1 00:00:24,649 --> 00:00:29,529 Alright, let me get Liver Transplant on the line for you. 2 00:00:29,529 --> 00:00:32,365 Hello, doctor. Why don't you tell us about the patient? 3 00:00:32,365 --> 00:00:34,659 She comes for fatigue and jaundice. 4 00:00:34,659 --> 00:00:37,245 She turned yellow, and she came into the hospital. 5 00:00:37,787 --> 00:00:39,831 You're thinking autoimmune here? 6 00:00:39,831 --> 00:00:43,376 Yeah, I think it's autoimmune. And now she's doing worse. 7 00:00:43,376 --> 00:00:47,547 Guys, this is an emergency meeting of the transplant listing group 8 00:00:47,547 --> 00:00:51,009 {\an8}because this young lady is getting much sicker. 9 00:00:51,009 --> 00:00:53,553 {\an8}She has acute liver failure, autoimmune. 10 00:00:53,553 --> 00:00:57,265 Is everyone in favor of making this patient a status one? 11 00:00:57,265 --> 00:00:58,266 Absolutely. 12 00:00:58,266 --> 00:01:02,145 So the patient is now status one, that's the highest status in the country. 13 00:01:02,145 --> 00:01:05,857 Starting from right now, we're going to be looking for a liver. 14 00:01:05,857 --> 00:01:09,652 And what happens to someone who suddenly gets a hit to the liver, 15 00:01:09,652 --> 00:01:11,738 there's no means of compensating. 16 00:01:11,738 --> 00:01:13,990 They begin to get confused. 17 00:01:13,990 --> 00:01:16,993 She will eventually not know her name. 18 00:01:16,993 --> 00:01:20,413 She's a fourth grade teacher, and she has two young kids. 19 00:01:20,997 --> 00:01:23,583 - What are your kids' names? - Mia and Taylor. 20 00:01:23,583 --> 00:01:25,001 {\an8} How old are they? 21 00:01:25,001 --> 00:01:28,421 {\an8}Uh... seven and... 22 00:01:30,507 --> 00:01:32,425 Okay. That's okay. 23 00:01:32,425 --> 00:01:36,471 Soon she won't be able to speak, and then she'll need to get intubated. 24 00:01:36,471 --> 00:01:40,058 This is the natural course of liver failure. 25 00:01:40,058 --> 00:01:41,559 It's a rush, it's a race. 26 00:01:41,559 --> 00:01:44,312 If there's no organ available in the next 48-72 hours, 27 00:01:44,312 --> 00:01:46,356 she will lose and she'll go to God. 28 00:01:46,356 --> 00:01:48,691 - We're going to find you a good liver. - Thank you. 29 00:01:48,691 --> 00:01:52,278 - First one to pop up will be hers. - Let's just find an organ. 30 00:02:15,343 --> 00:02:18,179 {\an8}Button your jacket. Fix your collar. 31 00:02:20,723 --> 00:02:21,558 Okay. 32 00:02:21,558 --> 00:02:24,185 - Thank you. - Alright, you're fine. Let's go. 33 00:02:27,856 --> 00:02:29,232 Beautiful day. 34 00:02:30,150 --> 00:02:33,319 Subway's packed, restaurants are busy. 35 00:02:33,319 --> 00:02:34,821 Things are looking up. 36 00:02:35,738 --> 00:02:36,990 Finally. 37 00:02:36,990 --> 00:02:40,493 - Oh, there he is. - How are you? 38 00:02:40,493 --> 00:02:43,788 - Thank you so much. - My pleasure, good to see both of you. 39 00:02:43,788 --> 00:02:45,290 And how was the drive up? 40 00:02:45,290 --> 00:02:48,001 It was good, very nice. They wouldn't let me drive. 41 00:02:48,001 --> 00:02:50,003 - I drive too fast. 42 00:02:50,003 --> 00:02:52,589 We're really blessed to be back here. I'm really lucky. 43 00:02:52,589 --> 00:02:55,592 - I want to show you some pictures. - Okay. 44 00:02:55,592 --> 00:02:59,262 {\an8}So, obviously, when I'm looking at you from the side here. 45 00:02:59,262 --> 00:03:02,599 Dad, you can see that this is the side view. 46 00:03:02,599 --> 00:03:03,516 Mm-hmm. 47 00:03:03,516 --> 00:03:06,352 - And this is the growth. - Wow. 48 00:03:06,352 --> 00:03:08,021 - Can I touch? - Of course. 49 00:03:08,021 --> 00:03:09,939 It's this right here. 50 00:03:10,440 --> 00:03:15,486 You see in the middle here where it's red, worn down, and starting to get infected? 51 00:03:15,486 --> 00:03:16,821 That's the issue. 52 00:03:16,821 --> 00:03:19,866 This became really an emergency. 53 00:03:19,866 --> 00:03:24,871 {\an8}The mass is growing so quickly, it's starting to erode through his scalp, 54 00:03:24,871 --> 00:03:27,540 {\an8}so I made him drive up from Kentucky over the weekend. 55 00:03:27,540 --> 00:03:29,375 {\an8}This is all cancer. 56 00:03:29,375 --> 00:03:32,587 {\an8}What's fascinating and difficult about his case 57 00:03:32,587 --> 00:03:34,923 {\an8}is that it's actually metastasized to the lung. 58 00:03:34,923 --> 00:03:36,591 That is a reportable event, 59 00:03:36,591 --> 00:03:39,636 meaning that it happens so infrequently where it leaves the brain. 60 00:03:40,220 --> 00:03:42,347 So, we're going to take all this, 61 00:03:42,347 --> 00:03:45,308 and then we're going to go in and take out the tumor in the brain. 62 00:03:45,308 --> 00:03:46,226 Awesome. 63 00:03:46,226 --> 00:03:48,394 I know you're going to ask, what about the lung? 64 00:03:48,394 --> 00:03:50,772 We're going to deal with that after we get a PET scan. 65 00:03:50,772 --> 00:03:52,899 - Remember we talked about that? - Yeah. 66 00:03:52,899 --> 00:03:55,485 I feel really confident to be here with you guys. 67 00:03:55,485 --> 00:03:57,195 I'm so glad we made this decision. 68 00:03:57,195 --> 00:04:00,198 We appreciate your trust, and we treat 'em like our own. 69 00:04:00,198 --> 00:04:03,201 - Exactly. - We'll keep him out of harm's way. 70 00:04:03,201 --> 00:04:07,413 What a spirit. His whole family, to have that kind of optimism. 71 00:04:07,413 --> 00:04:09,624 I told him to come, he's like, "We're on our way." 72 00:04:09,624 --> 00:04:15,421 I mean, incredible courage, and hopefully he's got a life in front of him. 73 00:04:15,421 --> 00:04:17,298 And you're really nervous. 74 00:04:17,799 --> 00:04:19,676 Thank you so much for being here. 75 00:04:19,676 --> 00:04:22,595 I wouldn't have it any other way. 76 00:04:30,395 --> 00:04:33,564 - What are you doing this weekend? - Sleeping. 77 00:04:33,564 --> 00:04:35,441 I told you. 78 00:04:35,441 --> 00:04:38,403 {\an8}- I'm taking a mental health day. - Because of the vaccine? 79 00:04:38,403 --> 00:04:41,155 {\an8}- Yeah, my body needs to recuperate. - I can't with you. 80 00:04:41,155 --> 00:04:43,825 My biggest thing is sleep. I don't sleep enough. 81 00:04:43,825 --> 00:04:48,663 What I try to do is no matter what, no matter what, 82 00:04:48,663 --> 00:04:53,209 I'm going home, take a shower, and get in my pajamas, and get in bed. 83 00:04:53,209 --> 00:04:54,168 Mm-hmm. 84 00:04:54,168 --> 00:04:57,005 If you wanna talk, come talk to me in my bed. 85 00:04:57,922 --> 00:05:00,675 If you want an excuse to be out-- and look... 86 00:05:00,675 --> 00:05:03,845 - Can you respond to emergency-- - Head injury. 87 00:05:06,889 --> 00:05:08,433 A couple of blocks down, right? 88 00:05:23,114 --> 00:05:24,324 Over there. 89 00:05:29,996 --> 00:05:31,789 Where's the kid? Damn. 90 00:05:31,789 --> 00:05:36,002 - Oh, he's crying. - Oh no, there's another kid, Kristina. 91 00:05:36,586 --> 00:05:39,130 He has a big hematoma on his head. 92 00:05:39,130 --> 00:05:42,008 Are you good? Be careful getting out. Put your mask on, okay? 93 00:05:42,008 --> 00:05:43,092 Yeah. 94 00:05:45,094 --> 00:05:48,056 No, you don't move. I want you to sit. Look at me. 95 00:05:48,056 --> 00:05:51,642 I want you to sit and don't move, okay? You're doing a great job. 96 00:05:52,435 --> 00:05:54,645 Okay, what school do you go to? 97 00:05:54,645 --> 00:05:57,315 They're having symptoms? Call another bus then. 98 00:05:57,315 --> 00:05:58,691 We need three busses. 99 00:05:58,691 --> 00:06:02,904 Requesting two additional busses, BLS to location. Two additional patients. 100 00:06:02,904 --> 00:06:06,115 - They're here, Kris. They're here. - Alright, sit down. 101 00:06:06,115 --> 00:06:08,201 Try to calm down, okay? 102 00:06:08,201 --> 00:06:10,620 Don't worry, we got you. 103 00:06:13,122 --> 00:06:14,832 Can you call the parent? 104 00:06:14,832 --> 00:06:16,209 I got you. 105 00:06:17,502 --> 00:06:19,545 Vicky, I need the blood pressure. 106 00:06:21,589 --> 00:06:23,091 - Okay. - We gotta go. 107 00:06:23,091 --> 00:06:27,178 He has to go to the trauma center now. Now. We gotta get off the scene. 108 00:06:28,846 --> 00:06:30,431 Yeah, can we check out right away? 109 00:06:34,519 --> 00:06:36,896 Squeeze my hand, sweetie, can you squeeze? 110 00:06:37,563 --> 00:06:41,567 You okay? Does this hurt right here? Does this hurt down here? 111 00:06:46,739 --> 00:06:51,119 {\an8}Every day, I've started my life before 5:30 in the morning for 20 years almost. 112 00:06:51,119 --> 00:06:53,621 And when I was in training, it was 4:00 in the morning. 113 00:06:54,122 --> 00:06:56,290 But I drink my, uh, Cuban coffee, 114 00:06:57,792 --> 00:06:59,252 and I get going. 115 00:07:05,675 --> 00:07:08,136 I can't remember. What name did you give her? 116 00:07:08,136 --> 00:07:10,179 - Did you guys pick a name for her? - Elliana. 117 00:07:10,179 --> 00:07:12,056 Elliana? Okay. 118 00:07:12,056 --> 00:07:14,183 So, I'm going to talk to the team, 119 00:07:14,183 --> 00:07:17,270 and we are going to look over her medical information, 120 00:07:17,270 --> 00:07:19,522 and then we will be heading out to the OR, okay? 121 00:07:19,522 --> 00:07:21,732 So, we're gonna make a final decision, 122 00:07:21,732 --> 00:07:24,735 but I think we're gonna go with the right thoracotomy, and then... 123 00:07:24,735 --> 00:07:28,781 There's a good chance we'll use a patch, depending on the size of the defect. 124 00:07:28,781 --> 00:07:30,616 And we're not gonna use the scope. 125 00:07:30,616 --> 00:07:33,286 We're gonna do it straight open, based on the size of the baby. 126 00:07:33,286 --> 00:07:34,412 Okay. 127 00:07:37,498 --> 00:07:39,459 We're gonna fix a diaphragmatic hernia 128 00:07:39,459 --> 00:07:42,753 in a tiny preemie baby that weighs four pounds, 129 00:07:43,337 --> 00:07:45,256 who is less than a week old. 130 00:07:45,965 --> 00:07:49,427 It was not clear it was going to survive, uh, when this was found. 131 00:07:49,427 --> 00:07:52,263 The baby was found to have a hole in the diaphragm, 132 00:07:52,263 --> 00:07:54,474 before being born, in an ultrasound. 133 00:07:55,308 --> 00:07:57,810 I'm seeing quite a bit of the liver here in the chest, 134 00:07:57,810 --> 00:08:01,814 and all of the intestines here in these gray holes. 135 00:08:01,814 --> 00:08:06,068 And the heart has been pushed completely out of the chest to the other side. 136 00:08:06,819 --> 00:08:11,199 So our job today is going to be to push all of this back into the belly 137 00:08:11,199 --> 00:08:15,703 and give the heart and the lungs the room they need to live and function, 138 00:08:15,703 --> 00:08:19,081 so that we can get to some day seeing her at her wedding. 139 00:08:19,957 --> 00:08:23,002 Say, "Bye, Mommy, Daddy. Be back soon." 140 00:08:25,129 --> 00:08:26,839 See you soon, okay? 141 00:08:35,765 --> 00:08:40,645 Medic 99. Trauma notification TBD, ETA is eight minutes. 142 00:08:40,645 --> 00:08:45,107 I have an 11-year-old male with a head injury, secondary to an MVA. 143 00:08:45,107 --> 00:08:49,362 He has a large frontal lobe hematoma. 144 00:08:49,362 --> 00:08:52,698 He appears lethargic but is alert and oriented. 145 00:08:52,698 --> 00:08:54,700 Let me see your bump. 146 00:08:54,700 --> 00:08:56,577 You gotta keep your eyes open. 147 00:09:00,039 --> 00:09:03,000 He's... He's not, like, alert. 148 00:09:03,000 --> 00:09:04,502 Like... 149 00:09:04,502 --> 00:09:09,131 We think that, you know, he needs immediate care. 150 00:09:16,597 --> 00:09:22,853 It's a kid, and you want to make them feel safe, and it's scary for them. 151 00:09:22,853 --> 00:09:26,107 All this is like chaos in their head, 152 00:09:26,107 --> 00:09:29,819 so we always, you know, try to keep them calm, 153 00:09:29,819 --> 00:09:33,573 but it doesn't matter how much you explain the situation to them, 154 00:09:33,573 --> 00:09:37,952 they're not going to be okay with all the sirens and police and people, 155 00:09:37,952 --> 00:09:39,453 strangers coming up to them. 156 00:09:40,705 --> 00:09:43,165 I'm trying to get there safe, 157 00:09:43,666 --> 00:09:46,544 and hopefully, you know, he's going to be okay. 158 00:09:50,172 --> 00:09:53,551 You gotta try to stay awake because you might have a concussion, okay? 159 00:09:54,135 --> 00:09:55,928 You gotta keep your eyes open. 160 00:09:57,179 --> 00:09:58,889 You're doing good, you're alright. 161 00:10:10,151 --> 00:10:13,904 {\an8} Jennifer went into coma as a result of fulminant liver failure, 162 00:10:13,904 --> 00:10:16,574 {\an8}where your liver just shuts off and stops working. 163 00:10:16,574 --> 00:10:19,535 She's on the operating room table right now. 164 00:10:19,535 --> 00:10:25,875 {\an8}If you cannot transplant her fast enough, then pressure will build up in her head, 165 00:10:25,875 --> 00:10:28,878 and her brain can herniate out of her skull, 166 00:10:28,878 --> 00:10:30,921 and patients don't recover from that. 167 00:10:30,921 --> 00:10:35,051 They either have lifelong brain damage, or more likely they just die. 168 00:10:38,596 --> 00:10:40,139 Luckily, we found a liver. 169 00:10:40,765 --> 00:10:45,394 And the clock has really already started, and it's a race against time. 170 00:10:47,688 --> 00:10:49,357 - Have a good day. - Thank you. 171 00:10:52,526 --> 00:10:56,030 We're going to another state to bring an organ back. 172 00:10:56,781 --> 00:10:59,241 {\an8}There's never a good donor story. 173 00:10:59,241 --> 00:11:02,578 {\an8}It's always somebody that unfortunately, in this case, 174 00:11:02,578 --> 00:11:05,998 it's somebody that, unfortunately, that-- that is brain dead. 175 00:11:05,998 --> 00:11:09,502 And the family was courageous 176 00:11:09,502 --> 00:11:13,839 and caring enough to say that they want to donate organs to somebody else. 177 00:11:15,675 --> 00:11:18,844 {\an8} This lady's sick. She just went down the tubes quickly. 178 00:11:18,844 --> 00:11:24,308 Yeah. Now, the percentage of donors under age 35 179 00:11:24,308 --> 00:11:29,897 who are narcotics is 75%? I mean, it's way more than trauma. 180 00:11:29,897 --> 00:11:33,693 People been home, and drugs, alcohol definitely on the up. 181 00:11:33,693 --> 00:11:34,610 Yeah. 182 00:11:34,610 --> 00:11:37,905 So, you know, we make triumph out of adversity. 183 00:11:45,496 --> 00:11:49,709 When you talk about the brain, it's fixed in a rigid skull. 184 00:11:49,709 --> 00:11:54,213 This is a box. And we have a very simple rule. 185 00:11:54,213 --> 00:11:56,549 There's only really three things in the box. 186 00:11:56,549 --> 00:11:59,135 Spinal fluid, brain, and blood. 187 00:11:59,719 --> 00:12:02,638 And if any one of those increase in any way, 188 00:12:02,638 --> 00:12:04,306 you're still in this fixed box. 189 00:12:04,306 --> 00:12:05,433 Good morning. 190 00:12:05,433 --> 00:12:07,893 Brain tumors, in general, tend to be urgent, 191 00:12:07,893 --> 00:12:12,440 meaning that those patients are under extremis, they're under pressure. 192 00:12:12,440 --> 00:12:16,277 We have to take that tumor out because they may be having pressure in the brain, 193 00:12:16,277 --> 00:12:20,531 and the urgency is making sure that patient starts treatment right away. 194 00:12:20,531 --> 00:12:21,449 Dr. Dennis. 195 00:12:21,949 --> 00:12:23,909 Boockvar, pleasure, as always. 196 00:12:23,909 --> 00:12:25,995 - My man. - Looking good. 197 00:12:25,995 --> 00:12:28,622 - How was your night? - It was good, yeah, got some rest. 198 00:12:28,622 --> 00:12:32,752 - Slept, meditated a lot, feeling good. - What do you do for meditation? 199 00:12:32,752 --> 00:12:36,589 Um, well, I do Qigong when I have time to kind of do the movements. 200 00:12:36,589 --> 00:12:42,678 Um, I do have breathing exercises, I pray a little bit, and things like that. 201 00:12:42,678 --> 00:12:46,223 Well, we'll be doing some mindfulness in the operating room. 202 00:12:46,223 --> 00:12:48,184 We do it right before every case, so... 203 00:12:48,184 --> 00:12:50,811 - Oh, I appreciate that. - ...we'll give you an extra mindful moment. 204 00:12:50,811 --> 00:12:52,188 I appreciate that so much. 205 00:12:52,188 --> 00:12:54,356 You got the whole world praying for you, Marcos, today. 206 00:12:54,356 --> 00:12:56,192 - I appreciate that. - Okay. 207 00:13:00,571 --> 00:13:03,699 This is for Marcos. He'll appreciate this. 208 00:13:20,841 --> 00:13:22,927 - Really nice guy. - The nicest. 209 00:13:22,927 --> 00:13:25,262 Does all the right things, 210 00:13:25,262 --> 00:13:30,851 and gets perhaps the worst of human cancers that exist. 211 00:13:30,851 --> 00:13:32,269 Just terrible. 212 00:13:44,198 --> 00:13:48,077 I just don't understand why. Guns is very dangerous. 213 00:13:50,329 --> 00:13:51,622 {\an8}You know. 214 00:13:51,622 --> 00:13:54,625 {\an8}This is what they can do to you, you know? 215 00:13:57,294 --> 00:13:59,129 He was with friends. 216 00:13:59,129 --> 00:14:01,674 To my knowledge, it was a gathering. 217 00:14:01,674 --> 00:14:05,886 Still have no information, if it's just a drive-by... 218 00:14:06,887 --> 00:14:08,722 It's all I know at this moment. 219 00:14:11,684 --> 00:14:15,563 If you can help take care of Josh, I can introduce you to the mom too. 220 00:14:15,563 --> 00:14:16,647 Yep, yep. 221 00:14:16,647 --> 00:14:18,858 So he's got multiple gunshots, 222 00:14:18,858 --> 00:14:22,528 was initially stabilized, and has an open abdomen. 223 00:14:22,528 --> 00:14:25,531 Maybe he's ready for closure. If not, you can take a look. 224 00:14:25,531 --> 00:14:27,741 If you need me, just let me know and I can pop over. 225 00:14:27,741 --> 00:14:28,659 Okay. 226 00:14:30,661 --> 00:14:32,162 Charlotte, you think we're good? 227 00:14:32,162 --> 00:14:34,748 Yeah. He's already sedated. 228 00:14:34,748 --> 00:14:37,042 Okay. I'll just talk to the mom. 229 00:14:37,835 --> 00:14:41,839 {\an8}Hi, Mom. The plan is to open up the abdomen that's already open, 230 00:14:41,839 --> 00:14:45,926 {\an8}but take off the dressing, wash out all the blood, look at the stomach, 231 00:14:45,926 --> 00:14:49,847 the liver, the diaphragm, make sure the repairs are all intact. 232 00:14:49,847 --> 00:14:52,099 If there's any extra bleeding, take care of it, 233 00:14:52,099 --> 00:14:56,103 because we do know there's blood coming out of the drain from the belly, 234 00:14:56,103 --> 00:14:58,522 so we want to make sure we're not missing anything, 235 00:14:58,522 --> 00:15:00,357 and then reapply that dressing. 236 00:15:00,983 --> 00:15:04,778 He's gonna pull through. We're seeing crazy amounts of firearm injury 237 00:15:05,571 --> 00:15:08,616 you know, throughout the city, so he's gonna pull through. 238 00:15:09,199 --> 00:15:12,661 - He's a fighter. - He is, he is. 239 00:15:13,412 --> 00:15:14,830 We'll take good care of him. 240 00:15:17,458 --> 00:15:20,002 Joshua suffered multiple gunshots. 241 00:15:21,045 --> 00:15:23,380 And he's now fighting for his life. 242 00:15:23,380 --> 00:15:25,674 A lot of these bullets don't remain in the body, 243 00:15:25,674 --> 00:15:28,427 they kind of hit all your organs and then exit. 244 00:15:28,427 --> 00:15:30,220 That's typically what we see. 245 00:15:31,055 --> 00:15:33,390 How do you live in a society 246 00:15:33,390 --> 00:15:36,727 where you're at constant risk for this type of violence? 247 00:15:36,727 --> 00:15:39,605 There's a bullet wound here and here, right? 248 00:15:39,605 --> 00:15:42,107 This is where the injury to the diaphragm happened, 249 00:15:42,107 --> 00:15:44,985 the spleen, liver, stomach. 250 00:15:44,985 --> 00:15:48,072 Multiple bullet wounds everywhere else as well. 251 00:15:52,868 --> 00:15:57,539 They're too infected, no? They're too infected. 252 00:16:02,836 --> 00:16:06,966 When we brought the kid to the ER, his mother was waiting there for him. 253 00:16:07,967 --> 00:16:10,636 That immediately made him feel better. 254 00:16:10,636 --> 00:16:13,889 When you go back to the ambulance, you get ready for the next call, 255 00:16:13,889 --> 00:16:18,018 but then you're always thinking about, "I wonder what happened to that patient." 256 00:16:18,811 --> 00:16:22,481 We don't get to see the results, like if they went home. 257 00:16:23,399 --> 00:16:27,528 When it comes to kids, you know, it's always a difficult call. 258 00:16:28,362 --> 00:16:29,822 They're so vulnerable. 259 00:16:30,656 --> 00:16:33,701 It always touches, you know, like, a part of your heart. 260 00:16:35,744 --> 00:16:36,870 Especially now. 261 00:16:44,920 --> 00:16:47,631 - You look really pale, are you okay? - I'm okay. 262 00:16:47,631 --> 00:16:49,675 You better tell me if you're not okay. 263 00:16:49,675 --> 00:16:52,803 I'm okay. Just, I feel like you just want to start an IV on me. 264 00:16:52,803 --> 00:16:56,557 I do. I just wanna hydrate you real quick. 265 00:16:56,557 --> 00:16:57,933 - Yeah? - Yeah. 266 00:17:00,519 --> 00:17:02,354 Dispatch to air transport. 267 00:17:02,354 --> 00:17:05,065 North Shore University Transplant Team is airborne. 268 00:17:05,065 --> 00:17:07,359 Flight time one hour, 11 minutes. Over. 269 00:17:11,613 --> 00:17:15,451 Right now, it's just trying to approximate the timing. 270 00:17:15,451 --> 00:17:18,871 We don't want to do anything with our patient that's getting the liver 271 00:17:18,871 --> 00:17:21,623 until we see the liver to make sure it's suitable. 272 00:17:22,499 --> 00:17:25,252 With a liver, we can go 14 hours. 273 00:17:25,252 --> 00:17:26,920 We prefer it less than 10. 274 00:17:26,920 --> 00:17:31,133 It works better the faster it gets in and it gets reperfused with blood. 275 00:17:32,134 --> 00:17:34,219 We're going to get the liver. 276 00:17:34,219 --> 00:17:39,349 There's going to be someone taking the heart, pancreas, and kidneys. 277 00:17:39,349 --> 00:17:43,771 So, there should be three teams there all working together to get the organs. 278 00:17:43,771 --> 00:17:48,817 But we're each going to do our own thing, so we won't get in each other's way. 279 00:17:48,817 --> 00:17:52,112 We're talking about an hour-and-twenty-minute flight, 280 00:17:52,112 --> 00:17:56,075 plus driving to the hospital, and then getting back to our hospital. 281 00:17:56,075 --> 00:17:58,368 So these are all the time constraints 282 00:17:58,368 --> 00:18:02,247 that we have to try to minimize as much as we can, whatever we can control. 283 00:18:08,837 --> 00:18:12,549 It's happened a few times where we land and there's no transportation. 284 00:18:12,549 --> 00:18:15,928 That's why there always has to be coordination with the coordinator 285 00:18:15,928 --> 00:18:18,138 to make sure that everything's good. 286 00:18:20,307 --> 00:18:22,976 - They took us to the wrong airport. - What's up? 287 00:18:22,976 --> 00:18:26,313 Anyone knows how long to go from here to the hospital? 288 00:18:26,313 --> 00:18:28,690 - I wouldn't know. - We'll ask the ambulance. 289 00:18:29,775 --> 00:18:33,695 Hey. Our OR is a little delayed, till 12:30 now. 290 00:18:34,404 --> 00:18:37,116 {\an8}Guess one of the other teams had a delay in getting here, 291 00:18:37,116 --> 00:18:38,784 {\an8}-so I'll keep you updated. - Okay. 292 00:18:38,784 --> 00:18:41,203 {\an8} One of the problems when working with so many teams, 293 00:18:41,203 --> 00:18:42,621 times get affected. 294 00:18:46,291 --> 00:18:49,336 {\an8} Unlike kidney failure where there's dialysis, 295 00:18:49,336 --> 00:18:51,672 {\an8}there's no such thing as liver dialysis, 296 00:18:51,672 --> 00:18:55,467 {\an8}and there's no replacement for a liver other than a liver transplant. 297 00:18:57,845 --> 00:19:01,056 So, Miss Perez is in hepatic coma, 298 00:19:01,056 --> 00:19:04,184 and you can't be in hepatic coma for that long. 299 00:19:04,184 --> 00:19:06,145 Guys, we have incised. 300 00:19:06,145 --> 00:19:07,646 Suction over here to me. 301 00:19:09,064 --> 00:19:10,774 - She's a bleeder. - Mm-hmm. 302 00:19:10,774 --> 00:19:12,067 She dumped a lot. 303 00:19:13,068 --> 00:19:14,695 She can herniate her brain. 304 00:19:24,913 --> 00:19:26,999 Do we have smaller patches than this? 305 00:19:26,999 --> 00:19:30,127 So we want the one millimeter thickness, we think? 306 00:19:30,127 --> 00:19:32,421 - I think for a 1.8 kilo preemie. - Yeah. 307 00:19:37,050 --> 00:19:40,262 The hole we're going to try to fix relative to the baby is big, 308 00:19:40,262 --> 00:19:43,015 but in the real world it's a tiny little opening. 309 00:19:43,515 --> 00:19:47,436 There's going to be teamwork between the anesthesiologist and surgical team, 310 00:19:47,436 --> 00:19:50,856 'cause we're pushing on the heart, the lung, pushing on the liver. 311 00:19:50,856 --> 00:19:53,483 All of that can affect the circulatory system 312 00:19:53,483 --> 00:19:55,903 and really put the baby's life at risk. 313 00:19:59,031 --> 00:20:01,617 So I need to do something with his little arm still. 314 00:20:02,951 --> 00:20:07,164 We're going to open up here, the chest, to be able to torque the liver, 315 00:20:07,164 --> 00:20:09,708 which we think is up here, down towards the belly. 316 00:20:09,708 --> 00:20:12,127 There's no liver in here right now. 317 00:20:12,127 --> 00:20:14,630 This is one of the things about a surgery like this. 318 00:20:14,630 --> 00:20:20,010 You can't really get MRIs and fancy CT scans like we do in big grown-ups. 319 00:20:20,010 --> 00:20:22,804 So I don't 100% know what I'm about to find. 320 00:20:26,600 --> 00:20:30,229 We're about to just pop into the chest, so we just did there. 321 00:20:30,854 --> 00:20:33,899 Now we're going to open up space, and this is an unusual thing. 322 00:20:33,899 --> 00:20:36,610 We open up the chest and we see intestines. 323 00:20:36,610 --> 00:20:39,655 I don't really wanna see them now because I don't wanna hurt them, 324 00:20:40,239 --> 00:20:44,117 so I'm going to try to see if I can tuck them away from us a little bit 325 00:20:44,117 --> 00:20:47,120 without putting too much pressure on the heart inside. 326 00:20:47,120 --> 00:20:50,707 I'm going to try to reduce the contents into the belly now. 327 00:20:50,707 --> 00:20:52,834 Okay, there's the heart. 328 00:20:52,834 --> 00:20:55,087 Can I have a second kittner like this? 329 00:20:56,129 --> 00:20:59,424 Putting pressure on the lungs and heart. Let us know if we need to take it off. 330 00:21:00,759 --> 00:21:02,928 So let's start unfurling what we can unfurl. 331 00:21:03,512 --> 00:21:04,846 A little bit back here. 332 00:21:04,846 --> 00:21:08,225 Gonna try to use the liver as a blocker for the bowel... 333 00:21:08,225 --> 00:21:09,768 Uh-huh. 334 00:21:09,768 --> 00:21:13,105 ...as long as the baby will tolerate the torque. 335 00:21:13,105 --> 00:21:15,649 Do you have something longer if we need it? 336 00:21:15,649 --> 00:21:20,112 We have such a privilege to serve the people who need it in those moments. 337 00:21:20,112 --> 00:21:21,780 I need something finer than this. 338 00:21:21,780 --> 00:21:26,076 I found that when I took care of children, it took it to such another higher level. 339 00:21:26,076 --> 00:21:28,704 Because when someone hands you their child, 340 00:21:28,704 --> 00:21:31,707 the weight of the responsibility, 341 00:21:31,707 --> 00:21:34,459 but also the tremendous privilege of making an impact, 342 00:21:34,459 --> 00:21:35,877 that really called to me. 343 00:21:35,877 --> 00:21:38,797 The idea that you're not just saving someone's life, 344 00:21:38,797 --> 00:21:41,591 but when you think about a child, you just saved a lifetime. 345 00:21:45,721 --> 00:21:48,807 I thought these were all in the right upper quadrant. 346 00:21:49,725 --> 00:21:52,811 Main concern is the fact that there's still blood draining 347 00:21:52,811 --> 00:21:56,064 from the temporary covering that's over his abdomen. 348 00:21:56,064 --> 00:21:58,608 You know, he still is very, very sick. 349 00:21:58,608 --> 00:22:01,486 - Okay. Alright. Careful there. - Slowly. 350 00:22:01,486 --> 00:22:02,988 Okay, here you go. 351 00:22:04,489 --> 00:22:06,950 - Oh God, these rings are terrible. - Really bad. 352 00:22:06,950 --> 00:22:11,830 Oh man, it's like plastered. You can see quite extensive liver injury. 353 00:22:12,706 --> 00:22:14,666 I don't see any active bleeding. 354 00:22:15,250 --> 00:22:18,128 Don't speak too soon. Lift up. 355 00:22:18,128 --> 00:22:20,380 - One here too. 356 00:22:20,380 --> 00:22:23,842 We have to get all these packs out. They were stopping the bleeding. 357 00:22:23,842 --> 00:22:26,261 Yeah, let's not rock the boat here. 358 00:22:26,261 --> 00:22:28,722 It's bleeding right there, see that? That's fresh. 359 00:22:28,722 --> 00:22:29,723 Okay. 360 00:22:29,723 --> 00:22:31,933 - So let's not touch that. - Mm-hmm. 361 00:22:31,933 --> 00:22:35,604 - Down there, suction. There. 362 00:22:35,604 --> 00:22:38,357 - Is that a hole? - Yeah, different. 363 00:22:39,566 --> 00:22:41,651 We've got a lot of blood in his gut. 364 00:22:42,444 --> 00:22:46,531 We're going to leave the packing in here because it's controlling liver bleeding. 365 00:22:46,531 --> 00:22:50,952 We've washed things out, stabilized stuff, and we're coming back in a couple of days. 366 00:22:50,952 --> 00:22:54,539 Hopefully by then, enough fluid's off the body and we can close the abdomen. 367 00:22:54,539 --> 00:22:56,541 As you can see, it's tight right now, 368 00:22:56,541 --> 00:22:59,753 and we need abdominal closure to see if any blood wells up. 369 00:22:59,753 --> 00:23:04,174 And hopefully his body will recover, then we'll be able to close the abdomen. 370 00:23:04,174 --> 00:23:05,801 That's the news we're hoping for. 371 00:23:18,355 --> 00:23:20,190 Alright, so bone is off. 372 00:23:24,903 --> 00:23:27,906 - Oh, baby. - It almost looks like it receded. 373 00:23:27,906 --> 00:23:31,201 - This looks like a cranioplasty. - Yeah, like a-- 374 00:23:31,201 --> 00:23:32,702 Oh, Marcos. 375 00:23:32,702 --> 00:23:37,874 - This is also... - Yeah. Send this for culture, dura. 376 00:23:37,874 --> 00:23:39,209 This little tumor... 377 00:23:41,044 --> 00:23:43,130 Gets weirder and weirder, this case. 378 00:23:43,130 --> 00:23:46,842 Nothing looks normal here. This is tumor. 379 00:23:48,260 --> 00:23:51,555 Drop the table down all the way, we're gonna go under the microscope. 380 00:23:51,555 --> 00:23:57,102 This is actually much more... ...upsetting than before. 381 00:24:02,649 --> 00:24:04,693 I think with what I'm looking at, 382 00:24:04,693 --> 00:24:06,528 and what we have in the lungs, 383 00:24:06,528 --> 00:24:09,781 and what we saw in the scalp, and the rapidity of what grew, 384 00:24:09,781 --> 00:24:13,326 I don't see how he can live more than six, twelve months. 385 00:24:16,872 --> 00:24:20,292 I didn't realize this disease was so extensive intracranially. 386 00:24:22,210 --> 00:24:26,465 Brian, we just filed our flight plan. We're going to start our initial descent. 387 00:24:26,465 --> 00:24:27,549 Okay. 388 00:24:33,680 --> 00:24:35,432 - Dr. Teperman? - Yes? 389 00:24:35,432 --> 00:24:37,476 They clamped at 15:09. 390 00:24:37,476 --> 00:24:39,769 - Okay, thank you. - Suction over here. 391 00:24:43,690 --> 00:24:45,942 They're calling me again. 392 00:24:45,942 --> 00:24:47,194 Okay, great. 393 00:24:48,361 --> 00:24:49,321 All right. 394 00:24:49,946 --> 00:24:51,990 - Dr. Grodstein? - Yeah, that's me. 395 00:24:51,990 --> 00:24:53,492 I just spoke to Dr. Winnick. 396 00:24:53,492 --> 00:24:56,411 He'll be leaving the hospital in about five minutes. 397 00:24:56,411 --> 00:25:00,290 It's stressful. It's very stressful while waiting for the liver to come. 398 00:25:00,290 --> 00:25:02,417 We have to synch operating rooms very closely 399 00:25:02,417 --> 00:25:05,837 because the liver can only be outside the body for a certain amount of time. 400 00:25:05,837 --> 00:25:10,383 We are praying that her brain is staying where it is, 401 00:25:10,383 --> 00:25:13,887 and that we can get this new liver in quickly so that it can 402 00:25:13,887 --> 00:25:17,474 lower a lot of the pressure in her head, and that she can wake up at the end. 403 00:25:17,474 --> 00:25:22,187 Why is Dr. Winnick taking so long? Doesn't he know that we're operating? 404 00:25:22,187 --> 00:25:26,942 Now we have to get this back soon as we can so they can sew it in. 405 00:25:28,151 --> 00:25:31,613 They already started there, and once we get there, 406 00:25:31,613 --> 00:25:34,658 we clean it up, and it's ready to go without any more delays. 407 00:25:34,658 --> 00:25:37,285 - They start flying yet? - Not yet. 408 00:25:38,161 --> 00:25:42,290 There's no reason for us to try to take the liver out until the liver's here. 409 00:25:42,874 --> 00:25:44,292 Where is Winnick? 410 00:25:44,292 --> 00:25:45,669 Look at this. 411 00:25:46,962 --> 00:25:50,173 He's gonna show us where the plane is. This is the app. 412 00:25:51,383 --> 00:25:53,552 Scheduled. They haven't taken off yet. 413 00:25:54,135 --> 00:25:57,180 Sixty-mile-an-hour winds, they said, in New York. 414 00:26:05,480 --> 00:26:09,317 No, I understand. They got delayed and we went faster. 415 00:26:09,317 --> 00:26:13,989 You know, normally, as soon as I leave, they'd sew it in, except there's no liver. 416 00:26:17,534 --> 00:26:18,785 I'm going. 417 00:26:18,785 --> 00:26:21,162 There's been cases where people haven't woken up. 418 00:26:21,162 --> 00:26:23,999 You do this whole thing, send a team out, do the operation, 419 00:26:23,999 --> 00:26:26,585 then they don't wake up after. That's it. 420 00:26:26,585 --> 00:26:27,669 Hey. 421 00:26:28,670 --> 00:26:31,715 Nothing. Yeah, but they still haven't landed. 422 00:26:31,715 --> 00:26:36,511 Yeah, so we're ready to cut out the liver, but do you wanna order some Italian? 423 00:26:41,600 --> 00:26:44,561 I think it looks great, and the closure looks good too. 424 00:26:44,561 --> 00:26:46,062 And this position? 425 00:26:46,855 --> 00:26:49,524 Back to the NICU. Intubated to the NICU. 426 00:26:50,609 --> 00:26:53,945 Thanks, everybody. It was a lot of set up. Thanks for running around. 427 00:26:56,656 --> 00:26:59,868 Takes about 10 years to be trained as a pediatric surgeon. 428 00:26:59,868 --> 00:27:03,872 Nine to ten years, between the research and the clinical training. 429 00:27:03,872 --> 00:27:07,959 There's more NFL football players than there are pediatric surgeons. 430 00:27:11,254 --> 00:27:14,299 Any more questions? Sorry, I don't know if you understand me. 431 00:27:14,299 --> 00:27:15,467 It's just that to me... 432 00:27:15,467 --> 00:27:18,470 Not sure if you understand my Cuban accent. 433 00:27:18,470 --> 00:27:20,764 I don't know if my accent makes it difficult. 434 00:27:20,764 --> 00:27:27,187 Now we won half the battle, but now we have to keep going. 435 00:27:27,187 --> 00:27:29,356 Yes, it's like a marathon. 436 00:27:29,356 --> 00:27:32,359 It's not a short run. It's a marathon overall. 437 00:27:32,359 --> 00:27:37,530 It's really common that everything won't go in a straight line. 438 00:27:37,530 --> 00:27:41,576 It's more likely that we're going to have good moments and bad moments. 439 00:27:41,576 --> 00:27:43,453 - Okay? - Thank you. 440 00:27:50,460 --> 00:27:53,713 - Dr. Boockvar. - How are you? Everything went fine. 441 00:27:53,713 --> 00:27:55,298 - Can I use that room? - Please. 442 00:27:55,298 --> 00:27:58,843 We removed that. It looked very, like, broken down. 443 00:27:59,552 --> 00:28:03,431 And basically enlarged the bone opening, and that's all being fixed, 444 00:28:03,431 --> 00:28:05,934 so you're not gonna be able to see any of it. 445 00:28:05,934 --> 00:28:07,102 Mm-hmm. 446 00:28:07,102 --> 00:28:09,270 I'm pleased that we made it bigger 447 00:28:09,270 --> 00:28:12,691 because there was tumor in there, underneath. 448 00:28:13,233 --> 00:28:16,695 And the tumor was growing in sort of both directions, 449 00:28:16,695 --> 00:28:20,365 up out through the scalp and down into the brain. 450 00:28:20,365 --> 00:28:22,909 - So, I took it all out of the brain. - Mm-hmm. 451 00:28:22,909 --> 00:28:26,121 If there is a lot of disease elsewhere, 452 00:28:26,121 --> 00:28:29,541 I'm going to tell you that that's going to impact his survival. 453 00:28:29,541 --> 00:28:34,087 However, we sort of reset the clock a little bit with this operation... 454 00:28:34,087 --> 00:28:35,046 Mm-hmm. 455 00:28:35,046 --> 00:28:37,298 ...and hopefully with the information 456 00:28:37,298 --> 00:28:39,467 we gleaned from the pathology and the genetics, 457 00:28:39,467 --> 00:28:42,595 we can come up with something that is effective. 458 00:28:42,595 --> 00:28:45,140 - He wants to live so bad. - I know. 459 00:28:47,267 --> 00:28:49,936 And this was a good step toward that. 460 00:28:51,563 --> 00:28:54,399 - It's a terrible case. - Thank you so much, Dr. Boockvar. 461 00:28:54,399 --> 00:28:55,567 Appreciate it. 462 00:28:55,567 --> 00:28:58,445 But you know, miracles do happen in some way. 463 00:28:58,445 --> 00:29:00,488 You know, we've seen 464 00:29:01,698 --> 00:29:06,244 turnarounds in cases, and I just pray he's one of them. 465 00:29:06,244 --> 00:29:10,290 - Be happy with what he has done. 466 00:29:27,182 --> 00:29:29,642 I have a transplant pickup at Republic Airport, 467 00:29:29,642 --> 00:29:31,936 going to North Shore University Hospital. 468 00:29:32,645 --> 00:29:34,105 10-4. 469 00:29:59,756 --> 00:30:01,090 Thank you, guys. 470 00:30:06,429 --> 00:30:07,931 Suction to me, please. 471 00:30:15,396 --> 00:30:17,148 Is Aaron here? 472 00:30:22,111 --> 00:30:23,613 Getting out of the elevator. 473 00:30:25,532 --> 00:30:29,244 - Let me see a pickup, hold this? - I can't, it won't move. 474 00:30:29,244 --> 00:30:31,704 - Thanks, see you in there. - Coming in the back? 475 00:30:31,704 --> 00:30:33,373 Yes, I'm gonna go change. 476 00:30:40,255 --> 00:30:42,590 Oh, look at that. 477 00:30:44,133 --> 00:30:47,053 - Do you have anything finer? - The key is not to drop it. 478 00:30:48,429 --> 00:30:50,014 - There you go. - Thank you. 479 00:30:50,014 --> 00:30:52,058 Wow, that's a big liver, Aaron. 480 00:30:54,185 --> 00:30:57,146 It's a beautiful liver. Big for her, but she'll be fine. 481 00:30:57,730 --> 00:30:59,274 It's life-saving. 482 00:31:01,192 --> 00:31:04,487 Why don't we check to make sure there's no holes that we missed? 483 00:31:06,406 --> 00:31:07,323 Yup. 484 00:31:07,323 --> 00:31:09,242 - Lew, you ready? - Ready. 485 00:31:09,242 --> 00:31:11,828 Alright, let's cut this thing slowly out. 486 00:31:11,828 --> 00:31:13,413 Okay, push, push. 487 00:31:13,413 --> 00:31:15,248 - Uh-huh. 488 00:31:15,248 --> 00:31:19,627 Okay. Take the liver out. Firm like a rock. 489 00:31:20,837 --> 00:31:23,840 She had autoimmune hepatitis, 490 00:31:23,840 --> 00:31:28,303 and possibly made a little worse by medication. 491 00:31:28,303 --> 00:31:30,305 This is basically a dead liver. 492 00:31:36,019 --> 00:31:39,230 Here. Excuse me. Excuse me. 493 00:31:40,356 --> 00:31:43,568 On my way. I need a blue towel up there. 494 00:31:43,568 --> 00:31:44,861 Right here. 495 00:31:59,792 --> 00:32:01,586 You guys, connect this thing. 496 00:32:05,381 --> 00:32:08,009 I'm going to pass this one behind the corner. 497 00:32:08,009 --> 00:32:09,093 It's a big liver. 498 00:32:21,189 --> 00:32:23,191 Okay, that's enough knots, guys. 499 00:32:23,191 --> 00:32:27,236 - We're going 40 knots on this ship. - We're being knotty? 500 00:32:27,236 --> 00:32:29,072 Irrigation, please. 501 00:32:32,867 --> 00:32:35,411 Okay, stop, pull it out. 502 00:32:35,411 --> 00:32:38,665 That's just... Okay, we're going to come out of bypass. 503 00:32:39,415 --> 00:32:41,209 Okay, everything's good. 504 00:32:41,209 --> 00:32:44,379 Liver full, it's in the hole, her old one is out. 505 00:32:44,379 --> 00:32:47,715 And now it just has to do its job, it has to give her life. 506 00:32:48,216 --> 00:32:51,260 We'll know right away. The question is, does she wake up? 507 00:32:55,223 --> 00:32:58,351 Okay, let's see if we can find her family. 508 00:33:08,111 --> 00:33:11,823 - Hey, things went very well. - Okay. 509 00:33:11,823 --> 00:33:17,412 Um, there was clearly extensive damage to the liver, the stomach. 510 00:33:17,412 --> 00:33:21,165 We have to wait, let his body recover, um, and take it day by day. 511 00:33:21,165 --> 00:33:24,627 In a couple of days, re-evaluate to take back, wash out, maybe even close. 512 00:33:24,627 --> 00:33:27,296 - That's good. That's really good news. - Yes. 513 00:33:27,296 --> 00:33:31,384 And we know there's some bullet fragments in the arm, some by the heart. 514 00:33:31,884 --> 00:33:34,178 It'll take time to tell the full extent 515 00:33:34,178 --> 00:33:37,098 of what type of long-term issues there might be. 516 00:33:37,098 --> 00:33:41,561 You know, he's doing a great job of fighting, and we'll be with you. 517 00:33:47,108 --> 00:33:48,776 We basically did a wash out. 518 00:33:50,236 --> 00:33:54,365 It's rewarding to be able to assist in the care of a child like this, 519 00:33:55,199 --> 00:34:00,288 but it gets tiring seeing a lot of these innocent kids being injured by bullets. 520 00:34:03,875 --> 00:34:07,628 We don't always, often have the chance to kind of save a life, 521 00:34:07,628 --> 00:34:11,716 or to see somebody come through after being shot this many times, 522 00:34:11,716 --> 00:34:15,470 so it's really very kind of encouraging to see what we saw today. 523 00:34:15,470 --> 00:34:18,848 You get to take not only a kid through a journey, but also parents. 524 00:34:18,848 --> 00:34:21,350 Because of the anxiety that parents go through 525 00:34:21,350 --> 00:34:23,561 when their kid goes through a health crisis, 526 00:34:23,561 --> 00:34:25,813 it's an insurmountable level of stress. 527 00:34:26,397 --> 00:34:27,356 I love you. 528 00:34:31,903 --> 00:34:33,321 I'm right here with you. 529 00:34:37,408 --> 00:34:40,328 I'm going nowhere, I'm not going to leave your beside. 530 00:34:40,328 --> 00:34:42,789 Be right here with you the whole time. 531 00:34:44,791 --> 00:34:48,669 Hi, beautiful. How are you? Let's see if I can do this without... 532 00:34:50,129 --> 00:34:52,507 totally detaching everything. 533 00:34:55,885 --> 00:34:56,928 That looks great. 534 00:34:59,097 --> 00:35:00,264 Okay, princess. 535 00:35:02,016 --> 00:35:05,686 After raising three kids, I still kind of remember how to do that, right? 536 00:35:05,686 --> 00:35:09,315 We went from her being born and not even sure if she's going to live. 537 00:35:09,315 --> 00:35:12,819 Now, she's breathing on her own, her x-rays look great, 538 00:35:12,819 --> 00:35:15,905 and the heart has kind of come back to where it belongs. 539 00:35:17,573 --> 00:35:20,535 To see that transformation, that sense of peace in a mother, 540 00:35:21,285 --> 00:35:26,582 it's the kind of thing that keeps us going and brings us back to do more of this. 541 00:35:28,417 --> 00:35:31,921 And you need those highs because the valleys are really deep. 542 00:35:38,052 --> 00:35:39,178 I'm so tired. 543 00:35:46,102 --> 00:35:47,812 This is just unbelievable. 544 00:35:47,812 --> 00:35:49,939 Look how amazing I look. 545 00:35:50,690 --> 00:35:54,068 Dr. Teperman, you really saved my life. 546 00:35:54,068 --> 00:35:56,821 I just am so thankful to the family 547 00:35:56,821 --> 00:36:00,158 because this person gave me a second chance at life. 548 00:36:00,158 --> 00:36:04,704 And I know that must have been really difficult to make that decision. 549 00:36:04,704 --> 00:36:07,290 You were sick, we weren't gonna let you go. 550 00:36:11,294 --> 00:36:13,921 - How are you? - Good, and you? 551 00:36:13,921 --> 00:36:15,673 Good, we just finished. 552 00:36:16,257 --> 00:36:18,176 Yeah, thank God. 553 00:36:18,176 --> 00:36:19,844 That's good. How did it go? 554 00:36:19,844 --> 00:36:21,637 It went well, thank God. 555 00:36:22,555 --> 00:36:23,848 I'll see you in a few. 556 00:36:24,932 --> 00:36:28,436 - And our little guy? - He's moving a lot. He's really hungry. 557 00:36:28,436 --> 00:36:29,562 He's hungry. 558 00:36:29,562 --> 00:36:31,981 - Okay, be careful, okay? - Okay, love you. 559 00:36:36,903 --> 00:36:41,032 At the end of the day, I always think about all the patients that I had. 560 00:36:41,032 --> 00:36:45,328 Sometimes you assess the situation in your head and you think about it, 561 00:36:45,328 --> 00:36:48,873 think about, well, what can I make different the next time? 562 00:36:48,873 --> 00:36:51,500 It just helps you to decompress, 563 00:36:52,752 --> 00:36:57,882 so by the time I get home, I don't bring that to my house. 564 00:36:59,508 --> 00:37:01,761 Because that's the time for my family. 565 00:37:02,553 --> 00:37:05,306 - Hi, papi, how are you? 566 00:37:05,306 --> 00:37:06,891 How's my son? 567 00:37:07,600 --> 00:37:09,352 - Mm? 568 00:37:15,066 --> 00:37:17,944 Medic 88. We have a call for a pregnant female. 569 00:37:17,944 --> 00:37:19,904 Complaining of vaginal bleeding. 570 00:37:20,404 --> 00:37:21,739 Does not speak English. 571 00:37:21,739 --> 00:37:25,326 Family member reported she was still conscious at the time of the call. 572 00:37:25,826 --> 00:37:27,828 Heading to Lenox Hill ER. 573 00:37:28,496 --> 00:37:29,372 This is a code 3.