Boston Med (2010) s01e03 Episode Script
Episode 3
Boston-- home to three of America's greatest hospitals-- Mass General, the Brigham and Children's.
These are the stories of the men and women who work in them.
I've never seen a guy piss off more nurses than you on rounds.
Oh, really? Are you asking me out in front of this camera? Code blue, e.
D.
Code team.
Can anyone feel a pulse? I got nothing.
Whoa! There's a pediatric trauma coming in.
We have pumps, monitor, suction, intubation.
I think we're all set.
The car jumped the--the curb Mm-hmm.
And pretty much crushed the kid.
Aww.
It's almost like your body goes on autopilot and your adrenaline just takes over and just do what you gotta do to try to save them.
I'm probably gonna be a little bit rude and yell at people to get out of the room, because there's already too many people in here as it is.
They're here.
Thank you.
We're all set.
All right.
Ready? Cables all clear? Ready? Everybody ready? One, two, three.
Ped struck by a car.
He has not woken up.
The last blood pressure was 67 systolic.
We've never been able to get a pulse Start chest compressions.
Somebody needs to get access in this boy right now.
I want to get Lidocaine.
Okay, who's working the bag? Epi.
Okay, Mike, I need a suture, please.
I need Betadine over here, please.
1 per 10,000 epi going in I.
V.
Epi is in, right fem line.
The heart is moving? I heard heart sounds, so we're getting--I heard heart sounds.
Can you please ask where the blood is? When I was doing the compressions, I was just telling myself, "don't look at his face, don't look at his face.
" I just didn't want to see that little child's face.
Emily, spike another bag of saline for me, please.
We need an O.
R.
Peter, what can I tell the O.
R.
that you're gonna do? Laparotomy, thoracotomy.
Yeah, laparotomy, thoracotomy.
All right, guys.
Let's go.
Let's go.
We got his heart beating again.
Go, go, go, go, go.
But he has massive internal bleeding, and we might not be able to stop it in time.
We have everything? ? Brigham and women's.
It's Richard reish.
R-e-I-s-h.
This month, I'm in the emergency department, working 50 hours a week.
They do, uh, 10-hour shifts, so it's, uh, it's really nice.
Today is Rick's first day in the emergency department, so we have to keep our close eye on him, make sure that he knows what he's doing.
We'll see.
She's been sitting here forever.
I need a Spanish interpreter for 37-a, please.
Let's go get her taken care of.
I don't want her to leave.
I was valedictorian of my college undergraduate class.
I came to Harvard medical school with a $300,000 scholarship, um, for--to do anything I wanted with.
And now coming in as an intern, you're the lowest of the lowest people on the totem pole.
You know nothing.
Um, room two.
She's still here? Oh.
She wants to discuss, um, her pain meds with you and-- her pain meds? Oh, great.
Yes.
Oh, I'm not gonna prescribe you any narcotics.
Narcotics? I never asked you for narcotics.
All right.
Calm down.
Uh-- well, that's--what, you just assumed something, and it's like-- you know, assuming can make-- j--ma Okay.
Hey, guys, first of all, listen to--listen to me-- no, no, no, no.
Just like you assumed that she u-- was a drunk.
On alcohol Who--who--when-- when did I assume this? You asked me, "when was her last drink?" I said--yeah Yeah.
Because she has a-a-- no, no, no.
Oh, wait.
This is a pointless conversation.
No, no, no.
I don't drink.
Okay.
I drink because of pain.
She's been under my care for the past five hours.
Like, I'm, like, really taking very good care of this patient.
I got her out of bed, I was doing a lot of extra things to help her, walking her around, making sure that she has a safe home environment.
Okay.
Uh, and then they just turn on you, like that.
You and narcotics-- I did not ask for narcotics.
You feel like you need something else for the pain than what you currently have? I have tried-- listen, I've been here for five years in this hospital Okay.
Okay? Okay.
That I had to die, okay? Came here on a Monday Okay.
And then came here on a Thursday Wednesday.
Sent me home Wednesday.
Wednesday--sent me home, and I hemorrhaged myself to death.
Okay.
Not on alcohol either.
Okay.
Well, I wasn't there for that, obviously.
Okay? My mother has attention deficit disorder.
Okay? Okay.
And I'm a teacher, and I know, and I'm also in the medical field.
I have, um, a thing in medical assistant.
And so don't put a smirk on your face, okay? You know, you keep your medication.
How's that? If you don't believe me-- okay.
Sounds good.
You keep it.
Send it home.
Okay.
Okay.
Maybe someday you might need it.
Okay.
Maybe I could've handled that a little differently.
But there's no way I'm gonna write a prescription for this patient.
Like, I don't care if they call patient relations, if they--if they want to file a complaint against me.
I'm not gonna do it.
We pushing blood? Um, one more.
We need a cross-clamp for the aorta, please.
Even if there's a one in a million chance you're still gonna do everything that you can to try to save a child.
Let's open him up.
It looks like he's got a big fracture here.
Okay.
Scissors, please.
You know what? You guys-- what do we got? Bleeding.
He's just bleeding to death.
By the time that we entered the room, pupils were fixed and nonreactive.
Okay, stop.
All right.
Hold on, folks.
Everybody see your time.
2:40.
2:40.
Zip him up for his family, please.
Yes.
There's nothing more devastating than losing a child.
? And when you see a kid laying there With his chest cut open where you can see his heart and it's not moving, I don't think a-- you would ever be able just to prepare yourself for that, ever.
? That's definitely the first time I've had to do chest compressions on a kid.
It was just nothing.
He had no blood whatsoever.
Wasn't even moving.
Poor baby.
? It is undeniably frustrating and saddening when people that you treat--when they die.
Brain surgery is a situation where, there are things you can't control.
Doing a lot of operations is physically and emotionally demanding.
And I knew this would be the case when I chose to go into neurosurgery, and I thought that I was well-suited for it.
You heard what they've been calling you lately, right? "Much cuter than Obama.
" Absolutely.
Really? Yeah, more than one person has said it.
Who--more than one person? He's absolutely much cuter than Obama.
I'm gonna reserve comment, 'cause he is the president, so I don't wanna-- I don't wanna go on record as comparing myself to the president, but I'll let everybody speak for themselves.
You look like Obama, by the way.
The only thing I will say is, I am 12 years younger than he is, so I hope, at least, I look younger than he does If not better.
You know, I-I hear that.
I usually hear it A young Obama.
I usually don't hear it in scrubs.
I hear it usually when I'm wearing a blue suit, but, uh No, you do look like him-- a younger him-- but you look like him.
I'll take that as a compliment, 'cause I'm a--I'm a fan.
Good, 'cause I think it's a compliment.
The reason why I went into medicine is because my father was a doctor.
He was the first african-american surgeon at New York hospital.
And it was obvious to me from my earliest memory that he loved his job.
All right.
Surgery time.
When I was an intern, I was assisting a surgeon on a hernia operation, and he had left the room.
They brought down the screen, and the patient, very pleasant, said, "oh, thank you" to the nurse, "thank you" to the scrub nurse.
Then he says, "oh, are you here to clean the room?" And I said, "no, I did your operation.
" Some people would be very upset by that and all riled up.
I only thought it was funny, 'cause I knew I did the operation.
About to see a new patient named Ronald haynes.
He's a young guy-- just 29 actually.
He had some scans, which showed a mass in his sinuses.
He has a big tumor, and it's positive for cancer.
This tumor sits in between and behind the eyes, right where the olfactory nerves, which are for smelling, come from the brain.
The tumor can track up those nerves and invade the brain.
It doesn't look like that's happened yet, but it's just on the verge.
Okay, you got your bobber ready? Yep.
Are you making one? Yep.
What's this part? Um, that's-- that's my bobber bobber.
You making homemade bobbers? Yep.
I'm taking the bobbers off.
You're funny.
I'm not.
Yes, you are.
I was eating very healthy.
I had quit smoking, worked out four days a week Ran 12 miles every week.
And then in march, I went to a wedding.
We were flying home, and I had a seizure.
I woke up four days later.
My son was sitting next to me on the plane.
Thinking about my son sitting there while In the ambulance where I'm not I'm not able to s-say anything to him That's scary.
This isn't scary.
Well, daddy's almost in the road, so daddy almost needs to hold hands.
Yeah.
Alison is my girlfriend.
We've been dating for almost two months, I guess.
She's stuck around through all the drama-- a guy with a kid and an ex-wife and cancer-- so that's plenty of baggage.
Can I just swing? One time.
She's awesome.
Ready? One, two, three.
This will be very similar to the view that we'll have during surgery.
If the patients ever saw a picture of themself during this operation or what this operation looks like before going into it, I think they'd be horrified, because it's-- we basically take somebody's head and face completely apart and push the tumor out through the nose.
Six cars? Yep.
I would freak out.
I would.
If I were a patient, and, like, that was the plan, I-I-I can't even imagine.
Will it work? ? There's only one reason why I voluntarily come to this building, and it's because of this kitchen.
They make the best milkshakes.
It's--it's incredible.
You could be clinically depressed, have one of those milkshakes, feel on top of the world.
It's unbelievable.
All right.
Sorry I'm-- I'm late today.
I was in the O.
R.
with a couple of cases.
How you doing? Ankles That's all painful? Okay.
Oh, yeah.
We've been trying to get his tubes out for two days, and I got a page this morning from thoracics that he was gonna have his tubes out, without question, early this morning.
It's 4:00, and his tubes have not come out.
It's totally unacceptable.
The chest tubes are coming out.
If thoracics doesn't want to come by to take 'em out, I will pull them myself.
I think we definitely need to make you more comfortable.
Thank you.
Ah, it pisses me off.
I mean, he has always been the best patient.
You know, he's always been in good spirits.
He has a bad, bad problem.
We've done a lot for him.
And, uh, to see him like that If there's one thing I'm not good at, it's at hiding things.
I am an open book.
Mr.
Russell, are we gonna get his chest tubes out? It's fine.
I mean--I mean, I'm not gonna argue with you.
I'm not gonna argue with you about your schedule.
Okay.
Thanks.
Yeah.
Bye.
[Bleep.]
Useless.
All right.
I can't tell you how many senior residents Have come up to me and have said, "you're arrogant.
You're cocky.
You really need to tone it down.
" Going down.
As hard as they've tried to change me, they haven't and they won't.
When I'm a chief resident and I have an intern like me I--it's really gonna piss me off.
Yeah.
All right, then.
So I was just talking to Mr.
wong here about what other tests we need.
So we should probably get that ultrasound of the gallbladder.
It's on the other side, actually.
The gallbladder's on the right.
No, I was looking for a pen.
Okay.
All right.
I was just checking.
Let me just borrow that.
Okay.
You have one, um-- I was talking about-- that--that face was because I ordered an ultrasound yesterday Okay.
Which you disapproved of, but that's Um, why don't we get a chest C.
T.
? Have you passed some gas? I don't think there's any gas to pass.
When you talk, you swallow air.
The air's gotta go somewhere.
So most of us pass gas about 42 times a day on average.
Yeah Andrew here is about double that.
That's nice.
Thanks, flavio.
But, uh, you'll always pass gas, even if you're not eating.
Hang in there.
Okay.
We'll get those tests, and then we'll let you know.
Okay.
All right.
Top of my list this morning is to see Ron haynes, a 29-year-old man with a cancerous tumor in his sinus cavities.
It's a very challenging case.
With these types of tumors, because they can go back through the nerves, uh, towards the brain, we've gotta take out all that skull tissue which it touches.
Mm-hmm.
We lift off what's called a bone flap Mm-hmm.
Bifrontally, so it goes pretty low, like, right over the eyebrows Okay.
Off like this.
Then we basically meet in between the eyes, going back about 3 or 4 centimeters, um, and get around the tumor and push it out through this incision.
Okay.
There's a risk of visual loss, uh, risk of neurological problems.
But I'm just-- any time I'm in that area, these risks exist.
Right.
And there's no way to preserve your sense of smell with this surgery.
Okay.
Um, and-- that's the one that I care the least about.
We wouldn't recommend the surgery if we didn't think we could get around it.
Right.
Well, I feel pretty comfortable with you guys, you know, being almost experts You know, basically experts in this field-- I like to think that we're experts, actually.
Yeah, well So I've got a lot of faith, and I just kinda know it's gonna be all right.
So I've never really doubted.
If you ruin one step, his frontal lobes of his brain could fall through this gap and into the nose.
It's a really fun environment in the emergency room, especially when it is slow and you get to hang out.
Hi, Dr.
binder.
Hi, Dr.
binder.
Megan.
Hello.
I caught that.
Why don't you know her name? Say it.
Oh! I'm having a bad I can't get the words out.
I know your name.
Oh, my God.
I'm heartbroken.
All right, nobody say my name for the rest of the night until bill figures it out.
I'm having a hard time.
You better grab and hold on tight, 'cause you're in for a long eight hours, bill.
You're in big trouble, bill.
Bill binder forgot my name.
He said, "hi, Megan a--" "and, uh" Perfect.
You have to be so careful around here.
Thank God bill's head is relatively round.
It's easy to cut out.
I think it's extremely fun that he forgot my name.
I mean, you are nurse of the year.
Shh.
I can name everybody's name here, but just had to forget Amanda's.
? William binder.
Amanda.
What? I'm s--I'm--you know what? Hi, doctor.
I was just in the middle of, like, 19 things.
I-I forget my own wife's name sometimes.
He's gonna spend the whole night apologizing to me.
I can already see it.
I have him right here.
? Today we're operating on Ron haynes to resect this malignant tumor from in between his eyes.
We take off the forehead, push the brain back and expose the tumor from above.
Okay, after he goes in for the procedure Mm-hmm.
Walk straight down the hall.
It's all the way down on the left-hand side.
Mm-hmm.
All right? Ron is my oldest son.
It's a scary thing he's gonna be going through.
But he's handling it very well.
Yeah.
And that helps us, that he has a positive attitude and he's attacking it.
It really helps us that he's confident.
Today is surgery.
It's not that big a deal, I guess, so I mean, it is, but it's like, you know, like I've said, I'm in the best place to have this done, so I'm not really worried about it.
Lock the stretcher.
The biggest danger Is not doing it right.
Really, if it's not done perfectly, the complications can be really devastating.
You gotta know how to do it right.
I know how to do it.
I'm trained to do it.
I don't want to sound arrogant, but, you know, it's brain surgery.
All hell can break loose in any case that I do.
? The E.
R.
is very different than any other rotation that we do in the hospital.
Ay! Ay! Ay! [Bleep.]
United States! Like you, mother [Bleep.]
! You like United States.
Son of a bitch.
I will Whoa! Mnh-mnh.
Ay! Ay! Ay! A little crazy in here.
Um, he's discharged.
Ay! So texting "bardouche" right now, one of my co-interns.
Ay! Oh.
Ay! Ay! All right, dude.
Oh, here's bardou.
Bardouche is in the house.
What's up, buddy? How you doing? Good, good.
Let me answer a f--a few calls.
Name--andrew elbardissi.
Everyone calls him "bardouche.
" So we're trying to get some of the nurses to start calling him bardouche.
He likes it.
He loves it.
So what's your plan for tonight? I was--really interesting, actually.
I'm gonna hang out with that mallory girl tonight.
Is she coming over to your place? That's what I'm gonna push for.
Okay, here's how you set it up.
Say, "look, I'm in the mood to sort of chill tonight, "relax a little bit.
Let's just do a movie.
" She'll say "yeah.
" And then say, "well, look, "I just looked at everything in the theater.
"Nothing really looks that good right now.
But have you seen the movie 'vicky Cristina Barcelona'?" Okay? Awesome movie.
Do you like--it's a Woody Allen movie.
It's, uh, it's sort of a bit, uh, it's--it's really good.
Trust me.
You've given me absolutely nothing about the movie.
Why don't you just tell me what it's about? It's this guy who tries to have a threesome with these girls, but--but, bardouche, it sounds sketchy, but it's really good.
Trust me.
Everyone loves this movie.
It actually sounds kinda good.
Trust me, she wouldn't have seen it.
It's not her type of movie.
And then you definitely get a bottle of wine, order some take-out sushi-- end of story.
You know what's also a pretty good strategy? I was gonna suggest to go and get some really fine, uh, goat cheese and then maybe some olive bread to start off with.
And, uh Have that with the wine and then go-- just stop.
Thank you.
? Mass general on line.
Mass general, we're coming to you with a 55-- 5-5-year-old, uh, male involved in a m-motorcycle accident.
Patient stable at this time.
Any questions? No questions, dispatch.
Mass general over.
There's a trauma coming in.
It's time to play rock, paper, scissors.
Okay, one, two, three.
That one for me.
Okay.
One, two, three.
I won.
You won.
Ready? One, two, three.
Sorry, friend.
So this is a, uh, 55-year-old gentleman.
He was riding his motorcycle today.
He was going a moderate speed.
Uh, somebody cut him off.
He t-boned the other vehicle.
Uh, at the scene, he reported some belly pain Reported some right hip pain and some back pain And vital signs have been stable throughout.
Tracy, 143 over 105.
All right, anything here, George? I know your back hurts.
Say yes or no.
No, no, no.
What if this was my dad? What would I want the nurse to say to him? Look at the pelvis, right I would want somebody to be there and hold his hand and tell him it's gonna be okay and tell him we're doing everything we can.
If you had to give me a number-- zero is no pain, and 10 is, like, the most pain you've ever had in your entire life-- what number would you say the pain you're having right now is? It's probably like a 6, but when I move, it's a 12.
Okay.
I just want to get this pain medicine into you.
I've been riding, you know, off and on, since college, and this is the first time I've had an accident.
So the left hemipelvis is opened up, and it looks like he's got a broken pelvis bone.
It's not as bad as it could be, but there definitely is bleeding around it.
Okay? So do this.
You can really rip some veins, and he has.
And if you wrap a sheet around him, bring it back down to size, then hopefully you slow down the bleeding.
Okay.
I'm sorry.
That's okay.
You gotta do what you gotta do.
Got it? Okay.
? Could you just cover his face with a towel? I always--I always do that just 'cause Sure.
Here.
I don't like looking at his eyes.
We want to be aggressive about getting out as much of the tumor and as much normal tissue around it as is safe to make sure that we've taken out every last cancer cell.
You just need one cancer cell to kill you.
We're gonna take off the forehead, basically.
We're probably at our riskiest, like, sinus area.
Yeah.
That's where his eyes go.
You see that? There's a fair amount of tumor pushing into the eye.
All right.
Here we go.
I have to drill out the base of the skull, around the eyes, around the optic nerves, and that's where the risk is.
You need the optic nerves for vision.
If you miscalculate, if you interpret the anatomy wrong, he could be blind.
It's been, what, four-- almost four hours.
I would hope he'd be about halfway done.
Oh, I'm sure.
I hope so.
I've got it right in the middle.
Perfect.
We have ways of preventing disaster.
The tumor should be pretty mobile.
Keep going.
I am.
I'm trying.
I'm pulling hard.
Uh wait.
Whew! Laterally.
Beautiful.
Here we go.
The tumor's out.
We're getting close to the end of this endeavor.
Time to put him back together.
? This is sheryl haynes.
He wanted me to just call and give you an update.
I'm down in the operating room.
Things are going well.
And I'll call you back with more updates as we have them.
Okay, bye.
Everything's going well.
He's doing good.
So Great.
Good.
We're all done.
So far, so good, you know? Big case.
The tumor's out.
All you can do is hold your breath until he wakes up.
So it's a, you know, it's like a leap of faith until then.
? Hi, Liz.
Hi, Leslie.
How are ya? Hi.
Hi, Dr.
brown.
Hello, Amanda.
You'd think work would be a great place to meet somebody.
But you know what? There's no mcdreamys or mcsteamys walking around here.
There's mcdumb, mcdud.
Oh, goodness.
There's, like, people here that are cute here in this environment, but you're like, I wonder if I took you out of the hospital and put you in real clothes and in a real social situation if you would still be cute.
So there's, like, a lot of "hospital cute" guys, but Hey, um Are you around over, like, Memorial Day weekend? I am.
I'm working that night.
We should do something then, because Rob, are you asking me out I was gonna get down on one knee, but, uh Okay.
Call me.
All right.
Bye.
I don't know.
It's, like, kind of hot in here.
I think I just got asked out on a date by Rob Miller.
And then I ran away I heard him.
Because I was so embarrassed.
Yay! This is the first guy that's ever asked me out.
I usually-- I'm usually the one that-- really? Mm-hmm.
Then this is the one.
I'm so excited for her.
Ron, squeeze my hand! ? Okay, give me a squeeze.
Give me a squeeze, Ron.
Squeeze.
Squeeze my hand.
Okay.
Ron, all done with surgery.
Surgery's all finished.
Young men wake up aggressively.
I don't know why.
I had surgery once, but I think I woke up peacefully.
The surgery's all done.
Everything went great.
Now you're talking.
Little mask on there.
Little breathing.
Looking good, looking good.
You're doing good.
Successful surgery-- achieved our goals, looks pretty good.
Gotta follow him closely tonight.
He's just waking up, so he's not completely coherent yet, but he's moving everything, following commands.
So far, so good.
Okay.
So the surgery went as-- basically, as planned.
Did they have any eye issues? 'Cause he said something about losing an eye? He still has both eyes.
I would expect him to be able to see.
Okay.
Okay? I haven't been able to actually formally test that yet.
Right, right, right.
Step-by-step.
One step--yeah.
Step-by-step, yeah.
I'm gonna get you a pillow.
I'll be right back, okay? Do I look a little better today, izzy? Yesterday, the environmental service people told me that I have to start doing my hair before I come to work.
It's nothing wrong with her, but, uh, she could've looked much, much excitement, you know? Could've been lookin' better.
Izzy, you're in trouble.
You think? We're all done for the night.
Rob and I and some of his friends are going tango dancing.
Oh, my God.
It's so tiny.
I'm scared.
I don't know.
It's kinda hot.
Yeah, it's really--it's really hot when they do it.
Oh.
Okay.
And you know Oh, really? I mean She--she--no, no, not the fingers locked.
Oh.
Like that.
Don't touch my fingers.
I don't want to-- so just keep the frame the same, and you just sort of, like, you know, walk together.
Gav-- Gavin, this is embarrassing.
You two dance together.
Okay.
So you--oh, okay.
Great.
Nothing sexier than two men who are comfortable enough to dance together To dance the tango First time, the tango.
Together.
All right.
Ready? Well, all right.
Just--just trust me.
All right.
I'm gonna close my eyes and I'm gonna trust you.
Okay.
And it's gonna be a mess.
See? I can't.
I guess I don't trust you, Rob.
That's okay.
Not a lot of people do.
I've made the mistake of dating somebody I work with before, and it was disastrous.
Oh, that was good.
Yes, it is.
Small steps.
I think you're pretty good.
You're pretty good, too.
Ooh, I'm getting, like, dizzy.
Rob's a great guy.
We'll see what happens.
We're on the way up to the I.
C.
U.
Where I'm just gonna take one last look at Ron just to watch him continue to progress towards where I really want him to be neurologically.
Hey, Ron.
Just checking in on you.
Hi.
Aah! The first noise that he made when we went in there was he just kind of bellowed, like Chewbacca.
It's probably a very appropriate noise for somebody who undergoes, like, a surgery like that, to wake up and kinda-- and kinda yell.
If he was mute, I'd be more worried.
The giving a shout? That's his prerogative.
Hey, Ron.
Surgery's all done, okay? Okay.
Everything went fine.
Great.
I just talked to your family.
They're gonna come up and see you in a little bit.
Okay.
Okay? Mm-hmm.
Can I ask you a couple of questions? Mm-hmm.
Say your name.
Ronald haynes.
Do you remember my name? Dr.
curry.
Where are you from? Michigan.
Okay, good.
How many fingers? Two.
How many fingers? One.
Good.
All right, good.
Everything went fine, okay? Okay.
Thanks, Dr.
curry.
Let me shake your hand.
He knows where he is, he knows he had surgery, he knows my name, recognizes me.
He can see.
He's gonna be fine.
I'm on my way home.
I'm gonna walk home.
I'm gonna enjoy the fresh air.
I'm gonna help my daughter eat dinner ? Get a good night's sleep, and then come back early in the morning and be ready for, uh, for surgery.
? You know, you live in the hospital, and so you see these people all the time.
And it's only natural that you start dating people in the hospital.
But things can get a little bit sticky if, uh, if it doesn't go well.
Hey.
Hey, what's going on? Um, the Spanish interpreter's here for ya.
Right there.
This is mallory.
She's taking care of my patient today.
You know, you always worry, because if it's a cute nurse and you're trying to ask her out, like, you can see all the other, like, old nurses kinda hone in on you and try to prevent you from eating their young.
So you have to be a little bit careful, you know? And now I'm gonna go see Katherine, who's a 26-year-old female who, um, over the past 24 hours, has had persistent abdominal pain, predominately in the right lower quadrant.
She came to the e.
D.
Here and was found to have an appendicitis.
My name's Andrew.
I'm one of the surgical residents.
I'll be helping out on the case.
I just want to get it over with, honestly.
I mean, I've been up for A long time now, and I kept waking up last night, so just get it over with.
Get it out if they need it out.
We're gonna try doing it laparoscopic first, which is, you know, make a couple of small incisions Mm-hmm.
Okay.
In some situations, that doesn't work out.
The appendix is perforated, it's difficult to safely remove the appendix with a laparoscope.
Great.
That'll be my luck.
Well, it's still a small incision, but you should be aware of it.
There are horror stories, right? You take a person's appendix out, and they can have major complications afterwards.
I remember, like, a couple months ago, I was having this, like, you know, abdominal pain myself, and I was thinking, even if this is an appendix, I don't want to go through surgery.
I'm not comfortable with this case at all.
I haven't done many at all, and the ones that I have done, I totally have not reached the comfort level.
? My dad actually died in, uh, 1997 from a-a medical error, which has definitely contributed to me going into medicine.
He had a pancreatic mass.
What they ended up doing was not biopsying the mass, but biopsying the aorta, which is a very bad idea, because then you just bleed, which is what happened to him.
He just bled out.
Um, and by the time they figured out what actually was happening, it was too late.
.
I really don't have a lot of experience removing the appendix.
Everyone's anatomy's different.
Things can get complicated fast.
I've never worked with Amy before.
I'm nervous about this operation.
So getting back to the--the patient that we're gonna operate on.
That we're operating on Yes, okay.
You think she has appendicitis? Yes.
Based on what? Epigastric pain that evolved into Migration, right? Right lower quadrant pain over a period of hours.
Yep.
She had a cat scan of her abdomen, and the presentation was atypical, right lower quadrant pain over a period of hours.
Yep.
So based on her physical exam, we're gonna go in and take a look with a laparoscope, and if we, uh See that her appendix is inflamed, we'll take it out.
So what do you think? Is it? You think it is? I-I think it is.
And if you're right, what-- oh, you think it isn't? You don't think it is? Acute? Do you wanna make a bet? Let's put a little friendly wager.
Let's put a few beers-- a few beers at the mission.
Andrew is great.
I mean, Andrew is obviously a very talented intern.
We would--he wouldn't be here if he wasn't.
Um, he does have an ego, which most young surgeons do.
Uh, so my job is to try to train him, but also to rein him in a little bit.
Shall we begin? Can we have a little local for the young doctor? Thank you.
It's a difficult task, dude.
Oh, Jesus.
? ? It's fun to hang out together, but it's also kind of pathetic, 'cause we're all so frustrated romantically.
I think dating in the hospital is very difficult.
So, Henry, what if a really hot nurse in the e.
D Right.
Asked you out on a date, you'd say no 'cause it could get murky? If Amanda grabowski asked you out, you'd say no? That's a flat-out lie, Henry epino.
Lie! Lie! Flat-out lie! Who has dated somebody you've worked with? There you go.
So everybody's done it, even though nobody wants-- I haven't done it.
Correct.
I didn't raise my hand.
If she were smart, fun, kind, hot anhonest, I would really consider it.
? What makes you think it's not appendicitis? I'll tell you afterwards.
But do you think it is? I do think it is.
Now go in straight.
Mm-hmm.
Don't stab the bowel.
All right.
Now it's time to go fishing.
So So where's the appendix gonna be? Yeah, there, it's coming.
It's gonna be at the end of that.
There it is.
All right.
Well, she's definitely got the disease.
I'm gonna grab this, if that's okay with everyone.
She has appendicitis.
That's fine.
Now why don't you use it-- grab the base there.
Now use your other hand And grasp it on the side.
And basically grasp it on the other side Use both hands.
And kind of feed--pull that appendix out of that pelvis.
Yep.
Oh, beautiful.
Okay.
Now here's what I want you doing-- okay, grab the appendix.
Okay.
What I want you to do is, I want you to feed that further into your stapler.
So use the stapler as a grasper.
Turn it towards you.
Use the stapler.
Yeah, exactly.
Okay? Let me see your blade.
Okay.
You like that? Yep.
Are you comfortable with it? I love it.
You don't have the ileum? No.
Hold on.
Let me just double-check.
I'll double-check for you.
It's not that I don't trust you.
Fire? Yep.
All right.
Okay.
Open up.
Surprisingly less painful than I thought it would be.
You did a fantastic job.
I was impressed.
He's the best intern on the service.
You know how to use that? Such a [Bleep.]
.
Best intern.
Best? All right, deploy the bag.
Dump the worm.
And I'll take a specimen cut now, please.
Dump the worm.
Worm down.
Okay.
Okay, take this bad boy out.
Yep.
Don't lose the worm.
I think I won the bet.
He won.
I owe him a beer.
It's okay.
It was, like, an early appendicitis, so we--I asked him if, um, he thought it was an, uh, appendicitis.
I kinda just wanted to get him thinking along the lines of why he's operating on the--the patient.
That was the, uh, first one that I've done myself.
That was your first appy? Yeah.
He did a satisfactory job.
He did well.
I don't know.
I was kinda sweating a little bit.
You're just easily picked on.
His skills are actually probably beyond the level of-- of an intern, but, um you know what? I'll tell him he--he did well, but I probably won't tell him that part.
I don't want his head to get too big.
? Rob, come here.
You were gonna go without saying good-bye? I gotta work tomorrow.
Some people are just cute in this environment and then you take them out of this environment, and then they're not so cute, and you passed.
What does that mean? That outside of here, you're-- you're, like, cool, too.
So you're saying I am hospital cute? No, you're not-- and then I'm--then I'm also "outside the world" cute? Yes.
Okay.
All right.
Go home.
Go to bed.
Now you can sleep soundly, knowing that you ? I saved all these e-mails from when my wife and I first met.
This is the very first e-mail my wife ever sent to me, after the day we met, which was a Sunday.
This was monday--monday night.
Monday morning.
Not even Monday night.
Monday morning, she e-mailed me.
She was eager.
Cut the day a little bit short 'cause today is my wife's birthday.
Is anybody home? Look! Come on down.
I have a birthday hat on.
Whose birthday is it? Mommy's.
We have two beautiful babies-- twins, these guys are twins-- and an older daughter.
Ding.
Ding.
We met at a--at a barbecue.
My best childhood friend, she went to school with will.
Yep.
We decided about a week later that we'd get married.
I don't know.
Did you decide you were gonna marry me a week later? You know quality when you see it.
Mama! Thank you.
Okay, ready? And then swing it down and then go straight.
Okay, ready? You wouldn't even know that I had, uh, brain surgery almost a year ago.
Now I'm healthy and cancer-free.
It's not just beating cancer.
It's you know, Alison coming into my life, and she's, like, the perfect girl for me.
I love you.
Uh, um oh, jeez.
I, uh Good.
You know what? J-jean? Mm.
Huh-huh-huh.
Your turn.
My turn.
Headlock! Ugh! Next on Boston med A pregnant woman who was shot in the left chest.
We got a problem, guys.
Who's the attending? I am gonna be so [Bleep.]
Pissed.
Get your ass down here.
We need to find that bleed now.
We may have to take the baby.
It's party time.
He wanted to dance, but I was like, "no, I'm all set," 'cause you probably have a small penis anyway.
" This type of delay is unacceptable.
The risk of sudden death is quite high.
Too many shrinks in her blood pressure.
Whenever your kids are sick, you want to fix them.
Things went, uh-- somebody better say something.
These are the stories of the men and women who work in them.
I've never seen a guy piss off more nurses than you on rounds.
Oh, really? Are you asking me out in front of this camera? Code blue, e.
D.
Code team.
Can anyone feel a pulse? I got nothing.
Whoa! There's a pediatric trauma coming in.
We have pumps, monitor, suction, intubation.
I think we're all set.
The car jumped the--the curb Mm-hmm.
And pretty much crushed the kid.
Aww.
It's almost like your body goes on autopilot and your adrenaline just takes over and just do what you gotta do to try to save them.
I'm probably gonna be a little bit rude and yell at people to get out of the room, because there's already too many people in here as it is.
They're here.
Thank you.
We're all set.
All right.
Ready? Cables all clear? Ready? Everybody ready? One, two, three.
Ped struck by a car.
He has not woken up.
The last blood pressure was 67 systolic.
We've never been able to get a pulse Start chest compressions.
Somebody needs to get access in this boy right now.
I want to get Lidocaine.
Okay, who's working the bag? Epi.
Okay, Mike, I need a suture, please.
I need Betadine over here, please.
1 per 10,000 epi going in I.
V.
Epi is in, right fem line.
The heart is moving? I heard heart sounds, so we're getting--I heard heart sounds.
Can you please ask where the blood is? When I was doing the compressions, I was just telling myself, "don't look at his face, don't look at his face.
" I just didn't want to see that little child's face.
Emily, spike another bag of saline for me, please.
We need an O.
R.
Peter, what can I tell the O.
R.
that you're gonna do? Laparotomy, thoracotomy.
Yeah, laparotomy, thoracotomy.
All right, guys.
Let's go.
Let's go.
We got his heart beating again.
Go, go, go, go, go.
But he has massive internal bleeding, and we might not be able to stop it in time.
We have everything? ? Brigham and women's.
It's Richard reish.
R-e-I-s-h.
This month, I'm in the emergency department, working 50 hours a week.
They do, uh, 10-hour shifts, so it's, uh, it's really nice.
Today is Rick's first day in the emergency department, so we have to keep our close eye on him, make sure that he knows what he's doing.
We'll see.
She's been sitting here forever.
I need a Spanish interpreter for 37-a, please.
Let's go get her taken care of.
I don't want her to leave.
I was valedictorian of my college undergraduate class.
I came to Harvard medical school with a $300,000 scholarship, um, for--to do anything I wanted with.
And now coming in as an intern, you're the lowest of the lowest people on the totem pole.
You know nothing.
Um, room two.
She's still here? Oh.
She wants to discuss, um, her pain meds with you and-- her pain meds? Oh, great.
Yes.
Oh, I'm not gonna prescribe you any narcotics.
Narcotics? I never asked you for narcotics.
All right.
Calm down.
Uh-- well, that's--what, you just assumed something, and it's like-- you know, assuming can make-- j--ma Okay.
Hey, guys, first of all, listen to--listen to me-- no, no, no, no.
Just like you assumed that she u-- was a drunk.
On alcohol Who--who--when-- when did I assume this? You asked me, "when was her last drink?" I said--yeah Yeah.
Because she has a-a-- no, no, no.
Oh, wait.
This is a pointless conversation.
No, no, no.
I don't drink.
Okay.
I drink because of pain.
She's been under my care for the past five hours.
Like, I'm, like, really taking very good care of this patient.
I got her out of bed, I was doing a lot of extra things to help her, walking her around, making sure that she has a safe home environment.
Okay.
Uh, and then they just turn on you, like that.
You and narcotics-- I did not ask for narcotics.
You feel like you need something else for the pain than what you currently have? I have tried-- listen, I've been here for five years in this hospital Okay.
Okay? Okay.
That I had to die, okay? Came here on a Monday Okay.
And then came here on a Thursday Wednesday.
Sent me home Wednesday.
Wednesday--sent me home, and I hemorrhaged myself to death.
Okay.
Not on alcohol either.
Okay.
Well, I wasn't there for that, obviously.
Okay? My mother has attention deficit disorder.
Okay? Okay.
And I'm a teacher, and I know, and I'm also in the medical field.
I have, um, a thing in medical assistant.
And so don't put a smirk on your face, okay? You know, you keep your medication.
How's that? If you don't believe me-- okay.
Sounds good.
You keep it.
Send it home.
Okay.
Okay.
Maybe someday you might need it.
Okay.
Maybe I could've handled that a little differently.
But there's no way I'm gonna write a prescription for this patient.
Like, I don't care if they call patient relations, if they--if they want to file a complaint against me.
I'm not gonna do it.
We pushing blood? Um, one more.
We need a cross-clamp for the aorta, please.
Even if there's a one in a million chance you're still gonna do everything that you can to try to save a child.
Let's open him up.
It looks like he's got a big fracture here.
Okay.
Scissors, please.
You know what? You guys-- what do we got? Bleeding.
He's just bleeding to death.
By the time that we entered the room, pupils were fixed and nonreactive.
Okay, stop.
All right.
Hold on, folks.
Everybody see your time.
2:40.
2:40.
Zip him up for his family, please.
Yes.
There's nothing more devastating than losing a child.
? And when you see a kid laying there With his chest cut open where you can see his heart and it's not moving, I don't think a-- you would ever be able just to prepare yourself for that, ever.
? That's definitely the first time I've had to do chest compressions on a kid.
It was just nothing.
He had no blood whatsoever.
Wasn't even moving.
Poor baby.
? It is undeniably frustrating and saddening when people that you treat--when they die.
Brain surgery is a situation where, there are things you can't control.
Doing a lot of operations is physically and emotionally demanding.
And I knew this would be the case when I chose to go into neurosurgery, and I thought that I was well-suited for it.
You heard what they've been calling you lately, right? "Much cuter than Obama.
" Absolutely.
Really? Yeah, more than one person has said it.
Who--more than one person? He's absolutely much cuter than Obama.
I'm gonna reserve comment, 'cause he is the president, so I don't wanna-- I don't wanna go on record as comparing myself to the president, but I'll let everybody speak for themselves.
You look like Obama, by the way.
The only thing I will say is, I am 12 years younger than he is, so I hope, at least, I look younger than he does If not better.
You know, I-I hear that.
I usually hear it A young Obama.
I usually don't hear it in scrubs.
I hear it usually when I'm wearing a blue suit, but, uh No, you do look like him-- a younger him-- but you look like him.
I'll take that as a compliment, 'cause I'm a--I'm a fan.
Good, 'cause I think it's a compliment.
The reason why I went into medicine is because my father was a doctor.
He was the first african-american surgeon at New York hospital.
And it was obvious to me from my earliest memory that he loved his job.
All right.
Surgery time.
When I was an intern, I was assisting a surgeon on a hernia operation, and he had left the room.
They brought down the screen, and the patient, very pleasant, said, "oh, thank you" to the nurse, "thank you" to the scrub nurse.
Then he says, "oh, are you here to clean the room?" And I said, "no, I did your operation.
" Some people would be very upset by that and all riled up.
I only thought it was funny, 'cause I knew I did the operation.
About to see a new patient named Ronald haynes.
He's a young guy-- just 29 actually.
He had some scans, which showed a mass in his sinuses.
He has a big tumor, and it's positive for cancer.
This tumor sits in between and behind the eyes, right where the olfactory nerves, which are for smelling, come from the brain.
The tumor can track up those nerves and invade the brain.
It doesn't look like that's happened yet, but it's just on the verge.
Okay, you got your bobber ready? Yep.
Are you making one? Yep.
What's this part? Um, that's-- that's my bobber bobber.
You making homemade bobbers? Yep.
I'm taking the bobbers off.
You're funny.
I'm not.
Yes, you are.
I was eating very healthy.
I had quit smoking, worked out four days a week Ran 12 miles every week.
And then in march, I went to a wedding.
We were flying home, and I had a seizure.
I woke up four days later.
My son was sitting next to me on the plane.
Thinking about my son sitting there while In the ambulance where I'm not I'm not able to s-say anything to him That's scary.
This isn't scary.
Well, daddy's almost in the road, so daddy almost needs to hold hands.
Yeah.
Alison is my girlfriend.
We've been dating for almost two months, I guess.
She's stuck around through all the drama-- a guy with a kid and an ex-wife and cancer-- so that's plenty of baggage.
Can I just swing? One time.
She's awesome.
Ready? One, two, three.
This will be very similar to the view that we'll have during surgery.
If the patients ever saw a picture of themself during this operation or what this operation looks like before going into it, I think they'd be horrified, because it's-- we basically take somebody's head and face completely apart and push the tumor out through the nose.
Six cars? Yep.
I would freak out.
I would.
If I were a patient, and, like, that was the plan, I-I-I can't even imagine.
Will it work? ? There's only one reason why I voluntarily come to this building, and it's because of this kitchen.
They make the best milkshakes.
It's--it's incredible.
You could be clinically depressed, have one of those milkshakes, feel on top of the world.
It's unbelievable.
All right.
Sorry I'm-- I'm late today.
I was in the O.
R.
with a couple of cases.
How you doing? Ankles That's all painful? Okay.
Oh, yeah.
We've been trying to get his tubes out for two days, and I got a page this morning from thoracics that he was gonna have his tubes out, without question, early this morning.
It's 4:00, and his tubes have not come out.
It's totally unacceptable.
The chest tubes are coming out.
If thoracics doesn't want to come by to take 'em out, I will pull them myself.
I think we definitely need to make you more comfortable.
Thank you.
Ah, it pisses me off.
I mean, he has always been the best patient.
You know, he's always been in good spirits.
He has a bad, bad problem.
We've done a lot for him.
And, uh, to see him like that If there's one thing I'm not good at, it's at hiding things.
I am an open book.
Mr.
Russell, are we gonna get his chest tubes out? It's fine.
I mean--I mean, I'm not gonna argue with you.
I'm not gonna argue with you about your schedule.
Okay.
Thanks.
Yeah.
Bye.
[Bleep.]
Useless.
All right.
I can't tell you how many senior residents Have come up to me and have said, "you're arrogant.
You're cocky.
You really need to tone it down.
" Going down.
As hard as they've tried to change me, they haven't and they won't.
When I'm a chief resident and I have an intern like me I--it's really gonna piss me off.
Yeah.
All right, then.
So I was just talking to Mr.
wong here about what other tests we need.
So we should probably get that ultrasound of the gallbladder.
It's on the other side, actually.
The gallbladder's on the right.
No, I was looking for a pen.
Okay.
All right.
I was just checking.
Let me just borrow that.
Okay.
You have one, um-- I was talking about-- that--that face was because I ordered an ultrasound yesterday Okay.
Which you disapproved of, but that's Um, why don't we get a chest C.
T.
? Have you passed some gas? I don't think there's any gas to pass.
When you talk, you swallow air.
The air's gotta go somewhere.
So most of us pass gas about 42 times a day on average.
Yeah Andrew here is about double that.
That's nice.
Thanks, flavio.
But, uh, you'll always pass gas, even if you're not eating.
Hang in there.
Okay.
We'll get those tests, and then we'll let you know.
Okay.
All right.
Top of my list this morning is to see Ron haynes, a 29-year-old man with a cancerous tumor in his sinus cavities.
It's a very challenging case.
With these types of tumors, because they can go back through the nerves, uh, towards the brain, we've gotta take out all that skull tissue which it touches.
Mm-hmm.
We lift off what's called a bone flap Mm-hmm.
Bifrontally, so it goes pretty low, like, right over the eyebrows Okay.
Off like this.
Then we basically meet in between the eyes, going back about 3 or 4 centimeters, um, and get around the tumor and push it out through this incision.
Okay.
There's a risk of visual loss, uh, risk of neurological problems.
But I'm just-- any time I'm in that area, these risks exist.
Right.
And there's no way to preserve your sense of smell with this surgery.
Okay.
Um, and-- that's the one that I care the least about.
We wouldn't recommend the surgery if we didn't think we could get around it.
Right.
Well, I feel pretty comfortable with you guys, you know, being almost experts You know, basically experts in this field-- I like to think that we're experts, actually.
Yeah, well So I've got a lot of faith, and I just kinda know it's gonna be all right.
So I've never really doubted.
If you ruin one step, his frontal lobes of his brain could fall through this gap and into the nose.
It's a really fun environment in the emergency room, especially when it is slow and you get to hang out.
Hi, Dr.
binder.
Hi, Dr.
binder.
Megan.
Hello.
I caught that.
Why don't you know her name? Say it.
Oh! I'm having a bad I can't get the words out.
I know your name.
Oh, my God.
I'm heartbroken.
All right, nobody say my name for the rest of the night until bill figures it out.
I'm having a hard time.
You better grab and hold on tight, 'cause you're in for a long eight hours, bill.
You're in big trouble, bill.
Bill binder forgot my name.
He said, "hi, Megan a--" "and, uh" Perfect.
You have to be so careful around here.
Thank God bill's head is relatively round.
It's easy to cut out.
I think it's extremely fun that he forgot my name.
I mean, you are nurse of the year.
Shh.
I can name everybody's name here, but just had to forget Amanda's.
? William binder.
Amanda.
What? I'm s--I'm--you know what? Hi, doctor.
I was just in the middle of, like, 19 things.
I-I forget my own wife's name sometimes.
He's gonna spend the whole night apologizing to me.
I can already see it.
I have him right here.
? Today we're operating on Ron haynes to resect this malignant tumor from in between his eyes.
We take off the forehead, push the brain back and expose the tumor from above.
Okay, after he goes in for the procedure Mm-hmm.
Walk straight down the hall.
It's all the way down on the left-hand side.
Mm-hmm.
All right? Ron is my oldest son.
It's a scary thing he's gonna be going through.
But he's handling it very well.
Yeah.
And that helps us, that he has a positive attitude and he's attacking it.
It really helps us that he's confident.
Today is surgery.
It's not that big a deal, I guess, so I mean, it is, but it's like, you know, like I've said, I'm in the best place to have this done, so I'm not really worried about it.
Lock the stretcher.
The biggest danger Is not doing it right.
Really, if it's not done perfectly, the complications can be really devastating.
You gotta know how to do it right.
I know how to do it.
I'm trained to do it.
I don't want to sound arrogant, but, you know, it's brain surgery.
All hell can break loose in any case that I do.
? The E.
R.
is very different than any other rotation that we do in the hospital.
Ay! Ay! Ay! [Bleep.]
United States! Like you, mother [Bleep.]
! You like United States.
Son of a bitch.
I will Whoa! Mnh-mnh.
Ay! Ay! Ay! A little crazy in here.
Um, he's discharged.
Ay! So texting "bardouche" right now, one of my co-interns.
Ay! Oh.
Ay! Ay! All right, dude.
Oh, here's bardou.
Bardouche is in the house.
What's up, buddy? How you doing? Good, good.
Let me answer a f--a few calls.
Name--andrew elbardissi.
Everyone calls him "bardouche.
" So we're trying to get some of the nurses to start calling him bardouche.
He likes it.
He loves it.
So what's your plan for tonight? I was--really interesting, actually.
I'm gonna hang out with that mallory girl tonight.
Is she coming over to your place? That's what I'm gonna push for.
Okay, here's how you set it up.
Say, "look, I'm in the mood to sort of chill tonight, "relax a little bit.
Let's just do a movie.
" She'll say "yeah.
" And then say, "well, look, "I just looked at everything in the theater.
"Nothing really looks that good right now.
But have you seen the movie 'vicky Cristina Barcelona'?" Okay? Awesome movie.
Do you like--it's a Woody Allen movie.
It's, uh, it's sort of a bit, uh, it's--it's really good.
Trust me.
You've given me absolutely nothing about the movie.
Why don't you just tell me what it's about? It's this guy who tries to have a threesome with these girls, but--but, bardouche, it sounds sketchy, but it's really good.
Trust me.
Everyone loves this movie.
It actually sounds kinda good.
Trust me, she wouldn't have seen it.
It's not her type of movie.
And then you definitely get a bottle of wine, order some take-out sushi-- end of story.
You know what's also a pretty good strategy? I was gonna suggest to go and get some really fine, uh, goat cheese and then maybe some olive bread to start off with.
And, uh Have that with the wine and then go-- just stop.
Thank you.
? Mass general on line.
Mass general, we're coming to you with a 55-- 5-5-year-old, uh, male involved in a m-motorcycle accident.
Patient stable at this time.
Any questions? No questions, dispatch.
Mass general over.
There's a trauma coming in.
It's time to play rock, paper, scissors.
Okay, one, two, three.
That one for me.
Okay.
One, two, three.
I won.
You won.
Ready? One, two, three.
Sorry, friend.
So this is a, uh, 55-year-old gentleman.
He was riding his motorcycle today.
He was going a moderate speed.
Uh, somebody cut him off.
He t-boned the other vehicle.
Uh, at the scene, he reported some belly pain Reported some right hip pain and some back pain And vital signs have been stable throughout.
Tracy, 143 over 105.
All right, anything here, George? I know your back hurts.
Say yes or no.
No, no, no.
What if this was my dad? What would I want the nurse to say to him? Look at the pelvis, right I would want somebody to be there and hold his hand and tell him it's gonna be okay and tell him we're doing everything we can.
If you had to give me a number-- zero is no pain, and 10 is, like, the most pain you've ever had in your entire life-- what number would you say the pain you're having right now is? It's probably like a 6, but when I move, it's a 12.
Okay.
I just want to get this pain medicine into you.
I've been riding, you know, off and on, since college, and this is the first time I've had an accident.
So the left hemipelvis is opened up, and it looks like he's got a broken pelvis bone.
It's not as bad as it could be, but there definitely is bleeding around it.
Okay? So do this.
You can really rip some veins, and he has.
And if you wrap a sheet around him, bring it back down to size, then hopefully you slow down the bleeding.
Okay.
I'm sorry.
That's okay.
You gotta do what you gotta do.
Got it? Okay.
? Could you just cover his face with a towel? I always--I always do that just 'cause Sure.
Here.
I don't like looking at his eyes.
We want to be aggressive about getting out as much of the tumor and as much normal tissue around it as is safe to make sure that we've taken out every last cancer cell.
You just need one cancer cell to kill you.
We're gonna take off the forehead, basically.
We're probably at our riskiest, like, sinus area.
Yeah.
That's where his eyes go.
You see that? There's a fair amount of tumor pushing into the eye.
All right.
Here we go.
I have to drill out the base of the skull, around the eyes, around the optic nerves, and that's where the risk is.
You need the optic nerves for vision.
If you miscalculate, if you interpret the anatomy wrong, he could be blind.
It's been, what, four-- almost four hours.
I would hope he'd be about halfway done.
Oh, I'm sure.
I hope so.
I've got it right in the middle.
Perfect.
We have ways of preventing disaster.
The tumor should be pretty mobile.
Keep going.
I am.
I'm trying.
I'm pulling hard.
Uh wait.
Whew! Laterally.
Beautiful.
Here we go.
The tumor's out.
We're getting close to the end of this endeavor.
Time to put him back together.
? This is sheryl haynes.
He wanted me to just call and give you an update.
I'm down in the operating room.
Things are going well.
And I'll call you back with more updates as we have them.
Okay, bye.
Everything's going well.
He's doing good.
So Great.
Good.
We're all done.
So far, so good, you know? Big case.
The tumor's out.
All you can do is hold your breath until he wakes up.
So it's a, you know, it's like a leap of faith until then.
? Hi, Liz.
Hi, Leslie.
How are ya? Hi.
Hi, Dr.
brown.
Hello, Amanda.
You'd think work would be a great place to meet somebody.
But you know what? There's no mcdreamys or mcsteamys walking around here.
There's mcdumb, mcdud.
Oh, goodness.
There's, like, people here that are cute here in this environment, but you're like, I wonder if I took you out of the hospital and put you in real clothes and in a real social situation if you would still be cute.
So there's, like, a lot of "hospital cute" guys, but Hey, um Are you around over, like, Memorial Day weekend? I am.
I'm working that night.
We should do something then, because Rob, are you asking me out I was gonna get down on one knee, but, uh Okay.
Call me.
All right.
Bye.
I don't know.
It's, like, kind of hot in here.
I think I just got asked out on a date by Rob Miller.
And then I ran away I heard him.
Because I was so embarrassed.
Yay! This is the first guy that's ever asked me out.
I usually-- I'm usually the one that-- really? Mm-hmm.
Then this is the one.
I'm so excited for her.
Ron, squeeze my hand! ? Okay, give me a squeeze.
Give me a squeeze, Ron.
Squeeze.
Squeeze my hand.
Okay.
Ron, all done with surgery.
Surgery's all finished.
Young men wake up aggressively.
I don't know why.
I had surgery once, but I think I woke up peacefully.
The surgery's all done.
Everything went great.
Now you're talking.
Little mask on there.
Little breathing.
Looking good, looking good.
You're doing good.
Successful surgery-- achieved our goals, looks pretty good.
Gotta follow him closely tonight.
He's just waking up, so he's not completely coherent yet, but he's moving everything, following commands.
So far, so good.
Okay.
So the surgery went as-- basically, as planned.
Did they have any eye issues? 'Cause he said something about losing an eye? He still has both eyes.
I would expect him to be able to see.
Okay.
Okay? I haven't been able to actually formally test that yet.
Right, right, right.
Step-by-step.
One step--yeah.
Step-by-step, yeah.
I'm gonna get you a pillow.
I'll be right back, okay? Do I look a little better today, izzy? Yesterday, the environmental service people told me that I have to start doing my hair before I come to work.
It's nothing wrong with her, but, uh, she could've looked much, much excitement, you know? Could've been lookin' better.
Izzy, you're in trouble.
You think? We're all done for the night.
Rob and I and some of his friends are going tango dancing.
Oh, my God.
It's so tiny.
I'm scared.
I don't know.
It's kinda hot.
Yeah, it's really--it's really hot when they do it.
Oh.
Okay.
And you know Oh, really? I mean She--she--no, no, not the fingers locked.
Oh.
Like that.
Don't touch my fingers.
I don't want to-- so just keep the frame the same, and you just sort of, like, you know, walk together.
Gav-- Gavin, this is embarrassing.
You two dance together.
Okay.
So you--oh, okay.
Great.
Nothing sexier than two men who are comfortable enough to dance together To dance the tango First time, the tango.
Together.
All right.
Ready? Well, all right.
Just--just trust me.
All right.
I'm gonna close my eyes and I'm gonna trust you.
Okay.
And it's gonna be a mess.
See? I can't.
I guess I don't trust you, Rob.
That's okay.
Not a lot of people do.
I've made the mistake of dating somebody I work with before, and it was disastrous.
Oh, that was good.
Yes, it is.
Small steps.
I think you're pretty good.
You're pretty good, too.
Ooh, I'm getting, like, dizzy.
Rob's a great guy.
We'll see what happens.
We're on the way up to the I.
C.
U.
Where I'm just gonna take one last look at Ron just to watch him continue to progress towards where I really want him to be neurologically.
Hey, Ron.
Just checking in on you.
Hi.
Aah! The first noise that he made when we went in there was he just kind of bellowed, like Chewbacca.
It's probably a very appropriate noise for somebody who undergoes, like, a surgery like that, to wake up and kinda-- and kinda yell.
If he was mute, I'd be more worried.
The giving a shout? That's his prerogative.
Hey, Ron.
Surgery's all done, okay? Okay.
Everything went fine.
Great.
I just talked to your family.
They're gonna come up and see you in a little bit.
Okay.
Okay? Mm-hmm.
Can I ask you a couple of questions? Mm-hmm.
Say your name.
Ronald haynes.
Do you remember my name? Dr.
curry.
Where are you from? Michigan.
Okay, good.
How many fingers? Two.
How many fingers? One.
Good.
All right, good.
Everything went fine, okay? Okay.
Thanks, Dr.
curry.
Let me shake your hand.
He knows where he is, he knows he had surgery, he knows my name, recognizes me.
He can see.
He's gonna be fine.
I'm on my way home.
I'm gonna walk home.
I'm gonna enjoy the fresh air.
I'm gonna help my daughter eat dinner ? Get a good night's sleep, and then come back early in the morning and be ready for, uh, for surgery.
? You know, you live in the hospital, and so you see these people all the time.
And it's only natural that you start dating people in the hospital.
But things can get a little bit sticky if, uh, if it doesn't go well.
Hey.
Hey, what's going on? Um, the Spanish interpreter's here for ya.
Right there.
This is mallory.
She's taking care of my patient today.
You know, you always worry, because if it's a cute nurse and you're trying to ask her out, like, you can see all the other, like, old nurses kinda hone in on you and try to prevent you from eating their young.
So you have to be a little bit careful, you know? And now I'm gonna go see Katherine, who's a 26-year-old female who, um, over the past 24 hours, has had persistent abdominal pain, predominately in the right lower quadrant.
She came to the e.
D.
Here and was found to have an appendicitis.
My name's Andrew.
I'm one of the surgical residents.
I'll be helping out on the case.
I just want to get it over with, honestly.
I mean, I've been up for A long time now, and I kept waking up last night, so just get it over with.
Get it out if they need it out.
We're gonna try doing it laparoscopic first, which is, you know, make a couple of small incisions Mm-hmm.
Okay.
In some situations, that doesn't work out.
The appendix is perforated, it's difficult to safely remove the appendix with a laparoscope.
Great.
That'll be my luck.
Well, it's still a small incision, but you should be aware of it.
There are horror stories, right? You take a person's appendix out, and they can have major complications afterwards.
I remember, like, a couple months ago, I was having this, like, you know, abdominal pain myself, and I was thinking, even if this is an appendix, I don't want to go through surgery.
I'm not comfortable with this case at all.
I haven't done many at all, and the ones that I have done, I totally have not reached the comfort level.
? My dad actually died in, uh, 1997 from a-a medical error, which has definitely contributed to me going into medicine.
He had a pancreatic mass.
What they ended up doing was not biopsying the mass, but biopsying the aorta, which is a very bad idea, because then you just bleed, which is what happened to him.
He just bled out.
Um, and by the time they figured out what actually was happening, it was too late.
.
I really don't have a lot of experience removing the appendix.
Everyone's anatomy's different.
Things can get complicated fast.
I've never worked with Amy before.
I'm nervous about this operation.
So getting back to the--the patient that we're gonna operate on.
That we're operating on Yes, okay.
You think she has appendicitis? Yes.
Based on what? Epigastric pain that evolved into Migration, right? Right lower quadrant pain over a period of hours.
Yep.
She had a cat scan of her abdomen, and the presentation was atypical, right lower quadrant pain over a period of hours.
Yep.
So based on her physical exam, we're gonna go in and take a look with a laparoscope, and if we, uh See that her appendix is inflamed, we'll take it out.
So what do you think? Is it? You think it is? I-I think it is.
And if you're right, what-- oh, you think it isn't? You don't think it is? Acute? Do you wanna make a bet? Let's put a little friendly wager.
Let's put a few beers-- a few beers at the mission.
Andrew is great.
I mean, Andrew is obviously a very talented intern.
We would--he wouldn't be here if he wasn't.
Um, he does have an ego, which most young surgeons do.
Uh, so my job is to try to train him, but also to rein him in a little bit.
Shall we begin? Can we have a little local for the young doctor? Thank you.
It's a difficult task, dude.
Oh, Jesus.
? ? It's fun to hang out together, but it's also kind of pathetic, 'cause we're all so frustrated romantically.
I think dating in the hospital is very difficult.
So, Henry, what if a really hot nurse in the e.
D Right.
Asked you out on a date, you'd say no 'cause it could get murky? If Amanda grabowski asked you out, you'd say no? That's a flat-out lie, Henry epino.
Lie! Lie! Flat-out lie! Who has dated somebody you've worked with? There you go.
So everybody's done it, even though nobody wants-- I haven't done it.
Correct.
I didn't raise my hand.
If she were smart, fun, kind, hot anhonest, I would really consider it.
? What makes you think it's not appendicitis? I'll tell you afterwards.
But do you think it is? I do think it is.
Now go in straight.
Mm-hmm.
Don't stab the bowel.
All right.
Now it's time to go fishing.
So So where's the appendix gonna be? Yeah, there, it's coming.
It's gonna be at the end of that.
There it is.
All right.
Well, she's definitely got the disease.
I'm gonna grab this, if that's okay with everyone.
She has appendicitis.
That's fine.
Now why don't you use it-- grab the base there.
Now use your other hand And grasp it on the side.
And basically grasp it on the other side Use both hands.
And kind of feed--pull that appendix out of that pelvis.
Yep.
Oh, beautiful.
Okay.
Now here's what I want you doing-- okay, grab the appendix.
Okay.
What I want you to do is, I want you to feed that further into your stapler.
So use the stapler as a grasper.
Turn it towards you.
Use the stapler.
Yeah, exactly.
Okay? Let me see your blade.
Okay.
You like that? Yep.
Are you comfortable with it? I love it.
You don't have the ileum? No.
Hold on.
Let me just double-check.
I'll double-check for you.
It's not that I don't trust you.
Fire? Yep.
All right.
Okay.
Open up.
Surprisingly less painful than I thought it would be.
You did a fantastic job.
I was impressed.
He's the best intern on the service.
You know how to use that? Such a [Bleep.]
.
Best intern.
Best? All right, deploy the bag.
Dump the worm.
And I'll take a specimen cut now, please.
Dump the worm.
Worm down.
Okay.
Okay, take this bad boy out.
Yep.
Don't lose the worm.
I think I won the bet.
He won.
I owe him a beer.
It's okay.
It was, like, an early appendicitis, so we--I asked him if, um, he thought it was an, uh, appendicitis.
I kinda just wanted to get him thinking along the lines of why he's operating on the--the patient.
That was the, uh, first one that I've done myself.
That was your first appy? Yeah.
He did a satisfactory job.
He did well.
I don't know.
I was kinda sweating a little bit.
You're just easily picked on.
His skills are actually probably beyond the level of-- of an intern, but, um you know what? I'll tell him he--he did well, but I probably won't tell him that part.
I don't want his head to get too big.
? Rob, come here.
You were gonna go without saying good-bye? I gotta work tomorrow.
Some people are just cute in this environment and then you take them out of this environment, and then they're not so cute, and you passed.
What does that mean? That outside of here, you're-- you're, like, cool, too.
So you're saying I am hospital cute? No, you're not-- and then I'm--then I'm also "outside the world" cute? Yes.
Okay.
All right.
Go home.
Go to bed.
Now you can sleep soundly, knowing that you ? I saved all these e-mails from when my wife and I first met.
This is the very first e-mail my wife ever sent to me, after the day we met, which was a Sunday.
This was monday--monday night.
Monday morning.
Not even Monday night.
Monday morning, she e-mailed me.
She was eager.
Cut the day a little bit short 'cause today is my wife's birthday.
Is anybody home? Look! Come on down.
I have a birthday hat on.
Whose birthday is it? Mommy's.
We have two beautiful babies-- twins, these guys are twins-- and an older daughter.
Ding.
Ding.
We met at a--at a barbecue.
My best childhood friend, she went to school with will.
Yep.
We decided about a week later that we'd get married.
I don't know.
Did you decide you were gonna marry me a week later? You know quality when you see it.
Mama! Thank you.
Okay, ready? And then swing it down and then go straight.
Okay, ready? You wouldn't even know that I had, uh, brain surgery almost a year ago.
Now I'm healthy and cancer-free.
It's not just beating cancer.
It's you know, Alison coming into my life, and she's, like, the perfect girl for me.
I love you.
Uh, um oh, jeez.
I, uh Good.
You know what? J-jean? Mm.
Huh-huh-huh.
Your turn.
My turn.
Headlock! Ugh! Next on Boston med A pregnant woman who was shot in the left chest.
We got a problem, guys.
Who's the attending? I am gonna be so [Bleep.]
Pissed.
Get your ass down here.
We need to find that bleed now.
We may have to take the baby.
It's party time.
He wanted to dance, but I was like, "no, I'm all set," 'cause you probably have a small penis anyway.
" This type of delay is unacceptable.
The risk of sudden death is quite high.
Too many shrinks in her blood pressure.
Whenever your kids are sick, you want to fix them.
Things went, uh-- somebody better say something.