1 00:00:12,721 --> 00:00:14,973 Baran, is this you? 2 00:00:20,562 --> 00:00:23,232 It began after a bad case of viral meningitis 3 00:00:23,315 --> 00:00:25,025 when I was five. 4 00:00:25,108 --> 00:00:27,361 They tried every anti-seizure medication, 5 00:00:27,444 --> 00:00:31,323 but I still had episodes every few months or so. 6 00:00:31,406 --> 00:00:32,533 No one's ever noticed before. 7 00:00:32,616 --> 00:00:34,076 They just think I'm thoughtful. 8 00:00:36,119 --> 00:00:37,496 Are you driving? 9 00:00:37,579 --> 00:00:40,582 I couldn't until laser ablation 10 00:00:40,666 --> 00:00:43,919 to my left temporal lobe 12 years ago. 11 00:00:44,002 --> 00:00:46,755 Between that and the Keppra, I've been seizure-free, 12 00:00:46,838 --> 00:00:50,467 cleared by Neurology to drive and to work as an attending. 13 00:00:52,302 --> 00:00:54,513 How long, uh, between the seizure 14 00:00:54,596 --> 00:00:56,390 you had today and the last one? 15 00:00:56,473 --> 00:00:59,685 It's been well over a year. 16 00:01:01,895 --> 00:01:03,272 But I had two today. 17 00:01:07,985 --> 00:01:09,444 I don't know why. 18 00:01:09,528 --> 00:01:12,698 It could be sleep deprivation, new job stress. 19 00:01:12,781 --> 00:01:15,951 I--I haven't had to deal with Peds cases 20 00:01:16,033 --> 00:01:17,494 since Afghanistan. 21 00:01:17,578 --> 00:01:19,246 What are your options now? 22 00:01:19,329 --> 00:01:21,373 Um... 23 00:01:21,456 --> 00:01:24,918 up my Keppra or maybe try 24 00:01:25,002 --> 00:01:26,545 one of the newer anti-seizure meds. 25 00:01:26,628 --> 00:01:29,381 But if that doesn't work, I'm left with two choices-- 26 00:01:29,464 --> 00:01:33,801 um, a temporal lobectomy, which could impair my speech, 27 00:01:33,884 --> 00:01:36,263 or get a neuromodulation device, 28 00:01:36,346 --> 00:01:38,015 which can sense and stop the seizures 29 00:01:38,098 --> 00:01:39,850 almost immediately. 30 00:01:39,933 --> 00:01:41,685 You need to disclose this. 31 00:01:41,768 --> 00:01:43,729 I know. I have a plan. 32 00:01:43,812 --> 00:01:44,813 Hey, Robby, Dana's looking for you. 33 00:01:44,896 --> 00:01:46,064 She's in Peds. 34 00:01:46,148 --> 00:01:47,399 Yeah, OK, I'll be right there. 35 00:01:48,859 --> 00:01:49,985 Sounds like you're needed in Peds, 36 00:01:50,068 --> 00:01:52,112 and I have patients to see. 37 00:01:52,195 --> 00:01:54,031 Robby, pregnant woman with severe headache 38 00:01:54,114 --> 00:01:55,741 on her way in by ambulance. 39 00:01:55,824 --> 00:01:58,243 Find Abbot or a night shift resident. 40 00:02:13,342 --> 00:02:15,177 Need you to turn out your pockets. 41 00:02:21,475 --> 00:02:23,310 OK. Show me your hands. 42 00:02:51,296 --> 00:02:52,631 Come here often? 43 00:03:01,431 --> 00:03:02,849 What's going on? 44 00:03:02,933 --> 00:03:04,601 Oh, sorry--false alarm. 45 00:03:04,685 --> 00:03:06,812 We thought she spiked a fever, but it was the wrong chart 46 00:03:06,895 --> 00:03:09,231 from our analog hell. 47 00:03:09,314 --> 00:03:11,817 You know anybody who might consider kinship adoption? 48 00:03:11,900 --> 00:03:13,568 Doctors and nurses qualify. 49 00:03:13,652 --> 00:03:15,195 Don't look at me. 50 00:03:15,278 --> 00:03:17,322 Hey, can your staff keep an eye on Dr. Al-Hashimi 51 00:03:17,406 --> 00:03:18,365 until she leaves? 52 00:03:18,448 --> 00:03:20,826 Why? 53 00:03:20,909 --> 00:03:22,994 Uh, because I think she's tired, 54 00:03:23,078 --> 00:03:24,579 and I don't want her to make any mistakes. 55 00:03:24,663 --> 00:03:26,665 Oh, great advice. Maybe you should take it. 56 00:03:26,748 --> 00:03:27,916 Yeah. 57 00:03:27,999 --> 00:03:29,376 I'm gonna go get some fresh air. 58 00:03:29,459 --> 00:03:30,919 Grab some for me while you're out there. 59 00:03:31,002 --> 00:03:32,045 Your lungs wouldn't know what to do with it. 60 00:03:32,129 --> 00:03:33,088 Screw you! 61 00:03:33,171 --> 00:03:34,756 In front of the baby? Nice. 62 00:03:37,676 --> 00:03:39,219 Yeah. 63 00:03:39,302 --> 00:03:41,096 We are the night crawlers. 64 00:03:41,179 --> 00:03:44,057 We deal with the weirdest and the wildest because... 65 00:03:44,141 --> 00:03:46,601 all: We are the weirdest and the wildest of them all. 66 00:03:46,685 --> 00:03:47,728 That is right, and tonight, 67 00:03:47,811 --> 00:03:49,062 they are really gonna be crawling. 68 00:03:49,146 --> 00:03:50,439 Now go get some! 69 00:03:50,522 --> 00:03:51,481 all: Hooah! 70 00:03:55,986 --> 00:03:57,487 Sorry to wake you. 71 00:03:57,571 --> 00:03:58,989 I--I was thinking. 72 00:04:02,868 --> 00:04:04,119 Doubt PTX. 73 00:04:04,202 --> 00:04:06,371 You're supposed to be leaving. 74 00:04:06,455 --> 00:04:07,539 I am. 75 00:04:09,833 --> 00:04:11,334 You know, this spirit quest of yours 76 00:04:11,418 --> 00:04:13,211 has a lot of people up in arms around here. 77 00:04:13,295 --> 00:04:14,671 Everyone's gonna be fine without me, 78 00:04:14,755 --> 00:04:16,298 and it's hardly a spirit quest. 79 00:04:16,380 --> 00:04:18,007 Whatever it is, it seems you've given people 80 00:04:18,091 --> 00:04:19,259 the impression you might not be coming back. 81 00:04:19,341 --> 00:04:20,719 Well, who knows 82 00:04:20,802 --> 00:04:22,179 what the future has in store for any of us? 83 00:04:22,262 --> 00:04:23,555 Yeah, saying shit like that right there 84 00:04:23,638 --> 00:04:24,598 isn't helping. 85 00:04:24,681 --> 00:04:26,016 People are worried about you. 86 00:04:26,099 --> 00:04:27,934 Dr. Abbot, the patient in South 21, 87 00:04:28,018 --> 00:04:29,394 Digby, he's missing again. 88 00:04:29,478 --> 00:04:30,771 Sounds like a day shift problem. 89 00:04:30,854 --> 00:04:33,023 Not if he was handed off already. 90 00:04:37,277 --> 00:04:38,820 Best I can do under the circumstances. 91 00:04:38,904 --> 00:04:40,113 Thank you. 92 00:04:40,197 --> 00:04:41,615 Hey, don't leave before I get back, yeah? 93 00:04:41,698 --> 00:04:43,450 Hell, I feel like I live here now. 94 00:04:46,870 --> 00:04:48,121 Your friend fixing your bike? 95 00:04:48,205 --> 00:04:49,372 Ambulance clipped it 96 00:04:49,456 --> 00:04:51,249 while it was just parked here today. 97 00:04:51,332 --> 00:04:53,460 Jesus Christ. 98 00:04:53,543 --> 00:04:55,086 That's a sign if I've ever seen one. 99 00:04:56,713 --> 00:04:58,465 Yeah, here's the thing-- when people worry about you, 100 00:04:58,548 --> 00:05:00,217 it makes me think that I should be worried about you, 101 00:05:00,300 --> 00:05:01,885 and I don't like worrying about things. 102 00:05:01,968 --> 00:05:03,094 Ooh. Now you're a shrink? 103 00:05:03,178 --> 00:05:04,179 No, I'm trying to be your friend. 104 00:05:04,262 --> 00:05:05,347 You got--you got Dana convinced 105 00:05:05,430 --> 00:05:07,140 that you're gonna hurt yourself. 106 00:05:07,224 --> 00:05:08,683 - Dana's got her own issues. - That sounds like projection. 107 00:05:08,767 --> 00:05:10,018 Are you seriously trying to have this fucking 108 00:05:10,101 --> 00:05:11,603 conversation with me right now, man? 109 00:05:11,686 --> 00:05:13,188 I--I'm not the one 110 00:05:13,271 --> 00:05:15,565 who spends his free time getting shot at. 111 00:05:15,649 --> 00:05:17,150 Hooah! 112 00:05:17,234 --> 00:05:19,486 Hey, Dr. Robby, this is Judith Lastrade-- 113 00:05:19,569 --> 00:05:21,738 36 weeks pregnant with two days of headache, 114 00:05:21,822 --> 00:05:24,241 now a 10 out of 10 with blurred vision. 115 00:05:24,324 --> 00:05:27,452 BP 174/120, heart rate 92. 116 00:05:27,536 --> 00:05:29,538 - No relief with fentanyl. - Judith, I'm Dr. Abbot. 117 00:05:29,621 --> 00:05:30,956 Any weakness in your arms or legs? 118 00:05:31,039 --> 00:05:32,499 No, no. Is this a stroke? 119 00:05:32,582 --> 00:05:33,875 We need to check for everything. 120 00:05:33,959 --> 00:05:36,628 Pitting edema with severe preeclampsia. 121 00:05:36,711 --> 00:05:38,547 Where are you doing your prenatal care? 122 00:05:38,630 --> 00:05:39,798 Nowhere. 123 00:05:39,881 --> 00:05:41,299 It's a wild pregnancy. 124 00:05:41,383 --> 00:05:43,218 I want a free birth. 125 00:05:45,428 --> 00:05:48,765 This 81-year-old nun presents with red, itchy eyes 126 00:05:48,849 --> 00:05:51,935 with secretions for the past two days. 127 00:05:52,018 --> 00:05:54,437 Patient complains of no URI symptoms, 128 00:05:54,521 --> 00:05:56,022 - no contact with any chemical... - Hey. 129 00:05:56,106 --> 00:05:57,399 Agents, no known exposures-- 130 00:05:57,482 --> 00:05:58,942 Want half a Monster? 131 00:05:59,025 --> 00:06:00,610 Oh, no, thanks. 132 00:06:00,694 --> 00:06:02,112 I--I don't really want to stay awake 133 00:06:02,195 --> 00:06:04,239 any longer than I have to. 134 00:06:04,322 --> 00:06:05,782 Yeah, I hear you. 135 00:06:07,325 --> 00:06:09,327 Did you find your ID badge? 136 00:06:09,411 --> 00:06:10,871 Uh, no. 137 00:06:10,954 --> 00:06:13,164 You any closer to deciding what's next for you? 138 00:06:13,248 --> 00:06:15,083 Uh, yeah, I'm seriously considering law school. 139 00:06:15,166 --> 00:06:16,585 What? What are you talking about? 140 00:06:16,668 --> 00:06:18,545 You're gonna be a great doctor. 141 00:06:20,005 --> 00:06:23,216 I mean, no offense, but look what this place does to you. 142 00:06:23,300 --> 00:06:24,885 Langdon's an addict. 143 00:06:24,968 --> 00:06:27,596 Is a person with a substance use disorder. 144 00:06:27,679 --> 00:06:29,556 McKay was on house arrest. 145 00:06:29,639 --> 00:06:31,057 Dana's a time bomb. 146 00:06:31,141 --> 00:06:32,767 Santos is one of the angriest people 147 00:06:32,851 --> 00:06:34,269 you are ever going to meet. 148 00:06:34,352 --> 00:06:35,770 Sarcastic, yes. Cynical, definitely. 149 00:06:35,854 --> 00:06:37,314 I don't know if she's, you know-- 150 00:06:37,397 --> 00:06:38,732 Mel? 151 00:06:39,816 --> 00:06:42,736 Samira has no life. 152 00:06:42,819 --> 00:06:45,947 Abbot's an adrenaline junkie who gets shot at for fun. 153 00:06:46,031 --> 00:06:48,825 Robby's got, like, PTSD or something way fucking worse. 154 00:06:48,909 --> 00:06:50,076 OK, well, I--I mean, 155 00:06:50,159 --> 00:06:52,120 I'd hate to know what you think about me. 156 00:06:53,788 --> 00:06:55,373 I don't know, I just-- 157 00:06:55,457 --> 00:06:58,001 the more time I spend here, 158 00:06:58,084 --> 00:06:59,252 the more I realize the importance 159 00:06:59,336 --> 00:07:01,922 of my mental health. 160 00:07:03,048 --> 00:07:04,090 Mm. 161 00:07:04,174 --> 00:07:05,383 For patients and for us. 162 00:07:05,467 --> 00:07:07,969 And this is... 163 00:07:08,053 --> 00:07:09,137 Yeah. 164 00:07:09,220 --> 00:07:10,430 Well, you know, 165 00:07:10,513 --> 00:07:13,266 maybe that's what you should focus on. 166 00:07:14,434 --> 00:07:16,603 - What? - Mental health. 167 00:07:16,686 --> 00:07:18,897 Clearly, you have a passion for it, right? 168 00:07:18,980 --> 00:07:20,440 I mean, that's--that's great. 169 00:07:20,523 --> 00:07:21,524 I don't know if I'd call it a passion. 170 00:07:21,608 --> 00:07:23,693 I would call it, like, a... 171 00:07:26,655 --> 00:07:28,198 Oh, my God. 172 00:07:30,158 --> 00:07:32,243 You might be right. 173 00:07:33,870 --> 00:07:35,413 Oh, you're a genius, Whitaker. 174 00:07:35,497 --> 00:07:36,665 Oh, OK. 175 00:07:38,332 --> 00:07:40,251 CTG is on. 176 00:07:40,335 --> 00:07:42,545 - CTG? - Cardiotocography. 177 00:07:42,629 --> 00:07:45,966 Measures the baby's heart rate and checks for contractions. 178 00:07:46,049 --> 00:07:47,550 Fetal heart rate 128. 179 00:07:47,634 --> 00:07:49,094 Normal range, Nazely? 180 00:07:49,177 --> 00:07:50,971 110 to 160. 181 00:07:51,054 --> 00:07:52,847 So the baby's OK? 182 00:07:52,931 --> 00:07:54,057 Right now, yes. 183 00:07:54,140 --> 00:07:55,475 128 is reassuring. 184 00:07:55,558 --> 00:07:57,686 BP's 170/119. 185 00:07:57,769 --> 00:07:59,479 6 grams of magnesium running in. 186 00:07:59,562 --> 00:08:01,064 Your next move, Crus? 187 00:08:01,147 --> 00:08:03,692 20 of labetalol, IV push over two minutes. 188 00:08:03,775 --> 00:08:05,235 Uh, what's happening? 189 00:08:05,318 --> 00:08:07,278 Uh, you have a condition called preeclampsia. 190 00:08:07,362 --> 00:08:08,530 And how did it happen? 191 00:08:08,613 --> 00:08:10,782 Uh, nobody really knows, actually. 192 00:08:10,865 --> 00:08:13,118 It affects about 10% of the pregnancies. 193 00:08:13,201 --> 00:08:14,577 High blood pressure, headaches, 194 00:08:14,661 --> 00:08:17,038 protein in the urine, and swollen ankles. 195 00:08:17,122 --> 00:08:19,332 OK, well, it's a wild pregnancy, 196 00:08:19,416 --> 00:08:21,543 so that means no medical care. 197 00:08:21,626 --> 00:08:23,586 Then why are you here? 198 00:08:25,130 --> 00:08:27,340 I just need to get rid of this headache. 199 00:08:29,551 --> 00:08:32,511 Well, if we don't lower your blood pressure 200 00:08:32,595 --> 00:08:35,432 and treat with magnesium, there can be problems. 201 00:08:35,515 --> 00:08:36,683 Like what? 202 00:08:36,765 --> 00:08:38,308 Seizures, bleeding, 203 00:08:38,393 --> 00:08:40,395 even death, for you and the baby. 204 00:08:40,477 --> 00:08:42,230 Oh, my God. 205 00:08:42,313 --> 00:08:43,940 Robby, your VIP's ready to go. 206 00:08:44,024 --> 00:08:46,026 OK, I'll be right there. 207 00:08:46,109 --> 00:08:47,652 - You good? - Yeah, I'm good. 208 00:08:47,736 --> 00:08:50,363 I got it. With my eyes closed. 209 00:08:50,447 --> 00:08:51,698 But I won't. Maybe one eye. 210 00:08:53,116 --> 00:08:54,159 Hey-- 211 00:08:57,579 --> 00:08:58,913 Hey, Becca. How you feeling? 212 00:08:58,997 --> 00:09:01,166 I'm better. Thanks. 213 00:09:02,751 --> 00:09:04,044 Where are you? 214 00:09:04,127 --> 00:09:05,962 I'm at Adam's house. 215 00:09:06,046 --> 00:09:07,714 Can I call you later? We're watching a movie. 216 00:09:07,797 --> 00:09:08,965 Oh, sure. I just--I thought 217 00:09:09,049 --> 00:09:10,508 you were gonna see the fireworks. 218 00:09:10,592 --> 00:09:13,094 Nope, we decided to watch "Elf" instead. 219 00:09:13,178 --> 00:09:14,429 Ah. 220 00:09:14,512 --> 00:09:16,431 - Of course you did. - OK. 221 00:09:16,514 --> 00:09:18,141 - I'll call you tomorrow! - Tomorrow? Wait. 222 00:09:18,224 --> 00:09:20,435 Uh, are--are you spending the night? 223 00:09:20,518 --> 00:09:22,312 Um, uh, yes. 224 00:09:22,395 --> 00:09:24,064 His parents invited me. 225 00:09:24,147 --> 00:09:25,565 They--they need to ask me that. 226 00:09:25,648 --> 00:09:28,026 Are--are you staying here too? 227 00:09:28,109 --> 00:09:32,072 No, they--they needed to ask if it was OK if you stayed. 228 00:09:32,155 --> 00:09:33,448 Why? 229 00:09:33,531 --> 00:09:38,119 Be--because, uh, it's polite. 230 00:09:38,203 --> 00:09:40,413 It's the right-- it's the right thing to do. 231 00:09:40,497 --> 00:09:43,500 Um, I need to talk to them. 232 00:09:43,583 --> 00:09:46,211 Um, they're not here. They're at a barbecue. 233 00:09:46,294 --> 00:09:48,338 OK, um, can you have them call me 234 00:09:48,421 --> 00:09:49,672 as soon as they get home? 235 00:09:49,756 --> 00:09:51,549 - Yes. - Can you promise? 236 00:09:51,633 --> 00:09:53,426 I promise. OK, bye, Mel! 237 00:09:53,510 --> 00:09:54,886 Bye. Have fun-- 238 00:09:56,304 --> 00:09:57,806 Thanks for fixing my bike. 239 00:09:57,889 --> 00:10:00,058 Well, you keep me running, I'll keep her going. 240 00:10:01,976 --> 00:10:05,438 You know, the Cree don't have a word for goodbye. 241 00:10:05,522 --> 00:10:06,606 You know a lot of Cree? 242 00:10:07,607 --> 00:10:08,566 A bit. 243 00:10:08,650 --> 00:10:09,526 I got around, man. 244 00:10:09,609 --> 00:10:10,819 I don't doubt it. 245 00:10:13,446 --> 00:10:15,824 Look, I'll come back for all this other shit... 246 00:10:15,907 --> 00:10:17,200 Great. 247 00:10:17,283 --> 00:10:18,660 If you promise to come back 248 00:10:18,743 --> 00:10:20,537 and let me take the Bonnie for a ride. 249 00:10:20,620 --> 00:10:21,746 Uh, I don't know. 250 00:10:21,830 --> 00:10:23,123 I've seen you ride, old man. 251 00:10:23,206 --> 00:10:24,582 Fuck you. 252 00:10:24,666 --> 00:10:26,501 I mean it. 253 00:10:26,584 --> 00:10:27,752 We got a deal? 254 00:10:30,880 --> 00:10:32,715 I'll think about it. 255 00:10:45,895 --> 00:10:47,856 This looks like an ambush. 256 00:10:47,939 --> 00:10:49,524 We got a slight hiccup in chairs. 257 00:10:49,607 --> 00:10:50,608 ICE is back? 258 00:10:50,692 --> 00:10:52,610 No, we got a dead body. 259 00:10:52,694 --> 00:10:54,237 - Somebody died out there? - Yeah. 260 00:10:54,320 --> 00:10:56,030 Poor devil checked in at 5:00 this morning. 261 00:10:56,114 --> 00:10:57,532 He was a DNR. 262 00:10:57,615 --> 00:10:58,700 - What was his chief complaint? - Hemorrhoids 263 00:10:58,783 --> 00:11:00,243 - and constipation. - No shit. 264 00:11:00,326 --> 00:11:02,579 Hence the constipation. 265 00:11:02,662 --> 00:11:04,330 Throw me a slow one, I'm gonna hit it. 266 00:11:04,414 --> 00:11:05,999 Tell the night shift. I'm saying that's when he died. 267 00:11:06,082 --> 00:11:07,250 We all in agreement on that? 268 00:11:07,333 --> 00:11:08,626 To the grave. 269 00:11:08,710 --> 00:11:10,378 Just like poor Jasper. 270 00:11:10,461 --> 00:11:11,880 You're on fire. 271 00:11:11,963 --> 00:11:13,381 Just getting my second wind. 272 00:11:14,716 --> 00:11:15,884 How's the headache? 273 00:11:15,967 --> 00:11:17,218 Still a 10. 274 00:11:17,302 --> 00:11:18,720 More fentanyl? 275 00:11:18,803 --> 00:11:21,139 - Yep. - BP's good. Another 50. 276 00:11:21,222 --> 00:11:22,599 Hey, Abbot. 277 00:11:22,682 --> 00:11:24,559 Attending and resident are stuck in the OR. 278 00:11:24,642 --> 00:11:26,394 Oh, you're the next best thing. 279 00:11:26,477 --> 00:11:27,770 Better, some would say. 280 00:11:27,854 --> 00:11:29,105 Mm. 281 00:11:29,189 --> 00:11:30,648 - What do you got? - This is Judith. 282 00:11:30,732 --> 00:11:33,109 G1, P0 with no prenatal care. 283 00:11:33,193 --> 00:11:35,195 Preeclampsia with severe hypertension. 284 00:11:35,278 --> 00:11:37,655 Hi, Judith. Nurse Garvin from OB. 285 00:11:37,739 --> 00:11:39,073 Some jelly on the belly. 286 00:11:39,157 --> 00:11:40,658 Gonna take a quick look with ultrasound. 287 00:11:40,742 --> 00:11:42,577 No, no, no. Ultrasound can harm the baby. 288 00:11:42,660 --> 00:11:44,579 - Not true. - Not doing the ultrasound 289 00:11:44,662 --> 00:11:46,706 could end up harming you and the baby. 290 00:11:48,665 --> 00:11:51,669 OK. Just do it as fast as you can. 291 00:11:51,753 --> 00:11:54,130 Why no prenatal care, Judith? 292 00:11:55,256 --> 00:11:57,592 I wanted a free birth-- 293 00:11:57,675 --> 00:11:59,761 no doctors, no hospital, no medicine. 294 00:11:59,844 --> 00:12:02,597 Mm. You have a midwife? 295 00:12:02,680 --> 00:12:03,681 A birth doula? 296 00:12:03,765 --> 00:12:06,100 No, I don't need one. 297 00:12:06,184 --> 00:12:07,393 Women have been having children on their own 298 00:12:07,477 --> 00:12:08,645 for thousands of years. 299 00:12:08,728 --> 00:12:10,188 Yeah, with an infant mortality rate 300 00:12:10,271 --> 00:12:13,066 of 30% for most of those thousands of years. 301 00:12:13,149 --> 00:12:15,360 - Femur length 7 centimeters. - 37 weeks. 302 00:12:15,443 --> 00:12:17,320 They'll probably induce. 303 00:12:17,403 --> 00:12:19,239 What? No. 304 00:12:19,322 --> 00:12:20,615 No, no, no, no. Absolutely not. 305 00:12:20,698 --> 00:12:22,158 At 37 weeks, 306 00:12:22,242 --> 00:12:24,369 the cure for preeclampsia is to deliver the baby. 307 00:12:24,452 --> 00:12:26,162 We need to get you upstairs so the OB doctors 308 00:12:26,246 --> 00:12:28,915 can induce labor to save you and your baby. 309 00:12:28,998 --> 00:12:31,417 No. No, no, no, no. Mm-mm. 310 00:12:33,795 --> 00:12:35,421 Yep, that's definitely Jasper. 311 00:12:35,505 --> 00:12:36,714 He was alive and kicking 312 00:12:36,798 --> 00:12:38,091 when my shift ended this morning. 313 00:12:38,174 --> 00:12:39,467 This is definitely a day shift patient. 314 00:12:39,550 --> 00:12:40,802 Now he's not a patient. 315 00:12:40,885 --> 00:12:42,345 He's a DB that we gotta deal with. 316 00:12:44,889 --> 00:12:46,099 Is this dude dead? 317 00:12:46,182 --> 00:12:47,600 both: Nope. 318 00:12:47,684 --> 00:12:49,435 All right, Mr. Reed, time to take you back 319 00:12:49,519 --> 00:12:50,895 and get you checked out, OK? 320 00:12:50,979 --> 00:12:52,313 - He sure looks dead. - Are you a doctor? 321 00:12:52,397 --> 00:12:54,649 - No, but he-- - Has hypernarcolepsy. 322 00:12:54,732 --> 00:12:56,401 - It's no joke. - Mm-hmm. 323 00:12:56,484 --> 00:12:57,652 Excuse me. 324 00:12:58,736 --> 00:13:00,613 Oh, sometimes I hate nights. 325 00:13:00,697 --> 00:13:01,864 - Yep. - Oof. 326 00:13:12,834 --> 00:13:14,127 Wow. 327 00:13:14,210 --> 00:13:17,338 Crazy how muggy it still is out here. 328 00:13:17,422 --> 00:13:20,049 You, uh--you seen Robby? 329 00:13:20,133 --> 00:13:22,218 Uh, not for a bit. 330 00:13:22,302 --> 00:13:23,553 You catch up on your charts 331 00:13:23,636 --> 00:13:25,054 from the beginning of the shift? 332 00:13:25,138 --> 00:13:26,306 Yeah. 333 00:13:26,389 --> 00:13:27,390 What are you still doing here? 334 00:13:27,473 --> 00:13:29,183 Uh, just gonna... 335 00:13:29,267 --> 00:13:31,602 You staying for the fireworks? 336 00:13:31,686 --> 00:13:32,979 Yeah. 337 00:13:33,062 --> 00:13:34,397 I was supposed to see them with Becca, 338 00:13:34,480 --> 00:13:38,401 but she is at her boyfriend Adam's 339 00:13:38,484 --> 00:13:40,320 family's house instead. 340 00:13:44,657 --> 00:13:50,788 Your sister seems like she's, uh, pretty put-together. 341 00:13:50,872 --> 00:13:52,081 Yeah. 342 00:13:52,165 --> 00:13:54,876 Uh, a lot more than I realized. 343 00:13:56,794 --> 00:13:58,212 How was your day? 344 00:14:00,089 --> 00:14:02,508 I've had better. 345 00:14:02,592 --> 00:14:03,634 You? 346 00:14:06,596 --> 00:14:08,931 Yeah. 347 00:14:09,015 --> 00:14:12,226 But then again, I've had a lot worse. 348 00:14:12,310 --> 00:14:14,771 Hell, I did a closed cervical reduction, like, an hour ago. 349 00:14:14,854 --> 00:14:17,065 Oh, I heard. That must have been so intense. 350 00:14:18,775 --> 00:14:20,902 My hands are still shaking. 351 00:14:20,985 --> 00:14:22,945 Hey, um, do you think you could teach me 352 00:14:23,029 --> 00:14:25,073 how to do that sometime? 353 00:14:25,156 --> 00:14:26,532 Uh, yeah. 354 00:14:26,616 --> 00:14:27,742 - Yeah? - Yeah, sure. I mean, 355 00:14:27,825 --> 00:14:29,327 I hope you never have to use it. 356 00:14:29,410 --> 00:14:31,287 I could have paralyzed that guy. 357 00:14:31,371 --> 00:14:33,998 Yeah, but you didn't. 358 00:14:34,082 --> 00:14:37,293 No, I didn't. 359 00:14:37,377 --> 00:14:39,712 Thank you... 360 00:14:39,796 --> 00:14:41,839 by the way, for... 361 00:14:41,923 --> 00:14:44,550 talking me down earlier. 362 00:14:44,634 --> 00:14:46,469 I'm sorry I snapped. 363 00:14:48,054 --> 00:14:49,347 It's OK. 364 00:14:57,522 --> 00:15:00,108 Dr. Mohan, you ever heard of kinship fostering? 365 00:15:00,191 --> 00:15:01,859 It's where a nurse or doctor can 366 00:15:01,943 --> 00:15:03,361 - become an emergency foster-- - Oh, no. 367 00:15:03,444 --> 00:15:04,862 I don't need any kids. 368 00:15:04,946 --> 00:15:07,031 I need to find a job first. 369 00:15:07,115 --> 00:15:09,450 Candice O'Grady is an 82-year-old female 370 00:15:09,534 --> 00:15:11,994 brought in by her son for intractable vomiting. 371 00:15:12,078 --> 00:15:14,997 No fever, no chills, no abdominal pain, no rash. 372 00:15:16,124 --> 00:15:18,042 Beep. 373 00:15:18,126 --> 00:15:21,421 Oh, I've already got one I can barely keep up with. 374 00:15:21,504 --> 00:15:23,339 What about Sleeping Beauty over here? 375 00:15:23,423 --> 00:15:25,383 She's already babysitting Whitaker. 376 00:15:25,466 --> 00:15:27,427 Well, if you know anyone who'd like to help us out 377 00:15:27,510 --> 00:15:29,387 with Baby Jane Doe, have them call the main desk. 378 00:15:29,470 --> 00:15:31,013 Sure thing. 379 00:15:31,097 --> 00:15:34,183 I'd take her myself, but Benji'd kill me. 380 00:15:35,643 --> 00:15:37,353 BP's 164/114. 381 00:15:37,437 --> 00:15:38,729 Another 40 of labetalol. 382 00:15:38,813 --> 00:15:39,856 Mag bolus is in. 383 00:15:39,939 --> 00:15:41,524 Now infusing 2 grams an hour. 384 00:15:41,607 --> 00:15:42,775 Labs are coming back. 385 00:15:42,859 --> 00:15:45,069 Hemoglobin 7.5, platelets 40. 386 00:15:45,153 --> 00:15:47,071 LFTs are sky high. 387 00:15:47,155 --> 00:15:48,823 - HELLP syndrome. - Hemolytic anemia, 388 00:15:48,906 --> 00:15:51,200 elevated liver enzymes, and low platelets. 389 00:15:51,284 --> 00:15:52,577 They're cleaning a room. 390 00:15:52,660 --> 00:15:54,495 We can bring her up in ten minutes. 391 00:15:54,579 --> 00:15:55,746 How you doing, Judith? 392 00:15:57,832 --> 00:15:59,917 I--I-- 393 00:16:00,835 --> 00:16:01,961 Oh, she's seizing. 394 00:16:02,044 --> 00:16:03,629 Oh, shit. 395 00:16:03,713 --> 00:16:06,174 10 of IV diazepam. Have another 10 ready. 396 00:16:06,257 --> 00:16:08,176 With all the movement, we can't get a fetal heartbeat. 397 00:16:08,259 --> 00:16:10,470 Putting on 15 liters by mask. Should we intubate? 398 00:16:10,553 --> 00:16:12,472 Hold intubation. Let's try to break this. 399 00:16:12,555 --> 00:16:14,390 We don't want to mask seizures with paralysis 400 00:16:14,474 --> 00:16:15,975 unless we have to. 401 00:16:16,058 --> 00:16:17,518 OK, um... 402 00:16:20,062 --> 00:16:21,772 Crus, CTG isn't reading. 403 00:16:21,856 --> 00:16:23,232 - Check with ultrasound. - On it. 404 00:16:23,316 --> 00:16:24,817 Nazely, what's the diagnosis? 405 00:16:24,901 --> 00:16:27,862 Um, with the seizure, now it's eclampsia. 406 00:16:29,155 --> 00:16:31,115 - Fetal heart rate is about 90. - Way too low. 407 00:16:31,199 --> 00:16:32,366 Mom's sats are going down. 408 00:16:32,450 --> 00:16:33,826 Time to tube her? 409 00:16:33,910 --> 00:16:35,495 Set up for it, but wait. 410 00:16:35,578 --> 00:16:36,829 Another 10 of diazepam. 411 00:16:36,913 --> 00:16:39,332 Push 4 grams of Keppra. 412 00:16:42,168 --> 00:16:43,586 History of hypertension 413 00:16:43,669 --> 00:16:44,921 presents to the emergency department 414 00:16:45,004 --> 00:16:47,256 with a chief complaint of dizziness 415 00:16:47,340 --> 00:16:49,467 after inadvertently ingesting 80 milligrams-- 416 00:16:49,550 --> 00:16:50,760 Hey, how are you guys making out? 417 00:16:50,843 --> 00:16:51,844 Yeah, we're getting there. 418 00:16:51,928 --> 00:16:53,596 Have you seen Dr. Al-Hashimi? 419 00:16:53,679 --> 00:16:55,473 - No. - Can I talk to you for a sec? 420 00:17:01,062 --> 00:17:02,313 So I just wanted to let you know that I've been 421 00:17:02,396 --> 00:17:03,564 checking out some of your online posts-- 422 00:17:03,648 --> 00:17:04,773 Look, I was just trying to help 423 00:17:04,857 --> 00:17:06,358 get some health messages out there, 424 00:17:06,442 --> 00:17:07,902 - especially for young people. - I think they're great. 425 00:17:07,984 --> 00:17:09,904 Really good. 426 00:17:09,987 --> 00:17:11,906 - You do? - Yeah. 427 00:17:11,989 --> 00:17:14,157 Yeah, um, keep it up. 428 00:17:14,242 --> 00:17:15,576 OK. 429 00:17:15,660 --> 00:17:17,912 As long as you follow the HIPAA laws. 430 00:17:17,994 --> 00:17:19,329 I do. 431 00:17:19,413 --> 00:17:21,165 And wait until you're done charting. 432 00:17:21,249 --> 00:17:22,250 Sure. 433 00:17:24,794 --> 00:17:29,048 Actually, Dr. Robby--sorry, um, can I ask you a question? 434 00:17:29,131 --> 00:17:30,258 Shoot. 435 00:17:30,341 --> 00:17:31,759 Um, I--I may be 436 00:17:31,842 --> 00:17:34,554 considering emergency psychiatry. 437 00:17:35,846 --> 00:17:38,015 Very cool. 438 00:17:38,099 --> 00:17:39,767 Think I could do it? 439 00:17:42,019 --> 00:17:43,479 I think that you could do 440 00:17:43,563 --> 00:17:46,065 anything that you put your mind to, Victoria. 441 00:17:50,236 --> 00:17:51,571 OK. 442 00:17:51,654 --> 00:17:53,281 Pulse ox is 88. 443 00:17:54,574 --> 00:17:56,534 Dr. Abbot? 444 00:17:56,617 --> 00:17:58,703 - Intubate? - Let's do it. 445 00:17:58,786 --> 00:18:02,039 Nazely, what do you suggest for rapid sequence induction? 446 00:18:02,123 --> 00:18:03,249 Etomidate and roc. 447 00:18:03,332 --> 00:18:04,417 Mm, not quite. 448 00:18:04,500 --> 00:18:05,543 120 of propofol, 449 00:18:05,626 --> 00:18:06,544 60 of succinylcholine. 450 00:18:06,627 --> 00:18:08,004 Why is that, Crus? 451 00:18:08,087 --> 00:18:09,714 Propofol for the anti-seizure effect, 452 00:18:09,797 --> 00:18:11,340 sux to avoid prolonged paralysis 453 00:18:11,424 --> 00:18:13,426 - so we can check her neuro exam. - Exactly. 454 00:18:13,509 --> 00:18:14,760 Pushing the propofol. 455 00:18:14,844 --> 00:18:16,262 Once she's flat for intubation, 456 00:18:16,345 --> 00:18:17,847 we need to displace the uterus to the left. 457 00:18:17,930 --> 00:18:19,473 Nazely, that's you. Big hug, both arms. 458 00:18:19,557 --> 00:18:21,809 - Get the baby off the vena cava. - Sux is on board. 459 00:18:21,892 --> 00:18:24,562 But after she's paralyzed, the seizing stops, right? 460 00:18:24,645 --> 00:18:26,063 It might look like that, 461 00:18:26,147 --> 00:18:28,107 but an ongoing seizure will still fry the brain. 462 00:18:28,190 --> 00:18:29,942 We monitor with EEG. 463 00:18:30,026 --> 00:18:31,819 - Is there time for that? - Wait and see. 464 00:18:33,029 --> 00:18:34,238 Paralytics kicked in. 465 00:18:34,322 --> 00:18:35,823 Let's go. Roll her to her back. 466 00:18:36,866 --> 00:18:38,492 Intubate, then EEG 467 00:18:38,576 --> 00:18:41,037 to see if her brain is still seizing. 468 00:18:41,120 --> 00:18:42,580 I need first pass success. 469 00:18:42,663 --> 00:18:43,831 You and me both. 470 00:18:52,757 --> 00:18:54,091 Have you seen Dr. Al-Hashimi? 471 00:18:54,175 --> 00:18:55,301 No. 472 00:18:55,384 --> 00:18:57,678 Have you seen Dr. Al-Hashimi? 473 00:18:57,762 --> 00:18:59,472 Al-Hashimi? 474 00:18:59,555 --> 00:19:02,058 With how this day's going, she probably quit. 475 00:19:02,141 --> 00:19:05,311 Last I saw her, she was in Peds with Baby Jane Doe. 476 00:19:05,394 --> 00:19:07,730 Nope, I was just in there. 477 00:19:07,813 --> 00:19:08,731 Want me to page her? 478 00:19:08,814 --> 00:19:10,524 Uh, no, that's OK. 479 00:19:10,608 --> 00:19:11,901 I will find her. 480 00:19:16,530 --> 00:19:17,740 Hello. 481 00:19:20,576 --> 00:19:22,912 Hey, how did our people do at the deposition? 482 00:19:22,995 --> 00:19:25,456 Oh, well, Dr. Ellis is a pit bull. 483 00:19:25,539 --> 00:19:27,541 Dr. King is a petunia. 484 00:19:27,625 --> 00:19:28,876 They were pretty brutal with her. 485 00:19:28,959 --> 00:19:30,753 - She's sensitive. - Very. 486 00:19:30,836 --> 00:19:32,338 And I'm afraid it isn't over. 487 00:19:32,421 --> 00:19:33,506 They want to call her back. 488 00:19:33,589 --> 00:19:35,341 Oh, that's unfortunate. 489 00:19:35,424 --> 00:19:36,592 Maybe I should go with you 490 00:19:36,676 --> 00:19:38,260 to break that news to her, actually. 491 00:19:38,344 --> 00:19:40,096 - Misery loves company. - Um, hey, while I have you, 492 00:19:40,179 --> 00:19:42,848 can I pose a hypothetical to you? 493 00:19:42,932 --> 00:19:44,850 If a doctor suspects another physician 494 00:19:44,934 --> 00:19:47,144 of having a medical condition that could negatively 495 00:19:47,228 --> 00:19:49,271 affect the way they would treat a patient, 496 00:19:49,355 --> 00:19:50,981 where would disclosing that fall 497 00:19:51,065 --> 00:19:52,983 on the HIPAA violation scale? 498 00:19:54,068 --> 00:19:55,986 First, do no harm. 499 00:19:58,489 --> 00:20:00,908 Dr. King, do you have a second? 500 00:20:03,536 --> 00:20:06,247 Mm... 501 00:20:08,124 --> 00:20:10,084 Good lung sliding bilaterally. 502 00:20:10,167 --> 00:20:12,169 Fetal heart rate borderline at 98. 503 00:20:13,713 --> 00:20:15,798 Roll her to the left again. That can help. 504 00:20:15,881 --> 00:20:18,050 One, two, three. 505 00:20:19,051 --> 00:20:22,430 OK, all set here. 506 00:20:22,513 --> 00:20:23,931 EEG monitor's good to go. 507 00:20:24,014 --> 00:20:25,725 That was fast. 508 00:20:25,808 --> 00:20:27,184 Still seizing while paralyzed. 509 00:20:27,268 --> 00:20:29,729 It's nonconvulsive status. 510 00:20:29,812 --> 00:20:31,105 What's she had so far? 511 00:20:31,188 --> 00:20:32,773 30 of diazepam, a full load of mag, 512 00:20:32,857 --> 00:20:33,983 Keppra, and propofol. 513 00:20:34,066 --> 00:20:35,359 Damn. What's your next step? 514 00:20:35,443 --> 00:20:36,569 Any ideas? 515 00:20:36,652 --> 00:20:38,821 Hmm? Nazely? 516 00:20:38,904 --> 00:20:40,740 Dilantin? Valproate? 517 00:20:40,823 --> 00:20:42,074 Mm, infusion is too long. 518 00:20:42,158 --> 00:20:43,617 So is onset of action. 519 00:20:43,701 --> 00:20:45,077 Push 100 of ketamine. 520 00:20:45,161 --> 00:20:47,329 That's had results with refractory status. 521 00:20:47,413 --> 00:20:49,623 She also has HELLP syndrome-- hemoglobin only 7, 522 00:20:49,707 --> 00:20:52,543 - platelets down to 30. - Two units whole blood? 523 00:20:52,626 --> 00:20:54,962 O-neg is going up on the rapid infuser as we speak. 524 00:20:55,045 --> 00:20:57,047 Uh, put the AP pads on, just in case. 525 00:20:57,131 --> 00:20:59,842 And 10 of Decadron IV push for the inflammatory storm. 526 00:20:59,925 --> 00:21:01,969 - Fetal heart rate up to 104. - Hmm. 527 00:21:02,052 --> 00:21:03,304 - Little better. - Yeah. 528 00:21:03,387 --> 00:21:05,681 She should be upstairs with OB. 529 00:21:05,765 --> 00:21:09,435 She will be after we break this seizure. 530 00:21:09,518 --> 00:21:12,646 There was a delay in history-taking 531 00:21:12,730 --> 00:21:15,775 due to a malfunctioning VRI interpretation device. 532 00:21:15,858 --> 00:21:18,360 During this time, there was a normal CBC 533 00:21:18,444 --> 00:21:20,029 and comprehensive metabolic panel 534 00:21:20,112 --> 00:21:21,781 that came back from the lab. 535 00:21:23,282 --> 00:21:25,117 What's wrong with you, Malfeasance? 536 00:21:25,201 --> 00:21:28,120 I have to do another deposition. 537 00:21:28,204 --> 00:21:30,080 Oh, that sucks. 538 00:21:30,164 --> 00:21:31,999 You must have really messed up. 539 00:21:33,167 --> 00:21:34,794 Dude, I'm joking. 540 00:21:34,877 --> 00:21:35,878 You gotta lighten up. 541 00:21:35,961 --> 00:21:37,588 It's all just bullshit. 542 00:21:40,174 --> 00:21:41,467 God, you know what? Fuck all this. 543 00:21:41,550 --> 00:21:42,885 Do you want to go get a drink? 544 00:21:44,053 --> 00:21:45,012 Me? 545 00:21:45,095 --> 00:21:46,680 Yes, you. 546 00:21:46,764 --> 00:21:49,016 You--you do go out, don't you? 547 00:21:49,099 --> 00:21:51,227 Well, I'm usually with Becca. 548 00:21:51,310 --> 00:21:52,520 Well, bring her along. 549 00:21:52,603 --> 00:21:53,854 Can she drive? 550 00:21:53,938 --> 00:21:56,148 No, and she's with her boyfriend. 551 00:21:57,191 --> 00:21:58,609 OK, Becca. 552 00:22:00,319 --> 00:22:02,196 So it's just you and me. 553 00:22:04,406 --> 00:22:06,742 Do you like karaoke? 554 00:22:06,826 --> 00:22:08,619 You do karaoke? 555 00:22:08,702 --> 00:22:12,998 Well, what I do is more like primal scream therapy. 556 00:22:13,082 --> 00:22:14,708 There's nothing like getting wasted 557 00:22:14,792 --> 00:22:16,210 and just absolutely wailing 558 00:22:16,293 --> 00:22:19,004 to shake off a shit show like today. 559 00:22:19,088 --> 00:22:20,881 I could use a fun night. 560 00:22:22,341 --> 00:22:24,134 You and me both, sister. 561 00:22:24,218 --> 00:22:25,886 There's been no improvement. 562 00:22:25,970 --> 00:22:27,471 Still seizing on the EEG. 563 00:22:27,555 --> 00:22:29,181 - Neurology has been called. - OK. Got it. 564 00:22:29,265 --> 00:22:31,141 OB says send her up. They have an OR ready. 565 00:22:31,225 --> 00:22:32,601 About time. 566 00:22:32,685 --> 00:22:34,311 Baby's been bradying down a bit more. 567 00:22:34,395 --> 00:22:35,855 This one looks like it took a turn for the worse. 568 00:22:35,938 --> 00:22:37,690 Eclampsia, refractory seizures, 569 00:22:37,773 --> 00:22:39,984 HELLP syndrome with anemia and thrombocytopenia. 570 00:22:40,067 --> 00:22:41,986 Yeah, about as bad as it gets. 571 00:22:42,069 --> 00:22:43,904 V-fib! 572 00:22:43,988 --> 00:22:45,948 Chest compressions, Nazely. 573 00:22:46,031 --> 00:22:48,701 Charge to 200. 574 00:22:48,784 --> 00:22:50,160 Prep the belly. 575 00:22:50,244 --> 00:22:51,495 Get a baby warmer. 576 00:22:51,579 --> 00:22:53,163 Call the NICU. Start a timer. 577 00:22:53,247 --> 00:22:54,999 Charged. 578 00:22:55,082 --> 00:22:56,250 Clear. 579 00:22:58,168 --> 00:22:59,420 Continue compressions. 580 00:22:59,503 --> 00:23:01,839 We'll check a rhythm in a minute. 581 00:23:01,922 --> 00:23:03,132 Gown up. 582 00:23:03,215 --> 00:23:04,466 Robby, it's you and me. 583 00:23:04,550 --> 00:23:06,468 Nazely, what's the four-minute rule? 584 00:23:06,552 --> 00:23:08,721 Uh, not sure. 585 00:23:08,804 --> 00:23:10,514 Pregnant patient with a viable fetus, 586 00:23:10,598 --> 00:23:12,141 you have four minutes after cardiac arrest 587 00:23:12,224 --> 00:23:14,435 - to save the baby. - And the mom. 588 00:23:14,518 --> 00:23:16,729 We don't call it a postmortem C-section anymore. 589 00:23:16,812 --> 00:23:17,980 It's a resuscitative hysterotomy 590 00:23:18,063 --> 00:23:19,481 to try to save them both. 591 00:23:19,565 --> 00:23:20,774 But she doesn't want any medical intervention. 592 00:23:20,858 --> 00:23:22,192 That doesn't matter. 593 00:23:22,276 --> 00:23:23,694 Mom and baby are both dead if we do nothing. 594 00:23:23,777 --> 00:23:25,487 OK, charge to 200. 595 00:23:25,571 --> 00:23:27,573 One more rhythm check and then Abbot and I are gonna cut. 596 00:23:28,908 --> 00:23:31,410 Ellis, you and Crus on Mom resuscitation. 597 00:23:31,493 --> 00:23:32,870 Shen, you and Nazely take the baby. 598 00:23:32,953 --> 00:23:34,371 OK, hold compressions. 599 00:23:36,123 --> 00:23:37,625 Still V-fib. 600 00:23:37,708 --> 00:23:38,834 Clear. 601 00:23:40,169 --> 00:23:41,629 No change. Resume compression, amp of epi. 602 00:23:41,712 --> 00:23:42,713 OK, showtime. 603 00:23:42,796 --> 00:23:44,381 We need to get this baby out right now. 604 00:23:44,465 --> 00:23:45,507 OK, take a break. 605 00:23:48,135 --> 00:23:51,555 OK, 10 blade. Good. 606 00:23:51,639 --> 00:23:53,766 First incision is from the xiphoid 607 00:23:53,849 --> 00:23:55,517 to the pubic symphysis 608 00:23:55,601 --> 00:23:58,479 through the skin to the linea alba. 609 00:23:58,562 --> 00:24:00,648 Units three and four on the infuser. 610 00:24:00,731 --> 00:24:03,484 Second incision goes through the peritoneum, 611 00:24:03,567 --> 00:24:05,277 exposing the uterus. 612 00:24:05,361 --> 00:24:06,987 Where do you need me? 613 00:24:07,071 --> 00:24:09,239 You're with the baby. Nazely's got the bag mask. 614 00:24:09,323 --> 00:24:11,450 You're on suction. Stand by for intubation. 615 00:24:11,533 --> 00:24:12,952 Bladder retractors. 616 00:24:13,035 --> 00:24:14,620 Neonatal monitor and pulse ox ready to go. 617 00:24:14,703 --> 00:24:17,039 Ellis, gentle traction. 618 00:24:17,122 --> 00:24:19,124 OK, making a small vertical incision 619 00:24:19,208 --> 00:24:22,753 through the lower uterus so as not to cut the baby. 620 00:24:22,836 --> 00:24:24,546 Mm-hmm. 621 00:24:24,630 --> 00:24:26,090 - Got it? - Yep, I got it. 622 00:24:26,173 --> 00:24:27,508 - OK. - OK. 623 00:24:27,591 --> 00:24:30,678 Using scissors to extend superiorly. 624 00:24:32,221 --> 00:24:34,223 Ellis, hand retract the uterus with me. 625 00:24:34,306 --> 00:24:36,141 Amniotic fluid looks good. 626 00:24:37,851 --> 00:24:39,478 Give me some fundal pressure. 627 00:24:39,561 --> 00:24:40,938 Breech position. 628 00:24:43,399 --> 00:24:46,485 OK, baby's out. 629 00:24:46,568 --> 00:24:48,320 - It's a girl. - All right. 630 00:24:50,072 --> 00:24:52,992 Milking the cord. 631 00:24:53,075 --> 00:24:55,494 Clamping. 632 00:24:55,577 --> 00:24:57,496 Cutting. 633 00:24:57,579 --> 00:24:59,123 OK, blue and flaccid. Coming to you, Shen. 634 00:24:59,206 --> 00:25:00,249 - You ready? - Yeah, you got her. 635 00:25:00,332 --> 00:25:02,292 I got it, yep. 636 00:25:02,376 --> 00:25:03,669 OK. 637 00:25:07,381 --> 00:25:09,717 Poor tone, no movement. 638 00:25:09,800 --> 00:25:12,386 Keep the blow-by closer. 639 00:25:12,469 --> 00:25:13,804 She's really blue. 640 00:25:13,887 --> 00:25:16,640 Some blue is normal, but not this much. 641 00:25:16,724 --> 00:25:18,559 - Do we need to intubate? - Not yet, no. 642 00:25:18,642 --> 00:25:21,311 They usually pink up with stimulation and blow-by. 643 00:25:21,395 --> 00:25:23,105 OK, removing the placenta. 644 00:25:23,188 --> 00:25:25,482 Sweeping to the left, trying to get it in one piece. 645 00:25:27,401 --> 00:25:28,610 - Looks intact. - Yeah. 646 00:25:28,694 --> 00:25:30,738 Nicely done. 647 00:25:30,821 --> 00:25:32,740 10 of IV Pitocin to contract the uterus. 648 00:25:32,823 --> 00:25:34,950 And lots of massage. 649 00:25:35,034 --> 00:25:36,577 Heart rate 76. 650 00:25:36,660 --> 00:25:38,203 Less than 100 means we need to bag. 651 00:25:38,287 --> 00:25:39,371 Suction first. 652 00:25:39,455 --> 00:25:40,539 OK. 653 00:25:42,583 --> 00:25:43,917 Hey, Jord, charge to 200. 654 00:25:44,001 --> 00:25:46,795 Stand by for the next rhythm check. 655 00:25:46,879 --> 00:25:48,505 She grimaced. Good sign. 656 00:25:48,589 --> 00:25:49,548 Bagging. 657 00:25:49,631 --> 00:25:51,550 Pulse ox 45%. 658 00:25:51,633 --> 00:25:53,177 Oh, I've never seen it that low. 659 00:25:53,260 --> 00:25:54,970 It's not as bad as it sounds. 660 00:25:55,054 --> 00:25:57,014 I'm more worried about the heart rate. 661 00:25:57,097 --> 00:25:59,183 McKay, get ready with an IO in case we need epi. 662 00:25:59,266 --> 00:26:00,601 OK. 663 00:26:02,519 --> 00:26:04,938 Rhythm check. Hold compressions. 664 00:26:05,022 --> 00:26:06,023 Still V-fib. 665 00:26:06,106 --> 00:26:07,524 - OK, shock it. - Clear. 666 00:26:08,609 --> 00:26:10,027 Resume compressions. 667 00:26:10,110 --> 00:26:11,528 Shen, how's she doing over there? 668 00:26:11,612 --> 00:26:12,821 Heart rate's up to 104. 669 00:26:12,905 --> 00:26:14,073 Uh, at one minute, 670 00:26:14,156 --> 00:26:16,408 she's 0 for color, 2 for heart rate, 671 00:26:16,492 --> 00:26:17,743 1 for reflex, tone, breathing. 672 00:26:17,826 --> 00:26:19,369 APGAR of 5. 673 00:26:19,453 --> 00:26:21,288 5 out of 10. Not great. 674 00:26:21,371 --> 00:26:22,998 Pulse ox 58%. 675 00:26:23,082 --> 00:26:24,917 - Intubation? - Uh, not yet. 676 00:26:25,000 --> 00:26:27,002 O2 sat in the 60s is normal at one minute. 677 00:26:27,086 --> 00:26:29,880 Her heart rate and pulse ox are trending higher. 678 00:26:29,963 --> 00:26:31,298 Let's keep doing what we're doing. 679 00:26:31,381 --> 00:26:32,841 A little tincture of time. 680 00:26:32,925 --> 00:26:34,510 Hold compressions. 681 00:26:34,593 --> 00:26:36,595 Looks like sinus. 682 00:26:36,678 --> 00:26:38,263 Can't feel a carotid. 683 00:26:38,347 --> 00:26:39,640 No. 684 00:26:39,723 --> 00:26:41,642 Heart's barely pumping. It's PEA. 685 00:26:41,725 --> 00:26:42,935 Back on compressions. 686 00:26:43,018 --> 00:26:44,436 Transfuse two more units. 687 00:26:44,520 --> 00:26:45,854 She needs more red cells and platelets. 688 00:26:45,938 --> 00:26:47,564 Ongoing blood loss from the uterus. 689 00:26:47,648 --> 00:26:49,149 Give me all the lap pads we got, please. 690 00:26:56,657 --> 00:26:57,908 Yeah. 691 00:26:57,991 --> 00:26:58,992 OK, yeah, thanks. 692 00:26:59,076 --> 00:27:00,452 I appreciate it, honey. 693 00:27:00,536 --> 00:27:02,371 Oh, gotta go. 694 00:27:02,454 --> 00:27:03,705 Whoa, whoa, whoa! 695 00:27:03,789 --> 00:27:04,706 Hold up. 696 00:27:04,790 --> 00:27:06,208 Is there a problem here? 697 00:27:06,291 --> 00:27:08,293 Yeah, you two aren't leaving empty-handed. 698 00:27:08,377 --> 00:27:09,378 What? 699 00:27:10,587 --> 00:27:12,131 One of you follow me. 700 00:27:13,841 --> 00:27:15,592 Rape kits are supposed to be picked up 701 00:27:15,676 --> 00:27:18,512 within 72 hours of collecting 'em. 702 00:27:18,595 --> 00:27:21,265 This one's been here for over two weeks. 703 00:27:21,348 --> 00:27:22,975 That's not on us. 704 00:27:23,058 --> 00:27:24,560 Well, it's on somebody. 705 00:27:24,643 --> 00:27:26,061 It's not bad enough these poor women 706 00:27:26,145 --> 00:27:27,646 go through an assault, plus the indignity 707 00:27:27,729 --> 00:27:29,314 of the whole collection process, 708 00:27:29,398 --> 00:27:31,066 but nobody from the police department 709 00:27:31,150 --> 00:27:33,652 even has the human decency to come get these things? 710 00:27:33,735 --> 00:27:34,778 Like nobody there gives a flying fuck? 711 00:27:34,862 --> 00:27:36,363 OK, we got it. 712 00:27:36,446 --> 00:27:38,323 We'll see that these get put into evidence properly. 713 00:27:38,407 --> 00:27:39,575 Thank you. 714 00:27:41,743 --> 00:27:42,911 How hard was that? 715 00:27:46,790 --> 00:27:47,916 Units five and six are in. 716 00:27:48,000 --> 00:27:49,334 Down to a slow ooze here. 717 00:27:49,418 --> 00:27:50,794 Hold compressions. 718 00:27:54,381 --> 00:27:56,341 Looks like sinus. 719 00:27:56,425 --> 00:27:57,759 - And I got a weak carotid. - OK. 720 00:27:57,843 --> 00:27:59,261 Cycle the BP. 721 00:27:59,344 --> 00:28:01,346 Better filling, better squeeze. 722 00:28:01,430 --> 00:28:02,973 No seizure activity on the EEG. 723 00:28:03,056 --> 00:28:04,474 That's progress. That's progress. 724 00:28:04,558 --> 00:28:05,517 We're at five minutes. 725 00:28:05,601 --> 00:28:07,477 Uh, heart rate is 132. 726 00:28:07,561 --> 00:28:09,146 Uh, pulse ox 79%. 727 00:28:09,229 --> 00:28:11,023 Nazely, the APGAR? 728 00:28:11,106 --> 00:28:12,608 Um... 729 00:28:12,691 --> 00:28:14,735 1 off for color, 1 off for tone, 730 00:28:14,818 --> 00:28:17,321 1 off for respiration with hypoxia, total of 7. 731 00:28:17,404 --> 00:28:18,697 Respiration score is for observed breathing, 732 00:28:18,780 --> 00:28:20,115 not pulse ox. 733 00:28:20,199 --> 00:28:21,658 Sat of 80 is normal at five minutes. 734 00:28:21,742 --> 00:28:23,118 With no crying, she still gets 1 off. 735 00:28:23,202 --> 00:28:24,161 Yeah. 736 00:28:27,414 --> 00:28:28,415 Ah! 737 00:28:28,498 --> 00:28:30,000 She just scored the winning point! 738 00:28:30,083 --> 00:28:32,377 APGAR of 8 is pretty normal. 739 00:28:35,672 --> 00:28:37,925 Holy shit. What did I miss? 740 00:28:38,008 --> 00:28:40,677 Eclampsia with status, HELLP syndrome, 741 00:28:40,761 --> 00:28:43,847 cardiac arrest, resuscitative hysterotomy. 742 00:28:43,931 --> 00:28:46,183 I was in the OR with a septic twin C-section. 743 00:28:46,266 --> 00:28:47,434 Got your text 12 minutes ago. 744 00:28:47,517 --> 00:28:48,977 Shit happens fast down here. 745 00:28:49,061 --> 00:28:51,521 Resuscitative hysterotomy in 36 seconds. 746 00:28:51,605 --> 00:28:53,815 - Impressive. - BP's 102/64. 747 00:28:53,899 --> 00:28:55,025 Hemoglobin is up to 9. 748 00:28:55,108 --> 00:28:57,069 That'll do. 749 00:28:57,152 --> 00:28:58,487 NICU's sending a team down. 750 00:28:58,570 --> 00:29:00,822 We can take Mom. You guys are rock stars. 751 00:29:00,906 --> 00:29:03,325 We like to be referred to as crawlers of the night. 752 00:29:06,578 --> 00:29:07,871 If you're not careful, 753 00:29:07,955 --> 00:29:09,414 you're gonna get stuck here all night. 754 00:29:09,498 --> 00:29:11,917 Nah, Henny said she'd be here in 30 minutes. 755 00:29:12,000 --> 00:29:14,503 - How's Mom and baby? - Whew. 756 00:29:14,586 --> 00:29:16,463 They're both gonna go upstairs. 757 00:29:16,546 --> 00:29:18,632 Good. You leaving now? 758 00:29:18,715 --> 00:29:20,300 Yeah, pretty soon. 759 00:29:20,384 --> 00:29:23,428 I gotta find Whitaker, I gotta find Al-Hashimi, 760 00:29:23,512 --> 00:29:25,681 and I gotta find Langdon before I leave. 761 00:29:25,764 --> 00:29:28,183 You missed Langdon. He just checked out. 762 00:29:31,561 --> 00:29:32,688 Shit. 763 00:29:56,169 --> 00:29:57,504 Can I help you? 764 00:29:57,587 --> 00:30:01,049 Uh, yeah, I'm Dr. Langdon from the ED. 765 00:30:01,133 --> 00:30:03,969 I was just, uh, checking in on the status 766 00:30:04,052 --> 00:30:06,638 of someone we sent up here earlier. 767 00:30:06,722 --> 00:30:09,266 Patient's name is, uh, Cohen. 768 00:30:09,349 --> 00:30:10,517 Let me check. 769 00:30:10,600 --> 00:30:11,810 What was she up here for? 770 00:30:11,893 --> 00:30:13,645 Uh, clean out a nasty neck fash. 771 00:30:16,398 --> 00:30:17,983 Oh, yeah, she's good. 772 00:30:18,066 --> 00:30:21,111 She's in 4202, recovering nicely. 773 00:30:21,194 --> 00:30:23,697 Great, great. 774 00:30:23,780 --> 00:30:26,616 I mean, she was--she was in not-great shape earlier. 775 00:30:26,700 --> 00:30:28,744 It was a good catch. 776 00:30:28,827 --> 00:30:32,748 Saved her life, even if we couldn't save her leg. 777 00:30:32,831 --> 00:30:35,709 Uh, was it below the knee? 778 00:30:35,792 --> 00:30:37,586 Unfortunately, it was above. 779 00:30:54,561 --> 00:30:57,606 My cell phone and the building manager's. 780 00:30:57,689 --> 00:30:59,524 He can help if there's any emergencies. 781 00:30:59,608 --> 00:31:01,651 Yeah, what kind of emergencies? 782 00:31:01,735 --> 00:31:03,028 Whatever. 783 00:31:03,111 --> 00:31:04,029 And follow up with Duke 784 00:31:04,112 --> 00:31:05,030 in a couple days, yeah? 785 00:31:05,113 --> 00:31:06,073 Yeah. 786 00:31:06,156 --> 00:31:08,492 You, um--you sure about this? 787 00:31:08,575 --> 00:31:10,327 I trust you, Whitaker. 788 00:31:10,410 --> 00:31:12,079 Great. 789 00:31:12,162 --> 00:31:13,538 Any questions? 790 00:31:13,622 --> 00:31:16,625 Uh, when are you back, exactly? 791 00:31:16,708 --> 00:31:18,085 You know, I'll text you. 792 00:31:18,168 --> 00:31:20,003 I'm trying to keep my dates kind of fluid. 793 00:31:21,421 --> 00:31:23,465 I think this is your ride. 794 00:31:23,548 --> 00:31:25,509 Yeah, uh, yes. 795 00:31:25,592 --> 00:31:28,053 I--I promise I'll check in on your house tomorrow. 796 00:31:28,136 --> 00:31:29,596 Sounds good. 797 00:31:30,764 --> 00:31:32,391 - Hey. - Hey. 798 00:31:32,474 --> 00:31:35,477 OK. Hey, Theo. 799 00:31:35,560 --> 00:31:37,312 You're up late, huh? 800 00:31:37,396 --> 00:31:38,688 What you got there? 801 00:31:41,608 --> 00:31:43,944 OK. 802 00:31:44,027 --> 00:31:45,612 He's been fussy all day. 803 00:31:45,695 --> 00:31:47,781 I think he's got another tooth coming in. 804 00:31:47,864 --> 00:31:49,491 Aw, right on, big guy. 805 00:31:49,574 --> 00:31:52,786 Are you ready to get funky? 806 00:31:52,869 --> 00:31:53,870 Yeah? 807 00:32:13,849 --> 00:32:15,183 Hey. 808 00:32:15,267 --> 00:32:17,185 Any luck picking an elective? 809 00:32:18,687 --> 00:32:20,021 Don't know. 810 00:32:21,523 --> 00:32:23,650 Maybe I will go into geriatrics. 811 00:32:25,235 --> 00:32:27,195 It's a smart choice. 812 00:32:30,949 --> 00:32:32,492 I know that life can be challenging, 813 00:32:32,576 --> 00:32:33,869 especially when it doesn't work out 814 00:32:33,952 --> 00:32:35,203 the way you expected. 815 00:32:35,287 --> 00:32:36,413 OK. 816 00:32:41,334 --> 00:32:42,711 I thought I would be married 817 00:32:42,794 --> 00:32:44,838 with two kids in college by now. 818 00:32:46,173 --> 00:32:48,842 Maybe have some property with a pond, 819 00:32:48,925 --> 00:32:51,094 and we could play hockey on it in the wintertime. 820 00:32:53,263 --> 00:32:54,431 And yet look at me now. 821 00:32:54,514 --> 00:32:58,560 No wife, no kids, no pond. 822 00:33:02,063 --> 00:33:04,191 It's never too late. 823 00:33:04,274 --> 00:33:06,693 Do you really believe that? 824 00:33:06,776 --> 00:33:08,069 Yeah. 825 00:33:08,153 --> 00:33:09,779 Only for me, or for you too? 826 00:33:09,863 --> 00:33:11,406 OK. 827 00:33:11,490 --> 00:33:13,033 I see what you did there. 828 00:33:14,284 --> 00:33:16,953 Was that true, or something you just said to make a point? 829 00:33:23,126 --> 00:33:25,795 Have you worked things out with your mom? 830 00:33:28,089 --> 00:33:29,633 We're not talking. 831 00:33:32,928 --> 00:33:37,224 I am sorry that, um, I let it distract me. 832 00:33:38,767 --> 00:33:40,352 She was treating me like a child, 833 00:33:40,435 --> 00:33:41,770 and I was letting her. 834 00:33:47,025 --> 00:33:48,485 Have a good trip. 835 00:33:49,653 --> 00:33:50,779 Please be safe. 836 00:33:52,781 --> 00:33:55,116 We need you here. 837 00:33:55,200 --> 00:33:57,285 Even if you can be a dick sometimes. 838 00:34:00,205 --> 00:34:01,373 Good luck. 839 00:34:02,749 --> 00:34:04,084 You too. 840 00:34:13,217 --> 00:34:15,262 Hey, I didn't think you were still here. 841 00:34:15,344 --> 00:34:17,764 I was just talking to the neurologist on call. 842 00:34:19,181 --> 00:34:20,891 And? 843 00:34:20,976 --> 00:34:24,228 We had a nice chat. 844 00:34:24,312 --> 00:34:26,898 She agrees I can work with double coverage. 845 00:34:26,982 --> 00:34:29,317 That's not her call to make. 846 00:34:29,400 --> 00:34:30,694 You can't do anything critical 847 00:34:30,777 --> 00:34:32,195 where a five-second lapse in consciousness 848 00:34:32,279 --> 00:34:34,030 could potentially kill a patient. 849 00:34:35,907 --> 00:34:37,074 I agree. 850 00:34:40,579 --> 00:34:41,788 But 90% of our patients 851 00:34:41,871 --> 00:34:43,081 don't require critical procedures. 852 00:34:43,164 --> 00:34:45,250 And the ones that do? 853 00:34:45,333 --> 00:34:47,627 Will be handled by whomever is working with me. 854 00:34:47,710 --> 00:34:49,545 Unless they're also tied up with a critical patient. 855 00:34:49,629 --> 00:34:50,922 What if it's a double or triple trauma? 856 00:34:51,005 --> 00:34:52,924 - Robby, I can handle it. - No, you can't. 857 00:34:53,007 --> 00:34:54,342 And I can't let you. 858 00:34:54,426 --> 00:34:55,760 I am fully capable of handling-- 859 00:34:55,844 --> 00:34:57,345 No, you are not fully capable, 860 00:34:57,429 --> 00:34:58,805 and you know it. 861 00:35:02,601 --> 00:35:03,977 What do you want from me? 862 00:35:04,060 --> 00:35:05,103 I want what's best for this department-- 863 00:35:05,186 --> 00:35:06,563 patients and staff. 864 00:35:06,646 --> 00:35:08,815 Best-case scenario, you get a handle on this, 865 00:35:08,898 --> 00:35:10,400 you're seizure-free for six months, 866 00:35:10,483 --> 00:35:11,610 you get your driver's license back, 867 00:35:11,693 --> 00:35:12,902 you are cleared to work. 868 00:35:12,986 --> 00:35:15,238 I am cleared for my driver's license. 869 00:35:15,322 --> 00:35:17,407 You shouldn't be driving at all like this. 870 00:35:17,490 --> 00:35:19,868 If you were a patient, we would have to report you. 871 00:35:19,951 --> 00:35:21,453 I am not your fucking patient. 872 00:35:21,536 --> 00:35:22,579 No, but I cannot let you work 873 00:35:22,662 --> 00:35:23,955 in my emergency department 874 00:35:24,039 --> 00:35:25,790 until you're fully capable of doing so. 875 00:35:25,874 --> 00:35:27,500 That is not your fucking call! 876 00:35:27,584 --> 00:35:29,044 You're fucking-A right, that's my call! 877 00:35:29,127 --> 00:35:31,004 I'm trying to protect you and my patients, 878 00:35:31,087 --> 00:35:32,339 and you know I'm right about this. 879 00:35:32,422 --> 00:35:34,090 Oh, "my department," "my patients." 880 00:35:34,174 --> 00:35:35,592 All you fucking think about is yourself! 881 00:35:35,675 --> 00:35:36,885 Do you hear yourself? 882 00:35:36,968 --> 00:35:37,927 You didn't rat out Langdon 883 00:35:38,011 --> 00:35:39,471 for stealing fucking drugs. 884 00:35:39,554 --> 00:35:41,056 No, but I kicked him out of this department 885 00:35:41,139 --> 00:35:42,974 until he got the appropriate help that he needs, 886 00:35:43,058 --> 00:35:44,851 and the same goes for you. 887 00:35:44,934 --> 00:35:46,478 You've got until Monday to let the administration know, 888 00:35:46,561 --> 00:35:47,646 or I will. 889 00:35:54,778 --> 00:35:56,571 I am finished. 890 00:35:56,655 --> 00:35:58,406 Last chart. 891 00:35:59,574 --> 00:36:00,992 - You and me both. - Really? 892 00:36:01,076 --> 00:36:02,535 Is this a thing? I finished a while ago. 893 00:36:04,079 --> 00:36:05,872 I never want to hear that fucking bell again. 894 00:36:10,460 --> 00:36:11,878 - Where's Dana? - Not sure. 895 00:36:11,961 --> 00:36:13,421 A bunch of day shift just headed to the roof 896 00:36:13,505 --> 00:36:14,631 to watch the fireworks. 897 00:36:14,714 --> 00:36:15,924 You want me to call her? 898 00:36:16,007 --> 00:36:17,467 No, that's OK. 899 00:36:19,386 --> 00:36:20,804 Yo. 900 00:36:20,887 --> 00:36:22,555 Thanks for your help in there. 901 00:36:24,474 --> 00:36:26,685 - Almost out? - Yep, just about. 902 00:36:28,978 --> 00:36:30,647 Is this where you try to talk me out of going? 903 00:36:30,730 --> 00:36:31,648 Me? 904 00:36:31,731 --> 00:36:33,441 No, not a chance. 905 00:36:33,525 --> 00:36:34,651 Why, are you having second thoughts? 906 00:36:34,734 --> 00:36:35,652 - Nope. - No? 907 00:36:35,735 --> 00:36:37,278 Nope. 908 00:36:37,362 --> 00:36:39,280 Don't have to convince me. 909 00:36:39,364 --> 00:36:40,615 I mean, it is a little strange the only place 910 00:36:40,699 --> 00:36:42,158 you talked about going is somewhere 911 00:36:42,242 --> 00:36:43,451 they used to drive buffalo off a cliff to die. 912 00:36:43,535 --> 00:36:44,744 - Here it comes. - I looked it up, 913 00:36:44,828 --> 00:36:46,454 and as far as summer vacations go, 914 00:36:46,538 --> 00:36:48,206 it's not exactly a holiday hotspot. 915 00:36:48,289 --> 00:36:51,334 I mean, what's in the fucking gift shop, man? 916 00:36:51,418 --> 00:36:52,544 It's just one place I'm going. 917 00:36:52,627 --> 00:36:54,129 As long as it's not the last. 918 00:36:54,212 --> 00:36:56,297 Don't be pulling a "Thelma and Louise" out there. 919 00:36:56,381 --> 00:36:58,508 I am minutes from taking a three-month vacation. 920 00:36:58,591 --> 00:37:00,051 When's the last time you took any time off, Jack? 921 00:37:00,135 --> 00:37:01,928 Yeah, but I've dealt with my demons. 922 00:37:03,304 --> 00:37:05,849 It's a process. 923 00:37:05,932 --> 00:37:08,560 You want to know why I never killed myself? 924 00:37:08,643 --> 00:37:11,980 After what I saw, lived through? 925 00:37:12,063 --> 00:37:15,608 Losing my leg, losing my wife? 926 00:37:16,901 --> 00:37:18,987 Because it comes for all of us, man. 927 00:37:19,070 --> 00:37:20,196 You and I know it more than most. 928 00:37:20,280 --> 00:37:21,906 We see it every shift, 929 00:37:21,990 --> 00:37:24,075 but we can't let ourselves succumb to it. 930 00:37:25,201 --> 00:37:26,995 Yes, life can suck. 931 00:37:28,371 --> 00:37:30,331 It can be unbearable 932 00:37:30,415 --> 00:37:32,167 and--and brutal 933 00:37:32,250 --> 00:37:34,878 and ugly and heartbreaking. 934 00:37:34,961 --> 00:37:39,048 But it's also beautiful-- and hilarious. 935 00:37:39,132 --> 00:37:41,342 And that woman today... 936 00:37:44,387 --> 00:37:45,930 Her baby, they'd both be in the morgue 937 00:37:46,014 --> 00:37:47,849 if you hadn't been here. 938 00:37:47,932 --> 00:37:49,684 That's us. That's you and me. 939 00:37:49,768 --> 00:37:52,645 That's what we're here for. 940 00:37:52,729 --> 00:37:55,273 The most important things I've ever done in my life 941 00:37:55,356 --> 00:37:57,942 have been in this hospital. 942 00:37:58,026 --> 00:38:00,403 Nothing will ever matter more than what I've done 943 00:38:00,487 --> 00:38:03,406 in this hospital, but it is killing me. 944 00:38:05,074 --> 00:38:07,118 You know how they say that a part of you dies 945 00:38:07,202 --> 00:38:08,745 when you lose someone you love? 946 00:38:08,828 --> 00:38:11,122 I'm not convinced that a part of you doesn't die 947 00:38:11,206 --> 00:38:13,291 every time you see a fellow human pass. 948 00:38:13,374 --> 00:38:17,796 And I've seen so many people die 949 00:38:17,879 --> 00:38:20,840 that I feel like it's leaching something from my soul. 950 00:38:22,592 --> 00:38:24,594 Go on a cruise, man. 951 00:38:27,013 --> 00:38:29,766 Knock off this helmetless motorcycle shit. 952 00:38:29,849 --> 00:38:31,851 Yeah, people talk. 953 00:38:31,935 --> 00:38:33,228 That's death-wish behavior. 954 00:38:33,311 --> 00:38:34,687 I'm tired of being a role model. 955 00:38:34,771 --> 00:38:36,606 I'm tired of feeling like you can't get ahead. 956 00:38:36,689 --> 00:38:38,358 I'm tired of feeling like I'm drowning every day. 957 00:38:38,441 --> 00:38:39,651 I'm tired of all of it. 958 00:38:39,734 --> 00:38:40,860 You need to get away for a while, 959 00:38:40,944 --> 00:38:42,278 and you need to get some help. 960 00:38:42,362 --> 00:38:45,740 You need this place as much as it needs you. 961 00:38:50,203 --> 00:38:52,205 Am I fucked up? 962 00:38:52,288 --> 00:38:53,873 100%. 963 00:38:57,418 --> 00:38:59,546 But nobody works here as long as you and me 964 00:38:59,629 --> 00:39:00,713 and doesn't get screwed up. 965 00:39:00,797 --> 00:39:03,883 You--you gotta find somebody 966 00:39:03,967 --> 00:39:06,636 to help you dance through the darkness. 967 00:39:10,723 --> 00:39:12,350 Did you just make that up? 968 00:39:14,602 --> 00:39:16,104 Maybe it's a song lyric. 969 00:39:16,187 --> 00:39:17,689 I don't-- maybe my therapist said it. 970 00:39:17,772 --> 00:39:19,691 I don't know. 971 00:39:22,527 --> 00:39:23,862 Some dude just pulled up. 972 00:39:23,945 --> 00:39:25,947 Looks like he blew half his face off. 973 00:39:28,825 --> 00:39:30,618 How can you not love this place? 974 00:39:33,079 --> 00:39:36,416 Look, don't make me look stupid. 975 00:39:36,499 --> 00:39:38,877 You come back to us in one piece. 976 00:39:42,297 --> 00:39:43,673 I'm still your emergency contact, 977 00:39:43,756 --> 00:39:46,092 and I do not want to be contacted. 978 00:39:48,469 --> 00:39:49,596 All right, night crawlers, 979 00:39:49,679 --> 00:39:50,889 what the hell's going on out here? 980 00:39:56,477 --> 00:39:57,729 25-year-old man... 981 00:39:57,812 --> 00:39:59,022 history, 982 00:39:59,105 --> 00:40:00,356 no meds, no allergies. 983 00:41:26,776 --> 00:41:28,653 More than 2,000 years ago, 984 00:41:28,736 --> 00:41:30,822 the Chinese were throwing bamboo into fire 985 00:41:30,905 --> 00:41:32,824 to make explosions. 986 00:41:32,907 --> 00:41:34,367 They went on to invent gunpowder. 987 00:41:34,450 --> 00:41:36,577 And boom! The rest is history. 988 00:41:38,246 --> 00:41:41,290 They had chemicals to get the different colors, you know? 989 00:41:41,374 --> 00:41:44,043 Sodium gives you yellow, strontium gives you red, 990 00:41:44,127 --> 00:41:47,130 and barium is green. 991 00:41:47,213 --> 00:41:50,717 Who knew chemistry could be so damn pretty? 992 00:42:59,702 --> 00:43:01,412 - Hey. - Hey. 993 00:43:01,496 --> 00:43:03,831 - I thought you'd left already. - On my way out. 994 00:43:03,915 --> 00:43:07,794 Hey, I'm sorry that I didn't find the time today 995 00:43:07,877 --> 00:43:08,961 to have that conversation. 996 00:43:09,045 --> 00:43:10,296 Yeah, that's all right. 997 00:43:10,379 --> 00:43:12,215 Seems like you didn't really want to. 998 00:43:12,298 --> 00:43:13,549 I didn't. 999 00:43:16,552 --> 00:43:17,929 Did you? 1000 00:43:18,012 --> 00:43:20,264 Uh... 1001 00:43:20,348 --> 00:43:23,059 yeah, actually. 1002 00:43:23,142 --> 00:43:26,145 Look, I'm doing the work. 1003 00:43:26,229 --> 00:43:28,606 I'm--I've been sober 186 days. 1004 00:43:28,689 --> 00:43:30,858 I'm going to meetings. I'm taking the drug tests. 1005 00:43:30,942 --> 00:43:33,152 - That's good. - And you're still riding me. 1006 00:43:36,197 --> 00:43:39,534 What would have happened if I'd paralyzed that guy? 1007 00:43:39,617 --> 00:43:41,202 I don't know. 1008 00:43:41,285 --> 00:43:42,787 What would have happened if I hadn't been here today? 1009 00:43:42,870 --> 00:43:44,497 You'd still be questioning yourself. 1010 00:43:44,580 --> 00:43:46,249 Now you know you can do it. You're welcome. 1011 00:43:46,332 --> 00:43:47,834 Oh, so that's-- that's how you teach now? 1012 00:43:47,917 --> 00:43:49,794 Sometimes. 1013 00:43:49,877 --> 00:43:52,130 You know who I saw in rehab? 1014 00:43:52,213 --> 00:43:54,799 I saw a bunch of guys just like you. 1015 00:43:54,882 --> 00:43:56,092 The only difference is, 1016 00:43:56,175 --> 00:43:59,220 they've accepted that they need help. 1017 00:43:59,303 --> 00:44:01,264 I think you're afraid to admit that 1018 00:44:01,347 --> 00:44:03,933 the mighty Dr. Robinavitch isn't perfect. 1019 00:44:04,016 --> 00:44:05,977 Oh, I never claimed to be perfect. 1020 00:44:06,060 --> 00:44:09,230 No, but you expect it of yourself, 1021 00:44:09,313 --> 00:44:11,691 and it's not realistic, man. 1022 00:44:11,774 --> 00:44:14,026 How can any of us live up to your standards 1023 00:44:14,110 --> 00:44:15,778 if you can't even do it? 1024 00:44:17,238 --> 00:44:20,116 You need help, Robby. 1025 00:44:20,199 --> 00:44:21,909 You need help. 1026 00:44:24,787 --> 00:44:25,913 Finished? 1027 00:44:27,165 --> 00:44:29,458 You don't gotta be honest with me, man. 1028 00:44:29,542 --> 00:44:31,502 At least be honest with yourself. 1029 00:44:47,059 --> 00:44:49,353 She is due for a new bottle. 1030 00:44:49,437 --> 00:44:52,148 I was hoping to get her some formula before I clocked out. 1031 00:44:53,900 --> 00:44:56,194 I'll stay with her. 1032 00:44:56,277 --> 00:44:57,486 Thanks. 1033 00:44:59,780 --> 00:45:01,908 Why are you--will you hit those lights on your way out? 1034 00:45:01,991 --> 00:45:04,952 - Yep. - Why are you crying? 1035 00:45:05,036 --> 00:45:07,538 Why are you crying, little one? 1036 00:45:07,622 --> 00:45:10,124 You're OK. You're safe. 1037 00:45:10,208 --> 00:45:12,418 Yeah, you're not alone. 1038 00:45:19,383 --> 00:45:21,844 Yeah, you're OK. 1039 00:45:21,928 --> 00:45:25,139 Do you need to be swaddled again? 1040 00:45:25,223 --> 00:45:26,891 Is that it? 1041 00:45:26,974 --> 00:45:28,851 I can do that. Look. 1042 00:45:28,935 --> 00:45:31,437 Aww. 1043 00:45:31,520 --> 00:45:35,191 I wish somebody would swaddle me. 1044 00:45:35,274 --> 00:45:37,610 Yes, I do. 1045 00:45:37,693 --> 00:45:39,695 Oh. 1046 00:45:42,156 --> 00:45:45,117 You got off to kind of a rough start, 1047 00:45:45,201 --> 00:45:48,246 didn't you, little one? 1048 00:45:48,329 --> 00:45:50,414 Yeah, you did. 1049 00:45:52,750 --> 00:45:55,336 Well, that makes two of us. 1050 00:45:59,006 --> 00:46:00,967 I got abandoned too. 1051 00:46:04,387 --> 00:46:06,722 When I was eight. 1052 00:46:10,309 --> 00:46:15,690 But I got through all of that, and so will you. 1053 00:46:15,773 --> 00:46:19,694 I got a good feeling that you're gonna be just fine. 1054 00:46:19,777 --> 00:46:23,197 Everything's gonna be just fine. 1055 00:46:23,281 --> 00:46:26,117 You got so many wonderful things to see 1056 00:46:26,200 --> 00:46:29,328 and so many people to love ahead of you. 1057 00:46:31,580 --> 00:46:36,544 So many wonderful things to see, 1058 00:46:36,627 --> 00:46:38,671 people to love ahead of you. 1059 00:46:44,885 --> 00:46:47,138 Shh. 1060 00:46:47,221 --> 00:46:51,934 It's OK. It's gonna be OK. 1061 00:46:52,018 --> 00:46:53,602 It's OK.