1 00:00:03,267 --> 00:00:04,938 Damn it! 2 00:00:15,671 --> 00:00:17,014 What's going on? 3 00:00:17,039 --> 00:00:19,503 I put too much damn salt on the rub. 4 00:00:19,528 --> 00:00:21,056 I got to get it out. 5 00:00:21,419 --> 00:00:22,886 Honey, it's 4:30 in the morning. 6 00:00:22,911 --> 00:00:24,543 Yeah, and if the meat loses its juices, 7 00:00:24,568 --> 00:00:26,947 it's gonna be all dry and burnt. 8 00:00:28,764 --> 00:00:30,821 Sweetie, I... I... 9 00:00:31,233 --> 00:00:33,660 I feel like this might be one of those anxiety attacks 10 00:00:33,685 --> 00:00:35,333 that Dr. Reese said you might have. 11 00:00:35,358 --> 00:00:36,803 It's not because of my condition. 12 00:00:36,828 --> 00:00:38,303 It's because I put too much damn salt... 13 00:00:38,328 --> 00:00:39,912 Whoa! Okay, okay, okay. 14 00:00:48,197 --> 00:00:49,660 Let me help you. 15 00:00:52,040 --> 00:00:54,937 Why don't you start measuring out another rub? 16 00:01:06,340 --> 00:01:08,074 Excuse me. Yeah... ah, whoa. 17 00:01:08,099 --> 00:01:09,314 Excuse me. 18 00:01:09,339 --> 00:01:10,747 Okay. Excuse me. 19 00:01:10,772 --> 00:01:11,806 Dr. Rhodes, you're late. 20 00:01:11,831 --> 00:01:13,532 I know. I am sorry. 21 00:01:13,557 --> 00:01:14,786 I understand you're under additional stress 22 00:01:14,811 --> 00:01:17,050 at home lately, but please try not to make this a habit. 23 00:01:17,075 --> 00:01:19,101 I assure you I will not. 24 00:01:19,458 --> 00:01:21,159 Dr. Rhodes, your CT patient's here. 25 00:01:21,184 --> 00:01:22,601 You're going to 1. 26 00:01:24,460 --> 00:01:26,597 Jerry Willis, 54, called 911 27 00:01:26,622 --> 00:01:28,250 with shortness of breath and tachycardia. 28 00:01:28,416 --> 00:01:30,899 BP 110 over 60, rate 120, 29 00:01:30,924 --> 00:01:33,130 satting at 89% on five liters 0-2. 30 00:01:33,427 --> 00:01:35,411 Mr. Willis, what are you doing back here so soon? 31 00:01:35,436 --> 00:01:36,521 I've been having trouble breathing. 32 00:01:36,546 --> 00:01:38,791 It started a few days after I left. 33 00:01:38,816 --> 00:01:40,549 What trouble are we talking about? 34 00:01:40,574 --> 00:01:43,157 Coughing. He's wheezing. It's been getting worse. 35 00:01:43,182 --> 00:01:45,497 All right, let's move him on my count. 36 00:01:45,864 --> 00:01:47,290 All right. 37 00:01:47,315 --> 00:01:49,387 And one, two, three. 38 00:01:54,825 --> 00:01:56,939 I replaced his aortic valve two weeks ago. 39 00:01:56,964 --> 00:01:58,150 Any intraoperative difficulties? 40 00:01:58,175 --> 00:01:59,976 - None. - Cardiac comorbidities? 41 00:02:00,001 --> 00:02:01,745 Nothing notable, no. 42 00:02:02,244 --> 00:02:04,255 Austin Flint murmur. The valve is leaking. 43 00:02:04,280 --> 00:02:05,468 That's impossible. 44 00:02:05,493 --> 00:02:08,286 Maybe you're hearing tricuspid stenosis 45 00:02:08,311 --> 00:02:09,883 or a subclinical MI. 46 00:02:09,908 --> 00:02:12,131 Is it possible you misoriented the valve? 47 00:02:12,156 --> 00:02:14,208 Obstructed one of the leaflets? 48 00:02:14,233 --> 00:02:16,681 No. I remember it very clearly. 49 00:02:17,056 --> 00:02:18,903 Surgery went off without a hitch. 50 00:02:26,443 --> 00:02:28,164 - We should order an echo? - What? 51 00:02:28,189 --> 00:02:30,423 What's wrong? Aortic insufficiency. 52 00:02:30,448 --> 00:02:32,141 The valve is definitely leaking. 53 00:02:32,166 --> 00:02:33,918 But you just replaced it. How could it leak? 54 00:02:33,943 --> 00:02:35,572 I don't know. It doesn't make any sense. 55 00:02:35,597 --> 00:02:36,947 I... 56 00:02:38,040 --> 00:02:39,803 Maybe Dr. Rhodes made a mistake. 57 00:02:47,724 --> 00:02:53,594 - Synced and corrected by martythecrazy - - www.addic7ed.com - 58 00:02:56,005 --> 00:02:57,583 - Morning. - Good morning. 59 00:02:57,608 --> 00:02:58,813 Hi. 60 00:02:59,126 --> 00:03:02,951 Whoa. Is that what you're planning on wearing tonight? 61 00:03:02,976 --> 00:03:04,883 It's a brand-new Chiara Boni. 62 00:03:05,378 --> 00:03:07,831 I mean... nah, I mean it's probably fine. 63 00:03:08,318 --> 00:03:09,911 I mean if you think it's fancy enough 64 00:03:09,936 --> 00:03:11,307 for the corner table at Alinea. 65 00:03:11,332 --> 00:03:12,402 Are you kidding? 66 00:03:12,427 --> 00:03:14,681 That's like the toughest reservation in town. 67 00:03:14,706 --> 00:03:16,571 "GQ" says 97% of relationships 68 00:03:16,596 --> 00:03:17,823 are decided on the first date. 69 00:03:17,848 --> 00:03:20,500 Oh, now you're getting your dating advice from "GQ"? 70 00:03:20,525 --> 00:03:22,006 Natalie, these are hard numbers. 71 00:03:22,031 --> 00:03:23,766 - Mm. - I'm just citing the research. 72 00:03:27,470 --> 00:03:29,299 I honestly don't know what happened. 73 00:03:29,324 --> 00:03:31,117 Go back over your notes. Try to learn from your error. 74 00:03:31,142 --> 00:03:33,202 I will, and I'll get him preop'd for a re-do. 75 00:03:33,284 --> 00:03:34,804 That will not be necessary. 76 00:03:34,829 --> 00:03:36,746 Between the adhesions and further procedural stress, 77 00:03:36,771 --> 00:03:38,538 reopening his heart is simply too risky. 78 00:03:38,563 --> 00:03:40,430 We'll manage him with medications instead. 79 00:03:40,455 --> 00:03:41,610 But if we don't fix the valve, 80 00:03:41,635 --> 00:03:43,238 his quality of life is gonna suffer. 81 00:03:43,263 --> 00:03:44,808 I understand, but at this point, 82 00:03:44,833 --> 00:03:46,487 it's our best option. 83 00:03:51,312 --> 00:03:52,446 Any plans tonight? 84 00:03:52,471 --> 00:03:54,285 Still got that chili. 85 00:03:54,310 --> 00:03:55,944 - You want to join? - No way. 86 00:03:56,176 --> 00:03:58,321 Is the sushi place on the corner still open? 87 00:03:58,346 --> 00:04:00,333 Why can't you just be nice? 88 00:04:00,358 --> 00:04:02,246 Oh, I can be nice. 89 00:04:08,402 --> 00:04:10,142 Hold that thought. 90 00:04:18,491 --> 00:04:21,157 Daniel. You're looking more rested. 91 00:04:21,320 --> 00:04:23,503 Doing my best. What's the word? 92 00:04:23,528 --> 00:04:26,397 The board is deciding whether to put metal detectors 93 00:04:26,422 --> 00:04:28,066 at all the hospital entrances. 94 00:04:28,091 --> 00:04:30,599 So I have to go prepare my recommendation. 95 00:04:30,624 --> 00:04:32,146 Which way you leaning? 96 00:04:32,179 --> 00:04:34,113 Toward yes. 97 00:04:34,138 --> 00:04:35,539 Really? 98 00:04:35,723 --> 00:04:37,110 Doesn't that kind of fly in the face 99 00:04:37,135 --> 00:04:40,061 of being a trusted community institution? 100 00:04:40,261 --> 00:04:42,188 You know, putting up barriers between us and the people 101 00:04:42,213 --> 00:04:43,847 that we're trying to help? 102 00:04:43,872 --> 00:04:46,840 One of those people shot you in the gut, Daniel. 103 00:04:46,916 --> 00:04:48,610 Yeah, outside the hospital. 104 00:04:48,635 --> 00:04:50,623 What kind of detector's gonna stop that? 105 00:04:54,496 --> 00:04:56,519 - Dr. Reese. - Dr. Charles. 106 00:04:59,589 --> 00:05:01,724 So, Nurse Sexton, 107 00:05:01,843 --> 00:05:04,309 - who do we got next? - Henry Lee. 108 00:05:04,691 --> 00:05:06,199 He's a sweetheart, comes in every month 109 00:05:06,224 --> 00:05:07,794 for his heart failure meds. 110 00:05:10,887 --> 00:05:13,245 Mr. Lee, I'm Dr. Choi. How are you doing today? 111 00:05:13,270 --> 00:05:15,832 A lot better now that my girl's here. 112 00:05:16,025 --> 00:05:18,256 She does have that effect on people. 113 00:05:18,532 --> 00:05:20,071 Any new complaints? 114 00:05:20,096 --> 00:05:22,397 Nope. Just got to get my meds. 115 00:05:22,422 --> 00:05:23,832 Take a deep breath. 116 00:05:27,057 --> 00:05:28,534 One more. 117 00:05:30,743 --> 00:05:32,601 How much Lasix does he usually get? 118 00:05:32,626 --> 00:05:34,561 - 40 IV. - That sounds good. 119 00:05:34,586 --> 00:05:36,675 But I'm also hearing some dullness near your lung base. 120 00:05:36,700 --> 00:05:37,981 I'd like to send you for an X-ray. 121 00:05:38,006 --> 00:05:39,825 Thanks, Doc, but if it's all the same, 122 00:05:39,850 --> 00:05:41,884 I'd rather just get my meds and go. 123 00:05:42,326 --> 00:05:43,793 Mr. Lee, I hear what you're saying, 124 00:05:43,818 --> 00:05:45,151 but I prefer to be thorough. 125 00:05:45,176 --> 00:05:48,521 Nah, let's just stick to the usual. 126 00:05:49,195 --> 00:05:52,788 Hey, can you do the IV in my left hand today? 127 00:05:52,815 --> 00:05:54,914 I got a good puffy one. 128 00:05:56,613 --> 00:05:59,700 - She never misses. - You got it. 129 00:06:07,645 --> 00:06:09,016 I really would like that X-ray. 130 00:06:09,041 --> 00:06:10,691 I bet he'd listen to you. 131 00:06:10,716 --> 00:06:12,617 Why? You think there's something else going on? 132 00:06:12,642 --> 00:06:14,609 I don't know. Probably not, 133 00:06:14,634 --> 00:06:16,134 but it's impossible to say. 134 00:06:16,159 --> 00:06:17,826 Okay, I'll try. 135 00:06:17,851 --> 00:06:19,536 Thank you. 136 00:06:20,148 --> 00:06:22,387 So I've got a 43-year-old woman who passed out 137 00:06:22,412 --> 00:06:24,243 at a Starbucks from hypoglycemia. 138 00:06:24,268 --> 00:06:26,040 - Mm-hmm. - Now, that's normal, right? 139 00:06:26,065 --> 00:06:27,866 But then her blood came back showing insulin 140 00:06:27,891 --> 00:06:29,215 with a high C-peptide count. 141 00:06:29,240 --> 00:06:30,843 So she gave herself too much insulin. 142 00:06:30,868 --> 00:06:32,639 Right, but here's the thing: 143 00:06:32,664 --> 00:06:34,294 she is not diabetic. 144 00:06:34,637 --> 00:06:35,692 Wait... so wait a minute. 145 00:06:35,717 --> 00:06:37,066 She somehow got her hands on insulin, 146 00:06:37,091 --> 00:06:38,612 then injected it into herself? 147 00:06:38,637 --> 00:06:39,741 Why would she do that? 148 00:06:39,800 --> 00:06:41,823 I don't know. That's why I called you. 149 00:06:42,186 --> 00:06:44,259 - Okay, I'll try to find out. - All right, cool, thank you. 150 00:06:44,284 --> 00:06:45,987 Oh, actually, um... 151 00:06:46,854 --> 00:06:49,102 Okay, so you know how I've been hounding you 152 00:06:49,127 --> 00:06:50,938 about getting a drink one night after work? 153 00:06:50,963 --> 00:06:53,591 - I'm familiar with it, yes. - Okay, well, I promise 154 00:06:53,730 --> 00:06:55,405 it's all going to stop. 155 00:06:55,695 --> 00:06:57,424 Right after you get a drink with me tonight. 156 00:06:57,449 --> 00:06:58,868 Oh, come on, Noah, couldn't we just stick 157 00:06:58,893 --> 00:07:00,298 to being colleagues? 158 00:07:00,323 --> 00:07:01,678 Sure. 159 00:07:01,948 --> 00:07:03,872 A drink as colleagues. 160 00:07:04,477 --> 00:07:05,940 Okay. 161 00:07:08,159 --> 00:07:11,618 Ms. Lake, I'm Dr. Reese from Psychiatry. 162 00:07:11,843 --> 00:07:13,972 Of course you are. 163 00:07:14,426 --> 00:07:17,083 - It's nice to meet you. - Nice to meet you. 164 00:07:17,373 --> 00:07:19,486 I understand that you may have injected yourself 165 00:07:19,511 --> 00:07:20,878 with insulin today. 166 00:07:20,903 --> 00:07:22,427 I did. 167 00:07:22,531 --> 00:07:24,189 Can you tell me why? 168 00:07:26,184 --> 00:07:28,070 Today's the court hearing. 169 00:07:28,535 --> 00:07:29,945 For my divorce. 170 00:07:30,258 --> 00:07:31,498 Oh. 171 00:07:31,523 --> 00:07:32,968 It just snuck up on me. 172 00:07:33,515 --> 00:07:35,549 I mean, I've been dreading it for months, but 173 00:07:35,574 --> 00:07:38,587 when I woke up today and realized that this is it... 174 00:07:38,694 --> 00:07:40,662 Did you try to harm yourself? 175 00:07:40,687 --> 00:07:42,389 Oh, no, no, no. 176 00:07:42,414 --> 00:07:44,220 I don't want to die. 177 00:07:45,045 --> 00:07:46,828 I just couldn't face the day. 178 00:07:46,853 --> 00:07:48,687 So let me understand. 179 00:07:48,712 --> 00:07:51,696 You made yourself pass out on purpose? 180 00:07:51,721 --> 00:07:53,316 I panicked. 181 00:07:53,556 --> 00:07:55,256 I did something stupid. 182 00:07:55,597 --> 00:07:57,625 And now I'm wasting your time. 183 00:07:57,650 --> 00:07:59,491 I'm sorry. 184 00:07:59,791 --> 00:08:02,489 Speaking of which, could you write a note for the judge? 185 00:08:02,514 --> 00:08:04,775 Just something saying I had a medical emergency. 186 00:08:04,800 --> 00:08:07,355 Ah, I am sorry, but I can't do that. 187 00:08:07,380 --> 00:08:08,859 It doesn't have to be anything big. 188 00:08:08,884 --> 00:08:10,751 Handwritten on a letterhead is fine. 189 00:08:10,776 --> 00:08:13,072 The thing is, you didn't have an emergency. 190 00:08:13,097 --> 00:08:14,383 You caused it. 191 00:08:14,408 --> 00:08:17,525 So it would be disingenuous for me to say otherwise. 192 00:08:19,703 --> 00:08:21,552 I'd like to speak with your supervisor. 193 00:08:22,402 --> 00:08:23,775 Excuse me? 194 00:08:23,800 --> 00:08:26,623 I'm seeing a doctor, now I need a doctor's note. 195 00:08:28,258 --> 00:08:31,360 And if you can't do that, then get me your supervisor. 196 00:08:34,305 --> 00:08:36,811 Um. Okay. 197 00:08:45,428 --> 00:08:47,195 You look like you need this more than I do. 198 00:08:47,220 --> 00:08:48,792 I'm fine. 199 00:08:48,850 --> 00:08:50,150 Sure. 200 00:08:50,263 --> 00:08:52,086 Hair's a mess, bags under your eyes. 201 00:08:52,111 --> 00:08:53,641 You look great. 202 00:08:55,899 --> 00:08:58,117 Don't be so hard on yourself. 203 00:08:58,365 --> 00:09:00,674 You work our schedule then go home 204 00:09:00,760 --> 00:09:03,652 to a girlfriend who's basically your patient too. 205 00:09:05,080 --> 00:09:07,219 Something like this was bound to happen. 206 00:09:07,707 --> 00:09:09,917 Really? Is that so? 207 00:09:12,719 --> 00:09:15,910 At least it hasn't affected your sunny disposition. 208 00:09:16,452 --> 00:09:18,169 Keep up the good work. 209 00:09:19,823 --> 00:09:21,816 Dr. Halstead, 210 00:09:21,841 --> 00:09:23,465 You're going to 3. Doris. 211 00:09:23,490 --> 00:09:24,652 Talk to me, Chout. 212 00:09:24,677 --> 00:09:26,881 Julie Dutra, 34, pregnant, 213 00:09:26,906 --> 00:09:29,871 para one gravita zero, fainted in a yoga class, 214 00:09:29,896 --> 00:09:32,525 in A-fib at 150, BP 90 over 60. 215 00:09:33,032 --> 00:09:35,718 Hi, Julie, I'm Dr. Manning. This is Dr. Halstead. 216 00:09:36,160 --> 00:09:37,662 I told them I don't want to be here. 217 00:09:37,687 --> 00:09:38,754 Hopefully this won't take long. 218 00:09:38,779 --> 00:09:40,517 On my count. One, two, three. 219 00:09:43,606 --> 00:09:45,128 Julie. Are you okay? 220 00:09:45,153 --> 00:09:47,803 - I'm fine, just call Mira. - Our midwife. 221 00:09:47,828 --> 00:09:50,058 I think Julie would be more comfortable at home with her. 222 00:09:50,083 --> 00:09:51,863 Uh, sir, your wife's in a dangerous arrhythmia. 223 00:09:51,888 --> 00:09:53,604 We can't let her go until we get it under control. 224 00:09:53,629 --> 00:09:55,009 Do you have any history of heart disease? 225 00:09:55,034 --> 00:09:56,590 No, I don't eat red meat, and I keep 226 00:09:56,615 --> 00:09:59,004 a high antioxidant profile to minimize inflammation. 227 00:09:59,029 --> 00:10:00,564 Okay, good. 228 00:10:00,589 --> 00:10:03,487 Let's get an EKG, cardiac labs, CBC, CMP, 229 00:10:03,512 --> 00:10:06,941 coags and a U/A, and let's start 5 of verapamil IV, okay? 230 00:10:06,966 --> 00:10:08,238 No, no medications. 231 00:10:08,263 --> 00:10:10,177 This one's safe for pregnancy. 232 00:10:10,202 --> 00:10:11,869 If we don't control your arrhythmia it could 233 00:10:11,894 --> 00:10:13,823 - put the baby in danger. - Is that true? 234 00:10:13,848 --> 00:10:14,567 - Scott. - What? 235 00:10:14,592 --> 00:10:16,128 We don't want anything bad to happen. 236 00:10:19,160 --> 00:10:20,542 Okay, fine, but then we're leaving. 237 00:10:20,567 --> 00:10:22,168 Thank you. All right. 238 00:10:22,202 --> 00:10:23,324 Let me ask you a few more questions. 239 00:10:23,349 --> 00:10:25,238 - Wait, what are you doing? - Just a quick fetal 240 00:10:25,263 --> 00:10:26,902 - ultrasound. - No, get that thing off me. 241 00:10:26,927 --> 00:10:28,781 Acoustic radiation impairs neurodevelopment. 242 00:10:28,806 --> 00:10:30,582 That's not actually true. 243 00:10:31,221 --> 00:10:32,888 Note that the fetus measures 244 00:10:32,913 --> 00:10:34,463 normal size and weight for five months. 245 00:10:34,659 --> 00:10:36,631 Wait, what did you say? 246 00:10:36,990 --> 00:10:39,771 That this looks like a normal five-month pregnancy. 247 00:10:39,977 --> 00:10:41,377 Measure it again. 248 00:10:41,402 --> 00:10:42,803 I'm sure of the numbers. 249 00:10:42,828 --> 00:10:44,997 Well, you're wrong. Measure it again. 250 00:10:49,502 --> 00:10:50,721 See? 251 00:10:51,173 --> 00:10:53,376 Totally normal for five months. 252 00:10:53,401 --> 00:10:55,651 Except I'm not five months pregnant. 253 00:10:56,286 --> 00:10:57,929 I'm eight. 254 00:11:04,954 --> 00:11:06,423 Julie's labs. 255 00:11:08,332 --> 00:11:10,336 Anemia, vitamin deficiencies, 256 00:11:10,427 --> 00:11:12,130 all the signs of early kidney failure. 257 00:11:12,155 --> 00:11:13,962 And no family history of troubled pregnancies 258 00:11:13,987 --> 00:11:15,487 or genetic conditions. 259 00:11:15,512 --> 00:11:17,887 Maybe a malabsorption syndrome? 260 00:11:20,138 --> 00:11:22,389 Ms. Dutra. 261 00:11:23,058 --> 00:11:25,008 Have you ever had any gastrointestinal issues? 262 00:11:25,033 --> 00:11:26,967 Crohn's, ulcerative colitis? 263 00:11:27,002 --> 00:11:28,595 I used to have leaky gut. 264 00:11:28,904 --> 00:11:31,008 At first we thought it was just lactose, 265 00:11:31,033 --> 00:11:33,398 but of course it was more complicated than that. 266 00:11:33,423 --> 00:11:35,642 I see, and were you seeing someone for this? 267 00:11:35,870 --> 00:11:37,755 My nutritionist. 268 00:11:38,525 --> 00:11:41,329 She got me off lecithin and phytic acid. 269 00:11:41,392 --> 00:11:42,681 It helped some, 270 00:11:42,706 --> 00:11:45,046 but then once I got pregnant I had to give up all GMOs 271 00:11:45,071 --> 00:11:47,189 and anything that wasn't locally sourced, too. 272 00:11:47,214 --> 00:11:48,648 So what do you eat? 273 00:11:48,673 --> 00:11:51,597 Certain strains of Swiss chard, broccoli. 274 00:11:51,622 --> 00:11:53,541 Sometimes I'll have a cup of adzuki beans. 275 00:11:53,566 --> 00:11:55,366 But she supplements a lot. 276 00:11:55,391 --> 00:11:57,568 Selenium, coenzyme Q. 277 00:11:57,898 --> 00:12:00,233 You eat three meals a day? More? Less? 278 00:12:00,353 --> 00:12:03,919 I do portion control to manage the baby's glucose. 279 00:12:04,391 --> 00:12:06,869 700 to 800 calories a day. Why? 280 00:12:08,002 --> 00:12:10,009 We suspect the difficulties with this pregnancy 281 00:12:10,034 --> 00:12:12,107 are being caused by your diet. 282 00:12:12,132 --> 00:12:14,634 That can't be. I only eat organic. 283 00:12:14,659 --> 00:12:17,230 But you're not getting enough protein or iron. 284 00:12:17,691 --> 00:12:20,244 And we're seeing the effects it's having on your baby. 285 00:12:20,269 --> 00:12:22,791 We need to start aggressive IV nutrition to help it grow 286 00:12:22,816 --> 00:12:24,571 as much as possible before you deliver. 287 00:12:24,596 --> 00:12:25,840 If we admit you to Obstetrics now we... 288 00:12:25,865 --> 00:12:27,245 No. 289 00:12:28,774 --> 00:12:30,915 I understand that you don't want to be here, 290 00:12:30,940 --> 00:12:31,798 but at this point it is... No. 291 00:12:31,823 --> 00:12:33,838 You're not giving me IV food. 292 00:12:33,863 --> 00:12:36,263 Your baby is severely malnourished. 293 00:12:36,288 --> 00:12:37,345 No, my baby is getting 294 00:12:37,370 --> 00:12:39,235 healthy farm-to-table nutrients. 295 00:12:39,260 --> 00:12:42,319 You're not gonna pump him full of toxins and chemicals. 296 00:12:42,344 --> 00:12:44,625 - Ms. Dutra... - I said no. 297 00:12:48,813 --> 00:12:50,766 Your arrhythmia hasn't resolved yet. 298 00:12:50,791 --> 00:12:53,107 We'll be back in a minute to check on you. 299 00:13:00,228 --> 00:13:02,464 She's starving that baby to death. 300 00:13:02,489 --> 00:13:04,208 We need to talk to Goodwin. 301 00:13:06,167 --> 00:13:08,880 Mr. Lee, we got your X-ray results back. 302 00:13:08,905 --> 00:13:10,722 Great. So I can get out of here? 303 00:13:10,747 --> 00:13:13,500 Actually, they show bilateral pleural effusions, 304 00:13:13,525 --> 00:13:14,950 fluid surrounding your lungs. 305 00:13:14,975 --> 00:13:17,455 - Is that bad? - It's hard to say. 306 00:13:17,480 --> 00:13:19,191 It could just be from your heart failure. 307 00:13:19,216 --> 00:13:21,051 Either way, it's not making your breathing any easier. 308 00:13:21,137 --> 00:13:22,680 I'd like to have Radiology remove it 309 00:13:22,705 --> 00:13:23,933 with a needle aspiration. 310 00:13:23,958 --> 00:13:25,925 You want to stick a needle in my lung? 311 00:13:25,950 --> 00:13:28,236 - Yes. - But I'm breathing fine now. 312 00:13:28,261 --> 00:13:30,556 - I'd rather just go. - I understand, but doing this 313 00:13:30,581 --> 00:13:32,320 will let you go longer between treatments. 314 00:13:32,345 --> 00:13:34,179 I think it's a good idea. 315 00:13:34,248 --> 00:13:36,000 Don't you agree? 316 00:13:37,497 --> 00:13:39,419 I don't know. Um... 317 00:13:39,466 --> 00:13:41,397 The effusions are pretty small. 318 00:13:41,551 --> 00:13:44,620 True, but it also wouldn't hurt to send the fluid 319 00:13:44,645 --> 00:13:46,964 out for analysis, just to be sure, right? 320 00:13:47,304 --> 00:13:49,014 I suppose. 321 00:13:49,201 --> 00:13:51,716 So, Henry, what do you say? 322 00:13:52,825 --> 00:13:55,154 You really think this is a good idea? 323 00:13:57,290 --> 00:13:58,665 Okay. 324 00:13:58,690 --> 00:14:00,858 We'll get you over there right away. 325 00:14:03,272 --> 00:14:05,173 Are you sure you want to be this aggressive? 326 00:14:05,198 --> 00:14:07,138 I want to cover all the bases, yeah. 327 00:14:07,163 --> 00:14:08,642 Henry's not a very healthy man. 328 00:14:08,667 --> 00:14:10,900 He doesn't do so well with procedures. 329 00:14:10,925 --> 00:14:13,861 I hear you, but medically, it's the best course of action. 330 00:14:17,326 --> 00:14:18,696 I don't think it is. 331 00:14:18,721 --> 00:14:21,003 I'm sorry you feel that way. 332 00:14:21,028 --> 00:14:23,196 What you should be sorry about is thinking 333 00:14:23,221 --> 00:14:24,626 that I would agree with you in there 334 00:14:24,651 --> 00:14:26,218 just because we're sleeping together. 335 00:14:26,469 --> 00:14:27,901 That has nothing to do with it. 336 00:14:27,926 --> 00:14:30,056 I thought you'd agree because that's my medical opinion. 337 00:14:30,081 --> 00:14:31,906 Well, you were wrong. 338 00:14:33,597 --> 00:14:34,955 The next time you want to put me 339 00:14:34,980 --> 00:14:38,132 on the spot in front of my patient, think again. 340 00:14:40,364 --> 00:14:41,642 Hey. 341 00:14:41,714 --> 00:14:43,343 April. 342 00:14:45,210 --> 00:14:47,740 You want to feed a patient against her will. 343 00:14:47,765 --> 00:14:49,864 A pregnant mother who's killing her baby. 344 00:14:49,889 --> 00:14:51,549 We believe she has something called orthorexia, 345 00:14:51,574 --> 00:14:53,820 an obsession with healthy living that has limited 346 00:14:53,845 --> 00:14:56,290 her diet so severely that it's become dangerous. 347 00:14:56,315 --> 00:14:58,033 And has led to a pathologic distrust 348 00:14:58,058 --> 00:15:00,075 of the entire medical system. She won't let us do anything. 349 00:15:00,100 --> 00:15:01,392 Well, is she delusional? 350 00:15:01,417 --> 00:15:03,101 Can she make decisions on her own? 351 00:15:03,126 --> 00:15:04,517 No, she's very clear about 352 00:15:04,542 --> 00:15:06,483 what she wants and what she does not want. 353 00:15:06,508 --> 00:15:08,196 Well, then we can't prove incompetence, 354 00:15:08,221 --> 00:15:10,009 and we can't force her to do anything 355 00:15:10,034 --> 00:15:11,681 to her body she doesn't want. 356 00:15:11,706 --> 00:15:13,288 The law sides with her. 357 00:15:13,313 --> 00:15:14,765 But there are two patients here. 358 00:15:14,789 --> 00:15:16,212 Yeah, one of whom has no control 359 00:15:16,237 --> 00:15:17,830 over what's being done to it. 360 00:15:18,096 --> 00:15:19,754 This is child abuse. 361 00:15:19,805 --> 00:15:22,517 Well, I can convene an emergency ethics committee. 362 00:15:22,542 --> 00:15:24,695 It's possible they may find grounds 363 00:15:24,720 --> 00:15:26,147 to override her decision. 364 00:15:26,172 --> 00:15:27,895 And in the meantime? 365 00:15:27,920 --> 00:15:31,321 See if you can find a way to help her trust us. 366 00:15:33,896 --> 00:15:35,897 Dr. Latham. We should do the surgery. 367 00:15:35,931 --> 00:15:37,079 - Dr. Rhodes... - No, I... I 368 00:15:37,104 --> 00:15:38,371 looked over all my notes. 369 00:15:38,396 --> 00:15:40,668 Okay? Mr. Willis' anatomy is good. 370 00:15:40,693 --> 00:15:42,219 We owe him a chance to get this right. 371 00:15:42,244 --> 00:15:43,823 We owe him our best clinical judgement. 372 00:15:43,848 --> 00:15:45,527 Yes, I was inside of his heart. 373 00:15:45,552 --> 00:15:48,388 He's got more than enough healthy muscle and vasculature. 374 00:15:48,413 --> 00:15:50,581 I'm telling you he can handle it. 375 00:15:54,128 --> 00:15:55,795 Have you had more than four hours' sleep 376 00:15:55,820 --> 00:15:57,393 this last several weeks? 377 00:15:57,566 --> 00:15:59,300 I am a cardiothoracic fellow. 378 00:15:59,325 --> 00:16:00,802 Sleep deprivation is part of the job. 379 00:16:00,827 --> 00:16:02,433 I understand that. 380 00:16:02,676 --> 00:16:04,915 But you have a lot on your plate. 381 00:16:04,940 --> 00:16:07,342 Dr. Bekker and I will take the case from here. 382 00:16:07,367 --> 00:16:08,828 No, Dr. Latham, that's not necessary... 383 00:16:10,367 --> 00:16:12,268 Dr. Rhodes, you have a phone call. 384 00:16:12,293 --> 00:16:13,627 Tell them I'll call them back. 385 00:16:13,652 --> 00:16:15,253 I'm sorry. It's your landlord. 386 00:16:15,278 --> 00:16:17,169 He says it's an emergency. 387 00:16:28,977 --> 00:16:31,243 Excuse me. Hey. Thank you. 388 00:16:31,268 --> 00:16:32,399 Excuse me. 389 00:16:32,424 --> 00:16:34,126 Robin. Robin. 390 00:16:34,326 --> 00:16:35,959 Hey, are you okay? 391 00:16:35,984 --> 00:16:37,685 I forgot the brisket in the oven when I went 392 00:16:37,710 --> 00:16:40,092 to the store, and then all the alarms went off. 393 00:16:40,117 --> 00:16:42,396 - I'm just such an idiot. - Come here, come here. 394 00:16:42,421 --> 00:16:43,834 - Come here. - Hey, Otis, when are we 395 00:16:43,859 --> 00:16:45,412 gonna get that thing shut down? 396 00:16:45,437 --> 00:16:47,156 - She okay? - Yeah. 397 00:16:47,181 --> 00:16:48,974 Thank you. 398 00:16:52,588 --> 00:16:55,231 Don't worry. It could happen to anybody. 399 00:16:57,702 --> 00:16:59,905 Shouldn't be more than a half hour. 400 00:17:03,036 --> 00:17:04,872 I'm sorry you had to deal with that. 401 00:17:05,970 --> 00:17:08,967 - No need to be sorry. - You know what I mean. 402 00:17:08,992 --> 00:17:10,296 The more time you spend with her, 403 00:17:10,321 --> 00:17:12,589 the less we have to see people who actually need our help. 404 00:17:12,717 --> 00:17:14,050 I don't know. 405 00:17:14,075 --> 00:17:15,630 I'm not quite sure we're... 406 00:17:15,655 --> 00:17:17,382 We're done with Ms. Lake yet. 407 00:17:17,512 --> 00:17:20,094 Why? She just wants to use us to game the system. 408 00:17:20,351 --> 00:17:22,207 Well, so do a lot of patients. 409 00:17:22,407 --> 00:17:23,808 We're not gonna let her. 410 00:17:23,905 --> 00:17:26,540 But the question is, why is she doing it? 411 00:17:26,565 --> 00:17:29,147 Wait, you still think this is a psych case? 412 00:17:29,172 --> 00:17:30,382 Why wouldn't I? 413 00:17:30,407 --> 00:17:32,234 I mean, she exhibited some pretty extreme behavior 414 00:17:32,259 --> 00:17:34,499 - this morning, didn't she? - To get out of a court date. 415 00:17:34,524 --> 00:17:35,975 Well, perhaps, but until we figure out 416 00:17:36,000 --> 00:17:37,679 what's behind the behavior, 417 00:17:37,704 --> 00:17:39,757 we haven't really done our job, have we? 418 00:17:40,770 --> 00:17:42,925 - I guess. - Good. 419 00:17:43,444 --> 00:17:44,969 Keep me in the loop. 420 00:17:57,290 --> 00:17:59,950 Your heart isn't responding to the meds. 421 00:18:00,974 --> 00:18:02,774 If things keep going in this direction, 422 00:18:02,809 --> 00:18:04,993 we may need to consider an emergency C-section 423 00:18:05,018 --> 00:18:06,788 to take the extra load off your heart. 424 00:18:06,813 --> 00:18:09,362 Drug me up then cut me open? No way. 425 00:18:09,387 --> 00:18:10,712 That's not what we want either, 426 00:18:10,737 --> 00:18:12,849 but we do need to protect you and your baby. 427 00:18:12,874 --> 00:18:14,634 That's why in the meantime, if you allow us to give you 428 00:18:14,659 --> 00:18:16,642 - some IV nutrition... - No way. 429 00:18:17,042 --> 00:18:19,831 Those bags off-gas BPAs. 430 00:18:20,327 --> 00:18:22,405 Look, you don't get it. 431 00:18:22,456 --> 00:18:25,366 This baby is being formed from every single molecule 432 00:18:25,391 --> 00:18:26,791 that enters my body. 433 00:18:26,961 --> 00:18:29,683 It is my job to keep it absolutely pure. 434 00:18:29,708 --> 00:18:31,378 That is how I'm protecting it. 435 00:18:31,403 --> 00:18:33,359 - They understand that. - No, they don't. 436 00:18:33,486 --> 00:18:35,412 Uh, excuse us. 437 00:18:40,824 --> 00:18:42,691 Please tell me you have some good news. 438 00:18:42,889 --> 00:18:44,186 I'm afraid not. 439 00:18:44,211 --> 00:18:46,462 The committee ruled that we can't intervene 440 00:18:46,487 --> 00:18:49,248 against her wishes, not even for the sake of the baby. 441 00:18:49,555 --> 00:18:50,777 So that's it? 442 00:18:50,802 --> 00:18:52,660 We just have to watch as she lets the baby die? 443 00:18:52,723 --> 00:18:55,486 If that's what she chooses to do. 444 00:18:55,511 --> 00:18:56,954 But that's not what she wants. 445 00:18:56,978 --> 00:18:58,345 She wants to help her baby. 446 00:18:58,370 --> 00:19:00,014 She's just confused about how to do it. 447 00:19:00,039 --> 00:19:02,433 I'm sorry. Our hands are tied. 448 00:19:10,921 --> 00:19:12,291 What happened? 449 00:19:12,316 --> 00:19:14,648 Satts are at 78 and dropping. 450 00:19:17,745 --> 00:19:19,241 He's in pulmonary edema. 451 00:19:19,266 --> 00:19:21,026 Get him on BiPAP and 40 of Lasix. 452 00:19:21,051 --> 00:19:23,022 He's my patient. 453 00:19:24,830 --> 00:19:26,986 Sublingual nitro, IV nitroprusside 454 00:19:27,011 --> 00:19:28,501 and ready an intra-aortic balloon pump. 455 00:19:28,526 --> 00:19:30,368 - What's happening? - The leak in your valve 456 00:19:30,393 --> 00:19:32,821 is causing fluid to back up into your lungs. 457 00:19:33,264 --> 00:19:35,000 BiPAP's at 100%. Balloon pump is here. 458 00:19:35,025 --> 00:19:36,453 What's that? 459 00:19:36,478 --> 00:19:38,581 It's a pump that we can implant directly 460 00:19:38,606 --> 00:19:41,060 into his aorta to take the strain off of his heart. 461 00:19:41,085 --> 00:19:43,780 Meds are in. Still satting at 78. 462 00:19:44,190 --> 00:19:47,532 So, then he's hooked up to a machine forever? 463 00:19:47,557 --> 00:19:49,950 Possibly if his heart doesn't respond to the medications. 464 00:19:49,975 --> 00:19:51,093 - Oh, my God. - Betadine. 465 00:19:51,118 --> 00:19:52,235 - Hold on. - Dr. Rhodes... 466 00:19:52,260 --> 00:19:53,289 Give the meds a minute to work. 467 00:19:53,314 --> 00:19:54,663 We may not have a minute. 468 00:19:54,899 --> 00:19:56,399 Look. 469 00:19:58,369 --> 00:20:00,069 Your sats are coming up. 470 00:20:00,094 --> 00:20:01,853 We'll hold off for now. 471 00:20:02,398 --> 00:20:05,720 Give him 1.25 of enalapril IV and another 40 of Lasix. 472 00:20:11,002 --> 00:20:13,137 Mr. Dutra. Hi. 473 00:20:13,162 --> 00:20:14,696 I need you to talk to your wife. 474 00:20:14,730 --> 00:20:16,086 She won't listen to me. 475 00:20:16,393 --> 00:20:18,959 But you do understand this has gotten out of hand. 476 00:20:18,984 --> 00:20:20,271 Of course I do. 477 00:20:20,296 --> 00:20:21,945 I mean, all she thinks about is how 478 00:20:21,970 --> 00:20:23,741 uric acid and compromised soil 479 00:20:23,766 --> 00:20:25,282 are infecting everything we eat. 480 00:20:25,307 --> 00:20:26,774 What do I say to that? 481 00:20:26,799 --> 00:20:28,433 Well, how did you handle it in the past? 482 00:20:28,458 --> 00:20:29,783 It wasn't this bad before. 483 00:20:29,808 --> 00:20:31,094 I mean, she's always struggled 484 00:20:31,119 --> 00:20:32,920 with anxiety and control issues. 485 00:20:32,945 --> 00:20:34,222 Even when she got pregnant, 486 00:20:34,247 --> 00:20:36,240 it's like she turned the dial straight to 11. 487 00:20:36,275 --> 00:20:37,975 Nothing's pure enough anymore. 488 00:20:38,000 --> 00:20:39,785 Everything looks like baby poison. 489 00:20:39,810 --> 00:20:41,561 But there has to be something you can say 490 00:20:41,586 --> 00:20:43,306 to get her to let us help. 491 00:20:43,331 --> 00:20:46,035 I am so scared my wife and my baby are gonna die. 492 00:20:46,442 --> 00:20:48,335 Can't you do something? 493 00:20:50,662 --> 00:20:54,100 So you think I avoid conflict to protect myself? 494 00:20:54,476 --> 00:20:56,510 I think it is a possibility. 495 00:20:56,535 --> 00:20:58,328 And you think that's a pattern. 496 00:20:58,353 --> 00:21:01,642 Yes, a destructive one from the sounds of it. 497 00:21:05,376 --> 00:21:07,450 I can't believe I didn't see it. 498 00:21:16,689 --> 00:21:19,163 I will get your discharge paperwork started. 499 00:21:27,400 --> 00:21:29,393 Looks like you had a little breakthrough. 500 00:21:30,112 --> 00:21:33,806 I... I think she sees that she has some issues 501 00:21:33,831 --> 00:21:34,985 and that it will be worthwhile 502 00:21:35,010 --> 00:21:37,126 for her to seek some long-term therapy. 503 00:21:37,253 --> 00:21:38,887 Sounds like a good start. 504 00:21:41,699 --> 00:21:44,751 I, um... I was wrong about her, Dr. Charles. 505 00:21:44,776 --> 00:21:46,640 Thank you for making me stick with her. 506 00:21:51,371 --> 00:21:53,008 Dr. Choi. 507 00:21:53,033 --> 00:21:55,010 Pulse ox is down to 82. 508 00:22:00,717 --> 00:22:01,746 No breath sounds on the left. 509 00:22:01,770 --> 00:22:02,536 He's got pneumothorax. 510 00:22:02,561 --> 00:22:04,482 Get a chest tube, 26 French. 511 00:22:04,847 --> 00:22:06,483 I can't breathe. 512 00:22:06,711 --> 00:22:08,097 I'm afraid your lung's collapsed. 513 00:22:08,122 --> 00:22:09,801 Radiology must've nicked it during the tap. 514 00:22:09,826 --> 00:22:10,731 You're kidding me. 515 00:22:10,756 --> 00:22:12,603 I'm so sorry, Henry. 516 00:22:12,869 --> 00:22:14,719 I need to insert a tube between your ribs 517 00:22:14,744 --> 00:22:16,005 to reinflate your lung. 518 00:22:16,675 --> 00:22:18,736 Do you understand, Mr. Lee? 519 00:22:18,761 --> 00:22:20,214 Lidocaine. 520 00:22:20,585 --> 00:22:22,783 Henry, I'm just gonna lift your arm. 521 00:22:23,523 --> 00:22:24,957 You're gonna feel a sting. 522 00:22:27,560 --> 00:22:29,581 Just breathe. 523 00:22:30,079 --> 00:22:31,847 It's okay. We're gonna get you through this. 524 00:22:31,872 --> 00:22:34,423 All I wanted was my damn medicine. 525 00:22:34,448 --> 00:22:35,989 I know. 526 00:22:36,383 --> 00:22:38,443 Then why'd you let him do this to me? 527 00:22:38,468 --> 00:22:39,756 I was fine. 528 00:22:45,774 --> 00:22:46,843 Oh, God. 529 00:22:46,868 --> 00:22:49,813 It feels like your stabbing me with a knife. 530 00:22:49,838 --> 00:22:51,549 Breathe. 531 00:22:56,128 --> 00:22:58,096 Put him on suction, get a portable chest X-ray, 532 00:22:58,121 --> 00:22:59,799 gram of cefazolin, a milligram of morphine 533 00:22:59,824 --> 00:23:01,467 and dress it with xeroform. 534 00:23:01,694 --> 00:23:03,977 At this point I'm gonna have to admit you, Mr. Lee. 535 00:23:04,002 --> 00:23:07,246 Probably for several days. I'm very sorry. 536 00:23:07,676 --> 00:23:09,656 I'll check back on him soon. 537 00:23:11,700 --> 00:23:13,495 I'm sorry. 538 00:23:14,461 --> 00:23:16,259 What the hell are you trying to do me? 539 00:23:16,284 --> 00:23:17,733 Please, Ms. Dutra, let me explai... 540 00:23:17,758 --> 00:23:19,329 - I told you no food! - Just one second. 541 00:23:19,354 --> 00:23:20,604 - What's going on? - I need you to calm down, 542 00:23:20,629 --> 00:23:22,112 - okay? Please. - She put this in my IV 543 00:23:22,137 --> 00:23:23,542 - behind my back. - Ms. Dutra, wait. 544 00:23:23,567 --> 00:23:24,846 Glucose, amino acids. 545 00:23:24,887 --> 00:23:25,815 You did this? 546 00:23:25,840 --> 00:23:27,464 - Ms. Dutra. - Julie. 547 00:23:27,489 --> 00:23:29,690 - Ms. Dutra, just relax. - Julie! 548 00:23:29,715 --> 00:23:31,870 Ms. Dutra, we need to get you back into bed. 549 00:23:31,895 --> 00:23:33,033 Get her away from me. 550 00:23:33,058 --> 00:23:35,351 Get her away from me! 551 00:23:35,376 --> 00:23:36,847 I need some help here. 552 00:23:36,872 --> 00:23:38,674 All right, easy. 553 00:23:38,699 --> 00:23:40,629 Relax, I have her. 554 00:23:41,203 --> 00:23:43,563 Let's get her back up. 555 00:23:48,770 --> 00:23:50,385 Dr. Reese. 556 00:23:50,509 --> 00:23:53,283 Your patient in 1's waiting for his prescription. 557 00:23:53,308 --> 00:23:54,853 Okay. 558 00:23:55,946 --> 00:23:57,446 Hey, have you seen my pad? 559 00:23:57,471 --> 00:23:58,923 Uh-uh. 560 00:23:59,815 --> 00:24:01,215 Huh. 561 00:24:01,240 --> 00:24:03,192 Have you seen my prescription pad? 562 00:24:03,434 --> 00:24:05,150 - No. - No? 563 00:24:05,175 --> 00:24:06,386 I couldn't have lost it. 564 00:24:06,411 --> 00:24:08,865 I always put it back in my pocket, always... 565 00:24:11,875 --> 00:24:13,876 Hey, do you still need that note for the judge? 566 00:24:13,901 --> 00:24:16,517 Oh, no, it's fine, my lawyer actually took care of it. 567 00:24:16,542 --> 00:24:18,657 Oh, good. Could you please open your purse? 568 00:24:18,682 --> 00:24:20,314 - I'm sorry? - I can't find 569 00:24:20,339 --> 00:24:22,065 my prescription pad. I want to check your purse. 570 00:24:22,090 --> 00:24:23,502 I don't know why you think it'd be in there. 571 00:24:23,527 --> 00:24:25,826 Because you decided to forge the judge a note 572 00:24:25,851 --> 00:24:27,823 and you took it from my pocket when you hugged me. 573 00:24:27,848 --> 00:24:29,964 I have no idea 574 00:24:29,989 --> 00:24:31,143 what you're talking about. 575 00:24:31,168 --> 00:24:33,064 Hey! Give me that! 576 00:24:33,089 --> 00:24:34,647 So what's this? 577 00:24:34,672 --> 00:24:37,369 You have no right. You're gonna pay for this! 578 00:24:37,394 --> 00:24:38,672 - Ma'am! - I am gonna make you pay! 579 00:24:38,697 --> 00:24:41,377 - Hey! Hey. - Ma'am, step away now! 580 00:24:41,402 --> 00:24:44,930 She assaulted me. She... she put that in my purse. 581 00:24:44,955 --> 00:24:46,369 Okay, everybody calm down. 582 00:25:04,197 --> 00:25:05,776 Dr. Reese. 583 00:25:06,237 --> 00:25:07,870 What happened in there? 584 00:25:07,895 --> 00:25:09,809 She stole my pad. 585 00:25:10,199 --> 00:25:11,851 That's a felony. 586 00:25:12,966 --> 00:25:15,322 She has been lying to us from the start. 587 00:25:15,347 --> 00:25:16,702 Of course she has. 588 00:25:16,727 --> 00:25:18,695 Lying, manipulating. 589 00:25:18,850 --> 00:25:21,937 Behaving recklessly with no regard for herself or others. 590 00:25:21,962 --> 00:25:23,863 - Exactly. - No. 591 00:25:23,888 --> 00:25:25,987 Not exactly. 592 00:25:26,012 --> 00:25:28,067 Look, off the top of my head, 593 00:25:28,222 --> 00:25:29,822 probably a sociopath, 594 00:25:29,847 --> 00:25:32,359 but that makes your job exploring that 595 00:25:32,384 --> 00:25:33,806 and trying to help her. 596 00:25:33,934 --> 00:25:35,387 Not punishing her. 597 00:25:35,412 --> 00:25:37,213 But all she did from the moment she got here 598 00:25:37,238 --> 00:25:40,302 was try to manipulate us and waste our time. 599 00:25:40,327 --> 00:25:42,007 Because she's mentally ill. 600 00:25:42,032 --> 00:25:44,667 No. No, it's because people like you let her. 601 00:25:45,932 --> 00:25:47,461 - People like me? - Yes. 602 00:25:47,486 --> 00:25:49,693 Yes, you enable and you make excuses 603 00:25:49,718 --> 00:25:51,642 and you give out psychiatric diagnoses 604 00:25:51,667 --> 00:25:54,806 so that no one has to be held accountable for their actions 605 00:25:54,831 --> 00:25:57,042 just like you did with the guy that shot you. 606 00:26:08,188 --> 00:26:09,917 You feeling any better? 607 00:26:10,334 --> 00:26:11,904 A little bit. 608 00:26:12,729 --> 00:26:14,319 Good. 609 00:26:16,009 --> 00:26:18,254 If there's anything that you need, 610 00:26:19,001 --> 00:26:22,299 Dr. Latham and Dr. Bekker are gonna be taking care of you 611 00:26:22,324 --> 00:26:23,972 from here on out, okay? 612 00:26:25,059 --> 00:26:26,675 Dr. Rhodes. 613 00:26:27,146 --> 00:26:29,567 Am I gonna be like this forever? 614 00:26:30,525 --> 00:26:32,979 Things will get better once they optimize your meds. 615 00:26:33,686 --> 00:26:37,248 But I'll always be coming back here for something, right? 616 00:26:43,741 --> 00:26:46,177 There's no way to go back to how I was? 617 00:26:47,196 --> 00:26:50,150 It is possible to redo your valve surgery. 618 00:26:50,175 --> 00:26:53,745 It comes with significant risks. 619 00:26:54,390 --> 00:26:57,218 You could end up with an even worse leak than before. 620 00:26:57,832 --> 00:26:59,662 You could even die. 621 00:27:00,230 --> 00:27:02,200 But it could work. 622 00:27:02,778 --> 00:27:04,500 I could go back to normal? 623 00:27:07,736 --> 00:27:10,899 Dr. Latham is the best this hospital's got. 624 00:27:12,685 --> 00:27:14,642 I promise he's gonna take great care of you. 625 00:27:37,950 --> 00:27:40,243 This is why I didn't want to do the lung test. 626 00:27:40,268 --> 00:27:42,039 - Still the right call. - No, you don't know that. 627 00:27:42,064 --> 00:27:43,189 - You don't know him... - But I know 628 00:27:43,214 --> 00:27:44,572 what heart failure looks like, and this just 629 00:27:44,597 --> 00:27:46,212 - seems like something else. - I've been treating 630 00:27:46,237 --> 00:27:48,529 Henry for years. This is what he looks like. 631 00:27:48,554 --> 00:27:50,558 I'm not asking for a second opinion. 632 00:27:50,779 --> 00:27:52,489 You don't want my opinion. 633 00:27:52,670 --> 00:27:54,802 Just because I don't have an MD after my name 634 00:27:54,827 --> 00:27:56,795 doesn't mean I don't know what's best for my patient. 635 00:27:56,820 --> 00:27:58,921 April, as the doctor, I'm responsible. 636 00:27:59,210 --> 00:28:00,981 I have to do what I think is right. 637 00:28:01,006 --> 00:28:03,718 Both of you, in there. Now. 638 00:28:09,103 --> 00:28:11,275 This has to stop. 639 00:28:12,806 --> 00:28:14,418 Do you need another nurse on your case, Dr. Choi? 640 00:28:14,443 --> 00:28:15,768 - No. - Uh, excuse me. 641 00:28:15,793 --> 00:28:17,280 Why didn't you ask me if I need a new doctor? 642 00:28:17,305 --> 00:28:18,606 - April. - He's just as much 643 00:28:18,631 --> 00:28:20,483 my patient as he is Dr. Choi's. 644 00:28:20,759 --> 00:28:22,861 I don't know what's going on between the two of you, 645 00:28:22,886 --> 00:28:25,101 but if you don't stop disturbing my E.D., 646 00:28:25,126 --> 00:28:26,976 I'm gonna separate you for good. 647 00:28:30,146 --> 00:28:31,503 Do you understand? 648 00:28:31,528 --> 00:28:32,928 Clear. 649 00:28:33,110 --> 00:28:34,578 Good. 650 00:28:38,603 --> 00:28:40,404 Carry on. 651 00:28:51,635 --> 00:28:53,617 You're very lucky her husband convinced her 652 00:28:53,642 --> 00:28:56,815 not to pursue action against you or the hospital. 653 00:28:56,957 --> 00:28:59,613 Ms. Goodwin, I'm sorry. 654 00:29:00,384 --> 00:29:03,586 I expect better from you, Dr. Manning. 655 00:29:09,074 --> 00:29:10,698 Nat, wait. 656 00:29:15,492 --> 00:29:17,243 Hi. 657 00:29:19,440 --> 00:29:20,807 I'm sorry. 658 00:29:20,832 --> 00:29:22,499 I'm really not interested. 659 00:29:22,829 --> 00:29:24,257 I understand. 660 00:29:24,628 --> 00:29:25,983 You didn't trust us before. 661 00:29:26,008 --> 00:29:28,653 You certainly have no reason to trust us now. 662 00:29:29,241 --> 00:29:31,559 Then we finally agree on something. 663 00:29:34,892 --> 00:29:36,411 Julie. 664 00:29:36,938 --> 00:29:39,006 Fearing for your baby's safety 665 00:29:39,103 --> 00:29:41,705 is the most natural thing in the world. 666 00:29:44,191 --> 00:29:45,821 When I was pregnant, 667 00:29:46,482 --> 00:29:48,317 I lost my husband. 668 00:29:49,725 --> 00:29:51,913 I was afraid of a lot of things. 669 00:29:53,157 --> 00:29:56,313 And then one day, after I had my son, 670 00:29:56,640 --> 00:29:59,534 I was up in a high-rise building on the balcony 671 00:29:59,941 --> 00:30:03,663 and suddenly had this vivid image of myself 672 00:30:03,688 --> 00:30:05,549 falling over the railing. 673 00:30:06,233 --> 00:30:09,712 And my first thought was, what would happen to my son 674 00:30:09,737 --> 00:30:11,834 if I wasn't here for him? 675 00:30:12,747 --> 00:30:14,971 And the craziest part is, my favorite thing in the world 676 00:30:14,996 --> 00:30:17,689 had always been Ferris wheels and roller coasters 677 00:30:17,714 --> 00:30:19,573 and being up in the air. 678 00:30:19,598 --> 00:30:21,689 But from that day on, 679 00:30:21,714 --> 00:30:25,168 I had this totally irrational fear of heights. 680 00:30:26,355 --> 00:30:30,010 It is really scary being solely responsible 681 00:30:30,035 --> 00:30:33,604 for that tiny, defenseless person inside of you. 682 00:30:34,193 --> 00:30:36,448 But you are letting your fear win. 683 00:30:37,006 --> 00:30:38,975 And it's gonna end badly. 684 00:30:42,356 --> 00:30:43,751 Anyway... 685 00:30:46,024 --> 00:30:47,413 I am sorry. 686 00:31:07,842 --> 00:31:10,669 I just got the analysis of Henry's lung tap. 687 00:31:17,856 --> 00:31:20,306 Non-small-cell lung cancer? 688 00:31:24,487 --> 00:31:26,400 You were right to do the tap. 689 00:31:28,087 --> 00:31:29,837 That's not important. 690 00:31:31,900 --> 00:31:33,788 What matters now is that he needs to be told, 691 00:31:33,813 --> 00:31:36,815 and I think it would be best if he hears it from you. 692 00:31:39,150 --> 00:31:42,037 You've treated him longer than anyone here. 693 00:31:43,452 --> 00:31:46,054 You know him better than anyone here. 694 00:32:16,992 --> 00:32:19,193 Why is Mr. Willis insisting on surgery? 695 00:32:19,228 --> 00:32:20,728 Despite my explicit recommendations 696 00:32:20,763 --> 00:32:22,163 - to the contrary? - Dr. Latham, I... 697 00:32:22,197 --> 00:32:23,679 Did you go behind my back? 698 00:32:23,704 --> 00:32:25,438 No, he asked if he had options. 699 00:32:25,463 --> 00:32:27,722 So I told him. I, in no way, suggested... 700 00:32:30,350 --> 00:32:33,438 You've shown extremely poor decision-making today. 701 00:32:34,219 --> 00:32:36,272 From this point on, you are not to step foot in the O.R. 702 00:32:36,297 --> 00:32:37,805 until I deem you ready to return. 703 00:32:37,829 --> 00:32:39,766 - Do you understand? - You're benching me? 704 00:32:39,792 --> 00:32:42,193 For the foreseeable future. Yes. 705 00:32:48,950 --> 00:32:50,685 Dr. Halstead. 706 00:32:53,892 --> 00:32:56,060 Her heart rate's too high and her pressure's dropping. 707 00:32:56,085 --> 00:32:57,352 Baby's heart rate's down to 90. 708 00:32:57,377 --> 00:32:58,991 My chest hurts. 709 00:32:59,016 --> 00:33:01,158 Your arrhythmia is escalating out of control. 710 00:33:01,183 --> 00:33:02,530 Push 10 milligrams of diltiazem stat 711 00:33:02,555 --> 00:33:04,252 and up her 0-2 to 6 liters. 712 00:33:04,277 --> 00:33:05,919 We need to do a C-section. We have to get the baby out. 713 00:33:05,944 --> 00:33:07,236 No. 714 00:33:07,261 --> 00:33:09,062 Julie, I know you don't trust me, 715 00:33:09,087 --> 00:33:10,545 but your baby is in real danger. 716 00:33:10,570 --> 00:33:12,487 - 84. - Julie, let them do it. 717 00:33:12,512 --> 00:33:14,107 I can't. 718 00:33:14,132 --> 00:33:15,900 Julie, if you don't let us do this, 719 00:33:15,925 --> 00:33:18,060 your baby is going to die. 720 00:33:21,572 --> 00:33:23,621 - Okay, do it. - Thank you. 721 00:33:24,157 --> 00:33:25,577 Call O.B. and tell them we're coming up 722 00:33:25,602 --> 00:33:27,151 for a crash C-section, now! 723 00:33:27,176 --> 00:33:28,810 You heard her. Let's move. 724 00:33:35,999 --> 00:33:38,290 I'm not seeing any cause for the leak. 725 00:33:38,315 --> 00:33:40,199 - Pickups. - Pickups. 726 00:33:40,909 --> 00:33:43,124 Are any of the leaflets impinged in the ventricle? 727 00:33:43,149 --> 00:33:47,294 No, they're opening freely, and the orientation is correct. 728 00:33:48,330 --> 00:33:50,561 - So what do we do? - Re-suture the valve. 729 00:33:51,362 --> 00:33:52,880 Won't give us much room to work, 730 00:33:52,905 --> 00:33:55,247 but I don't see where we have a choice. 731 00:33:56,930 --> 00:33:58,610 It's the valve. 732 00:34:00,083 --> 00:34:01,526 It's the valve. 733 00:34:01,551 --> 00:34:04,003 Dr. Rhodes, no one asked for your opinion. 734 00:34:06,556 --> 00:34:08,565 It's a brand-new valve. That's ridiculous. 735 00:34:08,590 --> 00:34:10,524 The leaflets must be asymmetrical. 736 00:34:10,714 --> 00:34:12,498 That would cause a large enough opening for the blood 737 00:34:12,523 --> 00:34:14,572 to keep leaking back through. 738 00:34:17,423 --> 00:34:19,884 It does seem that they're not closing properly. 739 00:34:20,286 --> 00:34:22,489 Really? They gave us a bad valve? 740 00:34:22,829 --> 00:34:24,779 It appears so. 741 00:34:25,091 --> 00:34:26,999 Dr. Rhodes, go change your clothes. 742 00:34:27,024 --> 00:34:30,080 I'd like you to scrub in for the remainder of the surgery. 743 00:34:44,003 --> 00:34:46,830 - How are you feeling? - I'm okay. 744 00:34:48,237 --> 00:34:50,205 What are they putting in him? 745 00:34:51,535 --> 00:34:54,504 Proteins, carbohydrates, fats. 746 00:34:54,765 --> 00:34:56,795 He needs them to grow. 747 00:35:06,789 --> 00:35:08,390 You paged about a consult? 748 00:35:08,415 --> 00:35:10,671 Yeah. Yeah. 749 00:35:10,820 --> 00:35:12,424 Um... 750 00:35:12,449 --> 00:35:16,883 50-something guy, post-op after getting shot by a patient. 751 00:35:18,144 --> 00:35:19,769 Is this a joke? 752 00:35:20,148 --> 00:35:22,282 No. I'm serious. 753 00:35:22,307 --> 00:35:25,876 Give me your clinical evaluation of my recovery. 754 00:35:28,442 --> 00:35:31,266 No residual anger or fear. 755 00:35:32,573 --> 00:35:33,748 Mm-hmm. 756 00:35:33,773 --> 00:35:36,061 Normal intellectual and emotional functioning. 757 00:35:36,086 --> 00:35:38,842 You seem like you have moved on. 758 00:35:39,463 --> 00:35:40,847 Yeah. 759 00:35:41,326 --> 00:35:43,084 And you should too. 760 00:35:44,083 --> 00:35:45,917 Excuse me? 761 00:35:47,060 --> 00:35:50,032 I'm just wondering if today was less about your patient 762 00:35:50,207 --> 00:35:52,910 and more about lingering fears for our safety. 763 00:35:52,943 --> 00:35:54,777 It is certainly true 764 00:35:55,021 --> 00:35:57,603 that a very few patients can be dangerous. 765 00:35:57,628 --> 00:36:00,605 But the overwhelming majority are... 766 00:36:00,976 --> 00:36:05,144 harmless and in fact very grateful for our help. 767 00:36:05,678 --> 00:36:08,388 Only they can't get that help if you come to work scared. 768 00:36:09,283 --> 00:36:10,760 I'm not scared. 769 00:36:10,785 --> 00:36:12,265 This is not an accusation, Doctor. 770 00:36:12,290 --> 00:36:14,652 I just want you to know that every psychiatrist 771 00:36:14,677 --> 00:36:17,182 goes through this at some point or another. 772 00:36:17,656 --> 00:36:19,184 And then it passes. 773 00:36:19,708 --> 00:36:21,463 And it'll pass for you, too. 774 00:36:39,525 --> 00:36:41,895 Seems the hospital changed valve manufacturers 775 00:36:41,920 --> 00:36:43,220 several weeks ago. 776 00:36:43,356 --> 00:36:44,866 This particular company didn't bother 777 00:36:44,891 --> 00:36:46,873 to conduct any human testing. 778 00:36:47,787 --> 00:36:49,367 And they can do that? 779 00:36:49,421 --> 00:36:50,671 All they have to do is prove 780 00:36:50,696 --> 00:36:53,705 that it performs the same function as a previous device. 781 00:36:56,025 --> 00:36:57,609 Unbelievable. 782 00:37:00,104 --> 00:37:01,764 Well... 783 00:37:03,211 --> 00:37:04,945 Good night, Dr. Latham. 784 00:37:07,120 --> 00:37:11,688 When surgeons burn out, it always starts with stress. 785 00:37:13,793 --> 00:37:16,954 Then a call goes the wrong way, an unlucky result. 786 00:37:17,450 --> 00:37:18,913 And they get in their own heads, 787 00:37:18,938 --> 00:37:21,240 and that's when the hesitation starts, 788 00:37:21,265 --> 00:37:23,536 the unsteady hands. 789 00:37:24,679 --> 00:37:26,361 And once you're there, 790 00:37:26,742 --> 00:37:29,123 it's a very hard road back. 791 00:37:32,741 --> 00:37:34,770 Are you okay, Dr. Rhodes? 792 00:37:36,531 --> 00:37:39,178 Yes. I am. 793 00:37:41,027 --> 00:37:43,487 Then you continue to have my full confidence. 794 00:37:44,439 --> 00:37:46,240 Good night. 795 00:37:46,274 --> 00:37:47,975 Good night. 796 00:37:57,952 --> 00:37:59,620 I'm sorry. 797 00:38:03,160 --> 00:38:04,719 Me too. 798 00:38:05,693 --> 00:38:08,059 This isn't gonna be easy, is it? 799 00:38:09,295 --> 00:38:11,045 No, it's not. 800 00:38:13,163 --> 00:38:15,275 Though, you know what would help? 801 00:38:16,158 --> 00:38:17,804 - Big pot of chili. - Sushi? 802 00:38:20,777 --> 00:38:23,429 - I'll see you later. - Yeah. 803 00:38:28,322 --> 00:38:29,876 - Hey. - Hey. 804 00:38:30,102 --> 00:38:32,403 How'd that metal detector thing turn out? 805 00:38:32,461 --> 00:38:34,194 I changed my mind. 806 00:38:34,455 --> 00:38:35,951 - Really? - Yeah. 807 00:38:35,976 --> 00:38:38,975 I saw a woman today who almost killed her baby 808 00:38:39,239 --> 00:38:41,066 because she didn't trust us. 809 00:38:41,091 --> 00:38:42,662 And I thought, 810 00:38:42,687 --> 00:38:45,897 "How can we encourage people to trust us more 811 00:38:45,922 --> 00:38:48,990 if we don't show them trust first?" 812 00:38:49,604 --> 00:38:51,405 Couldn't agree more. 813 00:38:56,419 --> 00:39:00,690 - Well, uh, good night. - All right, see you tomorrow. 814 00:39:09,497 --> 00:39:11,279 Dr. Reese, Dr. Sexton. 815 00:39:11,808 --> 00:39:13,442 Check it out. 816 00:39:13,696 --> 00:39:15,608 Someone slashed her tires. 817 00:39:18,273 --> 00:39:20,097 You still think patients are harmless? 818 00:39:20,122 --> 00:39:22,138 She did this. 819 00:39:23,331 --> 00:39:25,218 Yes, I'm still here. 820 00:39:30,380 --> 00:39:32,247 I'm sorry you don't even get a real meal 821 00:39:32,272 --> 00:39:34,594 after the day you have had. 822 00:39:34,619 --> 00:39:38,266 Oh, a little vegetarian living never hurt anybody. 823 00:39:39,662 --> 00:39:42,753 Well, I'm sorry that you have to put up with... 824 00:39:43,322 --> 00:39:45,010 all of this. 825 00:39:45,835 --> 00:39:49,241 I promise it will be better soon. 826 00:39:50,112 --> 00:39:51,959 I know. 827 00:40:13,319 --> 00:40:14,634 It's almost 9:00. 828 00:40:14,659 --> 00:40:16,305 Aren't we gonna miss our reservation? 829 00:40:16,330 --> 00:40:17,784 Maybe. 830 00:40:17,809 --> 00:40:20,278 So then what are we doing here? 831 00:40:22,093 --> 00:40:23,600 What? 832 00:40:23,625 --> 00:40:26,241 No. No, no, no. No way. Mm-mm. 833 00:40:26,266 --> 00:40:28,534 Hey, you're not gonna let fear win, are you? 834 00:40:28,559 --> 00:40:30,154 Uh, yes. Yes, I am. 835 00:40:30,179 --> 00:40:31,252 Aw, come on. 836 00:40:31,277 --> 00:40:32,818 Just one ride. 837 00:40:32,843 --> 00:40:35,547 Oh, Will, no. 838 00:40:36,102 --> 00:40:39,972 Natalie, I'm gonna be next to you the whole time. 839 00:40:41,878 --> 00:40:43,305 Trust me. 840 00:41:05,226 --> 00:41:07,226 - Synced and corrected by martythecrazy - - www.addic7ed.com -