1 00:00:01,123 --> 00:00:01,256 . 2 00:00:02,291 --> 00:00:03,125 - And easy on the CrossFit for a while, okay? 3 00:00:04,259 --> 00:00:05,527 - Okay. - Thank you. 4 00:00:05,560 --> 00:00:08,163 Just cleared Treatment 3. Just got to turn it over. 5 00:00:08,197 --> 00:00:10,765 - Sure. - Man, we're up again already? 6 00:00:10,799 --> 00:00:12,434 - Looks like it. - What's going on? 7 00:00:12,467 --> 00:00:14,236 Who are they? - Big brother. 8 00:00:14,269 --> 00:00:15,637 Hey. - Oh. 9 00:00:15,670 --> 00:00:17,839 - Up. - JCAHO. 10 00:00:17,872 --> 00:00:21,110 - Yeah, they're doing a surprise site survey. 11 00:00:21,143 --> 00:00:23,412 - Who's JCAHO? - The Joint Commission. 12 00:00:23,445 --> 00:00:24,746 They rate the performance standards 13 00:00:24,779 --> 00:00:26,248 of hospitals and certify them. 14 00:00:26,281 --> 00:00:28,383 - So far, JCAHO's reports have been positive. 15 00:00:28,417 --> 00:00:29,684 So let's keep it that way. 16 00:00:29,718 --> 00:00:34,189 Stick to protocols and with big smiles. 17 00:00:34,223 --> 00:00:35,390 Dr. Choi, we're gonna need 18 00:00:35,424 --> 00:00:37,892 some of your Navy-inspired discipline today. 19 00:00:37,926 --> 00:00:39,728 - Sorry, I'm with the paramedics today. 20 00:00:39,761 --> 00:00:41,263 Resident ride along. - Mm. 21 00:00:41,296 --> 00:00:44,133 - And discipline, that a nice way of saying I'm a tight ass? 22 00:00:44,166 --> 00:00:45,834 - Oh, yes. Tight. 23 00:00:45,867 --> 00:00:48,970 - I didn't say that. [laughs] 24 00:00:49,003 --> 00:00:51,005 - And, uh, getting those docs in line, 25 00:00:51,039 --> 00:00:53,208 isn't that the chief resident's job anyway? 26 00:00:53,242 --> 00:00:55,844 - Wonderful, the guy enforcing the rules 27 00:00:55,877 --> 00:00:57,312 is the one who's always breaking them. 28 00:00:57,346 --> 00:00:58,413 - Yeah. 29 00:00:58,447 --> 00:00:59,848 Good luck with that. - [chuckles] 30 00:00:59,881 --> 00:01:02,451 - Code One team to the ED. 31 00:01:02,484 --> 00:01:03,818 - What do we got? - Nathan Clay. 32 00:01:03,852 --> 00:01:06,020 58-year-old male. "Peeds" versus auto. 33 00:01:06,054 --> 00:01:07,689 GCS 12. Vitals stable. 34 00:01:07,722 --> 00:01:09,391 Gross deformity to the left upper arm. 35 00:01:09,424 --> 00:01:10,592 - Right in here. - Ow. 36 00:01:10,625 --> 00:01:11,860 - He's complaining of chest and back pains. 37 00:01:11,893 --> 00:01:13,728 - Mr. Clay, can you hear me? - [groaning] 38 00:01:13,762 --> 00:01:15,964 - Mr. Clay? On my count. 39 00:01:15,997 --> 00:01:17,499 One, two, three. 40 00:01:17,532 --> 00:01:18,533 - [grunts] 41 00:01:18,567 --> 00:01:20,569 - Central line and a CVC catheter. 42 00:01:20,602 --> 00:01:22,937 - Right away. - Airway's intact. 43 00:01:22,971 --> 00:01:25,174 Breath sounds clear bilaterally. - Ow! 44 00:01:25,174 --> 00:01:26,275 - Tenderness in the left chest 45 00:01:26,308 --> 00:01:27,642 and thoracic spine. What happened here? 46 00:01:27,676 --> 00:01:29,578 - He's walking with his wife on Michigan Avenue. 47 00:01:29,611 --> 00:01:32,046 Suddenly flips out, starts wailing on her. 48 00:01:32,080 --> 00:01:33,948 A couple of Samaritans jumped in to help out. 49 00:01:33,982 --> 00:01:36,318 He takes off right into traffic. 50 00:01:36,351 --> 00:01:38,687 Score one for, uh, karma. 51 00:01:38,720 --> 00:01:40,689 - 12-lead EKGs, chest x-rays, 52 00:01:40,722 --> 00:01:42,957 CT of the chest, abdomen, and pelvis, 53 00:01:42,991 --> 00:01:44,926 with recons of the TLS spine. 54 00:01:44,959 --> 00:01:46,195 - On it. - Leave me--no. 55 00:01:46,228 --> 00:01:47,296 Leave me alone. I'm fine. 56 00:01:47,329 --> 00:01:48,930 - Laura Clay. 55-year-old female. 57 00:01:48,963 --> 00:01:50,098 GCS 15. - I'm fine. 58 00:01:50,199 --> 00:01:51,433 I need to get to my husband. 59 00:01:51,466 --> 00:01:52,534 - Whoa, whoa, whoa. Ma'am, ma'am, ma'am. 60 00:01:52,567 --> 00:01:53,535 Okay. - Heart rate's tachycardic. 61 00:01:53,568 --> 00:01:55,204 - This is all my fault. 62 00:01:55,204 --> 00:01:58,707 Look, I blocked my fall with my hand, not my C spine. 63 00:01:58,740 --> 00:01:59,908 I'm neurologically intact. 64 00:01:59,941 --> 00:02:01,210 - Technical. Are you a doctor? 65 00:02:01,243 --> 00:02:04,379 - Yes, yes, I am. - Laura! Please-- 66 00:02:04,413 --> 00:02:05,947 - Dr. Rhodes! - Honey, I'm here. 67 00:02:05,980 --> 00:02:08,217 - Ma'am, stay right there. - I'm right here. 68 00:02:08,217 --> 00:02:10,219 - There are too many of them! [crying] 69 00:02:10,219 --> 00:02:11,453 - I'm here, my love! - Help me! 70 00:02:11,486 --> 00:02:14,756 - 2--I need restraints. 2 of Versed and 5 of Haldol. 71 00:02:14,789 --> 00:02:15,790 - There are too many of th-- - No, not Haldol! 72 00:02:15,824 --> 00:02:17,726 Quetiapine. He's not abusive. 73 00:02:17,759 --> 00:02:20,329 He has Lewy Body Dementia. 74 00:02:20,362 --> 00:02:23,298 - Wait, scratch the Haldol. 25 of quetiapine. 75 00:02:23,332 --> 00:02:24,666 - Laura! - It's all right, my love. 76 00:02:24,699 --> 00:02:26,435 - What the hell's Lewy Body? 77 00:02:26,468 --> 00:02:28,803 - Debilitating form of dementia. 78 00:02:42,284 --> 00:02:42,417 . 79 00:02:44,253 --> 00:02:44,786 - He took a pretty good whack. 80 00:02:46,087 --> 00:02:47,689 He's got a chest bruise, left first rib fracture, 81 00:02:47,722 --> 00:02:49,358 proximal humerus fracture. 82 00:02:49,391 --> 00:02:51,526 - How are his labs? - It's all good. 83 00:02:51,560 --> 00:02:53,262 Calcium was elevated. 84 00:02:53,295 --> 00:02:55,497 I suspect he'll develop a kidney stone down the road, 85 00:02:55,530 --> 00:02:57,999 but it's likely he's had a few before. 86 00:02:58,032 --> 00:02:59,268 - Prior heart surgery? 87 00:02:59,268 --> 00:03:01,470 - Says it was a quadruple bypass. 88 00:03:01,503 --> 00:03:03,472 Had it done at Northwestern five years ago. 89 00:03:03,505 --> 00:03:06,275 - He remembers the details? - Yeah, he's lucid. 90 00:03:06,308 --> 00:03:09,711 Somewhat. All right, EKG is normal, 91 00:03:09,744 --> 00:03:11,413 but because of the prior heart surgery, 92 00:03:11,446 --> 00:03:12,814 I'm gonna repeat it every few hours. 93 00:03:12,847 --> 00:03:14,916 He's all yours. 94 00:03:17,185 --> 00:03:18,887 - Mr. Clay? 95 00:03:18,920 --> 00:03:21,523 Mr. Clay, I'm Dr. Charles. How are you feeling? 96 00:03:21,556 --> 00:03:23,658 - My wife, Laura, where is she? 97 00:03:23,692 --> 00:03:27,462 - She's being treated right now, but will be in shortly. 98 00:03:27,496 --> 00:03:30,499 - I hurt her again, didn't I? [breathing heavily] 99 00:03:31,666 --> 00:03:37,005 This isn't the life she deserves. 100 00:03:38,573 --> 00:03:40,375 - Mr. Clay? 101 00:03:40,409 --> 00:03:43,312 Mr. Clay? 102 00:03:47,882 --> 00:03:51,019 - Damn, you got the online thing down, huh? 103 00:03:51,052 --> 00:03:53,455 - There was a time. - Yeah, what's her name? 104 00:03:53,488 --> 00:03:54,989 - Easy. She's taken. 105 00:03:55,023 --> 00:03:56,991 - Vicki. Doctor at the VA. 106 00:03:57,025 --> 00:03:58,159 - Oh, man. 107 00:03:58,192 --> 00:03:59,628 There are so many female paramedics 108 00:03:59,661 --> 00:04:01,830 who are gonna be sorry to hear you're off the market. 109 00:04:01,863 --> 00:04:03,064 Couple guys, too. 110 00:04:03,097 --> 00:04:04,366 - Well, you let 'em down easy for me. 111 00:04:04,399 --> 00:04:05,434 - All right. 112 00:04:05,467 --> 00:04:06,735 You sure you gonna be okay back here? 113 00:04:06,768 --> 00:04:08,136 'Cause we can just throw Desmond in the back. 114 00:04:08,169 --> 00:04:09,538 - Eh, I'm fine. 115 00:04:09,571 --> 00:04:11,573 Ambo's like the Humvee. You sit where there's room. 116 00:04:11,606 --> 00:04:13,575 Comfort's not a factor. - Well, good. 117 00:04:13,608 --> 00:04:15,109 This day's gonna go by quick then. 118 00:04:15,143 --> 00:04:17,979 - Ambo 61, 40-year-old male down in his home. 119 00:04:18,012 --> 00:04:19,548 222 Bromley Avenue. 120 00:04:19,581 --> 00:04:21,550 Some kind of lower extremity insult. 121 00:04:21,583 --> 00:04:23,418 He's in severe pain, possibly trapped. 122 00:04:23,452 --> 00:04:25,354 - Copy Main. Ambo 61 responding. 123 00:04:25,354 --> 00:04:27,356 All right, we're on! 124 00:04:30,058 --> 00:04:33,495 [siren wailing] 125 00:04:33,528 --> 00:04:34,729 - It doesn't make any sense. 126 00:04:34,763 --> 00:04:36,565 I've had Boomer since he was a puppy. 127 00:04:36,598 --> 00:04:38,467 He's super loyal. I leave the room for a second, 128 00:04:38,500 --> 00:04:39,834 he's looking for me. 129 00:04:39,868 --> 00:04:41,135 - I had a dog like that. 130 00:04:41,169 --> 00:04:43,505 - He might nip a little, but this was a full-on attack. 131 00:04:43,538 --> 00:04:46,107 - In my experience, dogs can be unpredictable. 132 00:04:46,140 --> 00:04:48,410 Even really friendly ones. 133 00:04:48,443 --> 00:04:49,911 - Sometimes if a dog's in pain, though, he-- 134 00:04:49,944 --> 00:04:51,380 - He wasn't. 135 00:04:51,413 --> 00:04:54,449 We were playing tug of war, like we always do. 136 00:04:54,483 --> 00:04:56,385 - Dog bites shouldn't be stitched. 137 00:04:56,385 --> 00:04:57,619 They need to stay open 138 00:04:57,652 --> 00:04:59,954 so the wound doesn't become infected. 139 00:04:59,988 --> 00:05:01,856 Also, I'm gonna give you a tetanus shot 140 00:05:01,890 --> 00:05:03,124 and an antibiotic. 141 00:05:03,157 --> 00:05:04,759 - Boomer's healthy. He's had all his shots. 142 00:05:04,793 --> 00:05:06,795 - It's just a precaution. 143 00:05:08,497 --> 00:05:09,564 - [inhales sharply] 144 00:05:17,205 --> 00:05:21,209 [indistinct radio chatter] 145 00:05:21,242 --> 00:05:22,711 - Paul's in trouble down there. 146 00:05:22,744 --> 00:05:25,246 - Did you call 911? - Yes, I'm his neighbor. 147 00:05:27,315 --> 00:05:29,283 - Paul? 148 00:05:29,317 --> 00:05:31,085 It's the paramedics. 149 00:05:33,855 --> 00:05:35,957 - Ooh. - Ooh, that's ripe. 150 00:05:37,526 --> 00:05:40,429 - Man, look at this. He's a hoarder. 151 00:05:45,800 --> 00:05:47,902 - [groans] 152 00:05:47,936 --> 00:05:49,438 - What do you think? 153 00:05:49,471 --> 00:05:50,672 - You good going in there? 154 00:05:50,705 --> 00:05:52,607 - I'm good. - Okay. 155 00:05:52,641 --> 00:05:54,142 Uh, get the truck company here. 156 00:05:54,175 --> 00:05:55,343 Tell 'em they're gonna have to help dig us out, 157 00:05:55,444 --> 00:05:56,745 and grab me a second radio. 158 00:05:56,778 --> 00:05:58,046 And, uh, I'm gonna try and go in through the back door. 159 00:05:58,079 --> 00:05:59,814 - You got it. 160 00:06:06,455 --> 00:06:08,490 - Paul! 161 00:06:08,523 --> 00:06:10,492 Everything okay? 162 00:06:11,560 --> 00:06:13,061 - [quietly] Okay. 163 00:06:15,530 --> 00:06:18,533 [grunting] 164 00:06:20,201 --> 00:06:21,870 - Third squad caught a high-rise fire. 165 00:06:21,903 --> 00:06:24,272 Dispatch is pulling a truck from up north to help us out. 166 00:06:24,305 --> 00:06:26,808 It'll be a while before they get here. 167 00:06:27,842 --> 00:06:29,010 [grunts] 168 00:06:29,043 --> 00:06:32,847 - In the beginning, I wanted to think it would pass. 169 00:06:32,881 --> 00:06:35,717 Any wife would, but I'm also a neurologist, 170 00:06:35,750 --> 00:06:38,920 and I couldn't ignore his symptoms. 171 00:06:38,953 --> 00:06:41,656 - Oh, so you diagnosed the Lewy Body Dementia? 172 00:06:41,690 --> 00:06:44,092 - Yes, but I got second and third opinions, 173 00:06:44,125 --> 00:06:46,194 and they both agreed it was LBD, 174 00:06:46,227 --> 00:06:47,996 and that was about four years ago. 175 00:06:48,029 --> 00:06:51,065 - Four years, really? 176 00:06:51,099 --> 00:06:53,401 You know, Nathan expressed deep regret to me 177 00:06:53,502 --> 00:06:54,936 about the pain that he's caused you. 178 00:06:54,969 --> 00:06:56,337 That kind of insight is rare 179 00:06:56,370 --> 00:06:59,508 for somebody who's been battling LBD for that long. 180 00:06:59,508 --> 00:07:02,410 - Well, my husband was an engineer, 181 00:07:02,511 --> 00:07:05,013 and his brain is wired to solve problems. 182 00:07:05,046 --> 00:07:06,681 Last year, I retired early. 183 00:07:06,715 --> 00:07:09,718 I wanted to devote more time to his cognitive therapy. 184 00:07:09,751 --> 00:07:11,620 - Hmm, well, it's been working. 185 00:07:11,653 --> 00:07:13,021 - There's moments when he's lucid. 186 00:07:13,054 --> 00:07:16,558 But more and more, it's this. 187 00:07:16,591 --> 00:07:18,226 - Mrs. Clay, 188 00:07:18,259 --> 00:07:21,830 Nathan's latest EKG is still normal. 189 00:07:21,863 --> 00:07:23,765 I want to do another one in a few hours, 190 00:07:23,798 --> 00:07:26,568 but if it is good too, I'll discharge him. 191 00:07:26,601 --> 00:07:28,737 - Thank you, doctor. - Mm-hmm. 192 00:07:32,440 --> 00:07:36,244 - I know that it would be better and safer for the both of us 193 00:07:36,277 --> 00:07:39,648 if Nathan went to a care facility, 194 00:07:39,681 --> 00:07:43,918 but if I do that, then it's over. 195 00:07:43,952 --> 00:07:46,087 And I'm not ready to give up our Sundays 196 00:07:46,120 --> 00:07:48,289 listening to opera. 197 00:07:48,322 --> 00:07:52,226 I know it's hard to imagine, but my Nathan is still in there. 198 00:07:52,260 --> 00:07:56,665 Last week he made me dinner, Florentine lasagna. 199 00:07:56,698 --> 00:07:58,166 - He can still cook? 200 00:07:58,199 --> 00:08:02,571 - Well, meals take longer to prepare than they used to, 201 00:08:02,604 --> 00:08:04,639 but... 202 00:08:04,673 --> 00:08:06,675 he does it for me. 203 00:08:09,410 --> 00:08:12,113 He's fighting just as hard as I am. 204 00:08:17,151 --> 00:08:19,387 Hi, honey. 205 00:08:21,455 --> 00:08:23,858 Everything's gonna be okay. 206 00:08:23,892 --> 00:08:26,127 Everything's okay. 207 00:08:27,929 --> 00:08:29,463 - How you doing, Ethan? 208 00:08:29,497 --> 00:08:32,500 - Fine, as long as I breathe through my mouth. 209 00:08:32,601 --> 00:08:34,368 - Is it as tight in there as I think it is? 210 00:08:34,402 --> 00:08:35,704 - It's worse. - [clears throat] 211 00:08:35,737 --> 00:08:37,672 - Are you claustrophobic? 212 00:08:37,706 --> 00:08:40,208 - Didn't used to be. 213 00:08:45,647 --> 00:08:47,481 - I mean, and Tate totally snores, 214 00:08:47,515 --> 00:08:49,618 but I don't mind. 215 00:08:49,618 --> 00:08:52,854 Oh, he does this thing where he shoots his dirty boxers 216 00:08:52,887 --> 00:08:57,158 into the hamper like a buzzer beater. 217 00:08:57,191 --> 00:08:58,426 Anyway, it's cute. 218 00:08:58,459 --> 00:09:01,029 - Oh, my God. 219 00:09:01,062 --> 00:09:03,231 You're in love. 220 00:09:03,264 --> 00:09:06,100 - Whoa, whoa, whoa, whoa. What's that? 221 00:09:06,134 --> 00:09:08,269 - What's what? 222 00:09:08,302 --> 00:09:11,339 - Used gloves go in the bio bin, not the trash. 223 00:09:11,372 --> 00:09:12,674 - Okay, those were actually clean though. 224 00:09:12,707 --> 00:09:14,342 - They were on the floor. - Probably just got stuck 225 00:09:14,375 --> 00:09:15,877 to the pair that came out before them. 226 00:09:15,910 --> 00:09:18,479 - Unless you're certain, it's bio. 227 00:09:18,512 --> 00:09:20,248 Come on, Maggie. You know the protocol. 228 00:09:20,281 --> 00:09:21,449 - I do. 229 00:09:21,482 --> 00:09:22,884 I've also been through this circus 230 00:09:22,917 --> 00:09:23,985 about a dozen times. 231 00:09:24,018 --> 00:09:26,320 JCAHO days are about patient care, 232 00:09:26,354 --> 00:09:28,723 not about a pair of latex gloves. 233 00:09:28,757 --> 00:09:32,160 - Look, I'm already in the doghouse with Goodwin. 234 00:09:32,193 --> 00:09:34,663 If there's any chance of getting out, I want it. 235 00:09:34,663 --> 00:09:39,100 So by the book--by the book. 236 00:09:39,133 --> 00:09:40,869 - By the book. 237 00:09:40,902 --> 00:09:42,904 [sighs] 238 00:09:45,106 --> 00:09:47,676 - Okay honey, eight across. 239 00:09:47,709 --> 00:09:48,810 It's five letters 240 00:09:48,843 --> 00:09:51,980 and the clue is rental agreement, 241 00:09:52,013 --> 00:09:54,683 and the first letter is L. 242 00:09:59,587 --> 00:10:02,623 I'm thinking the second is E. 243 00:10:02,657 --> 00:10:07,295 - L-E... 244 00:10:07,328 --> 00:10:08,930 Lease. 245 00:10:08,963 --> 00:10:11,866 - Good. Good, honey. 246 00:10:11,900 --> 00:10:13,234 All right, next one. 247 00:10:13,267 --> 00:10:15,870 We're gonna do 23 down. 248 00:10:15,904 --> 00:10:17,338 Six letters. 249 00:10:17,371 --> 00:10:18,873 The clue is collects... [rapid beeping] 250 00:10:18,907 --> 00:10:19,874 With an S. 251 00:10:19,908 --> 00:10:22,711 [beeping continues] 252 00:10:22,744 --> 00:10:24,112 - What happened? - I don't know. 253 00:10:24,145 --> 00:10:26,547 His blood pressure tanked. 254 00:10:26,580 --> 00:10:28,382 - All right, bag and hang a liter bolus. 255 00:10:28,416 --> 00:10:29,718 - Yes, doctor. - SATS are dropping. 256 00:10:29,751 --> 00:10:32,854 Intubate? - Yep. 257 00:10:32,887 --> 00:10:37,358 - Grab the bag and hook it up to the O2. 258 00:10:37,391 --> 00:10:39,293 - All right, 20 of etomidate. 100 of sux. 259 00:10:39,327 --> 00:10:40,461 Let's bring in the FAST scan. 260 00:10:40,494 --> 00:10:42,496 April, give me some pressure. - Here, doctor. 261 00:10:47,001 --> 00:10:49,871 - And I'm in. 262 00:10:49,904 --> 00:10:51,539 - Got it. - Okay. 263 00:10:51,572 --> 00:10:54,075 Scan. - Here you go. 264 00:10:57,178 --> 00:10:59,280 - Heart rate 110. 265 00:11:02,350 --> 00:11:05,353 - All right, belly's clean. 266 00:11:05,386 --> 00:11:08,156 Poor wall motion of the LV and a small effusion. 267 00:11:08,189 --> 00:11:10,124 - He's bleeding internally? 268 00:11:10,158 --> 00:11:12,861 - Dr. Charles. 269 00:11:12,894 --> 00:11:13,862 - Mrs. Clay, please, right over here. 270 00:11:13,895 --> 00:11:14,996 - SATS are back up. 271 00:11:15,029 --> 00:11:16,464 Oxygenation improving. 272 00:11:16,497 --> 00:11:18,466 - It's not gonna matter if he goes into cardiac arrest. 273 00:11:18,499 --> 00:11:20,201 CT of the heart and great vessels. 274 00:11:25,807 --> 00:11:25,940 . 275 00:11:28,209 --> 00:11:28,442 - Laura? 276 00:11:30,078 --> 00:11:31,913 If we may? 277 00:11:34,816 --> 00:11:36,484 The blunt trauma from the car accident 278 00:11:36,517 --> 00:11:39,253 displaced one of Nathan's bypass grafts. 279 00:11:39,287 --> 00:11:41,622 His aorta is leaking blood. 280 00:11:41,655 --> 00:11:43,925 - A pseudo-aneurysm. - Mm-hmm. 281 00:11:43,958 --> 00:11:45,559 - How bad? 282 00:11:45,593 --> 00:11:47,829 - Right now it's just a slow drip. 283 00:11:47,862 --> 00:11:49,230 It hasn't ruptured yet. 284 00:11:49,263 --> 00:11:51,299 - So there's still an opportunity 285 00:11:51,332 --> 00:11:52,867 to operate, repair the suture line, 286 00:11:52,901 --> 00:11:54,002 and plug the hole? 287 00:11:54,035 --> 00:11:55,336 - Normally, yes. 288 00:11:55,369 --> 00:11:58,139 - Your husband's prior heart bypass surgery 289 00:11:58,172 --> 00:12:01,976 significantly increases the difficulty of the operation. 290 00:12:02,010 --> 00:12:04,879 His odds of surviving the procedure plummet. 291 00:12:04,913 --> 00:12:08,316 - So if surgery isn't a viable option, what is? 292 00:12:13,087 --> 00:12:15,156 - Given the circumstances, 293 00:12:15,189 --> 00:12:17,591 we feel the safest choice 294 00:12:17,625 --> 00:12:20,294 is to make Nathan comfortable. 295 00:12:24,365 --> 00:12:25,967 - How long? 296 00:12:26,000 --> 00:12:28,069 - We can't be certain. 297 00:12:28,102 --> 00:12:30,538 A day, a week, 298 00:12:30,571 --> 00:12:32,340 maybe a few months 299 00:12:32,373 --> 00:12:34,442 until the aneurysm ruptures. 300 00:12:34,475 --> 00:12:36,477 - We're very sorry. 301 00:12:41,115 --> 00:12:42,951 - Help. I can't move. 302 00:12:42,984 --> 00:12:45,486 - I'm coming, Paul. 303 00:12:51,092 --> 00:12:53,627 - Don't touch that! 304 00:12:53,661 --> 00:12:55,997 - What was that? 305 00:13:01,002 --> 00:13:02,871 [exhales] 306 00:13:04,705 --> 00:13:06,040 Ah! 307 00:13:07,041 --> 00:13:09,010 [grunts] 308 00:13:09,043 --> 00:13:11,012 - Ethan, what happened? 309 00:13:11,045 --> 00:13:13,247 - Got bit by the lid of a tin can. 310 00:13:16,784 --> 00:13:18,419 - Truck company is almost here. 311 00:13:18,452 --> 00:13:21,489 They're going to clear a path to get the stretcher through. 312 00:13:23,757 --> 00:13:25,359 - Please, hurry! 313 00:13:25,393 --> 00:13:27,795 - Hold on, Paul! 314 00:13:27,896 --> 00:13:29,630 - Oh, thank God. 315 00:13:29,663 --> 00:13:32,300 I haven't been able to pee in over 16 hours. 316 00:13:32,333 --> 00:13:34,002 I thought I was gonna explode. 317 00:13:34,035 --> 00:13:35,904 - Brachytherapy for prostate cancer? 318 00:13:35,937 --> 00:13:37,138 - Two days ago. 319 00:13:37,171 --> 00:13:38,806 My urologist said it was the way to go. 320 00:13:38,907 --> 00:13:40,308 - Who's your urologist? 321 00:13:40,341 --> 00:13:42,210 I'll call and tell them you've experienced a blockage. 322 00:13:42,243 --> 00:13:44,278 - Dr. Mason, over at Advocate South. 323 00:13:44,312 --> 00:13:46,080 Uh, contact info's, uh, in my phone 324 00:13:46,114 --> 00:13:48,282 in my pants pocket. 325 00:13:50,151 --> 00:13:51,619 Oh, sorry. 326 00:13:51,652 --> 00:13:55,456 - Oh, whoa, whoa, whoa, whoa, whoa, whoa. 327 00:13:55,489 --> 00:13:56,790 - Everything okay? 328 00:13:56,824 --> 00:13:59,093 - Just a little spill. I got it. 329 00:13:59,127 --> 00:14:00,594 - Okay, hold on. 330 00:14:00,628 --> 00:14:02,830 I'll call environmental services and have them send a janitor. 331 00:14:02,931 --> 00:14:03,965 - It's just pee. 332 00:14:03,998 --> 00:14:05,199 I've cleaned it a thousand times. 333 00:14:05,233 --> 00:14:07,101 - Yeah, but not with JCAHO and Robocop Halstead 334 00:14:07,135 --> 00:14:08,269 on the prowl. 335 00:14:08,302 --> 00:14:10,504 By the book, remember? 336 00:14:10,538 --> 00:14:11,940 - Oh, man. 337 00:14:11,940 --> 00:14:14,808 I think the seed came out. It's radioactive, right? 338 00:14:14,842 --> 00:14:17,611 - Oh, it did. 339 00:14:17,645 --> 00:14:19,713 Okay, I'll call Urology instead. 340 00:14:26,020 --> 00:14:28,222 - Cath lab for a cardio angiogram? 341 00:14:28,256 --> 00:14:31,092 - Should give a better view of Nathan's pseudo-aneurysm 342 00:14:31,125 --> 00:14:33,794 and hopefully help me estimate a timeline for his wife. 343 00:14:33,827 --> 00:14:35,997 - You mind grabbing me an MRI of his head 344 00:14:36,030 --> 00:14:37,265 while you're up there? 345 00:14:37,298 --> 00:14:38,566 - Brain scan? 346 00:14:38,599 --> 00:14:39,733 His injuries don't necessitate it. 347 00:14:39,767 --> 00:14:42,203 - It's not for him. It's for me. 348 00:14:42,236 --> 00:14:43,837 - Uh, Dr. Charles. 349 00:14:43,871 --> 00:14:47,508 - Dr. Rhodes, his awareness and gross motor skills 350 00:14:47,541 --> 00:14:49,177 are just too strong 351 00:14:49,210 --> 00:14:52,680 for somebody who's been battling LBD as long as he has. 352 00:14:52,713 --> 00:14:55,984 No amount of cognitive therapy in the world is gonna outthink 353 00:14:55,984 --> 00:14:58,252 this disease to the degree that he appears to be. 354 00:14:58,286 --> 00:15:01,589 - Laura and two other neurologists 355 00:15:01,622 --> 00:15:03,824 have all agreed on the Lewy Body diagnosis. 356 00:15:03,857 --> 00:15:05,759 You think they're wrong? - I don't know what to think. 357 00:15:05,793 --> 00:15:08,062 That's why I need the scan. 358 00:15:08,096 --> 00:15:09,763 - I need the wife's consent. 359 00:15:09,797 --> 00:15:11,299 - Hasn't she been through enough? 360 00:15:11,332 --> 00:15:14,202 I'm just trying to spare her some false hope here. 361 00:15:14,235 --> 00:15:15,369 - Um. - Hello. 362 00:15:15,403 --> 00:15:17,238 - Gentlemen. - Doctors. 363 00:15:17,271 --> 00:15:19,007 - JCAHO day isn't exactly the time 364 00:15:19,007 --> 00:15:22,010 to be sneaking in unauthorized tests. 365 00:15:22,043 --> 00:15:23,644 - I don't know what to tell you. 366 00:15:23,677 --> 00:15:25,746 - Okay. - Thanks, pal. 367 00:15:25,779 --> 00:15:27,015 - Mm. 368 00:15:32,920 --> 00:15:36,157 [siren beeps] 369 00:15:36,190 --> 00:15:38,226 - What've we got? [indistinct chatter] 370 00:15:38,259 --> 00:15:40,728 - Hey, guys, start clearing out! 371 00:15:40,761 --> 00:15:42,896 [indistinct radio chatter] 372 00:15:42,930 --> 00:15:44,332 - Don't touch that. 373 00:15:44,365 --> 00:15:45,533 Get away. 374 00:15:45,566 --> 00:15:47,201 Get away. - There's a second person. 375 00:15:47,235 --> 00:15:49,137 I'm hearing another victim. 376 00:15:49,170 --> 00:15:51,639 - Ethan, the neighbors seem sure it's only Paul in there. 377 00:15:51,672 --> 00:15:54,108 - Don't touch that! 378 00:15:54,142 --> 00:15:57,278 - There's someone else here. 379 00:15:57,311 --> 00:15:58,779 - Dr. Perrington, 380 00:16:01,949 --> 00:16:04,085 got a hemoptysis patient. 381 00:16:04,118 --> 00:16:07,488 Chest x-ray says it's a COPD, but I think he needs a bronch. 382 00:16:07,521 --> 00:16:09,157 You want to take a quick look? 383 00:16:09,190 --> 00:16:10,424 - Really? 384 00:16:10,458 --> 00:16:13,861 The esteemed Dr. Halstead needs my help with a patient. 385 00:16:13,894 --> 00:16:16,497 I'm honored. 386 00:16:16,530 --> 00:16:19,200 - Look, I, uh--I'm sorry about what happened the other day. 387 00:16:19,233 --> 00:16:22,270 - You want a consult, page my resident. 388 00:16:28,342 --> 00:16:31,145 - Okay, no redness, no inflammation. 389 00:16:31,179 --> 00:16:32,246 Looks good. 390 00:16:32,280 --> 00:16:33,714 - So I can go? 391 00:16:33,747 --> 00:16:36,184 - The nurses are working on your discharge paperwork right now. 392 00:16:36,217 --> 00:16:38,852 Your wound should heal in about seven days or so. 393 00:16:38,886 --> 00:16:42,290 Until then, irrigate them and keep them covered. 394 00:16:43,657 --> 00:16:46,160 You all right? - Oh, just itchy 395 00:16:46,194 --> 00:16:47,695 and a little sweaty. 396 00:16:47,728 --> 00:16:50,398 - Mind if I take a look? 397 00:16:51,465 --> 00:16:52,733 No rash. 398 00:16:52,766 --> 00:16:56,104 Could be an allergic reaction to the antibiotics. 399 00:16:56,104 --> 00:16:59,140 You do feel warm though. - I'll get a temp. 400 00:16:59,173 --> 00:17:00,141 [phone vibrates and chimes] 401 00:17:00,174 --> 00:17:02,876 - Oh, my sister checking in. 402 00:17:02,910 --> 00:17:04,245 I left Boomer with her. 403 00:17:04,278 --> 00:17:06,714 She's not a dog person either. - [chuckles softly] 404 00:17:06,747 --> 00:17:08,482 - I get the impression they're not for you. 405 00:17:08,516 --> 00:17:09,950 - I've treated a lot of dog wounds, 406 00:17:09,983 --> 00:17:11,852 especially on kids. 407 00:17:11,885 --> 00:17:14,888 - It's 99.4. Was normal at intake. 408 00:17:15,956 --> 00:17:17,991 CBC and CMP? - Yeah. 409 00:17:18,025 --> 00:17:20,728 - I'm not out of here, am I? - Sorry. 410 00:17:20,761 --> 00:17:22,830 Itching and fever, even a low one, 411 00:17:22,863 --> 00:17:25,233 could be more than an allergic reaction. 412 00:17:25,266 --> 00:17:27,935 Someone will be with you shortly. 413 00:17:31,139 --> 00:17:33,441 - Paul, is there anyone else in the house? 414 00:17:33,474 --> 00:17:35,143 - No, no, it's just me. 415 00:17:35,143 --> 00:17:36,644 You've got to hurry! 416 00:17:36,677 --> 00:17:40,148 - Ah! Ah! 417 00:17:40,148 --> 00:17:42,683 - Ethan, what happened? 418 00:17:42,716 --> 00:17:44,818 Are you okay? 419 00:17:44,852 --> 00:17:46,920 - [grunting] 420 00:17:46,954 --> 00:17:47,921 [plane flying overhead] 421 00:17:47,955 --> 00:17:49,690 [explosion] 422 00:17:49,723 --> 00:17:51,825 [gunfire] 423 00:17:51,859 --> 00:17:54,495 [groaning] 424 00:17:54,528 --> 00:17:55,763 Ahh! 425 00:17:55,796 --> 00:17:57,498 [hyperventilating] 426 00:18:03,204 --> 00:18:03,337 . 427 00:18:08,008 --> 00:18:08,909 - What's all this? - Well, it's pretty clear 428 00:18:10,411 --> 00:18:11,779 an attending job at Med isn't gonna happen. 429 00:18:11,812 --> 00:18:13,181 - You don't know that. 430 00:18:13,181 --> 00:18:14,848 - Just being realistic. 431 00:18:14,882 --> 00:18:16,317 Perrington's on the hiring committee. 432 00:18:16,350 --> 00:18:17,585 She hates me. 433 00:18:17,618 --> 00:18:19,287 Not to mention Goodwin. 434 00:18:19,320 --> 00:18:21,489 - But really, Miami, Will? 435 00:18:21,522 --> 00:18:25,459 I've seen you sunburn walking from the ED to your car. 436 00:18:25,493 --> 00:18:28,496 - Hey, got to go where the jobs are. 437 00:18:31,064 --> 00:18:33,434 No coffee. JCAHO day. 438 00:18:33,467 --> 00:18:34,968 - Right. 439 00:18:44,044 --> 00:18:45,313 - I don't understand. 440 00:18:45,346 --> 00:18:47,915 There should be atrophy, heavy degeneration, 441 00:18:47,948 --> 00:18:49,517 tangled cells in the white matter. 442 00:18:49,550 --> 00:18:50,651 When was this taken? 443 00:18:50,684 --> 00:18:52,220 - About an hour ago. 444 00:18:52,253 --> 00:18:53,421 I'm sorry. I had a hunch. 445 00:18:53,454 --> 00:18:54,688 I rushed it. I really should have-- 446 00:18:54,722 --> 00:18:56,224 - That is a healthy brain. 447 00:18:56,257 --> 00:18:59,327 There's no disease. This means that-- 448 00:18:59,360 --> 00:19:01,495 - Nathan doesn't have Lewy Body Dementia. 449 00:19:01,529 --> 00:19:03,364 - He has the symptoms. 450 00:19:03,397 --> 00:19:05,933 Keeps getting worse. Practically a textbook case. 451 00:19:05,966 --> 00:19:07,335 How? 452 00:19:07,368 --> 00:19:10,504 - Take a look at this cross section we took during the MRI. 453 00:19:10,538 --> 00:19:12,840 Notice the adenoma, 454 00:19:12,873 --> 00:19:15,709 benign tumor, in the parathyroid gland. 455 00:19:15,743 --> 00:19:18,746 - So you think this is all hormonal irregularity? 456 00:19:18,779 --> 00:19:20,381 - Elevated parathyroid hormone 457 00:19:20,414 --> 00:19:22,350 is consistent with increased calcium 458 00:19:22,383 --> 00:19:24,385 and cognitive impairment. Nathan has both. 459 00:19:24,418 --> 00:19:26,254 - Yes, but he also has hallucinations, 460 00:19:26,287 --> 00:19:28,256 physical aggression. You don't see that 461 00:19:28,289 --> 00:19:30,524 in patients with hyperparathyroidism. 462 00:19:30,558 --> 00:19:33,627 - That's where his recent bypass surgery makes him unique, okay? 463 00:19:33,661 --> 00:19:36,129 The beta blocker he's been taking ever since 464 00:19:36,163 --> 00:19:39,433 causes increased levels of violent behavior 465 00:19:39,467 --> 00:19:41,569 in a select amount of patients. 466 00:19:41,602 --> 00:19:44,272 - Oh, my God. 467 00:19:46,674 --> 00:19:50,043 A hormonal imbalance 468 00:19:50,077 --> 00:19:52,313 with a medication side effect. 469 00:19:52,346 --> 00:19:54,682 [exhales] 470 00:19:54,715 --> 00:19:56,984 Why didn't I see that? 471 00:19:57,017 --> 00:19:59,287 The clues were right in front of me. 472 00:19:59,287 --> 00:20:02,556 - Because they mimic the symptoms 473 00:20:02,590 --> 00:20:05,192 of Lewy Body Dementia to a T, 474 00:20:05,225 --> 00:20:07,795 and four years ago that adenoma would have been so small 475 00:20:07,828 --> 00:20:09,630 no scan could have caught it. 476 00:20:09,663 --> 00:20:10,831 Look, I'm just telling you 477 00:20:10,864 --> 00:20:13,401 that presented with the same evidence, 478 00:20:13,434 --> 00:20:15,569 I would have done exactly the same thing, 479 00:20:15,603 --> 00:20:18,539 reached exactly the same diagnosis. 480 00:20:18,572 --> 00:20:19,673 Anybody would have. 481 00:20:19,707 --> 00:20:21,375 - You didn't. 482 00:20:21,409 --> 00:20:24,144 I did. 483 00:20:24,177 --> 00:20:27,648 And if I had caught the PTH four years ago, 484 00:20:27,681 --> 00:20:29,683 Nathan doesn't run into traffic, 485 00:20:29,717 --> 00:20:31,785 doesn't get hit by a car. 486 00:20:31,819 --> 00:20:35,756 Today never happens. 487 00:20:35,789 --> 00:20:37,057 He's dying 488 00:20:37,090 --> 00:20:40,428 and it's entirely my fault. 489 00:20:42,062 --> 00:20:44,231 - [hyperventilating] - Don't touch that! 490 00:20:44,264 --> 00:20:45,966 - Help. Please, please anybody! 491 00:20:45,999 --> 00:20:47,501 - [straining] 492 00:20:47,535 --> 00:20:49,437 - I need help! 493 00:20:49,470 --> 00:20:52,005 [screaming] 494 00:20:52,039 --> 00:20:53,541 - Ethan. 495 00:20:53,574 --> 00:20:55,909 Ethan, talk to me. 496 00:20:59,780 --> 00:21:01,349 Ethan, do you copy? 497 00:21:01,349 --> 00:21:02,350 - Let's go. 498 00:21:02,383 --> 00:21:04,184 - Living room's clear. 499 00:21:04,217 --> 00:21:07,187 [tense music] 500 00:21:07,220 --> 00:21:15,228 * 501 00:21:19,066 --> 00:21:21,068 - Thank God. - Paul? 502 00:21:21,101 --> 00:21:24,605 - Help me, please. - Paul, I'm Dr. Choi. 503 00:21:27,274 --> 00:21:28,709 Okay, your heart's racing. When's the last time 504 00:21:28,742 --> 00:21:32,813 you had any fluids? - [exhales] 505 00:21:32,846 --> 00:21:36,384 My leg, burned it. - Yeah. 506 00:21:36,417 --> 00:21:39,186 - I see that. - Don't touch that. 507 00:21:39,219 --> 00:21:40,888 [cawing] 508 00:21:43,056 --> 00:21:45,125 [cooing] 509 00:21:50,030 --> 00:21:52,232 - How did this happen? - I was cooking. 510 00:21:52,265 --> 00:21:56,036 I tripped and spilled a frying pan, grease. 511 00:21:56,069 --> 00:21:58,706 [grunts] - This didn't just happen. 512 00:21:58,739 --> 00:22:00,441 This burn is thick, leathery. 513 00:22:00,474 --> 00:22:02,209 24 hours old? - I guess. 514 00:22:02,242 --> 00:22:04,545 - Why didn't you seek help sooner? 515 00:22:04,578 --> 00:22:08,482 - I didn't want anybody to see how I live. 516 00:22:09,683 --> 00:22:12,720 - Okay, I'm here now. 517 00:22:12,753 --> 00:22:15,088 Gonna take care of you. 518 00:22:17,124 --> 00:22:19,627 - Brachytherapy seed. 519 00:22:19,660 --> 00:22:21,762 Yep, doesn't happen often, 520 00:22:21,795 --> 00:22:23,431 but it can get expelled in the urine. 521 00:22:23,431 --> 00:22:25,833 - So, um, how radioactive is it? 522 00:22:25,866 --> 00:22:27,100 - To us, harmless. 523 00:22:27,134 --> 00:22:29,437 Still, don't touch it with your bare hands. 524 00:22:29,437 --> 00:22:30,604 - Whoa. 525 00:22:30,638 --> 00:22:32,172 So you're not gonna dispose of it? 526 00:22:32,205 --> 00:22:33,507 - Not on JCAHO day. 527 00:22:33,541 --> 00:22:35,008 Sorry. 528 00:22:35,042 --> 00:22:37,845 Call the radiation safety officer. 529 00:22:37,878 --> 00:22:39,447 - Oh, man. 530 00:22:39,447 --> 00:22:40,814 Here we go. 531 00:22:40,848 --> 00:22:42,249 - I get it. 532 00:22:42,282 --> 00:22:44,151 You didn't do Nathan's bypass surgery. 533 00:22:44,184 --> 00:22:46,353 You don't know what you're walking into. 534 00:22:46,454 --> 00:22:50,090 I can get you every angio he had. 535 00:22:50,123 --> 00:22:53,794 You will know exactly where the surgeon placed every suture. 536 00:22:53,827 --> 00:22:55,162 - The bigger issues are the adhesions 537 00:22:55,195 --> 00:22:58,165 and scar tissue that have formed over the last five years. 538 00:22:58,198 --> 00:23:00,868 We can expose a healthy heart in 10 or 15 minutes. 539 00:23:00,901 --> 00:23:04,004 After a quadruple bypass surgery, 540 00:23:04,037 --> 00:23:05,606 it could take hours. 541 00:23:05,639 --> 00:23:07,975 An infinite number of complications can arise. 542 00:23:08,008 --> 00:23:11,779 - When I decided to make Nathan comfortable, 543 00:23:11,812 --> 00:23:15,483 I believed he had a neurological death sentence. 544 00:23:15,516 --> 00:23:17,585 Now it's a whole new world. 545 00:23:17,618 --> 00:23:19,587 The dementia can be reversed. 546 00:23:19,620 --> 00:23:22,556 - I understand, but the fact that he doesn't have LBD 547 00:23:22,590 --> 00:23:24,625 doesn't make the surgery any easier. 548 00:23:24,658 --> 00:23:26,794 Nathan's odds of dying in that operating room 549 00:23:26,827 --> 00:23:29,062 are just as high as they ever were. 550 00:23:29,096 --> 00:23:32,633 It's still my recommendation to not operate. 551 00:23:32,666 --> 00:23:34,668 I'm sorry. 552 00:23:37,571 --> 00:23:39,573 - I'll do the surgery. 553 00:23:42,175 --> 00:23:44,344 - Thank you. 554 00:23:45,546 --> 00:23:48,882 Thank you for giving us a second chance. 555 00:23:53,554 --> 00:23:56,389 - Difficult is not impossible. 556 00:23:58,325 --> 00:23:59,993 - Hmm. 557 00:24:05,866 --> 00:24:08,969 - Brett, how close are you? - Ugh, Ethan, finally. 558 00:24:09,002 --> 00:24:11,204 You okay? - I'm fine, but Paul's got 559 00:24:11,238 --> 00:24:13,040 a serious third degree burn that needs to be released 560 00:24:13,073 --> 00:24:14,407 in the ED. ETA? 561 00:24:14,441 --> 00:24:15,876 - I think we're almost to the kitchen. 562 00:24:15,909 --> 00:24:17,244 We need more room for the gear. 563 00:24:17,277 --> 00:24:19,813 - Don't touch that! Get away, get away. 564 00:24:19,847 --> 00:24:21,181 - Who was that? 565 00:24:21,214 --> 00:24:24,718 - The other person I heard, a parrot. 566 00:24:24,752 --> 00:24:26,153 Look, you still have the hallway to deal with 567 00:24:26,186 --> 00:24:27,588 and Paul's foot's still swelling. 568 00:24:27,621 --> 00:24:29,056 No pulse in the instep or ankle. 569 00:24:29,089 --> 00:24:31,559 - All right, uh, we're coming as fast as we can. 570 00:24:31,592 --> 00:24:35,362 - [exhales] But not fast enough? 571 00:24:35,395 --> 00:24:38,331 - Okay, Paul, here's the deal. 572 00:24:38,365 --> 00:24:40,200 Your skin's so burned, blood can't get in 573 00:24:40,233 --> 00:24:42,736 or out of your foot. I'm gonna cut into your leg 574 00:24:42,770 --> 00:24:44,437 on both sides of the burn to release the pressure. 575 00:24:44,471 --> 00:24:45,773 - Here? 576 00:24:45,806 --> 00:24:47,608 - I wait any longer, you're gonna lose your foot. 577 00:24:47,641 --> 00:24:50,043 - But--is it gonna hurt? 578 00:24:50,077 --> 00:24:51,579 - Already pushed morphine in your IV. 579 00:24:51,579 --> 00:24:52,813 That'll help. 580 00:24:52,846 --> 00:24:54,715 - But I'll feel it? 581 00:24:54,748 --> 00:24:57,317 - Focus on me, not my hands. 582 00:24:57,350 --> 00:24:59,352 It'll be over before you know it. 583 00:24:59,386 --> 00:25:00,453 Okay? 584 00:25:00,487 --> 00:25:03,290 Deep breath. [inhales] 585 00:25:03,323 --> 00:25:04,457 Then exhale. [exhales] 586 00:25:04,491 --> 00:25:06,393 - [exhales] [groaning] 587 00:25:06,426 --> 00:25:08,028 Keep breathing, Paul. Keep breathing. 588 00:25:08,061 --> 00:25:10,230 Big breath. [inhales] 589 00:25:10,263 --> 00:25:14,034 Bigger exhale. [exhales] 590 00:25:14,067 --> 00:25:16,269 Done. 591 00:25:16,303 --> 00:25:18,005 Good job, Paul. 592 00:25:18,038 --> 00:25:21,174 - [breathing heavy] 593 00:25:25,646 --> 00:25:25,779 . 594 00:25:27,615 --> 00:25:28,481 - A high white cell count, what does that mean? 595 00:25:29,617 --> 00:25:31,451 - You probably have an infection. 596 00:25:31,484 --> 00:25:33,420 - From Boomer? - It's possible. 597 00:25:33,453 --> 00:25:35,188 Have you felt sick recently? 598 00:25:35,222 --> 00:25:36,890 - No, not really. 599 00:25:36,924 --> 00:25:39,793 I mean, every now and then my throat aches a little. 600 00:25:39,827 --> 00:25:40,928 It doesn't really bother me though. 601 00:25:40,961 --> 00:25:42,295 - Hmm. 602 00:25:43,631 --> 00:25:46,834 - Hmm, the lymph nodes are swollen, 603 00:25:46,867 --> 00:25:49,102 consistent with an upper respiratory infection. 604 00:25:49,136 --> 00:25:51,805 - Let's get a rapid strep test. 605 00:25:53,641 --> 00:25:55,342 - What kind of dog is Boomer? 606 00:25:55,375 --> 00:25:57,277 - Boxer bulldog mix. 607 00:25:57,310 --> 00:25:58,712 A rescue. 608 00:25:58,746 --> 00:26:01,381 When I went to the shelter, all the dogs swarmed me, 609 00:26:01,414 --> 00:26:03,283 but Boomer hung back. 610 00:26:03,316 --> 00:26:04,652 Not because he was shy. 611 00:26:04,685 --> 00:26:06,319 It was a move so he'd stand out. 612 00:26:06,353 --> 00:26:08,088 He was playing me. 613 00:26:08,121 --> 00:26:10,323 - Smart dog. 614 00:26:10,357 --> 00:26:13,026 I'm gonna swab the back of your throat. 615 00:26:15,028 --> 00:26:17,865 I'll get this to the lab. 616 00:26:31,745 --> 00:26:35,148 - I'm doing what I think is right. 617 00:26:35,182 --> 00:26:38,251 Nathan's mental impairment is due to a pea-sized tumor 618 00:26:38,285 --> 00:26:39,352 that is easily removable. 619 00:26:39,386 --> 00:26:42,155 A 45-minute operation will cure him. 620 00:26:42,189 --> 00:26:45,125 - But first, he has to survive 621 00:26:45,158 --> 00:26:48,495 this monumentally difficult surgery. 622 00:26:56,503 --> 00:26:58,906 - I'm sorry, you can't bring your dog into the hospital. 623 00:26:58,939 --> 00:27:00,240 - It's my sister's dog. 624 00:27:00,273 --> 00:27:01,942 She's somewhere in the back not answering her texts. 625 00:27:01,975 --> 00:27:03,376 - Only service dogs in the ED. 626 00:27:03,410 --> 00:27:04,778 I'm sorry. - [sighs] 627 00:27:04,812 --> 00:27:07,815 - Oh, is this Boomer? - How'd you know? 628 00:27:07,848 --> 00:27:08,916 - I've been taking care of Tara. 629 00:27:08,949 --> 00:27:10,517 She said he was a boxer bulldog mix. 630 00:27:10,550 --> 00:27:12,552 - I thought it was only gonna be one or two hours. 631 00:27:12,585 --> 00:27:14,287 It's been five. Is she okay? 632 00:27:14,321 --> 00:27:15,889 - She spiked a low fever. 633 00:27:15,923 --> 00:27:17,590 We're testing for strep. - Strep? 634 00:27:17,624 --> 00:27:18,726 That's nothing. Okay, good. 635 00:27:18,759 --> 00:27:20,160 Look, I have to go to work. 636 00:27:20,193 --> 00:27:21,594 There's no pets allowed in my building. 637 00:27:21,628 --> 00:27:24,231 He barks one time and I can get evicted. 638 00:27:24,264 --> 00:27:25,733 I'm sorry, there's nowhere else to take him. 639 00:27:25,733 --> 00:27:27,534 - Um, no, no, no. I can't take this-- 640 00:27:35,308 --> 00:27:36,810 I know. 641 00:27:36,844 --> 00:27:40,247 It all happened really fast. 642 00:27:40,280 --> 00:27:43,016 What do I do? 643 00:27:43,050 --> 00:27:44,417 - Get him out of here. Now. 644 00:27:44,451 --> 00:27:46,419 - But where do I take-- - Reese, I don't care where. 645 00:27:46,453 --> 00:27:48,321 Just out. 646 00:27:48,355 --> 00:27:50,357 - [groans] 647 00:27:50,390 --> 00:27:52,826 - Hey, look at this guy. 648 00:27:52,860 --> 00:27:55,062 - Yeah, Earl, this is Boomer. 649 00:27:55,095 --> 00:27:56,663 Could you watch him for a minute? 650 00:27:56,764 --> 00:27:57,965 But don't get too close because-- 651 00:27:57,998 --> 00:27:59,299 - Oh, come on, fella. 652 00:27:59,332 --> 00:28:02,102 Come on, guy. Let's go. 653 00:28:02,135 --> 00:28:04,237 Come on, big boy. 654 00:28:04,271 --> 00:28:06,206 Hey. - Okay. 655 00:28:06,239 --> 00:28:08,008 Okay. 656 00:28:10,643 --> 00:28:12,479 - When I'm out, 657 00:28:12,512 --> 00:28:15,482 the city will condemn my home, 658 00:28:15,515 --> 00:28:17,017 won't they? 659 00:28:17,050 --> 00:28:19,787 - Fresh start, I guess. 660 00:28:23,891 --> 00:28:25,325 - Get away. Don't touch that. 661 00:28:25,358 --> 00:28:26,426 - Don't touch that. 662 00:28:26,459 --> 00:28:28,796 - There they are. Ethan. 663 00:28:28,796 --> 00:28:32,665 - Hey, guys. 664 00:28:32,699 --> 00:28:34,201 - Hey, you okay? 665 00:28:34,234 --> 00:28:35,602 For a second there, it sounded like-- 666 00:28:35,635 --> 00:28:38,138 - Little hairy for a while, that's all. 667 00:28:38,171 --> 00:28:40,373 - Escharotomy in the field. 668 00:28:40,407 --> 00:28:42,810 Damn, nice job. 669 00:29:13,140 --> 00:29:16,209 - One across. Six letters. 670 00:29:16,243 --> 00:29:19,412 Bread, milk, eggs. 671 00:29:21,882 --> 00:29:25,452 Thoughts? 672 00:29:25,485 --> 00:29:27,754 - Staple. 673 00:29:27,855 --> 00:29:29,456 - Nice. 674 00:29:34,561 --> 00:29:36,864 - Thank you. 675 00:29:36,864 --> 00:29:38,665 - Sure. 676 00:29:41,601 --> 00:29:43,570 - All right, guys. 677 00:29:43,603 --> 00:29:45,605 [indistinct radio chatter] 678 00:29:47,240 --> 00:29:50,410 - Got it, clear. - Lift him up. 679 00:29:59,887 --> 00:30:01,889 - Don't touch that. 680 00:30:08,261 --> 00:30:09,429 [bird squawks] 681 00:30:37,190 --> 00:30:38,591 - Dr. Manning, 682 00:30:38,625 --> 00:30:42,595 uh, Tara's rapid strep came back negative. 683 00:30:42,629 --> 00:30:44,932 - Okay, so we're back at square one. 684 00:30:44,965 --> 00:30:45,933 You know what, let's run a, uh-- 685 00:30:45,966 --> 00:30:47,734 [dog barking] 686 00:30:47,767 --> 00:30:49,869 [snarling] - Easy! Easy. 687 00:30:49,903 --> 00:30:51,171 [growling] 688 00:30:51,204 --> 00:30:53,706 - I'm sorry. I am so sorry. 689 00:30:53,740 --> 00:30:56,276 - Hey, Earl, what's going on? - I don't know what happened. 690 00:30:56,309 --> 00:30:57,710 Twenty people petted this dog, 691 00:30:57,744 --> 00:31:00,347 and this patient is the only one he barked at. 692 00:31:00,380 --> 00:31:01,982 Come on, boy. Come on. 693 00:31:02,015 --> 00:31:04,351 Come on, Boomer. Come on, come on, Boomer. 694 00:31:06,253 --> 00:31:09,957 - Let's run an infused CT chest and abdomen on Tara. 695 00:31:11,591 --> 00:31:13,093 - Oh, I've heard stories. 696 00:31:13,126 --> 00:31:15,128 - Mm-hmm. - Yeah. 697 00:31:23,003 --> 00:31:24,837 - Easy. 698 00:31:24,871 --> 00:31:27,507 Snakes in the grass. 699 00:31:27,540 --> 00:31:32,312 Bypass grafts are buried in the scar tissue, 700 00:31:32,345 --> 00:31:34,114 tough to see. 701 00:31:34,147 --> 00:31:36,616 Soften your grip... 702 00:31:36,649 --> 00:31:38,986 an--and go slow. 703 00:31:44,691 --> 00:31:47,094 - I see it. - Mm-hmm. 704 00:31:47,127 --> 00:31:50,397 - Proximal pseudo-aneurysm of the LAD bypass graft. 705 00:31:50,430 --> 00:31:51,664 - Let's cannulate and get him on the pump 706 00:31:51,698 --> 00:31:52,799 so we can do the repair. 707 00:31:52,832 --> 00:31:55,568 - No, I don't need the pump. 708 00:31:55,602 --> 00:31:57,137 It just needs a single repair stitch. 709 00:31:57,170 --> 00:32:00,007 I can do it on the beating heart. 710 00:32:00,007 --> 00:32:02,009 8-0 suture. - Suture. 711 00:32:02,042 --> 00:32:03,610 [monitor beeping] 712 00:32:03,643 --> 00:32:06,013 - EKG's ischemic. STs elevation. 713 00:32:06,013 --> 00:32:07,414 - Pseudo-aneurysm's ruptured. 714 00:32:07,447 --> 00:32:09,249 He's bleeding. 8-0 suture to me. 715 00:32:09,282 --> 00:32:11,584 - I've got the better angle. - Dr. Rhodes. 716 00:32:11,618 --> 00:32:14,187 - I pushed for the surgery. I can't lose him. 717 00:32:21,228 --> 00:32:23,730 - I'll get you better exposure. 718 00:32:32,039 --> 00:32:32,139 . 719 00:32:33,940 --> 00:32:34,707 - Going to put a second stitch in now. 720 00:32:35,942 --> 00:32:37,944 - Don't back-wall the graft. 721 00:32:40,580 --> 00:32:43,783 - Bleeding has stopped and EKG's improving. 722 00:32:43,816 --> 00:32:45,118 Pressure's good. 723 00:32:45,152 --> 00:32:46,486 We're out of the woods. 724 00:32:46,519 --> 00:32:48,055 - Not yet. 725 00:32:48,088 --> 00:32:50,757 I want to check his other bypass grafts. 726 00:32:50,790 --> 00:32:52,625 Something goes wrong in the future, 727 00:32:52,659 --> 00:32:56,096 no surgeon's gonna open his chest a third time. 728 00:33:02,069 --> 00:33:05,672 - Lymphoma. 729 00:33:05,705 --> 00:33:08,641 I have cancer? 730 00:33:08,675 --> 00:33:12,679 - The next step is a biopsy to determine exactly which kind. 731 00:33:12,712 --> 00:33:14,247 - But I'm only 26. 732 00:33:14,281 --> 00:33:15,848 I go to the gym every day. 733 00:33:15,882 --> 00:33:16,983 I don't smoke. 734 00:33:17,084 --> 00:33:18,085 - I know. 735 00:33:18,085 --> 00:33:19,119 It's not fair. 736 00:33:19,152 --> 00:33:20,587 - But I don't feel sick. 737 00:33:20,620 --> 00:33:23,156 - Well, that's because it was caught early. 738 00:33:23,190 --> 00:33:25,425 - You have time to get way ahead of this. 739 00:33:25,458 --> 00:33:26,626 - Mm-hmm. 740 00:33:26,659 --> 00:33:30,630 - The lymph nodes are around here, aren't they? 741 00:33:30,663 --> 00:33:32,999 Boomer's been nipping at me for a month. 742 00:33:33,100 --> 00:33:36,203 Always right there. 743 00:33:36,236 --> 00:33:38,571 Do you think he knew? 744 00:33:38,605 --> 00:33:40,340 - Maybe. 745 00:33:40,373 --> 00:33:44,544 It seems some dogs can smell cancers, 746 00:33:44,577 --> 00:33:46,613 even in the very early stages. 747 00:33:46,646 --> 00:33:49,249 - Yeah, he wasn't attacking you. - [sighs] 748 00:33:49,282 --> 00:33:51,951 - He was trying to protect you. 749 00:33:55,688 --> 00:33:58,691 - [laughs softly] 750 00:34:02,895 --> 00:34:04,431 - Maggie, what's going on with Treatment 4? 751 00:34:04,464 --> 00:34:05,598 We don't have the space for this-- 752 00:34:05,632 --> 00:34:07,400 - I know, I know. It's been all day. 753 00:34:07,434 --> 00:34:10,036 Dr. Halstead, environmental services hasn't shown up yet. 754 00:34:10,137 --> 00:34:13,039 I can't even get an estimate as to when they will. 755 00:34:13,140 --> 00:34:14,974 - [sighs] I'll go see them in person. 756 00:34:15,007 --> 00:34:16,843 I'll drag someone down here if I have to. 757 00:34:16,876 --> 00:34:18,010 - Knock some heads. 758 00:34:18,044 --> 00:34:20,380 I need that room back. 759 00:34:30,957 --> 00:34:33,760 - How's he doing? 760 00:34:33,793 --> 00:34:35,328 - Well. 761 00:34:35,362 --> 00:34:38,331 - Good. 762 00:34:38,365 --> 00:34:40,767 How are you doing? 763 00:34:40,800 --> 00:34:43,170 - As a neurologist, 764 00:34:43,170 --> 00:34:45,905 Lewy Body Dementia was my worst nightmare. 765 00:34:45,938 --> 00:34:49,176 I'd seen so many cases, 766 00:34:49,176 --> 00:34:51,278 and I'm wondering 767 00:34:51,311 --> 00:34:53,846 if it influenced my diagnosis. 768 00:34:53,880 --> 00:34:56,082 - Hmm. 769 00:34:56,183 --> 00:35:00,753 Medicine, you know. 770 00:35:00,787 --> 00:35:02,755 Imperfect science. 771 00:35:02,789 --> 00:35:04,724 Practiced by human beings, no less. 772 00:35:04,757 --> 00:35:07,194 - [sniffles] 773 00:35:07,227 --> 00:35:11,564 Four years we could have been doing CTs, 774 00:35:11,598 --> 00:35:14,501 but I had an answer, so there was no reason 775 00:35:14,534 --> 00:35:18,271 to continue radiating his brain. 776 00:35:18,305 --> 00:35:21,007 I robbed Nathan 777 00:35:21,040 --> 00:35:23,643 of his mind. 778 00:35:23,676 --> 00:35:26,213 I imprisoned him. 779 00:35:28,448 --> 00:35:30,217 I drained our savings. 780 00:35:30,217 --> 00:35:31,918 Squandered our time together, 781 00:35:31,951 --> 00:35:35,455 time that we can never get back. 782 00:35:37,224 --> 00:35:40,427 How am I gonna tell him what I've done? 783 00:35:40,460 --> 00:35:42,529 He's never gonna forgive me. 784 00:35:48,701 --> 00:35:52,071 - Your husband's gonna forgive you, Laura. 785 00:35:52,104 --> 00:35:55,408 I want you to trust me on that. 786 00:35:55,442 --> 00:35:57,410 Your struggle, 787 00:35:57,444 --> 00:35:59,312 if I may, 788 00:35:59,346 --> 00:36:01,814 is figuring out 789 00:36:01,848 --> 00:36:04,917 how you're gonna forgive yourself. 790 00:36:12,592 --> 00:36:13,693 - Vitals are stable. 791 00:36:13,726 --> 00:36:16,396 EKG looks good. 792 00:36:21,268 --> 00:36:23,603 - Cleveland Clinic has an axiom. 793 00:36:23,636 --> 00:36:26,273 Emergency surgery on a healthy heart? 794 00:36:26,273 --> 00:36:27,674 Yes. 795 00:36:27,707 --> 00:36:30,443 Redo surgery for a repaired heart? 796 00:36:30,477 --> 00:36:32,078 Yes. 797 00:36:32,111 --> 00:36:35,982 Emergency surgery for a repaired heart? 798 00:36:36,015 --> 00:36:38,418 No, 799 00:36:38,451 --> 00:36:41,421 because overwhelmingly, 800 00:36:41,454 --> 00:36:45,425 those patients die on the table. 801 00:36:45,458 --> 00:36:48,628 - I couldn't do nothing. 802 00:36:48,661 --> 00:36:51,664 - I suspect it was ego more than altruism. 803 00:36:53,366 --> 00:36:55,702 Great surgeons 804 00:36:55,735 --> 00:36:58,605 know the balance. 805 00:36:58,638 --> 00:37:00,640 You're confident, 806 00:37:00,673 --> 00:37:03,510 not arrogant. 807 00:37:03,543 --> 00:37:07,480 I like that, Dr. Rhodes. 808 00:37:07,514 --> 00:37:11,083 Nice job today. 809 00:37:19,125 --> 00:37:22,329 - You're good. You're good. 810 00:37:22,329 --> 00:37:23,863 Good boy. 811 00:37:23,896 --> 00:37:25,398 Good boy. 812 00:37:30,837 --> 00:37:32,772 Don't come from above. 813 00:37:32,805 --> 00:37:34,741 Come from the front so he can see you, 814 00:37:34,774 --> 00:37:36,509 and hold out the back of your hand first. 815 00:37:36,543 --> 00:37:38,511 - Okay. - Come on, buddy. 816 00:37:38,545 --> 00:37:41,113 - Yeah? - Yeah. 817 00:37:41,147 --> 00:37:44,884 Hey, there. - [laughs] 818 00:37:44,917 --> 00:37:48,521 - Did you ever hear that origin story about dogs? 819 00:37:48,555 --> 00:37:51,223 In Eden, humans and animals got along, 820 00:37:51,257 --> 00:37:52,959 even spoke the same language, 821 00:37:52,992 --> 00:37:56,162 but when Adam and Eve sinned and God drove them out, 822 00:37:56,195 --> 00:37:59,866 a great chasm opened up between people and animals. 823 00:37:59,899 --> 00:38:03,403 And as the chasm grew wider, at the very last moment, 824 00:38:03,436 --> 00:38:07,574 a dog leaped across it to be with us. 825 00:38:07,607 --> 00:38:09,442 [car trunk opening] 826 00:38:09,476 --> 00:38:11,478 - That's a great story. 827 00:38:13,513 --> 00:38:15,515 - Yeah. 828 00:38:19,552 --> 00:38:22,254 [knocks on door] - Come in. 829 00:38:22,288 --> 00:38:24,023 - Ms. Goodwin, can I talk to you for a moment? 830 00:38:24,056 --> 00:38:26,258 - Quickly, I'm on the homestretch with JCAHO, 831 00:38:26,292 --> 00:38:28,395 and I don't want to let up now. 832 00:38:28,395 --> 00:38:29,962 - I know my voice isn't official, 833 00:38:29,996 --> 00:38:31,197 but I'd like to put in a good word 834 00:38:31,230 --> 00:38:34,033 for Will regarding the open ED attending position. 835 00:38:34,066 --> 00:38:35,034 - Really? 836 00:38:35,067 --> 00:38:36,235 - It'd be a shame to lose him. 837 00:38:36,268 --> 00:38:37,404 He's a great doctor. 838 00:38:37,437 --> 00:38:38,905 He cares about this hospital. 839 00:38:38,938 --> 00:38:42,174 - Just a few weeks ago you asked to be taken off his shifts. 840 00:38:42,208 --> 00:38:43,976 - We don't always see eye to eye, 841 00:38:44,010 --> 00:38:47,414 but his heart is in the right place. 842 00:38:47,447 --> 00:38:48,915 - Well, Dr. Manning, 843 00:38:48,948 --> 00:38:53,420 I'm glad your opinion of Dr. Halstead has changed. 844 00:38:55,588 --> 00:38:57,590 - Okay. 845 00:38:59,926 --> 00:39:02,995 - [sighs] 846 00:39:03,029 --> 00:39:05,465 - Dr. Halstead, environmental services 847 00:39:05,498 --> 00:39:07,199 are on their way? 848 00:39:07,233 --> 00:39:08,668 - Nope. 849 00:39:08,701 --> 00:39:11,303 Turns out, every department in the hospital's calling ES 850 00:39:11,337 --> 00:39:13,840 to handle things they normally take care of themselves. 851 00:39:13,873 --> 00:39:16,008 Be tomorrow before a janitor shows up. 852 00:39:16,042 --> 00:39:18,545 - Ah, bureaucracy. - [chuckles] 853 00:39:21,514 --> 00:39:23,583 - Whew. 854 00:39:23,616 --> 00:39:24,784 Mm. 855 00:39:31,157 --> 00:39:32,492 [exhales] 856 00:39:32,525 --> 00:39:34,461 There. The room is yours again. 857 00:39:34,461 --> 00:39:37,129 - Against protocol? 858 00:39:37,163 --> 00:39:38,565 - I won't tell if you won't. 859 00:39:38,598 --> 00:39:41,734 - Huh, guess that means I get to clean this up now 860 00:39:41,768 --> 00:39:44,136 the way I wanted to eight hours ago. 861 00:39:44,170 --> 00:39:45,472 - [laughs] 862 00:39:45,505 --> 00:39:47,507 - You know, toss me a pair. - Oh? 863 00:39:47,540 --> 00:39:49,275 - You know, the kind that, uh, stick to yours 864 00:39:49,308 --> 00:39:52,679 when you pull 'em out. 865 00:39:52,712 --> 00:39:54,847 - You want in? - Heck yeah. 866 00:39:54,881 --> 00:39:56,949 We've come this far. 867 00:39:56,983 --> 00:39:59,351 And they call you Robocop. 868 00:39:59,385 --> 00:40:02,221 - [clears throat] - Robocop? 869 00:40:06,058 --> 00:40:09,061 [indistinct chatter] 870 00:40:11,030 --> 00:40:12,465 - Katrina. 871 00:40:12,499 --> 00:40:15,334 Reese, come with me. 872 00:40:15,367 --> 00:40:16,603 - Uh-oh. 873 00:40:16,636 --> 00:40:19,472 - Yeah, I've seen that look. 874 00:40:19,506 --> 00:40:21,774 - Dr. Rhodes. 875 00:40:21,808 --> 00:40:24,443 Everyone. 876 00:40:24,477 --> 00:40:28,314 Look, we all know how important JCAHO site visits are. 877 00:40:28,347 --> 00:40:31,951 Yet, despite what I said about the rules, 878 00:40:31,984 --> 00:40:35,287 my team ordered tests on the sly, 879 00:40:35,321 --> 00:40:37,657 brought a dog into the ED, 880 00:40:37,690 --> 00:40:41,528 and handled radioactive material. 881 00:40:44,096 --> 00:40:47,366 - Sharon, you have every right to be upset. 882 00:40:47,399 --> 00:40:49,902 Really. But we can't really be ignoring 883 00:40:49,936 --> 00:40:52,404 the, uh, the second law of thermodynamics here. 884 00:40:52,438 --> 00:40:53,740 Now, can we? 885 00:40:53,773 --> 00:40:55,041 - How's that? 886 00:40:55,074 --> 00:40:57,844 - Well, systems do tend to degenerate 887 00:40:57,877 --> 00:41:02,314 into ever more disordered versions of themselves, right? 888 00:41:02,348 --> 00:41:03,916 I mean, look around you. 889 00:41:03,950 --> 00:41:05,151 All we're doing here, all day long, 890 00:41:05,184 --> 00:41:08,721 is battle the universe's desire to fall apart. 891 00:41:08,755 --> 00:41:12,659 - Yeah, should've seen the house I was in today. 892 00:41:12,692 --> 00:41:13,960 - I'm just saying, I love rules. 893 00:41:13,993 --> 00:41:16,696 We all do, but in bringing order to disorder, 894 00:41:16,729 --> 00:41:20,733 every now and then a couple gonna get bent. 895 00:41:20,767 --> 00:41:24,436 - Nice try, Daniel. 896 00:41:24,470 --> 00:41:27,006 But the good news is JCAHO 897 00:41:27,039 --> 00:41:29,075 didn't catch any of you, 898 00:41:29,108 --> 00:41:32,612 so we keep our top rating. 899 00:41:35,281 --> 00:41:37,750 I'll see you all tomorrow. 900 00:41:37,784 --> 00:41:40,486 Second law of thermodynamics. 901 00:41:40,587 --> 00:41:42,121 Please.