1. You won't believe the crap
Armen pulled last night.Copy !req
2. He cut the power to my apartment!Copy !req
3. That's right!Copy !req
4. No lights, no Wi-Fi, nothing.Copy !req
5. For 15 minutes!Copy !req
6. - Mm...
- And if I had been on a ventilator,Copy !req
7. I could've suffocated
in that time, right?Copy !req
8. You're a doctor.Copy !req
9. You're not on a ventilator.Copy !req
10. Thank God for that. But I could be.Copy !req
11. I mean, it was dark. I could've tripped.Copy !req
12. I should sue him.Copy !req
13. Sorry.Copy !req
14. Were you gonna eat this? I stress eat.Copy !req
15. Okay, listen.Copy !req
16. I go to talk to him,Copy !req
17. and he claims I was playing
my music too loud again.Copy !req
18. I wear earplugs
when your music irritates me.Copy !req
19. I miss the dripping.Copy !req
20. You're missing the point here,
Shaun, okay?Copy !req
21. You knock. You ask.Copy !req
22. You don't cut someone's power.Copy !req
23. You knock, right?Copy !req
24. Of course, you would knock.
Any normal person would.Copy !req
25. I mean, am I crazy
or is he a total sociopath?Copy !req
26. You should get headphones.Copy !req
27. Headphones?Copy !req
28. They would eliminate the sound.Copy !req
29. Yeah. I got it.Copy !req
30. Thank you.Copy !req
31. Thank you for being
so objective about this.Copy !req
32. In fact, why don't you go help ArmenCopy !req
33. write my eviction notice!Copy !req
34. Yeah, and I'll never
drive down that street again.Copy !req
35. - Whoa.
- It's a pretty bad memory.Copy !req
36. Yeah, that sounds pretty...Copy !req
37. Wait, it's kind of hot
for a hike, isn't it?Copy !req
38. We're hiking.
We're gonna sweat. It happens.Copy !req
39. All right, don't do nothing stupid!Copy !req
40. Open the register
and put everything in the bag!Copy !req
41. Come on! Right now! Hey!Copy !req
42. Don't move. Give me your
wallets, phones, everything.Copy !req
43. Keep your hands where I can see 'em.Copy !req
44. I said get out your wallet!Copy !req
45. Do it now!Copy !req
46. Wallet, now!Copy !req
47. - Is he okay?
- We don't know.Copy !req
48. This is routed through Basecamp.Copy !req
49. It says Shaun was there,Copy !req
50. but it didn't say if he was hurt or not.Copy !req
51. Well, EMS has two critical inbounding.Copy !req
52. Their hands are a little full
to chat right now.Copy !req
53. 20-year-old female.Copy !req
54. Single gunshot wound to the abdomen.Copy !req
55. Hypotensive and tachy.Copy !req
56. Two liters of saline en route.Copy !req
57. Her name's Avery.Copy !req
58. We'll take good care of her.Copy !req
59. Jared, you're with me.Copy !req
60. Blunt-force neck injury.Copy !req
61. Oxygen sats just dropped below 80.Copy !req
62. Trachea's crushed.Copy !req
63. I inserted a laryngeal mask,Copy !req
64. but the airway is not secured.Copy !req
65. Are you okay? You weren't hurt?Copy !req
66. His oropharyngeal anatomy
is distorted from the contusion.Copy !req
67. Subcutaneous emphysema.
He's barely moving air.Copy !req
68. Let's take him to a bay,
and get me an O.R. now.Copy !req
69. I need four units
O-Negative type and cross her.Copy !req
70. She has decreased breath sounds
on her left.Copy !req
71. Let's get a chest X-ray on her.Copy !req
72. What the hell is he doing here?Copy !req
73. It's his fault.Copy !req
74. This is all his fault!Copy !req
75. Synced & corrected by -robtor-
www.addic7ed.comCopy !req
76. Yeah,
clerk says the guy entered,Copy !req
77. shouted orders,Copy !req
78. and apparently,
your doctor didn't comply.Copy !req
79. Girl gets shot,Copy !req
80. and the store clerk
clocks the gunman with a bat.Copy !req
81. - That's all we know.
- All right, what do you need?Copy !req
82. I need forensics on the gunman
and the girl.Copy !req
83. All right, we'll let you know
what we find out.Copy !req
84. Hey, police are gonna want
to talk to you.Copy !req
85. After that, you can go home.Copy !req
86. I should be helping.Copy !req
87. - My shift is just starting.
- You were at the shooting.Copy !req
88. I don't have time to hold your hand.Copy !req
89. I don't like my hand being held.Copy !req
90. Small-caliber bullets.Copy !req
91. They ricochet inside.Copy !req
92. They can cause multiple
and unpredictable injuries.Copy !req
93. And what do we need to do about it?Copy !req
94. Chest and abdominal X-raysCopy !req
95. and a Focused Assessment Sonogram.Copy !req
96. Three units of O-neg and...Copy !req
97. We could use your help
over here, Mr. Melendez!Copy !req
98. Are you okay?Copy !req
99. Yes, I'm fine.Copy !req
100. You're with me.Copy !req
101. - Get a gown on him.
- Okay.Copy !req
102. Entrance wound is down here.Copy !req
103. The bullet fractured the pelvis
on the way in.Copy !req
104. All right, let's look for an exit wound.Copy !req
105. We're gonna roll her on three.
One, two, three.Copy !req
106. All right, got it.Copy !req
107. Between the second and third rib.Copy !req
108. She's hemorrhaging here, too.Copy !req
109. Hey, Murphy, get us the ultrasound
so we can find out what's inside.Copy !req
110. Focused Assessment
with sonography and trauma.Copy !req
111. No chest contusions
or secondary injuries evident.Copy !req
112. Oxygen sat's 70.Copy !req
113. I can't squeeze a camera
past this collapse.Copy !req
114. O.R. 3 is prepped and ready,
but that's it.Copy !req
115. We got a full house right now
up in surgery.Copy !req
116. - Next show time is 15 minutes out.
- I could use it.Copy !req
117. I gotta get this bleeding under control.
What's the status on your guy?Copy !req
118. Take her up. Take the gunshot.Copy !req
119. Hold on.Copy !req
120. His airway's so damaged,
I can't even do a tracheotomy.Copy !req
121. He's got five minutes
until anoxic brain dead.Copy !req
122. Mine's got pressure.
I'll see what I can do here.Copy !req
123. You're scrubbing in with me.Copy !req
124. Go ahead and feed the tube
under the collapsed trachea.Copy !req
125. Starting high flow O2.Copy !req
126. And we're good.Copy !req
127. Now that our patient
is actually breathing,Copy !req
128. we can realign and repair.Copy !req
129. Four-O on a driver.Copy !req
130. Scissors. Sponge stick.Copy !req
131. It's a slippery thing letting
your feelings about a patientCopy !req
132. influence your medical judgment.Copy !req
133. I didn't.Copy !req
134. I get the instinct... She's a victim.Copy !req
135. He's a shooter, a racist.Copy !req
136. Often we don't even know we're doing it.Copy !req
137. I would never let my personal feelingsCopy !req
138. impact a patient's care.Copy !req
139. She was bleeding out.Copy !req
140. And this guy just drew his first
good breath 30 seconds ago.Copy !req
141. They were both critical!Copy !req
142. He was dying. You were wrong. Own it.Copy !req
143. You know as well as I do thatCopy !req
144. that was not an easy call to make.Copy !req
145. - Do I?
- Yes!Copy !req
146. Clear the field, Dr. Browne.Copy !req
147. Not my operative field.Copy !req
148. The surgical field. Scrub out.Copy !req
149. Excuse me?Copy !req
150. You're done.Copy !req
151. Step out of my O.R.Copy !req
152. Gail, can you please relieve
Dr. Browne of her instrumentsCopy !req
153. and page Dr. Cleland to assist me?Copy !req
154. Now, isn't this more pleasant?Copy !req
155. Aside from the spleen,
what else are we dealing with?Copy !req
156. The bullet ruptured her transverse colonCopy !req
157. at the splenic flexure.Copy !req
158. Put it on our to-do list.Copy !req
159. Why does her boyfriend think
it's your fault?Copy !req
160. It punctured her diaphragm hereCopy !req
161. and entered the posterior chest.Copy !req
162. She's bleeding again. Clamp the hilum.Copy !req
163. I already did. It's too damaged to hold.Copy !req
164. Gauze!Copy !req
165. Hold this right there. Don't let go.Copy !req
166. Oh, this isn't gonna work.Copy !req
167. It's gonna be like sewing
ground beef back into a steak.Copy !req
168. All right, new plan... she's gonna
have to live without her spleen.Copy !req
169. Metz and a pick-up.Copy !req
170. Need a ligating suture
on the splenic arteryCopy !req
171. while I make the cut.Copy !req
172. Can you do that for meCopy !req
173. before this young lady
bleeds out on us, Murphy?Copy !req
174. Yes.Copy !req
175. Okay, let's move on to the bowel perf.Copy !req
176. Shaun.Copy !req
177. Ah, thank God you're all right.Copy !req
178. I just heard what happened.Copy !req
179. Shaun. Are you all right?Copy !req
180. Yes. I wasn't injured.Copy !req
181. What happened this morning?Copy !req
182. Lea ate my apple.Copy !req
183. No, Shaun, at the store this morning.Copy !req
184. What happened at the store?Copy !req
185. Wallet now!Copy !req
186. I can't.Copy !req
187. Why the hell not?!Copy !req
188. You said keep my hands
where you could see them.Copy !req
189. My wallet is in my pocket.Copy !req
190. - You can't see my hands if...
- Are you trying to be a hero?!Copy !req
191. - I'm a surgical resident...
- Huh?! Hey!Copy !req
192. - Hey!
- Shut the hell up!Copy !req
193. This isn't a game, man.Copy !req
194. - I'm serious.
- Okay.Copy !req
195. Put your damn phone and wallet
on the ground right now.Copy !req
196. Hey, do you see this, man?
I am not playing around!Copy !req
197. Just put your phone and wallet
on the damn ground!Copy !req
198. Come on, man, just...
just do what he says!Copy !req
199. Please listen to him.Copy !req
200. Shut up! Just shut up
and get on your knees!Copy !req
201. Put your hands and knees on the ground.Copy !req
202. Get your wallet out right now. Hey!Copy !req
203. I will shoot your crazy
ass, I swear to God. Okay.Copy !req
204. - Are you listening to me?! I'll do it!
- Yes.Copy !req
205. Hey! You hear me?Copy !req
206. Hey!Copy !req
207. Oh, my God!Copy !req
208. Okay.Copy !req
209. You need to take the rest of the day off.Copy !req
210. Dr. Melendez said that, too.Copy !req
211. - Why?
- "Why?"Copy !req
212. Because you just experienced
a traumatic event.Copy !req
213. - It's not my fault.
- I-I know that.Copy !req
214. Avery has multiple injuries.Copy !req
215. Dr. Melendez wants me to monitor her.Copy !req
216. Dr. Lim.Copy !req
217. I was out of line.Copy !req
218. I shouldn't have argued with you.Copy !req
219. Primary enclosure went well.Copy !req
220. We'll extubate him in a few hoursCopy !req
221. to prevent any further internal damage.Copy !req
222. Well, that's good.Copy !req
223. It is, and you're gonna
make sure he stays that way.Copy !req
224. You'll be babysitting tonight in the ICU.Copy !req
225. I'm... I'm not on call.Copy !req
226. Great, then you're available.Copy !req
227. Should be a quiet night.Copy !req
228. Just want to keep an eye on those vitals.Copy !req
229. You never know with tracheal tears.Copy !req
230. Can't one of the ICU nurses do that?Copy !req
231. Yep.Copy !req
232. But they didn't lip off
in my operating room.Copy !req
233. And he'd better be breathing
in the morning.Copy !req
234. Excuse me, but why is Shaun
on the victim's case?Copy !req
235. I assessed him,
and he seemed perfectly capable.Copy !req
236. You assessed him?Copy !req
237. What does that mean? You asked
him how he was feeling?Copy !req
238. You psychic?Copy !req
239. D-Do you have an advanced degree
in psychology?Copy !req
240. You don't know
what's going on in his head.Copy !req
241. When I'm in surgery,
my focus is on the personCopy !req
242. whose guts are open in front of meCopy !req
243. rather than the soul of the
person standing across from me.Copy !req
244. - No.
- And it seems that Shaun doesn'tCopy !req
245. let anything impact his work.Copy !req
246. So, along with his photographic memory,Copy !req
247. I'm putting cold-hearted
in the plus column.Copy !req
248. Dr. Murphy, do you understand
why you're here?Copy !req
249. Yes.Copy !req
250. Dr. Glassman said I had to talk to you.Copy !req
251. After any doctor goes through
a potentially traumatic...Copy !req
252. You have to determine
if I'm a medicolegal liabilityCopy !req
253. - to the hospital.
- Yes.Copy !req
254. And, more importantly,
it's an opportunityCopy !req
255. to provide you with emotional support.Copy !req
256. How are you feeling?Copy !req
257. You don't have apples.Copy !req
258. I'll try to have some fruit
next time we meet.Copy !req
259. Good.Copy !req
260. Do you regret anything
about this morning?Copy !req
261. Why?Copy !req
262. After bad things happen,Copy !req
263. it's perfectly normal
to replay the events,Copy !req
264. wishing you had done things differently.Copy !req
265. It already happened.Copy !req
266. I can't do things differently.Copy !req
267. Is talking about this upsetting you?Copy !req
268. What are you thinking about right now?Copy !req
269. Systemic Inflammatory Response Syndrome.Copy !req
270. The surgery went well.Copy !req
271. After a serious trauma like this,Copy !req
272. the body can developCopy !req
273. a self-destructive inflammatory reaction.Copy !req
274. Kidneys, liver, lungs, heart...Copy !req
275. any or all of them
can start to shut down.Copy !req
276. We'll be giving her anti-inflammatoriesCopy !req
277. and monitoring her closely,Copy !req
278. - but the next 24 hours are critical.
- Okay.Copy !req
279. Thanks.Copy !req
280. Just get her through this.
Whatever you got to do.Copy !req
281. Yeah, well, I need consent formsCopy !req
282. from your girlfriend's next of kin.Copy !req
283. If you could please
get her family in hereCopy !req
284. as quickly as possible.Copy !req
285. I can't. I...Copy !req
286. I don't even know her last name.Copy !req
287. It was our first date.Copy !req
288. W-We met on a dating app.Copy !req
289. We were going hiking,Copy !req
290. so she wasn't carrying a purse or ID.Copy !req
291. Well, then, you really
don't need to be here.Copy !req
292. Someone out there cares about her.Copy !req
293. If she dies,Copy !req
294. I want them to know someone was with her.Copy !req
295. I'll have social work
try to locate her family.Copy !req
296. Stay as long as you want.Copy !req
297. It looks clean, dry, and healthy.Copy !req
298. My neck is killing me.Copy !req
299. How long have you been using?Copy !req
300. What's that got to do with anything?Copy !req
301. Well, you likely built up
a tolerance to pain meds.Copy !req
302. Now that you really need them,
they aren't there for you.Copy !req
303. That's why I need fentanyl.Copy !req
304. 100 micrograms.
Are you gonna help me or not?Copy !req
305. That wouldn't be helping.Copy !req
306. The worst thing I can do for you
is feed your habit.Copy !req
307. What?Copy !req
308. You saw my tattoo.Copy !req
309. Yeah.Copy !req
310. And now you're punishing me.Copy !req
311. You want this to hurt.Copy !req
312. - I'm treating you professionally.
- If you were treating me professionally,Copy !req
313. - I wouldn't be in so much pain.
- I'm sorry, but I...Copy !req
314. Just give me the damn drugs!Copy !req
315. Come on!Copy !req
316. Melendez thinks that he's okay
being on Avery's case.Copy !req
317. I don't.Copy !req
318. Dr. Melendez may be right.Copy !req
319. That case seems to be
Shaun's primary focus right now.Copy !req
320. Maybe his condition is
a blessing in this situation.Copy !req
321. - Maybe?
- Or obsessing over Avery's healthCopy !req
322. could be his only outlet
for a guilty conscience.Copy !req
323. Watching her suffer could just
be worsening those feelings.Copy !req
324. So, either it's a huge problemCopy !req
325. or it's not a problem at all.Copy !req
326. This is your professional opinion?Copy !req
327. Shaun has a very unique mindCopy !req
328. and an incredibly introverted nature.Copy !req
329. Well, thank you for that.Copy !req
330. I'm sorry, but without
a lot more time with him,Copy !req
331. that's the best I can offer.Copy !req
332. What did Lim expect me to do...Copy !req
333. stand there and smileCopy !req
334. while she called my
medical judgment into question?Copy !req
335. Your patient nearly died
waiting on that O.R., right?Copy !req
336. It was bad. What do you want me to do?Copy !req
337. Tell her to back off!Copy !req
338. - No.
- He's a complete and utter...Copy !req
339. Not one of those nice racists, huh?Copy !req
340. - I shouldn't have to be...
- Claire!Copy !req
341. Here's what you have to do...Copy !req
342. shut up and do exactly
what Dr. Lim tells you to do.Copy !req
343. But...Copy !req
344. Yes, sir.Copy !req
345. Maybe we could take turns.Copy !req
346. You keep an eye on my patient,Copy !req
347. I keep an eye on yours.Copy !req
348. No.Copy !req
349. Her creatinine is 1.6.Copy !req
350. Mild bump in renal numbersCopy !req
351. isn't surprising after all her trauma.Copy !req
352. This morning must've been crazy.Copy !req
353. Are you okay?Copy !req
354. This morning,Copy !req
355. my neighbor Lea came over
and ate my apple.Copy !req
356. That's too bad.Copy !req
357. Yes, it was my last one.Copy !req
358. She was upset with Armen, our landlord.Copy !req
359. She plays her music very loud.Copy !req
360. I gave her some advice.Copy !req
361. It seemed to anger herCopy !req
362. because she left without saying goodbye.Copy !req
363. And you think you did something wrong.Copy !req
364. No, it was good advice.Copy !req
365. Shaun, sometimes a woman wants advice,Copy !req
366. and sometimes she just wants support.Copy !req
367. How can I tell which one Lea wants?Copy !req
368. Err on the side of support.Copy !req
369. - That's not helpful.
- Yes, it is.Copy !req
370. Dr. Browne. You're being summoned.Copy !req
371. All right.Copy !req
372. About time.Copy !req
373. All your struggling,
you've pulled out your IV.Copy !req
374. Aren't nurses usually supposed
to do this kind of crap?Copy !req
375. They let you go to med school,Copy !req
376. but they don't trust you
with any real responsibility.Copy !req
377. Must be a competent doctor
tucked around here somewhereCopy !req
378. who can tell someone
I need more than aspirin.Copy !req
379. - "Competent"?
- Yeah.Copy !req
380. You know what I mean.Copy !req
381. Imhotep was the father
of modern medicine.Copy !req
382. - An Egyptian.
- Yeah.Copy !req
383. Good for your people.Copy !req
384. I'm willing to bet there's even
been a couple othersCopy !req
385. over the last 3,000 years,
but guess what?Copy !req
386. On average,Copy !req
387. you look at most great
technological advancements,Copy !req
388. you'll find a proud Northern EuropeanCopy !req
389. holding the patent.Copy !req
390. That's what you were trying
to do this morning?Copy !req
391. Get the patent on stealing 30 bucksCopy !req
392. from the corner store for a drug fix?Copy !req
393. You don't like drug addicts, do you?Copy !req
394. Mm, a lot of people I don't like.Copy !req
395. Thieves, racists, violent punks,Copy !req
396. but I'll treat 'em.Copy !req
397. Was your mama a drug addict?Copy !req
398. Wow.Copy !req
399. That's the beauty of clichés,Copy !req
400. is they're true so often, huh?Copy !req
401. You don't know anything about me.Copy !req
402. I didn't go to college.Copy !req
403. I didn't have no
affirmative action to get me in,Copy !req
404. but you did.Copy !req
405. All because some bleeding-heart
liberal in the Dean's officeCopy !req
406. teared up reading your essay
about your crack-whore mama.Copy !req
407. Aah! What the hell?Copy !req
408. I guess we're all violent punks.Copy !req
409. All you had to do
was give him your wallet.Copy !req
410. Her urine output is low.Copy !req
411. Whoa, whoa, what are you doing?!Copy !req
412. - Get away from her!
- Hey!Copy !req
413. You can't be in here
shoving my doctors around.Copy !req
414. Me? He... He's the...Copy !req
415. - Oh, my God.
- She needs dialysis.Copy !req
416. Her kidneys are failing fast.Copy !req
417. This is the first stage
of total organ failure.Copy !req
418. We removed two liters
of excess fluid with dialysis,Copy !req
419. but she's getting worse.Copy !req
420. Fluid's building up in her chest.Copy !req
421. She's in pulmonary failure, too.Copy !req
422. Draining the fluid in her pleural spaceCopy !req
423. would reduce airway resistance.Copy !req
424. Yeah, let's prep her for a thoracentesis.Copy !req
425. We're gonna have to work fast.Copy !req
426. I'll prep the evac drain.Copy !req
427. I'm gonna need you to put
that needle right between...Copy !req
428. 6th and 7th rib.Copy !req
429. Wait, you're gonna let him do...Copy !req
430. Shut up. All right, careful.Copy !req
431. Don't put the needle in too deep.Copy !req
432. - We don't want to give her...
- Pneumothorax.Copy !req
433. All right, you're in.Copy !req
434. Now, let me see what I can pull out.Copy !req
435. Hopefully she settles down.Copy !req
436. CO2's down, and O2's climbing.Copy !req
437. We can manage her kidneys and her lungs,Copy !req
438. but the last stop
in multiple organ failureCopy !req
439. would be her heart.Copy !req
440. Watch her ventilation pressures
like a hawk,Copy !req
441. push cardioprotective meds,
and page me if anything changes.Copy !req
442. Think you're being her hero?Copy !req
443. The fact is you hardly know her.Copy !req
444. And you don't know him at all.Copy !req
445. Go home.Copy !req
446. Yep.Copy !req
447. Okay, I am done.Copy !req
448. He's a foul-mouthed, spiteful bully.Copy !req
449. No problem.Copy !req
450. I'll have the concierge find a patientCopy !req
451. more suited to your liking.Copy !req
452. He doesn't need a doctor doting over him.Copy !req
453. He doesn't want me.Copy !req
454. I don't care.Copy !req
455. I'm sorry I disagreed with you, okay?Copy !req
456. But I don't deserve
to be scolded like a school girlCopy !req
457. because your ego can't handle
being challenged a little.Copy !req
458. Oh.Copy !req
459. That is some apology.Copy !req
460. Look, I had a legitimate...Copy !req
461. You really don't see the problem here?Copy !req
462. What? With challenging you?Copy !req
463. Right now, you are confronting meCopy !req
464. in front of two nurses.Copy !req
465. Would you do that to Melendez?Copy !req
466. Or would you wait five minutes?Copy !req
467. I have dealt with menCopy !req
468. undermining my authority
my entire career.Copy !req
469. We shouldn't do it to one another, too.Copy !req
470. Now go take care of him like
you would any other patient.Copy !req
471. Hey. Hey! Hey!Copy !req
472. Food services...
they double-check every order.Copy !req
473. What are you looking for?Copy !req
474. - An apple.
- An apple?Copy !req
475. - Who's getting an apple?
- I am!Copy !req
476. - No.
- Shaun.Copy !req
477. Forget the apple, please.Copy !req
478. I'm sorry. Can I have a minute?Copy !req
479. Shaun?Copy !req
480. Okay.Copy !req
481. Shaun, there's no need
to get defensive, okay?Copy !req
482. Do you want to sit down?Copy !req
483. No, thank you.Copy !req
484. I want you to tell me againCopy !req
485. exactly what happened this morning.Copy !req
486. I told you exactly
what happened this morning.Copy !req
487. Yes, but people have told you
that it's your fault.Copy !req
488. Haven't they?Copy !req
489. My actions and the shooting
were associative incidents.Copy !req
490. It is not a causal relationship.Copy !req
491. I paced, and she got shot,Copy !req
492. but pacing doesn't cause shootings,Copy !req
493. otherwise every time someone paced,Copy !req
494. a shooting would soon follow.Copy !req
495. Okay, that's a very good point.Copy !req
496. When someone has a gunCopy !req
497. and it's a dangerous situation, right?Copy !req
498. You don't want to upset the situation.Copy !req
499. You don't want to make it worse.Copy !req
500. You think this is my fault, too.Copy !req
501. No, no, it was the shoot...Copy !req
502. It was the shooter's fault,Copy !req
503. but your actions
may have contributed to it.Copy !req
504. Okay, Shaun, wait a second.Copy !req
505. Wait a second.Copy !req
506. I know your behavior is not
completely in your control,Copy !req
507. but I also know it's not
completely out of your control.Copy !req
508. Is it?Copy !req
509. So, yes, maybe it is
a little bit your fault.Copy !req
510. And definitely mine.Copy !req
511. You weren't even there.Copy !req
512. That's right.Copy !req
513. I wasn't there.Copy !req
514. Can we sit down, please,
just for a second?Copy !req
515. Shaun...Copy !req
516. I convinced myself
that everything was fineCopy !req
517. because in here, it is.Copy !req
518. It's great.Copy !req
519. But you need help.Copy !req
520. Shaun...Copy !req
521. you need guidance...Copy !req
522. much more than I can give you.Copy !req
523. I'm supposed to be with my patient.Copy !req
524. I'm supposed to be watching her
like a hawk.Copy !req
525. It's my fault.Copy !req
526. I didn't like her.Copy !req
527. When I first saw her
this morning, she just...Copy !req
528. didn't look...Copy !req
529. I don't know.Copy !req
530. I mean, I wanted to blow her off,Copy !req
531. so, uh... I said I forgot water.Copy !req
532. I mean, I figured we'd go to the storeCopy !req
533. and... and I'd pretend
that I forgot my wallet.Copy !req
534. I knew she didn't have her purse, so...Copy !req
535. We can't go hiking without water, right?Copy !req
536. I mean, no harm, no foul?Copy !req
537. Mm.Copy !req
538. She was there because of me.Copy !req
539. She's here...Copy !req
540. because of me.Copy !req
541. It's not a causal relationship.Copy !req
542. Wait, excuse me?Copy !req
543. It's not a causal relationship...Copy !req
544. lying and shootings.Copy !req
545. Lying doesn't cause shootings,Copy !req
546. otherwise, every time someone lied...Copy !req
547. Her pulse pressure is narrow.Copy !req
548. Wait, what does that mean?Copy !req
549. She's dying.Copy !req
550. Page Melendez. Stat!Copy !req
551. Your respiratory rate is up.Copy !req
552. Are you having trouble breathing?Copy !req
553. Yeah. It's tight.Copy !req
554. Find Dr. Lim.Copy !req
555. Narrow pulse pressure indicates
a reduced cardiac output.Copy !req
556. The inflammation is affecting her heart.Copy !req
557. She's in end-stage organ failure.Copy !req
558. Yes, we can insert
an intra-aortic balloon pump.Copy !req
559. It may reduce some
of the workload on her heart,Copy !req
560. but it's failing fast... really fast.Copy !req
561. It only needs to work overnight.Copy !req
562. The inflammatory reaction
will improve after that.Copy !req
563. What if it's failing so fast
because it's not her heart?Copy !req
564. Her hemoglobin's dropped from 14 to 12Copy !req
565. between her last two draws.Copy !req
566. What if the real problem
is she's bleeding somewhere?Copy !req
567. Given what she's been through, a
two-point drop could mean nothing.Copy !req
568. Or it could mean a bleed,Copy !req
569. which would account
for the narrow pulse pressure.Copy !req
570. Her heart could be fine.Copy !req
571. If you're right, that means
we'd have to open her back up.Copy !req
572. I don't know if her body
can handle another operation.Copy !req
573. No, it can't.Copy !req
574. Treating heart failure
with an aortic pumpCopy !req
575. is also a simple procedure.Copy !req
576. So we're going to diagnoseCopy !req
577. based on which procedure is simpler?Copy !req
578. If I'm right, there could be
no more blood to pump.Copy !req
579. She'll be dead.Copy !req
580. She's crashing!Copy !req
581. We should prepare the cath lab
for a pump.Copy !req
582. We should prepare the O.R.Copy !req
583. Let's get her into an O.R. now.Copy !req
584. Hemoglobin's dropped to 8.Copy !req
585. She is bleeding out.Copy !req
586. Yes, she is, but where?Copy !req
587. Got to find
where the bleeder's coming fromCopy !req
588. and clip it before she dies.Copy !req
589. I got nothing.Copy !req
590. Must be hidden under the
retroperitoneum or mediastinum.Copy !req
591. That's a whole lot of real estateCopy !req
592. to cut open and just go blindly looking.Copy !req
593. We should start at the abdomen.
She was shot there.Copy !req
594. The bullet passed through
the posterior thorax.Copy !req
595. BP's 40 over palp. She's dying, Neil.Copy !req
596. Whatever you're gonna do,
you need to do it now.Copy !req
597. We need to look everywhere.
Give me a knife and sternal saw.Copy !req
598. I'm gonna open her up
from chest to pelvis.Copy !req
599. Prep the sternum and abdomen
with Betadine.Copy !req
600. Gonna need a sponge stickCopy !req
601. to control the bleeding when we find it.Copy !req
602. Stop!Copy !req
603. Open her between the second
and third rib on the left side.Copy !req
604. The bullet nicked the left
supreme intercostal artery.Copy !req
605. The wall has blown.Copy !req
606. How do you know?Copy !req
607. I followed the injuries...Copy !req
608. pelvis to bowel to spleen to diaphragm.Copy !req
609. Next target has to be
left supreme intercostal artery.Copy !req
610. All right, prep left intercostal space.Copy !req
611. I can't breathe.Copy !req
612. Why aren't you helping me?Copy !req
613. Dr. Lim will be along
in just two minutes.Copy !req
614. You're the damn doctor. Do your job.Copy !req
615. I need to open up
the left neck compartmentCopy !req
616. to relieve the pressure.Copy !req
617. Procedure tray?Copy !req
618. You done this before?Copy !req
619. Nope.Copy !req
620. Scalpel.Copy !req
621. It's too swollen.Copy !req
622. I can't see the Adam's apple.Copy !req
623. Okay.Copy !req
624. Cut along the soft divotCopy !req
625. between the carotid sheath
and the trachea.Copy !req
626. Soft divot.Copy !req
627. Got it.Copy !req
628. Update me.Copy !req
629. What did you do?Copy !req
630. He had a cervical hematoma.
I had to relieve the pressure.Copy !req
631. Here?Copy !req
632. Oxygen sats are going up.Copy !req
633. It's rare,Copy !req
634. but post-op swelling can happen
with tracheal tears.Copy !req
635. That's why we watch them
so closely the first 24 hours.Copy !req
636. You mind if we finish this off
in the operating room?Copy !req
637. I don't see anything, Shaun...Copy !req
638. no blood and no arterial tear.Copy !req
639. You're too high.Copy !req
640. It's near the bifurcation.Copy !req
641. Get some light in.Copy !req
642. I got something. Blood's pooling
right under the bifurcation.Copy !req
643. Clamp now.Copy !req
644. She wasn't in heart failure.Copy !req
645. That means her heart is still strong
enough to get her through the night.Copy !req
646. I was wrong.Copy !req
647. Yeah.Copy !req
648. And you just made up for it.Copy !req
649. You were right, Jared.Copy !req
650. Good work.Copy !req
651. You know what?Copy !req
652. You were right.Copy !req
653. My mother had problems.Copy !req
654. So I couldn't afford to sit aroundCopy !req
655. expecting everything to be handed to meCopy !req
656. or whatever else it is
that's holding you back.Copy !req
657. And yeah, I got some breaks,Copy !req
658. but I worked my ass off.Copy !req
659. Two jobs, two roommates
every step of the way.Copy !req
660. And that is what got me to the placeCopy !req
661. where I could save your life.Copy !req
662. Your daughter's
not out of the woods yet,Copy !req
663. but I do expect her condition
to improve day by day.Copy !req
664. Thank you, Doctor.Copy !req
665. - Thank you.
- You're welcome.Copy !req
666. Mm.Copy !req
667. - Hey.
- Hi.Copy !req
668. Baby.Copy !req
669. Sorry we weren't here for you.Copy !req
670. How are you feeling?Copy !req
671. Uh...Copy !req
672. probably won't be hiking anytime soon.Copy !req
673. Mm.Copy !req
674. Hey.Copy !req
675. You sneaking out before I can thank you?Copy !req
676. Please, you don't need to thank me.Copy !req
677. Oh.Copy !req
678. Yeah, I do.Copy !req
679. And apologize.Copy !req
680. I was wrong about you.Copy !req
681. I thought you were trying to ditch me.Copy !req
682. I was...Copy !req
683. hoping you were trying to ditch me.Copy !req
684. I'm sorry.Copy !req
685. When you're feeling better,Copy !req
686. I'd like a second chance at a first date.Copy !req
687. I'm sorry.Copy !req
688. You were right.Copy !req
689. I publicly disrespected you,Copy !req
690. and so I thought it only rightCopy !req
691. to publicly respect you.Copy !req
692. I am gratefulCopy !req
693. for the chance to learn from you.Copy !req
694. I know you needed this victory.Copy !req
695. Glad you saved a life today.Copy !req
696. Just wish it wasn't a Nazi.Copy !req
697. Lane number two.Copy !req
698. Maddie always took that lane.Copy !req
699. She would tuck in behind meCopy !req
700. and draft until the last 200 meters.Copy !req
701. It was a dirty little trick.Copy !req
702. - It worked.
- Every time.Copy !req
703. 13 years ago today.Copy !req
704. Yeah.Copy !req
705. I miss her, too.Copy !req
706. Give her space, right?Copy !req
707. Give her space.Copy !req
708. She just drifted
farther and farther away.Copy !req
709. Everything I did...Copy !req
710. I did wrong.Copy !req
711. You did your best.Copy !req
712. I was...Copy !req
713. practically living at your house
back then, and...Copy !req
714. If I hadn't...Copy !req
715. You were both teenagers.Copy !req
716. You were idiots.Copy !req
717. You got lucky, she didn't.Copy !req
718. If I...Copy !req
719. was there more...Copy !req
720. if I...Copy !req
721. stayed on her...Copy !req
722. You're there for him.Copy !req
723. Here's your extended
forecast for the week.Copy !req
724. Starting off with a little bit
of cloud coverCopy !req
725. in San Francisco,
temperatures in the low 70s...Copy !req
726. ...just a few degrees as we get
closer to the weekend.Copy !req
727. Expect dry conditions
for the next seven days here...Copy !req
728. I, uh, saw your light.Copy !req
729. I'm sorry.Copy !req
730. Claire told me to apologizeCopy !req
731. because you didn't want me
to tell the truth.Copy !req
732. You only wanted me
to support your position,Copy !req
733. even though it's wrong.Copy !req
734. Well, I don't accept.Copy !req
735. I may have overreacted
this morning a little.Copy !req
736. And you were honest... brutally honest...Copy !req
737. but you shouldn't have to wear
ear plugs in your own home.Copy !req
738. And don't start lying to me
to make me feel good.Copy !req
739. You're the only honest guy I know.Copy !req
740. So...Copy !req
741. ...have a good night, Shaun Murphy.Copy !req
742. And I will try not to keep you up.Copy !req
743. I made a mistake today.Copy !req
744. Synced & corrected by -robtor-
www.addic7ed.comCopy !req