- Before I hit play, I wanna let you know that this video is
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them on a cooking video. (woman singing) - Can't handle the heat,
get out of the kitchen! Since we filmed that video, I've become even a bigger fan of Blue Apron, and I've seen the very positive comments you guys have left down
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who is a novice chef and doesn't really know how to cook, it makes the process a lot easier. I always say, the most important thing is to be in charge of your health, and one of the major ways to do that is to know what goes into your body. (intro music) I was probably four years
old when this show came out. So a lot has changed in medical practice. But I think it's gonna be kind of cool to show how we've evolved
in our medical practices. The colors are accurate. It looks like this could
have been filmed today. I think that probably has something to do with the fact that hospitals
haven't been updated in decades in their appearance. - You ain't seen nothin' yet. - It's never a good idea to take the cap off the syringe with your mouth. 'Cause what if it flicks off and then you end up stabbing yourself in the face. Not a good idea. I get sometimes in a trauma
situation people do it, there's no rush to be had here. So take it off with your hands, throw it in the sharps bin, make sure you don't stab
somebody and get a needle stick. - Your hand is still attached. Not by much, but it's gonna be okay. - Never a fan of promising
patients results. I understand in a trauma situation you need to calm people down, because when you calm them
down heart rate drops, and you have a better chance of survival. But, I just wouldn't give false promises, I would say, you know, we're
taking great care of you, we're working on saving your hand. The best thing you can do
for us right now is to relax. - Let's go people, that's
a shockable rhythm. - Clear. - He just literally put one of the paddles on the top of her chest, and the other one what looked like on her like abdomen to shock her. That's not the way you do it, you have to do it on the chest area. - I can't stand it! - I'll give you something
for the pain, just hold on. Notify the orthopaedic
we have an open fracture. Give him tetanus and
diamorphine right away! - The reason why they say
specifically open fracture, that means that your bone has broken and has penetrated out of your skin. So that's dangerous for two reasons. Number one, high chance of infection because you have an open wound. Second, because sometimes
the bone can put pressure on your blood vessels, and therefore cause something known as claudication. Which means that you're not getting enough circulation to a part of the body, and then that area can swell and it can be very dangerous and you need
emergen surgery for that. And then on top of it,
you could obviously lose a lot, a lot of blood, because you have an open fracture that you need
to get closed and reduced. - Come on back to us. Come on, baby. - I don't know where his
hands are in that scene. Just because you're seeing
the electrical activity look good on the monitor, you
have to feel for the pulse. If you don't feel the
pulse, that can just be pulseless electrical activity. It means that the heart has rhythm, and the electricity is
there but the heart's not completely beating properly to get the blood flow
going throughout your body. Patient's still in cardiac arrest. It means you have to keep going with your advanced cardiac life support. - Carna had a heart attack, and we were unable to revive him. I'm sorry. - Bastard! You bastards! You're sorry? - I sort of get what this
patient's going through. I mean, I've lost family members before. But it's also inappropriate to be physical with any healthcare professional. Doctor, nurse, PA, anybody. The one thing that Zdogg
does a really good job on, you could check out his channel, he also makes really good medical videos. He stands up for healthcare worker abuse. And we really need to put
more attention to that because it's contributing
to doctors burning out, nurses burning out, increasing rates of suicide in the
healthcare profession field, because, while this
patient lost his one father and he's acting this
way, it's understandable. But this doctor's gonna see,
20 30 patients like this, and if they all do this,
you're not gonna last a very long time practicing, especially if you're working five six days a week. Oh, paper charts. I haven't touched a paper chart in ages. - You work 36 hours on 18 off, which is 90 hours a week, 52 weeks a year. For that, we are paid
$23 739 before taxes, and we also have to make the coffee? - My heart is breaking. - Residents nowadays make
somewhere in the range of, I would say 40 to 65 000, depending where your program is, what
kind of program it is. Now there's hour
restrictions in place, where, interns especially can only
work 16 hour shifts at a time. You have to have a certain amount of hours in between your shifts,
there's weekly caps. As I mentioned in my Grey's
Anatomy review video, the Libby Zion Law in New York State started this trend of instituting
hourly caps on residents, and it spread to all 50
states at this point. - [Pager] Dr Green, your wife
is waiting in the cafeteria. - Dammit. - We still have pagers, and sometimes you can send them messages to your phones. But the reason they were trying to reduce the amount of pagers overhead is to allow patients to rest and sleep. If you think about it,
who's in the hospital? Sick people. People who need to get better. How do they get better? Through rest, because body heals itself. If you constantly have
pages going on overhead, it's very difficult
for a patient to sleep. - Oh now, would you look at this? That's the first tailored
white coat I've ever seen. - This is really funny. So, Noah Wyle, this actor. People tell me all the time
how much I remind them of him. - I probably get that more than I get the whole McDreamy thing, even though the McDreamy thing's a running joke, but people say I look so much like him. This first comment that I see of them is them making fun of the fact that he has a tailored white coat. And I actually have a white
coat that's very fitted, and my nurses and my colleagues always make fun of me, like, ooh, look at Doctor Mike with
his fancy white coat. I just think it's important
to look professional, clean, and you know, suited up as a doctor. You know, you work hard, you wanna preserve this image of professionalism. So I don't think it's a bad thing. And I know they're gonna
pick on him 'cause, I've experienced people
picking me about it. - It's an Angiocath with a 16 needle. You need a large for in
case they are bleeding and you need to transfuse them. Do you know how to start an IV? - Actually no. - I thought you were third year. - I am, but all I've done is
dermatology and psychiatry. - As a medical student,
in your first two years you're pretty much in a classroom and just learning the curriculum, everything you need to
know about the human body. - In your third year, you start doing your clinical rotations,
especially your cores. Family medicine, internal
medicine, surgery. It's not unusual for a third year to come in and not know how to do an IV. And generally, they're trained by either senior students, or young
residents or interns. It's scary, being on your
rotation for the first time. The way that I came about
it, and I had some success, was that I came very
very excited to learn. And I wanted to learn how to do IVs, and I wanted to learn
how to do procedures. And anything that
somebody would let me do, or let me watch, or let me practice, I would be the first to volunteer. I wouldn't try and steal
opportunities from other people, 'cause I don't wanna be a gunner. And a gunner's a person who tries to, put other people down, or get
themselves ahead at all costs. Even if it hurts someone else. Wasn't one of those people. But I was very motivated. And if you're a medical student, and you wanna shine on
rotations, be motivated. - Okay ma'am, we are gonna
push on the next one, okay? One, two, three. - The best way to deliver a
baby is during the contractions, you should tell the patient to push, and you want them to hold the pressure for the push as much as possible. And then if there's time, they can exhale, gather their strength, and push again while the contraction is going on. Pushing while the
contraction is not going on is not ideal because the uterus is not contracting the baby out. Therefore you're not gonna have any real success in getting the baby out. And is that a newborn baby. It's a very large baby, you could tell. So now what we do in the hospitals, is, if the baby's crying,
and the baby's breathing, the first thing we do is right away put the baby on the mom's breast. That has shown the best results. Bonding with the baby is very important. It calms the mother down,
it calms the baby down, it's one of the things that we're really pushing in all the
major hospital systems. - Nice and red. He has otitis media, you'll be fine. - Otitis media is a very
common ear infection in young children, it's
when the middle ear becomes infected with usually
a bacterial infection. You do need antibiotics for it because it can actually spread to the
local tissues, to the bone. There's a part of the skull
called the mastoid process and you can get mastoiditis there. It can be very dangerous, especially when a baby's so young and fragile, especially in the early days of life. - Everyone has a family, Mark. My wife wants to shop, kids grow up. You go to private school, college. You gotta think about that. Now, the office for our
next associate is here. - The constant dilemma for ER physicians is that you often work very long hours. The hours that you do
work are very stressful. You're seeing a lot of patients. There's a high stress rate in this type of job because you never know what kind of patients you're gonna get. What this doctor's
essentially offering Dr Green is to leave the ER, work
as an outpatient physician. Where he would have a
little bit more flexibility, a little less stress, better lifestyle, but he's not practicing
the type of medicine he seems to wanna practice,
and he dreamed of practicing. So it's always a decision that I see my colleagues struggle with that do they want the intense excitement of working in an ER
setting, or do they want something more suitable
to their lifestyle, that they can start a family,
be attentive to their family, have a more set schedule
with weekends off. If you are really passionate
about a specific field of medicine, you can't
imagine doing anything else. So I can totally see Dr
Green saying no to this and saying I would prefer
to work in the stressful ER because that's where his passion lies. - Are you afraid to tell me the truth? - Your history of coughing blood, weight loss, and this x-ray,
is suggestive of cancer. But the diagnoses has not been confirmed, and it may very well be something else. And none of us should jump to
any conclusions until we know. That's what I think. - How long do I have? - Six months to a year. - No doctor could look at an x-ray and from the x-ray just make a guess of how long a patient has from
life expectancy standpoint without a biopsy, bronchoscopy,
without a CAT scan even. What she was doing in the
first place was correct, you have to tell them that
what you suspect it to be, give your differential, explain
the next step in treatment, but not to give him a life expectancy. That's wrong. It's gonna be inaccurate. - You told me how long has it been since you had your last period? - I don't know. - Just think back. Tell me roughly. - It was after Christmas. - Okay. So it's been a few months? - I guess so, I haven't
really paid attention. - And you've had sexual intercourse? - Yes. - Dr Carter? What you have is an ectopic pregnancy and she needs to be scheduled
for ultrasound and surgery. Right away. - What is going on right now? He asked her when her last period was, she said she wasn't sure,
maybe a few months ago. He asked if she had sexual
intercourse, she said yes. And he just makes a diagnoses
of an ectopic pregnancy without doing a physical exam? This is just, this is so inaccurate. You may suspect an ectopic pregnancy from doing a physical exam,
and getting a full history, but you don't diagnose someone with that. That's just, it's wild. She could have so many other things. She could have, because
it's left lower side in abdominal pain, it could be something with her stool,
she could have a lot of gas, she could have diverticulitis, obviously not so common in her age group. Even sometimes appendicitis,
which normally happens on the right side, can present with lower left side in abdominal pain. She could also have a cyst in her ovary that could be causing discomfort. So to just say that she
has an ectopic pregnancy from that, oh my god that's so wrong. - You people standing around for, huh? - Do the arterial stick. She got a Babinski? - Yeah. - So, a Babinski Reflex is
when you stroke the bottom, or the sole of the foot
with a sharp object. Not a very sharp object,
with like a pointy object, like the back of a reflex hammer. And if you stroke upwards,
the toes in an adult are supposed to flex downwards as if they're grabbing the object. If they extend away,
and the big toe goes up, that's actually a sign of
central nervous system damage. And in times of an overdose, that could be a very bad predictive sign. - How did this happen? - He fell out of his crib. - He fell out of his crib. - I mean, he was crying all
night, so I brought him here. - I bet he's been
crying, when did he fall? - I don't know. I don't want to get into trouble. - Ma'am, your son has
multiple contusions -- - He's not my son. - You know, whatever! - So, a young child
with multiple bruising, multiple contusions, is very suspicious for child abuse, and it would need to be screened by children or family services. Another thing that makes this suspicious about child abuse is fractures in different stages of healing. Also a child that is scared to talk in front of their parents. Could be an early sign, speak in front of their parents, could be an early sign. Because they're hiding how
they got their injuries and lying to you to try and
cover up for their family. A very unfortunate
common death in children, especially young infants,
like six months of age, three months of age, is
Shaken Baby Syndrome, where after crying for a
very long period of time, frustrated parents will
shake their baby very hard to get them to stop and actually cause severe spinal and or brain damage, which causes the baby to
stop breathing and die. It's horrible when this happens. I've seen this happen. So that's why I always screen my parents, my parents, my patients who are parents, to find out how they're
doing in raising their child, if there's any symptoms of depression, if they are overly stressed out because then I try and get them help, and give them some stress
management techniques and really tell them what to do in case that they're feeling
these emotions creep in so they don't make a
horrible mistake like that. - He was standing. Blocking traffic. But he's got that smell,
so I thought I'd check. - You did the right thing. We've got a diabetic
ketoacidosis, let's go. - Very commonly, folks who are in diabetic ketoacidosis, which means that their blood sugar is so high, their blood is become acidotic and, all the functions, all
the cellular processes that go on in your body, start collapsing, and breaking down, and you can die from diabetic ketoacidosis, and what this police officer is saying is
you got that smell on him is 'cause you have a very fruity aroma when you're going through
diabetic ketoacidosis. It's a very distinct smell that
if you've smelled it before you know exactly what the
police officer's talking about. That feeling when you go to sleep, and you know you have couple hours to nap when you're on call, oh my god those are the most precious hours 'cause your eyes are just closing. And you're just exhausted,
but it feels so good, even like 30 minutes of
sleep, it's really important to prevent you from going crazy. - [Woman] 6:30, Dr Green. - And it really does feel like that. You slept 10 seconds
and it's been two hours. ER is a classic, it's
well-written, it's well-produced. I really could see myself
binge-watching this show. I mean, I watched this show when I was like eight nine years old, but now being a doctor,
it's cool watching this and learning how they did certain things back in the '90s, what problems they had. So if you wanna binge this show, it's actually available on Hulu right now. Like I always say, if you
have any recommendations, or you have some questions,
jump into the comment section. 'Cause you know I respond,
if not down there, in my monthly Responding
to Comments video. As always, stay happy and healthy. (epic music)
