- We haven't found you a kidney yet, but I have some ideas.
(laughs)
(upbeat music and whistling)
- I reacted to Scrubs for the first time, a few weeks back,
and I asked you guys to let me know in the comments
what episode I needed to review next
and the majority of the vote was for the episode "My Lunch"
and if you know anything about Scrubs,
their episodes are pretty zany. I'm excited to check it out,
but before we get into it, if you're new to my channel,
welcome, my name is Dr. Jordan Wagner. I'm an ER doctor.
If you enjoy the educational reaction videos and other stuff
that you see here on this channel,
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when I post a new video.
All right, let's dive right in.
- Asking Dr. Cox to lunch.
Hey, Dr. Cox, what are you doing for lunch?
- As an ER doctor, we don't get any breaks for lunch,
to go to the bathroom, nothing. We have either eight,
10, 12 hour, 24 hour shift.
It's just depends where you work,
but there is no time allotted to take a break.
It's just in between seeing patients.
- Lunch for us, not going to happen.
Normally I tell you something harsh right about now.
Like we're not friends,
but then you'll just grin that stupid grin, shake your head.
- There are times when you have an attending,
which is one of the doctors that you learned from,
you're scared of, you don't want to like talk to.
It's a world of different personalities
so you just never know who you're going to get.
- Some doctors like to change into their streets
when they go out for lunch, not me.
I like how the world reacts to me as a doctor.
- God, could this be any more of a nightmare?
- Yes, it could be
- Oh no.
- Jill Tracy was a former patient.
- Rule of thumb. I can speak for myself.
There's a huge line.
That's patient doctor relationship that never gets crossed,
cannot get crossed.
- Oh my God, what are you doing here?
I was supposed to meet a guy for a date.
I know what you're thinking.
"A Tuesday lunch date to the supermarket,
He is so not into her"
Well, guess what? He's not.
(laughing)
I waited for like an hour just thinking how many more guys
from my yoga class can totally reject me without me
just saying enough, you know?
- Well we have to get back to the hospital.
- The same thing happens at the hospital.
I see typically anywhere between two to four patients
an hour so unfortunately you don't get to spend as much time
with the patient. So if you're stuck
in a room listening to a story for a little bit too long,
it kind of impedes on the care.
- We had three separate patients waiting for transplants
and we were doing everything we could to keep them alive
while we could locate donors.
There was Mrs. Sykes who needed a new liver.
- Livers typically don't happen just like overnight.
They progressively get worse to where
then they stop functioning.
You can have a liver failure that just boom,
happens super crazy fast and getting the new liver,
obviously it's difficult.
- There was Mr. Dennison who needed a new heart valve.
- Most of the time, a new heart valve is related to
like the aortic heart valve.
There are other valves in a heart.
You can actually get a prosthetic one.
You can get a pig valve,
you don't have to necessarily get a human one.
- And there was Dr. Cox's guy, Dave Radford.
- So now Davey boy, I promise you,
we're going to find you a kidney.
- And then kidneys. The kidney donor list is really long,
unfortunately. You can survive without a kidney
if you're on dialysis, if you can have a native kidney,
that's much better.
- We need to keep these people going
until we can find donors.
- Alrighty, Barbie,
go check on Mrs. Sykes ammonia level.
She is encephalopathic.
- There we go. Ammonia level, encephalopathic.
A high ammonia level is due to liver problems
and your ammonia builds up and gets to your brain.
Basically, you become confused, altered.
We call that any type of metabolic encephalopathy,
meaning like confusion of the brain itself.
- Donny, review Denison's chart and get me a consent.
Get on the horn to your cronies at local hospitals
and get me a donor update.
- So am I ever getting out of here?
- We haven't found you a kidney yet.
- You can be on the list for months, years.
It all depends on the rarity of your blood and tissue,
that sort of thing.
Timing, a lot of different factors.
- But I have some ideas.
(laughs)
- Oh my gosh. It's a little black market kidney action.
- I can live with one kidney,
- Cause we'll probably just go and sell this one.
- Oh no! Yes, no.
(laughs)
You can't live without your kidneys.
You need them or need to be hooked up to a machine.
Typically you can live with one kidney,
when you actually get donor kidney,
you don't take the other ones out.
You just add in the donor itself,
you have to be matched with blood type, tissue type,
all these different things to make sure that
the donor kidney doesn't get rejected by the recipient.
- Give me the update here.
- Hugo Bradford's electrolyte and fluid balance are stable.
- Mr. Dennison isn't looking so good.
He's on maxinitropes and still in failure.
- Mrs. Sykes is fully encephalopathic.
Her ammonium level's through the roof.
She's circling the drain.
- Come on now. Let's try to keep these people alive.
- Oh my gosh. The kidney guy dealing with the electrolytes,
the heart guy dealing with medications
to optimize blood pressure and keep him from having
like abnormal rhythms and then the liver lady,
unfortunately becoming encephalopathic more and more.
To treat the ammonia,
we actually give medication called lactulose,
which actually binds the ammonia. The way it gets out
of the body is via poop.
- She was admitted a short time ago
and she hasn't regained consciousness.
- Oh Gosh.
- Tox screen's positive for cocaine
- The tox screen shows cocaine only in her system.
Tox screens Don't test for everything.
Tox screens tests for like main things,
cocaine, opiates, marijuana.
- Oh, no.
- Do you think she could have ODed?
She had been stood up on a couple of dates.
- Oh no!
- She hadn't seen her shrink in awhile.
She was definitely depressed.
- So just so everybody knows, there are hotlines,
if you're feeling suicidal, depressed,
that's where you give a call.
Cocaine causes tachycardia, causes you to sweat,
get palpitations, all that stuff.
Typically you're not going to kind of be comatose.
The only time you'd actually be comatose off of cocaine,
like a rupture of a vessel in your brain
and you basically are having a hemorrhagic stroke.
Cocaine acutely shouldn't cause you to just be in a coma
per se, there's gotta be something else going on.
- I've got our organs.
- What? He's got his organs.
- It probably means bad news for another.
- You can use her organs.
- Always difficulty having the conversation
about body donation,
giving the gift of life to somebody else by allowing them
to survive their ailment by using sadly
your loved ones organs.
Such a hard decision because either
the minute somebody passes away
or shortly before that happens,
the family members are literally,
whoever is basically next of kin, is getting questioned.
Hey, do you want to do this or not?
Literally, this is such a hard conversation
to have on both ends.
- Is there anything anyone could have done?
- No.
- In the emergency department,
this happens to where we know that somebody's going to die
and sometimes the family makes that decision
and depending on the organ,
it needs to be, it's a really messed up term,
but like harvested appropriately
and so that way it's taken out at the right time,
There are some things that can be donated just shortly
after death.
There are some that need to happen potentially
while the patient might be still alive.
- Perry, the autopsy just came in on your donor,
Jill Tracy. She didn't die in of an overdose.
- Good news for one person can mean bad news for another.
- She died of rabies?
- What?
- All of our transplant patients are infected.
We now know what we're dealing with here.
Let's get involved. We can do this.
- Oh no. What the heck is going on?
Wait a minute.
So you would assume that somebody who is healthy,
that their organs are healthy, right?
You don't typically test an organ per se,
you're testing the blood levels of the organ to make sure
that they're functioning appropriately.
Because rabies is so rare,
it's not typically something that's really tested
in organ tissue or in the bloodstream for transplants.
There is always some sort of risk
and this is just unfortunately a bad situation.
- We did all we could over the next few days to keep
the transplant patients going, but odds were against us.
First, we lost Mrs. Sykes.
- What? I just want to make a point of like when
actually somebody does pass away,
you do turn off the monitors and you take off
the oxygen and the body does lay there for a little while,
depending if the family is around or not
and then you call the next of kin and let them know
and sometimes they want to see the patient
in the hospital bed where they're at before they're moved
to the morgue of the hospital.
- Hey. Hungry?
- No.
- Guess that lunch was kind of a one-time thing, huh?
- I know this feeling, sucks.
- There's no way you could've seen that coming.
I mean, rabies? Those people were going to die
in a number hours and you had to make a call.
I would've made the same call.
- Yeah?
- Yes and I got us lunch and I think we should eat it.
- Okay. That last section, that really intense
and in the sense that you are busting your butt
with all the training and all the experience
that you have to save people's lives
and to do everything possible for them.
Nobody cares about the glory, the paycheck,
our job as physicians is to help people,
having a colleague then come talk to you about it,
it helps you move on so that way you can be
the best doctor and the best human being for the next case,
for that next patient.
That was really intense.
There's so much that we can dissect and learn from
the TV show Scrubs And as I said before,
it's like the most accurate to what residency is like
and how hospitals are kind of run. If you liked this video,
I think you're also going to like this one
So check it out and as always,
thank you so much for watching and stay healthy. My friends.
(upbeat music and whistling)