1 00:00:02,091 --> 00:00:02,224 . 2 00:00:02,257 --> 00:00:02,857 - Whoa, whoa, whoa, we're live. 3 00:00:03,558 --> 00:00:05,060 Naima? 4 00:00:05,094 --> 00:00:06,261 - 22-year-old male, 5 00:00:06,295 --> 00:00:08,230 gunshot wound to the abdomen. GCS 15. 6 00:00:08,263 --> 00:00:10,299 - Dr. Choi, GSW! - On it! 7 00:00:10,332 --> 00:00:11,533 - BP, 100 over 50. - Oh, wait a second. 8 00:00:11,566 --> 00:00:13,202 Wait a sec. Whoa. 9 00:00:13,235 --> 00:00:15,404 - Get this one up to surgery. - All right, let's go. 10 00:00:15,437 --> 00:00:18,340 - [groaning, coughing] - Okay, here we go. 11 00:00:18,373 --> 00:00:20,409 Dr. Choi, you're good? - Good. 12 00:00:20,442 --> 00:00:22,544 - All right, Monique... 13 00:00:22,577 --> 00:00:24,579 Seven treatment rooms on the East side, 14 00:00:24,613 --> 00:00:26,515 four trauma bays on the West. 15 00:00:26,548 --> 00:00:29,451 Bays three and four combine to treat gunshot wounds, 16 00:00:29,484 --> 00:00:33,122 a place affectionately known as Baghdad. 17 00:00:33,155 --> 00:00:34,523 4,000 shootings in Chicago. 18 00:00:34,556 --> 00:00:36,425 Some days, we get... - [yells] 19 00:00:36,458 --> 00:00:37,426 - A dozen. 20 00:00:37,459 --> 00:00:40,395 - [yelling] 21 00:00:40,429 --> 00:00:44,199 - Drug dispensers are in the North and South end of the E.D, 22 00:00:44,233 --> 00:00:47,669 extra gurneys, isolations suites in the ambulance bay. 23 00:00:47,702 --> 00:00:51,240 Uh, Band-Aid, wound dressings, gauze, and extra weaponry 24 00:00:51,273 --> 00:00:53,375 are in the supply closet next to the elevator, 25 00:00:53,408 --> 00:00:56,111 which brings us right here to the command center. 26 00:00:56,145 --> 00:00:57,546 - Deer in the headlights. - Mm-hmm. 27 00:00:57,579 --> 00:00:59,481 - Nursling? - Monique Lawson. 28 00:00:59,514 --> 00:01:02,351 She's got her Pediatric Advanced Life Support certification, 29 00:01:02,384 --> 00:01:05,187 and is doing her E.D. check-off skills training 30 00:01:05,220 --> 00:01:07,156 with yours truly. 31 00:01:07,189 --> 00:01:09,124 - Be careful, she bites. 32 00:01:09,158 --> 00:01:11,092 - Monique, Doris, move. 33 00:01:12,427 --> 00:01:15,530 - I hardly slept last night. [laughs] 34 00:01:15,564 --> 00:01:16,331 I couldn't stop thinking. 35 00:01:16,365 --> 00:01:18,200 I mean, so many people coming in, 36 00:01:18,233 --> 00:01:19,334 horrible injuries. 37 00:01:19,368 --> 00:01:21,370 - And this isn't even a busy day. 38 00:01:21,403 --> 00:01:23,405 - I just hope I'm up to it. 39 00:01:23,438 --> 00:01:25,507 - Quick, nurses' credo? 40 00:01:25,540 --> 00:01:29,178 - Uh, cure sometimes, treat often, comfort always. 41 00:01:29,211 --> 00:01:31,313 - Uh-uh. Don't kill your patient... 42 00:01:31,346 --> 00:01:33,348 all: Because that's the doctor's job. 43 00:01:33,382 --> 00:01:35,717 - I heard that. - [laughs] 44 00:01:35,750 --> 00:01:37,586 - Maggie, what you got for me? 45 00:01:37,619 --> 00:01:38,653 - Alzheimer's patient, 46 00:01:38,687 --> 00:01:40,422 here from long-term care facility. 47 00:01:40,455 --> 00:01:43,492 Hypotensive and high fever in Treatment 2. 48 00:01:43,525 --> 00:01:45,194 - Any family? Advanced directives? 49 00:01:45,227 --> 00:01:47,262 - No, surrogate just passed away, 50 00:01:47,296 --> 00:01:49,564 and no one else was designated, so it's going to be our call. 51 00:01:50,765 --> 00:01:54,469 Okay, and you need to be initiating catheter duty. 52 00:01:54,503 --> 00:01:57,539 Patient in Treatment 6. Have a stab at her. 53 00:02:03,278 --> 00:02:05,947 - Wait, we need to page Will. 54 00:02:05,980 --> 00:02:06,948 - What is it? 55 00:02:06,981 --> 00:02:09,384 - This is Bella Rowan-- Dr. Rowan. 56 00:02:09,418 --> 00:02:11,220 She was Will's teacher, his mentor. 57 00:02:32,841 --> 00:02:32,974 . 58 00:02:33,007 --> 00:02:34,743 - Lungs are wet. 59 00:02:36,578 --> 00:02:38,647 Does this hurt, Dr. Rowan? 60 00:02:38,680 --> 00:02:40,349 [laboring exhale] 61 00:02:47,589 --> 00:02:50,625 Oh-- - Okay, all right, all right. 62 00:02:52,827 --> 00:02:55,797 - Who are you? 63 00:02:55,830 --> 00:02:58,300 - I'm Dr. Halstead. 64 00:02:58,333 --> 00:03:00,935 - Oh... 65 00:03:00,969 --> 00:03:03,938 - I'm gonna help Dr. Manning here take care of you. 66 00:03:03,972 --> 00:03:06,708 Is that all right? - Oh, good. 67 00:03:06,741 --> 00:03:10,279 - Okay. - Gotta go. 68 00:03:10,312 --> 00:03:13,315 - Why is that? - Mm, miss my bus. 69 00:03:13,348 --> 00:03:16,385 - Oh, where are you going? 70 00:03:18,853 --> 00:03:21,022 - What? 71 00:03:21,055 --> 00:03:24,293 [coughing] 72 00:03:27,028 --> 00:03:27,929 - Okay, okay, okay... 73 00:03:27,962 --> 00:03:29,798 - [moans] - Tell you what, Dr. Rowan... 74 00:03:29,831 --> 00:03:32,301 - [moaning] 75 00:03:32,334 --> 00:03:34,336 - We promise to do our best, 76 00:03:34,369 --> 00:03:37,272 to get you out of here so you can catch that bus. 77 00:03:37,306 --> 00:03:39,608 How's that sound? - Good. 78 00:03:39,641 --> 00:03:40,642 - Good. - Good. 79 00:03:40,675 --> 00:03:43,412 [labored breathing] 80 00:03:43,445 --> 00:03:46,315 - All right. 81 00:03:46,348 --> 00:03:48,383 I'll be back to check on you in a few minutes. 82 00:03:53,455 --> 00:03:55,890 I'm pretty sure she's got aspiration pneumonia. 83 00:03:55,924 --> 00:03:57,959 - Yeah. - You start antibiotics? 84 00:03:57,992 --> 00:04:00,729 - Vanc and Zosyn, plus Levophed to maintain her pressure. 85 00:04:00,762 --> 00:04:02,063 Metabolic panel, urine analysis, 86 00:04:02,096 --> 00:04:04,833 and blood cultures are all pending. 87 00:04:04,866 --> 00:04:06,435 - She's obviously been sick for days. 88 00:04:06,468 --> 00:04:08,337 Why did they wait so long to bring her in? 89 00:04:08,370 --> 00:04:09,671 - I'm sorry, Will. 90 00:04:09,704 --> 00:04:12,907 - Dr. Halstead, I came as soon as I heard. 91 00:04:12,941 --> 00:04:15,410 I was an O.R. nurse under Dr. Rowan 92 00:04:15,444 --> 00:04:17,412 when I was starting out. 93 00:04:17,446 --> 00:04:19,314 How is she? 94 00:04:19,348 --> 00:04:22,050 - Not good, and we're playing catchup. 95 00:04:24,052 --> 00:04:26,020 All right, let's put in a central line 96 00:04:26,054 --> 00:04:27,121 and get a chest X-Ray, 97 00:04:27,155 --> 00:04:28,990 and I wanna keep close tabs on her volume status. 98 00:04:29,023 --> 00:04:30,792 Please, keep me updated every 20 minutes. 99 00:04:30,825 --> 00:04:32,327 - Of course. 100 00:04:37,666 --> 00:04:39,368 - Hey, we went to Joe's last night. 101 00:04:39,401 --> 00:04:41,102 My sister loves stone crab. 102 00:04:41,135 --> 00:04:41,903 It was nice. 103 00:04:41,936 --> 00:04:43,372 I mean, there were a lot of years 104 00:04:43,405 --> 00:04:44,238 when Claire wasn't speaking to me. 105 00:04:44,272 --> 00:04:47,376 - Eh, I'm sure she had very good reason. 106 00:04:47,409 --> 00:04:50,044 - Well, she can tell you all about it herself. 107 00:04:50,078 --> 00:04:52,747 - What do you mean? - She wants to meet you. 108 00:04:52,781 --> 00:04:54,449 She wants to have you over for dinner. 109 00:04:54,483 --> 00:04:56,385 - By meet, you mean grill? 110 00:04:56,418 --> 00:04:57,986 Make sure I'm worthy of a Rhodes? 111 00:04:58,019 --> 00:05:00,355 - No, that's more my father. Claire's not like that. 112 00:05:00,389 --> 00:05:03,692 She's happy if I'm happy, and I'm happy. 113 00:05:05,159 --> 00:05:09,831 - I'm not sure if I'm ready to, uh, meet the family. 114 00:05:09,864 --> 00:05:11,800 - Morning, Dr. Rhodes. 115 00:05:11,833 --> 00:05:13,702 Robin... - Leah. 116 00:05:13,735 --> 00:05:16,805 - Dr. Bardovi, are you ready for your first coarctation repair? 117 00:05:16,838 --> 00:05:17,939 - I've been studying cases all week. 118 00:05:17,972 --> 00:05:19,007 - Good. 119 00:05:19,040 --> 00:05:21,976 - Course there's nothing like watching the maestro. 120 00:05:22,010 --> 00:05:24,413 - [chuckles] 121 00:05:24,446 --> 00:05:27,416 I will catch you at lunch, Maestro. 122 00:05:27,449 --> 00:05:29,851 - We'll continue this conversation later. 123 00:05:29,884 --> 00:05:31,953 Let's go. 124 00:05:31,986 --> 00:05:33,688 - Patient's 13. 125 00:05:33,722 --> 00:05:35,757 Pretty late to get a coarctation diagnosis. 126 00:05:35,790 --> 00:05:39,461 - Uh, his dad's an oil worker. He did a stint in Nigeria. 127 00:05:39,494 --> 00:05:42,431 Nobody there caught it. 128 00:05:42,464 --> 00:05:44,433 Knock, knock? 129 00:05:44,466 --> 00:05:46,735 - Dr. Rhodes. - Mitch, how are you doing? 130 00:05:46,768 --> 00:05:47,702 This is Dr. Bardovi. 131 00:05:47,736 --> 00:05:50,705 She's gonna be assisting me in the surgery. 132 00:05:50,739 --> 00:05:52,707 Brandon, how are we doing this morning, bud? 133 00:05:52,741 --> 00:05:53,808 - We are both looking forward to getting on 134 00:05:53,842 --> 00:05:57,479 the other side of this thing. Ain't that right, buddy? 135 00:05:57,512 --> 00:05:59,914 - Uh, yeah, sure. 136 00:05:59,948 --> 00:06:02,817 Hey, are you guys gonna have to saw me open to do this? 137 00:06:02,851 --> 00:06:04,953 - Yes. Yes, we are. [chuckles] 138 00:06:04,986 --> 00:06:06,087 - I'm not scared. 139 00:06:06,120 --> 00:06:09,491 I'm just wondering if Halloran's gonna have a cool scar 140 00:06:09,524 --> 00:06:11,893 after the battle of Madigan. 141 00:06:11,926 --> 00:06:14,062 - Halloran? - It's a character 142 00:06:14,095 --> 00:06:16,498 in some dumb online game that he plays. 143 00:06:16,531 --> 00:06:20,535 - Dad, it's not a game. It's fan fiction. 144 00:06:20,569 --> 00:06:21,803 I published a chapter today, 145 00:06:21,836 --> 00:06:24,573 and my followers are gonna wanna know what happens to Halloran 146 00:06:24,606 --> 00:06:27,476 after he slays the High Locust. 147 00:06:27,509 --> 00:06:28,376 That's you. 148 00:06:28,409 --> 00:06:30,545 - All right, then. Well, I am honored. 149 00:06:30,579 --> 00:06:34,849 And yes, Halloran's gonna have a pretty gnarly battle scar. 150 00:06:34,883 --> 00:06:36,785 - Sweet. 151 00:06:36,818 --> 00:06:38,920 - Well, at least one of us isn't nervous. 152 00:06:40,889 --> 00:06:43,525 - So, coarctation repair. 153 00:06:43,558 --> 00:06:44,593 It sounds complicated, 154 00:06:44,626 --> 00:06:47,195 but it's actually a relatively simple procedure. 155 00:06:47,228 --> 00:06:49,964 Uh, I'm gonna make an incision in Brandon's left chest. 156 00:06:49,998 --> 00:06:51,900 We'll place him on partial bypass, 157 00:06:51,933 --> 00:06:53,902 and then resect, or cut out, 158 00:06:53,935 --> 00:06:55,504 the narrowed portion of his aorta, 159 00:06:55,537 --> 00:06:57,038 and place a graft. 160 00:06:57,071 --> 00:06:58,840 Now I know all this is a lot, 161 00:06:58,873 --> 00:07:00,509 but any questions, feel free. 162 00:07:00,542 --> 00:07:03,177 - Uh, yeah, I was doing some research online, 163 00:07:03,211 --> 00:07:05,914 and it seems that, uh, 164 00:07:05,947 --> 00:07:08,517 Brandon's chicken legs and his puny size 165 00:07:08,550 --> 00:07:10,251 are because of his condition? 166 00:07:10,284 --> 00:07:13,922 I mean, any chance that that'll change? 167 00:07:13,955 --> 00:07:18,860 - Uh, obviously, Brandon's health is our primary concern, 168 00:07:18,893 --> 00:07:21,496 uh, but yes, he may grow at a more rapid rate 169 00:07:21,530 --> 00:07:24,533 once the blood flow issue is corrected. 170 00:07:24,566 --> 00:07:27,268 - Good. [exhales] Okay. 171 00:07:27,301 --> 00:07:29,638 - All right, Brandon, see ya on the battle field. 172 00:07:41,115 --> 00:07:43,217 - Dr. Reese? 173 00:07:43,251 --> 00:07:45,554 You didn't answer your page. 174 00:07:45,587 --> 00:07:47,255 - Oh, sorry. 175 00:07:47,288 --> 00:07:50,925 I--I was just-- 176 00:07:53,127 --> 00:07:55,196 Uh... 177 00:08:00,234 --> 00:08:04,305 When Jason Wheeler jumped, do you think he was scared? 178 00:08:04,338 --> 00:08:06,074 Was-- 179 00:08:06,107 --> 00:08:12,113 I mean, was--was he at peace? 180 00:08:12,146 --> 00:08:13,181 Right before he stepped off, 181 00:08:13,214 --> 00:08:15,684 was there a moment of regret? 182 00:08:18,720 --> 00:08:22,123 I just--I just can't stop thinking about him. 183 00:08:25,694 --> 00:08:27,862 - Yeah. 184 00:08:27,896 --> 00:08:29,964 - But see, I--I don't want to, 185 00:08:29,998 --> 00:08:33,902 and then I feel guilty, because I don't. 186 00:08:35,336 --> 00:08:38,006 - The thing about suicide, 187 00:08:38,039 --> 00:08:40,942 it's never really a lone act. 188 00:08:40,975 --> 00:08:43,678 It tends to leave a lot of victims in its wake. 189 00:08:46,147 --> 00:08:50,018 I'd be lying if I said I'd been sleeping too well recently. 190 00:08:53,054 --> 00:08:57,158 But, um--but you and I-- 191 00:08:57,191 --> 00:08:59,060 we've got work to do. 192 00:09:02,230 --> 00:09:04,666 - Excuse me. 193 00:09:04,699 --> 00:09:06,601 Sean Adams, formal Naval aviator, 194 00:09:06,635 --> 00:09:08,903 now flies for a private charter company. 195 00:09:08,937 --> 00:09:10,204 And he was doing his pre-flight check 196 00:09:10,238 --> 00:09:11,305 and felt faint. 197 00:09:11,339 --> 00:09:13,307 Co-pilot brought him in. Says it's not the first time. 198 00:09:13,341 --> 00:09:15,910 Now I checked Mr. Adams out. Can't find anything wrong. 199 00:09:15,944 --> 00:09:17,646 Probably just dehydrated and overworked. 200 00:09:17,679 --> 00:09:19,313 Says he feels fine and wants to go. 201 00:09:19,347 --> 00:09:21,315 - So, um--so why are we here? 202 00:09:21,349 --> 00:09:24,018 - Charter company wants a psych evaluation. 203 00:09:24,052 --> 00:09:26,320 - Uh-huh. 204 00:09:26,354 --> 00:09:29,190 Co-pilot says he's also been acting different. 205 00:09:29,223 --> 00:09:30,759 Doesn't go out with the boys anymore, 206 00:09:30,792 --> 00:09:32,661 naps a lot, 207 00:09:32,694 --> 00:09:34,395 seems to be low energy. Huh. 208 00:09:34,428 --> 00:09:36,097 - Sounds like depression. 209 00:09:36,130 --> 00:09:37,766 - Possibly. - In any case, 210 00:09:37,799 --> 00:09:40,301 the company won't let him fly till you sign off. 211 00:09:40,334 --> 00:09:41,402 - Why don't we have a little chat? 212 00:09:41,435 --> 00:09:43,071 - Thanks. 213 00:09:45,106 --> 00:09:48,176 - Code blue! 214 00:09:48,209 --> 00:09:50,411 Unresponsive two-year-old. Quick, what do we do first? 215 00:09:50,444 --> 00:09:53,014 - Check pulse, start compressions. 216 00:09:53,047 --> 00:09:55,650 - There is no pulse. - Compressions at what rate? 217 00:09:55,684 --> 00:09:58,252 - 150 beats per minute. - Good. 218 00:09:58,286 --> 00:10:01,122 You got a team behind you. What's next? 219 00:10:01,155 --> 00:10:03,124 - I tell them to start bagging. 220 00:10:03,157 --> 00:10:04,726 Pulse check. 221 00:10:04,759 --> 00:10:07,095 - Okay, but there's still no pulse. 222 00:10:07,128 --> 00:10:08,663 Patient's dying. What now? 223 00:10:08,697 --> 00:10:12,066 - Use the paddles to do a quick look. 224 00:10:12,100 --> 00:10:14,435 - Shows v-fib. She's coding, so? 225 00:10:14,468 --> 00:10:17,238 - Need to shock at 4 joules per kilo? 226 00:10:17,271 --> 00:10:19,774 - Well, move then. You're losing her. 227 00:10:19,808 --> 00:10:21,342 Charge to 28 joules. 228 00:10:21,375 --> 00:10:23,144 - I'm shocking the patient. 229 00:10:23,177 --> 00:10:24,713 - Great. 230 00:10:24,746 --> 00:10:26,314 You just killed me. 231 00:10:26,347 --> 00:10:27,782 - I did? - Mm-hmm. 232 00:10:27,816 --> 00:10:29,984 - You forgot to yell "clear" before shocking. 233 00:10:30,018 --> 00:10:32,086 Just one of those minor details. 234 00:10:32,120 --> 00:10:34,756 Reset. Let's take it from the top. 235 00:10:34,789 --> 00:10:37,391 Come on. 236 00:10:37,425 --> 00:10:39,093 - It just seems like everyone's overreacting. 237 00:10:39,127 --> 00:10:40,094 - But you can see their point of view. 238 00:10:40,128 --> 00:10:42,296 I mean, people put their lives in your hands. 239 00:10:42,330 --> 00:10:43,331 - And I'm fine. 240 00:10:43,364 --> 00:10:46,334 I've answered your question. I know what today is. 241 00:10:46,367 --> 00:10:48,469 I know where I am. 242 00:10:48,502 --> 00:10:50,772 - Aside from lack of energy, 243 00:10:50,805 --> 00:10:54,208 your co-pilot says that at times you seem mildly confused. 244 00:10:54,242 --> 00:10:56,010 - I have no idea what he's talking about. 245 00:10:56,044 --> 00:10:57,211 [stammers, laughs] 246 00:10:57,245 --> 00:10:59,280 Maybe he's the one that's confused. 247 00:10:59,313 --> 00:11:03,351 - Mr. Adams, I imagine there's a lot of pressure at your job. 248 00:11:03,384 --> 00:11:06,420 - I used to land F-14s on an aircraft carrier. 249 00:11:06,454 --> 00:11:08,289 That's pressure. 250 00:11:08,322 --> 00:11:10,291 - Have you ever had thoughts of hurting yourself? 251 00:11:10,324 --> 00:11:12,761 - What? No. 252 00:11:12,794 --> 00:11:15,163 - Let's see here. Are you on any medication? 253 00:11:15,196 --> 00:11:16,264 - You mean do I take anything 254 00:11:16,297 --> 00:11:17,766 that might affect my performance? 255 00:11:17,799 --> 00:11:19,467 No. 256 00:11:19,500 --> 00:11:22,771 I take a statin, like 10 million other Americans. 257 00:11:22,804 --> 00:11:25,339 And no, I don't drink, if that's your next question. 258 00:11:25,373 --> 00:11:28,877 - All right, Mr. Adams, well, thank you for your time. 259 00:11:35,216 --> 00:11:38,086 Getting, um, a little ahead of yourself. 260 00:11:38,119 --> 00:11:39,020 Don't you think? 261 00:11:39,053 --> 00:11:41,422 - Well, he is exhibiting signs of depression, 262 00:11:41,455 --> 00:11:43,424 and there is a high rate of suicide among pilots. 263 00:11:43,457 --> 00:11:44,425 - Dr. Reese, trust me, 264 00:11:44,458 --> 00:11:47,796 I understand what's on your mind, but suicidality 265 00:11:47,829 --> 00:11:50,231 should not necessarily be a default diagnosis. 266 00:11:50,264 --> 00:11:51,399 - So what do you think? 267 00:11:51,432 --> 00:11:54,068 - I think that Mr. Adams is linear, lucid. 268 00:11:54,102 --> 00:11:55,770 I mean, he's certainly not confused. 269 00:11:55,804 --> 00:11:57,305 - Are you gonna sign off on him? 270 00:11:57,338 --> 00:11:58,472 - Well, I didn't say that. 271 00:11:58,506 --> 00:12:01,109 I mean, I thought he was a little defensive 272 00:12:01,142 --> 00:12:02,476 around the medication issue. 273 00:12:02,510 --> 00:12:04,813 - Well, the man has to prove himself to keep his job. 274 00:12:04,846 --> 00:12:06,214 That would make me defensive. 275 00:12:06,247 --> 00:12:07,916 - And you know what, that could be all there is to it. 276 00:12:07,949 --> 00:12:11,152 But look, he's a pilot. Let's just take the extra step. 277 00:12:11,185 --> 00:12:13,354 You know, run a tox screen, make sure he's clean. 278 00:12:13,387 --> 00:12:14,823 - Okay. 279 00:12:14,856 --> 00:12:17,191 - To your point, depressives often self-medicate, 280 00:12:17,225 --> 00:12:20,294 so I'm not ruling out the diagnosis. 281 00:12:22,263 --> 00:12:23,898 - Dr. Rowan's LFTs are high, 282 00:12:23,932 --> 00:12:25,433 her creatinine's through the roof. 283 00:12:25,466 --> 00:12:27,235 - Kidneys are struggling. 284 00:12:27,268 --> 00:12:28,870 White cell count's high too. 285 00:12:28,903 --> 00:12:32,907 - Multiple organ failure and pending respiratory failure. 286 00:12:32,941 --> 00:12:35,509 - We need to intubate her. - What--at her age? 287 00:12:35,543 --> 00:12:37,946 - Nurse! - No, mm, Will... 288 00:12:37,979 --> 00:12:40,815 you know what this means. She might never get off. 289 00:12:40,849 --> 00:12:42,350 What if we bridge her with BiPAP? 290 00:12:42,383 --> 00:12:43,517 That'll take the stress off the lungs, 291 00:12:43,551 --> 00:12:45,153 until the infection cools. 292 00:12:45,186 --> 00:12:46,520 - We'd still wind up intubating her, 293 00:12:46,554 --> 00:12:49,223 and we'd have lost time. - Dr. Halstead... 294 00:12:49,257 --> 00:12:51,860 there's a Mr. Sherwood here from the nursing home. 295 00:12:51,893 --> 00:12:54,528 He wants to know how Dr. Rowan is doing. 296 00:12:54,562 --> 00:12:56,564 - I'll be happy to tell him. 297 00:12:58,432 --> 00:13:01,469 Sherwood, is it? 298 00:13:01,502 --> 00:13:03,504 You mind telling me how you and your staff 299 00:13:03,537 --> 00:13:05,273 let a textbook case of aspiration pneumonia 300 00:13:05,306 --> 00:13:06,975 go unattended? 301 00:13:07,008 --> 00:13:09,410 - I-I don't think that happened. 302 00:13:09,443 --> 00:13:10,711 - You don't? 303 00:13:10,744 --> 00:13:12,613 Then--then how was she allowed to aspirate in the first place? 304 00:13:12,646 --> 00:13:14,849 - Dr. Halstead... - 'cause I-- 305 00:13:14,883 --> 00:13:16,484 I visited her every month. 306 00:13:16,517 --> 00:13:17,485 I knew she had trouble swallowing. 307 00:13:17,518 --> 00:13:19,153 Your staff knew she had trouble swallowing. 308 00:13:19,187 --> 00:13:21,155 - Okay, I-I promise you I'll look into this. 309 00:13:21,189 --> 00:13:23,892 - I'm sure you will. - Oh, you better. 310 00:13:23,925 --> 00:13:26,627 I mean, that she--that Dr. Rowan should come to this, 311 00:13:26,660 --> 00:13:29,964 all because you denied her the most basic--hey! 312 00:13:29,998 --> 00:13:32,366 - Dr. Halstead... 313 00:13:33,667 --> 00:13:35,436 Thank you, Mr. Sherwood. 314 00:13:37,538 --> 00:13:39,307 - Will... 315 00:13:39,340 --> 00:13:41,642 - They're criminals. 316 00:13:52,653 --> 00:13:52,786 . 317 00:13:52,820 --> 00:13:54,055 - You've all achieved something very special today. 318 00:13:56,991 --> 00:14:01,062 Now you're physicians, doctors. 319 00:14:01,095 --> 00:14:04,065 In a few months, you'll begin your residencies, 320 00:14:04,098 --> 00:14:06,968 caring for people in need. 321 00:14:07,001 --> 00:14:10,538 If you take one thing away from me today, 322 00:14:10,571 --> 00:14:13,674 let it be this. 323 00:14:13,707 --> 00:14:17,979 Treat the patient, not the disease. 324 00:14:19,948 --> 00:14:21,983 - Brought you some Vitner's. - Ah... 325 00:14:22,016 --> 00:14:25,619 - Triple cheese. [chuckles] - Thanks. 326 00:14:25,653 --> 00:14:27,521 - Dr. Rowan? 327 00:14:29,523 --> 00:14:31,492 I'm really sorry, Will. 328 00:14:31,525 --> 00:14:33,594 I know how hard it'll be-- - No. 329 00:14:33,627 --> 00:14:36,965 No, if we can get her temp down and her sats up, 330 00:14:36,998 --> 00:14:39,467 I think we'll be over the hump. 331 00:14:39,500 --> 00:14:41,569 - Hm. 332 00:14:41,602 --> 00:14:43,137 Kay. 333 00:14:46,507 --> 00:14:48,076 I just remember when my grandma got sick, 334 00:14:48,109 --> 00:14:50,478 how tough it was for my mom. 335 00:14:50,511 --> 00:14:53,581 The options, decisions-- [chuckles] 336 00:14:53,614 --> 00:14:56,985 Seeing my grandma so ill. 337 00:14:57,018 --> 00:14:59,553 It was awful. 338 00:14:59,587 --> 00:15:02,991 - Yeah, I hear what you're saying. 339 00:15:03,024 --> 00:15:07,161 But, Nina, she can beat this. 340 00:15:07,195 --> 00:15:09,998 Dr. Rowan gave me so much. 341 00:15:10,031 --> 00:15:12,600 Getting her through this, 342 00:15:12,633 --> 00:15:15,669 it's the least I can do. 343 00:15:18,239 --> 00:15:20,508 - Enter the patient's first and last name, 344 00:15:20,541 --> 00:15:22,610 select an urgency level, 345 00:15:22,643 --> 00:15:24,979 pick your labs, and then hit submit. 346 00:15:25,013 --> 00:15:26,147 - Okay. 347 00:15:28,049 --> 00:15:29,150 - Excuse me... - Yep. 348 00:15:29,183 --> 00:15:31,552 - I'm looking for my husband, Sean Adams. 349 00:15:31,585 --> 00:15:33,487 - He's in Treatment 4. I'll page his doctor. 350 00:15:33,521 --> 00:15:34,688 - Thank you. 351 00:15:38,192 --> 00:15:39,727 - How's it look? 352 00:15:39,760 --> 00:15:41,662 - Systolic's still 50 higher in the arms, 353 00:15:41,695 --> 00:15:44,265 but that's not uncommon right after surgery. 354 00:15:44,298 --> 00:15:48,036 It should come down in the next 24 hours or so. 355 00:15:48,069 --> 00:15:52,073 It looks like Halloran slayed the High Locust after all. 356 00:15:56,477 --> 00:15:59,113 - Hey, um, so how much longer 357 00:15:59,147 --> 00:16:02,783 before he's up and running around? 358 00:16:02,816 --> 00:16:04,152 - Uh, well, over the next few months, 359 00:16:04,185 --> 00:16:06,054 you should see an increase in energy 360 00:16:06,087 --> 00:16:08,756 and some improvement in muscle development. 361 00:16:08,789 --> 00:16:10,658 - Oh, thanks. I can't tell ya. 362 00:16:10,691 --> 00:16:13,561 I've been dreaming about the day I could get out in the yard 363 00:16:13,594 --> 00:16:17,498 and toss a football with my son, like my dad did with me. 364 00:16:17,531 --> 00:16:19,500 - Well, hopefully that'll happen. 365 00:16:19,533 --> 00:16:22,636 Right now, why don't you just let him get some rest? 366 00:16:27,808 --> 00:16:30,144 - See, Mr. Adams, as part of our evaluation, 367 00:16:30,178 --> 00:16:31,612 we run a toxicology screen, 368 00:16:31,645 --> 00:16:34,748 and I'm happy to say that yours was normal. 369 00:16:34,782 --> 00:16:36,750 - I told you I don't take drugs. 370 00:16:36,784 --> 00:16:38,719 - However, we did find something else. 371 00:16:38,752 --> 00:16:40,754 Profound anemia. - Anemia? 372 00:16:40,788 --> 00:16:43,624 - It could explain your feeling faint. 373 00:16:43,657 --> 00:16:45,793 - Okay, I-I guess I gotta eat more steak. [chuckles] 374 00:16:45,826 --> 00:16:47,628 - It's actually more serious than that. 375 00:16:47,661 --> 00:16:48,562 We need to transfuse you 376 00:16:48,596 --> 00:16:50,331 with several units of blood right away. 377 00:16:50,364 --> 00:16:51,565 We also need to find out what's causing it, 378 00:16:51,599 --> 00:16:53,767 so I'd like to admit you for a battery of scans and tests. 379 00:16:53,801 --> 00:16:55,203 - Uh-uh, I've got my own doctor. 380 00:16:55,236 --> 00:16:56,437 I'll make an appointment with him. 381 00:16:56,470 --> 00:16:58,506 - Mr. Adams, we don't want you to leave in this condition. 382 00:16:58,539 --> 00:16:59,740 You're not well. - I feel fine. 383 00:16:59,773 --> 00:17:01,509 - Sean, are you sure about that? 384 00:17:01,542 --> 00:17:03,277 - Yes, and a car ride home 385 00:17:03,311 --> 00:17:05,646 and sleeping in my own bed isn't gonna hurt me. 386 00:17:05,679 --> 00:17:06,847 - That may not be true. 387 00:17:06,880 --> 00:17:10,251 I-I emphatically recommend that you take Dr. Choi's advice. 388 00:17:10,284 --> 00:17:11,785 - As far as the psych evaluation goes, 389 00:17:11,819 --> 00:17:13,654 am I in the clear? 390 00:17:13,687 --> 00:17:16,090 - Well, not listening to your physician 391 00:17:16,124 --> 00:17:17,658 isn't the greatest sign to me. 392 00:17:17,691 --> 00:17:19,660 - Well, you're not the only psychiatrist in Chicago. 393 00:17:19,693 --> 00:17:21,129 I'll get a referral from my primary. 394 00:17:21,162 --> 00:17:22,363 - Sean... - Viv, we're going. 395 00:17:22,396 --> 00:17:23,364 Hand me my clothes. 396 00:17:23,397 --> 00:17:25,333 Please get me whatever paperwork I need to sign, 397 00:17:25,366 --> 00:17:27,201 so I can get out of here. 398 00:17:27,235 --> 00:17:29,137 - I'll be back shortly. 399 00:17:31,805 --> 00:17:33,241 - Something's just not right with him. 400 00:17:33,274 --> 00:17:35,276 - I agree. - But is it physical or mental? 401 00:17:35,309 --> 00:17:36,644 - Your guess is as good as mine. 402 00:17:36,677 --> 00:17:40,114 Unfortunately, we have no grounds to hold him. 403 00:17:40,148 --> 00:17:42,116 - I'll get the paperwork ready. 404 00:17:45,386 --> 00:17:47,755 - Okay, so your patient is in SVT. 405 00:17:47,788 --> 00:17:49,757 What do you do? 406 00:17:49,790 --> 00:17:53,294 - Um, cardiovert at 7 joules. 407 00:17:53,327 --> 00:17:54,628 - Right. 408 00:17:54,662 --> 00:17:56,164 So she's back in sinus rhythm. What now? 409 00:17:56,197 --> 00:17:57,298 - Check her vitals... - Mm-hmm. 410 00:17:57,331 --> 00:17:59,200 - Establish IV access, 411 00:17:59,233 --> 00:18:02,236 provide fluids if her BP drops below 75 systolic. 412 00:18:02,270 --> 00:18:05,306 - And? The adenosine? You got a dose? 413 00:18:05,339 --> 00:18:06,740 - Um... 414 00:18:08,342 --> 00:18:09,710 Adenosine is scratched out. 415 00:18:09,743 --> 00:18:11,179 - Calculate then. 416 00:18:11,212 --> 00:18:12,780 Your patient's gonna revert back to SVT. 417 00:18:12,813 --> 00:18:14,315 Come on. - Um... 418 00:18:14,348 --> 00:18:15,783 - It's a life and death situation here. 419 00:18:15,816 --> 00:18:18,852 - 6.5 milligrams of adenosine. 420 00:18:18,886 --> 00:18:21,189 - * Dum, dum, duh-dum 421 00:18:21,222 --> 00:18:23,657 * Dum, dum, dum, dum, dum, dum, dum * 422 00:18:23,691 --> 00:18:27,361 - It's 0.65, not 6.5. Here. 423 00:18:27,395 --> 00:18:29,597 - Oh... [sighs] I'm sorry. 424 00:18:29,630 --> 00:18:30,798 - [sighs] 425 00:18:33,801 --> 00:18:37,871 - What happened? - He can't feel his left arm. 426 00:18:37,905 --> 00:18:39,640 - All right, left BP is 80 over 30. 427 00:18:39,673 --> 00:18:41,675 Check the right. Sat's at 70. 428 00:18:41,709 --> 00:18:44,745 Hey, Brandon, can you squeeze my hand? 429 00:18:44,778 --> 00:18:46,780 - [gasps] No. No, I can't. 430 00:18:46,814 --> 00:18:49,317 - Okay. - Right arm's 150 over 100. 431 00:18:49,350 --> 00:18:50,818 - What's--what's going on? 432 00:18:50,851 --> 00:18:52,953 - All right, legs are cold. We need a CT angio now! 433 00:18:52,986 --> 00:18:54,688 - Got it! 434 00:18:54,722 --> 00:18:56,390 - Dad? - What is happening? 435 00:18:56,424 --> 00:18:58,459 - Brandon's not getting blood to his left arm, 436 00:18:58,492 --> 00:19:00,294 but I need a picture of it to see. 437 00:19:00,328 --> 00:19:02,863 It's possible that the graft we put in has become occluded. 438 00:19:02,896 --> 00:19:04,465 - Occlud--occluded? What does that mean? 439 00:19:04,498 --> 00:19:06,200 - The first surgery may not have worked. 440 00:19:06,234 --> 00:19:07,901 - So you have to do it again? 441 00:19:07,935 --> 00:19:09,870 - It may be more complicated than that. 442 00:19:18,746 --> 00:19:20,448 - She's in v-fib! 443 00:19:22,883 --> 00:19:23,951 - Paddles. Start compressions. 444 00:19:23,984 --> 00:19:28,756 - Will, I'll break her ribs. - Charge to 200 joules. 445 00:19:28,789 --> 00:19:30,258 Star compressions now! 446 00:19:30,291 --> 00:19:32,493 - Are you sure? I-- 447 00:19:32,526 --> 00:19:34,762 - Out of my way. - No, Will. 448 00:19:34,795 --> 00:19:38,399 [valve hissing] 449 00:19:38,432 --> 00:19:40,801 - Are we charged? - 200 joules. 450 00:19:40,834 --> 00:19:42,803 - Holding the CPR. Clear. 451 00:19:45,439 --> 00:19:49,410 One milligram of epi, charge to 200 again. 452 00:19:49,443 --> 00:19:51,812 - 200. - All right, clear. 453 00:20:16,470 --> 00:20:16,604 . 454 00:20:16,637 --> 00:20:16,837 - Hey. 455 00:20:19,440 --> 00:20:22,343 - Dr. Halstead decided to intubate. 456 00:20:26,380 --> 00:20:30,651 You know, this woman is the reason I stayed in nursing. 457 00:20:30,684 --> 00:20:33,354 My first year as an O.R. nurse, 458 00:20:33,387 --> 00:20:35,556 I actually thought about quitting. 459 00:20:35,589 --> 00:20:37,558 - You? - Oh, I had a rough time. 460 00:20:37,591 --> 00:20:39,059 [chuckles] 461 00:20:39,092 --> 00:20:42,796 There was this, um, surgery I scrubbed on. 462 00:20:42,830 --> 00:20:44,698 I think it was a vascular case. 463 00:20:44,732 --> 00:20:48,035 The resident asked for a ten blade scalpel. 464 00:20:48,068 --> 00:20:51,472 It slipped out of my hand, dropped in the incision. 465 00:20:51,505 --> 00:20:54,408 - Oh, my God. - It didn't hurt the patient, 466 00:20:54,442 --> 00:20:58,579 but that resident reamed me out. 467 00:20:58,612 --> 00:21:01,549 Dr. Rowan stepped in, called him out, 468 00:21:01,582 --> 00:21:06,620 said everyone in the O.R. deserved civility. 469 00:21:06,654 --> 00:21:09,056 Everyone. 470 00:21:09,089 --> 00:21:11,024 Bella Rowan. 471 00:21:13,361 --> 00:21:16,697 Wonderful woman. 472 00:21:16,730 --> 00:21:19,633 Extraordinary teacher. 473 00:21:23,837 --> 00:21:26,774 - Sean? Sean, oh, my God. 474 00:21:26,807 --> 00:21:29,076 Oh, my God. Uh, help, someone! 475 00:21:29,109 --> 00:21:31,379 Help my husband, please. 476 00:21:31,412 --> 00:21:33,080 - Okay, hey, I need a gurney here. 477 00:21:33,113 --> 00:21:34,715 - Whoa! Mr. Adams, can you hear me? 478 00:21:34,748 --> 00:21:36,817 - What's wrong with him? - Unresponsive, 479 00:21:36,850 --> 00:21:38,419 has a pulse. Let's get him in a room. 480 00:21:38,452 --> 00:21:40,788 - Bring it over here. 481 00:21:40,821 --> 00:21:42,756 - [whimpers] 482 00:21:42,790 --> 00:21:44,725 - Let's transfer on my count. Ready, one, two, three. 483 00:21:44,758 --> 00:21:45,726 [grunts] - [whimpers] 484 00:21:45,759 --> 00:21:47,728 - Here we go. - All right, he's not breathing. 485 00:21:47,761 --> 00:21:50,364 Get a laryngoscope and a 7.5 ET tube. 486 00:21:50,398 --> 00:21:51,765 - Sean! - Trauma 1 to prep. 487 00:21:53,401 --> 00:21:55,503 - He's totally flaccid. Don't need drugs. 488 00:21:57,471 --> 00:21:59,473 - Monique, you start the IV. 489 00:21:59,507 --> 00:22:01,742 - Okay. 490 00:22:01,775 --> 00:22:02,876 - Sean... 491 00:22:02,910 --> 00:22:04,512 - Okay, you stand right here. - Okay. 492 00:22:04,545 --> 00:22:06,414 - He's got a massive upper GI bleed. 493 00:22:06,447 --> 00:22:08,382 His stomach's filling with blood. 494 00:22:08,416 --> 00:22:10,083 I'm in. April, listen to his lungs. 495 00:22:10,117 --> 00:22:11,652 - Yep. 496 00:22:14,121 --> 00:22:15,523 Good breath sounds bilaterally. 497 00:22:15,556 --> 00:22:16,557 - All right, hang two units of blood 498 00:22:16,590 --> 00:22:18,626 and get another four ready. - What's going on? 499 00:22:18,659 --> 00:22:19,827 Why--why is this happening? - I don't know, 500 00:22:19,860 --> 00:22:21,729 but we're gonna find out. 501 00:22:21,762 --> 00:22:22,863 [valve hissing] - Hang saline. 502 00:22:22,896 --> 00:22:24,832 - Saline's up. - All right, stay on it. 503 00:22:34,608 --> 00:22:36,744 - Got your page. 504 00:22:36,777 --> 00:22:39,613 - Dr. Rowan's latest labs. 505 00:22:39,647 --> 00:22:42,115 I am so sorry. She's in acute renal failure. 506 00:22:42,149 --> 00:22:44,918 Hyperkalemic and still acidotic. 507 00:22:46,587 --> 00:22:49,823 - All right, we'll start her on low flow dialysis. 508 00:22:49,857 --> 00:22:51,525 It should correct her electrolytes and PH. 509 00:22:51,559 --> 00:22:53,561 - Will... 510 00:22:53,594 --> 00:22:55,896 - I won't stand by and let her die. 511 00:22:58,131 --> 00:23:00,167 Tell April to call renal. 512 00:23:02,703 --> 00:23:04,672 - [sighs] 513 00:23:06,774 --> 00:23:09,677 - Graft occlusion is a possible outcome of any vascular surgery. 514 00:23:09,710 --> 00:23:11,845 It's nobody's fault. 515 00:23:11,879 --> 00:23:13,747 Okay, so there are two options, right? 516 00:23:13,781 --> 00:23:17,485 We could either-- - Just let me handle this, okay? 517 00:23:18,986 --> 00:23:20,888 Mitch, a moment? 518 00:23:20,921 --> 00:23:22,623 - Uh... 519 00:23:25,559 --> 00:23:27,728 What is it? 520 00:23:27,761 --> 00:23:29,497 - So the CT revealed that the graft 521 00:23:29,530 --> 00:23:31,231 I placed in Brandon's chest kinked, 522 00:23:31,264 --> 00:23:32,299 causing re-coarctation, 523 00:23:32,332 --> 00:23:36,804 or essentially a, uh-- a narrowing of his aorta. 524 00:23:36,837 --> 00:23:39,607 - Like before? 525 00:23:39,640 --> 00:23:41,241 - I'm sorry. 526 00:23:41,274 --> 00:23:44,878 - So--so what? We're just back at square one? 527 00:23:44,912 --> 00:23:48,682 - Yes, but this time, things are more complicated. 528 00:23:48,716 --> 00:23:50,751 Now I can repair the graft by placing a stent, 529 00:23:50,784 --> 00:23:52,853 and we would do that in the cath lab. 530 00:23:52,886 --> 00:23:54,655 But the stent will cover 531 00:23:54,688 --> 00:23:57,858 the opening of his left subclavian artery. 532 00:23:57,891 --> 00:24:01,895 That will cut off circulation to his left arm, 533 00:24:01,929 --> 00:24:06,233 meaning Brandon will lose that arm. 534 00:24:06,266 --> 00:24:08,235 - Lose his arm? - Mm-hmm. 535 00:24:14,808 --> 00:24:17,244 - Uh, no. 536 00:24:17,277 --> 00:24:20,180 No--[stammers]--he can't. He can't. 537 00:24:20,213 --> 00:24:22,816 It--there must be something else you can do. 538 00:24:24,552 --> 00:24:26,554 - I'm sorry, but no. 539 00:24:26,587 --> 00:24:29,489 I'm afraid this is our only viable option. 540 00:24:30,924 --> 00:24:33,994 - Oh, God. 541 00:24:34,027 --> 00:24:34,895 - Hey, look, Mitch, 542 00:24:34,928 --> 00:24:37,297 why don't you go be with your son, okay? 543 00:24:37,330 --> 00:24:39,867 We'll take him up to surgery soon. 544 00:24:39,900 --> 00:24:41,569 I'm very sorry. 545 00:24:42,903 --> 00:24:44,572 - [sighs] 546 00:24:46,006 --> 00:24:47,775 - Pardon me, Dr. Rhodes. 547 00:24:47,808 --> 00:24:49,543 I know you must've had a very good reason, 548 00:24:49,577 --> 00:24:51,579 but you didn't present the other option, 549 00:24:51,612 --> 00:24:52,846 the carotid subclavian bypass. 550 00:24:52,880 --> 00:24:55,549 Wouldn't that preserve Brandon's arm? 551 00:24:55,583 --> 00:24:58,786 - Dr. Bardovi, 20 to 30% of young patients 552 00:24:58,819 --> 00:25:00,988 will stroke out and possibly die 553 00:25:01,021 --> 00:25:02,823 when you clamp their carotid. 554 00:25:02,856 --> 00:25:03,991 It's too big of a risk. - Okay, but still-- 555 00:25:04,024 --> 00:25:06,727 - It's too big of a risk. 556 00:25:13,867 --> 00:25:16,837 - What was that all about? 557 00:25:16,870 --> 00:25:19,873 - Look, this boy's father-- I know the type. 558 00:25:19,907 --> 00:25:21,241 I grew up with one. 559 00:25:21,274 --> 00:25:23,243 He wants his son to be something he isn't. 560 00:25:23,276 --> 00:25:26,580 He'll choose the bypass. It's too dangerous. 561 00:25:26,614 --> 00:25:28,816 - But it's his decision, not yours. 562 00:25:28,849 --> 00:25:30,317 - I already opened Brandon up once. 563 00:25:30,350 --> 00:25:31,652 I'm not gonna do it again. 564 00:25:31,685 --> 00:25:32,853 I'm not gonna risk this boy's life 565 00:25:32,886 --> 00:25:34,788 just to save his arm. 566 00:25:46,099 --> 00:25:46,566 . 567 00:25:46,600 --> 00:25:47,067 - Huge gastric ulcer. 568 00:25:47,968 --> 00:25:49,336 That's where all the blood was coming from. 569 00:25:49,369 --> 00:25:50,503 - Were you able to stop the bleeding? 570 00:25:50,537 --> 00:25:53,140 - Yeah, GI cauterized it, but that's not the headline. 571 00:25:53,173 --> 00:25:57,811 Sean's endoscopy shows chronic caustic esophageal erosions. 572 00:25:57,845 --> 00:25:59,847 And his chest X-Ray... 573 00:25:59,880 --> 00:26:02,182 - Pneumonitis. - Yeah. 574 00:26:02,215 --> 00:26:04,051 This is a pattern suggestive of ingesting 575 00:26:04,084 --> 00:26:06,153 some sort of hydrocarbon. 576 00:26:06,186 --> 00:26:08,021 - Isn't that in cleaning products? 577 00:26:08,055 --> 00:26:10,991 - And lighter fluid, motor oil, gasoline. 578 00:26:11,024 --> 00:26:13,694 Extremely toxic, so we must be talking about 579 00:26:13,727 --> 00:26:15,896 low doses over a long period of time. 580 00:26:15,929 --> 00:26:17,097 - So I was right. 581 00:26:17,130 --> 00:26:18,832 We should be concerned he's suicidal. 582 00:26:18,866 --> 00:26:20,400 - Why assume he's doing this to himself? 583 00:26:20,433 --> 00:26:23,103 - Well, what, you think someone's poisoning him? 584 00:26:23,136 --> 00:26:24,972 - I don't know. It's possible. 585 00:26:25,005 --> 00:26:26,206 I had a case where a wife was slipping something 586 00:26:26,239 --> 00:26:27,775 into her husband's food. 587 00:26:27,808 --> 00:26:29,977 - So you think it's his wife? 588 00:26:30,010 --> 00:26:32,112 - You know, hydrocarbons are extremely noxious, 589 00:26:32,145 --> 00:26:34,882 so he would've smelled it. - Not necessarily. 590 00:26:34,915 --> 00:26:36,750 They're all over any aircraft hanger. 591 00:26:36,784 --> 00:26:38,786 With constant exposure, he could be nose blind. 592 00:26:38,819 --> 00:26:41,088 - I don't know. Suicide? 593 00:26:41,121 --> 00:26:43,056 Attempted murder? 594 00:26:43,090 --> 00:26:45,759 I think it might be something else altogether. 595 00:26:56,136 --> 00:26:59,740 - I just checked in on Dr. Rowan. 596 00:26:59,773 --> 00:27:02,075 I heard you ordered dialysis. 597 00:27:02,109 --> 00:27:03,176 - She's in renal failure. 598 00:27:03,210 --> 00:27:04,845 That's the appropriate treatment. 599 00:27:04,878 --> 00:27:09,149 - I understand the medicine, doctor. 600 00:27:09,182 --> 00:27:11,952 Even if you dialyze her-- - I am. 601 00:27:11,985 --> 00:27:13,887 - Even if you dialyze her, 602 00:27:13,921 --> 00:27:16,423 she's unlikely to come off the vent. 603 00:27:16,456 --> 00:27:19,159 That means she'll be bedridden. 604 00:27:19,192 --> 00:27:22,763 Eventually, she'll need a tracheostomy. 605 00:27:24,898 --> 00:27:28,035 You've already broken her ribs. 606 00:27:28,068 --> 00:27:31,739 Now she'll have bed sores, a feeding tube. 607 00:27:33,206 --> 00:27:38,846 Shouldn't quality of life be a consideration? 608 00:27:57,064 --> 00:27:59,833 - I mean, remember that ballplayer I told you about? 609 00:27:59,867 --> 00:28:03,470 He was a pitcher with one arm. He was one of the best. 610 00:28:03,503 --> 00:28:07,007 All right, so, you know, be strong. 611 00:28:07,040 --> 00:28:09,109 We can do this. 612 00:28:09,142 --> 00:28:11,912 I mean, the important thing is that you're gonna be alive. 613 00:28:11,945 --> 00:28:14,948 And healthy. 614 00:28:14,982 --> 00:28:18,118 We'll figure out the rest, okay? Together. 615 00:28:20,253 --> 00:28:21,521 - Mitch... - Yeah. 616 00:28:21,554 --> 00:28:23,957 - Guys, if you can hold on for a second. 617 00:28:23,991 --> 00:28:26,226 Have a word with you? - Okay, buddy. 618 00:28:29,863 --> 00:28:33,033 - So, I've been thinking about Brandon's case, 619 00:28:33,066 --> 00:28:35,302 and there is something else we can try. 620 00:28:38,839 --> 00:28:40,974 [device whirs] - Wrong angle. 621 00:28:41,008 --> 00:28:44,211 You need to go in perpendicular, or you'll stay in the cortex. 622 00:28:44,244 --> 00:28:46,814 - Okay. 623 00:28:46,847 --> 00:28:49,950 [device whirring] 624 00:28:49,983 --> 00:28:51,084 - You're too shallow. 625 00:28:51,118 --> 00:28:54,321 You need to keep on drilling until you hub the needle. 626 00:28:58,892 --> 00:29:00,527 - Not like that. 627 00:29:00,560 --> 00:29:02,362 Who taught her how to do an IO? An orangutan? 628 00:29:02,395 --> 00:29:06,266 - Okay. She'll get there. 629 00:29:06,299 --> 00:29:08,969 We've all gone through this. Just take it slowly. 630 00:29:11,004 --> 00:29:13,807 Go ahead. 631 00:29:13,841 --> 00:29:15,943 [device whirs] 632 00:29:17,878 --> 00:29:19,179 There you go. 633 00:29:26,987 --> 00:29:30,924 - White board says carotid subclavian bypass. 634 00:29:30,958 --> 00:29:32,292 It's just, I thought-- 635 00:29:32,325 --> 00:29:34,862 - I presented both options to the patient's father. 636 00:29:34,895 --> 00:29:39,166 As I suspected, he chose the carotid subclavian bypass. 637 00:29:39,199 --> 00:29:41,601 - And you're gonna do a great job, Dr. Rhodes. 638 00:29:41,634 --> 00:29:43,270 You're an exceptional surgeon, and it is an honor to be-- 639 00:29:43,303 --> 00:29:45,906 - Dr. Bardovi, you don't have to do that. 640 00:29:47,174 --> 00:29:49,176 You're a fine surgeon, 641 00:29:49,209 --> 00:29:51,879 and trust me, I'm a less than perfect teacher. 642 00:29:57,885 --> 00:30:01,388 - Mr. Adams, can I ask you, um-- 643 00:30:01,421 --> 00:30:04,057 you ever find yourself doing something 644 00:30:04,091 --> 00:30:06,159 that you know you shouldn't, 645 00:30:06,193 --> 00:30:08,428 but you just can't stop? 646 00:30:08,461 --> 00:30:11,264 - I have no idea what you're talking about. 647 00:30:11,298 --> 00:30:13,066 [chuckles] 648 00:30:13,100 --> 00:30:16,036 My wife would say that I-- I watch too much football. 649 00:30:16,069 --> 00:30:17,938 - [chuckles] 650 00:30:17,971 --> 00:30:20,307 Can I tell you my dirty little secret? 651 00:30:20,340 --> 00:30:21,374 I went through this phase 652 00:30:21,408 --> 00:30:25,078 where I would come home every night, 653 00:30:25,112 --> 00:30:29,416 cut my nails every night, like down to the quick. 654 00:30:29,449 --> 00:30:31,384 Hm, couldn't stop. 655 00:30:31,418 --> 00:30:35,655 On some level, I must've been satisfying some urge, 656 00:30:35,688 --> 00:30:38,358 but my hands were bleeding. 657 00:30:38,391 --> 00:30:40,260 [stammers] 658 00:30:40,293 --> 00:30:42,095 It wasn't good. 659 00:30:42,129 --> 00:30:43,263 - And the point of this? 660 00:30:43,296 --> 00:30:47,400 - The point is that I understand compulsive behavior. 661 00:30:47,434 --> 00:30:49,369 You know, it's not rational. You can't explain it. 662 00:30:49,402 --> 00:30:53,373 You just--you just do it. 663 00:30:53,406 --> 00:30:55,642 Yeah, but eventually, 664 00:30:55,675 --> 00:30:59,279 like with me, your fingers bleed, 665 00:30:59,312 --> 00:31:01,281 or something similar. 666 00:31:01,314 --> 00:31:05,285 And it just starts to-- to cost you too much, 667 00:31:05,318 --> 00:31:07,420 and you wanna stop. 668 00:31:07,454 --> 00:31:10,991 I mean, you realize that it's interfering with your life, 669 00:31:11,024 --> 00:31:14,361 and you--you just really, really wanna stop. 670 00:31:16,496 --> 00:31:19,199 Sean, I think you have a compulsion, 671 00:31:19,232 --> 00:31:22,435 and you're tired, 672 00:31:22,469 --> 00:31:24,437 and you're also getting scared. 673 00:31:24,471 --> 00:31:26,006 I mean, who wouldn't be scared? 674 00:31:26,039 --> 00:31:30,177 All that--all that blood? All that vomiting? 675 00:31:39,052 --> 00:31:40,353 - Yes. 676 00:31:43,290 --> 00:31:45,125 I'm tired. 677 00:31:50,563 --> 00:31:52,232 - Mr. Adams, we think you're ingesting 678 00:31:52,265 --> 00:31:55,702 something very harmful. 679 00:31:55,735 --> 00:31:57,370 Can you tell us what it is? 680 00:32:02,175 --> 00:32:05,178 Mr. Adams, please, we can help you. 681 00:32:10,417 --> 00:32:12,019 - Gasoline. 682 00:32:12,052 --> 00:32:13,486 - I'm sorry? Say again? 683 00:32:29,336 --> 00:32:29,469 . 684 00:32:29,502 --> 00:32:29,969 - Is my husband crazy? 685 00:32:33,340 --> 00:32:36,209 Why would anyone drink gasoline? 686 00:32:36,243 --> 00:32:39,046 - I know it's very difficult to fathom, 687 00:32:39,079 --> 00:32:41,448 but I'm quite sure that your husband is suffering from 688 00:32:41,481 --> 00:32:45,118 a psychiatric disorder known as Pica, 689 00:32:45,152 --> 00:32:49,322 which involves the compulsive consumption of non-nutritive, 690 00:32:49,356 --> 00:32:52,492 and sometimes even hazardous, substances. 691 00:32:52,525 --> 00:32:54,561 - For some, it's paint chips. 692 00:32:54,594 --> 00:32:57,464 For others, dirt. 693 00:32:57,497 --> 00:33:00,233 For your husband, it's gasoline. 694 00:33:00,267 --> 00:33:01,634 - Why? 695 00:33:01,668 --> 00:33:04,671 - There's no unified theory as to the cause. 696 00:33:04,704 --> 00:33:07,707 All we know is that it manifests itself as a compulsion, 697 00:33:07,740 --> 00:33:12,412 an irresistible urge, against one's conscious wishes. 698 00:33:12,445 --> 00:33:15,215 - [sighs] Can he stop? 699 00:33:15,248 --> 00:33:16,683 - Probably not on his own, 700 00:33:16,716 --> 00:33:20,353 but if he'll allow us, we can help him. 701 00:33:20,387 --> 00:33:22,422 - Okay. 702 00:33:22,455 --> 00:33:25,625 We'll do whatever it takes to get him healthy. 703 00:33:25,658 --> 00:33:28,195 - Before we discuss the course of psychotherapy, 704 00:33:28,228 --> 00:33:29,462 I'd like to talk to you and your husband 705 00:33:29,496 --> 00:33:30,663 about repairing the physical damage. 706 00:33:30,697 --> 00:33:32,165 - Of course. - Thanks. 707 00:33:32,199 --> 00:33:33,533 - Yes. 708 00:33:37,337 --> 00:33:40,540 - He could've killed himself. 709 00:33:40,573 --> 00:33:43,276 Sometimes we get a win, right? 710 00:33:43,310 --> 00:33:45,612 - Sometimes we get a win. 711 00:33:45,645 --> 00:33:49,349 - If you take one thing away from me today, 712 00:33:49,382 --> 00:33:52,185 let it be this: 713 00:33:52,219 --> 00:33:56,256 treat the patient, not the disease. 714 00:34:25,285 --> 00:34:26,786 - Good. You haven't started. 715 00:34:26,819 --> 00:34:30,190 - Just finished the line. Why? 716 00:34:30,223 --> 00:34:33,593 - You were right. We shouldn't do this. 717 00:34:33,626 --> 00:34:35,162 - What changed your mind? 718 00:34:35,195 --> 00:34:37,597 - Treat the patient, not the disease. 719 00:34:40,400 --> 00:34:43,603 Our patient wouldn't have wanted this. 720 00:34:43,636 --> 00:34:45,505 April, 10 milligrams of morphine, 721 00:34:45,538 --> 00:34:46,806 and hang a drip, please. 722 00:34:52,612 --> 00:34:55,315 Dr. Rowan... 723 00:34:55,348 --> 00:34:58,318 I'm going to extubate you. 724 00:34:58,351 --> 00:35:00,753 I promise you won't feel any pain. 725 00:35:04,224 --> 00:35:06,759 - I'll let you two be alone with her now. 726 00:35:26,413 --> 00:35:29,449 - [coughing] 727 00:35:58,545 --> 00:36:00,713 - Okay, going to start the carotid anastomosis. 728 00:36:00,747 --> 00:36:02,682 Everybody get ready. 729 00:36:02,715 --> 00:36:04,751 We're going to clamp the left carotid. 730 00:36:04,784 --> 00:36:07,620 Carla, tell me if you see any change on the EEG. 731 00:36:07,654 --> 00:36:09,722 - Right. 732 00:36:09,756 --> 00:36:12,692 - Peripheral cross clamp times two? 733 00:36:27,874 --> 00:36:31,411 Carotid is cross-clamped. - Brain waves look good. 734 00:36:31,444 --> 00:36:34,581 - Okay, eleven blade, followed by 5-0 prolene. 735 00:36:45,458 --> 00:36:48,761 Let's sew this graft in quickly. 736 00:36:48,795 --> 00:36:50,930 - Brain waves flattening on the right. 737 00:36:50,963 --> 00:36:53,866 He's impending infarct. 738 00:36:53,900 --> 00:36:57,437 - We only have four minutes of hypoxia before deficits occur. 739 00:36:57,470 --> 00:36:58,938 - Do we unclamp him? 740 00:36:58,971 --> 00:37:00,840 We can still call this off and take him to the cath lab. 741 00:37:00,873 --> 00:37:03,576 It's safer. 742 00:37:03,610 --> 00:37:04,911 Dr. Rhodes... 743 00:37:04,944 --> 00:37:08,615 - No. This kid's not losing his arm. 744 00:37:10,717 --> 00:37:12,419 Coming around the front wall now. 745 00:37:12,452 --> 00:37:14,621 - Left side brain's 50, right side's 70. 746 00:37:14,654 --> 00:37:18,725 - Dr. Bardovi, follow me. Eyes on the field. 747 00:37:18,758 --> 00:37:20,527 - Dr. Rhodes, you need to get those clamps off. 748 00:37:20,560 --> 00:37:22,762 - Thank you, Marty, I'm almost there. 749 00:37:25,665 --> 00:37:28,501 - Left side's 30, right side's 50. 750 00:37:31,604 --> 00:37:34,741 - Okay, done. 751 00:37:34,774 --> 00:37:37,877 Coming off cross clamp. 752 00:37:37,910 --> 00:37:39,979 Cross clamps are off. 753 00:37:40,012 --> 00:37:42,482 I've reestablished flow. 754 00:37:44,484 --> 00:37:45,918 - EEG is normalizing. 755 00:37:47,987 --> 00:37:50,623 You have a good wave pattern. 756 00:37:50,657 --> 00:37:52,759 - He's good. 757 00:37:52,792 --> 00:37:54,494 - Nice work, Dr. Rhodes. 758 00:37:54,527 --> 00:37:57,464 - Okay, everyone, let's get set up for the stent. 759 00:38:01,000 --> 00:38:02,635 - Good night. - Good night. 760 00:38:02,669 --> 00:38:05,638 - How could you do this to us? 761 00:38:05,672 --> 00:38:09,542 - Uh, excuse me? - My husband told me. 762 00:38:09,576 --> 00:38:10,943 He'll lose his pilot's license. 763 00:38:10,977 --> 00:38:12,879 We'll lose everything. 764 00:38:12,912 --> 00:38:15,648 - I'm very sorry. Uh, I had no choice. 765 00:38:15,682 --> 00:38:18,785 I am legally obligated to report him. 766 00:38:18,818 --> 00:38:20,853 - It's his life. 767 00:38:29,629 --> 00:38:31,998 - I called the FAA. I had to. 768 00:38:32,031 --> 00:38:35,602 Every time he gets on a plane, he puts his own life 769 00:38:35,635 --> 00:38:37,737 and the lives of all of his passengers at risk. 770 00:38:39,706 --> 00:38:42,575 I know this wasn't, um, 771 00:38:42,609 --> 00:38:44,977 necessarily the win that you were looking for, 772 00:38:45,011 --> 00:38:48,981 but at least we saved a man's life. 773 00:38:49,015 --> 00:38:50,950 See you in the morning? 774 00:39:07,800 --> 00:39:10,803 - I heard the surgery went well. 775 00:39:10,837 --> 00:39:12,572 - Yeah, thankfully. 776 00:39:12,605 --> 00:39:14,541 - [chuckles] 777 00:39:14,574 --> 00:39:17,510 Yeah, don't worry, I won't tell anyone. 778 00:39:17,544 --> 00:39:20,046 - Tell 'em what? - Mm, that you were scared. 779 00:39:20,079 --> 00:39:21,914 - Oh, that's what you think, huh? 780 00:39:21,948 --> 00:39:24,684 - Yeah. 781 00:39:24,717 --> 00:39:28,721 - [sighs] Man, you're definitely a Charles. 782 00:39:28,755 --> 00:39:30,890 You're very perceptive. - Hm. 783 00:39:33,626 --> 00:39:35,462 - I was after that first time. 784 00:39:35,495 --> 00:39:36,596 I was--I was afraid. 785 00:39:36,629 --> 00:39:38,998 I was afraid I was gonna lose him. 786 00:39:39,031 --> 00:39:40,600 - [soft exhale] 787 00:39:40,633 --> 00:39:43,803 I have fears of my own, you know. 788 00:39:43,836 --> 00:39:47,006 - Cholera? Typhus? - [chuckles] Yeah. 789 00:39:47,039 --> 00:39:50,009 And relationships. [chuckles] 790 00:39:50,042 --> 00:39:53,112 There are a lot of pitfalls in dating a surgeon. 791 00:39:53,145 --> 00:39:56,516 It's crazy hours, stress of the job-- 792 00:39:56,549 --> 00:39:59,919 - Great case, Dr. Rhodes. Very impressive. 793 00:39:59,952 --> 00:40:02,054 And thanks for the vote of confidence. 794 00:40:04,657 --> 00:40:08,528 - Fawning women falling at your feet. 795 00:40:08,561 --> 00:40:10,763 Yeah, I don't know if I can compete with all of that. 796 00:40:10,797 --> 00:40:11,964 [laughs] 797 00:40:11,998 --> 00:40:14,967 - You don't have to compete. 798 00:40:15,001 --> 00:40:16,903 I'm all in. 799 00:40:23,810 --> 00:40:27,146 - So your sister... 800 00:40:27,179 --> 00:40:29,716 [both laugh] 801 00:40:29,749 --> 00:40:32,919 Let's see, is she a red or white wine drinker? 802 00:40:32,952 --> 00:40:34,921 - Mm, white. 803 00:40:34,954 --> 00:40:37,624 Not Chardonnay. Uh, Sauvignon Blanc. 804 00:40:42,161 --> 00:40:45,765 - Will? - [sniffles] 805 00:40:45,798 --> 00:40:47,066 - Hey. 806 00:40:48,935 --> 00:40:53,573 I'm--I'm so sorry for your loss. 807 00:41:01,948 --> 00:41:04,984 - [sobbing]