1 00:00:12,679 --> 00:00:15,015 Baran, is this you? 2 00:00:20,521 --> 00:00:23,314 It began after a bad case of viral meningitis 3 00:00:23,315 --> 00:00:25,066 when I was five. 4 00:00:25,067 --> 00:00:27,401 They tried every anti-seizure medication, 5 00:00:27,402 --> 00:00:31,364 but I still had episodes every few months or so. 6 00:00:31,365 --> 00:00:32,615 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 --> 00:00:37,537 Are you driving? 9 00:00:37,538 --> 00:00:40,665 I couldn't until laser ablation 10 00:00:40,666 --> 00:00:44,001 to my left temporal lobe 12 years ago. 11 00:00:44,002 --> 00:00:46,796 Between that and the Keppra, I've been seizure-free, 12 00:00:46,797 --> 00:00:50,467 cleared by Neurology to drive and to work as an attending. 13 00:00:52,261 --> 00:00:54,554 How long, uh, between the seizure 14 00:00:54,555 --> 00:00:56,430 you had today and the last one? 15 00:00:56,431 --> 00:00:59,685 It's been well over a year. 16 00:01:01,853 --> 00:01:03,355 But I had two today. 17 00:01:07,985 --> 00:01:09,527 I don't know why. 18 00:01:09,528 --> 00:01:12,738 It could be sleep deprivation, new job stress. 19 00:01:12,739 --> 00:01:16,033 I... I haven't had to deal with Peds cases 20 00:01:16,034 --> 00:01:17,535 since Afghanistan. 21 00:01:17,536 --> 00:01:19,287 What are your options now? 22 00:01:19,288 --> 00:01:21,414 Um... 23 00:01:21,415 --> 00:01:24,959 up my Keppra or maybe try 24 00:01:24,960 --> 00:01:26,586 one of the newer anti-seizure meds. 25 00:01:26,587 --> 00:01:29,422 But if that doesn't work, I'm left with two choices... 26 00:01:29,423 --> 00:01:33,884 um, a temporal lobectomy, which could impair my speech, 27 00:01:33,885 --> 00:01:36,345 or get a neuromodulation device, 28 00:01:36,346 --> 00:01:38,055 which can sense and stop the seizures 29 00:01:38,056 --> 00:01:39,890 almost immediately. 30 00:01:39,891 --> 00:01:41,726 You need to disclose this. 31 00:01:41,727 --> 00:01:43,769 I know. I have a plan. 32 00:01:43,770 --> 00:01:44,895 Hey, Robby, Dana's looking for you. 33 00:01:44,896 --> 00:01:46,105 She's in Peds. 34 00:01:46,106 --> 00:01:47,440 Yeah, OK, I'll be right there. 35 00:01:48,817 --> 00:01:50,067 Sounds like you're needed in Peds, 36 00:01:50,068 --> 00:01:52,153 and I have patients to see. 37 00:01:52,154 --> 00:01:54,071 Robby, pregnant woman with severe headache 38 00:01:54,072 --> 00:01:55,781 on her way in by ambulance. 39 00:01:55,782 --> 00:01:58,285 Find Abbot or a night shift resident. 40 00:02:13,300 --> 00:02:15,177 Need you to turn out your pockets. 41 00:02:21,433 --> 00:02:23,310 OK. Show me your hands. 42 00:02:51,296 --> 00:02:52,631 Come here often? 43 00:03:01,390 --> 00:03:02,890 What's going on? 44 00:03:02,891 --> 00:03:04,642 Oh, sorry... false alarm. 45 00:03:04,643 --> 00:03:06,852 We thought she spiked a fever, but it was the wrong chart 46 00:03:06,853 --> 00:03:09,313 from our analog hell. 47 00:03:09,314 --> 00:03:11,857 You know anybody who might consider kinship adoption? 48 00:03:11,858 --> 00:03:13,651 Doctors and nurses qualify. 49 00:03:13,652 --> 00:03:15,277 Don't look at me. 50 00:03:15,278 --> 00:03:17,363 Hey, can your staff keep an eye on Dr. Al-Hashimi 51 00:03:17,364 --> 00:03:18,447 until she leaves? 52 00:03:18,448 --> 00:03:20,866 Why? 53 00:03:20,867 --> 00:03:23,035 Uh, because I think she's tired, 54 00:03:23,036 --> 00:03:24,620 and I don't want her to make any mistakes. 55 00:03:24,621 --> 00:03:26,706 - Oh, great advice. Maybe you should take it. 56 00:03:26,707 --> 00:03:27,998 Yeah. 57 00:03:27,999 --> 00:03:29,417 I'm gonna go get some fresh air. 58 00:03:29,418 --> 00:03:30,960 Grab some for me while you're out there. 59 00:03:30,961 --> 00:03:32,086 Your lungs wouldn't know what to do with it. 60 00:03:32,087 --> 00:03:33,170 Screw you! 61 00:03:33,171 --> 00:03:34,797 In front of the baby? Nice. 62 00:03:37,676 --> 00:03:39,301 Yeah. 63 00:03:39,302 --> 00:03:41,137 We are the night crawlers. 64 00:03:41,138 --> 00:03:44,140 We deal with the weirdest and the wildest because... 65 00:03:44,141 --> 00:03:46,684 We are the weirdest and the wildest of them all. 66 00:03:46,685 --> 00:03:47,810 That is right, and tonight, 67 00:03:47,811 --> 00:03:49,145 they are really gonna be crawling. 68 00:03:49,146 --> 00:03:50,521 Now go get some! 69 00:03:50,522 --> 00:03:51,522 Hooah! 70 00:03:55,944 --> 00:03:57,528 Sorry to wake you. 71 00:03:57,529 --> 00:03:59,030 I... I was thinking. 72 00:04:02,409 --> 00:04:04,201 Doubt PTX. 73 00:04:04,202 --> 00:04:06,412 You're supposed to be leaving. 74 00:04:06,413 --> 00:04:07,539 I am. 75 00:04:09,833 --> 00:04:11,375 You know, this spirit quest of yours 76 00:04:11,376 --> 00:04:13,252 has a lot of people up in arms around here. 77 00:04:13,253 --> 00:04:14,712 Everyone's gonna be fine without me, 78 00:04:14,713 --> 00:04:16,380 and it's hardly a spirit quest. 79 00:04:16,381 --> 00:04:18,048 Whatever it is, it seems you've given people 80 00:04:18,049 --> 00:04:19,341 the impression you might not be coming back. 81 00:04:19,342 --> 00:04:20,760 Well, who knows 82 00:04:20,761 --> 00:04:22,219 what the future has in store for any of us? 83 00:04:22,220 --> 00:04:23,596 Yeah, saying shit like that right there 84 00:04:23,597 --> 00:04:24,638 isn't helping. 85 00:04:24,639 --> 00:04:26,056 People are worried about you. 86 00:04:26,057 --> 00:04:27,975 Dr. Abbot, the patient in South 21, 87 00:04:27,976 --> 00:04:29,435 Digby, he's missing again. 88 00:04:29,436 --> 00:04:30,811 Sounds like a day shift problem. 89 00:04:30,812 --> 00:04:33,064 Not if he was handed off already. 90 00:04:37,235 --> 00:04:38,903 Best I can do under the circumstances. 91 00:04:38,904 --> 00:04:40,196 Thank you. 92 00:04:40,197 --> 00:04:41,697 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 --> 00:04:48,204 Your friend fixing your bike? 95 00:04:48,205 --> 00:04:49,413 Ambulance clipped it 96 00:04:49,414 --> 00:04:51,290 while it was just parked here today. 97 00:04:51,291 --> 00:04:53,501 Jesus Christ. 98 00:04:53,502 --> 00:04:55,085 That's a sign if I've ever seen one. 99 00:04:56,671 --> 00:04:58,506 Yeah, here's the thing... when people worry about you, 100 00:04:58,507 --> 00:05:00,257 it makes me think that I should be worried about you, 101 00:05:00,258 --> 00:05:01,926 and I don't like worrying about things. 102 00:05:01,927 --> 00:05:03,135 Ooh. Now you're a shrink? 103 00:05:03,136 --> 00:05:04,261 No, I'm trying to be your friend. 104 00:05:04,262 --> 00:05:05,429 You got... you got Dana convinced 105 00:05:05,430 --> 00:05:07,181 that you're gonna hurt yourself. 106 00:05:07,182 --> 00:05:08,766 - Dana's got her own issues. - That sounds like projection. 107 00:05:08,767 --> 00:05:10,100 Are you seriously trying to have this fucking 108 00:05:10,101 --> 00:05:11,644 conversation with me right now, man? 109 00:05:11,645 --> 00:05:13,270 I... I'm not the one 110 00:05:13,271 --> 00:05:15,606 who spends his free time getting shot at. 111 00:05:15,607 --> 00:05:17,233 Hooah! 112 00:05:17,234 --> 00:05:19,568 Hey, Dr. Robby, this is Judith Lastrade... 113 00:05:19,569 --> 00:05:21,779 36 weeks pregnant with two days of headache, 114 00:05:21,780 --> 00:05:24,281 now a 10 out of 10 with blurred vision. 115 00:05:24,282 --> 00:05:27,493 BP 174/120, heart rate 92. 116 00:05:27,494 --> 00:05:29,620 No relief with fentanyl. - Judith, I'm Dr. Abbot. 117 00:05:29,621 --> 00:05:30,996 Any weakness in your arms or legs? 118 00:05:30,997 --> 00:05:32,540 No, no. Is this a stroke? 119 00:05:32,541 --> 00:05:33,958 We need to check for everything. 120 00:05:33,959 --> 00:05:36,669 Pitting edema with severe preeclampsia. 121 00:05:36,670 --> 00:05:38,629 Where are you doing your prenatal care? 122 00:05:38,630 --> 00:05:39,839 Nowhere. 123 00:05:39,840 --> 00:05:41,340 It's a wild pregnancy. 124 00:05:41,341 --> 00:05:43,301 I want a free birth. 125 00:05:45,428 --> 00:05:48,806 This 81-year-old nun presents with red, itchy eyes 126 00:05:48,807 --> 00:05:51,976 with secretions for the past two days. 127 00:05:51,977 --> 00:05:54,478 Patient complains of no URI symptoms, 128 00:05:54,479 --> 00:05:56,063 no contact with any chemical... - Hey. 129 00:05:56,064 --> 00:05:57,481 Agents, no known exposures... 130 00:05:57,482 --> 00:05:58,983 Want half a Monster? 131 00:05:58,984 --> 00:06:00,651 Oh, no, thanks. 132 00:06:00,652 --> 00:06:02,152 I... I don't really want to stay awake 133 00:06:02,153 --> 00:06:04,321 any longer than I have to. 134 00:06:04,322 --> 00:06:05,782 Yeah, I hear you. 135 00:06:07,325 --> 00:06:09,368 Did you find your ID badge? 136 00:06:09,369 --> 00:06:10,953 Uh, no. 137 00:06:10,954 --> 00:06:13,205 You any closer to deciding what's next for you? 138 00:06:13,206 --> 00:06:15,165 Uh, yeah, I'm seriously considering law school. 139 00:06:15,166 --> 00:06:16,667 - 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 --> 00:06:23,299 I mean, no offense, but look what this place does to you. 142 00:06:23,300 --> 00:06:24,967 Langdon's an addict. 143 00:06:24,968 --> 00:06:27,678 Is a person with a substance use disorder. 144 00:06:27,679 --> 00:06:29,597 McKay was on house arrest. 145 00:06:29,598 --> 00:06:31,098 Dana's a time bomb. 146 00:06:31,099 --> 00:06:32,850 Santos is one of the angriest people 147 00:06:32,851 --> 00:06:34,351 you are ever going to meet. 148 00:06:34,352 --> 00:06:35,853 - Sarcastic, yes. Cynical, definitely. 149 00:06:35,854 --> 00:06:37,354 I don't know if she's, you know... 150 00:06:37,355 --> 00:06:38,732 Mel? 151 00:06:39,774 --> 00:06:42,818 Samira has no life. 152 00:06:42,819 --> 00:06:46,030 Abbot's an adrenaline junkie who gets shot at for fun. 153 00:06:46,031 --> 00:06:48,866 Robby's got, like, PTSD or something way fucking worse. 154 00:06:48,867 --> 00:06:50,159 OK, well, I... I mean, 155 00:06:50,160 --> 00:06:52,203 I'd hate to know what you think about me. 156 00:06:53,747 --> 00:06:55,414 I don't know, I just... 157 00:06:55,415 --> 00:06:58,042 the more time I spend here, 158 00:06:58,043 --> 00:06:59,293 the more I realize the importance 159 00:06:59,294 --> 00:07:01,963 of my mental health. 160 00:07:03,048 --> 00:07:04,131 Mm. 161 00:07:04,132 --> 00:07:05,424 For patients and for us. 162 00:07:05,425 --> 00:07:08,052 And this is... 163 00:07:08,053 --> 00:07:09,219 Yeah. 164 00:07:09,220 --> 00:07:10,471 Well, you know, 165 00:07:10,472 --> 00:07:13,308 maybe that's what you should focus on. 166 00:07:14,392 --> 00:07:16,685 - What? - Mental health. 167 00:07:16,686 --> 00:07:18,938 Clearly, you have a passion for it, right? 168 00:07:18,939 --> 00:07:20,522 I mean, that's... that's great. 169 00:07:20,523 --> 00:07:21,565 I don't know if I'd call it a passion. 170 00:07:21,566 --> 00:07:23,735 I would call it, like, a... 171 00:07:26,613 --> 00:07:28,239 Oh, my God. 172 00:07:30,116 --> 00:07:32,285 You might be right. 173 00:07:33,828 --> 00:07:35,454 Oh, you're a genius, Whitaker. 174 00:07:35,455 --> 00:07:36,664 Oh, OK. 175 00:07:38,291 --> 00:07:40,292 CTG is on. 176 00:07:40,293 --> 00:07:42,586 - CTG? - Cardiotocography. 177 00:07:42,587 --> 00:07:46,048 Measures the baby's heart rate and checks for contractions. 178 00:07:46,049 --> 00:07:47,591 Fetal heart rate 128. 179 00:07:47,592 --> 00:07:49,134 Normal range, Nazely? 180 00:07:49,135 --> 00:07:51,053 110 to 160. 181 00:07:51,054 --> 00:07:52,930 So the baby's OK? 182 00:07:52,931 --> 00:07:54,098 Right now, yes. 183 00:07:54,099 --> 00:07:55,557 128 is reassuring. 184 00:07:55,558 --> 00:07:57,768 BP's 170/119. 185 00:07:57,769 --> 00:07:59,520 6 grams of magnesium running in. 186 00:07:59,521 --> 00:08:01,105 Your next move, Crus? 187 00:08:01,106 --> 00:08:03,774 20 of labetalol, IV push over two minutes. 188 00:08:03,775 --> 00:08:05,275 Uh, what's happening? 189 00:08:05,276 --> 00:08:07,319 Uh, you have a condition called preeclampsia. 190 00:08:07,320 --> 00:08:08,612 And how did it happen? 191 00:08:08,613 --> 00:08:10,823 Uh, nobody really knows, actually. 192 00:08:10,824 --> 00:08:13,158 It affects about 10% of the pregnancies. 193 00:08:13,159 --> 00:08:14,618 High blood pressure, headaches, 194 00:08:14,619 --> 00:08:17,121 protein in the urine, and swollen ankles. 195 00:08:17,122 --> 00:08:19,415 OK, well, it's a wild pregnancy, 196 00:08:19,416 --> 00:08:21,625 so that means no medical care. 197 00:08:21,626 --> 00:08:23,627 Then why are you here? 198 00:08:25,130 --> 00:08:27,382 I just need to get rid of this headache. 199 00:08:29,509 --> 00:08:32,553 Well, if we don't lower your blood pressure 200 00:08:32,554 --> 00:08:35,472 and treat with magnesium, there can be problems. 201 00:08:35,473 --> 00:08:36,724 Like what? 202 00:08:36,725 --> 00:08:38,350 Seizures, bleeding, 203 00:08:38,351 --> 00:08:40,477 even death, for you and the baby. 204 00:08:40,478 --> 00:08:42,312 Oh, my God. 205 00:08:42,313 --> 00:08:43,981 Robby, your VIP's ready to go. 206 00:08:43,982 --> 00:08:46,066 OK, I'll be right there. 207 00:08:46,067 --> 00:08:47,693 You good? - Yeah, I'm good. 208 00:08:47,694 --> 00:08:50,404 I got it. With my eyes closed. 209 00:08:50,405 --> 00:08:51,739 But I won't. Maybe one eye. 210 00:08:53,074 --> 00:08:54,158 Hey... 211 00:08:57,537 --> 00:08:58,996 - Hey, Becca. How you feeling? 212 00:08:58,997 --> 00:09:01,207 I'm better. Thanks. 213 00:09:02,709 --> 00:09:04,126 Where are you? 214 00:09:04,127 --> 00:09:06,003 I'm at Adam's house. 215 00:09:06,004 --> 00:09:07,796 Can I call you later? We're watching a movie. 216 00:09:07,797 --> 00:09:09,006 - Oh, sure. I just... I thought 217 00:09:09,007 --> 00:09:10,549 you were gonna see the fireworks. 218 00:09:10,550 --> 00:09:13,177 Nope, we decided to watch "Elf" instead. 219 00:09:13,178 --> 00:09:14,511 Ah. 220 00:09:14,512 --> 00:09:16,513 Of course you did. - OK. 221 00:09:16,514 --> 00:09:18,182 I'll call you tomorrow! - Tomorrow? Wait. 222 00:09:18,183 --> 00:09:20,517 Uh, are... are you spending the night? 223 00:09:20,518 --> 00:09:22,352 Um, uh, yes. 224 00:09:22,353 --> 00:09:24,146 His parents invited me. 225 00:09:24,147 --> 00:09:25,647 They... they need to ask me that. 226 00:09:25,648 --> 00:09:28,067 Are... are you staying here too? 227 00:09:28,068 --> 00:09:32,154 No, they... they needed to ask if it was OK if you stayed. 228 00:09:32,155 --> 00:09:33,530 Why? 229 00:09:33,531 --> 00:09:38,160 Be... because, uh, it's polite. 230 00:09:38,161 --> 00:09:40,454 It's the right... it's the right thing to do. 231 00:09:40,455 --> 00:09:43,540 Um, I need to talk to them. 232 00:09:43,541 --> 00:09:46,251 - Um, they're not here. They're at a barbecue. 233 00:09:46,252 --> 00:09:48,378 OK, um, can you have them call me 234 00:09:48,379 --> 00:09:49,713 as soon as they get home? 235 00:09:49,714 --> 00:09:51,590 - Yes. - Can you promise? 236 00:09:51,591 --> 00:09:53,467 - I promise. OK, bye, Mel! 237 00:09:53,468 --> 00:09:54,886 Bye. Have fun... 238 00:09:56,262 --> 00:09:57,888 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 00:10:01,935 --> 00:10:05,521 You know, the Cree don't have a word for goodbye. 241 00:10:05,522 --> 00:10:06,688 You know a lot of Cree? 242 00:10:06,689 --> 00:10:08,440 A bit. 243 00:10:08,441 --> 00:10:09,566 I got around, man. 244 00:10:09,567 --> 00:10:10,902 I don't doubt it. 245 00:10:13,404 --> 00:10:15,906 Look, I'll come back for all this other shit... 246 00:10:15,907 --> 00:10:17,241 Great. 247 00:10:17,242 --> 00:10:18,742 If you promise to come back 248 00:10:18,743 --> 00:10:20,577 and let me take the Bonnie for a ride. 249 00:10:20,578 --> 00:10:21,787 Uh, I don't know. 250 00:10:21,788 --> 00:10:23,205 I've seen you ride, old man. 251 00:10:23,206 --> 00:10:24,623 Fuck you. 252 00:10:24,624 --> 00:10:26,583 I mean it. 253 00:10:26,584 --> 00:10:27,794 We got a deal? 254 00:10:30,880 --> 00:10:32,757 I'll think about it. 255 00:10:45,854 --> 00:10:47,938 This looks like an ambush. 256 00:10:47,939 --> 00:10:49,606 We got a slight hiccup in chairs. 257 00:10:49,607 --> 00:10:50,649 ICE is back? 258 00:10:50,650 --> 00:10:52,651 No, we got a dead body. 259 00:10:52,652 --> 00:10:54,278 - Somebody died out there? - Yeah. 260 00:10:54,279 --> 00:10:56,113 Poor devil checked in at 5:00 this morning. 261 00:10:56,114 --> 00:10:57,573 He was a DNR. 262 00:10:57,574 --> 00:10:58,782 - What was his chief complaint? - Hemorrhoids 263 00:10:58,783 --> 00:11:00,284 and constipation. - No shit. 264 00:11:00,285 --> 00:11:02,619 Hence the constipation. 265 00:11:02,620 --> 00:11:04,371 Throw me a slow one, I'm gonna hit it. 266 00:11:04,372 --> 00:11:06,039 - Tell the night shift. I'm saying that's when he died. 267 00:11:06,040 --> 00:11:07,291 We all in agreement on that? 268 00:11:07,292 --> 00:11:08,667 To the grave. 269 00:11:08,668 --> 00:11:10,460 Just like poor Jasper. 270 00:11:10,461 --> 00:11:11,962 You're on fire. 271 00:11:11,963 --> 00:11:13,381 Just getting my second wind. 272 00:11:14,674 --> 00:11:15,966 How's the headache? 273 00:11:15,967 --> 00:11:17,301 Still a 10. 274 00:11:17,302 --> 00:11:18,802 More fentanyl? 275 00:11:18,803 --> 00:11:21,180 - Yep. - BP's good. Another 50. 276 00:11:21,181 --> 00:11:22,639 Hey, Abbot. 277 00:11:22,640 --> 00:11:24,641 Attending and resident are stuck in the OR. 278 00:11:24,642 --> 00:11:26,476 Oh, you're the next best thing. 279 00:11:26,477 --> 00:11:27,811 Better, some would say. 280 00:11:27,812 --> 00:11:29,146 Mm. 281 00:11:29,147 --> 00:11:30,689 - What do you got? - This is Judith. 282 00:11:30,690 --> 00:11:33,150 G1, P0 with no prenatal care. 283 00:11:33,151 --> 00:11:35,277 Preeclampsia with severe hypertension. 284 00:11:35,278 --> 00:11:37,696 - Hi, Judith. Nurse Garvin from OB. 285 00:11:37,697 --> 00:11:39,156 Some jelly on the belly. 286 00:11:39,157 --> 00:11:40,699 Gonna take a quick look with ultrasound. 287 00:11:40,700 --> 00:11:42,659 - No, no, no. Ultrasound can harm the baby. 288 00:11:42,660 --> 00:11:44,661 - Not true. - Not doing the ultrasound 289 00:11:44,662 --> 00:11:46,748 could end up harming you and the baby. 290 00:11:47,999 --> 00:11:49,166 OK. 291 00:11:49,167 --> 00:11:51,710 Just do it as fast as you can. 292 00:11:51,711 --> 00:11:54,172 Why no prenatal care, Judith? 293 00:11:55,215 --> 00:11:57,674 I wanted a free birth... 294 00:11:57,675 --> 00:11:59,843 no doctors, no hospital, no medicine. 295 00:11:59,844 --> 00:12:02,679 Mm. You have a midwife? 296 00:12:02,680 --> 00:12:03,722 A birth doula? 297 00:12:03,723 --> 00:12:06,141 No, I don't need one. 298 00:12:06,142 --> 00:12:07,434 Women have been having children on their own 299 00:12:07,435 --> 00:12:08,685 for thousands of years. 300 00:12:08,686 --> 00:12:10,229 Yeah, with an infant mortality rate 301 00:12:10,230 --> 00:12:13,148 of 30% for most of those thousands of years. 302 00:12:13,149 --> 00:12:15,400 - Femur length 7 centimeters. - 37 weeks. 303 00:12:15,401 --> 00:12:17,361 They'll probably induce. 304 00:12:17,362 --> 00:12:19,321 What? No. 305 00:12:19,322 --> 00:12:20,697 No, no, no, no. Absolutely not. 306 00:12:20,698 --> 00:12:22,199 At 37 weeks, 307 00:12:22,200 --> 00:12:24,409 the cure for preeclampsia is to deliver the baby. 308 00:12:24,410 --> 00:12:26,203 We need to get you upstairs so the OB doctors 309 00:12:26,204 --> 00:12:28,997 can induce labor to save you and your baby. 310 00:12:28,998 --> 00:12:31,417 No. No, no, no, no. Mm-mm. 311 00:12:33,753 --> 00:12:35,504 Yep, that's definitely Jasper. 312 00:12:35,505 --> 00:12:36,755 He was alive and kicking 313 00:12:36,756 --> 00:12:38,173 when my shift ended this morning. 314 00:12:38,174 --> 00:12:39,549 This is definitely a day shift patient. 315 00:12:39,550 --> 00:12:40,884 Now he's not a patient. 316 00:12:40,885 --> 00:12:42,386 He's a DB that we gotta deal with. 317 00:12:44,889 --> 00:12:46,139 Is this dude dead? 318 00:12:46,140 --> 00:12:47,641 Nope. 319 00:12:47,642 --> 00:12:49,476 All right, Mr. Reed, time to take you back 320 00:12:49,477 --> 00:12:50,936 and get you checked out, OK? 321 00:12:50,937 --> 00:12:52,396 - He sure looks dead. - Are you a doctor? 322 00:12:52,397 --> 00:12:54,731 - No, but he... - Has hypernarcolepsy. 323 00:12:54,732 --> 00:12:56,441 It's no joke. - Mm-hmm. 324 00:12:56,442 --> 00:12:58,735 Excuse me. 325 00:12:58,736 --> 00:13:00,654 Oh, sometimes I hate nights. 326 00:13:00,655 --> 00:13:01,905 - Yep. - Oof. 327 00:13:12,792 --> 00:13:14,209 Wow. 328 00:13:14,210 --> 00:13:17,421 Crazy how muggy it still is out here. 329 00:13:17,422 --> 00:13:20,090 You, uh... you seen Robby? 330 00:13:20,091 --> 00:13:22,259 Uh, not for a bit. 331 00:13:22,260 --> 00:13:23,593 You catch up on your charts 332 00:13:23,594 --> 00:13:25,095 from the beginning of the shift? 333 00:13:25,096 --> 00:13:26,388 Yeah. 334 00:13:26,389 --> 00:13:27,431 What are you still doing here? 335 00:13:27,432 --> 00:13:29,266 Uh, just gonna... 336 00:13:29,267 --> 00:13:31,643 You staying for the fireworks? 337 00:13:31,644 --> 00:13:33,061 Yeah. 338 00:13:33,062 --> 00:13:34,438 I was supposed to see them with Becca, 339 00:13:34,439 --> 00:13:38,442 but she is at her boyfriend Adam's 340 00:13:38,443 --> 00:13:40,320 family's house instead. 341 00:13:44,615 --> 00:13:50,829 Your sister seems like she's, uh, pretty put-together. 342 00:13:50,830 --> 00:13:52,122 Yeah. 343 00:13:52,123 --> 00:13:54,876 Uh, a lot more than I realized. 344 00:13:56,794 --> 00:13:58,212 How was your day? 345 00:14:00,048 --> 00:14:02,549 I've had better. 346 00:14:02,550 --> 00:14:03,676 You? 347 00:14:06,554 --> 00:14:08,972 Yeah. 348 00:14:08,973 --> 00:14:12,309 But then again, I've had a lot worse. 349 00:14:12,310 --> 00:14:14,811 Hell, I did a closed cervical reduction, like, an hour ago. 350 00:14:14,812 --> 00:14:17,065 - Oh, I heard. That must have been so intense. 351 00:14:18,775 --> 00:14:20,942 My hands are still shaking. 352 00:14:20,943 --> 00:14:22,986 Hey, um, do you think you could teach me 353 00:14:22,987 --> 00:14:25,155 how to do that sometime? 354 00:14:25,156 --> 00:14:26,615 Uh, yeah. 355 00:14:26,616 --> 00:14:27,824 - Yeah? - Yeah, sure. I mean, 356 00:14:27,825 --> 00:14:29,368 I hope you never have to use it. 357 00:14:29,369 --> 00:14:31,328 I could have paralyzed that guy. 358 00:14:31,329 --> 00:14:34,039 Yeah, but you didn't. 359 00:14:34,040 --> 00:14:37,334 No, I didn't. 360 00:14:37,335 --> 00:14:39,795 Thank you... 361 00:14:39,796 --> 00:14:41,880 by the way, for... 362 00:14:41,881 --> 00:14:44,633 talking me down earlier. 363 00:14:44,634 --> 00:14:46,511 I'm sorry I snapped. 364 00:14:48,012 --> 00:14:49,347 It's OK. 365 00:14:57,522 --> 00:15:00,190 Dr. Mohan, you ever heard of kinship fostering? 366 00:15:00,191 --> 00:15:01,900 It's where a nurse or doctor can 367 00:15:01,901 --> 00:15:03,402 become an emergency foster... - Oh, no. 368 00:15:03,403 --> 00:15:04,903 I don't need any kids. 369 00:15:04,904 --> 00:15:07,072 I need to find a job first. 370 00:15:07,073 --> 00:15:09,533 Candice O'Grady is an 82-year-old female 371 00:15:09,534 --> 00:15:12,035 brought in by her son for intractable vomiting. 372 00:15:12,036 --> 00:15:14,997 No fever, no chills, no abdominal pain, no rash. 373 00:15:16,082 --> 00:15:18,083 Beep. 374 00:15:18,084 --> 00:15:21,503 Oh, I've already got one I can barely keep up with. 375 00:15:21,504 --> 00:15:23,380 What about Sleeping Beauty over here? 376 00:15:23,381 --> 00:15:25,424 She's already babysitting Whitaker. 377 00:15:25,425 --> 00:15:27,509 Well, if you know anyone who'd like to help us out 378 00:15:27,510 --> 00:15:29,428 with Baby Jane Doe, have them call the main desk. 379 00:15:29,429 --> 00:15:31,054 Sure thing. 380 00:15:31,055 --> 00:15:34,225 I'd take her myself, but Benji'd kill me. 381 00:15:35,601 --> 00:15:37,394 BP's 164/114. 382 00:15:37,395 --> 00:15:38,770 Another 40 of labetalol. 383 00:15:38,771 --> 00:15:39,896 Mag bolus is in. 384 00:15:39,897 --> 00:15:41,565 Now infusing 2 grams an hour. 385 00:15:41,566 --> 00:15:42,858 Labs are coming back. 386 00:15:42,859 --> 00:15:45,110 Hemoglobin 7.5, platelets 40. 387 00:15:45,111 --> 00:15:47,112 LFTs are sky high. 388 00:15:47,113 --> 00:15:48,905 - HELLP syndrome. - Hemolytic anemia, 389 00:15:48,906 --> 00:15:51,241 elevated liver enzymes, and low platelets. 390 00:15:51,242 --> 00:15:52,617 They're cleaning a room. 391 00:15:52,618 --> 00:15:54,578 We can bring her up in ten minutes. 392 00:15:54,579 --> 00:15:55,788 How you doing, Judith? 393 00:15:57,790 --> 00:16:00,333 I... I... 394 00:16:00,334 --> 00:16:02,002 Oh, she's seizing. 395 00:16:02,003 --> 00:16:03,670 Oh, shit. 396 00:16:03,671 --> 00:16:06,256 10 of IV diazepam. Have another 10 ready. 397 00:16:06,257 --> 00:16:08,216 With all the movement, we can't get a fetal heartbeat. 398 00:16:08,217 --> 00:16:10,510 - Putting on 15 liters by mask. Should we intubate? 399 00:16:10,511 --> 00:16:12,512 - Hold intubation. Let's try to break this. 400 00:16:12,513 --> 00:16:14,431 We don't want to mask seizures with paralysis 401 00:16:14,432 --> 00:16:16,016 unless we have to. 402 00:16:16,017 --> 00:16:17,601 OK, um... 403 00:16:20,062 --> 00:16:21,813 Crus, CTG isn't reading. 404 00:16:21,814 --> 00:16:23,273 Check with ultrasound. - On it. 405 00:16:23,274 --> 00:16:24,900 Nazely, what's the diagnosis? 406 00:16:24,901 --> 00:16:27,945 Um, with the seizure, now it's eclampsia. 407 00:16:29,113 --> 00:16:31,156 - Fetal heart rate is about 90. - Way too low. 408 00:16:31,157 --> 00:16:32,449 Mom's sats are going down. 409 00:16:32,450 --> 00:16:33,909 Time to tube her? 410 00:16:33,910 --> 00:16:35,577 Set up for it, but wait. 411 00:16:35,578 --> 00:16:36,912 Another 10 of diazepam. 412 00:16:36,913 --> 00:16:39,373 Push 4 grams of Keppra. 413 00:16:42,126 --> 00:16:43,627 History of hypertension 414 00:16:43,628 --> 00:16:44,961 presents to the emergency department 415 00:16:44,962 --> 00:16:47,297 with a chief complaint of dizziness 416 00:16:47,298 --> 00:16:49,508 after inadvertently ingesting 80 milligrams... 417 00:16:49,509 --> 00:16:50,800 Hey, how are you guys making out? 418 00:16:50,801 --> 00:16:51,885 Yeah, we're getting there. 419 00:16:51,886 --> 00:16:53,637 Have you seen Dr. Al-Hashimi? 420 00:16:53,638 --> 00:16:55,473 - No. - Can I talk to you for a sec? 421 00:17:01,020 --> 00:17:02,354 So I just wanted to let you know that I've been 422 00:17:02,355 --> 00:17:03,647 checking out some of your online posts... 423 00:17:03,648 --> 00:17:04,814 Look, I was just trying to help 424 00:17:04,815 --> 00:17:06,399 get some health messages out there, 425 00:17:06,400 --> 00:17:07,984 especially for young people. - I think they're great. 426 00:17:07,985 --> 00:17:09,986 Really good. 427 00:17:09,987 --> 00:17:11,988 - You do? - Yeah. 428 00:17:11,989 --> 00:17:14,199 Yeah, um, keep it up. 429 00:17:14,200 --> 00:17:15,659 OK. 430 00:17:15,660 --> 00:17:17,994 As long as you follow the HIPAA laws. 431 00:17:17,995 --> 00:17:19,371 I do. 432 00:17:19,372 --> 00:17:20,956 And wait until you're done charting. 433 00:17:20,957 --> 00:17:22,583 Sure. 434 00:17:24,794 --> 00:17:29,130 Actually, Dr. Robby... sorry, um, can I ask you a question? 435 00:17:29,131 --> 00:17:30,340 Shoot. 436 00:17:30,341 --> 00:17:31,800 Um, I... I may be 437 00:17:31,801 --> 00:17:34,595 considering emergency psychiatry. 438 00:17:35,846 --> 00:17:38,056 Very cool. 439 00:17:38,057 --> 00:17:39,850 Think I could do it? 440 00:17:42,019 --> 00:17:43,520 I think that you could do 441 00:17:43,521 --> 00:17:46,107 anything that you put your mind to, Victoria. 442 00:17:50,194 --> 00:17:51,653 OK. 443 00:17:51,654 --> 00:17:53,363 Pulse ox is 88. 444 00:17:54,532 --> 00:17:56,575 Dr. Abbot? 445 00:17:56,576 --> 00:17:58,743 Intubate? - Let's do it. 446 00:17:58,744 --> 00:18:02,080 Nazely, what do you suggest for rapid sequence induction? 447 00:18:02,081 --> 00:18:03,290 Etomidate and roc. 448 00:18:03,291 --> 00:18:04,457 Mm, not quite. 449 00:18:04,458 --> 00:18:05,584 120 of propofol, 450 00:18:05,585 --> 00:18:06,585 60 of succinylcholine. 451 00:18:06,586 --> 00:18:08,044 Why is that, Crus? 452 00:18:08,045 --> 00:18:09,754 Propofol for the anti-seizure effect, 453 00:18:09,755 --> 00:18:11,381 sux to avoid prolonged paralysis 454 00:18:11,382 --> 00:18:13,466 so we can check her neuro exam. - Exactly. 455 00:18:13,467 --> 00:18:14,801 Pushing the propofol. 456 00:18:14,802 --> 00:18:16,303 Once she's flat for intubation, 457 00:18:16,304 --> 00:18:17,887 we need to displace the uterus to the left. 458 00:18:17,888 --> 00:18:19,514 - Nazely, that's you. Big hug, both arms. 459 00:18:19,515 --> 00:18:21,850 Get the baby off the vena cava. - Sux is on board. 460 00:18:21,851 --> 00:18:24,603 But after she's paralyzed, the seizing stops, right? 461 00:18:24,604 --> 00:18:26,104 It might look like that, 462 00:18:26,105 --> 00:18:28,189 but an ongoing seizure will still fry the brain. 463 00:18:28,190 --> 00:18:30,025 We monitor with EEG. 464 00:18:30,026 --> 00:18:31,902 - Is there time for that? - Wait and see. 465 00:18:33,029 --> 00:18:34,279 Paralytics kicked in. 466 00:18:34,280 --> 00:18:35,823 - Let's go. Roll her to her back. 467 00:18:36,866 --> 00:18:38,575 Intubate, then EEG 468 00:18:38,576 --> 00:18:41,077 to see if her brain is still seizing. 469 00:18:41,078 --> 00:18:42,621 I need first pass success. 470 00:18:42,622 --> 00:18:43,872 You and me both. 471 00:18:51,589 --> 00:18:54,132 Have you seen Dr. Al-Hashimi? 472 00:18:54,133 --> 00:18:55,342 No. 473 00:18:55,343 --> 00:18:57,761 Have you seen Dr. Al-Hashimi? 474 00:18:57,762 --> 00:18:59,512 Al-Hashimi? 475 00:18:59,513 --> 00:19:02,098 With how this day's going, she probably quit. 476 00:19:02,099 --> 00:19:05,352 Last I saw her, she was in Peds with Baby Jane Doe. 477 00:19:05,353 --> 00:19:07,771 Nope, I was just in there. 478 00:19:07,772 --> 00:19:08,772 Want me to page her? 479 00:19:08,773 --> 00:19:10,607 Uh, no, that's OK. 480 00:19:10,608 --> 00:19:11,901 I will find her. 481 00:19:16,489 --> 00:19:17,740 Hello. 482 00:19:20,534 --> 00:19:22,952 Hey, how did our people do at the deposition? 483 00:19:22,953 --> 00:19:25,497 Oh, well, Dr. Ellis is a pit bull. 484 00:19:25,498 --> 00:19:27,624 Dr. King is a petunia. 485 00:19:27,625 --> 00:19:28,958 They were pretty brutal with her. 486 00:19:28,959 --> 00:19:30,794 - She's sensitive. - Very. 487 00:19:30,795 --> 00:19:32,420 And I'm afraid it isn't over. 488 00:19:32,421 --> 00:19:33,588 They want to call her back. 489 00:19:33,589 --> 00:19:35,423 Oh, that's unfortunate. 490 00:19:35,424 --> 00:19:36,633 Maybe I should go with you 491 00:19:36,634 --> 00:19:38,301 to break that news to her, actually. 492 00:19:38,302 --> 00:19:40,136 - Misery loves company. - Um, hey, while I have you, 493 00:19:40,137 --> 00:19:42,931 can I pose a hypothetical to you? 494 00:19:42,932 --> 00:19:44,933 If a doctor suspects another physician 495 00:19:44,934 --> 00:19:47,185 of having a medical condition that could negatively 496 00:19:47,186 --> 00:19:49,312 affect the way they would treat a patient, 497 00:19:49,313 --> 00:19:51,022 where would disclosing that fall 498 00:19:51,023 --> 00:19:53,025 on the HIPAA violation scale? 499 00:19:54,026 --> 00:19:56,028 First, do no harm. 500 00:19:58,489 --> 00:20:00,908 Dr. King, do you have a second? 501 00:20:03,494 --> 00:20:06,288 Mm... 502 00:20:08,082 --> 00:20:10,166 Good lung sliding bilaterally. 503 00:20:10,167 --> 00:20:12,169 Fetal heart rate borderline at 98. 504 00:20:13,671 --> 00:20:15,839 - Roll her to the left again. That can help. 505 00:20:15,840 --> 00:20:19,008 One, two, three. 506 00:20:19,009 --> 00:20:22,512 OK, all set here. 507 00:20:22,513 --> 00:20:24,013 EEG monitor's good to go. 508 00:20:24,014 --> 00:20:25,765 That was fast. 509 00:20:25,766 --> 00:20:27,225 Still seizing while paralyzed. 510 00:20:27,226 --> 00:20:29,811 It's nonconvulsive status. 511 00:20:29,812 --> 00:20:31,187 What's she had so far? 512 00:20:31,188 --> 00:20:32,856 30 of diazepam, a full load of mag, 513 00:20:32,857 --> 00:20:34,023 Keppra, and propofol. 514 00:20:34,024 --> 00:20:35,400 Damn. What's your next step? 515 00:20:35,401 --> 00:20:36,651 Any ideas? 516 00:20:36,652 --> 00:20:38,862 Hmm? Nazely? 517 00:20:38,863 --> 00:20:40,822 Dilantin? Valproate? 518 00:20:40,823 --> 00:20:42,157 Mm, infusion is too long. 519 00:20:42,158 --> 00:20:43,700 So is onset of action. 520 00:20:43,701 --> 00:20:45,160 Push 100 of ketamine. 521 00:20:45,161 --> 00:20:47,370 That's had results with refractory status. 522 00:20:47,371 --> 00:20:49,664 - She also has HELLP syndrome... hemoglobin only 7, 523 00:20:49,665 --> 00:20:52,584 platelets down to 30. - Two units whole blood? 524 00:20:52,585 --> 00:20:55,044 O-neg is going up on the rapid infuser as we speak. 525 00:20:55,045 --> 00:20:57,088 Uh, put the AP pads on, just in case. 526 00:20:57,089 --> 00:20:59,883 And 10 of Decadron IV push for the inflammatory storm. 527 00:20:59,884 --> 00:21:02,051 - Fetal heart rate up to 104. - Hmm. 528 00:21:02,052 --> 00:21:03,386 - Little better. - Yeah. 529 00:21:03,387 --> 00:21:05,722 She should be upstairs with OB. 530 00:21:05,723 --> 00:21:09,476 She will be after we break this seizure. 531 00:21:09,477 --> 00:21:12,687 There was a delay in history-taking 532 00:21:12,688 --> 00:21:15,815 due to a malfunctioning VRI interpretation device. 533 00:21:15,816 --> 00:21:18,401 During this time, there was a normal CBC 534 00:21:18,402 --> 00:21:20,069 and comprehensive metabolic panel 535 00:21:20,070 --> 00:21:21,781 that came back from the lab. 536 00:21:23,240 --> 00:21:25,158 What's wrong with you, Malfeasance? 537 00:21:25,159 --> 00:21:28,161 I have to do another deposition. 538 00:21:28,162 --> 00:21:30,121 Oh, that sucks. 539 00:21:30,122 --> 00:21:32,082 You must have really messed up. 540 00:21:33,125 --> 00:21:34,876 Dude, I'm joking. 541 00:21:34,877 --> 00:21:35,919 You gotta lighten up. 542 00:21:35,920 --> 00:21:37,588 It's all just bullshit. 543 00:21:39,089 --> 00:21:41,549 God, you know what? Fuck all this. 544 00:21:41,550 --> 00:21:42,927 Do you want to go get a drink? 545 00:21:44,053 --> 00:21:45,094 Me? 546 00:21:45,095 --> 00:21:46,763 Yes, you. 547 00:21:46,764 --> 00:21:49,098 You... you do go out, don't you? 548 00:21:49,099 --> 00:21:51,267 Well, I'm usually with Becca. 549 00:21:51,268 --> 00:21:52,602 Well, bring her along. 550 00:21:52,603 --> 00:21:53,937 Can she drive? 551 00:21:53,938 --> 00:21:56,190 No, and she's with her boyfriend. 552 00:21:57,149 --> 00:21:58,609 OK, Becca. 553 00:22:00,277 --> 00:22:02,238 So it's just you and me. 554 00:22:04,365 --> 00:22:06,783 Do you like karaoke? 555 00:22:06,784 --> 00:22:08,660 You do karaoke? 556 00:22:08,661 --> 00:22:13,039 Well, what I do is more like primal scream therapy. 557 00:22:13,040 --> 00:22:14,791 There's nothing like getting wasted 558 00:22:14,792 --> 00:22:16,292 and just absolutely wailing 559 00:22:16,293 --> 00:22:19,045 to shake off a shit show like today. 560 00:22:19,046 --> 00:22:20,923 I could use a fun night. 561 00:22:22,299 --> 00:22:24,175 You and me both, sister. 562 00:22:24,176 --> 00:22:25,969 There's been no improvement. 563 00:22:25,970 --> 00:22:27,512 Still seizing on the EEG. 564 00:22:27,513 --> 00:22:29,222 Neurology has been called. - OK. Got it. 565 00:22:29,223 --> 00:22:31,182 OB says send her up. They have an OR ready. 566 00:22:31,183 --> 00:22:32,642 About time. 567 00:22:32,643 --> 00:22:34,352 Baby's been bradying down a bit more. 568 00:22:34,353 --> 00:22:35,937 This one looks like it took a turn for the worse. 569 00:22:35,938 --> 00:22:37,772 Eclampsia, refractory seizures, 570 00:22:37,773 --> 00:22:40,024 HELLP syndrome with anemia and thrombocytopenia. 571 00:22:40,025 --> 00:22:41,484 Yeah, about as bad as it gets. 572 00:22:41,485 --> 00:22:43,987 V-fib! 573 00:22:43,988 --> 00:22:45,989 Chest compressions, Nazely. 574 00:22:45,990 --> 00:22:48,783 Charge to 200. 575 00:22:48,784 --> 00:22:50,201 Prep the belly. 576 00:22:50,202 --> 00:22:51,536 Get a baby warmer. 577 00:22:51,537 --> 00:22:53,204 Call the NICU. Start a timer. 578 00:22:53,205 --> 00:22:55,039 Charged. 579 00:22:55,040 --> 00:22:56,332 Clear. 580 00:22:58,168 --> 00:22:59,502 Continue compressions. 581 00:22:59,503 --> 00:23:01,880 We'll check a rhythm in a minute. 582 00:23:01,881 --> 00:23:03,172 Gown up. 583 00:23:03,173 --> 00:23:04,507 Robby, it's you and me. 584 00:23:04,508 --> 00:23:06,509 Nazely, what's the four-minute rule? 585 00:23:06,510 --> 00:23:08,761 Uh, not sure. 586 00:23:08,762 --> 00:23:10,555 Pregnant patient with a viable fetus, 587 00:23:10,556 --> 00:23:12,181 you have four minutes after cardiac arrest 588 00:23:12,182 --> 00:23:14,475 to save the baby. - And the mom. 589 00:23:14,476 --> 00:23:16,769 We don't call it a postmortem C-section anymore. 590 00:23:16,770 --> 00:23:18,021 It's a resuscitative hysterotomy 591 00:23:18,022 --> 00:23:19,522 to try to save them both. 592 00:23:19,523 --> 00:23:20,857 But she doesn't want any medical intervention. 593 00:23:20,858 --> 00:23:22,233 That doesn't matter. 594 00:23:22,234 --> 00:23:23,735 Mom and baby are both dead if we do nothing. 595 00:23:23,736 --> 00:23:25,528 OK, charge to 200. 596 00:23:25,529 --> 00:23:27,573 One more rhythm check and then Abbot and I are gonna cut. 597 00:23:28,866 --> 00:23:31,451 Ellis, you and Crus on Mom resuscitation. 598 00:23:31,452 --> 00:23:32,911 Shen, you and Nazely take the baby. 599 00:23:32,912 --> 00:23:34,412 OK, hold compressions. 600 00:23:36,081 --> 00:23:37,707 Still V-fib. 601 00:23:37,708 --> 00:23:38,875 Clear. 602 00:23:38,876 --> 00:23:40,710 No change. 603 00:23:40,711 --> 00:23:42,754 Resume compression, amp of epi. - OK, showtime. 604 00:23:42,755 --> 00:23:44,422 We need to get this baby out right now. 605 00:23:44,423 --> 00:23:45,549 OK, take a break. 606 00:23:48,093 --> 00:23:51,596 OK, 10 blade. Good. 607 00:23:51,597 --> 00:23:53,848 First incision is from the xiphoid 608 00:23:53,849 --> 00:23:55,558 to the pubic symphysis 609 00:23:55,559 --> 00:23:58,561 through the skin to the linea alba. 610 00:23:58,562 --> 00:24:00,688 Units three and four on the infuser. 611 00:24:00,689 --> 00:24:03,566 Second incision goes through the peritoneum, 612 00:24:03,567 --> 00:24:05,360 exposing the uterus. 613 00:24:05,361 --> 00:24:07,070 Where do you need me? 614 00:24:07,071 --> 00:24:09,280 - You're with the baby. Nazely's got the bag mask. 615 00:24:09,281 --> 00:24:11,491 You're on suction. Stand by for intubation. 616 00:24:11,492 --> 00:24:12,992 Bladder retractors. 617 00:24:12,993 --> 00:24:14,661 Neonatal monitor and pulse ox ready to go. 618 00:24:14,662 --> 00:24:17,080 Ellis, gentle traction. 619 00:24:17,081 --> 00:24:19,165 OK, making a small vertical incision 620 00:24:19,166 --> 00:24:22,794 through the lower uterus so as not to cut the baby. 621 00:24:22,795 --> 00:24:24,587 Mm-hmm. 622 00:24:24,588 --> 00:24:26,130 - Got it? - Yep, I got it. 623 00:24:26,131 --> 00:24:27,590 - OK. - OK. 624 00:24:27,591 --> 00:24:30,718 Using scissors to extend superiorly. 625 00:24:32,179 --> 00:24:34,263 Ellis, hand retract the uterus with me. 626 00:24:34,264 --> 00:24:36,182 Amniotic fluid looks good. 627 00:24:37,810 --> 00:24:39,560 Give me some fundal pressure. 628 00:24:39,561 --> 00:24:40,979 Breech position. 629 00:24:43,399 --> 00:24:46,567 OK, baby's out. 630 00:24:46,568 --> 00:24:48,403 It's a girl. - All right. 631 00:24:50,072 --> 00:24:53,074 Milking the cord. 632 00:24:53,075 --> 00:24:55,576 Clamping. 633 00:24:55,577 --> 00:24:57,578 Cutting. 634 00:24:57,579 --> 00:24:59,163 - OK, blue and flaccid. Coming to you, Shen. 635 00:24:59,164 --> 00:25:00,289 You ready? - Yeah, you got her. 636 00:25:00,290 --> 00:25:02,333 I got it, yep. 637 00:25:02,334 --> 00:25:03,751 OK. 638 00:25:07,339 --> 00:25:09,799 Poor tone, no movement. 639 00:25:09,800 --> 00:25:12,468 Keep the blow-by closer. 640 00:25:12,469 --> 00:25:13,845 She's really blue. 641 00:25:13,846 --> 00:25:16,681 Some blue is normal, but not this much. 642 00:25:16,682 --> 00:25:18,641 - Do we need to intubate? - Not yet, no. 643 00:25:18,642 --> 00:25:21,352 They usually pink up with stimulation and blow-by. 644 00:25:21,353 --> 00:25:23,146 OK, removing the placenta. 645 00:25:23,147 --> 00:25:25,523 Sweeping to the left, trying to get it in one piece. 646 00:25:27,359 --> 00:25:28,651 - Looks intact. - Yeah. 647 00:25:28,652 --> 00:25:30,820 Nicely done. 648 00:25:30,821 --> 00:25:32,822 10 of IV Pitocin to contract the uterus. 649 00:25:32,823 --> 00:25:34,991 And lots of massage. 650 00:25:34,992 --> 00:25:36,659 Heart rate 76. 651 00:25:36,660 --> 00:25:38,244 Less than 100 means we need to bag. 652 00:25:38,245 --> 00:25:39,454 Suction first. 653 00:25:39,455 --> 00:25:40,621 OK. 654 00:25:42,541 --> 00:25:44,000 Hey, Jord, charge to 200. 655 00:25:44,001 --> 00:25:46,836 Stand by for the next rhythm check. 656 00:25:46,837 --> 00:25:48,546 She grimaced. Good sign. 657 00:25:48,547 --> 00:25:49,630 Bagging. 658 00:25:49,631 --> 00:25:51,632 Pulse ox 45%. 659 00:25:51,633 --> 00:25:53,217 Oh, I've never seen it that low. 660 00:25:53,218 --> 00:25:55,011 It's not as bad as it sounds. 661 00:25:55,012 --> 00:25:57,055 I'm more worried about the heart rate. 662 00:25:57,056 --> 00:25:59,223 McKay, get ready with an IO in case we need epi. 663 00:25:59,224 --> 00:26:00,683 OK. 664 00:26:02,519 --> 00:26:05,021 - Rhythm check. Hold compressions. 665 00:26:05,022 --> 00:26:06,064 Still V-fib. 666 00:26:06,065 --> 00:26:07,565 OK, shock it. - Clear. 667 00:26:08,567 --> 00:26:10,068 Resume compressions. 668 00:26:10,069 --> 00:26:11,569 Shen, how's she doing over there? 669 00:26:11,570 --> 00:26:12,862 Heart rate's up to 104. 670 00:26:12,863 --> 00:26:14,113 Uh, at one minute, 671 00:26:14,114 --> 00:26:16,449 she's 0 for color, 2 for heart rate, 672 00:26:16,450 --> 00:26:17,784 1 for reflex, tone, breathing. 673 00:26:17,785 --> 00:26:19,410 APGAR of 5. 674 00:26:19,411 --> 00:26:21,370 5 out of 10. Not great. 675 00:26:21,371 --> 00:26:23,039 Pulse ox 58%. 676 00:26:23,040 --> 00:26:24,957 - Intubation? - Uh, not yet. 677 00:26:24,958 --> 00:26:27,043 O2 sat in the 60s is normal at one minute. 678 00:26:27,044 --> 00:26:29,921 Her heart rate and pulse ox are trending higher. 679 00:26:29,922 --> 00:26:31,380 Let's keep doing what we're doing. 680 00:26:31,381 --> 00:26:32,882 A little tincture of time. 681 00:26:32,883 --> 00:26:34,550 Hold compressions. 682 00:26:34,551 --> 00:26:36,636 Looks like sinus. 683 00:26:36,637 --> 00:26:38,304 Can't feel a carotid. 684 00:26:38,305 --> 00:26:39,722 No. 685 00:26:39,723 --> 00:26:41,724 - Heart's barely pumping. It's PEA. 686 00:26:41,725 --> 00:26:43,017 Back on compressions. 687 00:26:43,018 --> 00:26:44,519 Transfuse two more units. 688 00:26:44,520 --> 00:26:45,895 She needs more red cells and platelets. 689 00:26:45,896 --> 00:26:47,605 Ongoing blood loss from the uterus. 690 00:26:47,606 --> 00:26:49,190 Give me all the lap pads we got, please. 691 00:26:56,615 --> 00:26:57,949 Yeah. 692 00:26:57,950 --> 00:26:59,075 OK, yeah, thanks. 693 00:26:59,076 --> 00:27:00,535 I appreciate it, honey. 694 00:27:00,536 --> 00:27:02,411 Oh, gotta go. 695 00:27:02,412 --> 00:27:03,746 Whoa, whoa, whoa! 696 00:27:03,747 --> 00:27:04,747 Hold up. 697 00:27:04,748 --> 00:27:06,249 Is there a problem here? 698 00:27:06,250 --> 00:27:08,376 Yeah, you two aren't leaving empty-handed. 699 00:27:08,377 --> 00:27:09,419 What? 700 00:27:10,587 --> 00:27:12,131 One of you follow me. 701 00:27:13,799 --> 00:27:15,633 Rape kits are supposed to be picked up 702 00:27:15,634 --> 00:27:18,594 within 72 hours of collecting 'em. 703 00:27:18,595 --> 00:27:21,305 This one's been here for over two weeks. 704 00:27:21,306 --> 00:27:23,015 That's not on us. 705 00:27:23,016 --> 00:27:24,600 Well, it's on somebody. 706 00:27:24,601 --> 00:27:26,102 It's not bad enough these poor women 707 00:27:26,103 --> 00:27:27,687 go through an assault, plus the indignity 708 00:27:27,688 --> 00:27:29,355 of the whole collection process, 709 00:27:29,356 --> 00:27:31,107 but nobody from the police department 710 00:27:31,108 --> 00:27:33,693 even has the human decency to come get these things? 711 00:27:33,694 --> 00:27:34,819 Like nobody there gives a flying fuck? 712 00:27:34,820 --> 00:27:36,445 OK, we got it. 713 00:27:36,446 --> 00:27:38,364 We'll see that these get put into evidence properly. 714 00:27:38,365 --> 00:27:39,575 Thank you. 715 00:27:41,702 --> 00:27:42,953 How hard was that? 716 00:27:46,790 --> 00:27:47,957 Units five and six are in. 717 00:27:47,958 --> 00:27:49,417 Down to a slow ooze here. 718 00:27:49,418 --> 00:27:50,793 Hold compressions. 719 00:27:54,339 --> 00:27:56,424 Looks like sinus. 720 00:27:56,425 --> 00:27:57,800 And I got a weak carotid. - OK. 721 00:27:57,801 --> 00:27:59,302 Cycle the BP. 722 00:27:59,303 --> 00:28:01,429 Better filling, better squeeze. 723 00:28:01,430 --> 00:28:03,014 No seizure activity on the EEG. 724 00:28:03,015 --> 00:28:04,515 - That's progress. That's progress. 725 00:28:04,516 --> 00:28:05,600 We're at five minutes. 726 00:28:05,601 --> 00:28:07,518 Uh, heart rate is 132. 727 00:28:07,519 --> 00:28:09,187 Uh, pulse ox 79%. 728 00:28:09,188 --> 00:28:11,105 Nazely, the APGAR? 729 00:28:11,106 --> 00:28:12,648 Um... 730 00:28:12,649 --> 00:28:14,817 1 off for color, 1 off for tone, 731 00:28:14,818 --> 00:28:17,361 1 off for respiration with hypoxia, total of 7. 732 00:28:17,362 --> 00:28:18,738 Respiration score is for observed breathing, 733 00:28:18,739 --> 00:28:20,156 not pulse ox. 734 00:28:20,157 --> 00:28:21,699 Sat of 80 is normal at five minutes. 735 00:28:21,700 --> 00:28:23,159 With no crying, she still gets 1 off. 736 00:28:23,160 --> 00:28:24,203 Yeah. 737 00:28:26,580 --> 00:28:28,080 Ah! 738 00:28:28,081 --> 00:28:30,041 She just scored the winning point! 739 00:28:30,042 --> 00:28:32,377 APGAR of 8 is pretty normal. 740 00:28:35,672 --> 00:28:38,007 Holy shit. What did I miss? 741 00:28:38,008 --> 00:28:40,718 Eclampsia with status, HELLP syndrome, 742 00:28:40,719 --> 00:28:43,888 cardiac arrest, resuscitative hysterotomy. 743 00:28:43,889 --> 00:28:46,224 I was in the OR with a septic twin C-section. 744 00:28:46,225 --> 00:28:47,516 Got your text 12 minutes ago. 745 00:28:47,517 --> 00:28:49,018 Shit happens fast down here. 746 00:28:49,019 --> 00:28:51,562 Resuscitative hysterotomy in 36 seconds. 747 00:28:51,563 --> 00:28:53,856 - Impressive. - BP's 102/64. 748 00:28:53,857 --> 00:28:55,066 Hemoglobin is up to 9. 749 00:28:55,067 --> 00:28:57,151 That'll do. 750 00:28:57,152 --> 00:28:58,527 NICU's sending a team down. 751 00:28:58,528 --> 00:29:00,863 - We can take Mom. You guys are rock stars. 752 00:29:00,864 --> 00:29:03,367 We like to be referred to as crawlers of the night. 753 00:29:06,536 --> 00:29:07,912 If you're not careful, 754 00:29:07,913 --> 00:29:09,497 you're gonna get stuck here all night. 755 00:29:09,498 --> 00:29:11,999 Nah, Henny said she'd be here in 30 minutes. 756 00:29:12,000 --> 00:29:14,543 How's Mom and baby? - Whew. 757 00:29:14,544 --> 00:29:16,545 They're both gonna go upstairs. 758 00:29:16,546 --> 00:29:18,714 Good. You leaving now? 759 00:29:18,715 --> 00:29:20,383 Yeah, pretty soon. 760 00:29:20,384 --> 00:29:23,469 I gotta find Whitaker, I gotta find Al-Hashimi, 761 00:29:23,470 --> 00:29:25,721 and I gotta find Langdon before I leave. 762 00:29:25,722 --> 00:29:28,225 - You missed Langdon. He just checked out. 763 00:29:30,644 --> 00:29:32,688 Shit. 764 00:29:56,128 --> 00:29:57,545 Can I help you? 765 00:29:57,546 --> 00:30:01,090 Uh, yeah, I'm Dr. Langdon from the ED. 766 00:30:01,091 --> 00:30:04,051 I was just, uh, checking in on the status 767 00:30:04,052 --> 00:30:06,721 of someone we sent up here earlier. 768 00:30:06,722 --> 00:30:09,307 Patient's name is, uh, Cohen. 769 00:30:09,308 --> 00:30:10,599 Let me check. 770 00:30:10,600 --> 00:30:11,892 What was she up here for? 771 00:30:11,893 --> 00:30:13,728 Uh, clean out a nasty neck fash. 772 00:30:16,398 --> 00:30:18,065 Oh, yeah, she's good. 773 00:30:18,066 --> 00:30:21,152 She's in 4202, recovering nicely. 774 00:30:21,153 --> 00:30:23,738 Great, great. 775 00:30:23,739 --> 00:30:26,657 I mean, she was... she was in not-great shape earlier. 776 00:30:26,658 --> 00:30:28,784 It was a good catch. 777 00:30:28,785 --> 00:30:32,788 Saved her life, even if we couldn't save her leg. 778 00:30:32,789 --> 00:30:35,791 Uh, was it below the knee? 779 00:30:35,792 --> 00:30:37,627 Unfortunately, it was above. 780 00:30:54,519 --> 00:30:57,646 My cell phone and the building manager's. 781 00:30:57,647 --> 00:30:59,607 He can help if there's any emergencies. 782 00:30:59,608 --> 00:31:01,692 Yeah, what kind of emergencies? 783 00:31:01,693 --> 00:31:03,110 Whatever. 784 00:31:03,111 --> 00:31:04,111 And follow up with Duke 785 00:31:04,112 --> 00:31:05,112 in a couple days, yeah? 786 00:31:05,113 --> 00:31:06,155 Yeah. 787 00:31:06,156 --> 00:31:08,532 You, um... you sure about this? 788 00:31:08,533 --> 00:31:10,368 I trust you, Whitaker. 789 00:31:10,369 --> 00:31:12,161 Great. 790 00:31:12,162 --> 00:31:13,621 Any questions? 791 00:31:13,622 --> 00:31:16,665 Uh, when are you back, exactly? 792 00:31:16,666 --> 00:31:18,167 You know, I'll text you. 793 00:31:18,168 --> 00:31:20,003 I'm trying to keep my dates kind of fluid. 794 00:31:21,380 --> 00:31:23,506 I think this is your ride. 795 00:31:23,507 --> 00:31:25,549 Yeah, uh, yes. 796 00:31:25,550 --> 00:31:28,094 I... I promise I'll check in on your house tomorrow. 797 00:31:28,095 --> 00:31:29,596 Sounds good. 798 00:31:30,722 --> 00:31:32,431 - Hey. - Hey. 799 00:31:32,432 --> 00:31:35,518 OK. Hey, Theo. 800 00:31:35,519 --> 00:31:37,353 You're up late, huh? 801 00:31:37,354 --> 00:31:40,023 What you got there? 802 00:31:41,566 --> 00:31:44,026 OK. 803 00:31:44,027 --> 00:31:45,694 He's been fussy all day. 804 00:31:45,695 --> 00:31:47,863 I think he's got another tooth coming in. 805 00:31:47,864 --> 00:31:49,532 Aw, right on, big guy. 806 00:31:49,533 --> 00:31:52,952 Are you ready to get funky? 807 00:31:52,953 --> 00:31:54,745 Yeah? 808 00:32:13,849 --> 00:32:15,224 Hey. 809 00:32:15,225 --> 00:32:17,227 Any luck picking an elective? 810 00:32:18,687 --> 00:32:21,522 Don't know. 811 00:32:21,523 --> 00:32:23,733 Maybe I will go into geriatrics. 812 00:32:25,235 --> 00:32:27,195 It's a smart choice. 813 00:32:30,907 --> 00:32:32,575 I know that life can be challenging, 814 00:32:32,576 --> 00:32:33,909 especially when it doesn't work out 815 00:32:33,910 --> 00:32:35,244 the way you expected. 816 00:32:35,245 --> 00:32:36,455 OK. 817 00:32:41,293 --> 00:32:42,751 I thought I would be married 818 00:32:42,752 --> 00:32:44,838 with two kids in college by now. 819 00:32:46,131 --> 00:32:48,924 Maybe have some property with a pond, 820 00:32:48,925 --> 00:32:51,135 and we could play hockey on it in the wintertime. 821 00:32:53,263 --> 00:32:54,472 And yet look at me now. 822 00:32:54,473 --> 00:32:58,602 No wife, no kids, no pond. 823 00:33:02,063 --> 00:33:04,273 It's never too late. 824 00:33:04,274 --> 00:33:06,775 Do you really believe that? 825 00:33:06,776 --> 00:33:08,110 Yeah. 826 00:33:08,111 --> 00:33:09,820 Only for me, or for you too? 827 00:33:09,821 --> 00:33:11,447 OK. 828 00:33:11,448 --> 00:33:13,033 I see what you did there. 829 00:33:14,242 --> 00:33:16,952 Was that true, or something you just said to make a point? 830 00:33:23,084 --> 00:33:25,837 Have you worked things out with your mom? 831 00:33:28,048 --> 00:33:29,633 We're not talking. 832 00:33:32,886 --> 00:33:37,224 I am sorry that, um, I let it distract me. 833 00:33:38,725 --> 00:33:40,392 She was treating me like a child, 834 00:33:40,393 --> 00:33:41,811 and I was letting her. 835 00:33:46,983 --> 00:33:48,485 Have a good trip. 836 00:33:49,653 --> 00:33:50,820 Please be safe. 837 00:33:52,739 --> 00:33:55,157 We need you here. 838 00:33:55,158 --> 00:33:57,327 Even if you can be a dick sometimes. 839 00:34:00,163 --> 00:34:01,373 Good luck. 840 00:34:02,707 --> 00:34:04,084 You too. 841 00:34:13,176 --> 00:34:15,344 Hey, I didn't think you were still here. 842 00:34:15,345 --> 00:34:17,764 I was just talking to the neurologist on call. 843 00:34:19,182 --> 00:34:20,975 And? 844 00:34:20,976 --> 00:34:24,311 We had a nice chat. 845 00:34:24,312 --> 00:34:26,981 She agrees I can work with double coverage. 846 00:34:26,982 --> 00:34:29,358 That's not her call to make. 847 00:34:29,359 --> 00:34:30,734 You can't do anything critical 848 00:34:30,735 --> 00:34:32,236 where a five-second lapse in consciousness 849 00:34:32,237 --> 00:34:34,030 could potentially kill a patient. 850 00:34:35,865 --> 00:34:37,075 I agree. 851 00:34:40,537 --> 00:34:41,829 But 90% of our patients 852 00:34:41,830 --> 00:34:43,122 don't require critical procedures. 853 00:34:43,123 --> 00:34:45,291 And the ones that do? 854 00:34:45,292 --> 00:34:47,710 Will be handled by whomever is working with me. 855 00:34:47,711 --> 00:34:49,587 Unless they're also tied up with a critical patient. 856 00:34:49,588 --> 00:34:50,963 What if it's a double or triple trauma? 857 00:34:50,964 --> 00:34:52,965 - Robby, I can handle it. - No, you can't. 858 00:34:52,966 --> 00:34:54,383 And I can't let you. 859 00:34:54,384 --> 00:34:55,801 I am fully capable of handling... 860 00:34:55,802 --> 00:34:57,386 No, you are not fully capable, 861 00:34:57,387 --> 00:34:58,847 and you know it. 862 00:35:02,559 --> 00:35:04,059 What do you want from me? 863 00:35:04,060 --> 00:35:05,185 I want what's best for this department... 864 00:35:05,186 --> 00:35:06,604 patients and staff. 865 00:35:06,605 --> 00:35:08,897 Best-case scenario, you get a handle on this, 866 00:35:08,898 --> 00:35:10,441 you're seizure-free for six months, 867 00:35:10,442 --> 00:35:11,692 you get your driver's license back, 868 00:35:11,693 --> 00:35:12,943 you are cleared to work. 869 00:35:12,944 --> 00:35:15,279 I am cleared for my driver's license. 870 00:35:15,280 --> 00:35:17,448 You shouldn't be driving at all like this. 871 00:35:17,449 --> 00:35:19,908 If you were a patient, we would have to report you. 872 00:35:19,909 --> 00:35:21,535 I am not your fucking patient. 873 00:35:21,536 --> 00:35:22,620 No, but I cannot let you work 874 00:35:22,621 --> 00:35:24,038 in my emergency department 875 00:35:24,039 --> 00:35:25,873 until you're fully capable of doing so. 876 00:35:25,874 --> 00:35:27,583 That is not your fucking call! 877 00:35:27,584 --> 00:35:29,084 You're fucking-A right, that's my call! 878 00:35:29,085 --> 00:35:31,086 I'm trying to protect you and my patients, 879 00:35:31,087 --> 00:35:32,421 and you know I'm right about this. 880 00:35:32,422 --> 00:35:34,131 Oh, "my department," "my patients." 881 00:35:34,132 --> 00:35:35,633 All you fucking think about is yourself! 882 00:35:35,634 --> 00:35:36,925 Do you hear yourself? 883 00:35:36,926 --> 00:35:37,968 You didn't rat out Langdon 884 00:35:37,969 --> 00:35:39,511 for stealing fucking drugs. 885 00:35:39,512 --> 00:35:41,096 No, but I kicked him out of this department 886 00:35:41,097 --> 00:35:43,015 until he got the appropriate help that he needs, 887 00:35:43,016 --> 00:35:44,933 and the same goes for you. 888 00:35:44,934 --> 00:35:46,518 You've got until Monday to let the administration know, 889 00:35:46,519 --> 00:35:47,687 or I will. 890 00:35:54,778 --> 00:35:56,612 I am finished. 891 00:35:56,613 --> 00:35:58,447 Last chart. 892 00:35:59,532 --> 00:36:01,033 - You and me both. - Really? 893 00:36:01,034 --> 00:36:02,618 - Is this a thing? I finished a while ago. 894 00:36:04,079 --> 00:36:05,872 I never want to hear that fucking bell again. 895 00:36:10,460 --> 00:36:11,960 - Where's Dana? - Not sure. 896 00:36:11,961 --> 00:36:13,462 A bunch of day shift just headed to the roof 897 00:36:13,463 --> 00:36:14,672 to watch the fireworks. 898 00:36:14,673 --> 00:36:15,964 You want me to call her? 899 00:36:15,965 --> 00:36:17,467 No, that's OK. 900 00:36:19,344 --> 00:36:20,844 Yo. 901 00:36:20,845 --> 00:36:22,555 Thanks for your help in there. 902 00:36:24,474 --> 00:36:26,685 Almost out? - Yep, just about. 903 00:36:28,978 --> 00:36:30,688 Is this where you try to talk me out of going? 904 00:36:30,689 --> 00:36:31,689 Me? 905 00:36:31,690 --> 00:36:33,482 No, not a chance. 906 00:36:33,483 --> 00:36:34,692 Why, are you having second thoughts? 907 00:36:34,693 --> 00:36:35,693 - Nope. - No? 908 00:36:35,694 --> 00:36:37,319 Nope. 909 00:36:37,320 --> 00:36:39,321 Don't have to convince me. 910 00:36:39,322 --> 00:36:40,656 I mean, it is a little strange the only place 911 00:36:40,657 --> 00:36:42,199 you talked about going is somewhere 912 00:36:42,200 --> 00:36:43,492 they used to drive buffalo off a cliff to die. 913 00:36:43,493 --> 00:36:44,827 - Here it comes. - I looked it up, 914 00:36:44,828 --> 00:36:46,495 and as far as summer vacations go, 915 00:36:46,496 --> 00:36:48,247 it's not exactly a holiday hotspot. 916 00:36:48,248 --> 00:36:51,375 I mean, what's in the fucking gift shop, man? 917 00:36:51,376 --> 00:36:52,584 It's just one place I'm going. 918 00:36:52,585 --> 00:36:54,169 As long as it's not the last. 919 00:36:54,170 --> 00:36:56,338 Don't be pulling a "Thelma and Louise" out there. 920 00:36:56,339 --> 00:36:58,549 I am minutes from taking a three-month vacation. 921 00:36:58,550 --> 00:37:00,092 When's the last time you took any time off, Jack? 922 00:37:00,093 --> 00:37:01,970 Yeah, but I've dealt with my demons. 923 00:37:03,263 --> 00:37:05,889 It's a process. 924 00:37:05,890 --> 00:37:08,642 You want to know why I never killed myself? 925 00:37:08,643 --> 00:37:12,020 After what I saw, lived through? 926 00:37:12,021 --> 00:37:15,608 Losing my leg, losing my wife? 927 00:37:16,860 --> 00:37:19,027 Because it comes for all of us, man. 928 00:37:19,028 --> 00:37:20,237 You and I know it more than most. 929 00:37:20,238 --> 00:37:21,989 We see it every shift, 930 00:37:21,990 --> 00:37:24,117 but we can't let ourselves succumb to it. 931 00:37:25,201 --> 00:37:27,036 Yes, life can suck. 932 00:37:28,371 --> 00:37:30,372 It can be unbearable 933 00:37:30,373 --> 00:37:32,207 and... and brutal 934 00:37:32,208 --> 00:37:34,918 and ugly and heartbreaking. 935 00:37:34,919 --> 00:37:39,089 But it's also beautiful... and hilarious. 936 00:37:39,090 --> 00:37:41,342 And that woman today... 937 00:37:44,387 --> 00:37:45,971 Her baby, they'd both be in the morgue 938 00:37:45,972 --> 00:37:47,890 if you hadn't been here. 939 00:37:47,891 --> 00:37:49,725 That's us. That's you and me. 940 00:37:49,726 --> 00:37:52,728 That's what we're here for. 941 00:37:52,729 --> 00:37:55,314 The most important things I've ever done in my life 942 00:37:55,315 --> 00:37:57,983 have been in this hospital. 943 00:37:57,984 --> 00:38:00,444 Nothing will ever matter more than what I've done 944 00:38:00,445 --> 00:38:03,406 in this hospital, but it is killing me. 945 00:38:05,033 --> 00:38:07,159 You know how they say that a part of you dies 946 00:38:07,160 --> 00:38:08,786 when you lose someone you love? 947 00:38:08,787 --> 00:38:11,205 I'm not convinced that a part of you doesn't die 948 00:38:11,206 --> 00:38:13,373 every time you see a fellow human pass. 949 00:38:13,374 --> 00:38:17,878 And I've seen so many people die 950 00:38:17,879 --> 00:38:20,924 that I feel like it's leaching something from my soul. 951 00:38:22,592 --> 00:38:24,594 Go on a cruise, man. 952 00:38:26,971 --> 00:38:29,807 Knock off this helmetless motorcycle shit. 953 00:38:29,808 --> 00:38:31,892 Yeah, people talk. 954 00:38:31,893 --> 00:38:33,268 That's death-wish behavior. 955 00:38:33,269 --> 00:38:34,728 I'm tired of being a role model. 956 00:38:34,729 --> 00:38:36,647 I'm tired of feeling like you can't get ahead. 957 00:38:36,648 --> 00:38:38,440 I'm tired of feeling like I'm drowning every day. 958 00:38:38,441 --> 00:38:39,691 I'm tired of all of it. 959 00:38:39,692 --> 00:38:40,943 You need to get away for a while, 960 00:38:40,944 --> 00:38:42,319 and you need to get some help. 961 00:38:42,320 --> 00:38:45,782 You need this place as much as it needs you. 962 00:38:50,161 --> 00:38:52,287 Am I fucked up? 963 00:38:52,288 --> 00:38:53,873 100%. 964 00:38:57,377 --> 00:38:59,628 But nobody works here as long as you and me 965 00:38:59,629 --> 00:39:00,796 and doesn't get screwed up. 966 00:39:00,797 --> 00:39:03,966 You... you gotta find somebody 967 00:39:03,967 --> 00:39:06,677 to help you dance through the darkness. 968 00:39:10,682 --> 00:39:12,392 Did you just make that up? 969 00:39:14,602 --> 00:39:15,978 Maybe it's a song lyric. 970 00:39:15,979 --> 00:39:17,771 - I don't... maybe my therapist said it. 971 00:39:17,772 --> 00:39:19,773 I don't know. 972 00:39:22,485 --> 00:39:23,944 Some dude just pulled up. 973 00:39:23,945 --> 00:39:25,989 Looks like he blew half his face off. 974 00:39:28,825 --> 00:39:30,660 How can you not love this place? 975 00:39:33,037 --> 00:39:36,498 Look, don't make me look stupid. 976 00:39:36,499 --> 00:39:38,918 You come back to us in one piece. 977 00:39:42,255 --> 00:39:43,714 I'm still your emergency contact, 978 00:39:43,715 --> 00:39:46,092 and I do not want to be contacted. 979 00:39:48,428 --> 00:39:49,678 All right, night crawlers, 980 00:39:49,679 --> 00:39:50,888 what the hell's going on out here? 981 00:39:56,436 --> 00:39:57,769 25-year-old man... 982 00:39:57,770 --> 00:39:59,062 history, 983 00:39:59,063 --> 00:40:00,397 no meds, no allergies. 984 00:41:26,776 --> 00:41:28,735 More than 2,000 years ago, 985 00:41:28,736 --> 00:41:30,904 the Chinese were throwing bamboo into fire 986 00:41:30,905 --> 00:41:32,906 to make explosions. 987 00:41:32,907 --> 00:41:34,449 They went on to invent gunpowder. 988 00:41:34,450 --> 00:41:36,619 And boom! The rest is history. 989 00:41:38,246 --> 00:41:41,331 They had chemicals to get the different colors, you know? 990 00:41:41,332 --> 00:41:44,126 Sodium gives you yellow, strontium gives you red, 991 00:41:44,127 --> 00:41:47,170 and barium is green. 992 00:41:47,171 --> 00:41:50,757 Who knew chemistry could be so damn pretty? 993 00:42:59,702 --> 00:43:01,453 - Hey. - Hey. 994 00:43:01,454 --> 00:43:03,872 - I thought you'd left already. - On my way out. 995 00:43:03,873 --> 00:43:07,876 Hey, I'm sorry that I didn't find the time today 996 00:43:07,877 --> 00:43:09,044 to have that conversation. 997 00:43:09,045 --> 00:43:10,378 Yeah, that's all right. 998 00:43:10,379 --> 00:43:12,255 Seems like you didn't really want to. 999 00:43:12,256 --> 00:43:14,383 I didn't. 1000 00:43:16,552 --> 00:43:17,969 Did you? 1001 00:43:17,970 --> 00:43:20,347 Uh... 1002 00:43:20,348 --> 00:43:23,100 yeah, actually. 1003 00:43:23,101 --> 00:43:26,228 Look, I'm doing the work. 1004 00:43:26,229 --> 00:43:28,688 I'm... I've been sober 186 days. 1005 00:43:28,689 --> 00:43:30,899 I'm going to meetings. I'm taking the drug tests. 1006 00:43:30,900 --> 00:43:33,152 - That's good. - And you're still riding me. 1007 00:43:36,197 --> 00:43:39,574 What would have happened if I'd paralyzed that guy? 1008 00:43:39,575 --> 00:43:41,243 I don't know. 1009 00:43:41,244 --> 00:43:42,869 What would have happened if I hadn't been here today? 1010 00:43:42,870 --> 00:43:44,538 You'd still be questioning yourself. 1011 00:43:44,539 --> 00:43:46,289 Now you know you can do it. You're welcome. 1012 00:43:46,290 --> 00:43:47,916 - Oh, so that's... that's how you teach now? 1013 00:43:47,917 --> 00:43:49,876 Sometimes. 1014 00:43:49,877 --> 00:43:52,170 You know who I saw in rehab? 1015 00:43:52,171 --> 00:43:54,840 I saw a bunch of guys just like you. 1016 00:43:54,841 --> 00:43:56,133 The only difference is, 1017 00:43:56,134 --> 00:43:59,261 they've accepted that they need help. 1018 00:43:59,262 --> 00:44:01,304 I think you're afraid to admit that 1019 00:44:01,305 --> 00:44:03,974 the mighty Dr. Robinavitch isn't perfect. 1020 00:44:03,975 --> 00:44:06,017 Oh, I never claimed to be perfect. 1021 00:44:06,018 --> 00:44:09,271 No, but you expect it of yourself, 1022 00:44:09,272 --> 00:44:11,773 and it's not realistic, man. 1023 00:44:11,774 --> 00:44:14,109 How can any of us live up to your standards 1024 00:44:14,110 --> 00:44:15,820 if you can't even do it? 1025 00:44:17,196 --> 00:44:20,157 You need help, Robby. 1026 00:44:20,158 --> 00:44:21,950 You need help. 1027 00:44:24,787 --> 00:44:25,955 Finished? 1028 00:44:27,123 --> 00:44:29,499 You don't gotta be honest with me, man. 1029 00:44:29,500 --> 00:44:31,585 At least be honest with yourself. 1030 00:44:47,018 --> 00:44:49,436 She is due for a new bottle. 1031 00:44:49,437 --> 00:44:52,190 I was hoping to get her some formula before I clocked out. 1032 00:44:53,858 --> 00:44:56,234 I'll stay with her. 1033 00:44:56,235 --> 00:44:57,486 Thanks. 1034 00:44:59,739 --> 00:45:01,990 Why are you... will you hit those lights on your way out? 1035 00:45:01,991 --> 00:45:04,993 - Yep. - Why are you crying? 1036 00:45:04,994 --> 00:45:07,579 Why are you crying, little one? 1037 00:45:07,580 --> 00:45:10,165 You're OK. You're safe. 1038 00:45:10,166 --> 00:45:12,500 Yeah, you're not alone. 1039 00:45:19,342 --> 00:45:21,885 Yeah, you're OK. 1040 00:45:21,886 --> 00:45:25,180 Do you need to be swaddled again? 1041 00:45:25,181 --> 00:45:26,973 Is that it? 1042 00:45:26,974 --> 00:45:28,892 I can do that. Look. 1043 00:45:28,893 --> 00:45:31,519 Aww. 1044 00:45:31,520 --> 00:45:35,232 I wish somebody would swaddle me. 1045 00:45:35,233 --> 00:45:37,692 Yes, I do. 1046 00:45:37,693 --> 00:45:39,736 Oh. 1047 00:45:42,156 --> 00:45:45,200 You got off to kind of a rough start, 1048 00:45:45,201 --> 00:45:48,328 didn't you, little one? 1049 00:45:48,329 --> 00:45:50,413 Yeah, you did. 1050 00:45:52,708 --> 00:45:55,377 Well, that makes two of us. 1051 00:45:58,965 --> 00:46:01,049 I got abandoned too. 1052 00:46:04,387 --> 00:46:06,721 When I was eight. 1053 00:46:10,268 --> 00:46:15,730 But I got through all of that, and so will you. 1054 00:46:15,731 --> 00:46:19,734 I got a good feeling that you're gonna be just fine. 1055 00:46:19,735 --> 00:46:23,238 Everything's gonna be just fine. 1056 00:46:23,239 --> 00:46:26,199 You got so many wonderful things to see 1057 00:46:26,200 --> 00:46:29,411 and so many people to love ahead of you. 1058 00:46:31,580 --> 00:46:36,584 So many wonderful things to see, 1059 00:46:36,585 --> 00:46:38,753 people to love ahead of you. 1060 00:46:44,260 --> 00:46:47,220 Shh. 1061 00:46:47,221 --> 00:46:51,975 It's OK. It's gonna be OK. 1062 00:46:51,976 --> 00:46:54,561 It's OK.