1
00:00:24,107 --> 00:00:26,609
[atmospheric music playing]
2
00:00:29,070 --> 00:00:31,448
[alarm blaring]
3
00:00:32,991 --> 00:00:35,785
[emergency responder 1] Skyhealth 1
Northwest Center for a physician...
4
00:00:35,785 --> 00:00:38,329
[emergency responders' voices overlapping]
5
00:00:38,329 --> 00:00:41,082
[emergency responder 2]
Tell me why you think it's a stroke.
6
00:00:44,502 --> 00:00:46,212
[field responder 1]
871 to medic six. Assisting
7
00:00:46,212 --> 00:00:50,383
a 74-year-old male, shortness of breath,
down to two-word sentences.
8
00:00:52,469 --> 00:00:55,722
[phone responder] All right. Let me get
liver transplant on the line for you.
9
00:00:55,722 --> 00:00:58,224
[field responder 1]
No relief from the nebulizer.
10
00:00:58,224 --> 00:01:01,144
[phone responder 3] What's the address
of the destination for the patient?
11
00:01:01,144 --> 00:01:03,021
Is the patient ready to go now?
12
00:01:03,021 --> 00:01:06,858
[ambulance siren blaring]
13
00:01:07,400 --> 00:01:09,903
[phone responder 4] An admitting diagnosis
whenever you're ready.
14
00:01:09,903 --> 00:01:12,739
[field responder 2] 6 medic 99.
That's a normal response for alpha site.
15
00:01:12,739 --> 00:01:15,617
- [responder 5] 10-4.
- [responder 6] Tell me what happened.
16
00:01:15,617 --> 00:01:16,576
Is she awake?
17
00:01:17,410 --> 00:01:18,411
Is she breathing?
18
00:01:18,995 --> 00:01:21,873
{\an8}[responder 7] Sky Health One Pilot.
I have admission request.
19
00:01:21,873 --> 00:01:23,625
{\an8}[pilot] Sky Health One Pilot, go.
20
00:01:23,625 --> 00:01:26,836
{\an8}[responder 7]
I have a 53-year-old male patient.
21
00:01:26,836 --> 00:01:28,671
{\an8}Patient weight...
22
00:01:28,671 --> 00:01:31,382
[responder 8] Six medic 40,
I have a 27-year-old female
23
00:01:31,382 --> 00:01:35,720
complaining of severe stomach pain,
lower right side, possible appendicitis.
24
00:01:35,720 --> 00:01:38,681
- Address, 85 Hoffman Avenue...
- [emergency responder] Copy.
25
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[indistinct responder radio chatter]
26
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[helicopter blades whirring]
27
00:01:54,739 --> 00:01:57,158
- [tense music builds]
- [overlapping responders' voices]
28
00:01:57,158 --> 00:01:59,494
- [music ends abruptly]
- [phones ringing]
29
00:02:01,871 --> 00:02:04,124
[responder] Sky Health One Pilot,
I have a mission request
30
00:02:04,124 --> 00:02:06,918
{\an8}coming out of Staten Island,
North University Hospital.
31
00:02:06,918 --> 00:02:10,380
{\an8}Possible stroke victim
going to Lenox Hill Hospital in Manhattan.
32
00:02:10,380 --> 00:02:13,424
[Mackenzie Labonte]
It's imperative that we move quickly.
33
00:02:13,424 --> 00:02:15,093
Time is of the essence.
34
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[alarm blaring]
35
00:02:17,804 --> 00:02:21,015
[tense music playing]
36
00:02:23,685 --> 00:02:24,853
[grunts]
37
00:02:25,645 --> 00:02:26,729
All right, I'm clear.
38
00:02:26,729 --> 00:02:29,774
- [pilot] Right, south liftoff.
- [Mackenzie] All right. Ready.
39
00:02:29,774 --> 00:02:32,443
[indistinct radio chatter]
40
00:02:44,497 --> 00:02:49,627
{\an8}All we know right now is that the patient
is having complaints of potential stroke.
41
00:02:49,627 --> 00:02:50,962
{\an8}Not sure what kind yet.
42
00:02:51,838 --> 00:02:54,924
Time is brain, you know,
so we want to make sure that
43
00:02:54,924 --> 00:02:57,343
we're doing
all the right things for this person.
44
00:02:58,720 --> 00:03:00,763
Complication in New York City
45
00:03:00,763 --> 00:03:03,766
and Long Island,
in general, is obviously traffic.
46
00:03:04,350 --> 00:03:05,894
When time is of the essence,
47
00:03:05,894 --> 00:03:10,815
we can go where the patient needs to go,
that's having the worst day of their life.
48
00:03:12,525 --> 00:03:15,069
[indistinct pilot radio chatter]
49
00:03:16,446 --> 00:03:18,448
[helicopter blades whirring]
50
00:03:22,160 --> 00:03:24,537
[Mackenzie]
I'm very decisive in those moments.
51
00:03:24,537 --> 00:03:26,122
I know exactly what I want.
52
00:03:26,122 --> 00:03:28,708
I know exactly what needs to be done.
53
00:03:29,292 --> 00:03:30,418
Let's do this.
54
00:03:30,418 --> 00:03:33,004
[Mackenzie]
I think in stressful situations,
55
00:03:33,004 --> 00:03:36,382
you just almost go into autopilot.
56
00:03:36,382 --> 00:03:37,926
People don't need your tears.
57
00:03:37,926 --> 00:03:40,887
They need you
to be their nurse or their medic.
58
00:03:40,887 --> 00:03:41,888
Hey, I'm MacKenzie.
59
00:03:41,888 --> 00:03:44,724
I'm gonna be the flight nurse
taking care of you in the back.
60
00:03:44,724 --> 00:03:46,768
[nurse] Just want to do
a couple of tests on you.
61
00:03:46,768 --> 00:03:48,353
Push up with both legs.
62
00:03:48,353 --> 00:03:49,270
Good.
63
00:03:49,270 --> 00:03:51,439
[Mackenzie]
So, I just got a report from the nurse.
64
00:03:51,439 --> 00:03:55,193
She sustained a fall.
She's been aphasic the entire time.
65
00:03:55,193 --> 00:03:56,444
That hasn't changed.
66
00:03:56,444 --> 00:03:58,821
Possible MCA bleed.
67
00:03:59,447 --> 00:04:01,407
- [nurse] One, two, three.
- [Mackenzie] Okay.
68
00:04:03,201 --> 00:04:06,079
Gonna put a blood pressure cuff
on your arm, okay?
69
00:04:06,079 --> 00:04:08,373
We're gonna take good care of you,
I promise.
70
00:04:08,373 --> 00:04:10,875
120 over 78. She's good.
71
00:04:13,503 --> 00:04:15,797
- [nurse] Have a good one.
- [Mackenzie] Have a good one.
72
00:04:16,714 --> 00:04:19,717
[nurse] We're gonna get you into Manhattan
really quick at this time of day
73
00:04:19,717 --> 00:04:22,136
'cause we're gonna
fly over all that traffic.
74
00:04:22,136 --> 00:04:25,890
Once we get to Manhattan, we're gonna take
a quick ambulance ride to the hospital.
75
00:04:25,890 --> 00:04:29,310
O2 stat dropped a little. Do you
want to put her on a non-rebreather?
76
00:04:29,310 --> 00:04:30,228
[Mackenzie] Yeah.
77
00:04:30,812 --> 00:04:32,397
[indistinct pilot radio chatter]
78
00:04:33,564 --> 00:04:35,358
[Mackenzie] Is your pain doing any better?
79
00:04:36,234 --> 00:04:37,777
Can you hear me right now?
80
00:04:38,695 --> 00:04:41,281
She's a little less responsive
than she was before.
81
00:04:41,281 --> 00:04:43,408
- I'm coming out of my belt.
- [Mackenzie] Alright.
82
00:04:43,408 --> 00:04:44,659
How far out, then?
83
00:04:44,659 --> 00:04:46,452
- [pilot] Two minutes.
- [Mackenzie] Okay.
84
00:04:46,452 --> 00:04:49,539
All right, darling,
we're gonna take good care of you, okay?
85
00:04:49,539 --> 00:04:53,084
[tense music playing]
86
00:04:58,464 --> 00:04:59,799
- Now.
- Yep.
87
00:05:02,635 --> 00:05:03,636
[nurse] Three.
88
00:05:10,018 --> 00:05:12,729
{\an8}[ambulance siren blaring]
89
00:05:15,690 --> 00:05:19,652
So, we have a 34-year-old female,
and she fell.
90
00:05:19,652 --> 00:05:22,655
She was not acting herself,
she wasn't talking,
91
00:05:22,655 --> 00:05:28,953
{\an8}so we are concerned
that she might be having a stroke.
92
00:05:29,704 --> 00:05:32,123
Because of the way that she hit her head,
93
00:05:32,123 --> 00:05:34,334
she may have a bleed.
94
00:05:34,334 --> 00:05:38,171
We are gonna try to get her
to Lenox Hill to get her further care.
95
00:05:38,755 --> 00:05:44,135
6 Medic 99 Central. Do you
have me en route to Lenox Hill Hospital?
96
00:05:44,719 --> 00:05:48,014
[phone responder]
6 Medic 99, you are 82 to Lennox Hill.
97
00:05:48,014 --> 00:05:50,099
[car horns honking]
98
00:05:50,099 --> 00:05:52,143
[ambulance siren blaring]
99
00:05:52,143 --> 00:05:54,979
[Vicky] You know, if you've
never been in the ambulance,
100
00:05:54,979 --> 00:05:58,816
you don't know how important
a minute is until you're back here.
101
00:05:58,816 --> 00:06:01,110
It's very touching,
and she's almost my age.
102
00:06:01,110 --> 00:06:03,112
Things that go through my head,
her family.
103
00:06:04,155 --> 00:06:05,907
- [nurse] You got a flush over there?
- Yeah.
104
00:06:05,907 --> 00:06:07,617
[Vicky]
It's the first thing they tell you.
105
00:06:07,617 --> 00:06:09,035
Don't get so involved,
106
00:06:09,035 --> 00:06:12,205
because then when it's time to leave,
it breaks your heart
107
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because you wish
you could do a little bit more.
108
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All we can do is pray for her.
109
00:06:22,215 --> 00:06:24,842
[Mackenzie] Hey, we have
the transfer from Staten Island.
110
00:06:24,842 --> 00:06:26,260
[nurse] Okay, great.
111
00:06:26,260 --> 00:06:29,305
Thirty-four-year-old female
sustained a fall.
112
00:06:29,305 --> 00:06:32,433
Was complaining of a headache.
Worst headache of her life.
113
00:06:32,433 --> 00:06:35,895
She's had a sudden onset
of right-sided weakness.
114
00:06:35,895 --> 00:06:37,980
Two, three. Okay.
115
00:06:38,606 --> 00:06:40,775
[nurse] Hi! Can you tell me your name?
116
00:06:40,775 --> 00:06:43,820
[man] Let's get her finger stick.
Let's get her on the monitor.
117
00:06:43,820 --> 00:06:46,739
[indistinct chatter]
118
00:06:46,739 --> 00:06:47,865
[man] You're in good hands.
119
00:06:47,865 --> 00:06:49,283
[Mackenzie] You're gonna be okay.
120
00:06:49,283 --> 00:06:50,993
[nurse] Blood pressure is 109 over 69.
121
00:06:50,993 --> 00:06:52,286
[doctor] Lift this leg up.
122
00:06:53,037 --> 00:06:55,915
- Very good. Nice shoes, by the way.
- [all chuckling]
123
00:06:55,915 --> 00:06:59,085
[doctor] Squeeze my fingers.
Squeeze tight. Good.
124
00:07:01,212 --> 00:07:02,880
We're gonna get you back to CAT Scan.
125
00:07:02,880 --> 00:07:05,508
We're going to take care of you.
Sorry you're going through this.
126
00:07:07,343 --> 00:07:09,345
[indistinct radio chatter]
127
00:07:12,557 --> 00:07:14,559
[ambulance siren blaring]
128
00:07:39,500 --> 00:07:41,502
[dramatic music playing]
129
00:07:43,463 --> 00:07:44,422
[click]
130
00:07:49,427 --> 00:07:50,970
[producer] Can you take off your mask?
131
00:07:50,970 --> 00:07:53,473
Yeah. Is it okay like this?
132
00:07:53,473 --> 00:07:54,849
- [producer] Yeah.
- Okay.
133
00:07:56,184 --> 00:07:59,979
{\an8}[Jose] My grandfather was a doctor
in Cuba. He was a pediatrician.
134
00:07:59,979 --> 00:08:02,440
{\an8}I didn't grow up with him
because he never left Cuba.
135
00:08:02,440 --> 00:08:05,818
{\an8}I grew up and was born and raised
here in New York, in Queens.
136
00:08:06,319 --> 00:08:09,489
{\an8}I went to medical school
thinking that I would probably do
137
00:08:09,489 --> 00:08:13,534
{\an8}like my grandfather and be a pediatrician,
and then I fell in love with surgery.
138
00:08:13,534 --> 00:08:17,246
{\an8}I fell in love with the immediacy
of helping someone with a problem,
139
00:08:17,246 --> 00:08:18,789
and seeing it fixed right away.
140
00:08:19,373 --> 00:08:21,209
I grew up ten blocks from here.
141
00:08:21,209 --> 00:08:23,461
My mother still
lives in the house I grew up in,
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00:08:23,461 --> 00:08:27,757
so the children I care for
are not just anybody's children.
143
00:08:27,757 --> 00:08:29,383
This is really home for me.
144
00:08:29,884 --> 00:08:34,138
Helping to build the biggest, busiest,
pediatric trauma center in New York City,
145
00:08:34,138 --> 00:08:35,264
it matters to me.
146
00:08:36,682 --> 00:08:39,685
[child screaming]
147
00:08:39,685 --> 00:08:41,771
[Donald Darby]
Okay. Do the other side too, okay?
148
00:08:42,522 --> 00:08:45,107
- [child crying]
- [phones ringing]
149
00:08:45,107 --> 00:08:46,651
[Donald] We're done, we're done.
150
00:08:46,651 --> 00:08:50,404
My role is a pediatric transport nurse
for the health system.
151
00:08:50,905 --> 00:08:54,534
We're all trained in critical care
and have ER/ICU background,
152
00:08:54,534 --> 00:08:57,870
so a trauma comes in, we're all able
to jump in and assist if needed.
153
00:08:57,870 --> 00:08:58,788
[crying]
154
00:08:58,788 --> 00:09:00,873
[Donald] All hands on deck
when a trauma comes in.
155
00:09:00,873 --> 00:09:03,960
Mom, Dad, we're giving some Benadryl.
Might get a little sleepy.
156
00:09:03,960 --> 00:09:06,879
Don't get concerned about that.
I'll be right outside the room.
157
00:09:06,879 --> 00:09:08,673
We'll be going over in a few minutes.
158
00:09:09,549 --> 00:09:12,051
It's a great feeling
to come in and make a difference,
159
00:09:12,051 --> 00:09:15,388
{\an8}'cause I have children in the area,
and if something were to happen,
160
00:09:15,388 --> 00:09:16,347
{\an8}they'd end up here.
161
00:09:16,347 --> 00:09:17,557
[phone ringing]
162
00:09:17,557 --> 00:09:19,100
[phone responder] Transplants coming.
163
00:09:19,100 --> 00:09:20,560
Alright, hold on one second.
164
00:09:20,560 --> 00:09:23,854
Hi, it's Donald from Cohen's.
Can I get the Peds ER, please?
165
00:09:24,647 --> 00:09:27,066
This office is our pediatric call center.
166
00:09:27,066 --> 00:09:31,737
We are one of the only pediatric
critical care transport teams in the area.
167
00:09:31,737 --> 00:09:32,655
Transport, Donald.
168
00:09:32,655 --> 00:09:35,866
And as nurses,
our physicians train us to a higher level.
169
00:09:35,866 --> 00:09:38,494
Outside facilities call us
as if we're 9-1-1,
170
00:09:38,494 --> 00:09:42,498
and frequently it requires
actual transport into our facility.
171
00:09:42,498 --> 00:09:43,583
Transport, Donald.
172
00:09:46,836 --> 00:09:50,840
[field responder] He's a 17-year-old male
coming in with two entrance wounds.
173
00:09:50,840 --> 00:09:52,717
Probably two exit wounds.
174
00:09:52,717 --> 00:09:55,511
Pierced the diaphragm,
lacerated the liver,
175
00:09:55,511 --> 00:09:57,597
as well as the stomach and spleen.
176
00:09:58,097 --> 00:09:58,931
Ready to go!
177
00:10:00,141 --> 00:10:01,976
[field responder] Still actively bleeding.
178
00:10:01,976 --> 00:10:04,437
[ambulance siren blaring]
179
00:10:05,187 --> 00:10:08,065
[Jose] We just got activated
for a level one trauma.
180
00:10:08,816 --> 00:10:12,278
A 17-year-old who was shot last night.
181
00:10:12,278 --> 00:10:16,824
He was brought to the emergency department
at another hospital of ours.
182
00:10:16,824 --> 00:10:20,745
In the middle of the night,
he actually tried to die three times.
183
00:10:22,204 --> 00:10:24,665
{\an8}We don't really have
all the information at this point,
184
00:10:24,665 --> 00:10:27,752
{\an8}which is really common
in a trauma kind of world.
185
00:10:27,752 --> 00:10:31,255
We have to make decisions
with imperfect information.
186
00:10:31,255 --> 00:10:33,966
Hi, guys, how are you?
Who's here from my team?
187
00:10:33,966 --> 00:10:35,343
[man] Good morning, Dr. Prince.
188
00:10:35,343 --> 00:10:36,927
[Jose] The key thing for the team
189
00:10:36,927 --> 00:10:39,889
is this kid's
been in an ICU setting all night.
190
00:10:39,889 --> 00:10:41,349
So this needs to be efficient.
191
00:10:41,349 --> 00:10:43,142
We really just want the CT/Angio.
192
00:10:43,142 --> 00:10:46,646
We want to be quiet, efficient,
and get him to the next step.
193
00:10:48,606 --> 00:10:50,483
- Family is here too?
- [nurse] Mom is here.
194
00:10:50,483 --> 00:10:51,484
[Jose] Okay.
195
00:10:53,444 --> 00:10:55,863
[tense music playing]
196
00:11:16,008 --> 00:11:16,884
[woman] Good.
197
00:11:16,884 --> 00:11:19,720
Okay, this is Joshua, a 17-year-old male.
198
00:11:19,720 --> 00:11:21,931
He has multiple gunshot wounds.
199
00:11:21,931 --> 00:11:23,349
He had a splenectomy.
200
00:11:23,349 --> 00:11:28,646
They did repair lacerations of the liver,
also gastrectomy times three.
201
00:11:31,315 --> 00:11:33,651
[beeping]
202
00:11:33,651 --> 00:11:35,236
[man] One, two, three, ready.
203
00:11:35,945 --> 00:11:39,156
[nurse] Joshua, everything's okay.
You're in the hospital.
204
00:11:39,156 --> 00:11:41,492
[Jose] Was there
a penetrating injury to the neck?
205
00:11:41,492 --> 00:11:44,537
- There was not.
- Was there an assault as part of this?
206
00:11:44,537 --> 00:11:46,622
[nurse] Unclear of the history prior to--
207
00:11:46,622 --> 00:11:47,957
[hissing]
208
00:11:47,957 --> 00:11:51,127
[nurse] The injuries are
the humerus and belly.
209
00:11:51,127 --> 00:11:52,128
[Jose] Okay.
210
00:11:52,128 --> 00:11:54,922
[indistinct chatter]
211
00:11:57,049 --> 00:12:00,177
[indistinct chatter continues]
212
00:12:02,263 --> 00:12:04,849
- If you happen to have an FFP.
- Can we get him an FFP?
213
00:12:04,849 --> 00:12:07,101
Alright, so somebody get the FFP,
I'll give it.
214
00:12:08,936 --> 00:12:10,855
[indistinct chatter]
215
00:12:10,855 --> 00:12:12,481
Another. Get it.
216
00:12:12,481 --> 00:12:13,858
[man] Can I have another FFP?
217
00:12:14,442 --> 00:12:15,609
[Jose] Hi, I'm Dr. Prince.
218
00:12:15,609 --> 00:12:18,779
Sorry you're meeting someone like me
in the middle of the morning like this.
219
00:12:18,779 --> 00:12:22,116
Right now, they're just
calmly getting him from the stretcher
220
00:12:22,116 --> 00:12:23,534
and all the transport stuff here,
221
00:12:23,534 --> 00:12:25,911
and set up to our equipment
so we can track everything.
222
00:12:25,911 --> 00:12:28,664
And then we're gonna go next door
to get another CAT scan.
223
00:12:28,664 --> 00:12:31,083
We spoke to the surgeons
that did the surgery there.
224
00:12:31,083 --> 00:12:33,294
We're very up to speed
with where things stand.
225
00:12:33,294 --> 00:12:35,713
Just wanna make sure
with the move in the ambulance,
226
00:12:35,713 --> 00:12:36,839
there's a lot going on,
227
00:12:36,839 --> 00:12:39,300
and get information
so we can draw out the next step.
228
00:12:39,300 --> 00:12:40,593
- [Leslie] Okay.
- [Jose] Um...
229
00:12:40,593 --> 00:12:43,095
Do you have questions for me
right off the bat? Or...
230
00:12:43,095 --> 00:12:44,430
[Leslie] I'm just scared.
231
00:12:44,430 --> 00:12:46,682
That's appropriate, ma'am.
232
00:12:46,682 --> 00:12:47,725
I'm so sorry.
233
00:12:49,059 --> 00:12:52,354
{\an8}And that's appropriate, ma'am.
You're allowed to be scared.
234
00:12:52,354 --> 00:12:54,982
{\an8}Look, you are not here alone.
235
00:12:54,982 --> 00:12:56,942
{\an8}There's everyone here.
236
00:12:56,942 --> 00:12:59,320
All of us are here to help you with this,
237
00:12:59,320 --> 00:13:02,114
and I know I was told
there was a lot of family with you,
238
00:13:02,114 --> 00:13:04,909
so we'll get them all in
when the time is right.
239
00:13:05,534 --> 00:13:06,410
And...
240
00:13:06,410 --> 00:13:09,038
[nurse] We'll walk you through this.
We're here for you.
241
00:13:09,038 --> 00:13:10,039
I'm sorry.
242
00:13:10,039 --> 00:13:13,167
[atmospheric music playing]
243
00:13:20,841 --> 00:13:22,635
[ambulance siren blaring]
244
00:13:22,635 --> 00:13:27,890
[David Langer] I'm not sure how much
of this is just New York City, COVID,
245
00:13:27,890 --> 00:13:29,517
but the world's changed.
246
00:13:32,520 --> 00:13:34,772
COVID was like a real wake-up call,
247
00:13:34,772 --> 00:13:39,360
{\an8}but also a stressor that we still haven't
fully recovered from.
248
00:13:40,986 --> 00:13:44,532
{\an8}One of the reasons we saw so many deaths
early was hospitals were overwhelmed,
249
00:13:44,532 --> 00:13:46,700
{\an8}but people wouldn't come in
until they were really sick
250
00:13:46,700 --> 00:13:47,868
{\an8}because they were afraid.
251
00:13:48,911 --> 00:13:51,622
People that had moderate problems,
or even major ones,
252
00:13:51,622 --> 00:13:54,208
that were staying out of hospitals,
suddenly reappeared,
253
00:13:54,208 --> 00:13:57,419
that had been hibernating
under the cover of COVID.
254
00:13:57,419 --> 00:13:59,505
I'm just worried about
the size of this clot.
255
00:13:59,505 --> 00:14:01,423
She's young and she's healthy.
256
00:14:01,423 --> 00:14:04,260
You know, I wouldn't want to wait on this.
This is too big.
257
00:14:04,760 --> 00:14:08,681
- [John Boockvar] What's her first name?
- [David] Julian. She wants a family.
258
00:14:08,681 --> 00:14:09,598
Good morning.
259
00:14:10,224 --> 00:14:11,725
- How you doing?
- [woman] I'm doing well.
260
00:14:11,725 --> 00:14:12,726
Good.
261
00:14:13,352 --> 00:14:14,228
Hi, team.
262
00:14:15,604 --> 00:14:17,773
[David] So, this girl was at a wedding.
263
00:14:17,773 --> 00:14:21,068
The left side of her face was weak,
she's getting weakness of her arm.
264
00:14:21,068 --> 00:14:24,029
She literally was having a stroke,
comes in emergently.
265
00:14:24,029 --> 00:14:27,449
She has a huge blood clot
in the right hemisphere.
266
00:14:27,449 --> 00:14:29,869
[John] Can you lower your mask
just to look at your face?
267
00:14:29,869 --> 00:14:30,786
Smile for me.
268
00:14:30,786 --> 00:14:33,581
[David] It's consistent with
what's called a cavernous malformation.
269
00:14:33,581 --> 00:14:36,041
We confirmed that with follow-up study,
270
00:14:36,041 --> 00:14:39,712
which showed that
the amount of clot shrunk a little bit,
271
00:14:39,712 --> 00:14:42,798
but you know, a 29-year-old girl
with all her life ahead of her?
272
00:14:42,798 --> 00:14:46,051
The last thing we want to do
is take the risk of it bleeding again
273
00:14:46,051 --> 00:14:48,387
and giving her a big
deficit the rest of her life.
274
00:14:48,387 --> 00:14:49,638
After seeing her improve,
275
00:14:49,638 --> 00:14:52,391
and the thing is shrinking,
let's get it out of her.
276
00:14:52,391 --> 00:14:54,602
That's why we're doing this
quickly as we can.
277
00:14:54,602 --> 00:14:56,937
[tender music playing]
278
00:15:01,442 --> 00:15:04,695
[David] Most of our surgeries
are "should and must,"
279
00:15:04,695 --> 00:15:07,907
and that means that you have to have
the operation in order to prevent
280
00:15:07,907 --> 00:15:09,116
loss of life or limb.
281
00:15:09,116 --> 00:15:12,828
[surgeon] One percent lidocaine
with epi 1:100,000 was injected.
282
00:15:12,828 --> 00:15:15,873
We have defibrillator in
regular surgery center and surgery floor.
283
00:15:15,873 --> 00:15:16,790
Let's rock.
284
00:15:16,790 --> 00:15:18,334
[David] So, this lady's 29.
285
00:15:18,334 --> 00:15:20,878
She was at a wedding with her husband
286
00:15:20,878 --> 00:15:23,339
who's an orthopedic surgery resident
in North Shore.
287
00:15:23,339 --> 00:15:26,258
She actually is an opera singer,
of all things,
288
00:15:26,258 --> 00:15:29,011
and a really sweet lady.
289
00:15:29,011 --> 00:15:32,806
And her husband is a good guy too.
So let's do a good job.
290
00:15:32,806 --> 00:15:35,935
[news reporter] ...in Times Square,
as a shooter fires after a fight,
291
00:15:35,935 --> 00:15:37,978
sending people scrambling for cover as--
292
00:15:37,978 --> 00:15:42,274
[Brandon] This is our engagement party.
We got married four months ago.
293
00:15:42,983 --> 00:15:45,402
She's a classically trained opera singer.
294
00:15:45,402 --> 00:15:48,113
She also auditions for Broadway.
295
00:15:48,906 --> 00:15:50,616
This was like her first show.
296
00:15:54,912 --> 00:15:58,290
She must have been on the phone
with like 50 different people.
297
00:15:58,290 --> 00:16:00,709
She was like,
"I don't want to go to sleep,
298
00:16:00,709 --> 00:16:04,797
and I don't know
if I'll talk to these people again."
299
00:16:06,715 --> 00:16:11,053
[John] During the COVID pandemic,
people delayed their healthcare.
300
00:16:11,053 --> 00:16:14,348
That had significant
consequences for everything,
301
00:16:14,348 --> 00:16:17,977
{\an8}from detection of cancer,
to checking your blood pressure,
302
00:16:17,977 --> 00:16:21,730
{\an8}and that led to an increase in just about
everything we see, including emergencies
303
00:16:21,730 --> 00:16:25,859
and late diagnoses
that should have been picked up earlier.
304
00:16:26,777 --> 00:16:29,613
[David] And even more importantly,
people had been staying home.
305
00:16:29,613 --> 00:16:31,365
Now people were going out in public.
306
00:16:31,365 --> 00:16:34,618
Assaults went up,
shootings all of a sudden went up.
307
00:16:34,618 --> 00:16:37,246
There was frustration, there was fear,
308
00:16:37,246 --> 00:16:41,750
and all these things basically
resulted in human beings acting out again.
309
00:16:50,467 --> 00:16:52,177
[phone ringing]
310
00:16:53,470 --> 00:16:54,888
[Jose] If we can get him scanned,
311
00:16:54,888 --> 00:16:57,349
so we can get him in the ICU,
it'll be a better place.
312
00:16:57,349 --> 00:16:58,517
- [man] Donald?
- [Donald] Yes?
313
00:16:58,517 --> 00:17:01,520
- [man] Are we on a portable monitor?
- [Donald] Not yet.
314
00:17:01,520 --> 00:17:03,230
I'm checking the line first.
315
00:17:05,190 --> 00:17:07,359
- [woman] Cover him up, please.
- [man] Airway, we're okay?
316
00:17:07,359 --> 00:17:09,236
Mary Anne, we're okay to move?
317
00:17:09,862 --> 00:17:10,779
Donald?
318
00:17:11,280 --> 00:17:12,239
Okay, let's go.
319
00:17:12,239 --> 00:17:14,158
[indistinct chatter]
320
00:17:17,870 --> 00:17:20,706
[tense music playing]
321
00:17:22,166 --> 00:17:23,584
[Donald] He was at a party.
322
00:17:23,584 --> 00:17:25,377
He was shot a few times,
323
00:17:25,377 --> 00:17:29,673
and then he was taken by private vehicle
to a small community hospital.
324
00:17:30,966 --> 00:17:32,634
With the report that we received,
325
00:17:32,634 --> 00:17:35,345
what I expected was someone
to be completely comatose.
326
00:17:36,305 --> 00:17:38,474
He had cardiac arrested three times,
327
00:17:38,474 --> 00:17:43,187
and we were informed that he was actually
brain-dead for all intents and purposes.
328
00:17:44,438 --> 00:17:48,859
And that further leads to the shock when
I arrived and started my rapid assessment,
329
00:17:48,859 --> 00:17:51,612
he actually opened his eyes,
and I saw fear in his face.
330
00:17:53,906 --> 00:17:57,284
That's not something that
you want in your patient, because fear
331
00:17:57,284 --> 00:17:59,286
increases your oxygen demand, stress.
332
00:17:59,286 --> 00:18:01,580
We need to be compliant
with what we're providing
333
00:18:01,580 --> 00:18:03,499
so they don't further injure themselves.
334
00:18:03,499 --> 00:18:05,417
- Have we given a PRBC yet?
- Just now.
335
00:18:05,417 --> 00:18:09,171
- Do we have platelets?
- [doctor] We should give platelets now.
336
00:18:09,171 --> 00:18:12,966
[Donald] Keeping someone alive
for 25 minutes in an outside ambulance,
337
00:18:12,966 --> 00:18:15,928
in an unstable environment,
is extremely difficult at best.
338
00:18:16,887 --> 00:18:19,473
[nurse] The platelets is
the one unit they gave me...
339
00:18:19,473 --> 00:18:21,934
- [doctor] And we're giving it? Perfect!
- We're giving it all.
340
00:18:21,934 --> 00:18:23,477
Give another FFP next.
341
00:18:23,477 --> 00:18:24,686
[Jose] Thanks, Donald.
342
00:18:26,396 --> 00:18:29,233
[Donald] 65 milligrams. Rock and rolling.
343
00:18:29,942 --> 00:18:31,735
[indistinct chatter]
344
00:18:31,735 --> 00:18:34,196
[airway MD] ...here and we'll reattach
as soon as we move over.
345
00:18:34,196 --> 00:18:36,698
- I'm going to disconnect.
- [doctor] Okay...
346
00:18:36,698 --> 00:18:37,783
[airway MD] Take this.
347
00:18:37,783 --> 00:18:40,369
Everything's okay, Joshua.
We're going to move you over.
348
00:18:40,369 --> 00:18:41,453
[Jose] And pull tight.
349
00:18:41,453 --> 00:18:43,038
[airway MD] One, two, three.
350
00:18:43,038 --> 00:18:46,250
Doing this job, as a parent,
makes it more difficult for me.
351
00:18:49,378 --> 00:18:52,965
I have a son that's 16 years old.
That could have been my son hanging out.
352
00:18:52,965 --> 00:18:55,134
We don't know what happens
when people are out.
353
00:18:55,134 --> 00:18:58,345
Egos start to blow
and you don't think clearly,
354
00:18:58,345 --> 00:19:01,557
and unfortunately, the families
are left to hold the ball afterwards.
355
00:19:01,557 --> 00:19:03,600
[Jose] Are you an older brother
or younger brother?
356
00:19:03,600 --> 00:19:05,352
- [Josh's brother] Older brother.
- [Jose] Um...
357
00:19:05,853 --> 00:19:08,647
I know you guys know
there's a lot going on, okay?
358
00:19:08,647 --> 00:19:11,191
I'm just going to try and get him
over here next door,
359
00:19:11,191 --> 00:19:15,195
and then we're going to figure out what
we're getting you guys to the next step.
360
00:19:15,195 --> 00:19:17,406
- Okay, you got your mom? Yeah.
- Yeah.
361
00:19:17,406 --> 00:19:20,075
[indistinct chatter]
362
00:19:21,451 --> 00:19:24,037
So we just gave platelet.
We're giving another FFP now.
363
00:19:24,037 --> 00:19:26,707
It'll be our 4th FFP here.
And the next one will be blood.
364
00:19:26,707 --> 00:19:29,209
[beeping]
365
00:19:29,209 --> 00:19:31,962
[Jose] Guys, it's already coming down.
126. 119, guys.
366
00:19:31,962 --> 00:19:34,131
[nurse] He doesn't have
a blood pressure right now.
367
00:19:34,131 --> 00:19:35,924
Get him back on the pressers.
368
00:19:35,924 --> 00:19:38,510
- [doctor 1] How much, one gram?
- [doctor 2] Give me 10cc syringe.
369
00:19:38,510 --> 00:19:41,013
If this becomes a code,
will you run it for us? Okay.
370
00:19:41,013 --> 00:19:42,347
[Jose] It's so devastating.
371
00:19:42,347 --> 00:19:45,851
A couple pieces of metal
and you take a young person's life
372
00:19:45,851 --> 00:19:48,312
and put them on the edge in two seconds.
373
00:19:58,322 --> 00:19:59,448
[phone responder] Medic 99,
374
00:19:59,448 --> 00:20:02,201
we have a suspected hit-and-run
with bleeding shunt.
375
00:20:02,201 --> 00:20:03,535
NYPD at location.
376
00:20:03,535 --> 00:20:06,330
{\an8}Suspecting assault.
This is a code three. Over.
377
00:20:06,330 --> 00:20:09,750
{\an8}It's 57, female bleeding
from the outside shunt.
378
00:20:09,750 --> 00:20:12,502
[ambulance siren blaring]
379
00:20:22,763 --> 00:20:24,890
[Kristina]
When did this happen? What happened?
380
00:20:24,890 --> 00:20:27,142
[Leo] I'm not fighting nobody but you.
381
00:20:27,142 --> 00:20:29,770
Everybody knows your ass disrespectful.
382
00:20:29,770 --> 00:20:32,731
Why the fuck you
talking about nobody saved your ass?
383
00:20:32,731 --> 00:20:34,191
{\an8}[beeping]
384
00:20:34,191 --> 00:20:35,776
{\an8}[tense music builds]
385
00:20:35,776 --> 00:20:38,946
[man] Don't go nowhere. Stay here.
Tell them what happened.
386
00:20:38,946 --> 00:20:41,031
- [Kristina] Hello.
- [man] ...fuck are ya talking about?
387
00:20:41,031 --> 00:20:42,741
- [Kristina] What happened?
- [man] I saved...
388
00:20:42,741 --> 00:20:45,869
[Kristina] Hold on one second.
Let us take care of her, okay?
389
00:20:45,869 --> 00:20:48,372
Sir, can you just give us a second?
390
00:20:48,372 --> 00:20:50,791
We're just trying to help her, okay?
391
00:20:50,791 --> 00:20:53,377
- What's your name, ma'am?
- Vickie Williams.
392
00:20:53,377 --> 00:20:56,922
[Kristina] Okay. Hi, Ms. Williams.
Let's concentrate on you, okay?
393
00:20:56,922 --> 00:21:00,092
[Vicky] Rob? PD for scene control, please.
394
00:21:00,092 --> 00:21:01,176
[Vickie groans]
395
00:21:01,176 --> 00:21:04,012
[Kristina] Okay, so this young man
in the green is your family member?
396
00:21:04,012 --> 00:21:05,472
- [Vickie] Yeah.
- [Kristina] Okay.
397
00:21:05,472 --> 00:21:07,599
And who was the driver of this vehicle?
398
00:21:07,599 --> 00:21:09,726
[Vickie] That guy right there.
399
00:21:09,726 --> 00:21:11,645
- [Kristina] With a black hat on?
- Yes.
400
00:21:11,645 --> 00:21:13,981
He didn't put the strap over me.
401
00:21:13,981 --> 00:21:16,525
[Kristina] Okay,
you have any dizziness or pain?
402
00:21:16,525 --> 00:21:20,487
- [Vickie] I hit my head. My head hurts.
- [Kristina] Can you grip my hand?
403
00:21:20,487 --> 00:21:23,365
Do you want to stay here or do you want
to go to the hospital?
404
00:21:23,365 --> 00:21:25,200
- [Vickie] Hospital...
- [Kristina] No problem.
405
00:21:25,200 --> 00:21:27,869
Okay, Miss Williams,
my name is Vicky, okay?
406
00:21:28,954 --> 00:21:31,748
We're going to take your blood pressure.
On the left arm.
407
00:21:31,748 --> 00:21:36,295
Your name is Vickie, and my name is Vicky.
So, what we gonna do here? [chuckles]
408
00:21:36,295 --> 00:21:40,007
- [Kristina] You lost a lot of blood here.
- [Vicky] Go to Applebee's, have dinner?
409
00:21:40,507 --> 00:21:43,593
Don't worry,
we're gonna figure everything out, okay?
410
00:21:43,593 --> 00:21:44,678
[Vickie] Thank you, Vicky.
411
00:21:44,678 --> 00:21:45,595
Okay.
412
00:21:47,139 --> 00:21:49,516
- [Vicky] That good?
- [man] Yeah, that's good.
413
00:21:49,516 --> 00:21:50,851
One, two, three.
414
00:21:52,853 --> 00:21:55,439
- [Vicky] You comfortable?
- [woman speaking indistinctly]
415
00:21:55,439 --> 00:21:57,858
[man] I'm not talking to you!
416
00:21:57,858 --> 00:21:59,359
I am not talking to you!
417
00:22:03,655 --> 00:22:05,615
- [Vickie groans]
- [both] Sorry.
418
00:22:05,615 --> 00:22:06,825
[Vickie] My ribs!
419
00:22:06,825 --> 00:22:09,286
- [Vicky] Is that better? A little better?
- [Vickie] My ribs!
420
00:22:09,870 --> 00:22:11,580
- [Vicky] I'm sorry.
- [Vickie groans]
421
00:22:12,080 --> 00:22:13,332
Oh, my ribs!
422
00:22:13,332 --> 00:22:15,208
How can we help you with the pain?
423
00:22:15,208 --> 00:22:18,295
Just put something here,
then I can rest my arm.
424
00:22:18,295 --> 00:22:21,173
- [Vicky] Okay.
- [Kristina] You want us to move that?
425
00:22:21,173 --> 00:22:24,384
When we start driving, your ribs are going
to hit against this handle.
426
00:22:24,384 --> 00:22:26,136
- So we're trying to pad you.
- [Vickie] Yeah...
427
00:22:26,136 --> 00:22:27,971
[Kristina] We're having you
sit on the pillow.
428
00:22:27,971 --> 00:22:29,931
That's what's
leaning you to the left side.
429
00:22:29,931 --> 00:22:31,141
[Vicky] Let's start rolling.
430
00:22:31,141 --> 00:22:34,061
- Leo's a demon. I keep telling you that.
- [Kristina] Is that your husband?
431
00:22:34,061 --> 00:22:36,521
He's not my husband.
I'm not married to him.
432
00:22:36,521 --> 00:22:38,357
[Kristina] I'm just asking, I'm sorry.
433
00:22:38,357 --> 00:22:39,691
[Vickie] I understand.
434
00:22:39,691 --> 00:22:41,860
He's been in my life for 12 years.
435
00:22:41,860 --> 00:22:44,780
- And 12 agony ass long years.
- [Kristina laughs]
436
00:22:44,780 --> 00:22:47,324
[Vicky] Okay, you want
to say something before you leave?
437
00:22:47,991 --> 00:22:50,118
- [sighs]
- [Vicky] Something nice, okay?
438
00:22:50,118 --> 00:22:52,454
Mooks, I'm right behind you.
439
00:22:52,454 --> 00:22:54,247
I'll be right up there. You heard me?
440
00:22:54,247 --> 00:22:56,625
Don't talk to me, Leo. You wrong.
441
00:22:56,625 --> 00:22:58,377
- Why am I wrong?
- Know how to get there?
442
00:22:58,377 --> 00:23:01,338
She's mad at me because
I didn't beat the goddamn driver's ass.
443
00:23:01,338 --> 00:23:03,673
That's why she's mad? [laughs]
444
00:23:03,673 --> 00:23:06,760
He should've whooped his ass
when he sees all the blood.
445
00:23:07,260 --> 00:23:10,263
I'm about to bury my son Tuesday.
446
00:23:10,263 --> 00:23:14,142
- [Kristina] I'm sorry to hear that.
- He ain't protecting me!
447
00:23:14,142 --> 00:23:18,980
What, you want my kids to protect
your 78-year-old ass?
448
00:23:18,980 --> 00:23:21,024
- [Leo mutters indistinctly]
- Yeah, whatever.
449
00:23:21,024 --> 00:23:23,193
[Kristina] We'll see you there, Leo, okay?
450
00:23:23,193 --> 00:23:24,611
[Vickie] You ain't got no soul.
451
00:23:24,611 --> 00:23:28,490
[Kristina] We're trying to keep her calm,
so we'll see you there. Thank you.
452
00:23:29,533 --> 00:23:32,744
[Vickie] "You gonna talk about
a damn latch on the floor."
453
00:23:32,744 --> 00:23:35,956
I said, "Sir, could you please
get in the middle lane?"
454
00:23:35,956 --> 00:23:37,707
{\an8}"What the fuck's she scared of?"
455
00:23:37,707 --> 00:23:41,211
{\an8}- [Kris] That's what he said to you? Oh no.
- [Vickie] "What the fuck's she scared of?"
456
00:23:41,211 --> 00:23:42,421
He gangster.
457
00:23:43,213 --> 00:23:45,882
He Crip or he a Blood.
458
00:23:45,882 --> 00:23:48,009
One of them. He got the tear.
459
00:23:48,802 --> 00:23:50,846
You want to be heard and sound
460
00:23:51,638 --> 00:23:52,556
and seen.
461
00:23:52,556 --> 00:23:55,976
That's all that is.
You want to be heard and seen.
462
00:23:56,560 --> 00:23:59,771
[atmospheric music playing]
463
00:24:03,650 --> 00:24:05,360
[John] That vein's gonna have to go.
464
00:24:07,070 --> 00:24:09,448
Another vein underneath that, which is
465
00:24:10,740 --> 00:24:12,117
entirely predictable.
466
00:24:13,243 --> 00:24:14,578
You see this?
467
00:24:14,578 --> 00:24:17,372
This is what he's splitting now
with the knife,
468
00:24:18,206 --> 00:24:21,334
and once he's down,
spreads the frontal and temporal lobe,
469
00:24:21,334 --> 00:24:23,628
you can, basically,
doing this, spread this open.
470
00:24:23,628 --> 00:24:25,172
We're going to get into it here.
471
00:24:25,964 --> 00:24:27,340
This needs to come out.
472
00:24:28,467 --> 00:24:29,468
On.
473
00:24:30,594 --> 00:24:31,887
[David] Veins everywhere.
474
00:24:34,055 --> 00:24:35,056
On.
475
00:24:35,056 --> 00:24:37,184
Wait till I say it, goddamn it. On.
476
00:24:37,767 --> 00:24:40,937
[John] The walls of a vein are
much thinner than the walls of an artery,
477
00:24:40,937 --> 00:24:45,442
so you can move an artery with
more aggressiveness than a vein.
478
00:24:46,026 --> 00:24:46,902
[David] Scissor.
479
00:24:47,777 --> 00:24:51,531
I'm gonna cut through this shit.
Should be right in the damn thing.
480
00:24:51,531 --> 00:24:53,617
[John] No, you're not,
you're a centimeter off.
481
00:24:53,617 --> 00:24:56,870
[David] I'm not.
It should be right there. I don't get it.
482
00:24:56,870 --> 00:24:59,456
- [John] See yellow right there?
- [David] I see yellow everywhere.
483
00:24:59,456 --> 00:25:00,624
[John and David] Nav.
484
00:25:01,374 --> 00:25:03,710
[David] What the fuck?
I mean, what is this?
485
00:25:03,710 --> 00:25:05,545
- Could this be a fucking tumor?
- [John] Nav.
486
00:25:05,545 --> 00:25:07,714
Oh yeah, it looks a little gray.
487
00:25:07,714 --> 00:25:10,425
Rachel, can I come over?
Step on the pedal for a second.
488
00:25:10,425 --> 00:25:13,595
- [David] The nav is right on it.
- [John] You're skiving off the front end.
489
00:25:13,595 --> 00:25:15,889
[David] It's so big
I shouldn't hit it anywhere.
490
00:25:15,889 --> 00:25:18,058
That's the thing. It's bleeding now.
491
00:25:18,058 --> 00:25:21,353
Can I have the cortical stemmed electrode?
I want to stimulate.
492
00:25:21,353 --> 00:25:22,812
I think I see it.
493
00:25:22,812 --> 00:25:25,440
I'm gonna stay away from that artery.
That's it.
494
00:25:25,941 --> 00:25:27,567
[John, whistling] You guys see that?
495
00:25:27,567 --> 00:25:29,778
[David] It's too big
to take out in one piece.
496
00:25:30,278 --> 00:25:31,279
Bipolar?
497
00:25:33,114 --> 00:25:35,158
On. There's the blood inside.
498
00:25:35,158 --> 00:25:37,160
[John] It's like popping a blood blister.
499
00:25:37,160 --> 00:25:39,788
[David] Turn the pipe up to 35. On.
500
00:25:39,788 --> 00:25:41,540
[machinery hissing]
501
00:25:41,540 --> 00:25:43,583
- [David] So much blood.
- [man] Give me a second.
502
00:25:44,459 --> 00:25:45,544
[David] It’s nonstop.
503
00:25:47,379 --> 00:25:49,839
Look, it's still coming, John. Incredible.
504
00:25:50,549 --> 00:25:54,386
Man, I've never seen it bleed this much.
There's a lot of clot in there.
505
00:25:54,386 --> 00:25:56,054
Can we get a bigger sucker, please?
506
00:25:56,054 --> 00:25:57,889
[loud sucking]
507
00:25:57,889 --> 00:26:00,141
[John] They're just really good
at grabbing shit.
508
00:26:00,141 --> 00:26:01,810
[David] Here it comes.
509
00:26:01,810 --> 00:26:04,396
[John] So what about this stuff
right here coming out?
510
00:26:06,773 --> 00:26:07,607
[David] There it is.
511
00:26:09,651 --> 00:26:11,653
Here's my finger to give you size.
512
00:26:13,405 --> 00:26:16,241
We got it all in one fell swoop.
I don't think anything's left.
513
00:26:16,241 --> 00:26:17,784
[man speaks indistinctly]
514
00:26:17,784 --> 00:26:18,702
[machinery sucking]
515
00:26:18,702 --> 00:26:21,329
- [David] I think we're done, bro.
- [John] Yeah, I like it.
516
00:26:21,329 --> 00:26:23,331
If you look at the size of this thing,
517
00:26:23,873 --> 00:26:26,960
you can picture this though,
just sitting in the middle of her brain.
518
00:26:26,960 --> 00:26:29,004
And that's what ruptured. Looks perfect.
519
00:26:29,004 --> 00:26:30,797
- [David] That's great.
- [John] Lucky girl.
520
00:26:30,797 --> 00:26:33,967
[David] I mean, I think it was really
what we needed to do,
521
00:26:33,967 --> 00:26:37,053
and I appreciate your being here
and doing this with me.
522
00:26:37,053 --> 00:26:39,139
[David] When there's an emergency,
we work together
523
00:26:39,139 --> 00:26:41,141
and support one another through that
524
00:26:41,141 --> 00:26:43,476
because they can be
remarkably emotional moments,
525
00:26:43,476 --> 00:26:47,856
and very memorable times
when these things go well or go poorly.
526
00:26:47,856 --> 00:26:48,857
[John] Call me.
527
00:26:50,150 --> 00:26:52,819
[David] Okay, uh... [continues indistinctly]
528
00:26:53,486 --> 00:26:56,698
[atmospheric music playing]
529
00:26:56,698 --> 00:26:59,659
[ambulance siren blaring]
530
00:26:59,659 --> 00:27:02,245
- Miss Williams, are you okay?
- [Vickie] Yeah.
531
00:27:02,746 --> 00:27:05,832
[Kristina] I know you're tired,
but I don't want you to sleep, okay?
532
00:27:05,832 --> 00:27:08,460
In case you had a concussion
from hitting your head.
533
00:27:08,460 --> 00:27:10,795
So try to stay up. We're almost there.
534
00:27:14,174 --> 00:27:16,343
[Vicky] Every call is a new story.
535
00:27:17,677 --> 00:27:22,807
You encounter so many different
situations, you know, people's lives.
536
00:27:22,807 --> 00:27:25,685
When people say like,
everybody's fighting a different battle.
537
00:27:25,685 --> 00:27:31,900
Sometimes you wonder how
the person got to be in this situation.
538
00:27:31,900 --> 00:27:35,153
They call us because they feel like,
for them, it's an emergency,
539
00:27:35,153 --> 00:27:38,073
and even though
we are used to seeing it every day,
540
00:27:38,073 --> 00:27:41,409
I feel like it's very important
that we never lose that touch,
541
00:27:41,409 --> 00:27:46,456
to always care for them in those
30, 40 minutes that they're with us.
542
00:27:47,123 --> 00:27:49,793
My goal is to always make them feel safe,
543
00:27:49,793 --> 00:27:53,588
and let them know that they've been
heard for what they need.
544
00:27:56,174 --> 00:27:58,510
[Kristina]
I'm gonna take a look at your arm again.
545
00:27:58,510 --> 00:28:00,011
Very good. Put it down.
546
00:28:02,514 --> 00:28:03,431
We're here.
547
00:28:03,431 --> 00:28:05,225
- Thank you.
- [Kristina] No problem.
548
00:28:08,103 --> 00:28:11,940
[Vicky] It definitely makes you think
in how much you need to be here,
549
00:28:11,940 --> 00:28:14,359
a hundred percent body and mind,
550
00:28:14,859 --> 00:28:17,362
to make that difference in somebody's day.
551
00:28:27,497 --> 00:28:30,750
{\an8}- [nurse] Don, are you getting anything?
- [Donald] I'm getting nothing.
552
00:28:31,543 --> 00:28:33,586
[Jose] Give him a hundred. Crank it.
553
00:28:33,586 --> 00:28:35,547
Put it to 100. There's no reason not to.
554
00:28:35,547 --> 00:28:37,006
What's your heart rate now?
555
00:28:37,006 --> 00:28:38,883
[Donald] 118 heart rate now.
556
00:28:38,883 --> 00:28:40,385
[Jose] Did you start norepi?
557
00:28:41,928 --> 00:28:44,472
{\an8}[nurse] Blood pressure is under 90...
558
00:28:45,265 --> 00:28:48,143
{\an8}[indistinct chatter]
559
00:28:49,352 --> 00:28:50,437
How's her pulse?
560
00:28:54,941 --> 00:28:58,153
[nurse 1] It's palpable.
I can't tell you a rate.
561
00:28:58,153 --> 00:28:59,988
[nurse 2] Okay,
let me know when you hear it.
562
00:29:02,198 --> 00:29:04,784
[indistinct chatter]
563
00:29:05,577 --> 00:29:09,706
[nurse 2] It looks like blood pressure
is approximately just under 140. Systolic.
564
00:29:09,706 --> 00:29:12,959
[Jose] 140 systolic?
So he responded to the norepi very well.
565
00:29:12,959 --> 00:29:14,669
- [man] Think so.
- [Jose] Great.
566
00:29:15,253 --> 00:29:18,757
If we get a reasonable rate
and reasonable pressure,
567
00:29:18,757 --> 00:29:20,091
can we scan him?
568
00:29:21,593 --> 00:29:23,845
[doctor] I don't think he's bleeding
from the stomach.
569
00:29:23,845 --> 00:29:27,015
- There's no blush in the stomach.
- [Jose] Yeah, the chest looks good.
570
00:29:27,015 --> 00:29:29,476
So there's no reason
to open his chest if he arrests.
571
00:29:29,476 --> 00:29:31,644
[doctor] No, I don't see
any reason to open his chest.
572
00:29:31,644 --> 00:29:34,189
[Jose] Alright, so we
just got to get him to the ICU.
573
00:29:37,567 --> 00:29:40,069
[nurse] And Don's got
push pen epi if we need it.
574
00:29:40,820 --> 00:29:42,322
- [Jose] Disconnect. Yep.
- [nurse] Okay.
575
00:29:42,322 --> 00:29:43,907
- [Jose] On your count.
- [nurse] Ready?
576
00:29:43,907 --> 00:29:45,450
One, two, three.
577
00:29:45,950 --> 00:29:48,328
[nurse 2] I have the tube.
And we're reconnected.
578
00:29:51,623 --> 00:29:53,541
He got quite sick
while we were doing this,
579
00:29:53,541 --> 00:29:56,669
and we had to make a few adjustments,
give him quite a bit of blood,
580
00:29:56,669 --> 00:29:59,672
and give quite a bit
of blood pressure medicines
581
00:29:59,672 --> 00:30:01,925
and a mix of the two different things.
582
00:30:01,925 --> 00:30:02,967
Uh...
583
00:30:03,593 --> 00:30:05,929
And the whole time,
it's kind of been a dance to see
584
00:30:05,929 --> 00:30:10,517
if he loses his blood pressure
or his heart goes into a bad rhythm
585
00:30:10,517 --> 00:30:13,520
like happened last night,
where he tries to go.
586
00:30:13,645 --> 00:30:15,939
Um, I came looking for you.
587
00:30:15,939 --> 00:30:19,984
The good news, at least for now,
is that we don't see any bleeding
588
00:30:19,984 --> 00:30:22,362
from a major artery
or something like that,
589
00:30:22,362 --> 00:30:24,405
or like the liver I was telling you about.
590
00:30:24,405 --> 00:30:27,408
So what we want to do
is get him upstairs to the ICU.
591
00:30:27,408 --> 00:30:29,536
I don't think he needs
an operation right now.
592
00:30:29,536 --> 00:30:30,453
Okay...
593
00:30:30,453 --> 00:30:32,956
[Jose] The most acute problems
are the ones where you realize
594
00:30:32,956 --> 00:30:35,917
you can't change something terrible
that has happened to a child
595
00:30:35,917 --> 00:30:38,211
and maybe that
moment of time where I know it,
596
00:30:38,211 --> 00:30:41,089
but the parents
still hope that it's not the case,
597
00:30:41,089 --> 00:30:44,467
and that gap in time
until you help to bring them
598
00:30:44,968 --> 00:30:47,637
into the new reality
that they're going to face.
599
00:30:47,637 --> 00:30:51,015
This is going to be
hour by hour for the afternoon,
600
00:30:51,015 --> 00:30:54,394
see what happens,
and then decide whether--
601
00:30:54,394 --> 00:30:56,980
- But he's in the clear right now?
- He's--
602
00:30:56,980 --> 00:31:00,483
For right now, he's in the clear
for this moment as far as doing surgery.
603
00:31:00,483 --> 00:31:03,278
He's not clear big picture,
which I know you're asking me.
604
00:31:03,278 --> 00:31:04,404
Um...
605
00:31:04,404 --> 00:31:07,365
We can-- Really for now,
it's one hour at a time.
606
00:31:07,365 --> 00:31:09,492
We want to get him up there safely,
607
00:31:09,492 --> 00:31:12,370
keep him from having
these major medical problems
608
00:31:12,370 --> 00:31:14,581
where his heart is trying to not function.
609
00:31:15,164 --> 00:31:16,374
And...
610
00:31:16,374 --> 00:31:18,042
Um...
611
00:31:19,335 --> 00:31:22,463
And then get through the night
tonight again, right?
612
00:31:22,463 --> 00:31:24,507
[Jose] As a parent,
you don't know what's going on,
613
00:31:24,507 --> 00:31:27,260
you're not with them,
and so there's sometimes this gap
614
00:31:27,260 --> 00:31:31,264
where a lot has happened, but the parents
don't know what has happened.
615
00:31:31,264 --> 00:31:34,684
And I understand, really,
what this means for how this child's life
616
00:31:34,684 --> 00:31:37,520
will probably not be
what anyone dreamed it would be.
617
00:31:40,356 --> 00:31:43,902
[intriguing music playing]
618
00:31:51,951 --> 00:31:54,704
[David] As a young neurosurgeon,
even as a medical student,
619
00:31:54,704 --> 00:31:59,000
what attracts us to nurture
this kind of urgent need to be needed.
620
00:31:59,751 --> 00:32:02,128
You have to respect
the fact that that commitment
621
00:32:02,128 --> 00:32:05,423
to the life of another human being
is something that we make,
622
00:32:05,423 --> 00:32:09,135
and that we do,
and that we live with that all the time.
623
00:32:09,135 --> 00:32:11,346
- All done, Julianne.
- So lucky, I know.
624
00:32:11,346 --> 00:32:12,597
You don't even need that.
625
00:32:12,597 --> 00:32:15,475
I spoke to your husband.
Brandon knows everything's okay.
626
00:32:16,559 --> 00:32:18,561
- Okay, show me your teeth.
- Smile.
627
00:32:18,561 --> 00:32:20,146
[David] Give me a squeeze.
628
00:32:20,146 --> 00:32:22,523
It's a little weaker, but it's normal.
629
00:32:22,523 --> 00:32:23,608
Wiggle your toes.
630
00:32:24,609 --> 00:32:25,735
Good.
631
00:32:25,735 --> 00:32:27,362
Everything went perfect.
632
00:32:28,571 --> 00:32:30,698
Should I let
your husband know you're alive?
633
00:32:30,698 --> 00:32:32,158
[chuckling]
634
00:32:32,158 --> 00:32:33,076
Okay.
635
00:32:34,077 --> 00:32:35,370
All right, sweetie.
636
00:32:35,370 --> 00:32:36,621
[nurse] Aww.
637
00:32:36,621 --> 00:32:37,956
[David] Looks good.
638
00:32:44,253 --> 00:32:45,505
- Went great.
- Did it?
639
00:32:45,505 --> 00:32:47,590
Yeah, no problems, everything's fine.
640
00:32:47,590 --> 00:32:49,217
I'm as optimistic as I could be.
641
00:32:49,217 --> 00:32:52,845
When you're up against her motor area
and deep, you only have so much latitude.
642
00:32:52,845 --> 00:32:54,931
You don't want
to push the envelope too much.
643
00:32:54,931 --> 00:32:56,933
I'd rather her be strong, normal,
644
00:32:56,933 --> 00:32:59,602
have a little thing to follow
than the other way.
645
00:32:59,602 --> 00:33:03,272
And it's not cancer,
so it's something we could always follow.
646
00:33:03,272 --> 00:33:05,984
I think you'll have a long,
happy life together.
647
00:33:05,984 --> 00:33:07,819
- All right.
- Thanks, buddy.
648
00:33:07,819 --> 00:33:09,237
- Hang in there.
- Thanks.
649
00:33:09,237 --> 00:33:10,738
- All right.
- Thank you.
650
00:33:10,738 --> 00:33:12,448
- Take care.
- You're awesome.
651
00:33:14,951 --> 00:33:16,661
I got emotional with the guy.
652
00:33:17,161 --> 00:33:18,705
She'll look great, I think.
653
00:33:18,705 --> 00:33:21,165
She may have
some deficit afterwards, actually.
654
00:33:21,165 --> 00:33:22,500
I wouldn't be surprised.
655
00:33:23,876 --> 00:33:24,961
[machine beeping]
656
00:33:24,961 --> 00:33:26,587
[David] We were really close.
657
00:33:27,547 --> 00:33:29,340
[neuro nurse] Bring you up.
You warm enough?
658
00:33:29,882 --> 00:33:30,758
All right.
659
00:33:31,759 --> 00:33:34,595
[singing opera over phone]
660
00:33:46,691 --> 00:33:49,527
[hopeful music playing]
661
00:33:51,446 --> 00:33:52,697
[recovery nurse] Hello.
662
00:33:52,697 --> 00:33:54,991
Julianne, how are you?
663
00:33:54,991 --> 00:33:57,035
- [Julianne] I'm fine.
- [recovery nurse] Good.
664
00:34:01,122 --> 00:34:02,749
[indistinct chatter]
665
00:34:07,670 --> 00:34:09,172
[Brandon] Hello.
666
00:34:09,172 --> 00:34:11,424
- What's wrong?
- I'm so happy.
667
00:34:11,424 --> 00:34:12,759
[Brandon chuckles]
668
00:34:18,848 --> 00:34:20,683
[Mackenzie] People deserve you.
669
00:34:25,605 --> 00:34:28,858
People deserve someone
that wants to give their best.
670
00:34:28,858 --> 00:34:30,068
It was a good day.
671
00:34:35,740 --> 00:34:38,993
[Mackenzie] Healthcare is going to be
important for all of us.
672
00:34:41,412 --> 00:34:43,581
This pandemic has proven that.
673
00:34:45,750 --> 00:34:50,296
[John] We proved that, you know,
human beings still want to help.
674
00:34:51,506 --> 00:34:53,758
Sirens are the soundtrack of the city.
675
00:34:55,176 --> 00:34:58,012
And many of those sirens
are people in need.
676
00:34:59,639 --> 00:35:02,475
And all of a sudden, out of this morass...
677
00:35:03,810 --> 00:35:05,770
when you need people and they're there.
678
00:35:08,189 --> 00:35:09,816
[Jose] The team is different every day.
679
00:35:09,816 --> 00:35:11,984
Which nurses are here.
Which surgeons are here.
680
00:35:12,485 --> 00:35:16,864
The effort that's involved
to really have the expertise here 24/7.
681
00:35:17,949 --> 00:35:21,911
That's the magic that
comes together to take care of children.
682
00:35:24,205 --> 00:35:26,415
- [Leslie] That's my youngest child.
- Yeah.
683
00:35:27,250 --> 00:35:28,668
To watch him suffer,
684
00:35:29,168 --> 00:35:31,921
it hurts that I can't physically
685
00:35:32,588 --> 00:35:35,550
do anything to help him, to help his pain.
686
00:35:35,550 --> 00:35:36,759
It hurts.
687
00:35:37,969 --> 00:35:40,388
[Jose] All the Pampers,
all the years, all the tears,
688
00:35:40,388 --> 00:35:42,682
and all of that work that, you know,
689
00:35:42,682 --> 00:35:45,143
a whole family pours themselves into it.
690
00:35:45,768 --> 00:35:48,771
And in a second... [snaps fingers]
...one bullet, and it's all gone.
691
00:35:48,771 --> 00:35:51,149
[indistinct chatter]
692
00:35:51,149 --> 00:35:52,900
[Jose] He's a great big 17-year-old,
693
00:35:52,900 --> 00:35:55,695
but my son
has a 16th birthday in two days.
694
00:35:56,445 --> 00:35:58,447
Inside, they're still little boys.
695
00:35:59,240 --> 00:36:01,993
And I know for that mother,
that's still her little boy.
696
00:36:04,912 --> 00:36:08,708
I worry that as healthy and strong
as he was coming into this,
697
00:36:09,667 --> 00:36:13,963
the hit to his body is so huge that, um,
698
00:36:14,505 --> 00:36:17,133
it's like he's an airplane
that's about to crash.
699
00:36:17,842 --> 00:36:20,970
He hasn't even leveled off at this point,
and so that's the question.
700
00:36:20,970 --> 00:36:24,182
Is he going to hit that ground
before we can pull him out of it?
701
00:36:31,731 --> 00:36:34,775
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