1. "It's Not Easy Being Greene"Copy !req
2. - I love it when those endorphins kick in.
- You're not on today, are you?Copy !req
3. I thought I'd drop by,
ease up your workload a little bit.Copy !req
4. After I take a shower.Copy !req
5. - It's his day off?
- That's dedication.Copy !req
6. Dedication? Man, that's sad.Copy !req
7. Don't move, Mrs. Zarian.Copy !req
8. It's a little bit of glass,
and it's almost free.Copy !req
9. Susan, were your ears burning?Copy !req
10. David Morgenstern and I
were just talking about you.Copy !req
11. He feels you're the top contender
for Chief Resident next year.Copy !req
12. Oh, thanks.Copy !req
13. This year's field
was pretty disappointing...Copy !req
14. but we found your work
to be consistently solid.Copy !req
15. Now, I know you're concerned about
taking time away from the baby...Copy !req
16. but that doesn't have
to be the case.Copy !req
17. Keep the bevel facing out.Copy !req
18. By applying
time-management techniques...Copy !req
19. you can work more efficiently...Copy !req
20. reduce on-the-job stress
and get home at a reasonable hour.Copy !req
21. Mrs. Zarian...Copy !req
22. I've got a book on the subject,
if you're interested. No pressure.Copy !req
23. I just wanna let you know
how we're thinking.Copy !req
24. - Son of a bitch!
- What?Copy !req
25. They cut me back
to three shifts a week.Copy !req
26. - They're cutting back on nurses?
- Nurse managers...Copy !req
27. because of our outrageous salaries.Copy !req
28. I still need $12,000 worth of work
on my house!Copy !req
29. They bumped me up to six shifts a week.
So much for my weekend.Copy !req
30. - I know a way to make some quick cash.
- Talk to me.Copy !req
31. I joined this guy Alvin's investment club.
Put up a $2000 membership fee...Copy !req
32. and in a week to 10 days,
you collect 10 to $20,000.Copy !req
33. - From?
- The fees of the new people who join.Copy !req
34. - It's called a pyramid scam, it's illegal.
- Well, that's not what Alvin says.Copy !req
35. Trust me, if you're not in early,
you lose your shirt.Copy !req
36. When did you get in?Copy !req
37. - Hey.
- Hey, yourself.Copy !req
38. All right, let's see what we got here.Copy !req
39. - Where'd you learn to do sub-q sutures?
- From your med student.Copy !req
40. - I obviously taught him well, didn't I?
- Benton.Copy !req
41. - See you later.
- Listen, I should warn you:Copy !req
42. You might want to invest in a new suit
and some luggage.Copy !req
43. You're going to Paris to present
our clamp-and-run study to the institute.Copy !req
44. - Are you serious?
- Oui. Simon did an analysis of our result.Copy !req
45. Our P-value was. 06.Copy !req
46. We're one successful outcome away
from statistical significance.Copy !req
47. - We can publish?
- Soon.Copy !req
48. One more aneurysm and our numbers
will blind the most dubious skeptics.Copy !req
49. After that, we head to D.C.
to play dog-and-pony for the FDA.Copy !req
50. Now, Simon doesn't fly,
so he stays here...Copy !req
51. which makes you the next choice for
Clamp-and-Run Ambassador to Europe.Copy !req
52. I don't know what to say. I'm honored.Copy !req
53. It's good practice for the future.
You've gotta find another patient soon...Copy !req
54. because the Norwegians
are doing a similar study.Copy !req
55. And, Peter, we cannot let the Vikings
pillage our thunder.Copy !req
56. - Malik, you seen Carter?
- He called and said he'd be late.Copy !req
57. He should be coming any minute.Copy !req
58. No, wait! Wait! Wait!Copy !req
59. Yeah! Oh, God! John! Oh, God!Copy !req
60. Oh, God!Copy !req
61. Oh, baby.Copy !req
62. I think we broke my record.Copy !req
63. Yeah.Copy !req
64. - Oh, John.
- What?Copy !req
65. Your control is phenomenal.Copy !req
66. - Yeah?
- Yeah.Copy !req
67. Yeah. Thank you.Copy !req
68. You know, you may find this hard to
believe, but that wasn't always the case.Copy !req
69. - No?
- It's hard to believe, it's true though.Copy !req
70. But I found if I could distract myself
and think about mundane things...Copy !req
71. then I could delay the inevitable.Copy !req
72. Well, what kind of things
do you think about?Copy !req
73. Let's see. Sometimes I take a mental
inventory of the machines in the O.R.Copy !req
74. Thora-Seal, ventilators, auto-infusers.Copy !req
75. And then, as the degree of difficulty
increases, I run the procedures.Copy !req
76. Appendectomies, thyroidectomies,
bowel resections.Copy !req
77. - Yuck!
- What?Copy !req
78. While we're making love,
you're thinking about bowel resections.Copy !req
79. Given your earlier testimonial...Copy !req
80. this is a case of the ends
justifying the means.Copy !req
81. - What? Get out!
- I'm kidding. I'm just kidding.Copy !req
82. So last night I get a letter from
Jen's lawyer politely informing me...Copy !req
83. that she's suing me
for full custody of Rachel.Copy !req
84. - Oh, no.
- Yeah, it seems I've been...Copy !req
85. a distant and absent father.Copy !req
86. This after commuting from Milwaukee
for half a year.Copy !req
87. Well, it sounds like a lot of lawyer B.S.Copy !req
88. I can't imagine she'd actually
go through with it.Copy !req
89. - I was climbing the walls all night.
- Well, that's why you're here.Copy !req
90. - Tiny prick.
- I beg your pardon?Copy !req
91. I need a TB test too.Copy !req
92. So I hear Morgenstern has really
turned up the pressure...Copy !req
93. on you becoming Chief Resident.Copy !req
94. Yeah, it's a good opportunity,
but can I do it and not work killer hours?Copy !req
95. You know how well I managed
to balance work and family.Copy !req
96. - Guess that answers that.
- You'll be able to work it out.Copy !req
97. Take your paperwork home,
hours won't be that bad.Copy !req
98. - You have to cut Weaver some slack.
- What do you mean?Copy !req
99. You go out of your way to avoid her.Copy !req
100. And if she's gonna be training you...Copy !req
101. you're gonna have to work together
hand in hand.Copy !req
102. Oh, there's an image.Copy !req
103. - Why are you here on your day off?
- I went for a jog and ended up here.Copy !req
104. - Figured I might as well save some lives.
- One other good reason not to exercise.Copy !req
105. 32-year-old male, postictal,
five-minute grand mal seizure.Copy !req
106. I'll take it. Start a chart.Copy !req
107. On his day off?Copy !req
108. - The orders should've been in already.
- I forgot.Copy !req
109. - I thought you wanted a Residency.
- I do.Copy !req
110. Keep forgetting, you'll be in North
Dakota. We got 300 applications.Copy !req
111. - When do the interviews start?
- They already have.Copy !req
112. Vucelich needs one more aneurysm
for his study.Copy !req
113. Abdominal pains, chest pains,
traumas, call me.Copy !req
114. How often do you get dizzy spells,
Mrs. Henry?Copy !req
115. Oh, I get three or four a day.
Usually when I'm working in the shed.Copy !req
116. - You garden this time of year?
- I'm a vermiculturist.Copy !req
117. - I raise earthworms.
- Really?Copy !req
118. Big ones from Belgium.
Finest castings in the world.Copy !req
119. - And by castings you mean?
- Worm dung. Black gold.Copy !req
120. It's the best fertilizer money can buy.
It fixes the nitrogen in the soil.Copy !req
121. - And you sell the stuff?
- I sell the worms.Copy !req
122. Your blood pressure's a little high.Copy !req
123. - So it pays well?
- Six figures.Copy !req
124. Has he had a seizure before?Copy !req
125. No, he's a health nut.
He runs every day.Copy !req
126. We're gonna have to get a CAT scan
of his head to pinpoint the cause.Copy !req
127. Alan. Alan?Copy !req
128. - When's he gonna come back?
- It takes a little time to recover.Copy !req
129. - Well, how long?
- Usually about 30 minutes.Copy !req
130. Multifocal PVCs.Copy !req
131. What?Copy !req
132. His heart rhythm's a little off. Probably
oxygen deprivation from the seizure.Copy !req
133. - Has he had a murmur before?
- No.Copy !req
134. Well, it's probably nothing serious.Copy !req
135. Let's get an echo of his heart
after the CT, just to be safe.Copy !req
136. Lidocaine bolus, 100 milligrams,
then start a drip.Copy !req
137. No, Carter. John Carter.Copy !req
138. I thought maybe you were trying
to get in touch with me...Copy !req
139. to set up an interview
for the Residency.Copy !req
140. No, huh? Well, I'm available at any-Copy !req
141. Okay, great- Right.Copy !req
142. I hear Vucelich doubled his finder's fee...Copy !req
143. - ... for an aneurysm.
- Could be.Copy !req
144. I made 1000 bucks.Copy !req
145. Patient with a history of ulcers,
says the pain's different this time.Copy !req
146. - Rigid belly?
- Hard to tell. He's so fat.Copy !req
147. But see the calcifications
on the descending aorta?Copy !req
148. - No, where?
- Here.Copy !req
149. It's too lateral.
Probably just schmutz on his lungs.Copy !req
150. - I shouldn't call Vucelich?
- If you wanna get yelled at.Copy !req
151. Harper, I need you
to get this guy to CT.Copy !req
152. Coming.
Can you return this x-ray to his room?Copy !req
153. - Which room?
- Six.Copy !req
154. Hey, you done with that?
Wow, that's a mother of an aneurysm.Copy !req
155. - How can you tell?
- Calcification on the descending aorta.Copy !req
156. Yeah.Copy !req
157. Yeah.Copy !req
158. We're gonna run the CAT scan
on his head...Copy !req
159. to rule out lesions
that could've caused the seizure.Copy !req
160. What's wrong?Copy !req
161. He's in V-tach.
Let's get him to Trauma.Copy !req
162. - Haleh?
- I'm here.Copy !req
163. - What's wrong with him?
- His heart rhythm's worse.Copy !req
164. You sure he hasn't taken medication?
Any non-prescription drugs?Copy !req
165. - No, never!
- We're gonna get this under control.Copy !req
166. Can someone take Mrs. Wimbur
to the waiting room?Copy !req
167. - But I just wanna-
- It's okay.Copy !req
168. - Another 50 of lidocaine, IV push.
- Heart's racing, 200.Copy !req
169. - Rhythm is all over the place.
- Looks like Torsade de Pointes.Copy !req
170. All right, Harper.
Let's get lytes and the tox screen.Copy !req
171. And see if we got any records
on this guy.Copy !req
172. Anything that can give us a clue.Copy !req
173. Lido's on board.Copy !req
174. - What's your gut say, Haleh?
- Low potassium.Copy !req
175. - Lydia?
- Cocaine.Copy !req
176. His wife says he's tox-free.
We'll know soon enough.Copy !req
177. Heart rate's up to 210.Copy !req
178. Let's try and cardiovert. Paddles.
Start him at 100.Copy !req
179. - Hands off!
- Clear.Copy !req
180. - Faint pulse.
- There we go. Nice rhythm.Copy !req
181. - He's moved his head.
- His rate's down to 160.Copy !req
182. - One-eighty. Here we go again.
- All right, lidocaine's not working.Copy !req
183. Let's try bretylium, 500 IV push.
Prep a transvenous pacemaker.Copy !req
184. Charge 200. Hands off!Copy !req
185. What makes you think
there's an aneurysm?Copy !req
186. The calcium plaque
on the descending aorta.Copy !req
187. While you saved his life, you made
the Norwegian surgeons very unhappy.Copy !req
188. - Good work.
- Thank you.Copy !req
189. - Where's the patient?
- Room 6.Copy !req
190. To Room 6.Copy !req
191. Hey, way to go, Carter.Copy !req
192. Labs are back.
Lytes are normal, tox screen's negative.Copy !req
193. We were both wrong.Copy !req
194. - What the hell's wrong with this guy?
- Rate's up to 220.Copy !req
195. - Faint pulse.
- All right, pacer's in.Copy !req
196. Let's overdrive him to 230.
Maximum gain.Copy !req
197. - See if I can grab hold of this rhythm.
- You've got capture.Copy !req
198. Lovely. Let's take him down slowly.Copy !req
199. - Two-ten.
- Two hundred.Copy !req
200. One-eighty.Copy !req
201. - He's jumping back up.
- Lost capture.Copy !req
202. Let's start CPR. Add Pronestyl,
100 mgs, IV push.Copy !req
203. Paddles, set them at 360.Copy !req
204. - What time is it?
- 0845.Copy !req
205. Mark that time.Copy !req
206. - Hands off. Clear.
- Clear.Copy !req
207. - Wide-complex tachycardia.
- Still no pulse.Copy !req
208. - Time?
- 9:05.Copy !req
209. - How long has he been down?
- Twenty minutes.Copy !req
210. Tried the pacer, he went into V-fib.
Shocked him 15-20 times.Copy !req
211. He keeps running these chaotic rhythms.Copy !req
212. - Could he be hypocalcemic?
- No, lytes are fine.Copy !req
213. - Cocaine?
- Tox screen's negative.Copy !req
214. - Acidotic?
- Good question. Let's get another gas.Copy !req
215. - How much Pronestyl?
- That makes 900.Copy !req
216. - Time?
- 0922.Copy !req
217. - Another hundred of Pronestyl.
- Got your blood gases here:Copy !req
218. PH 7.24, PO-2's 110.Copy !req
219. - He's still in fib.
- He's going down.Copy !req
220. - The anti-arrhythmics?
- Still got a few more.Copy !req
221. - Stand by with the amiodarone.
- Charging up to 360.Copy !req
222. - Back up. Clear!
- Clear.Copy !req
223. - Time?
- 0932.Copy !req
224. - Still no pulse.
- Try magnesium sulfate.Copy !req
225. - Clear.
- Clear.Copy !req
226. - Time?
- 9:41.Copy !req
227. - High dose epi, five mgs. Clear.
- Hit of epi in.Copy !req
228. - Time?
- 9:45.Copy !req
229. - Clear!
- Clear.Copy !req
230. - Clear!
- Clear.Copy !req
231. 32 years old.Copy !req
232. Time of death...Copy !req
233. 9:55.Copy !req
234. Why?Copy !req
235. There was an electrical disturbance
in your husband's heart...Copy !req
236. that caused it to beat
in an irregular way.Copy !req
237. I wish I could tell you what caused
it to happen...Copy !req
238. but the truth is, I don't know.Copy !req
239. Well, that's not good enough.Copy !req
240. I mean, we came in here,
and his heart was okay.Copy !req
241. You said it wasn't anything serious,
so somebody must have screwed up!Copy !req
242. - How did you let this happen?
- Mrs. Wimbur.Copy !req
243. What did you do to him?Copy !req
244. Hello, Alvin.Copy !req
245. Well, do you have his new number?Copy !req
246. - So, Kerry-
- One second.Copy !req
247. Yes, Susan?Copy !req
248. I've been thinking about
your invitation...Copy !req
249. and I would like to throw my hat in
for Chief Resident.Copy !req
250. I'm glad. I look forward
to showing you the ropes.Copy !req
251. Me too.Copy !req
252. Nobody's signed up
for the gallbladder in 2 yet.Copy !req
253. I've got it.Copy !req
254. - How long does a CAT scan take?
- Hopefully, not more than an hour...Copy !req
255. but sometimes there's a wait.Copy !req
256. I'm a little concerned about my worms
in the truck.Copy !req
257. - You brought them with you?
- Just one bin.Copy !req
258. I was making a delivery
when the dizziness hit.Copy !req
259. - Do you think someone'll steal them?
- No, they're locked up.Copy !req
260. You don't leave $5000 worth of
worms unsecured, but they could freeze.Copy !req
261. Listen, if I gave you my keys,
could you bring them in out of the cold?Copy !req
262. - We can't have animals in the hospital.
- Oh, there's no danger.Copy !req
263. Worms are the only disease-free
organisms on Earth. It's a fact.Copy !req
264. - I really shouldn't.
- Please, they're my worms.Copy !req
265. - All right.
- Thank you.Copy !req
266. And could you feed them, please?Copy !req
267. - What do they eat?
- Table scraps, as long as it's vegetarian.Copy !req
268. Nothing too greasy because
fat doesn't sit well with worms.Copy !req
269. Mrs. D'Angelo, I see you've been
with us before.Copy !req
270. - Gallstones flaring up again?
- They're killing me.Copy !req
271. I can't sleep, I can't eat. And every
three weeks, I end up back here.Copy !req
272. Pain pills didn't help?Copy !req
273. I took twice as much.
Didn't do anything.Copy !req
274. - Yeah, you shouldn't do that.
- Please, doctor...Copy !req
275. get a surgeon to take
these damn stones out.Copy !req
276. It's been going on like this
for six months now.Copy !req
277. Okay. Sorry.Copy !req
278. Okay.Copy !req
279. I'll get an ultrasound. Unless your
condition is life-threatening...Copy !req
280. any surgery would be considered
elective, and unfortunately...Copy !req
281. - There's an 18-month waiting list.
- Yeah, I'm afraid so.Copy !req
282. - My neighbor got hers out the next day.
- Does she have private insurance?Copy !req
283. Is it my fault I'm on Medicaid?Copy !req
284. Okay, we'll start with the ultrasound
and see what we have.Copy !req
285. Thank you.Copy !req
286. His name is Alan Wimbur.
You guys just picked him up.Copy !req
287. I was hoping you could
do the autopsy today.Copy !req
288. - Hey, Jerry, where's the ultrasound?
- You've got me.Copy !req
289. Let me know,
because I'd like to observe.Copy !req
290. Autopsy?Copy !req
291. I wanna find out what happened
to his heart.Copy !req
292. You should go home.Copy !req
293. His wife accused me of killing him.
She's probably gonna sue.Copy !req
294. People get upset and feel
they need to blame someone.Copy !req
295. I heard a murmur on exam. Before
getting an echo, I wanted to get a CT.Copy !req
296. Yeah, guy comes in with a seizure,
first thing you want is a CT.Copy !req
297. Thanks, I was just checking.Copy !req
298. Dr. Greene? Dr. Morgenstern's office
just called. He'd like to see you upstairs.Copy !req
299. Word travels fast.Copy !req
300. - You're making excellent time, Peter.
- Suction!Copy !req
301. Let Carter suction. It's his reward for
hunting down an aneurysm like a hound.Copy !req
302. I feel privileged for the opportunity.Copy !req
303. - Well, now, that's what I call suction.
- Thank you, thank you.Copy !req
304. - MacGruder, is this patient warm?
- Shoot, shoot, shoot!Copy !req
305. - MacGruder!
- Temp is 106.Copy !req
306. - He has malignant hypothermia.
- Is he reacting to anesthesia?Copy !req
307. Give him dantrolene, get ice packs,
cooling blankets.Copy !req
308. If we don't get his temp down, he's
gonna have scrambled eggs for brains.Copy !req
309. Who took this patient's history?
He was intolerant to fluoroethane.Copy !req
310. Damn it! I lay out a banquet
and you crap all over my table!Copy !req
311. - He never had an operation.
- Cooling blankets!Copy !req
312. Well, lift him up, get him under. Peter,
come on over here. Evert the cortex.Copy !req
313. Log-roll him over. Suction, Peter.Copy !req
314. 5.0 proline, more ice.
Tie that off, Peter.Copy !req
315. - He never had an operation before?
- No.Copy !req
316. Well, you're right, there was no way
of knowing. My apologies. Metz! Metz!Copy !req
317. Are you free for lunch?Copy !req
318. - Susan?
- Yeah.Copy !req
319. Medical records sent down
the chart on your gallstone lady.Copy !req
320. - Thanks.
- I took a peek.Copy !req
321. - I know she's been on cefoxitin.
- Yeah.Copy !req
322. Cefotaxime has better
biliary penetration.Copy !req
323. I know it's hard memorizing
all the antibiotics out there...Copy !req
324. - ... but it's well worth the time.
- Right.Copy !req
325. - Who's the ultrasound for?
- Same lady.Copy !req
326. Didn't she have one last month?Copy !req
327. She's complaining of more pain. I wanna
rule out obstruction and cholangitis.Copy !req
328. Remember Charcot's triad. Cholangitis
is indicated by pain, fever and jaundice...Copy !req
329. of which she has only one.Copy !req
330. You can rule her out without
the expense of an ultrasound.Copy !req
331. If you're gonna be Chief,
you gotta watch the bottom line.Copy !req
332. Mark.Copy !req
333. I don't believe you've met Kathy Snyder,
one of the hospital attorneys.Copy !req
334. - Hello.
- Hello.Copy !req
335. Is this about this cardiac arrest
who died this morning?Copy !req
336. - I haven't heard anything. Have you?
- No.Copy !req
337. Kathy wanted to talk about
the O'Brien lawsuit.Copy !req
338. - You get a court date?
- We've worked out a settlement.Copy !req
339. - I'm not sure I want to settle.
- The hospital is sure.Copy !req
340. It's a good thing.Copy !req
341. Mr. O'Brien gets compensated,
and you can put this behind you.Copy !req
342. If I settle, this will follow me
my entire career.Copy !req
343. Every time I apply for a staff job
or insurance...Copy !req
344. If we took it to trail,
we could lose 2 million easily.Copy !req
345. You wanna lug that around
your entire career?Copy !req
346. I've been over this a thousand times.
I didn't do anything wrong.Copy !req
347. It was a very complicated delivery.Copy !req
348. I did as good a job as any
emergency physician could have.Copy !req
349. Other emergency physicians would
and have disagreed with you.Copy !req
350. A pregnant woman comes in
with preeclampsia...Copy !req
351. and for whatever reason,
you didn't pick up on it.Copy !req
352. Her condition was masked
by urinary infection!Copy !req
353. I don't want to argue the details
with you, Mark.Copy !req
354. You make thousands of diagnoses
a year, 99 percent of them are right on.Copy !req
355. - You made a mistake, as we all do.
- I don't accept that.Copy !req
356. - Mark, please-
- This is about my reputation as a doctor.Copy !req
357. I'm not gonna settle.
Take my name off of it.Copy !req
358. You can't separate yourself
from the suit.Copy !req
359. Well, I'll hire my own lawyer,
and I'll fight it myself.Copy !req
360. - That's a lot of worms.
- Hey, big fella.Copy !req
361. - Woman makes a fortune selling these.
- To whom?Copy !req
362. Landscapers, farmers.
Could be a great sideline.Copy !req
363. - You're kidding, right?
- No.Copy !req
364. This could pay
for the hole in my roof.Copy !req
365. - I took the spoiled food from the fridge.
- Veggie?Copy !req
366. - That's what you asked for.
- They don't like grease.Copy !req
367. How do they feel about yogurt?Copy !req
368. I don't hear any complaining.Copy !req
369. Eat up, little worms.Copy !req
370. John!Copy !req
371. - Hi.
- Told you it was an aneurysm.Copy !req
372. - You were right.
- Did Vucelich know who I was?Copy !req
373. Didn't you tell him about me?Copy !req
374. - That I found it?
- I meant to.Copy !req
375. I mean, I should have.Copy !req
376. The whole thing
happened really fast.Copy !req
377. I was gonna say something,
and they just assumed that...Copy !req
378. What are you doing in here?Copy !req
379. The hospital decided
to settle the O'Brien suit.Copy !req
380. Isn't that good news?Copy !req
381. Morgenstern thinks I'm at fault
for not picking up the preeclampsia.Copy !req
382. - That's not fair. He wasn't even there.
- You were there.Copy !req
383. It was as complicated a case as I've
ever seen. You did everything you could.Copy !req
384. You think I should have caught
the preeclampsia?Copy !req
385. It was a difficult diagnosis.
Anyone could have missed it.Copy !req
386. If you were called up
on the witness stand and asked:Copy !req
387. "Did Greene screw up? "
What would you say?Copy !req
388. I'm sorry, Mark.Copy !req
389. Come on, dude. Be bold.Copy !req
390. We start our own investment club.
We collect right off the bat.Copy !req
391. - No, thanks, man.
- What's to lose?Copy !req
392. - What'd you lose? Two grand?
- Alvin's gonna come through.Copy !req
393. Can you find out why the worm lady
isn't back from CT?Copy !req
394. She had palpitations,
so they're doing a cardiac workup.Copy !req
395. Call me when she comes down.Copy !req
396. Jerry, medical records copy
a chart for me?Copy !req
397. - Yeah, O'Brien, right?
- Yeah, thanks.Copy !req
398. Hey! What happened to those worms
in Radiology?Copy !req
399. - They're doing a consult.
- No, those earthworms.Copy !req
400. I put a bucket of earthworms in there.
They're gone.Copy !req
401. Well, I didn't take them.Copy !req
402. Ray, I'm Dr. Ross.Copy !req
403. I understand you've been having
some headaches and missing school.Copy !req
404. - Yeah, they're pretty bad.
- Okay.Copy !req
405. - Where in your head does it hurt?
- Here.Copy !req
406. - How long you been having these?
- About a month.Copy !req
407. - How often?
- All the time, I guess.Copy !req
408. - Do you feel dizzy?
- Yeah.Copy !req
409. Okay, pull like that.Copy !req
410. - Play sports?
- J.V. football, middle linebacker.Copy !req
411. I was a running back.
We used to hate you guys.Copy !req
412. Squeeze my hand.Copy !req
413. - You ever get headaches playing sports?
- No.Copy !req
414. No. Okay. We're gonna get you
a CAT scan. You know what that is?Copy !req
415. No? It's when we take a picture
of your brain.Copy !req
416. We wanna make sure it's still in there.Copy !req
417. All right. I'll be back in a minute.Copy !req
418. Dr. Vucelich, Dr. Benton.
I'm sorry to say...Copy !req
419. Tradition holds they serve olives
and walnuts with the drink.Copy !req
420. Dr. Vucelich, Dr. Benton,
I'm sorry to interrupt you.Copy !req
421. I misled you both earlier.Copy !req
422. The finder's fee for the aneurysm
should go to Harper Tracy.Copy !req
423. She's a third-year student.
She caught it.Copy !req
424. Taking credit for a colleague's work is
a very dangerous precedent, Mr. Carter.Copy !req
425. I can assure you that it will never
happen again.Copy !req
426. Well, your reassurance rings hollow
just now.Copy !req
427. One has to wonder if this is
a momentary lapse of integrity...Copy !req
428. or a fundamental flaw
in your character.Copy !req
429. Well, time will tell. In any event,
the patient's secondary condition...Copy !req
430. means he's not an appropriate
candidate for the study...Copy !req
431. so there will be no finder's fee.Copy !req
432. - Is there anything else?
- No.Copy !req
433. Strange boy.Copy !req
434. - The patient is being excluded?
- What's that? Oh, yes.Copy !req
435. It seems that he has a history of,
excuse me, neurological problems...Copy !req
436. which exceed the parameters
of the protocol, so...Copy !req
437. What were we talking about, Peter?
Oh, I remember.Copy !req
438. George Cinq. Walnuts, olives.Copy !req
439. Actually, I was an habitué of this bistro,
called "L'Ami Louis," and there was...Copy !req
440. - Mrs. D'Angelo. Feeling any better?
- No. Are you going to do that test?Copy !req
441. I consulted with another doctor, and
we feel the ultrasound is unnecessary.Copy !req
442. - You don't have any new symptoms.
- You're not even gonna check?Copy !req
443. Given that you don't have a fever
or any other symptoms...Copy !req
444. there's no way
I can justify the expense.Copy !req
445. The expense. I see.Copy !req
446. I can take it from here.
I know the routine.Copy !req
447. The nurse gives me a few pills that don't
work, and I'm pushed out the door.Copy !req
448. I checked with the elective
surgery waiting list...Copy !req
449. and they can get you in
by the end of the year.Copy !req
450. It's February 1 st.Copy !req
451. - Help!
- What happened?Copy !req
452. They were out by the trash.
Must've been there an hour.Copy !req
453. Get some blankets, heat up some
saline, we'll do a warm-water lavage.Copy !req
454. - The lamps they use on newborns.
- Great idea.Copy !req
455. Go up to OB, see if they'll lend us some.Copy !req
456. - All right. Oh, damn it!
- The lid's frozen.Copy !req
457. Oh, God! All right.
Rib spreader, rib spreader.Copy !req
458. - What are you doing?
- I'm gonna knock it loose.Copy !req
459. - What do you got?
- Hypothermia, earthworms.Copy !req
460. - Five grand worth.
- Earthworms?Copy !req
461. Yeah. They're Belgian.
They don't take kindly to cold.Copy !req
462. Got it, got it!Copy !req
463. - Oh, no!
- It's frozen solid.Copy !req
464. Well, maybe they're still alive
underneath.Copy !req
465. Surgical mallet, reflex hammer.Copy !req
466. Thanks. All right. All right.Copy !req
467. Oh, no.
What am I gonna tell Mrs. Henry?Copy !req
468. Good news, buddy.
Your brain's right were it should be.Copy !req
469. - All right. Let's talk about school.
- Why?Copy !req
470. Well, because school can cause stress,
and stress can cause headaches.Copy !req
471. Do you have any trouble with your
classes or students or teachers...Copy !req
472. - ... or anything like that?
- No.Copy !req
473. All right, what about your girlfriend?Copy !req
474. - Which one?
- There's a problem right there.Copy !req
475. - How many girlfriends do you have?
- A few. I don't know.Copy !req
476. All right.
You're not doing drugs, are you?Copy !req
477. - Smoking pot?
- No.Copy !req
478. - No?
- No.Copy !req
479. - You okay?
- Yeah, I'm fine.Copy !req
480. What's the matter?Copy !req
481. I can't. I can't.Copy !req
482. What?Copy !req
483. - There's something wrong with me.
- Okay.Copy !req
484. All guys who are your age, they think
that there's something wrong with them.Copy !req
485. No.Copy !req
486. - I'm different.
- How are you different?Copy !req
487. The girls at school...Copy !req
488. I...Copy !req
489. I don't feel anything
when I'm around them.Copy !req
490. I think I'm gay.Copy !req
491. I know I am.Copy !req
492. I mean, what am I supposed to tell
my dad, my brothers?Copy !req
493. I'm just sick of being this fake person.Copy !req
494. Haleh, will you call Psych?Copy !req
495. See if we can get a Resident
down to look at the kid in 1.Copy !req
496. Preferably someone
from adolescent medicine.Copy !req
497. - What's the problem?
- Kid thinks he's gay.Copy !req
498. Needs somebody to talk to.
I'm going to lunch.Copy !req
499. I'll check the charts.
Try and make yourself useful.Copy !req
500. Okay.Copy !req
501. Hey, good catch this morning
on the aneurysm.Copy !req
502. Harper, Carter, give me a hand.Copy !req
503. - What happened?
- She collapsed.Copy !req
504. Acute shortness of breath,
chest pain.Copy !req
505. - Pulse is high.
- Carter, start on an oxygen mask.Copy !req
506. - Harper, what do we order?
- EKG, chest film, blood gas...Copy !req
507. - ... Chem-7, CBC, cardiac enzymes.
- And?Copy !req
508. - Myoglobin.
- Myoglobin.Copy !req
509. - Do it.
- She has neck-vein distention.Copy !req
510. - Temp's 101.
- Susan?Copy !req
511. - Chief complaint?
- Shortness of breath, chest pain.Copy !req
512. - She has a history of renal failure.
- What's the differential?Copy !req
513. - Susan?
- Harper?Copy !req
514. Acute MI, pulmonary embolism,
pneumonia...Copy !req
515. - ... pericarditis, congestive heart failure.
- Pleural effusion.Copy !req
516. Pleural effusion. Stop that!Copy !req
517. - Prompting from the peanut gallery?
- Let's get a gas cooking.Copy !req
518. Get an EKG,
let's see how her heart's doing.Copy !req
519. After you.Copy !req
520. Hell of a way to spend your day off.Copy !req
521. Yeah. Wish I never would have come in.
Believe me.Copy !req
522. What's that? Jody O'Brien?Copy !req
523. It's the first time I looked at that
since the big day.Copy !req
524. She had two high BPs, proteinuria.
I missed a preeclampsia.Copy !req
525. If I hadn't, she'd be alive.Copy !req
526. - Could've happened to any of us.
- It's not supposed to happen to me.Copy !req
527. - Well, you are arrogant.
- Arrogant?Copy !req
528. It's like there's you and the Pope.
You guys are infallible.Copy !req
529. - Then, of course, there's the rest of us.
- Yeah?Copy !req
530. Well, after today,
the Pope's on his own.Copy !req
531. Good.Copy !req
532. I think I might have killed
that guy this morning.Copy !req
533. Mark. Hey, Mark!Copy !req
534. When I first checked his heart,
I heard a murmur.Copy !req
535. He must've had a congenital defect.Copy !req
536. That guy crashed 10 minutes
after he got in there.Copy !req
537. There's nothing you could have done.Copy !req
538. Yeah, yeah. Yes, there is.Copy !req
539. Could've gotten an echo, and then
I could've gotten him to the O.R.Copy !req
540. You're holding yourself
to a ridiculous standard, Mark.Copy !req
541. - I gotta get to an autopsy.
- It's your day off. Go home!Copy !req
542. Low-voltage EKG.Copy !req
543. - BP's falling.
- She's decompensating.Copy !req
544. - Where's that blood gas?
- I'll check.Copy !req
545. - You got it?
- These numbers don't make sense.Copy !req
546. - What?
- You hit a vein instead of an artery.Copy !req
547. - Is that the blood gas?
- Yeah, no. I mean yeah.Copy !req
548. - But I tapped a vein instead of an artery.
- No, I tapped a vein.Copy !req
549. Whoever did it,
do it again and do it right.Copy !req
550. Carter, you do it.Copy !req
551. - Non-specific ST changes.
- Where are we? Susan?Copy !req
552. I don't know where you are...Copy !req
553. - ... I'm at pericardial effusion.
- Or pump failure, or an embolism.Copy !req
554. - Let's get an echo!
- Positive Ewart's sign.Copy !req
555. Pressure's down, 50/30.Copy !req
556. Pericardiocentesis tray!Copy !req
557. Shouldn't you confirm your diagnosis
before sticking a needle in her heart?Copy !req
558. - I've made my diagnosis.
- Alligator clamp is on the needle.Copy !req
559. The diagnostic gold standard
is an echocardiogram.Copy !req
560. You wait while Tech comes down.Copy !req
561. I'll see if there's any fluid
around her heart. Okay.Copy !req
562. I'm in.Copy !req
563. - Anything yet?
- No, not yet.Copy !req
564. - Here it comes.
- What do you know?Copy !req
565. Looks cloudy. I wonder if it's
transudate or exudate fluid.Copy !req
566. Anyone know the gold standard
to differentiate the two? Kerry?Copy !req
567. Measure LDH to protein.Copy !req
568. What's the LDH ratio
to identify exudate fluid?Copy !req
569. - I'd have to look it up.
- It's. 5 to 1.Copy !req
570. - Greene?
- Yeah.Copy !req
571. You guys should come here more often,
brush up on your gross anatomy.Copy !req
572. - You guys find anything conclusive?
- Why, what are you looking for?Copy !req
573. - Something wrong with the heart.
- Think you missed something?Copy !req
574. - Possibly.
- Well, you came at just the right time.Copy !req
575. Size and shape normal.Copy !req
576. 380 grams.
Okay. Who wants to section this?Copy !req
577. Bill? I think it's your turn.
Martin, will you hand him a knife?Copy !req
578. Doug. It's been an hour, and Psych still
hasn't come down for that boy.Copy !req
579. - All right, I'll call them.
- Why don't you talk to him yourself?Copy !req
580. Because there's nothing physically wrong
with him, and I have four other patients.Copy !req
581. Is it because the kid's gay?Copy !req
582. - What?
- You heard me.Copy !req
583. If you mean, is it because
that boy's particular problems...Copy !req
584. fall out of my frame of reference
or my area of expertise...Copy !req
585. then the answer is yes.Copy !req
586. If you mean, is it because
I'm homophobic...Copy !req
587. then the answer is no. Okay?Copy !req
588. No congenital or valvular anomalies.Copy !req
589. Endocardium normal. Myocardium
of normal thickness and color.Copy !req
590. Blood vessels at base, normal.Copy !req
591. Coronary ostia are in the usual
anatomical position.Copy !req
592. Arteries show no sign of plaque.
He's normal.Copy !req
593. - No sign of anything congenital?
- Were you here a second ago?Copy !req
594. What was the cause of death?Copy !req
595. Typical ER thinking.
Gotta be cause and effect.Copy !req
596. See, down here we operate
on a slightly different gestalt.Copy !req
597. Sometimes there are answers,
but many times, mystery.Copy !req
598. It's not very satisfying.Copy !req
599. You think you're a scientist?Copy !req
600. You want explanations, hard answers,
algorithms of care? That's dog crap.Copy !req
601. Medicine's an art. And art is ambiguous.Copy !req
602. All right. Preliminary results:
Idiopathic dysrhythmia.Copy !req
603. No known cause of death.Copy !req
604. - Nurse?
- Hi, how are you feeling?Copy !req
605. Oh, tired.Copy !req
606. They gave me a million-dollar workup
and couldn't find anything wrong.Copy !req
607. I just want to take my worms
and go home.Copy !req
608. I have some bad news for you.Copy !req
609. Your worms were mistaken for trash
and put outside in the snow.Copy !req
610. - No.
- By the time I found out...Copy !req
611. they were already frozen solid.
We brought them in.Copy !req
612. We tried to warm them with blankets
and water. We used all our capabilities.Copy !req
613. But we couldn't get them back.
I'm very sorry.Copy !req
614. Can I see them?Copy !req
615. - What's that?
- Vucelich's study protocol.Copy !req
616. "Parameters for exclusionary status. "
Are you excluding someone?Copy !req
617. - Vucelich did.
- Anyone I know?Copy !req
618. The guy we worked on today.
He went bad.Copy !req
619. He ever drop people who do well?Copy !req
620. Why are you reading this now?
Has he dropped someone before this?Copy !req
621. Mrs. Rubadoux.Copy !req
622. He's not- I mean...Copy !req
623. Vucelich wouldn't drop bad outcomes
just to pretty-up his numbers, would he?Copy !req
624. I don't know.Copy !req
625. I don't need you to hide my mistakes.
If I screw up, let me deal with it.Copy !req
626. - You're right.
- Don't lie on my behalf.Copy !req
627. - I won't.
- It's insulting.Copy !req
628. I got it, okay? I gave you the credit.
What do you want?Copy !req
629. - What is with you today?
- Sorry, this Residency thing.Copy !req
630. My chances of getting in here
are about 1 in 50.Copy !req
631. I don't even have an interview set up
yet. I'm gonna end up in North Dakota.Copy !req
632. - Damn it.
- What?Copy !req
633. I forgot Dr. Benton's TPN orders. None
of his post-ops are getting their IVs.Copy !req
634. - Susan?
- One second.Copy !req
635. Yes, Kerry?Copy !req
636. According to The Washington Manual,
the determinative LDH ratio...Copy !req
637. isn't.5 to 1, it's.6.Copy !req
638. Oh, you got me again.Copy !req
639. If you're gonna be Chief,
get your facts straight.Copy !req
640. You know, if being Chief means
having you breathing down my back...Copy !req
641. to hell with it. I don't want you
as my mentor. Just stay out of my way.Copy !req
642. That's the first time I've ever seen you
act like a Chief Resident.Copy !req
643. Maybe Morgenstern was right.Copy !req
644. Where are you going?
I was coming to talk to you.Copy !req
645. I was telling my dad
how good I'm feeling.Copy !req
646. It was taking a long time. The nurse
said the CAT scan, it was okay?Copy !req
647. - Yeah, it's normal.
- No tumors, or- I hate to tell you...Copy !req
648. - ... what's been going through my head.
- He's fine.Copy !req
649. Thank God.Copy !req
650. It could be migraines.Copy !req
651. Yes, it could also be stress-related,
something I wanted...Copy !req
652. to talk to Ray about,
if I could-Copy !req
653. I know what it is. It's that damn trig.Copy !req
654. Every time I have one of those quizzes,
I get headaches.Copy !req
655. - You're kidding.
- No, I do.Copy !req
656. - Could that be what it is?
- It could.Copy !req
657. Because if that's it,
I mean, I know the prescription.Copy !req
658. Applying the seat of your pants
to the chair.Copy !req
659. Yeah.Copy !req
660. Button your coat. I'm sorry about this.
I spent the whole damn day waiting.Copy !req
661. It's okay.Copy !req
662. Listen, Ray, if you wanna talk
about this or anything else at all...Copy !req
663. - ... you just call me here, okay?
- Sure.Copy !req
664. Well, I thought she was
still at Beth Israel...Copy !req
665. doing whatever it is she does.
Oh, right, right.Copy !req
666. - He's on the phone. Be off in a minute.
- I don't need him anyway.Copy !req
667. I just wanna get the records
on a patient.Copy !req
668. - Which one?
- Rubadoux, Sylvie.Copy !req
669. I believe she was dropped.Copy !req
670. Claire, could you come here?
I can't find my pocket schedule.Copy !req
671. Help yourself.Copy !req
672. Yeah, my life is unraveling
as we speak.Copy !req
673. What jacket did you wear
to the lecture?Copy !req
674. Claire, let's be serious.
How can I possibly know?Copy !req
675. Why don't you just find my schedule
like I asked you to?Copy !req
676. Who's that? Who's been asking?
No, tell me. Kemper's been asking?Copy !req
677. Well, you can tell Kemper
that I am centimeters away.Copy !req
678. With any luck, I'll be in the New England
Journal next month...Copy !req
679. 21, 22, 23, 24, 25, 26...Copy !req
680. - Damn, man. Where'd you get all that?
- Alvin came through.Copy !req
681. - No guts, no glory.
- You've gotta be kidding me.Copy !req
682. - Life ain't fair.
- Are you gonna report that to the IRS?Copy !req
683. I assume that's a rhetorical question.Copy !req
684. Well, I'm gonna make my fortune
the old-fashioned legal way.Copy !req
685. - Delivering Chinese food?
- No, raising earthworms.Copy !req
686. - I got a dozen in there.
- I thought they froze to death.Copy !req
687. No, most of them moved into the middle
of the bin for warmth and survived.Copy !req
688. You took that lady's worms.Copy !req
689. No, she gave me enough to start my
own colony. It's my ticket out of here.Copy !req
690. Come on, guys, let's go home.
Good night.Copy !req
691. - Good night.
- Bye.Copy !req
692. - Didn't mean to scare you.
- No, you didn't.Copy !req
693. I finished your discharge summaries,
called in your orders...Copy !req
694. and I rounded the patients upstairs.
Can I go home?Copy !req
695. - Bye, Carter.
- I'm sorry about what happened earlier.Copy !req
696. Good night.Copy !req
697. - Carter?
- Yeah?Copy !req
698. - Were the TPN orders called in on time?
- Yeah.Copy !req
699. No. I screwed up again.
They were 45 minutes late.Copy !req
700. I know. I called the pharmacy.Copy !req
701. - So are we sworn enemies forever?
- No.Copy !req
702. Denial's a funny thing. It keeps you
from asking the scary questions.Copy !req
703. Which ones?Copy !req
704. The ones I've been asking myself
all day today.Copy !req
705. Am I dangerous?Copy !req
706. Should I be practicing medicine?Copy !req
707. We all ask those questions.Copy !req
708. And the answers are "no" and "yes. "
In that order.Copy !req
709. I hope so.
I lost my family for this job.Copy !req
710. You're wallowing.Copy !req
711. Yes, I am wallowing.Copy !req
712. The first good wallow I've had
in a while, so don't ruin it.Copy !req
713. Well, I'm gonna drive home.
You want a ride?Copy !req
714. No. I jogged in, I'm gonna jog out.Copy !req
715. - Hey, you wanna hear something funny?
- Definitely.Copy !req
716. You know that guy who died
this morning? It wasn't my fault.Copy !req
717. I did everything right,
and he died anyway.Copy !req
718. - So, what's the lesson in that?
- Can't win.Copy !req
719. Oh, man. You are wallowing.Copy !req
720. - Good night.
- Night.Copy !req
721. - Susan?
- Yeah?Copy !req
722. Did anybody think it was odd,
my coming in today?Copy !req
723. No.Copy !req
724. I was just checking.Copy !req
725. - Night.
- Good night.Copy !req