- (speaks in foreign language)
- She did not have the reaction I thought she would have,
watching her friend slash whoever this person is
get electrocuted and falling off a ladder.
- (speaks in foreign language)
- She just said call an ambulance,
casually, call an ambulance.
- (speaks in foreign language)
- This is really accurate in the sense of you wanna call
for help, so they're doing that.
They're trying to wake the patient up
and see if they're conscious, that is the way you do it.
And then if that person is unconscious
and is not breathing and doesn't have a pulse,
chest compressions time.
- (speaks in foreign language)
- Oh, chest compressions.
It's a show that does chest,
let me judge the chest compressions before I get excited,
I feel like they may not be good quality.
- (speaks in foreign language)
- These are good chest compressions.
These are good chest compressions.
The rate, the depth, the intensity, the look on her face,
what a start to a show.
Maybe it's a medical drama that I'm gonna like,
maybe it's an accurate one.
(camera whooshing)
- (speaks in foreign language)
- It's funny, 'cause when you show kids
what you're about to do, on somebody else,
that right away takes the fear away from them.
And it may be not fully, but at least it takes it down
to a degree where they're more comfortable
in letting you try whatever it is you're trying to do.
You know what I do as a strategy,
if I wanna listen to a child's heart,
I let them first play with the stethoscope,
even while I'm talking to them,
after I disinfect it, of course.
And then once they play with it and they see what it is,
I show them that they can listen to my heart,
and then I listen to their heart,
'cause it's cool listening to someone else's heart.
And right away they realize that there's no pain involved
with the procedure, so they get excited.
I also like to make a lot of jokes.
Like if I'm looking into a child's ears, I always say,
oh, I'm just gonna take a look at your thoughts
or I'm gonna read your mind
and they get all giddy and excited about it.
I reuse the same jokes over and over again,
I'm one of those guys.
- (speaks in foreign language)
- I have a small problem with the way the doctor
presented all the options to the patient.
And while it's important to give the patient
all the possibilities and all the options,
I think right here we're jumping to a lot of conclusions.
The way that I would do this is in order.
First, I would tell the patient what we know.
We see a tumor on the CAT scan.
Now we've done the MRI and we've in fact confirmed
that there is a tumor present.
We then have to say that in order to confirm what kind
of tumor and the staging of the tumor
we would have to perform a biopsy.
We would then give options
of all the things that could happen
depending on whether or not the tumor is a certain grade.
We wouldn't go into these details, we will just say,
depending on what we find you may need chemotherapy,
radiation or perhaps even surgery.
Now here's the most important step.
If a patient is against radiation, chemotherapy and surgery,
you do not perform the biopsy.
The purpose of performing the biopsy
is to act on the results.
And if you already know
that you're not gonna act on the results
the biopsy is just putting the patient at a high risk
for complications without any benefit being added.
A great example of this is I had a patient
who is in her late 80s,
who we suspected to have colon cancer.
And as a result, we recommended her getting a colonoscopy
so that we can then treat the cancer
and get it surgically removed.
She said, very clearly, I will never want surgery
at this point in my life.
I am happy with the way my life is,
and I've lived long enough,
and that is my patient autonomy being spoken, fine.
Then we shouldn't even do the colonoscopy
in the first place, because if the colonoscopy
is just gonna tell us that there's a cancer there,
but the patient already knows
that they don't want to act on it.
Save the test, save the patient to discomfort.
Allow them to have a good quality of life,
and that's what should be done here.
Now, it's also important to note
that even if you know removing a part of a tumor
might not improve a patient's survivability,
meaning it doesn't extend their five-year survival rate,
for example.
But we know that during those five years
if we shrink the size of the tumor with the surgery
we can at least give them a better quality of life.
For example, they get less headaches.
It might be worthwhile to proceed with that surgery.
That is why we give all these options to patients
and get a really good understanding
of what their symptoms are,
before we jump in to give our recommendations.
- [Doctor] (speaks in foreign language)
- (speaks in foreign language)
(cries)
- (speaks in foreign language)
- Yeah, that's a tough emotion to deal with
'cause, you know, your child or someone you love
needs an organ transplant,
and someone had to die in order
for that organ transplant to be given to your family.
And as a result, I've seen a lot of touching stories
of family members who received the organs,
reach out to the family members of the ones
who gave the transplant, because that person passed,
and it makes them feel like something good came out
of a really horrible situation.
Not that anything can make them feel completely fine
or completely whole, but at least a little semblance
of hope and positivity during a really dark time.
- (speaks in foreign language)
- Is this the guy that was supposed to do the procedures?
Is that what is? - Mm-hmm.
- (speaks in foreign language)
- I don't understand. - This guy
has a Darth Vader helmet on.
- He's a surgeon? - And he is a surgeon.
He's one of the main characters,
but they haven't really introduced him yet.
So because the professor is injured,
he now has to perform the liver transplant surgery
wearing this Darth Vader helmet
because they haven't been able to remove it
'cause it's got glue in it.
I had to watch that back like three times
before I really pieced together what happened there.
(laughs)
Very silly.
- (speaks in foreign language)
- I love that he has a hairnet.
Why even bother putting the hairnet on the helmet?
Like it's just for decor at this point.
I don't even know how you would take super glue
or crazy glue off of someone's head
if it's truly like on now.
Is there some kind of antidote to super glue
that you would put to take it off skin?
Like honestly, I have no idea.
Like WD-40, like, I don't know.
I would have to look that up
or talk to a very experienced ER physician.
- (speaks in foreign language)
- You know, it's really difficult talking to a parent
who's going through a situation like that.
You just wanna consistently, without emotions,
repeat the information that the parent needs to grasp.
And I think the more straightforward and non-confrontational
you can be in the beginning especially,
the better your chances of the parent understanding
what's going on.
Also, it's sometimes important to say what you've said
and in a short time, come back, repeat it, leave,
and do the same thing maybe several times,
in order for the parent to have the time to process
what you just said.
'Cause many times the doctor will come in,
give bad news, leave, and the patient or the parent
didn't grasp at all what's going on,
because there's so many other things
that are going on in their minds, you know,
preconceived notions, things that they think is going on,
things that they think should be going on that aren't,
or maybe negative thoughts about you.
And when you come in and you constantly reinforce
the same bit of instructions that you give,
it really increases the chances for the patient
to understand or the parent to understand what's going on.
- [Female Voice] (speaks in foreign language)
- At least they tell them to do CPR.
Like, I feel like in all the medical dramas they're like,
what's CPR, we have the defibrillator?
How about you check the rhythm?
Okay, so this is a really important point.
If they knew and they were preparing for this child to pass,
a conversation should have been had with the mother
as to whether or not this patient should be made DNR.
Meaning do not resuscitate, meaning do not perform CPR.
Why?
If you know that even if you revive this child,
meaning that you restart the heart,
that the child is already gonna die
and you're not gonna be any more well off
than if the patient never had their heart stop.
You do not want to perform CPR.
CPR can cause more damage.
It can break ribs.
It could make the child feel uncomfortable.
You would only do this
if you think that the child has a chance
at returning back to a healthy baseline.
In this moment, this child does not have the ability.
So performing a CPR here is almost brutal on this child
and it's not something I would advise to a parent.
- (cries in foreign language)
- (speaks in foreign language)
- Yeah, but this is not a good way to do it.
Someone, one member of the team, should pull the mother away
and have this discussion very quickly,
and then tell the team members they can stop
once they get approval from the mother.
- (speaks in foreign language)
- This switch off should be happening every two minutes
- Min-Yeong.
Min-Yeong.
- (speaks in foreign language)
- Even hang in there is not the correct phrase
because she's already died, like her heart has stopped.
She's clinically dead.
And they're trying to resuscitate her,
bring her back to life, so hang in there
is not even the right thing to say.
And the reason I'm pointing that out is because
if they bring her back, she's just gonna be
in a worse state than she was before
when they were ready telling that the mother
should make peace with her daughter's life being over.
Like, if that's the case,
you should probably let her go peacefully.
This code is also being run very responsibly.
There should be a team there, a delegation.
You do chest compressions for two minutes.
You check the rhythm.
You give the medications, 'cause every two minutes
the child should be getting epinephrine.
Someone else should be counting which medications
have been given, writing all this down, being the recorder,
and someone should be switching off every two minutes.
'cause it gets tiring doing chest compressions like that.
Chest compression shouldn't stop
just because someone gets tired,
and you shouldn't decide to call a death
just because someone gets tired.
If you're calling a death
that should be for clinical reason,
not because your arms hurt.
(heart monitor beeps)
- (speaks in foreign language)
(heart rate to death beep)
- If we made that decision, turn off the monitors.
There's no point for the mom to hear that
and make her more upset.
- (speaks in foreign language)
- This is like serious stuff.
None of it is hyper dramatic.
No, one's like falling off of a building,
being saved by somebody.
These are like serious medical conversations
that are had every day within our hospitals
that I think the public should be more wary of,
because if you, God forbid, are finding yourself
in that position, you'll be more realistic
about what to expect from your doctors and nurses.
(camera whooshing)
(soft jazz music)
- Aah!
- (speaks in foreign language)
(doing vocal warm-ups)
- (laughs) Do eggs help your throat?
I think honey helps your throat.
- I have never heard- - Honey with tea warm up
the vocal chords. - It's actually like six eggs.
- Six eggs, raw eggs, albumin, aah!
(instrumental music)
- Is this how BTS was started?
Oh, bet you didn't know I knew that.
Check out my reaction to Cells at Work,
the popular anime that brings cells to life.
This is a real fun one or the other episode here
and as always, stay happy.
(bouncy instrumental music)