The Pitt 1x15

1. {\an8}- Robby! - Whoa, whoa, whoa.

2. {\an8}What's going on here?

3. {\an8}I disabled my ankle monitor because it was going off

4. and fucking with our ability to help patients

5. during the mass casualty.

6. Tell that to your judge.

7. This is my resident. I need her.

8. Call Gloria. Can you at least wait a second

9. to speak to our chief medical officer?

10. No, but they can call the Department

11. if they have any questions.

12. We just came through the worst mass casualty incident

13. in this city's history, and you two are

14. fucking around with this? Are you serious?

15. You don't have anything better to do?

16. Officer Harrelson, can you--please.

17. Is there a problem here?

18. She disabled her ankle monitor.

19. It was malfunctioning.

20. She's in a custody battle with a restraining order

21. and is considered a flight risk.

22. That is bullshit.

23. It was interfering with our ability to treat patients.

24. I'm not sure we could have saved Officer Stefano

25. if she hadn't disabled the damn thing.

26. Is that true?

27. They saved Stefano's life.

28. They saved a lot of lives.

29. Take care of this first thing tomorrow morning?

30. I swear.

31. Take the cuffs off.

32. Thank you.

33. - Thank you. - Thank you.

34. For everything you did here tonight.

35. - Do I even want to know? - Probably not.

36. Good.

37. What's your status down here?

38. We have had 112 mass casualty patients

39. come through here in the last three hours.

40. Only six people that we couldn't save.

41. They are still in our makeshift morgue in Pedes.

42. 71 people went upstairs.

43. Last I heard, surgery had stabilized

44. the 39 most critical red zone, 32 pink zone patients.

45. We also had 24 yellow zone patients,

46. many of whom are getting orthopedic surgery as we speak.

47. The police are still interviewing

48. everybody else that's still down here.

49. We discharged eight people,

50. and I don't know the status of the green zone patients

51. because I wasn't there.

52. You'll have to check with Family Medicine.

53. Impressive.

54. I need you and Abbot to turn your patients over

55. to the night shift now, and then--

56. Oh, sorry.

57. Hello?

58. What? No.

59. We need to be back up and running now.

60. Tell security to open the ER doors for walk-ins.

61. If you've got a triage nurse and registration clerks,

62. you should already be open.

63. You ready to give this measles kid to Dr. Shen

64. - and go home? - Oh, no. I'm--I'm OK.

65. - Are you sure? - Yeah.

66. It's just-- we've repeatedly tried

67. to explain the importance and low risk of the spinal tap,

68. and the parents are--

69. they're risking their son's life.

70. Hopefully, they'll come around.

71. And if they don't?

72. We do the best that we can.

73. Some things are out of our control.

74. Dr. Shen, how are we progressing in here?

75. No improvement-- in the patient or his family.

76. Where is your wife and daughter, Mr. Edwards?

77. My wife took Georgia to the bathroom.

78. OK.

79. Well, your son, Flynn, is critically ill,

80. and the longer that we wait, the worse this could get.

81. Without the spinal tap,

82. we don't know the best treatment to give him

83. to give him the best chance of recovery.

84. What's going on?

85. We were discussing the options

86. for treating your son.

87. He already looks better.

88. He is not.

89. And by refusing the spinal tap, we don't know how to help him.

90. The steroids could kill him if it's just pneumonia.

91. The steroids could save him if it's ADEM,

92. and the longer that we wait,

93. the greater the risk of him dying.

94. - Flynn might die? - No, honey.

95. He's just got a worse version of what you had.

96. I'll keep him intubated, hydrated,

97. and pumping the antibiotics.

98. I'll let you know if anything changes.

99. Mr. Edwards, may I speak with you outside please?

100. Go. I've heard enough.

101. Tell me about your son.

102. He's a great kid. He's kind.

103. He's very good to his little sister.

104. - You two close? - Yeah.

105. Not like my old man.

106. - Samira, finish up. - He was not around very much.

107. He didn't really care what we were doing.

108. Does Flynn play any sports?

109. Baseball, soccer, basketball.

110. David?

111. My wife doesn't want him playing football,

112. or he'd be doing that too.

113. Do you get to many games?

114. I do my best.

115. Vic identification.

116. What the hell is this?

117. These are the people from the PittFest shooting

118. that we couldn't save today.

119. We couldn't save them,

120. but we can still save your son.

121. You're an asshole.

122. Yeah.

123. I'm an asshole

124. who's trying to save your son's life.

125. We still need charts for two patients

126. in North, three in South.

127. All right, we're on it. Just give us a hot minute.

128. Hey, Lee Ann, can you check out the ones she's talking about?

129. Code Tan, basement receiving.

130. - Code Tan, basement receiving. - What's a Code Tan?

131. Illness or injury in a public area of the hospital.

132. Usually a fainting or a fall.

133. Hey, Gloria wants day shift to get out of here,

134. sooner rather than later, so wrap it up.

135. Gotcha.

136. Repeat labs back on our blue man, Max.

137. Running through agents that cause methemoglobinemia,

138. mainly drugs and toxins.

139. Yeah, drugs like topical anesthetics from the dentist,

140. antibiotics to treat malaria, leprosy.

141. Yeah, I can see if he's taking any of those.

142. Also ask about industrial toxins.

143. Aniline dyes, benzene.

144. There's also food additives, nitrates, nitrites.

145. Some of those are available online as suicide kits.

146. You think he may have tried to hurt himself?

147. Maybe, or he was poisoned.

148. I had a guy today whose wife was spiking

149. - his coffee with progesterone. - Jesus.

150. And I thought the crazies were for the night shift.

151. She wasn't crazy, just desperate.

152. Help. Police!

153. Officer.

154. I'm being held here against my will.

155. What else do we know about him?

156. Nothing, really.

157. He was too groggy to talk, but I can give it another shot.

158. - Go for it, Sherlock. - Will do.

159. Last pink patient going upstairs.

160. - You two hanging in? - Oh, yeah.

161. OK, start wrapping it up, and then hand off

162. what you have left to the night shift.

163. - Can we talk? - Go home.

164. - I don't want to tell you again. - You needed me here.

165. Do you have any idea how much trouble you're in?

166. Only if you report me.

167. I'm gonna pretend that I didn't--

168. Robby! Pelvic crush injury.

169. Don't even think about it.

170. Thought we were closed to trauma.

171. This is the Code Tan.

172. He got pinned behind a truck backing up

173. with replacement supplies.

174. Pulse is weak and thready, tachy at...

175. Grab me some monitor leads please.

176. 100% non-rebreather.

177. Let's draw up 120 of ketamine,

178. 100 of rock, and page trauma surgery please.

179. The hell did this guy come from?

180. - Our loading dock. - Oh, my God.

181. OK, I got the EFAST. Grab a binder.

182. - Obvious pelvic fracture. - I'm in a lot of pain!

183. You taking any medications?

184. Crestor.

185. - Any drug allergies? - No.

186. - Am I gonna be OK? - Absolutely.

187. - We got you, Hector. - BP 68 over 42, pulse 130.

188. I got a 14 gauge in the left AC.

189. Whole blood massive transfusion protocol.

190. Uh, we got whole blood coming in

191. from Erie and Youngstown. I'm not sure it's here yet.

192. Let's go one-to-one-to-one, red cells,

193. platelets, and plasma. We've got that.

194. Let's place an IJ after the intubation please.

195. - On it. - OK, EFAST negative.

196. It's all retroperitoneal. No blood at the meatus.

197. Pass a Foley.

198. Hector, you crushed all the bones in your pelvis,

199. and you've got some internal bleeding.

200. We need to sedate you to treat you.

201. Hurts a lot!

202. When you wake up, you're not gonna be able to talk.

203. You're going to have a breathing tube in your throat.

204. Can I speak to my wife first?

205. Afraid we have to move now, Hector.

206. First unit of packed cells in the infuser.

207. What have we here?

208. It looks like two old white guys poached our patient.

209. Oh, I know you're not talking about us.

210. Well, I know he's not talking about me.

211. Crushed pelvis, hemorrhagic shock.

212. MTP, pelvic binder.

213. I'm doing an intubation, about to place an IJ.

214. You need us?

215. We got this for now. Hold down the fort.

216. Get caught up on the day shift's remaining

217. PittFest patients, and we'll get this guy stabilized.

218. How are you feeling, Max?

219. Yeah, I'm all right.

220. So, we are treating you for methemoglobinemia.

221. Um, have you taken anything or eaten anything

222. out of the ordinary lately?

223. No, just some unhealthy food truck choices.

224. OK.

225. Do you work around toxic chemicals?

226. No, I'm a graphic designer.

227. Have you had dental work done lately?

228. - Used topical pain relievers? - Nope.

229. Do you know anyone with leprosy?

230. Leprosy?

231. Yeah, I don't know anyone with leprosy.

232. Well, something that you ingested

233. or came into contact with made you really sick,

234. and you could have died.

235. So we need to figure out what caused it

236. - so it doesn't happen again. - It won't.

237. Um, is there anything else going on in your life

238. that you want to talk about?

239. Anything causing you undue stress or worry?

240. No.

241. I think I just need a little rest.

242. All right.

243. Well, I will be back.

244. This has to be the slowest elevator in the world.

245. Are you in a hurry to get back down there?

246. There's still a backlog of cases to check on.

247. Our shift was over hours ago.

248. You don't want to go home and sleep?

249. I hope this didn't turn you off

250. of practicing emergency medicine.

251. I'm pretty sure today turned me off of practicing

252. all forms of medicine.

253. Everything will be a cakewalk after today.

254. I promise.

255. Come on, let's go find a good case.

256. Yeah.

257. I'll be right there.

258. Sorry.

259. Central line is in.

260. Let's hook up the rapid infuser over to the IJ,

261. and then we can shoot the film.

262. Clear for X-ray.

263. Shooting.

264. Clear.

265. Oh, that ain't good.

266. What have you got?

267. Widened symphysis pubis anteriorly.

268. Distorted sacroiliac posteriorly.

269. Guy's bleeding like a stuck pig.

270. I got Dr. Walsh on speakerphone from the OR.

271. Hey, guys. What's up?

272. We've got an unstable pelvic ring fracture,

273. systolic of 68, EFAST negative.

274. I thought we were closed to trauma.

275. Hospital worker versus reversing supply truck.

276. MTP and pelvic binder in place.

277. - TXA? - Gave it.

278. Stable for CT angiogram?

279. - Uh, not at the moment, no. - Keep transfusing.

280. The blood bank is still waiting on a delivery,

281. unless you have some upstairs.

282. He doesn't need surgery.

283. He needs interventional radiology

284. to embolize the bleeders.

285. They don't like unstable patients.

286. They will tonight.

287. I'll be down as soon as I finish

288. this grade 5 liver lac.

289. - Hodges, wrist shrapnel. - Check.

290. - Malloy, leg shrapnel. - Yup.

291. Montgomery, abdominal shrapnel.

292. Uh, no.

293. This is supposed to be Cheu,

294. female with a head lac.

295. Ugh, great. Where the hell did she go?

296. Dr. King, Whitaker!

297. There's supposed to be a female Asian patient

298. with a head lac in this bed!

299. Uh, yeah, I don't think that's her.

300. Right.

301. Whitaker, I need you to find the patient

302. that's supposed to be here.

303. Cheu, elderly female with a head lac.

304. - Me? - I saw you caught that rat.

305. You're the closest thing we got to a bloodhound.

306. I mean that as a compliment.

307. - Hey, is this a good time? - No, I got a missing patient.

308. You've seen a woman with a scalp lac, last name Cheu?

309. Uh, no, but I need to talk to you.

310. So talk.

311. You treat a woman with a scalp lac named Cheu?

312. - Doesn't ring a bell. - You're a lot of help.

313. Start wrapping up and get out of here.

314. - Oh, gladly. - In private.

315. Ugh! Keep looking.

316. - I'll be with you in a minute. - Yeah.

317. OK.

318. What the hell?

319. It's not like I'm gonna sleep tonight anyway.

320. What have you been hearing?

321. A lot of screaming and crying.

322. Got a feeling that's gonna stick with me for a while.

323. I mean about me.

324. Doctors.

325. Always with the me, me, me.

326. I heard you went home early, but you came back,

327. so cutting you some slack this time.

328. Why? Why'd I go home?

329. Just figured you were being a pussy.

330. What did Robby tell you?

331. Dana.

332. He said I didn't want to know,

333. so I didn't ask.

334. You in trouble, kid?

335. No, no, it's just a--

336. - just a stupid misunderstanding. - Then no worries.

337. Misunderstandings can be sorted out.

338. Look, everyone's nerves are frazzled from today.

339. Just go home, get some rest.

340. Robby believes something that's not entirely true.

341. That's not like Robby.

342. I need you to have my back on this.

343. Look, I love you, kid, but this sounds like

344. it's between you and Robby and above my pay grade.

345. Hell, I'm not even sure I'm ever coming back

346. after I walk out of here tonight--fuck!

347. What are you talking about?

348. Just--

349. Just--

350. I think I'm done.

351. Just getting too old for this shit.

352. What?

353. No, Dana, you can't quit.

354. It's like the fucking world is imploding.

355. Dana, you can't quit.

356. We need you.

357. Robby, me, everybody.

358. I just gotta wrap things up and get out of here.

359. I need you to vouch for me.

360. Robby thinks I'm a fucking drug addict.

361. Are you?

362. No.

363. No, what I--

364. what I am is scared, OK?

365. I'm really fucking--

366. fucking scared of what happens next.

367. I fucked up, Dana.

368. I fucked up, and I don't know what I'm supposed to do.

369. You're a smart kid.

370. You'll figure it out. Trust Robby, OK?

371. He'll do what's best for you.

372. What's best for me is being a doctor.

373. Hey, um, no luck finding Mrs. Cheu.

374. All right, I'm coming.

375. Shit.

376. - Yes, yes. I told him that. - How's he doing?

377. The same.

378. So he's not getting any worse?

379. Uh, not at the moment.

380. Our family physician is making arrangements

381. to move him to West Penn.

382. Will you excuse me for a second?

383. 54 after 3 rounds packed cells,

384. - FFP, and platelets. - Not too shabby.

385. Our measle kid's parents are trying

386. to move him to West Penn.

387. Let 'em.

388. They've been warned multiple times.

389. I even took the father into the PittFest morgue

390. - to drive the point home. - You what?

391. Yeah, I doubt any hospital will take him

392. without a spinal tap.

393. I'll be there in a minute. Don't let them move that kid.

394. OK, great. Thank you.

395. They can see this guy in 45 minutes

396. in Interventional Radiology.

397. That's a long time for this guy.

398. They're just starting a REBOA.

399. You did a REBOA during the mass casualty?

400. One of his interns did.

401. - Shut up. - I was busy.

402. That was ballsy.

403. Yeah, we can babysit this guy until IR is ready.

404. You guys are three hours post-shift.

405. - Whoo! - This was supposed to be

406. my day off.

407. We got this.

408. Hasta la vista, vatos.

409. Hey, hey, hey, have you seen

410. an elderly woman with a head lac?

411. Last name Cheu?

412. No, sorry.

413. Our shift is over.

414. Dana asked me to find her,

415. said I'm the department bloodhound now.

416. Well, you did catch the rat.

417. Hey, have you seen a elderly woman with a head lac?

418. - Last name Cheu? - Nope.

419. OK.

420. Anything interesting up here?

421. - Oh, we are off the clock. - I know.

422. But it's gonna take a couple more hours

423. to get caught up on every patient.

424. Are you feeling OK?

425. I feel great.

426. Better than great.

427. Today was horrific, but we got through it.

428. We did some amazing things.

429. Yeah.

430. Like, I drilled a burr hole

431. with an EZ-IO.

432. Yeah, that was something.

433. Uh, you should probably go home now.

434. I'm good.

435. No, you're running on an adrenaline high,

436. and you are going to crash soon.

437. - Trust me. - I'd rather be here.

438. This job can't be your life, Samira.

439. It's not.

440. What, because I'm not in a relationship

441. and I don't like socializing after work?

442. All that other stuff can wait until I finish my residency

443. and get to where I want to be in my career.

444. Yeah. For sure.

445. Yeah.

446. I love my life.

447. Can you let me in?

448. Hey.

449. Can I, um--can I talk to David alone for a sec?

450. I guess so.

451. I'll be right outside.

452. Can I get you anything, David?

453. Yeah, get me out of here.

454. I mean, I can't do that.

455. They caught the guy that did this.

456. He's dead.

457. I'm still locked up.

458. Yeah.

459. Look.

460. Do you know what it's like to be afraid?

461. I mean, really, truly frightened

462. for your own physical safety?

463. I'm pretty sure I got a taste of that tonight.

464. Right.

465. So imagine if you felt that way every day

466. from half the people that you meet,

467. because that's every woman's life.

468. So when you make a hit list for girls at your school--

469. - I didn't make a hit list. - Eliminate, man,

470. whatever you want to call it, it's unacceptable.

471. And it's a form of violence against women.

472. How would you feel if your mom

473. was on somebody's eliminate list?

474. I know life can be shitty,

475. and we all do stupid things,

476. but you're 18.

477. They're gonna treat you like an adult,

478. so I suggest you start acting like one.

479. Look, this is your chance to turn things around.

480. Take the help that's offered.

481. Try and figure out why you wrote what you did,

482. and please never, ever think that way again.

483. Uh, OK.

484. I'm gonna take this and this out there.

485. If anybody needs me, that is where I will be.

486. Yep.

487. What was that all about?

488. You told me it was my mess to fix, right?

489. So that's what I was trying to do.

490. Did he talk to you?

491. Not really.

492. Do you think I made it worse

493. by bringing the police in on this one?

494. We may never know.

495. He's probably gonna be stuck down here

496. for his entire 72-hour hold.

497. Well, maybe if he gets

498. the help he needs, it's worth it.

499. Go home.

500. Don't show up tomorrow before taking care

501. of the ankle monitor.

502. I think our blue man, Max, needs a psych eval.

503. Based on what?

504. No health reason for taking anything

505. that could have caused this.

506. No exposure to anything in the workplace.

507. He didn't ask me to call anyone.

508. I'm just worried he was trying to hurt himself.

509. It's a stretch, new girl.

510. Well, he's also not asking to go home.

511. I mean, if this was a failed suicide attempt,

512. it makes sense that he's too frightened

513. or embarrassed to admit to what he did

514. and too afraid to go home

515. because of what he might still do.

516. OK, I'll call Psych,

517. but find someone to take over for you.

518. Your shift ended a couple of hours ago.

519. I'd like to try and get a little more out of him,

520. see if I can get him to confess to something.

521. I've seen your bedside manner.

522. OK, that is reserved for assholes.

523. I don't want this kid slipping through the cracks.

524. OK.

525. Thanks.

526. Thanks for letting me come back.

527. I didn't let you come back.

528. You came back on your own, and I let you stay.

529. I figured it was the one time throwing my career away

530. was for a greater good.

531. I--I was never high.

532. I was just treating my own withdrawal symptoms.

533. Well, you should have done that

534. under the care and supervision of a physician.

535. With that on my record, I could--

536. I could have my hospital privileges denied

537. - whenever I apply for a job. - No.

538. No, that's not true anymore.

539. That's not true anymore. You could have come to me.

540. Instead, you could be arrested on felony charges

541. for stealing controlled substances from the hospital.

542. Robby, I could lose my medical license.

543. Come on, man.

544. You never heard of second chances?

545. Here's your second chance.

546. 30-day inpatient treatment program,

547. followed by random urine tests, 50 to 60 a year,

548. followed by mandatory NA meetings

549. three to four times a week for the first three years.

550. - Three years? - Of a five-year program.

551. - You need help. - What about you, man?

552. What about you? I'm not the only one

553. who's a little fucked up here, Robby!

554. Why don't you look in the mirror?

555. What's that supposed to mean?

556. I never had a complete meltdown.

557. No, you just caused them in other people.

558. You're blaming me for what happened to you?

559. What happened to me?

560. - What happened to me? - Yeah.

561. You are so full of shit!

562. You let me down!

563. You let everybody down, especially yourself.

564. Someone saw you in Pedes.

565. Who, Whitaker?

566. No.

567. A night shift nurse saw you on the floor,

568. said it looked like--

569. Looked like what?

570. This job will fuck you up if you let it.

571. - You let it. - Yeah?

572. I wasn't the one talking to cartoon animals in Pedes.

573. Fuck you!

574. Doing OK, man?

575. Why do you keep asking me that?

576. Oh, I don't know.

577. You did take the parent of a patient

578. into our makeshift morgue.

579. Forget that it's technically a fucking crime scene.

580. That's just not cool, man.

581. Just the two heroes I wanted to see.

582. We're holding a press conference

583. in the education auditorium.

584. Not a chance.

585. I know you hate this stuff,

586. but it's important for this department

587. - and the hospital. - Trust me, Gloria.

588. You don't want me speaking to the press right now.

589. Or ever.

590. Look, as much as you ER cowboys

591. are a pain in my ass, what you and your department

592. did here tonight was nothing short of miraculous.

593. People need to know that.

594. - Take the win. - Need a second round of MTP.

595. What the fuck?

596. Systolic's down to 64 over 38.

597. - He's tachy to 132. - Pelvic fracture?

598. Yeah, rechecking for delayed intra-abdominal bleed.

599. I thought you said he was stable.

600. He was, after three units.

601. And he continued to improve.

602. Pressure got up to 118 systolic after the full MTP.

603. - Systolic at 118? - It was 90 after three units.

604. You gave him too much blood and raised his pressure so high

605. that it blew apart the developing clots

606. that was stopping him from bleeding out.

607. First round of MTP is 6 units red cells,

608. 6 FFP, 6 platelets. That's what we gave him.

609. Treat the patient, not the protocol.

610. Systolic of 90 is ideal.

611. Robby, you teach your residents about permissive hypotension?

612. - Dr. Shen was on this case. - Shen is a resident.

613. He is an attending now.

614. We thought with the long delay

615. in getting him to IR, that--

616. He might not make it to IR.

617. You over-transfused, you popped the clots,

618. - and now he's exsanguinating. - OK.

619. There's no bleeding in the belly.

620. It's too deep in the pelvis to see on ultrasound.

621. Second round of MTP is here.

622. Blood and plasma on the infuser.

623. We got him back once. We'll get him back again.

624. - 3 grams calcium gluconate. - Why calcium?

625. Citrate in the transfusions chelates,

626. leading to hypercalcemia.

627. Excellent call, Dr. Ellis.

628. Hey, I found Mrs. Cheu in the stairwell smoking.

629. Oh, good job.

630. You know, Mrs. Cheu,

631. tobacco use is not a healthy habit.

632. I've outlived three husbands.

633. Yeah, they probably died of secondhand smoke.

634. Dr. King, we want you to do the spinal tap

635. before Flynn gets any worse.

636. Great. I will meet you in there.

637. Dr. Shen, nice of you to join us.

638. - Systolic's only 68. - After how many units?

639. Three units into the second MTP.

640. Total of nine.

641. This is not looking good, kids.

642. I'm--I'm sorry if I gave him too much blood.

643. - I thought-- - Dr. Ellis,

644. now that Dr. Shen is here,

645. we have plenty of hands on deck.

646. Why don't you go check on your other patients?

647. Hey, what about REBOA?

648. The balloon cuts off blood to the lower half of the body--

649. No, with bilateral crush injuries,

650. we don't know if we have an intact artery to thread it in.

651. We can always crack the chest,

652. cross-clamp the aorta, and stabilize.

653. - I got a better idea. - Yeah?

654. Preperitoneal packing.

655. Simple midline incision below the umbilicus,

656. pack like hell around and behind the bladder.

657. That pressure should stop the bleeding

658. until we get him upstairs.

659. Robby.

660. Preperitoneal packing. Thoughts?

661. Uh, I've only ever done one in cadaver lab.

662. Because it's an OR procedure.

663. We did them all the time at the combat support hospitals.

664. All right! What the hell?

665. Suprapubic prep and drape. Sterile gowns all around.

666. Hey, let's go. Get on the horn to the OR.

667. We need at least six lap pads

668. and the biggest goddamn retractors you got.

669. Deavers, right angles, whatever.

670. Saddle up, cowboy. We got this.

671. Dr. Ellis, where do you need me?

672. Back here at 7:00 a.m. to relieve the night shift.

673. I can work a double.

674. Samira, you are a great doctor,

675. but you need to know when to turn it off.

676. Go home.

677. Oh, Dr. Ellis, the parents of the measles patient

678. have finally consented to an LP,

679. but Dr. Shen is tied up with a trauma.

680. - I can do it. - We got this. Go.

681. - You still doing OK? - I'm fine.

682. Did you witness any of the shooting?

683. No.

684. OK, but, um,

685. you were found in one of the parking lots.

686. Yeah.

687. What were you doing?

688. I was just hanging out.

689. Were you with friends?

690. No.

691. You know...

692. you can tell me anything, right?

693. I'm--I'm here to help, if I can.

694. I had a--a good friend who, um,

695. went through some really ugly stuff with me.

696. We were young, and someone older was

697. taking advantage of our age.

698. And things got so bad that

699. my friend took her own life.

700. There isn't a day that I don't regret

701. not being able to stop my friend,

702. but there also isn't a day that I'm not grateful

703. I didn't do the same.

704. Life can be so fucking hard.

705. But it gets better.

706. And there are people who can and want to help you

707. with whatever you're dealing with.

708. I just don't want to be here anymore.

709. Then let's have you talk to a professional

710. who can help you with those feelings.

711. So what do you say?

712. Will you talk to someone?

713. - Here come more lap pads. - Drop them on the Mayo.

714. Ten blade to me.

715. I've done a hundred of these.

716. Just somebody fucking do it.

717. All right, fine.

718. But just down to the linea alba.

719. I don't want you going down too deep

720. and slicing the bladder.

721. Thank you for the safety tip.

722. Metz.

723. OK.

724. Adson forceps.

725. Once I'm through the fascia,

726. you're gonna sweep a finger around the bladder,

727. open up the space of Retzius.

728. Named after Anders Retzius,

729. 19th-century Swedish professor of anatomy.

730. Seriously?

731. History of medicine is the closest thing

732. I have to a hobby.

733. You might want to leave that off your dating profile.

734. All right, three lap pads

735. on each side of the bladder, deep as you can.

736. Deaver retractor.

737. Named for John Blair Deaver,

738. Philadelphia surgeon who revolutionized

739. abdominal surgery in the early 1900s.

740. - I'm surrounded by med nerds. - I went to med school at Penn.

741. I walked by his portrait every day.

742. Dude did, like, 100,000 surgeries.

743. Guys, BP is not any better.

744. Systolic is 72.

745. One more check of the transverse view.

746. Perfectly in the midline.

747. And the longitudinal view?

748. Right between the vertebra.

749. Good to go.

750. - You're up. - OK.

751. Is it painful? Will he feel it?

752. Not at all. He's fully sedated.

753. Enter bevel up.

754. Aim for the umbilicus.

755. Oh, I felt a pop.

756. That's the supraspinous ligament.

757. Enter slowly.

758. The next pop is the ligamentum flavum,

759. and you're in.

760. Felt it.

761. All right.

762. Removing stylet.

763. OK, Dad, we're in.

764. It's gonna take a minute to collect,

765. but the fluid looks clear.

766. - That's good, right? - It's a good sign.

767. The lab still needs to run some tests,

768. look under the microscope to rule out some bad stuff.

769. What are you doing?

770. You said she didn't want to be in the room.

771. I was getting Georgia something to eat.

772. OK, wait outside.

773. Stop what you're doing right now.

774. No, they're almost done!

775. I can't believe you went behind my back.

776. I did what was best for Flynn, not for you.

777. Take that needle out of his back!

778. - No. - Yes!

779. Ma'am, I don't want to have to ask you to leave.

780. Take it out right now.

781. Yep, coming out... now. All done.

782. My son is leaving this hospital.

783. I'm sorry.

784. She really is a good mom.

785. Fifth lap pad in place.

786. Yep.

787. - Number six, and we're done. - OK.

788. BP 92 over 48.

789. - That's good enough for me. - How much blood so far?

790. Uh, up to five on the second MTP.

791. No more unless he tanks again.

792. Sounds good.

793. Hey, I'll stay with him until IR's ready.

794. - OK. By yourself? - Yeah.

795. I need to make sure he doesn't get another drop of blood.

796. You're not needed in the OR?

797. Nah, it's ortho surgeries all night long now.

798. Hey, is he OK?

799. Yeah.

800. He's just tired. I think we all are.

801. - Holler if you need us. - I won't.

802. Why are you still here?

803. Almost done.

804. That was the cops. They arrested Doug Driscoll.

805. Good.

806. They want to know if I want to press charges.

807. Uh, yes.

808. I just want to forget this whole fucking day.

809. Me too.

810. But you still have to press charges.

811. Have you heard anything about me today?

812. Just, like, any kind of rumors?

813. Since when do you care about rumors?

814. - About you or anybody else? - I don't.

815. It's just something I heard that--

816. Langdon told me that he heard from a night shift nurse.

817. Yeah, well, there's a reason

818. we stick 'em on the night shift.

819. - Hey. - I'm kidding.

820. You want to tell me what it was?

821. I'll tell you if I heard something.

822. No. Never mind.

823. Can you find the remaining day shifts

824. so I can do a debrief before we all go home?

825. - Yeah. - Is Jake still here?

826. Yeah, he and Mom are in North 3 now.

827. Dr. Robby, I think you need to look at this kid.

828. Find Dr. Shen. I'm done.

829. You're gonna want to see this.

830. - Trust me. - I got this.

831. What am I looking at?

832. 14-year-old girl playing with her older brother,

833. takes a fall as her older brother

834. chases her up the stairs after she stole

835. a forkful of his takeout.

836. Told you you'd want to see this one

837. This has Dr. Shen written all over it.

838. Don't worry, we're bringing in our, um...

839. utensils specialist.

840. We're gonna start you out with some nasal numbing spray

841. for the pain.

842. Do you mind if I take a photo?

843. For the medical record.

844. Are you OK?

845. Yeah.

846. I think today is finally catching up to me,

847. physically and emotionally.

848. It happens.

849. How are you two still going?

850. I'm not.

851. I don't require much sleep, and I have a fast metabolism.

852. All right, everybody!

853. Listen up!

854. You got it, Cap.

855. Today should never have happened.

856. It's impossible to imagine what would possess somebody

857. to commit such a horrific act.

858. It's the worst of humanity,

859. but it brought out the best in the rest of us.

860. We saw our better angels

861. come to the aid of our patients.

862. Each of you rose to the occasion.

863. And I--I can't tell you

864. how proud I am of all of you.

865. This place will break your heart.

866. But it is also full of miracles,

867. and that is a testament to all of you coming together

868. and doing what we do best.

869. Thank you for everything you did here today.

870. We saw 112 mass casualty patients

871. come through here in the last four hours,

872. and 106 of them are gonna live.

873. None of us are gonna forget today...

874. Even if we really, really want to.

875. So go home.

876. Let yourselves cry.

877. You'll feel better.

878. It's just grief leaving the body.

879. You want to grab a drink?

880. Um, yeah. Yes.

881. - When? - Now.

882. Oh, some of us just get a beer in the park across the street.

883. - Oh. - Helps to download

884. before you go home.

885. OK. Sure, sure.

886. OK.

887. Mom!

888. Hey, buddy. You're still up?

889. Yeah, me and Grandpa just started watching

890. "Planet of the Apes."

891. What did I tell you about scary movies?

892. Sorry.

893. I need to get past. Sorry.

894. Hey, hey, sorry. Excuse me.

895. Doc Anderson would have made the same decision you did.

896. I could have kept him for a few more days on ECMO.

897. You gave him a fighting chance,

898. and then you used the limited resources we had

899. to give that little girl a chance.

900. - And lost them both. - Yeah.

901. But you did your best.

902. We all did.

903. Hey.

904. He would have been proud of you for what you did

905. and for everything else since then.

906. Come here.

907. You wouldn't let anyone else blame themselves for this.

908. Time to give yourself some grace.

909. See you Monday.

910. Yeah

911. Body makes me--

912. - Nice moves, Raygun. - Holy shit!

913. What the hell are you doing up here?

914. What the hell are you doing up here?

915. Just one second.

916. OK. OK.

917. Uh, I will, on occasion,

918. after a long shift, crash here.

919. This was your first day here.

920. Well, it's my first day--

921. uh, it's my first day of emergency rotation.

922. I did internal medicine last month.

923. Do you actually have a place to live?

924. Uh, I'm currently between places.

925. Do you own a car?

926. Uh, not at the moment, no, I--

927. I'm actually--

928. Between cars.

929. Yeah, something like that.

930. OK, so I have a spare room with its own bathroom.

931. Sweet.

932. Oh, for God's sakes. Do you want the room or not?

933. OK, that is extremely generous,

934. but no, I can't afford to pay you rent right now.

935. How are you at cleaning and fixing things?

936. Grew up on a farm. I guess I'm pretty handy.

937. Cleaning, I know how to muck out a stall.

938. Just keep to yourself, don't annoy me,

939. and you can move in.

940. Wow. I--I don't know what to say.

941. Thank you.

942. Well, you can move in tonight if you want.

943. Really?

944. Yeah, but quick, before I change my mind.

945. Yeah, yeah. No, I mean, this is--

946. this is all I really have, so...

947. Oh, God, you're not some, like, nudist

948. or religious freak, are you?

949. No.

950. No, I like to remain fully dressed at all times,

951. except bathing. I'm just--

952. - I know Krav Maga. - Cool.

953. I don't know who that is,

954. but he sounds very protective of you.

955. The chances of this working are diminishing by the second.

956. I'm just fucking with you, Whitaker.

957. You're such a Huckleberry.

958. Yeah. OK. Uh, hold on!

959. How are we doing?

960. Uh, we're doing OK. Right?

961. I know that this is difficult.

962. This is gonna hurt for a long time,

963. and it's OK if you want to blame me.

964. Just please don't blame yourself.

965. We've been friends a long time. I would hate it.

966. No, we're not friends.

967. And you're not my father, so fuck off!

968. Jake.

969. Robby.

970. Parents of Jake's girlfriend, Leah, are here.

971. I put them in the viewing room.

972. Hello.

973. - Hey, Becca. - Hi, Mel!

974. - You ready to go? - Yep.

975. - All right, let's go! - Let's go.

976. Oh, wow. It's, uh--it's dark out.

977. Oh, yeah. Sorry about that.

978. I had to stay a little later than expected at work.

979. - Because of your boss? - Oh, no, no, no.

980. A bunch of people got hurt at a music festival.

981. And you had to help them.

982. Yeah.

983. We're supposed to go to a restaurant on Fridays.

984. We could still go to a restaurant.

985. It's not too late?

986. Not for us King sisters.

987. - What do you want to eat? - Pizza!

988. Or spaghetti!

989. I don't know. I can't decide.

990. Well, why don't we do both?

991. - Both? - Yeah.

992. We can go out for spaghetti,

993. and then take a pizza home with us.

994. - Really? - Yeah, why not?

995. Can we still watch a movie?

996. It is Friday, isn't it?

997. "Elf"!

998. Yeah. Um, we could do "Elf."

999. Or we could see a movie that we've never seen before.

1000. - But "Elf" is so funny! - Yup.

1001. You're in my spot.

1002. Just so you know, Grubhub will not deliver

1003. to the roof, but there is a DoorDash guy--

1004. uh, Marco--who will trek up here for an extra 10 bucks,

1005. 20 if you want beer.

1006. Nice speech down there.

1007. Wish I had given it.

1008. No, you don't.

1009. No. Fuck no.

1010. But I'm glad somebody did.

1011. Yeah.

1012. I think I finally understand

1013. why I keep coming back now.

1014. It's in our DNA.

1015. It's what we do. We can't help it.

1016. We're the--we're the bees that protect the hive.

1017. Maybe you, not me.

1018. What are you talking about?

1019. You know damn well what I'm talk--

1020. I'm talking about.

1021. I broke.

1022. You didn't break.

1023. - You didn't break. - I shut down.

1024. At the moment everybody needed me the most,

1025. I wasn't there.

1026. I couldn't do it. I choked.

1027. For what, for 40 seconds?

1028. Three minutes? Ten minutes?

1029. So fucking what? We all have that.

1030. That is what happens when you're in a war

1031. and nothing makes sense.

1032. We survived as a species because we learned

1033. how to cooperate and communicate,

1034. so when we're in the middle of killing each other,

1035. it divides the very logic of our existence.

1036. Your brain starts to short-circuit.

1037. All you can do is focus on the medicine.

1038. The medicine's the only thing that saves the patient

1039. and your sanity.

1040. I'm gonna need a drink if you keep talking.

1041. You get what I'm saying, right?

1042. You rocked that shit down there tonight.

1043. Yeah?

1044. You rocked that shit down there tonight.

1045. We all did.

1046. Now that is a compliment.

1047. Accept the damn compliment for once.

1048. What if we just didn't talk for a minute?

1049. - I'm just trying to help. - I know.

1050. - I appreciate you-- - Still talking.

1051. Sorry.

1052. - Get that drink now? - Yeah.

1053. Whoa.

1054. It didn't take long to fill up in here.

1055. Never does.

1056. How long until we run out of boarding beds?

1057. Probably sunrise.

1058. Mm. Mm-mm.

1059. - She had a seizure. - Of course she did.

1060. Looking good, Dr. Abbot.

1061. - You too, Myrna. - Oh, thanks.

1062. Hey, fruitcake.

1063. - Fruitcake. - Don't ask.

1064. {\an8}- When are you coming back? - I don't know.

1065. {\an8}Grab a couple hours' sleep, come back around 2:00.

1066. {\an8}I don't think they're gonna need relief

1067. - until the morning. - You know me.

1068. I prefer working nights.

1069. You're not sick of working nights yet?

1070. My therapist thinks I find comfort in the darkness.

1071. Huh.

1072. Could give you his number

1073. if you ever feel like talking to him.

1074. Does it help?

1075. I haven't jumped off the roof, have I?

1076. Not yet.

1077. Hey! Hey!

1078. Somebody help me! There are rats in here!

1079. There were rats in my bed!

1080. I don't think there are any rats in your bed.

1081. - There were two of them. - OK, sir.

1082. We'll take care of that.

1083. Head trauma. Starting to hallucinate.

1084. Put him in line for a CT.

1085. Hey, hide the hard drugs, kids.

1086. Oh, nice catch.

1087. Oh.

1088. Man.

1089. Today was a motherfucker.

1090. Have you ever been in anything like that before?

1091. Let's hope none of us ever has to again.

1092. No shit.

1093. We probably will.

1094. If not us, others.

1095. Yeah, but we survived that craziness, right?

1096. To the Pitt crew.

1097. To all the people we saved.

1098. - Here, here. - And the ones we couldn't.

1099. Is this where all the cool kids hang out?

1100. Oh, you know it.

1101. Nice of you to join us.

1102. If there ever was a day.

1103. Actually, sorry, I don't drink.

1104. I don't know why I took that.

1105. - She's not old enough. - I'd say if she's old enough

1106. to put in a chest tube and intubate,

1107. she's old enough to drink a beer.

1108. We won't tell your mom.

1109. Shut up.

1110. But seriously, don't.

1111. Thank you.

1112. You guys do this after every shift?

1113. Not always.

1114. Usually, it's a little more lively.

1115. The Emergency Department throws wicked parties.

1116. - What's so funny? - Mm.

1117. I just realized this is your first shift.

1118. Yeah.

1119. That was baptism by fire, baby.

1120. I can pretty much guarantee you

1121. the next one will be easier.

1122. I really fucking hope so.

1123. Hey, at least you didn't get pissed on.

1124. I will drink to that.

1125. Aww, poor Whitaker.

1126. Where is he?

1127. Yeah, probably quit.

1128. Oh, that kid's tough.

1129. He'll be back.

1130. Just like the rest of us.

1131. OK, that's it for me.

1132. Beer for the road?

1133. Yeah, why not?

1134. Good night.

1135. Get some rest.

1136. Tomorrow is another day.