The Pitt (2025) s01e10 Episode Script

You know where your son is now?
No, but he hasn't done anything.
Officer, why are you here?
We received a call that her son, David,
has created a list of girls
he would like to eliminate.
Who called you?
Do you know anything about this list?
Somebody called you. Who?
Somebody from my hospital?
Uh, Dr. McKay.
- Air retinue, ETA now.
- Who is that?
Air retinue, ETA now.
I will be right back.
[ELEVATOR DINGS]
Teddy, 28 years old,
burned in a gas tank explosion.
Paramedics estimate 90% BSA.
Trauma 1's open.
We managed to get
a 20 gauge on the right AC.
First liter of LR running wide open.
Vitals are good, pulse ox 97.
Teddy, are you in
a lot of pain right now?
[HOARSELY] Not as much as I should be.
OK.
Mainly third degree.
Singed nasal hairs. Soot in oropharynx.
Do you have family on the way?
Amy. My wife.
What happened?
I was transferring gas from a 200-gallon
fuel tank to my tractor.
Kaboom.
Let's set up for intubation.
Whitaker, run the Parkland formula.
OK, titrate morphine. Page Garcia.
And I will be back for the intubation.
On it, boss.
Don't, don't, don't! Don't touch me!
I'm fine.
Jesus fucking Christ!
[GROANS]
- It's it's OK.
- OK.
- I'm fine.
- OK. OK, come here.
- Holy shit!
- Whoa, whoa, whoa, whoa!
- Grabbing ice packs.
- I got the cart.
What happened?
Just got punched. Just took a fall.
OK. I'm fine.
Who punched you?
Just an unhappy patient.
- A patient hit you?
- Yeah.
Happens all the time.
I got my cheek broken.
- I lost a tooth.
- Oh.
- We've all been assaulted.
- Go get Ahmad.
- Did you hit your head?
- Uh, yep, probably,
but no LOC, just just a bloody nose.
OK, pressure.
OK, OK, OK.
Any trouble seeing? Any double vision?
- No.
- I'll grab you new scrubs.
- What about a headache?
- A little, yeah.
- We need to find her a room.
- I do not need a room!
Dave, move North 1 to the hall.
- Follow my finger.
- [BREATHING HEAVILY]
Right, left, up, down.
EOM is intact.
Who did this?
It was a pissed off patient,
but he split,
so just forget it.
Forget hell no.
Look, I want a name.
Doug Driscoll. Doug Driscoll.
- That asshole in Chairs?
- Yeah.
I'm calling the cops.
I'll get a wheelchair.
Pupils are equal and reactive.
No septal hematoma.
Should someone call your husband?
- Absolutely not.
- OK.
- [SIGHS]
- Tell me when it's sore.
Ah! [GASPING]
Tender at the nasion.
CT head and maxillofacial.
I'll give them a heads up.
Is that really necessary?
You have at least one facial fracture.
With the headache and the fall,
I want to rule out
anything intracranial.
OK, who can step up for Dana
while she's getting checked out?
- Perlah.
- Thank you.
[BOTH SPEAKING TAGALOG]
OK, guys, we got about three
hours left in this shift,
and I need everybody to step up.
- Is that clear?
- Yes.
- Yep.
- Yes, sir.
I can't believe they allow you
around med students, Langdon.
Don't pick up any of his bad habits.
You know the difference
between surgeons and serial killers?
Serial killers don't bill their victims.
Cute.
You guys staying ahead with his fluids?
Per the Parkland,
4 per kilo times 90% burned.
- Wow.
- 27 liters over 24 hours.
He's had two so far.
Lactated ringers
at 1.785 liters per hour
for the next seven hours.
I'll program the pump.
We got a second IV.
Hello, sir. I'm Dr. Garcia.
Need to peek under these dressings.
Are we ready to intubate?
Wife should be here any minute.
Whitaker, earlier,
you said third degree.
We refer to burns
as either being full thickness
or partial thickness.
Looks like 60% to 70% full,
20% to 30% partial.
Intubation meds?
- 120 Rocuronium, 100 Ketamine.
- Got it.
Can you draw them up and hold them?
Vitals are good, but gonna need
a pan scan after intubation.
Oh, my God!
Oh, my God! No, no, no.
Oh, Teddy.
I I'm Amy.
I'm Teddy's wife. How is he?
He's stable for now.
- I'm OK, honey.
- OK.
Teddy, you've got severe burns
covering most of your body.
You've also burned
the inside of your throat.
Just to be safe, I need
to put in a breathing tube,
and you won't be able to speak.
We need to do this now
before his throat swells,
and it becomes difficult
for him to breathe.
So if there's anything you two
want to say to each other,
this is the time to do it.
OK.
I'm gonna be OK.
[CRYING]
Can can I kiss him?
Yes, of course.
- [CHUCKLES]
- [COUGHING]
Ready to intubate.
Push Ketamine, then Roc.
I'm right here, OK?
Code stroke, emergency department.
Code stroke, emergency department.
- Ketamine is going in.
- OK, I will be right back.
Jane Doe, looks like she's in her 20s.
Obvious aphasia, right-sided
hemiparesis, and facial droop.
- Hi. What's your name?
- [MOANING]
Nod your head if you understand.
Receptive and expressive aphasia.
No motor strength in the right arm.
Open your mouth.
[MOANING, CHOKING]
Gag reflex present.
Left motor intact.
BP's 150 over 88.
- Where should we go?
- AccuCheck is 73.
Straight to Radiology.
CT brain without contrast,
perfusion scan,
CT angio head and neck.
- Hey, Crowe, wanna hang back?
- Yeah.
So you didn't get a name on her?
Uh, we looked.
Couldn't find a wallet or an ID.
But we had to jam out of there
'cause it was a Code Stroke.
- Who called 911?
- Well, apparently,
our Jane Doe is a professional gamer.
She was a no-show
for some big tournament.
So her teammate in Dubai calls
another teammate in Houston,
who called 911 here.
Who gets a stroke in their 20s?
That's what you get to figure out.
OK, come find me after
the scan results are back.
Who called the cops on David Saunders?
I did.
Mom!
Harrison?
Hey. Hey.
Are you OK? How'd you get here?
With Dad.
Chad Ashcroft, 39,
skateboarding accident.
Deformity of the right ankle.
No LOC, good vitals.
Got four of morphine en route.
Skateboarding? Really?
I'm fine, by the way.
You know this guy?
Unfortunately.
- Ah!
- Looks trimalleolar.
I was hoping for a dislocation.
40 hospitals in Pittsburgh,
and you just had to choose mine?
You think I want to be in this shithole?
I told him to take me to Presby.
You were the closest hospital,
so here we are. Where should we put him?
- On the curb?
- Ah.
Are you two family?
- Ex.
- Ex.
This is Chad, Harrison's dad.
Oh, nice to finally put
a face to a name.
What's open?
McKay, stay with your kid.
Let's take this half-pipe prince
to South 19.
- Hey, what's the golden rule?
- No hospitals.
OK, let's add "no skating
without a helmet ever again."
- You hear me?
- Yes, Mom.
When was the last time you took a bath?
Where's Robby?
Intubating the burn patient.
Ma'am, can you close your eyes for me?
Robby, it's Samira.
Jane Doe's CT came back no bleed,
but there was a carotid
artery dissection left neck
with a thrombus that threw a clot
to the left middle cerebral artery.
OK, got it.
We'll wait.
With no intracranial hemorrhage,
she might be a TNK candidate.
But couldn't TNK cause
a brain bleed and kill her?
TNK is still the best
clot-busting possibility.
Um, shouldn't we do
endovascular therapy?
I mean, it's the safest option to
What do you call
a Tyrannosaurus under stress?
What?
A nervous Rex.
Dr. King, meet Dr. Mehta,
one of our esteemed stroke neurologists.
How's the patient?
NIH stroke scale of 27,
no last known well time.
Dr. Mehta, should we take her to EVT?
Not yet.
We'll take her for a spin in the MRI,
check for irreversible damage first.
If there's a diffusion-flare mismatch,
she's still in the window
for thrombolytics.
And she still gets EVT
two-for-one special.
What type of person is best suited
to work with an MRI machine?
A trained technician.
Someone with a magnetic personality.
[CHUCKLES]
That one's new.
[CHUCKLES]
Somebody punched her?
A patient. Broke her nose.
Is she OK?
Robby checked her out, sent her to CT.
Sorry to interrupt the hot goss,
but what about me?
Uh, you got some
pretty good cuts here, sir.
We're working on closing them up
to prevent infection.
Yeah, can you call in a plastic surgeon?
Uh, the lacerations aren't that deep.
Medical glue should do the trick.
If you have any extra, do you want
to maybe apply some to his lips?
Your son was worried about you
and wanted to make sure you were OK.
- Are you OK?
- Yeah, totally.
Just a few battle wounds. [CHUCKLES]
Uh, did you hear? Dana got assaulted.
- What?
- Yeah. Patient.
Broke her nose.
When can I get out of here, please?
We're waiting for Radiology to come down
with a portable X-ray machine
so we can take
a better look at your leg.
You'll need a splint
and eventually a cast.
Ah, hear that?
Your dad's gonna have a cool cast.
Big Harry in the house. Up top.
Mateo!
I told my dad that we went
skateboarding last weekend.
- Ah!
- So he took me today,
- and
- Ah.
Then he fell and broke his leg.
[WHISPERING] Yeah, I can see that.
[NORMALLY] Hey, man. Mateo.
Hey.
Ugh.
You wanna go raid
the break room with me?
I hear there's a bag of Takis
with your name on it.
Sure. Yeah, yeah.
But not too much sugar.
Says the man who eats
Cap'n Crunch for breakfast.
No, not anymore.
Chloe makes me an acai bowl
every morning.
Oh, Chloe,
the gift that keeps on giving.
I already apologized for that.
How are those lacs coming, Dr. Santos?
- Good. All done.
- Mm-hmm.
I'm gonna go check on Radiology.
I'll come with you.
Sooner we get you in,
sooner we get you out.
BOTH: Thank you.
[INDISTINCT CHATTER]
Dr. McKay.
Somebody hit Dana?
I specifically told you
to leave Theresa Saunders alone,
and you called the cops on her son?
We talked about it.
A decision a decision was not made.
So I made it.
It was not yours to make!
No, it was yours, and you didn't do it.
I didn't do it
because it wasn't warranted.
Wasn't it?
If Theresa left,
how are we gonna get David
assessed for his risk to others?
I couldn't live with myself
if something terrible happened.
Yeah, well, now the police are involved,
so you may have ruined
this kid's life forever.
And what about the girls on this list?
Are you telling me their safety,
their lives, are worth less than his?
I can live with this one.
And now you can too.
[BUTTON BEEPS]
Uh, distal tibia and fibula
with an unstable mortise.
Hold on. Show us the lateral, please.
- [BEEPS]
- Here you go.
- [CLICKS TONGUE]
- Mm.
Not two three breaks.
Jesus.
What, so now I get a cast?
Uh, no, splint and surgery
to stabilize the bones
with plates and screws
so they can heal properly.
Ugh, how long am I gonna be stuck here?
[CHUCKLES] That is above my pay grade.
- [GROANING]
- Gabriel.
[CRYING]
But you may want to cancel
any dinner reservations you may have.
Set up for a double splint,
posterior leg and sugar tong.
Oh, is that gonna be painful?
There may be some discomfort.
I assure you, we will prescribe
proper pain medication
to provide you with adequate relief.
Draw up 100 of propofol, 50 of fent.
Whatever, just knock me out.
With pleasure.
[BACKGROUND CHATTER]
Perlah, which of our patients
can we send on their merry way?
Right.
Barry, yoga split lip,
moved from North 1 to the Hall;
Walter, road rash
with the rat killing dog, South 20;
and Vince, basketball elbow fracture,
outside Central 2.
OK, you can run another set of vitals
on Crosby's papa and discharge.
You can tell Ortho to get
their head out of their ass
and take Joel Embiid with them.
And you can release Yoga Barry,
but tell him
to refrain from doing any handstands
for at least 48 hours.
Copy that.
Go, go. You heard the man.
I do not know how Dana
does this every day.
Haha, running the ER
is a Sisyphean task.
So this is a punishment?
- No.
- Sisyphus.
Sisyphus pissed off the gods,
so they punished him
by making him push this massive
boulder up a hill for eternity.
One must imagine Sisyphus happy.
You're doing great.
Hey, Ahmad.
Is Theresa still out in Chairs
talking to those cops?
- Yeah.
- Will you do me a favor
and just kind of keep an eye on it?
Don't let her leave
without talking to me.
- OK.
- Any word on Driscoll?
I issued an alert
throughout PTMC security
and called the cops with his
home address from his chart.
They want a statement from Dana.
She's in CT.
Let's let's, um, clear her medically,
and then she can decide
when she wants to talk to them.
What about other hospitals?
- You let them know?
- Notified.
Everyone's on the lookout
for this guy, Driscoll.
- Thanks, Ahmad.
- You got it.
Glad to know the authorities
are looking for this psycho,
but what are you gonna do
to protect the rest of us?
Violence against health care
workers is a national problem.
And it's only getting worse.
No surprise there's a nursing
shortage everywhere.
I hear you, I hear you,
I hear you, I hear you,
and it is unacceptable.
What the hell kind of circus
are you running down here?
My God. You're like a bad penny.
Where is Dana? How is she?
She's all right.
We sent her to CT to make sure.
Did you fill out an incident report?
I don't know, I was
more concerned with her
having a skull fracture
than with your liability.
How'd a guy from the waiting room
get back here without anyone noticing?
Wow, Gloria! What a great question.
Our hard-working nurses were
just asking me
what steps the hospital plans to take
to ensure their safety in the future.
Maybe you would like to explain to them
why you've denied my request
for additional security measures
three times in the last four months?
If nurses don't feel safe,
they're not gonna come to work.
First off, the safety of all
our employees is paramount
Do you remember the last nursing strike?
Yeah, that was a real shit show.
Maybe this is something our
union rep should know about?
OK, well, just take a beat
and remember that PTMC is a family.
- Come on.
- A dysfunctional family.
You should be worried about
the nurses' satisfaction
and the safety of
We are worried about everyone.
We worry Robby.
Robby.
Dr. Robby, I got a question for you.
Shoot.
Uh, we're working on Chad
in 19, McKay's ex.
He's a nightmare.
[INDISTINCT CHATTER]
[INDISTINCT CHATTER]
Here's your driver's license
and insurance card, Mr. Pugliesi.
Have a seat, and the triage
nurse will call you back soon.
- Thank you.
- Hello.
Uh, my my son,
he needs help, his eye.
Let me ask you about your eyes.
Do you see the line you just cut?
What? No, please. It's an emergency.
You think everybody's
waiting for manicures?
He caught a line drive to the eye.
We're so sorry, ma'am.
We thought this was
the line for pediatrics.
I'm 16.
I'm doing this 'cause you're
a minor and you have manners.
Thank you so much.
Name and date of birth?
Everett Young. December 7, 2008.
I'll get your insurance
information from your father.
- Take a seat.
- What? No, we're not waiting.
Show her. Show her.
OK, then.
Come around to the double doors.
[DOOR BUZZES]
- Tenecteplase on deck?
- All set.
She's 62 kilos, 0.25 per kilo
is 15.5 milligrams.
- Push over 10 seconds.
- What's the status?
Diffusion flare mismatch means
she's less than four hours into it.
- Getting TNK now.
- Sounds great.
Would you mind hanging
down here for a bit?
I could use your expertise on this.
Can't believe you have the nerve to ask.
Good one. OK, keep me posted.
50 on board.
Anything I can do to help in here?
[SLURRING] No, I'm pretty good.
How are you doing?
[CHUCKLES] Not as good
as you, apparently.
Push another 25.
Wet the splints now, please.
You can help lift his leg
for the splint.
And we're at 75, mm-hmm.
When we lift his leg,
it's really gonna hurt him,
but he won't remember
benefits of propofol.
Pulse ox 99, good end tidal CO2.
Mm-hmm.
Hey, Chad?
Chad.
[SLURRING] Ow.
Perfect.
Let's do this.
[SLURRING] Ow.
I feel sad.
Uh, don't worry.
We'll have you fixed up good as new.
[SLURRING] What does he have
that I don't have?
I mean, sure, he's younger.
And that hair.
Who?
[SLURRING] Mateo.
- Oh.
- [CHUCKLING]
[SLURRING] What's his story anyway?
Is she having sex with him?
Well, if she isn't, she probably should.
Stop.
[SNORTING]
Who do we have the pleasure
of meeting this afternoon?
Everett Young, 16, took
a line drive to the left eye.
- Tachy at 118.
- Oof.
4 of morphine, 4 of Zofran.
Excuse me.
It was easily 100 miles per hour.
Oof. Did you pass out?
- Uh, no, ma'am.
- OK.
Baseball is a fun activity.
You any good?
[SCOFFS] Any good?
He's got a 95 mile an hour
fastball, a 12-6 slider,
a 0.94 ERA, and he's a southpaw.
What's that?
That's a future Cy Young.
I don't know what that is either.
Ms. Javadi is a student doctor.
She's a bit of a prodigy
herself, actually.
Do you mind if she helps out?
- No, ma'am.
- OK.
Tell me how many fingers I'm holding up.
Um ah, I can't tell.
Oh, my God. Oh, my God.
OK, tell me when the light turns on.
Now?
- Light perception only.
- Mm-hmm.
Do you want a portable slit lamp?
Definitely, yeah.
Javadi, what do you think
of the anterior chamber?
- Hyphema?
- Exactly.
Grade 4.
- Yeah, meaning?
- Javadi.
Meaning blood is filling up
the front eye chamber.
He'll need an emergency
evaluation by ophthalmology.
OK, is that why he can't see?
That's part of it. Yeah.
You see how the eye is pushing out?
There seems to be a collection
of blood behind the eyeball.
The eye pressure is too high.
We have to act quickly.
- OK, well, check the pressure!
- We're going to right now.
Can you get Robby?
[KEYBOARD CLACKING]
It looked like you were having
a pretty intense conversation
with Robby earlier.
Everything OK?
Uh, it was nothing.
Nothing?
Yeah, well, not nothing,
but nothing for you
to be concerned about.
An intern has a problem around here,
they come to the senior resident,
not the attending.
He is my attending,
and I wanted his input on a patient.
Is that not OK with you?
Just, um
come to me first next time.
Got it?
Yep.
Got it.
Are you a junior?
Yeah.
You thinking about college?
I have some D1 interest, but
where'd you go to college?
Uh, Pitt for undergrad
and now med school.
Didn't wanna leave town?
Look up at the ceiling
for some numbing drops.
It's not exactly an option
to live anywhere but home
when you go to college at 13.
Wow.
Add some drops to the fluorescein strip.
I was thinking about California,
maybe UCLA or USC.
- Hold still.
- Hey, maybe you go
straight to the Majors, huh?
College can wait.
I don't know.
I do.
Ev's got a God-given gift.
It's why we spent every
weekend doing travel ball
when he was young
pro camp, showcases.
He's not throwing away
his shot at the Majors.
Uh, we have to check for a puncture
before we can measure the pressure.
Look straight ahead and try
not to move your eyes, OK?
- Yes, ma'am.
- Lights going out.
Hello. I'm Dr. Robinavitch.
Everybody calls me Dr. Robby.
Hey, Greg Young.
This is my boy, Everett.
Nice to meet you both.
OK, I will take that slit lamp,
and you can calibrate for tonometry.
- OK.
- They're holding CT for him.
Let's take a look.
Negative Seidel.
No globe rupture.
OK, go with the Tono-Pen.
OK. Hold still.
OK.
Left eye pressure 58.
- Is that high?
- Yes, it is. 1% lido with epi.
Push one of Versed, and open
a lateral canthotomy tray.
- Excuse me.
- What?
- Whoa.
- Without a CT? Isn't that
Exactly what the patient needs?
Yes, it is, Dr. McKay.
OK.
Uh, we're gonna lie you back
a little, Everett, OK?
We need to do a little minor surgery
to relieve the pressure behind your eye.
So we are going to cut a small opening
on the side of your eye,
not in your eye.
- Got it?
- Yeah.
Do you wanna watch?
No, I'll I'll sit down.
Javadi, step up so you can see.
Dr. McKay, Chad is splinted
and is awaiting Ortho
for surgery to take him.
Thanks for the update.
[CLEARS THROAT]
Versed's on board.
Numbing medicine here, OK?
OK.
Pinprick and some burning.
Ouch.
What is Dana gonna be OK?
It's gonna take more
than a punch to the face
to keep that mama down.
She's tough.
Yeah.
Um, hi.
I'm sorry to bother you.
Hi.
Uh, I I just wanna make sure
that Teddy's not in any pain.
Oh, he's heavily sedated.
- He can't feel a thing.
- Right.
It's just that when
I look at him, I just
I just feel so helpless.
Look, his, uh, CT scans
came back negative
for internal injuries.
He's on IV therapy
to replace any lost fluids.
I assure you,
we are doing everything we can
to give him the best treatment possible.
Thank you.
Yeah.
Teddy's ring.
Um
I had to cut it off
because of the swelling.
Hopefully you can find
a good jeweler to fix it.
I don't know how it works.
[SNIFFLING]
Um
do you have a best friend, Doctor
Oh, it's a another year to go
till you can call me "Doctor."
You can just call me Whitaker, though.
Do you have a best friend, Whitaker?
Uh, I have three older brothers.
I guess they're kind of my best friends.
They kind of tortured me
growing up, so maybe not.
[CHUCKLES] But yeah.
Teddy's been my best friend
since we were 15.
High school sweethearts?
We were just a couple
of nerdy aggies who, uh
we met in 4-H, and we fell in love.
I'm sorry.
No, it's fine.
I'm a third generation
Nebraska farm kid myself.
Get out.
Well well, if you're ever
homesick, you should, uh
you should come by our farm sometime.
That's very kind.
[CHUCKLES]
I need some help in here!
[RAPID BEEPING]
- What's going on?
- Respiratory distress.
Sats are dropping, 87%.
Uh, lung injury from the fire?
It's not just the low sats.
The vent's showing
high peak pressure, low tidal volume.
- Uh, restrictive pattern?
- Most likely.
I'll grab Robby and Langdon.
Wait, wait, wait, wait, wait, wait.
What's that? What's going on?
Ventilator is having trouble
pumping air into Teddy's lungs.
Burnt skin loses elasticity.
Now his chest wall is too tight.
What can you do?
We're gonna have to cut the burnt skin,
release pressure on the chest wall,
help Teddy breathe.
So after you cut his eye,
he'll see again?
This will give us our best shot
at preserving his vision, yes.
Dr. McKay, are you ready
to do the honors?
Who, me?
We are a teaching hospital.
Are you still here to learn?
Yes. Yeah.
[GRUNTS]
OK.
You can release that hemostat now.
Pair of scissors.
The length of the crushed area
is going to be your guide
for the length of your cut.
OK.
Good.
Toothed forceps.
Feeling for the inferior
And superior crus.
How can you see with all that blood?
You can't. It's all tactile.
It feels like two guitar strings.
Metzenbaum.
[SQUELCHING]
Inferior
Yeah.
And superior.
Nice.
Good.
Oh, that's a lot of blood.
OK, let's get a repeat pressure.
It's getting a lot brighter in here.
Pressure of 18.
Perfect.
CT can take him as soon
as we dress the wound.
Let's page Ophthalmology and
tell them to prep for surgery.
Doc, thank you. Thank you.
My pleasure, my pleasure.
Good luck to you, Everett.
Hey.
Thanks for letting me do that.
You sound surprised.
Yeah, I figured after
the whole Theresa thing,
you might bench me.
[SIGHS] Am I still pissed
that you went behind my back?
Absolutely.
And if you ever do it again,
you can bet your ass
that I will bench you.
But this is a teaching hospital,
and teachers can still learn stuff.
I saw a sad, confused boy,
and that's all I thought about.
I did not think enough
about those girls.
Any word on Dana?
She should be coming back from CT soon.
Burn victim's tanking. We need you.
Oh, my God, I can't wait
for this shift to be over.
[MYSTICAL MUSIC PLAYING]
Hey, bud, you doing OK?
Yeah. Mateo hooked me up.
Right, I can see that.
How's Dad?
He's gonna need surgery,
but he's gonna be OK.
You know, I was thinking,
since your dad's gonna be
laid up for a while,
maybe you'd wanna stay with me
until he gets better?
For real?
For real.
What do you think?
I'll take that as a yes. [CHUCKLES]
This procedure is called an escharotomy.
We need to cut the skin so that
the chest wall can expand.
That sounds painful.
Whitaker?
He's still heavily sedated.
He won't feel a thing.
This is gonna help Teddy breathe.
Sat's 83.
Peak pressure is over 40.
Tidal volume is only 300.
I want you to watch Dr. Langdon
as he makes this vertical incision.
Then you're gonna do the exact
same thing on your side
and follow his instructions.
I'm sorry, I just
I don't think I can watch it.
Jordan, would you
[CRYING]
Start at lateral clavicle.
[SQUELCHING]
Down anterior axillary
to lower rib margin.
That tissue is really popping out.
Which illustrates what?
The pressure underneath.
Your turn.
[EXHALES SHARPLY]
Here goes.
- A little more pressure.
- Yeah.
Need to make a decisive incision
to get through the eschar into sub-Q.
Go back a little deeper
on that first section.
OK.
Yep.
- Yep, good.
- Uh-huh.
Looking good.
OK.
Now the horizontal incision,
Dr. Langdon.
And connecting the two incisions.
That ought to do it.
Peak pressure's already down to the 30s.
And tidal volume is coming up.
Sat's 91.
That was wild.
Let's dress these wounds
and send off a blood gas.
Well done,
and very well taught, Dr. Langdon.
Thank you.
[BACKGROUND CHATTER]
[PHONE RINGING]
You think Wholey's will still
be open by the time we get off?
- No.
- No. No.
Damn.
I was hoping to surprise
Abby and the kids,
grill up some salmon for dinner.
Mm, such an adrenaline junkie.
What'd you call me?
Your ice plunges. Marathon man.
Surprise, here's a dog.
Surprise, here's some salmon.
[LAUGHTER]
Who pissed in your cornflakes?
Oh, oh.
What, I touch a nerve?
You're regretting buying
that dog, aren't you?
Ew.
Ooh, Robby.
Dana's CT results are back.
No intracranial hemorrhage,
no skull fracture,
non-displaced nasal fracture,
but the rest of the facial
bones look intact.
Any hemorrhaging into the sinuses?
- Nada.
- Great.
We could really use her
back on the floor.
- [CLEARS THROAT]
- What? I'm just saying.
Mind if I give her the good news?
No, go for it
and anything else she needs.
I got it.
About the whole thing with Santos
and the seizure patient
What about it?
I'm sorry for laying into her so hard.
Why do I feel there's a "but" coming?
But I don't think she's a team player.
How so?
She's cherry-picking cases.
She gave Whitaker a shitty nickname
after his patient died this morning.
She's she's even harassing Javadi
to get a rec from her mom for surgery.
[LAUGHS] If she wants to be in surgery,
what's she doing in the ER?
That's a great question.
Why don't you ask her new BFF, Garcia?
I know that you've seen those two.
I'm the only one calling her out,
so she has an axe to grind.
You've always said
that being in the Pitt
is like playing a team sport.
A team has to be able
to trust each other.
If we have one weak link,
this whole place goes to shit.
Good meeting.
Call Zauzy in Family Med.
They open up their urgent care at 5:00.
Let them know we're sending up
the two hockey kids.
Yep, Zauzy in Fam Med.
OK, copy that.
And, uh, please check in on Earl.
Poor thing got caught
in the crosshairs of that mom fight.
Maybe bring him another sandwich.
- Yeah, OK.
- Good.
No egg salad.
Dana, I got you. OK? Rest up, bud.
[SIGHS] You can take
the girl out of the ER,
but you can't take
the ER out of the girl.
Old habits die hard.
Let me take a look?
[BREATHING SHARPLY]
Oh, she's a real beauty, all right.
But your CT came back clean
nothing Mother Nature
can't heal on her own.
Hmm. Too bad.
I was hoping for a free nose job.
Probably get hazard pay.
Two for one.
[BOTH LAUGH]
[SIGHING]
Ooh.
Ugh.
[CHUCKLES]
You know, you're cleared to go
back to work if you want
or home.
Oh, not ready yet.
[SIGHS] You?
Nope.
Got a lot to think about.
Yeah.
Been a pretty fucked up day.
[BOTH LAUGH]
What do you call a group of brains
who form a singing group?
What?
A glia club.
Oh. [LAUGHS]
Good one.
Keep me posted if there are any changes.
[LINE BEEPS]
Um, what's with Dr. Mehta and the
the jokes?
You know why they say
laughter is the best medicine?
Because it's true.
Laughter releases endorphins.
Endorphins help relieve pain.
Um, so
Dr. Mehta thinks that
if a joke helps raise spirits
and makes people feel better,
then he's all for it.
It's his special sauce.
[LAUGHS]
Um, do you have a special sauce?
I'm pretty data-driven,
but I really like
to talk to my patients
about their lives.
Makes them feel important.
She's waking up.
How are you feeling?
[SLURRING] OK.
Are you trying to say "OK"?
Yes!
The thrombolytics are working.
Um, can you, uh, lift
your right leg for me?
That's OK.
Um, try moving it from side to side.
Can you tell us your name?
[SLURRING INDISTINCTLY]
Oh, um, maybe you can type it
out on the screen here.
Vera.
OK, uh, and what's your last name?
Mullahy?
Well, hello, Vera Mullahy.
- Hey.
- Oh.
- Hey.
- Chad's a real piece of work.
I appreciate you dealing with him.
You know, it was actually kind of fun.
I did not have that on my bingo card.
Well, you know, patients under propofol
are always a good time.
Yeah?
What did he say?
Nothing.
Nothing to worry about,
unless you're concerned
he still has a thing for you.
Oh, please, euthanize me
if I ever even consider it.
But, you know, if I could go back,
I wouldn't change a thing.
Without Chad, I wouldn't have Harrison.
You're very lucky.
I know, right?
[SIGHS] All right.
Thanks again.
I was getting ready to take her up
when she developed angioedema,
and her sats dropped.
[RAPID BEEPING]
A little bit of stridor.
Swollen lips, swollen tongue.
Vera, this is a side effect
of the medication we gave you.
[MOANING]
Sats are up with high flow nasal.
It's anaphylaxis. Get Robby.
Angioedema is not always anaphylaxis.
I know, but it can progress
to it and cause an obstruction.
If it's just angioedema, I can reverse
the swelling fast with IV epi.
BP's 165 over 85.
Prep Ketamine and Roc for intubation.
Hold on. Wait, wait.
But Dr. Mohan, you just said
We're not intubating yet.
But she's gonna arrest.
What happened?
Angioedema with stridor.
Respiratory is on their way.
- We should intubate, right?
- Good BP and O2 sats.
Epinephrine can reverse
the swelling right away.
I pushed 10 mics of IV epi.
Starting her drip at 5 cc's,
5 mikes per minute.
Sats are holding at 95 on high flow.
BP is good.
Vera, we're gonna sedate you
so that we can help you breathe better.
Or not. Let's just wait a minute.
How'd you get that epi drip
hung so fast?
Bedside drip.
I mixed 1 milligram with a liter.
Nice.
Are we intubating?
Are we not intubating?
Not.
Stridor is improving.
Is it getting easier to breathe?
Mm-hmm, hmm.
Speech is coming back.
50 diphenhydramine, 125 Solumedrol.
Do you think Dr. Mehta
will want her intubated
- for the thrombectomy?
- Not necessarily.
If she can talk and move
during the procedure,
then they can monitor
any changes in the neuro exam.
Slo-Mo, No-Mo!
Sorry, I think Dr. Mehta
is rubbing off on me.
We're taking him up to our burn unit.
He'll be in great hands.
They've had lots of experience
with cases like Teddy's.
What now?
We will continue
with IV fluids and pain meds.
We'll support his breathing
with the ventilator,
and we'll keep his wounds clean,
look for any signs of infection.
And later, the plastic
surgeons can do skin grafts.
He's gonna be OK.
Teddy's condition is
very critical, so no promises.
But our team is gonna do
everything they can
to give him the best chance possible.
I'll make sure to stop by the ICU,
check in on both of you.
I can't begin to thank you
enough, Dr. Whitaker.
Oh, uh, student doctor.
Oh, uh, don't forget
about dinner at the farm.
And, uh, make sure to brush up
on your diaper-changing skills.
Oh, with seven nieces and nephews,
I'm a Diaper Genie, so
[CHUCKLES]
You know you just called
yourself a trash can, right?
Before you grab your next
patient, um, call Kiara.
Have somebody go upstairs
and talk to the wife.
Amy? Why?
We wanted to give her hope,
but the reality is,
her husband's not gonna make it.
He's stable.
His chance of dying in the next week
is over 90%.
He's young, he's strong.
- Maybe he's the 10%.
- Maybe.
But he's a lot more likely
to die of sepsis
before his kid is born.
Call Kiara.
The CT shows a hairline
orbital floor fracture.
But thanks to the canthotomy,
the hematoma isn't
pushing on his eyeball.
Will I be able to see?
That's why you need surgery.
The ophthalmologists will drain
the blood inside the front
of your eye and replace it
with the clear fluid
you need to see, OK?
They're ready for you now.
Hey, hey, hey.
Don't worry, bud.
All right?
So so he has the surgery,
stays overnight,
he goes home tomorrow?
It depends on how the surgery goes
and what his post-op results are like.
Give or take.
It could be as soon as tomorrow, yeah.
OK.
So he could be
could be game-ready by Thursday.
Sir, your son is freaking out
because he may never see
out of his left eye again.
- Yeah, that's
- No, no, forget baseball
and just be his dad.
God, it can't be that fucking hard.
- [SCOFFS]
- Uh, there's a waiting room
up by surgery, sixth floor.
Right off the elevator.
You can't miss it.
Angioedema responded to epi,
diphenhydramine, and steroids.
Excellent.
Thank you.
You're very welcome.
Which neurotransmitter
makes the best adhesive?
- I don't know
- Glutamate!
"Glue" -tamate.
Am I right?
Nicely done, Dr. King. [LAUGHS]
That was really quick
thinking back there.
I'm really sorry if
it seemed like I doubted you.
I didn't. I just
Honestly, I surprised myself a bit.
Yeah?
Well, you trusted your gut.
Maybe that's your special sauce.
Maybe.
Um, Dr. Mohan,
what if I don't have special sauce?
Of course you do.
Just be yourself.
It'll come.
So now might be a good time to go over
some doctor-patient
interaction guidelines.
I'm sorry. That dad was just such
- So overbearing.
- An asshole.
I'm sorry.
Look, do I think he needed
to chill out a little bit?
Yes.
But he's a parent, and this might be
his way of coping with the stress
of a very frightening situation.
I'm sorry.
I don't know what came over me.
No, I do.
You and that baseball kid
are two pressure cooker
prodigies in a pod.
Just as physicians, we gotta learn
to keep our emotions in check
and not let
our personal experiences interfere
with our professional responsibilities.
How long did it take you to learn that?
I'm still learning.
And I also learned
to never get on your bad side.
- [CHUCKLES]
- Yo, yo, yo.
- Hey.
- Almost quitting time.
I so appreciate you
helping me out with Harrison.
- Oh.
- And my douchebag ex.
- Hey, we all have them.
- Yeah.
Oh. Totally.
Me too. Me too.
Yeah.
I'm always happy to help.
Yeah.
So I get off in a couple hours.
Do you mind just doing
a loop every once in a while
to make sure he's not
burning the place down?
- Can do.
- Great.
And, you know, a new foot massage place
just opened in the Strip District.
Do you wanna go on Sunday?
- For sure. Yeah, yeah.
- OK, cool.
I'm free Sunday
um, to to help or just do
yeah, whatever. Wherever.
Oh, my God.
I mean, Harrison would love
a sitter closer to his own age.
I [LAUGHS] I'll get your number
and text you the address?
That's awesome.
- Oh.
- Thank you.
Oh, sure.
Dr. Santos, a moment, please?
[CLEARS THROAT]
So how's your first day going?
So far, so good.
Getting along with everyone?
Yeah, pretty much.
Except Langdon?
So in this ER,
we all need to work together
as a single unified entity.
And if two people on my team
can't work together,
it kind of throws
the rhythm of the place off.
Understood.
My duty, regardless
of personal relationships,
is to make sure everybody
on my team is doing OK.
So are you doing OK?
Uh, it's not a big deal.
I can handle it.
Handle what?
Nothing. It it's fine.
I
I don't wanna get anyone in trouble.
Hmm.
OK, if there is anything
anything that could affect my ER,
I need to know about it,
and you have
a responsibility to tell me.
- Hey.
- Hey.
Did they catch the bastard
who sucker punched you?
I haven't heard.
Well, when they do, just send him to me.
I can make it look like an accident.
[CHUCKLES]
I might just take you up on that.
Mm, you betcha.
You've been paroled!
- Are you sure?
- Yeah.
- Oh.
- OK. Yeah.
Ow. OK.
Yep. Go check on Myrna.
- You got a sec?
- Bless you.
For you, boss, I got two.
What's up?
[INDISTINCT CHATTER]
[SIGHS]
I heard there's been
some inconsistencies with meds
intended for your patients.
What?
Frank, have you been helping
yourself to benzos from the ER?
Yeah, I've been stealing blood too.
I asked you a question.
Wait, are you serious?
What are you doing?
Really?
Santos?
Whatever the hell
she told you is bullshit.
[SIGHS]
I didn't mention Santos.
You didn't have to.
I told you, she is trouble.
Have you ever taken
a patient's medication?
This is insane.
This is completely fucking insane.
I need you to open your locker.
- Yeah, right.
- Open your locker.
- You're gonna regret
- [BANGING]
Open your fucking locker,
or I will have security smash it open.
[KEYPAD BEEPING]
[SIGHS]
Is the imprint code on these pills
gonna match Louie's Librium?
Go home, Frank.
No, no, it's not like you think.
You remember, whenever
I helped my parents move,
I was too cheap to pay for movers.
I hurt my back. I told you that.
You teased me about it, remember?
Well, our own Dr. Hagan prescribed me
some pain meds and muscle relaxants.
I was just weaning myself off.
It was just for maintenance. I'm done.
Robby, come on.
You know me, Robby.
You know me, man.
I'm sorry. I fucked up.
- I just I I was trying to
- Trying to what?
Steal pills without getting caught?
No, it's not like you don't under
- I don't fucking understand?
- It's not like you think!
I'm not high. I'm not high.
You've seen what I do, Robby.
Could a drug addict do what I do?
Apparently.
And I just fucking let him!
You're done.
Leave now, or I will have
Ahmad escort you out.
Robby, please.
You are done.
[SHOUTING] What?