[soft beeping]
[whooshing]
[indistinct chatter]
- What now?
- Now we wait.
- How long before...
- I have no idea.
Could be hours. [device whirs]
- This doesn't feel right.
- Remember, Robby talked about--
- It still feels wrong.
- OK. This is Roxie's decision.
Everything else in her life is out of her control except this.
She wants to go out on her own terms.
Very few of us get to do that.
- I should pick up more patients.
- So Adam lives at Middle Hill?
- He lives at Middle Hill.
- And he's three years older than you?
- He's three years older than me.
- And he asked you to be his girlfriend
6 months ago?
- He asked me to be his girlfriend at game night,
and I said yes.
- Got a patient waiting for a doctor.
Vertigo in 13.
- OK. I'll be right there.
[door closes]
Did Adam ask you if you wanted to have sex?
- I--Mel, I don't know if I can tell you.
- Of course you can tell me. I'm your sister.
- Well, it's private.
- Look, it's just--it's really important that I know.
- Why? - Because.
- Well...[sighs] I can tell Dr. Langdon
because Dr. Langdon is my doctor,
but I don't think I can tell you.
- Becca, just tell me!
- Why are you yelling? - I'm not yelling.
It's just--look, it's really important that I know.
- You're definitely yelling. - Becca--
- Uh, maybe--maybe we should step outside for a minute.
- Why won't you tell me?
- Dr. King. - [crying]
- Why don't you get some air?
- [crying]
- Sorry.
Sorry.
[door closes]
- Hey, have you seen any of the X-ray techs around?
- Nope.
- Got an update for me?
- I'm just checking in.
- What are the chances of me getting out of here on time,
do you think? - That's up to you, Cap.
We can handle this.
Question is, will you let us?
How are you two getting along?
- I can play nice for another two hours.
- [scoffs] OK.
- Kept calling me "Doc."
Didn't know he was the real doc until a few months in.
He was keeping his secret life from me.
- Hmm.
Where are we with his chest X-ray?
- Uh, X-rays are still six or seven behind.
- When's the last time you checked?
- Maybe 10 minutes ago, but I--
- Stay on them. - Yeah.
- Come on, give the kid a break.
It says here it takes an hour to get an X-ray.
- You're the first person
who read this fucking thing all day.
[shout in distance]
[chuckles]
Don't get me started on those.
- How are you feeling?
- I'm good.
- You know, I take Lexapro.
It helps with panic attacks, not just depression.
- Promise, I'm fine.
Sorry about that, Mrs. Torres.
- Are you OK?
I thought you were going to pass out.
- Yep, all good.
Let's just pick up where we left off.
- Mrs. Torres presents with one week
of painful, swollen right calf.
No trauma, no fever,
no history of hypercoagulable state.
However, she did take a 15-hour bus ride
from Orlando to Pittsburgh last week.
- Mrs. Torres, we're concerned about
a possible blood clot in your leg
that can lead to serious complications.
We need to do an ultrasound, but no need to worry.
If it's positive,
we can treat with a blood thinner.
- Bueno.
If there's something I've learned,
it's to stop worrying.
Can all your worries add a single moment to your life?
[bell dings] - Fresh from the lab.
They said one's critical. - They're supposed to
call those up. - I know.
Every time they try, the red phone's been busy.
- Jesus Christ.
This was resulted 25 minutes ago.
Sodium 112.
Mohan!
Sprinkle some salt on your patient before he seizes.
- Where are we?
- Kidney stone patient's not obstructed.
Just waiting on meds.
Ortho is performing the replantation
on our water slide trauma.
Our perforated diverticulitis patient, Howard,
made it through surgery.
And I'm calling the CYF resource navigator
to see if we're getting anywhere
with emergency foster care for Baby Jane Doe.
Other than that, labs and X-rays are way behind,
but our Golden Girls are getting their steps in.
- Does Robby usually leave as soon as his shift ends,
or does he like to stick around
for all the handoffs to night shift?
- Depends, but he's usually pretty good
about getting out of here.
[bell dings]
- Shortness of breath in South 16.
He could totally decompensate.
I'm hoping to catch another intubation before 7:00.
One more gets me to three in my first week.
Probably a record.
- I'm looking for an easy one.
[sighs] Shift ends in 2 hours.
- You're supposed to pick up the stable patients in order.
- Do you need a-- a second opinion on that?
- No.
- Dr. McKay. - Yeah.
- A girl named Kiki came into reception looking for you.
- Kiki?
- She said she'll be in the park.
- Yeah, great, thanks.
[indistinct chatter]
- Hey, I think the labs are back on your PID patient.
- Thanks. [sighs]
- Is everything OK?
- Uh, fantastic.
- Langdon?
- Kind of hoping I would never see him again.
- Well, you know, maybe he's changed.
When you got a sec, there's something--
- Santos!
I need you to pick up food poisoning in 12.
- Yeah, sure. Why not?
- What?
No snark? No pushback?
What have you done with Santos?
- Only 2 hours to go.
I surrender.
- That's the spirit.
[bell dings]
- How's Becca?
- She's good.
- I'm trying to call her living community,
but they are not picking up.
- Why you calling 'em?
- Because I don't know anything about this Adam person.
I mean, they've been dating for 6 months, and--and--
and I don't know anything.
She never said anything about wanting a boyfriend
or even liking anyone.
- Yeah, but that doesn't mean she hasn't thought about it.
- No, I don't--I don't want to think about my sister
thinking about having sex.
I mean, who's to say he didn't take advantage of her?
Middle Hill just let it happen.
Why didn't they tell me?
- Well, maybe they didn't know about it.
- Six months, they had to have known.
I just--maybe it was a mistake choosing Middle Hill.
I--I mean, we saw a lot of good places,
but that--that is where Becca wanted to go.
I--
- Are you Becca's legal guardian?
- No, I have durable power of attorney.
But we did this thing called supportive decision-making,
where she can...
make her own decisions.
- There you go. [tires screeching]
- Well, this is different. - Why?
- Because it is.
I-- [horn honking]
[tires screeching]
- My son, he's-- he's not moving.
- OK.
Come on, buddy.
Come on.
I got a hot and unresponsive child.
I need a room, Dana.
- Trauma Two.
- We need a core temp ASAP.
Hi, I'm Dr. Al-Hashimi. Are you Mom?
- Brenda Azurmendi. - And this is?
- Micah.
- Has Micah been sick with a fever?
- No. He was fine all day.
I found him in the car.
[beeping]
- Pupils are sluggish, but reactive.
No reaction to pain.
[chiming]
- Uh, airway is patent with low tidal volume.
Uh, let's set up for intubation.
- Heart rate is 22 in 10 seconds.
That's 132. - Do you know his weight?
- No. - Joy, the Broselow.
- The what? - The Broselow tape gives us
all the drug doses based on length.
- Assisting with ventilation.
Somebody call respiratory.
- You said you just found him in the car?
- I was working in the garden
while he rode his trike in the driveway.
One minute he was there, and then he wasn't.
I--I thought he had gone into the house,
but I couldn't find him anywhere.
He must have gotten tired
and--and climbed in and fallen asleep.
By the time I found him, I--I couldn't wake him up.
- How long was he in there?
- Uh, m-m-maybe--
maybe 15 minutes or--or 20.
- And the car was just unlocked?
- It's a safe neighborhood.
- Uh, Joy.
OK, so you're gonna want to start at the head,
measure the length, and then read it off.
- Uh, approximate weight is 25 kilograms.
- 250 bolus of LR.
- I have doses for rock and ketamine.
- Almost no tone. I can do this without meds.
Uh, it's easy enough to bag.
Let's wait for RT.
- When the temperature is this high,
the muscles can lose their strength,
so we're going to help him breathe with a tube.
- Uh, rectal temp is 105.5.
- Heatstroke.
- Ice packs to the groin and axilla.
- See if we have an Arctic Sun that's not in use.
We need all the ice we can get.
[softly] And a pediatric body bag.
- Still waiting on your ketorolac pills.
I will keep following up with the pharmacy.
- I told my son I would meet him at the park.
We always watch the fireworks together.
- Sorry, Mr. Green.
We won't forget about you.
- Mm.
- Heard you had a heart attack.
- I did not have a heart attack.
- Hey, Samira, how are you feeling?
- I am totally fine.
- Uh, glad to hear it.
Hey, do you mind watching my patients
for 5 minutes?
I have to step out for a sec.
- No problem.
- Ogilvie, you, uh, want to get some air?
Got a good case for you.
- Might an intubation be required?
- No.
It's an unhoused patient
I've treated on the street team.
- Thank you so much.
- Hi, Becca. - Hey.
- I'm sorry I yelled at you.
I was just...
surprised.
- The nurse said I can leave.
- Yeah, um,
can we just finish our conversation first?
- About what?
- Look, I--I know you don't have to tell me anything.
I just...
kind of hope you'd want to.
When Adam asked you to have sex--
- He didn't ask me.
I asked him.
- So he didn't pressure--
- No.
- So you wanted to have sex.
- I wanted to have sex.
Sex is great!
We talked about sex in my mind and body class.
I told my therapist too.
- Hey, the, uh, pancreatitis in North 3's
still waiting for you. - OK.
- Can I go now? - Uh, just one second.
Uh, I'll be right there.
I'm just gonna walk my sister out.
Yeah, sorry, I'm right behind you.
- Curtis Larson, 42.
Called to the golf course for combative behavior
with his buddies.
No signs of trauma, just alcohol on the breath.
- Seems to have calmed down a bit.
- He was fighting us so hard,
had to give 4 milligrams of Versed
to get vitals and a line.
Good BP, pulse ox 99 on two liters.
- Between the booze and the Versed,
he'll be sleeping it off for a while.
- Central 14, guys.
[beeping]
- [sighs]
Roxie's gone.
- Is the husband still in there with her?
- Yeah, Javadi's with him.
She needs a death note. I can't find McKay.
- OK, I'll be right there.
- OK.
- Have you seen McKay anywhere?
- No.
- Have you ever seen a xylazine wound?
- No. - But you know what it is?
- Yes.
- Then you know its street name is Tranq,
and this shit is nasty
and can lead to skin necrosis.
- I've never understood drug addiction.
- Well, you need to try.
A little empathy goes a long way in this job.
- I am empathetic, I ju--
I don't understand how an intelligent person
allows themselves to-- - Can make mistakes?
Heal themselves? Take away the pain?
Hide from the abuse?
We're healers, not judges.
- Shouldn't we go to the crosswalk?
No?
OK, this is what we're doing.
I see organ donation in my future.
Sorry! [tires screeching]
[horn honking]
[muffled chatter]
- How's it going, Kiki?
- Who's this?
- Oh, it's, uh, Ogilvie.
He's a student doctor here to help me.
So what's happening with you?
- My leg's getting stinky again.
- Yeah? OK, let's take a look.
- [softly] OK.
- Is that an injection site?
- No. - No.
Xylazine wounds can show up anywhere.
You, uh-- you still using Tranq?
- Sometimes.
- Sometimes is not good, Kiki.
You know it's nasty stuff.
- I'm trying to quit.
- How you going about that?
- I go to meetings sometimes.
- Meetings are good.
Uh, not using's even better.
Uh, OK. What's your plan, Ogilvie?
Ogilvie, you OK?
- Yes. - Yeah?
- Absolutely.
Uh, my plan is clean with saline.
Antibiotics?
- Medihoney to break down the eschar.
And then?
- Um, redress with Xeroform
and an ABD pad and a Kerlix wrap.
- Yeah, that'll do it.
You need to change this dressing every day, Kiki, OK?
- I don't think I can do that.
- We'll give you all the supplies.
You can do it yourself.
You won't even have to come back here.
- Yeah. OK.
- OK.
OK, pass the saline.
[indistinct chatter]
- Hey, I'm Dr. Whitaker.
This is Dr. Santos.
- Roberto. Like Roberto Clemente.
- Oh, sorry. I--I don't know who that is.
- Pirates Hall of Famer Roberto Clemente.
You--you don't watch baseball?
- Well, I am from Nebraska.
We went to a few Storm Chasers games as a kid.
That's about it.
No Major League team, you know.
- All right. What happened to your elbow?
- [chuckles] Oneil Cruz hits a walk-off tater, right?
And I--I--I catch it, you know,
um, but then somebody fell on top of me,
and I--I think I heard a pop,
but hard to tell with all the screaming.
- That sounds pretty dangerous. - Yeah.
- You're not one of those guys
who steals balls from kids, are you?
- I didn't steal this. I wouldn't do that.
I would never do that. I would never do that.
[scoffs] - OK.
Can you move your fingers for me?
- And the thumb?
- Uh...
No. - OK, you know what?
We can put that in a belongings bag--
- [laughs] No, thanks.
I, um--I think I will hold on to this.
- OK. Uh, you know what?
We can put you in a sling,
and then you can hold on to the ball
while we examine you.
- OK. Yeah, I guess.
[grunts]
- Uh, you're gonna throw in an IV
and start with 4 of morphine.
- No, no, no, no. I don't want to be knocked out.
- No, it's a low dose. You won't be knocked out.
It'll just help with the pain.
Might make you a little drowsy.
- No. I need to stay alert.
- OK.
Uh, we will order you an X-ray.
Just please let us know if you change your mind.
- OK, yeah.
[beeping]
- Temp is down to 103.5.
- Long way to 98.6.
- 102, we take him off the ice.
Otherwise, we can overshoot and cause hypothermia.
I put in orders for CK.
- What does the CK tell us, Joy?
- Rhabdo from muscle breakdown can take out the kidneys.
- I'm more concerned about his brain.
- It's two times a day for three days,
and, uh, a nurse can crush it up.
- Dr. Langdon already told me.
OK, bye, Mel.
- I'll see you, uh-- I'll see you at fireworks.
- Oh, I was going to watch fireworks
with Adam and his parents.
- Where? - At the park.
They're picking us up. They go every year.
- But we always watch the fireworks together.
I have your headphones.
- Adam said that he has extra.
- OK, well, um, do you have Adam's parents' phone number?
- Why?
- Just in case I need to reach them.
- I want to go now.
- Well, I guess I could call-- - Bye, Mel!
- So how long have you been part of the street team?
- Oh, about a year.
- And why do you do it?
- Oh, most of these unhoused folks feel abandoned.
Sorry.
They, uh, don't trust easily.
Meeting them where they're at makes a big difference.
I've been trying to get Kiki to come by for months.
You should, uh, volunteer.
It's great training.
Street team could always use the help.
- Yeah, uh, maybe.
- Thank you.
Hey, how did the deposition go?
- Um, I'm glad it's over,
but I didn't feel good about it at all.
You know, I'm still not supposed to talk about it.
- No, but you can talk about how you feel.
Who do you have to talk to when things aren't going so good?
Friends? Family?
- Actually, I don't really have anyone--
- Hey, McKay, where have you been?
- Oh, I, uh--I stepped out.
- Did you tell anybody?
- Oh, I was, uh, treating a young woman
I met on the street team.
- Did she check in as a patient?
- No, we treated her in the park.
- "We"?
- I, uh--I took Ogilvie.
- Oh, OK, so you treated her
outside the ED on PTMC's dime
and you brought a medical student with you,
right when we're in the middle of crisis mode,
and we need all hands on deck.
- We were gone for 10 minutes, tops.
- When you're here, I need you to be here.
And while you stepped out, Roxie died.
- What?
Oh, man, I'm sorry.
I didn't think she would be gone that quickly.
- Shit.
- Excuse me.
Um, she took a nasty fall. Her shoulder.
Screamed in pain when we put the ties on her.
- Hello, I'm Dr. Robinavitch.
This is Dr. McKay.
- Agents Correa and Russo.
She needs to be looked at before we process her.
- What's your name, ma'am?
- Pranita.
- We're gonna take care of you, OK?
- You said she fell?
- We were conducting a sweep at her restaurant.
Everyone in the kitchen took off.
She was shoved down some alley stairs.
- Right. - Could be a rotator cuff tear
or an AC separation.
- Let's put her in a chair, find her a room.
- South 19.
- Yeah. Just through here.
- Curtis, dude.
[chuckles] What happened?
- Medics had to sedate him to transport.
- [sighs]
I didn't realize he was such an angry drunk.
- So you've seen him drunk before?
- Sure, yeah, but never like this.
He tried to pick a fight with the guys in front of us.
He said they were going too slow.
That's when they called the cops.
- Could he have taken drugs?
- If he did, they were not the performance-enhancing kind.
[chuckles]
He shot a 112.
- We'll order labs, see what we can figure out.
- Uh, any family we can contact?
- I have no idea. We don't talk about that shit.
How long is he gonna be here?
- At least 3 or 4 hours, till he sobers up.
- Cool.
Is it OK if I just come back around 9:00?
- Sure. - Great, thanks.
- I need those removed so I can check her vital signs.
- [gasps]
- OK, tender over the AC.
- Can you, uh, lift your right arm up
above your shoulder like this?
- Ah! - Heart rate's 110.
Pulse ox 98.
- Painful arc test is positive.
- Try the drop arm test.
- I'm gonna lift your arm up, OK?
And you just lower it as slowly as you can, OK?
OK.
Positive drop arm test. - What's that mean?
- That means that she's gonna require an X-ray.
It's most likely a rotator cuff tear,
which sometimes can come with a fracture.
We need an X-ray to rule it out.
- How long is that gonna take?
- [sighs] Our computers are down today.
Everything's moving a little slower than usual,
but we will fast-track her.
- Is there anyone you want us to call, Pranita?
- No phone calls.
Got a bathroom?
- Right there.
- I do not want these guys here
any longer than they need to be,
so let's find X-ray and fast-track this one.
- Her family might be worried. Maybe I can call them--
- No, no, no. Just stay with her.
Make sure she has everything she needs.
We treat her injury, and that's it.
- OK.
- Jamie Guerrero to window three, please.
Jamie Guerrero to window three.
[indistinct chatter]
[both speaking Spanish]
- Got a lateral.
Best I could.
- Posterior dislocation, no fracture.
Thanks. - Mm-hmm.
- OK, good news, Roberto.
No broken bones, but the elbow joint is dislocated
and we need to get the ball back in the socket.
The best way is with sedation and pain meds.
- No, no, no. - I know you said no morphine,
but we can put local anesthetic into the joint
to block the pain.
That way you won't be sedated.
- No, thanks, Doc. [chuckles]
Just--just give me a bullet to bite on.
- They raided Joe's over in Green Tree.
- Oh, man, I love that place.
- Brought in one of the employees.
- So ICE is here?
People are leaving the waiting room.
Ten patients already. What should I do?
- Just tell them the truth and hope they stay
for the treatment that they need.
- Martha took off.
I'm gonna call her when I get a chance.
- Oh, shit. Yeah, make sure she's OK.
Will you call the EVS department too
and let 'em know? - Will do.
- All right, hold down the fort.
Let us know if you need backup.
- You got it.
- Can't we just tell the agents to fuck off?
- They are not gonna leave without their patient.
We just need to treat her.
- Even if she's undocumented?
- All patients, regardless of immigration status,
have the right to emergency care under EMTALA.
- Pranita is next in line for X-ray.
- OK, good. Thank you.
- Propofol is down to 100 mikes per minute.
- Temp is 101.8.
- Great, let's get him off the ice.
- OK, hands.
On my count. One, two, three.
- What's the latest?
- Uh, we got some arm movement.
- That's a good sign.
- And pupils are minimally reactive.
- Plantars are downgoing.
- All encouraging signs.
Any luck getting a lawyer for our detainee?
- Uh, no.
- Keep me posted.
- Yeah.
[beeping]
- That's a pretty bracelet.
- [sighs]
My daughter made it for me.
She doesn't know where I am.
I just want her to know that I'm OK.
- You seriously won't let her make a phone call?
- Not until she's processed.
- Unbelievable.
- Thanks, and just let me know when she gets back.
Uh, one other thing.
Uh, do you have a resident named Adam?
I was wondering if I could get his parents' phone number.
- Nope! - I--
- Red phone is for emergencies only.
- This is kind of an emergency.
Sorry. Bye.
- Hey, Mel, we need an R3
to supervise a reduction in North 4.
Are you free? - Uh, I guess.
- Should we move the deceased woman
in Central 9 to viewing?
- Uh, no, let's leave the husband in there
for a little while longer. - We need the room.
- We're not moving her yet!
- OK, sorry.
- [sighs] I'm gonna do a room check.
- Pedes ICU says they'll have a bed soon.
- OK.
[indistinct chatter]
- So what do we think?
- About what?
- The mom of our heatstroke kid.
- Uh, that is not our job.
That is what CYF is for.
- So you think it was on purpose?
- No, I did not say that.
- I just don't buy it.
She lost her kid at home?
Plus, she just looks guilty.
Has anyone seen her cry?
- People don't always respond to trauma
the way you expect them to.
Stay focused on the kid.
[rapid beeping]
- BP 78 over 42, sats 87.
- You having some pain again, Mr. Green?
Mr. Green? - This one's yours?
- Yeah, a kidney stone. Possible vasovagal.
- Can't assume that. We need some help here!
Does he have an IV?
- N-no, he didn't need one.
- Hypotensive and hypoxic.
- Clear a trauma room.
- Yeah.
- Uh, he was just waiting on his discharge meds.
Pain-free.
- A few more patients are gone from chairs.
South 15 took off too.
- History of renal colic.
Heme-positive urine. BP crashing.
- Heme-positive urine doesn't always mean kidney stone.
Two antecubital lines, biggest ones we've got,
E-FAST, and let's get two units of whole blood hung, please.
Good.
Who worked up this patient? - I did.
Ultrasound showed dilated ureter a--
and mild left hydronephrosis
consistent with his history of renal colic.
- What about the aorta?
- I didn't look at the aorta.
- Who did you present to? - Dr. Mohan.
- You said the rest of the ultrasound was normal.
- I meant that the other kidney was normal.
- [sighs] - [sighs]
8-centimeter triple-A with massive free fluid.
- Ruptured aortic aneurysm. He's bleeding out.
- OK, go with the MTP.
- 16-gauge in the left AC.
Two units whole blood on the infuser.
[rapid beeping]
- Assisting ventilations.
Resps are agonal.
- OK, who wants to intubate?
Javadi? - Sure.
- OK, call for six more units of whole blood.
Eusebio, call surgery.
If we stay ahead of him, we might get him up to the OR.
Here you go.
[rapid beeping]
- We're lightening up his sedation
to see if he has any purposeful movement.
If so, that will be an encouraging sign.
- He'll be back to normal?
- There's no certainty
as to how much recovery Micah will have.
His response over the next 24 hours will tell.
There is a chance of cognitive impairment,
but also a chance of meaningful recovery.
- Dr. Al-Hashimi, the patient in 22 needs you.
- I will be right back.
- I'm in. Bag him.
- Nicely done. Good job.
- Unit three is up and running.
- I've got a 16-gauge EJ.
- That one goes on the rapid infuser.
- Good end tidal waveform.
[rapid beeping]
- Strong radial pulse. That's a very good sign.
- BP's up. 86 over 52.
- Some progress.
How about 2 grams TXA? - Yeah.
What else do we give after four units of blood?
- Um-- - Calcium gluconate
to counteract hypocalcemia
caused by the citrate anticoagulant.
- Why don't you see if you can't squeeze a unit
into that peripheral line?
[machinery beeping]
- Should somebody place a central line?
- Long central line is slower than
short large-bore peripheral.
- Flow is proportional
to the fourth power of the radius.
Physics.
- Right.
- OK.
Bite down on this.
- OK.
I'm stabilizing the humerus. - All right.
After I supinate with traction,
Dr. Whitaker will apply downward pressure
on the proximal forearm.
- [grunting] - OK.
This is gonna hurt like hell, Roberto.
- Mm, mm.
- One, two, three.
- [muffled scream] [cracking]
[screaming] - OK.
I'm flexing at the elbow.
- [screaming]
- Systolic's down to 68.
- Units five and six are up and running.
[rapid beeping]
- I'm here for Garcia. Vascular can't come down.
- Triple A with hemorrhagic shock.
- Most of these die in the field.
- He was stable.
Presented with a history of renal colic.
- And nobody saw the triple A on ultrasound?
Was this you?
- No. It was me.
[flatlining] - Looks like sinus tach.
- Nope, lost the pulse. It's PEA.
- Bag him. Ogilvie, start compressions.
- We're having a hard time
staying ahead of the blood loss.
- Sterile gloves. Prep for a thoracotomy.
- Dr. Javadi, why don't you glove up and show Dr. Shamsi
why you belong in the ED?
If we can cross-clamp the aorta,
we can stop the blood flow from below the diaphragm.
We can perfuse the heart and the brain.
- Ten blade. - Right in there.
[rapid beeping]
- Mayo scissors.
- Rib spreader.
- Satinsky.
- Let me know when you have enough exposure.
- Right there.
- Do you need me on suction?
- No, there's no blood in the chest.
It's all in the belly.
Here, keep squeezing.
- Aorta's clamped.
Heart is empty.
- OK, Javadi, get in there.
Internal compressions, go.
Put two more units on the rapid infuser, please.
- That'll be units seven and eight.
- All right. Neuro's intact.
So we'll do a posterior splint,
a sling, and an ortho referral.
- You know, I'm actually kind of impressed
you did that without pain meds.
- [chuckles] Definitely worth it.
You know, last year I caught McCutchen's 300th career homer,
but another fan stole it from me.
I promised myself I would never let that happen again.
- Whitaker, can you write the procedure note?
- Yeah, you already filled in the T-sheet, so--
- Yeah, well, I'm already here.
- Yeah, I kind of had a handle--
- I just did everything else,
so can you just fill out the chart?
- You should probably finish it.
- Well-- - OK, someone do this!
I don't--I don't-- I don't care who.
- Yeah.
[sighs]
[beeping]
- Where's Mrs. Azurmendi?
- She stepped out.
- Stepped out?
- Feels like the heart's filling back up.
- Let's have a peek.
[steady beeping]
- Looks good. Really good.
- Strong radial pulse.
- Moist lap pads. Prep for transfer.
- Systolic of 94. That's the best so far.
- Can I go with you?
He's my patient.
- OK by me.
- Bring two extra units.
- [sighs]
[softly] ICE is in the building?
- Word travels fast. Yeah.
We have a detainee with a rotator cuff tear.
- Two of our nurses went home.
They have temporary protected status,
but they just don't feel safe.
- Um, I'm really sorry, Dr. Robby.
I should have checked the aorta.
- It's an easy one to miss.
Got a heartbeat back, though, so still some hope.
- I'm sorry too.
I--I should have asked Ogilvie
if he'd checked the aorta.
It's--it's my fault. - It is.
You're the senior resident.
You don't look to others. Others look to you.
- I know. I'm really sorry. - This is what happens
when you bring your personal life into work.
Patient almost died. - I know.
- You have to think of these walls like a force field.
You cannot let anything in.
Your mother's not in here. She is out there.
You keep everything out there. That is the key.
That is the difference between the best doctors
and the ones that don't make it.
- You're right.
Maybe I just don't belong here.
- [sighs]
- Pranita's X-ray results.
No fracture. - OK.
We'll just have Jesse fit her for a sling, I guess,
and then we have to discharge her.
- To the immigration guys?
- I'm afraid so.
OK, time for you to go.
- I was just having a chat with Ms. Peters here.
- You can see how busy this department is, right?
You've been nothing but a distraction
and a disruption since you've been here.
I'm already short-staffed, and I just lost five nurses
and half my environmental services team
because you walked in.
You know patients come in here for help, right?
Because they're either sick or they're injured,
and documented or undocumented,
they have a right to emergency care.
TB, measles, fractures-- none of it's getting treated
'cause everybody's too scared to come in.
But then they end up here anyway,
but then it's too fucking late!
So please, for the love of God, can you just go
wait over there in the room with your detainee,
so I don't lose any more patients or staff?
- No problem, Doc.
- Mrs. Azurmendi.
Brenda.
Where are you going?
[horn blares] Brenda!
- [crying] - OK, OK.
It's OK.
Let's get you back inside to your son.
It's OK. It's OK. It's OK. It's OK.
- Come on. She's cleared to go.
- Wait. Hold on. She needs a sling.
- This will only take a minute. - We're leaving.
- [whimpers] - Hey, man, you're hurting her!
[objects clattering] [shouting]
- Jesus Christ. What's going on now?
- [screams] - Robby!
- Help! [shouting]
- You can't do this! What are you doing?
- This is bullshit. - What the hell is going on?
- Get your hands off me. - He hurt her,
and Jesse stepped in!
- Robby, I didn't do shit. - I know.
I know. I'm just gonna-- - [speaking indistinctly]
[indistinct shouting, chatter]
No! - We gotta go.
- No, don't! - Come on.
- Don't say anything. You don't have to say anything.
They can't make you say anything.
We'll get you an attorney.
I promise we'll get you out.
Call the hospital attorney again.
- No, no! - Can't believe this shit!
- Can you at least tell us where you're taking them?
- No!
- Is there a detention center near Pittsburgh?
That's gotta be where they're going, right?
- It could be hours before he's processed.
- I'll stay on it.
- What can we do?
- Uh--hey, Javadi!
Javadi, please come back.
Everybody, just go check on your patients.
Assure them. Tell them what happened.
But please, everybody get back to work.
- Who's gonna take Jesse's patients?
- I can do it, D. - Thanks, Perlah.
[indistinct chatter]
- Hey, you OK? - Yeah, I'm OK.
Are you OK? - Yeah.
- The lawyers are tied up with the cyberattacks upstairs.
They probably won't come down for a while.
[beeping]
- What's the latest with the heatstroke kid?
- I sent him up to Pedes ICU.
- [softly] What's going on?
- I found her outside, wandering into the street.
She almost got hit by a truck.
[sighs] I think it was intentional.
- Christ almighty.
- I told Nurse Kim not to let her out of her sight.
We need to call a 302 and observe her.
- Danger to self.
- Is she gonna be able to see her kid?
- Not if she's on an involuntary psych hold.
- Well, what happens if he's ready to be discharged
before she is?
- Does she have a partner or a relative we can call?
- I can find out.
- Why don't you and I talk to her together?
- Sure, I just need to check on a patient,
and I will meet you there. - OK.
[indistinct chatter]
- Uh, OK.
- Hey, Emma,
have you seen this patient?
- Oh, I--I haven't.
- Oh, she took off when those ICE guys
arrested your nurse.
- Damn it.
- [whispering] I tried to get him
to help me in the garden,
but he just wanted to ride his trike.
So I let him.
Every time I looked over,
he was just riding around.
And then he wasn't.
- Have you ever thought about hurting yourself?
- CBC and blood alcohol are
back on your golfer, Curtis Larson.
0.14. - Copy that.
OK, we'll wait for the other labs.
He'll need to sleep it off in the meantime.
- Hey, Gabriel, can you wait up a sec?
Do you have Duke Ekins' chest X-ray?
- Yeah. - How's it look?
- Radiologists still need to read it.
- Can you pull it up for me?
Shit.
- [sighs] I gotta call the funeral home,
start making arrangements.
- Or you could slow down,
take some time for yourself.
How you doing?
- Oh, you know, been better.
You spend so much time with these people,
you become a part of their family.
It's not like it is here, where patients come and go.
- Don't stay for the night shift.
We got reinforcements coming in.
- I'd rather work.
I don't know if I want to sit with this at home.
- Try. For once, just listen to me.
Take the night off.
I'll cover for you until
I can find someone else to come in.
Go. - OK.
- You think she's gonna be OK?
- I don't know.
I just hope she can forgive herself.
[bell dings]
I've noticed some tension between you and Dr. Santos.
You two have history?
- Uh, yeah.
She doesn't like me very much.
Uh...
we worked together one time.
I was a pretty big asshole.
She called me out on some things that I...
wasn't ready to face, and I overreacted.
I'm gonna talk to her.
I just haven't found the right time.
- Good.
Do.
- Thought you might be in here.
What's going on? - [sighs]
It's just the deposition and my sister coming in.
It's been a--a day.
- Oh.
Screw the deposition.
Is your sister OK?
- Yeah, it's just a UTI,
so meds will clear it up.
- Well, that's good.
- She has a boyfriend she didn't tell me about,
and other things she didn't tell me about.
- Well, maybe she didn't know how.
- She's having sex.
Great s-sex.
And she lied to me.
I mean, she--she lied to my face for 6 months.
My sister is a fucking liar.
- Did you just curse?
- It's how I feel.
- Look, kid,
I say this with love.
People got their own reasons for keeping secrets.
Most of the time, it's got nothing to do with you.
- I've seen "Elf" 164 times.
Becca loves "Elf," so we watch "Elf."
And she's got everything,
and n--and now she's got a boyfriend,
and they're gonna fall in love and they're gonna get married,
and I'm gonna be completely alone.
- Did it feel good to say that out loud?
- No.
- Mel, you're a good egg,
but this is not about you.
I learned a long time ago
to quit feeling sorry for myself.
Now come on.
Pity party's over.
- OK, so this is your heart,
and these are your lungs.
- They look OK? - Yeah.
It's this part right here,
this space right between your lungs.
It's called the mediastinum, and it is enlarged.
It is too wide.
- From what?
- Can't really tell from the plain film.
Could be any number of things.
- Yeah, stop the bullshit.
- It could be an enlarged thyroid.
It could be enlarged lymph nodes
from an infection.
It could possibly be a tumor.
- You think I have lung cancer?
- Nope, I don't see that.
But cancer of the lymph nodes is called lymphoma.
And there are a lot of diseases of the aorta,
which is this big artery that comes off the heart,
which can get enlarged
because of weak spot in the wall.
Kind of like a, uh, bubble in a tire that can have a blowout.
And the only way to make sure
is to do a CT scan of your chest.
Today.
- How long does that take?
- A few hours, couple hours.
- You still gonna be here?
- Yeah, I would not feel good about riding if I rushed this.
- This is important?
- Hey.
I think the, uh, labs are back
on your COPD patient.
Saw 'em in the rack.
- Thanks.
- Uh, look.
I don't know how to say this.
Um...
I know you don't like me, and--and that's fine.
You don't have to. I just--
I want to say I'm sorry
for being an asshole on your first day.
That was completely inappropriate,
and if I could take back what happened,
I would, but I can't.
- OK.
[bell dings]
OK, I'm sorry, I just--
I don't buy it.
Everyone thinks you're just an addict
who went to rehab,
and you've convinced everyone here
that you've changed
and you're owning up to your mistakes,
and they welcome you back with open arms
because you're still the golden boy,
and I think it's bullshit.
- I'm genuinely sorry.
And I can promise you, I have faced my fair share
of punishment for what I did.
- You fucking stole drugs from the hospital.
Only three people here actually know that.
Have you told anyone else what you did?
Have you? - Look.
I'm just trying to get through my first day back.
- You shouldn't even be here!
I should have reported you to the state medical board.
You should have lost your license and gone to prison.
- You don't know what I've been through.
- What you've been through?
- My wife threatened to divorce me, OK?
I almost lost my kids.
- Yeah, that's what happens when you fuck up.
- [sighs]
You don't have to accept my apology.
I just-- I wanted to say it, OK?
- You really want to atone for your sins?
Tell everyone here you stole drugs
and got kicked out of the ED because of it.
Until then, stay out of my way.
[soft beeping]
- [gasps] - Oh, hi.
- What the fuck?
- I'm just checking your vital signs.
- [grunts] - Oh.
- Where am I?
- Oh! - What did you do to me?
- [whimpers] - Huh?
- [gasping] - [grunting]
[dramatic music]
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[soft acoustic music]
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