Emergency: NYC (2023) s01e07 Episode Script

1
[phone ringing]
- [man] Huntington called.
- [woman] Yeah, she has a Tylenol overdose.
[man] We got a kid running
with a broken toothbrush, tripped, fell
- [woman] Yeah, this is a new one.
- [man] Has laceration in the left tonsil.
- [Donald] The tonsil?
- [man] Yeah.
[woman] That was 147.
Transport. Donald.
Hey, Dave, what's up, man?
[woman] All of her labs are fine.
Code 3?
Did they give you vitals or anything?
[Dave] Negative.
Does she have vitals?
Uh, in fact,
we're resuscitating her right now.
All right, bye.
Hey, Deirdre.
Hey, don't get comfortable.
They called us with a pedestrian struck.
They're resuscitating,
I don't know to the level, and obviously
I will like you to come ride with me.
Alright, let's go.
Hey, Ro, I'm going to go help him
resuscitate, and I'll let you know.
[nurse] Okay.
[Donald] We'll be there in 18 minutes.
We're leaving now.
[woman] Okay, thank you so much.
Come on, come on! Let's go!
Diesel fuel is actually an arrest.
Yeah, let's go!
- [Deirdre] Hi.
- [Donald] Hi.
A child was hit by a car.
Mom carried the child into the hospital.
Shortly after arrival,
the patient cardiac arrested,
just got intubated, and we requested
emergency blood transfusion.
The little things make a big difference,
that's why we bring respiratory
with us and the doctor.
One person can't do it all.
Our six hands can do an awful lot more
than 12 untrained hands.
Anything I ask,
Donald has already done it.
"Can you do this?" "No, I already did it."
"Do you want this? Do you want that?"
- [Donald] I anticipate what she needs.
- [Deirdre] Mm-hmm.
There's no time.
[Deirdre] You know, I think the prognosis
in this situation is really poor.
It's hard to know
if there's anything reversible here.
I would do one more round,
and I think if you're still pulseless,
that'll probably be like 35 minutes,
um, and unfortunately, this poor child,
we'll have to declare him dead.
- We're going to help him out.
- Yup. Definitely.
[warning back-up system beeping]
[Donald] Is it open, or? Okay.
Is there a flush port down there,
where your hand is? Can I hand it to you?
What line do we have?
Deirdre, I have blood.
- Can I have a board, please?
- [Deirdre speaks indistinctly]
[Donald] CPR board.
Where's all that blood coming from?
That's swelling. That's not good.
[silence]
[whirring]
[Donald] What's the time of death?
[Deirdre] Um
- Oh, classic, I didn't pay attention.
- [Donald] Okay.
[somber music playing]
[Donald] We did a debrief there
at the hospital,
just to make sure
everyone's voice was heard
and kind of get your emotions out,
and it's been shown to improve
staff well-being through these processes,
because it's not normal for you
to hold a child, and have them to die.
[Deirdre] It just sucks because
this is not how it's supposed to go,
and we all feel it.
- [Donald] I'm gonna go back home now.
- [Deirdre] Okay.
[Donald] In the moment, you got
to take care of what's acute at hand,
and deal with your emotions afterwards.
Unfortunately this time,
it didn't make any difference,
due to the patient's injuries.
They were pretty drastic.
Mom was able to climb into bed
and hold her child,
obviously, before the child
goes off to the morgue, unfortunately.
So this will be the last time
she sees her child this way.
See you later.
- How are you?
- How are you?
- Everything alright?
- Yeah.
- Superhero!
- [Donald] No.
Unfixable.
- [nurse] Thanks, Donald.
- [Donald] You're welcome.
[Donald] I've been extremely conditioned
to deal with death and the grief process.
There are times
where you have to reset your energy,
so you can go back
and be 110% for your patients.
[bittersweet music playing]
Alright, let's get out of here.
I got my rabbit foot.
Dude, what's up? How you doing? Nice hat.
[nurse] Oh, nice hat, right?
- [David] Everything okay?
- [nurse] Welcome back!
[David] Thanks, great to see you!
Be careful my neck, you'll kill me!
- [nurse] Oh, shit! [laughs]
- [David] Be careful.
- No, I'm doing great.
- Good to see you.
- [David] Thanks a lot.
- Okay.
[David] This week's the three-month
anniversary of my surgery.
Hi. How are you guys doing? Hey, Jay.
I was in rehab for about a week and a half
and went home.
I was home for two months.
I've been in some physical therapy,
but now I'm back in the gym
three days a week.
[sighs]
I have no deficits. In fact,
I feel in some ways I've improved,
because my mindset is so much better.
Near-death experience like that
affects you, you know? It has to.
If it doesn't, then you probably
aren't taking advantage of it.
It's one thing if I was quadriplegic,
I don't think I'd be so happy,
but the fact that you lost everything,
thought it was over,
and then come back to this level,
go and operate on a case like this?
I mean, come on.
[John] I just want you to know
I'm wearing my lucky socks for this case.
A day like today with Langer back,
it's a good day.
- [Jill] Are we admitting for both here?
- No.
- He's the patient?
- They're both patients.
[Salvatore] We're both the patients.
[chuckling]
[nurse] Can you spell your
first and last name for us?
S-A-L-V-A-T-O-R-E.
[nurse] Can you tell me in your own words
what you're having done today?
I am donating my kidney to my son.
[Elliot] Tyler's a 14-year-old kid
who has renal dysplasia
uh, and a solitary kidney,
so that's a birth defect.
[nurse] Can you remove the mask for me?
[Elliot] From birth, he had
one kidney that was missing,
and the other kidney was very malformed,
so his dad is donating him a kidney
before he needs to go onto dialysis.
[nurse] I see you brought me a nice vein.
[Salvatore] Yeah, they usually
don't have a problem with that.
[Jill] Oh, he has really nice veins!
We've been told that numerous times.
[laughter]
[Elliot] He's an athlete, plays baseball.
If he had to go on dialysis,
all of those activities would stop.
He would get a metallic taste in his mouth
often and wouldn't be able to eat.
He'd be vomiting a lot,
he'd develop swelling in his legs.
He'd become a completely different kid,
unrecognizable to his parents.
[nurse] He doesn't want it, thank you.
[Salvatore]
It was going to be my wife or I,
but they started testing me first,
and they saw that I was a match.
[voice breaking] Like, I'm not crying
because I'm sad, you know, I'm just
[sighs deeply]
I'm worried about him. That's all.
[Jill] You look good in blue.
You're all done with your blood?
You're all ready?
Yeah, I'm just waiting on doc to call me.
[Jill] Okay.
All right, Tyler?
- [Tyler] Love you.
- I love you too.
[kisses]
[MacKenzie laughing]
You know what's about to transpire!
It's This is about to happen.
Um, I have to pump because Fiamma is
um, just exclusively breastfeeding,
or receiving my breast milk right now.
So trying to be a good mommy.
It's like liquid gold. You can't drop any,
or you feel really terrible about it.
[MacKenzie] Monday was the first time
I've ever been away from her
for any length of time.
Yeah. Oh!
[MacKenzie] Twelve and a half hours away
from her. It's going to be a transition.
Look, she's with another baby,
making new friends.
Ooh!
[groans]
- [MacKenzie on phone] Such a happy girl!
- [man] Come on, we gotta go do something.
She's gonna be a wreck now.
- We gotta get a job.
- [MacKenzie] Yeah.
[flight dispatch] Northwell Center
SkyHealth One with a mission request.
Roger.
[dispatch] Sky crew,
you've got a 55-year-old female,
diagnosis of pulmonary embolism.
Patient is on a HEC and a cardiac monitor.
[man] Got it. 10-4.
[MacKenzie] I love what I do,
and I want to continue doing it
because I know that I'm supposed to be
doing it since I was young,
and I want her to know that it's important
to work hard and fight for what you want.
But, um I don't have to fight
for what I want anymore.
I have everything I want now.
[tense music playing]
I have to send this up to OR 1.
Can you see my hand?
[Lisa] Come closer.
- Yes.
- You can see it there? How about here?
[David] It's a 45-year-old woman who's
really had a very acute loss of vision.
Is basically going blind.
She has a very large tumor,
and her optic nerves are humped up
way over the top of the tumor.
This rapidly progressed,
we put her on some steroids,
and we just took her to the OR emergently
to take the pressure off the optic nerves.
John's with us. We have both of us here.
It's a big deal.
There's a good chance she could go blind,
even in the best of hands,
so we want to get this thing going,
really, as soon as possible.
There's emergencies where people die,
that's not this.
This is an emergency
where people are gonna go blind.
That's a frickin' big deal.
Are we all set? We're good?
[whistling]
[David] I'm excited
because I'm finally back
to where I'm doing the things I feel like
was born to do and that I trained to do.
And that it's a great demonstration
of that for myself.
[rock music playing in the background]
[David] So funny, even doing
little things like that,
you start thinking about
what I can do with hands.
And the fact that I'm able
to operate on a woman like this,
who's going blind, and with John,
this could all not have happened.
Looks good, bro.
And, you know, you can feel my neck
and feel the incision,
that reminds me of how close I came.
Time out, time out.
The procedure's a right craniotomy,
tumor section, navigation.
Langer, Boockvar.
Name, medical, birthdate are correct.
Consent is correct. It's cosigned.
She basically just barely has vision,
so this is sort of a vision-saving
operation attempt.
This is my first case
real case since I've been back.
It's a humbling moment for me and for
And I think I've had a very, uh,
unique experience the last couple months,
and I appreciate the support
I've gotten from everybody, and uh,
I'm excited to do this because
it's, uh, what I was trained to do,
and the fact that I can still do it
is, uh is very important to me.
And I appreciate what you guys do
every day. So, you too.
- [staff clapping]
- Alright.
For two hours I thought my life was over,
so there's an element of,
once I got better,
I was getting better so quickly
that I assumed I'd be able to come back.
You know, my hands worked.
I could do
everything I needed to do at home.
I could tie things,
I'd practice sewing in rehab.
But, you know, my head's different though.
I'm thinking better.
I think I'm more calm.
I can be a better surgeon that way.
[Caroline] Okay.
[whirring]
[David] Monopolar. See how calm I am?
That would have freaked me the fuck out.
[surgeon] So probably what would happen?
What do you mean?
[David] I don't know.
My brain just would get fried, I guess.
[nurse] He just wants to make sure he can
call his wife beforehand.
[Ahmed] I expect you to be
in the hospital for about two days.
You'll be able to come down
and visit Tyler next day.
Okay.
[Ahmed] He will be in the pediatric ICU.
You will be in a regular room.
Again, laparoscopy is a small cut
around the belly button,
and we're taking the left kidney.
- Okay?
- Yeah.
[Ahmed] Alright, I will see you inside
- [Salvatore] Take good care of me.
- [Ahmed] Twenty minutes.
[Elliot] Alright.
- What's up, bud?
- [Tyler] Nothing.
- [Elliot] Excited?
- [Tyler] Sure.
[Elliot] Sure?
That doesn't sound too convincing.
[nurse] He's tired.
[Elliot] How was breakfast?
- [Tyler] I didn't have breakfast.
- [Elliot] Good! The right answer.
Awesome.
If you said, "Oh my God,
the eggs were delicious,"
I'd say, "Alright,
we'll see you tomorrow, man." [laughs]
- And Dad is over there?
- [Jill] Yeah.
[Elliot] Uh
I expect the kidney to work immediately.
You'll be making a lot of urine.
You're gonna have a catheter
in your bladder, called a Foley catheter.
It's gonna be your best friend.
Um, people, especially kids,
they love having tubes in their penises,
is pretty much what I've experienced.
It'll come out on Thursday, Friday,
something like that.
After the surgery,
you'll be feeling like a million bucks.
You're gonna grow more,
all of the kidney failure problems
are gonna leave.
But, at some point,
you're going to have this feeling where,
"I feel so good, why do I need
these medications?" Okay?
And at that point, you might have the urge
to stop taking the medications,
and I want you to remember
this part where I say,
"Don't stop taking the medications."
Okay? Because you'll reject the kidney
and have a problem. Okay?
Alright, Mom, let's have you sign consent.
- How is the end of school?
- [Tyler] Good.
Yeah? High school's next?
[Elliot] Whew!
- Oh, baby. You psyched?
- [Tyler] Sure.
Well, listen, I remember
8th grade dances are super awkward.
[Jill, chuckling] Yeah.
[Elliot] You have to do right angles
when you dance with a girl.
Your hands have to be
at a complete right angle,
- and you can't get any closer.
- [Jill] No touching girls. Sorry.
[Elliot] Stay safe.
I'll see you guys.
Any questions, I'm right out here.
[dispatch] Asthmatic 2-year-old male
in severe distress,
having a hard time breathing.
Needs transport to Cohen Children's.
[Donald] The tank is on.
[man] His BP was 95 over 190.
[Donald] You want to try dropping the O2
a little bit? Make Grace happy?
- [child] Yeah.
- [Donald] Her thresh He said yes. Okay!
[man] Blood pressure at 111 over 73.
[Donald] Good.
Looks like he wants to go to sleep.
[man] I know, right?
[Donald] He's a severe asthmatic.
So he's required epi, terbutaline,
several puffs of albuterol,
and magnesium, and steroids,
and he's still having a lot of wheezing.
[whirring]
[Donald] He's good. Yep.
Hi!♣
[Donald] So, severe asthmatic,
intubated in March,
all the URI symptoms for the last day.
No fever. Lives at home with Mom,
doesn't go to daycare.
He came in severe distress.
Mom gave him some puffs at home,
EMS gave him epi, and I gave him
a fluid bolus, so here we are.
[mother] Breathe, baby, in and out.
Yeah, in and out.
It's traumatizing seeing
five doctors surrounding him.
The nurses Jabs here, jabs there.
Babies screaming.
He's only two.
So it's
That's my best friend.
You want your whales?
- Huh?
- Juice.
Your juice?
Oh, I don't have any juice right now!
[pediatrician] How about we'll give you
some in a little bit, okay?
- [child crying]
- Ooh. All right.
[mother] That's the juice monster.
It's just me and him right now,
and we went through so much together.
I don't know what I would do without him.
- [Donald] Hey. See you in a little bit.
- [nurse] Yup.
[Donald] Some days
you come back and save a life,
and other days you walk in
and pronounce someone dead,
and you walk out without him,
but it's what we do.
But it has a toll, eventually.
[hospital PA] Rapid response team to LIJ,
Adult Emergency Room. Room 9.
Surgical rapid response team to LIJ,
Adult Emergency Department, Room 9.
[tense music playing]
[Donald] One more!
- Oren, hurry up!
- [nurse] Why are you sweating?
- Wait, who's on wheels, then?
- [Donald] Because I was in a Code Gray.
- [groans]
- [man] Sorry!
So Code W in an outpatient center
can be a rapid response,
someone's not feeling well,
everything to a cardiac arrest.
Um, the ER response and transport,
I think they should also be there.
ER physician's here with us.
So everyone goes to see what's going on
and we figure it out.
- [man] Right here, buddy.
- [Donald] Oren, some driving you got.
- [man] What's your name?
- Donald.
[indistinct chatter]
Nice to meet you. Transport.
[man] Nice to meet you, Donald.
[nurse] We're gonna go,
because I guess he's inpatient.
[Emily] Yeah, he's inpatient.
He's on mid-break.
- [Donald] Hey, Paula!
- [Paula] Hi, how's it going?
[Donald] It's busy.
[Emily] Okay.
- Do you work tomorrow night?
- [Donald] I do.
Did the food come?
It did. I was eating.
I was gonna come get you.
[Emily] Back to regular life.
- [Donald] Yeah. So that was uneventful.
- [Emily] For the most part.
For the most part. We never know
what we get when we come here.
Until the next one.
[woman] Was it real?
Uh, inpatient seized on an MRI table.
- [woman] Oh, okay.
- [Donald] So pretty decent.
- I'll take that.
- [woman] Over here.
No, that's a wrong number.
Transport. Okay, good.
I didn't get up yet. Bye.
[woman laughs]
- She wants her food.
- [woman] Her food?
She said she's coming.
- [Emily] Hi.
- Hi.
[Donald] I have food for you. You wanna
lock that up, come back and eat?
- [Emily] No, SV is here, so I have to go.
- Alright.
[Emily] Alright. Yeah.
[chuckles]
That was my significant other
that came in, who happens to be my boss.
[bittersweet music playing]
[beeping]
[man] Yeah, sounds good. Yeah.
So, what I'll do
- [MacKenzie] It hasn't been accepted yet.
- [pilot] Go so I can burn some fuel.
[MacKenzie] No problem.
[man] Yeah, we can leave this over here.
[man] Do you have any questions?
I'm MacKenzie, I'm the flight nurse.
I'm so sorry
that we have to meet this way.
Now, when you passed out,
did you lose consciousness?
I believe I did.
[nurse] There also might be a retrieval,
so it's unclear if they
[MacKenzie] If they were going to go
to IR or something? Okay.
IR just means Interventional Radiology,
and that's just a special area
where they can retrieve a blood clot.
When did that happen?
[woman] Oh, about three weeks ago.
I think that's the reason for everything.
[MacKenzie] I think so too.
This patient was actually
involved in a roller skating incident
about three weeks ago,
which caused her to have
a tib-fib fracture.
When you break an extremity
and it has to be casted
or it has to be splinted
and remain in a certain position
for a long period of time,
sometimes the blood can pool,
and it can form a blood clot.
She has a significant blood clot
in that left leg,
and she also has bilateral blood clots
and a large blood clot that's saddled,
so it's very important to make sure
that they're not overexerting,
because she is going to be
short of breath.
Her heart is going to be working
extra hard at times to pump.
Blood clots can be scary.
She could go into respiratory arrest,
meaning she'd stop breathing.
She could go into cardiac arrest.
I mean, they're pretty serious.
Like, the worst-case scenario is death.
[David] We gotta focus on the nerves,
and the tumor will fall down.
Tenotomy. With an irrigation first.
Scissor.
The optic nerve, it's under pressure.
The tumor is pressing on it,
and now we're loosening it
by drilling it out of the bone here.
You do everything you can to prevent
damage just by manipulating the nerve.
I'm just cutting it out of its canal here.
[John] Chiefy!
- [David] Yeah, buddy.
- [John] How's it going?
[David] It's a meningioma.
- A big-ass
- [John] Oh. What's the consistency like?
[David] It's bad. It's hard.
[John] Meningioma. Can I get some glasses?
[David] And I'm pushing down the tumor
away from the nerve.
[John] It looks pretty good, size-wise.
- Langer's back! Clap it up!
- [nurse] Yeah!
[all clapping]
[John, chanting] Here we go,
David, here we go!
So you see the right optic nerve?
It's really thin as it gets
sort of right under his bipolar.
This is his right optic nerve here.
So David's basically looking right down
on this optic nerve from this angle.
Problem is, all of this
is very, very tough,
gritty tumor, and you're basically now
working in between the optic nerves,
so this is a much safer approach
to protect your vision.
- [David] There's tumor there.
- [John] Oh, yeah.
[Caroline] How long did she have symptoms
until she couldn't see?
[David] It was slow.
It takes time for people to notice it,
it's really weird.
But she got much worse. Scissor.
The nerve's all humped up
over the tumor here,
and it's squeezed between the tumor
and the anterior cerebral artery,
which is right here.
Can't be moved up anymore,
then you start losing vision.
It's like a peach pit
pushing into a peach.
[John] You want some help?
[David] Well, you can scrub in.
Just having David back, it's like getting
your slugger back on the baseball team.
It changes the entire lineup.
You don't take it for granted. This is why
I go home and hug my dog, kids, and wife.
Not in that order of importance,
but it really is it's an inspiring day.
Let's go save some vision.
- [Jill] Hi.
- [Ahmed] How are you?
[Jill] You have my husband.
Please do take care of my husband. Okay?
[Ahmed] How are you? All good? Ready?
- Alright.
- [Jill] Tell him, "Take care of Daddy."
- Tell him.
- [Tyler] Take care of him.
- [Ahmed] I will.
- [Jill laughs]
Thank you, Dr. Fahmy.
[Ahmed] Salvatore has been asking for
the surgery for the past couple of months.
And we talked about
all the possible complications,
but he is very, very eager
to donate to his son.
- [nurse] You got a surprise visitor!
- [Salvatore] 'Sup, buddy?
- [Jill] Oh my God! I didn't even
- [Salvatore chuckles]
- [Jill] I saw you, I didn't see him!
- [Salvatore] You good?
- [Salvatore] Yeah. You ready?
- [Tyler] Mm-hmm.
- [Salvatore] Yeah?
- [Tyler] Yup.
[Salvatore] You sure? Yes?
- [chuckles]
- [Tyler] I love you.
[Salvatore] I love you too, buddy.
See you in a little while.
Take good care of my kidney.
- I love you.
- [Jill] I'll see you
[Salvatore]
Take the fucking mask off. [chuckles]
[Jill laughs]
- Love you, son.
- [Tyler] I love you too.
Alright, good luck.
- [nurse] We'll take care of him, okay?
- [Jill] Thank you.
[exhales]
[nurse] We're just doing our last
safety checks, all your paperwork.
[Ahmed] This particular patient
has two renal arteries,
two arteries going to the left kidney,
so he has an anomalous anatomy.
So that's a huge emotional impact
and a huge ethical decision.
Should we use the father as a donor
if he potentially develops complications.
So there is always an emotional
and ethical aspect to transplantation.
A father donating to a son,
I think, is just is is natural.
[propulsive music playing]
- [David] The nerve looks great, bro.
- [John] I know.
[David] Yeah, that's beautiful.
That looks really good. You're starting
to make some progress on that nerve.
Um, I like what you're doing.
I don't like pulling.
If we can avoid pulling
We may have to pull the right,
this side. Or push.
Let me take a look for a second.
[nurse]
Could we still go through the notes?
[John] He's back! Oh my God!
That's it. It's beautiful.
Just keep buzzing that back.
Yes. Guys, he's dissecting
right on the optic chiasm.
[David] Give me a cottonoid here.
Oh, baby!
[John] Just buzz up. Yes! Oh yeah!
- I want that.
- [David] Fuckin' A!
[John] Oh!
[nurse] Mazel tov!
- [David] Irrigation.
- [John] Come here. Brian, look.
He just took a tumor out.
[David] I think it's all out.
I mean, tumor's all out here for sure.
Bring the exoscope in, please.
- [John] I'm going back to the office.
- [David] That was great.
[John] We got another case.
[David] Seriously, thank you, man.
I love you. Head bump.
[indistinct chatter]
[David] I think we deserve
a drink after work.
- [John] David, great job. That was sick.
- [David] That was great, man.
- That was really tremendous.
- [John] Welcome back. Langer 2.0.
[David] I'm sorry if I ever
yelled at anybody. Suction. Caroline.
[Caroline] Why do you think
it's not working?
[David] Speaking of yelling
[John] He's like a recovering alcoholic.
He's got to apologize.
- [David] I'm so sorry.
- [John] He's a recovering workaholic.
[David] We were done. Nothing left.
I'm pretty sure.
Give me a little Floseal
after the irrigation.
- She's seizing.
- [nurse] Yup.
[David] Are you giving her anything?
Can you call Jane?
- Did she get Keppra?
- [nurse] Keppra, we gave her 500.
[David] Give her another 500, please.
And then can we get
a neurology consult, please?
After post-op, okay?
She had a little seizure,
which sometimes happens.
It'll slow her down when she wakes up.
I'll tell the family.
We gave her extra medication,
but after you have a seizure,
you're really a little sleepy.
So we may not be able to retake
the breathing tube out today.
- [doctor] You look great under the scope.
- [David] Oh, thank you.
So no identifiable source of seizure
was noted, period.
Plan was to assess
the patient postoperatively,
determine whether a CAT scan
would be necessary, period.
Ugh.
[Ahmed] So this is the kidney.
This pump here is the kidney.
That's the spleen.
[Ahmed] The kidneys are not sitting there
in the abdomen waiting to be picked up.
The kidney is surrounded
by major vessels, major organs
And you can see the heart pumping up there
above the diaphragm.
so injury to adjacent organs can happen,
requiring a more complicated procedure
and a longer hospital stay.
Now, this is the renal vein.
[Lewis] There is Dr. Grodstein.
So he's got a nice vein out.
Go now a lumbar down, looks good.
[Elliot] I'm thinking
that on a young, healthy kid,
that's a perfect size match potentially.
With We'll see what it looks like.
He needs his external iliac more.
[Lewis] He needs all the things to supply
all the things down there.
- [Elliot] Yeah, correct.
- [Lewis] Right?
Because he's 14!
You ready or not?
- [Ahmed] Uh, fifteen minutes.
- [Lewis] Okay.
[Elliot] Alright. Go time.
[Jill] You okay?
[nurse] How're you doing, Tyler? Okay?
My baby.
- Thank you, Mom.
- [Jill] Thank you.
[nurse] We will talk.
[indistinct chatter]
I don't see any obvious major injuries.
He is a strong boy!
[Donald] Hello. Sorry I'm late.
[woman] Hello! Welcome!
It's very important that we need
to complete the FRE form for patients
who have a chief complaint
of sexual assault.
This is so they're not billed
for their visit and it gets billed
to the Office of Victims Services
for New York State.
We do have a patient here right now who
is getting a sexual assault kit completed.
Um, COVID booster is mandatory
for all staff by February
[Donald] She was a staff nurse in the ER,
but recently she became assistant manager,
so in essence, she's my boss now.
[chuckles]
So I kind of get it all the time.
[Emily] Project Breathe
is being reinvigorated on the unit
[Donald] It's been four years.
It definitely caught me by surprise.
I wasn't in the headspace
for what it developed into.
[Emily] If you have
a question about our goal
[Donald] A couple of comments
back and forth and interactions led to,
"Oh, let me call you."
And then, "Let's go for a run."
And then, you know And here we are.
We live together. [chuckles]
And she's a great person. She's wonderful.
[Emily] Oh. Break!
[Donald] Some people need separation,
but we do spend a lot of time together
and I don't feel like I get sick of her,
which is weird for me.
In my past, you know,
things were just different.
You know, work was my space
to kind of decompress.
But work's not my space, because
she works here, it's her space also.
So it's, um, it's our space.
If she needs help, she calls.
But it's same thing, she'll call anyone
in the office, and we'll all lend a hand.
If you work with a significant other,
to me, there's an inherent duty
to act a certain way
and always make sure that
they're at their best as much as you can.
- [woman groans]
- [MacKenzie] I promise, it's almost over.
It's like, please!
And her chest X-ray revealed
bilateral pulmonary embolisms,
and she does have a
saddle PE component as well.
Um, she's had a what was
7,000-unit bolus of heparin,
and she's also on an infusion
at 1,800 units an hour.
Her shirt says, "When was the last time
you did something for the first time?"
And today was her first helicopter ride!
Yep.
[man] Everyone ready?
One, two, three. Okay.
[MacKenzie]
I hope you get to feeling better.
[woman] Thank you.
Thank you for everything, really.
[MacKenzie] I hope she's gonna do well.
[atmospheric music playing]
Alright, I gotta do my walk around.
Walk around's good.
I mean, it's been really good
coming back to work.
I've really missed everyone.
But I mean, if I'm honest, I really liked
hanging out with my kid for four months.
I just didn't
Didn't want it to be over yet.
She makes me better for sure.
She definitely has made me better.
You know, she was my little safety net
through the whole pandemic.
I felt like we did that together
while she was inside me or whatever,
and I really miss her.
Look at my girl.
[on phone] Fiamma! What are you doing?
[Fiamma coos]
[MacKenzie] "Yeah," she says.
Can't wait to go home.
- [nurse] Lazarus!
- [David] How you doing?
[nurse] We missed you!
It wasn't the same
without our fearless leader.
- Missed you a lot.
- [David] Good to be back. Thank you.
Good people.
[indistinct chatter]
[Ahmed] How cold is the dam?
Thank you, sir.
[Lewis] Okay,
so now we have to perfuse it.
This is the vein that the kidney
is going to have its outflow to.
This is one artery,
and this is the other artery.
- They're really nice arteries, Fahmy.
- [Ahmed] Yes, they are.
[Lewis] It's perfect. It's large.
If it's not here,
the ureter will fall apart,
and then we'll all be upset.
[Ahmed] You can use the harmonic.
[Lewis] Fahmy, the kidney is beautiful.
[Ahmed] Very good.
[Lewis] All right, I'm gonna go
visit the other team.
Dr. Fahmy, I'm leaving you.
- [Ahmed] Thank you. Good luck.
- It looks fantastic.
- Okay, I have the football.
- [nurse] You have the football?
[Lewis] Dr. Grodstein!
[Elliot] Is that Dr. Tepperman,
my trusted assistant?
[Lewis] I am honored to bring you
a beautiful kidney that Fahmy has removed.
It's gorgeous.
[Elliot] Thank you, Dr. Tepperman.
Four by eight.
And some ice.
Beautiful.
What's that?
Why is the beeping getting lower?
Is he alright?
Watch out for the artery over here.
Watch both of our hands.
- We evened up?
- [anesthesiologist] Yup.
- [Elliot] Wonderful.
- [surgeon] Good job. That was wonderful.
[nurse] Sal, open your eyes!
You're fine, you're just waking up.
Everything went well.
Open your eyes.
[beeping]
[Ahmed] Alright,
thank you very much, everyone.
[nurse chuckles]
Sal did very well.
Single port laparoscopy, a tiny
little hole, you're not going to see it.
And the kidney looks beautiful.
Everything went well.
Okay.
Now we got one more.
We'll be good.
[Elliot] Okay, we're reprofused.
[surgeon] Yeah, that's it.
The kidney looks pretty good.
[Elliot] Yeah, but you'll see it.
It takes a little bit.
You see how the kidney's nice and pink?
[nurse] Just letting the mom know
that the surgery is progressing.
Yeah, everything's going well.
Kidney's reprofused, looks beautiful.
[surgeon] Take the green one off.
[Elliot] What's easy for me as a dad
is to get caught up
in the emotion of the moment,
but the act of doing surgery,
the act of transplantation,
needs to be methodical.
It can't be emotional.
- [surgeon] How are we doing?
- [Elliot] Good.
- [surgeon] Happy?
- [Elliot] Yeah, kidney's a little spasmy.
Doppler?
[assistant] Doppler on.
[Doppler swishing]
[Doppler swishing]
[Elliot] Will you call Fahmy?
Want him to take a look at that.
Just tell him to come to OR 7.
He'll figure out where.
This artery I don't like.
- I'm not hearing a great pulse.
- [surgeon] I know.
- We don't have clearance?
- [squirting]
[Elliot] I see it.
Yeah, look. There's thrombus in there.
Take off my glasses. Just take them off.
[tense music playing]
- [nurse] Dr. Fahmy is here.
- [Elliot] Good. Tell him to scrub now.
[nurse] Yup. If you could.
You can scrub up over here.
[surgeon] Watt 7 and a half white.
[Elliot] This clot in the artery,
I just took it down to flush,
but look, man, it's pancaked.
It's years and years of training
and just repeating the same thing
over and over and over again
so that there's no mistakes.
Because there's no room, considering
what his family's going through,
there's no room for a technical error,
and there's no room for Tyler
to have any other outcome
than not being on dialysis
and joining his baseball team again.
[David] Hi.
I'll talk to the family, but I think I'd
rather see if she's gonna wake up or not.
[assistant] Lisa, can you hear me?
[David] Her pupils are tiny.
[muttering]
Yeah, it's just unfortunate. Yeah.
Yep.
Turn the room lights off for a second.
[assistant] Hey, Lisa, do you hear me?
[David mutters]
[assistant] Hey, Lisa?
[David] It's just hard to tell.
[closing theme music playing]