1 00:00:00,172 --> 00:00:02,695 And easy on the CrossFit for a while, okay? 2 00:00:02,734 --> 00:00:04,295 - Okay. - Thank you. 3 00:00:04,320 --> 00:00:06,875 Just cleared Treatment 3. Just got to turn it over. 4 00:00:06,900 --> 00:00:09,592 - Sure. - Man, we're up again already? 5 00:00:09,617 --> 00:00:11,250 - Looks like it. - What's going on? 6 00:00:11,275 --> 00:00:13,046 - Who are they? - Big brother. 7 00:00:13,071 --> 00:00:14,292 - Hey. - Oh. 8 00:00:14,317 --> 00:00:16,571 - Up. - JCAHO. 9 00:00:16,596 --> 00:00:19,936 Yeah, they're doing a surprise site survey. 10 00:00:19,961 --> 00:00:22,211 - Who's JCAHO? - The Joint Commission. 11 00:00:22,236 --> 00:00:23,519 They rate the performance standards 12 00:00:23,544 --> 00:00:24,994 of hospitals and certify them. 13 00:00:25,019 --> 00:00:27,193 So far, JCAHO's reports have been positive. 14 00:00:27,218 --> 00:00:28,522 So let's keep it that way. 15 00:00:28,547 --> 00:00:31,526 Stick to protocols and with big smiles. 16 00:00:32,923 --> 00:00:34,122 Dr. Choi, we're gonna need 17 00:00:34,147 --> 00:00:36,713 some of your Navy-inspired discipline today. 18 00:00:36,738 --> 00:00:38,584 Sorry, I'm with the paramedics today. 19 00:00:38,609 --> 00:00:40,185 - Resident ride along. - Mm. 20 00:00:40,210 --> 00:00:42,882 And discipline, that a nice way of saying I'm a tight ass? 21 00:00:42,907 --> 00:00:44,515 Oh, yes. Tight. 22 00:00:44,540 --> 00:00:47,470 I didn't say that. 23 00:00:47,668 --> 00:00:49,973 And, uh, getting those docs in line, 24 00:00:49,998 --> 00:00:52,094 isn't that? the chief resident's job anyway? 25 00:00:52,119 --> 00:00:54,617 Wonderful, the guy enforcing the rules 26 00:00:54,642 --> 00:00:56,109 is the one who's always breaking them. 27 00:00:56,134 --> 00:00:57,134 Yeah. 28 00:00:57,159 --> 00:00:59,038 Good luck with that. 29 00:00:59,063 --> 00:01:01,125 Code One team to the ED. 30 00:01:01,149 --> 00:01:02,546 - What do we got? - Nathan Clay. 31 00:01:02,572 --> 00:01:04,739 58-year-old male. "Peeds" versus auto. 32 00:01:04,764 --> 00:01:06,380 GCS 12. Vitals stable. 33 00:01:06,405 --> 00:01:08,072 Gross deformity to the left upper arm. 34 00:01:08,097 --> 00:01:09,203 - Right in here. - Ow. 35 00:01:09,228 --> 00:01:10,609 He's complaining of chest and back pains. 36 00:01:10,775 --> 00:01:12,608 Mr. Clay, can you hear me? 37 00:01:12,633 --> 00:01:14,641 Mr. Clay? On my count. 38 00:01:14,666 --> 00:01:16,116 One, two, three. 39 00:01:17,644 --> 00:01:19,446 Central line and a CVC catheter. 40 00:01:19,471 --> 00:01:21,579 - Right away. - Airway's intact. 41 00:01:21,604 --> 00:01:23,771 - Breath sounds clear bilaterally. - Ow! 42 00:01:23,796 --> 00:01:25,081 Tenderness in the left chest 43 00:01:25,106 --> 00:01:26,532 and thoracic spine. What happened here? 44 00:01:26,557 --> 00:01:28,473 He's walking with his wife on Michigan Avenue. 45 00:01:28,498 --> 00:01:30,845 Suddenly flips out, starts wailing on her. 46 00:01:30,870 --> 00:01:32,621 A couple of Samaritans jumped in to help out. 47 00:01:32,646 --> 00:01:34,743 He takes off right into traffic. 48 00:01:34,966 --> 00:01:37,300 Score one for, uh, karma. 49 00:01:37,325 --> 00:01:39,421 12-lead EKGs, chest X-rays, 50 00:01:39,446 --> 00:01:41,696 CT of the chest, abdomen, and pelvis, 51 00:01:41,721 --> 00:01:43,582 with recons of the TLS spine. 52 00:01:43,607 --> 00:01:44,703 - On it. - Leave me... no. 53 00:01:44,728 --> 00:01:45,930 Leave me alone. I'm fine. 54 00:01:45,955 --> 00:01:47,696 Laura Clay. 55-year-old female. 55 00:01:47,720 --> 00:01:48,555 - GCS 15. - I'm fine. 56 00:01:48,580 --> 00:01:49,438 I need to get to my husband. 57 00:01:49,463 --> 00:01:50,672 Whoa, whoa, whoa. Ma'am, ma'am, ma'am. 58 00:01:50,697 --> 00:01:52,456 - Okay. - Heart rate's tachycardic. 59 00:01:52,481 --> 00:01:53,846 This is all my fault. 60 00:01:53,870 --> 00:01:57,297 Look, I blocked my fall with my hand, not my C spine. 61 00:01:57,322 --> 00:01:58,563 I'm neurologically intact. 62 00:01:58,588 --> 00:01:59,787 Technical. Are you a doctor? 63 00:01:59,812 --> 00:02:03,138 - Yes, yes, I am. - Laura! Please... 64 00:02:03,163 --> 00:02:05,008 - Dr. Rhodes! - Honey, I'm here. 65 00:02:05,033 --> 00:02:07,171 - Ma'am, stay right there. - I'm right here. 66 00:02:07,196 --> 00:02:09,057 There are too many of them! 67 00:02:09,082 --> 00:02:10,500 - I'm here, my love! - Help me! 68 00:02:10,552 --> 00:02:13,376 2... I need restraints. 2 of Versed and 5 of Haldol. 69 00:02:13,401 --> 00:02:14,507 - There are too many of th... - No, not Haldol! 70 00:02:14,532 --> 00:02:16,614 Quetiapine. He's not abusive. 71 00:02:16,639 --> 00:02:19,020 He has Lewy Body Dementia. 72 00:02:19,045 --> 00:02:22,174 Wait, scratch the Haldol. 25 of quetiapine. 73 00:02:22,199 --> 00:02:23,359 - Laura! - It's all right, my love. 74 00:02:23,384 --> 00:02:25,084 What the hell's Lewy Body? 75 00:02:25,109 --> 00:02:27,069 Debilitating form of dementia. 76 00:02:27,094 --> 00:02:30,589 Alzheimer's meets Parkinson's. 77 00:02:33,757 --> 00:02:37,957 - Synced and corrected by martythecrazy - - www.addic7ed.com - 78 00:02:39,601 --> 00:02:41,402 He took a pretty good whack. 79 00:02:41,427 --> 00:02:43,772 He's got a chest bruise, left first rib fracture, 80 00:02:43,797 --> 00:02:45,413 proximal humerus fracture. 81 00:02:45,465 --> 00:02:47,582 - How are his labs? - It's all good. 82 00:02:47,626 --> 00:02:49,474 Calcium was elevated. 83 00:02:49,499 --> 00:02:51,552 I suspect he'll develop a kidney stone down the road, 84 00:02:51,588 --> 00:02:53,825 but it's likely he's had a few before. 85 00:02:53,850 --> 00:02:55,202 Prior heart surgery? 86 00:02:55,341 --> 00:02:57,475 Says it was a quadruple bypass. 87 00:02:57,510 --> 00:02:59,374 Had it done at Northwestern five years ago. 88 00:02:59,399 --> 00:03:02,290 - He remembers the details? - Yeah, he's lucid. 89 00:03:02,315 --> 00:03:05,756 Somewhat. All right, EKG is normal, 90 00:03:05,781 --> 00:03:07,447 but because of the prior heart surgery, 91 00:03:07,468 --> 00:03:09,126 I'm gonna repeat it every few hours. 92 00:03:09,151 --> 00:03:11,201 He's all yours. 93 00:03:13,122 --> 00:03:14,788 Mr. Clay? 94 00:03:14,813 --> 00:03:17,484 Mr. Clay, I'm Dr. Charles. How are you feeling? 95 00:03:17,509 --> 00:03:19,643 My wife, Laura, where is she? 96 00:03:19,730 --> 00:03:23,139 She's being treated right now, but will be in shortly. 97 00:03:23,164 --> 00:03:27,208 I hurt her again, didn't I? 98 00:03:27,705 --> 00:03:32,561 This isn't the life she deserves. 99 00:03:34,297 --> 00:03:36,130 Mr. Clay? 100 00:03:36,155 --> 00:03:38,990 Mr. Clay? 101 00:03:44,165 --> 00:03:47,299 Damn, you got the online thing down, huh? 102 00:03:47,335 --> 00:03:49,426 - There was a time. - Yeah, what's her name? 103 00:03:49,451 --> 00:03:50,950 Easy. She's taken. 104 00:03:50,975 --> 00:03:52,925 Vicki. Doctor at the VA. 105 00:03:52,950 --> 00:03:54,171 Oh, man. 106 00:03:54,196 --> 00:03:55,612 There are so many female paramedics 107 00:03:55,637 --> 00:03:57,720 who are gonna be sorry to hear you're off the market. 108 00:03:57,745 --> 00:03:59,124 Couple guys, too. 109 00:03:59,149 --> 00:04:00,216 Well, you let 'em down easy for me. 110 00:04:00,241 --> 00:04:01,290 All right. 111 00:04:01,315 --> 00:04:02,565 You sure you gonna be okay back here? 112 00:04:02,590 --> 00:04:04,083 'Cause we can just throw Desmond in the back. 113 00:04:04,108 --> 00:04:05,409 Eh, I'm fine. 114 00:04:05,434 --> 00:04:07,343 Ambo's like the Humvee. You sit where there's room. 115 00:04:07,368 --> 00:04:09,703 - Comfort's not a factor. - Well, good. 116 00:04:09,728 --> 00:04:10,974 This day's gonna go by quick then. 117 00:04:10,999 --> 00:04:14,041 Ambo 61, 40-year-old male down in his home. 118 00:04:14,066 --> 00:04:15,755 222 Bromley Avenue. 119 00:04:15,780 --> 00:04:17,531 Some kind of lower extremity insult. 120 00:04:17,556 --> 00:04:19,305 He's in severe pain, possibly trapped. 121 00:04:19,330 --> 00:04:21,197 Copy Main. Ambo 61 responding. 122 00:04:21,222 --> 00:04:23,436 All right, we're on! 123 00:04:29,670 --> 00:04:30,886 It doesn't make any sense. 124 00:04:30,911 --> 00:04:32,558 I've had Boomer since he was a puppy. 125 00:04:32,583 --> 00:04:34,466 He's super loyal. I leave the room for a second, 126 00:04:34,491 --> 00:04:35,749 he's looking for me. 127 00:04:35,774 --> 00:04:37,003 I had a dog like that. 128 00:04:37,028 --> 00:04:39,543 He might nip a little, but this was a full-on attack. 129 00:04:39,568 --> 00:04:42,027 In my experience, dogs can be unpredictable. 130 00:04:42,052 --> 00:04:44,091 Even really friendly ones. 131 00:04:44,116 --> 00:04:45,953 Sometimes if a dog's in pain, though, he... 132 00:04:45,978 --> 00:04:46,968 He wasn't. 133 00:04:47,025 --> 00:04:50,059 We were playing tug of war, like we always do. 134 00:04:50,197 --> 00:04:52,134 Dog bites shouldn't be stitched. 135 00:04:52,159 --> 00:04:53,725 They need to stay open 136 00:04:53,750 --> 00:04:55,827 so the wound doesn't become infected. 137 00:04:55,852 --> 00:04:57,870 Also, I'm gonna give you a tetanus shot 138 00:04:57,895 --> 00:04:59,035 and an antibiotic. 139 00:04:59,060 --> 00:05:00,676 Boomer's healthy. He's had all his shots. 140 00:05:00,701 --> 00:05:02,701 It's just a precaution. 141 00:05:16,992 --> 00:05:18,647 Paul's in trouble down there. 142 00:05:18,672 --> 00:05:21,373 - Did you call 911? - Yes, I'm his neighbor. 143 00:05:22,735 --> 00:05:24,735 Paul? 144 00:05:24,900 --> 00:05:26,700 It's the paramedics. 145 00:05:29,848 --> 00:05:32,516 - Ooh. - Ooh, that's ripe. 146 00:05:33,095 --> 00:05:35,890 Man, look at this. He's a hoarder. 147 00:05:43,460 --> 00:05:44,959 What do you think? 148 00:05:45,213 --> 00:05:46,644 You good going in there? 149 00:05:46,669 --> 00:05:48,460 - I'm good. - Okay. 150 00:05:48,485 --> 00:05:50,196 Uh, get the truck company here. 151 00:05:50,221 --> 00:05:51,484 Tell 'em they're gonna have to help dig us out, 152 00:05:51,509 --> 00:05:52,575 and grab me a second radio. 153 00:05:52,600 --> 00:05:54,027 And, uh, I'm gonna try and go in through the back door. 154 00:05:54,052 --> 00:05:55,802 You got it. 155 00:06:01,945 --> 00:06:03,702 Paul! 156 00:06:03,727 --> 00:06:06,233 Everything okay? 157 00:06:07,438 --> 00:06:09,537 Okay. 158 00:06:15,908 --> 00:06:17,897 Third squad caught a high-rise fire. 159 00:06:17,922 --> 00:06:20,256 Dispatch is pulling a truck from up north to help us out. 160 00:06:20,281 --> 00:06:22,696 It'll be a while before they get here. 161 00:06:25,126 --> 00:06:28,682 In the beginning, I wanted to think it would pass. 162 00:06:28,707 --> 00:06:31,658 Any wife would, but I'm also a neurologist, 163 00:06:31,683 --> 00:06:34,851 and I couldn't ignore his symptoms. 164 00:06:34,876 --> 00:06:37,471 Oh, so you diagnosed the Lewy Body Dementia? 165 00:06:37,496 --> 00:06:40,149 Yes, but I got second and third opinions, 166 00:06:40,174 --> 00:06:42,285 and they both agreed it was LBD, 167 00:06:42,310 --> 00:06:44,059 and that was about four years ago. 168 00:06:44,102 --> 00:06:46,753 Four years, really? 169 00:06:46,777 --> 00:06:49,421 You know, Nathan expressed deep regret to me 170 00:06:49,446 --> 00:06:50,945 about the pain that he's caused you. 171 00:06:50,970 --> 00:06:52,411 That kind of insight is rare 172 00:06:52,436 --> 00:06:54,768 for somebody who's been battling LBD for that long. 173 00:06:55,123 --> 00:06:58,338 Well, my husband was an engineer, 174 00:06:58,363 --> 00:07:00,947 and his brain is wired to solve problems. 175 00:07:00,972 --> 00:07:02,768 Last year, I retired early. 176 00:07:02,793 --> 00:07:05,698 I wanted to devote more time to his cognitive therapy. 177 00:07:05,777 --> 00:07:07,498 Hmm, well, it's been working. 178 00:07:07,522 --> 00:07:09,011 There's moments when he's lucid. 179 00:07:09,036 --> 00:07:12,433 But more and more, it's this. 180 00:07:12,458 --> 00:07:13,973 Mrs. Clay, 181 00:07:14,156 --> 00:07:17,516 Nathan's latest EKG is still normal. 182 00:07:17,541 --> 00:07:19,772 I want to do another one in a few hours, 183 00:07:19,797 --> 00:07:22,548 but if it is good too, I'll discharge him. 184 00:07:22,573 --> 00:07:25,138 - Thank you, doctor. - Mm-hmm. 185 00:07:28,126 --> 00:07:32,251 I know that it would be better and safer for the both of us 186 00:07:32,276 --> 00:07:35,381 if Nathan went to a care facility, 187 00:07:35,406 --> 00:07:38,587 but if I do that, then it's over. 188 00:07:39,637 --> 00:07:41,911 And I'm not ready to give up our Sundays 189 00:07:41,936 --> 00:07:43,846 listening to opera. 190 00:07:43,913 --> 00:07:47,832 I know it's hard to imagine, but my Nathan is still in there. 191 00:07:48,038 --> 00:07:52,196 Last week he made me dinner, Florentine lasagna. 192 00:07:52,298 --> 00:07:53,993 He can still cook? 193 00:07:54,018 --> 00:07:57,330 Well, meals take longer to prepare than they used to, 194 00:07:57,731 --> 00:07:59,765 but... 195 00:08:00,282 --> 00:08:02,282 he does it for me. 196 00:08:04,880 --> 00:08:07,598 He's fighting just as hard as I am. 197 00:08:12,326 --> 00:08:14,543 Hi, honey. 198 00:08:16,631 --> 00:08:18,998 Everything's gonna be okay. 199 00:08:19,023 --> 00:08:21,273 Everything's okay. 200 00:08:23,501 --> 00:08:25,027 How you doing, Ethan? 201 00:08:25,211 --> 00:08:28,212 Fine, as long as I breathe through my mouth. 202 00:08:28,237 --> 00:08:29,934 Is it as tight in there as I think it is? 203 00:08:29,959 --> 00:08:31,644 It's worse. 204 00:08:31,669 --> 00:08:33,330 Are you claustrophobic? 205 00:08:33,362 --> 00:08:35,757 Didn't used to be. 206 00:08:41,102 --> 00:08:43,293 I mean, and Tate totally snores, 207 00:08:43,318 --> 00:08:45,151 but I don't mind. 208 00:08:45,177 --> 00:08:48,668 Oh, he does this thing where he shoots his dirty boxers 209 00:08:48,693 --> 00:08:51,767 into the hamper like a buzzer beater. 210 00:08:52,514 --> 00:08:54,093 Anyway, it's cute. 211 00:08:54,118 --> 00:08:56,193 Oh, my God. 212 00:08:56,294 --> 00:08:58,061 You're in love. 213 00:08:58,700 --> 00:09:01,618 Whoa, whoa, whoa, whoa. What's that? 214 00:09:01,643 --> 00:09:03,294 What's what? 215 00:09:03,799 --> 00:09:07,110 Used gloves go in the bio bin, not the trash. 216 00:09:07,135 --> 00:09:08,434 Okay, those were actually clean though. 217 00:09:08,509 --> 00:09:10,142 - They were on the floor. - Probably just got stuck 218 00:09:10,167 --> 00:09:11,591 to the pair that came out before them. 219 00:09:11,616 --> 00:09:14,150 Unless you're certain, it's bio. 220 00:09:14,175 --> 00:09:15,895 Come on, Maggie. You know the protocol. 221 00:09:15,920 --> 00:09:17,054 I do. 222 00:09:17,080 --> 00:09:18,592 I've also been through this circus 223 00:09:18,617 --> 00:09:19,650 about a dozen times. 224 00:09:19,675 --> 00:09:21,958 JCAHO days are about patient care, 225 00:09:21,983 --> 00:09:24,077 not about a pair of latex gloves. 226 00:09:24,375 --> 00:09:27,770 Look, I'm already in the doghouse with Goodwin. 227 00:09:27,795 --> 00:09:30,241 If there's any chance of getting out, I want it. 228 00:09:30,266 --> 00:09:34,586 So by the book... by the book. 229 00:09:34,610 --> 00:09:36,250 By the book. 230 00:09:40,487 --> 00:09:43,021 Okay honey, eight across. 231 00:09:43,214 --> 00:09:44,604 It's five letters 232 00:09:44,629 --> 00:09:47,678 and the clue is rental agreement, 233 00:09:47,703 --> 00:09:50,337 and the first letter is L. 234 00:09:55,022 --> 00:09:57,904 I'm thinking the second is E. 235 00:09:58,258 --> 00:10:02,315 L-E... 236 00:10:02,998 --> 00:10:04,581 Lease. 237 00:10:04,641 --> 00:10:07,509 Good. Good, honey. 238 00:10:07,534 --> 00:10:08,944 All right, next one. 239 00:10:08,969 --> 00:10:11,459 We're gonna do 23 down. 240 00:10:11,484 --> 00:10:12,933 Six letters. 241 00:10:13,047 --> 00:10:14,547 The clue is collects... 242 00:10:14,572 --> 00:10:15,521 With an S. 243 00:10:18,257 --> 00:10:19,670 - What happened? - I don't know. 244 00:10:19,695 --> 00:10:22,059 His blood pressure tanked. 245 00:10:22,211 --> 00:10:24,084 All right, bag and hang a liter bolus. 246 00:10:24,109 --> 00:10:25,392 - Yes, doctor. - SATS are dropping. 247 00:10:25,417 --> 00:10:27,840 - Intubate? - Yep. 248 00:10:28,407 --> 00:10:32,515 Grab the bag and hook it up to the O2. 249 00:10:32,849 --> 00:10:35,003 All right, 20 of etomidate. 100 of sux. 250 00:10:35,028 --> 00:10:36,053 Let's bring in the FAST scan. 251 00:10:36,078 --> 00:10:38,968 - April, give me some pressure. - Here, doctor. 252 00:10:42,445 --> 00:10:45,069 And I'm in. 253 00:10:45,330 --> 00:10:46,996 - Got it. - Okay. 254 00:10:47,021 --> 00:10:49,679 - Scan. - Here you go. 255 00:10:52,489 --> 00:10:54,962 Heart rate 110. 256 00:10:57,686 --> 00:11:00,576 All right, belly's clean. 257 00:11:00,810 --> 00:11:03,800 Poor wall motion of the LV and a small effusion. 258 00:11:03,825 --> 00:11:05,681 He's bleeding internally? 259 00:11:05,706 --> 00:11:07,656 Dr. Charles. 260 00:11:08,175 --> 00:11:09,377 Mrs. Clay, please, right over here. 261 00:11:09,402 --> 00:11:10,485 SATS are back up. 262 00:11:10,647 --> 00:11:12,025 Oxygenation improving. 263 00:11:12,050 --> 00:11:13,989 It's not gonna matter if he goes into cardiac arrest. 264 00:11:14,014 --> 00:11:15,754 CT of the heart and great vessels. 265 00:11:15,779 --> 00:11:17,612 Let's get him ready to go. 266 00:11:21,194 --> 00:11:22,912 Laura? 267 00:11:22,947 --> 00:11:24,780 If we may? 268 00:11:28,136 --> 00:11:29,802 The blunt trauma from the car accident 269 00:11:29,827 --> 00:11:32,578 displaced one of Nathan's bypass grafts. 270 00:11:32,607 --> 00:11:34,941 His aorta is leaking blood. 271 00:11:34,976 --> 00:11:37,021 - A pseudo-aneurysm. - Mm-hmm. 272 00:11:37,046 --> 00:11:38,629 How bad? 273 00:11:38,874 --> 00:11:41,124 Right now it's just a slow drip. 274 00:11:41,149 --> 00:11:42,532 It hasn't ruptured yet. 275 00:11:42,557 --> 00:11:44,716 So there's still an opportunity 276 00:11:44,741 --> 00:11:46,241 to operate, repair the suture line, 277 00:11:46,266 --> 00:11:47,382 and plug the hole? 278 00:11:47,407 --> 00:11:48,809 Normally, yes. 279 00:11:48,834 --> 00:11:51,435 Your husband's prior heart bypass surgery 280 00:11:51,582 --> 00:11:55,146 significantly increases the difficulty of the operation. 281 00:11:55,264 --> 00:11:58,486 His odds of surviving the procedure plummet. 282 00:11:58,511 --> 00:12:01,896 So if surgery isn't a viable option, what is? 283 00:12:06,211 --> 00:12:08,261 Given the circumstances, 284 00:12:08,444 --> 00:12:10,861 we feel the safest choice 285 00:12:10,934 --> 00:12:13,602 is to make Nathan comfortable. 286 00:12:17,519 --> 00:12:19,102 How long? 287 00:12:19,146 --> 00:12:21,089 We can't be certain. 288 00:12:21,234 --> 00:12:23,651 A day, a week, 289 00:12:23,734 --> 00:12:25,484 maybe a few months 290 00:12:25,581 --> 00:12:27,664 until the aneurysm ruptures. 291 00:12:27,800 --> 00:12:29,800 We're very sorry. 292 00:12:33,631 --> 00:12:35,968 Help. I can't move. 293 00:12:35,993 --> 00:12:38,460 I'm coming, Paul. 294 00:12:43,980 --> 00:12:46,390 Don't touch that! 295 00:12:46,415 --> 00:12:48,330 What was that? 296 00:12:57,512 --> 00:12:59,285 Ah! 297 00:13:01,913 --> 00:13:04,065 Ethan, what happened? 298 00:13:04,090 --> 00:13:07,056 Got bit by the lid of a tin can. 299 00:13:09,785 --> 00:13:11,489 Truck company is almost here. 300 00:13:11,514 --> 00:13:14,065 They're going to clear a path to get the stretcher through. 301 00:13:16,898 --> 00:13:18,531 Please, hurry! 302 00:13:18,556 --> 00:13:20,784 Hold on, Paul! 303 00:13:20,809 --> 00:13:22,608 Oh, thank God. 304 00:13:23,194 --> 00:13:25,828 I haven't been able to pee in over 16 hours. 305 00:13:25,853 --> 00:13:27,519 I thought I was gonna explode. 306 00:13:27,629 --> 00:13:29,495 Brachytherapy for prostate cancer? 307 00:13:29,520 --> 00:13:30,736 Two days ago. 308 00:13:30,761 --> 00:13:32,740 My urologist said it was the way to go. 309 00:13:32,765 --> 00:13:33,970 Who's your urologist? 310 00:13:33,995 --> 00:13:35,878 I'll call and tell them you've experienced a blockage. 311 00:13:35,903 --> 00:13:37,903 Dr. Mason, over at Advocate South. 312 00:13:37,928 --> 00:13:39,741 Uh, contact info's, uh, in my phone 313 00:13:39,766 --> 00:13:41,933 in my pants pocket. 314 00:13:43,676 --> 00:13:45,280 Oh, sorry. 315 00:13:45,305 --> 00:13:48,822 Oh, whoa, whoa, whoa, whoa, whoa, whoa. 316 00:13:48,848 --> 00:13:50,440 Everything okay? 317 00:13:50,464 --> 00:13:52,748 Just a little spill. I got it. 318 00:13:52,773 --> 00:13:53,999 Okay, hold on. 319 00:13:54,024 --> 00:13:56,522 I'll call environmental services and have them send a janitor. 320 00:13:56,547 --> 00:13:57,366 It's just pee. 321 00:13:57,391 --> 00:13:58,673 I've cleaned it a thousand times. 322 00:13:58,698 --> 00:14:00,663 Yeah, but not with JCAHO and Robocop Halstead 323 00:14:00,688 --> 00:14:01,803 on the prowl. 324 00:14:01,828 --> 00:14:04,029 By the book, remember? 325 00:14:04,054 --> 00:14:05,362 Oh, man. 326 00:14:05,387 --> 00:14:08,390 I think the seed came out. It's radioactive, right? 327 00:14:08,415 --> 00:14:10,838 Oh, it did. 328 00:14:10,902 --> 00:14:13,263 Okay, I'll call Urology instead. 329 00:14:19,353 --> 00:14:21,673 Cath lab for a cardio angiogram? 330 00:14:21,698 --> 00:14:24,696 Should give a better view of Nathan's pseudo-aneurysm 331 00:14:24,721 --> 00:14:27,389 and hopefully help me estimate a timeline for his wife. 332 00:14:27,414 --> 00:14:29,581 You mind grabbing me an MRI of his head 333 00:14:29,606 --> 00:14:30,822 while you're up there? 334 00:14:30,847 --> 00:14:31,976 Brain scan? 335 00:14:32,106 --> 00:14:33,536 His injuries don't necessitate it. 336 00:14:33,561 --> 00:14:35,301 It's not for him. It's for me. 337 00:14:35,326 --> 00:14:37,278 Uh, Dr. Charles. 338 00:14:37,303 --> 00:14:40,938 Dr. Rhodes, his awareness and gross motor skills 339 00:14:41,111 --> 00:14:42,744 are just too strong 340 00:14:42,780 --> 00:14:45,981 for somebody who's been battling LBD as long as he has. 341 00:14:46,006 --> 00:14:49,565 No amount of cognitive therapy in the world is gonna outthink 342 00:14:49,590 --> 00:14:51,928 this disease to the degree that he appears to be. 343 00:14:51,953 --> 00:14:55,071 Laura and two other neurologists 344 00:14:55,096 --> 00:14:57,303 have all agreed on the Lewy Body diagnosis. 345 00:14:57,328 --> 00:14:59,245 - You think they're wrong? - I don't know what to think. 346 00:14:59,270 --> 00:15:01,044 That's why I need the scan. 347 00:15:01,130 --> 00:15:03,060 I need the wife's consent. 348 00:15:03,085 --> 00:15:04,916 Hasn't she been through enough? 349 00:15:04,941 --> 00:15:07,670 I'm just trying to spare her some false hope here. 350 00:15:07,694 --> 00:15:08,940 - Um. - Hello. 351 00:15:08,966 --> 00:15:10,799 - Gentlemen. - Doctors. 352 00:15:10,824 --> 00:15:12,194 JCAHO day isn't exactly the time 353 00:15:12,219 --> 00:15:15,220 to be sneaking in unauthorized tests. 354 00:15:15,302 --> 00:15:16,919 I don't know what to tell you. 355 00:15:17,038 --> 00:15:19,132 - Okay. - Thanks, pal. 356 00:15:19,157 --> 00:15:20,323 Mm. 357 00:15:28,930 --> 00:15:30,980 What've we got? 358 00:15:31,014 --> 00:15:33,282 Hey, guys, start clearing out! 359 00:15:35,555 --> 00:15:37,102 Don't touch that. 360 00:15:37,174 --> 00:15:38,414 Get away. 361 00:15:38,439 --> 00:15:40,055 - Get away. - There's a second person. 362 00:15:40,080 --> 00:15:41,870 I'm hearing another victim. 363 00:15:42,414 --> 00:15:45,077 Ethan, the neighbors seem sure it's only Paul in there. 364 00:15:45,102 --> 00:15:47,245 Don't touch that! 365 00:15:47,270 --> 00:15:50,157 There's someone else here. 366 00:15:50,345 --> 00:15:52,574 Dr. Perrington, 367 00:15:54,758 --> 00:15:57,422 got a hemoptysis patient. 368 00:15:57,447 --> 00:16:00,921 Chest X-ray says it's a COPD, but I think he needs a bronch. 369 00:16:00,946 --> 00:16:02,766 You want to take a quick look? 370 00:16:02,992 --> 00:16:03,985 Really? 371 00:16:04,010 --> 00:16:07,109 The esteemed Dr. Halstead needs my help with a patient. 372 00:16:07,134 --> 00:16:08,748 I'm honored. 373 00:16:09,700 --> 00:16:12,797 Look, I, uh... I'm sorry about what happened the other day. 374 00:16:12,822 --> 00:16:16,492 You want a consult, page my resident. 375 00:16:22,188 --> 00:16:24,717 Okay, no redness, no inflammation. 376 00:16:24,742 --> 00:16:25,825 Looks good. 377 00:16:25,850 --> 00:16:27,266 So I can go? 378 00:16:27,291 --> 00:16:29,775 The nurses are working on your discharge paperwork right now. 379 00:16:29,800 --> 00:16:32,330 Your wound should heal in about seven days or so. 380 00:16:32,355 --> 00:16:35,773 Until then, irrigate them and keep them covered. 381 00:16:37,022 --> 00:16:39,627 You all right? Oh, just itchy 382 00:16:39,652 --> 00:16:41,347 and a little sweaty. 383 00:16:41,372 --> 00:16:43,234 Mind if I take a look? 384 00:16:44,589 --> 00:16:46,131 No rash. 385 00:16:46,156 --> 00:16:48,891 Could be an allergic reaction to the antibiotics. 386 00:16:49,266 --> 00:16:52,188 - You do feel warm though. - I'll get a temp. 387 00:16:53,639 --> 00:16:56,157 Oh, my sister checking in. 388 00:16:56,182 --> 00:16:57,768 I left Boomer with her. 389 00:16:57,792 --> 00:17:00,075 She's not a dog person either. 390 00:17:00,100 --> 00:17:02,102 I get the impression they're not for you. 391 00:17:02,127 --> 00:17:03,227 I've treated a lot of dog wounds, 392 00:17:03,252 --> 00:17:05,135 especially on kids. 393 00:17:05,379 --> 00:17:08,380 It's 99.4. Was normal at intake. 394 00:17:09,161 --> 00:17:11,258 - CBC and CMP? - Yeah. 395 00:17:11,283 --> 00:17:14,094 - I'm not out of here, am I? - Sorry. 396 00:17:14,119 --> 00:17:16,202 Itching and fever, even a low one, 397 00:17:16,227 --> 00:17:18,403 could be more than an allergic reaction. 398 00:17:18,539 --> 00:17:20,642 Someone will be with you shortly. 399 00:17:23,756 --> 00:17:26,611 Paul, is there anyone else in the house? 400 00:17:26,636 --> 00:17:28,404 No, no, it's just me. 401 00:17:28,429 --> 00:17:29,834 You've got to hurry! 402 00:17:29,859 --> 00:17:32,450 Ah! Ah! 403 00:17:32,864 --> 00:17:35,448 Ethan, what happened? 404 00:17:35,473 --> 00:17:36,938 Are you okay? 405 00:17:47,506 --> 00:17:48,989 Ahh! 406 00:17:58,985 --> 00:18:01,236 - What's all this? - Well, it's pretty clear 407 00:18:01,261 --> 00:18:02,968 an attending job at Med isn't gonna happen. 408 00:18:02,993 --> 00:18:04,276 You don't know that. 409 00:18:04,301 --> 00:18:05,793 Just being realistic. 410 00:18:05,942 --> 00:18:07,408 Perrington's on the hiring committee. 411 00:18:07,433 --> 00:18:08,649 She hates me. 412 00:18:08,758 --> 00:18:10,424 Not to mention Goodwin. 413 00:18:10,449 --> 00:18:12,466 But really, Miami, Will? 414 00:18:12,620 --> 00:18:15,977 I've seen you sunburn walking from the ED to your car. 415 00:18:16,375 --> 00:18:18,955 Hey, got to go where the jobs are. 416 00:18:21,907 --> 00:18:24,059 No coffee. JCAHO day. 417 00:18:24,303 --> 00:18:26,289 Right. 418 00:18:35,367 --> 00:18:36,616 I don't understand. 419 00:18:36,641 --> 00:18:39,086 There should be atrophy, heavy degeneration, 420 00:18:39,112 --> 00:18:40,821 tangled cells in the white matter. 421 00:18:40,846 --> 00:18:41,928 When was this taken? 422 00:18:41,980 --> 00:18:43,239 About an hour ago. 423 00:18:43,327 --> 00:18:44,559 I'm sorry. I had a hunch. 424 00:18:44,584 --> 00:18:45,833 I rushed it. I really should have... 425 00:18:45,858 --> 00:18:47,494 That is a healthy brain. 426 00:18:47,519 --> 00:18:50,603 There's no disease. This means that... 427 00:18:50,628 --> 00:18:52,662 Nathan doesn't have Lewy Body Dementia. 428 00:18:52,687 --> 00:18:54,359 He has the symptoms. 429 00:18:54,384 --> 00:18:57,121 Keeps getting worse. Practically a textbook case. 430 00:18:57,146 --> 00:18:58,443 How? 431 00:18:58,468 --> 00:19:01,633 Take a look at this cross section we took during the MRI. 432 00:19:01,658 --> 00:19:03,830 Notice the adenoma, 433 00:19:03,905 --> 00:19:06,922 benign tumor, in the parathyroid gland. 434 00:19:06,955 --> 00:19:09,852 So you think this is all hormonal irregularity? 435 00:19:09,877 --> 00:19:11,601 Elevated parathyroid hormone 436 00:19:11,626 --> 00:19:13,461 is consistent with increased calcium 437 00:19:13,486 --> 00:19:15,605 and cognitive impairment. Nathan has both. 438 00:19:15,630 --> 00:19:17,491 Yes, but he also has hallucinations, 439 00:19:17,516 --> 00:19:19,466 physical aggression. You don't see that 440 00:19:19,491 --> 00:19:21,691 in patients with hyperparathyroidism. 441 00:19:21,747 --> 00:19:24,705 That's where his recent bypass surgery makes him unique, okay? 442 00:19:24,730 --> 00:19:27,352 The beta blocker he's been taking ever since 443 00:19:27,392 --> 00:19:30,516 causes increased levels of violent behavior 444 00:19:30,541 --> 00:19:32,322 in a select amount of patients. 445 00:19:32,501 --> 00:19:35,616 Oh, my God. 446 00:19:37,567 --> 00:19:40,420 A hormonal imbalance 447 00:19:40,843 --> 00:19:43,313 with a medication side effect. 448 00:19:45,606 --> 00:19:47,876 Why didn't I see that? 449 00:19:47,901 --> 00:19:50,118 The clues were right in front of me. 450 00:19:50,350 --> 00:19:53,533 Because they mimic the symptoms 451 00:19:53,558 --> 00:19:56,203 of Lewy Body Dementia to a T, 452 00:19:56,374 --> 00:19:59,032 and four years ago that adenoma would have been so small 453 00:19:59,057 --> 00:20:00,588 no scan could have caught it. 454 00:20:00,613 --> 00:20:01,998 Look, I'm just telling you 455 00:20:02,023 --> 00:20:04,381 that presented with the same evidence, 456 00:20:04,411 --> 00:20:06,628 I would have done exactly the same thing, 457 00:20:06,653 --> 00:20:09,604 reached exactly the same diagnosis. 458 00:20:09,635 --> 00:20:10,767 Anybody would have. 459 00:20:10,792 --> 00:20:12,124 You didn't. 460 00:20:12,260 --> 00:20:14,246 I did. 461 00:20:14,922 --> 00:20:18,783 And if I had caught the PTH four years ago, 462 00:20:18,808 --> 00:20:20,622 Nathan doesn't run into traffic, 463 00:20:20,647 --> 00:20:22,648 doesn't get hit by a car. 464 00:20:22,827 --> 00:20:25,313 Today never happens. 465 00:20:26,352 --> 00:20:27,932 He's dying 466 00:20:27,957 --> 00:20:30,913 and it's entirely my fault. 467 00:20:33,009 --> 00:20:35,357 Don't touch that! 468 00:20:35,382 --> 00:20:36,962 Help. Please, please anybody! 469 00:20:38,681 --> 00:20:40,055 I need help! 470 00:20:42,639 --> 00:20:44,167 Ethan. 471 00:20:44,192 --> 00:20:46,783 Ethan, talk to me. 472 00:20:50,312 --> 00:20:52,116 Ethan, do you copy? 473 00:20:52,141 --> 00:20:53,140 Let's go. 474 00:20:53,165 --> 00:20:54,771 Living room's clear. 475 00:21:09,921 --> 00:21:12,222 - Thank God. - Paul? 476 00:21:12,247 --> 00:21:16,047 - Help me, please. - Paul, I'm Dr. Choi. 477 00:21:18,107 --> 00:21:19,874 Okay, your heart's racing. When's the last time 478 00:21:19,899 --> 00:21:23,385 you had any fluids? 479 00:21:23,743 --> 00:21:27,451 My leg, burned it. Yeah. 480 00:21:27,476 --> 00:21:30,016 - I see that. - Don't touch that. 481 00:21:41,027 --> 00:21:43,277 - How did this happen? - I was cooking. 482 00:21:43,302 --> 00:21:47,087 I tripped and spilled a frying pan, grease. 483 00:21:47,112 --> 00:21:49,284 This didn't just happen. 484 00:21:49,309 --> 00:21:51,501 This burn is thick, leathery. 485 00:21:51,526 --> 00:21:53,538 - 24 hours old? - I guess. 486 00:21:53,563 --> 00:21:55,543 Why didn't you seek help sooner? 487 00:21:55,617 --> 00:21:59,815 I didn't want anybody to see how I live. 488 00:22:00,417 --> 00:22:03,451 Okay, I'm here now. 489 00:22:03,476 --> 00:22:05,810 Gonna take care of you. 490 00:22:07,795 --> 00:22:10,296 Brachytherapy seed. 491 00:22:10,478 --> 00:22:12,611 Yep, doesn't happen often, 492 00:22:12,636 --> 00:22:14,488 but it can get expelled in the urine. 493 00:22:14,513 --> 00:22:16,930 So, um, how radioactive is it? 494 00:22:16,955 --> 00:22:18,204 To us, harmless. 495 00:22:18,229 --> 00:22:20,480 Still, don't touch it with your bare hands. 496 00:22:20,505 --> 00:22:21,671 Whoa. 497 00:22:21,696 --> 00:22:23,195 So you're not gonna dispose of it? 498 00:22:23,220 --> 00:22:24,656 Not on JCAHO day. 499 00:22:24,681 --> 00:22:26,039 Sorry. 500 00:22:26,064 --> 00:22:28,499 Call the radiation safety officer. 501 00:22:28,524 --> 00:22:30,374 Oh, man. 502 00:22:30,399 --> 00:22:31,765 Here we go. 503 00:22:31,979 --> 00:22:33,395 I get it. 504 00:22:33,420 --> 00:22:35,345 You didn't do Nathan's bypass surgery. 505 00:22:35,370 --> 00:22:37,222 You don't know what you're walking into. 506 00:22:37,247 --> 00:22:41,007 I can get you every angio he had. 507 00:22:41,032 --> 00:22:44,911 You will know exactly where the surgeon placed every suture. 508 00:22:44,936 --> 00:22:46,379 The bigger issues are the adhesions 509 00:22:46,404 --> 00:22:49,280 and scar tissue that have formed over the last five years. 510 00:22:49,305 --> 00:22:51,907 We can expose a healthy heart in 10 or 15 minutes. 511 00:22:51,932 --> 00:22:54,376 After a quadruple bypass surgery, 512 00:22:54,869 --> 00:22:56,582 it could take hours. 513 00:22:56,607 --> 00:22:59,039 An infinite number of complications can arise. 514 00:22:59,065 --> 00:23:02,254 When I decided to make Nathan comfortable, 515 00:23:02,533 --> 00:23:05,855 I believed he had a neurological death sentence. 516 00:23:06,206 --> 00:23:08,289 Now it's a whole new world. 517 00:23:08,549 --> 00:23:10,680 The dementia can be reversed. 518 00:23:10,706 --> 00:23:13,372 I understand, but the fact that he doesn't have LBD 519 00:23:13,397 --> 00:23:15,571 doesn't make the surgery any easier. 520 00:23:15,596 --> 00:23:17,933 Nathan's odds of dying in that operating room 521 00:23:17,958 --> 00:23:19,684 are just as high as they ever were. 522 00:23:19,865 --> 00:23:22,844 It's still my recommendation to not operate. 523 00:23:23,293 --> 00:23:25,293 I'm sorry. 524 00:23:28,090 --> 00:23:30,090 I'll do the surgery. 525 00:23:32,851 --> 00:23:35,017 Thank you. 526 00:23:36,088 --> 00:23:39,422 Thank you for giving us a second chance. 527 00:23:44,080 --> 00:23:47,221 Difficult is not impossible. 528 00:23:49,240 --> 00:23:51,439 Hmm. 529 00:23:56,638 --> 00:23:59,742 - Brett, how close are you? - Ugh, Ethan, finally. 530 00:23:59,767 --> 00:24:02,029 - You okay? - I'm fine, but Paul's got 531 00:24:02,054 --> 00:24:04,040 a serious third degree burn that needs to be released 532 00:24:04,065 --> 00:24:05,333 in the ED. ETA? 533 00:24:05,358 --> 00:24:06,808 I think we're almost to the kitchen. 534 00:24:06,833 --> 00:24:08,166 We need more room for the gear. 535 00:24:08,191 --> 00:24:10,561 Don't touch that! Get away, get away. 536 00:24:10,586 --> 00:24:12,081 Who was that? 537 00:24:12,106 --> 00:24:15,162 The other person I heard, a parrot. 538 00:24:15,186 --> 00:24:17,208 Look, you still have the hallway to deal with 539 00:24:17,233 --> 00:24:18,599 and Paul's foot's still swelling. 540 00:24:18,624 --> 00:24:19,961 No pulse in the instep or ankle. 541 00:24:19,986 --> 00:24:22,486 All right, uh, we're coming as fast as we can. 542 00:24:22,511 --> 00:24:25,898 But not fast enough? 543 00:24:26,035 --> 00:24:29,264 Okay, Paul, here's the deal. 544 00:24:29,289 --> 00:24:31,122 Your skin's so burned, blood can't get in 545 00:24:31,147 --> 00:24:33,548 or out of your foot. I'm gonna cut into your leg 546 00:24:33,573 --> 00:24:35,451 on both sides of the burn to release the pressure. 547 00:24:35,476 --> 00:24:36,364 Here? 548 00:24:36,389 --> 00:24:38,475 I wait any longer, you're gonna lose your foot. 549 00:24:38,500 --> 00:24:40,820 But... is it gonna hurt? 550 00:24:40,845 --> 00:24:42,501 Already pushed morphine in your IV. 551 00:24:42,525 --> 00:24:43,675 That'll help. 552 00:24:43,700 --> 00:24:45,250 But I'll feel it? 553 00:24:45,372 --> 00:24:47,996 Focus on me, not my hands. 554 00:24:48,021 --> 00:24:50,021 It'll be over before you know it. 555 00:24:50,046 --> 00:24:51,387 Okay? 556 00:24:51,412 --> 00:24:53,980 Deep breath. 557 00:24:54,005 --> 00:24:55,428 Then exhale. 558 00:24:57,361 --> 00:24:58,944 Keep breathing, Paul. Keep breathing. 559 00:24:58,969 --> 00:25:00,971 Big breath. 560 00:25:00,996 --> 00:25:04,505 Bigger exhale. 561 00:25:04,530 --> 00:25:06,561 Done. 562 00:25:06,642 --> 00:25:08,342 Good job, Paul. 563 00:25:11,654 --> 00:25:13,875 Good job. 564 00:25:16,133 --> 00:25:18,524 A high white cell count, what does that mean? 565 00:25:18,549 --> 00:25:20,563 You probably have an infection. 566 00:25:20,833 --> 00:25:22,749 - From Boomer? - It's possible. 567 00:25:22,774 --> 00:25:24,314 Have you felt sick recently? 568 00:25:24,368 --> 00:25:26,219 No, not really. 569 00:25:26,244 --> 00:25:29,111 I mean, every now and then my throat aches a little. 570 00:25:29,163 --> 00:25:30,319 It doesn't really bother me though. 571 00:25:30,344 --> 00:25:31,677 Hmm. 572 00:25:32,906 --> 00:25:36,168 Hmm, the lymph nodes are swollen, 573 00:25:36,204 --> 00:25:38,421 consistent with an upper respiratory infection. 574 00:25:38,456 --> 00:25:40,911 Let's get a rapid strep test. 575 00:25:42,672 --> 00:25:44,524 What kind of dog is Boomer? 576 00:25:44,549 --> 00:25:46,536 Boxer bulldog mix. 577 00:25:46,561 --> 00:25:47,977 A rescue. 578 00:25:48,049 --> 00:25:50,716 When I went to the shelter, all the dogs swarmed me, 579 00:25:50,741 --> 00:25:52,402 but Boomer hung back. 580 00:25:52,427 --> 00:25:53,913 Not because he was shy. 581 00:25:53,938 --> 00:25:55,500 It was a move so he'd stand out. 582 00:25:55,525 --> 00:25:57,149 He was playing me. 583 00:25:57,281 --> 00:25:59,447 Smart dog. 584 00:25:59,472 --> 00:26:02,139 I'm gonna swab the back of your throat. 585 00:26:03,687 --> 00:26:06,343 I'll get this to the lab. 586 00:26:20,365 --> 00:26:23,611 I'm doing what I think is right. 587 00:26:24,122 --> 00:26:27,375 Nathan's mental impairment is due to a pea-sized tumor 588 00:26:27,400 --> 00:26:28,633 that is easily removable. 589 00:26:28,658 --> 00:26:30,872 A 45-minute operation will cure him. 590 00:26:31,207 --> 00:26:34,439 But first, he has to survive 591 00:26:34,464 --> 00:26:37,798 this monumentally difficult surgery. 592 00:26:45,718 --> 00:26:48,164 I'm sorry, you can't bring your dog into the hospital. 593 00:26:48,192 --> 00:26:49,406 It's my sister's dog. 594 00:26:49,431 --> 00:26:51,014 She's somewhere in the back not answering her texts. 595 00:26:51,039 --> 00:26:52,588 Only service dogs in the ED. 596 00:26:52,613 --> 00:26:54,227 I'm sorry. 597 00:26:54,688 --> 00:26:57,003 - Oh, is this Boomer? - How'd you know? 598 00:26:57,028 --> 00:26:58,266 I've been taking care of Tara. 599 00:26:58,291 --> 00:26:59,727 She said he was a boxer bulldog mix. 600 00:26:59,752 --> 00:27:01,887 I thought it was only gonna be one or two hours. 601 00:27:01,912 --> 00:27:03,579 It's been five. Is she okay? 602 00:27:03,604 --> 00:27:05,096 She spiked a low fever. 603 00:27:05,121 --> 00:27:06,727 - We're testing for strep. - Strep? 604 00:27:06,752 --> 00:27:07,904 That's nothing. Okay, good. 605 00:27:07,929 --> 00:27:09,438 Look, I have to go to work. 606 00:27:09,463 --> 00:27:11,024 There's no pets allowed in my building. 607 00:27:11,049 --> 00:27:13,324 He barks one time and I can get evicted. 608 00:27:13,349 --> 00:27:14,837 I'm sorry, there's nowhere else to take him. 609 00:27:14,862 --> 00:27:16,695 Um, no, no, no. I can't take this... 610 00:27:23,997 --> 00:27:25,496 I know. 611 00:27:25,521 --> 00:27:27,902 It all happened really fast. 612 00:27:28,838 --> 00:27:31,343 What do I do? 613 00:27:31,753 --> 00:27:33,521 Get him out of here. Now. 614 00:27:33,546 --> 00:27:35,469 - But where do I take... - Reese, I don't care where. 615 00:27:35,494 --> 00:27:37,328 Just out. 616 00:27:39,126 --> 00:27:42,190 Hey, look at this guy. 617 00:27:42,215 --> 00:27:44,349 Yeah, Earl, this is Boomer. 618 00:27:44,374 --> 00:27:45,868 Could you watch him for a minute? 619 00:27:45,892 --> 00:27:47,175 But don't get too close because... 620 00:27:47,200 --> 00:27:48,533 Oh, come on, fella. 621 00:27:48,558 --> 00:27:51,275 Come on, guy. Let's go. 622 00:27:51,300 --> 00:27:53,108 Come on, big boy. 623 00:27:53,134 --> 00:27:55,084 Hey. Okay. 624 00:27:55,218 --> 00:27:57,018 Okay. 625 00:27:59,438 --> 00:28:01,271 When I'm out, 626 00:28:01,393 --> 00:28:04,116 the city will condemn my home, 627 00:28:04,271 --> 00:28:05,771 won't they? 628 00:28:05,838 --> 00:28:08,204 Fresh start, I guess. 629 00:28:12,592 --> 00:28:14,385 Get away. Don't touch that. 630 00:28:14,409 --> 00:28:15,751 Don't touch that. 631 00:28:15,776 --> 00:28:17,891 There they are. Ethan. 632 00:28:17,916 --> 00:28:19,607 Hey, guys. 633 00:28:21,378 --> 00:28:23,183 Hey, you okay? 634 00:28:23,248 --> 00:28:24,580 For a second there, it sounded like... 635 00:28:24,605 --> 00:28:27,079 Little hairy for a while, that's all. 636 00:28:27,104 --> 00:28:29,321 Escharotomy in the field. 637 00:28:29,346 --> 00:28:31,679 Damn, nice job. 638 00:29:01,790 --> 00:29:05,224 One across. Six letters. 639 00:29:05,249 --> 00:29:08,417 Bread, milk, eggs. 640 00:29:10,444 --> 00:29:12,882 Thoughts? 641 00:29:13,995 --> 00:29:16,246 Staple. 642 00:29:16,461 --> 00:29:18,127 Nice. 643 00:29:22,850 --> 00:29:25,100 Thank you. 644 00:29:25,308 --> 00:29:27,141 Sure. 645 00:29:30,813 --> 00:29:32,763 All right, guys. 646 00:29:36,162 --> 00:29:40,383 - Got it, clear. - Lift him up. 647 00:29:48,709 --> 00:29:51,062 Don't touch that. 648 00:30:26,004 --> 00:30:27,420 Dr. Manning, 649 00:30:27,445 --> 00:30:30,874 uh, Tara's rapid strep came back negative. 650 00:30:31,520 --> 00:30:33,985 Okay, so we're back at square one. 651 00:30:34,010 --> 00:30:35,158 You know what, let's run a, uh... 652 00:30:36,747 --> 00:30:38,882 Easy! Easy. 653 00:30:40,107 --> 00:30:42,607 I'm sorry. I am so sorry. 654 00:30:42,632 --> 00:30:45,451 - Hey, Earl, what's going on? - I don't know what happened. 655 00:30:45,476 --> 00:30:46,938 Twenty people petted this dog, 656 00:30:46,963 --> 00:30:49,442 and this patient is the only one he barked at. 657 00:30:49,467 --> 00:30:50,954 Come on, boy. Come on. 658 00:30:50,979 --> 00:30:53,426 Come on, Boomer. Come on, come on, Boomer. 659 00:30:54,592 --> 00:30:59,172 Let's run an infused CT chest and abdomen on Tara. 660 00:30:59,712 --> 00:31:02,012 Oh, I've heard stories. 661 00:31:02,037 --> 00:31:04,501 - Mm-hmm. - Yeah. 662 00:31:11,633 --> 00:31:13,466 Easy. 663 00:31:13,681 --> 00:31:16,481 Snakes in the grass. 664 00:31:16,506 --> 00:31:21,259 Bypass grafts are buried in the scar tissue, 665 00:31:21,284 --> 00:31:23,033 tough to see. 666 00:31:23,058 --> 00:31:25,652 Soften your grip... 667 00:31:25,678 --> 00:31:28,012 an... and go slow. 668 00:31:32,969 --> 00:31:35,839 - I see it. - Mm-hmm. 669 00:31:35,904 --> 00:31:39,295 Proximal pseudo-aneurysm of the LAD bypass graft. 670 00:31:39,324 --> 00:31:40,879 Let's cannulate and get him on the pump 671 00:31:40,904 --> 00:31:41,887 so we can do the repair. 672 00:31:41,912 --> 00:31:44,176 No, I don't need the pump. 673 00:31:44,201 --> 00:31:46,063 It just needs a single repair stitch. 674 00:31:46,088 --> 00:31:47,977 I can do it on the beating heart. 675 00:31:48,401 --> 00:31:50,969 - 8-0 suture. - Suture. 676 00:31:52,546 --> 00:31:54,554 EKG's ischemic. STs elevation. 677 00:31:54,579 --> 00:31:56,344 Pseudo-aneurysm's ruptured. 678 00:31:56,370 --> 00:31:58,321 He's bleeding. 8-0 suture to me. 679 00:31:58,346 --> 00:32:00,463 - I've got the better angle. - Dr. Rhodes. 680 00:32:00,488 --> 00:32:04,767 I pushed for the surgery. I can't lose him. 681 00:32:09,609 --> 00:32:11,911 I'll get you better exposure. 682 00:32:11,936 --> 00:32:14,512 There. 683 00:32:20,181 --> 00:32:22,317 Going to put a second stitch in now. 684 00:32:22,342 --> 00:32:25,027 Don't back-wall the graft. 685 00:32:27,227 --> 00:32:30,796 Bleeding has stopped and EKG's improving. 686 00:32:30,821 --> 00:32:32,103 Pressure's good. 687 00:32:32,128 --> 00:32:33,316 We're out of the woods. 688 00:32:33,341 --> 00:32:34,840 Not yet. 689 00:32:34,865 --> 00:32:37,252 I want to check his other bypass grafts. 690 00:32:37,489 --> 00:32:39,638 Something goes wrong in the future, 691 00:32:39,663 --> 00:32:44,455 no surgeon's gonna open his chest a third time. 692 00:32:48,190 --> 00:32:50,830 Lymphoma. 693 00:32:52,063 --> 00:32:54,438 I have cancer? 694 00:32:55,166 --> 00:32:59,238 The next step is a biopsy to determine exactly which kind. 695 00:32:59,263 --> 00:33:01,123 But I'm only 26. 696 00:33:01,148 --> 00:33:02,615 I go to the gym every day. 697 00:33:02,640 --> 00:33:03,803 I don't smoke. 698 00:33:03,828 --> 00:33:04,861 I know. 699 00:33:04,886 --> 00:33:06,031 It's not fair. 700 00:33:06,056 --> 00:33:07,415 But I don't feel sick. 701 00:33:07,440 --> 00:33:09,773 Well, that's because it was caught early. 702 00:33:09,829 --> 00:33:12,124 You have time to get way ahead of this. 703 00:33:12,149 --> 00:33:13,453 Mm-hmm. 704 00:33:13,478 --> 00:33:16,794 The lymph nodes are around here, aren't they? 705 00:33:17,404 --> 00:33:19,928 Boomer's been nipping at me for a month. 706 00:33:19,953 --> 00:33:22,002 Always right there. 707 00:33:22,820 --> 00:33:24,834 Do you think he knew? 708 00:33:25,120 --> 00:33:26,962 Maybe. 709 00:33:27,005 --> 00:33:31,426 It seems some dogs can smell cancers, 710 00:33:31,451 --> 00:33:33,501 even in the very early stages. 711 00:33:33,526 --> 00:33:36,266 Yeah, he wasn't attacking you. 712 00:33:36,336 --> 00:33:39,581 He was trying to protect you. 713 00:33:49,368 --> 00:33:51,191 Maggie, what's going on with Treatment 4? 714 00:33:51,216 --> 00:33:54,204 - We don't have the space for this... - I know, I know. It's been all day. 715 00:33:54,229 --> 00:33:56,999 Dr. Halstead, environmental services hasn't shown up yet. 716 00:33:57,024 --> 00:33:59,071 I can't even get an estimate as to when they will. 717 00:33:59,954 --> 00:34:01,976 I'll go see them in person. 718 00:34:02,001 --> 00:34:03,834 I'll drag someone down here if I have to. 719 00:34:03,859 --> 00:34:04,975 Knock some heads. 720 00:34:05,000 --> 00:34:07,333 I need that room back. 721 00:34:17,237 --> 00:34:19,429 How's he doing? 722 00:34:20,161 --> 00:34:21,710 Well. 723 00:34:21,735 --> 00:34:23,885 Good. 724 00:34:24,685 --> 00:34:27,103 How are you doing? 725 00:34:27,222 --> 00:34:29,555 As a neurologist, 726 00:34:29,760 --> 00:34:32,821 Lewy Body Dementia was my worst nightmare. 727 00:34:32,853 --> 00:34:35,619 I'd seen so many cases, 728 00:34:35,762 --> 00:34:37,770 and I'm wondering 729 00:34:38,045 --> 00:34:40,383 if it influenced my diagnosis. 730 00:34:40,408 --> 00:34:41,719 Hmm. 731 00:34:42,656 --> 00:34:47,019 Medicine, you know. 732 00:34:47,281 --> 00:34:49,571 Imperfect science. 733 00:34:49,596 --> 00:34:51,513 Practiced by human beings, no less. 734 00:34:54,151 --> 00:34:57,919 Four years we could have been doing CTs, 735 00:34:58,329 --> 00:35:01,452 but I had an answer, so there was no reason 736 00:35:01,477 --> 00:35:04,968 to continue radiating his brain. 737 00:35:04,993 --> 00:35:07,352 I robbed Nathan 738 00:35:07,377 --> 00:35:09,288 of his mind. 739 00:35:10,135 --> 00:35:12,636 I imprisoned him. 740 00:35:14,860 --> 00:35:16,901 I drained our savings. 741 00:35:16,926 --> 00:35:18,586 Squandered our time together, 742 00:35:18,611 --> 00:35:21,701 time that we can never get back. 743 00:35:23,580 --> 00:35:26,290 How am I gonna tell him what I've done? 744 00:35:26,933 --> 00:35:29,016 He's never gonna forgive me. 745 00:35:35,097 --> 00:35:38,348 Your husband's gonna forgive you, Laura. 746 00:35:38,451 --> 00:35:41,061 I want you to trust me on that. 747 00:35:41,726 --> 00:35:43,726 Your struggle, 748 00:35:43,751 --> 00:35:45,634 if I may, 749 00:35:45,858 --> 00:35:48,477 is figuring out 750 00:35:48,502 --> 00:35:51,503 how you're gonna forgive yourself. 751 00:35:58,876 --> 00:36:00,534 Vitals are stable. 752 00:36:00,559 --> 00:36:02,750 EKG looks good. 753 00:36:07,663 --> 00:36:10,030 Cleveland Clinic has an axiom. 754 00:36:10,200 --> 00:36:12,636 Emergency surgery on a healthy heart? 755 00:36:12,661 --> 00:36:14,336 Yes. 756 00:36:14,361 --> 00:36:16,654 Redo surgery for a repaired heart? 757 00:36:16,915 --> 00:36:18,498 Yes. 758 00:36:18,745 --> 00:36:22,477 Emergency surgery for a repaired heart? 759 00:36:22,502 --> 00:36:24,199 No, 760 00:36:24,740 --> 00:36:27,707 because overwhelmingly, 761 00:36:27,830 --> 00:36:30,883 those patients die on the table. 762 00:36:31,583 --> 00:36:34,035 I couldn't do nothing. 763 00:36:34,841 --> 00:36:38,297 I suspect it was ego more than altruism. 764 00:36:39,601 --> 00:36:41,935 Great surgeons 765 00:36:42,148 --> 00:36:44,194 know the balance. 766 00:36:44,919 --> 00:36:46,919 You're confident, 767 00:36:46,944 --> 00:36:49,516 not arrogant. 768 00:36:49,820 --> 00:36:52,635 I like that, Dr. Rhodes. 769 00:36:53,126 --> 00:36:56,259 Nice job today. 770 00:37:05,279 --> 00:37:08,413 You're good. You're good. 771 00:37:08,667 --> 00:37:10,313 Good boy. 772 00:37:10,338 --> 00:37:12,552 Good boy. 773 00:37:17,035 --> 00:37:19,376 Don't come from above. 774 00:37:19,400 --> 00:37:21,316 Come from the front so he can see you, 775 00:37:21,341 --> 00:37:23,310 and hold out the back of your hand first. 776 00:37:23,335 --> 00:37:25,092 - Okay. - Come on, buddy. 777 00:37:25,117 --> 00:37:27,475 - Yeah? - Yeah. 778 00:37:27,500 --> 00:37:30,890 Hey, there. 779 00:37:31,334 --> 00:37:34,789 Did you ever hear that origin story about dogs? 780 00:37:35,105 --> 00:37:37,993 In Eden, humans and animals got along, 781 00:37:38,018 --> 00:37:39,596 even spoke the same language, 782 00:37:39,621 --> 00:37:43,109 but when Adam and Eve sinned and God drove them out, 783 00:37:43,134 --> 00:37:46,430 a great chasm opened up between people and animals. 784 00:37:46,611 --> 00:37:50,062 And as the chasm grew wider, at the very last moment, 785 00:37:50,087 --> 00:37:53,734 a dog leaped across it to be with us. 786 00:37:55,829 --> 00:37:57,990 That's a great story. 787 00:37:59,220 --> 00:38:01,220 Yeah. 788 00:38:05,738 --> 00:38:08,439 Come in. 789 00:38:08,667 --> 00:38:10,521 Ms. Goodwin, can I talk to you for a moment? 790 00:38:10,546 --> 00:38:12,746 Quickly, I'm on the homestretch with JCAHO, 791 00:38:12,771 --> 00:38:14,673 and I don't want to let up now. 792 00:38:14,699 --> 00:38:16,507 I know my voice isn't official, 793 00:38:16,532 --> 00:38:17,731 but I'd like to put in a good word 794 00:38:17,756 --> 00:38:20,540 for Will regarding the open ED attending position. 795 00:38:20,565 --> 00:38:21,514 Really? 796 00:38:21,539 --> 00:38:23,037 It'd be a shame to lose him. 797 00:38:23,062 --> 00:38:24,099 He's a great doctor. 798 00:38:24,124 --> 00:38:25,653 He cares about this hospital. 799 00:38:25,678 --> 00:38:28,836 Just a few weeks ago you asked to be taken off his shifts. 800 00:38:28,861 --> 00:38:30,611 We don't always see eye to eye, 801 00:38:30,636 --> 00:38:33,940 but his heart is in the right place. 802 00:38:33,965 --> 00:38:35,431 Well, Dr. Manning, 803 00:38:35,456 --> 00:38:40,215 I'm glad your opinion of Dr. Halstead has changed. 804 00:38:41,453 --> 00:38:43,453 Okay. 805 00:38:49,550 --> 00:38:51,967 Dr. Halstead, environmental services 806 00:38:51,992 --> 00:38:53,316 are on their way? 807 00:38:53,341 --> 00:38:54,807 Nope. 808 00:38:54,890 --> 00:38:57,665 Turns out, every department in the hospital's calling ES 809 00:38:57,690 --> 00:39:00,267 to handle things they normally take care of themselves. 810 00:39:00,292 --> 00:39:02,636 Be tomorrow before a janitor shows up. 811 00:39:02,661 --> 00:39:05,275 Ah, bureaucracy. 812 00:39:07,609 --> 00:39:09,642 Whew. 813 00:39:09,667 --> 00:39:11,267 Mm. 814 00:39:19,016 --> 00:39:20,883 There. The room is yours again. 815 00:39:20,908 --> 00:39:22,614 Against protocol? 816 00:39:23,364 --> 00:39:24,982 I won't tell if you won't. 817 00:39:25,007 --> 00:39:27,909 Huh, guess that means I get to clean this up now 818 00:39:27,934 --> 00:39:30,721 the way I wanted to eight hours ago. 819 00:39:32,071 --> 00:39:34,071 - You know, toss me a pair. - Oh? 820 00:39:34,096 --> 00:39:35,796 You know, the kind that, uh, stick to yours 821 00:39:35,821 --> 00:39:38,104 when you pull 'em out. 822 00:39:39,049 --> 00:39:41,321 - You want in? - Heck yeah. 823 00:39:41,346 --> 00:39:43,379 We've come this far. 824 00:39:43,404 --> 00:39:45,744 And they call you Robocop. 825 00:39:45,769 --> 00:39:48,603 Robocop? 826 00:39:57,476 --> 00:39:59,201 Katrina. 827 00:39:59,226 --> 00:40:01,554 Reese, come with me. 828 00:40:01,579 --> 00:40:03,154 Uh-oh. 829 00:40:03,179 --> 00:40:05,729 Yeah, I've seen that look. 830 00:40:05,754 --> 00:40:07,825 Dr. Rhodes. 831 00:40:08,018 --> 00:40:10,058 Everyone. 832 00:40:10,914 --> 00:40:14,970 Look, we all know how important JCAHO site visits are. 833 00:40:14,995 --> 00:40:18,538 Yet, despite what I said about the rules, 834 00:40:18,562 --> 00:40:21,897 my team ordered tests on the sly, 835 00:40:21,922 --> 00:40:24,255 brought a dog into the ED, 836 00:40:24,280 --> 00:40:27,683 and handled radioactive material. 837 00:40:30,465 --> 00:40:34,078 Sharon, you have every right to be upset. 838 00:40:34,103 --> 00:40:36,364 Really. But we can't really be ignoring 839 00:40:36,389 --> 00:40:38,851 the, uh, the second law of thermodynamics here. 840 00:40:38,876 --> 00:40:40,159 Now, can we? 841 00:40:40,184 --> 00:40:41,507 How's that? 842 00:40:41,531 --> 00:40:44,673 Well, systems do tend to degenerate 843 00:40:44,698 --> 00:40:48,563 into ever more disordered versions of themselves, right? 844 00:40:48,644 --> 00:40:50,483 I mean, look around you. 845 00:40:50,508 --> 00:40:51,820 All we're doing here, all day long, 846 00:40:51,845 --> 00:40:54,995 is battle the universe's desire to fall apart. 847 00:40:55,020 --> 00:40:59,098 Yeah, should've seen the house I was in today. 848 00:40:59,123 --> 00:41:00,506 I'm just saying, I love rules. 849 00:41:00,531 --> 00:41:03,211 We all do, but in bringing order to disorder, 850 00:41:03,236 --> 00:41:06,379 every now and then a couple gonna get bent. 851 00:41:06,737 --> 00:41:09,608 Nice try, Daniel. 852 00:41:10,459 --> 00:41:13,474 But the good news is JCAHO 853 00:41:13,499 --> 00:41:15,499 didn't catch any of you, 854 00:41:15,523 --> 00:41:18,448 so we keep our top rating. 855 00:41:21,213 --> 00:41:23,914 I'll see you all tomorrow. 856 00:41:23,939 --> 00:41:26,602 Second law of thermodynamics. 857 00:41:26,627 --> 00:41:28,593 Please. 858 00:41:29,515 --> 00:41:33,741 - Synced and corrected by martythecrazy - - www.addic7ed.com -