1 00:00:02,070 --> 00:00:02,203 . 2 00:00:02,236 --> 00:00:02,836 - Whoa, whoa, whoa, we're live. 3 00:00:03,537 --> 00:00:05,039 Naima? 4 00:00:05,073 --> 00:00:06,240 - 22-year-old male, 5 00:00:06,274 --> 00:00:08,209 gunshot wound to the abdomen. GCS 15. 6 00:00:08,242 --> 00:00:10,278 - Dr. Choi, GSW! - On it! 7 00:00:10,311 --> 00:00:11,512 - BP, 100 over 50. - Oh, wait a second. 8 00:00:11,545 --> 00:00:13,181 Wait a sec. Whoa. 9 00:00:13,214 --> 00:00:15,383 - Get this one up to surgery. - All right, let's go. 10 00:00:15,416 --> 00:00:18,319 - [groaning, coughing] - Okay, here we go. 11 00:00:18,352 --> 00:00:20,388 Dr. Choi, you're good? - Good. 12 00:00:20,421 --> 00:00:22,523 - All right, Monique... 13 00:00:22,556 --> 00:00:24,558 Seven treatment rooms on the East side, 14 00:00:24,592 --> 00:00:26,494 four trauma bays on the West. 15 00:00:26,527 --> 00:00:29,430 Bays three and four combine to treat gunshot wounds, 16 00:00:29,463 --> 00:00:33,101 a place affectionately known as Baghdad. 17 00:00:33,134 --> 00:00:34,502 4,000 shootings in Chicago. 18 00:00:34,535 --> 00:00:36,404 Some days, we get... - [yells] 19 00:00:36,437 --> 00:00:37,405 - A dozen. 20 00:00:37,438 --> 00:00:40,374 - [yelling] 21 00:00:40,408 --> 00:00:44,178 - Drug dispensers are in the North and South end of the E.D, 22 00:00:44,212 --> 00:00:47,648 extra gurneys, isolations suites in the ambulance bay. 23 00:00:47,681 --> 00:00:51,219 Uh, Band-Aid, wound dressings, gauze, and extra weaponry 24 00:00:51,252 --> 00:00:53,354 are in the supply closet next to the elevator, 25 00:00:53,387 --> 00:00:56,090 which brings us right here to the command center. 26 00:00:56,124 --> 00:00:57,525 - Deer in the headlights. - Mm-hmm. 27 00:00:57,558 --> 00:00:59,460 - Nursling? - Monique Lawson. 28 00:00:59,493 --> 00:01:02,330 She's got her Pediatric Advanced Life Support certification, 29 00:01:02,363 --> 00:01:05,166 and is doing her E.D. check-off skills training 30 00:01:05,199 --> 00:01:07,135 with yours truly. 31 00:01:07,168 --> 00:01:09,103 - Be careful, she bites. 32 00:01:09,137 --> 00:01:11,071 - Monique, Doris, move. 33 00:01:12,406 --> 00:01:15,509 - I hardly slept last night. [laughs] 34 00:01:15,543 --> 00:01:16,310 I couldn't stop thinking. 35 00:01:16,344 --> 00:01:18,179 I mean, so many people coming in, 36 00:01:25,519 --> 00:01:29,157 - Uh, cure sometimes, treat often, comfort always. 37 00:01:29,190 --> 00:01:31,292 - Uh-uh. Don't kill your patient... 38 00:01:31,325 --> 00:01:33,327 all: Because that's the doctor's job. 39 00:01:33,361 --> 00:01:35,696 - I heard that. - [laughs] 40 00:01:35,729 --> 00:01:37,565 - Maggie, what you got for me? 41 00:01:37,598 --> 00:01:38,632 - Alzheimer's patient, 42 00:01:38,666 --> 00:01:40,401 here from long-term care facility. 43 00:01:40,434 --> 00:01:43,471 Hypotensive and high fever in Treatment 2. 44 00:01:43,504 --> 00:01:45,173 - Any family? Advanced directives? 45 00:01:45,206 --> 00:01:47,241 - No, surrogate just passed away, 46 00:01:47,275 --> 00:01:49,543 and no one else was designated, so it's going to be our call. 47 00:01:50,744 --> 00:01:54,448 Okay, and you need to be initiating catheter duty. 48 00:01:54,482 --> 00:01:57,518 Patient in Treatment 6. Have a stab at her. 49 00:02:03,257 --> 00:02:05,926 - Wait, we need to page Will. 50 00:02:05,959 --> 00:02:06,927 - What is it? 51 00:02:06,960 --> 00:02:09,363 - This is Bella Rowan-- Dr. Rowan. 52 00:02:09,397 --> 00:02:11,199 She was Will's teacher, his mentor. 53 00:02:47,568 --> 00:02:50,604 Oh-- - Okay, all right, all right. 54 00:02:52,806 --> 00:02:55,776 - Who are you? 55 00:03:03,951 --> 00:03:06,687 Is that all right? - Oh, good. 56 00:03:06,720 --> 00:03:10,258 - Okay. - Gotta go. 57 00:03:10,291 --> 00:03:13,294 - Why is that? - Mm, miss my bus. 58 00:03:13,327 --> 00:03:16,364 - Oh, where are you going? 59 00:03:18,832 --> 00:03:21,001 - What? 60 00:03:21,034 --> 00:03:24,272 [coughing] 61 00:03:27,007 --> 00:03:27,908 - Okay, okay, okay... 62 00:03:27,941 --> 00:03:29,777 - [moans] - Tell you what, Dr. Rowan... 63 00:03:29,810 --> 00:03:32,280 - [moaning] 64 00:03:32,313 --> 00:03:34,315 - We promise to do our best, 65 00:03:34,348 --> 00:03:37,251 to get you out of here so you can catch that bus. 66 00:03:37,285 --> 00:03:39,587 How's that sound? - Good. 67 00:03:39,620 --> 00:03:40,621 - Good. - Good. 68 00:03:40,654 --> 00:03:43,391 [labored breathing] 69 00:03:43,424 --> 00:03:46,294 - All right. 70 00:03:46,327 --> 00:03:48,362 I'll be back to check on you in a few minutes. 71 00:03:53,434 --> 00:03:55,869 I'm pretty sure she's got aspiration pneumonia. 72 00:03:55,903 --> 00:03:57,938 - Yeah. - You start antibiotics? 73 00:03:57,971 --> 00:04:00,708 - Vanc and Zosyn, plus Levophed to maintain her pressure. 74 00:04:00,741 --> 00:04:02,042 Metabolic panel, urine analysis, 75 00:04:02,075 --> 00:04:04,812 and blood cultures are all pending. 76 00:04:04,845 --> 00:04:06,414 - She's obviously been sick for days. 77 00:04:06,447 --> 00:04:08,316 Why did they wait so long to bring her in? 78 00:04:08,349 --> 00:04:09,650 - I'm sorry, Will. 79 00:04:09,683 --> 00:04:12,886 - Dr. Halstead, I came as soon as I heard. 80 00:04:12,920 --> 00:04:15,389 I was an O.R. nurse under Dr. Rowan 81 00:04:15,423 --> 00:04:17,391 when I was starting out. 82 00:04:17,425 --> 00:04:19,293 How is she? 83 00:04:19,327 --> 00:04:22,029 - Not good, and we're playing catchup. 84 00:04:24,031 --> 00:04:25,999 All right, let's put in a central line 85 00:04:26,033 --> 00:04:27,100 and get a chest X-Ray, 86 00:04:27,134 --> 00:04:28,969 and I wanna keep close tabs on her volume status. 87 00:04:29,002 --> 00:04:30,771 Please, keep me updated every 20 minutes. 88 00:04:30,804 --> 00:04:32,306 - Of course. 89 00:04:37,645 --> 00:04:39,347 - Hey, we went to Joe's last night. 90 00:04:39,380 --> 00:04:41,081 My sister loves stone crab. 91 00:04:41,114 --> 00:04:41,882 It was nice. 92 00:04:41,915 --> 00:04:43,351 I mean, there were a lot of years 93 00:04:52,760 --> 00:04:54,428 She wants to have you over for dinner. 94 00:04:54,462 --> 00:04:56,364 - By meet, you mean grill? 95 00:04:56,397 --> 00:04:57,965 Make sure I'm worthy of a Rhodes? 96 00:05:05,138 --> 00:05:09,810 - I'm not sure if I'm ready to, uh, meet the family. 97 00:05:09,843 --> 00:05:11,779 - Morning, Dr. Rhodes. 98 00:05:11,812 --> 00:05:13,681 Robin... - Leah. 99 00:05:13,714 --> 00:05:16,784 - Dr. Bardovi, are you ready for your first coarctation repair? 100 00:05:16,817 --> 00:05:17,918 - I've been studying cases all week. 101 00:05:17,951 --> 00:05:18,986 - Good. 102 00:05:19,019 --> 00:05:21,955 - Course there's nothing like watching the maestro. 103 00:05:21,989 --> 00:05:24,392 - [chuckles] 104 00:05:24,425 --> 00:05:27,395 I will catch you at lunch, Maestro. 105 00:05:27,428 --> 00:05:29,830 - We'll continue this conversation later. 106 00:05:29,863 --> 00:05:31,932 Let's go. 107 00:05:31,965 --> 00:05:33,667 - Patient's 13. 108 00:05:33,701 --> 00:05:35,736 Pretty late to get a coarctation diagnosis. 109 00:05:35,769 --> 00:05:39,440 - Uh, his dad's an oil worker. He did a stint in Nigeria. 110 00:05:39,473 --> 00:05:42,410 Nobody there caught it. 111 00:05:42,443 --> 00:05:44,412 Knock, knock? 112 00:05:50,718 --> 00:05:52,686 Brandon, how are we doing this morning, bud? 113 00:05:52,720 --> 00:05:53,787 - We are both looking forward to getting on 114 00:05:53,821 --> 00:05:57,458 the other side of this thing. Ain't that right, buddy? 115 00:05:57,491 --> 00:05:59,893 - Uh, yeah, sure. 116 00:05:59,927 --> 00:06:02,796 Hey, are you guys gonna have to saw me open to do this? 117 00:06:02,830 --> 00:06:04,932 - Yes. Yes, we are. [chuckles] 118 00:06:04,965 --> 00:06:06,066 - I'm not scared. 119 00:06:06,099 --> 00:06:09,470 I'm just wondering if Halloran's gonna have a cool scar 120 00:06:09,503 --> 00:06:11,872 after the battle of Madigan. 121 00:06:21,815 --> 00:06:24,552 and my followers are gonna wanna know what happens to Halloran 122 00:06:24,585 --> 00:06:27,455 after he slays the High Locust. 123 00:06:27,488 --> 00:06:28,355 That's you. 124 00:06:44,605 --> 00:06:47,174 but it's actually a relatively simple procedure. 125 00:06:47,207 --> 00:06:49,943 Uh, I'm gonna make an incision in Brandon's left chest. 126 00:06:49,977 --> 00:06:51,879 We'll place him on partial bypass, 127 00:06:51,912 --> 00:06:53,881 and then resect, or cut out, 128 00:06:53,914 --> 00:06:55,483 the narrowed portion of his aorta, 129 00:06:55,516 --> 00:06:57,017 and place a graft. 130 00:06:57,050 --> 00:06:58,819 Now I know all this is a lot, 131 00:06:58,852 --> 00:07:00,488 but any questions, feel free. 132 00:07:00,521 --> 00:07:03,156 - Uh, yeah, I was doing some research online, 133 00:07:03,190 --> 00:07:05,893 and it seems that, uh, 134 00:07:05,926 --> 00:07:08,496 Brandon's chicken legs and his puny size 135 00:07:08,529 --> 00:07:10,230 are because of his condition? 136 00:07:10,263 --> 00:07:13,901 I mean, any chance that that'll change? 137 00:07:13,934 --> 00:07:18,839 - Uh, obviously, Brandon's health is our primary concern, 138 00:07:18,872 --> 00:07:21,475 uh, but yes, he may grow at a more rapid rate 139 00:07:21,509 --> 00:07:24,512 once the blood flow issue is corrected. 140 00:07:24,545 --> 00:07:27,247 - Good. [exhales] Okay. 141 00:07:27,280 --> 00:07:29,617 - All right, Brandon, see ya on the battle field. 142 00:07:41,094 --> 00:07:43,196 - Dr. Reese? 143 00:07:43,230 --> 00:07:45,533 You didn't answer your page. 144 00:07:45,566 --> 00:07:47,234 - Oh, sorry. 145 00:07:47,267 --> 00:07:50,904 I--I was just-- 146 00:07:53,106 --> 00:07:55,175 Uh... 147 00:08:00,213 --> 00:08:04,284 When Jason Wheeler jumped, do you think he was scared? 148 00:08:04,317 --> 00:08:06,053 Was-- 149 00:08:06,086 --> 00:08:12,092 I mean, was--was he at peace? 150 00:08:25,673 --> 00:08:27,841 - Yeah. 151 00:08:27,875 --> 00:08:29,943 - But see, I--I don't want to, 152 00:08:29,977 --> 00:08:33,881 and then I feel guilty, because I don't. 153 00:08:35,315 --> 00:08:37,985 - The thing about suicide, 154 00:08:38,018 --> 00:08:40,921 it's never really a lone act. 155 00:08:40,954 --> 00:08:43,657 It tends to leave a lot of victims in its wake. 156 00:08:57,170 --> 00:08:59,039 we've got work to do. 157 00:09:02,209 --> 00:09:04,645 - Excuse me. 158 00:09:11,318 --> 00:09:13,286 Co-pilot brought him in. Says it's not the first time. 159 00:09:13,320 --> 00:09:15,889 Now I checked Mr. Adams out. Can't find anything wrong. 160 00:09:15,923 --> 00:09:17,625 Probably just dehydrated and overworked. 161 00:09:17,658 --> 00:09:19,292 Says he feels fine and wants to go. 162 00:09:19,326 --> 00:09:21,294 - So, um--so why are we here? 163 00:09:21,328 --> 00:09:23,997 - Charter company wants a psych evaluation. 164 00:09:24,031 --> 00:09:26,299 - Uh-huh. 165 00:09:26,333 --> 00:09:29,169 Co-pilot says he's also been acting different. 166 00:09:29,202 --> 00:09:30,738 Doesn't go out with the boys anymore, 167 00:09:30,771 --> 00:09:32,640 naps a lot, 168 00:09:41,414 --> 00:09:43,050 - Thanks. 169 00:09:45,085 --> 00:09:48,155 - Code blue! 170 00:09:48,188 --> 00:09:50,390 Unresponsive two-year-old. Quick, what do we do first? 171 00:09:50,423 --> 00:09:52,993 - Check pulse, start compressions. 172 00:09:53,026 --> 00:09:55,629 - There is no pulse. - Compressions at what rate? 173 00:09:55,663 --> 00:09:58,231 - 150 beats per minute. - Good. 174 00:10:04,738 --> 00:10:07,074 - Okay, but there's still no pulse. 175 00:10:07,107 --> 00:10:08,642 Patient's dying. What now? 176 00:10:08,676 --> 00:10:12,045 - Use the paddles to do a quick look. 177 00:10:12,079 --> 00:10:14,414 - Shows v-fib. She's coding, so? 178 00:10:14,447 --> 00:10:17,217 - Need to shock at 4 joules per kilo? 179 00:10:17,250 --> 00:10:19,753 - Well, move then. You're losing her. 180 00:10:19,787 --> 00:10:21,321 Charge to 28 joules. 181 00:10:21,354 --> 00:10:23,123 - I'm shocking the patient. 182 00:10:23,156 --> 00:10:24,692 - Great. 183 00:10:24,725 --> 00:10:26,293 You just killed me. 184 00:10:26,326 --> 00:10:27,761 - I did? - Mm-hmm. 185 00:10:27,795 --> 00:10:29,963 - You forgot to yell "clear" before shocking. 186 00:10:29,997 --> 00:10:32,065 Just one of those minor details. 187 00:10:32,099 --> 00:10:34,735 Reset. Let's take it from the top. 188 00:10:34,768 --> 00:10:37,370 Come on. 189 00:10:37,404 --> 00:10:39,072 - It just seems like everyone's overreacting. 190 00:10:39,106 --> 00:10:40,073 - But you can see their point of view. 191 00:10:40,107 --> 00:10:42,275 I mean, people put their lives in your hands. 192 00:10:42,309 --> 00:10:43,310 - And I'm fine. 193 00:10:43,343 --> 00:10:46,313 I've answered your question. I know what today is. 194 00:10:46,346 --> 00:10:48,448 I know where I am. 195 00:10:48,481 --> 00:10:50,751 - Aside from lack of energy, 196 00:10:50,784 --> 00:10:54,187 your co-pilot says that at times you seem mildly confused. 197 00:10:54,221 --> 00:10:55,989 - I have no idea what he's talking about. 198 00:10:56,023 --> 00:10:57,190 [stammers, laughs] 199 00:10:57,224 --> 00:10:59,259 Maybe he's the one that's confused. 200 00:10:59,292 --> 00:11:03,330 - Mr. Adams, I imagine there's a lot of pressure at your job. 201 00:11:03,363 --> 00:11:06,399 - I used to land F-14s on an aircraft carrier. 202 00:11:06,433 --> 00:11:08,268 That's pressure. 203 00:11:08,301 --> 00:11:10,270 - Have you ever had thoughts of hurting yourself? 204 00:11:10,303 --> 00:11:12,740 - What? No. 205 00:11:12,773 --> 00:11:15,142 - Let's see here. Are you on any medication? 206 00:11:15,175 --> 00:11:16,243 - You mean do I take anything 207 00:11:16,276 --> 00:11:17,745 that might affect my performance? 208 00:11:17,778 --> 00:11:19,446 No. 209 00:11:35,195 --> 00:11:38,065 Getting, um, a little ahead of yourself. 210 00:11:38,098 --> 00:11:38,999 Don't you think? 211 00:11:39,032 --> 00:11:41,401 - Well, he is exhibiting signs of depression, 212 00:11:41,434 --> 00:11:43,403 and there is a high rate of suicide among pilots. 213 00:11:43,436 --> 00:11:44,404 - Dr. Reese, trust me, 214 00:11:44,437 --> 00:11:47,775 I understand what's on your mind, but suicidality 215 00:11:47,808 --> 00:11:50,210 should not necessarily be a default diagnosis. 216 00:11:50,243 --> 00:11:51,378 - So what do you think? 217 00:11:51,411 --> 00:11:54,047 - I think that Mr. Adams is linear, lucid. 218 00:11:54,081 --> 00:11:55,749 I mean, he's certainly not confused. 219 00:11:55,783 --> 00:11:57,284 - Are you gonna sign off on him? 220 00:11:57,317 --> 00:11:58,451 - Well, I didn't say that. 221 00:11:58,485 --> 00:12:01,088 I mean, I thought he was a little defensive 222 00:12:01,121 --> 00:12:02,455 around the medication issue. 223 00:12:02,489 --> 00:12:04,792 - Well, the man has to prove himself to keep his job. 224 00:12:04,825 --> 00:12:06,193 That would make me defensive. 225 00:12:06,226 --> 00:12:07,895 - And you know what, that could be all there is to it. 226 00:12:07,928 --> 00:12:11,131 But look, he's a pilot. Let's just take the extra step. 227 00:12:11,164 --> 00:12:13,333 You know, run a tox screen, make sure he's clean. 228 00:12:13,366 --> 00:12:14,802 - Okay. 229 00:12:14,835 --> 00:12:17,170 - To your point, depressives often self-medicate, 230 00:12:17,204 --> 00:12:20,273 so I'm not ruling out the diagnosis. 231 00:12:22,242 --> 00:12:23,877 - Dr. Rowan's LFTs are high, 232 00:12:23,911 --> 00:12:25,412 her creatinine's through the roof. 233 00:12:25,445 --> 00:12:27,214 - Kidneys are struggling. 234 00:12:27,247 --> 00:12:28,849 White cell count's high too. 235 00:12:28,882 --> 00:12:32,886 - Multiple organ failure and pending respiratory failure. 236 00:12:32,920 --> 00:12:35,488 - We need to intubate her. - What--at her age? 237 00:12:35,522 --> 00:12:37,925 - Nurse! - No, mm, Will... 238 00:12:37,958 --> 00:12:40,794 you know what this means. She might never get off. 239 00:12:51,872 --> 00:12:54,507 He wants to know how Dr. Rowan is doing. 240 00:12:54,541 --> 00:12:56,543 - I'll be happy to tell him. 241 00:12:58,411 --> 00:13:01,448 Sherwood, is it? 242 00:13:01,481 --> 00:13:03,483 You mind telling me how you and your staff 243 00:13:03,516 --> 00:13:05,252 let a textbook case of aspiration pneumonia 244 00:13:05,285 --> 00:13:06,954 go unattended? 245 00:13:06,987 --> 00:13:09,389 - I-I don't think that happened. 246 00:13:09,422 --> 00:13:10,690 - You don't? 247 00:13:10,723 --> 00:13:12,592 Then--then how was she allowed to aspirate in the first place? 248 00:13:12,625 --> 00:13:14,828 - Dr. Halstead... - 'cause I-- 249 00:13:14,862 --> 00:13:16,463 I visited her every month. 250 00:13:26,639 --> 00:13:29,943 all because you denied her the most basic--hey! 251 00:13:29,977 --> 00:13:32,345 - Dr. Halstead... 252 00:13:33,646 --> 00:13:35,415 Thank you, Mr. Sherwood. 253 00:13:37,517 --> 00:13:39,286 - Will... 254 00:13:39,319 --> 00:13:41,621 - They're criminals. 255 00:13:52,632 --> 00:13:52,765 . 256 00:13:52,799 --> 00:13:54,034 - You've all achieved something very special today. 257 00:13:56,970 --> 00:14:01,041 Now you're physicians, doctors. 258 00:14:01,074 --> 00:14:04,044 In a few months, you'll begin your residencies, 259 00:14:04,077 --> 00:14:06,947 caring for people in need. 260 00:14:06,980 --> 00:14:10,517 If you take one thing away from me today, 261 00:14:10,550 --> 00:14:13,653 let it be this. 262 00:14:13,686 --> 00:14:17,958 Treat the patient, not the disease. 263 00:14:19,927 --> 00:14:21,962 - Brought you some Vitner's. - Ah... 264 00:14:21,995 --> 00:14:25,598 - Triple cheese. [chuckles] - Thanks. 265 00:14:25,632 --> 00:14:27,500 - Dr. Rowan? 266 00:14:29,502 --> 00:14:31,471 I'm really sorry, Will. 267 00:14:31,504 --> 00:14:33,573 I know how hard it'll be-- - No. 268 00:14:33,606 --> 00:14:36,944 No, if we can get her temp down and her sats up, 269 00:14:36,977 --> 00:14:39,446 I think we'll be over the hump. 270 00:14:39,479 --> 00:14:41,548 - Hm. 271 00:14:41,581 --> 00:14:43,116 Kay. 272 00:14:46,486 --> 00:14:48,055 I just remember when my grandma got sick, 273 00:14:48,088 --> 00:14:50,457 how tough it was for my mom. 274 00:14:50,490 --> 00:14:53,560 The options, decisions-- [chuckles] 275 00:14:53,593 --> 00:14:56,964 Seeing my grandma so ill. 276 00:15:07,174 --> 00:15:09,977 Dr. Rowan gave me so much. 277 00:15:10,010 --> 00:15:12,579 Getting her through this, 278 00:15:22,622 --> 00:15:24,958 pick your labs, and then hit submit. 279 00:15:24,992 --> 00:15:26,126 - Okay. 280 00:15:28,028 --> 00:15:29,129 - Excuse me... - Yep. 281 00:15:29,162 --> 00:15:31,531 - I'm looking for my husband, Sean Adams. 282 00:15:31,564 --> 00:15:33,466 - He's in Treatment 4. I'll page his doctor. 283 00:15:33,500 --> 00:15:34,667 - Thank you. 284 00:15:38,171 --> 00:15:39,706 - How's it look? 285 00:15:39,739 --> 00:15:41,641 - Systolic's still 50 higher in the arms, 286 00:15:41,674 --> 00:15:44,244 but that's not uncommon right after surgery. 287 00:15:44,277 --> 00:15:48,015 It should come down in the next 24 hours or so. 288 00:15:48,048 --> 00:15:52,052 It looks like Halloran slayed the High Locust after all. 289 00:15:56,456 --> 00:15:59,092 - Hey, um, so how much longer 290 00:15:59,126 --> 00:16:02,762 before he's up and running around? 291 00:16:02,795 --> 00:16:04,131 - Uh, well, over the next few months, 292 00:16:04,164 --> 00:16:06,033 you should see an increase in energy 293 00:16:06,066 --> 00:16:08,735 and some improvement in muscle development. 294 00:16:08,768 --> 00:16:10,637 - Oh, thanks. I can't tell ya. 295 00:16:10,670 --> 00:16:13,540 I've been dreaming about the day I could get out in the yard 296 00:16:13,573 --> 00:16:17,477 and toss a football with my son, like my dad did with me. 297 00:16:17,510 --> 00:16:19,479 - Well, hopefully that'll happen. 298 00:16:19,512 --> 00:16:22,615 Right now, why don't you just let him get some rest? 299 00:16:27,787 --> 00:16:30,123 - See, Mr. Adams, as part of our evaluation, 300 00:16:30,157 --> 00:16:31,591 we run a toxicology screen, 301 00:16:31,624 --> 00:16:34,727 and I'm happy to say that yours was normal. 302 00:16:34,761 --> 00:16:36,729 - I told you I don't take drugs. 303 00:16:36,763 --> 00:16:38,698 - However, we did find something else. 304 00:16:38,731 --> 00:16:40,733 Profound anemia. - Anemia? 305 00:16:40,767 --> 00:16:43,603 - It could explain your feeling faint. 306 00:16:43,636 --> 00:16:45,772 - Okay, I-I guess I gotta eat more steak. [chuckles] 307 00:16:45,805 --> 00:16:47,607 - It's actually more serious than that. 308 00:16:47,640 --> 00:16:48,541 We need to transfuse you 309 00:16:48,575 --> 00:16:50,310 with several units of blood right away. 310 00:16:50,343 --> 00:16:51,544 We also need to find out what's causing it, 311 00:16:51,578 --> 00:16:53,746 so I'd like to admit you for a battery of scans and tests. 312 00:16:53,780 --> 00:16:55,182 - Uh-uh, I've got my own doctor. 313 00:16:55,215 --> 00:16:56,416 I'll make an appointment with him. 314 00:16:56,449 --> 00:16:58,485 - Mr. Adams, we don't want you to leave in this condition. 315 00:16:58,518 --> 00:16:59,719 You're not well. - I feel fine. 316 00:16:59,752 --> 00:17:01,488 - Sean, are you sure about that? 317 00:17:01,521 --> 00:17:03,256 - Yes, and a car ride home 318 00:17:03,290 --> 00:17:05,625 and sleeping in my own bed isn't gonna hurt me. 319 00:17:05,658 --> 00:17:06,826 - That may not be true. 320 00:17:06,859 --> 00:17:10,230 I-I emphatically recommend that you take Dr. Choi's advice. 321 00:17:17,670 --> 00:17:19,639 - Well, you're not the only psychiatrist in Chicago. 322 00:17:19,672 --> 00:17:21,108 I'll get a referral from my primary. 323 00:17:21,141 --> 00:17:22,342 - Sean... - Viv, we're going. 324 00:17:22,375 --> 00:17:23,343 Hand me my clothes. 325 00:17:23,376 --> 00:17:25,312 Please get me whatever paperwork I need to sign, 326 00:17:25,345 --> 00:17:27,180 so I can get out of here. 327 00:17:27,214 --> 00:17:29,116 - I'll be back shortly. 328 00:17:31,784 --> 00:17:33,220 - Something's just not right with him. 329 00:17:33,253 --> 00:17:35,255 - I agree. - But is it physical or mental? 330 00:17:35,288 --> 00:17:36,623 - Your guess is as good as mine. 331 00:17:36,656 --> 00:17:40,093 Unfortunately, we have no grounds to hold him. 332 00:17:40,127 --> 00:17:42,095 - I'll get the paperwork ready. 333 00:17:45,365 --> 00:17:47,734 - Okay, so your patient is in SVT. 334 00:17:47,767 --> 00:17:49,736 What do you do? 335 00:17:49,769 --> 00:17:53,273 - Um, cardiovert at 7 joules. 336 00:17:53,306 --> 00:17:54,607 - Right. 337 00:17:54,641 --> 00:17:56,143 So she's back in sinus rhythm. What now? 338 00:17:56,176 --> 00:17:57,277 - Check her vitals... - Mm-hmm. 339 00:17:57,310 --> 00:17:59,179 - Establish IV access, 340 00:17:59,212 --> 00:18:02,215 provide fluids if her BP drops below 75 systolic. 341 00:18:02,249 --> 00:18:05,285 - And? The adenosine? You got a dose? 342 00:18:05,318 --> 00:18:06,719 - Um... 343 00:18:08,321 --> 00:18:09,689 Adenosine is scratched out. 344 00:18:09,722 --> 00:18:11,158 - Calculate then. 345 00:18:11,191 --> 00:18:12,759 Your patient's gonna revert back to SVT. 346 00:18:12,792 --> 00:18:14,294 Come on. - Um... 347 00:18:14,327 --> 00:18:15,762 - It's a life and death situation here. 348 00:18:15,795 --> 00:18:18,831 - 6.5 milligrams of adenosine. 349 00:18:18,865 --> 00:18:21,168 - * Dum, dum, duh-dum 350 00:18:21,201 --> 00:18:23,636 * Dum, dum, dum, dum, dum, dum, dum * 351 00:18:23,670 --> 00:18:27,340 - It's 0.65, not 6.5. Here. 352 00:18:27,374 --> 00:18:29,576 - Oh... [sighs] I'm sorry. 353 00:18:29,609 --> 00:18:30,777 - [sighs] 354 00:18:33,780 --> 00:18:37,850 - What happened? - He can't feel his left arm. 355 00:18:37,884 --> 00:18:39,619 - All right, left BP is 80 over 30. 356 00:18:39,652 --> 00:18:41,654 Check the right. Sat's at 70. 357 00:18:41,688 --> 00:18:44,724 Hey, Brandon, can you squeeze my hand? 358 00:18:44,757 --> 00:18:46,759 - [gasps] No. No, I can't. 359 00:18:46,793 --> 00:18:49,296 - Okay. - Right arm's 150 over 100. 360 00:18:49,329 --> 00:18:50,797 - What's--what's going on? 361 00:18:50,830 --> 00:18:52,932 - All right, legs are cold. We need a CT angio now! 362 00:18:52,965 --> 00:18:54,667 - Got it! 363 00:18:54,701 --> 00:18:56,369 - Dad? - What is happening? 364 00:18:56,403 --> 00:18:58,438 - Brandon's not getting blood to his left arm, 365 00:18:58,471 --> 00:19:00,273 but I need a picture of it to see. 366 00:19:00,307 --> 00:19:02,842 It's possible that the graft we put in has become occluded. 367 00:19:07,914 --> 00:19:09,849 - It may be more complicated than that. 368 00:19:18,725 --> 00:19:20,427 - She's in v-fib! 369 00:19:22,862 --> 00:19:23,930 - Paddles. Start compressions. 370 00:19:23,963 --> 00:19:28,735 - Will, I'll break her ribs. - Charge to 200 joules. 371 00:19:28,768 --> 00:19:30,237 Star compressions now! 372 00:19:30,270 --> 00:19:32,472 - Are you sure? I-- 373 00:19:32,505 --> 00:19:34,741 - Out of my way. - No, Will. 374 00:19:34,774 --> 00:19:38,378 [valve hissing] 375 00:19:38,411 --> 00:19:40,780 - Are we charged? - 200 joules. 376 00:19:40,813 --> 00:19:42,782 - Holding the CPR. Clear. 377 00:19:45,418 --> 00:19:49,389 One milligram of epi, charge to 200 again. 378 00:19:49,422 --> 00:19:51,791 - 200. - All right, clear. 379 00:20:16,449 --> 00:20:16,583 . 380 00:20:16,616 --> 00:20:16,816 - Hey. 381 00:20:19,419 --> 00:20:22,322 - Dr. Halstead decided to intubate. 382 00:20:26,359 --> 00:20:30,630 You know, this woman is the reason I stayed in nursing. 383 00:20:30,663 --> 00:20:33,333 My first year as an O.R. nurse, 384 00:20:33,366 --> 00:20:35,535 I actually thought about quitting. 385 00:20:35,568 --> 00:20:37,537 - You? - Oh, I had a rough time. 386 00:20:37,570 --> 00:20:39,038 [chuckles] 387 00:20:39,071 --> 00:20:42,775 There was this, um, surgery I scrubbed on. 388 00:20:42,809 --> 00:20:44,677 I think it was a vascular case. 389 00:20:44,711 --> 00:20:48,014 The resident asked for a ten blade scalpel. 390 00:20:48,047 --> 00:20:51,451 It slipped out of my hand, dropped in the incision. 391 00:20:51,484 --> 00:20:54,387 - Oh, my God. - It didn't hurt the patient, 392 00:20:54,421 --> 00:20:58,558 but that resident reamed me out. 393 00:20:58,591 --> 00:21:01,528 Dr. Rowan stepped in, called him out, 394 00:21:01,561 --> 00:21:06,599 said everyone in the O.R. deserved civility. 395 00:21:06,633 --> 00:21:09,035 Everyone. 396 00:21:09,068 --> 00:21:11,003 Bella Rowan. 397 00:21:13,340 --> 00:21:16,676 Wonderful woman. 398 00:21:16,709 --> 00:21:19,612 Extraordinary teacher. 399 00:21:23,816 --> 00:21:26,753 - Sean? Sean, oh, my God. 400 00:21:26,786 --> 00:21:29,055 Oh, my God. Uh, help, someone! 401 00:21:29,088 --> 00:21:31,358 Help my husband, please. 402 00:21:31,391 --> 00:21:33,059 - Okay, hey, I need a gurney here. 403 00:21:33,092 --> 00:21:34,694 - Whoa! Mr. Adams, can you hear me? 404 00:21:34,727 --> 00:21:36,796 - What's wrong with him? - Unresponsive, 405 00:21:36,829 --> 00:21:38,398 has a pulse. Let's get him in a room. 406 00:21:38,431 --> 00:21:40,767 - Bring it over here. 407 00:21:40,800 --> 00:21:42,735 - [whimpers] 408 00:21:42,769 --> 00:21:44,704 - Let's transfer on my count. Ready, one, two, three. 409 00:21:44,737 --> 00:21:45,705 [grunts] - [whimpers] 410 00:21:45,738 --> 00:21:47,707 - Here we go. - All right, he's not breathing. 411 00:21:47,740 --> 00:21:50,343 Get a laryngoscope and a 7.5 ET tube. 412 00:21:50,377 --> 00:21:51,744 - Sean! - Trauma 1 to prep. 413 00:21:53,380 --> 00:21:55,482 - He's totally flaccid. Don't need drugs. 414 00:21:57,450 --> 00:21:59,452 - Monique, you start the IV. 415 00:21:59,486 --> 00:22:01,721 - Okay. 416 00:22:01,754 --> 00:22:02,855 - Sean... 417 00:22:02,889 --> 00:22:04,491 - Okay, you stand right here. - Okay. 418 00:22:04,524 --> 00:22:06,393 - He's got a massive upper GI bleed. 419 00:22:06,426 --> 00:22:08,361 His stomach's filling with blood. 420 00:22:08,395 --> 00:22:10,062 I'm in. April, listen to his lungs. 421 00:22:10,096 --> 00:22:11,631 - Yep. 422 00:22:18,638 --> 00:22:19,806 Why--why is this happening? - I don't know, 423 00:22:19,839 --> 00:22:21,708 but we're gonna find out. 424 00:22:21,741 --> 00:22:22,842 [valve hissing] - Hang saline. 425 00:22:22,875 --> 00:22:24,811 - Saline's up. - All right, stay on it. 426 00:22:34,587 --> 00:22:36,723 - Got your page. 427 00:22:36,756 --> 00:22:39,592 - Dr. Rowan's latest labs. 428 00:22:39,626 --> 00:22:42,094 I am so sorry. She's in acute renal failure. 429 00:22:42,128 --> 00:22:44,897 Hyperkalemic and still acidotic. 430 00:22:46,566 --> 00:22:49,802 - All right, we'll start her on low flow dialysis. 431 00:22:49,836 --> 00:22:51,504 It should correct her electrolytes and PH. 432 00:22:51,538 --> 00:22:53,540 - Will... 433 00:22:53,573 --> 00:22:55,875 - I won't stand by and let her die. 434 00:22:58,110 --> 00:23:00,146 Tell April to call renal. 435 00:23:02,682 --> 00:23:04,651 - [sighs] 436 00:23:06,753 --> 00:23:09,656 - Graft occlusion is a possible outcome of any vascular surgery. 437 00:23:09,689 --> 00:23:11,824 It's nobody's fault. 438 00:23:11,858 --> 00:23:13,726 Okay, so there are two options, right? 439 00:23:13,760 --> 00:23:17,464 We could either-- - Just let me handle this, okay? 440 00:23:18,965 --> 00:23:20,867 Mitch, a moment? 441 00:23:20,900 --> 00:23:22,602 - Uh... 442 00:23:25,538 --> 00:23:27,707 What is it? 443 00:23:27,740 --> 00:23:29,476 - So the CT revealed that the graft 444 00:23:29,509 --> 00:23:31,210 I placed in Brandon's chest kinked, 445 00:23:31,243 --> 00:23:32,278 causing re-coarctation, 446 00:23:32,311 --> 00:23:36,783 or essentially a, uh-- a narrowing of his aorta. 447 00:23:48,695 --> 00:23:50,730 Now I can repair the graft by placing a stent, 448 00:23:50,763 --> 00:23:52,832 and we would do that in the cath lab. 449 00:23:52,865 --> 00:23:54,634 But the stent will cover 450 00:23:54,667 --> 00:23:57,837 the opening of his left subclavian artery. 451 00:23:57,870 --> 00:24:01,874 That will cut off circulation to his left arm, 452 00:24:01,908 --> 00:24:06,212 meaning Brandon will lose that arm. 453 00:24:06,245 --> 00:24:08,214 - Lose his arm? - Mm-hmm. 454 00:24:14,787 --> 00:24:17,223 - Uh, no. 455 00:24:17,256 --> 00:24:20,159 No--[stammers]--he can't. He can't. 456 00:24:20,192 --> 00:24:22,795 It--there must be something else you can do. 457 00:24:24,531 --> 00:24:26,533 - I'm sorry, but no. 458 00:24:26,566 --> 00:24:29,468 I'm afraid this is our only viable option. 459 00:24:30,903 --> 00:24:33,973 - Oh, God. 460 00:24:34,006 --> 00:24:34,874 - Hey, look, Mitch, 461 00:24:34,907 --> 00:24:37,276 why don't you go be with your son, okay? 462 00:24:37,309 --> 00:24:39,846 We'll take him up to surgery soon. 463 00:24:39,879 --> 00:24:41,548 I'm very sorry. 464 00:24:42,882 --> 00:24:44,551 - [sighs] 465 00:24:45,985 --> 00:24:47,754 - Pardon me, Dr. Rhodes. 466 00:24:47,787 --> 00:24:49,522 I know you must've had a very good reason, 467 00:24:49,556 --> 00:24:51,558 but you didn't present the other option, 468 00:24:51,591 --> 00:24:52,825 the carotid subclavian bypass. 469 00:24:52,859 --> 00:24:55,528 Wouldn't that preserve Brandon's arm? 470 00:24:55,562 --> 00:24:58,765 - Dr. Bardovi, 20 to 30% of young patients 471 00:24:58,798 --> 00:25:00,967 will stroke out and possibly die 472 00:25:01,000 --> 00:25:02,802 when you clamp their carotid. 473 00:25:02,835 --> 00:25:03,970 It's too big of a risk. - Okay, but still-- 474 00:25:04,003 --> 00:25:06,706 - It's too big of a risk. 475 00:25:21,253 --> 00:25:23,222 He wants his son to be something he isn't. 476 00:25:23,255 --> 00:25:26,559 He'll choose the bypass. It's too dangerous. 477 00:25:26,593 --> 00:25:28,795 - But it's his decision, not yours. 478 00:25:28,828 --> 00:25:30,296 - I already opened Brandon up once. 479 00:25:30,329 --> 00:25:31,631 I'm not gonna do it again. 480 00:25:31,664 --> 00:25:32,832 I'm not gonna risk this boy's life 481 00:25:32,865 --> 00:25:34,767 just to save his arm. 482 00:25:46,078 --> 00:25:46,545 . 483 00:25:46,579 --> 00:25:47,046 - Huge gastric ulcer. 484 00:25:47,947 --> 00:25:49,315 That's where all the blood was coming from. 485 00:25:49,348 --> 00:25:50,482 - Were you able to stop the bleeding? 486 00:25:50,516 --> 00:25:53,119 - Yeah, GI cauterized it, but that's not the headline. 487 00:25:53,152 --> 00:25:57,790 Sean's endoscopy shows chronic caustic esophageal erosions. 488 00:25:57,824 --> 00:25:59,826 And his chest X-Ray... 489 00:25:59,859 --> 00:26:02,161 - Pneumonitis. - Yeah. 490 00:26:02,194 --> 00:26:04,030 This is a pattern suggestive of ingesting 491 00:26:04,063 --> 00:26:06,132 some sort of hydrocarbon. 492 00:26:06,165 --> 00:26:08,000 - Isn't that in cleaning products? 493 00:26:08,034 --> 00:26:10,970 - And lighter fluid, motor oil, gasoline. 494 00:26:11,003 --> 00:26:13,673 Extremely toxic, so we must be talking about 495 00:26:13,706 --> 00:26:15,875 low doses over a long period of time. 496 00:26:15,908 --> 00:26:17,076 - So I was right. 497 00:26:17,109 --> 00:26:18,811 We should be concerned he's suicidal. 498 00:26:18,845 --> 00:26:20,379 - Why assume he's doing this to himself? 499 00:26:20,412 --> 00:26:23,082 - Well, what, you think someone's poisoning him? 500 00:26:23,115 --> 00:26:24,951 - I don't know. It's possible. 501 00:26:24,984 --> 00:26:26,185 I had a case where a wife was slipping something 502 00:26:26,218 --> 00:26:27,754 into her husband's food. 503 00:26:27,787 --> 00:26:29,956 - So you think it's his wife? 504 00:26:29,989 --> 00:26:32,091 - You know, hydrocarbons are extremely noxious, 505 00:26:38,798 --> 00:26:41,067 - I don't know. Suicide? 506 00:26:41,100 --> 00:26:43,035 Attempted murder? 507 00:26:43,069 --> 00:26:45,738 I think it might be something else altogether. 508 00:26:56,115 --> 00:26:59,719 - I just checked in on Dr. Rowan. 509 00:26:59,752 --> 00:27:02,054 I heard you ordered dialysis. 510 00:27:02,088 --> 00:27:03,155 - She's in renal failure. 511 00:27:03,189 --> 00:27:04,824 That's the appropriate treatment. 512 00:27:04,857 --> 00:27:09,128 - I understand the medicine, doctor. 513 00:27:09,161 --> 00:27:11,931 Even if you dialyze her-- - I am. 514 00:27:11,964 --> 00:27:13,866 - Even if you dialyze her, 515 00:27:13,900 --> 00:27:16,402 she's unlikely to come off the vent. 516 00:27:16,435 --> 00:27:19,138 That means she'll be bedridden. 517 00:27:19,171 --> 00:27:22,742 Eventually, she'll need a tracheostomy. 518 00:27:24,877 --> 00:27:28,014 You've already broken her ribs. 519 00:27:28,047 --> 00:27:31,718 Now she'll have bed sores, a feeding tube. 520 00:27:33,185 --> 00:27:38,825 Shouldn't quality of life be a consideration? 521 00:27:57,043 --> 00:27:59,812 - I mean, remember that ballplayer I told you about? 522 00:27:59,846 --> 00:28:03,449 He was a pitcher with one arm. He was one of the best. 523 00:28:03,482 --> 00:28:06,986 All right, so, you know, be strong. 524 00:28:07,019 --> 00:28:09,088 We can do this. 525 00:28:09,121 --> 00:28:11,891 I mean, the important thing is that you're gonna be alive. 526 00:28:11,924 --> 00:28:14,927 And healthy. 527 00:28:14,961 --> 00:28:18,097 We'll figure out the rest, okay? Together. 528 00:28:20,232 --> 00:28:21,500 - Mitch... - Yeah. 529 00:28:21,533 --> 00:28:23,936 - Guys, if you can hold on for a second. 530 00:28:23,970 --> 00:28:26,205 Have a word with you? - Okay, buddy. 531 00:28:29,842 --> 00:28:33,012 - So, I've been thinking about Brandon's case, 532 00:28:33,045 --> 00:28:35,281 and there is something else we can try. 533 00:28:38,818 --> 00:28:40,953 [device whirs] - Wrong angle. 534 00:28:40,987 --> 00:28:44,190 You need to go in perpendicular, or you'll stay in the cortex. 535 00:28:44,223 --> 00:28:46,793 - Okay. 536 00:28:46,826 --> 00:28:49,929 [device whirring] 537 00:28:49,962 --> 00:28:51,063 - You're too shallow. 538 00:28:51,097 --> 00:28:54,300 You need to keep on drilling until you hub the needle. 539 00:28:58,871 --> 00:29:00,506 - Not like that. 540 00:29:00,539 --> 00:29:02,341 Who taught her how to do an IO? An orangutan? 541 00:29:02,374 --> 00:29:06,245 - Okay. She'll get there. 542 00:29:06,278 --> 00:29:08,948 We've all gone through this. Just take it slowly. 543 00:29:10,983 --> 00:29:13,786 Go ahead. 544 00:29:13,820 --> 00:29:15,922 [device whirs] 545 00:29:17,857 --> 00:29:19,158 There you go. 546 00:29:26,966 --> 00:29:30,903 - White board says carotid subclavian bypass. 547 00:29:30,937 --> 00:29:32,271 It's just, I thought-- 548 00:29:32,304 --> 00:29:34,841 - I presented both options to the patient's father. 549 00:29:34,874 --> 00:29:39,145 As I suspected, he chose the carotid subclavian bypass. 550 00:29:39,178 --> 00:29:41,580 - And you're gonna do a great job, Dr. Rhodes. 551 00:29:41,613 --> 00:29:43,249 You're an exceptional surgeon, and it is an honor to be-- 552 00:29:43,282 --> 00:29:45,885 - Dr. Bardovi, you don't have to do that. 553 00:29:47,153 --> 00:29:49,155 You're a fine surgeon, 554 00:30:01,400 --> 00:30:04,036 you ever find yourself doing something 555 00:30:04,070 --> 00:30:06,138 that you know you shouldn't, 556 00:30:06,172 --> 00:30:08,407 but you just can't stop? 557 00:30:08,440 --> 00:30:11,243 - I have no idea what you're talking about. 558 00:30:11,277 --> 00:30:13,045 [chuckles] 559 00:30:13,079 --> 00:30:16,015 My wife would say that I-- I watch too much football. 560 00:30:16,048 --> 00:30:17,917 - [chuckles] 561 00:30:17,950 --> 00:30:20,286 Can I tell you my dirty little secret? 562 00:30:20,319 --> 00:30:21,353 I went through this phase 563 00:30:21,387 --> 00:30:25,057 where I would come home every night, 564 00:30:25,091 --> 00:30:29,395 cut my nails every night, like down to the quick. 565 00:30:29,428 --> 00:30:31,363 Hm, couldn't stop. 566 00:30:31,397 --> 00:30:35,634 On some level, I must've been satisfying some urge, 567 00:30:35,667 --> 00:30:38,337 but my hands were bleeding. 568 00:30:38,370 --> 00:30:40,239 [stammers] 569 00:30:40,272 --> 00:30:42,074 It wasn't good. 570 00:30:42,108 --> 00:30:43,242 - And the point of this? 571 00:30:43,275 --> 00:30:47,379 - The point is that I understand compulsive behavior. 572 00:30:47,413 --> 00:30:49,348 You know, it's not rational. You can't explain it. 573 00:30:49,381 --> 00:30:53,352 You just--you just do it. 574 00:30:53,385 --> 00:30:55,621 Yeah, but eventually, 575 00:30:55,654 --> 00:30:59,258 like with me, your fingers bleed, 576 00:30:59,291 --> 00:31:01,260 or something similar. 577 00:31:16,475 --> 00:31:19,178 Sean, I think you have a compulsion, 578 00:31:19,211 --> 00:31:22,414 and you're tired, 579 00:31:22,448 --> 00:31:24,416 and you're also getting scared. 580 00:31:24,450 --> 00:31:25,985 I mean, who wouldn't be scared? 581 00:31:26,018 --> 00:31:30,156 All that--all that blood? All that vomiting? 582 00:31:39,031 --> 00:31:40,332 - Yes. 583 00:31:43,269 --> 00:31:45,104 I'm tired. 584 00:31:50,542 --> 00:31:52,211 - Mr. Adams, we think you're ingesting 585 00:31:52,244 --> 00:31:55,681 something very harmful. 586 00:31:55,714 --> 00:31:57,349 Can you tell us what it is? 587 00:32:02,154 --> 00:32:05,157 Mr. Adams, please, we can help you. 588 00:32:10,396 --> 00:32:11,998 - Gasoline. 589 00:32:12,031 --> 00:32:13,465 - I'm sorry? Say again? 590 00:32:29,315 --> 00:32:29,448 . 591 00:32:29,481 --> 00:32:29,948 - Is my husband crazy? 592 00:32:41,460 --> 00:32:45,097 a psychiatric disorder known as Pica, 593 00:32:45,131 --> 00:32:49,301 which involves the compulsive consumption of non-nutritive, 594 00:32:49,335 --> 00:32:52,471 and sometimes even hazardous, substances. 595 00:32:52,504 --> 00:32:54,540 - For some, it's paint chips. 596 00:32:54,573 --> 00:32:57,443 For others, dirt. 597 00:32:57,476 --> 00:33:00,212 For your husband, it's gasoline. 598 00:33:00,246 --> 00:33:01,613 - Why? 599 00:33:01,647 --> 00:33:04,650 - There's no unified theory as to the cause. 600 00:33:04,683 --> 00:33:07,686 All we know is that it manifests itself as a compulsion, 601 00:33:07,719 --> 00:33:12,391 an irresistible urge, against one's conscious wishes. 602 00:33:12,424 --> 00:33:15,194 - [sighs] Can he stop? 603 00:33:15,227 --> 00:33:16,662 - Probably not on his own, 604 00:33:16,695 --> 00:33:20,332 but if he'll allow us, we can help him. 605 00:33:20,366 --> 00:33:22,401 - Okay. 606 00:33:22,434 --> 00:33:25,604 We'll do whatever it takes to get him healthy. 607 00:33:25,637 --> 00:33:28,174 - Before we discuss the course of psychotherapy, 608 00:33:28,207 --> 00:33:29,441 I'd like to talk to you and your husband 609 00:33:29,475 --> 00:33:30,642 about repairing the physical damage. 610 00:33:30,676 --> 00:33:32,144 - Of course. - Thanks. 611 00:33:32,178 --> 00:33:33,512 - Yes. 612 00:33:37,316 --> 00:33:40,519 - He could've killed himself. 613 00:33:40,552 --> 00:33:43,255 Sometimes we get a win, right? 614 00:33:43,289 --> 00:33:45,591 - Sometimes we get a win. 615 00:33:45,624 --> 00:33:49,328 - If you take one thing away from me today, 616 00:33:49,361 --> 00:33:52,164 let it be this: 617 00:33:52,198 --> 00:33:56,235 treat the patient, not the disease. 618 00:34:25,264 --> 00:34:26,765 - Good. You haven't started. 619 00:34:26,798 --> 00:34:30,169 - Just finished the line. Why? 620 00:34:30,202 --> 00:34:33,572 - You were right. We shouldn't do this. 621 00:34:33,605 --> 00:34:35,141 - What changed your mind? 622 00:34:35,174 --> 00:34:37,576 - Treat the patient, not the disease. 623 00:34:40,379 --> 00:34:43,582 Our patient wouldn't have wanted this. 624 00:34:43,615 --> 00:34:45,484 April, 10 milligrams of morphine, 625 00:34:45,517 --> 00:34:46,785 and hang a drip, please. 626 00:34:52,591 --> 00:34:55,294 Dr. Rowan... 627 00:34:55,327 --> 00:34:58,297 I'm going to extubate you. 628 00:34:58,330 --> 00:35:00,732 I promise you won't feel any pain. 629 00:35:04,203 --> 00:35:06,738 - I'll let you two be alone with her now. 630 00:35:26,392 --> 00:35:29,428 - [coughing] 631 00:35:58,524 --> 00:36:00,692 - Okay, going to start the carotid anastomosis. 632 00:36:00,726 --> 00:36:02,661 Everybody get ready. 633 00:36:02,694 --> 00:36:04,730 We're going to clamp the left carotid. 634 00:36:04,763 --> 00:36:07,599 Carla, tell me if you see any change on the EEG. 635 00:36:27,853 --> 00:36:31,390 Carotid is cross-clamped. - Brain waves look good. 636 00:36:31,423 --> 00:36:34,560 - Okay, eleven blade, followed by 5-0 prolene. 637 00:36:45,437 --> 00:36:48,740 Let's sew this graft in quickly. 638 00:36:48,774 --> 00:36:50,909 - Brain waves flattening on the right. 639 00:36:50,942 --> 00:36:53,845 He's impending infarct. 640 00:36:53,879 --> 00:36:57,416 - We only have four minutes of hypoxia before deficits occur. 641 00:36:57,449 --> 00:36:58,917 - Do we unclamp him? 642 00:36:58,950 --> 00:37:00,819 We can still call this off and take him to the cath lab. 643 00:37:00,852 --> 00:37:03,555 It's safer. 644 00:37:03,589 --> 00:37:04,890 Dr. Rhodes... 645 00:37:04,923 --> 00:37:08,594 - No. This kid's not losing his arm. 646 00:37:10,696 --> 00:37:12,398 Coming around the front wall now. 647 00:37:12,431 --> 00:37:14,600 - Left side brain's 50, right side's 70. 648 00:37:14,633 --> 00:37:18,704 - Dr. Bardovi, follow me. Eyes on the field. 649 00:37:18,737 --> 00:37:20,506 - Dr. Rhodes, you need to get those clamps off. 650 00:37:20,539 --> 00:37:22,741 - Thank you, Marty, I'm almost there. 651 00:37:25,644 --> 00:37:28,480 - Left side's 30, right side's 50. 652 00:37:31,583 --> 00:37:34,720 - Okay, done. 653 00:37:34,753 --> 00:37:37,856 Coming off cross clamp. 654 00:37:37,889 --> 00:37:39,958 Cross clamps are off. 655 00:37:39,991 --> 00:37:42,461 I've reestablished flow. 656 00:37:44,463 --> 00:37:45,897 - EEG is normalizing. 657 00:37:47,966 --> 00:37:50,602 You have a good wave pattern. 658 00:37:50,636 --> 00:37:52,738 - He's good. 659 00:37:52,771 --> 00:37:54,473 - Nice work, Dr. Rhodes. 660 00:37:54,506 --> 00:37:57,443 - Okay, everyone, let's get set up for the stent. 661 00:38:00,979 --> 00:38:02,614 - Good night. - Good night. 662 00:38:02,648 --> 00:38:05,617 - How could you do this to us? 663 00:38:05,651 --> 00:38:09,521 - Uh, excuse me? - My husband told me. 664 00:38:09,555 --> 00:38:10,922 He'll lose his pilot's license. 665 00:38:10,956 --> 00:38:12,858 We'll lose everything. 666 00:38:12,891 --> 00:38:15,627 - I'm very sorry. Uh, I had no choice. 667 00:38:15,661 --> 00:38:18,764 I am legally obligated to report him. 668 00:38:18,797 --> 00:38:20,832 - It's his life. 669 00:38:29,608 --> 00:38:31,977 - I called the FAA. I had to. 670 00:38:32,010 --> 00:38:35,581 Every time he gets on a plane, he puts his own life 671 00:38:35,614 --> 00:38:37,716 and the lives of all of his passengers at risk. 672 00:38:39,685 --> 00:38:42,554 I know this wasn't, um, 673 00:38:42,588 --> 00:38:44,956 necessarily the win that you were looking for, 674 00:38:44,990 --> 00:38:48,960 but at least we saved a man's life. 675 00:38:48,994 --> 00:38:50,929 See you in the morning? 676 00:39:07,779 --> 00:39:10,782 - I heard the surgery went well. 677 00:39:10,816 --> 00:39:12,551 - Yeah, thankfully. 678 00:39:12,584 --> 00:39:14,520 - [chuckles] 679 00:39:14,553 --> 00:39:17,489 Yeah, don't worry, I won't tell anyone. 680 00:39:17,523 --> 00:39:20,025 - Tell 'em what? - Mm, that you were scared. 681 00:39:20,058 --> 00:39:21,893 - Oh, that's what you think, huh? 682 00:39:21,927 --> 00:39:24,663 - Yeah. 683 00:39:24,696 --> 00:39:28,700 - [sighs] Man, you're definitely a Charles. 684 00:39:28,734 --> 00:39:30,869 You're very perceptive. - Hm. 685 00:39:33,605 --> 00:39:35,441 - I was after that first time. 686 00:39:35,474 --> 00:39:36,575 I was--I was afraid. 687 00:39:36,608 --> 00:39:38,977 I was afraid I was gonna lose him. 688 00:39:39,010 --> 00:39:40,579 - [soft exhale] 689 00:39:40,612 --> 00:39:43,782 I have fears of my own, you know. 690 00:39:43,815 --> 00:39:46,985 - Cholera? Typhus? - [chuckles] Yeah. 691 00:39:47,018 --> 00:39:49,988 And relationships. [chuckles] 692 00:39:50,021 --> 00:39:53,091 There are a lot of pitfalls in dating a surgeon. 693 00:39:53,124 --> 00:39:56,495 It's crazy hours, stress of the job-- 694 00:39:56,528 --> 00:39:59,898 - Great case, Dr. Rhodes. Very impressive. 695 00:39:59,931 --> 00:40:02,033 And thanks for the vote of confidence. 696 00:40:04,636 --> 00:40:08,507 - Fawning women falling at your feet. 697 00:40:08,540 --> 00:40:10,742 Yeah, I don't know if I can compete with all of that. 698 00:40:10,776 --> 00:40:11,943 [laughs] 699 00:40:11,977 --> 00:40:14,946 - You don't have to compete. 700 00:40:14,980 --> 00:40:16,882 I'm all in. 701 00:40:23,789 --> 00:40:27,125 - So your sister... 702 00:40:27,158 --> 00:40:29,695 [both laugh] 703 00:40:29,728 --> 00:40:32,898 Let's see, is she a red or white wine drinker? 704 00:40:32,931 --> 00:40:34,900 - Mm, white. 705 00:40:34,933 --> 00:40:37,603 Not Chardonnay. Uh, Sauvignon Blanc. 706 00:40:42,140 --> 00:40:45,744 - Will? - [sniffles] 707 00:40:45,777 --> 00:40:47,045 - Hey. 708 00:40:48,914 --> 00:40:53,552 I'm--I'm so sorry for your loss. 709 00:41:01,927 --> 00:41:04,963 - [sobbing]