1. E.R.Copy !req
2. Previously on the E.R.Copy !req
3. So the baby's a girl today.Copy !req
4. You turned me in?Copy !req
5. There's a guy from the medical board
here, questioning my competency.Copy !req
6. Minority kids don't have the same
access to academic opportunities.Copy !req
7. You want to address that...Copy !req
8. by advancing underqualified applicants
at the expense of our integrity and theirs?Copy !req
9. I want him to have an interview.Copy !req
10. Everyone deserves to be comforted
in their darkest hour.Copy !req
11. Too bad you weren't there to comfort
the little girl he killed.Copy !req
12. I didn't need to be. God was there.Copy !req
13. Was he?Copy !req
14. Bishop Stewart, can you hear me?Copy !req
15. Call 911.Copy !req
16. Again.Copy !req
17. It hurts when I breathe.
Could it be my heart?Copy !req
18. E.R. 7x15 "THE CROSSING"Copy !req
19. Something wrong?Copy !req
20. - Hey.
- What?Copy !req
21. - Is there something wrong with my heart?
- Probably a bruise to your chest wall.Copy !req
22. We'll get an x-ray to make sure.
You were lucky.Copy !req
23. We'll probably be sifting through
the walking wounded until morning...Copy !req
24. but I think we're over the hump.
Carter brought up the last critical.Copy !req
25. - How many came in?
- Thirty-seven. Five in surgery.Copy !req
26. Only two ER deaths.
That's not too bad, considering.Copy !req
27. If you don't count the DOAs.Copy !req
28. You did a great job. You should
go home. We got it from here.Copy !req
29. - The board's backing up.
- We're fine. Go home.Copy !req
30. We'll see you tomorrow.Copy !req
31. Hey. You leaving?Copy !req
32. No, I thought I'd check on the bishop.Copy !req
33. - Another critical come in?
- No. That's it.Copy !req
34. Is she stable?Copy !req
35. - Yeah. After three rounds of terbutaline.
- Good.Copy !req
36. - It was scary, though.
- Yeah.Copy !req
37. So are you heading home soon?Copy !req
38. I don't know.Copy !req
39. You okay?Copy !req
40. Yeah.Copy !req
41. - Any change?
- He didn't want the breathing mask.Copy !req
42. - Has he been awake?
- Napping on and off.Copy !req
43. What time is it?Copy !req
44. 11:30.Copy !req
45. You're here late.Copy !req
46. You'll have to be intubated soon.Copy !req
47. On a ventilator?Copy !req
48. Your oxygen level is down to 65
on 100% oxygen-Copy !req
49. I've seen what happens
after a ventilator.Copy !req
50. - If it drops below 50...
- Thanks. But no thanks.Copy !req
51. Anyway, my bags are packed.Copy !req
52. E.R.Copy !req
53. SEVEN HOURS EARLIERCopy !req
54. Water! I need water.Copy !req
55. - Mr. Martin!
- It stings!Copy !req
56. Mr. Martin, just give it a few seconds.Copy !req
57. No, it stings.Copy !req
58. - A few seconds and the pain will fade.
- Need some help?Copy !req
59. No. I just put in a drop of Alcaine.Copy !req
60. Mr. Martin fell asleep
under a tanning lamp.Copy !req
61. I wasn't tanning. I was depressed
due to lack of sunlight.Copy !req
62. Tell me about it.
Got back from lunch and it was dark.Copy !req
63. UTI in 4 is gone.Copy !req
64. - Groundhog see its shadow this year?
- Seeing his shadow...Copy !req
65. has nothing to do
with how much sunlight we get.Copy !req
66. Yes, it does.
Six more weeks of winter.Copy !req
67. Seven-year-old with diarrhea
and wheezing.Copy !req
68. Ordered Solu-Medrol
and breathing treatments.Copy !req
69. - Any history of asthma?
- Nope.Copy !req
70. - Fever or cough?
- Nothing.Copy !req
71. - Carter, want to figure this one out?
- Bring it on.Copy !req
72. Okay, that's it. Weaver's on at 6:00.Copy !req
73. Could you tell her I'm finished testing
tonight so she can stop avoiding me?Copy !req
74. How'd your personality test go?Copy !req
75. I scored somewhere between
serial killer and talk-show host.Copy !req
76. - I thought they were memory tests.
- That was Monday.Copy !req
77. What's next, Rorschach? Spelling bee?Copy !req
78. Swimwear competition,
sudden-death Twister.Copy !req
79. Who knows? Maybe a chili cook-off.Copy !req
80. The needle goes in, but you can
squeeze on the owie ball. See that?Copy !req
81. - What's up?
- Hold that for me?Copy !req
82. Kid freaked out when
I tried to start an IV.Copy !req
83. - Who's...?
- She's a new intern for Pedes.Copy !req
84. - to give you medicine. And then
it won't hurt anymore, okay?Copy !req
85. Hey, Jason. I'm Dr. Carter. I understand
you're having some trouble breathing.Copy !req
86. - You mom?
- Yes.Copy !req
87. - Any history of asthma here?
- No.Copy !req
88. Mrs. Fabrone works as a
cleaning lady at a church.Copy !req
89. She found a bottle of holy water
in the sanctuary and thought...Copy !req
90. - ... it might help with Jason's diarrhea.
- Holy water?Copy !req
91. Only it tasted funny. When Jason started
coughing, she checked. It was lamp oil.Copy !req
92. - He aspirated holy oil?
- I guess so.Copy !req
93. That's the common duct.
We don't cut that. What time is it?Copy !req
94. - 4:55.
- No, no, no. Your interview tomorrow.Copy !req
95. - Oh. 10:00 a. m.
- Get there by 9:30.Copy !req
96. Right.Copy !req
97. - So why do you want to be a doctor?
- What?Copy !req
98. - It's a common question in the interview.
- Oh, yeah.Copy !req
99. Clips. So, what's the answer?Copy !req
100. I wanna help people?Copy !req
101. No?Copy !req
102. All right. Now we dissect
the gallbladder from the liver.Copy !req
103. - What's the right answer?
- You tell me.Copy !req
104. The money?Copy !req
105. I wanna be a role model.Copy !req
106. - If you're not gonna take this seriously-
- I am. I just don't know.Copy !req
107. - I guess I always thought it'd be cool.
- Well, at least that's honest.Copy !req
108. - So I should say that?
- Of course not.Copy !req
109. Dr. Benton, how much
longer do you have?Copy !req
110. Are you timing me?Copy !req
111. Mass-cas called in.
They need you downstairs.Copy !req
112. - What happened?
- They didn't give details.Copy !req
113. All right. Let me get some more suction.
I'll be maybe 15 minutes.Copy !req
114. You should hang out.
You never know what you'll see.Copy !req
115. Great job, Jason. I'll stop by and see
you later, okay? You're admitting him?Copy !req
116. Yeah, just for a day. Keep him on
continuous nebs and monitor his sats.Copy !req
117. - Where's mom?
- She went to go talk to her priest.Copy !req
118. Could've used you, actually.
She got a little upset after you left.Copy !req
119. About her kid or because
she stole from the church?Copy !req
120. My friend used to lift communion wine
for us. He just went to confession.Copy !req
121. - What about you?
- Me? I just got sick.Copy !req
122. - So you're a heathen.
- Protestant.Copy !req
123. Is there a difference?Copy !req
124. - Will you sign this for me?
- What is it?Copy !req
125. It's for my supervisor. If you think
I did a good job with the kid.Copy !req
126. "Child Life Specialist."Copy !req
127. Intern. First day.Copy !req
128. Oh, yeah? Hey, welcome. John Carter.Copy !req
129. Rena Trujillo. Nice to meet you.Copy !req
130. And you.Copy !req
131. - Don't forget your voodoo doll.
- It's a procedure doll.Copy !req
132. They make them life-size
for really big kids?Copy !req
133. - Why, you lonely?
- Yeah. I work a lot.Copy !req
134. That's too bad.Copy !req
135. - John, Luka needs you.
- Abby, this is Rena.Copy !req
136. Hi. A train derailed by Lakeshore.
They need to set up a triage center.Copy !req
137. Excuse me.Copy !req
138. - Any passenger cars?
- Commuter train.Copy !req
139. - How many?
- They don't know.Copy !req
140. They're pulling bodies out.
They need docs on-site.Copy !req
141. Prep trauma rooms, set up Curtain 2
and 3 for majors. Pull everybody in.Copy !req
142. - Carter, let's go.
- Is the chopper already here?Copy !req
143. - They'll meet us on the roof.
- We don't have an Attending.Copy !req
144. Kerry's due in 15. Call me
if you have any problem.Copy !req
145. Four units of O-neg.Copy !req
146. Move all stable patients into the hall.
Double up the rooms.Copy !req
147. Anyone walking waits in Chairs.Copy !req
148. Put all surgical teams on alert
and notify the O.R.Copy !req
149. - Already did. We're low on vents.
- Then grab some from the ICU.Copy !req
150. - Found it.
- Randi, call the nursing supervisor...Copy !req
151. - ... float some nurses from the unit.
- They'll need them up there.Copy !req
152. - Get them from Med-Surg.
- Oh, my God.Copy !req
153. Captain Davis, incident commander.
We were evacuating the first car...Copy !req
154. when it rolled. I got a man crushed
underneath. His legs are pinned.Copy !req
155. 14 DOAs so far, we're still pulling them
out. Two middle cars are the worst.Copy !req
156. - What happened?
- An automobile stalled on the tracks.Copy !req
157. We think the brakes on the back cars
failed when the train tried to stop.Copy !req
158. Blunt chest trauma over here,
dropping his pressure!Copy !req
159. I've got it. You take the crush injury.Copy !req
160. - What's on the monitor?
- Sinus tach.Copy !req
161. - Vitals?
- BP, 90/60. Pulse is 120.Copy !req
162. I was supposed to fly.
My damn flight was canceled.Copy !req
163. Okay. Rales on the left.Copy !req
164. My chest.
Feels like something tore inside.Copy !req
165. Try a 14-gauge and bolus
a liter of saline.Copy !req
166. Mitch! Mitch, I'm sorry, man!Copy !req
167. Don't apologize to me.Copy !req
168. I didn't know it was
gonna tip over like that.Copy !req
169. BP, 85/60. Pulse, 110.Copy !req
170. - I need something more for the pain.
- What did you give him?Copy !req
171. Ten of morphine. Held off
when he dropped his pressure.Copy !req
172. Give him five more,
but after the liter.Copy !req
173. - How long till you can get him out?
- We couldn't lift it with the jacks-Copy !req
174. - How long?
- How long do you have?Copy !req
175. - Get a jack on this.
- That's not gonna hold.Copy !req
176. - She conscious?
- Yeah.Copy !req
177. - I'm Dr. Kovac. What's your name?
- I couldn't get out.Copy !req
178. - Your name? Do you know your name?
- Shannon.Copy !req
179. - Okay. Does your neck hurt?
- No.Copy !req
180. Hey, Luka!Copy !req
181. - What?
- We may need a surgeon.Copy !req
182. Call it in.Copy !req
183. We might not be able to get him out.
I need a surgeon...Copy !req
184. - ... with a field amputation kit.
- He's on stand-by.Copy !req
185. No, not on stand-by. Here now.
He's losing a lot of blood.Copy !req
186. Help.Copy !req
187. - Ma'am, has someone examined you?
- They're looking for my son.Copy !req
188. He wanted to go to the bathroom
by himself.Copy !req
189. - Okay, let's get you out.
- I can't move my legs.Copy !req
190. - Does your neck hurt?
- Please, you have to find my son.Copy !req
191. - Okay, lean forward.
- I can't!Copy !req
192. Doris!Copy !req
193. - Are you allergic to any medicines?
- No.Copy !req
194. - He's wearing a blue sweater.
- Doris!Copy !req
195. - In a sec!
- I need a line and a set of vitals!Copy !req
196. He's 7.Copy !req
197. He wanted to go
to the bathroom by himself.Copy !req
198. Saline, wide open. Nasal O-2,
and get me if she's hypotensive.Copy !req
199. Please, you have to find him!Copy !req
200. - Are you looking for a little boy?
- He's pinned. We have to cut him free.Copy !req
201. - Can you get a BP?
- No room. Pulse is thready.Copy !req
202. - How do I get in there?
- The roof.Copy !req
203. Systolic's 95.Copy !req
204. Make it two liters. Radio the IC.
I need the metal cut before we transport.Copy !req
205. - Did they find him?
- I think so.Copy !req
206. - Is he okay?
- I don't know yet.Copy !req
207. - What's his name?
- Myles.Copy !req
208. - Where is he?
- Over here.Copy !req
209. - Got an airway?
- Breathing on his own.Copy !req
210. We're waiting on a circular saw.Copy !req
211. Myles? Myles, can you hear me?Copy !req
212. Pupils, poorly reactive. Looks like a closed
head injury. We need to get him out.Copy !req
213. - I told you, equipment's on its way.
- Get it here, now!Copy !req
214. She's throwing PVCs.
Do you want us to treat?Copy !req
215. - What?
- Ectopic beats. Can we give lidocaine?Copy !req
216. - What's the injury?
- Train hit her car.Copy !req
217. - Possible pubic ramus fracture.
- Not at her age. Just get her to County.Copy !req
218. - Where's the amputation?
- Over here.Copy !req
219. We've got a crush injury to the legs.
BP's 90/65 with fluids.Copy !req
220. I don't know how much longer
we can keep it that way.Copy !req
221. - They can't get him out?
- They're trying to, but...Copy !req
222. - You all right? You okay?
- Damn it.Copy !req
223. I'm fine. I'm fine.Copy !req
224. - What's his name?
- Who?Copy !req
225. - The firefighter.
- Lorcan.Copy !req
226. I had to inflate two BP cuffs to use
as tourniquets. Watch your step.Copy !req
227. - Right.
- You okay?Copy !req
228. Yes.Copy !req
229. Lorcan, I'm Elizabeth Corday.
I'm a surgeon.Copy !req
230. You gonna cut them off?Copy !req
231. Only if I have to. Now, listen.Copy !req
232. We can't give you more pain medication
because we need to keep...Copy !req
233. your blood pressure up.
So I'm going to give you a nerve block.Copy !req
234. Do it fast.Copy !req
235. Prep the groin area. Betadine.Copy !req
236. - How much fluid in?
- Three liters saline, two of O-neg.Copy !req
237. 20-gauge for the injection.Copy !req
238. These cuffs aren't holding. I'm gonna
reinflate them and then clamp them.Copy !req
239. - Lorcan, you want me to call Patty?
- No!Copy !req
240. - You sure?
- I'm not dying, man.Copy !req
241. - All right, buddy.
- Who's Patty?Copy !req
242. Patty's my ex-wife.Copy !req
243. Guys and I were going out after the shift
to celebrate my divorce going through.Copy !req
244. - Get back. We're gonna hammer through.
- Just a second!Copy !req
245. - Come on, let's do this!
- Hold on, Lorcan.Copy !req
246. Get me out!Copy !req
247. Got it?Copy !req
248. - Done.
- Thanks.Copy !req
249. That's it!Copy !req
250. Okay, on three. One, two, three...Copy !req
251. - Where's the backboard?
- Paramedics are bringing it in.Copy !req
252. All right.Copy !req
253. Is he still breathing?Copy !req
254. - Yes. Good air entry.
- How many did you say we could take?Copy !req
255. I didn't. They're transporting
all over the city.Copy !req
256. We're two docs down
and a surgeon in the field.Copy !req
257. - You want me to page Dr. Greene?
- He's at his competency testing.Copy !req
258. Find out how many they're sending us.Copy !req
259. Malucci's on his way with the
first air-evac. Possible aortic rupture.Copy !req
260. - Peter, you're up first.
- Got it.Copy !req
261. No, elevator. Call CT.Copy !req
262. Have them cancel all elective cases.
I don't want them jamming up on us.Copy !req
263. Stay close to me.
If you have any questions, ask.Copy !req
264. Don't be surprised if the nurses push
you out of the way. It's their job.Copy !req
265. - I don't need to stay?
- Only if you want to.Copy !req
266. Blunt chest trauma, asymmetric BPs.Copy !req
267. Dropped his pressure en route.
60 palp. Tachy at 120.Copy !req
268. - Sir, do you know where you are?
- I was taking a plane.Copy !req
269. - Oriented times one only.
- Marked tachypnea. Pulse ox, 88.Copy !req
270. - Heart sounds muffled.
- What's that mean?Copy !req
271. - Trashed his aorta.
- The major artery from the heart.Copy !req
272. - Neck veins are distended.
- He's in tamponade.Copy !req
273. Have the O.R. prime bypass.Copy !req
274. - You our new third-year?
- No, I'm just applying.Copy !req
275. Come on. Get over here.Copy !req
276. - Move!
- Let's prep for pericardiocentesis.Copy !req
277. Too late. Lost the pulse.Copy !req
278. Thoracotomy tray. You better put on
a gown. It's gonna get bloody in here.Copy !req
279. - What do you got?
- Abdominal wound.Copy !req
280. BP's 120/90.
We're taking her to Lakeshore.Copy !req
281. Are you kidding me? She needs a trauma
center. All right. Reroute to County.Copy !req
282. - Give her 10 more of MS. Do it!
- We're supposed to rotate-Copy !req
283. - Doc! Doc!
- Yeah?Copy !req
284. Tracheal shift to the left.
I need to stick him.Copy !req
285. - What's his pulse ox?
- 88 on high-flow O-2.Copy !req
286. I can't hear anything with all this noise.Copy !req
287. Did you get it?Copy !req
288. I don't know.Copy !req
289. - Are these all ours?
- No, it's the damn news.Copy !req
290. Okay, he's moving air.
Take him to County.Copy !req
291. Not Lakeshore. County. Tell them
he needs a chest tube, maybe a vent.Copy !req
292. Stop! Stop!Copy !req
293. - You okay?
- I think I may have strained my back.Copy !req
294. Come on! Keep digging!Copy !req
295. We can't. The weight of the train
will shift on you.Copy !req
296. - That crane coming?
- From Indiana.Copy !req
297. - What?
- It's on its way, Lorcan.Copy !req
298. What's his pressure?Copy !req
299. 85 palp. Pulse 110. Four units in.Copy !req
300. - Can you assist?
- Yeah. I can start.Copy !req
301. Lorcan, listen to me. I'm gonna have to
proceed with amputating both your legs.Copy !req
302. No! I've had people trapped
for hours before we got them out!Copy !req
303. I appreciate that.
But you've lost too much blood.Copy !req
304. If I don't amputate and control
the bleeding, you're going to die.Copy !req
305. Okay, then. I'm gonna start.Copy !req
306. Do you understand? I have to start now.Copy !req
307. Prep the area.Copy !req
308. 10 blade.Copy !req
309. Can you tell my fortune with these?Copy !req
310. Pick up each card from your pile and put
it under the card to which it belongs.Copy !req
311. Is that the death card?Copy !req
312. I'll tell you if you're right or wrong.
Are you ready to begin?Copy !req
313. - Hit me.
- Begin.Copy !req
314. No. No, just try the next card.Copy !req
315. No.Copy !req
316. - Yes.
- Third one's a charm.Copy !req
317. Yes.Copy !req
318. Yes.Copy !req
319. - Yes.
- Look, two hands.Copy !req
320. Yes.Copy !req
321. - No.
- No?Copy !req
322. No.Copy !req
323. No.Copy !req
324. - Ever say anything besides yes or no?
- No.Copy !req
325. I've isolated the femoral artery.
Retract distally.Copy !req
326. - Got some oozing from the SFA.
- Mitch?Copy !req
327. - Can't do much about that in the field.
- Mitch!Copy !req
328. - I'm right here, buddy.
- I think maybe you should get Patty.Copy !req
329. - You got it.
- I need to dissect this vessel out. Metz.Copy !req
330. - What? What is it?
- Carter, quick. Clamp that. Clamp it.Copy !req
331. - What, what, what, what?
- Medial to the muscle bed. Clamp it now.Copy !req
332. - Is it your back?
- It's coming and going.Copy !req
333. - Intermittent pain?
- Yes.Copy !req
334. How often?Copy !req
335. - What's her pressure?
- Dropping. 80 palp.Copy !req
336. - Myles.
- Start her on dopamine. Titrate to 100.Copy !req
337. Save him, please.Copy !req
338. - How long till you are through?
- I don't know. Ten minutes, maybe.Copy !req
339. Pupils are still sluggish.Copy !req
340. Okay. 0.3 of atropine.
Do you have any mannitol?Copy !req
341. - On board.
- Hang 40 grams.Copy !req
342. - He's hypertensive and bradying down.
- I know.Copy !req
343. He could have a bleed.
You're not coming with us?Copy !req
344. Okay, load him. I'll be right back.Copy !req
345. Carter, I have to take this boy in.
There is a woman back there...Copy !req
346. impaled, with spinal shock. And I want
you to stay with... What is it?Copy !req
347. - She's having contractions.
- What?Copy !req
348. - She's having contractions at 25 weeks.
- I need tocolytics and a fetal monitor.Copy !req
349. I can keep on going
if I can just get them to stop.Copy !req
350. - Have any terbutaline?
- No.Copy !req
351. - In the rig?
- We don't carry it.Copy !req
352. You should fly back with us. Carter, take
the mother. The woman down there.Copy !req
353. What about him?
We opened the interior compartment.Copy !req
354. - Call another surgeon!
- We're out of O-neg.Copy !req
355. We have to finish him now.Copy !req
356. If we put you on the chopper, could you
monitor this boy on the flight back?Copy !req
357. Yes. But he could exsanguinate
from his left leg.Copy !req
358. - You were a surgical resident, yeah?
- Interned. For a year.Copy !req
359. - Trauma panel and get a HemoCue.
- Sinus, rate of 95.Copy !req
360. - Any chest pain?
- No.Copy !req
361. Mild guarding. No rebound.
Set her up for a CT and put in a Foley.Copy !req
362. - Is that man from the train?
- Yeah.Copy !req
363. - Is he dying?
- I don't know.Copy !req
364. Abby, could you shut the doors?
Type and cross for four. Dip a urine.Copy !req
365. More O-neg on the infuser.
The heart's not filling.Copy !req
366. - Unit seven going up.
- Got it. Cut.Copy !req
367. - Okay, you're done. We gotta shock him.
- Hold on. Couple more sutures.Copy !req
368. Dr. Benton, Dr. Finch needs you.
Bad leg injury.Copy !req
369. Got it.Copy !req
370. Clear!Copy !req
371. Malucci, he's all yours.
You get a rhythm, send him up.Copy !req
372. - White, you're coming with me.
- Still in V-fib.Copy !req
373. Another amp of epi.
Stand by with lidocaine. Clear.Copy !req
374. Peter, I have a right orbital trauma
with loss of vision.Copy !req
375. Set up the slit lamp,
tetracaine and fluorescein.Copy !req
376. Dr. Benton, blunt abdominal trauma.
Possible liver injury.Copy !req
377. - What's the crit?
- Thirty-four, but he's pretty tender.Copy !req
378. - Do an ultrasound. If you see fluid-
- Chuny, I need vitals now.Copy !req
379. - Traumatic extrusion of the tibia.
- You call Ortho?Copy !req
380. - Yes, but he's looking pretty dusky.
- Hold on, that's my bone!Copy !req
381. All right. All the major vessels
seem intact. Just try to get him up.Copy !req
382. - Peter, Carter needs to talk to you.
- Not now!Copy !req
383. He's performing a double
amputation by himself.Copy !req
384. - What?
- A guy pinned under a train.Copy !req
385. - Don't worry. That can be reattached.
- Give another 20 MS.Copy !req
386. Okay, he's on Bravo Three.Copy !req
387. - Carter, what are you doing?
- Left anterior thigh.Copy !req
388. I've incised through the fascia
and muscle planes.Copy !req
389. I need to isolate
the neurovascular bundle.Copy !req
390. - I thought Corday went with you.
- She did.Copy !req
391. What is she doing?Copy !req
392. We've got to control his airway.Copy !req
393. BP's rocketing, 240/120.
Pulse, down to 30.Copy !req
394. Another mig of atropine
and mix Nipride.Copy !req
395. - He's in respiratory distress.
- I'll intubate. 6.5 ET tube.Copy !req
396. - Should we stay on the ground?
- No, let's go.Copy !req
397. Fifty of lido, one of Pavulon, 50 of sux.Copy !req
398. You okay?Copy !req
399. No.Copy !req
400. Using the dull edge of the Metz, let
your finger continue blunt dissection...Copy !req
401. of the artery from
the neurovascular bundle.Copy !req
402. - What?
- Blunt dissection-Copy !req
403. You' re gonna have to shout.
I can barely hear you.Copy !req
404. Do you know what you're doing?
Does anybody know what they' re doing?Copy !req
405. What's he down to now?Copy !req
406. 190/100. Pulse, 44 after two migs.Copy !req
407. - Try 80 of Lasix.
- Let them take him downstairs.Copy !req
408. Go! Go straight to CT.Copy !req
409. There's a case on the table.Copy !req
410. - He probably has an epidural.
- I'll tell him.Copy !req
411. - How often you been having back pain?
- Every four or five minutes.Copy !req
412. When's the last time
you felt the baby move?Copy !req
413. I don't know. I haven't.Copy !req
414. Okay.Copy !req
415. Got it!Copy !req
416. Can you call on the radio
and see how he is?Copy !req
417. - We'll be there soon.
- BP, 96/65. Pulse is 110.Copy !req
418. Am I gonna die? Am I?Copy !req
419. We'll get you out.Copy !req
420. If I die before I get there, you have to
make sure they take care of Myles.Copy !req
421. - They will.
- He's 7.Copy !req
422. I know.Copy !req
423. His father's in Kansas City on business.
We were coming back from visiting him.Copy !req
424. I thought it'd be fun
for Myles to take the train.Copy !req
425. What about the sciatic nerve?Copy !req
426. Pull it down as far as possible,
then apply an Ochsner clamp.Copy !req
427. That one. Third to the right.Copy !req
428. Okay. I got it. Now what?Copy !req
429. Put a second clamp
five millimeters distally.Copy !req
430. We' re gonna get you through this,
Lorcan. You're gonna be all right.Copy !req
431. Remove the proximal clamp
and ligate the crushed area.Copy !req
432. - 0-Vicryl?
- No, no, no. Nonabsorbable.Copy !req
433. - Peter, this boy's herniating.
- Use silk if you've got it.Copy !req
434. - Okay. Done that. Now what?
- We've got to drain the hematoma.Copy !req
435. Carter, I've gotta go.
Call me on your cell phone.Copy !req
436. - I don't have it. It's in my locker.
- Find one.Copy !req
437. - Peter, now. Keep bagging him.
- What do I do about this nerve?Copy !req
438. - Step off in the right parietal region.
- Dr. Benton?Copy !req
439. - Pulse ox is dropping.
- Dr. Benton?Copy !req
440. - What is it?
- You have a cell phone?Copy !req
441. - Do you?
- No.Copy !req
442. - Terbutaline's on board.
- Repeat in another hour.Copy !req
443. - You sure McLucas hasn't answered?
- We just paged her. Give her a second.Copy !req
444. - What about Mark?
- He's on his way.Copy !req
445. Okay. You're about 25% effaced.
But dimpled, not dilated.Copy !req
446. - Okay? We can control that.
- You think so?Copy !req
447. - An OB Resident's on his way.
- I don't want a Resident!Copy !req
448. You have to calm down.
And focus, okay?Copy !req
449. - Give the terbutaline a chance to work.
- Mark's on the phone.Copy !req
450. - What line?
- Three.Copy !req
451. - Climbing again, 220/115.
- Blown right pupil.Copy !req
452. He needs a burr hole.
Where's your perforating drill?Copy !req
453. - Is 1 open?
- Yeah. Malucci's calling it.Copy !req
454. Connect the chisel bit. Let's keep
hyperventilating. Let's move!Copy !req
455. - Coming through!
- Hold on. I gotta move this guy out.Copy !req
456. No, no, no. Shove him up
against the wall. Move!Copy !req
457. Have somebody shave his head.
Give me 8.5 gloves.Copy !req
458. Sit him up to 30 degrees.Copy !req
459. Carter's on line three.
He needs to talk to you.Copy !req
460. White, get over here and hold
the phone up to my ear. 10 blade.Copy !req
461. - Pressure's through the roof, 260/140.
- Not good. Up the Nipride to three mics.Copy !req
462. Put my glasses down.
Carter, talk to me. Where are you?Copy !req
463. - Sciatic nerve.
- All right, good. Cut proximally...Copy !req
464. and let the muscle retract
into the muscle belly.Copy !req
465. Lorcan, they found Patty.
They' re gonna send a truck...Copy !req
466. - ... to take her straight to the hospital.
- No, no. Forget it.Copy !req
467. Okay. Cutting now.Copy !req
468. Good. Make sure you use
a scalpel instead of scissors.Copy !req
469. - Otherwise you'll get a neuroma.
- She's on her way. She wants to come.Copy !req
470. - No! No! Not now!
- Would you please hold him still?Copy !req
471. - Okay, now what?
- Take two Kellys...Copy !req
472. and clamp the femoral artery
and vein together.Copy !req
473. - I don't want her to see me like this!
- Can you give him something?Copy !req
474. - He's seizing!
- Five of Ativan.Copy !req
475. Five of Valium.
Put the phone right here.Copy !req
476. I don't want her to see me!Copy !req
477. - You gotta hold him still until it kicks in.
- You're almost free.Copy !req
478. - Is that two clamps each or altogether?
- Two clamps altogether!Copy !req
479. - Two of Ativan?
- Five.Copy !req
480. Am I clamping the vein
and the artery separately?Copy !req
481. Carter, clamp the vessels
as one unit at both ends.Copy !req
482. Ativan's on board. Still seizing.Copy !req
483. All right. You know what?
I gotta go in. Just reparalyze him.Copy !req
484. - Both proximally...
- Don't do it!Copy !req
485. - ... and distally or one proximally-?
- Carter, just clamp the damn vessels!Copy !req
486. - How many liters in?
- Two and a half. Lost a pulse.Copy !req
487. - She's in V-fib. Charge to 200.
- Do you want to run her inside?Copy !req
488. No, here. Paddles.Copy !req
489. Charging.Copy !req
490. Clear!Copy !req
491. - Still in V-fib.
- Charge to 300. Clear.Copy !req
492. Mark, penetrating back injury.
Needs to go straight to the O.R.Copy !req
493. All right, I'll tell Randi.Copy !req
494. Mark.Copy !req
495. - You feeling any more contractions?
- I'm sorry.Copy !req
496. Don't be.Copy !req
497. I slipped and fell.
I thought it was just backache.Copy !req
498. - Did you give her terbutaline?
- Ten minutes ago.Copy !req
499. Fetal heart tones?Copy !req
500. One fifty-five. No decels.Copy !req
501. Well, that's good.Copy !req
502. - They haven't stopped.
- You gotta give it some time to work.Copy !req
503. Or maybe we should try magnesium.Copy !req
504. We will if we have to. Okay?
Let's just wait and see.Copy !req
505. It's okay. It's okay. It's okay.Copy !req
506. - Irrigate.
- More Ativan?Copy !req
507. No. Stopped seizing once he relieved
intercranial pressure.Copy !req
508. Suction catheter. Carter,
are you through the tibia yet?Copy !req
509. Done. Almost there, Lorcan.Copy !req
510. Good. Use the rongeur
to bevel the anterior apex.Copy !req
511. - Where is that?
- Sharp edge at the end of the bone.Copy !req
512. - What's his pressure?
- Down to 170/60.Copy !req
513. They' re all sharp! Damn it!Copy !req
514. - It's the anterior surface.
- Dr. Weaver, I need you.Copy !req
515. - What patient?
- The girl whose car got hit.Copy !req
516. - I'm sorry. What?
- The anterior surface.Copy !req
517. - Get him upstairs.
- Carter, you're almost there.Copy !req
518. When you're done, use the
rongeur to crack the fibula.Copy !req
519. Wait, wait, wait!
Hold on! Hold on!Copy !req
520. Dr. Benton!Copy !req
521. Dr. Benton!Copy !req
522. Good luck.Copy !req
523. BP's low. Want me to put
the dopamine back on?Copy !req
524. - Hold the elevator!
- No. This one goes straight up.Copy !req
525. - Status, post-cardiac arrest.
- I just opened up this kid's head.Copy !req
526. Did you evacuate the clot?Copy !req
527. - There's still active bleeding at the site.
- She's in shock. Lucky he got her back.Copy !req
528. All right, go.Copy !req
529. No. Take the boy first.Copy !req
530. Call Neurosurg, tell them
we're on our way.Copy !req
531. I need two units of FFP
and an ICP monitor.Copy !req
532. Eighty-five palp.Copy !req
533. Start the dopamine.Copy !req
534. - What is it?
- I wanted to ask you something. He die?Copy !req
535. - Who?
- That man.Copy !req
536. They cut open his chest,
but he died.Copy !req
537. - Yes. He had a fatal injury.
- What about the boy?Copy !req
538. He went up to surgery.Copy !req
539. - Is he going to die?
- I don't know.Copy !req
540. Is there someone we can call for you?
Your mom or dad?Copy !req
541. They won't understand.Copy !req
542. Won't understand what?Copy !req
543. I thought it would be painless.
The train would hit my car...Copy !req
544. I'd just be gone.Copy !req
545. Yeah, don't talk to me about saturated.
You haven't seen saturated.Copy !req
546. Chuny, I need a trauma panel.
What's open?Copy !req
547. I don't care. I'm admitting them!Copy !req
548. - Carter, they're holding O.R. 6-
- I was just there. No surgeon.Copy !req
549. - Is he stable?
- Yeah...Copy !req
550. but I had to sedate him
with 10 of Valium.Copy !req
551. - Carter, are you deaf?
- What?Copy !req
552. I keep shouting, you keep
getting on the elevator?Copy !req
553. - Is this the pre-op amputation?
- This is the post-op amputation.Copy !req
554. What, in the field?
What did they use, a chain saw?Copy !req
555. - Dr. Benton talked me through-
- You did this?Copy !req
556. There was nobody else-Copy !req
557. Well, by all means, let's get whoever's
available. You ought to try it next time.Copy !req
558. - Maybe if you'd respond to your page-
- I can't wear my pager in the dojo.Copy !req
559. Brenda knew where I was.
Should have called her. Let's go.Copy !req
560. Dr. Weaver, flail chest in 4 just
dropped his pulse ox down to 81.Copy !req
561. Carter, can you take this?Copy !req
562. - Yeah, give him another one. I'll clean up.
- Maybe I should have just let him die.Copy !req
563. - Good work, Carter.
- I know.Copy !req
564. Really. He was lucky
that you were out there.Copy !req
565. - Thank you. I'm coming!
- Carter!Copy !req
566. - Kerry?
- Yeah.Copy !req
567. - You have a suicidal ideation?
- Young girl in Trauma 2.Copy !req
568. - Does she have a plan?
- Parked her car in front of a train.Copy !req
569. - I suppose that qualifies.
- She's also in a major depression.Copy !req
570. - Flat affect?
- No real remorse.Copy !req
571. - About the suicide attempt?
- For the train wreck.Copy !req
572. Oh, my.Copy !req
573. - Think you're gonna get off before 12?
- Probably not.Copy !req
574. Okay.Copy !req
575. - I'll try to be quiet.
- No. Wake me.Copy !req
576. Something wrong?Copy !req
577. Hey.Copy !req
578. - What?
- There something wrong with my heart?Copy !req
579. Probably a bruise to your chest wall.
We'll get an x-ray to make sure.Copy !req
580. - You were lucky.
- We're still sifting through...Copy !req
581. the walking wounded,
but we're over the hump.Copy !req
582. - Carter just took the last critical.
- How many came in?Copy !req
583. Thirty-seven. Five up in surgery.
Only two ER deaths.Copy !req
584. - That's not bad, considering.
- If you don't count the DOAs.Copy !req
585. You did great work today.
You should go home. We got it.Copy !req
586. - Board's backing up.
- That's all right. Go home.Copy !req
587. - Shirley called for you.
- What?Copy !req
588. O.R. nurse. You asked her to call when
the mom and son came out of surgery.Copy !req
589. - Did they?
- Yeah. They're in Recovery.Copy !req
590. Mom's got sensation in her legs,
and the kid's neurologically intact.Copy !req
591. - That's good, right?
- Yeah. That's good.Copy !req
592. You still here?Copy !req
593. The nurses put me to work,
thought I was a volunteer or something.Copy !req
594. Good. Now you've got an experience
to talk about in your interview.Copy !req
595. - I don't know.
- It's yours. You might as well use it.Copy !req
596. - I mean, I don't know if I want to.
- Want to what?Copy !req
597. What I saw tonight...Copy !req
598. Most people go their whole lives
without seeing stuff like that.Copy !req
599. Drilling into a little boy's head.
Guys having their legs cut off.Copy !req
600. - People dying right in front of you.
- You get used to it.Copy !req
601. Yeah. That's what I'm afraid of.Copy !req
602. - But thanks for helping me find out early.
- Go to the interview.Copy !req
603. - Dr. Benton-
- You may feel differently in a few days.Copy !req
604. - I know, but-
- Hey, give yourself options.Copy !req
605. Anything?Copy !req
606. No contractions since the third round.
Fetal heart rate looks good.Copy !req
607. - So it's over.
- Aside from bed rest.Copy !req
608. How long do you think?Copy !req
609. You can catch me up on my soaps.Copy !req
610. It'll be okay.Copy !req
611. When I felt the baby move before,
obviously I knew it was in there, but...Copy !req
612. - Suddenly this feels real, you know?
- Yes, Mom.Copy !req
613. OB's waiting, and Transpo promises
they'll be down soon to take you up.Copy !req
614. - Thanks, Abby.
- The monitor stays on...Copy !req
615. - ... for at least 24 hours.
- I'll keep it on until I give birth.Copy !req
616. You just have to slow down.
No more helicopters.Copy !req
617. Right.Copy !req
618. - Hey.
- Hey.Copy !req
619. - You leaving?
- No. I thought I'd check on the bishop.Copy !req
620. - Another critical come in?
- No. That's it.Copy !req
621. Is she stable?Copy !req
622. - Yeah. After three rounds of terbutaline.
- Good.Copy !req
623. - Yeah. It was scary, though.
- Yeah.Copy !req
624. You heading home soon?Copy !req
625. I don't know.Copy !req
626. - Are you okay?
- Yeah.Copy !req
627. - Any change?
- He didn't want the breathing mask.Copy !req
628. - Has he been awake?
- Napping on and off.Copy !req
629. What time is it?Copy !req
630. - 11:30.
- You're here late.Copy !req
631. - You'll have to be intubated soon.
- On a ventilator?Copy !req
632. Your oxygen level is down to 65
on 100% oxygen.Copy !req
633. I've seen what happens
after the ventilator.Copy !req
634. - If it drops below 50-
- Thanks, but no thanks.Copy !req
635. Anyway...Copy !req
636. my bags are packed.Copy !req
637. How long do I have?Copy !req
638. Maybe hours.Copy !req
639. - Then I'd better hear it now.
- Hear what?Copy !req
640. - Your confession.
- Bishop, I don't think...Copy !req
641. That's what you came up here for,
isn't it?Copy !req
642. - I wanted to check on you.
- You're searching for your faith.Copy !req
643. You think you lost it,
but you only buried it.Copy !req
644. It's never left you.Copy !req
645. In the name of the Father, of the Son
and of the Holy Spirit.Copy !req
646. Amen.Copy !req
647. May God, who enlightens
every heart...Copy !req
648. help you to know your sins
and trust in his mercy.Copy !req
649. - Father, I can't...
- Luka.Copy !req
650. Your heart is burdened, Luka.Copy !req
651. Talk to me.
Let me take that burden with me.Copy !req
652. I don't know. I...Copy !req
653. Lost my family.Copy !req
654. Danijela, my wife, she wanted
to move out of Vukovar.Copy !req
655. But I had to finish my internship.Copy !req
656. And soon it was too late.
It wasn't safe to move.Copy !req
657. I was gonna get some supplies...Copy !req
658. and I made them stay behind.Copy !req
659. I was just crossing the street when...Copy !req
660. the mortar shell hit
the apartment building.Copy !req
661. Go on.Copy !req
662. I ran inside.Copy !req
663. There were my neighbors. Hurt.
Bleeding. Dying. But I passed them by.Copy !req
664. I had to get to my family.Copy !req
665. Danijela!Copy !req
666. Danijela!Copy !req
667. Luka.Copy !req
668. Luka...Copy !req
669. Marko...Copy !req
670. A piece of shrapnel had torn
into Danijela's spleen...Copy !req
671. and she was bleeding to death.Copy !req
672. When I turned back to my daughter,
she wasn't breathing.Copy !req
673. I lost her pulse. But as long as
I kept doing CPR and breathing...Copy !req
674. for my daughter,
I thought she had a chance.Copy !req
675. I could only pray that someone
would get there to help.Copy !req
676. If I had picked up Danijela at that
moment and gotten her to the hospital...Copy !req
677. she could have had surgery.
You know, she could have lived.Copy !req
678. But I couldn't leave my little girl.Copy !req
679. I waited and prayed.
I prayed someone would come.Copy !req
680. And no one came.Copy !req
681. No one came.Copy !req
682. Jasna. Jasna.Copy !req
683. I called out for hours
as I stayed there...Copy !req
684. breathing for her, doing CPR.Copy !req
685. I finally had to stop from exhaustion.Copy !req
686. I lost them all.Copy !req
687. You couldn't sacrifice the one
to save the other.Copy !req
688. Even if you had,
you'd still blame yourself.Copy !req
689. These things can't be explained.Copy !req
690. Why it happens.Copy !req
691. The providence of God
and the mysteries of life and death...Copy !req
692. are the very fiber of our faith.Copy !req
693. They were gifts of love and life.Copy !req
694. You are a gift of love and life.Copy !req
695. Don't turn your back on them.Copy !req
696. God, father of all mercies,
through the death and resurrection...Copy !req
697. of your only begotten Son...Copy !req
698. was reconciled himself to the world...Copy !req
699. and sent the Holy Spirit among us
for the forgiveness of sins.Copy !req
700. Through the ministry of Holy Church...Copy !req
701. may God give you pardon and peace.Copy !req
702. And I absolve you of all your sins...Copy !req
703. in the name of the Father
and of the Son...Copy !req
704. and of the Holy Spirit.Copy !req
705. Amen.Copy !req