The Pitt

Hey, I need my cast off.

As soon as you park that outside.

- Morning, Doc. - Olsen.

Happy Fourth.

Excuse me, guys.

Sorry.

Hey, how's it going, Dad?

I'm so sleep-deprived.

My house is starting to feel like a CIA black site.

Have you considered hiring a night nurse?

- You're looking at him. - You got a ripe one coming in

you're gonna have to deal with before everybody out there

- starts puking. - Lovely.

Your replacement came in early.

She brought in a full bagel spread.

- I'm just saying. - She's not my replacement.

She's just covering as chief while I go

- on my little sabbatical. - Three months?

I'll be back before your daughter

- sleeps through the night. - Hey, dude, that's cold.

- Morning. - Good morning.

Good morning, John.

I could have sworn it was still around 4:00 a.m..

Did you guys have an easy night last night?

The waiting room actually looks manageable.

I wouldn't call it easy, but not too bad.

I figured we'd have hands and burns down here a bunch,

but so far nobody's blown off any fingers.

Oh, you know you just jinxed it.

You guys and your jinxes.

- Please, Jesus, please. - Hail Mary again.

- In the sanctified flesh. - Don't let me die alone.

- Just try to relax, Margaret. - I need a priest.

- Hey, hey, Dr. Robby. - What's the good word, Perlah?

All your results came back normal, Mrs. Walker.

I'm dying.

You're not dying, Mrs. Walker, I promise.

Jesus is coming for me.

If He is, He hasn't checked in at registration yet.

Please don't let me die a sinner.

Don't worry, Margaret... We're going to have

the hospital chaplain come and see you in a moment.

I'm not going to last that long.

Yes, you will, because we're going to give you a shot

to keep you alive until they get here.

What are you thinking, Dr. Robinavitch?

500 mikes of cyanocobalamin?

In her condition, I'd push a full 1,000.

Whoo. You heard the man, Perlah.

God bless you. God bless all of you.

Amen to that.

Hail Mary, full of grace, the Lord is with thee...

Ooh, nothing like the miracle healing powers

of a good old B12 shot.

- How does she hold down a job? - She doesn't.

She's wearing a waitress uniform.

Yeah, from a diner that closed 20 years ago.

Tier One Trauma, ETA six minutes.

And so it begins.

My husband is still waiting to see a doctor.

I apologize for the wait,

but here are two doctors just for you.

Mr. Burgess has been complaining

of leg cramps for a day.

Slightly tachy at 110, BP 128 over 75.

Afebrile, good sats.

I'm Dr. Shen, but I'm going off shift.

Dr. Robinavitch will be one of the doctors looking after you.

What other medications

are you currently taking, Mr. Burgess?

I brought his meds.

Thank you.

These are his supplements,

mostly all-natural and organic where possible.

And these are his homeopathic prescriptions.

I also have a list of his refrigerated probiotics.

Where the hell is everybody?

Our new attending is torturing

our intern and med students in Trauma One.

She came in early to meet the night shift

and took things over.

Okay, that takes giant balls of disrespect.

Giant Balls of Disrespect

was the name of my band in high school.

And my nickname for my ex-husband.

Hey, uh, is this your last shift?

- For a while, yeah. - Oh, I am so jealous.

Hey, I'll pay you a grand if you take my second husband.

Tempting.

So tell me about this new attending.

Uh, she's pretty, divorced, one kid.

Can already tell she is a strict rule follower.

I'm probably going to grow to hate her.

- What's her name, again? - Dr. Baran Al-Hashimi.

Al-Hashimi? What is that?

Irish?

She's some sort of clinical informatics expert.

Once she started talking about AI,

I started thinking about robots and kind of stopped listening.

Clear. Off the chest, Ogilvie.

Get ready to step up here, Joy.

Ogilvie, off the chest!

Clear!

Still V-tach, but it looks weird.

- Agreed. - No pulse.

No effusion, good lung sliding.

Start compressions, Joy.

We haven't considered all the Ts.

I checked for tamponade and tension pneumo.

What if it's thrombosis?

If it's a pulmonary or cardiac clot, TNK could save him.

We are sticking with the algorithm for now.

- Algorithm's not working. - Faster and deeper, please.

- Uh, you need a break, Joy? - No, I need an attending.

I'm right here.

Stop compressions. We're calling it.

Sorry, the patient's dead.

All right. Who can tell me what went well?

We followed the V-tach algorithm.

We checked for reversible causes.

We limited our rhythm and pulse checks to 10 seconds.

Excellent.

Should we have given thrombolytics?

No, you should have recognized

that the cardiac rhythm on the monitor was polymorphic,

not just V-tach.

It was torsades de pointes.

That's French... "twisting of the points."

From prolonged QT, antiarrhythmics,

electrolyte disorders.

Your patient would have lived

if you had pushed magnesium sulfate.

Good news is he's an organ donor.

Parts of him are going to get used to make Frisbees

and water bottles and end up as micro plastics

in our brains and reproductive organs.

Thank you for the words of encouragement, boss.

Dr. Al-Hashimi, Dr. Michael Robinavitch.

- Everybody calls me Robby. - Baran, please.

- Welcome to the Pitt. - Yeah, about that...

Trauma's a minute out.

Ooh, who wants to treat a real patient?

Yes, please.

This thing's going to give me nightmares.

I hope you don't mind me jumping right into things.

I find that a mock code is a great way

to assess the students' capabilities.

Well, it might have been nice if we'd had a little time

to go over how we do things.

Did you not get a packet from Dr. Underwood? Gloria?

It outlined the quality-improvement changes

I instituted at the VA.

We're adopting the program

at all of the university hospitals.

- You didn't read it? - No, I did. I mean, I will.

I'm going to. I want to.

I thought I had a little bit more time

- before you came in today. - We've already distributed

patient passports to everyone at registration.

What is a patient passport?

So glad you asked.

- Samira? - Dr. Al.

We worked together at the VA a few years ago.

- And now you're an R4. - Yes.

And I'm so excited you're joining us.

Dr. Mel King is here, too.

I think you worked with her as well.

- Incoming! - I did indeed.

John Doe... dishwasher, penetrating trauma

from a kitchen knife to the right chest.

- Assault or accident? - Unclear.

Initially had a pulse, lost it two blocks away.

What do we got, party people?

Dr. Yolanda Garcia, trauma surgery fellow,

meet Dr. Baran Al-Hashimi, new E.D. attending.

She's gonna be covering for me while I'm gone.

So nice to meet you.

About time they replaced you, Rabbit-bitch.

I'm gonna miss you, too, Yolo.

Dr. Garcia has a hard time expressing her feelings.

Not all of them.

One, two, three.

- Prep for a left thoracotomy. - I'm on it.

What's up, White Chocolate?

Did you know our farm boy here is a vintage-funk freak?

Unfortunately, he also likes to use

- other people's toothbrushes. - It was one time.

They were the same color.

- What's your plan, Samira? - Dr. Mohan, next steps?

Chest tube to the right.

Stand by with massive transfusion protocol.

I put two units on the infuser.

Sterile gloves, 6 1/2.

Here, we let the fellows

and the residents kind of take charge.

I'll hold on to them just in case.

Is the VA even a trauma center?

Not for medic runs, but they walk in...

Falls, major MVCs, GSWs.

Stab wound's on the right.