility. 621 00:21:44,360 --> 00:21:45,410 Go do your job. 622 00:21:46,360 --> 00:21:48,060 Mr. rocksickler. 623 00:21:48,060 --> 00:21:49,240 Stan. 624 00:21:49,240 --> 00:21:50,420 I'm sorry for the wait out there. 625 00:21:50,430 --> 00:21:52,360 It must've been a long night. 626 00:21:52,360 --> 00:21:54,360 Night? I've been here for 10 hours. 627 00:21:54,360 --> 00:21:56,420 My back's killing me. 628 00:21:56,430 --> 00:21:57,830 Is there anything you can give me? 629 00:21:57,830 --> 00:21:59,730 How long have you had the pain? 630 00:21:59,740 --> 00:22:01,405 On and off the past few months. 631 00:22:01,406 --> 00:22:03,000 Finally got so bad in the last week, 632 00:22:03,010 --> 00:22:04,540 I couldn't take it anymore. 633 00:22:04,540 --> 00:22:06,080 [ Chuckling ] I feel like it's broken or something. 634 00:22:06,080 --> 00:22:08,380 Eh, it sounds like it worsened pretty dramatically. 635 00:22:08,380 --> 00:22:09,380 I'll say. 636 00:22:09,380 --> 00:22:10,650 You work in construction? Yeah. 637 00:22:10,650 --> 00:22:11,680 Lot of heavy lifting? 638 00:22:11,680 --> 00:22:13,150 Oh, yeah. 639 00:22:13,150 --> 00:22:14,620 Sounds like a persistent muscle spasm. 640 00:22:14,620 --> 00:22:16,720 Maybe. 641 00:22:21,690 --> 00:22:23,360 Heart rate 110. 642 00:22:23,360 --> 00:22:24,600 What... what if it's not his back? 643 00:22:24,600 --> 00:22:25,990 What if it's his heart? 644 00:22:25,990 --> 00:22:27,390 Dude, that heart rate is barely elevated. 645 00:22:27,400 --> 00:22:30,030 This is not a zebra. It's a plain old horse. 646 00:22:30,030 --> 00:22:33,390 At best, he gets a few Percocet and maybe a ct of his back. 647 00:22:33,400 --> 00:22:34,130 I don't know. 648 00:22:34,140 --> 00:22:35,570 It seems to be that an event 649 00:22:35,570 --> 00:22:37,400 that changes rapidly like he's describing 650 00:22:37,410 --> 00:22:38,775 is not a musculoskeletal problem. 651 00:22:38,776 --> 00:22:40,600 If it's not cardiac, maybe it's vascular. 652 00:22:40,610 --> 00:22:42,710 What do you have? 653 00:22:42,710 --> 00:22:44,810 Patient came in with persistent yet worsening back pain. 654 00:22:44,810 --> 00:22:47,710 He had a long wait... 10 hours... which didn't help. 655 00:22:47,720 --> 00:22:49,620 To me, it sounds like a muscle spasm, 656 00:22:49,620 --> 00:22:52,690 or, at worst, a compression fracture of the spine. 657 00:22:52,690 --> 00:22:55,990 Which is probably common in his line of work. 658 00:22:55,990 --> 00:22:58,390 I think a ct of his back would be the right precaution. 659 00:22:58,390 --> 00:22:59,720 Sounds right. Get him scanned. 660 00:22:59,730 --> 00:23:01,900 Let me know what comes back. 661 00:23:01,900 --> 00:23:03,770 Dude, you could've told her your theory. 662 00:23:03,770 --> 00:23:05,070 I don't have a theory. Yes, you do. 663 00:23:05,070 --> 00:23:06,140 But you don't believe me. 664 00:23:06,140 --> 00:23:08,100 Let's get the ct. 665 00:23:08,100 --> 00:23:11,770 Excuse me. [ Sighs ] 666 00:23:20,020 --> 00:23:21,620 Get the hell out of here. 667 00:23:21,620 --> 00:23:22,820 I want the real doctor. 668 00:23:25,050 --> 00:23:26,880 You've had a series of parenchymal hemorrhages. 669 00:23:26,890 --> 00:23:28,990 You just learn that word? 670 00:23:28,990 --> 00:23:31,820 They're small bleeds in your brain 671 00:23:31,830 --> 00:23:33,160 caused by multiple concussions. 672 00:23:33,160 --> 00:23:35,120 I hit hard. 673 00:23:35,130 --> 00:23:37,100 Well, the blows to your head have created a serious problem. 674 00:23:37,100 --> 00:23:38,735 Darius said he's got medicine. 675 00:23:38,736 --> 00:23:40,660 The medication will mitigate it, yeah. 676 00:23:40,670 --> 00:23:42,940 All right. So, can I get out of here now? 677 00:23:42,940 --> 00:23:44,990 You need to know 678 00:23:44,990 --> 00:23:47,040 that the medication should stop the seizures, 679 00:23:47,040 --> 00:23:49,740 but it won't reverse the damage that's already been done. 680 00:23:49,750 --> 00:23:53,520 The next concussion could kill you. 681 00:23:53,520 --> 00:23:56,590 What? 682 00:23:56,590 --> 00:23:57,820 What are you saying? 683 00:23:58,690 --> 00:24:01,460 I'm saying you can never play hockey again. 684 00:24:01,460 --> 00:24:03,560 Not if you want to live. 685 00:24:07,700 --> 00:24:10,470 I'm sorry. I really am. 686 00:24:16,570 --> 00:24:18,730 They have an open O.R., but they have no surgeons. 687 00:24:18,740 --> 00:24:20,040 We still have an hour to save the ovary. 688 00:24:20,040 --> 00:24:21,370 There's an option. 689 00:24:21,380 --> 00:24:22,710 Dr. Hudson did a surgical residency... 690 00:24:22,710 --> 00:24:23,940 But he's not a surgeon. 691 00:24:23,950 --> 00:24:25,180 Why is everybody saying no to this? 692 00:24:25,180 --> 00:24:26,480 We can help her. 693 00:24:26,480 --> 00:24:27,780 One of the hardest parts about this job 694 00:24:27,780 --> 00:24:28,880 is prioritizing patient need. 695 00:24:28,880 --> 00:24:30,850 She's esi-2, non-life threatening. 696 00:24:30,850 --> 00:24:33,750 As long as there's an esi-1 patient in front of her, 697 00:24:33,760 --> 00:24:34,730 she has to wait. 698 00:24:34,730 --> 00:24:35,820 What do you got? 699 00:24:35,820 --> 00:24:36,920 14-year-old male. Climbing accident. 700 00:24:36,930 --> 00:24:38,910 At 2:00 A.M.? 701 00:24:38,910 --> 00:24:40,900 We were doing the annual full moon climb at scarbo canyon. 702 00:24:40,900 --> 00:24:42,970 He fell 15 feet. Face hit the ground hard. 703 00:24:42,970 --> 00:24:44,500 His nose hasn't stopped bleeding. 704 00:24:44,500 --> 00:24:46,600 And who are you? His father. 705 00:24:46,600 --> 00:24:48,700 Persistent epistaxis. Ebl is north of 200 cc. 706 00:24:48,700 --> 00:24:49,800 Tried anterior packing, but no luck. 707 00:24:49,810 --> 00:24:50,770 Uh-huh. He's on Coumadin. 708 00:24:50,770 --> 00:24:52,200 Coumadin. 709 00:24:52,210 --> 00:24:53,810 Sir, why is your son on blood thinners? 710 00:24:53,810 --> 00:24:55,780 He had blood clots on his retinas when he was 4. 711 00:24:55,780 --> 00:24:57,650 Just roll him. Okay, hang on. 712 00:24:57,650 --> 00:24:58,810 Ready. Ready? 713 00:24:58,810 --> 00:24:59,810 And, one, two, three. 714 00:24:59,820 --> 00:25:01,920 Woman: Easy. Mind the board. 715 00:25:01,920 --> 00:25:04,850 I got it. Clear. Jesse, suction, please. 716 00:25:04,850 --> 00:25:06,810 Careful. We need to tamponade this bleeding. 717 00:25:06,820 --> 00:25:08,650 Two a/p nasal packs, please. 718 00:25:08,660 --> 00:25:10,280 Flying in. Come on. 719 00:25:10,280 --> 00:25:11,900 Blood clots on his retinas? Is he blind? 720 00:25:11,900 --> 00:25:13,650 Not totally. He sees shapes. 721 00:25:13,660 --> 00:25:14,990 He's blind, and you took him climbing? 722 00:25:15,000 --> 00:25:16,930 Not our business, Dr. Lorenson. I'm sorry. 723 00:25:16,930 --> 00:25:18,290 Okay. 724 00:25:18,300 --> 00:25:20,240 Jesse, prep some pcc at 50 units per kilogram 725 00:25:20,240 --> 00:25:22,870 and send off coags, type and cross stat. 726 00:25:22,870 --> 00:25:24,530 He's gonna be okay, right? 727 00:25:24,540 --> 00:25:28,080 Uh, his blood isn't clotting because of the thinners. 728 00:25:28,080 --> 00:25:29,810 Uh, I need more nasal packs, please. 729 00:25:29,810 --> 00:25:31,140 Page e.N.T., please. Woman: Paging now. 730 00:25:31,150 --> 00:25:33,050 Let's get six units in the can. 731 00:25:33,050 --> 00:25:35,150 Hey, Jesse, I don't know if I can get this bleeding under control. 732 00:25:35,150 --> 00:25:37,090 Blood bank out of o-neg. We're waiting on more from county. 733 00:25:37,090 --> 00:25:38,855 Okay. Blood pressure's tanking. 734 00:25:38,856 --> 00:25:41,300 [ Monitor beeping rapidly ] We're gonna need that blood. 735 00:25:41,310 --> 00:25:43,760 This kid's tank is gonna run dry unless we find a way to... 736 00:25:52,900 --> 00:25:54,630 Whoa, whoa! Whoa, whoa, whoa, whoa. 737 00:25:54,640 --> 00:25:56,210 Get him down. Get him down. Get him down. 738 00:25:56,200 --> 00:25:58,000 Okay, get him down. Get him down. Get him down. 739 00:25:58,010 --> 00:26:00,080 Watch his head. 740 00:26:07,620 --> 00:26:10,960 Okay, so, even in a significant bleed, "a-b-c" applies. 741 00:26:10,960 --> 00:26:12,810 Airway's always first. 742 00:26:12,820 --> 00:26:16,150 Dr. Lorenson, I want you to clamp open the nares 743 00:26:16,160 --> 00:26:18,260 while Jesse suctions inside. 744 00:26:18,260 --> 00:26:22,360 We need to find the source of the bleed, okay? 745 00:26:22,360 --> 00:26:23,660 If we're lucky, it'll be in his anterior 746 00:26:23,670 --> 00:26:25,420 and we'll be able to see it. 747 00:26:25,420 --> 00:26:27,170 But if it's posterior, which I fear it is, then... 748 00:26:27,170 --> 00:26:28,740 Blood pressure's tanking. 749 00:26:28,740 --> 00:26:29,910 Damn it. We need that blood. 750 00:26:29,910 --> 00:26:31,275 Unless we find a way to... 751 00:26:31,276 --> 00:26:33,000 [ Rapid beeping continues ] 752 00:26:33,010 --> 00:26:35,110 Get me two urinary catheters. 753 00:26:35,110 --> 00:26:36,850 Urinary catheters? Two folies. Now, please. 754 00:26:38,110 --> 00:26:39,910 Okay, we're gonna make a tamponade. 755 00:26:39,920 --> 00:26:41,285 [ Chatter continues ] 756 00:26:41,286 --> 00:26:42,310 Dr. Lorenson? Yeah. 757 00:26:42,320 --> 00:26:43,850 Give me that coffee over there. 758 00:26:43,850 --> 00:26:45,380 Jesse: Right there. Right there. 759 00:26:45,390 --> 00:26:48,025 I need any liquid, and I need it now, all right? 760 00:26:48,026 --> 00:26:51,250 We just need it to inflate the balloon inside the nose. 761 00:26:51,260 --> 00:26:53,010 Sorry. 762 00:26:53,010 --> 00:26:54,760 See how the balloon conforms to the cavity in the nose... Mm-hmm. 763 00:26:54,760 --> 00:26:55,990 and packs the bleed. 764 00:26:56,000 --> 00:26:57,070 Blood supply coming up the ramp now. 765 00:26:57,070 --> 00:26:58,370 About time. Sorry. 766 00:26:58,370 --> 00:26:59,800 Pressure's stabilizing. Got it. Got it. 767 00:26:59,800 --> 00:27:01,830 Okay? A perfect tamponade. 768 00:27:01,840 --> 00:27:03,770 All right? It's gonna work. 769 00:27:03,770 --> 00:27:05,370 Now we give him more pcc 770 00:27:05,370 --> 00:27:08,300 and, uh, reverse the anti-coag, 771 00:27:08,310 --> 00:27:09,950 and... and we get him upstairs. 772 00:27:09,950 --> 00:27:10,950 Phew! 773 00:27:10,950 --> 00:27:13,050 [ Monitor beeping ] 774 00:27:17,790 --> 00:27:19,120 [ Monitor beeping rapidly ] 775 00:27:19,120 --> 00:27:21,750 [ Beeping stops, indistinct chatter ] 776 00:27:21,760 --> 00:27:23,120 What's this for? 777 00:27:23,120 --> 00:27:24,480 Well, you're up next, kid. And you better hurry. 778 00:27:24,490 --> 00:27:25,850 She says she's got a turtle sticking its head out. 779 00:27:25,860 --> 00:27:27,660 Excuse me? 780 00:27:27,660 --> 00:27:30,120 She's got thumbelina in a headlock. 781 00:27:30,130 --> 00:27:31,760 Look, just get moving, blondie, 782 00:27:31,770 --> 00:27:33,800 or we're gonna have a mudslide in here. 783 00:27:38,040 --> 00:27:41,450 Man: Just let me know when the anesthesiologist gets here... 784 00:27:48,380 --> 00:27:49,810 Still touch and go... 785 00:27:49,820 --> 00:27:52,060 Oh. Ohh. 786 00:27:56,220 --> 00:27:58,090 Leanne: Yeah? All right. 787 00:27:59,230 --> 00:28:01,960 Oh. Coming through. 788 00:28:01,960 --> 00:28:03,960 Sign there. 789 00:28:03,970 --> 00:28:06,100 Do you think that I'm a terrible father 790 00:28:06,100 --> 00:28:07,830 for taking my blind son climbing? 791 00:28:07,840 --> 00:28:11,410 I think Harley's lucky 792 00:28:11,410 --> 00:28:14,010 to have a father who doesn't have a blind son. 793 00:28:15,180 --> 00:28:17,210 He has a son. 794 00:28:17,210 --> 00:28:18,710 Enjoy every minute. Trust me. 795 00:28:18,710 --> 00:28:22,010 Okay, just hear me out. Just hear me out. 796 00:28:22,020 --> 00:28:23,750 I may be personalizing the torsion... fine. 797 00:28:23,750 --> 00:28:25,380 But Dr. Rorish, even if you had just one chance 798 00:28:25,390 --> 00:28:26,720 to get back what you lost, anything... 799 00:28:26,720 --> 00:28:28,020 We are not here to fix 800 00:28:28,020 --> 00:28:29,320 the events of our own lives, Christa. 801 00:28:29,320 --> 00:28:31,320 The last thing you want to do in this job is make it about you. 802 00:28:31,330 --> 00:28:33,200 I don't believe a word of that. 803 00:28:33,200 --> 00:28:34,230 Excuse me? 804 00:28:34,230 --> 00:28:36,265 I lost my son, my husband left me, 805 00:28:36,266 --> 00:28:37,730 and you lost... you said... 806 00:28:37,730 --> 00:28:39,840 No, I didn't say anything. 807 00:28:39,850 --> 00:28:41,960 You don't know a thing about me, Dr. Lorenson. 808 00:28:41,970 --> 00:28:43,440 We're not friends. 809 00:28:43,440 --> 00:28:45,380 I-I'm the director of the residency program, 810 00:28:45,380 --> 00:28:46,700 you're a resident. 811 00:28:46,710 --> 00:28:48,040 Fine, but I heard what you said to that kid's father, 812 00:28:48,040 --> 00:28:49,340 and you were right. 813 00:28:49,340 --> 00:28:51,110 Hold onto the people we love, 814 00:28:51,110 --> 00:28:52,870 because you never know when they're gonna slip away. 815 00:28:52,880 --> 00:28:54,910 Neal: What's going on? 816 00:28:56,420 --> 00:28:58,490 She wants you to do the detorse. 817 00:28:58,490 --> 00:29:00,190 Yeah, she told me. 818 00:29:00,190 --> 00:29:02,110 I'm sorry. 819 00:29:02,110 --> 00:29:04,190 He was the love of her life. I just want to help her. 820 00:29:06,760 --> 00:29:08,190 Taylor would have to sign off on it. 821 00:29:08,200 --> 00:29:09,370 Wait. What? 822 00:29:11,500 --> 00:29:13,140 It would have to be fast. 823 00:29:14,100 --> 00:29:15,130 Can you do it laparoscopically? 824 00:29:15,140 --> 00:29:16,770 Laparoscope was my jam. 825 00:29:16,770 --> 00:29:18,430 Don't ask Taylor. 826 00:29:18,440 --> 00:29:19,440 It's easier to ask for forgiveness 827 00:29:19,440 --> 00:29:20,430 than it is permission. 828 00:29:20,440 --> 00:29:22,340 Thank you. Thank you. Go. 829 00:29:22,340 --> 00:29:24,200 Clock is ticking. 830 00:29:24,210 --> 00:29:26,010 [ Door closes ] 831 00:29:26,010 --> 00:29:28,280 [ Police radio chatter ] 832 00:29:42,860 --> 00:29:45,890 You know in high school when they have career day? 833 00:29:46,540 --> 00:29:48,300 I wasn't there. 834 00:29:48,300 --> 00:29:51,900 I was too busy winning state. 835 00:29:51,910 --> 00:29:55,080 Hell am I supposed to do if I'm not playing hockey? 836 00:29:55,080 --> 00:29:57,550 You know, there's a woman here who just became a doctor at 40. 837 00:29:57,550 --> 00:30:00,550 [ Scoffs ] Oh, I'm gonna be a doctor now? 838 00:30:00,550 --> 00:30:02,150 You can do anything you want, you put your mind to it. 839 00:30:02,150 --> 00:30:03,990 Who told you that? 840 00:30:03,990 --> 00:30:07,120 You did. 841 00:30:07,120 --> 00:30:10,220 After Edmonton, a reporter asked if that goal was dumb luck. 842 00:30:10,230 --> 00:30:11,595 You said it was smart luck. 843 00:30:11,596 --> 00:30:13,390 He asked you what you meant. 844 00:30:13,400 --> 00:30:15,530 You said, "smart luck is when you work your ass off 845 00:30:15,530 --> 00:30:17,330 so when the opportunity presents itself, 846 00:30:17,330 --> 00:30:20,190 you don't have to pray for dumb luck." 847 00:30:20,200 --> 00:30:22,460 [ Siren wails ] 848 00:30:22,470 --> 00:30:25,540 You can be anything you want to be, man. 849 00:30:25,540 --> 00:30:28,380 Trust me. I'm living proof. 850 00:30:28,380 --> 00:30:31,180 [ Siren wails ] 851 00:30:34,220 --> 00:30:36,990 Guys, your patient in ct's going sideways. 852 00:30:36,990 --> 00:30:38,590 Rocksickler? The one with the back problem. 853 00:30:38,590 --> 00:30:40,220 Wait, what do you mean sideways? 854 00:30:40,220 --> 00:30:41,450 They just said get up there stat. 855 00:30:41,460 --> 00:30:42,590 Find Dr. Rorish. 856 00:30:43,960 --> 00:30:45,930 [ Screaming ] 857 00:30:45,930 --> 00:30:47,530 Oh, no. 858 00:30:47,530 --> 00:30:48,530 Angus, this was your hunch. You were right. 859 00:30:48,530 --> 00:30:50,230 We don't know that. 860 00:30:50,230 --> 00:30:51,890 Take his pulse in the right hand. I'll grab the left. 861 00:30:51,900 --> 00:30:52,900 Ow! 862 00:30:52,900 --> 00:30:54,600 I have a pulse. 863 00:30:54,600 --> 00:30:56,030 I don't. You know what that means. 864 00:30:56,040 --> 00:30:57,610 It's bounding. God, you knew it! 865 00:30:57,610 --> 00:30:59,480 Knew what? What's happening? We need an attending in here now! 866 00:30:59,480 --> 00:31:01,440 We have to be sure we're right. We are right. 867 00:31:01,440 --> 00:31:03,070 Guys, he's already on the scanner. 868 00:31:03,080 --> 00:31:04,580 Run his chest, cta down to t10. 869 00:31:04,580 --> 00:31:05,800 We have to make sure that we're right. 870 00:31:05,800 --> 00:31:07,020 Malaya, we don't have time for that! 871 00:31:07,020 --> 00:31:08,920 Somebody tell me what's happening! 872 00:31:08,920 --> 00:31:10,650 We think you're having an aortic dissection. 873 00:31:10,650 --> 00:31:12,650 The pain in your back is actually being caused 874 00:31:12,650 --> 00:31:14,310 by the vertical splitting of your aorta, 875 00:31:14,320 --> 00:31:15,620 the main artery in your heart. 876 00:31:15,620 --> 00:31:16,950 Am I gonna die? 877 00:31:16,960 --> 00:31:18,630 Definitely not. 878 00:31:18,630 --> 00:31:20,160 [ Monitor beeping rapidly ] Oh, God. 879 00:31:20,160 --> 00:31:21,320 [ Groaning ] 880 00:31:21,330 --> 00:31:23,070 Get him out of here. Get him out of here! 881 00:31:23,070 --> 00:31:25,130 Malaya, get in here now! 882 00:31:30,640 --> 00:31:31,940 Get me a paracentesis kit! 883 00:31:31,940 --> 00:31:33,240 It's the harpoon with the syringe at the end of it. 884 00:31:33,240 --> 00:31:35,270 I know what a paracentesis kit is! 885 00:31:35,280 --> 00:31:37,110 I just can't believe this is happening. 886 00:31:37,110 --> 00:31:38,210 Believe it. This is happening. 887 00:31:38,210 --> 00:31:40,070 He's crumping! I know! 888 00:31:40,080 --> 00:31:42,280 [ Monitor beeping rapidly ] Stan: [ Groaning ] 889 00:31:42,280 --> 00:31:46,210 What the hell are you doing? 890 00:31:46,220 --> 00:31:50,020 Neal: Elevated white count over 18,000 with a left shift. 891 00:31:50,030 --> 00:31:52,000 Let's, uh, get her into trendelenburg position, please. 892 00:31:52,000 --> 00:31:53,190 Woman: Right away, doctor. 893 00:31:53,190 --> 00:31:55,690 This allows gravity to move the bowel 894 00:31:55,700 --> 00:31:57,430 up out of the pelvis and lower abdomen. 895 00:31:57,430 --> 00:31:59,130 Uh, Christa, can you hand me the veress needle? 896 00:31:59,130 --> 00:32:02,160 [ Monitor beeping ] 897 00:32:05,170 --> 00:32:06,470 Okay, Stan. 898 00:32:06,470 --> 00:32:08,640 I'm gonna have to put this needle into your chest 899 00:32:08,640 --> 00:32:10,400 to drain the blood that is crushing your heart. 900 00:32:10,410 --> 00:32:12,540 We're gonna monitor it on the ultrasound 901 00:32:12,550 --> 00:32:14,420 to make sure we don't penetrate the heart wall. 902 00:32:14,420 --> 00:32:15,800 What can I do? Grab a collection tube. 903 00:32:15,800 --> 00:32:17,190 There could be a liter or more of blood in there. 904 00:32:17,190 --> 00:32:19,350 He's unconscious. Better for him. 905 00:32:19,350 --> 00:32:21,420 Okay, guys, we've got one shot at this or he's dead. 906 00:32:21,420 --> 00:32:22,420 Understood? 907 00:32:22,420 --> 00:32:24,420 Together: Understood. 908 00:32:24,430 --> 00:32:26,030 All right. [ Inhales sharply ] 909 00:32:26,030 --> 00:32:28,460 I'm putting the needle in now. 910 00:32:28,460 --> 00:32:29,620 You see what I mean? 911 00:32:29,630 --> 00:32:32,560 That dark, black ribbon around the heart? 912 00:32:32,570 --> 00:32:34,970 That's blood, and lots of it. 913 00:32:34,970 --> 00:32:37,510 There's our needle. 914 00:32:37,510 --> 00:32:40,310 See it? 915 00:32:40,310 --> 00:32:42,410 We're in the tube now. 916 00:32:42,410 --> 00:32:44,680 See that blue color? 917 00:32:44,680 --> 00:32:46,750 That's the tube not getting enough blood. 918 00:32:46,750 --> 00:32:48,750 Just like a kinked garden hose. 919 00:32:48,750 --> 00:32:51,120 So let's find the spot where it's kinked. 920 00:32:51,120 --> 00:32:52,990 There. 921 00:32:52,990 --> 00:32:54,620 That's it. 922 00:32:54,620 --> 00:32:56,720 Now, with this hand, I'm gonna move the probe 923 00:32:56,730 --> 00:33:01,760 up to the tip of the ovary and just flip it over. 924 00:33:01,760 --> 00:33:04,690 Now watch. 925 00:33:04,700 --> 00:33:06,740 The blood should flow into the ovary, 926 00:33:06,740 --> 00:33:08,040 and the color will change. 927 00:33:08,040 --> 00:33:10,670 Any second. 928 00:33:10,670 --> 00:33:13,670 [ Sighs ] There you go. 929 00:33:13,680 --> 00:33:14,780 You want to drive? 930 00:33:14,780 --> 00:33:16,050 Come here. 931 00:33:17,580 --> 00:33:19,680 Take the wand. 932 00:33:21,720 --> 00:33:24,050 And the camera. 933 00:33:24,050 --> 00:33:27,210 Gently. 934 00:33:27,220 --> 00:33:30,150 Now you're slowly gonna back the camera out. 935 00:33:30,160 --> 00:33:33,290 Okay. And watch the image. 936 00:33:33,290 --> 00:33:34,790 Why did you ever leave surgery? 937 00:33:34,800 --> 00:33:37,030 Ah, long story. 938 00:33:37,030 --> 00:33:39,060 Okay, now you're gonna pull it 939 00:33:39,070 --> 00:33:40,600 all the way out through the port. 940 00:33:40,600 --> 00:33:43,130 Gentle. 941 00:33:47,440 --> 00:33:48,440 [ Sighs ] 942 00:33:48,440 --> 00:33:51,640 Now just ease the sleeve out. 943 00:33:51,650 --> 00:33:53,080 [ Monitor beeping rapidly ] What's happening? 944 00:33:53,080 --> 00:33:54,540 Step out? Did I do that? 945 00:33:54,550 --> 00:33:56,820 No. I must've nicked a vessel when I put the sleeve in. 946 00:33:56,820 --> 00:33:58,620 The sleeve kept the pressure on. 947 00:33:58,620 --> 00:33:59,790 Uh, we're gonna have to open her up. 948 00:33:59,790 --> 00:34:02,290 Can we have a surgical tray, please? 949 00:34:03,760 --> 00:34:06,100 I'm gonna puncture the sac now. 950 00:34:07,130 --> 00:34:08,730 Fingers crossed. 951 00:34:10,300 --> 00:34:11,700 There it is. 952 00:34:11,700 --> 00:34:14,600 [ Monitor beeping ] 953 00:34:14,600 --> 00:34:16,830 I'm in. 954 00:34:19,570 --> 00:34:22,400 Pull back on the syringe. 955 00:34:22,410 --> 00:34:24,510 [ Liquid gurgling ] Hear that sound? 956 00:34:24,510 --> 00:34:26,710 [ Chuckles ] 957 00:34:26,710 --> 00:34:29,480 It's working. 958 00:34:33,090 --> 00:34:34,460 Blood pressure's tanking. 959 00:34:34,460 --> 00:34:35,830 Let's, uh, squeeze some fluids into her. 960 00:34:35,830 --> 00:34:37,350 Starting the incision now. 961 00:34:37,360 --> 00:34:38,690 Wait. What? 962 00:34:38,690 --> 00:34:40,490 Urinary catheter. What are you talking about? 963 00:34:40,500 --> 00:34:42,600 It's what Dr. Rorish used with that kid with the nose bleed. 964 00:34:42,600 --> 00:34:44,300 She fed the catheter, and she filled it with liquid 965 00:34:44,300 --> 00:34:45,400 to put pressure on the artery. 966 00:34:45,400 --> 00:34:47,800 Can we... Can do the same thing here? 967 00:34:47,800 --> 00:34:49,860 I believe we can. Is there a foley on that cart? 968 00:34:49,870 --> 00:34:51,700 [ Monitor beeping rapidly ] 969 00:34:51,710 --> 00:34:53,420 Okay. 970 00:34:53,420 --> 00:34:55,140 Okay, let's get it in through the port. 971 00:34:55,140 --> 00:34:57,870 Dr. Lorenson... 972 00:34:57,880 --> 00:35:00,350 You're gonna squeeze the fluids on my mark. 973 00:35:00,350 --> 00:35:02,680 ♪♪ 974 00:35:02,680 --> 00:35:05,450 Now, please. Push the fluids in. 975 00:35:07,590 --> 00:35:09,290 Look at her BP. It's working. 976 00:35:09,290 --> 00:35:11,760 Yeah. It worked. 977 00:35:11,760 --> 00:35:12,860 [ Beeping slows ] [ Chuckles ] 978 00:35:12,860 --> 00:35:14,750 Very well done, doctor. 979 00:35:14,760 --> 00:35:16,620 Very well done. 980 00:35:16,630 --> 00:35:19,490 ♪♪ 981 00:35:23,770 --> 00:35:25,330 [ indistinct chatter ] 982 00:35:25,340 --> 00:35:26,380 If you're ready to go home, 983 00:35:26,370 --> 00:35:27,800 I'll call them to come pick you up. 984 00:35:27,810 --> 00:35:29,850 Growing old is a swirling toilet bowl. 985 00:35:29,850 --> 00:35:32,640 Best you can do is cling to the rim. 986 00:35:32,650 --> 00:35:33,650 Am I right? 987 00:35:33,650 --> 00:35:35,780 Right as rain, kid. 988 00:35:35,780 --> 00:35:36,880 Right as rain. 989 00:35:37,890 --> 00:35:40,190 You got ice cream in this joint? 990 00:35:40,190 --> 00:35:43,530 I think we can make that happen. 991 00:35:45,460 --> 00:35:47,530 [ Sighs ] 992 00:35:50,330 --> 00:35:52,460 Dr. Rorish? 993 00:35:53,700 --> 00:35:54,790 It's my fault. 994 00:35:54,800 --> 00:35:56,800 Angus had a feeling 995 00:35:56,800 --> 00:35:59,330 that it was an aortic dissection. 996 00:36:02,640 --> 00:36:04,340 Why didn't you act on it? 997 00:36:04,350 --> 00:36:07,350 I-i wasn't sure. 998 00:36:07,350 --> 00:36:08,820 I-i guess. 999 00:36:08,820 --> 00:36:13,390 Both of you listen to me very closely. 1000 00:36:13,390 --> 00:36:16,430 There are certain things you never, ever want to see 1001 00:36:16,430 --> 00:36:18,470 on a ct scan. 1002 00:36:18,480 --> 00:36:20,530 An aortic dissection is one of them. 1003 00:36:20,530 --> 00:36:21,600 Why? 1004 00:36:21,600 --> 00:36:24,430 Because if you took the time to take a picture, 1005 00:36:24,430 --> 00:36:26,430 it means you didn't act fast enough. 1006 00:36:26,430 --> 00:36:29,630 Your instinct has to be sharper than your scalpel 1007 00:36:29,640 --> 00:36:32,580 and faster than any machine. 1008 00:36:35,310 --> 00:36:39,620 You ignore those instincts at your peril and theirs. 1009 00:36:43,480 --> 00:36:45,480 ♪♪ 1010 00:36:45,490 --> 00:36:47,560 [ monitor beeping ] 1011 00:36:48,590 --> 00:36:50,660 [ Telephone rings in distance ] 1012 00:36:57,630 --> 00:36:58,930 Did it work? 1013 00:36:58,930 --> 00:37:01,530 Yes. 1014 00:37:01,540 --> 00:37:03,505 Things got complicated, but... 1015 00:37:03,506 --> 00:37:05,500 [ Voice breaking ] But it worked. 1016 00:37:05,510 --> 00:37:07,810 It appears so. 1017 00:37:15,020 --> 00:37:18,520 I hope everything works out for you. 1018 00:37:22,260 --> 00:37:23,830 Thank you, doctor. 1019 00:37:23,830 --> 00:37:26,830 [ Door opens ] 1020 00:37:32,330 --> 00:37:34,030 She's gonna be okay. 1021 00:37:34,040 --> 00:37:35,610 [ Voice breaking ] I know. 1022 00:37:35,610 --> 00:37:37,560 Then why are you crying? 1023 00:37:37,570 --> 00:37:39,830 I'm not. 1024 00:37:42,280 --> 00:37:44,280 [ Sighs ] 1025 00:37:44,280 --> 00:37:46,580 You may be my boss and my teacher, 1026 00:37:46,580 --> 00:37:50,540 and I may be overstepping, 1027 00:37:50,550 --> 00:37:53,510 but you and I, we are in the same club. 1028 00:37:53,520 --> 00:37:55,720 [ Sighs ] 1029 00:37:55,720 --> 00:38:00,290 And this stuff matters to us. 1030 00:38:00,300 --> 00:38:01,730 It matters. 1031 00:38:06,630 --> 00:38:09,060 [ Siren wails in distance ] 1032 00:38:09,070 --> 00:38:11,940 ♪♪ 1033 00:38:15,010 --> 00:38:16,550 Leanne: You have a patient in real trouble. 1034 00:38:16,550 --> 00:38:18,540 Death's door. 1035 00:38:18,550 --> 00:38:20,550 You're so panicked that you can no longer tell the difference 1036 00:38:20,550 --> 00:38:23,520 between instinct and raw fear. 1037 00:38:23,520 --> 00:38:28,820 But a voice somewhere deep inside you whispers, 1038 00:38:28,820 --> 00:38:31,420 "i can still bring him back. 1039 00:38:31,430 --> 00:38:34,600 I've got one more move left." 1040 00:38:36,000 --> 00:38:39,530 Here's a secret. 1041 00:38:39,530 --> 00:38:41,830 If you hear that voice, 1042 00:38:41,840 --> 00:38:44,470 it means you're in the right place, 1043 00:38:44,470 --> 00:38:46,700 you're in the right job. 1044 00:38:48,510 --> 00:38:50,010 You're home. 1045 00:38:53,350 --> 00:38:56,720 24 hours ago, we had a patient just like that. 1046 00:38:56,720 --> 00:39:02,120 We opened up his heart right here in this room. 1047 00:39:02,120 --> 00:39:03,720 He'd like to meet you. 1048 00:39:11,530 --> 00:39:14,660 [ Applause ] 1049 00:39:17,510 --> 00:39:19,080 Jake: Thank you so much. 1050 00:39:30,150 --> 00:39:32,410 ♪♪ 1051 00:39:38,630 --> 00:39:40,800 Becca: Thank you. 1052 00:39:42,600 --> 00:39:44,670 Thank you.