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