All right, everyone, listen up.
Before we start rounds, Dr. Frost
has a very special announcement.
I certainly do.
Today, we are piloting
a new program to improve emotional support
for our patients.
I'd like to introduce you to our newest volunteers.
Oh!
These intrepid canines will accompany you
to visit patients who have expressed an interest in meeting them.
And who have been medically cleared for the visit,
since dogs are unsanitary and don't belong in a hospital.
Just my opinion.
I'll leave you to it.
Have fun working with your dog-tors.
I was thinking it, but I didn't say it.
Mm.
This is so great.
You know, research shows that a therapy dog visit
can really benefit an anxious patient.
Research also shows that dogs aren't doctors.
Now-a-days, you stick a vest on a dog,
and, suddenly, it can go anywhere.
Okay, there's a difference between that
and a real service animal.
All I'm saying is, I was at a restaurant
and a "real service animal" stole my hamburger.
I'm a cat person.
I like an animal that bends you to its will.
All right, we have actual humans
who'd like our attention, too.
Interns, let's move.
Dogs, let's move.
- Synced and corrected by Firefly - - www.addic7ed.com -
Oh, good, Macy. You've already met
- one of our therapy dogs. - Yeah.
Finnegan's great. He's a nice distraction.
- Keeping me chill. - Oh, really?
Sounds like he's being very helpful.
Oh, yeah. I see
he's already attached her heart monitor leads.
Oh, you didn't do that?
'Cause you don't have thumbs and you're just a dog?
Mm-hmm.
So, I understand you were admitted from the ER
this morning for acute tendonitis?
Yeah, I played tennis yesterday.
And then, last night, my arm started
swelling and cramping.
It still hurts.
Oh. Yeah.
Yeah, I can see the swelling. Still fairly pronounced.
The ER doctor was concerned that she isn't responding
- to ibuprofen. - Mm.
Ooh, your lymph nodes are swollen.
Were you ill recently?
- I had strep throat. - When was that?
Last week, but I had a Z-Pak and it cleared up.
Okay. Well, we'll schedule an MRI
and find out what's going on.
Can Finnegan stay?
Yes. He can also sit, roll over
and if there's any squirrels in the room,
he will find them.
Mm.
Seems like she's really responding to Finnegan.
I know you don't think dogs are helpful,
but I read about a woman who was having a heart attack
and her Pomeranian called 911.
Lexie?
Huh?
Yeah. 911's great.
Easy to remember.
Okay, what's wrong?
Because that's more than your usual level
of disinterest in my stories.
Yeah, it's... nothing.
Come on. What is it?
I was just thinking about Macy's swelling,
plus her recent strep.
It made me think of acute compartment syndrome.
ACS?
- That's very rare. - Yeah.
- You're right. Stupid idea. - Wait, hold on.
Are-are you thinking that because of the strep infection?
Yeah, if it spread to her arm,
it could be causing the swelling.
I mean, if you're right, that's very serious.
Maybe we should check the pressure on her arm.
But, again, it's so rare.
I don't want to put her through a painful test
just based on my dumb hunch.
It's not dumb. Let's just check.
Hey, Macy, listen,
we're concerned that the swelling
in your arm is affecting your circulation.
So we just wanted to run a little test.
It's gonna hurt just a tiny bit.
Okay.
So, take a deep breath.
One, two, three.
42 mmHg.
I'll call Surgery.
- Wait, what? - Listen, Macy,
your strep has spread to your arm,
and the infected tissue is cutting off circulation.
You're gonna be fine, but we have to get you
to the OR immediately.
Patient is a 45-year-old man
admitted with chest pains and light-headedness.
We tested for a heart attack and pulmonary embolism,
but both tests came back clean.
His vitals are normal, so our plan is to discharge.
Oh. Well, Gordon,
we hope you've enjoyed your stay at Loyola Memorial.
We know you have many options when it comes to medical care,
and we appreciate you choosing us.
I feel like a flight attendant.
Take care, Gordon.
Actually, I-I probably should have brought this up earlier,
but I've also been feeling pretty nauseous.
Oh. How long has this been going on?
Well, it started a few days ago at the gym.
I mean, usually, just the idea of going to the gym
- makes me sick. - Mm-hmm.
But then I got nauseous picking up groceries
and then again golfing w-with my wife and her dad.
Mm. Very interesting.
Wait, have you felt a dull pain
in the arch of your foot and your ear?
Actually, a little of both.
Ooh. Very interesting.
You know, I'm gonna consult with my colleagues.
Uh, if you do need to vomit,
try not to do it near Noodles.
She'll eat it.
Well, I think it's pretty clear what Gordon's ailment is.
It is?
Yes. He has appendic...
Gall...
Kidney...
I don't know either.
Well, this is a fantastic exercise in medical deduction.
Since the patient is in no immediate danger,
I'm gonna give you one hour to figure out
what Gordon's ailment is.
And we can run whatever tests we want?
Mm, no tests. Everything you need
is either in this chart or in that room.
Like a medical escape room.
I've never done one,
because I'm not a total nerd.
I love them.
Yeah! 'Cause they're so much fun!
Ah,
the hour begins now.
60, 59:59,
59:58, 59:57...
You know what, I'm just gonna set a timer.
The surgeons are predicting
that Macy will make a full recovery.
Great work.
Did you hear that?
Not decent, not pretty good, not even full good... great.
Well, most new doctors wouldn't have made the diagnostic leap
to acute compartment syndrome.
Most new doctors didn't.
It was all Dr. Gilani.
If you think I am not buying her a hot chocolate,
you're crazy!
Carol, stop it.
It was a team effort.
Okay, you two.
Take the compliment and move on.
Pfft.
More people have won the Super Bowl
than have gotten a compliment from Dr. Jacobs.
You're a hero.
No, I'm not.
Come on. You saved a woman's arm.
This girl deserves a cheering section.
Okay, Dennis,
when I say "Lexie", you say "did it".
Lexie!
Can we move on?
I don't want to make a big deal of it.
If you don't broadcast your successes, who will?
Dennis? Doesn't sound like it.
Unless...
Lexie!
Come on!
Carol, I said I don't want to make a big deal of it.
Let's just drop it.
Did it! Did it!
I could tell she wasn't in the mood, but I love a good cheer.
All right, let's solve a medical mystery.
Dr. Frost said it's obvious and he mentioned ears,
so let's start there.
Hey, Gordon. We are gonna figure out
what's wrong with you in... 58 minutes.
But if you don't do it in that amount of time,
you're still gonna keep trying, right?
Sure, sure, sure.
He has no external signs of infection.
Light seborrheic dermatitis.
Kind of pointy.
Hey!
It's not like your ears are so great.
Buzz cut was a bold move on your part.
All right.
Ear canals look normal.
Uh, hey, Gordon,
have you had any vision problems recently?
A little, yeah.
But now I only have eyes for Noodles.
What about headaches?
Now that you mention it, I have had some headaches.
Oh, Caleb, get ready to escape in record time.
Chest pressure, headaches, vision issues?
- Gordon has giant cell arteritis. - Of course.
Now all we need to do is confirm
his lymph nodes are swollen,
and they feel...
completely normal.
So, not giant cell arteritis.
I'm not a doctor, but could it be small cell arteritis?
Yeah. Uh-huh. Thanks, Gordon.
Uh...
Oh, what's this?
Blue nail beds.
It's COPD.
Y-Yeah, actually, my pen broke.
So, blue.
And you're just telling us this now?
Gordon, when we asked if there was anything else
we should know, you didn't think to mention that your pen broke?
I didn't think it was relevant.
- Are you a doctor? - No.
That's right.
We'll decide what's relevant.
Listen, um, I'm sorry if I said something back there.
No, we're cool. Really.
I was just thinking I would tap out for the day.
Tap out?
You mean go home?
We can't do that. We're doctors.
Today was just really intense.
It was.
You want to talk about it?
Oh. No.
The Gilanis are not "talk it out" people.
We prefer inappropriate jokes and isolation.
Fine. Don't talk to me.
Although you should,
because I am universally lauded
for giving excellent advice.
But if you're feeling stressed,
you know, there's things you can do.
Right, like drink water, get plenty of sleep
and eat vegetables.
Steal drugs from the supply closet.
Carol!
That's me being inappropriate.
Nice one.
Listen,
remember when we were at orientation?
You made fun of me for listening, but they told us
about a Doctor Wellness Center.
I mean, they probably have resources...
somebody to talk to,
a quiet place to meditate, a massage chair.
Plus, it's nice to see how many other doctors
are dealing with the exact same thing.
That sounds good.
But so does sitting in a room by myself.
I'll bet they have snacks.
What are the chances you give this up?
- Zero. - Fine.
And trust me, as soon as we walk in there,
the feeling of wellness will just wash right over you.
Oh, yeah.
Yeah, baby.
I see what you mean, Carol.
I feel better already.
Now, where should the healing begin?
On this treadmill from 1982?
Or in this box of trash?
Oh, I know.
By that pile of mouse feces.
Okay, Lexie, I-I'm disappointed, too.
You know, they really made this place
sound much nicer at orientation.
Clearly, I'm the only person that's needed to come here
in the past 10,000 years.
Look, I-I'm sorry, Lexie.
I'm just trying to make you feel better.
Well, I feel worse.
Great idea, Carol.
My first idea was hot chocolate.
I'm gonna get you hot chocolate!
Where's Lexie?
Not here.
But do you know who is here
and wuvs hot chocowate?
Hands off. Lexie earned this.
I can't say no to that face.
You can have mine.
Anyway, have you seen her?
She's not responding to my pages.
- Mm-mm. - Dr. Kenney,
the dog that was with your patient in 416
is missing. Where is it?
So some shenanigans happen in the hospital,
and you assume I have something to do with it?
Uh, yes.
That's fair.
You and Dennis need to find it.
What? But it's cocoa time.
Oh.
The hot chocolates are getting in the way?
Here.
I'll take them. Find the dog.
EKG is normal.
Regular intervals.
There's something we're not seeing.
Hey, you guys are blocking the TV.
Do you mind scooching a bit?
Wait a second.
You mentioned that you'd been to the gym.
Oh, yes!
A gym is a cesspool of viruses and staph infection.
It's basically a toilet with treadmills.
Yeah, a-actually, I-I kind of exaggerated.
The gym is my garage.
It's just a ThighMaster and a bag of sand.
Oh! Didn't you also mention
you felt your symptoms at the supermarket?
Were you in the produce aisle?
Those misters are basically E. coli fountains.
They are?
Wow, I might have gotten some in my mouth
when I was shaking out the romaine.
Do you think it was the romaine?
Hey, Gordon, pro tip:
next time you walk into a hospital, do us all a favor
and announce that you've eaten romaine.
Yeah, but E. coli generally presents as fever.
15 minutes, gents.
Wait, I got it.
Gordon, have you urinated blood today?
Um, no.
Gordon, why can't you just urinate blood?
Finnegan!
Finnegan! Here, boy!
Finnegan?
You know, I can't stop thinking about Lexie.
I hope she's okay. I mean,
I just wish she would get back to me.
It's like she doesn't want to be found.
Dennis, I got to go.
So I guess it's just me looking for the dog?
Finnegan?
Hey, Lexie.
Everything okay?
Yeah, I'm great. Why do you ask?
Oh, I don't know. Just...
looks like you've stolen a service dog,
and you're hiding in a basement room
that smells like an old diaper.
You know what?
I'm just gonna join you down there.
Huh.
It's much wetter than I expected.
Time's almost up.
Frost will be back any second.
- Are you an IV drug user? - No.
- Have you eaten blowfish recently? - No.
- Are you allergic to peanuts? - The food or the comic?
Gordon, thin ice.
Actually, I am allergic to peanuts.
What does that mean?
Nothing.
And time.
Do you have a diagnosis?
Looks like neither of you escaped this room.
And, Gordon, for you to escape the hospital,
I'll need to confirm my diagnosis
by performing a cardiac catheterization.
Okay. What is that?
Well, we insert a thin, hollow tube
through a blood vessel and pass it up to your heart.
- We go in through the groin. - I made it all up!
What?!
I was trying to get out of dinner with my in-laws.
Dude, you let me do a rectal exam.
You haven't met my in-laws.
Mm.
You don't deserve Noodles.
Wait, how'd you figure it out so quickly?
Well, first, I noticed
that his wife's emergency contact number
had a Florida area code.
Now, when in-laws visit from Florida,
they don't come for a day.
It's been ten days.
Mm-hmm.
Why did you ask
about the arches of his feet and his ears?
Well, there are no diseases that cause pain
in the feet and the ears.
Outside of his in-law-itis,
Gordon is what we call a malingerer.
So,
you mean, he's trying to stay in the hospital?
Mm, it's more common than you think.
So, next time, before you run a bunch of expensive tests,
consider if the answer is right in front of you.
I'm sorry, but you understand.
In-laws are stressful.
Can I stay the night?
Gordon, for goodness sake,
just say it's a work trip.
Book a hotel room like a normal man.
I-I was gonna walk away from our patient.
- That woman could've lost her arm. - But she didn't.
Only 'cause you were there.
This job is crazy pressure.
Yeah, it's a big difference from med school
where you just practiced on dummies you couldn't kill.
Oh, I killed a dummy once.
Put her on a radiator, and its head melted off.
See, that's why I never would have guessed
anything was bothering you.
You're always cracking jokes.
That's just always how I've dealt with things.
It's easier to laugh.
And honestly, feelings?
Lame.
Well, that's the thing about getting old.
You realize you have to deal with your feelings.
I thought the thing about getting old
was not liking your neck.
- That's a big one, too. - Hmm.
We were working together today.
- How is this not getting to you? - Oh, it is.
I guess I just have more practice
dealing with intense situations.
Like life or death?
Have you ever been afraid of accidentally killing someone?
Have you ever brought an infant home from the hospital?
No.
But I'll admit, when I walk through the maternity ward,
it is tempting.
You know, maybe I'm not thrown by this
'cause I've already been through so much in my life.
Faced pressures, experienced failures...
Like your marriage.
That's fine.
If that helps you get through this, make your jokes.
And I promise, I will be here, and I will listen.
I will also pretend that they're funny.
Wow. Solid burn, Carol.
Mm-hmm.
Thanks.
And, you know, this place is definitely not gonna help
with any of this.
But you know what will?
Aw, I thought maybe we could all use this.
- It's been a stressful day. - Yeah.
Today, Dr. Sommers and I couldn't even diagnose nothing.
I really need a hug.
May I?
These dogs are way more effective
than the Wellness Center, aka the place
where hope and spiders go to die.
We need better resources than a haunted storage closet
to deal with the stresses of this job.
Agreed.
When I was an intern,
if you had any emotions,
you were just supposed to stuff them down
until your heart exploded.
I lost two of my best friends.
Oh, no. I'm so sorry.
To investment banking.
Wow, I really thought I was the only one.
You're not the only one.
You're just the first in your class.
You'll all go through it.
That's why it's important
you rely on your fellow interns for support.
Very true.
They understand what you're going through
better than anyone else.
That's a great idea.
You guys must be under a lot of stress, too.
Sure, you're here for us, but who's here for you?
I don't think dogs get stressed.
Clearly, someone has never seen Scooby-Doo.
- Well, we can support each other. - Deal.
Ah! I found the dog.
He was in the alley behind the dumpster.
He fought me a little, but, uh, I cornered him.
Dennis,
that's not a service animal.
I think you found a stray dog.
I may need one of you to give me a tetanus shot.
Gordon, what are you still doing here?
Oh, I'm gonna be out of your hair in two seconds.
Just getting a quick snack.
Wait, aren't you allergic to peanuts?
This ought to keep me here through the weekend.
- No, no, no, no, no, no! - No, no, no, no!