- What do you get when you mix Uber
with a Hospital?
Royal Pains.
Beewoop!
(hip hop music)
Oh, ball time.
All right, good dish, good dish.
Oh, oh, oh.
We have a athlete that's collapsed.
What are you gonna do?
Check for a pulse.
Call for help!
Call for help, first thing you do, call for help.
- [Dr. Lawson] Alright, call 911!
- Yes, he pointed the person out.
- I need those two gym bags, right now.
- If he-
- I want some ice from those cooler, okay?
Move it!
- Does he have a pulse?
- [Dr. Lawson] Ice, ice, bring it in!
Okay, I need to ice his crotch,
his armpits, and his scalp.
He can't breathe.
- All right we have to break this little
scene down.
Athlete collapses while playing basketball.
He's saying he's not breathing, it sounds like
he has no pulse.
At that point, you call help, 911.
Point somebody out, because if you just yell it,
hoping someone else will call 911, that may not happen.
So point to someone, say, "You call 911!"
and then right away chest compressions, chest
compressions, chest compressions.
Don't push with your arms, push with your upper body.
Because then you could use your weight to your advantage
and not tire as quickly than just by using your arms.
When you're pushing you want to do it to the tune
of Stayin' Alive!
Stayin' Alive!
Ah, ah, ah, ah!
All right, that was bad singing but good effort.
(tune of Stayin' Alive!) Chest, chest,
chest, chest compressions.
Sorry.
- [Female Nurse] Aren't you off today, Doctor Lawson?
- [Dr. Lawson] I was.
Status, post cardiac arrest.
Got his pulse back an opened his airway.
- [Female Nurse] Did you really use gym bags
for immobilization?
- Yeah, can't wait to tell him some sweaty boxers
saved his neck.
- So the thing with opening up his airway,
if the patient is still basically in a coma state,
they can't protect their airway.
That's why we do the Glasgow Coma Scale to see
whether or not the person can protect their airway,
and if they can't they should be intubated.
Because what can happen is some secretions, whether its
saliva, mucus, vomit, can get into the mouth and
then get aspirated into the airway which will go
into the lungs and that will create a pneumonitis,
which is a very serious condition which causes serious
inflammation of the lungs an can be deadly.
- [Dr. Wolf] O2 sat 80.
BP 100 over 60.
- Drop five of versa and 150 of sucs.
- Dr. Lawson, paramedics bringing in a 68 year old
with a STEMI.
- When?
- Now.
- A 68 year old with a STEMI means an
ST-Elevation MI.
And ST-Elevation is something that we look
for on an EKG when someone's having a heart attack.
An MI means myocardial infarction, just another name
for a heart attack.
- [Dr. Lawson] And into the femoral artery.
(machines beeping)
And there's the blockage.
You can finish up, I'm gonna go out.
He's stable, he just needs an angio.
Dr. Wolf, how's the kid?
- [Dr. Wolf] The EKG shows a third degree AV block
and he's unresponsive to meds.
I placed an external pacer but I'm not getting capture.
- What's his BP?
- [Dr. Wolf] Hovering around 60 systolic.
- All right, he needs a wire, stat.
- Is Hank a cardiologist?
I'm so confused.
What I'm interested in here is, this young athlete,
he said he as an AV block, which is a problem with
the electricity within the heart that can cause
the heart to stop beating.
He's saying that they're trying to create capture
which is when they put a device on the outside
of the chest that tries to capture the heart's beat
and reset it and give it the proper rhythm.
Now, they're not having success with that
so he says, "I'm gonna put in a wire."
essentially what he's saying is he's gonna go
from the internal structures and control
the electricity of the heart that way.
Now, we do this all the time for pacemakers
and defibrillators, basically for all sorts of
congestive heart failure and electrical
anomalies of the heart.
- Priority is Mr. Gardner!
You'll see him all the way through.
- Gardner is stable, his BP is up,
his sat is 98% on two liters.
The ST segments are normalizing and his pain is gone.
So, how about today we save two for the price of one.
Let's go.
- I mean I totally agree with him here.
Why, what does she want him to do?
Babysit the other VIP patient?
What good is that going to do them?
If he did the procedure, he opened up his arteries,
his ST segments are normalizing, which means
that the EKG is improving, what else is he gonna do?
(smooth jazz music)
Ooh!
- Wow.
- Still can't stop with the romance
in these medical shows.
With the making and the (kissing noises).
Medicine is fun, we don't need the (kissing noises).
Just saying.
- Let's go give that long day of yours a happy ending.
- This is a dirty show.
- [Dr. Lawson] I recognized Mr. Gardner's level
of blockage, I knew it had to be relieved and
I was confident that he would be successfully
angioplastied and survive, barring any bad luck.
- Well bad luck rained and poured, didn't it?
While you had our senior CT surgeon in another room.
- To help me try to rescue a crashing patient,
I made a judgment call.
- You made a mistake, a fatal one, and
that's a shame, Dr. Lawson, because we all
know you're the most talented physician
this emergency department has seen, and your
star was only on the rise.
- Was?
- I know for the average person that may watch this,
and think, "Oh, that makes sense he got fired."
To me, it makes no sense at all.
I have no idea what he did wrong, it looked
like he completed most of the procedure and then
left the rest of it for another doctor
and then went to perform another procedure.
He didn't go home to hang out, so I'm still
flabbergasted as to why he got fired,
but whatever, it's clearly not important for the
show's story line.
- [Man In Black Shirt] You really need to get out of
this apartment and get some fresh air, bro.
- In Brooklyn?
- Honestly it smells so bad, it smells like
moose had sex with a bucket of Chinese food in here.
Like musty.
And you kind of look like Jesus and Patrick Dempsey
had a child and that child grew older and then
got really sick.
- That's weird.
- Look, look, look this trip is gonna get
you back on your feet, I promise.
- Trip?
What trip?
- Are you kidding?
To the Hamptons!
I've been telling you about this all month!
- Yeah, and all month I've been saying, "No way."
- A lot of medicine up front,
a lot of no medicine in the middle.
(retching)
- [Dr. Silver] Clear, clear.
Dr. Silver, here.
When are you damn kids gonna learn how
to hold your drugs?
(laughing)
- Concierge doctor.
- [Dr. Silver] Start with some oxy?
Then a little crystal?
Ripped a few lines and chase a little down
with champagne.
Having salad, you kids call that, right?
- What? Ava doesn't do drugs.
- Why? Because she says she doesn't?
Newsflash, pretty boy, most drug
addicts are also liars.
Sorry, April, we're gonna get this
straight into your system.
- Doctor, you may have misdiagnosed.
- Oh really, who are you?
- Just a concerned observer.
- Well I observed nausea, photosensitivity, disorientation,
a few of the tell tale symptoms of a opioid overdose.
What are you observing?
- The same symptoms you are, plus a couple
you're not.
Like her miotic pupils and sludge toxidrome.
- I don't understand, he didn't even look at her eyes.
How does he know what her pupils look like?
I mean, it sounds like he has x-ray vision.
He can see from across the room.
Especially in a dark room, how is he able to see a-
Not buying it, Hank!
- [Lifeguard] All right lookout, lookout.
I've got this from here, guy.
- Who are you?
- I'm a lifeguard.
(laughing)
- Are you board certified in clinical toxicology?
- Huh?
- Help me get her up, Baywatch.
- I somehow doubt that this guy's an interventional
cardiologist, clinical toxicologist.
How many board certifications does he have?
And they're not even ones that go hand in hand.
Like if you're an ER doctor and you're a toxicologist,
I get it, but being an interventional cardiologist
and a toxicologist, eh.
Those are nice Ferraris.
360 Modena?
- This isn't my blood, it's my girlfriends.
Can you come inside?
- Yeah, yeah sure.
- No malpractice insurance, no anything.
Just oh yeah, I'm just gonna be casually your doctor.
- [Dr. Lawson] I got you!
- Uh oh, fainting.
Is he gonna vomit?
(retching)
- [Dr. Lawson] Tucker, Tucker.
- He's sweating.
Ooh!
- [Libby] Are you okay?
- Is that the seatbelt mark on his chest?
(groaning)
- Could have a cardiac contusion,
which is a bruise of the heart.
- Why didn't you tell me you're
a hemophiliac?
- Ooh.
- Dude, my chest is killing me.
- Where's your Factor VIII supply?
- Bottom drawer, next to my aquarium.
- So he has a bleeding disorder that if you
get into a car accident or any kind of accident,
for that matter, you start bleeding excessively.
And you're missing one of the clotting factors,
specifically Factor VIII.
That's what he's talking about here.
I don't know how he knows it's specifically
Factor VIII, that's really impressive.
And also how he knows exactly that he's a
hemophiliac.
Its very impressive diagnostic skills that
I feel are a little bit past human abilities.
- Stay with me pal.
- I can't breathe.
- Stay with me.
Tucker, stay with me.
Tucker, stay-
(choking)
Tucker.
All right, jugular's up, muffled heart sounds,
minimal pulses, damn it's a bex.
- What's happening to him?
- I don't know what a bex is.
- [Libby] What do you mean, bex?
- He probably contused his heart and
bled into the paracardial center.
- What are you talking about?
- Look at that!
(horns)
- His heart is being squeezed and not
circulating blood to his brain.
He needs the fluid drained,
but because of his hemophilia, I could kill him
trying to save him.
- This is actually really similar to what happened
with The Good Doctor's pilot episode,
where the patient got into also an accident
and blood was pooling around the heart and we
were worried about cardiac tamponade, where the
heart's trying to beat but there's a build up of fluid
in the sac surrounding the heart, so it has no room
to beat properly, therefore, all the vital organs
are not getting enough blood supply.
What complicates this case even further,
I have no idea, again, how he knows he's a hemophiliac,
is that he's a hemophiliac.
So if he's to do any kind of procedure like insert
a needle into the paracardial sac and take the fluid
away so that the heart can beat properly, he can kill
him because he could bleed out.
(laughing)
- Oh my god, this is so fake, its crazy!
- He's clotting, he's clotting.
Give me the pen.
Okay.
Tape.
He's doing great, he's clotting.
- Get it in.
- [Dr. Lawson] Okay.
Good, good.
(gasping)
- Its okay.
- Ow, ow!
- Tucker!
- Just take it easy pal, take it easy.
- Take it easy, I just cut open into your heart and
your ribs, you're all good though, just take it easy.
- [Libby] He saved you, he saved you that's what he did.
- What?!
- Libby helped out big time.
- Libby helped out?!
My man, call 911.
This show is really funny, I actually enjoyed
watching it as a regular show, not just
as a medical drama.
There's obviously some crazy, unrealistic
situations that go on.
But the one part that is true, is VIP
Concierge Doctors are all the rage.
What my goal was when I was in medical school,
was to become a VIP Concierge Doctor, but for everybody.
Make it as a low-cost option.
And that's sort of coming into existence with
something known as Direct Primary Care,
and I'm kind of excited about it.
Click here for my three favorite videos
from the last few months.
As always, stay happy and healthy.
(R&B music playing)