- Parks and Rec is about
to get medically wrecked. Pee-woo! (gun shoots) - [Ron] Ah! I've been shot! - [Woman] Oh my God. Oh my God. Oh my God. Ron, I have you hat. Ron I have your hat. - Why is no one calling 9 1 1? Why do they think they could solve this? Like, this is an office issue. - I was shot in the head with a shotgun. - Ron. It's actually not that serious. I just need you to stay calm, okay? - Yeah. I'm just gonna stay angry. I find that relaxes me. - Okay, here's your scotch. - Okay, Jerry. Jerry's here. Here's your scotch, Ron.
Here we go, Ron. Okay. - Scotch can actually make you bleed more. So that's not something that we want. - The pain medication I
gave you is pretty strong. Donny uses it for menstrual cramps. How many did you take? - Seven, eight...but I washed them down with plenty of fluids. - But Ron, you cannot
drink scotch with this. You're gonna need to purge right now. - Pain medications,
especially ones that include acetaminophen, AKA Tylenol, with alcohol, can be quite disastrous. In fact, one of the leading causes of acute liver injury happens to be Tylenol intoxication. Whether on purpose or even by accident. I see it quite often
when patients are like, oh I took some Tylenol, and then I took some Coricidin or NyQuil, these are all things that
contain acetaminophen, but because they have
different brand names, people don't realize it, and they like get a toxic dose of Tylenol. We recommend ideally maxing out at 2000 milligrams of Tylenol a day. But the max dose is 4,000. - This is for your own good. - I don't want you. - Open your mouth? - If that is Ipecac, this would make it a lot easier. - Hey Anne, are you still a nurse? Or did they fire you because
you slept with all the doctors? - Whoa! Someone belongs on Grey's Anatomy. - Andy's not feeling well. - What's wrong Andy? - Just got a headache
and I'm seeing double. And I got a song stuck on
my head, and my teeth hurt. Also, I'm hungry. - Not gonna lie. Most of my patient visits
go exactly like this. For us doctors, we want to address one concern at a time in order to give it adequate time and effort. But patients don't work by check boxes. So they tell you everything
that's wrong with him. Then we have to decide, is
this all due to one cause, or are we gonna take this
apart in several visits? - Did you hit your head? - Yeah, he was hanging up his gold record. (head bangs) Oh my God. Are you okay? - Yeah. I'm good. (Andy falls) - Look to the left. The right. Whatever. (laughs loudly) - The best fundoscopic
exam I've ever seen. You can't do a proper fundoscopic exam when a patient looks so far to the left and so far to the right, 'cause you gotta look through the pupil. - Well, if it's a concussion,
it's extremely mild. So I wouldn't worry about it. Anything else bothering you? - The way that I like to do it, is say, okay, based on reason, X, Y, and Z is why I don't think this is inherently dangerous right now. Things you need to be on the
lookup for are X, Y, and Z. The patient can then
understand why I'm making the recommendation. To understand that if something changes, that now is outside of my
initial recommendation, they know when to come back. - Got a weird rash in my knee pit. Sometimes when I walk my ankles make like a
weird rattle snake sound. Broke my thumb on the way over here. - Whoa, that's a serious break. There's a lot of bruising. - We made like a hundred
million doctor's appointments for ourselves in one week. After this, we won't
have to go to the doctor for like 10 years. - That's not true. But seeing a family medicine
doctor is really ideal, because a lot of these
problems are really not requiring the consultation
with a subspecialist. We can handle them in family medicine. So Dr. Harris seems to be a-lackin'. - Oh let's get you home
and get me some ice cream. - Here's your bill. - Oh yeah. We won't be needing that. I've got the free medicine card. - (chuckles) Free medicine card. - (Indistinct) a deductible
for dental procedures. - Oh, I think you're wrong. We have the insurance thing. I believe we're covered. - It's still $500. - You know what? Go! Dine and dash. Out of the way! - Wait, he got a dentist appointment and then he's in an ICU all of a sudden? Where is he? - Woo-hoo! (head bangs) - Oh, call an ambulance! - I'm making the water
fountain hygiene upgrade our number one priority. - Great! For some reason, when people in Pawnee
use the water fountain they put their mouth completely open. - Ew! Oh my God! That's my worst fear! Oh, that's a sure-fire way to get herpes. Speaking of it. - I have a hernia this morning. I made the mistake of sneezing. (sneezes) - Oh, that looks like he
has an inguinal hernia where intestinal contents actually go through the inguinal
canal into your scrotum. That's right. You can end up with
intestines in your scrotum. - But as long as I sit still
and don't move, I'm good. I got this. - The most dangerous part about having a hernia is
if it becomes strangulated, which means that within the
opening that was created and that it went through, some
kind of inflammation happens or stress happens where it
starts getting choked out. And this choking out actually
cuts off the blood supply to that part of the
intestine, thereby causing it to necrose and die, which leads
it to develop an infection. So a strangulate hernia
is a surgical emergency. (bread thumps) (laughs) - That was actually really funny. - But the best part about
being an MRI technician is I can see inside of everything. Look inside this steak or
this butter or this bread. - Well if you look inside this bread all you're gonna find is more bread. - I don't know. I'd have to do an MRI. (laughs loudly) - I mean, I've never
even had an MRI before. - What? - Is he taking her to get an MRI, in a claustrophobic loud little
space that you have to sit for long periods of time? Ugh. - I don't know about this. - I'm offering you a free scan. Usually cost up to $2,000. - Free scans are not
necessarily good scans. In our bodies, we have all sorts of little growths and
differentiating markers. Some of these things go away. Some of these things,
aren't actually a problem. If we find them on imaging when we're looking something else we actually have a name for
them called Incidentalomas. And these things are not
usually meant to be found. Finding them just results in more scans, more radiation, more
healthcare related anxiety, more testing that you don't need, and the reality of us actually
trying to save your life by finding this thing, are almost zero. - How's that feel? - Ah, weird. - Perfect. - How about asking her if she has any metallic objects on her? Oh, so much can go wrong. - You never had any kids, right Leslie? - No. - You got a great oven. - Okay. Time to go. - Got ample room in there. - What is this even an image of? - You got a big industrial sized oven. - Ah, I'm feeling sweaty. Do I look sweaty? I feel, you know, I need to
use the bathroom one more time. - That's like five times in an hour. - Well, somebody's nervous
about the ceremony. - Or he could have a UTI
causing him to have a fever, which is causing him to sweat, which is causing him
to urinate quite often. (Ben groans) - Ben? Oh my God! - Kidney stone? - Are you okay? I think I'm giving birth. - Kidney stone? - Yep. Big sucker too. - Big sucker. Size is one of
the most important factors when we're looking at kidney stones to decide what to do moving forward. You know, Lithotripsy is
a really unique option where we can actually break up the stone while its inside of you. But we could also go in and
physically retrieve them. - I want candy. - What is he on? - Morphine. That's good stuff. - We could also give
medications like Flomax which can help in the
passage of smaller stones. - Ron, you've been
sweating in here all day. - My God, why is everyone sick? - Yes. Plenty. - No, you need to drink water. - Usually I take it neat but I will make an exception
in the name of health. Last night, I watched a movie
with Diane and the girls in which an orange fish is
separated from his father. The children were sniffling,
which I believe to be due to the sad nature of the film. I was wrong. - Kids are Petri dishes. They touch everything. They bring it right up
to their noses, mouths, eat it, then get sick and
then pass it along to us. - I am a grown man. I've had a cold before I need no help. So if you don't mind... (Ron falls) - Oh no. He fainted. - Make sure that he has a pulse. Otherwise start chest compressions. - Before you begin a few ground rules. I need you to explain everything
you do before you do it, so I can determine whether
I will allow you...uh! - It's funny. That's what I usually do with my patients. But the other day I had a patient who I was draining an
abscess off of his back, which means that there
was like a pocket of pus, tennis ball size. Almost like what you would
see on Pimple Popper. And as I was doing it,
because it was on his back I wanted to narrate what I
was doing before I did it, so he would feel comfortable. He actually got mad at me multiple times. The first time he said please stop telling me
everything you're doing, 'cause it makes me feel worse. I apologized. And then, when I realized
it was taking a little long, I reassured him and said,
everything's going well, and he reminded me, please stop telling me what you're doing. And I made the mistake
and I apologized again. - Yuck! Balsa wood? You could at least use mahogany. - There's something occluding your ear. - It's sawdust. Just blow. (blows) - Why is there sawdust in his ear, not earwax? - You've got strep throat. Running a prescription for penicillin. - Why was he admitted into the hospital? A, for strep throat? And B, why in the world are his eyes so red for strep throat? Something doesn't add up. - Hey, you look better. I guess actual medicine can be effective. Who would have thunk? - Please leave me alone. - A lot of people don't realize this, but by taking antibiotics
for strep throat, you only decrease the time
that you have symptoms by about 16 hours. That whole, oh, I'd
like to get antibiotics so I can get better for my trip thing, doesn't quite work. - The only problem I see is
that your potassium is low. So just eat a banana once in a while. - Ladies, ladies. - See now a gag reflect? What's happening? - (indistinct). - Oh! That's disgusting! - Let's go wait outside the
bathroom for Tom and scare him. - Ready? And...boo! (girls laugh) (Jerry farts) - Jerry! God, gross! - Guys. - Oh God. I think he might be having a heart attack. - And faring simultaneously? - Medically speaking, how would you describe
what happened to Jerry? - He had mild heart attack. - Is there a term for
having a heart attack while releasing so much gas? - Not really. Gastrointestinal distress is common during a cardiac event. - It's common during any
stressful event, actually. That's why the term, butterflies in my stomach, exists. - I just want to hear the doctors say that Jerry had a fart attack. Is that too much to ask? - You could just have
said it yourself, my man. And if you're having a heart attack, the most important thing
you can do is call 9 1 1 because the time that we
have to save your heart that is not getting enough
blood flow, is limited. And if you're not getting there in time we could actually lose parts of your heart which then can lead to rupture of valves
or walls of the heart. And obviously that could be lethal. If you're having chest pain, you're dizzy, it's radiating up, down, left, right, call 9 1 1. In fact, here's the recommended guidance from the American Heart Association. - I'm just feeling really tired. I think maybe my allergies are acting up. I've already vomited
like five times today. - Vomiting can be a sign of anaphylaxis. That's something we don't talk about enough because people are saying, oh, I'm vomiting, that has
nothing to do with allergies. It can be. From a skin allergy? Very unlikely. Just like a mild skin allergy. - Oh my God. - Is she, is she sick? Are you sick? - No. - Yeah! She's sick. That's why I'm wearing this, and misting myself with hand sanitizer. - Yeah, that doesn't work. And it kind of reminds me of the new Dyson product
that was just put out. I have questions about that thing. - I'm getting better.. - All right, you're burning up. - You're burning up. What? - The fact that she's having
multiple systems involved, watery eyes, runny nose,
abdominal discomfort, vomiting, all of that point to the fact that it's a multi-system
issue likely to be a virus. - Leslie, I typed your symptoms into the thing up here and it says you could have cancer, network connectivity problems. (laughs) - That's actually really funny. - 104.1. - That high. - Leslie you're dehydrated, and I'm admitting you. - Well...temperature is not
correlated to dehydration. If she checked her skin turgor, or evaluated her lips being very chapped, or checked if she was tachycardic, all those things can point to dehydration. In fact, there's something
we could note on the chart, dry MM, which means dry mucus membranes. - It's food poisoning. I have it too. I did not sleep for one second last night. - Did they vomit? - And I cracked the
bottom of the toilet bowl. - Oh God. Don't say that. - It's important that if
you have food poisoning that you don't take motility slowing drugs like Imodium because your body's trying to get rid of the toxin. And by slowing down the
motility of the intestines you could actually keep
that toxin in longer creating a bigger problem. Warning signs in your stool that you could have a
really bad infection, blood, mucus, changes
in your stool caliber, fever, worsening lower abdominal pain. The blood is one of the main ones though. - All right, moving on to recycling. (Ron groans) - You okay, Ron? Just a little tooth pain. I'm fine. - Do you need to go to the dentist, Ron? - I don't like dentists, just a second. (blade opens) - Hey no, no, no, no, no, no. - Don't extract your own tooth now. - Oh no! - Dentist pulled the tooth out yesterday, but it's always a good idea to demonstrate to your coworkers that you are capable of withstanding a tremendous amount of pain. - Why did you have to have
a healthy tooth extracted? Could he just get a root canal? Check out what happens when a doctor lies. Click here to check that out. Crazy patient story. As always stay happy and healthy.
