- Structural collapse at the water park--
two victims coming in via helicopter.
ETA, five minutes. - Time to rally the troops.
- I'll get environmental
to clear and prep the trauma rooms.
- Emma, restock the crash carts.
Makedah, take the latest scripts to the drug cage.
- Should be a fun one. - "Fun one"? What's up?
- Slide broke at the water park--
two victims, five minutes to touchdown.
No information on extent of injuries.
- I can jump in with--
- Ogilvie, grab some goggles, gloves, gown.
Go up to the roof.
First patient that lands, bring 'em down.
We got two choppers.
You want to grab some bodies and meet me?
- What injuries are we expecting?
- Structural collapse. Could be anything.
- I can increase the morphine drip to manage the pain,
but that could also slow down your breathing.
You will likely feel very drowsy.
You may lose consciousness.
And it could cause you to stop breathing altogether.
- [gasps, mouths words]
[door closes]
I'll be right back.
[indistinct chatter]
Hey, you okay? - Yeah.
Yeah. Sorry.
- Look, it's hard seeing your patients die.
But as professionals, we have to create emotional boundaries
for ourselves.
It's not about us. It's about them.
- She's so calm. I just--
- Yeah.
She's had a long time to prepare for this moment.
What she's doing for her sons--
managing this with so much grace--
it's a real gift of love.
- I feel like an asshole. [breathes deeply]
All they want is more time with their mother.
All I want is less time with mine.
- Don't feel guilty.
I mean, you can be grateful and gracious from a distance.
Just talk to her. Tell her what you want.
She'll understand.
- I just--I doubt that.
- Give her a chance, you know? She may surprise you.
- Hey.
Two birds headed our way. Need a hand?
- That's the rumor.
Santos, trauma incoming. Grab a gown.
You can assist Dr. Langdon.
[elevator bell dings]
- Fuck me.
- Jesus, I got blood tubes growing moss over here.
Ticktock, people.
Hey, Olive, do me a solid-- run these to the lab.
- No problem.
- Uh, I got more lab results.
- Start putting them on the patient clipboards,
- PTMC Emergency. Go ahead, Medic Command.
- Do cyber attacks happen often?
- More than you realize. - I blame the Russkies.
- Dr. Mohan, it's your mother?
She sounds pretty upset.
Says she really needs to talk to you.
- You're shitting me.
Um, tell her I'm not available.
[helicopter whirring loudly]
- How's your shift going?
- It's been a lot already.
You know, I worked in an ER before, up in Vermont,
and we had MVAs and ODs, MIs.
But this place...
this place is relentless.
- Holiday weekend. We're not normally offline.
- I think we have a very different idea of normal.
- It's not for everyone.
- I'm not sure it's healthy for anybody.
- Here's her leg.
- Jesus.
- I need more runners.
- Oh, you could shut down the gift shop.
They always have a couple of volunteers there.
- Most of those volunteers use walkers.
- [chuckles] Beggars can't be choosers.
- Go get 'em.
- Okay, I'm gonna grab a smoke first.
- No time. Nicotine gum-- take the edge off.
You two, head to triage to help out the front of the house.
They're running out of space,
and there's a line out the door.
- Okay, let's go. - Hang on, Mohan.
Sign this.
- Nicotine patch, 21 milligrams.
Who's it for?
- Monica. This nicotine gum's shit.
She'll never survive the shift,
and I need her so I don't lose my goddamn mind.
Thanks.
- Is Dr. Abbot still around?
- He went to get some sleep
before his night shift starts in a couple hours.
- Shit. Okay, I should have planned this better.
I was hoping he'd write me a letter of rec for an elective
so I could have a shot at a fellowship next year.
- Which one?
- Whichever will take me.
- Didn't the electives fill up a while ago?
- Don't remind me.
I'm gonna throw myself at the mercy of the court,
beg for them to take me anyway.
Just kill me now. It'll be less painful.
- Dana, I can't read this handwriting.
- It says...
1,000 milligrams acetaminophen orally,
4 milligrams ondansetron under the tongue,
and trial of clear fluids.
- Seriously? It says all that?
- If it's not in a text with emojis,
you kids can't read for shit.
- What do we have?
- A fall from 10 feet onto a metal fence.
Right below the knee. Good vitals.
- Oh, it hurts. Oh, my God.
- What's she had so far? - 50 of fent, repeated 25.
No meds, no allergies.
- Where should I put this? - Just hang on to it for now.
- On my count. One, two, three.
[person groans in pain]
- Okay, Whitaker, E-FAST. Donnie, primary survey, please.
- Pupils equal and reactive.
What's your name? - My leg hurts really bad.
Did I break it?
- Um, I-I wouldn't say that it's broken exactly.
- We're gonna get an X-ray to determine that.
Put that on the gurney, line it up for X-ray,
keep your fucking mouth shut.
- Good lung sliding right and left.
- Airway patent, breath sounds bilaterally.
- Please, it hurts. - BP 100 over 60.
Pulse 118, pulse ox 98%.
- Does your belly hurt? - No, asshole! It's my leg!
- Okay, she's really moving here.
- 100 of ketamine?
- Yeah, we can't evaluate like this.
- Hey, Ogilvie?
Deep breaths, yeah? - Yeah, okay.
- Whitaker, what's next?
- Uh, once she's sedated, finish the E-FAST,
plain X-ray, check her back, straight to CT.
- What if the ketamine wears off?
- Right. Uh, we should do
a popliteal nerve block before the CT,
anesthetize from the knee down.
- Two view tib-fib. - Pushing ketamine now.
- What's the bullet?
- 42-year-old male with 20-foot fall.
Blunt chest trauma with hand injury.
- Where's my son? Where's my son?
- He's tachy to 108, sats 98 on 2 liters,
BP 122 over 84.
- We'll pan scan due to mechanism.
You? - Tib-fib amputation.
Hoping ortho can, uh, give us a little hope for replantation.
- Derek, where are you hurting? - Chest and my finger.
Did they find my son?
- Did you hit your head? - Don't think so.
I need to find my son!
- We'll find him for you,
but we need to take care of you first.
- Pericardium's clear. No fluid in Morrison's.
- Move both arms, wiggle your feet.
Good. Any pain in your neck? - No.
- Spleen looks good. - Start with his chest.
That's where he hurts.
No hemotympanum. - Normal sliding.
- Best to start with the side he's complaining about first.
- Uh, I don't see much sliding there.
- His name is Zack. He's seven.
- Pneumothorax? - Set up for a chest tube.
- Not yet. Uh, let's go posterolateral.
Look for fluid first.
- Traumatic pneumothorax. We should prep the chest.
- Not necessarily. He's hemodynamically stable.
- Okay.
Does that look like some fluid there?
- Hard to say for sure.
- Okay, he's tachycardic hemopneumothorax.
He needs a chest tube.
- BP and sats are fine. We can wait for CT.
If it's small, it'll resolve on its own.
We observe and reimage. - I agree. He's stable for now.
Let's wait for the scan, Dr. Santos.
- Okay, let's order... - Okay.
- A CT chest, abdomen, pelvis, and X-ray left hand.
- Whoa, major degloving. - Focus on the primary.
- Dr. Langdon's correct. We need to logroll him.
- [shouting in pain] - Oh, okay.
How about another four of morphine?
- Put it in. Hang in there, Derek.
- We got you. - [mouths words]
[cell phone vibrating] - Fuck off already.
- Boyfriend? - Wish. My mom.
Every time I get a second of service,
another dozen texts come in. - Hey!
How much longer do I have to wait?
I got a broken leg here.
- Someone will be with you shortly, sir.
- Am I allowed to use the bathroom?
I really have to go. - I don't know, ma'am.
I am not your doctor.
- It says right there "doctor."
- Yes, but I'm not your doctor.
But if you go back to your room,
a nurse will come find you. - I wasn't in a room.
- I'm sorry. Um, are either of you treating my mother?
- Nope!
[breathing heavily]
- Take a seat. It's gonna be a while.
[indistinct chatter]
Helen Torres, come on down.
Helen Torres?
- [speaking Spanish]
[door buzzes]
- Thank you.
Ay. [winces]
- I'm Dr. Mohan. This is Student Doctor Kwon.
- Helen.
- How long has your leg been swollen, Helen?
- Uh, it's been getting worse over the past week.
- Dr. Mohan, your mom called again.
She said you need to call her back.
- Not now!
I'm with a patient.
Sorry about that.
Um, did you--did you fall or hit your leg?
- No.
Have--have you ever had a blood clot before?
- No. - [inhales deeply]
[grunts softly]
- Are you all right? - Excuse me?
- Do you need to sit down? - Oh, no. I'm--I'm fine.
- You don't look too good.
- What?
No, it's just, um...
it's really hot in here.
And, uh--and, uh--
- You need to sit down. - I'm good.
I just need some air.
Excuse me one second.
[wheezing, breathing heavily]
[all voices echoing] - You a doctor?
- Sorry, Doctor, does this look infected?
- I've been waiting six hours,
and people keep cutting in front of me.
- Doctor, can you just look at my throat
just to see if it's strep?
[normal voices] - Look out! Make way!
- [breathing heavily] - Get in.
- No, I'm--I'm okay.
I'm okay. - Get in the fucking chair.
- [continues breathing heavily] - Excuse me, ma'am.
- Excuse me, coming through!
Out of my way!
- We were going down the water slide,
and the bottom just fell off.
I grabbed Zack's arm,
and I tried to hold on to the sides,
but my hand slipped, and my ring got stuck.
My finger was ripping off, and I just--and I lost him.
- We can numb up your finger as soon as we gauge
the extent of the injury.
- You can cut the damn thing off for all I care.
I just need to find Zack.
- Okay, do you feel anything here?
- Yeah, sharp.
- How about here? - Sharp again.
- A little late for the show, Yoyo.
- I am the show, Dr. Langdon. You're the warm-up act.
- I knew somebody missed me.
- Mr. Foster suffered a degloving injury
of the ring finger.
Stable pneumothorax awaiting imaging.
- Hello, sir. I'm Dr. Garcia from the trauma service.
I need the ring cutter.
- That's why they pay the surgeons the big bucks.
- Possible flexor tendon injury.
- Ay. Ow.
- Try to bend up your ring finger.
- [groans in pain]
- Let's go with the block.
- You're gonna feel a pinprick and some burning.
- Which tendon did we test, Dr. Santos?
- Seriously? That's a med-student question.
- We're a teaching hospital. It's always good to review.
- [sighs] Flexor digitorum superficialis is intact
as it inserts on the middle phalanx.
- Correct.
- Gee, thanks.
- No sign of tension.
At least no tension pneumo.
Let's wait for the CT. I'll be next door.
- Langdon, Mel's sister's been asking for you.
She's getting antsy, and we could really use the room.
- CT's ready. - Okay.
Let Becca know I'll be there soon.
And Mr. Foster got separated from his son Zack
at the water park.
- Anyone we can call for you? - My wife, Angela.
- Dr. Santos, will you escort Mr. Foster to CT?
- [smacks table]
- Help!
Need a hand here.
- What the hell happened? - I think I'm having an MI.
My chest is so tight, I can barely breathe.
- Okay, I got to get a 12 lead.
Perlah, can I get an assist here?
- Yeah, I'm on it. - [wheezes]
- CT's normal.
- Why do we take down the tourniquet, Whitaker?
- To give the residual limb blood flow.
- Uh-oh. Ah-- - Just two little pumpers.
- A couple of figure eights ought to take care of those.
- Uh-huh. - Park.
- Park the Shark, orthopedic surgeon.
- Is this a favorable amputation?
- Pretty clean cut.
Fence sliced through like a guillotine.
- X-ray?
Not too bad. - Mm-hmm.
- Just, uh, tying off a couple arterioles.
- I'm not blind.
Where's the amputated leg? - Double bagged on ice.
- Sterile saline on the inner bag.
Ice water in the outer bag. No direct ice-on-skin contact.
- We spent a lot of time prepping--
- He still needs to look.
- Get Robby.
- [breathing heavily]
- Antibiotics? - Cefazolin and gent.
- We've cleared her chest, abdomen, and pelvis.
- Clean wound, no crush injury,
rapid transport time.
Replantation is a go. I'll book an OR.
Irrigate the hell out of this with 3 liters.
- 3 liters? - Of saline, genius.
- Thanks, Shark.
- [scoffs] I knew he meant saline.
- Dr. Robby, we need you in Central 6.
Dr. Mohan may be having a heart attack.
- What?
- EKG is normal. - You sure?
- Check it out. You can be your own second opinion.
- What's going on? - It's okay. I'm--I'm okay.
- You don't look okay.
- You look like shit. - I feel like shit.
- What happened? - I-I don't know.
I just got really hot,
and I started having trouble breathing.
- We should send up some labs just to be safe.
Any chance you're pregnant?
- I'm not sure I feel comfortable answering that.
No.
- She was tachy, but it's resolved now.
- Have you eaten anything? - Yeah.
- You staying hydrated? - 100%.
I'm doing everything right.
It's everything around me that's all fucked up.
It's just my mom moving and calling me over and over again
and now me scrambling to find a job next year.
I had it all planned out,
and now everything's just out the window.
- Wait a minute-- is this a panic attack
because of your mommy issues? - What? No.
- Jesus. Do you need to go home?
You should go home. - No, I'm fine.
- I don't need the fucking liability--go home.
And the rest of you, the last time I checked,
the ED is a shit show.
So let's all get back to work, huh?
- Sorry for taking so long, Becca.
- Nurse Dana said you'd be back in a few minutes,
but it's definitely been more than a few minutes.
- You're right. My apologies.
I brought some drink options. - Okay.
- We've got apple juice, cranberry juice,
OJ, and Pittsburgh's finest.
- What's that? - Oh, water.
- Oh. OJ, please.
- Okay.
Let's see.
All right.
Now, I am going to give you two pills.
The first is an antibiotic.
That will get rid of the infection.
The second should take care of the burning.
You want to take both pills for three days
and drink lots of water.
I'll write it all down.
- I-I hate pills.
Could you mash those up and put them in the OJ for me?
- Coming right up.
Okay.
- Mel's gonna be super worried when you tell her.
- You are gonna be just fine.
But, um, as far as telling your sister
what's going on with you, that is your decision, not mine.
- So you're not going to tell Mel?
- I can't, not unless you, my patient, tell me to.
- Do you know when Mel's gonna be done
with her important meeting?
- Hopefully soon. [knock at door]
- Dr. Langdon, they need you back in Trauma Two.
Hi.
- Becca, I got to go. I'll be--
- Don't say "in a few minutes" unless you actually mean
in a few minutes.
- I would never. - [giggles]
- And I need you to be kind to each other.
- I am kind.
Shane's just a butthead sometimes.
- He's your brother, and he loves you.
- Don't go.
- I don't want to go.
But it's--it's not up to me.
Hey.
We'll always be connected...
no matter what.
Invisible string.
- Invisible string.
- Hey.
You gonna go in and see your mom?
- Cancer sucks.
- Yeah.
Yeah, it does.
- It's not fair. - No, it's not.
- I don't want to go in there.
- Nobody's gonna make you.
- [sniffles]
She didn't used to look like that.
[sniffles] - Yeah, I get that.
But if you don't go in there and say goodbye
and tell your mom you love her...
I think you might wish you had for a very long time.
- [sniffles]
- It's your call.
- D-5 half normal saline, 20 of K running at 125 an hour.
- One of the most common reasons
for traumatic-replantation failure is infections.
So we do what, Whitaker?
- Uh, rinse and repeat until surgery calls for us.
I-is everything okay with Dr. Mohan?
- She's fine.
Focus.
- [groaning softly]
Where am I?
- Uh, ketamine's wearing off.
- I can't feel my leg.
- I'm Dr. Michael Robinavitch. You're at a hospital.
And we gave you a nerve block
so that you can't feel any pain.
- Why?
- You were on a water slide that collapsed
and did serious injury to your leg.
- [mutters indistinctly]
What the fuck? Is that my leg?
Is that my fu--did you cut my fucking leg off?
- Your leg was cut off in the accident.
Our surgeons are going to try for replantation.
- I--No--
- She needs more ketamine. - Just wrap up the leg.
Emily, I know that this is really hard.
I need you to focus on me right now,
because we need to get your consent
to proceed with the surgery. - Why?
- There are risks with the surgery.
There's anesthesia, and there's no guarantee--
Emily?
- Can you just-- just put it back on?
Can you just put it back on? - Sounds like consent to me.
- Now can she have sedation? - Okay, load her up.
Ketamine and rock. It's gonna be okay.
We're gonna intubate before the OR.
It's gonna be okay.
- Finishing second cut.
- Success. [ring clatters]
- Can that be saved? - The finger or the ring?
- The wedding ring. - Uh, yes, sir.
A jeweler can weld it back together good as new.
Uh, uh, stop.
Irrigate the ring shavings off first.
[telephone rings] - What did I miss?
- Finishing irrigation.
Okay.
Doesn't look like you lost any skin.
- It's a little dusky. Might not be viable.
- There's intact skin on the dorsum.
- More irrigation, then tack it down with one suture.
- Okay, thanks.
Radiologist reports a 25% pneumothorax.
- Is that bad?
- That is a partially collapsed lung that needs treatment.
- I can put in a chest tube. - He doesn't need a chest tube.
- Okay, what do you want-- a pigtail catheter?
- I was thinking a ThoraVent.
- What? Why?
- It's not a bad idea. No need for wall suction.
- If Hand can operate today,
he can go home tomorrow with the ThoraVent.
- You can learn a lot from your senior residents.
- I'm happy to teach Dr. Santos.
- Thank you, Dr. Langdon.
- Janelle, I need you to take the samples to the lab
and come back with any results that are ready.
Geoffrey, head to CT to see if any new results are printed
and bring those back.
Pam, check in with whoever's running the PDS
to see if any orders need to go to the pharmacy
and bring back any meds that are ready for pickup.
Rinse and repeat every 15 minutes.
- Double-tie those shoelaces and hydrate.
It's not a sprint. It's a marathon.
- Fly, my pretties.
Okay, any word on finding our water slide dad's kid?
- Not yet. Called the wife, went straight to voicemail.
Police dispatch said that there were a couple of fatalities
on site--one adult, one kid. - Sweet Jesus.
Who the fuck did this?
No sign-off on orders for labs or X-rays,
and it's in the wrong freaking rack?
You guys trying to kill me and the patient?
- Uh, I'll take care of it. - Thanks.
- Dana, this gum is abso-- - Shit. I know.
- Pharmacy said you needed this right away.
- Just in time. Slap one on and give it an hour to kick in.
You're welcome.
What? - The prescription is for you.
- My insurance will cover it. Hers won't.
- Isn't that insurance fraud?
- Throw me in jail. I could use a vacation.
- [chuckles]
- [clears throat]
- Mom.
I'm--I'm really glad to see you, Mom. I--
- Garcia told me about the sigmoid volvulus you missed.
- It was an oversight. - That could have killed her.
- Without electronic records,
it's been kind of a challenge to figure out--
- Chaos is the status quo in the ED,
even when the computers are working properly.
You have to be hypervigilant and double-check everything.
- I can handle it. Um, I-- - Why would you want to?
Down here your learning street-level medicine,
all seat of your pants.
Oh, well, I made a mistake,
but the more talented practitioners upstairs
will fix it.
[sighs] You are better than this.
- [sighing] I love you, too.
- Well, that is one way to do a debrief.
- You should talk to her.
- Which one? - Honestly, both of them.
- Can you call in some extra doctors?
- Sure. Everyone's dying to work on the Fourth of July.
Why? - Dr. Mohan went down.
- Yeah. I saw your pep talk.
- She's taking a little break until her labs are back.
She's going to be fine,
but I'm not sure her head is in the game.
- I'm on it, Cap.
- Small stab incision with the 11 blade,
midclavicular line, second intercostal space.
- Sh--she's gonna stab me? - It's just a medical term.
- Stay superior to the rib.
[monitor beeping]
- Is there a problem?
- Nope, everything's going well.
- Place the trocar.
Hold back the, uh, adhesive wings
and advance until you see the red diaphragm move.
That means you're in the pleural space.
Now remove the trocar.
- Perfect. - Okay.
Now we can either, uh, hook up to wall suction,
or we can use this one-way valve
to repeatedly aspirate with a syringe.
- Well, with all your vast experience, Dr. Langdon,
you should probably decide.
- We can avoid wall suction if I pump manually.
- Have at it, Doc. - Enough.
Apparently, decency and decorum need to be reintroduced
to our R2 curriculum.
- Nice work, Dr. Langdon.
I'll go check on an OR for Mr. Foster.
[door opens, closes]
- Hey.
I'm gonna need you to pick up the pace.
- Can I get a sec?
Dr. Mohan just almost died on me.
- Not even close. She's tougher than she looks.
Propane hero in North 4.
- Hey, any word from surgery
on how are big patient Howard's perforated diverticulitis
is doing? - Still in the OR.
- What about our drunk firework kid?
- Waiting his turn in the surgical conga line.
- Shoo. What about Social Services?
Have they found a temporary foster home
for our baby Jane Doe? - Still working on it.
- Kid's gonna be old enough to drive
by the time she gets out of here.
- You joke...
Oh, for fuck's sake!
Go, quickly, before I change my mind.
- Hey, did the county pick up Louie's body yet?
- No. He's still in the viewing room.
- Jesus. He's just laying in there?
- Yeah. Another couple minutes, I'm gonna wheel him
down to the morgue myself.
- What's the bullet?
- Eight-year-old boy, part of the water park accident.
Thrown off the water slide. - How far did he fall?
- Maybe 6 or 7 feet, landed in a tree.
Had to wait for a ladder truck to get him down.
- Major neck trauma--must've taken all the impact there.
- Couldn't tube him, hard to bag.
Sats in the 80s. BP 85 over 60.
Pulse 50.
- Okay, one, two, and three.
- Possible laryngeal fracture. - Hypoxic bradycardic.
- Kid needs an airway before he arrests.
- Broselow tape, pedes cart, set up suction.
- Oh, my God. Is that Zack?
- Hey. Hey, kid, can you look at me?
No response, no purposeful movement to pain.
- Oh, my God.
- Is this your kid? - No.
- Sir, go back to your room now.
- Broselow says 25 kilograms. - Jesse?
- 5 1/2 ET tube. - Okay.
Uh, 30 of rock, 50 ketamine.
- You're gonna paralyze? - Yep.
- If we can't intubate, we crike?
- He's too young for a crike.
- Needle crike? - Can't ventilate through that.
- Sats down to 78.
- 11 blade, Kelly, and a pedes bougie.
One quick look, and then we cut.
- I can't tell if there's lung sliding.
No movement, no air entry. - Way too edematous.
I can't see the cords.
- Better with cricoid pressure? - Nothing. Fuck.
- Okay. Towel roll between the shoulder blades, please.
- Heart rate down to 49. Headed to cardiac arrest.
Trake's going to take 20 minutes.
This kid's not gonna last 60 seconds.
- That's why we're doing a slash trake.
- Don't know it. - Me neither.
- Boss? - Show me what you got.
[monitor beeping rapidly]
- Pull up the trachea between your thumb and middle finger.
Vertical incision right over the trachea.
Vertical, not horizontal, or you transect the trachea
and cut the jugular veins.
- That's a lot of blood.
- Now it's a tactile procedure.
2-centimeter incision through the tracheal rings.
Finger in the trachea.
Bougie into the airway.
Thoughts on what's next, Dr. Whitaker?
- Insert the ET tube into the trachea.
- Suction. Lots of blood in the airway.
[device slurping]
Okay, bag him.
Check the CO2.
- Sats coming up, in the 80s.
- Bilateral breath sounds. End tidal CO2 is 70.
That's crazy high. - It'll come down.
Tie down the tube, control all the bleeders.
Spray an amp of epi on a stack of 4-by-4s.
- Okay. Sats are up to the 90s.
Good. CO2's in the 50s. Good heart rate.
- You forgot the last step.
Change your underwear. - [chuckles]
- How many of these you done? - Uh, first one.
- You serious?
How about you? - None.
- I practiced in the Sim Lab when I was at Stanford.
- What'd I miss? - All the fun.
- Slash trake. - Seriously?
- Uh, fractured larynx.
Couldn't oxygenate, couldn't ventilate.
- You use a meat cleaver on this kid?
- ENT can revise the trake in the OR.
- They'll be thrilled to clean up your mess.
- Or maybe they'll thank us for not letting him die.
- So we're still waiting on your prescription,
and the pharmacy is a little backed up.
But I'm glad to see you're doing good.
- Well.
I'm well.
- Glad to see you're well.
- Can you expedite my medication?
- Sure, but it may still be a little while
before Dr. Mohan can sign off on the discharge, so sit tight.
- [sighs] And do what?
[chuckles] You just keep this handy for occasions like this?
- Uh, I thought that I might not have that much to do today.
But...
man, I was wrong.
[indistinct chatter]
- Thank you.
What brings you in today? - A friend made me come in.
Name's Robby. He said I should--
- Ah, you're Duke.
Donnie? - Yep?
- Robby's VIP is here.
[door opens]
- Hi. I'm Donnie, nurse practitioner.
Robby's already put in orders for a numbing spray
for your nostril.
- "Nostril"? It's--it's my throat.
It's not my nose. - Okay.
Let's get you, uh... [device beeps]
Set up in a room.
- [groans]
- That was the most unprofessional deposition
I've ever witnessed.
They were nowhere near that aggressive with Dr. Ellis.
- Oh, okay.
[elevator bell dings, doors open]
- It didn't go as badly as you think.
- They suggested I was incompetent.
- They're posturing to set the stage
for a ridiculous settlement request.
This isn't about those parents or that kid.
It's only about trying to make a lot of money.
- Well, I-I don't have a lot of money.
- Not your money, Dr. King. It's an insurance game.
You're protected by the hospital.
This won't affect your career.
- Hey. How was your deposition?
- [stammers] Have you seen Dr. Langdon?
- Uh, no. Why?
[bell dings]
- Okay, okay. How--how's Becca?
- Oh, she's fine. - Yeah?
Okay, I should go see her, then.
- How was your deposition? I'm sure it was stressful.
- It, uh--
Um, what's going on with Becca? What's her diagnosis?
- I can't tell you.
- Why?
- HIPAA. - Seriously?
- If you want to know what's going on with Becca,
you're gonna have to ask her yourself.
- Hey, you survived your deposition.
Welcome back to the seventh circle of hell.
- Wha--uh, what's this?
- You're welcome for covering your patients.
They're yours again.
Might want to check on the pancreatitis in North 3 first.
- O-okay.
- Langdon, I got some intel on Louie.
- They move him out of the viewing room?
- No, but county's promised
they're on the way to come get him.
- Can I get the county coroner's number?
- What for?
- I just want to make sure if no family shows up,
Louie gets a proper burial. - That's expensive.
You may want to run it by the missus first.
- Uh, maybe I'll start a GoFundMe.
I bet people around here would pitch in.
- Hey, kid, you can't do this for every unhoused guy
that dies around here.
- There but for the grace of God.
- No, the success of your sobriety
is a testament to your support system.
Louie didn't have that.
- Still, Louie was a good man.
He deserves to be put to rest with dignity.
- Okay. I'll dig it up.
You heard all that?
- Robby, your VIP's here. Got him in Central 11.
- Finally.
[door opens] About fucking time.
- If I knew you were gonna make me wear a dress,
I wouldn't have come at all.
- Dennis Whitaker, meet my buddy Duke.
- Uh, nice to meet you.
Any friend of Dr. Robby's is a friend of mine.
- "Friend" is a vast overstatement.
He's more just a pain in my ass.
- Don't let his surly exterior fool you.
Deep down inside, he's just as grumpy.
- How did you two meet?
- Tinder. - [laughs]
Duke is a motorcycle engineer.
- You should've seen his Bonneville
when he first brought it in six months ago.
Someone left it for dead.
- He helped me bring it back to life.
Today we're going to return the favor.
Dr. Whitaker's one of our most trusted physicians,
and today he's going to help me oversee your care.
- Uh, what seems to be troubling you?
- Ask him. He's the one who made me come in.
- He's had some hoarseness on and off for a couple months.
- Okay, any history of tobacco or alcohol use?
- [chuckles] Two of my oldest and closest friends.
- Former two-pack-a-day smoker and lover of the drink.
- Okay. He on any medication?
- Uh, blood-pressure meds. - Mm-hmm.
- Which he forgets to take.
- He's all numbed up and ready to go.
- Okay. Thank you, Donnie.
My man, I am gonna take this scope,
and I'm gonna stick it in your nose,
and we're going to check out your upper airway.
- Eh, that seems like a lot of fuss for a sore throat.
- Dr. Whitaker, you want to explain to Duke
why this procedure is absolutely necessary?
- The scope is gonna give us a better view of your voice box
and your vocal cords.
- Here we go.
- [groans]
Gonna feel a little pressure between your eyes.
I am sorry about that.
Okay, just breathe through your nose.
- This is gonna help us see if there are any abnormalities
like inflammation, tumors, nodules.
- That all looks pretty normal. I don't see too much drainage.
Stick your tongue out for me, all the way.
All the way out. Good. Now say "eeeh."
- Eeeh. - Good. Now again, say "eeeh."
- Eeeh. - Good.
Removing the scope.
- Mm.
- Dr. Whitaker, what do you think?
- Looks normal, no abnormalities.
- Told you it was nothing.
- With your history of smoking, I'd like to do a chest X-ray.
If there are growths, they can push
against the recurrent laryngeal nerve intermittently.
That can paralyze one of the vocal cords
and cause the hoarseness.
- That sounds like a lot of bullshit doctor speak
to charge me more.
- You've got Medicare.
And, besides, I finally got you into my ED.
You're gonna get the golden workup
before I leave town tonight.
- Only an idiot would ride all night
after working a 12-hour day.
- That does sound pretty dangerous.
- You gonna stay put, or do I have to tie you down?
- Fine, so long as you keep your hands where I can see 'em.
- No promises.
Let me know when his chest X-ray is back.
- Yeah.
- Hey. - Hey.
- Are we okay?
- Uh, yeah. Why? - I don't know.
You kind of ripped me a new one in front of Langdon.
Whose side are you on? - This isn't middle school.
Langdon made a mistake and owned up to it.
Let it go. - He should--
He should have been fired.
But instead, he waltzes back in here, no big deal.
Meanwhile, I've been a goddamn pariah for the last 10 months
for doing the right thing.
- Or maybe you're a pariah
because you don't play well with others.
If you've still got beef with Langdon, go tell him.
He's here to stay.
So put on your big-girl panties and work it out.
- He is no-- - Nope.
You want to have sex and eat ramen in bed, I'm your girl.
But if you want to talk about this Langdon shit, again,
call a therapist.
- How's it hanging, Dr. J?
- Never call me that again. - It was a joke.
- Relax. He's clueless about your TikToks.
- But you're not.
- Props on the side hustle. - There is no hustle.
They're just some stupid videos.
- Wait, are you an influencer? - No!
- Yep. - [laughing]
- Yo, pre-docs, it's not happy hour yet.
There's still a shit ton of patients to be seen.
[bell dings]
- Uh, Ben, our slash-trake kid from the water park
had some purposeful movement in pre-op.
- That's a good sign. - Mm-hmm.
- Take the win.
- We need to talk.
- We are talking. - In private.
What the hell was that with Samira earlier?
- That was tough love. - You are her superior.
She was obviously struggling, and your advice was "go home"?
- Essentially, yeah.
This is the ED--it's not for the faint of heart.
- It's not for the unempathetic either.
- [sighs] Samira's not having a panic attack
because of her patient.
She's having one because of personal baggage.
What she needs to do is pull her head out of her ass
and focus on the work. - What about you?
What do you need to get some basic human empathy back?
- [laughing] Sh--I don't know.
Something that gives me a little hope this place
won't fall to shit when I'm gone.
- Found him!
- Found who?
- The water slide dad's kid. - How'd you manage that?
- I went outside, stalked the dad's IG,
found a pic of his son, sent it to Pittsburgh PD.
Now they're on their way over. - Oh.
Well, maybe Gen Z should be working for the FBI.
- [sighs] Hi, Becca. - Mel!
- Hi. [door opens]
You, uh--you doing all right? - I'm a little bored.
[giggles] - Yeah?
Um, how are you feeling? - A lot better.
Dr. Langdon gave me some medicine and OJ.
Oh, he's super nice. I see why you like him.
- Did he tell you what the medicine was for?
- Yes. Um, did you tell her?
- I did not.
Uh, I explained to Becca
that due to doctor-patient confidentiality,
everything she told me was private
and that it was her decision
if she wanted to share anything with you or not.
- Um, do you want to share? - Yes.
[breathes deeply]
I have a urinary-tract infection.
- Oh. Okay.
Yeah, those, um--those can happen if you, you know,
hold your pee in for too long or you accidentally wipe
from back to front-- - Mel, I know. I know, Mel.
He told me. - Oh, good.
- You know, he also told me it can happen from having sex.
- Uh, yeah, it can.
Uh, it's not like you're having sex.
- Yes, I am.
- I'm sorr--What? - I'm having sex.
- With who? - My boyfriend.
- You have a boyfriend? - Yes.
His name is Adam, and we're having sex...
lots of sex.
- Okay.
- Um, Mel, are--are you okay?
- Mm-hmm.
[knock at door]
- Got a sec? - Sure.
- How you feeling? - I'm fine.
- Are you sure? - Yeah.
Troponin, D-dimer, and TSH all normal.
- Listen, I'm sorry about earlier.
I think I was being-- - A dick?
- I was gonna say "unprofessional,"
but probably that, too.
I'm sorry. - Thanks.
- But now I kind of need you to stop feeling sorry for yourself
and focus back on your patients.
Think you can do that? - Sure.
- Great.
- With this extra dose and increased morphine
from the pump,
your pain should subside.
- Your breathing will slow down.
You may get very sleepy.
- Paul, go be with the boys.
They need you more than I do now.
- Later.
Right now I'm exactly where I'm supposed to be.
- Yeah.
Okay.
Here we go.
[Adam Torres's "Juniper Arms"]
♪ ♪
- ♪ Carry me down ♪
♪ ♪
♪ Down from the stars ♪
♪ ♪
♪ Wrap me around ♪
♪ ♪
♪ Juniper arms ♪
♪ ♪
♪ Carry me down ♪
♪ Down from the stars ♪
♪ Wrap me around ♪
♪ Juniper arms ♪
♪ ♪
♪ Juniper arms ♪
♪ ♪