1 00:00:11,720 --> 00:00:15,472 Good morning. It's 6 a.m. on a beautiful morning in Boston. 2 00:00:15,682 --> 00:00:16,932 These are the top stories: 3 00:00:17,100 --> 00:00:21,228 Mayor White's assistant has met with the Redevelopment Authority... 4 00:00:21,438 --> 00:00:24,398 ...over the controversy on the Town Heights project. 5 00:00:25,233 --> 00:00:28,277 Saugus: Police have arrested contractor James McManus... 6 00:00:28,486 --> 00:00:31,071 ...on $23 million graft and bribery charges... 7 00:00:31,281 --> 00:00:35,743 ...in connection with the Mystic River extension. Hyannis Port... 8 00:00:47,547 --> 00:00:50,507 Mrs. Levine is day five post-cholecystectomy. 9 00:00:50,717 --> 00:00:54,636 She remains afebrile and her previous anorexia is gone, draining well. 10 00:00:54,804 --> 00:00:58,182 An AP chest film is clear. Her white count is nine-four. 11 00:00:58,391 --> 00:01:01,727 BUN has stabilized at 40.2, good output of 1600cc's. 12 00:01:01,936 --> 00:01:03,937 - Blood cultures? - No growth times two. 13 00:01:04,397 --> 00:01:07,524 Well, Harris can't nail us on this one. 14 00:01:07,734 --> 00:01:08,817 Next case. 15 00:01:12,906 --> 00:01:15,699 - It was a long time ago. - And is he good? 16 00:01:15,909 --> 00:01:18,202 Yeah, he can really break it up! 17 00:01:18,411 --> 00:01:19,870 Billy's weird. 18 00:01:20,080 --> 00:01:21,663 He gets so tired. 19 00:01:21,831 --> 00:01:23,415 Do you like this lipstick? 20 00:01:23,708 --> 00:01:24,833 She was terrific. 21 00:01:25,043 --> 00:01:26,835 It's 32 now and going fast. 22 00:01:27,045 --> 00:01:28,629 He can't afford to get out. 23 00:01:28,838 --> 00:01:31,131 I got a thousand shares of that. 24 00:01:32,092 --> 00:01:36,428 We have to have the AP, lateral and 10 units done before they can begin. 25 00:01:36,638 --> 00:01:39,348 It says here, type and cross-match was done yesterday. 26 00:01:39,557 --> 00:01:41,934 Just standard workup procedure. 27 00:01:42,268 --> 00:01:43,310 Well, I don't know. 28 00:01:43,520 --> 00:01:46,021 So it was a clear case of endocarditis. 29 00:01:46,189 --> 00:01:48,357 We're ready when you are, Dr. Wheeler. 30 00:01:48,525 --> 00:01:49,942 No response to antibiotics. 31 00:01:54,405 --> 00:01:55,531 Cut her, okay? 32 00:01:55,698 --> 00:01:58,117 - Sponge. - Begin to tie off. 33 00:02:04,207 --> 00:02:06,250 It's all politics. Today, for instance... 34 00:02:06,459 --> 00:02:11,255 ...Rudnick says to me, "I hear you're the new chief resident in surgery." 35 00:02:11,464 --> 00:02:14,049 - That's great! - He was testing me. 36 00:02:14,217 --> 00:02:16,343 Then he says that Harris told him... 37 00:02:16,553 --> 00:02:19,847 ...that Mark Bellows was going to be the next chief resident. 38 00:02:20,056 --> 00:02:22,224 - Wonderful, Mark. - But here's the thing. 39 00:02:22,433 --> 00:02:26,478 He waited for me to say I knew about it. That wouldn't look right. 40 00:02:26,688 --> 00:02:29,982 That would look as if I expected it. So I said I hadn't heard anything. 41 00:02:30,150 --> 00:02:33,152 Heh. You've wanted it for two years. 42 00:02:33,361 --> 00:02:36,321 But there's no point in saying that, is there? 43 00:02:36,531 --> 00:02:37,739 I said, uh... 44 00:02:37,907 --> 00:02:40,659 ...I thought it'd be wonderful if it happened. 45 00:02:40,869 --> 00:02:43,245 I said Chandler was doing an excellent job as chief resident. 46 00:02:44,914 --> 00:02:47,457 But I said there was a little room left for improvement. 47 00:02:47,667 --> 00:02:49,501 Chandler's damn good. 48 00:02:50,670 --> 00:02:52,921 I really laid it on thick with old Rudnick. 49 00:02:53,089 --> 00:02:57,634 I told him I was following his hepatic research, cited some references. 50 00:02:57,844 --> 00:02:59,511 He was impressed. 51 00:02:59,721 --> 00:03:01,930 Procedure went well too. 52 00:03:02,098 --> 00:03:04,600 So all in all, it was a good day. 53 00:03:05,310 --> 00:03:08,854 I'm gonna take a shower. Can you grab me a beer before dinner? 54 00:03:09,063 --> 00:03:10,397 Hey, Mark. 55 00:03:10,607 --> 00:03:11,732 Get your own beer. 56 00:03:12,108 --> 00:03:15,235 - Honey, for chrissakes, come on. - I want to take a shower. 57 00:03:15,445 --> 00:03:17,696 - I was on call last night. - So was I. 58 00:03:17,906 --> 00:03:19,531 I know, but I had two arrests... 59 00:03:19,741 --> 00:03:22,868 ...aortic aneurysm blew at 4 a.m., had to be done stat. 60 00:03:23,077 --> 00:03:25,871 So I didn't get any sleep, and I'd really like to take a shower. 61 00:03:29,083 --> 00:03:31,043 If you don't mind. 62 00:03:31,252 --> 00:03:32,961 I had a hard day too. 63 00:03:34,297 --> 00:03:37,090 You get in the shower faster than any person alive. 64 00:03:37,550 --> 00:03:39,551 Have a beer. You'll feel better. 65 00:03:42,805 --> 00:03:45,140 I know what'd make me feel better. 66 00:03:45,350 --> 00:03:47,392 Goddamn doctors. 67 00:03:48,228 --> 00:03:50,812 Couldn't have fallen in love with a nurse. 68 00:03:53,650 --> 00:03:55,859 Dorothy on the eighth floor. 69 00:03:56,819 --> 00:03:58,487 She liked me. 70 00:04:00,782 --> 00:04:01,823 My own apartment. 71 00:04:05,662 --> 00:04:07,663 Did you hear about Louis? 72 00:04:07,872 --> 00:04:09,039 What about Louis? 73 00:04:09,249 --> 00:04:12,000 They passed him up as assistant professor. 74 00:04:12,168 --> 00:04:15,504 Guy's really paid his dues too. Now they don't take him. 75 00:04:15,672 --> 00:04:18,757 Plus his son is waiting for a kidney transplant. 76 00:04:19,217 --> 00:04:20,842 Did you start dinner? 77 00:04:22,345 --> 00:04:23,428 What? 78 00:04:23,638 --> 00:04:24,805 Did you start dinner? 79 00:04:25,014 --> 00:04:29,685 - Did you hear anything I said? - It's in the fridge. Just heat it up. 80 00:04:29,852 --> 00:04:34,106 - I was telling you about my day. - I had a hard day too. 81 00:04:34,774 --> 00:04:36,733 Just go heat it up. 82 00:04:37,026 --> 00:04:40,821 Why is it, whenever we're about to fight, you're always undressed? 83 00:04:41,030 --> 00:04:43,740 What's the big deal? Just heat up the stew. 84 00:04:43,950 --> 00:04:46,743 - Why won't you help out? - Is that the way you see it? 85 00:04:46,953 --> 00:04:49,705 I make my concessions. You always take a shower first. 86 00:04:49,914 --> 00:04:53,500 - I don't. - You do too, and I'm getting tired of it. 87 00:04:55,211 --> 00:04:57,296 - Honey, come on. - Don't call me honey. 88 00:04:57,505 --> 00:05:01,091 I'm trying to tell you about my day. Something that happened. 89 00:05:01,301 --> 00:05:03,760 Your days are always the same. 90 00:05:05,722 --> 00:05:07,431 What is that supposed to mean? 91 00:05:07,640 --> 00:05:09,558 Just politics, that's all. 92 00:05:09,726 --> 00:05:12,728 Who said what to whom. Who's rising, who's falling. 93 00:05:12,937 --> 00:05:15,605 Who's made a good move, a bad move. Politics! 94 00:05:15,815 --> 00:05:18,692 Somebody has to be interested in hospital politics. 95 00:05:18,901 --> 00:05:20,027 You certainly are not. 96 00:05:20,236 --> 00:05:23,363 I thought you were a surgical resident, not a political one. 97 00:05:23,906 --> 00:05:25,574 I like politics. 98 00:05:25,742 --> 00:05:28,952 They interest me. Just because you're always looking for— 99 00:05:29,537 --> 00:05:31,705 You want me to heat up the dinner, is that it? 100 00:05:32,749 --> 00:05:34,916 I want some respect. 101 00:05:35,126 --> 00:05:37,586 Susan, come on. Don't leave again. 102 00:05:38,046 --> 00:05:40,172 Why can't you share half the responsibility? 103 00:05:40,381 --> 00:05:42,549 I share more than half the responsibility! 104 00:05:42,759 --> 00:05:45,010 - No need to shout. - Why are you running off? 105 00:05:45,219 --> 00:05:48,055 You think I want this? Let me tell you something. 106 00:05:48,264 --> 00:05:50,766 I make concessions for this so-called relationship. 107 00:05:50,975 --> 00:05:53,810 - I know it's hard on you politically. - I also want you to— 108 00:06:00,818 --> 00:06:01,902 Susan, don't go. 109 00:06:04,197 --> 00:06:06,323 You know what the trouble with you is? 110 00:06:06,532 --> 00:06:08,950 All you care about is being chief resident. 111 00:06:09,160 --> 00:06:12,704 You know what your trouble is? You don't want a relationship. 112 00:06:12,914 --> 00:06:15,123 Look at you. You run away from it. 113 00:06:15,333 --> 00:06:17,000 This is ridiculous. 114 00:06:17,752 --> 00:06:19,252 You don't want a lover... 115 00:06:19,462 --> 00:06:21,505 ...you want a goddamn wife! 116 00:07:03,089 --> 00:07:04,548 Bastard. 117 00:07:15,518 --> 00:07:18,353 Hmm. I have a bleeder here. 118 00:07:18,521 --> 00:07:21,022 - I need more suction. - Clamp. 119 00:07:24,694 --> 00:07:28,155 He's not di-toxic. He has advanced ASHD. 120 00:07:30,575 --> 00:07:32,701 I just bought some at 43. 121 00:07:32,869 --> 00:07:36,371 Yeah, I hear they have management problems. I sold at 37. 122 00:07:38,624 --> 00:07:40,667 - Hi. - Hi. 123 00:07:41,210 --> 00:07:42,836 - How are you? - Mm-hm. 124 00:07:43,045 --> 00:07:45,046 I'm fine. The case went well. No problem. 125 00:07:45,256 --> 00:07:46,590 Good. 126 00:07:47,925 --> 00:07:50,802 I'm really sorry about last night. 127 00:07:51,012 --> 00:07:52,554 So am I. 128 00:07:52,763 --> 00:07:55,432 - You want to have some lunch? - I have class. 129 00:07:55,641 --> 00:07:58,477 You don't think this is more important than the class? 130 00:07:58,686 --> 00:08:02,481 Mark, that class is the only time I get out of this damn hospital. 131 00:08:02,690 --> 00:08:05,358 Can you understand that? It's important to me! 132 00:08:06,068 --> 00:08:07,444 You're impossible! 133 00:08:07,653 --> 00:08:09,237 Seven, eight, step! 134 00:08:12,408 --> 00:08:14,242 Back. Step. 135 00:08:15,411 --> 00:08:16,578 Out! 136 00:08:18,664 --> 00:08:22,083 One, two, down three, up four and open. 137 00:08:22,835 --> 00:08:25,462 And one and two, three and four. 138 00:08:25,755 --> 00:08:27,214 Stretch. 139 00:08:27,965 --> 00:08:29,758 Walk two, three, four... 140 00:08:29,967 --> 00:08:33,470 ...and five and six, seven, eight and back. 141 00:08:33,679 --> 00:08:36,556 - You gonna leave Mark? - I don't know. 142 00:08:36,766 --> 00:08:37,933 I went home last night. 143 00:08:38,601 --> 00:08:39,643 Again? 144 00:08:41,062 --> 00:08:42,812 He's impossible. 145 00:08:43,606 --> 00:08:45,732 Did you see Dr. Richards? 146 00:08:45,983 --> 00:08:48,527 - And? - I don't know. 147 00:08:48,736 --> 00:08:53,031 Apparently you can tell by looking at the cervix. It's a different color. 148 00:08:53,241 --> 00:08:57,202 He did the lab tests and he says I'm definitely 8 to 10 weeks pregnant. 149 00:08:57,411 --> 00:09:00,747 So Dr. Richards is doing a D and C tomorrow. 150 00:09:01,582 --> 00:09:04,543 - For menstrual irregularity. - Mm-hm. 151 00:09:05,836 --> 00:09:06,878 It's simple, isn't it? 152 00:09:07,588 --> 00:09:09,047 Are you worried? 153 00:09:09,632 --> 00:09:13,426 I know you do this every day but, sure, I'm worried. Who wouldn't be? 154 00:09:13,970 --> 00:09:17,055 It'll be fine, Nancy. It's routine procedure. 155 00:09:24,063 --> 00:09:25,814 We're going to the Ice Capades. 156 00:09:26,649 --> 00:09:28,858 - It's real crowded. - Patient on call? 157 00:09:29,068 --> 00:09:32,654 - Coming right down, Dr. Cowans. - The instruments are autoclaved. 158 00:09:32,863 --> 00:09:35,532 Let's teach you fellas some anesthesiology. 159 00:09:35,741 --> 00:09:37,325 This is your standard anesthesia. 160 00:09:37,535 --> 00:09:42,122 You've got two main wall lines. Nitrous oxide on the left and oxygen. 161 00:09:42,331 --> 00:09:44,541 We got a case today that's a D and C. 162 00:09:44,750 --> 00:09:48,086 It's one of Dr. Richard's cases. Actually, it's a TAB. 163 00:09:48,296 --> 00:09:52,716 That's a therapeutic abortion. Keep it clean. It's a married patient. 164 00:09:53,509 --> 00:09:55,844 On the cart here, we got two manometers... 165 00:09:56,012 --> 00:09:59,264 ...with flow valves here and here to regulate gas. 166 00:09:59,473 --> 00:10:01,808 We got emergency oxygen down here... 167 00:10:02,018 --> 00:10:04,519 ...which we checked and that's full. 168 00:10:04,729 --> 00:10:08,315 During surgery, we'll be recording this and the vital signs. 169 00:10:08,524 --> 00:10:09,649 Hey, how is Bess? 170 00:10:09,859 --> 00:10:11,109 I don't know. 171 00:10:11,319 --> 00:10:12,694 In and out. 172 00:10:13,613 --> 00:10:14,654 Yeah. 173 00:10:14,822 --> 00:10:17,657 Boy, she has more rails than anybody I know. 174 00:10:17,867 --> 00:10:19,200 She's seeing a shrink now. 175 00:10:19,410 --> 00:10:21,119 One, two, three, up! 176 00:10:21,329 --> 00:10:23,538 - Anybody we know? - Mm-mm. 177 00:10:23,706 --> 00:10:27,125 Morning, Nancy. Remember me? I'm Dr. Cowans. 178 00:10:28,044 --> 00:10:29,044 Dr. Cowans. 179 00:10:29,211 --> 00:10:32,213 That's right, dear, and you'll have a nice long sleep. 180 00:10:32,423 --> 00:10:35,717 Pre-op, she's received a 0.01 of Demerol and 0.4 of atropine... 181 00:10:35,885 --> 00:10:38,178 ...so believe me, she's pretty relaxed. 182 00:10:38,387 --> 00:10:42,932 I'll say she's relaxed! Come on, Mrs. Greenly, on your back. 183 00:10:43,142 --> 00:10:44,434 That's it. 184 00:10:44,644 --> 00:10:47,312 - Gonna meet me for lunch? - I don't know. 185 00:10:47,521 --> 00:10:50,065 - I'll let you know, okay? - Okay. 186 00:10:50,483 --> 00:10:51,941 - I'll be in the lounge. - Yeah. 187 00:10:52,151 --> 00:10:55,403 Henry might be calling, and if he does, you know... 188 00:10:55,571 --> 00:10:58,448 - Okay, no problem. - Yeah, okay. 189 00:10:59,241 --> 00:11:02,327 - Afternoon, Tom. - Afternoon, Jim. How's our lady? 190 00:11:02,536 --> 00:11:05,080 - Just about ready. - I'm still awake. 191 00:11:05,289 --> 00:11:07,582 - But not for long, dear. - You promise? 192 00:11:07,792 --> 00:11:10,877 I'll induce with sodium Pentothal, give an IV by syringe. 193 00:11:11,087 --> 00:11:12,629 Nance, what I want you to do... 194 00:11:12,838 --> 00:11:16,591 ...is start counting from 100 backwards real slow, okay? 195 00:11:17,093 --> 00:11:18,718 Here we go. 196 00:11:18,928 --> 00:11:21,930 - A hundred. - Ninety-nine... 197 00:11:22,723 --> 00:11:24,432 ...ninety-eight... 198 00:11:25,434 --> 00:11:27,268 ...ninety-seven... 199 00:11:28,145 --> 00:11:29,938 ...ninety-six... 200 00:11:31,982 --> 00:11:34,109 It's quick. Stop the pentothal. 201 00:11:34,318 --> 00:11:36,611 You see, pentothal isn't really an anesthetic. 202 00:11:36,821 --> 00:11:39,531 Any deep pain right now and she'd wake right up. 203 00:11:39,740 --> 00:11:42,534 What we need for anesthesia is gas. 204 00:11:42,743 --> 00:11:45,120 First I'll inject some succinylcholine. 205 00:11:45,329 --> 00:11:49,374 I want you to watch her chest gauge because she'll stop breathing. 206 00:11:53,003 --> 00:11:56,548 She's now experiencing complete muscular paralysis. 207 00:11:56,757 --> 00:11:59,884 She's got three minutes to breathe or she'll suffocate. 208 00:12:00,094 --> 00:12:01,928 So now we intubate. 209 00:12:02,513 --> 00:12:04,723 Taking a laryngoscope like so. 210 00:12:04,932 --> 00:12:06,850 Hold her head in an extended position. 211 00:12:07,059 --> 00:12:10,603 Enter laterally, put up the base of the tongue, up and out... 212 00:12:10,813 --> 00:12:12,355 ...visualizing the trachea. 213 00:12:12,565 --> 00:12:14,941 There it is, fellas. Take a look. 214 00:12:15,609 --> 00:12:17,485 You see it? It's right over there. 215 00:12:19,029 --> 00:12:20,864 Come on, guys! 216 00:12:21,073 --> 00:12:25,869 Take our tube and enter here. So. 217 00:12:26,036 --> 00:12:29,289 In the middle of surgery, I'll switch over to the telothane. 218 00:12:31,000 --> 00:12:33,126 - Stirrups up? - Yeah. 219 00:12:34,920 --> 00:12:36,337 How is John? 220 00:12:36,547 --> 00:12:40,175 His fever broke today. He'll go back to school tomorrow. 221 00:12:40,342 --> 00:12:42,260 Now we can check the pupillary reflexes. 222 00:12:42,470 --> 00:12:45,972 Though she's unconscious, the pupils should react to light... 223 00:12:46,182 --> 00:12:48,558 ...and let us know that the old brain is okay. 224 00:12:48,768 --> 00:12:53,563 That's it. Anesthesia's the easiest job in the world until something goes wrong. 225 00:12:53,773 --> 00:12:57,192 It's 99% boredom and 1% scared-shitless panic... 226 00:12:57,443 --> 00:13:01,613 ...which we try to avoid. The patient's yours, Dr. Richards. 227 00:13:01,822 --> 00:13:03,531 If you move in behind me... 228 00:13:03,699 --> 00:13:06,868 ...you'll see what I am going to do for this young woman. 229 00:13:07,036 --> 00:13:08,077 Some music, please. 230 00:13:10,748 --> 00:13:14,709 Actually, what I'm going to do is get her out of a hell of a mess. 231 00:13:15,336 --> 00:13:16,669 She's pregnant. 232 00:13:16,879 --> 00:13:19,255 She doesn't want her husband to know. 233 00:13:20,508 --> 00:13:22,550 It's none of my business. 234 00:13:23,052 --> 00:13:26,012 I'm just her surgeon. I don't run her life. 235 00:13:28,182 --> 00:13:30,725 So in fact, our task is simplified... 236 00:13:30,935 --> 00:13:33,686 ...when the uterus is anteverted and anteflexed. 237 00:13:33,896 --> 00:13:37,816 This is a function of the muscular attachments, of which there are five. 238 00:13:38,025 --> 00:13:39,067 You should know them. 239 00:13:39,944 --> 00:13:43,780 They're the broad ligaments, the round and cardinal ligaments... 240 00:13:43,989 --> 00:13:47,367 ...and the endopelvic fascia, the uterosacral ligaments. 241 00:13:47,576 --> 00:13:49,994 Again, part of the endopelvic fascia. 242 00:13:52,998 --> 00:13:55,124 - Something wrong? - Yeah. 243 00:13:55,292 --> 00:13:58,294 She just threw a PVC, and her blood pressure's falling. 244 00:13:58,963 --> 00:14:00,713 I got 90 over 60. 245 00:14:00,923 --> 00:14:04,008 She's fully oxygenated. Red as a cherry down here. 246 00:14:04,218 --> 00:14:06,344 Uh, how much longer you got? 247 00:14:07,805 --> 00:14:09,138 Just a couple of minutes. 248 00:14:09,348 --> 00:14:11,933 I don't like this. Her blood pressure is still falling. 249 00:14:14,061 --> 00:14:15,103 Damn! 250 00:14:15,271 --> 00:14:19,023 We should stop. She may be getting too much vagal stimulation. 251 00:14:19,233 --> 00:14:20,608 Jesus Christ. 252 00:14:20,818 --> 00:14:24,112 - What's the matter? - I don't know. Nothing's the matter! 253 00:14:24,321 --> 00:14:26,531 Something's the matter. She's going to arrest! 254 00:14:26,740 --> 00:14:27,782 I can't find anything! 255 00:14:44,800 --> 00:14:47,594 I get a 100 over 80. Her pressure's climbing. 256 00:14:47,803 --> 00:14:51,472 Let's finish up. I'd like to get this mother off the table. 257 00:14:53,976 --> 00:14:55,768 Sponge, please. 258 00:14:58,814 --> 00:15:02,233 One-twenty over 80 and climbing. She's okay. 259 00:15:04,028 --> 00:15:07,739 - These tissues go to pathology. - Can I start bringing her out? 260 00:15:07,948 --> 00:15:09,449 Yeah, bring her out, Jim. 261 00:15:14,455 --> 00:15:17,540 Okay, Mrs. Greenly, it's time to wake up. 262 00:15:17,875 --> 00:15:19,334 Okay, Nancy? 263 00:15:19,501 --> 00:15:22,170 Mrs. Greenly? Wake up. 264 00:15:22,588 --> 00:15:25,340 Nance, can you give me a cough, please? 265 00:15:26,800 --> 00:15:28,509 Nancy? 266 00:15:39,939 --> 00:15:44,233 Oh, Jesus Christ! Her pupils are fixed and dilated. 267 00:15:44,443 --> 00:15:47,820 - What? - The pupils, they're fixed. 268 00:15:48,405 --> 00:15:49,906 Dilated. 269 00:15:53,953 --> 00:15:56,120 Oh, my God! 270 00:15:56,997 --> 00:16:00,458 Pre-op diagnosis, acute gastric ulceration. 271 00:16:00,668 --> 00:16:03,044 Post-op diagnosis, the same. 272 00:16:03,545 --> 00:16:06,172 Surgeon, Dr. Wilson. 273 00:16:06,340 --> 00:16:08,383 Anesthesia, general... 274 00:16:08,550 --> 00:16:11,594 - Where's Schwartz? Cholecystectomy? - Bed three. 275 00:16:14,139 --> 00:16:18,059 - Mr. Schwartz, I'm Dr. Bellows. - You don't got to talk so loud. 276 00:16:18,227 --> 00:16:19,435 - How you feel? - Ehh. 277 00:16:19,645 --> 00:16:20,770 Just "eh"? 278 00:16:20,980 --> 00:16:23,564 You want to get on your side for me, please? 279 00:16:23,774 --> 00:16:26,484 - On your side. - Speak up, I can't hear you. 280 00:16:26,694 --> 00:16:29,237 What'd they give you in that operating room? 281 00:16:29,446 --> 00:16:30,780 Do you have any pain? 282 00:16:30,990 --> 00:16:34,283 If I had any pain, I would go see a doctor. 283 00:16:34,660 --> 00:16:37,245 Now you want to breathe for me real easy? 284 00:16:38,872 --> 00:16:40,832 That's it. Slowly. 285 00:16:41,000 --> 00:16:42,750 She was given 4 milligrams narceine... 286 00:16:42,918 --> 00:16:45,211 ...to rule out idiosyncratic hyper susceptibility... 287 00:16:45,379 --> 00:16:46,796 - ...to pre-op narcotic... - Easy! 288 00:16:47,006 --> 00:16:49,882 Two units without effect, a few peripheral fasciculations. 289 00:16:50,092 --> 00:16:51,759 So it's not succinylcholine? 290 00:16:53,637 --> 00:16:56,222 Delayed return of consciousness of cryptogenic origin. 291 00:16:58,851 --> 00:17:02,311 I see no reason not to transfer her to the intensive care unit. 292 00:17:02,521 --> 00:17:04,814 Mr. Schwartz, you're gonna be fine. 293 00:17:05,024 --> 00:17:06,649 That's what you think! 294 00:17:09,528 --> 00:17:13,531 - A grim prognosis, to say the least. - Rather tragic. 295 00:17:13,741 --> 00:17:15,575 Someone should notify Dr. George. 296 00:17:15,784 --> 00:17:18,077 He'll want to review the anesthetic protocol. 297 00:17:18,287 --> 00:17:20,288 Right, he's been paged. 298 00:17:20,456 --> 00:17:22,540 Looks like another anesthetic reaction. 299 00:17:24,668 --> 00:17:27,587 Page Dr. Bendix, 44432. 300 00:17:27,755 --> 00:17:28,796 Check. 301 00:17:28,964 --> 00:17:30,840 George is not here. 302 00:17:31,050 --> 00:17:34,218 No, Dr. Bendix. Bendix! 303 00:17:34,428 --> 00:17:37,096 Maybe he left the hospital. Try his office. 304 00:17:38,307 --> 00:17:40,683 Could you page Dr. Wheeler, please? 305 00:17:40,893 --> 00:17:44,187 So you see, Jimmy, your kidneys are sick. 306 00:17:44,396 --> 00:17:45,563 They don't work right. 307 00:17:45,773 --> 00:17:49,317 We need to take out the sick kidneys and put in a new one. 308 00:17:49,485 --> 00:17:53,488 - Today? - No, not today. We have to wait until... 309 00:17:53,655 --> 00:17:56,824 - ...there's a kidney we can put in. - Tomorrow? 310 00:17:57,326 --> 00:18:00,369 I don't know when. But it could be a while. 311 00:18:01,997 --> 00:18:05,291 Dr. Wheeler, call extension 3-5-6. 312 00:18:05,501 --> 00:18:08,461 You can have one of these. Which color do you like? 313 00:18:10,339 --> 00:18:11,380 Purple. 314 00:18:12,007 --> 00:18:13,007 Take two. 315 00:18:13,217 --> 00:18:15,051 I like purple. 316 00:18:15,594 --> 00:18:17,637 I can see that. 317 00:18:22,434 --> 00:18:23,935 I like red too. 318 00:18:25,395 --> 00:18:27,063 Dr. Wheeler. 319 00:18:28,357 --> 00:18:36,697 Yes. 320 00:18:37,449 --> 00:18:38,533 Um— 321 00:18:38,700 --> 00:18:42,036 Excuse me, I have to go to intensive care now. 322 00:18:42,246 --> 00:18:44,038 A nurse should be right in. 323 00:18:45,791 --> 00:18:47,625 Surgical ICU. 324 00:18:55,676 --> 00:18:57,218 What's her status? 325 00:18:57,511 --> 00:19:00,638 Greenly? Complete squash rot. 326 00:19:00,848 --> 00:19:02,515 She's a total Gomer. 327 00:19:03,559 --> 00:19:04,892 It's brain death. 328 00:19:17,739 --> 00:19:21,701 That patient was transferred to the Jefferson Institute yesterday. 329 00:19:57,863 --> 00:19:59,906 How can this happen? 330 00:20:00,782 --> 00:20:02,074 All this... 331 00:20:10,417 --> 00:20:12,251 Did you do an EEG? 332 00:20:12,794 --> 00:20:13,836 Flat. 333 00:20:14,671 --> 00:20:16,380 Completely flat? 334 00:20:16,798 --> 00:20:18,507 Completely flat. 335 00:20:19,468 --> 00:20:20,968 Did you repeat it? 336 00:20:21,303 --> 00:20:22,678 No, not yet. 337 00:20:24,181 --> 00:20:26,224 What happened during the D and C? 338 00:20:26,433 --> 00:20:27,475 Nothing. 339 00:20:27,643 --> 00:20:30,353 It's an unremarkable case, according to the notes. 340 00:20:30,729 --> 00:20:32,813 Transient PVCs late in the operation. 341 00:20:33,232 --> 00:20:34,690 Nothing else. 342 00:20:35,025 --> 00:20:36,192 She never woke up? 343 00:20:37,194 --> 00:20:38,486 No. 344 00:20:40,280 --> 00:20:41,989 I want to look at her chart. 345 00:20:56,255 --> 00:20:59,465 If it were my friend, I don't know if I'd be that cool. 346 00:21:03,512 --> 00:21:05,179 The potassium was what? 347 00:21:05,555 --> 00:21:07,556 One-eight? Are you sure? 348 00:21:07,808 --> 00:21:09,558 It must be a mistake. 349 00:21:11,436 --> 00:21:12,853 Honey, I'm sorry. 350 00:21:13,063 --> 00:21:14,647 I know you two were really close. 351 00:21:18,026 --> 00:21:19,193 Susan? 352 00:21:22,698 --> 00:21:24,198 Well... 353 00:21:25,784 --> 00:21:28,661 There doesn't seem to be anything unusual in the chart. 354 00:21:28,870 --> 00:21:32,331 Normal 28-year-old patient in good health for a D and C... 355 00:21:32,541 --> 00:21:35,334 ...underwent telothane anesthesia, comes out in irreversible coma. 356 00:21:35,502 --> 00:21:37,128 Hey. Hey, Susan. 357 00:21:37,296 --> 00:21:40,339 It's well-documented that telothane causes liver damage... 358 00:21:40,549 --> 00:21:43,968 ...and severe side effects in a small percentage of surgical cases. 359 00:21:44,177 --> 00:21:48,097 - That's just the risk of anesthesia. - I know you're upset. 360 00:21:48,765 --> 00:21:50,391 I'm not upset. 361 00:21:51,518 --> 00:21:55,396 You think because I'm a woman, I'm going to be upset. I'm fine, Mark. 362 00:21:56,231 --> 00:21:59,734 I want to understand the variables as they apply to this patient. 363 00:21:59,943 --> 00:22:02,862 - I'm sure you agree that's indicated. - "This patient"? 364 00:22:03,071 --> 00:22:05,865 Here we have an ordinary, uninteresting case... 365 00:22:06,074 --> 00:22:10,703 ...of surgical reaction to telothane anesthesia in a healthy patient. 366 00:22:10,912 --> 00:22:13,748 As far as I can determine, there are no unusual aspects... 367 00:22:13,915 --> 00:22:17,043 ...except that the patient was tissue-typed. 368 00:22:17,252 --> 00:22:18,461 Tissue-typed for D and C? 369 00:22:19,838 --> 00:22:21,630 There's got to be some mistake. 370 00:22:21,840 --> 00:22:25,634 Here it is. No name on the slip and no billing number. 371 00:22:25,802 --> 00:22:27,094 The patient is stable. 372 00:22:27,262 --> 00:22:30,931 That's not the first time the lab ran a test on the wrong patient. 373 00:22:34,978 --> 00:22:38,272 Let's go home. I think you're tired. 374 00:22:39,107 --> 00:22:42,276 I think I'd better check the tissue-typing lab. 375 00:22:43,653 --> 00:22:44,695 Why? 376 00:22:48,241 --> 00:22:51,619 Nancy's problem was not caused by wrong lab tests. 377 00:22:53,789 --> 00:22:54,872 I know. 378 00:22:55,082 --> 00:22:57,124 Honey, you're grabbing at straws. 379 00:22:58,293 --> 00:22:59,835 Let's go have some dinner. 380 00:23:00,045 --> 00:23:02,088 - I'm not hungry. - We'll check the lab later. 381 00:23:02,297 --> 00:23:05,299 Stop acting as if there's something wrong with me... 382 00:23:05,467 --> 00:23:08,344 ...or the way I'm thinking! I'm checking the lab now. 383 00:23:08,553 --> 00:23:11,263 - They're closed. - I won't just stand here! 384 00:23:11,640 --> 00:23:13,891 Susan, the lab is closed. 385 00:23:14,101 --> 00:23:16,143 It closed at 6:00. 386 00:23:19,231 --> 00:23:20,272 Is she all right? 387 00:23:21,775 --> 00:23:24,402 Yeah, she just, uh... 388 00:23:25,320 --> 00:23:27,196 She likes to do things her own way. 389 00:23:37,499 --> 00:23:39,208 Who's that? 390 00:23:39,376 --> 00:23:41,419 - Dr. Wheeler. - Uh, we're closed. 391 00:23:41,586 --> 00:23:42,920 We don't do any determinations... 392 00:23:44,297 --> 00:23:45,339 ...after 6, doctor. 393 00:23:45,507 --> 00:23:47,341 I want to look at your requisition book. 394 00:23:47,509 --> 00:23:48,509 Ugh. 395 00:23:48,677 --> 00:23:51,804 What does it mean when there's no name and number on the slip? 396 00:23:52,180 --> 00:23:53,472 There's... 397 00:23:54,015 --> 00:23:57,059 There's always a name or a number, doctor. 398 00:23:57,269 --> 00:24:00,271 For example, Nancy Greenly. You did tissue-typing... 399 00:24:00,480 --> 00:24:02,731 ...but there's no physician name and billing number. 400 00:24:03,024 --> 00:24:04,358 Let me see. 401 00:24:08,029 --> 00:24:10,823 Yes, you see, it's been printed out by computer. 402 00:24:11,158 --> 00:24:12,783 That's hospital policy. 403 00:24:12,993 --> 00:24:16,996 See, uh, a certain number of these tests are randomly ordered by computer... 404 00:24:17,247 --> 00:24:18,456 ...as a quality check. 405 00:24:18,665 --> 00:24:20,666 We do the tests here, they're sent out... 406 00:24:20,876 --> 00:24:22,751 ...and done again by an outside lab. 407 00:24:22,961 --> 00:24:25,254 The computer ordered this test on Greenly? 408 00:24:26,131 --> 00:24:28,090 Yeah, central computer. 409 00:24:28,758 --> 00:24:30,468 Why don't you just show me? 410 00:24:30,677 --> 00:24:32,011 - I can't. - Why not? 411 00:24:32,387 --> 00:24:33,637 I'm not supposed to. 412 00:24:33,847 --> 00:24:35,347 It's really important. 413 00:24:37,100 --> 00:24:39,435 Anyway, that information isn't coded. 414 00:24:39,644 --> 00:24:41,687 If it isn't coded, I can't pull it out. 415 00:24:42,272 --> 00:24:43,731 I mean, who would want it? 416 00:24:43,899 --> 00:24:47,151 Well, let's say, um, I wanted a list of all the patients... 417 00:24:47,360 --> 00:24:49,236 ...who had tissue-typing in the last month. 418 00:24:49,404 --> 00:24:50,529 Same thing. Not coded. 419 00:24:50,697 --> 00:24:53,532 Oh, what do you do? What good is all this equipment? 420 00:24:53,742 --> 00:24:55,242 I thought you recorded information. 421 00:24:55,410 --> 00:24:59,747 We do, but the truth is, we install these computers to bill patients. 422 00:25:00,081 --> 00:25:02,917 We code patient name and number, medical or surgical... 423 00:25:03,084 --> 00:25:06,587 ...admission diagnosis, therapy and discharge diagnosis. 424 00:25:06,755 --> 00:25:08,589 Okay, wait a minute. 425 00:25:08,757 --> 00:25:12,092 Can you give me a list of all surgical patients... 426 00:25:12,302 --> 00:25:14,470 ...with discharge diagnoses of coma? 427 00:25:29,319 --> 00:25:31,320 Okay, we have... 428 00:25:31,530 --> 00:25:34,281 ...one general category under "coma"... 429 00:25:34,658 --> 00:25:37,910 ...and nine subcategories under "brain syndromes." 430 00:25:38,078 --> 00:25:39,119 Good. 431 00:25:39,287 --> 00:25:42,164 I want a list of all surgical patients... 432 00:25:42,374 --> 00:25:45,376 ...with general category of coma in the past year. 433 00:25:46,294 --> 00:25:47,378 Phew. 434 00:25:47,546 --> 00:25:48,629 You're sure you want it? 435 00:25:59,808 --> 00:26:01,267 I had no idea. 436 00:26:01,476 --> 00:26:03,185 It's a big hospital. 437 00:26:03,979 --> 00:26:05,813 Are you married or what? 438 00:26:08,233 --> 00:26:09,733 Thank you. 439 00:26:31,673 --> 00:26:34,550 Surgical ICU. That's right. 440 00:27:05,123 --> 00:27:06,582 Where'd you get this? 441 00:27:08,543 --> 00:27:11,920 It's against the law. It's illegal to tap a data bank. 442 00:27:12,130 --> 00:27:13,464 I don't see why. I'm a doctor. 443 00:27:13,673 --> 00:27:16,258 - I've got research— - That's not the point! 444 00:27:16,468 --> 00:27:19,887 Every officer got the lecture. No access without authorization. 445 00:27:20,055 --> 00:27:21,889 - They can throw you out. - Never mind that. 446 00:27:22,098 --> 00:27:24,558 - What do you mean "never mind"? - Mark. 447 00:27:24,976 --> 00:27:26,310 Look at this. 448 00:27:26,645 --> 00:27:28,228 Two hundred and forty names. 449 00:27:28,438 --> 00:27:31,732 Ten are young people admitted for minor procedures. 450 00:27:31,941 --> 00:27:34,693 Breast biopsy, appendectomy. 451 00:27:34,903 --> 00:27:37,905 They all come out in a coma. Aren't you surprised? 452 00:27:38,531 --> 00:27:42,409 The risk of surgical anesthesia is six per 100,000. 453 00:27:42,577 --> 00:27:46,163 In a hospital this size, 10 patients in a year is not surprising. 454 00:27:46,915 --> 00:27:48,290 So what are you doing? 455 00:27:48,500 --> 00:27:51,835 You missed your rounds. You didn't scrub in at the gastrectomy. 456 00:27:52,045 --> 00:27:53,379 I had to do something. 457 00:27:53,588 --> 00:27:55,005 Why don't you do your job? 458 00:27:57,175 --> 00:27:58,926 Surgical ICU. 459 00:27:59,219 --> 00:28:01,553 Mr. Murphy is a 35-year-old in good health... 460 00:28:01,763 --> 00:28:05,057 ...admitted for a meniscectomy. He's scheduled for this morning. 461 00:28:05,266 --> 00:28:07,434 Promises, promises. They keep telling me... 462 00:28:07,644 --> 00:28:09,436 ...there's a delay, another half-hour. 463 00:28:09,604 --> 00:28:11,897 Well, the suspense is really killing me. 464 00:28:12,107 --> 00:28:14,108 I thought you doctors liked to operate. 465 00:28:14,275 --> 00:28:16,777 - We'll get to you. - Oh, I'd hate to be left out. 466 00:28:16,945 --> 00:28:18,404 How did you get your injury? 467 00:28:18,822 --> 00:28:20,114 Playing touch football. 468 00:28:20,281 --> 00:28:22,783 You know, with the guys, horsing around. 469 00:28:24,119 --> 00:28:26,161 Dr. Wheeler, see Dr. Harris. 470 00:28:26,371 --> 00:28:28,080 See Dr. Harris in his office. 471 00:28:28,289 --> 00:28:30,457 The chief of surgery himself. 472 00:28:30,917 --> 00:28:32,960 Playing touch football, huh? 473 00:28:33,169 --> 00:28:37,131 Yeah. So I come in, and all that happens— 474 00:28:40,844 --> 00:28:42,469 Thanks very much, Herb. 475 00:28:42,679 --> 00:28:44,513 We'll get together on it later. 476 00:28:45,807 --> 00:28:46,807 Would you come in? 477 00:28:50,979 --> 00:28:52,271 Excuse me. 478 00:29:04,409 --> 00:29:06,034 Sit down, Sue. 479 00:29:12,959 --> 00:29:14,001 Yes. 480 00:29:14,169 --> 00:29:16,170 Dr. Harris, it's Senator Brooke's office. 481 00:29:16,379 --> 00:29:19,089 He wonders if you can change the meeting to 4. 482 00:29:19,299 --> 00:29:21,258 Yes, 4 is fine. Notify Henry. 483 00:29:21,468 --> 00:29:22,718 Yes, sir. 484 00:29:27,515 --> 00:29:28,932 Sue. 485 00:29:31,352 --> 00:29:35,773 I like to think that Boston Memorial is the best hospital in the city... 486 00:29:35,982 --> 00:29:37,775 ...perhaps in the country. 487 00:29:38,401 --> 00:29:40,194 I'm committed to it... 488 00:29:40,570 --> 00:29:43,697 ...to the house staff we have here, and to you. 489 00:29:43,907 --> 00:29:45,532 I think you know that. 490 00:29:45,950 --> 00:29:48,827 But we have certain constraints imposed on us. 491 00:29:49,370 --> 00:29:54,124 One is the state law concerning privacy in computer data access. 492 00:29:55,210 --> 00:29:57,211 An unauthorized entry was made last night. 493 00:29:57,420 --> 00:30:00,047 We put the young man on probation. 494 00:30:02,050 --> 00:30:06,220 But he told us he made the illegal entry on your behalf. 495 00:30:06,387 --> 00:30:07,429 That's true, sir. 496 00:30:07,722 --> 00:30:11,558 All the discharge diagnoses of coma over a 12-month period? 497 00:30:11,768 --> 00:30:15,395 - I wanted it because I had an idea— - Well, forgive me. 498 00:30:15,688 --> 00:30:19,233 But it isn't a question of why you wanted it... 499 00:30:19,526 --> 00:30:21,235 ...it's how you got it. 500 00:30:22,070 --> 00:30:25,572 I understand you have personal reasons for being under stress... 501 00:30:25,782 --> 00:30:28,325 ...for not acting as carefully as you might. 502 00:30:28,910 --> 00:30:32,871 And I'm sympathetic to the way you must feel about the, uh... 503 00:30:33,456 --> 00:30:35,249 ...uh, Greely case. 504 00:30:35,458 --> 00:30:37,167 Greenly. Nancy Greenly. 505 00:30:37,377 --> 00:30:40,379 Greenly. Yes, Nancy Greenly case. 506 00:30:43,758 --> 00:30:46,885 I certainly don't want to lose a good surgical resident. 507 00:30:51,140 --> 00:30:52,599 Well... 508 00:30:53,101 --> 00:30:55,602 I think we can handle this, Sue. 509 00:30:55,770 --> 00:30:58,730 I'll keep the, uh, evidence... 510 00:30:59,357 --> 00:31:02,067 ...and we'll forget it ever happened, all right? 511 00:31:05,196 --> 00:31:07,948 But I'd like you to see someone. 512 00:31:08,449 --> 00:31:10,325 I was thinking of Dick Morelind. 513 00:31:10,535 --> 00:31:13,203 Dr. Harris, I'm fine. I don't need a shrink. 514 00:31:13,413 --> 00:31:14,830 No, no, I know you don't. 515 00:31:15,039 --> 00:31:18,417 But it's important to have on record a talk with Dick Morelind. 516 00:31:18,626 --> 00:31:20,419 - I don't see why. - Actually... 517 00:31:20,628 --> 00:31:24,131 ...it's a precondition to your continuing on here at Memorial. 518 00:31:24,924 --> 00:31:26,550 Okay? 519 00:31:28,303 --> 00:31:29,344 I understand. 520 00:31:29,679 --> 00:31:32,472 I think it's unfair. Everybody's on my back. 521 00:31:32,640 --> 00:31:35,601 Mark's whining about how I can't make a commitment... 522 00:31:35,810 --> 00:31:38,103 ...and I'm cold, and I'm afraid of intimacy. 523 00:31:38,313 --> 00:31:40,147 Then this happens to Nancy... 524 00:31:40,315 --> 00:31:43,150 ...and she's my best friend since boarding school. 525 00:31:43,318 --> 00:31:45,986 Everyone jumps on my back, acts like I'm neurotic... 526 00:31:46,195 --> 00:31:48,155 ...and I'm not doing my job! 527 00:31:48,740 --> 00:31:50,490 There's concern about breaking the law. 528 00:31:50,783 --> 00:31:53,368 I wanted to do something. Do you understand? 529 00:31:53,578 --> 00:31:55,287 Do something right away. 530 00:31:55,496 --> 00:31:58,874 I just couldn't sit there and watch Nancy and... 531 00:31:59,500 --> 00:32:01,501 How do you feel about what happened? 532 00:32:04,797 --> 00:32:06,131 Confused... 533 00:32:06,549 --> 00:32:07,841 ...that's all. 534 00:32:08,009 --> 00:32:09,843 Just confused. 535 00:32:10,053 --> 00:32:11,803 It's very... 536 00:32:12,013 --> 00:32:13,639 ...confusing. 537 00:32:13,932 --> 00:32:17,643 I wanted to understand what happened to her. 538 00:32:18,269 --> 00:32:20,520 Nobody else here seems to care. 539 00:32:20,730 --> 00:32:23,148 - Nobody else cares? - Listen. 540 00:32:24,317 --> 00:32:27,110 There have been 10 cases of unexplained coma... 541 00:32:27,320 --> 00:32:30,864 ...in young, healthy patients in the last year. 542 00:32:31,032 --> 00:32:33,200 - Now, don't you find that surprising? - No. 543 00:32:35,703 --> 00:32:36,912 You don't. 544 00:32:37,747 --> 00:32:42,167 Susan, this hospital does 30,000 operations a year. 545 00:32:42,377 --> 00:32:46,880 I'm not surprised a few turn out with serious unexplained side effects. 546 00:32:47,048 --> 00:32:48,799 Medicine isn't perfect. 547 00:32:49,008 --> 00:32:50,133 We all accept that. 548 00:32:51,260 --> 00:32:52,594 Don't we? 549 00:32:54,389 --> 00:32:56,390 There's a crisis in her personal life. 550 00:32:56,557 --> 00:32:58,684 - She's involved with a resident. - I know. 551 00:32:58,893 --> 00:33:01,228 It's led her to overreact to this situation... 552 00:33:01,396 --> 00:33:03,689 ...which she has not consciously faced. 553 00:33:03,898 --> 00:33:06,358 She's under stress and a little paranoid. 554 00:33:06,526 --> 00:33:09,861 Mm. Think we'll have any more trouble with her? 555 00:33:10,071 --> 00:33:11,571 I don't think so. 556 00:33:11,739 --> 00:33:13,156 I hope you're right. 557 00:33:13,449 --> 00:33:16,618 I hate to admit it. I think I was really upset about Nancy. 558 00:33:16,786 --> 00:33:18,120 Yeah. 559 00:33:18,287 --> 00:33:19,871 - You on call tonight? - Mm-hm. 560 00:33:20,081 --> 00:33:21,248 So am I. 561 00:33:21,416 --> 00:33:23,166 Why don't we have a terrific dinner... 562 00:33:23,376 --> 00:33:25,794 ...just the two of us in the hospital cafeteria? 563 00:33:26,004 --> 00:33:27,713 - Sounds great! - About 11? 564 00:33:27,922 --> 00:33:28,964 You got a date. 565 00:33:29,173 --> 00:33:31,299 Maybe afterwards, we can go to our favorite room... 566 00:33:31,467 --> 00:33:33,010 - ...on the eighth floor. - Mm. 567 00:33:33,428 --> 00:33:35,095 Nobody will be there after midnight. 568 00:33:35,263 --> 00:33:37,973 I think we're looking at cortical anoxia. 569 00:33:38,182 --> 00:33:40,267 - I'll check the Babinski. - How old is he? 570 00:33:40,476 --> 00:33:41,560 Thirty-five. 571 00:33:41,769 --> 00:33:44,062 When did you administer the additional dosage? 572 00:33:44,272 --> 00:33:47,774 At the onset of cardiac irritability. The surgeon said he was light. 573 00:33:47,984 --> 00:33:51,028 Surgeons know nothing about anesthesia. What'd you give? 574 00:33:51,237 --> 00:33:52,320 Two cc's push. 575 00:33:52,613 --> 00:33:54,698 There was no reason there'd be a problem. 576 00:33:55,366 --> 00:33:56,908 Just seemed a little light. 577 00:33:57,118 --> 00:33:59,286 Some PVC in runs, transient hypotension... 578 00:33:59,495 --> 00:34:01,329 ...but no sign of hypoxia. 579 00:34:01,539 --> 00:34:04,708 Skin color and blood were all red and fully oxygenated. 580 00:34:05,084 --> 00:34:08,545 The pupils are fixed and dilated, I must presume brain death. 581 00:34:08,963 --> 00:34:10,630 Any relation to your other case? 582 00:34:10,798 --> 00:34:14,926 Completely different. Different staffs, different anesthetic agents. 583 00:34:15,136 --> 00:34:18,305 - He better be trached. - Do we need a pulmonary consult? 584 00:34:18,514 --> 00:34:21,641 Request the consult, but go ahead with the tracheotomy. 585 00:34:21,851 --> 00:34:24,144 This is a long-term management problem. 586 00:34:24,312 --> 00:34:26,188 - Come on. - It happened again. 587 00:34:26,397 --> 00:34:29,983 That's Dr. George, chief of anesthesia. He's got it under control. 588 00:34:30,401 --> 00:34:33,070 Is there a research protocol this case would fit? 589 00:34:33,279 --> 00:34:36,198 He's a good research case. Excellent teaching material. 590 00:34:36,407 --> 00:34:39,034 It's true, Mr. Murphy presents challenges... 591 00:34:39,243 --> 00:34:41,787 ...electrolyte balance IV, caloric maintenance... 592 00:34:41,996 --> 00:34:44,372 ...possible pseudomonas infection. 593 00:34:45,041 --> 00:34:48,085 There may be additional risk of staph osteomyelitis. 594 00:34:48,294 --> 00:34:51,963 But I think you'll be agreeably surprised, Dr. George. 595 00:34:52,173 --> 00:34:54,216 We can keep him alive... 596 00:34:54,675 --> 00:34:57,677 ...in stable vital signs, a year... 597 00:34:57,845 --> 00:35:00,472 ...two years, indefinitely. 598 00:35:00,681 --> 00:35:02,682 You can't just look the other way. 599 00:35:02,892 --> 00:35:04,643 Nobody's looking the other way. 600 00:35:04,852 --> 00:35:08,021 Mark, twice in two days. It's not normal. 601 00:35:08,231 --> 00:35:11,108 - In certain cases, patients always— - You told me that. 602 00:35:11,692 --> 00:35:13,193 Two in two days. 603 00:35:13,402 --> 00:35:15,320 You're just sensitized to it. 604 00:35:15,530 --> 00:35:18,990 It just happened to a friend and now you're looking for it. 605 00:35:19,200 --> 00:35:22,702 Twice in two days is just our lousy luck. 606 00:35:23,204 --> 00:35:24,204 Hmm. 607 00:35:24,372 --> 00:35:26,164 - Did Harris take the readout? - Yes. 608 00:35:26,374 --> 00:35:28,041 All right, then forget it. 609 00:35:28,209 --> 00:35:30,460 The hospital has review boards and committees. 610 00:35:30,670 --> 00:35:32,087 They'll look into it. 611 00:35:32,296 --> 00:35:35,632 Now, you got a job to do, so forget about this. 612 00:35:40,388 --> 00:35:42,889 You're right. You're right. 613 00:35:45,601 --> 00:35:46,643 I'll see you at dinner? 614 00:35:46,853 --> 00:35:48,520 Mm-hm. 615 00:35:56,154 --> 00:36:00,365 Dr. Williams, Dr. Peter Williams, 1174. 616 00:36:09,417 --> 00:36:11,251 This is Dr. Wheeler. 617 00:36:13,171 --> 00:36:16,840 I know about the conference but I'm tied up with a patient now. 618 00:36:17,925 --> 00:36:20,594 Well, I'm afraid I can't make it there in time. 619 00:36:21,971 --> 00:36:23,263 Where am I? 620 00:36:23,973 --> 00:36:25,974 I'm in the emergency ward. 621 00:36:26,767 --> 00:36:28,226 Yes, it is important. 622 00:36:28,436 --> 00:36:29,728 Will you hold on? 623 00:36:30,396 --> 00:36:33,398 Well, that's funny, but all these charts you wanted... 624 00:36:33,608 --> 00:36:37,360 ...they're all signed out to Dr. George, the chief of anesthesiology. 625 00:36:39,155 --> 00:36:40,572 Good afternoon, Dr. George. 626 00:36:41,073 --> 00:36:42,741 Good afternoon, staff. 627 00:36:44,285 --> 00:36:46,203 We have a happy lab here. 628 00:36:46,412 --> 00:36:48,955 It's precise. There's nothing left to chance. 629 00:36:49,165 --> 00:36:51,124 There are no mistakes. 630 00:36:51,876 --> 00:36:54,252 The charts are right here. There's no mystery. 631 00:36:54,462 --> 00:36:56,463 They're right here. What is it you wanted? 632 00:36:56,631 --> 00:36:58,340 I'd like to look at them. 633 00:36:59,091 --> 00:37:00,300 For what reason? 634 00:37:00,468 --> 00:37:03,845 I'm interested in unexplained coma following routine surgery. 635 00:37:04,055 --> 00:37:05,597 - You're interested? - Yes. 636 00:37:06,641 --> 00:37:08,141 Young lady, I'm more than interested. 637 00:37:08,309 --> 00:37:10,810 My anesthesiology staff is more than interested. 638 00:37:11,020 --> 00:37:12,604 We're deeply, intensely concerned. 639 00:37:13,272 --> 00:37:16,191 - I understand your feelings. - I'm not sure you do. 640 00:37:17,610 --> 00:37:19,319 Perhaps something was missed? 641 00:37:19,654 --> 00:37:20,946 Missed? 642 00:37:21,614 --> 00:37:24,199 Every professor of anesthesia, most of our staff... 643 00:37:24,408 --> 00:37:27,160 ...more than 40 experts have gone over these charts. 644 00:37:27,328 --> 00:37:29,537 You think something was missed? 645 00:37:29,830 --> 00:37:31,915 But if anything links them together— 646 00:37:32,124 --> 00:37:33,959 If anything linked them, we'd know it. 647 00:37:34,210 --> 00:37:36,878 Here they are, 10 cases. There are now 12. 648 00:37:37,588 --> 00:37:40,966 Different ages and sexes. Different surgeons and anesthetists. 649 00:37:41,175 --> 00:37:43,176 Different methods of induction. 650 00:37:43,344 --> 00:37:48,181 They share nothing in common except they all emerged with unexplained coma. 651 00:37:48,557 --> 00:37:50,892 We're certainly not neglecting that problem. 652 00:37:51,477 --> 00:37:53,353 I didn't say you were. 653 00:37:53,854 --> 00:37:55,480 Do you mind if I have a look? 654 00:37:58,150 --> 00:38:00,193 I'm afraid I do mind. 655 00:38:07,743 --> 00:38:10,245 Thank you for your interest, however misplaced, Dr. Wheeler. 656 00:38:10,454 --> 00:38:11,538 Good afternoon. 657 00:38:25,720 --> 00:38:28,221 Oh, my God, you did— How could you do that? 658 00:38:29,765 --> 00:38:31,224 Susan... 659 00:38:31,392 --> 00:38:33,310 Dr. George is a past president... 660 00:38:33,519 --> 00:38:35,979 ...of the American Society of Anesthesiologists. 661 00:38:36,188 --> 00:38:39,566 He's a member of the AAAS. He's on the board of the NIH... 662 00:38:39,775 --> 00:38:41,526 ...and you tell him he's doing his job wrong. 663 00:38:41,736 --> 00:38:45,322 - I just wanted to see the charts. - That's not your area. 664 00:38:45,531 --> 00:38:48,533 That's not your responsibility. You're way off base. 665 00:38:50,411 --> 00:38:52,120 You know who his wife is? 666 00:38:52,371 --> 00:38:54,664 - I don't care. - Well, you should. 667 00:38:54,874 --> 00:38:57,917 His wife is Amy Cabot. She's related to Godfrey Lowell. 668 00:38:58,127 --> 00:38:59,794 I don't care about Boston society. 669 00:39:00,004 --> 00:39:01,338 Dr. George's wife... 670 00:39:01,547 --> 00:39:05,633 ...is worth somewhere between 50 and 100 million dollars. 671 00:39:05,843 --> 00:39:07,927 When she dies, that money will go somewhere. 672 00:39:08,304 --> 00:39:09,346 So what? 673 00:39:09,805 --> 00:39:13,141 So he has a lot of muscle here. He's the wrong man to cross. 674 00:39:13,434 --> 00:39:15,602 You afraid to be seen with me? 675 00:39:18,606 --> 00:39:21,274 - Come in. - Hi, Bill. 676 00:39:21,442 --> 00:39:22,609 - How are you, Mark? - Good. 677 00:39:23,694 --> 00:39:25,111 Sit down. 678 00:39:29,784 --> 00:39:31,117 You know, Mark... 679 00:39:31,285 --> 00:39:35,497 ...I always thought that you'd have this job when I leave next year. 680 00:39:35,706 --> 00:39:36,915 Everybody thinks so. 681 00:39:37,124 --> 00:39:39,125 You're the logical choice. You're a good surgeon. 682 00:39:39,418 --> 00:39:41,795 You're well-organized. You run a good service. 683 00:39:41,962 --> 00:39:44,005 Well, thank you very much, Bill. 684 00:39:44,215 --> 00:39:47,217 I'd hate to see anything stand in your way. 685 00:39:47,426 --> 00:39:48,968 You know what I mean. 686 00:39:50,137 --> 00:39:52,138 She has the chiefs of service in an uproar. 687 00:39:52,348 --> 00:39:55,725 - She's under a lot of pressure. - And so are we. 688 00:39:56,227 --> 00:40:00,146 They're talking about releasing her from her position here at the Mem. 689 00:40:00,439 --> 00:40:02,649 But nobody really wants that kind of... 690 00:40:02,858 --> 00:40:05,652 ...adverse publicity, that commotion. 691 00:40:05,820 --> 00:40:07,278 Of course not. 692 00:40:08,406 --> 00:40:09,739 You have influence with her? 693 00:40:11,617 --> 00:40:13,201 I don't know. She's paranoid. 694 00:40:13,869 --> 00:40:16,037 She thinks there's a conspiracy. 695 00:40:16,247 --> 00:40:19,082 George keeping the charts from her did not help. 696 00:40:19,417 --> 00:40:21,751 Does she think, uh, you're involved? 697 00:40:24,422 --> 00:40:26,673 No. No, I don't think so. 698 00:40:27,508 --> 00:40:31,845 Let's hope not, Mark. What happens to Susan may depend on you. 699 00:40:32,054 --> 00:40:34,139 I understand that, Bill. 700 00:40:34,974 --> 00:40:36,933 You know, a good chief resident... 701 00:40:37,143 --> 00:40:40,603 ...handles problems like this every day. 702 00:40:41,313 --> 00:40:45,233 I think if you're able to exert some influence over her... 703 00:40:45,651 --> 00:40:47,318 ...people would be appreciative. 704 00:40:49,196 --> 00:40:50,530 Well, I'll try. 705 00:40:51,866 --> 00:40:53,158 Good man. 706 00:41:10,926 --> 00:41:11,968 Where's Greenly? 707 00:41:12,178 --> 00:41:16,264 That coma case? She was to be transferred to the Jefferson Institute. 708 00:41:16,474 --> 00:41:17,682 I guess she went there. 709 00:41:17,892 --> 00:41:20,059 Liz, did Greenly go to Jefferson? 710 00:41:20,269 --> 00:41:22,645 No, she arrested at 6 this morning. 711 00:41:22,855 --> 00:41:25,023 - She's down in pathology. - In pathology? 712 00:41:25,274 --> 00:41:27,233 Yeah, they're probably doing the autopsy now. 713 00:41:28,611 --> 00:41:30,778 Surgical ICU. 714 00:41:31,071 --> 00:41:32,780 There's a wrinkled appearance. 715 00:41:32,948 --> 00:41:35,575 The interior edge of the organ can be bent without tearing... 716 00:41:35,743 --> 00:41:38,203 ...as evidence of its structure. 717 00:41:38,370 --> 00:41:41,706 The gross appearance is consistent with acute yellow necrosis of the liver. 718 00:41:41,874 --> 00:41:44,918 Presumably secondary to fatal viral hepatitis. 719 00:41:45,085 --> 00:41:47,045 Do you have a patient named Greenly? 720 00:41:47,254 --> 00:41:50,840 I don't know. Check in there. I can't keep track of names. 721 00:41:52,927 --> 00:41:55,595 In microscopic section, we may expect evidence... 722 00:41:55,763 --> 00:41:57,931 ...of fatty degeneration in necrotic cells... 723 00:41:58,140 --> 00:42:00,808 ...with polymorphs and histiocytes around them. 724 00:42:04,939 --> 00:42:07,023 Okay, incise the kidney there. 725 00:42:07,274 --> 00:42:08,691 Looks normal. 726 00:42:09,026 --> 00:42:11,444 - Okay, remove it. - Greenly? 727 00:42:11,654 --> 00:42:14,030 This is Howard. Greenly's over there. 728 00:42:18,285 --> 00:42:20,537 - Hi, Jim. - Hi, Sue. 729 00:42:20,704 --> 00:42:22,497 What brings you here? Interested in this case? 730 00:42:22,790 --> 00:42:24,999 - That's right. - Hell of a puzzler. 731 00:42:25,167 --> 00:42:26,793 Young girl, good health... 732 00:42:27,002 --> 00:42:30,380 ...in for a therapeutic AB, comes out comatose. 733 00:42:30,839 --> 00:42:34,092 - Found anything? - Naturally, we started with the brain. 734 00:42:34,301 --> 00:42:37,845 Grossly, it was normal. I'm doing a section. Want to see? 735 00:42:38,472 --> 00:42:41,766 Ordinarily, these coma cases get shipped to Jefferson. 736 00:42:42,017 --> 00:42:44,060 - What's Jefferson? - Jefferson Institute. 737 00:42:44,270 --> 00:42:46,813 A chronic-care facility. Government thing. 738 00:42:47,106 --> 00:42:48,898 They take care of the vegetables. 739 00:42:49,108 --> 00:42:52,485 Sometimes they die before they get there, like this one. 740 00:42:52,695 --> 00:42:54,696 More work for us. 741 00:42:55,823 --> 00:42:57,240 Huh. 742 00:42:57,908 --> 00:42:59,075 Now we'll get an idea. 743 00:43:00,160 --> 00:43:03,997 We're looking for anything. Micro-infarcts, staph loci... 744 00:43:05,249 --> 00:43:08,543 ...gross hemorrhagic areas, congenital defects... 745 00:43:09,253 --> 00:43:12,505 Nothing. Just like the other cases, we come up cold. 746 00:43:12,756 --> 00:43:14,132 I know it sounds silly... 747 00:43:14,300 --> 00:43:18,553 ...but, um, if you wanted to put people in a coma, what would you do? 748 00:43:19,013 --> 00:43:21,806 - On purpose? - Diethyl para-amino tannadol. 749 00:43:22,016 --> 00:43:23,683 No, it leaves a serum trace. 750 00:43:23,892 --> 00:43:26,352 - If you look for it. - It also peaks alk phos. 751 00:43:26,520 --> 00:43:28,896 A real giveaway. Besides, who can get tannadol? 752 00:43:29,106 --> 00:43:31,316 - Use paradine. - It has a taste. 753 00:43:31,775 --> 00:43:35,445 We'd make great murderers. Who knows more than a pathologist? 754 00:43:35,613 --> 00:43:37,447 Heh. It keeps my wife in line. 755 00:43:37,698 --> 00:43:40,658 Hell of a lot of crimes slip through our fingers. 756 00:43:41,035 --> 00:43:43,703 But in this case, a coma. 757 00:43:44,580 --> 00:43:46,289 First rule of crime: 758 00:43:47,333 --> 00:43:48,833 Keep it simple. 759 00:43:49,335 --> 00:43:50,877 What's simple? 760 00:43:51,420 --> 00:43:53,713 - Carbon monoxide. - Boring. 761 00:43:54,632 --> 00:43:57,717 - Carbon monoxide? - Sure, it's perfect. 762 00:43:57,885 --> 00:44:01,095 Anesthetist uses carbon monoxide instead of oxygen. 763 00:44:01,305 --> 00:44:05,433 It's colorless and makes the blood red so the surgeon doesn't notice. 764 00:44:05,643 --> 00:44:10,355 But the brain dies from lack of oxygen. The patient doesn't wake up. 765 00:44:10,522 --> 00:44:12,940 - No other effects? - Sure other effects. 766 00:44:13,108 --> 00:44:15,234 - Cardiac irritability. - Which this case had. 767 00:44:15,569 --> 00:44:18,780 It'd be better to block the neuro-muscular junction... 768 00:44:18,989 --> 00:44:20,865 ...with succinylcholine. That's a nice murder. 769 00:44:21,075 --> 00:44:24,494 - Who's gonna do it? - Who'll feed your carbon monoxide? 770 00:44:24,870 --> 00:44:25,995 That's the problem. 771 00:44:26,205 --> 00:44:28,665 Been 12 coma cases here in the last year. 772 00:44:28,874 --> 00:44:30,249 They're always different. 773 00:44:30,459 --> 00:44:34,087 Different case, different anesthetist, different operation. 774 00:44:34,296 --> 00:44:36,422 Hard to imagine it's murder. 775 00:44:37,257 --> 00:44:38,341 Are you sure? 776 00:44:38,926 --> 00:44:43,721 What do you think? There's a conspiracy at the Boston Memorial Hospital... 777 00:44:43,931 --> 00:44:45,556 ...involving all the anesthetists? 778 00:44:47,059 --> 00:44:51,437 I've had a rather hysterical call from Dr. George in anesthesiology. 779 00:44:51,647 --> 00:44:56,025 Dr. George is a powerful person here, not only because of his position. 780 00:44:56,235 --> 00:44:59,153 - There are other reasons. - I gather. 781 00:45:00,656 --> 00:45:01,698 What does that mean? 782 00:45:02,116 --> 00:45:04,534 Just because somebody has a rich wife, he shouldn't be able... 783 00:45:04,702 --> 00:45:06,869 - ...to throw his weight around. - Oh. 784 00:45:07,037 --> 00:45:09,247 You're looking for truth and justice, huh? 785 00:45:09,623 --> 00:45:10,957 I'm looking for fairness. 786 00:45:11,166 --> 00:45:14,836 In fairness, you've challenged the professional competence... 787 00:45:15,045 --> 00:45:17,171 ...of a chief of service at this hospital. 788 00:45:17,381 --> 00:45:20,258 And he didn't take it well. No reason he should. 789 00:45:20,467 --> 00:45:23,177 - Now he's out for blood. - I've noticed. 790 00:45:23,804 --> 00:45:26,556 Sue, believe me, I'm on your side... 791 00:45:26,765 --> 00:45:28,725 ...for all kinds of reasons. 792 00:45:29,101 --> 00:45:32,186 I don't want to let another chief of service... 793 00:45:32,396 --> 00:45:34,772 ...get one of my house officers fired. 794 00:45:35,065 --> 00:45:38,234 Dr. Harris, I just wanted to look at his charts. 795 00:45:38,736 --> 00:45:41,279 Sue, right now, I can protect you... 796 00:45:41,488 --> 00:45:45,032 ...because you're good. And frankly, because you're a woman. 797 00:45:45,325 --> 00:45:46,659 I don't want concessions. 798 00:45:46,952 --> 00:45:49,996 At the moment, you'd better take any you can get. 799 00:45:58,589 --> 00:46:00,840 You know what happened to Greenly? 800 00:46:02,092 --> 00:46:03,342 Yes. 801 00:46:04,803 --> 00:46:05,928 What happened? 802 00:46:08,515 --> 00:46:09,932 She died. 803 00:46:11,685 --> 00:46:13,311 How do you feel about that? 804 00:46:14,521 --> 00:46:15,813 How do I feel? 805 00:46:16,857 --> 00:46:18,149 I feel... 806 00:46:20,277 --> 00:46:22,361 She was my best friend. 807 00:46:24,865 --> 00:46:30,328 She understood me. 808 00:46:42,966 --> 00:46:44,550 It's not fair. 809 00:46:44,885 --> 00:46:46,886 None of this is fair. 810 00:46:48,972 --> 00:46:50,056 Here. 811 00:46:52,559 --> 00:46:54,393 Nobody understands. 812 00:46:54,603 --> 00:46:56,771 - No one. - I know, I know. 813 00:47:01,735 --> 00:47:02,777 Yes. 814 00:47:02,945 --> 00:47:07,406 Dr. Harris, the secretary of HEW is on the phone from Washington. 815 00:47:07,574 --> 00:47:08,616 Call back. 816 00:47:17,751 --> 00:47:20,962 Too many of us shut ourselves off from our feelings. 817 00:47:21,171 --> 00:47:23,172 We don't explore them. 818 00:47:23,632 --> 00:47:25,716 We don't understand them. 819 00:47:25,926 --> 00:47:28,427 We don't understand ourselves. 820 00:47:29,263 --> 00:47:32,306 It's the toughest thing about our profession. 821 00:47:32,975 --> 00:47:35,601 - Dr. Harris— - I'll take care of the politics. 822 00:47:35,769 --> 00:47:38,104 You just look out for yourself. 823 00:47:39,398 --> 00:47:41,524 Take the weekend off, Sue. 824 00:47:42,067 --> 00:47:45,111 Go walk on the beach. Get away from the hospital. 825 00:47:48,115 --> 00:47:49,782 - I'm so embarrassed by this. - No. 826 00:47:49,992 --> 00:47:52,285 Don't be. Don't be. 827 00:47:52,995 --> 00:47:55,830 Our emotions are what make us human. 828 00:47:57,124 --> 00:47:58,499 Come on. 829 00:47:59,918 --> 00:48:01,627 Come and see me next week, all right? 830 00:48:01,962 --> 00:48:03,462 - Right. - Good. 831 00:48:05,549 --> 00:48:08,301 - Have a good weekend. - Thank you, sir. 832 00:48:20,022 --> 00:48:21,063 Women! 833 00:48:22,357 --> 00:48:23,482 Christ! 834 00:48:54,097 --> 00:48:55,181 God! 835 00:49:57,244 --> 00:49:59,328 Just say you don't believe me. 836 00:49:59,913 --> 00:50:02,999 A man fixed your car so it wouldn't start... 837 00:50:03,208 --> 00:50:05,418 ...then followed you into the MTA station. 838 00:50:05,836 --> 00:50:07,378 Well, it's true. 839 00:50:10,007 --> 00:50:11,924 They're gonna wave him in. 840 00:50:13,301 --> 00:50:15,469 Your car is always breaking down. 841 00:50:15,887 --> 00:50:17,763 I just think you're tired. 842 00:50:18,432 --> 00:50:21,767 - I'm not tired. - Why don't we go away for the weekend? 843 00:50:22,019 --> 00:50:26,522 Go up the coast, have some fun and just forget the hospital. 844 00:50:27,274 --> 00:50:28,607 Mark... 845 00:50:28,817 --> 00:50:31,610 There are 12 coma cases. 846 00:50:31,945 --> 00:50:35,614 Nobody thinks they're linked, but I've seen charts for two of them: 847 00:50:36,366 --> 00:50:38,951 Nancy, and now this new guy, Murphy. 848 00:50:39,286 --> 00:50:40,411 And? 849 00:50:41,246 --> 00:50:42,913 And both occurred in O.R. 8. 850 00:50:44,041 --> 00:50:45,082 O.R. 8? 851 00:50:46,960 --> 00:50:48,586 What if...? 852 00:50:50,047 --> 00:50:53,674 What if carbon monoxide were being pumped in O.R. 8? 853 00:50:53,884 --> 00:50:55,718 What if that were true? 854 00:51:02,350 --> 00:51:04,226 - Get your coat on. - Why? 855 00:51:05,395 --> 00:51:07,188 We're going to take a look. 856 00:51:07,481 --> 00:51:10,149 Right now. O.R. 8. 857 00:51:15,238 --> 00:51:16,322 Well? 858 00:51:18,075 --> 00:51:19,492 Well... 859 00:51:24,664 --> 00:51:26,332 Looks okay. 860 00:51:30,253 --> 00:51:33,380 - How many operations you done in here? - A lot. 861 00:51:34,216 --> 00:51:36,675 - You ever had any problems? - No. 862 00:51:37,552 --> 00:51:39,095 Well, I already checked. 863 00:51:40,347 --> 00:51:45,184 The day Nancy had her problem, there were five other operations. 864 00:51:46,394 --> 00:51:49,021 Four before and one after. 865 00:51:49,606 --> 00:51:53,150 The day Sean Murphy had his, there were six others. 866 00:51:53,610 --> 00:51:55,152 Two before... 867 00:51:55,362 --> 00:51:56,862 ...and four after. 868 00:51:58,198 --> 00:52:00,032 They were all normal. 869 00:52:06,456 --> 00:52:08,165 Let's get out of here. 870 00:52:32,524 --> 00:52:34,984 This is what you call really working for it. 871 00:52:41,825 --> 00:52:42,992 No fair. 872 00:52:45,245 --> 00:52:46,453 Fair. 873 00:54:19,172 --> 00:54:21,340 I thought we were taking the weekend off? 874 00:54:21,549 --> 00:54:24,593 Come on. Just a quick look. 875 00:54:25,387 --> 00:54:26,470 Please? 876 00:54:27,514 --> 00:54:28,806 For me? 877 00:54:31,268 --> 00:54:32,893 I don't know. 878 00:55:22,485 --> 00:55:24,862 There doesn't seem to be anybody around. 879 00:55:25,405 --> 00:55:28,073 - You want to go in? - Not really, no. 880 00:55:28,533 --> 00:55:29,616 I do. 881 00:56:40,188 --> 00:56:41,230 Can I help you? 882 00:56:41,564 --> 00:56:43,232 I'm Dr. Wheeler. 883 00:56:43,942 --> 00:56:46,902 - You're early, aren't you, doctor? - Early? 884 00:56:47,737 --> 00:56:51,281 You're supposed to come on Tuesday, day after tomorrow... 885 00:56:51,491 --> 00:56:52,866 ...when the tour is scheduled. 886 00:56:53,827 --> 00:56:57,496 - The tour? - Yes, it's every Tuesday at 11. 887 00:56:57,747 --> 00:56:59,456 The regular tour for physicians. 888 00:57:01,209 --> 00:57:03,293 Could I, uh, see it now? 889 00:57:04,379 --> 00:57:06,213 I'm afraid that's impossible. 890 00:57:07,215 --> 00:57:09,091 I just thought as long as I'm here... 891 00:57:09,884 --> 00:57:11,468 We're simply not set up for it. 892 00:57:13,471 --> 00:57:15,597 May I speak with the senior physician in charge? 893 00:57:16,808 --> 00:57:18,809 There is no physician in charge. 894 00:57:19,018 --> 00:57:21,019 Well, then, your supervisor. 895 00:57:21,187 --> 00:57:23,272 I have no supervisor. 896 00:57:23,773 --> 00:57:27,025 - Who runs the staff? - There is no staff. 897 00:57:28,153 --> 00:57:29,611 You're here alone? 898 00:57:30,029 --> 00:57:33,699 Of course not. There are technicians, security people... 899 00:57:34,492 --> 00:57:38,912 I'm sure when you've taken the tour Tuesday, it will all be clear to you. 900 00:57:39,539 --> 00:57:41,498 What did you say your name was? 901 00:57:41,833 --> 00:57:44,209 Dr. Wheeler. Susan Wheeler. 902 00:57:44,752 --> 00:57:48,839 We look forward to seeing you at 11 on Tuesday. Goodbye. 903 00:58:36,221 --> 00:58:39,056 I heard what you said to Dr. George... 904 00:58:39,265 --> 00:58:40,807 ...in the lab. 905 00:58:42,393 --> 00:58:44,394 I heard what you said to him. 906 00:58:44,604 --> 00:58:46,104 You're right. 907 00:58:47,023 --> 00:58:48,398 Right about what? 908 00:58:49,776 --> 00:58:51,902 I've seen how they do it. 909 00:58:54,614 --> 00:58:56,949 I know how it works. 910 00:58:57,534 --> 00:59:00,285 - How what works? - Susan. Uh... 911 00:59:01,079 --> 00:59:04,957 Do you want to, uh, scrub in on an aortic valve replacement? 912 00:59:05,124 --> 00:59:07,417 Harvey's doing one in room 16 in 10 minutes. 913 00:59:07,585 --> 00:59:08,627 - Sure. - Great! 914 00:59:08,795 --> 00:59:12,089 Tom was going to scrub in, but, uh, his case is running late. 915 00:59:15,301 --> 00:59:16,885 - I checked them out. - Mm-hm. 916 00:59:17,095 --> 00:59:19,972 You come down to maintenance tonight. I'll show it to you. 917 00:59:20,139 --> 00:59:21,181 Hello, Sue. 918 00:59:22,141 --> 00:59:23,725 Good morning, sir. 919 00:59:24,018 --> 00:59:26,728 - Did you have a good weekend? - Yes, I did. Thank you. 920 01:00:01,389 --> 01:00:02,639 Evening. 921 01:00:03,600 --> 01:00:04,850 Good evening. 922 01:00:12,525 --> 01:00:13,859 You just gonna stare at me? 923 01:00:15,028 --> 01:00:16,361 No. 924 01:00:21,284 --> 01:00:22,868 What'd you do that for? 925 01:00:23,036 --> 01:00:25,245 They said make it look like an accident. 926 01:00:43,890 --> 01:00:46,767 - What's happening? - Emergency generator will kick in. 927 01:00:50,355 --> 01:00:51,563 Kelly? 928 01:00:54,359 --> 01:00:55,525 Kelly? 929 01:01:22,428 --> 01:01:23,970 What do you got now? 930 01:01:24,555 --> 01:01:25,597 Nothing. 931 01:01:26,933 --> 01:01:28,433 Try the connector cable. 932 01:01:28,810 --> 01:01:31,895 I think that does it for me. You got anything else? 933 01:01:32,105 --> 01:01:33,980 No, I don't need anything else. 934 01:01:34,357 --> 01:01:37,442 - If we need you again— - You can reach me at the hospital. 935 01:01:38,986 --> 01:01:41,613 Must be a short in the junction box... 936 01:01:41,781 --> 01:01:43,699 ...or the step-down panel. 937 01:01:44,951 --> 01:01:47,160 It should read 14 point something. 938 01:01:47,620 --> 01:01:49,287 14.3. 939 01:01:49,789 --> 01:01:52,332 Okay, now we should have 11.9. 940 01:01:52,875 --> 01:01:54,334 Eleven-nine. 941 01:01:55,128 --> 01:01:56,628 And now there's— 942 01:01:57,505 --> 01:01:58,839 Fourteen-three. 943 01:01:59,465 --> 01:02:01,550 Good. Nothing's shorted so far. 944 01:02:01,759 --> 01:02:03,635 We got lucky. 945 01:02:03,928 --> 01:02:05,303 Poor Kelly. 946 01:02:05,763 --> 01:02:07,597 Poor Kelly? Heh. 947 01:02:08,558 --> 01:02:10,058 He got sloppy. 948 01:02:10,268 --> 01:02:12,644 You know what it is? That drinking at lunch. 949 01:02:12,854 --> 01:02:15,480 I said, "Stop drinking. You'll get into trouble." 950 01:06:50,965 --> 01:06:52,757 Two and two's the count. 951 01:06:52,925 --> 01:06:54,134 Can't get much more than that. 952 01:06:58,014 --> 01:07:01,016 - What did you leave in here? - Just some charts. 953 01:07:01,392 --> 01:07:03,685 I'll call Dr. George and tell him I let you in. 954 01:07:03,853 --> 01:07:05,478 It's all right. I have to call him anyway. 955 01:07:06,856 --> 01:07:08,273 Well, okay. 956 01:07:08,482 --> 01:07:11,276 - Boston ahead by one. - That's great. 957 01:07:11,444 --> 01:07:13,987 I've got 20 bucks on this game. 958 01:07:58,657 --> 01:08:00,033 What is it? 959 01:08:00,242 --> 01:08:02,619 Hospital security, doctor. 960 01:08:12,171 --> 01:08:15,715 - What's the score? - Just a routine check, doctor. 961 01:08:25,309 --> 01:08:26,643 Easy, kids. 962 01:08:50,459 --> 01:08:51,876 Jerry? 963 01:08:52,169 --> 01:08:55,588 - What's going on? - Jerry, I'm so happy to see you. 964 01:08:55,798 --> 01:08:58,883 That's the nicest thing anybody's said to me all day. 965 01:08:59,969 --> 01:09:01,177 Is something wrong? 966 01:09:01,387 --> 01:09:04,389 You see, there's this guy. 967 01:09:04,557 --> 01:09:06,891 - He said he was hospital security. - Yeah. 968 01:09:07,059 --> 01:09:10,645 Well, I happen to know that he— 969 01:09:11,981 --> 01:09:14,607 It's a high fly ball and... 970 01:09:15,442 --> 01:09:16,901 ...he's out! 971 01:09:17,111 --> 01:09:20,405 - You were saying? - I guess I have an overactive imagination. 972 01:09:20,573 --> 01:09:24,909 Heh. Be like me. Everybody says I have no imagination at all. 973 01:09:27,288 --> 01:09:29,914 I'm going over to the medical school library. 974 01:09:30,082 --> 01:09:31,833 I'll go with you. 975 01:09:35,921 --> 01:09:40,633 The tubular filtration gradient may be more than 500 milliequivalents. 976 01:09:40,843 --> 01:09:44,429 That means there's an active transport with phosphorylated ATP. 977 01:09:44,972 --> 01:09:49,767 But if you trace radioisotopes, densities don't look right. 978 01:09:50,269 --> 01:09:52,812 It's a breakthrough in understanding the kidney. 979 01:09:53,189 --> 01:09:56,733 Remember that yellow cadaver skin under your fingernails? 980 01:09:56,942 --> 01:09:58,610 Nobody could eat lunch. 981 01:09:58,777 --> 01:10:00,778 It seems like a long time ago. 982 01:10:00,988 --> 01:10:03,573 Back in the days when we couldn't eat lunch. 983 01:10:06,535 --> 01:10:07,994 Wouldn't you know? 984 01:10:11,707 --> 01:10:13,124 Dr. Marcus. 985 01:10:14,043 --> 01:10:15,335 Yes. 986 01:10:15,628 --> 01:10:17,545 Well, if he's complaining of pain. 987 01:10:18,088 --> 01:10:20,548 Try another five cc's I.M. 988 01:10:22,968 --> 01:10:26,012 I see. Well, then, uh, MS 10 milligrams. 989 01:10:27,473 --> 01:10:30,934 Yes, morphine sulphate. He's not in respiratory difficulty. 990 01:10:32,686 --> 01:10:35,730 You can put him on respiratory arrest with morphine. 991 01:10:35,940 --> 01:10:38,399 Particularly if he's on wall O-2. 992 01:10:41,487 --> 01:10:44,030 You'll have to check and see what he's on. 993 01:10:45,699 --> 01:10:49,327 Air is fine, but oxygen... 994 01:10:50,871 --> 01:10:54,582 If he's on wall oxygen, tell me how many liters of flow. 995 01:10:55,542 --> 01:10:58,336 Six liters! You can't put him on MS. 996 01:10:58,504 --> 01:11:00,838 You'll have to stay with Talwin. 997 01:11:04,009 --> 01:11:06,511 Give him five cc's of water. Say it's morphine. 998 01:11:06,679 --> 01:11:09,097 He won't know. He's a pain in the ass anyway. 999 01:16:16,780 --> 01:16:18,364 Aah! Unh! 1000 01:16:39,678 --> 01:16:40,678 Agh! 1001 01:16:41,763 --> 01:16:44,307 Mark, it's so awful! It's so terrible. 1002 01:16:45,100 --> 01:16:46,684 Take it easy. Honey, slow down. 1003 01:16:46,852 --> 01:16:49,687 He was trying to kill me. And I had to keep going. 1004 01:16:49,896 --> 01:16:53,274 - And all the bodies. It's horrible! - Easy. Easy, honey. 1005 01:16:53,483 --> 01:16:54,775 Take it easy. Slow down. 1006 01:16:54,985 --> 01:16:58,154 Mark, it's all happening. It's really happening. 1007 01:16:58,363 --> 01:17:01,699 Somebody's putting people into comas. They're murdering them. 1008 01:17:01,867 --> 01:17:05,202 - I know, I know. - No, no, really. 1009 01:17:05,412 --> 01:17:09,540 Kelly's dead. I was down there. I found the gas line. 1010 01:17:10,208 --> 01:17:14,211 It starts in the basement and it goes up the main tunnel... 1011 01:17:14,421 --> 01:17:18,674 ...then plugs into the oxygen line in the ceiling that goes to O.R. 8. 1012 01:17:18,884 --> 01:17:20,760 - Honey, slow down. - They're killing people... 1013 01:17:20,969 --> 01:17:23,179 ...with carbon monoxide in O.R. 8. 1014 01:17:23,388 --> 01:17:27,642 - They have a radio to turn the valve. - I believe you. I do, I believe you. 1015 01:17:27,851 --> 01:17:29,727 All the cases happened in O.R. 8. 1016 01:17:29,895 --> 01:17:33,356 And they all went to the Jefferson Institute. 1017 01:17:34,733 --> 01:17:39,695 And this guy, he chased me all over. And there were so many bodies. 1018 01:17:39,905 --> 01:17:42,281 It's all right. It's okay. 1019 01:17:42,699 --> 01:17:45,451 And this is real. Call the police. 1020 01:17:45,661 --> 01:17:49,455 We have to do something! This is real, Mark. 1021 01:17:49,623 --> 01:17:51,791 - Shh, shh. - I can prove it. 1022 01:17:52,000 --> 01:17:53,876 Sure, you can. You can. 1023 01:17:54,086 --> 01:17:55,920 - Just lie down. - This is real. 1024 01:17:56,129 --> 01:17:58,589 I know you can. Now one thing at a time. 1025 01:17:59,257 --> 01:18:01,258 - I want to give you a Valium and— - No. 1026 01:18:01,426 --> 01:18:02,927 Okay. 1027 01:18:03,261 --> 01:18:06,055 How about a cup of tea to settle you down? 1028 01:18:06,264 --> 01:18:08,099 - A cup of hot tea? - Okay. 1029 01:18:09,059 --> 01:18:11,602 Then we're gonna talk after you settle down. 1030 01:18:11,770 --> 01:18:13,688 - Okay. - All right. 1031 01:18:13,855 --> 01:18:16,941 So you just rest right here. Okay? 1032 01:18:17,109 --> 01:18:19,944 You just stay right here on the bed? 1033 01:18:20,112 --> 01:18:22,863 Thattagirl. That's it. You just relax. 1034 01:18:23,073 --> 01:18:27,952 - I can't— - That's it. Just relax. Close your eyes. 1035 01:18:28,161 --> 01:18:32,206 That's it. Okay, thattagirl. 1036 01:18:32,416 --> 01:18:36,544 - Now, I'll get you a cup of tea. - You're so great, Mark. 1037 01:18:36,878 --> 01:18:39,338 Stay here, honey. Just stay right here. 1038 01:18:48,598 --> 01:18:51,142 That's a hell of a story, Susan. 1039 01:18:52,894 --> 01:18:55,229 You really had a lot of people worried. 1040 01:18:57,816 --> 01:19:00,526 Don't worry. Everything's gonna be okay now. 1041 01:19:14,499 --> 01:19:17,543 She came back. Yeah. 1042 01:19:18,170 --> 01:19:19,920 No, she's here now. 1043 01:19:21,089 --> 01:19:24,049 Of course. No, I can manage that. 1044 01:19:25,719 --> 01:19:26,761 I'll keep her here. 1045 01:19:27,888 --> 01:19:29,513 Look, I'd better go. 1046 01:19:33,018 --> 01:19:35,352 Susan, you want some honey with your tea? 1047 01:19:38,064 --> 01:19:39,607 Susan? 1048 01:19:42,736 --> 01:19:44,069 Su—? 1049 01:19:59,085 --> 01:20:03,172 Susan! 1050 01:20:43,588 --> 01:20:45,756 Memorial Hospital residents' exchange. 1051 01:20:46,049 --> 01:20:48,592 This is Dr. Wheeler. Are there any messages for me? 1052 01:20:48,927 --> 01:20:52,346 Oh, yes, doctor. Quite a few. Just a minute, please. 1053 01:20:56,268 --> 01:20:58,727 I'm sorry. I'll have to call you back. 1054 01:20:58,937 --> 01:21:01,188 What number can you be reached at? 1055 01:21:04,401 --> 01:21:08,487 Dr. Wheeler, are you there? What number can we reach you at? 1056 01:21:11,449 --> 01:21:13,909 We are dealing in an area of uncertainty. 1057 01:21:14,286 --> 01:21:17,621 An area where there are no rules, contradictory laws... 1058 01:21:17,831 --> 01:21:21,625 ...and no clear social consensus as to what should be done. 1059 01:21:21,835 --> 01:21:26,046 And the cost of care for the chronic patient has become prohibitive. 1060 01:21:26,256 --> 01:21:30,467 This is particularly the case with the long-term comatose patient. 1061 01:21:30,677 --> 01:21:35,139 The Jefferson Institute is a government— sponsored experimental facility... 1062 01:21:35,307 --> 01:21:39,518 ...designed to provide quality life support to the comatose patient. 1063 01:21:40,145 --> 01:21:41,604 I wish to emphasize... 1064 01:21:41,813 --> 01:21:45,399 ...no moral or ethical position is being taken here. 1065 01:21:45,692 --> 01:21:49,695 We do not participate in the debate over whether these patients... 1066 01:21:49,905 --> 01:21:51,071 ...are alive or dead... 1067 01:21:51,656 --> 01:21:54,992 ...or whether their care should be continued or terminated. 1068 01:21:55,201 --> 01:21:59,330 Society will decide if there will be more of these facilities or not. 1069 01:21:59,956 --> 01:22:04,835 In the meantime, we merely provide care as inexpensively as possible. 1070 01:22:05,045 --> 01:22:07,504 Now, if you will please come this way... 1071 01:22:08,340 --> 01:22:10,132 This is our visiting room... 1072 01:22:10,342 --> 01:22:13,510 ...where relatives can see patients who are stored here. 1073 01:22:13,678 --> 01:22:15,679 You see, it all looks quite normal. 1074 01:22:16,181 --> 01:22:18,182 We've found it is inadvisable... 1075 01:22:18,391 --> 01:22:22,603 ...for relatives to know the actual circumstances of patient care. 1076 01:22:22,812 --> 01:22:25,856 It's too much of a shock. So we bring the patient here. 1077 01:22:26,066 --> 01:22:29,610 After the visit, we return them to the main care facility. 1078 01:22:29,819 --> 01:22:33,155 If you will put on your glasses, we'll go there now. 1079 01:22:33,865 --> 01:22:36,575 This is our main care facility. 1080 01:22:36,785 --> 01:22:39,703 Temperature here is 94.7 degrees Fahrenheit... 1081 01:22:39,913 --> 01:22:42,122 ...humidity 82 percent. 1082 01:22:42,332 --> 01:22:45,376 This stability reduces patient heat loss... 1083 01:22:45,543 --> 01:22:47,586 ...and caloric requirements. 1084 01:22:47,796 --> 01:22:51,924 There's a low-level ultraviolet bacteriostatic flux... 1085 01:22:52,133 --> 01:22:53,884 ...and to prevent bedsores... 1086 01:22:54,094 --> 01:22:57,221 ...patients are suspended by wires through long bones. 1087 01:22:57,472 --> 01:23:01,183 - How do you get to them up there? - There's no need for contact. 1088 01:23:01,393 --> 01:23:05,229 Every one of our patients is individually monitored by the computer. 1089 01:23:05,730 --> 01:23:09,650 Indwelling telemetry records weight, fluid balance... 1090 01:23:09,859 --> 01:23:13,612 ...blood pressure, blood gases, temperature, metabolic balance. 1091 01:23:13,905 --> 01:23:18,575 Our computer makes an immediate adjustment for any change in condition. 1092 01:23:18,743 --> 01:23:19,952 For example... 1093 01:23:20,745 --> 01:23:25,582 ...we simulate hypotension by direct compression of the telemetry unit. 1094 01:23:25,750 --> 01:23:29,670 The computer will sense this and make an immediate adjustment. 1095 01:23:35,218 --> 01:23:37,386 Well, almost immediate. 1096 01:23:39,723 --> 01:23:41,807 Sometimes there's a— 1097 01:23:42,267 --> 01:23:43,976 There we are. 1098 01:23:44,436 --> 01:23:47,438 Sometimes there is a short delay, but as you can see... 1099 01:23:47,605 --> 01:23:50,441 ...the computer put the patient in the Trendelenburg position... 1100 01:23:50,650 --> 01:23:52,943 ...and administered a vasoconstrictor. 1101 01:23:53,528 --> 01:23:57,489 We have very few crises here. With the assistance of technology... 1102 01:23:57,699 --> 01:24:00,284 ...these patients are maintained beautifully. 1103 01:24:00,452 --> 01:24:03,704 Without it, they would have died long ago. 1104 01:24:03,913 --> 01:24:08,000 But the law says they must be maintained, and this is one solution. 1105 01:24:08,626 --> 01:24:10,502 How large is your staff? 1106 01:24:10,879 --> 01:24:12,629 One nurse, a physician on call... 1107 01:24:12,839 --> 01:24:16,425 ...two computer technicians and a small security staff. That's all. 1108 01:24:16,634 --> 01:24:18,010 And the rest of the building? 1109 01:24:18,219 --> 01:24:21,722 It's of no interest. Just mechanical and technical facilities. 1110 01:24:21,973 --> 01:24:26,268 - What's the cost? - For each patient, about $60 a day. 1111 01:24:26,478 --> 01:24:31,190 But we can store 1,000 patients and then the cost will go down. 1112 01:24:31,399 --> 01:24:35,486 We expect to maintain patients for about $5 a day. 1113 01:24:35,653 --> 01:24:39,073 Less than it costs to hire a baby-sitter for a few hours. 1114 01:24:39,324 --> 01:24:41,408 If there are no further questions... 1115 01:24:41,618 --> 01:24:44,912 ...this concludes our tour of the Jefferson Institute. 1116 01:24:45,121 --> 01:24:48,665 Before you go, we have some literature we'd like you to take. 1117 01:24:48,875 --> 01:24:52,878 It explains some of the background and details of our work here. 1118 01:24:53,088 --> 01:24:55,089 We hope the tour has been informative. 1119 01:24:55,298 --> 01:24:59,176 And if you have any questions about the Jefferson Institute... 1120 01:24:59,385 --> 01:25:01,011 ...don't hesitate to call. 1121 01:25:01,179 --> 01:25:02,721 It shouldn't be about money. 1122 01:25:02,931 --> 01:25:05,933 Maybe your patients don't complain about their bills. 1123 01:25:06,142 --> 01:25:07,684 Thank you for your interest. 1124 01:25:07,852 --> 01:25:08,977 Goodbye. 1125 01:26:16,629 --> 01:26:18,338 Do you know what I wanted? 1126 01:26:18,548 --> 01:26:20,757 I wanted corned beef on rye... 1127 01:26:20,967 --> 01:26:24,511 ...or else a roast beef with Russian. And what do you bring me? 1128 01:26:24,721 --> 01:26:26,180 Ham and cheese. 1129 01:26:26,389 --> 01:26:28,223 Well, that's all they had. 1130 01:26:28,433 --> 01:26:31,894 You mean to tell me they didn't have any corned beef? No corned beef? 1131 01:26:32,103 --> 01:26:33,854 That's what the man said. 1132 01:26:34,063 --> 01:26:37,524 No corned beef. The guy must have been putting you on. 1133 01:26:40,778 --> 01:26:44,698 George says we're having an electrical inspection tomorrow morning. 1134 01:26:44,908 --> 01:26:46,450 Are we set for that? 1135 01:26:46,659 --> 01:26:47,868 Norman! 1136 01:26:48,077 --> 01:26:49,578 Yes, we should be. 1137 01:26:49,787 --> 01:26:52,873 - Do you want the bidding program now? - In a moment. 1138 01:26:55,168 --> 01:26:58,045 Did you see the game last night? Two out, Bumbry's up. 1139 01:26:58,254 --> 01:27:00,172 He hits a ball to left field. 1140 01:27:00,381 --> 01:27:03,592 White misses it and goes for a triple. 1141 01:27:04,260 --> 01:27:06,220 Lungs, 1100 grams. 1142 01:27:06,971 --> 01:27:09,431 Kidneys, 780, 620. 1143 01:27:10,016 --> 01:27:12,476 Eighty and six-twenty. 1144 01:27:13,311 --> 01:27:14,978 What about the heart? 1145 01:27:15,855 --> 01:27:18,565 - I wrote it down someplace. - What's the temperature? 1146 01:27:18,983 --> 01:27:21,109 Right now, 12 degrees centigrade... 1147 01:27:21,319 --> 01:27:23,820 ...and all the rest at 14. 1148 01:27:25,323 --> 01:27:27,157 Bottom of the ninth. 1149 01:27:43,216 --> 01:27:45,717 - Hey. - What? 1150 01:27:45,927 --> 01:27:47,844 - Where's that heart going? - Um... 1151 01:27:49,639 --> 01:27:50,931 San Francisco. 1152 01:27:51,140 --> 01:27:53,433 I think they're getting $75,000 for it. 1153 01:27:53,643 --> 01:27:56,812 - Is that all? - It was a bad match on tissue-typing. 1154 01:27:57,021 --> 01:27:59,523 Only two out of four. But it's a rush order. 1155 01:27:59,732 --> 01:28:02,734 The kidney's a four-tissue match and in perfect condition. 1156 01:28:02,944 --> 01:28:05,070 They'll get 200 grand for that. 1157 01:28:05,280 --> 01:28:07,698 It's going to Texas. A millionaire's son. 1158 01:28:07,907 --> 01:28:09,992 Good old George has the connections. 1159 01:28:10,201 --> 01:28:13,412 So far, George is doing fine. What about the other kidney? 1160 01:28:13,621 --> 01:28:16,540 They're putting it up for bids. They'll get 100 for it. 1161 01:28:16,749 --> 01:28:19,668 We have a left kidney, two hours old, ready to ship. 1162 01:28:19,877 --> 01:28:22,754 It's a 4367. A 31-year-old male. 1163 01:28:22,964 --> 01:28:25,048 The bidding now stands at forty-two five. 1164 01:28:26,384 --> 01:28:27,968 Thank you. 1165 01:28:28,177 --> 01:28:29,303 Forty-five. 1166 01:28:29,512 --> 01:28:30,762 Hello? It's at 45. 1167 01:28:31,014 --> 01:28:33,015 Well, it could be in Zurich in... 1168 01:28:33,266 --> 01:28:36,852 The fastest routing is New York-Rome. It'll arrive local time... 1169 01:28:37,061 --> 01:28:40,647 ...1300 hours, which means elapsed time is 23 hours. 1170 01:28:40,857 --> 01:28:45,485 Twenty-three hours elapsed time, which would make it 1 p.m. your time. 1171 01:28:46,070 --> 01:28:47,195 That's the best we can do. 1172 01:28:48,573 --> 01:28:49,698 Thank you. 1173 01:28:49,866 --> 01:28:50,907 Hello. 1174 01:28:57,081 --> 01:28:58,081 What's that? 1175 01:28:59,417 --> 01:29:01,251 Look at monitor four. 1176 01:29:04,547 --> 01:29:06,882 All units! 1177 01:29:07,091 --> 01:29:09,134 There is an unauthorized woman in the building. 1178 01:29:09,302 --> 01:29:12,262 - Contain this person maintaining... - Let's take her alive. 1179 01:29:12,430 --> 01:29:14,139 Don't shoot. 1180 01:29:15,850 --> 01:29:17,934 Visiting room, clear. Over. 1181 01:29:18,478 --> 01:29:21,396 Second floor lobby, clear. 1182 01:29:21,773 --> 01:29:24,691 Has anyone checked the main care facility? Over. 1183 01:29:24,901 --> 01:29:27,486 We have no reports from that sector. 1184 01:29:40,958 --> 01:29:43,794 Now on the second floor corridor. 1185 01:30:16,494 --> 01:30:17,536 System's all clear. Repeat. 1186 01:30:20,331 --> 01:30:22,290 Don't you have a key to this place? 1187 01:30:27,922 --> 01:30:30,006 No intruders on sub-basement one. 1188 01:30:30,174 --> 01:30:33,593 Repeat: No intruders on sub-basement one. 1189 01:30:33,803 --> 01:30:37,264 Unit one, she's out on the ledge. It's too far for her to jump. 1190 01:30:42,186 --> 01:30:43,437 I don't see her. 1191 01:30:43,646 --> 01:30:46,982 She's out there. She won't get far. We got her now. 1192 01:30:47,191 --> 01:30:50,944 Have the dogs start on the north side and circle the building. 1193 01:30:51,154 --> 01:30:54,197 I want security at all exits. Notify them by radio. 1194 01:30:54,365 --> 01:30:58,660 Search the labs and the roof. I've had enough of this inefficiency. 1195 01:30:59,162 --> 01:31:01,037 Perimeter dog team, come in. 1196 01:31:01,205 --> 01:31:02,205 Repeat. Come in! 1197 01:31:47,460 --> 01:31:50,921 Main control, any readings from outside? Where are the dogs? 1198 01:32:13,736 --> 01:32:15,946 I don't know where the hell she is. 1199 01:32:16,155 --> 01:32:18,573 She's got to be around here somewhere. 1200 01:32:31,128 --> 01:32:32,837 There, there. 1201 01:32:33,965 --> 01:32:40,512 It's going to be all right. 1202 01:33:05,830 --> 01:33:08,164 First floor lobby, check in. 1203 01:33:08,624 --> 01:33:10,959 First floor lobby, please respond. 1204 01:33:11,502 --> 01:33:13,169 No, she's not here. 1205 01:33:13,588 --> 01:33:15,630 Of course I've been notified. 1206 01:33:16,549 --> 01:33:18,425 I'm keeping an eye out for her. 1207 01:33:18,718 --> 01:33:23,013 If she comes here, we'll get her. There's no way she can escape. 1208 01:33:44,285 --> 01:33:46,244 Let's get this loaded quick. 1209 01:33:46,537 --> 01:33:49,581 I got to make it in time for the Dallas flight. 1210 01:33:49,790 --> 01:33:51,875 And we got rush-hour traffic. 1211 01:33:52,043 --> 01:33:54,919 Even with the siren, I gotta get through the tunnel. 1212 01:33:55,630 --> 01:33:58,381 Life gets tougher all the time. 1213 01:33:59,383 --> 01:34:00,800 I see you got the dogs out. 1214 01:34:01,010 --> 01:34:04,387 - We got a little security problem. - We all got problems. 1215 01:34:04,597 --> 01:34:06,598 World's full of problems. 1216 01:34:10,853 --> 01:34:12,228 Take it away! 1217 01:34:48,599 --> 01:34:50,975 Dr. Rogers, 2204. 1218 01:34:51,143 --> 01:34:54,604 Dr. Earl Rogers, 2204. 1219 01:35:11,122 --> 01:35:12,247 Do me a favor, will you? 1220 01:35:13,124 --> 01:35:15,291 Don't say anything to upset her. 1221 01:35:15,459 --> 01:35:16,918 I wouldn't say anything. 1222 01:35:17,128 --> 01:35:19,462 She's an old woman. She's sick. 1223 01:35:19,672 --> 01:35:21,923 - She may die. - Did the doctor say that? 1224 01:35:22,133 --> 01:35:25,343 - I don't know. - You don't know what the doctor said? 1225 01:35:25,886 --> 01:35:29,472 - I'll believe what the doctor says. - Just don't upset her. 1226 01:35:30,391 --> 01:35:31,683 This could be it. 1227 01:35:32,101 --> 01:35:33,309 This could be the end. 1228 01:35:37,773 --> 01:35:39,399 It's incredible. 1229 01:35:41,152 --> 01:35:44,571 Well, I could use a drink. How about you? Scotch? 1230 01:35:45,948 --> 01:35:47,407 Whatever you're having. 1231 01:35:47,616 --> 01:35:50,160 I like a woman who drinks Scotch. 1232 01:35:53,664 --> 01:35:55,415 You've done a remarkable thing, Sue. 1233 01:35:56,292 --> 01:35:57,917 Your dedication... 1234 01:35:58,127 --> 01:36:00,044 ...your concern... 1235 01:36:00,755 --> 01:36:03,214 ...your pursuit of this problem. 1236 01:36:04,133 --> 01:36:06,468 It's all extremely impressive. 1237 01:36:07,636 --> 01:36:08,928 And I'm very grateful. 1238 01:36:09,680 --> 01:36:11,848 - Thank you. - Cheers. 1239 01:36:16,562 --> 01:36:19,022 In fact, I'm more than grateful. 1240 01:36:19,774 --> 01:36:21,691 I'm deeply in your debt. 1241 01:36:23,694 --> 01:36:25,820 The question is, how do we handle this? 1242 01:36:26,197 --> 01:36:27,530 You arrest Dr. George. 1243 01:36:31,452 --> 01:36:32,494 Yes. 1244 01:36:32,661 --> 01:36:34,996 Sorry, Dr. Harris. It's Landis in Washington. 1245 01:36:35,372 --> 01:36:36,498 Put him on. 1246 01:36:36,791 --> 01:36:38,333 Excuse me. 1247 01:36:41,253 --> 01:36:42,629 Hello, Tom. How are you? 1248 01:36:43,714 --> 01:36:46,007 Fine, fine, just fine. 1249 01:36:47,176 --> 01:36:49,302 Sure, I'd be delighted to testify. 1250 01:36:49,512 --> 01:36:52,055 You know how strongly I feel about the matter. 1251 01:36:52,223 --> 01:36:54,516 But have you consulted the president? 1252 01:36:54,809 --> 01:36:56,100 Uh-huh. 1253 01:36:56,268 --> 01:36:57,310 I see. 1254 01:36:58,437 --> 01:36:59,646 This won't take long. 1255 01:37:07,822 --> 01:37:09,197 Uh-huh. 1256 01:37:15,746 --> 01:37:16,746 Good, good. 1257 01:37:23,254 --> 01:37:26,631 Good. Thanks for calling, Tom. Bye. 1258 01:37:32,096 --> 01:37:35,473 You've put me in a difficult position, Sue. 1259 01:37:37,017 --> 01:37:38,685 It seems you know everything. 1260 01:37:44,233 --> 01:37:45,525 You're George. 1261 01:37:45,776 --> 01:37:48,444 I wonder if you can understand... 1262 01:37:49,321 --> 01:37:52,532 ...if you can take the long view... 1263 01:37:53,909 --> 01:37:57,453 ...the view of a person in my position. 1264 01:38:02,084 --> 01:38:03,334 You did it? 1265 01:38:03,544 --> 01:38:06,379 No decision is easy, Sue. 1266 01:38:06,672 --> 01:38:09,465 It only looks that way when you're young. 1267 01:38:10,467 --> 01:38:12,218 When you're older... 1268 01:38:12,678 --> 01:38:15,346 ...everything is complicated. 1269 01:38:16,056 --> 01:38:18,391 There is no black and white. 1270 01:38:18,601 --> 01:38:20,268 Only gray. 1271 01:38:22,062 --> 01:38:24,939 But our society faces momentous decisions. 1272 01:38:26,066 --> 01:38:28,651 Decisions about the right to die... 1273 01:38:29,028 --> 01:38:31,905 ...about abortion, about terminal illness... 1274 01:38:32,114 --> 01:38:34,991 ...prolonged coma, transplantation. 1275 01:38:35,159 --> 01:38:38,036 Decisions about life and death. 1276 01:38:38,245 --> 01:38:40,496 But society isn't deciding. 1277 01:38:40,831 --> 01:38:43,583 Congress isn't deciding. The courts aren't deciding. 1278 01:38:43,792 --> 01:38:45,960 Religion isn't deciding. Why? 1279 01:38:46,337 --> 01:38:50,340 Because society is leaving it up to us, the experts. 1280 01:38:50,507 --> 01:38:51,674 The doctors. 1281 01:38:53,844 --> 01:38:54,844 You're crazy. 1282 01:38:55,054 --> 01:38:58,973 Americans spend $125 billion a year on health. 1283 01:38:59,183 --> 01:39:00,475 More than defense. 1284 01:39:01,060 --> 01:39:03,853 Because Americans believe in medical care. 1285 01:39:04,021 --> 01:39:08,733 These great hospital complexes are the cathedrals of our age. 1286 01:39:08,943 --> 01:39:12,445 Billions of dollars, thousands of beds... 1287 01:39:13,238 --> 01:39:16,616 ...a whole nation of sick people turning to us for help. 1288 01:39:22,164 --> 01:39:23,623 You... 1289 01:39:24,208 --> 01:39:26,209 You ought to see somebody. 1290 01:39:26,377 --> 01:39:28,878 - They're children, Sue. - Ha-ha-ha. 1291 01:39:29,046 --> 01:39:30,546 They trust us. 1292 01:39:32,049 --> 01:39:34,050 We can't tell them everything. 1293 01:39:34,969 --> 01:39:39,555 Our job is to make things easier for them. I'm sure you agree. 1294 01:39:40,891 --> 01:39:42,392 You're killing people. 1295 01:39:42,977 --> 01:39:46,354 We must always take the long view... 1296 01:39:46,939 --> 01:39:51,067 ...not of the individual, but of society as a whole... 1297 01:39:51,235 --> 01:39:55,613 ...because medicine is now a great social force. 1298 01:39:56,240 --> 01:39:59,367 The individual is too small. 1299 01:40:08,919 --> 01:40:10,336 That's the drug. 1300 01:40:10,963 --> 01:40:15,299 It produces abdominal spasm and peritoneal symptoms. 1301 01:40:16,301 --> 01:40:18,011 It must be very painful. 1302 01:40:20,389 --> 01:40:21,639 It's too bad. 1303 01:40:23,434 --> 01:40:26,436 But look at it from the practical standpoint. 1304 01:40:26,812 --> 01:40:31,232 Somebody has to make these decisions. We can't wait around forever. 1305 01:40:31,567 --> 01:40:33,776 If society won't decide, we'll decide. 1306 01:40:33,944 --> 01:40:35,737 We'll make the hard decisions. 1307 01:40:43,412 --> 01:40:44,996 This is Dr. Harris. 1308 01:40:45,205 --> 01:40:49,042 Schedule an emergency appendectomy in O.R. 8. 1309 01:40:49,793 --> 01:40:51,836 It's a member of the house staff, Dr. Wheeler. 1310 01:40:52,087 --> 01:40:54,797 I've examined her. She requires immediate surgery. 1311 01:40:55,007 --> 01:40:56,507 Okay, honey, now just sit up. 1312 01:40:56,717 --> 01:40:59,218 Come on, that's it. That's good. 1313 01:41:00,596 --> 01:41:02,680 Yes. Here we go. 1314 01:41:03,599 --> 01:41:04,640 It's... 1315 01:41:04,975 --> 01:41:06,017 ...the drug. 1316 01:41:06,185 --> 01:41:08,227 Yes, yes, it's gonna be just fine. 1317 01:41:08,395 --> 01:41:09,979 Doctors make the worst patients. 1318 01:41:10,147 --> 01:41:12,148 They know too much, I guess. 1319 01:41:17,529 --> 01:41:20,156 Dr. Edwards, 1011. 1320 01:41:20,324 --> 01:41:22,366 Dr. Edwards, 1011. 1321 01:41:22,534 --> 01:41:25,536 Susan. Susan. 1322 01:41:26,663 --> 01:41:28,331 Why'd you run away? 1323 01:41:28,916 --> 01:41:31,501 I was just talking to your mother. She was worried about you. 1324 01:41:31,668 --> 01:41:34,587 - Mark. Mark. - Everybody's been worried about you. 1325 01:41:37,091 --> 01:41:38,716 Mark. 1326 01:41:39,093 --> 01:41:40,676 Honey, I love you. 1327 01:41:41,512 --> 01:41:43,012 You're gonna be just fine. 1328 01:41:43,222 --> 01:41:44,972 No, Mark, listen. 1329 01:41:45,307 --> 01:41:47,016 You have to stop this. 1330 01:41:47,226 --> 01:41:49,852 I'm fine. I am. 1331 01:41:51,230 --> 01:41:53,397 - But your appendix is not fine. - No, Mark. 1332 01:41:53,690 --> 01:41:56,400 You've got plus-four peritonitis, guarding and spasm, honey. 1333 01:41:56,568 --> 01:41:59,028 - No. - Susan, you do. 1334 01:41:59,238 --> 01:42:00,696 No, I don't. 1335 01:42:02,699 --> 01:42:04,492 There's no question about it. 1336 01:42:07,246 --> 01:42:11,707 Mark. Check my white count and sed. rate. It's normal. 1337 01:42:12,376 --> 01:42:13,835 Please. 1338 01:42:20,843 --> 01:42:21,926 Huh. 1339 01:42:22,094 --> 01:42:24,387 - The tests aren't here. - Unh. 1340 01:42:25,639 --> 01:42:29,142 But with these physical signs, it has to be appendicitis. 1341 01:42:29,393 --> 01:42:30,393 Please! 1342 01:42:30,561 --> 01:42:32,812 It's better to be safe and have the operation. 1343 01:42:32,980 --> 01:42:35,064 - Unh. - Besides, you're in the best of hands. 1344 01:42:35,274 --> 01:42:38,651 Dr. Harris himself will do the procedure, huh? How about that? 1345 01:42:38,986 --> 01:42:40,903 The chief of surgery is taking your case. 1346 01:42:41,071 --> 01:42:42,321 I don't want him. 1347 01:42:42,531 --> 01:42:46,075 - Well, how's our patient doing? - Fine. Just slightly delirious. 1348 01:42:46,285 --> 01:42:48,911 That's normal with appendicitis. 1349 01:42:49,121 --> 01:42:52,039 Besides, we all know doctors make the worst patients. 1350 01:42:52,374 --> 01:42:53,583 You gonna scrub in? 1351 01:42:53,792 --> 01:42:57,211 Dr. Harris, we have O.R. 7 ready for your case. 1352 01:42:57,421 --> 01:42:59,172 I wanted O.R. 8. 1353 01:42:59,381 --> 01:43:01,007 It isn't ready yet. 1354 01:43:01,216 --> 01:43:05,720 - I specifically requested O.R. 8. - It'll take a couple of minutes. 1355 01:43:05,929 --> 01:43:08,931 Well, hurry it up. Our patient can't wait all night, can she? 1356 01:43:11,059 --> 01:43:12,101 You scrubbing in? 1357 01:43:12,978 --> 01:43:15,938 Uh, excuse me. Let me just answer this page, sir. 1358 01:43:21,904 --> 01:43:23,487 Yeah, this is Dr. Bellows. 1359 01:43:23,697 --> 01:43:24,739 Yes, Dr. Bellows. 1360 01:43:24,948 --> 01:43:25,948 It's that serious, huh? 1361 01:43:26,408 --> 01:43:28,284 Is what that serious? 1362 01:43:28,493 --> 01:43:29,994 All right, I'll be right there. 1363 01:43:30,204 --> 01:43:31,787 Dr. Bellows? 1364 01:43:34,625 --> 01:43:36,375 We're ready in O.R. 8, Dr. Harris. 1365 01:43:36,585 --> 01:43:38,044 We'll start at once. 1366 01:43:38,295 --> 01:43:39,378 Bellows? 1367 01:43:39,630 --> 01:43:41,797 Patient on surgical two's got convulsions. 1368 01:43:41,965 --> 01:43:44,008 - Join me as soon as you can. - Yes, sir. 1369 01:43:44,301 --> 01:43:46,010 You can take her in. 1370 01:43:46,720 --> 01:43:50,473 You certainly are lucky with Dr. Harris doing the operation. 1371 01:43:50,807 --> 01:43:53,142 Couldn't ask for a better man, huh? 1372 01:43:53,352 --> 01:43:55,144 - I want— - Now, now, just lie back. 1373 01:43:55,312 --> 01:43:58,147 You're going to have a nice sleep. Just relax. 1374 01:43:58,523 --> 01:44:00,316 Easy, we'll take good care of you. 1375 01:44:01,360 --> 01:44:04,695 I found the oxygen line. It starts in the basement... 1376 01:44:04,905 --> 01:44:06,781 ...and it goes up the main tunnel... 1377 01:44:06,990 --> 01:44:10,493 ...and then it plugs in the ceiling that goes to O.R. 8. 1378 01:44:15,499 --> 01:44:17,083 Do we have enough sponges? 1379 01:44:17,292 --> 01:44:21,003 We better order some more 4-0 Chromex. We're almost out. 1380 01:44:41,858 --> 01:44:44,193 We have to do this one right. 1381 01:44:44,820 --> 01:44:49,657 House officers deserve the very best of care in their own hospital. 1382 01:44:54,705 --> 01:44:58,332 I'm giving you Pentothal. Take some good, deep breaths, dear. 1383 01:45:00,335 --> 01:45:02,003 - In and out. - Unh. 1384 01:45:23,108 --> 01:45:24,608 The patient's film, Dr. Harris. 1385 01:45:25,402 --> 01:45:26,986 They look normal, don't they? 1386 01:45:27,321 --> 01:45:31,615 Pity acute appendicitis doesn't show up more clearly in the x-rays. 1387 01:45:39,249 --> 01:45:40,666 She has an inny. 1388 01:45:40,876 --> 01:45:42,084 A what? 1389 01:45:42,294 --> 01:45:44,754 An inny. The bellybutton. 1390 01:45:45,088 --> 01:45:47,715 Some are innies, some are outties. Hers is an inny. 1391 01:46:06,026 --> 01:46:08,486 Let me know when she's fully under. 1392 01:46:13,742 --> 01:46:15,534 She's ready for you. 1393 01:46:16,119 --> 01:46:17,161 Scalpel, please. 1394 01:47:04,209 --> 01:47:06,919 - What's that? - It's a PVC. 1395 01:47:08,547 --> 01:47:09,588 There's another one. 1396 01:47:10,215 --> 01:47:11,340 Too light? 1397 01:47:11,716 --> 01:47:13,008 I don't think so, sir. 1398 01:47:13,760 --> 01:47:15,511 Maybe you'd better deepen anesthesia. 1399 01:47:26,273 --> 01:47:28,816 Blood pressure's dropping. I don't understand. 1400 01:47:29,693 --> 01:47:32,403 - Want me to stop? - No. 1401 01:47:33,071 --> 01:47:34,113 It'll be all right, sir. 1402 01:47:34,698 --> 01:47:38,742 - I'll be happy to stop a moment. - It's okay, Dr. Harris. 1403 01:47:39,161 --> 01:47:40,494 You recommend I go on? 1404 01:47:52,048 --> 01:47:53,090 Son of a... 1405 01:47:56,678 --> 01:48:01,140 Son of a bitch! Son of a bitch! 1406 01:48:01,433 --> 01:48:02,892 Here it is. 1407 01:48:04,019 --> 01:48:05,394 Hmm. 1408 01:48:05,854 --> 01:48:08,272 Looks normal. Never know it from her symptoms. 1409 01:48:08,565 --> 01:48:11,442 It's nice to see the chief get caught sometimes. 1410 01:48:12,277 --> 01:48:13,819 Happens to the best of us. 1411 01:48:14,946 --> 01:48:16,906 Okay. 1412 01:48:30,670 --> 01:48:31,712 All right. 1413 01:48:33,381 --> 01:48:35,299 - You can bring her out now. - Right, sir. 1414 01:48:42,349 --> 01:48:44,767 - Uh-oh, Dr. Harris. - Yes? 1415 01:48:44,935 --> 01:48:46,852 She's not coming around. 1416 01:48:47,020 --> 01:48:50,272 Just give her a minute. I'm sure she'll be just fine. 1417 01:48:50,440 --> 01:48:51,440 I don't know, sir. 1418 01:49:03,119 --> 01:49:04,578 She's okay, sir. 1419 01:49:05,163 --> 01:49:07,289 She's just fine, Dr. Harris. 1420 01:49:07,666 --> 01:49:09,166 Nice case, Dr. Harris. 1421 01:49:49,874 --> 01:49:53,085 Mark. Mark. 1422 01:49:54,170 --> 01:49:56,880 - Don't let him do the operation. - I know, baby. 1423 01:49:57,591 --> 01:49:59,008 I know. 1424 01:50:14,774 --> 01:50:17,234 We're waiting for you, Dr. Harris.