Boston Med (2010) s01e05 Episode Script
Episode 5
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? Rob, 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! B.
M.
G.
, p.
D.
Medical control.
On board we have an 8-year-old female.
Uh, that's an 8-year-old female with cardiac arrest.
Uh, she was in the school gymnasium, uh, apparently without any specific complaints, just walking around the gym when she had a sudden collapse.
Uh, an 8 year old with some kind of cardiac arrest who had return of circulation after one shock, per the e.
M.
S.
Report.
Uh, 8 years old.
Her name is Olivia.
She was at her school in the gymnasium, apparently not doing much of anything except for walking around, had no specific complaints, and then just had a sudden collapse.
Time between when she went down and when they arrived? Um, pr-probably like seven minutes or so.
Seven minutes.
Yeah.
I'm not getting great breath sounds on the left.
Why don't we give her a little versed now? Okay.
No allergies to any medications that you know of? Not that I--no.
Okay.
I've just called her pediatrician.
Uh, the only thing she's allergic to is cats.
Why is it not You can come up if you want.
Can I? You can come right up to the head of the bed.
Yep.
If you feel okay with it, you come on--right on up.
She had a heart attack.
I want to start-- do a bag on her.
You okay? Go ahead.
Just push me out of the way.
Okay? So you hear, uh Decreased-- bilateral, just decreased on-- decreased on left.
I'm running-- wondering whether it's down the right main stem.
She breathing on her own? Occasionally, bucking.
I'm much better on the right than the left.
I'm wondering Medicine shows you life is short.
Anything can happen.
Yeah.
Go, Dee.
They cal-- they called.
Are they calling it yet? Nothing is guaranteed.
This baby's heart rate-- it's gone down and has not come back up.
It's probably been over five minutes now.
So we're getting the operating room ready.
Go.
We're going.
So we're going.
This is a stat.
It's an emergency.
People have an expectation in this country to a right to deliver when they want to deliver and to have a perfect baby at the end.
Can we quiet it down a little bit, please? Shh.
Quiet down.
Quiet.
Careful.
You're doing okay.
It's okay.
Mm-hmm.
I know.
You're being fabulous.
I know it's scary.
We want that, too, but it's not reality.
It's called labor for a reason.
So you're just gonna feel my hand, okay? Just like a regular cervical exam.
Okay.
Okay.
Now he's really kicking.
So the baby's heart rate came back up, so it's no longer an emergency.
The baby looks great now.
I know.
Couldn't look better.
What a troublemaker you have.
I guess I'll go back out, make sure everybody else is okay.
Yeah, make sure I remember saying this to my parents and to my friends.
It was like, "I'm 100% sure I'm not going to go into ob-gyn.
" That's it.
That's it.
A lot of pressure now.
A lot of pressure.
Perfect job.
That's it.
That's it.
That's it.
There you go.
More, more, more.
I got the perineum for you.
Okay, now a big breath.
Push, okay? Good job.
Beautiful! What do we got? Suction.
A couple of years ago, two really wonderful obstetricians lost a lawsuit for $26 million.
And they quit.
They quit medicine.
They were done.
Hey.
How you doing? How you doing? Hi.
How can you recover from that? He's a little doll.
He's a little, like, gloworm.
I mean We just want to pay off our med school loans.
so, um, this morning I got an urgent phone call about a patient of mine by the name of Marvin pollet.
He's a very nice man from Louisiana who fainted this morning, and, uh, his heart stopped.
The team was able to do chest compressions and bring him back to life.
He was referred here for an evaluation for a heart transplant, and this makes things much more urgent.
So we gotta go evaluate him and see what we can do about getting him a heart transplant quick.
By the way, I want to get the name Of those? These--these thing-- you can't-- I've never bought 'em in a store to be this good.
I'm-a Rob you-- Rob you of these.
I-I was a licensed private investigator.
Uh, I practiced it all the way up till November the 19th, when, uh, all this happened to me.
His cardiologist told me they did not expect him to make it through the night.
He had, uh, went to work that day.
He began a new medicine and passed out.
His blood pressure plummeted, kidneys and liver started shutting down.
That was our--the night of our 25th anniversary.
And the whole time, I could feel her put her hands on my face, you know, and, you know, stroking me on the side of my face like this and telling me, "it's gonna be okay.
Calm down.
" And, uh I leaned to his ear and told him, "please don't give up.
"I-I want to have you for a few more years.
Please, you know, fight to stay alive.
" I don't want anybody to-- to stamp me with a time and a date, saying that's all-- as long as you can live.
That's almost like a threat to me, you know? He likes a good challenge.
Knock, knock.
Hi.
All right.
So we've had a very busy morning.
Okay.
You've had a lot of people in and out.
Yes.
Okay? Things are progressing rapidly.
Right.
And I want to get you listed for a heart transplant Okay.
Sooner rather than later.
Sounds good.
Any questions? Um, not really, no.
Just The priority right now is to get Marvin listed for a heart.
Right now I predict, he only has weeks to live.
Where do you think you're going off to? I have only been delivering another patient.
Sorry I couldn't come I'm just saying.
Talk to your patient about her drug use.
One of the fellows here said, "if you don't think about committing suicide every day in residency, you're not showing up.
" And don't forget the baby orders.
I know.
I won't forget the baby orders.
Oh, I was just gonna page you, Kelly.
Yes.
Your patient in room four would like to go home.
Of course she would, and I know she's told you guys that four times, so I really-- she asked me to page you, 'cause her ride Ugh.
So this is a patient, she has twins.
She's very uncomfortable, understandably.
Babies are doing great, and they are far from term, and they need some more time.
So every time she comes in, it's kind of Trying to convince her that she can do it.
What's going on? I just want to go home.
So you just want to go home and sleep.
I want to go home and go to bed.
Okay, but we need to make sure your babies are okay.
We need to give 'em a little while longer.
Really? Yeah.
I mean, now they look fabulous.
And you're feeling better, and I am reassured that you are feeling better.
Thank you.
You're gonna be a mama.
Yes.
So much you have to go through for it.
It's the octuplet mom giving birth.
I like how he's just hitting 'em away.
They just keep flying out.
He's, like, hitting 'em away.
You can disconnect for now.
Let's just disconnect this, then when we get her back over there, I'll put her back on.
So her vital signs are stable, um, her heart's beating again, and now we need to get a picture to see what's going on.
One, two, three.
She's in v-tach.
She's in v-tach.
We were just starting the scan when her heart goes crazy, beating way too fast.
Everybody off? Look out.
All right, clear.
By shocking her, we got her heartbeat back into rhythm.
Yeah, we're skipping the C.
T.
We had to give up on the scan and take her to the pediatric I.
C.
U.
, where the pediatric specialists could start to work on her right away.
She's just having a lot of ectopy.
Mindy, can you just make sure she's got a good pulse? Make sure she's perfusing these Yeah.
Yeah? Just cross our fingers and hope that the time that she spent down out in the field, you know, hasn't had some sort of, you know, lasting effect on her, uh, on her neurologic status.
Oh! Who is that? Is that from last night? Oh! Is that mine? Oh! This is what I'm gonna do.
Yeah.
Oh! Oh! Ohh! Being pregnant is the most dangerous thing an American woman will do in her lifetime.
Can I have an available o.
B.
To O.
R.
one? Available o.
B.
To O.
R.
one.
It is very natural.
It's very natural.
But it's also very natural for things to go wrong.
Can't get a baby out.
They did or can't? They can't get a baby out.
Ah.
I'm sorry, babe.
Most of where your cervix is is right on the front.
Okay.
So it would be good if we could get some pressure on it.
Get you to roll over so that you're on all fours.
I'm sorry.
This is kind of a weird angle to do an exam in.
So it might feel a little different.
Let's see if this hurts.
Are you still having a contraction? Yeah.
Yeah, she's having one now.
Oh, lord.
Hey, Ms.
Marcus, you're doing really good.
Okay? I know it doesn't feel like it You're almost there, honey.
But you are doing good, and you're getting close.
You're getting close.
Okay, this is take two, but it's much easier from this end for me, okay? Mm.
That one part of your cervix, it's really swollen.
That makes me worry a little bit, like the baby's not fitting right through there.
I think we should place an epidural.
You don't have to use it, okay? I think very much, you'll still have a vaginal delivery Yeah.
But just in case, I don't want you to be put to sleep when your baby's born.
No.
You know what I mean? Yeah.
So let's have them place that, okay? Okay.
And that way, we have it as a safety.
Okay.
Are you okay with that? Yep.
But, you know, if we don't use it, then it's still like we never put it there.
Okay? Yeah.
Okay.
So I think my chapstick is down in the call room, which is really sad.
It's not really a lip gloss kind of day, you know what I mean? It's really a chapstick kind of day.
Marvin's here, hoping that we can help him with a heart transplant.
How are you feeling today compared to yesterday? Almost 1000% better.
He's pretty sick.
If he doesn't get a heart transplant soon, Marvin will likely die.
So today we're gonna meet, we're gonna discuss his case, and hopefully, we can list him.
This is my heart For you, to get you through this weekend.
Great.
All right.
You hold on to that.
Keep that close by.
Marvin has a condition called amyloidosis.
And not only is his heart affected, but many of his other organs are affected.
And it's gonna be difficult to convince my colleagues just to list him, period.
For those of you who haven't heard about Mr.
Marvin pollet, he's a, uh, 55 year old who was referred to us from an outside facility for evaluation for cardiac transplant.
He has a history of, um, primary amyloidosis.
He's been seen at this point by our hematologist, endocrinologist.
Um, my hope today is that we can come to a conclusion and either get him listed today So, Tommy, what do you think? Out the outset, I'll say, he looks better in person than he does on paper.
He's a pretty robust guy.
I would say that there's no smoking gun right now.
The liver is probably the highest on the list in terms of concern.
I don't expect that this is gonna contraindicate a transplantation.
Go ahead and list him as a 1-a.
This is great news.
Great news.
We all just met.
We've gone over your biopsy results.
Mm-hmm.
We're listing you for a heart transplant today.
oh.
It's a big day for you.
so I'm on my way to see Olivia quigley.
She is a little girl who came into the e.
D.
The other day in cardiac arrest.
Uh, when the e.
M.
S.
Guys brought her in, they said she was 8, but she's actually 6.
And from what I understand, she's doing pretty well.
Give me a hug, huh? I'm very, very happy.
It was a good day for me.
You--you know, it's Hey, liv.
Hey, buddy.
You want to get close? Yeah, I'd like to say hello, too.
She made huge, um, progress yesterday.
She came off the intubator and She's, you know, she's doing awesome.
This is the first time I've kind of been able to breathe Yeah.
A little easier, you know? I have, um, I have a 5-year-old son and a 3-year-old daughter, and I-I can't imagine and I can imagine all at the same time Mm-hmm.
How it, you know, how it must feel.
In a time of complete chaos Yeah.
I kind of felt that-- I looked at your face, and I looked at Dr.
sherman's face, and I kind of felt, like, huge confidence, you--you know? Oh, that's good.
I'm glad.
I mean-- and--and I just felt that It--it was just so reassuring, y-you know? I'm really glad that you feel better, and that it's going in the right direction.
I know.
Me, too.
So it sounds like what they're gonna do is put a defibrillator into Olivia, uh, so that if her heart stops again, the defibrillator will help to restart it.
You know, it's amazing that she's come out of this the way she has.
my job is to make sure that Marvin stays alive so that the surgeons can do their job.
Knock, knock.
Come in here, lady.
Hello.
Good evening.
How you doing? How's my favorite patient? I don't know.
Uh, who is he? I'm looking at him right now.
All right.
So your kidney function is staying nice and stable.
Okay.
All right? The liver function is getting a teeny bit better, which is good.
It's moving in the right direction.
Okay.
That's good.
Jeanette, if you have things you need to take care of at home, go as soon as you can.
You're only a couple of hours away, all right? And if he gets an offer, we have about 12 hours.
You'll know in advance.
So as soon as we find out, we'll call you.
You can make arrangements to get here on the next flight.
Fine.
Oh, I don't think we ought to call her.
I think we oughta wait till the next day.
Kidding.
Yeah.
Good idea.
I'm one of the strong ones in the family.
I gotta keep it together, pull it together, and I will.
I just have a weak moment every now and then.
And not knowing how long Marvin will wait on the transplant list, I'm gonna go home and try to help keep my job.
All right.
We've gotta go find those surgeons and see what's going on in terms of activity with donors.
Now it's time to start putting pressure on the surgeons.
Mr.
pollet upstairs.
Yeah.
He needs a heart.
Okay.
Bad.
Good.
Take a gun and shoot somebody, and we'll get a heart.
I mean-- how did I know you were gonna say something like that? Well, I mean, you know-- well, can't you do your donor net magic or something? Go and-- well, it's, you know, I mean, when they--when they call us, we'll go out and get one.
What--what's his blood type? Yeah.
So he's an "a" and he's no crossmatch.
Yeah.
Okay.
Yeah.
Marvin was supposed to come here three weeks ago, and I got a call that the insurance company didn't want to pay for his visit.
He and his wife had plane tickets to come here on a Sunday night, and on Saturday, they canceled their trip.
If Marvin would've been here, we could've listed him then and we wouldn't be where we are now.
So if this guy dies because his insurance company wouldn't approve a visit That's awful.
To see previous episodes of "boston med," go to Cardiac arrest, ple went into v-tach at one point.
Shocked into rhythm.
At this time, in the 90s.
We're about ten minutes out.
Uh, a 34-year-old male, cardiac arrest.
We didn't get a lot of details, but it sounds like they found this guy pulseless, shocked him once.
Stable vital signs, but he's intubated on a Lidocaine drip.
No, this was a crystal meth overdose.
One, two, three.
Go.
He was also seizing on scene prior to cardiac arrest.
Okay, could we start c.
P.
R.
? 15 compressions is fine.
Sure.
Can we check for a pulse now? You know, it's hard for people to understand, but in some weird way, it's just, it's cool.
You're keeping them alive by pumping their blood through their body.
Hold--hold c.
P.
R.
Oh, yeah, check on the pulse.
We have pulses? Yes, he has a strong pulse.
Okay.
Someone's hand is on the pulse? Airway.
We have an airway.
He has bilateral breath sounds.
We have a pulse.
We have a blood pressure.
I feel like nursing is a profession, something I can be proud of.
Is that line secured? Yeah, she's doing it now.
He's got a rhythm.
His heart's pumping.
And now it's kind of one step at a time, and the first step is just making sure the guy stays alive, more or less.
Marvin looks really, really bad today.
He is, um, very lethargic.
He has been on a downward spiral, and he continues on a downward spiral.
And then this is all a result of the inability of the heart to effectively pump blood to the brain.
Hi, Jeanette.
Um, you know, Marvin actually has--is, uh, not looking, uh, near as well as he did yesterday, and--and, you know, yesterday when I called you, he wasn't looking near as well as he did the day before.
And honestly, Jeanette, I mean, I-I-- if he were my husband, I-I probably would be here.
That's bad news.
I'll get there as soon as I can.
If we can't get him a heart soon, that makes me a little more worried, because he has a disease that, you know, he could have the best care around him, he could have all of us around him, and if his heart just stops, and we can't get it back No more Marvin.
A couple of weeks ago, I come out of my house, and it's--it's still dark out, and all of a sudden I hear this Like--like, bleh.
It sounded like someone was getting, like, strangled.
And I see this--this-- this thing with this huge wingspan going "wop, wop.
" Scared the living crap out of me.
And it's this thing.
It's a Turkey vulture.
I never in a million years thought I would end up being a nurse.
I was a punk, really into having fun.
Been a psychic for 37 years.
I'm known as the amazing Mr.
b.
Of e.
S.
P.
I'm here with my mother.
She's been going to a lot of hospitals.
She's ill today.
Are you gertrude? Mm-hmm.
Gertrude beam? Hi, I'm Michael.
I'm one of the nurses.
Nice to meet you.
Hi, sir.
Can you see her now? I'm gonna take, uh, yeah, I'm gonna take you guys back to a room, okay, so you can see the doctor.
I always worked and I always worked hard, but I wasn't doing anything positive.
What's that? Yep, the doctor will be in very shortly.
I mean, you name it, I've done it-- installing floors, painting houses.
I used to drive for a limo service.
Uh, Dr.
Goldstein is the--is the doc.
What's his name? It's doc--his name is Dr.
Goldstein.
He's gonna be in to see you in a couple of minutes.
I predicted his name would be Goldman before I came here.
You predicted that? Yeah.
Really? You just--it just popped into your head that the doctor's name would be Goldman? I've been psychic my whole life.
You h--really? I did, like, ten shows with Jerry springer Oh, yeah? Johnny Carson.
Interesting.
I don't know.
Psychics freak me out a little bit, but they were cute.
They're a cute little-- I'd say couple, but I guess they're son and--and mom.
Well, there's only a couple of quick things I touched upon him.
He didn't start out to be what he is today, but it happened to turn that way because of kind of a Twist of fate.
So, yeah, he was-- he's on the money.
Mister-- Mr.
b.
With e.
S.
P.
Is He's the real deal, man.
hey.
You know what? You are by far the healthiest patient I have seen tonight.
Oh.
So you think you broke your water, huh? I think so.
You want to check, see what we think? Yeah, we might as well get that awesome part over with.
All right.
It's a little hard to tell if you're ruptured.
But you look pretty ruptured to me.
Okay.
Holy mackerel.
You have such a nice, gentle voice, so then I felt bad that I was like, "oh!" No.
Don't feel bad.
But I didn't hit you or anything, so-- it's the Southern accent.
They fool you.
I think that growing up in the South, a lot of people feel like other people think, you know, we're stupid or, you know, we all date our cousins or this, that and the other.
The first Saturday in may, everyone comes to Kentucky-- louisville, Kentucky-- um, to Churchill downs for the Kentucky derby.
See, this is a very big deal.
Every year, you have to get your hat made.
That's a mint julep right there.
That's very important.
There's my hat.
There she is.
Hi, honey.
Hi.
How's it going? Good.
How you doing? Busy.
I know.
Rachel and I are two Southern bookends in this residency program of New englanders.
Kelly's had a tough couple of years, and you had a crazy intern year.
She was involved in, like, a really bad case on the o.
B.
Floor.
A mom who died four hours after giving birth on the labor floor.
Everything was going well until it didn't go well.
Most obstetricians will not see a maternal death in their lifetime.
I think for everybody in our class, it put a lot of people off of o.
B.
, just to even see somebody you care about be involved in something like that.
My mom told me I should quit.
Oh, whatever.
Screw your mom.
I mean, I've been thinking about quitting for the last year, and it's just getting worse Oh.
As my personal life goes downhill.
I'm gay, and I got here, and I met somebody who was really special.
I gave her a chance, and Mnh-mnh-mnh.
I've never loved like that before.
This person left me for somebody else.
She just tried to put the blame on me, because I wasn't there.
It's hard to be in a relationship with a doctor.
Marvin's condition has started to deteriorate rapidly.
So I called his wife Jeanette, and she and the kids have come up from Louisiana.
So what-- what's your understanding of where we are right now and how sick-- sick your husband is right now? Oh, I knew he was critical coming in.
Uh, everyone needing a transplant is dying.
Uh, you know, no False pretenses there.
Having a meeting called-- I can't imagine we're here to hear good news.
What's happened is, metabolically, he's gotten sicker over the--the last couple days.
And what I'm coming in here to tell you guys is that I think we've reached a point where we don't have anything else to offer him and that it may be time to take him off of the list altogether.
Okay? The ultimate thing here, is that he's going to die.
Okay? And what I'd like to do is try to make that time as comfortable and as meaningful to you guys as possible.
So if it were your wife laying in that bed, you think you would stop treatment? Yes.
If it were any of my family members, that would be my recommendation.
Right, I think we-- we had a window, and unfortunately, we just didn't have a heart come available for him in that time.
I'm sorry.
The door opens, and we're all thinking, who's coming in here right now? And it was his nurse telling us that Marvin was having a cardiac arrest.
Clear! Clear! Yeah, start bagging him.
Yep.
Yes, get his wife.
Who's on the pulse? Somebody on the pulse? I need you to back away for a second while they do this now.
Okay.
Let's put the board under.
I'm doing the board.
We also need 1-- Patrick, we need 1 milligram of epinephrine, please.
Okay.
Resume compressions.
Oh, shoot.
Up one floor.
so today we're gonna do a surgery to remove an ovarian cyst.
I am kind of a different person when I'm in the operating room.
I still try to be funny and, like, have fun, and I like to have music playing, but, like, I'm definitely much more serious.
Now in the middle, that's the uterus.
That's the cyst that I'm pointing out.
Wow.
There's the rest of it.
I see.
Look at that.
Wow.
The O.
R.
's the most honest place in this hospital.
You did wonderfully.
That's perfect.
Then it's one little buzz, and you're set.
It's you and it's this, and either you can fix it or you can't, and it's become patently obvious to everyone in the room whether or not you're up for the challenge.
Whoa, whoa.
Hold on.
Don't move.
Don't move.
Okay, no moving, no moving.
Good.
You got it.
Yay.
Yeah.
Hot damn.
Nice.
Good job.
All right.
So I got a little needle scrape.
But since it's actually, like, bleeding, I'll probably have her, if you're okay with it, just get her consent, actually, on testing.
I hate needle sticks.
Everything's fine.
And then all of a sudden, there's an accident and you get cut on a patient who's high risk.
I mean, it sucks, 'cause she's, like, not exactly a low-risk, uh, needle stick.
With her, you worry about hepatitis c, 'cause she's had, uh, she has a history of heroin abuse.
And hepatitis c is the most communicable.
Hi, I was supposed to be connected to employee health or whoever I would speak to for a needle stick.
From a technical viewpoint, uh, the surgery went very well.
I'm just a little concerned about the needle stick.
I hate this .
It's been a while since I've been stuck.
Certainly that's something that You know, it's just a moment, and everything changes.
I got a pretty bad needle stick from a pretty, uh High risk? High-risk patient.
Yeah.
We send the employee down to the emergency room.
Yeah, employee--mm-hmm.
Okay? So that's where you need to go.
So I heard a needle stick? Gotcha.
Yes.
She's a high risk, so I-I probably-- yeah, she's real high risk.
And it's, you know, you certainly can discontinue the medications once-- okay.
Once it comes back negative.
If you think I should, then, yeah.
If it was, like, a much more low-risk patient, I'd maybe not be so Yeah, yeah.
Antsy about it, but I've never--yeah.
She sounds like high risk.
Okay.
That's the best advice I can give.
You talked me into it.
Oh, God.
Whatever.
It was a good case, though.
I mean, it was a good case.
I'm here, Marvin.
I'm here with you, baby.
Resume compressions.
I'm thinking, Marvin's not gonna make it.
I felt paralyzed, like there's nothing I can do.
Kathy, guys, stop, stop, stop.
Do you want a milligram of epi? Just call it, okay? I-I want you to be surrounded with the people, you know, who love you most, okay? Sorry.
Your--your heart's weak.
Your heart's just so weak.
But you showed strength.
I'll love you forever.
We'll all get through it.
Everybody's gonna be okay? Yeah, everybody will be okay.
You--you've given us a lot of strength.
Daddy Thank you for everything.
This has been a terrible Twist of fate-- a terrible Twist of fate for Marvin.
Um, this is part of our job.
And while sometimes, uh, we bring people new life, it doesn't always work out that way.
so right now we're gonna go to my house.
And then we're gonna change clothes and go out and have a drink since it's my boyfriend's birthday.
We've been together now for three and a half years.
He's from California originally.
So he's, like, totally an adopted southerner, kind of.
I mean, ideally, someday, we would both like to, like, get back there.
Hi! Happy Birthday.
Hi, honey.
Hello.
Mwah.
Mm.
Happy Birthday, baby.
Thanks, sweetie.
Oh, God.
How was your guys' day? Mine was okay.
We're at that point in our lives, I think-- she's working hard at her career, I'm working hard on my career.
We're both just-- what we try and say is, live in parallel lives that happen to intersect every once in a while.
I always say I'm gonna be ready in like two seconds, and it's, like, two hours later.
Yeah.
I'm tough to date right now.
I would not want to date me for anything.
So this is the disgusting, hot mess that is my room.
It's, like, you can operate with a dad in the room when you're doing a c-section, but you can't pick out your clothes when somebody's watching.
That's really sad.
Everyone complains about their job.
I have never, ever seen anything-- what these residents are putting in.
I mean, just in terms of-- the hours alone, fine.
Maybe other jobs can match that.
But I mean, on your feet, eating whatever you can find, under fluorescent lights, and then she still manages to look beautiful.
I don't know how she does it.
Honey, I'm almost ready.
I promise.
I hate parking in Cambridge.
I know.
she's so far beyond what I could ever even anticipated in a relationship.
Well, Happy Birthday.
Big 2-7.
Thank you.
So there's not a question in my mind that Rachel's the girl I want to marry.
This is about as good as it gets, right? It is about as good as it gets, actually.
If you ever opened up a cd or anything else-- I just cut the edge off and I slid the knife, but there was no plastic to catch it.
You know, you try to fight with it and peel it off, and it gets stuck.
Yeah.
So what I do is just take a little knife and cut the edge.
Yeah, I've got you.
Okay.
All right.
All right.
Are you a righty or a lefty? I'm a righty.
So you could still play? You can get home and play a little playstation.
No? 14, 15 years as an e.
M.
T.
, this is my first impaled object.
This is pretty deep.
I mean, I'd say about an inch.
Can't wait, man.
Going away with the guys on our annual trip-- blow off a little steam, a little vacay.
a lot of the nurses, uh, really, the male nurses, started going to tampa.
Uh, and it was a way to get away and have some fun.
We--we just laugh from the time we get on the plane till the time we come home, and it's a good-- it's just a good release.
You know, like-- there's nothing worse than just-- than having one of them say, "you're just a nurse.
" That resident will die.
That resident will be miserable.
That resident will be put in their place.
Yesterday they weren't a doctor.
Right.
Today they're a doctor.
They're a doctor.
Right.
The--the doctor for a day needs to appreciate the--the nurses of 30, 40 years and what we bring to the table.
The residents visit.
They stay for four years.
We, like me, live-- live there.
I live there.
This is it.
My house! You know, it's my house.
My house! They come and visit You're right.
And, you know They're guests as far as I'm concerned.
It's a good gig.
Seriously.
It is a great gig.
It's a really good gig.
It's a good gig.
You know, that's all that matters.
when we lose a patient who we've become close to or there's a traumatic situation involving the staff, oftentimes, we'll have a debriefing meeting so that we can all get closure.
You've had a chance in the last week and a half to begin to process what happened.
We're kind of used to being able to fix things, you know? And that's what attracted me to this.
And Marvin's the first person that I've really followed through that, um That didn't make it.
I am hearing that there is a-a connection, that you get caught up in the hope with them Mm-hmm.
And that it hurts so much to have to-- to have to h-have them lose that hope.
You know, to have that joy of being able to get him listed Yeah.
And I'm used to telling-- bearing bad news and giving bad news to families all the time.
And, um I don't know.
For some reason, this This one hit me much harder than, um Perhaps other cases that I've dealt with, you know? I'm, like, such a romanticizer.
I'm, like, this would be great to share with somebody else.
So now I want to get married.
This idea of, like, this finality and, like, some chapter closes and yet another one "supposedly opens," but does it? I don't know.
Maybe what opens is, like, a mortgage.
Like, I was never that girl who dreamed about, like, my white dress and whatever.
I never thought about it.
No, I want the security.
I want signed contract-- you want it signed.
Okay.
Yeah, but the thing is-- I want to say it's forever, 'cause I believe that that's a com--a commitment.
I don't think you need marriage to have security, though.
Yeah.
No.
Right.
Because you could have marriage and not have security.
I think I got to the point where I was like, I have, like, the perfect person that I should marry.
And I was sort of afraid that if we didn't get married See? That's what's wrong with marriage right there.
I would make Marriage isn't for-- like, the contract isn't-- it's for forcing people's hands.
It is.
It's not for the good times.
It's for the bad times.
I agree.
I think that if I were to get married, I would marry Jeff.
Let's go.
I was telling Rachel But I may not be the marrying kind.
Right now, I live my life for work.
I want to be an amazing cancer surgeon.
Like, and I don't care about much other stuff.
Jeff should definitely dump me.
But he doesn't.
He's an idiot.
He should totally dump me.
so, uh, I heard Olivia's here, and I'm gonna go out and see her.
Uh, it's been about two months since her cardiac arrest.
She's got an implantable defibrillator in her chest now.
And hopefully, that will protect her against any future events where her heart might stop.
I was just sitting here at the greeter desk doing my thing, and this beautiful little creature came through the door who I know but I haven't seen.
You know, not a lot of fun the last time I saw you, right? You don't probably remember, but it wasn't fun for me.
No.
Michael took care of you right here and right until you got onto the sixth floor.
Yeah.
So that's why we wanted to come by and say "hi, Michael.
" We're a long way away from where we were.
That's for sure.
You know what, though? That's okay.
What about one more hug? Can I have one more little hug before I go? Big hug.
Uh, duh.
Oh, thank you, kiddo.
You're welcome.
That's actually I'll always remember you.
You know what? It-- like I said You know, when I was, like, crazy, I was, you know As corny and as goofy as it sounds, it makes doing every single thing I've done up until that day worth it.
It really does.
Yeah.
living across the street from the hospital is convenient, but from a mental health perspective, probably not the best idea.
Ready to go.
Okay.
All right.
We're all finished packing up.
This is my last night here next to mass general hospital.
I think this is it.
This is a very significant move for me, because this is-- this sort of symbolizes me separating myself from my work, which is something I haven't done in the last 11 months, 12 months.
So I think it'll be good for me to sort of Separate my life from my work, and I can wake up in the morning and not look at the back door of the hospital.
Every day I come to work, I learn a heck of a lot about life.
You're one of the nerdiest ones out of all of us.
I am not.
I don't think I am at all.
And you know what? You hide behind these high heels, honey, but you're the nerdiest one of all.
Do you really think I'm nerdy? Yeah, but nerd-nerdy is sexy.
Well, they're very telling of the job you're on, right? That's true.
So Kelly is on the labor floor.
Uh-huh.
Kelly's shoes get bloody, so they need to be able to get wiped off.
Cecile is g.
Y.
N.
Intern, so hers can get bloody Like tonight.
But shouldn't on a regular basis.
All I am is clinic all day, so I wear heels.
It really is dependent on how much of the hospital you have to run around in in a given day.
It's totally true.
Me-- or whether or not you're married, and you really care what you look like.
And I kid you not.
I want to recognize and personally thank Marvin's transplant team cardiologist, Dr.
Kimberly parks.
we are having a fund-raiser for my dad's medical bills.
He told us he wanted us to continue life, to enjoy life, and we're putting our best foot forward.
next on Gloves, gloves, gloves, guys.
He's just bleeding to death.
His lips are blue.
You have five seconds to find that suture.
Why is this thing not willing to move? We're at that difficult stage right now.
So I think the one thing that could solve it is to purchase property together that neither one of us can afford.
This infant was born with a defect of his heart.
Oh, man.
Oh, man.
There was a lot of complications.
We went back and revised the original operation.
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? Rob, 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! B.
M.
G.
, p.
D.
Medical control.
On board we have an 8-year-old female.
Uh, that's an 8-year-old female with cardiac arrest.
Uh, she was in the school gymnasium, uh, apparently without any specific complaints, just walking around the gym when she had a sudden collapse.
Uh, an 8 year old with some kind of cardiac arrest who had return of circulation after one shock, per the e.
M.
S.
Report.
Uh, 8 years old.
Her name is Olivia.
She was at her school in the gymnasium, apparently not doing much of anything except for walking around, had no specific complaints, and then just had a sudden collapse.
Time between when she went down and when they arrived? Um, pr-probably like seven minutes or so.
Seven minutes.
Yeah.
I'm not getting great breath sounds on the left.
Why don't we give her a little versed now? Okay.
No allergies to any medications that you know of? Not that I--no.
Okay.
I've just called her pediatrician.
Uh, the only thing she's allergic to is cats.
Why is it not You can come up if you want.
Can I? You can come right up to the head of the bed.
Yep.
If you feel okay with it, you come on--right on up.
She had a heart attack.
I want to start-- do a bag on her.
You okay? Go ahead.
Just push me out of the way.
Okay? So you hear, uh Decreased-- bilateral, just decreased on-- decreased on left.
I'm running-- wondering whether it's down the right main stem.
She breathing on her own? Occasionally, bucking.
I'm much better on the right than the left.
I'm wondering Medicine shows you life is short.
Anything can happen.
Yeah.
Go, Dee.
They cal-- they called.
Are they calling it yet? Nothing is guaranteed.
This baby's heart rate-- it's gone down and has not come back up.
It's probably been over five minutes now.
So we're getting the operating room ready.
Go.
We're going.
So we're going.
This is a stat.
It's an emergency.
People have an expectation in this country to a right to deliver when they want to deliver and to have a perfect baby at the end.
Can we quiet it down a little bit, please? Shh.
Quiet down.
Quiet.
Careful.
You're doing okay.
It's okay.
Mm-hmm.
I know.
You're being fabulous.
I know it's scary.
We want that, too, but it's not reality.
It's called labor for a reason.
So you're just gonna feel my hand, okay? Just like a regular cervical exam.
Okay.
Okay.
Now he's really kicking.
So the baby's heart rate came back up, so it's no longer an emergency.
The baby looks great now.
I know.
Couldn't look better.
What a troublemaker you have.
I guess I'll go back out, make sure everybody else is okay.
Yeah, make sure I remember saying this to my parents and to my friends.
It was like, "I'm 100% sure I'm not going to go into ob-gyn.
" That's it.
That's it.
A lot of pressure now.
A lot of pressure.
Perfect job.
That's it.
That's it.
That's it.
There you go.
More, more, more.
I got the perineum for you.
Okay, now a big breath.
Push, okay? Good job.
Beautiful! What do we got? Suction.
A couple of years ago, two really wonderful obstetricians lost a lawsuit for $26 million.
And they quit.
They quit medicine.
They were done.
Hey.
How you doing? How you doing? Hi.
How can you recover from that? He's a little doll.
He's a little, like, gloworm.
I mean We just want to pay off our med school loans.
so, um, this morning I got an urgent phone call about a patient of mine by the name of Marvin pollet.
He's a very nice man from Louisiana who fainted this morning, and, uh, his heart stopped.
The team was able to do chest compressions and bring him back to life.
He was referred here for an evaluation for a heart transplant, and this makes things much more urgent.
So we gotta go evaluate him and see what we can do about getting him a heart transplant quick.
By the way, I want to get the name Of those? These--these thing-- you can't-- I've never bought 'em in a store to be this good.
I'm-a Rob you-- Rob you of these.
I-I was a licensed private investigator.
Uh, I practiced it all the way up till November the 19th, when, uh, all this happened to me.
His cardiologist told me they did not expect him to make it through the night.
He had, uh, went to work that day.
He began a new medicine and passed out.
His blood pressure plummeted, kidneys and liver started shutting down.
That was our--the night of our 25th anniversary.
And the whole time, I could feel her put her hands on my face, you know, and, you know, stroking me on the side of my face like this and telling me, "it's gonna be okay.
Calm down.
" And, uh I leaned to his ear and told him, "please don't give up.
"I-I want to have you for a few more years.
Please, you know, fight to stay alive.
" I don't want anybody to-- to stamp me with a time and a date, saying that's all-- as long as you can live.
That's almost like a threat to me, you know? He likes a good challenge.
Knock, knock.
Hi.
All right.
So we've had a very busy morning.
Okay.
You've had a lot of people in and out.
Yes.
Okay? Things are progressing rapidly.
Right.
And I want to get you listed for a heart transplant Okay.
Sooner rather than later.
Sounds good.
Any questions? Um, not really, no.
Just The priority right now is to get Marvin listed for a heart.
Right now I predict, he only has weeks to live.
Where do you think you're going off to? I have only been delivering another patient.
Sorry I couldn't come I'm just saying.
Talk to your patient about her drug use.
One of the fellows here said, "if you don't think about committing suicide every day in residency, you're not showing up.
" And don't forget the baby orders.
I know.
I won't forget the baby orders.
Oh, I was just gonna page you, Kelly.
Yes.
Your patient in room four would like to go home.
Of course she would, and I know she's told you guys that four times, so I really-- she asked me to page you, 'cause her ride Ugh.
So this is a patient, she has twins.
She's very uncomfortable, understandably.
Babies are doing great, and they are far from term, and they need some more time.
So every time she comes in, it's kind of Trying to convince her that she can do it.
What's going on? I just want to go home.
So you just want to go home and sleep.
I want to go home and go to bed.
Okay, but we need to make sure your babies are okay.
We need to give 'em a little while longer.
Really? Yeah.
I mean, now they look fabulous.
And you're feeling better, and I am reassured that you are feeling better.
Thank you.
You're gonna be a mama.
Yes.
So much you have to go through for it.
It's the octuplet mom giving birth.
I like how he's just hitting 'em away.
They just keep flying out.
He's, like, hitting 'em away.
You can disconnect for now.
Let's just disconnect this, then when we get her back over there, I'll put her back on.
So her vital signs are stable, um, her heart's beating again, and now we need to get a picture to see what's going on.
One, two, three.
She's in v-tach.
She's in v-tach.
We were just starting the scan when her heart goes crazy, beating way too fast.
Everybody off? Look out.
All right, clear.
By shocking her, we got her heartbeat back into rhythm.
Yeah, we're skipping the C.
T.
We had to give up on the scan and take her to the pediatric I.
C.
U.
, where the pediatric specialists could start to work on her right away.
She's just having a lot of ectopy.
Mindy, can you just make sure she's got a good pulse? Make sure she's perfusing these Yeah.
Yeah? Just cross our fingers and hope that the time that she spent down out in the field, you know, hasn't had some sort of, you know, lasting effect on her, uh, on her neurologic status.
Oh! Who is that? Is that from last night? Oh! Is that mine? Oh! This is what I'm gonna do.
Yeah.
Oh! Oh! Ohh! Being pregnant is the most dangerous thing an American woman will do in her lifetime.
Can I have an available o.
B.
To O.
R.
one? Available o.
B.
To O.
R.
one.
It is very natural.
It's very natural.
But it's also very natural for things to go wrong.
Can't get a baby out.
They did or can't? They can't get a baby out.
Ah.
I'm sorry, babe.
Most of where your cervix is is right on the front.
Okay.
So it would be good if we could get some pressure on it.
Get you to roll over so that you're on all fours.
I'm sorry.
This is kind of a weird angle to do an exam in.
So it might feel a little different.
Let's see if this hurts.
Are you still having a contraction? Yeah.
Yeah, she's having one now.
Oh, lord.
Hey, Ms.
Marcus, you're doing really good.
Okay? I know it doesn't feel like it You're almost there, honey.
But you are doing good, and you're getting close.
You're getting close.
Okay, this is take two, but it's much easier from this end for me, okay? Mm.
That one part of your cervix, it's really swollen.
That makes me worry a little bit, like the baby's not fitting right through there.
I think we should place an epidural.
You don't have to use it, okay? I think very much, you'll still have a vaginal delivery Yeah.
But just in case, I don't want you to be put to sleep when your baby's born.
No.
You know what I mean? Yeah.
So let's have them place that, okay? Okay.
And that way, we have it as a safety.
Okay.
Are you okay with that? Yep.
But, you know, if we don't use it, then it's still like we never put it there.
Okay? Yeah.
Okay.
So I think my chapstick is down in the call room, which is really sad.
It's not really a lip gloss kind of day, you know what I mean? It's really a chapstick kind of day.
Marvin's here, hoping that we can help him with a heart transplant.
How are you feeling today compared to yesterday? Almost 1000% better.
He's pretty sick.
If he doesn't get a heart transplant soon, Marvin will likely die.
So today we're gonna meet, we're gonna discuss his case, and hopefully, we can list him.
This is my heart For you, to get you through this weekend.
Great.
All right.
You hold on to that.
Keep that close by.
Marvin has a condition called amyloidosis.
And not only is his heart affected, but many of his other organs are affected.
And it's gonna be difficult to convince my colleagues just to list him, period.
For those of you who haven't heard about Mr.
Marvin pollet, he's a, uh, 55 year old who was referred to us from an outside facility for evaluation for cardiac transplant.
He has a history of, um, primary amyloidosis.
He's been seen at this point by our hematologist, endocrinologist.
Um, my hope today is that we can come to a conclusion and either get him listed today So, Tommy, what do you think? Out the outset, I'll say, he looks better in person than he does on paper.
He's a pretty robust guy.
I would say that there's no smoking gun right now.
The liver is probably the highest on the list in terms of concern.
I don't expect that this is gonna contraindicate a transplantation.
Go ahead and list him as a 1-a.
This is great news.
Great news.
We all just met.
We've gone over your biopsy results.
Mm-hmm.
We're listing you for a heart transplant today.
oh.
It's a big day for you.
so I'm on my way to see Olivia quigley.
She is a little girl who came into the e.
D.
The other day in cardiac arrest.
Uh, when the e.
M.
S.
Guys brought her in, they said she was 8, but she's actually 6.
And from what I understand, she's doing pretty well.
Give me a hug, huh? I'm very, very happy.
It was a good day for me.
You--you know, it's Hey, liv.
Hey, buddy.
You want to get close? Yeah, I'd like to say hello, too.
She made huge, um, progress yesterday.
She came off the intubator and She's, you know, she's doing awesome.
This is the first time I've kind of been able to breathe Yeah.
A little easier, you know? I have, um, I have a 5-year-old son and a 3-year-old daughter, and I-I can't imagine and I can imagine all at the same time Mm-hmm.
How it, you know, how it must feel.
In a time of complete chaos Yeah.
I kind of felt that-- I looked at your face, and I looked at Dr.
sherman's face, and I kind of felt, like, huge confidence, you--you know? Oh, that's good.
I'm glad.
I mean-- and--and I just felt that It--it was just so reassuring, y-you know? I'm really glad that you feel better, and that it's going in the right direction.
I know.
Me, too.
So it sounds like what they're gonna do is put a defibrillator into Olivia, uh, so that if her heart stops again, the defibrillator will help to restart it.
You know, it's amazing that she's come out of this the way she has.
my job is to make sure that Marvin stays alive so that the surgeons can do their job.
Knock, knock.
Come in here, lady.
Hello.
Good evening.
How you doing? How's my favorite patient? I don't know.
Uh, who is he? I'm looking at him right now.
All right.
So your kidney function is staying nice and stable.
Okay.
All right? The liver function is getting a teeny bit better, which is good.
It's moving in the right direction.
Okay.
That's good.
Jeanette, if you have things you need to take care of at home, go as soon as you can.
You're only a couple of hours away, all right? And if he gets an offer, we have about 12 hours.
You'll know in advance.
So as soon as we find out, we'll call you.
You can make arrangements to get here on the next flight.
Fine.
Oh, I don't think we ought to call her.
I think we oughta wait till the next day.
Kidding.
Yeah.
Good idea.
I'm one of the strong ones in the family.
I gotta keep it together, pull it together, and I will.
I just have a weak moment every now and then.
And not knowing how long Marvin will wait on the transplant list, I'm gonna go home and try to help keep my job.
All right.
We've gotta go find those surgeons and see what's going on in terms of activity with donors.
Now it's time to start putting pressure on the surgeons.
Mr.
pollet upstairs.
Yeah.
He needs a heart.
Okay.
Bad.
Good.
Take a gun and shoot somebody, and we'll get a heart.
I mean-- how did I know you were gonna say something like that? Well, I mean, you know-- well, can't you do your donor net magic or something? Go and-- well, it's, you know, I mean, when they--when they call us, we'll go out and get one.
What--what's his blood type? Yeah.
So he's an "a" and he's no crossmatch.
Yeah.
Okay.
Yeah.
Marvin was supposed to come here three weeks ago, and I got a call that the insurance company didn't want to pay for his visit.
He and his wife had plane tickets to come here on a Sunday night, and on Saturday, they canceled their trip.
If Marvin would've been here, we could've listed him then and we wouldn't be where we are now.
So if this guy dies because his insurance company wouldn't approve a visit That's awful.
To see previous episodes of "boston med," go to Cardiac arrest, ple went into v-tach at one point.
Shocked into rhythm.
At this time, in the 90s.
We're about ten minutes out.
Uh, a 34-year-old male, cardiac arrest.
We didn't get a lot of details, but it sounds like they found this guy pulseless, shocked him once.
Stable vital signs, but he's intubated on a Lidocaine drip.
No, this was a crystal meth overdose.
One, two, three.
Go.
He was also seizing on scene prior to cardiac arrest.
Okay, could we start c.
P.
R.
? 15 compressions is fine.
Sure.
Can we check for a pulse now? You know, it's hard for people to understand, but in some weird way, it's just, it's cool.
You're keeping them alive by pumping their blood through their body.
Hold--hold c.
P.
R.
Oh, yeah, check on the pulse.
We have pulses? Yes, he has a strong pulse.
Okay.
Someone's hand is on the pulse? Airway.
We have an airway.
He has bilateral breath sounds.
We have a pulse.
We have a blood pressure.
I feel like nursing is a profession, something I can be proud of.
Is that line secured? Yeah, she's doing it now.
He's got a rhythm.
His heart's pumping.
And now it's kind of one step at a time, and the first step is just making sure the guy stays alive, more or less.
Marvin looks really, really bad today.
He is, um, very lethargic.
He has been on a downward spiral, and he continues on a downward spiral.
And then this is all a result of the inability of the heart to effectively pump blood to the brain.
Hi, Jeanette.
Um, you know, Marvin actually has--is, uh, not looking, uh, near as well as he did yesterday, and--and, you know, yesterday when I called you, he wasn't looking near as well as he did the day before.
And honestly, Jeanette, I mean, I-I-- if he were my husband, I-I probably would be here.
That's bad news.
I'll get there as soon as I can.
If we can't get him a heart soon, that makes me a little more worried, because he has a disease that, you know, he could have the best care around him, he could have all of us around him, and if his heart just stops, and we can't get it back No more Marvin.
A couple of weeks ago, I come out of my house, and it's--it's still dark out, and all of a sudden I hear this Like--like, bleh.
It sounded like someone was getting, like, strangled.
And I see this--this-- this thing with this huge wingspan going "wop, wop.
" Scared the living crap out of me.
And it's this thing.
It's a Turkey vulture.
I never in a million years thought I would end up being a nurse.
I was a punk, really into having fun.
Been a psychic for 37 years.
I'm known as the amazing Mr.
b.
Of e.
S.
P.
I'm here with my mother.
She's been going to a lot of hospitals.
She's ill today.
Are you gertrude? Mm-hmm.
Gertrude beam? Hi, I'm Michael.
I'm one of the nurses.
Nice to meet you.
Hi, sir.
Can you see her now? I'm gonna take, uh, yeah, I'm gonna take you guys back to a room, okay, so you can see the doctor.
I always worked and I always worked hard, but I wasn't doing anything positive.
What's that? Yep, the doctor will be in very shortly.
I mean, you name it, I've done it-- installing floors, painting houses.
I used to drive for a limo service.
Uh, Dr.
Goldstein is the--is the doc.
What's his name? It's doc--his name is Dr.
Goldstein.
He's gonna be in to see you in a couple of minutes.
I predicted his name would be Goldman before I came here.
You predicted that? Yeah.
Really? You just--it just popped into your head that the doctor's name would be Goldman? I've been psychic my whole life.
You h--really? I did, like, ten shows with Jerry springer Oh, yeah? Johnny Carson.
Interesting.
I don't know.
Psychics freak me out a little bit, but they were cute.
They're a cute little-- I'd say couple, but I guess they're son and--and mom.
Well, there's only a couple of quick things I touched upon him.
He didn't start out to be what he is today, but it happened to turn that way because of kind of a Twist of fate.
So, yeah, he was-- he's on the money.
Mister-- Mr.
b.
With e.
S.
P.
Is He's the real deal, man.
hey.
You know what? You are by far the healthiest patient I have seen tonight.
Oh.
So you think you broke your water, huh? I think so.
You want to check, see what we think? Yeah, we might as well get that awesome part over with.
All right.
It's a little hard to tell if you're ruptured.
But you look pretty ruptured to me.
Okay.
Holy mackerel.
You have such a nice, gentle voice, so then I felt bad that I was like, "oh!" No.
Don't feel bad.
But I didn't hit you or anything, so-- it's the Southern accent.
They fool you.
I think that growing up in the South, a lot of people feel like other people think, you know, we're stupid or, you know, we all date our cousins or this, that and the other.
The first Saturday in may, everyone comes to Kentucky-- louisville, Kentucky-- um, to Churchill downs for the Kentucky derby.
See, this is a very big deal.
Every year, you have to get your hat made.
That's a mint julep right there.
That's very important.
There's my hat.
There she is.
Hi, honey.
Hi.
How's it going? Good.
How you doing? Busy.
I know.
Rachel and I are two Southern bookends in this residency program of New englanders.
Kelly's had a tough couple of years, and you had a crazy intern year.
She was involved in, like, a really bad case on the o.
B.
Floor.
A mom who died four hours after giving birth on the labor floor.
Everything was going well until it didn't go well.
Most obstetricians will not see a maternal death in their lifetime.
I think for everybody in our class, it put a lot of people off of o.
B.
, just to even see somebody you care about be involved in something like that.
My mom told me I should quit.
Oh, whatever.
Screw your mom.
I mean, I've been thinking about quitting for the last year, and it's just getting worse Oh.
As my personal life goes downhill.
I'm gay, and I got here, and I met somebody who was really special.
I gave her a chance, and Mnh-mnh-mnh.
I've never loved like that before.
This person left me for somebody else.
She just tried to put the blame on me, because I wasn't there.
It's hard to be in a relationship with a doctor.
Marvin's condition has started to deteriorate rapidly.
So I called his wife Jeanette, and she and the kids have come up from Louisiana.
So what-- what's your understanding of where we are right now and how sick-- sick your husband is right now? Oh, I knew he was critical coming in.
Uh, everyone needing a transplant is dying.
Uh, you know, no False pretenses there.
Having a meeting called-- I can't imagine we're here to hear good news.
What's happened is, metabolically, he's gotten sicker over the--the last couple days.
And what I'm coming in here to tell you guys is that I think we've reached a point where we don't have anything else to offer him and that it may be time to take him off of the list altogether.
Okay? The ultimate thing here, is that he's going to die.
Okay? And what I'd like to do is try to make that time as comfortable and as meaningful to you guys as possible.
So if it were your wife laying in that bed, you think you would stop treatment? Yes.
If it were any of my family members, that would be my recommendation.
Right, I think we-- we had a window, and unfortunately, we just didn't have a heart come available for him in that time.
I'm sorry.
The door opens, and we're all thinking, who's coming in here right now? And it was his nurse telling us that Marvin was having a cardiac arrest.
Clear! Clear! Yeah, start bagging him.
Yep.
Yes, get his wife.
Who's on the pulse? Somebody on the pulse? I need you to back away for a second while they do this now.
Okay.
Let's put the board under.
I'm doing the board.
We also need 1-- Patrick, we need 1 milligram of epinephrine, please.
Okay.
Resume compressions.
Oh, shoot.
Up one floor.
so today we're gonna do a surgery to remove an ovarian cyst.
I am kind of a different person when I'm in the operating room.
I still try to be funny and, like, have fun, and I like to have music playing, but, like, I'm definitely much more serious.
Now in the middle, that's the uterus.
That's the cyst that I'm pointing out.
Wow.
There's the rest of it.
I see.
Look at that.
Wow.
The O.
R.
's the most honest place in this hospital.
You did wonderfully.
That's perfect.
Then it's one little buzz, and you're set.
It's you and it's this, and either you can fix it or you can't, and it's become patently obvious to everyone in the room whether or not you're up for the challenge.
Whoa, whoa.
Hold on.
Don't move.
Don't move.
Okay, no moving, no moving.
Good.
You got it.
Yay.
Yeah.
Hot damn.
Nice.
Good job.
All right.
So I got a little needle scrape.
But since it's actually, like, bleeding, I'll probably have her, if you're okay with it, just get her consent, actually, on testing.
I hate needle sticks.
Everything's fine.
And then all of a sudden, there's an accident and you get cut on a patient who's high risk.
I mean, it sucks, 'cause she's, like, not exactly a low-risk, uh, needle stick.
With her, you worry about hepatitis c, 'cause she's had, uh, she has a history of heroin abuse.
And hepatitis c is the most communicable.
Hi, I was supposed to be connected to employee health or whoever I would speak to for a needle stick.
From a technical viewpoint, uh, the surgery went very well.
I'm just a little concerned about the needle stick.
I hate this .
It's been a while since I've been stuck.
Certainly that's something that You know, it's just a moment, and everything changes.
I got a pretty bad needle stick from a pretty, uh High risk? High-risk patient.
Yeah.
We send the employee down to the emergency room.
Yeah, employee--mm-hmm.
Okay? So that's where you need to go.
So I heard a needle stick? Gotcha.
Yes.
She's a high risk, so I-I probably-- yeah, she's real high risk.
And it's, you know, you certainly can discontinue the medications once-- okay.
Once it comes back negative.
If you think I should, then, yeah.
If it was, like, a much more low-risk patient, I'd maybe not be so Yeah, yeah.
Antsy about it, but I've never--yeah.
She sounds like high risk.
Okay.
That's the best advice I can give.
You talked me into it.
Oh, God.
Whatever.
It was a good case, though.
I mean, it was a good case.
I'm here, Marvin.
I'm here with you, baby.
Resume compressions.
I'm thinking, Marvin's not gonna make it.
I felt paralyzed, like there's nothing I can do.
Kathy, guys, stop, stop, stop.
Do you want a milligram of epi? Just call it, okay? I-I want you to be surrounded with the people, you know, who love you most, okay? Sorry.
Your--your heart's weak.
Your heart's just so weak.
But you showed strength.
I'll love you forever.
We'll all get through it.
Everybody's gonna be okay? Yeah, everybody will be okay.
You--you've given us a lot of strength.
Daddy Thank you for everything.
This has been a terrible Twist of fate-- a terrible Twist of fate for Marvin.
Um, this is part of our job.
And while sometimes, uh, we bring people new life, it doesn't always work out that way.
so right now we're gonna go to my house.
And then we're gonna change clothes and go out and have a drink since it's my boyfriend's birthday.
We've been together now for three and a half years.
He's from California originally.
So he's, like, totally an adopted southerner, kind of.
I mean, ideally, someday, we would both like to, like, get back there.
Hi! Happy Birthday.
Hi, honey.
Hello.
Mwah.
Mm.
Happy Birthday, baby.
Thanks, sweetie.
Oh, God.
How was your guys' day? Mine was okay.
We're at that point in our lives, I think-- she's working hard at her career, I'm working hard on my career.
We're both just-- what we try and say is, live in parallel lives that happen to intersect every once in a while.
I always say I'm gonna be ready in like two seconds, and it's, like, two hours later.
Yeah.
I'm tough to date right now.
I would not want to date me for anything.
So this is the disgusting, hot mess that is my room.
It's, like, you can operate with a dad in the room when you're doing a c-section, but you can't pick out your clothes when somebody's watching.
That's really sad.
Everyone complains about their job.
I have never, ever seen anything-- what these residents are putting in.
I mean, just in terms of-- the hours alone, fine.
Maybe other jobs can match that.
But I mean, on your feet, eating whatever you can find, under fluorescent lights, and then she still manages to look beautiful.
I don't know how she does it.
Honey, I'm almost ready.
I promise.
I hate parking in Cambridge.
I know.
she's so far beyond what I could ever even anticipated in a relationship.
Well, Happy Birthday.
Big 2-7.
Thank you.
So there's not a question in my mind that Rachel's the girl I want to marry.
This is about as good as it gets, right? It is about as good as it gets, actually.
If you ever opened up a cd or anything else-- I just cut the edge off and I slid the knife, but there was no plastic to catch it.
You know, you try to fight with it and peel it off, and it gets stuck.
Yeah.
So what I do is just take a little knife and cut the edge.
Yeah, I've got you.
Okay.
All right.
All right.
Are you a righty or a lefty? I'm a righty.
So you could still play? You can get home and play a little playstation.
No? 14, 15 years as an e.
M.
T.
, this is my first impaled object.
This is pretty deep.
I mean, I'd say about an inch.
Can't wait, man.
Going away with the guys on our annual trip-- blow off a little steam, a little vacay.
a lot of the nurses, uh, really, the male nurses, started going to tampa.
Uh, and it was a way to get away and have some fun.
We--we just laugh from the time we get on the plane till the time we come home, and it's a good-- it's just a good release.
You know, like-- there's nothing worse than just-- than having one of them say, "you're just a nurse.
" That resident will die.
That resident will be miserable.
That resident will be put in their place.
Yesterday they weren't a doctor.
Right.
Today they're a doctor.
They're a doctor.
Right.
The--the doctor for a day needs to appreciate the--the nurses of 30, 40 years and what we bring to the table.
The residents visit.
They stay for four years.
We, like me, live-- live there.
I live there.
This is it.
My house! You know, it's my house.
My house! They come and visit You're right.
And, you know They're guests as far as I'm concerned.
It's a good gig.
Seriously.
It is a great gig.
It's a really good gig.
It's a good gig.
You know, that's all that matters.
when we lose a patient who we've become close to or there's a traumatic situation involving the staff, oftentimes, we'll have a debriefing meeting so that we can all get closure.
You've had a chance in the last week and a half to begin to process what happened.
We're kind of used to being able to fix things, you know? And that's what attracted me to this.
And Marvin's the first person that I've really followed through that, um That didn't make it.
I am hearing that there is a-a connection, that you get caught up in the hope with them Mm-hmm.
And that it hurts so much to have to-- to have to h-have them lose that hope.
You know, to have that joy of being able to get him listed Yeah.
And I'm used to telling-- bearing bad news and giving bad news to families all the time.
And, um I don't know.
For some reason, this This one hit me much harder than, um Perhaps other cases that I've dealt with, you know? I'm, like, such a romanticizer.
I'm, like, this would be great to share with somebody else.
So now I want to get married.
This idea of, like, this finality and, like, some chapter closes and yet another one "supposedly opens," but does it? I don't know.
Maybe what opens is, like, a mortgage.
Like, I was never that girl who dreamed about, like, my white dress and whatever.
I never thought about it.
No, I want the security.
I want signed contract-- you want it signed.
Okay.
Yeah, but the thing is-- I want to say it's forever, 'cause I believe that that's a com--a commitment.
I don't think you need marriage to have security, though.
Yeah.
No.
Right.
Because you could have marriage and not have security.
I think I got to the point where I was like, I have, like, the perfect person that I should marry.
And I was sort of afraid that if we didn't get married See? That's what's wrong with marriage right there.
I would make Marriage isn't for-- like, the contract isn't-- it's for forcing people's hands.
It is.
It's not for the good times.
It's for the bad times.
I agree.
I think that if I were to get married, I would marry Jeff.
Let's go.
I was telling Rachel But I may not be the marrying kind.
Right now, I live my life for work.
I want to be an amazing cancer surgeon.
Like, and I don't care about much other stuff.
Jeff should definitely dump me.
But he doesn't.
He's an idiot.
He should totally dump me.
so, uh, I heard Olivia's here, and I'm gonna go out and see her.
Uh, it's been about two months since her cardiac arrest.
She's got an implantable defibrillator in her chest now.
And hopefully, that will protect her against any future events where her heart might stop.
I was just sitting here at the greeter desk doing my thing, and this beautiful little creature came through the door who I know but I haven't seen.
You know, not a lot of fun the last time I saw you, right? You don't probably remember, but it wasn't fun for me.
No.
Michael took care of you right here and right until you got onto the sixth floor.
Yeah.
So that's why we wanted to come by and say "hi, Michael.
" We're a long way away from where we were.
That's for sure.
You know what, though? That's okay.
What about one more hug? Can I have one more little hug before I go? Big hug.
Uh, duh.
Oh, thank you, kiddo.
You're welcome.
That's actually I'll always remember you.
You know what? It-- like I said You know, when I was, like, crazy, I was, you know As corny and as goofy as it sounds, it makes doing every single thing I've done up until that day worth it.
It really does.
Yeah.
living across the street from the hospital is convenient, but from a mental health perspective, probably not the best idea.
Ready to go.
Okay.
All right.
We're all finished packing up.
This is my last night here next to mass general hospital.
I think this is it.
This is a very significant move for me, because this is-- this sort of symbolizes me separating myself from my work, which is something I haven't done in the last 11 months, 12 months.
So I think it'll be good for me to sort of Separate my life from my work, and I can wake up in the morning and not look at the back door of the hospital.
Every day I come to work, I learn a heck of a lot about life.
You're one of the nerdiest ones out of all of us.
I am not.
I don't think I am at all.
And you know what? You hide behind these high heels, honey, but you're the nerdiest one of all.
Do you really think I'm nerdy? Yeah, but nerd-nerdy is sexy.
Well, they're very telling of the job you're on, right? That's true.
So Kelly is on the labor floor.
Uh-huh.
Kelly's shoes get bloody, so they need to be able to get wiped off.
Cecile is g.
Y.
N.
Intern, so hers can get bloody Like tonight.
But shouldn't on a regular basis.
All I am is clinic all day, so I wear heels.
It really is dependent on how much of the hospital you have to run around in in a given day.
It's totally true.
Me-- or whether or not you're married, and you really care what you look like.
And I kid you not.
I want to recognize and personally thank Marvin's transplant team cardiologist, Dr.
Kimberly parks.
we are having a fund-raiser for my dad's medical bills.
He told us he wanted us to continue life, to enjoy life, and we're putting our best foot forward.
next on Gloves, gloves, gloves, guys.
He's just bleeding to death.
His lips are blue.
You have five seconds to find that suture.
Why is this thing not willing to move? We're at that difficult stage right now.
So I think the one thing that could solve it is to purchase property together that neither one of us can afford.
This infant was born with a defect of his heart.
Oh, man.
Oh, man.
There was a lot of complications.
We went back and revised the original operation.