- If I loved you, not the woman
that I'm trying to make you be--
- What is happening right now?
I think it's a beautiful day to save lives, don't you agree?
(squeals)
- I'm gonna like being married.
It's the wedding part that's ridiculous.
(laughing)
(pager beeping)
(groans)
Party's over.
- You know what's funny?
Even though this show was filmed so long ago, this scene
of them hanging around and having pagers still rings true.
All my residents still carry their beepers around
and they get paged, and they have to interrupt what
they're doing to go respond to an emergency.
Now, we're not surgical residents,
we're family medicine residents,
but equally as important, just on different terms.
- You marrying Burke, it's a sign.
A sign that people like you and me can do this.
Be healthy, be happy.
- Did she just steal my line in the show?
- They found the fourth climber.
Vitals are stabilizing after fluids, but--
- I thought he was dead.
- He was, according to his friends.
Did the CT show him bleeding?
- We haven't done a CT yet.
- I don't understand.
You said there was a head trauma.
- Yeah, there's been a little head trauma.
Ice axe to the head.
- Whoa.
So you really need, probably, a neurosurgery consult
at this point for having an ice pick stuck
in this gentleman's head.
Now, as I told you earlier on this channel,
if you ever get hit with something
and it stays inserted into you,
a knife, an ice pick, whatever it is,
you don't take it out because it's putting pressure on there
to prevent you from bleeding out.
So, if you take that ice pick out, what's gonna happen?
The person's gonna bleed, especially from the skull.
If you ever needed to get staples placed in your scalp
because you cut yourself, you know how much it bleeds.
Even the smallest little cut on the scalp
bleeds a tremendous amount.
It's actually really scary.
But it's only because there's a lot
of blood supply to that area, not because
there's a lot of damage to that area.
So just keep that in mind.
- My wife came into my hospital
and you neglected to tell me?
- Doctor-patient confidentiality.
- It's actually a very difficult place to find yourself
because, if you have one of your colleagues, family members
as your patient, you want to share and you feel
like you should be able to share, but in reality, you can't.
I actually treat a lot of my colleagues, even my attendings,
when I was a resident, their children.
And as a result, the things that their children tell me,
I can't share with them.
Only when they're brought into the room by the patient
or the patient expressed the fact
that I can discuss their case with them,
do I then incorporate them into the conversation.
But in reality, it's two separate people.
Just because I know both of you doesn't mean
I can freely talk about your care to one another.
There's some things we share with our family,
some things we don't, and that's a right.
- She's unconscious.
There are medical decisions to be made!
Legally, I have the right to know!
I have a right!
- She might be having a miscarriage.
- What's wrong with me?
- I'm going to explain everything to you, I promise.
But right now, we need to get you up to the surgical floor.
- [Patient] Surgery?
What about my babies?
- Well, I think those babies are coming out today.
- But, I haven't decided.
I haven't chosen parents.
I need time to decide.
- It looked like he was doing an ultrasound of her heart,
which is an echocardiogram.
I didn't follow the case from the previous story,
but it sounds like she's pregnant
and she's acting as a surrogate to give the child
to one of the two families there.
I wonder what could be going on with her heart
that they need to take her for an operation?
The medical curiosity in me is a-peaking!
- How's Rena?
- I need to get a CT adrenal,
but I'm pretty sure it's a tear in her aorta.
Her heart is about to blow.
- Whoa!
So, dissecting an aortic aneurysm is when there's
an aneurysm within the aorta, which is the largest
blood vessel that comes off of the heart
and brings blood to the rest of your body.
An aneurysm, first of all, is a weakness in the wall
where it actually protrudes out.
So, if you imagine your artery being like a balloon,
and then one area of the balloon is very weak,
so it creates almost like an outpouching.
When that happens, that wall's very susceptible to bursting
and rupturing because it doesn't have all the layers
that the rest of the artery has.
So, what can happen is you can have a dissecting
aortic aneurysm, where it's getting so bad
that that weak arterial wall is literally about to burst,
and that patient can rightfully bleed out and die
because of all the bleeding internally.
So you have to go for surgery immediately.
I just don't know how this is happening in such a calm
situation because it's really a medical emergency
or a surgical emergency where you need
to go, go, go, and start the operation.
- I didn't page you.
Go home and get some sleep.
- Yeah, but I'm here already, so--
- You're getting married in less than 12 hours.
- (music drowns out speaker)
- Well, Burke's getting married too, and he gets to operate.
- There's only one Preston Burke.
- There's only one Christina Yang.
- I've given you the day off, the whole day.
It's a kindness, take it.
It's your wedding day.
There will always be more surgeries.
- But--
- Really, what would you rather be doing?
Prepping a patient or prepping for your wedding?
Go home.
- Those who love our jobs and who are passionate
about our jobs, we want to be there.
But, at times, we have to pump the brakes
and realize that, if we want to perform better at work,
it's actually ideal to take some time off.
This is why one of the biggest problems that people face
is that as they make more money, you would think
they would become more financially independent,
therefore take more time off, but in reality,
they just become slaves to their money and to their job.
It's really important to not burn out
because too many people in our society right now are
working day in and day out, and there's times
we need to do that and we need to put our foot down,
but then there's also times where we need to understand that
a break will actually yield better results.
- They recovered Lonnie's body?
- Not his body, he's alive.
So why don't you tell me what really happened
up there with the mountain?
- So, I'm assuming, because I don't know a lot
about this case, they're on a mountain,
they were trapped, there's frostbite happening.
Frostbite generally happens on areas that have
less circulation, and areas that not only have
less circulation, but are ones that your body
will decrease blood flow to in order to conserve warmth.
So, for example, if you ever see your hands get blue
when you're really cold, that's your body
naturally protecting yourself from losing heat.
What it does is redirects the blood back to your core
so that you stay warm, your vital organs stay well profuse
with blood flow, and you don't need a lot of blood flow
to keep your hands alive.
So, if they look blue, that's what's happening.
There's also a condition called Raynaud's Phenomenon.
You have an ultrasensitive reaction to cold.
So, just being in a cold location for a short period of time
will make your hands turn blue.
A simple test for that is to put your hand in cold water,
and I'm not recommending you do this,
but you could put your hand in cold water
and take it right out.
If your hand turns blue really quickly,
you have what's known as Raynaud's.
- It was an accident.
- I feel like it's not McDreamy's place
to make the decision on whether or not it was an accident.
In this scenario, if I have people talking about self-harm,
or I don't know what you would call this,
like an assault-type situation.
Even if you think it may be on accident or self-defense,
you have to get the authorities involved.
I think that's the ideal situation.
Maybe not right in this moment because no one's
escaping here, they all look really injured,
but at some point, you have to get the authorities involved.
- So, should I be worried or something?
- Should you be worried that I met a woman?
No.
Should you worried that, for me,
flirting with that woman was the highlight of my week?
Yeah, you should be worried or something.
- (laughs) What kind of threat was that?
That's manipulative, McDreamy.
Don't do that.
- I just checked, Chief Resident hasn't been posted yet.
- No, no, I wasn't looking for--
- Yeah, you were.
- (laughs) Yeah okay, I was.
- For those of you who don't know, Chief Resident
is a really important position.
Even more important when you're a surgical resident.
I'll give you an example.
In family medicine, the senior attendings all sit together
on a committee and nominate
who's going to be the Chief Resident.
Generally, the way it works is the Chief Resident,
in their last year of residency, takes on the additional
role of doing all the scheduling, all the organizing
of the rest of the junior residents.
In internal medicine, they may actually stay on
for a fourth additional year.
To do that, consult on difficult cases, work in specialties
that they feel they need more help in,
or they use it as an opportunity to showcase themselves
for fellowship positions that they may have not gotten
or to make themselves more competitive
in the upcoming match.
Very prestigious, but very difficult to be successful in.
- Housing a human for nine long months
is all that I can think about.
The thoughts are invading the surgeries that I love,
and it's hormonal and horrible, but it is happening to me.
- You want to have a baby.
- (laughs) Did one resident just ask another resident
to impregnate her because she wants a baby?
I hope I'm missing something and they're actually
in a long-term relationship, and that was their way
of talking about it.
- Pressure's dropped to 60.
She's bringing it down.
Edison, how much longer?
- Rupturing the membrane now.
I just need two minutes to get these babies out.
- Make it one.
She's flat-lined.
Stephen, start compressions.
- Yay, they're starting chest compressions
before shocking the patient first!
I'm sorry I'm so excited that a patient's flat-lining,
but I'm just happy that he said start chest compressions
before whipping out the machine to shock.
- Clamp.
- Come on, come on.
(cries)
- Second baby's out.
Okay, go.
- Oh, my God.
But look at those horrible chest compressions
happening in the background.
Oh, my God.
The doctors, they're going like this. (laughs)
Hold on.
That is not 100 beats per minutes.
That's not two inches deep.
Chest compressions, chest compressions, chest compressions!
I think I'm yelling it every video.
- Is he going to wake up?
- Do you want him to?
- What?
- The axe in his head was put there deliberately.
I just want to give you three guys another opportunity
to tell me the truth.
- You're not a cop!
(groans)
- What's going on?
- She started cramping and then she got really diaphoretic.
- Alert (background noise drowns out speaker) to a possible
DNC due to an incomplete miscarriage.
- So, a DNC is a dilation and curettage.
It's basically a medical procedure
to get the uterine contents out.
That can be really important if there is bleeding going on,
you're trying to figure out
where the source of bleeding is coming from.
This is something you need to do very urgently.
I understand why, because this patient is bleeding out,
diaphoretic, cramping ...
Cramping means that there's bleeding, probably,
happening in the uterine cavity.
We need to diagnosis and treat
it simultaneously with a DNC.
- She went into early DIC.
I gave her blood, platelets, FFP.
Pregnancy at 52 is dangerous.
I tried everything.
I couldn't save ...
(emotional music)
- Oh, wow.
(exhales)
Oh, the babies.
(groans)
- I thought ...
I thought ...
For a second, I thought I had lost you.
- I thought he lost her too, because DIC can be a
very deadly, and quickly deadly condition.
It stands for disseminated intravascular coagulation.
It's basically when inside your blood,
you use up all the clotting factors and you start clotting,
so two things happen.
The more platelets you have, the more clotting that happens,
but then you also use up all your platelets so that you
could bleed from other areas.
Very unique situation.
There's very specific protocols we have to follow
in order to make sure these patients A) don't bleed out,
and B) don't form clots in areas where they can be
life-threatening: brain, heart, lungs, etc.
I think that might have been the best explanation
of DIC I've ever given in my life. (laughs)
- He's a much better man than I thought.
Looking over his initial judgments, and he'll sit with you,
- Is it him?
And he'll make you drink your water.
(dramatic music)
- He's the papa bear!
I mean, sad that he lost his child, God.
All right, I got to really adjust my emotions here.
- Because I'm your best friend, and because I love you.
I also have to say that I'm in love with you.
- I officially want to check what they're pumping
into the air conditioning units in Seattle Grace's
whatever-the-name-is hospital is.
I don't know if they're pumping pheromones in there,
angel, Cupid arrows ...
Everyone's in love with everybody.
Everyone wants to cheat on everybody.
People want to get married, they don't want to get married.
They want to have babies, what?
This is the most dysfunctional
group of humans I've ever seen.
- I want you to give me a reason to stay.
- Even the patients are falling in love with the doctors!
I can't even, I lost count of how many
love triangles and circles and squares.
I feel like, in order to understand their relationships
fully, I got to bring out the
Pythagorean theorem on this one.
I mean, for God's sakes, Grey's Anatomy, keep it together.
- You don't want me?
- Maybe I do.
- No, you don't.
You want Ava.
- She's not Ava anymore, she--
- (laughs) I know why this is
one of the top fan-favorite episodes.
Because everyone's in love with every--
Is it something about weddings?
Or is this every Grey's Anatomy episode?
For some reason, every episode I watched before this,
there was a lot of medical stuff, a little bit of romance.
This is everyone is on top of everybody all the time.
- I'm up there waiting for you to come down the aisle,
and I know you don't want to come.
I know you don't want to come, but that you'll come
anyway because you love me.
And if I loved you, if I loved you, not the woman that
I'm trying to make you be, not the woman that I hope--
- What is happening right now?
Did they need to make everything
more dramatic than it needs to be?
You decide to get married, you love each other,
but the person's hesitant, so now
you're being worried that they're hesitant,
and your love contradicts their love.
We should just change the name of this episode to
Dr. Mike Loses His Mind Over Grey's Anatomy
instead of react.
Just no reacting.
I'm just losing my mind at this point.
I feel like you guys missed out my latest
medical memes review and my hospital vlog,
so if you did, click one of those bad boys.
And, as always, stay happy and healthy.
(calm music)