John, what happened?
You know David. He fucking skis off of the trail, you know?
So he hit a gully.
He was face-down in the snow for an hour,
and he couldn't move his arms and legs.
So I thought-- I thought it was over.
He hyper-extended his neck. The nerve signals get disrupted.
It's like someone pulled the plug out of his spinal cord.
I just don't think it's a good idea to be treated at Lenox.
I think he needs some privacy.
And nobody wants to see the Chair of Neurosurgery when they're sick.
Go somewhere else, get fixed, come back in healthy.
But David also, you know,
is this...
...he wears his emotions a bit more publicly.
He beats by his own drum sometimes. That's why we love him.
Now we're heading to the airport,
and we're picking up a 58-year-old male who was involved in a skiing accident.
Thank you.
- So he was skiing in Vail on Friday... - Okay.
...ended up kind of falling face-first onto his head,
hyperextending his neck.
Okay.
So you have some pain on your shoulders?
Everything from C5 to C7.
On both sides.
The big risk of any kind of injury,
of the C5 injury the doc has suffered,
is any kind of respiratory issues, so...
um...
paralysis, or becoming a quadriplegic, or a tetraplegic.
It just depends on how bad or severe the fracture is.
We don't know exactly the severity of it.
We have seen people with these kinds of injuries.
Like anybody else, they went from doing things on their own,
now, they have to, "Hey, I need help."
When you're able to be the person that everybody looks for for help,
and then all of a sudden,
you're looking for somebody else to help you,
it's dire.
Home sweet home.
Oof!
Oh my God.
Is it better now?
No, it feels like it's cramped up there. Right there.
I told you, you're not making it to the end of the month.
Oh, please, just relax.
We're at work.
He's like right here, like...
I'm going to try to step out.
Do you need help?
Let me come help you, before you walk out into traffic.
- Go for a walk in the park? - I literally want to cry.
Why? You're hurting? Come on.
- Alright, better? - Yeah, it feels better.
I feel like it was the position when I was sitting.
- Right. - Mm-hmm.
Alright.
- Yep.
Hello there, sexy.
Just like that.
Hello.
How are you? I'm Stephanie, I'll be your nurse for tonight.
One, two, three.
Alright. Nice and easy.
- There's a pillow. - Alright.
That's pretty darn good.
Dr. Langer, do you have any weakness, numbness, tingling anywhere?
I have, well, my neck pain.
- My hands are killing me. - Mm-hmm.
My arms hurt at gravity.
I can hold them up for a while.
These two fingers there, I feel like I have frostbite. That finger's numb.
Push me away.
Good.
- Feel this? It's equal on both sides? - Yep.
- 100% equal. Equal. - Could use some anesthesia.
- And here?
- I'm sorry. - Yeah, equal.
The pain really is prohibitive,
so until the pain starts dying down, I'm still a little anxious.
Take deep breaths for me.
In and out. Okay.
How are you feeling? That's the most important thing.
Lucky. Glad to be home.
We'll go fix the rest of this crap. I'll be okay.
Welcome home.
I know some people are afraid of me being here
and being shown being weak, and...
I wouldn't rather be anywhere else. You know?
We have a great team, we put together great people.
- There's no better place, so-- - Yes.
It's just a heavy weight to take care of you.
I know, but you know what? When you're here,
we take care of family and take care of your family.
Because it's me, it's different, but let's not make it different.
- Do what we always do. - Exactly.
Do everything really well.
You're one of the most resilient people I've seen, so...
Couldn't be happier you're taking care of me.
Dr. Langer, your flight kept delaying until it was my shift.
- So I said, it was meant for me.
You know, he took in my dad, same exact room, and I was so grateful.
And now he comes to me, so I'm gonna take care of him like my dad,
and I always tell him he's been my dad.
It's kind of crazy, right?
- No, no... - Your boss, your dad.
But he's always been like that, and so that's why I felt a little nervous.
I'm like, "Oh my God, the weight of taking care of Dr. Langer."
But we got this.
It's okay to mistake once in a while.
We're not going to make a mistake with you.
Feel better because we have Nerf guns here.
They gave one to us, one to the nurses, and one for you.
That's for him to behave.
Alright. I'm a little tired, you know.
- We'll let you sleep. Meds are coming. - We'll let you rest.
And the bath is ordered.
- Hi. Where's he coming from? - Subway.
Subway. Is he on restraint?
- 'Cause he was combative? - Yeah.
Can I get a PCT to get some Yankauers for suction?
Don't wanna cut off his clothes. That might be the only clothes he has.
- You okay, buddy? - Fifteen walked out?
I'm gonna go see her next.
No, stay back.
- She ripped both of her IVs. - Oh my goodness!
I'm happy to sedate her. Want to give her some Ativan?
You want food? You want ginger ale?
Okay. Will that keep you here?
Just gotta give her what she wants because I don't want her walking out.
Hi, I'm Dr. Macri.
Hello, Doctor.
- We've met before. - Alright.
Long time ago.
So what happened this time around? Why did you come in tonight?
I relapsed on drugs again.
Heroin?
Heroin, cocaine.
Okay.
- Are you homeless right now? - Yep.
Alright.
Do I get any mayonnaise?
- No, we don't have mayonnaise. - Alright, thank you.
What medications are you supposed to be taking right now?
- Geodon. - When's the last time you took it?
A long time ago.
Were you thinking about trying to hurt yourself tonight?
Yeah.
What did you tell the charge nurse?
I tried to kill myself.
Okay. How were you going to kill yourself?
Run into a car.
Okay.
Is that something you still plan on doing?
Maybe.
Oh. Okay.
Do you have any family members here in New York?
Nope. Everybody died.
Everybody died.
- Do you have any friends here who'd you-- - Definitely not.
No friends.
I'm going to call the psychiatrist after all your blood work's come back,
then they're going to talk to you.
- Alright. - If you need anything, just let us know.
I'm definitely seeing people who are sicker,
people who are on disability or who can't work anymore.
People, during the pandemic, lost medical care.
What's the story?
They lost medications for psychiatric conditions.
Apparently, she was on K2.
She told us in back of the ambulance after she woke up with us.
Okay. Hi. Did you do K2?
She's responding, and her blood pressure's already going up.
We get a lot of these in the West Village, drug overdoses.
K2 does funky things to your blood pressure, to your heart.
It's unfortunate that it's so cheap and people buy it.
Nice teamwork, guys.
One minute, it was nice and manageable.
And then the next minute, it kind of exploded.
And that's just the nature of the emergency room.
I kind of love that, actually. I love it.
Uh, I like that middle of the night influx that sometimes happens.
It's unpredictable.
No, my dear. No, my dear. You're gonna sit down.
Did we not bring her ginger ale?
She uses it to assault people.
It's all over the floor, she threw it at the security staff.
So we have spice, spice, and spice.
Doing this type of work, you know, we appreciate the team.
When the pandemic happened, we needed, in a time of crisis,
to pull together, and being this close is a good support system.
Thanks, Trevor.
Teamwork is a very good thing for patient care.
I'm going to go in and see my next patient who needs some attention.
You're shooting me, for what? I didn't do anything.
No, I'd never.
We took off your name out there, and we'll keep this closed.
I think you have one patient there.
- They're okay? - Yeah, they're okay.
Could I walk over and say hi?
No. They're calm.
That's the end of my vacation.
Just like when you got COVID, it was the first day of vacation.
- Okay. - There's a theme here, David.
You can't go on vacation anymore.
We do, we have to try.
I know, but you get fucked up every time you go away.
What song do you want to play as your post-quad life?
Pearl Jam song.
I love you. You're doing a great job.
Thank you for everything.
Okay.
Thanks for being so great.
♪ He could've tuned in Tuned in but he tuned out ♪
Good luck, guys. Don't take his bullshit. You know what to do.
- Thank you, Nancy. Team David. - Get home safe.
Take care. Team David.
Alright, yeah.
- Have a good night. See ya in the morning. - Thank you.
It was weird. All I could see was the snow because my face was down.
My arms were pinned behind me.
I was like in a Superman position, waiting for ski patrol to come.
I was like in shock...
"Oh my God, I cannot feel my arms and legs. I can't move."
Oh my God, there's a baby!
Hello. Hi.
Oh no, that's teasing me. Hold on. Let me go wash my hands.
Good to see you.
She's going to be a pilot.
- No, don't do that to her. - She's gonna be an astronaut.
- There you go. Nice.
Can't wait for Laura to hold her.
Hi!
First of all, hi. I'm sweaty. How are you?
Laura, you can hold her. I just need like 35, 45 minutes or so.
- No. How about you just surrender her now? - Oh my God!
Hello, Mama.
- I've missed you so much. - How are you?
Welcome back.
- No. - No, no, no.
- What did you do? I had her-- - I don't know.
- Really?
Hi.
She's still figuring out emotions.
Do you miss us? Probably not.
No, I really miss you guys. I talk about you guys all the time.
She's adorb. It's like a nice little toy.
Look at her. She's, like, passing out.
Thanks for letting us see her. Thanks for bringing her by.
Yeah, no, of course.
This is like a treat. This is the highlight of my day.
Yeah!
I was really excited. I couldn't wait. Well, have fun, guys.
- Thanks so much. Bye. Enjoy your day. - See you later.
That makes my cheeks hurt. Now my cheeks hurt.
- From excessive smiling? - Yeah.
- Hi. - Hi.
- We're going to go down to MRI. - Okay.
- You alright? - Mm-hmm.
This is from Denver Health Medical Center.
John Langer, David's brother, called me at 5:00 on this day.
It broke my freaking heart.
Thankfully, his brain is perfect.
His spinal cord looks good, and right here in the middle,
he has some congenital narrowing.
He kind of pinched his cord.
So when he whipped his head back, this kind of crunched down.
Now he's got inflammation here. Basically, when you do that,
it's called the central cord syndrome, and you can actually stop the signals,
motor and sensory, that go from your brain to your extremities.
Either way, he needs to have that released and relieved,
so he's going to need a laminectomy infusion.
Yes, sir. Dr. Langer, what happened?
I need to take a little morphine.
- More medication? - I got it.
Okay, we're coming.
If you just took off these bones and gave him the room that he needs,
basically for his spinal cord...
he should be full strength, is my hope.
We're all done. We're gonna get you out.
Now, David does the most complex surgery in humankind.
He's a microvascular surgeon in the human brain,
and he's gotta tie blood vessels together.
And so that takes, you know, the finest suture,
the finest threads, holding the finest, um, instruments.
It's much easier to do what I do, which is take bigger instruments
and take out brain tumors. He's gotta use the finest instruments.
So even if it takes three months, four months, five months,
he's got to be able to sew.
At least I'll have someone to snowshoe with now.
New York State states that every healthcare worker has to be vaccinated,
and the way that the laws are working now dictates that
you can't take care of patients without vaccination.
I think I'm the only one part of the team not vaccinated.
My last day in the ER was Thursday. My last day at SkyHealth is today, so...
I'm not gonna cry though.
Right where I'm in the prime of my career, where I like where I am, I'm comfortable.
You know, I have to make this decision and the consequence to it.
Northwell Center SkyHealth,
I have a patient coming in from Peconic Bay Medical Center...
You got it?
This is going to be a STEMI rescue. Patient's on an Impella and BiPAP,
cardiac monitor and a couple drips.
Copy. It sounds like the patient's unstable.
Let's make sure that we move the patient very carefully.
Throttles and switches. Environmental considerations?
Ready when you are.
- Northwell Center SkyHealth One,
skids up at 13:21 with four souls on board.
- Ready, my love? - I'm ready.
- Okay. - Alright.
We decided that we're going to do the C-section
because of the position of the baby.
If he's not able to come out without any help,
they're going to have to dislocate his shoulder.
I know I just got to let it go and get ready for the surgery.
And I just want to think on that moment
when I'm going to see my son's face for the first time.
That's what I'm looking forward to.
Um, hit three, please?
Are you okay?
Yes?
Later on, we're going to see our baby.
I wish I wasn't having other things going through my brain,
because it's not usually optimal.
But once you get at the bedside, everything else gets pushed out the way.
Hi. My name is Laura, I'm one of the nurses. What's going on?
This gentleman, 52-year-old male, came in around midnight last night,
brought in by ambulance, for respiratory distress and abdominal pain.
He doesn't have any family or any friends.
He doesn't have family? Aw, poor baby.
"How am I supposed to get home from here?" He was concerned about that.
We were thinking he didn't have insurance so he didn't follow up with doctors.
But it's more of he didn't know how to set up the follow-up appointments.
- He might need a little social work. - Yeah.
So his medications ran out, and he never got them refilled.
Oh, poor thing.
Because he stopped those medications, he ended up in here.
One, two, three.
Okay.
Comfy? Good.
- How you doing, Curtis? - Tank can go right in here.
Are you having any pain?
Any discomfort?
He's not tolerating the BiPAP mask.
I want you to take some deep breaths in and out.
Try not to focus on talking for a couple of seconds. Okay?
Can I have that bag that I gave you earlier?
You just watch that Impella, and then I'll deal with that. Two seconds.
Okay. We got to go.
- Rotor RPM? - 100%
- Throttles and switches? - Clean.
- Doors? - Secure.
Northwell Center SkyHealth One. We are skids up.
- Peconic, en route to the South Side. - Hit it one more time.
Something's going on with this thing.
Just take it off. We'll give him a non-rebreather for a minute, okay?
We're going to the medical ICU. We need to go, get up there now.
We have the transfer coming from Peconic.
A couple of hiccups in the air, but we have everything.
Everybody ready? One, two, three. Awesome.
Curtis, good luck, okay? It was a pleasure meeting you.
I left my helmet. I had to run back. I dunno what's wrong with me.
My brain was elsewhere.
- Hello, you. - Hi, Dr. Langer.
- Good morning, Dr. Langer. - How are you?
How are you?
- Gotta put you back on our monitor, okay? - Okay.
I'm just going to put these back on the leads, okay?
Take his mask off.
- Hey, Dave. Gary Giangola. - Hi, Gary.
- How you doing, buddy? - I'm okay. Hanging in there.
Alright. Hang in there. I'll see you later, okay?
Hey, Dr. Langer. I'm going to be your nurse today, okay?
Sure thing.
- Good morning, Dr. Langer. - Good morning.
I'm Marvin, I'm one of the PCA's up here. I just gotta grab your temperature.
I'm going to leave this just in case you need pain meds. You click it, right?
- I got it. - Yeah? Okay.
And which is the nurse call?
- The nurse call button-- - I don't want to confuse the two.
It's okay if you do, right?
- Where is she, goddamn it?
Forget about it.
I'm so happy you still have your sense of humor, Dr. Langer.
That I have.
You know, the decision whether to have surgery here at Lenox
or go somewhere else where there is more anonymity is a tough decision
because... you built this team.
You know who's a good surgeon.
We have the best PA team, best residents, best nurses. So there's trust there.
But there's also a vulnerability, you know.
As leaders, nobody wants to see us in a vulnerable position,
so, can you unsee that?
You know, which a lot of our staff will have to unsee this.
And of course, as surgeons,
you have to be able to maintain that level of excellence.
Wow. Beautiful.
There's a balance.
David is an open book, and that's why we love him.
He's not afraid to show vulnerability,
but we have to all protect his privacy and recognize the vulnerabilities,
and just pray everything goes perfectly and not change his treatment.
He's an incredible guy, you know? He's David. He lives like he's dying.
- Good morning, team. - Good morning.
David?
I'll just--
Hi, David.
I'm sorry.
You sleeping?
- Oh, my God.
I love you.
How was the MRI?
- I moved. - Yes, you did.
- You look good. - I feel like my face and my neck hurts.
Oh. Your eye looks good.
Yeah. That's okay.
What color is my gray suit? I'll shut up.
You look good.
You're in pain?
Yeah, my arms hurt, and my back--
- You're still having the pain? - Yeah.
Boom.
Thanks, John.
I see you there, enjoying that food.
- He's rude. - Yeah.
- Day is here. - Yeah.
It's a good day to bring life into the world.
Let's take a peek at baby.
- A hand.
- A little finger.
Some toes, here.
Yeah, that's exactly where the foot has been all this time.
Right under.
- Baby looks good. - Yeah.
- Just waiting to come out. - Yeah. Want to hold him already.
Okay, so we gotta talk consent.
So we talked about possible risk of shoulder dystocia,
of baby's head delivering and the shoulder getting stuck.
We talked about birth injury for the baby,
injury to you if there is shoulder dystocia.
And considering all of those things, you decided to proceed with C-section.
Okay.
I've read through your chart a little bit.
Just quickly, you had suffered some head trauma in a motor vehicle accident?
Yes, from the ambulance accident in 2013.
But the only thing I have is, like, the tremors sometimes with the hand.
- You can ask questions anytime. - I talk a lot, so--
- They have medication for that too.
Do you have some of that medication to go?
No!
Oh, you want a doggy bag?
Hello. I hope you're this cheerful when it's game time.
You know, I feel like part of it is like,
I'm anxious and, like, I'm nervous. Yeah.
Don't be a hero.
- Tell them when you're in pain, okay?
- Don't be like me. Be better than me. - Yeah.
It's a lot of emotions, um...
I've been with the system for, what, 16 years?
I've been a nurse for 14, been with SkyHealth for seven,
and over a vaccination mandate is how my career here is gonna...
Gonna end.
- Adapt, improvise, and overcome. - That's right.
In my point of view, there's no longevity studies on fetuses or babies.
I kind of want to be comforted with a couple of years behind that to say,
"Yeah, okay, I feel comfortable with the vaccine,
that it doesn't do anything negative to a baby that I have."
It's frustrating because I worked a lot during COVID.
You think about the things that you bust your ass for,
you sacrifice so much, especially working during the pandemic, you know?
You watch people come into the ER waiting room
and just die right in front of you, and it's not just a job at that point.
You're putting everything into taking care of these patients.
My cleaning lady, I got her a vaccine appointment.
I've been helping out some people get vaccine appointments in Jersey.
It's such a weird thing that now I have to ask people,
"Are you vaccinated?" I have one friend that's not comfortable,
and I don't want to put her in that position. I don't want to ask her.
Like, I don't know. Such a weird time.
I want to socialize. I've been so conservative about it.
Hi, Gloria.
I was reading your triage note briefly.
It said something about your apartment having a fire?
The microwave was on fire.
I was sleeping when it happened.
It was up to the ceiling.
Oh, I see.
It was scary because I couldn't get anybody.
Okay. Did the ambulance come?
- Yeah. - And the firefighters?
About 20 trucks outside in the street.
Before the fire, were you doing fine?
I've been doing fine.
Okay, so do you have any pets in the apartment?
- No. - Great.
Could you show me your face? Just want to make sure there's--
Can you show me your teeth? Okay. Any difficulty speaking tonight or--?
- A little bit. - A little bit? Okay.
And have you been vaccinated?
- Yes, twice. - Okay, great.
You know, we can't safely discharge her. She doesn't have an apartment, possibly.
She may be minimizing the situation,
but she did say that the apartment's completely destroyed,
so is she going to have a home after this? And for how long?
Can she get her belongings? So, yeah, we'll see.
The apartment was on fire. Are you sure you didn't get any smoke inhalation?
I probably got some, but I must leave.
- You want to go? - Yes, I wasn't injured. I must go.
I'm very irritated now. I must go.
Okay. What's making you upset? You can tell me.
I don't want analysis. What's making me upset?
I've been through a trauma this evening, and I don't want to be here.
I want to go.
Okay. Can we have somebody come pick you up?
- Probably. - That would be better.
Let's press green for talk.
You know, I feel like the medicine is the easy part.
We went to medical school, we trained to do the medicine.
For me, it's always harder with the social aspects of patients in the ER
because you're met with these situations where they're hanging on.
Okay. Alright, my dear.
Her daughter's coming to get her.
Her daughter said she was in the apartment and the fire was unbelievable.
Like, it was everywhere.
The whole building was up in smoke, apparently,
so I'm surprised I didn't get more people from there, but who knows?
I still want to scan her head and make sure she doesn't have
some type of acute something going on, but numbers look fine.
Wonder where my food went.
You're a very strong woman.
You're a superhero who saves lives.
Every day in the ambulance.
And during nine months, you saved lives
with our little guy.
Thank you for helping me with everything.
I'm very proud of you.
Very much.
Well, I know you're going to be okay, my love.
In just a few...
Yeah, we're close to holding him.
- I love you, Mother.
- May God bless you both. - Amen.
- Amen, Mami. - And thank you.
Thank you for that baby.
- There? - There's your little nephew.
I also prayed this morning.
- Thank you, Julie. - Thank you so much, Julie.
Thank you so much for your support and love.
- Bye-bye. - Love you guys.
You ready to rock?
Okay.
- Relax, okay? I love you. - See you there.
- Thank you for everything. - Your partner's here.
- She has her own fan club here. - Yes, she does.
They're not gonna help raise the baby?
They are.
Isn't there a college fund already set?
Bye, Grace. Bye.
It really takes a village to raise a kid because you've got to--
Sure.
- JB. - Yeah, hold on.
John. Come here for one sec. Baker?
So JB's running the department, okay, in my absence.
If there's things he's uncomfortable with that he wants to run by me, great.
If not, they're his decisions, okay?
So meetings, chairman meetings, blah blah blah,
he needs to be invited on the email chain.
Good. We're gonna rearrange the whole department.
Terrific. It's set up that way.
So what's the plan from here?
I'm gonna decide about surgery today, and I want to do it tomorrow if they can.
I'd like to.
Oh, ay, ay. Drama.
You know, we'd spent eight years together building this.
I thought of both of our lives,
just flash through, like, everything we built was, in an instant,
you know, over, in a way.
Because what good am I here without David?
So I don't have my partner across the hall.
So there's that hole that sort of can't be filled.
Is that normal in the neck?
- Everything is normal. - Okay.
And you'll feel better in a moment.
A little nausea?
Yeah. I feel like I'm gonna vomit, yeah.
That could happen, but hopefully not now.
Okay, Vicky, you won't see me, but you'll hear me.
I don't feel good.
Poor bunny.
Good. They've tested already. You're nice and numb, okay?
Everything's okay.
Incision.
Let's do this nice and bloodlessly.
So, have a seat.
My queen, I'm right here.
- Nice deep breaths. - I'm here, love.
- She got nauseous. - I'm right here.
Good. Kochers.
What's going to be his name?
Mauricio Andrés.
Mauricio Andrés?
He's coming.
- We did it, my love. - Take that down.
Huh?
- And like that. - Try to relax.
Just like that. Very good.
You're my warrior princess.
- You're doing a great job, my love. - I'll take a Rich.
And everyone that's here with us.
Incision?
- You done? - Yeah, that's good.
Gonna feel pushing and pulling, and we're gonna have a baby.
- Yeah, you're about to be a mother. - And if you would.
Our little chubby guy is almost here.
He's coming.
- He's almost here. Relax. - Nice ear there.
Table down.
- Is it coming? - Yep.
Here comes our little boy. Here comes Mauricio.
- Here comes Mauricio. - Yeah...
Here he comes.
And there's Mauricio!
There we are.
Congratulations, my love.
- That.
- Alright, lower the drape. Yup.
There he is. And the baby, there he is. Alright? Good.
- You have a beautiful baby. - Alright.
Yeah? Good, there he goes. Nice and pink.
Happy birthday!
Congratulations, guys.
Congratulations, Mom.
You did good.
He's really big.
My love, look who's here.
She's on the phenylephrine. She's getting her fluids.
You know.
- I know you're hungry.
Do you want chocolate?
That's good. Alright.
We're going to go eat good food.
I love you so much.
Look, look!
- Oh! - Look! Look at him!
Alright, Dr. Langer, we're going to put a mask on you for transport.
It's hard to believe.
Here I am as a neurosurgeon with a spinal cord injury,
not that long ago unable to move anything,
face down in the snow,
assuming my life was over.
Contemplating not being able to walk down the aisle
at my daughter's wedding someday.
And then being here at my home, in my own hospital,
asking my partners to save my life, in a way.
It's super dangerous, and a lot's at stake.
Life is very fragile.
It's precious.
So cute.
Good luck, Dr. Langer!
Thank you.
Alright, let's do this.
Alright, we ready for a time-out.