Complete Season OneDVD - 2018
From the critics
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Um, hey, man. Know where I can find Dr. Conrad Hawkins?
-Namaste. You found him. Take off that tie. You're not at Harvard anymore.
Top of your class, followed all the rules, and you think that puts you at an advantage. It doesn't. It just means you have more to unlearn than the guys who weren't paying attention.
I have only one rule. Covers everything. I'm never wrong. You do whatever the hell I tell you. No questions asked.
- Do you want me to speak now?
That's a question. No, no, no, no, no, no, no. Don't do that. Don't do that. Eyes on me. My last resident had an attitude, too, and you know where he is now? He's teaching eighth grade biology. I cut him. Do you know what that means? It means I can end your career. Just like that. Remove you from this residency at any time, for any reason. And if I do that, no other residency will take you. All you'll have left from that fancy Harvard medical school degree is a mountain of debt.
What's the first sign of paralysis?
- Anal tone.
Stick your finger up his ass.
-Normal procedure is to get an MRI.
Thank you so much for telling me about normal procedure. An MRI would take hours and delay steroid treatment and surgery,
Let's say your car has a rattle. So you take it to a mechanic and this guy's kind, polite, eager to help. For two days, he runs every test in the book. And then he calls you and says it's gonna set you back a thousand bucks. So you max out your credit card and on your drive home, guess what.
You hear the same rattle. Or you could take the same car with the same rattle to another mechanic. And this guy is rude, uh, dismissive, arrogant, but he tightens a bolt, fixes the rattle, charges you five bucks. Problem solved.
-This is nothing like that.
No, because your car can't end up dead. Watch and learn. Conrad's the guy who tightens the bolt.
You need to consider a change before you kill any more patients.
-How dare you?
Go be one of those celebrity TV doctors. You look the part. Make a lot of money, wear nice clothes. You'd be great at it.
- You watch yourself, Conrad. You know, I'm remembering a pretty, young resident that reported a fatal chemo overdose a couple years back. That good deed that led to a lawsuit that cost the hospital millions. You tell me, Conrad, where is she today?
These are Osler's nodes caused by bacteria swarming in your blood and moving throughout your body. Classic for endocarditis, an infection of the heart valve. Happens to drug users all the time. If you walk out of here without any antibiotics, this will kill you. If you give us a chance, we can save your life.
-I'll stay if you give me three milligrams of Dilaudid.
As you can see, the robotic instruments are smaller than your fingernails. But that blade is sharper than a #11. This represents the union of human ingenuity and cutting-edge technology. Man and machine are melded, working as one.
She's been without oxygen to her brain for 26 minutes. Congratulations, you got her heart beating again, but she's brain-dead. You came in here all bright-eyed and bushy-tailed, ready to save lives, but today you didn't save a life. You saved a brain stem because you didn't listen to me. Now the repercussions on Chloe's family will be catastrophic. There's no way they'll accept this. Chloe looks alive. They'll think she can wake up. So they will hover over her, tend to her for days, weeks, maybe years, waiting for a miracle to happen that's utterly impossible. What was rule one, Devon? Do whatever you tell me to do. No questions asked. All we want to do is help our patients, but what they don't teach us in medical school is there are so many ways to do harm.
I heard a nurse call him HODAD. What does it stand for?
-Hands of Death and Destruction.
You're kidding. Does that mean everyone knows about his complication rate?
-All the nurses, some of the doctors. The ones who pay attention. Poetry. But none of the patients. They're clueless.
Medical error is the third-leading cause of death in the United States after cancer and heart disease. They don't want us talking about that.
-But you still show up here every day.
'Cause it's personal to me. And there are still plenty of good doctors and nurses trying to do the right thing. I'm just trying to be one of 'em.
I've thought about becoming a millionaire.
-That's not a career path.
So, do you cut people open and take them apart?
-That's a surgeon, Treena. I'm an internist. Someone has to first figure out what's wrong.
Micah's waited two years for a heart. You can't just cut in line for a VIP who hasn't waited two minutes.
- Well, they-they both need a heart. There was only one. It was a tough decision.
My patient is 28, with his whole life ahead of him. That heart could give him 50 more years. Trip Dunlap is 63 and a smoker. His body's far more likely to reject the heart. And even if the transplant takes, what does it buy him, ten more years?
- Look, Dunlap is critical. I mean, he could die tonight.
And Micah, he's waited this long.
- He can safely wait a bit longer.
His quality of life is zero. He was an athlete. He's a science teacher. Loved by his students. I know him. We all do, because he's been in and out of here so often. Three times we thought we had a heart. Three times he was sent home. Zero complaining or self-pity, ever. This guy, he's golden.
-You want to tell Dunlap's daughter her father is less deserving?
I used to practice making stitches with my hands jammed inside a tin can, just to simulate that tight body cavity.
Why didn't she want to be a doctor?
-Because she's smart. Nurses get to spend time with patients. We don't. They have a strong union, earn overtime, make good money. For all of residency, if you figure the hours we're working, interns and residents make minimum wage.
Well, I still think she'd make a good doctor.
-She's working on her doctorate. Doctor of Nursing.
No doctor whose patient could benefit from an organ donation can make the case to a family to withdraw life support.
-It's a hard and fast rule, and a good one. The hospital, on the other hand, could step in.
Lily's more likely to get another infection here than she would be at home. One in seven patients end up with a hospital-based infection. People on chemo are most at risk for everything from the flu to MRSA.
-That's why I get my chemo at Dr. Hunter's clinic.
Now, my approach to this complex procedure will die with me if it isn't passed on to the next generation. We are a teaching hospital. See one, do one, teach one. It's our tradition.
I am not your slave, your shadow, or your echo.
Now, to simplify, doctors and nurses at Chastain need to charge more per procedure. For example: ear infection. Typically billed to insurance as service code one at about yeah? $200. But what if that ear infection took a trip to the brain? That's now a code four. Serious. Costly. We can bill in the thousands. Illness is unpredictable, so billing must be proactive. Right? It's called upcoding. Think CUTE. Code. Up. To. Excellence.
My brother was in the army, two tours in Iraq. He came back a very different guy.
A well-insured patient should be tested for all possible outcomes, no matter how unlikely.
What is the most fun you have had in the last week? My guess? You and me fixing up Hank in the back of that pickup truck. Seat-of-our-pants medicine.
-Nobody telling us what to do or making us fill out forms. Then what happens? We come back to work, and a patient is trying to run away because she doesn't have insurance.
How many wounded Marines did you ever ask for proof of insurance?
-Well, I guess I got my work cut out for me, then, don't I?
You keep tilting at windmills, huh?
She didn't run away because she doesn't have insurance, she ran away because she's an undocumented immigrant. She has a highly aggressive tumor. If she doesn't get surgery right away, she dies.
-No more tests, no more treatment on our dime. This hospital isn't a charity.
Ms. Rodriguez is an uninsured, undocumented immigrant. She has no family in this country. She was brought here from El Salvador as a child. No one can take her once she leaves the hospital. State rules are clear on this. Ms. Rodriguez cannot be released into her own care. That means Chastain would be stuck with her for a long time. She'd be living here at our expense. She would be a Perma Patient.
Okay, best-case scenario, what is Louisa's care gonna cost us? Chastain does the surgery, it goes well, post-op, she can walk with a physical therapist down the hall half a million dollars.
-And worst case?
Post-op, Ms. Rodriguez can't even get out of the bed two million dollars.
Mm, you know how to cut. But you don't know when not to.
Doctors must support each other through good times and bad. You, of all people, should know that.
-I'm grateful for all you did for me in the past, but I have to speak for my patient.
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