1
00:00:06,154 --> 00:00:07,674
They've installed cameras.
2
00:00:07,675 --> 00:00:09,347
They're all over the C.C.U.
3
00:00:09,348 --> 00:00:12,109
Next they'll be in the O.R.s,
the hallways,
4
00:00:12,677 --> 00:00:14,165
the on-call rooms.
5
00:00:15,044 --> 00:00:16,761
We're being spied on, Mer.
6
00:00:17,395 --> 00:00:18,689
Who knows what evil lurks
7
00:00:18,690 --> 00:00:21,077
behind that electronic eye?
8
00:00:21,247 --> 00:00:22,740
Morning, Dr. Yang.
9
00:00:23,717 --> 00:00:25,288
Big Brother knows my name.
10
00:00:28,219 --> 00:00:30,198
Big Brother can see your name tag.
11
00:00:30,199 --> 00:00:31,403
Excuse me.
12
00:00:31,404 --> 00:00:33,019
The cameras are not here to spy on you.
13
00:00:33,020 --> 00:00:34,610
They are here to supplement you.
14
00:00:34,611 --> 00:00:37,163
On the other side of
the camera is a remote physician,
15
00:00:37,164 --> 00:00:40,311
an extra set of eyes to
help reduce mistakes,
16
00:00:40,312 --> 00:00:43,347
improve patient care,
and maximize physician hours...
17
00:00:43,348 --> 00:00:45,433
- We've all heard the buzz words...
- Now the initial program...
18
00:00:45,434 --> 00:00:47,861
"Streamline, optimize,"
19
00:00:47,862 --> 00:00:50,185
integrate, adapt."
20
00:00:50,311 --> 00:00:53,711
Every day someone comes up
with a new strategy or tool
21
00:00:53,712 --> 00:00:57,479
or technology to increase our efficiency.
22
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The idea is to make our lives easier.
23
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But the question is, does it?
24
00:01:02,382 --> 00:01:05,488
And of course, ultimately
reduce costly litigation.
25
00:01:05,538 --> 00:01:07,421
So does that answer your questions?
26
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With disturbing clarity.
27
00:01:09,367 --> 00:01:11,706
All right. Let's move on then.
28
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As you can see,
this O.R. has been arranged
29
00:01:14,760 --> 00:01:16,385
with maximum efficiency,
30
00:01:16,386 --> 00:01:18,264
specifically for O.R. turnover.
31
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Now what are the main
causes for bottleneck?
32
00:01:21,552 --> 00:01:23,638
The layout of O.R. supplies,
33
00:01:23,639 --> 00:01:25,632
equipment, and instruments.
34
00:01:25,633 --> 00:01:28,090
- So what we have done here...
- What did we miss?
35
00:01:28,091 --> 00:01:29,561
O.R.s are sloppy.
36
00:01:29,562 --> 00:01:31,640
There are doctors in the ceilings.
37
00:01:31,641 --> 00:01:33,370
What? What do... what does that even mean?
38
00:01:33,371 --> 00:01:35,881
We'd know if you'd just put
her stupid tights on her.
39
00:01:35,882 --> 00:01:37,112
I was talking her into it, okay?
40
00:01:37,113 --> 00:01:38,862
- She was getting on board.
- Um, she's 2. At a certain point,
41
00:01:38,863 --> 00:01:39,621
she doesn't have to get on board.
42
00:01:39,622 --> 00:01:40,477
She has to be in day care.
43
00:01:40,478 --> 00:01:41,929
So you pick her up and you
yank her tights on her.
44
00:01:41,930 --> 00:01:43,588
That's what you do. And then she cries.
45
00:01:43,589 --> 00:01:44,921
Yeah, because you wasted
all that time cajoling her,
46
00:01:44,922 --> 00:01:45,938
so now I have to be the bad cop.
47
00:01:45,939 --> 00:01:47,294
If you just made it
clear in the first place
48
00:01:47,295 --> 00:01:48,364
that she has no choice...
49
00:01:48,365 --> 00:01:49,681
Because when every second counts,
50
00:01:49,682 --> 00:01:52,024
you need the most efficient approach.
51
00:01:52,025 --> 00:01:53,823
- Mm.
- What she said.
52
00:01:55,623 --> 00:01:57,274
It's about new hospital procedures,
53
00:01:57,275 --> 00:01:58,425
and we weren't invited.
54
00:01:58,426 --> 00:01:59,883
Thank god. It looks boring.
55
00:01:59,884 --> 00:02:01,348
Don't you guys get what's going on?
56
00:02:01,349 --> 00:02:03,919
Yeah, they're closing the E.R.
and streamlining the place.
57
00:02:03,920 --> 00:02:04,694
It sucks, but...
58
00:02:04,695 --> 00:02:05,953
They're gonna fire us.
59
00:02:05,954 --> 00:02:07,389
Why bother teaching us the new protocols
60
00:02:07,390 --> 00:02:08,604
if we're gonna be gone anyway?
61
00:02:08,605 --> 00:02:11,051
- You're crazy.
- It's not that bad.
62
00:02:11,122 --> 00:02:11,741
Is it?
63
00:02:11,742 --> 00:02:12,845
Look at this.
64
00:02:15,389 --> 00:02:17,379
Nurses are stockpiling.
65
00:02:17,561 --> 00:02:18,804
The end is coming.
66
00:02:20,722 --> 00:02:22,695
Your average time between surgeries
67
00:02:22,696 --> 00:02:24,387
is 37 minutes.
68
00:02:24,388 --> 00:02:26,477
With these new O.R. procedures,
69
00:02:26,478 --> 00:02:28,392
I'd like to see that cut in half.
70
00:02:28,617 --> 00:02:29,788
Thank you, everyone.
71
00:02:32,736 --> 00:02:34,509
Closing the E.R. should cut down on time.
72
00:02:34,510 --> 00:02:35,791
We won't have any patients.
73
00:02:35,792 --> 00:02:36,858
How's Hunt feel about that?
74
00:02:36,859 --> 00:02:38,354
Oh, he says he's not gonna
do anything about it
75
00:02:38,355 --> 00:02:39,827
until it actually happens.
76
00:02:39,828 --> 00:02:40,532
Oh, it's happening.
77
00:02:40,533 --> 00:02:43,187
And he can't be a trauma
surgeon without an E.R.
78
00:02:43,188 --> 00:02:43,954
Is he gonna leave town?
79
00:02:43,955 --> 00:02:45,351
'Cause if you go with him, I'm screwed.
80
00:02:45,352 --> 00:02:46,939
I'm kind of depending on your rent check.
81
00:02:46,940 --> 00:02:48,033
Way to make this all about you.
82
00:02:48,034 --> 00:02:49,646
The E.R. is not going to close.
83
00:02:49,647 --> 00:02:51,079
Derek has a plan.
84
00:02:51,080 --> 00:02:51,807
Where is Derek?
85
00:02:51,808 --> 00:02:53,562
He spent the night with Kepner.
86
00:02:54,159 --> 00:02:54,896
It's gonna work, right?
87
00:02:54,897 --> 00:02:56,563
Of course. See, 'cause derm cuts a fellow,
88
00:02:56,564 --> 00:02:58,941
and then cardio skips the TED conference,
89
00:02:58,942 --> 00:03:01,331
plastic/ortho shares, uh, lab facilities,
90
00:03:01,332 --> 00:03:02,746
we'll get a little bit here,
a little bit there.
91
00:03:02,747 --> 00:03:04,656
And we'll have enough saved
to keep the E.R. alive.
92
00:03:04,657 --> 00:03:06,668
Oh, there gonna be mad
about the TED conference.
93
00:03:06,669 --> 00:03:07,627
Oh, they're gonna be
pissed about everything,
94
00:03:07,628 --> 00:03:09,146
but that's okay. It's gonna work.
95
00:03:09,147 --> 00:03:10,303
Do we have a reply yet?
96
00:03:10,304 --> 00:03:12,543
Uh, no, not yet.
97
00:03:12,856 --> 00:03:14,261
That was the subject line?
98
00:03:14,169 --> 00:03:15,534
Wh-wh-wh, is that bad?
99
00:03:15,535 --> 00:03:18,101
Well, would you open
any that said "Proposed budget cuts"?
100
00:03:18,101 --> 00:03:19,860
Oh, no. Did I just kill our proposal?
101
00:03:19,861 --> 00:03:21,826
No. We're just gonna have
to pitch it in person.
102
00:03:21,827 --> 00:03:23,632
Go door to door, which is better anyway.
103
00:03:23,974 --> 00:03:25,274
It's hard to say no to someone's face.
104
00:03:25,275 --> 00:03:26,783
Oh. No offense, sir.
105
00:03:26,784 --> 00:03:28,604
You have an unusually
appealing face, but...
106
00:03:28,605 --> 00:03:29,553
I have to brush my tee.
107
00:03:29,554 --> 00:03:31,219
- I know. You do, too.
- Oh.
108
00:03:30,907 --> 00:03:33,397
Standardizing an O.R. is one thing,
109
00:03:33,711 --> 00:03:35,828
but that's not going
to make much difference
110
00:03:35,829 --> 00:03:39,353
if we don't standardize
what happens in the O.R.
111
00:03:39,326 --> 00:03:41,924
To that end, I have brought in
Dr. Darrell Nesbaum
112
00:03:41,925 --> 00:03:43,527
to show us how it can be done.
113
00:03:45,101 --> 00:03:46,223
Everything will be scanned...
114
00:03:46,074 --> 00:03:48,096
When did you become such a kiss-ass?
115
00:03:48,561 --> 00:03:51,308
The last five hospitals whose
efficiency she improved
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00:03:51,309 --> 00:03:53,546
ended up cutting their staff by 30%.
117
00:03:53,547 --> 00:03:56,054
I'll learn to rope cattle
if it means keeping my job.
118
00:03:56,055 --> 00:03:59,159
Well, I'm safe because they
can't fire the pregnant lady.
119
00:04:00,761 --> 00:04:01,511
Can they?
120
00:04:01,512 --> 00:04:03,797
Uh, Dr. Nesbaum,
you can take it from here.
121
00:04:03,798 --> 00:04:04,766
Of course.
122
00:04:05,851 --> 00:04:07,244
Good morning, everybody.
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00:04:07,413 --> 00:04:10,678
Now I have just one
question before we begin.
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00:04:10,926 --> 00:04:14,150
Are you ready to rock some hernias?
125
00:04:14,402 --> 00:04:16,132
That's what I'm talkin' about.
126
00:04:23,165 --> 00:04:24,257
Has she moved yet?
127
00:04:24,258 --> 00:04:25,601
What do you think?
128
00:04:25,602 --> 00:04:26,471
Is her mom here?
129
00:04:26,472 --> 00:04:28,071
'Cause she's nicer when her mom's here.
130
00:04:28,072 --> 00:04:29,125
No, she had to leave for work.
131
00:04:29,126 --> 00:04:30,816
You sure the kid didn't eat her?
132
00:04:31,367 --> 00:04:32,475
You guys, stop.
133
00:04:32,476 --> 00:04:34,951
She's angry. She's 13 and she
had a double hip replacement.
134
00:04:34,952 --> 00:04:35,900
You'd be angry, too.
135
00:04:35,901 --> 00:04:36,870
She's mean.
136
00:04:36,871 --> 00:04:37,596
Like a badger.
137
00:04:37,597 --> 00:04:40,201
She's three days post-op now. Okay?
138
00:04:40,202 --> 00:04:42,084
If she doesn't move her hips,
we're looking at clots,
139
00:04:42,085 --> 00:04:43,908
contractures, poor recovery.
140
00:04:43,909 --> 00:04:45,782
We just have to make her
do it for her own good.
141
00:04:46,194 --> 00:04:48,808
Oh. Look who I'm talking to.
142
00:04:49,216 --> 00:04:51,128
Can't even put a toddler in tights.
143
00:04:53,131 --> 00:04:54,298
Gr... well, then you just...
144
00:04:54,299 --> 00:04:56,316
you show me how a bad cop does it.
145
00:04:59,036 --> 00:05:00,773
Karev, get in there.
146
00:05:00,774 --> 00:05:01,552
Why me?
147
00:05:01,553 --> 00:05:02,641
We're attendings. You're a fellow.
148
00:05:02,642 --> 00:05:03,695
It's an order.
149
00:05:06,590 --> 00:05:08,193
That's how a bad cop does it.
150
00:05:08,194 --> 00:05:11,657
Dr. Hunt, I sent contractors
to measure the E.R. space.
151
00:05:11,658 --> 00:05:12,964
Yeah, and I told them to get lost.
152
00:05:12,965 --> 00:05:14,493
I know. That's why we're talking.
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00:05:14,494 --> 00:05:16,973
The E.R. is open for one more day.
154
00:05:16,974 --> 00:05:18,197
Uh, Dr. Hunt,
155
00:05:18,198 --> 00:05:19,725
the E.R. is closing.
156
00:05:19,726 --> 00:05:20,871
I know you don't want it to,
157
00:05:20,872 --> 00:05:22,324
but you're gonna need to let that go.
158
00:05:22,325 --> 00:05:23,887
While we are treating patients,
159
00:05:23,888 --> 00:05:26,324
I don't want your workmen in the way.
160
00:05:26,574 --> 00:05:28,759
We are on a tight schedule
with the renovation.
161
00:05:28,760 --> 00:05:30,563
I was hoping that you would cooperate.
162
00:05:30,564 --> 00:05:32,244
Yeah, well, you're gonna
need to let that go.
163
00:05:32,376 --> 00:05:33,666
Well...
164
00:05:35,301 --> 00:05:36,756
I'd just like to hear you name one thing
165
00:05:36,757 --> 00:05:39,189
that you can put in there
that's more useful than an E.R.
166
00:05:39,190 --> 00:05:40,601
It's still under review, but...
167
00:05:40,602 --> 00:05:42,890
In the army, the guys at the
front get the most saves.
168
00:05:42,891 --> 00:05:45,070
Why? Because the closer
you are to the moment of injury,
169
00:05:45,071 --> 00:05:46,658
the better chance you have to help.
170
00:05:46,659 --> 00:05:48,050
That is what an E.R. is.
171
00:05:48,051 --> 00:05:48,887
Where are we going?
172
00:05:48,888 --> 00:05:50,447
Roof. Medevac's coming.
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00:05:50,559 --> 00:05:52,575
Uh, I-I-I shouldn't.
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00:05:52,576 --> 00:05:53,625
I should hop off now...
175
00:05:53,626 --> 00:05:55,538
Emergency medicine is the front line.
176
00:05:55,539 --> 00:05:57,458
We're the first responder. We're closest.
177
00:05:57,459 --> 00:05:59,483
It's the most important
thing that a hospital does.
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00:05:59,484 --> 00:06:00,166
It's arguably...
179
00:06:00,167 --> 00:06:01,588
So name me one thing
180
00:06:01,589 --> 00:06:03,921
that you would replace it
with that matters more.
181
00:06:04,732 --> 00:06:05,887
You've made your point.
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00:06:05,888 --> 00:06:08,130
Now if you don't mind,
I have a big day, and I...
183
00:06:08,131 --> 00:06:11,070
40-year-old male logger versus chain saw.
184
00:06:11,071 --> 00:06:13,425
Deep neck laceration affecting
most of the major blood vessels
185
00:06:13,426 --> 00:06:14,837
and extending into the chest.
186
00:06:14,838 --> 00:06:16,822
He's hypotensive and tachycardic.
187
00:06:16,823 --> 00:06:18,752
Oh, and his nose is
pretty much sliced off.
188
00:06:18,753 --> 00:06:19,576
How's his airway?
189
00:06:19,577 --> 00:06:20,927
Intact. It was never stridorous.
190
00:06:20,928 --> 00:06:22,866
Did not appear to involve the trachea.
191
00:06:24,237 --> 00:06:25,811
Oh! I got it. I got it.
192
00:06:25,812 --> 00:06:27,848
It's the carotid. I have it.
193
00:06:28,658 --> 00:06:29,665
I got it.
194
00:06:30,802 --> 00:06:32,313
I was closest.
195
00:06:50,431 --> 00:06:51,356
Okay, everything appears stable.
196
00:06:51,357 --> 00:06:53,343
Let's redress the nose. Page plastics.
197
00:06:53,344 --> 00:06:54,730
- Right away.
- Gown me.
198
00:06:54,771 --> 00:06:56,052
Work around Dr. Cahill.
199
00:06:56,053 --> 00:06:57,310
And see who else is available.
200
00:06:57,311 --> 00:06:58,907
- I'll check.
- Keep holding pressure.
201
00:06:58,908 --> 00:07:00,616
As soon as I find another surgeon,
202
00:07:00,617 --> 00:07:01,630
I'll take over and I'll
get you out of there.
203
00:07:01,631 --> 00:07:02,698
No, I got it.
204
00:07:02,942 --> 00:07:04,530
Having one person control the carotid
205
00:07:04,531 --> 00:07:06,451
limits his chance of stroking out.
206
00:07:07,988 --> 00:07:09,770
All right. Gown her, too.
207
00:07:09,771 --> 00:07:10,753
Right away.
208
00:07:11,331 --> 00:07:12,282
Start with Russell.
209
00:07:12,283 --> 00:07:13,505
You want to do the opener or me?
210
00:07:13,506 --> 00:07:14,674
Well, the numbers are so compelling.
211
00:07:14,675 --> 00:07:15,735
I think I'd start with how much
212
00:07:15,736 --> 00:07:17,314
his department's cuts
will save the hospital.
213
00:07:17,315 --> 00:07:18,319
And then I would...
214
00:07:18,320 --> 00:07:19,459
I'll-I'll do the opener.
215
00:07:19,460 --> 00:07:21,365
Sorry. I get a little
excited about statistics.
216
00:07:21,366 --> 00:07:23,512
- Not everybody shares that passion.
- Not everybody.
217
00:07:23,513 --> 00:07:24,377
Okay, so you do the talking,
218
00:07:24,378 --> 00:07:25,998
and I'll hold up the chart
when you give me the signal?
219
00:07:25,999 --> 00:07:27,575
Perfect. Oh, damn it.
220
00:07:27,576 --> 00:07:28,929
Hunt needs me in the O.R.
221
00:07:28,930 --> 00:07:29,916
You're gonna have to start without me.
222
00:07:29,917 --> 00:07:31,052
No. P-people don't like me.
223
00:07:31,053 --> 00:07:31,947
Talk from your heart,
224
00:07:31,948 --> 00:07:33,881
not about the charts or the numbers.
225
00:07:33,966 --> 00:07:35,129
You can do this.
226
00:07:40,303 --> 00:07:41,459
And there you have it.
227
00:07:41,460 --> 00:07:43,260
A technique I have developed through years
228
00:07:43,261 --> 00:07:44,834
of highly focused research.
229
00:07:44,835 --> 00:07:47,645
I eat, sleep, and breathe hernias, folks.
230
00:07:47,725 --> 00:07:49,819
After today, something
tells me you will, too.
231
00:07:49,820 --> 00:07:50,503
Gross.
232
00:07:50,504 --> 00:07:51,739
Dr. Nesbaum.
233
00:07:52,227 --> 00:07:54,965
Over the years,
I've developed my own technique
234
00:07:54,966 --> 00:07:56,363
for a hernia repair.
235
00:07:56,364 --> 00:07:59,034
So if it's all the same to you,
I'll stick to that.
236
00:07:59,035 --> 00:08:00,960
I'm sure it's lovely, but the point here
237
00:08:00,961 --> 00:08:03,706
is to standardize the way
Seattle Grace Mercy West
238
00:08:03,707 --> 00:08:04,732
approaches the hernia
239
00:08:04,733 --> 00:08:06,910
so every O.R. can be prepped the same way.
240
00:08:06,911 --> 00:08:09,977
It's quick, clean, efficient.
241
00:08:09,978 --> 00:08:11,297
I suppose.
242
00:08:12,062 --> 00:08:13,566
Listen to old man Webber,
243
00:08:13,567 --> 00:08:15,432
"My ways are the best ways."
244
00:08:15,433 --> 00:08:19,126
"Ooh, it's drafty in here.
Somebody bring me a blanket."
245
00:08:19,279 --> 00:08:22,595
Now what do you say to a little
friendly competition, hmm?
246
00:08:22,596 --> 00:08:25,197
The first surgeon who can
perform 20 hernia repairs
247
00:08:25,198 --> 00:08:27,720
using my exact tension-free mesh technique
248
00:08:27,721 --> 00:08:31,695
will win bragging rights,
the respect of their peers,
249
00:08:31,696 --> 00:08:33,292
and aha...
250
00:08:36,013 --> 00:08:37,429
this sweet baby.
251
00:08:38,262 --> 00:08:39,593
Oh. I've seen those in the gift shop.
252
00:08:39,594 --> 00:08:40,515
They're not cheap.
253
00:08:40,516 --> 00:08:42,850
I knew it. They're making
us fight to survive.
254
00:08:42,851 --> 00:08:43,956
First prize is a fleece.
255
00:08:43,957 --> 00:08:46,634
Second prize is a one-way
ticket to the curb.
256
00:08:46,878 --> 00:08:48,104
Shall we begin?
257
00:08:49,280 --> 00:08:50,223
Tributes,
258
00:08:50,224 --> 00:08:52,671
may the odds be ever in your favor.
259
00:08:59,218 --> 00:09:00,606
Take 'em off.
260
00:09:02,724 --> 00:09:03,678
What?
261
00:09:04,240 --> 00:09:06,636
Well, we gotta get you up and moving.
262
00:09:06,637 --> 00:09:07,398
Today's the day.
263
00:09:07,399 --> 00:09:08,476
Maybe tomorrow's the day.
264
00:09:08,477 --> 00:09:10,173
Look, if you don't get up,
265
00:09:10,174 --> 00:09:11,748
your hips aren't gonna heal right.
266
00:09:11,749 --> 00:09:12,795
I don't care.
267
00:09:12,796 --> 00:09:13,988
I know it's hard.
268
00:09:13,989 --> 00:09:15,159
But you're only 13.
269
00:09:15,160 --> 00:09:16,743
You talk like your whole life is over.
270
00:09:16,744 --> 00:09:18,708
Like you even know what my life was.
271
00:09:18,709 --> 00:09:21,849
I know that you were into gymnastics.
272
00:09:22,523 --> 00:09:24,716
I wasn't "Into gymnastics," stupid.
273
00:09:24,717 --> 00:09:26,166
It was my career.
274
00:09:26,269 --> 00:09:27,450
Ever since I was 4 years old,
275
00:09:27,451 --> 00:09:29,554
it's all I've ever wanted to do.
276
00:09:29,750 --> 00:09:31,384
My mom worked double shifts
277
00:09:31,385 --> 00:09:33,599
so I could be in the gym five hours a day.
278
00:09:33,600 --> 00:09:34,862
More on the weekends.
279
00:09:34,863 --> 00:09:36,999
And I knew that if I worked really hard,
280
00:09:37,000 --> 00:09:39,034
someday she wouldn't have to anymore.
281
00:09:40,284 --> 00:09:41,611
I ranked number one
282
00:09:41,612 --> 00:09:43,855
at the future stars nationals last year.
283
00:09:43,856 --> 00:09:45,832
I was going to the Rio Olympics.
284
00:09:45,833 --> 00:09:47,303
I was next.
285
00:09:47,304 --> 00:09:49,134
When my hips started to hurt,
286
00:09:49,355 --> 00:09:50,427
I thought that I pulled a muscle,
287
00:09:50,428 --> 00:09:51,948
so I trained through it.
288
00:09:52,955 --> 00:09:55,074
I'm not next anymore.
289
00:09:55,075 --> 00:09:57,260
I'm nothing. I'm number zero.
290
00:09:57,261 --> 00:09:59,419
Hey. No, you're not.
291
00:09:59,735 --> 00:10:01,607
Maybe this part might be over,
292
00:10:01,608 --> 00:10:04,655
but you got time to do
all sorts of things.
293
00:10:04,656 --> 00:10:07,270
They said that
if the surgery was successful,
294
00:10:07,456 --> 00:10:09,447
I might be able to ride a bike,
295
00:10:09,448 --> 00:10:12,659
'cause that's as good as having
your face on a slurpee cup, right?
296
00:10:14,161 --> 00:10:16,354
You might understand if...
297
00:10:16,710 --> 00:10:18,693
you've ever been great at something...
298
00:10:19,852 --> 00:10:22,012
been best at something.
299
00:10:23,010 --> 00:10:27,143
So, yeah, my life is over at 13.
300
00:10:27,416 --> 00:10:30,006
I get to ride a bike and go to school
301
00:10:30,966 --> 00:10:32,556
and wait to die.
302
00:10:40,628 --> 00:10:42,370
Cardio tech to the E.R.
303
00:10:42,470 --> 00:10:44,233
Cardio tech to the E.R.
304
00:10:45,229 --> 00:10:48,626
Dr. Yang, about the I.V.
heparin you ordered for room three.
305
00:10:50,779 --> 00:10:52,263
Is there a problem?
306
00:10:52,385 --> 00:10:54,949
No. It's just Dr. Richardson insists
307
00:10:54,950 --> 00:10:57,065
I give Sub-Q Enoxaparin.
308
00:10:58,935 --> 00:11:00,948
Who the hell is Dr. Richardson?
309
00:11:03,858 --> 00:11:06,413
Oh, yeah. Ignore it.
310
00:11:06,691 --> 00:11:07,672
I tried.
311
00:11:07,673 --> 00:11:08,621
He keeps insisting,
312
00:11:08,622 --> 00:11:10,661
and it's really upsetting the patient.
313
00:11:20,141 --> 00:11:22,206
Open the pod bay doors, Hal.
314
00:11:22,207 --> 00:11:25,051
It's Bob Richardson. Dr. Richardson.
315
00:11:25,052 --> 00:11:27,401
I have a little problem, Bob.
316
00:11:27,402 --> 00:11:28,617
I'm here to help.
317
00:11:28,618 --> 00:11:30,977
You're supposed to be our
eyes in the sky, correct?
318
00:11:30,978 --> 00:11:31,631
Yes.
319
00:11:31,632 --> 00:11:34,053
Then how about you just do that?
320
00:11:34,054 --> 00:11:34,758
I'm sorry?
321
00:11:34,759 --> 00:11:36,514
Don't question my medical decisions.
322
00:11:36,515 --> 00:11:38,363
If I order my intern to give I.V. Heparin,
323
00:11:38,364 --> 00:11:39,692
I want I.V. Heparin.
324
00:11:39,693 --> 00:11:41,685
Uh, I guess you haven't read the results
325
00:11:41,686 --> 00:11:43,254
from the SYNERGY trial,
326
00:11:43,255 --> 00:11:46,742
which showed Enoxaparin reduced
the need for monitoring.
327
00:11:46,743 --> 00:11:49,881
Oh. Got a lot of time to read, Bob,
328
00:11:49,899 --> 00:11:51,192
hanging out in your underwear,
329
00:11:51,193 --> 00:11:53,285
watching your wall of monitors?
330
00:11:53,301 --> 00:11:54,383
'Cause that same trial
331
00:11:54,384 --> 00:11:55,985
- found that there was more bleeding...
- Dr. Yang.
332
00:11:55,986 --> 00:11:58,202
The pit's calling with a possible
cardiac trauma in the field.
333
00:11:58,203 --> 00:11:59,338
Five minutes away.
334
00:12:01,418 --> 00:12:02,907
Don't try and be a doctor, Bob.
335
00:12:02,908 --> 00:12:05,609
Just make sure my idiot
interns don't screw up.
336
00:12:05,900 --> 00:12:07,282
Give the I.V. Heparin.
337
00:12:07,392 --> 00:12:08,460
Don't butt in.
338
00:12:08,739 --> 00:12:09,612
Let's go.
339
00:12:15,983 --> 00:12:18,796
Dr. Russell. Dr. Kepner, trauma.
340
00:12:18,797 --> 00:12:21,304
Trauma, of sainted memory.
341
00:12:21,305 --> 00:12:23,712
Actually, um, we're trying
to save the department,
342
00:12:23,713 --> 00:12:25,575
I was wondering if could
talk to you about some ideas.
343
00:12:25,576 --> 00:12:28,358
Got your e-mail. "Proposed budget cuts."
344
00:12:28,363 --> 00:12:29,466
Nice try.
345
00:12:29,509 --> 00:12:31,367
Well, I think you'll see that a 2%...
346
00:12:31,755 --> 00:12:33,835
Okay, uh, numbers don't
really matter. I, um...
347
00:12:33,836 --> 00:12:35,786
Ever been to a TED conference?
348
00:12:35,787 --> 00:12:36,354
I haven't.
349
00:12:36,355 --> 00:12:37,380
Inspiring.
350
00:12:37,381 --> 00:12:39,830
Finest minds of our
generation under one roof,
351
00:12:39,831 --> 00:12:42,271
sharing stories of
mind-bending innovation.
352
00:12:42,272 --> 00:12:43,307
That sounds great but...
353
00:12:43,308 --> 00:12:46,435
Innovation is what's gonna
save this hospital...
354
00:12:46,436 --> 00:12:49,110
- Okay.
- Not this penny saved, penny earned crap.
355
00:12:49,111 --> 00:12:50,422
Okay, but, um...
356
00:12:50,423 --> 00:12:52,229
Good to meet you, Dr. Kepler.
357
00:12:52,230 --> 00:12:53,704
Kepner.
358
00:12:57,331 --> 00:12:58,160
This is a mess.
359
00:12:58,161 --> 00:12:59,761
I don't think we can fix this primarily.
360
00:12:59,762 --> 00:13:01,409
Can you check for back bleeding?
361
00:13:03,268 --> 00:13:04,246
Cahill?
362
00:13:04,422 --> 00:13:05,094
Me?
363
00:13:05,095 --> 00:13:06,409
Yeah, you're holding the clamp.
364
00:13:06,410 --> 00:13:08,330
- If you can't do it, then...
- Okay.
365
00:13:12,216 --> 00:13:13,202
He doesn't have any.
366
00:13:13,203 --> 00:13:14,830
Okay. Which means he has
poor collateral flow.
367
00:13:14,831 --> 00:13:15,802
We're gonna need a shunt.
368
00:13:15,803 --> 00:13:18,430
I can put it in if someone will
get me a rummel tourniquet.
369
00:13:21,184 --> 00:13:22,124
Thank you.
370
00:13:33,917 --> 00:13:34,586
Sorry.
371
00:13:34,587 --> 00:13:36,278
I-I used to do that.
372
00:13:36,368 --> 00:13:37,337
It's like riding a bike, huh?
373
00:13:37,338 --> 00:13:39,401
Yeah, if the bike's
going 200 miles an hour.
374
00:13:39,402 --> 00:13:40,406
That's what makes it fun.
375
00:13:40,407 --> 00:13:42,104
Yeah, damn right, it does.
376
00:13:42,105 --> 00:13:44,295
So why did you stop in the first place?
377
00:13:45,594 --> 00:13:46,599
Yeah, Hunt, I got your page.
378
00:13:46,600 --> 00:13:47,886
You're worried about a brain bleed?
379
00:13:47,887 --> 00:13:49,368
Yeah, we didn't get a
chance to do the scan.
380
00:13:49,369 --> 00:13:50,587
His carotid blew.
381
00:13:50,656 --> 00:13:51,511
Is that Kepner?
382
00:13:51,512 --> 00:13:53,804
Cahill. Dr. Shepherd, hi.
383
00:13:54,308 --> 00:13:55,759
So instead of telling
us how to do our jobs,
384
00:13:55,760 --> 00:13:56,702
now you're just doing them?
385
00:13:56,703 --> 00:13:57,872
That would be more efficient.
386
00:13:57,873 --> 00:14:00,213
No, she was in the right
place at the right time.
387
00:14:00,264 --> 00:14:01,416
She probably saved his life.
388
00:14:01,417 --> 00:14:02,708
I got lucky.
389
00:14:02,710 --> 00:14:05,189
Lucky for this guy his
chain saw slipped today.
390
00:14:05,190 --> 00:14:06,903
Tomorrow he'd be dead already.
391
00:14:10,399 --> 00:14:10,963
What do you got?
392
00:14:10,964 --> 00:14:12,429
Skateboarder versus car.
393
00:14:12,430 --> 00:14:13,830
Late teens. Didn't have I.D.
394
00:14:13,831 --> 00:14:15,744
The kid was slaloming hills with a buddy.
395
00:14:15,745 --> 00:14:17,102
Was nonresponsive in the field.
396
00:14:17,103 --> 00:14:18,653
His last systolic was 70.
397
00:14:18,654 --> 00:14:20,617
Heart rate tacking along in the 130s.
398
00:14:20,618 --> 00:14:23,196
E.K.G. shows some changes,
so I suspect cardiac trauma.
399
00:14:23,197 --> 00:14:25,456
Okay, I need a portable
X-ray up here, stat.
400
00:14:25,457 --> 00:14:28,359
I need a 12-lead, and, uh,
let's get a T.E.E. bedside.
401
00:14:28,360 --> 00:14:30,401
- Right away.
- Ready on three. One, two, three.
402
00:14:31,444 --> 00:14:33,225
- Murphy, set up the T.E.E.
- Got it.
403
00:14:33,226 --> 00:14:34,571
Type and cross for six units.
404
00:14:34,572 --> 00:14:36,870
Hang two units of O-neg
as soon as possible.
405
00:14:36,871 --> 00:14:38,093
Hey, what's your buddy's name?
406
00:14:38,094 --> 00:14:39,632
Um, Rich. Rich Campion.
407
00:14:39,633 --> 00:14:40,835
Does he have any allergies
that you know of?
408
00:14:40,836 --> 00:14:42,021
Is he on any medications?
409
00:14:42,022 --> 00:14:43,490
I-I-I don't know.
410
00:14:43,994 --> 00:14:45,257
Look, is he going to be okay?
411
00:14:45,258 --> 00:14:47,455
We're doing everything we can.
412
00:14:48,345 --> 00:14:50,581
No breath sounds on the right.
Someone set up a chest tube.
413
00:14:50,582 --> 00:14:51,558
On it.
414
00:14:52,005 --> 00:14:54,047
It looks like a mediastinal hematoma.
415
00:14:54,048 --> 00:14:55,287
Could be an aortic transection.
416
00:14:55,288 --> 00:14:57,443
Uh, we need to move fast, people.
417
00:14:58,000 --> 00:14:59,450
B.P.'s still dropping. Scissors.
418
00:14:59,451 --> 00:15:01,326
Yeah, he's crashing. Where is that blood?
419
00:15:01,327 --> 00:15:02,571
Right here, doctor.
420
00:15:03,499 --> 00:15:05,200
Oh, he has a medical I.D.
It must have broken off.
421
00:15:05,201 --> 00:15:06,603
Okay. What's it say?
What's he allergic to?
422
00:15:06,604 --> 00:15:07,626
Oh, god.
423
00:15:07,627 --> 00:15:08,936
What is he allergic to?
424
00:15:10,601 --> 00:15:11,670
Okay, stop.
425
00:15:12,804 --> 00:15:15,279
He's a Jehovah's witness.
We can't give him blood.
426
00:15:23,279 --> 00:15:24,997
They're prepping the O.R.
for a bloodless surgery
427
00:15:24,998 --> 00:15:26,555
so we'll need to recirculate his blood.
428
00:15:26,556 --> 00:15:28,004
So we'll put him on a cell saver machine,
429
00:15:28,005 --> 00:15:29,916
and then continue the hypertonic saline,
430
00:15:29,980 --> 00:15:32,995
colloids, and factor VII to pump
up his intravascular volume.
431
00:15:32,996 --> 00:15:34,867
We're seriously repairing
an aortic transection
432
00:15:34,868 --> 00:15:35,888
without blood?
433
00:15:35,889 --> 00:15:38,037
- Yeah, we have no choice.
- We could use blood.
434
00:15:38,038 --> 00:15:40,360
Oh, we could also be arrested
for assault and battery.
435
00:15:40,361 --> 00:15:41,073
Very funny.
436
00:15:41,074 --> 00:15:41,917
I'm not joking.
437
00:15:41,918 --> 00:15:43,994
There are protocols in
place for people who won't
438
00:15:43,995 --> 00:15:45,861
or can't accept supplemental blood.
439
00:15:45,888 --> 00:15:47,420
We do bloodless surgeries
here all the time.
440
00:15:47,421 --> 00:15:50,368
Have you ever done this...
a bloodless aortic transection?
441
00:15:50,536 --> 00:15:51,386
No.
442
00:15:52,079 --> 00:15:54,107
Dr. Radnor to labor and delivery...
443
00:15:54,108 --> 00:15:56,046
I-I hear you. I did.
444
00:15:56,047 --> 00:15:57,157
And...
445
00:15:57,553 --> 00:15:58,844
- Alex.
- Oh.
446
00:15:58,845 --> 00:15:59,879
You don't have her walking yet?
447
00:15:59,880 --> 00:16:01,897
Oh, there's no talking to that girl.
448
00:16:01,898 --> 00:16:03,085
It's dark in there.
449
00:16:03,086 --> 00:16:03,901
Really dark.
450
00:16:03,902 --> 00:16:05,012
- Karev...
- I'm serious.
451
00:16:05,013 --> 00:16:07,222
That girl turned me into a suicide risk.
452
00:16:07,805 --> 00:16:09,096
I'm gonna move her myself then.
453
00:16:09,097 --> 00:16:11,732
Mm. Excessive force...
bad cop's go-to move.
454
00:16:13,411 --> 00:16:14,839
You know what makes a bad cop bad?
455
00:16:14,840 --> 00:16:17,343
When the good cop's namby-pamby
approach gets us nowhere.
456
00:16:17,344 --> 00:16:18,743
Then bad cop has to set a limit
457
00:16:18,743 --> 00:16:20,249
and ends up looking like a big meanie.
458
00:16:20,250 --> 00:16:22,668
A good cop's approach takes time
459
00:16:22,669 --> 00:16:23,753
and patience.
460
00:16:23,754 --> 00:16:25,205
Bad cop is a notorious hothead.
461
00:16:25,206 --> 00:16:27,264
If she's going to insist
on wearing dresses,
462
00:16:27,265 --> 00:16:28,174
she has to wear tights.
463
00:16:28,175 --> 00:16:29,599
I'm gonna go lie down.
464
00:16:33,305 --> 00:16:34,385
His vitals are worse.
465
00:16:34,386 --> 00:16:36,387
- How's the cell saver coming?
- Almost ready.
466
00:16:36,388 --> 00:16:38,037
- Do we have surgical glue?
- Yes.
467
00:16:38,038 --> 00:16:39,528
- Avitene?
- Yes.
468
00:16:39,529 --> 00:16:41,215
Okay, I want two bovies set up.
469
00:16:41,216 --> 00:16:43,150
- I'm on it.
- Joy, get my headlamp ready.
470
00:16:43,151 --> 00:16:45,481
Here it is. Wait a minute. Wait a minute.
471
00:16:45,482 --> 00:16:47,469
Where is my gel foam and thrombin?
472
00:16:47,470 --> 00:16:48,980
We're trying to keep
blood loss to a minimum.
473
00:16:48,981 --> 00:16:50,557
We need a whole bunch more.
474
00:16:50,972 --> 00:16:52,702
- Okay, hypertonic saline?
- Check.
475
00:16:52,703 --> 00:16:54,109
- Factor VII?
- Check.
476
00:16:54,110 --> 00:16:55,555
- Cell saver ready?
- Check.
477
00:16:55,556 --> 00:16:57,372
Okay, let's go before he bleeds out.
478
00:17:03,322 --> 00:17:05,600
I can't cut. He'll lose too much blood.
479
00:17:05,601 --> 00:17:06,621
What do we do?
480
00:17:07,177 --> 00:17:08,404
We'll go in percutaneously.
481
00:17:08,405 --> 00:17:10,990
Get the O.R. ready for
an endovascular repair.
482
00:17:10,991 --> 00:17:12,044
Let's move.
483
00:17:20,492 --> 00:17:22,244
Excellent, Dr. Grey.
484
00:17:22,938 --> 00:17:24,314
19 more to go.
485
00:17:25,120 --> 00:17:26,338
You're gonna choke, Grey.
486
00:17:26,339 --> 00:17:28,772
You'll choke and die,
and I will dance and sing.
487
00:17:29,333 --> 00:17:31,416
Damn it. Damn it!
488
00:17:32,600 --> 00:17:35,107
The mesh is bunching up
at the pubic tubercle.
489
00:17:35,772 --> 00:17:37,635
You know, I still feel that you do not...
490
00:17:37,636 --> 00:17:39,597
I understand this can be tricky at first,
491
00:17:39,598 --> 00:17:40,983
but once you get the hang of it,
492
00:17:40,984 --> 00:17:42,822
you'll see why a dozen
hospitals around the country
493
00:17:42,823 --> 00:17:44,206
have already adopted this approach,
494
00:17:44,207 --> 00:17:45,998
and I've already had
inquiries from a dozen more.
495
00:17:45,999 --> 00:17:47,582
- Check!
- Excuse me.
496
00:17:51,954 --> 00:17:54,306
Okay. All right. That's the right idea.
497
00:17:54,328 --> 00:17:55,865
- But, um...
- But-but what?
498
00:17:55,866 --> 00:17:57,132
- Well...
- Check.
499
00:17:57,133 --> 00:17:58,231
- Check!
- Check!
500
00:17:58,232 --> 00:17:59,215
Hey, don't beat around the bush.
501
00:17:59,216 --> 00:18:01,507
Tell me what you don't like,
'cause it looks perfect to me.
502
00:18:01,508 --> 00:18:02,631
O-okay.
503
00:18:02,799 --> 00:18:05,034
Take a look at what
Dr. Grey is doing over here.
504
00:18:05,121 --> 00:18:06,321
You see how she doesn't rush,
505
00:18:06,322 --> 00:18:07,585
cut the mesh just right?
506
00:18:07,586 --> 00:18:10,786
See, now when done properly,
the mesh will fit perfectly
507
00:18:10,787 --> 00:18:12,782
and not require extra sutures to hold it,
508
00:18:12,783 --> 00:18:16,138
thereby reducing the risk
of future complications.
509
00:18:16,193 --> 00:18:19,236
So do this over,
pay attention to the details,
510
00:18:19,237 --> 00:18:20,762
and take your time.
511
00:18:22,317 --> 00:18:23,360
I would be happy
512
00:18:23,361 --> 00:18:25,384
to give you some pointers if you'd like.
513
00:18:25,385 --> 00:18:28,211
That bun in the oven may give
you job security, Meredith Grey,
514
00:18:28,212 --> 00:18:29,411
but it does not make you immune
515
00:18:29,412 --> 00:18:31,035
from a smack in the mouth.
516
00:18:39,055 --> 00:18:40,314
Rich is still in surgery.
517
00:18:40,315 --> 00:18:42,337
Uh, Dr. Yang sent me down
to talk to his family.
518
00:18:42,338 --> 00:18:43,387
Well, how-how's he doing?
519
00:18:43,388 --> 00:18:45,009
It's touch and go.
520
00:18:45,010 --> 00:18:47,130
They're gonna take him
back up to the C.C.U.
521
00:18:47,227 --> 00:18:48,398
Is his family here?
522
00:18:48,872 --> 00:18:50,149
Dude, like...
523
00:18:50,562 --> 00:18:52,616
- dozens of them.
- Lord...
524
00:18:52,663 --> 00:18:55,177
You know, I swear,
we hung out practically every day.
525
00:18:55,178 --> 00:18:57,578
We have the same shift at the skate shop.
526
00:18:58,322 --> 00:19:00,031
And he never once mentioned to me
527
00:19:00,032 --> 00:19:01,867
that he was a Jehovah's witness.
528
00:19:01,950 --> 00:19:03,531
He never talked about it.
529
00:19:03,924 --> 00:19:04,978
Father of all mercy...
530
00:19:04,979 --> 00:19:06,698
I kind of don't think he is.
531
00:19:07,289 --> 00:19:08,961
Well, maybe it was just a personal thing.
532
00:19:08,962 --> 00:19:10,682
Maybe, but I mean, if you...
533
00:19:11,342 --> 00:19:12,919
if you believed in something so hard
534
00:19:12,920 --> 00:19:15,022
that you would die for it...
535
00:19:17,294 --> 00:19:18,078
Would you keep it a secret?
536
00:19:18,079 --> 00:19:20,090
Wouldn't you at least tell your friends?
537
00:19:20,865 --> 00:19:23,155
Yeah. Yeah, I guess.
538
00:19:23,156 --> 00:19:25,023
I should... look, I gotta...
I gotta get out of here.
539
00:19:25,024 --> 00:19:27,318
Will you... will you call me when he's out?
540
00:19:27,319 --> 00:19:28,975
Sure. No problem.
541
00:19:29,876 --> 00:19:32,863
With which we ourselves are
being comforted by now.
542
00:19:33,303 --> 00:19:37,139
Blessed be the god and father
of our lord Jesus Christ.
543
00:19:37,650 --> 00:19:39,665
We can't repair the carotid under tension.
544
00:19:39,666 --> 00:19:40,572
It'll pull apart.
545
00:19:40,573 --> 00:19:42,179
Or clot. It's tricky.
546
00:19:42,180 --> 00:19:44,099
We can't use one of these
vessels to patch it.
547
00:19:44,100 --> 00:19:46,634
The chain saw chewed
everything up pretty good.
548
00:19:47,236 --> 00:19:49,764
I could take a piece of
saphenous vein from the leg...
549
00:19:49,765 --> 00:19:51,003
Yes. Good.
550
00:19:51,004 --> 00:19:53,129
Good. Go ahead. Prep the leg.
551
00:19:53,130 --> 00:19:54,938
All right. Scissors and betadine, please.
552
00:19:54,939 --> 00:19:56,097
Right away, doctor.
553
00:19:56,585 --> 00:19:58,448
So I hear somebody's nose came off?
554
00:19:58,478 --> 00:19:59,445
Can I have a headlamp, please?
555
00:19:59,446 --> 00:20:00,714
Almost. Take a look.
556
00:20:00,715 --> 00:20:02,419
Well, I would if we could find out
557
00:20:02,420 --> 00:20:04,652
Where we're keeping
the headlamps these days.
558
00:20:05,152 --> 00:20:07,015
And what should've
shaved off half a second
559
00:20:07,016 --> 00:20:08,825
has now added five.
560
00:20:09,617 --> 00:20:10,556
Thank you.
561
00:20:10,607 --> 00:20:11,563
Gauze, please.
562
00:20:11,564 --> 00:20:14,574
Oh, sorry. Meant to just say "Gauze."
563
00:20:14,971 --> 00:20:16,757
That "Please" just cost
me a tenth of second.
564
00:20:16,758 --> 00:20:17,878
All right, Avery. That's enough.
565
00:20:17,879 --> 00:20:19,326
Chief, you know this is all about
566
00:20:19,327 --> 00:20:20,996
turning over the tables for her.
567
00:20:21,151 --> 00:20:22,784
I mean, I feel like I'm
working the dinner shift
568
00:20:22,785 --> 00:20:24,752
- at a jumbo burger in here.
- Dr. Avery...
569
00:20:24,753 --> 00:20:26,917
She should just replace us
with surgical robots, really.
570
00:20:26,918 --> 00:20:29,301
I mean, that's essentially
what she's asking us to be.
571
00:20:29,406 --> 00:20:31,187
Bless you. You don't tell
us how to run an O.R.
572
00:20:31,188 --> 00:20:32,980
if you don't actually work in one.
That's all I'm saying.
573
00:20:32,987 --> 00:20:35,488
You can tell Dr. Pantsuit
hasn't been in one in years.
574
00:20:35,489 --> 00:20:36,766
Until today.
575
00:20:43,149 --> 00:20:44,197
Well...
576
00:20:44,402 --> 00:20:46,657
I can repair this post-op.
577
00:20:46,658 --> 00:20:49,650
So just give me a shout when you're done.
578
00:20:50,364 --> 00:20:51,331
Thank you...
579
00:20:51,393 --> 00:20:52,447
doctors.
580
00:20:53,783 --> 00:20:55,008
Best of luck.
581
00:20:56,085 --> 00:20:57,920
I thought I was gonna be fired.
582
00:21:00,953 --> 00:21:01,925
Sorry about that.
583
00:21:01,926 --> 00:21:03,055
Oh, it's fine.
584
00:21:03,144 --> 00:21:05,560
It's easier if there's a bad guy.
585
00:21:07,348 --> 00:21:09,042
My people just care about this place.
586
00:21:09,043 --> 00:21:09,997
I know.
587
00:21:09,998 --> 00:21:12,152
I know you're all upset, especially you,
588
00:21:12,153 --> 00:21:13,707
losing your E.R.
589
00:21:13,791 --> 00:21:15,430
But I also know that without me,
590
00:21:15,431 --> 00:21:17,473
you'd lose this entire hospital.
591
00:21:17,620 --> 00:21:20,138
So if you need to blame
me instead of thank me,
592
00:21:20,139 --> 00:21:21,494
I'm fine with that,
593
00:21:21,963 --> 00:21:23,966
because I will know who saved it.
594
00:21:24,644 --> 00:21:27,302
I've saved a dozen before
just like this one,
595
00:21:28,324 --> 00:21:30,354
and no one thanked me for those either.
596
00:21:39,030 --> 00:21:41,449
Let's add a C.P.K. to his next blood draw.
597
00:21:41,458 --> 00:21:42,917
What was his last hemoglobin?
598
00:21:42,995 --> 00:21:43,622
4.
599
00:21:44,301 --> 00:21:45,879
The guy's on fumes.
600
00:21:46,702 --> 00:21:47,927
Try and stimulate blood production
601
00:21:47,928 --> 00:21:49,824
by giving E.P.O.
602
00:21:49,825 --> 00:21:51,629
Or we could... give him blood
603
00:21:51,630 --> 00:21:52,981
and cut out the middle man.
604
00:21:52,982 --> 00:21:55,581
We can also give I.V. Iron-dextran.
605
00:21:55,582 --> 00:21:56,598
Thanks, Bob.
606
00:21:56,980 --> 00:21:59,644
We can give him iron? How is that logical?
607
00:21:59,645 --> 00:22:01,097
We can give him the components of blood,
608
00:22:01,098 --> 00:22:01,865
just not blood?
609
00:22:01,866 --> 00:22:03,216
We have to respect his wishes.
610
00:22:03,217 --> 00:22:05,378
What wishes? He can't tell us anything.
611
00:22:05,458 --> 00:22:06,452
His friend didn't even know
612
00:22:06,453 --> 00:22:07,618
that he was a Jehovah's witness.
613
00:22:07,619 --> 00:22:08,587
Yeah, it's not the kind of thing
614
00:22:08,588 --> 00:22:10,277
you talk about at the skate park.
615
00:22:10,278 --> 00:22:12,191
I'm just saying, he's 19.
616
00:22:12,376 --> 00:22:14,089
How can he even know what he believes?
617
00:22:14,090 --> 00:22:14,969
When I was 19,
618
00:22:14,970 --> 00:22:17,730
I was a completely different
person than I am now.
619
00:22:17,731 --> 00:22:19,273
I wanted to be a radiologist.
620
00:22:19,274 --> 00:22:22,377
Wow. I feel like
I'm seeing a whole new you.
621
00:22:22,392 --> 00:22:23,541
Uh, start his E.P.O.
622
00:22:23,542 --> 00:22:24,619
and keep a close eye on his crit.
623
00:22:24,620 --> 00:22:25,842
Right away, doctor.
624
00:22:26,994 --> 00:22:28,537
So you're fine with this?
625
00:22:28,538 --> 00:22:30,042
Even though he could die,
you're fine with just...
626
00:22:30,043 --> 00:22:31,784
It doesn't matter what I think.
627
00:22:31,797 --> 00:22:34,369
He had an alert.
It was very clear... no blood.
628
00:22:34,372 --> 00:22:35,901
I don't get to have an opinion about it,
629
00:22:35,902 --> 00:22:37,157
and neither do you.
630
00:22:42,887 --> 00:22:44,315
So there's nothing we can do?
631
00:22:44,362 --> 00:22:45,606
Yeah, there is.
632
00:22:45,960 --> 00:22:47,630
We can talk to the family.
633
00:22:47,842 --> 00:22:48,749
Good luck.
634
00:22:51,965 --> 00:22:53,859
Simmi, I need you to take my hand.
635
00:22:53,860 --> 00:22:54,901
I'm gonna help you sit up.
636
00:22:54,902 --> 00:22:56,918
You're gonna swing your legs to the side
637
00:22:57,052 --> 00:22:58,504
and you're gonna stand up.
638
00:22:59,420 --> 00:23:00,284
Now.
639
00:23:00,326 --> 00:23:02,311
I don't give you permission to touch me...
640
00:23:02,789 --> 00:23:04,263
like, bodily.
641
00:23:04,357 --> 00:23:05,409
I'll scream.
642
00:23:08,338 --> 00:23:09,726
Simmi, if you don't move,
I'm gonna have to say
643
00:23:09,727 --> 00:23:11,244
that you're acting against medical advice.
644
00:23:11,245 --> 00:23:13,257
We will discharge you, you will go home,
645
00:23:13,258 --> 00:23:15,352
and you will rot, okay?
646
00:23:15,353 --> 00:23:16,809
The muscles around
your new hips will atrophy,
647
00:23:16,810 --> 00:23:19,015
and you will probably never walk again.
648
00:23:19,191 --> 00:23:20,631
Why do you care?
649
00:23:21,482 --> 00:23:22,875
Because I'm your doctor
650
00:23:23,539 --> 00:23:25,513
and I worked very hard to help you.
651
00:23:28,543 --> 00:23:30,604
Wouldn't it suck if you didn't help me?
652
00:23:31,103 --> 00:23:32,602
If you went through all of that training
653
00:23:32,603 --> 00:23:34,102
to become a big doctor,
654
00:23:34,174 --> 00:23:35,559
you came up with a plan,
655
00:23:36,057 --> 00:23:37,947
you did my operation,
you did it just right,
656
00:23:37,948 --> 00:23:39,320
just perfect,
657
00:23:39,884 --> 00:23:41,822
you made me so I could walk again,
658
00:23:41,864 --> 00:23:43,050
but I didn't,
659
00:23:43,837 --> 00:23:45,777
wouldn't you feel helpless,
660
00:23:46,478 --> 00:23:48,428
like nothing matters?
661
00:23:49,125 --> 00:23:50,969
No matter how much you care,
662
00:23:51,151 --> 00:23:52,812
how hard you try,
663
00:23:54,079 --> 00:23:56,353
how badly you want something,
664
00:23:57,021 --> 00:23:58,707
you will never have it...
665
00:24:00,363 --> 00:24:03,348
because everything is
totally out of your control.
666
00:24:09,375 --> 00:24:10,323
Feel that?
667
00:24:17,839 --> 00:24:19,165
Couldn't have done it better myself.
668
00:24:19,166 --> 00:24:19,800
Yes!
669
00:24:19,801 --> 00:24:21,276
Yes, indeed.
670
00:24:21,282 --> 00:24:23,336
Okay, all right, people often ask me
671
00:24:23,337 --> 00:24:26,630
how I can focus so much time on hernias
672
00:24:26,631 --> 00:24:28,440
and maintain this level of excitement.
673
00:24:28,441 --> 00:24:29,555
Well, now you see...
674
00:24:29,616 --> 00:24:31,860
perfection is exciting.
675
00:24:32,747 --> 00:24:33,715
Yeah.
676
00:24:34,273 --> 00:24:35,150
Hear that, Grey?
677
00:24:35,151 --> 00:24:36,303
I'm perfect.
678
00:24:37,468 --> 00:24:39,439
Oh, look at miss slow
and steady over there.
679
00:24:39,440 --> 00:24:41,447
Can't even bother to participate.
680
00:24:44,387 --> 00:24:45,782
No, seriously, Grey, you okay?
681
00:24:45,783 --> 00:24:48,063
Um, yeah, yeah. I just need to...
682
00:24:53,921 --> 00:24:54,895
Darn it.
683
00:24:59,267 --> 00:25:00,396
Something's wrong.
684
00:25:01,464 --> 00:25:02,558
Something's wrong.
685
00:25:03,240 --> 00:25:04,724
You're right. I got comfortable and flip,
686
00:25:04,725 --> 00:25:06,558
and the universe is
smacking me down for it.
687
00:25:06,559 --> 00:25:08,345
I-I'm not immune. I'm not safe.
688
00:25:08,346 --> 00:25:09,730
Wait, wait. Grey, stop.
689
00:25:09,731 --> 00:25:10,758
What is going on?
690
00:25:10,759 --> 00:25:13,925
There-there's a flutter.
I-it's... it can't be right.
691
00:25:18,648 --> 00:25:20,831
Oh, sweetie. This is not a bad thing.
692
00:25:20,832 --> 00:25:22,472
What? It's not?
693
00:25:22,570 --> 00:25:24,431
Oh, no, it's good.
694
00:25:24,960 --> 00:25:26,285
It's so good.
695
00:25:28,348 --> 00:25:30,183
Your baby's kicking.
696
00:25:32,726 --> 00:25:33,875
Oh.
697
00:25:36,046 --> 00:25:37,729
He's lost a lot of blood.
698
00:25:37,730 --> 00:25:39,648
I'd say more than half his volume.
699
00:25:39,656 --> 00:25:41,175
He'll make new blood.
700
00:25:41,877 --> 00:25:44,622
It takes about four days
to make new blood cells.
701
00:25:44,623 --> 00:25:46,529
He may not have that much time.
702
00:25:46,708 --> 00:25:47,678
What would really help
703
00:25:47,679 --> 00:25:48,863
is a blood transfusion.
704
00:25:48,864 --> 00:25:51,150
No. No blood.
705
00:25:51,199 --> 00:25:53,212
If you're worried about
disease transmission,
706
00:25:53,213 --> 00:25:55,057
I can assure you that all of our blood
707
00:25:55,058 --> 00:25:56,510
is meticulously screened.
708
00:25:56,511 --> 00:25:58,322
It's not that we don't trust your blood.
709
00:25:58,323 --> 00:25:59,161
We just...
710
00:25:59,162 --> 00:26:01,466
We believe that life is a gift from god
711
00:26:01,576 --> 00:26:03,990
and we don't try to sustain it
by taking in blood.
712
00:26:06,076 --> 00:26:07,779
Let me be perfectly clear,
713
00:26:08,372 --> 00:26:10,501
your son's condition is critical.
714
00:26:10,571 --> 00:26:13,495
Without blood, his organs
will start shutting down.
715
00:26:13,683 --> 00:26:15,232
And once he starts that spiral,
716
00:26:15,403 --> 00:26:16,892
there is nothing we can do.
717
00:26:16,893 --> 00:26:17,941
Oh, dear god.
718
00:26:17,942 --> 00:26:20,850
We are juggling all kinds
of substitute measures,
719
00:26:20,851 --> 00:26:23,553
but nothing is as good as blood.
720
00:26:23,650 --> 00:26:25,655
As his surgeon, I urge you
721
00:26:25,656 --> 00:26:28,066
to let us give him the best chance we can.
722
00:26:28,067 --> 00:26:29,479
Let us give him blood.
723
00:26:32,079 --> 00:26:35,422
We have seen amazing
miracles through prayer.
724
00:26:35,948 --> 00:26:37,893
If it's god's will...
725
00:26:38,595 --> 00:26:39,619
So you won't allow blood,
726
00:26:39,620 --> 00:26:41,152
even if it's gonna save his life?
727
00:26:41,153 --> 00:26:42,652
- 'Cause prayer...
- Murphy.
728
00:26:43,005 --> 00:26:46,188
We appreciate all
you're doing for our boy.
729
00:26:46,564 --> 00:26:47,855
But your blood wouldn't save his life.
730
00:26:47,856 --> 00:26:49,213
It would condemn him.
731
00:26:52,615 --> 00:26:54,442
Living with it would be
so much worse for him
732
00:26:54,443 --> 00:26:55,887
than dying without it.
733
00:26:58,199 --> 00:26:59,348
We understand.
734
00:26:59,525 --> 00:27:01,286
We will do everything in our power
735
00:27:01,287 --> 00:27:02,899
to keep your son alive.
736
00:27:03,510 --> 00:27:04,562
Thank you.
737
00:27:08,722 --> 00:27:11,893
Colvin said I was insulting him
and everyone in his field.
738
00:27:11,943 --> 00:27:14,065
B** said she doesn't talk to fundraisers.
739
00:27:14,103 --> 00:27:16,866
And-and Springfield basically
had me agreeing to give him money.
740
00:27:16,867 --> 00:27:18,835
- And then Russell...
- You talked about the numbers?
741
00:27:19,416 --> 00:27:20,052
No.
742
00:27:20,053 --> 00:27:20,669
April.
743
00:27:20,670 --> 00:27:23,020
I... didn't. I mean, just... a ti...
744
00:27:23,021 --> 00:27:24,269
like barely at all.
745
00:27:24,270 --> 00:27:26,486
We don't have a lot of time,
but I'll see what I can do.
746
00:27:26,556 --> 00:27:27,754
Oh, there's Redmond.
747
00:27:27,755 --> 00:27:29,201
Hey, hey, Tim.
748
00:27:29,324 --> 00:27:30,625
I saw your little Howie today
749
00:27:30,626 --> 00:27:32,240
when I was dropping Zola off at day care.
750
00:27:32,241 --> 00:27:32,801
Man, he's cute.
751
00:27:32,802 --> 00:27:34,285
Ah, thanks. Yeah, he's a kick.
752
00:27:34,286 --> 00:27:35,131
Yeah, Zola's at that age
753
00:27:35,132 --> 00:27:36,711
where she's just putting
everything in her mouth.
754
00:27:36,712 --> 00:27:37,833
Yeah, we're not quite there yet.
755
00:27:37,834 --> 00:27:39,975
Oh, just you wait.
It's like, legos, magnets.
756
00:27:39,976 --> 00:27:40,366
Really?
757
00:27:40,366 --> 00:27:42,667
Anything that is a choking hazard,
they find it.
758
00:27:42,669 --> 00:27:44,152
- Jeez.
- Yeah, well, lucky for us,
759
00:27:44,153 --> 00:27:46,105
the E.R. is right downstairs
from the, uh, day care.
760
00:27:46,106 --> 00:27:47,507
Yeah, that's for sure.
761
00:27:47,983 --> 00:27:48,956
Wait, isn't that closing?
762
00:27:48,957 --> 00:27:50,454
Yeah, that's what I wanted
to talk to you about.
763
00:27:50,455 --> 00:27:51,982
Dermatology has two fellows.
764
00:27:51,983 --> 00:27:54,640
Now if we could just cut one of them...
765
00:27:54,823 --> 00:27:56,829
maybe we could possibly...
766
00:28:06,050 --> 00:28:07,308
I hate her.
767
00:28:07,639 --> 00:28:08,431
Who?
768
00:28:08,432 --> 00:28:10,498
- My intern.
- Why?
769
00:28:10,763 --> 00:28:11,821
Look at her, all mopey-faced
770
00:28:11,822 --> 00:28:13,496
just 'cause she didn't get her way.
771
00:28:13,819 --> 00:28:16,632
We were never mopey-faced.
We sucked it up.
772
00:28:17,534 --> 00:28:18,512
Why aren't you in your skills lab?
773
00:28:18,513 --> 00:28:19,980
Oh, because the baby kicked.
774
00:28:19,981 --> 00:28:21,452
Wouldn't stop kicking, actually.
775
00:28:21,453 --> 00:28:22,182
Jerk.
776
00:28:22,183 --> 00:28:24,704
No, it's good. It's great.
Kicking is a good thing.
777
00:28:25,101 --> 00:28:26,733
Maybe I should kick my intern.
778
00:28:26,776 --> 00:28:29,657
Maybe my baby's kicking because
it wants a granola bar.
779
00:28:30,623 --> 00:28:32,360
That's possible.
780
00:29:09,468 --> 00:29:11,287
You want to stop right there.
781
00:29:19,999 --> 00:29:22,316
You tried to give blood instead of fluids?
782
00:29:22,403 --> 00:29:23,888
He's not stupid, you know, the eyeball?
783
00:29:23,889 --> 00:29:26,167
- He has eyes.
- And a zoom lens.
784
00:29:26,168 --> 00:29:27,509
Rich is circling the drain,
785
00:29:27,510 --> 00:29:28,742
and he doesn't have to be.
786
00:29:28,743 --> 00:29:30,398
We are giving him everything we have,
787
00:29:30,399 --> 00:29:31,705
just like the family requested.
788
00:29:31,706 --> 00:29:33,958
Yeah, I know. And they're
praying. Awesome.
789
00:29:33,959 --> 00:29:36,882
You never administer anything
to a patient without my orders.
790
00:29:36,883 --> 00:29:38,576
You think that because
you've been here all of,
791
00:29:38,577 --> 00:29:40,214
what, six months, you know everything?
792
00:29:40,215 --> 00:29:41,349
You know nothing.
793
00:29:41,362 --> 00:29:43,425
On the timeline of doctoring,
you are an amoeba.
794
00:29:43,426 --> 00:29:45,283
I thought that he deserved a chance.
795
00:29:45,284 --> 00:29:47,249
You have passion. I get it.
796
00:29:47,504 --> 00:29:48,878
You still have to do what I say.
797
00:29:48,879 --> 00:29:51,705
I am your boss and I am trying
to save this patient's life.
798
00:29:51,706 --> 00:29:53,707
Now get out of here.
You're off my service.
799
00:29:53,708 --> 00:29:55,093
- I just...
- Now.
800
00:29:59,124 --> 00:30:00,286
I'm sorry.
801
00:30:04,934 --> 00:30:07,424
What are you gonna do, get her fired?
802
00:30:07,807 --> 00:30:09,258
She didn't do anything.
803
00:30:10,148 --> 00:30:11,636
There's nothing to tell.
804
00:30:12,791 --> 00:30:14,091
She's right, you know?
805
00:30:14,296 --> 00:30:15,640
He's circling the drain.
806
00:30:15,641 --> 00:30:17,778
Yeah, I know.
807
00:30:20,630 --> 00:30:21,733
Okay.
808
00:30:23,296 --> 00:30:24,168
Ready?
809
00:30:25,561 --> 00:30:26,913
Fingers crossed.
810
00:30:26,914 --> 00:30:28,047
Yes.
811
00:30:28,603 --> 00:30:29,947
The sutures will hold.
812
00:30:31,258 --> 00:30:32,933
There will be no bloodbath.
813
00:30:32,952 --> 00:30:34,351
Okay, let's go, doctor.
814
00:30:34,702 --> 00:30:36,030
Remove your clamps.
815
00:30:37,095 --> 00:30:38,493
Dr. Cahill?
816
00:30:51,689 --> 00:30:52,692
Okay.
817
00:30:52,820 --> 00:30:54,012
Okay, good.
818
00:30:54,113 --> 00:30:56,494
I-I-I totally wasn't sure
that was gonna work.
819
00:30:56,856 --> 00:30:57,642
I get it. I get it.
820
00:30:57,643 --> 00:30:58,764
But you did great.
821
00:30:58,774 --> 00:30:59,413
I'd never have thought
822
00:30:59,414 --> 00:31:01,138
you'd spent a day outside of an O.R.
823
00:31:01,139 --> 00:31:03,701
Oh, thank you very much.
824
00:31:04,436 --> 00:31:06,644
Oh, good god. I have to go.
825
00:31:06,645 --> 00:31:08,465
I-I've-I've lost a whole day.
826
00:31:08,466 --> 00:31:10,284
You're all right if I...
827
00:31:10,285 --> 00:31:11,561
No, no, we're not done.
828
00:31:11,562 --> 00:31:12,380
But it's pretty straightforward...
829
00:31:12,381 --> 00:31:14,201
No, we need to finish debriding.
830
00:31:14,202 --> 00:31:15,551
We need to put in drains, close,
831
00:31:15,552 --> 00:31:19,153
then you get to tell
the family that you saved him,
832
00:31:19,999 --> 00:31:21,679
he's alive because of you.
833
00:31:21,999 --> 00:31:24,414
And then they get to thank you.
834
00:31:25,931 --> 00:31:27,433
And that's the best part.
835
00:31:31,163 --> 00:31:32,549
10-blade, please.
836
00:31:36,876 --> 00:31:38,090
I'm saying, they always cut
837
00:31:38,091 --> 00:31:40,423
the lowest on the totem pole first.
838
00:31:40,424 --> 00:31:41,683
And we're below that.
839
00:31:41,684 --> 00:31:43,513
I've been emptying urine bags all morning.
840
00:31:43,514 --> 00:31:44,766
You gotta stop.
841
00:31:45,343 --> 00:31:47,539
All these cuts, the reconfiguring,
842
00:31:47,682 --> 00:31:49,015
this is designed to make the hospital run
843
00:31:49,016 --> 00:31:50,360
more efficiently in the future.
844
00:31:50,361 --> 00:31:50,959
So?
845
00:31:50,960 --> 00:31:51,782
That means Cahill
846
00:31:51,783 --> 00:31:53,857
is planning for
the hospital to have a future.
847
00:31:53,858 --> 00:31:54,609
If you're gonna have a hospital,
848
00:31:54,610 --> 00:31:57,097
- there's one thing you can't cut.
- Doctors.
849
00:31:58,147 --> 00:32:00,081
Crap. My patient's coding.
850
00:32:00,261 --> 00:32:01,275
See that?
851
00:32:01,367 --> 00:32:02,515
We save lives, people.
852
00:32:02,516 --> 00:32:05,166
We are smart, young,
853
00:32:05,471 --> 00:32:06,724
vital doctors.
854
00:32:06,725 --> 00:32:07,681
You're right.
855
00:32:07,682 --> 00:32:10,159
If she's planning for the future...
856
00:32:10,160 --> 00:32:11,690
We are that future.
857
00:32:16,763 --> 00:32:18,312
Oh, you hope.
858
00:32:19,272 --> 00:32:21,213
'Cause you can talk all you want
859
00:32:21,240 --> 00:32:23,073
and work hard, hustle,
860
00:32:23,504 --> 00:32:25,696
you can empty more urine
bags than the next guy.
861
00:32:26,114 --> 00:32:27,365
The future, kids,
862
00:32:27,696 --> 00:32:29,640
is completely out of your control.
863
00:32:46,427 --> 00:32:47,398
Jeff.
864
00:32:47,940 --> 00:32:48,910
How's the research coming?
865
00:32:48,911 --> 00:32:51,034
Save it. Your sidekick
already made the pitch.
866
00:32:51,035 --> 00:32:51,807
Not gonna happen.
867
00:32:51,808 --> 00:32:52,622
Oh, come on.
868
00:32:52,623 --> 00:32:54,479
Your team can watch the TED talks online.
869
00:32:54,480 --> 00:32:56,748
It's not about the talks.
It's about the networking.
870
00:32:56,749 --> 00:32:58,180
- The real conf...
- This isn't about me.
871
00:32:58,181 --> 00:32:59,415
This is what's good for the hospital.
872
00:32:59,416 --> 00:33:01,346
Everyone can benefit from the E.R.,
873
00:33:01,387 --> 00:33:03,306
- the patients especially.
- Mm.
874
00:33:03,307 --> 00:33:06,135
You know what might open
my heart to your cause?
875
00:33:06,550 --> 00:33:08,136
Your parking space.
876
00:33:10,153 --> 00:33:11,812
My space is right next to yours.
877
00:33:11,813 --> 00:33:13,438
Uh, it's not even an advantage.
878
00:33:13,439 --> 00:33:15,113
In fact, you're 5 feet
further from the door.
879
00:33:15,114 --> 00:33:16,659
I don't want to swap. I want 'em both.
880
00:33:16,660 --> 00:33:18,688
I don't want you dinging my doors.
881
00:33:19,289 --> 00:33:20,538
- What?
- I want both spots
882
00:33:20,539 --> 00:33:22,760
So I can park in the middle.
883
00:33:30,225 --> 00:33:31,591
How's your sister, Jeff?
884
00:33:32,474 --> 00:33:33,592
Really?
885
00:33:34,030 --> 00:33:36,399
Really? You're really gonna go there?
886
00:33:36,400 --> 00:33:38,158
Well, I'll never forget
how grateful you were
887
00:33:38,159 --> 00:33:39,955
when I clipped her aneurysm.
888
00:33:40,277 --> 00:33:40,957
And you said,
889
00:33:40,958 --> 00:33:43,074
"If there's anything I
can ever do for you"...
890
00:33:44,546 --> 00:33:45,644
This is just plain bullying.
891
00:33:45,645 --> 00:33:47,409
Say good-bye to TED, Jeff.
892
00:33:55,768 --> 00:33:57,675
I still want your parking space.
893
00:33:59,857 --> 00:34:02,489
May as well swallow
your poison berries now, Webber,
894
00:34:02,490 --> 00:34:05,336
because I am the girl... who's on fire.
895
00:34:05,337 --> 00:34:06,501
Check.
896
00:34:07,039 --> 00:34:08,864
Very good, Dr. Webber.
897
00:34:09,029 --> 00:34:10,885
Oh, let's just, um...
898
00:34:11,535 --> 00:34:13,062
I'm-I'm confused.
Where-where's the mesh?
899
00:34:13,063 --> 00:34:14,060
Oh, I didn't use any.
900
00:34:14,061 --> 00:34:16,418
I wanted to give you
a look at the Webber method
901
00:34:16,419 --> 00:34:18,395
so you can see just what you're missing.
902
00:34:19,471 --> 00:34:20,210
It's lovely, but...
903
00:34:20,211 --> 00:34:20,808
Isn't it?
904
00:34:20,837 --> 00:34:23,384
See, when I use the relaxing incision
905
00:34:23,385 --> 00:34:25,859
to oppose the tissue without tension,
906
00:34:25,882 --> 00:34:28,533
I achieve the same result
without the use of mesh.
907
00:34:28,954 --> 00:34:31,253
But this method will
no longer be performed
908
00:34:31,254 --> 00:34:32,518
at Seattle Grace.
909
00:34:33,276 --> 00:34:36,083
The method we learned today
is the accepted method
910
00:34:36,084 --> 00:34:38,709
for open primary repairs hospital-wide.
911
00:34:39,020 --> 00:34:41,464
Because we're cogs in an assembly line,
912
00:34:41,714 --> 00:34:44,164
churning out product over and over,
913
00:34:44,301 --> 00:34:45,581
standardized across the country.
914
00:34:45,582 --> 00:34:46,303
Don't you think every patient
915
00:34:46,304 --> 00:34:47,712
deserves the same standard of care?
916
00:34:47,713 --> 00:34:48,932
And how good can that care be
917
00:34:48,933 --> 00:34:50,785
when we see 50 patients in a day?
918
00:34:50,786 --> 00:34:52,554
What are their names?
Who are their families?
919
00:34:52,555 --> 00:34:54,468
With that kind of volume,
who in the hell knows?
920
00:34:54,469 --> 00:34:56,595
As long as you can slap
a sign on the door that says,
921
00:34:56,596 --> 00:34:58,144
"Over ten million served,"
who the hell cares?
922
00:34:58,145 --> 00:35:00,384
You're missing the point.
The patients don't matter.
923
00:35:00,385 --> 00:35:01,642
What matters is...
924
00:35:01,643 --> 00:35:03,320
Mm. I didn't...
925
00:35:03,554 --> 00:35:05,653
Obviously, I didn't mean that. Okay?
926
00:35:05,654 --> 00:35:07,586
We are only concerned about hernias,
927
00:35:07,587 --> 00:35:09,409
right now, I mean.
928
00:35:10,821 --> 00:35:12,470
See, that... that is really quite good.
929
00:35:12,471 --> 00:35:13,363
I-in the months to come,
930
00:35:13,364 --> 00:35:15,693
I think everyone should
follow your lead, okay?
931
00:35:15,694 --> 00:35:17,341
Okay. Keep it up.
932
00:35:24,128 --> 00:35:25,119
Still in V-fib.
933
00:35:25,120 --> 00:35:26,835
- How long has it been?
- 26 minutes.
934
00:35:26,836 --> 00:35:29,222
Push another epi and, uh,
charge again to 200.
935
00:35:29,223 --> 00:35:30,386
Charging.
936
00:35:31,435 --> 00:35:32,540
Clear.
937
00:35:34,668 --> 00:35:35,420
Still nothing.
938
00:35:35,421 --> 00:35:36,353
Damn it.
939
00:35:36,354 --> 00:35:38,982
Uh... charge to 200 again.
940
00:35:38,987 --> 00:35:40,116
Clear.
941
00:36:07,031 --> 00:36:08,338
Okay, I'm calling it.
942
00:36:09,024 --> 00:36:11,337
Time of death... 6:42.
943
00:36:21,350 --> 00:36:22,877
He didn't have to die.
944
00:36:23,181 --> 00:36:24,971
All they had to do was
let us give him blood.
945
00:36:24,972 --> 00:36:26,683
And he still could've died.
946
00:36:26,981 --> 00:36:29,412
The C.C.U. is full of people
we pump full of blood,
947
00:36:29,413 --> 00:36:30,769
and they still die.
948
00:36:31,636 --> 00:36:32,546
People die.
949
00:36:32,547 --> 00:36:34,162
You know, what you did was wrong
950
00:36:34,163 --> 00:36:35,661
in about a hundred different ways.
951
00:36:35,662 --> 00:36:37,306
And I plan on telling you all of them,
952
00:36:37,307 --> 00:36:39,155
just not right now.
953
00:36:40,195 --> 00:36:43,126
'Cause right now,
I have to go talk to the family.
954
00:36:44,449 --> 00:36:46,101
Hey, show's over, Bob.
955
00:36:46,102 --> 00:36:47,467
You can change the channel.
956
00:36:56,288 --> 00:36:58,157
Oh, hey.
957
00:36:58,099 --> 00:36:59,277
How'd it go?
958
00:37:01,551 --> 00:37:03,091
Oh, for god sakes.
959
00:37:03,092 --> 00:37:05,892
I mean, s... okay, see, officer hard-ass?
960
00:37:05,893 --> 00:37:08,014
Your approach doesn't always work either.
961
00:37:13,309 --> 00:37:14,374
Hey.
962
00:37:15,284 --> 00:37:17,149
You need to get up now.
963
00:37:17,318 --> 00:37:18,553
You need to take a few steps
964
00:37:18,554 --> 00:37:19,992
and remember how it feels.
965
00:37:19,993 --> 00:37:21,986
And I know... I know how hard this is.
966
00:37:21,987 --> 00:37:23,535
But you want this. You do.
967
00:37:23,536 --> 00:37:25,259
You don't know what I want.
968
00:37:26,777 --> 00:37:28,094
No? Okay.
969
00:37:37,443 --> 00:37:39,199
I lost my leg...
970
00:37:39,719 --> 00:37:41,331
less than a year ago.
971
00:37:41,584 --> 00:37:44,836
And I was scared and in pain
972
00:37:44,837 --> 00:37:47,134
and I thought that
I would never be able to do
973
00:37:47,135 --> 00:37:49,927
the things that I like to do anymore.
974
00:37:50,119 --> 00:37:51,340
But I did.
975
00:37:52,842 --> 00:37:54,087
I operated on you.
976
00:37:56,128 --> 00:37:57,307
Wow.
977
00:37:57,607 --> 00:38:00,445
They send the cripple in to
teach me how to live my life.
978
00:38:02,887 --> 00:38:04,413
Okay. Okay.
979
00:38:04,414 --> 00:38:05,384
You know what?
980
00:38:05,389 --> 00:38:06,956
You can be scared and you can be pissed
981
00:38:06,957 --> 00:38:09,099
and you can lie here like a garden slug
982
00:38:09,100 --> 00:38:10,735
till you die for all I care.
983
00:38:10,736 --> 00:38:13,328
But you will not, not, become a monster
984
00:38:13,329 --> 00:38:15,389
that takes everyone else down with them.
985
00:38:15,440 --> 00:38:18,249
You will treat people
with kindness and respect.
986
00:38:18,285 --> 00:38:20,702
Ooh. And you will start with yourself.
987
00:38:20,703 --> 00:38:23,191
And you will start by standing up.
988
00:38:23,192 --> 00:38:25,376
And you will do so by the
time I count to three,
989
00:38:25,377 --> 00:38:27,507
or I will drag your ass out of this bed.
990
00:38:27,508 --> 00:38:28,864
So one...
991
00:38:29,424 --> 00:38:30,434
two...
992
00:38:33,118 --> 00:38:34,989
three. Okay. You got it.
You got it.You got it.
993
00:38:34,989 --> 00:38:36,178
Okay. Okay, I got you. I got you.
994
00:38:36,178 --> 00:38:37,642
All right. Good. Good.
995
00:38:37,642 --> 00:38:39,228
Good. Good.
996
00:38:40,007 --> 00:38:41,057
Wow.
997
00:38:41,198 --> 00:38:42,282
Take a step.
998
00:38:44,346 --> 00:38:46,106
- Great.
- Look at that. You got it.
999
00:38:48,014 --> 00:38:48,942
Good.
1000
00:38:49,007 --> 00:38:52,151
Good job. All right. Look at you.
1001
00:38:54,021 --> 00:38:56,718
Oh, my... he's gonna live?
1002
00:38:57,735 --> 00:38:58,644
Thank you.
1003
00:38:58,645 --> 00:39:01,335
This is who you really should be thanking.
1004
00:39:01,336 --> 00:39:02,163
If it wasn't for her...
1005
00:39:02,164 --> 00:39:04,531
Thank you. Thank you so much!
1006
00:39:04,532 --> 00:39:07,023
God bless you. Thank you.
1007
00:39:15,410 --> 00:39:17,131
Hold the elevator, please!
1008
00:39:21,336 --> 00:39:22,314
Oh.
1009
00:39:22,556 --> 00:39:24,061
Oh. Off to celebrate, are we?
1010
00:39:27,807 --> 00:39:29,418
Ah. I get it.
1011
00:39:29,985 --> 00:39:31,349
Well, change can be rough.
1012
00:39:31,350 --> 00:39:33,052
But once you get used to it,
1013
00:39:33,053 --> 00:39:35,979
you'll never believe you did
a hernia repair any other way.
1014
00:39:37,363 --> 00:39:38,282
And if I may say,
1015
00:39:38,283 --> 00:39:40,943
that sweatshirt is quite becoming on you.
1016
00:39:40,980 --> 00:39:42,328
It's itchy.
1017
00:39:47,745 --> 00:39:49,442
I did forget what a rush it is.
1018
00:39:49,443 --> 00:39:51,397
Uh, yeah. What, saving someone's life?
1019
00:39:51,398 --> 00:39:52,065
Yeah, it's not bad.
1020
00:39:52,066 --> 00:39:53,323
You know, we could do that again tomorrow
1021
00:39:53,324 --> 00:39:55,045
if we had an E.R.
1022
00:39:55,200 --> 00:39:56,529
We figured it out.
1023
00:39:56,570 --> 00:39:57,547
We can save the E.R.
1024
00:39:57,548 --> 00:39:59,138
We got each department to make some cuts,
1025
00:39:59,139 --> 00:40:00,837
and I'm gonna have to park in Tacoma,
1026
00:40:00,838 --> 00:40:02,214
but it is going to work.
1027
00:40:02,215 --> 00:40:03,661
I'm sorry.
1028
00:40:03,959 --> 00:40:05,595
You misunderstood.
1029
00:40:05,834 --> 00:40:08,346
No amount of budget cutting or shuffling
1030
00:40:08,347 --> 00:40:09,433
is gonna save your E.R.
1031
00:40:09,434 --> 00:40:11,546
or your hospital, for that matter.
1032
00:40:14,824 --> 00:40:16,466
You're getting us ready to sell.
1033
00:40:16,467 --> 00:40:17,658
What?
1034
00:40:18,626 --> 00:40:21,859
A buyer is going to save your hospital.
1035
00:40:22,325 --> 00:40:24,640
I just need to make it presentable.
1036
00:40:24,641 --> 00:40:26,846
I'm sorry. Wh-what? It's...
1037
00:40:26,847 --> 00:40:28,869
You're staging it, like a house.
1038
00:40:28,924 --> 00:40:29,859
Exactly.
1039
00:40:29,860 --> 00:40:32,925
And the E.R. is like the shag carpet.
1040
00:40:33,386 --> 00:40:34,558
It's gotta go.
1041
00:40:36,462 --> 00:40:37,510
Sorry.
1042
00:40:39,578 --> 00:40:41,079
I had a wonderful time today.
1043
00:40:54,653 --> 00:40:56,291
To really be efficient...
1044
00:40:57,842 --> 00:41:00,012
you have to eliminate what doesn't work.
1045
00:41:12,386 --> 00:41:14,619
You have to figure out what's important...
1046
00:41:30,628 --> 00:41:32,100
What are you gonna do?
1047
00:41:33,162 --> 00:41:34,793
You mean right now or...
1048
00:41:36,715 --> 00:41:38,691
Or both. Whichever.
1049
00:41:42,037 --> 00:41:45,435
Right now I am going to drink a lot.
1050
00:41:47,817 --> 00:41:48,985
That's all I know.
1051
00:41:51,135 --> 00:41:52,917
Can I buy the first one?
1052
00:41:53,850 --> 00:41:55,042
Yeah.
1053
00:41:57,770 --> 00:41:58,458
And hold on tight...
1054
00:42:00,888 --> 00:42:03,141
to the things that matter most.
1055
00:42:14,590 --> 00:42:15,473
Wow.
1056
00:42:15,675 --> 00:42:16,894
Oh, I felt that.
1057
00:42:21,269 --> 00:42:22,665
Uh-huh. Wait.
1058
00:42:23,550 --> 00:42:24,671
Oh!
1059
00:42:25,325 --> 00:42:26,356
Ooh.
1060
00:42:26,713 --> 00:42:28,805
Oh, you got a soccer player,
I think, right there.
1061
00:42:28,805 --> 00:42:33,886
Sync by YYeTs
Corrected by MystEre
www.addic7ed.com