The Pitt (2025) s02e04 Episode Script

10:00 A.M.

1
[INDISTINCT CHATTER]
[POLICE RADIO CHATTER]
- The man is in his element.
- What's he doing?
Age-old ritual, meant to capitalize
off the unknown origins
of Westbridge's current state
of affairs.
Whoever guesses the reason they
went code black wins the pot.
Ah, interesting.
We didn't do this at the VA.
- You game?
- Of course.
Now, how's this look to you?
My wager is on flooding.
They're going to be down for 3 hours,
and we're going to get 20
of their patients.
Put me down for flooding,
4 hours and 30 patients.
Okay, okay, okay.
Hey, Dr. Robby, looks like
you got some competition.
Yes, it would appear that I do.
All right, guys and gals, enough fun.
We have people to take care of.
You want to bring Langdon
back from triage
for the extra hands?
No, I do not.
I don't think that's necessary.
We're doing just fine without him.
You're the boss, boss.
[INDISTINCT CHATTER]
Daniel Ortiz,
tu licencia en el mostrador.
Next. [PHONE NOTIFICATIONS PINGING]
Hi. Uh, the doctor guy told me
to put this mineral oil
on my eye for 20 minutes.
That was 2 hours ago.
We're really busy, but we'll get to you.
- Oh, my God. Okay, when?
- I will check.
Listen for your name to be called.
- Thanks.
- Next.
Excuse me.
Uh, hi. I heard my brother
was brought here.
- His name is Jackson Davis.
- Do you have ID?
Yes, yes, um,
I am his sister Jada Davis.
I'm sorry. I just, uh
my friend told me that he was
brought in by campus police.
There was some sort of fight
that broke out at his school.
- Is he okay? Is he here?
- Don't know, hon.
Can you just tell me
if he's a patient here?
I'll check. Take a seat.
And I'll let you know.
- Okay.
- Next.
Is Harlow feeling lightheaded
or faint now?
It's not as bad as it was before,
but my head still hurts.
And now my stomach does, too.
Well, did she eat
before she took her ibuprofen?
Ugh, it's not my
Breakfast is my least
favorite meal of the day.
It's okay to look at me.
I don't bite.
[SIGHS] I'm sorry.
Um, we're going to get started
with some blood tests.
Is that baby from
the bathroom going to be okay?
She'll be fine.
Uh, good news
nose swab came back negative for COVID,
influenza, and RSV,
but a lot of other viruses
can cause a cough.
Lucky me. [DEVICE BEEPS]
You can take off your mask.
Pulse ox is at 91.
Your oxygen level is down
since we checked you an hour ago,
and your temp is up to 102.4.
Let's get you some Tylenol.
Have you been outside today?
It's already stifling.
Could be heat-related,
but we're going to take you
back to the big ER
for a full evaluation.
Can't you just
write me a prescription
for some medicine?
I'm sure it's just a summer cold.
- Got somewhere to be?
- Work.
I know. It's Saturday.
But I don't think I've had
a day off since
Well, your holiday weekend starts now.
Hey, Javadi.
What are you doing for your birthday?
- Who told you?
- Word gets around.
Nothing. I hate celebrating my birthday.
You only turn 21 once.
It's your birthday?
Oh, that makes you a Cancer, right?
I didn't peg you
for an astrology girlie.
- [CHUCKLES]
- Yeah.
Been spending too much time
around Santos.
Yes, you have.
I don't know how you guys do it.
Live together and work together?
It's my cross to bear.
It can't be as bad as having
to live with your parents.
I don't know. I haven't lived
at home in years.
- I kind of miss it.
- I can tell.
You've been spending a lot
of time on that farm.
"Farm"?
Remember the burned farmer
who came in last year?
Propane tank exploded,
he died in the ICU?
Yeah, that was sad.
Well, this guy has been playing house
with his widow and their baby.
Oh, that's messy.
No.
It's not like that, okay?
I've been helping Amy out on the farm
after her husband died,
and she is a friend.
She's just a friend.
Sure, just a friend, with farm benefits.
What are farm benefits?
Oh, use your imagination.
You ever see a milking machine?
Oh, can we not talk about this, please?
We're getting two runs rerouted
from Westbridge already
chest pain and belly pain.
- Robby wants you three out back.
- Thank you.
Come on.
Dr. Santos, making progress
on your charting, I hope?
Getting there.
Deficient charts leave a gap
for the providers
who give continuity of care
and delays hospital billing.
Oh, I'd hate to delay billing.
Timely documentation is essential.
Let's fix this before end of shift.
- I'm on it, boss.
- Good.
You wouldn't want to repeat
your R2 year again
because of this.
[SOFTLY] Fuck.
God, it's humid as shit out here.
It is.
What's going on at Westbridge?
They're closed, so we're
covering their paramedic runs
until they come back up.
As if a holiday weekend wasn't enough.
So, Dr. Al-Hashimi
Yes?
Do we like her?
- [LAUGHS]
- She seems pretty cool so far.
You're trying to gossip about
an attending with an attending?
Dr. Robby doesn't mind. Do you?
Oh, uh, that's a nice bike, by the way.
- Thank you.
- Yeah.
Pamela Perry, 48, abdominal pain
with vomiting after eating
chilaquiles with fried eggs.
BP 108 over 64, pulse 98, good sats.
Okay, let's see how she feels
with some Zofran
- and a liter wide open.
- Got it.
- Yo, Whitaker.
- How are you feeling? OK?
Not so good.
- Who do we have here?
- Jean Samba
54, half an hour
of left-sided chest pain.
History of hypertension,
on lisinopril and Crestor.
Some relief with two nitro.
Decent vitals, no STEMI on 12-lead.
Gave him 324 of chewable aspirin.
Okay, we're going to give you
a full evaluation, sir.
Oh, if I am to die, God willing,
I will see His pearly gates.
What's the plan?
Repeat 12-lead, check a troponin,
admit for new onset angina.
Evaluate for PE, aortic dissection.
- That goes without saying.
- Sounds good.
I'm a minute behind you.
[SIRENS WAILING]
[SIREN CHIRPS]
And who do we have here?
Vince Cole, 23, fell through
the skylight of a florist shop,
10 feet down to a bunch of ferns.
Complained of headache,
asking repetitive questions,
and only responds to pain.
Multiple lacs from the glass.
BP, 118 over 72, pulse 98,
sats, 99 on 5 liters.
No meds, no allergies.
Hey, Vince, how'd you fall
through a skylight?
Vince?
Were you with him?
Yeah, we were parkouring,
and he overshot a kong vault.
What, like, jumping off of buildings?
People still do that?
It was almost an Olympic sport.
Now we know why it isn't.
Pupils are equal and reactive.
- What do you got?
- A 10-foot fall, altered.
- That's a long way down.
- 10 feet is the threshold
for trauma center activation
10 feet, 10% mortality.
0%, anything over 0% is a concern.
Somebody's annoying, and it's not me.
Hey, you said two. You missed one.
Sent you backup, didn't I?
One, two, three.
Okay. Thanks, guys. Good to see you.
Get the EFAST.
Ogilvie, Joy, GCS, please.
Uh, open your eyes, sir.
- [GROANS]
- Two for eyes, two for verbal.
Uh, good lung sliding bilaterally.
Joy, finish GCS.
Squeeze my hand.
He gets a 4 for motor.
Pulse ox 99, heart rate 102,
blood pressure 114 over 78.
- And EFAST is negative.
- Music to my ears.
Somebody shooting a documentary here?
Whoa, whoa, whoa,
you can't film in here.
We've got patient-privacy laws.
- What happened to your hand?
- Cut it.
Can somebody show Spielberg
here out to the waiting room
and get her registered
at triage, please?
He's my creative partner
I have his written consent
to film everything for our TikTok page.
Put the camera down.
We have to drop this video
for the Fourth tonight.
That literally means nothing to me.
Seriously, Sean,
can you escort her out, please?
Somebody will come and find you
once he's stabilized.
Thank you.
I would have let her stay
if she'd asked nicely.
What is the, uh, story with surgery?
You guys getting
any Westbridge transfers yet?
Not yet, but I'm sure it's coming.
Pan scan, head through pelvis.
Let's get him to CT ASAP.
Absent gag.
We need to intubate before CT.
C-can I do it?
Uh, I'm keeping a procedure log,
and I need more intubations
on this rotation.
If Dr. McKay wants to teach?
Sure.
Okay, uh, I need suction.
8-oh tube, etomidate and sux,
end tidal CO2.
Ambitious.
He reminds me of someone
I know very well.
[MOUSE CLICKING]
Can you not?
Yeah, sorry.
Hot off the press.
Okay.
No STEMI, doesn't need
to go right to the cath lab.
And orders are in.
Whitaker, try another nitro
and let me know
when the troponin's back.
Yeah. Hey, hey, Jesse?
Do you think you could repeat this
but with the chest leads on his back?
Why?
T Waves are kind of high
with ST depression anterior.
We see ST depression all the time.
Yeah, but it could be a posterior MI.
All right, run it by the attending.
If they agree, we'll do it.
Thank you.
Uh, Victoria, if his CT's
normal, he'll need an LP.
Got it.
Dr. Al-Hashimi.
This is Jada Davis, Jackson's sister.
- Oh, thank you. Hi.
- Is he okay?
And why is he asleep?
Well, he was uncooperative
when he first arrived
- and needed to be sedated.
- "Uncooperative"?
That doesn't make any sense.
What happened?
We're still trying
to piece the story together.
He was brought in
by a campus security guard
who Tased him after he was allegedly
- "Tased him"?
- Combative and violent.
Wait, what do you mean, Tased him?
We've treated his injury,
and now we're trying
to understand why he was so agitated.
Okay, this doesn't
sound like my brother.
Well, his drug screen
came back negative,
so now we're taking Jackson
to get a CT scan of his brain
- to look for any abnormalities.
- Can I go with him?
You can't go into the CT,
but you can wait for him to come back.
And then we can discuss next steps.
Okay.
Just did my first ER intubation.
- That's great, man.
- Such a prick.
- You got a second?
- What's up?
12-lead on my chest-pain
patient shows no STEMI,
but the anterior leads might be
suspicious for a posterior MI?
Uh agreed.
Yeah, I was going to repeat,
but with the chest leads
- on the back.
- V7 through V9.
- Good idea.
- Thank you.
Hey, Dr. Robby gave the
go-ahead for the back leads.
Sorry, man, I got a call report
on a septic patient going to the ICU.
Busy today, huh?
Uh, well, it's 10:15.
We're actually just getting started.
- Oh.
- There she is.
Dr. Mohan, uh, this is
Lorrie Diaz, Orlando's wife.
- Thank you, Perlah.
- Thank you.
- Hi, Mrs. Diaz.
- Hi.
Let me take you to your husband.
Ay, mi amor.
I'm sorry you have to be here alone.
I missed my first bus transfer and
Anyway
Hey.
How'd I get here?
You fell at your construction site.
A coworker brought you in.
He's a lot better
but doesn't remember anything.
That's common after a concussion or DKA.
DKA?
It's a serious complication
of your husband's diabetes.
How serious? Can he go home?
We still have to clear the
ketones from his bloodstream.
He'll need to be
on an insulin drip for a while
until things get back to normal.
Best if he stays in the hospital.
It's okay, Mom.
Things are headed in
the right direction, Mrs. Diaz.
- He's going to be better.
- Mm.
[DOOR CLICKS]
Sorry. I got to check his blood sugar.
- Oh, do you mind?
- Absolutely.
So the thing is
we don't have health insurance.
So
[VOICE BREAKING] I don't think
that we can afford this.
I'll have our case manager,
Noelle Hastings, come by.
She's an expert in health insurance.
She might have some options
for you for coverage.
- Okay.
- Thank you.
[DOOR CLICKS]
[SIGHS]
- Crap.
- What's wrong?
Uh, some of the leads
aren't sticking here.
Can I lay down now? I'm tired.
Yeah, as soon as we're done here.
Whitaker, Louie's all numb.
His tooth is ready for you.
That's great.
Hey, I'm having some trouble
here with adherence.
Oh. Of course you are.
Uh, try this.
Oh, yeah. That makes sense.
Uh, you think you could
[SIGHS]
Do you mind if I paint
some sticky stuff on you?
Oh.
If you must prolong
the inevitable, so be it.
You'll get to lie down afterwards.
No success with the mineral oil.
That's what I said.
So now what?
You can wait one to two weeks
for the superglue
to break down on its own.
I'm hosting
a Fourth of July party tonight.
You want me to show up like this?
The other option is I trim
your eyelashes halfway down.
That'll lower the strength of
the glue holding them together.
Let's do that.
Lie back, please.
I need you to hold your head
perfectly still,
keep your eye closed.
My eye can't open. That's why I'm here.
No, I mean, your other eye, too.
Okay, here we go.
Perfect, Mr. Samba.
All good here.
- [MEDICAL MACHINE BEEPING]
- Feeling dizzy.
We'll put you down in a second.
Holy shit.
ST elevation, V7, V8, V9.
- It's a posterior STEMI.
- What's that?
It's the worst kind of heart attack.
[ALARM BLARING] Mr. Samba.
Mr. Samba!
Hey, I could use
a second set of hands here!
Pulseless V tach.
Start compressions.
Charging to 200.
[MACHINE WHIRS, BEEPING CONTINUES]
Clear.
Okay, resume compressions.
Code STEMI. It was posterior.
Yeah, good call.
- You put the defib pads on?
- Yeah, just in case.
Hold compressions.
[STEADY BEEPING]
- Normal sinus.
- All right.
Got a strong pulse. Check the BP.
All right, we'll prep him for cath lab.
[MUMBLES]
Hey, Mr. Samba, you're going to be okay.
No pearly gates today.
- Really good pickup, Whitaker.
- Thank you.
Ah [CHUCKLES]
Has a patient ever flirted with you?
Sure. Why?
There was this guy this morning
he turned out to be a criminal,
but, yeah, it was a nice distraction
from the deposition.
[SIGHS] You still worried about that?
Yep. Yeah, counting down the hours.
There are five left,
if you're wondering.
[COUGHING]
Hi, Miss Ronson.
Phylicia, please.
Phylicia, I'm Dr. King.
This is my colleague Dr. Santos.
What brings you in today?
I've had this pretty bad cough
for a few days now.
Do you smoke?
Are coughing up anything,
any chest pain?
No, no, and no.
I honestly think I picked it up at work.
- It was going around.
- Oh, where do you work?
- I'm in corporate at PNC Bank.
- Sit forward, please.
It could be an office bug.
Or I got it from the gym.
I'm there all the time.
[COUGHS]
Do you have anything to ask, Dr. Santos?
What?
Do you have any questions
to ask our patient?
Uh, no, I'm good.
Okay. What'd you hear?
Maybe some crackles at the right base.
Okay, well, we're going
to need a chest X-ray
to check your lungs.
Will that take long?
Maybe I can still make it to the office.
It shouldn't.
- You can go put the orders in.
- Yeah.
- How are we doing in here?
- Oh, this is thrilling.
Definitely worth $200,000
worth of student debt.
Ha.
Superficial ones get a steri-strip.
Full thickness, try Dermabond.
How can you tell
they need a suture, Joy?
If the edges are
under significant tension.
I didn't realize your name was Joy.
I'm going to have to tell my
parents how trendy they were.
[OBJECT CLANKS]
CT head, neck, chest,
abdomen, and pelvis,
- all normal on preliminary read.
- Lucky guy.
Little bit of oozing.
Uh, pressure for two minutes.
Lidocaine and epi if that doesn't work.
Are the admit orders in
for Surgical ICU?
Fuck!
What?
- This.
- Ah.
- Irrigation saline.
- It's just a small cut.
It is a work-related blood exposure,
which means you're a patient now.
- Are you serious?
- Needle stick?
Piece of glass.
- Here you go.
- Thanks.
[DEVICE BEEPS]
No past records on this guy.
We don't know HIV or hepatitis status.
I'll put the orders in,
HIV antibody, Hep B surface,
and Hep C.
She needs post-exposure medication.
Maybe not.
For occupational exposure,
the rapid HIV test
- takes an hour or two.
- Subcutaneous puncture wound.
No risk of joint or tendon involvement.
Elevate, pressure, and then a Band-Aid.
Give yourself a dose of PEP if you want
while you're waiting for results.
Start a chart,
and I'll find another nurse
for your blood draw.
Great.
Looks like we've got a couple
more diverted from Westbridge.
Any estimate on their downtime?
Not yet.
Time to pull Dr. Langdon from triage?
No, no. First day back.
I want to let him
kind of ease into things.
Understood. I'll keep an eye on it.
Thank you very much.
Thinking about changing your bet?
I am just weighing my odds.
Don't worry. I'll buy you
a drink with my winnings.
[INDISTINCT PA ANNOUNCEMENTS]
Your brother should be back shortly.
There was a little holdup at CT.
Um, should I be worried?
Let's wait and see
what his test results say.
This is just, um
this just doesn't make any sense.
It doesn't sound like my brother at all.
He's the the friendliest guy I know.
He never even gets angry, barely yells.
He's never had an episode
like this in the past?
No, or not that I know of.
He's in a great relationship.
And he's in law school
'cause he wants to help people.
He always tells me that I should, um
follow my dreams,
even if it means
my parents may disown me.
Should I call them?
I think that's a good idea.
This this could be pretty serious.
- Thanks.
- Mm-hmm.
The new radiologist is a hottie.
Okay.
Um
his head CT is normal, as
are his blood and urine tests.
Then then what's wrong with him?
We're not, um, sure yet.
There is another test a-a spinal tap.
This could be, um, an infection
in the fluid that surrounds
the brain viral encephalitis.
Um, it can also cause
altered mental status and confusion.
Can you treat it, if it is?
Yes.
Okay.
Okay.
I'll go find Dr. Al-Hashimi,
and and we'll do it together.
- Thank you.
- Of course.
Just what we thought
it's a fracture of your coccyx.
It's your tailbone.
Yeah, see, these pieces here
should be lined up with that part here.
- Do I need surgery?
- No.
No, no, these heal pretty well,
but it'll take about six weeks.
"Six weeks"?
I have dinner dates every weekend.
[CHUCKLES] You can keep your
still keep your dinner plans.
Dinner starts at Pino's,
the best Italian in town.
Mm-hmm.
A nightcap at my place usually follows,
and then breakfast in bed.
Ah, okay.
Well, in that case, you might
you might need to take a little break.
[SIGHS] My greatest joy
in life is my social calendar.
- Mm.
- Hmm?
Is there something else you can do?
W-well, there there is a procedure
to push the fragments back in place.
- It could help it heal faster.
- Now we're talking.
Yeah, but it'll hurt pretty
bad but only for a second.
I can take it.
Okay.
Come here. Back in the gown.
How's it going over here?
Better now.
Uh
Oh, the X-ray is back on your foot,
and no fracture.
So, um, ACE wrap,
ice, rest, and elevate,
and you can take ibuprofen
if you need it.
So that's it?
Well, if it's if it's
too painful to bear weight,
we can give you crutches
to use for a day or two.
So I won't be seeing you again.
[CHUCKLES] Uh
as a patient, no, but
it was nice meeting you, Brian.
It was nice meeting you, too, Dr. McKay.
[SIGHS]
You know, I was
I was going to go check out
a few of the art galleries
in Lawrenceville tonight.
Have you been to that one
on 40th and Butler?
No, I was, um, gonna go by.
Maybe around 9:00?
Okay. [CHUCKLES]
- Cool.
- Cool.
Dude, I resuscitated that parkour guy
and and intubated a STEMI.
I think I can handle this.
It's best if you watch the first one.
How's that tooth feeling?
[GROANS] The whole side
of my face is numb.
That's how we like it.
Okay, we've got a
a fluctuant gumline at
Tooth number 23, lateral incisor.
- With an extension to an
- Apical abscess.
- Right again.
- Ah, the kid's smart.
Hook up the Yankauer.
Get ready to retract the gum.
Hey, Louie,
this is a temporary fix, okay?
You're going to need to get
that tooth pulled by a dentist.
Hey, you going to find me one?
We can have you talk to Dylan.
Is Dr. Collins around?
Sister always helps me out.
Uh, Dr. Collins finished her residency,
took up a job in Portland
as an attending physician.
"Portland"?
Yeah, I think that's where she's from.
She's adopting a baby.
Wanted to be closer to her family.
Well, that's a beautiful thing.
- We're set.
- Okay. Ready?
Okay, 3-cc syringe,
20-gauge needle
entering at the juiciest part,
aiming for the apex.
- Send that for culture?
- No.
Pen V.K. for a few days.
Bugs in the mouth are old school.
Ah, just like me.
[ELEVATOR BELL DINGS]
Both parents work,
but neither of them
have health coverage?
Orlando and his wife have
multiple part-time jobs
that don't offer insurance.
Can they qualify for Medicaid?
Unfortunately, no, because
their combined annual income
is over the Medicaid threshold
for a family of five.
So they make too much money?
And not enough at the same time.
They live over the poverty line,
and yet they are still living
paycheck to paycheck.
I think their best option
would be to buy private insurance
through the Affordable Care Act.
Thank you.
My parents don't have insurance?
I'm sorry, Ana.
How much will it cost
to keep my dad in the hospital?
I don't know.
But the ER visit alone will
likely be in the thousands.
We will figure something out, okay?
Purple top for the CBC.
Red top for chemistries and serologies.
Okay.
- Ready?
- Uh, yeah.
I can be a hard stick, though.
Now or never, hon.
Okay.
One, two
three.
- Good blood return.
- Oh, thank God.
Pop one on.
You're supposed to release
the tourniquet now.
Right. Sorry.
Lab won't take it without your initials,
time, and date drawn.
- How you feeling?
- Peachy.
Hopefully I get to do this
several times every day.
All set.
Keep some pressure here for a minute.
Initials, time, and date.
Oh.
Shit.
Environmental to North.
Sorry.
How is he?
He's stable. He's doing great.
Doesn't look great.
Is there brain damage?
The head CT showed
no bleeding or skull fracture.
It's most likely a bad concussion.
It's hard to know when
he'll regain consciousness.
- Did he break any bones?
- We don't think so.
He should thank those ferns.
Uh, chest and abdomen CT scans
also showed no major internal injuries.
Mm-hmm.
What's that?
Whoa, whoa, whoa, whoa, whoa.
We need respiratory therapy in here!
Okay.
One, two, three, over.
You got a problem with the vent?
No, he's bleeding from the back.
Got to prone him to take a look.
Back away, Tanya. One, two, three, up.
One, two, three, over.
- Good.
- Oh, shit.
- Left-flank area.
- Careful. Careful, everybody.
- There might be glass.
- That's a lot of blood.
2-centimeter simple laceration.
Open a suture kit, 4-0 Prolene.
He wasn't bleeding
when we flipped him on arrival.
No, but when we moved him around for CT,
it might have rubbed off a clot.
Slow venous oozing.
I might need a figure of eight.
[BEEPING]
Yeah, little piece of glass in there.
It's just under the skin.
- Is it a loose fragment?
- Yeah, I can wiggle it around.
- Here, I'll pull it out.
- No, don't
Shit. [ALARM BLARING]
Uh, that's it's bigger
than I thought it would be.
- Shit.
- That looks arterial.
Can I get some 4-by-4s
over here, please?
Oh, I'm going to be sick.
Put some pressure
on this from all sides.
Hard and deep, please.
I can push it back in. BOTH: No!
No, you've done enough damage.
Should I keep pulling it out, then?
Absolutely not. The glass
was tamponading a vessel.
Not anymore. BP's down. Page surgery!
[BLARING CONTINUES]
- Ah, I was looking for you.
- Well, you found me.
Um, the X-ray came back
on the lady with the cough.
Weird infiltrate. Have you seen it yet?
No, I've been trying
to catch up on my charting.
- Right here.
- [CLEARS THROAT]
Yep, stringy right lower lobe.
It looks like aspiration pneumonia.
Think about it.
How do oral and gastric fluids
end up in lungs?
Um, dysphagia, swallowing disorders.
But she's not an old person
choking on their food.
Right, and there's protracted vomiting.
Okay, maybe recent gastroenteritis,
food poisoning.
Yeah, or
or
[SIGHS] An eating disorder.
You think she's bulimic?
I mean, she's fixated on working out.
Check the, uh, enamel
behind her front incisors.
Um, oh, it's, uh
if it's not in the differential,
it won't be in the diagnosis.
You know that
Yeah, you know you know that.
[SIGHS]
Nice job on the tap.
Thanks.
Hi. You called for a consult
on Jackson Davis?
Yes, we did.
I'll let Victoria present the case.
This is Jada, Jackson's sister.
This is Dr. Jefferson from psychiatry.
"Psychiatry"?
Do you think this is
a mental-health problem?
We thought it best
to cover all our bases.
We'll know more
once I speak with your brother.
Okay.
Hi, Jackson.
Jackson, can you wake up?
- Jackson.
- They said he's sedated.
I'll come back a little later.
- Oh, that was fast.
- Yeah.
Next time, maybe wait
until the patient wakes up
before calling me down.
Psychiatrists do best
when we can actually talk
to our patients.
I got a little ahead of myself.
Um, will do.
Thank you. [CHUCKLES AWKWARDLY]
Sorry.
Pressure's up
with one unit type specific.
[ALARM BLARING]
What the fuck? He was stable.
- Slight change in status.
- Okay, get the clamp ready.
Who's the genius who pulled that out?
I thought it was a loose fragment.
Next time, leave
the decisions to the adults.
Okay, Dr. McKay, ready to go?
- Whoa.
- Hoo.
Looks like an icicle.
Christmas in July. [TELEPHONE RINGING]
Hey, Sophie, can you answer that?
Okay, I am injecting the X-stat.
- Hello?
- What is that?
It's a syringe filled
with tiny, rapid-expanding
hemostatic sponges.
Okay, got it. Thanks.
Radiology attending says
a resident missed something.
There's a radiopaque foreign body
in the left paralumbar musculature.
Not anymore.
Sounds like
"first week in July" syndrome.
Mm-hmm.
Okay.
- That looks pretty dry.
- On the surface.
Okay, let's turn him back down.
Okay, one, two, three, over.
One, two, three, flip.
One, two, three, down.
All right, CT is ready to rescan.
Interventional radiology
is holding a room.
Look at you so on top of things.
Hasta la próxima.
How you doing over here?
Definitely not great.
Right, well, let's get you a ginger ale.
So we never, ever remove
a deep foreign body in the ER.
We always leave that to surgery.
It won't happen again.
I was just coming to find you.
Sure you were.
It's almost like you're avoiding me.
Me? Never.
No, I'm just having one
of those busy days,
you know, living the dream,
saving America's tired,
poor, huddled masses
yearning to breathe free.
- You're a saint.
- I tell myself that every day.
I heard you had a, uh, motorcycle crash
- come through about an hour ago.
- Yeah.
Couldn't save him.
And, no, he was not wearing a helmet.
Interesting.
One motorcycle crash is not
going to scare me off my trip.
I didn't say it should.
I hope he died doing what he loved.
That's optimistic.
"Glass half full" kind of guy.
- I am not on your couch.
- I'm aware.
- Conflict of interest here.
- Why? Because we're friends?
Ooh, look at you, using the F word.
That's growth.
I use F words all the time.
I guess this therapy must be working.
Ah, I got somebody new for you.
She takes no shit. You'll love her.
I hope so.
The last two have not
exactly been my speed.
- Meaning what, empathetic?
- [EXHALES]
Look, sometimes it just takes
a little while
to, you know, find the right fit.
Well, it's going to have to wait,
because I'm going
on my sabbatical tomorrow.
There's always Zoom therapy.
Motorcycle trip is zoom therapy.
I'll bet somebody set off
fireworks in the shitter.
- [IMITATES EXPLOSION]
- How dumb is that?
[SCOFFS] You think people are smart?
- [LAUGHS]
- [CHUCKLES] Yeah.
What's up, man?
You want to get on the books?
Uh, yeah.
Yeah, yeah. May maybe. Yeah.
Hey, look here.
I only take real money,
none of that "I owe you" bullshit.
[SCOFFS]
Okay, I have money, okay?
My first direct deposit
finally hit, so
Nice. Hmm.
Put me down for $40
for power outage.
- [CHUCKLES]
- Nice.
We got a big baller on our hands.
- Congrats, Doctor.
- Thank you.
I like this side of you, man.
- Any improvement?
- No.
What kind of super glue did you use?
Does it matter?
My eye is still fucking shut.
Okay, there's one other thing I can try.
No. I'm done. I asked for Dr. J earlier,
and I would like to see her now.
I haven't been
in the hospital for a while.
I don't know a Dr. J.
She's one of the best doctors
in Pittsburgh.
Oh, Dr. J.
Hmm.
- Do what you must, milady.
- Mm-hmm.
Okay, first, I need to get
a good grip for the reduction.
Uh-huh.
Here we go.
Try to relax.
Deep breath, with your mouth open.
[EXHALES SHARPLY] Not how I imagined
our first intimate encounter.
Okay, got it.
Now, on three, okay?
One [CRACK]
Ah! Motherfucker.
Ho-ho! You said "on three."
I I know.
Sorry. It keeps you from tensing up.
- [EXHALES]
- Okay, I think that worked.
- How does it feel?
- Can I sit up?
- Uh-huh.
- Oh.
Oh.
[SIGHING] Oh, my God.
Oh.
That is definitely better.
Oh, my God.
- Great.
- [LAUGHING]
Can I give you a hug?
Mm, maybe maybe later, okay?
[CHUCKLES]
Aspiration pneumonia?
How does that happen?
It's when bacteria
from the mouth or stomach
get into the breathing tube,
uh, when you're choking,
if you're eating or vomiting.
Oh.
Do you ever drink a lot of alcohol,
maybe so much that you pass out?
No, I'm not a big drinker.
Have you had the stomach flu
recently, food poisoning?
No and no.
Do you mind if we take
a look inside your mouth?
[COUGHING]
You can lean your head back
and open up wide.
[MONITOR BEEPING]
What?
The enamel on the back
of your teeth is worn away.
What does that mean?
Um, it can happen
if someone makes themselves
vomit repeatedly.
All the stomach acid
dissolves the enamel.
What does that have to do
with having pneumonia?
It may have caused it.
Can you just give me some medicine?
Yeah, we can do that.
Dr. J, finally.
It is so nice to meet you, Dr. J.
This is Willow, your new patient.
I'm actually a student doctor.
I, uh, watch all of your videos.
The one about coping
with difficult coworkers
was super helpful.
I got to watch that.
Um, um, so so what is
Willow's health issue?
Uh, my eye it's superglued shut.
Halfway trim
and mineral oil didn't work?
Nope.
Then then I would suggest
cutting the full lash down.
I concur, Dr. J.
As long as you're the one doing it.
Oh.
Okay, yeah, sure.
[CHUCKLES] Um, yeah.
Uh, sit back for me.
I'll get you to close both your eyes
and be as still as possible.
Okay.
All you, Doc.
Thank you, Dr. Langdon.
Okay, here we go.
How many followers do you have, Dr. J?
More than you'd guess, Dr. Langdon.
There.
[SIGHS]
[CHUCKLES] You did it.
[GIGGLES, SIGHS IN RELIEF]
Oh, my God. This looks terrible.
I can still put a false lash
on it, though, right?
How are you feeling, Mr. Diaz?
Much better.
We need to talk about how your diabetes
progressed to this place.
This is Student Dr. Kwon.
What you say here remains between us.
I'm taking a lower dose
of insulin than I should be.
How much of your prescribed
dose are you using at a time?
Half.
I used to have insurance through work,
but I lost that job
when the pandemic hit.
It was easy to keep up
with my medication then.
I had a great primary doctor, too.
Now I'm kind of on my own.
Do you have a glucose monitor?
Uh, yes.
But I can't afford
the test strips every week.
They're too expensive.
Can we not talk about this
in front of my family?
- Hi.
- Hi.
There are my girls. [SIGHS]
- Did you call your brothers?
- They're still at soccer.
I have good news.
I started a GoFundMe for Dad.
A what?
To help raise money
for Dad's medical care
- since we don't have insurance.
- No, no.
- Take it down, now.
- But why?
I work hard. I don't need charity.
But, Dad, we've already
Ana, you heard me!
Take it down.
Jesus, Orlando.
No necesito eso.
Louie, thought I'd sneak
back here to check on you.
- How we doing in here?
- Good.
- Tooth's feeling much better.
- Glad to hear it.
Looks like you're stuck with us
for the next three hours.
We need to monitor your blood pressure.
How about a drink while I wait?
[CHUCKLES]
Water or orange juice?
Uh, never mind.
So, uh
how are the kids doing?
Oh, they're perfect little monsters.
Tanner's five now. Penny's three.
Oh, ain't that a blessing.
It is, but they have
zero interest in bedtime.
And there's the dog
always digging up the yard.
[CHUCKLES]
How much sun does your lawn get?
I don't know. Plenty.
Seed it with perennial ryegrass.
And you want to lightly water it
and put up a temporary fence so
the dog can't get back to it.
Color me impressed.
What can I say? I like grass.
[BOTH CHUCKLE]
No, seriously, how do you
how do you know all that?
[SIGHS] I was a groundskeeper.
I worked with gardens and lawns
back in the day.
Robby.
Got a sec?
- Dr. Langdon.
- Dr. Al-Hashimi.
How's triage looking?
Donnie and I have it under control.
Good. I want you to wrap up
what you're doing out there
and join us back here.
We're expecting more diverted
traffic from Westbridge.
Will do.
And I just want to say,
I think it's great
that you're in
the Physicians' Health Program.
I know it's a big commitment.
Uh, yeah, it was hard at the beginning,
but, you know, I'm almost done
with year one now.
- Only four more years to go.
- [CHUCKLES]
Penny for your thoughts.
Oh, they're
way more expensive than that.
I'm on a budget. Take it or leave it.
My day is not turning out
the way that I expected.
We had a callout. Langdon was available.
I was sort of hoping to be
on my sabbatical
when he came back.
You two were very close.
Maybe this is the universe's way
of telling you it's time
to clear the air.
Maybe it is.
Maybe it isn't.
Okay, so, um, we'll need
to keep you for the day
for your IV antibiotics and
to monitor your oxygen level.
Okay.
What if
[SIGHS]
I have been making myself vomit?
Well
bulimia is treatable.
I was going to stop.
I stopped before.
My family gathers around food.
We eat when we're celebrating.
We eat when we're mourning.
We just eat.
But then I got to college,
and it was all about how you looked.
That's a lot of pressure.
I started vomiting.
Everyone said I looked great.
So I went to the gym more.
I didn't need to purge as much.
[HEAVY SIGH]
Last year, I went through a breakup.
It all came back.
[SNIFFLES]
You're
doing long-term damage to your body.
And it doesn't just go away on its own.
It's okay to ask for help.
We can set you up
with our eating-disorder
program upstairs.
- It's here in the hospital?
- It's an outpatient program.
You'd meet with a therapist
for individual and group therapy
once or twice a week.
Would you be open
to meeting with a therapist?
I guess.
Do you have any preference
for type of therapist
male, female?
[CRYING] If there's
a Black woman, I'd like that.
[SIGHS]
Yeah, we can arrange that.
[SNIFFLES]
Thank you.
That was a good catch.
Black women tend to go underdiagnosed
when it comes to eating disorders.
- Really?
- Yeah, unfortunately.
You know, I thought I had an
eating disorder in high school,
and so I did a lot of research
on the subject.
I didn't no, I just
My sister and I were
really picky eaters growing up,
you know?
Color and texture.
Vegetables and fish.
Oh, eggs.
Slimy okra, asparagus
ugh, disgusting.
Drove our parents crazy.
Oh, eggs, weird.
It's not that weird.
I got to catch up on my charting.
Ah.
You know, if if you want
to talk, I'm around.
Talk about what?
Being an R2?
Way harder than intern year.
Oh, yeah, um
yeah, overseeing
the med students, the interns,
having no time to do my own charts.
Yeah, just wait
until you get into Medical,
Surgical, and Cardiac ICU.
- I stands for "intense."
- [CHUCKLES]
Somehow that seems
like an understatement.
Well, it does help you
grow your clinical skills,
you know, caring
for the sickest patients.
Tell that to these charts.
Um, dictate. Helps you go faster.
Oh, uh, what happened with
our patient from Westbridge?
You never grabbed me for his troponin.
Mr. Samba it was a posterior STEMI.
What? Didn't show on the 12-lead.
Oh, usually doesn't.
And I think most clinicians
would have missed it.
But you didn't.
[SCOFFS]
Guess I got lucky.
Whatever, Fuckleberry.
Okay, I'm sorry. Did I do
something to bother you?
Nope.
[SIGHS] Okay.
- Yo.
- What's up?
I got a bounce-back.
You remember Debbie Cohen?
Not really. I've seen
16 patients this morning.
The restaurant worker with cellulitis
- on the dorsum of the foot?
- Yes, yes, she's on Keflex.
I marked the border.
Yeah, I got a hot pack on it,
but, uh, you should take a look.
Hi. Dr. Langdon.
I wasn't expecting
to see you back so soon.
- Meds upset your stomach?
- Uh, no.
The pain got worse,
and you said to come back
if the redness spread
outside the Sharpie line.
Let's take a look.
Ah.
[WINCING]
It looks like the infection
isn't responding
to the pills I prescribed you,
so we need to get you
on some IV antibiotics
and get you back to the ED now.
Uh, i-is it bad?
Not if we can get a handle on it.
- MRSA?
- Or maybe worse.
Previous Episode