- I'm so happy you guys are enjoying the Doctor Reacts series. Please subscribe if you're
enjoying the videos. I jumped into the comments section and I hear you loud and clear. Code Black is up next. (rhythmic pop music) (static) An influx of patients so great, At the different hospitals that I worked there were different definitions of code followed by a different color. For example Code Blue generally meant that someone's heart stopped
or they weren't breathing. Rapid response meant something. Code Pink sometimes meant
that a baby was abducted from the newborn nursery. Code Black generally referred
to like a terrorist threat or some kind of crime going on. I've never heard this type
of definition from this show but, it does make sense. Hospitals get overcrowded,
especially in busy areas like Los Angeles. I'm excited to watch this. - Your momma know when you're
lying, crying, or dying and it's not only my job to
teach you right from wrong, but to make sure you don't
leave here in three years thinking you can do no wrong. - One of the biggest things
you have to do as a doctor is learn that there's
a lot you can do wrong. I'm talking about over treating,
over diagnosing patients. That's truly a health
hazard that most people don't even think about. So, I love this nurse and
frankly I love this actor, so I'm super excited to
see him in this show. - The most famous strip
of hospital real estate in the nation, where
emergency medicine was born, where the secret service
reserves a trauma bed for the President of the United States when he is in Los Angeles. This is trauma one. - Wow. - Angels Memorial. You are not under any
circumstances allowed to kill a guest in my house. - I love this orientation,
this is so good. - What the hell is the homeboy drop off? - Gang bangers leave the
wounded on the sidewalk. - I've worked in numerous
hospitals uh where the ER was in a part of town where there was a lot of gang related activities and literally people would
walk into the hospital or get thrown out of a
car with a gunshot wound and there was one time I
literally got a patient that crawled into the uh emergency room bleeding from his femoral artery, so I had to grab a glove, stick my finger into his femoral artery and
pull him to the bed and pull him to the bed and get the
whole process started with the trauma team. I remember that because my
hands were so covered uh in blood, at least up to my
uh elbows, that I was like oh man, I have to wash
this off really quickly cause that's the first step
of infection control is to wash your hands. I left the trauma scene and
the trauma bay and walked to one of the nearest um sinks
to wash my hands properly because the situation
was being taken care of by a lot of doctors, and then I realized I was tracking blood
all across the hospital, so the maintenance staff looked
at me with these angry eyes and I was like I'm so sorry,
I didn't mean to make a mess, but literally they had to
clean up my bloody footsteps that traveled halfway across the hospital to go wash my hands. It's part of life, it's
scary but it's part of life. - Gunshot wound to the
neck, obliterated carotid. He's lost half his volume here, Jess, we got to get him out of here
- Oh my god, that's dangerous - Just get the gurney
underneath him please. - Alright, you get over
there on the other side and push with both legs. One, two, three, go. - So this is very realistic. I know it looks like they're being rough and they're kicking the
patient out of the uh SUV, but that's true because
you literally have uh seconds before the person
completely bleeds out and dies, especially from the carotid artery. Plugging the wound
obviously is the first step, so they're doing a great job. I'm assuming they still feel a pulse cause they said that the
artery was still wiggling. So right now, the most important thing is to fluid resuscitate this person, meaning to give as much fluids as you can with two large bore ivs. Large bore meaning thick ivs
so they can deliver a lot of fluids very quickly and then it's to obviously
give them uh blood back, donated blood that we have in the hospital from the blood bank, and give
them as much blood as we can in the short period of time. - Look at his pulse, doctor, this man's heart need's assistance. - Stop compressing til we can intubate. - Got it? - Yeah. - Who can tell me why this
patient can not be transfused in type and crossmatched blood? Anyone? - Because it takes time to
type and cross someone's blood, so therefore you want to give them blood that's universally considered donor blood, which is O negative blood. - I need a hero, come on. Come on, let's go find
you an attending to annoy. - Honestly, this is so accurate, because at times the hospital's busy you have to find a doctor
to shadow or learn from or follow around and it is
sometimes unorganized like this, especially when it gets busy. - What's your name? - Ariel. - Ariel, I'm Dr. Rorish and the truth is we don't know
why your father's unconscious and I can't learn anything
out here in the dark. So with your permission,
I want to take him inside and I promise you I will
tell you everything I know as soon as I know it, okay? - Okay. - Very good doctor-patient relationship. I found myself very often
in the emergency room having very serious
conversations like that and I found that yields the best results, so even in dire situations when a family is hysterical like that, the more honest I was with them, and I was brutally honest at times, saying that these treatments
aren't going to help your father, mother,
whoever I was talking about at the time, and I would apologize, I would say I'm sorry I'm being
brutally honest right now, but I want you to make the best decision with the limited amount of time we have and people respected that,
they appreciated that because in reality nobody
wants them to lie to them, nobody wants false promises. - What's your evaluation, doctor? - Patient unconscious,
low bp, warm extremities and he's in spinal shock. - No additional examination. - Uh, it's pretty textbook. - Pretty textbook, huh? - Yeah. - Okay, what about you doctor, textbook? - The way that this attending is teaching, while trying to actively
save the patient's life is very accurate. Like I feel like I'm in the
hospital as a resident learning. It's very accurate, this
is exactly how it happens. She's not giving the patient worse care, which is also educating with pressure in a time sensitive
situation to the residents. Excellent, excellent recreation. - 654 is normal, brain
function 111 is the lowest. - He's brain dead. - That poor kid. - He was confused that
I didn't understand him. - Yes, called expressive aphasia. It's word salad, sounds
right to him but the words come out all tossed around. - Yeah, expressive aphasia
is really interesting, it's also known as Broca's aphasia and that happens if you have
damage to the left front uh frontal area of your brain, so that can happen in car accidents, it can happen in traumatic illnesses, also strokes, basically what happens is, in your mind you know what you want to say and it's you think you're
saying the right words but when it comes out you're saying completely different words and the way that I memorized
this when I was studying and learning about it was
boca means mouth in Spanish so it was like what's coming
out of your mouth is wrong. - TPA is a kind of miracle
drug that has the potential to bust the clot up
and reverse the stroke, but only if there's no actual
bleeding yet in the brain. We're going to need a
scan to know for sure. - So this is the one part about this that's pretty inaccurate. So, most hospitals have stroke protocols when a patient even comes in
with remotely similar symptoms to a stroke they instantly
go to a CAT scan, they instantly get blood work drawn, you instantly page the internal medicine or family medicine residents
to follow stroke protocol, we instantly call the
neurologist and get the robot out and all of this happens
right away because again you have a small time of window that you could actually give the TPA. So it's about the fastest fastest way you can get things done. Never is it standing at
bedside having conversations of oh, let's get the CT scan and see if there's any
bleeding going on. No. - He's brain dead. - Oh, god. - And she's all alone til tomorrow. - Has someone called
child and family services to come get her? - Yeah, but you know how
that goes it could be hours. - It gets worse, he's an organ donor. Transplant team's on the way. - Then we can't wait for
CFS, I have to tell her. - This is definitely the
most medically accurate show I've seen in such a long time. I don't know why I'm
getting excited about it but it's just it's very accurate. These conversations happen in this matter. - Your father died, Ariel. - Well, technically, technically
it's uh a brain death. - So he's not dead? - No, no. That's, what I mean is machines are keeping
his body at a state of - What are you saying? - I'm trying to explain to you - No you're not. What happened to just
giving it to me straight? - I'm giving it to you straight. - So he's dead, but
technically not really, right? Oh, I want to go see
him, I want to see him - I've had conversations like this, again the more brutally honest you can be, at least in the beginning,
that's usually the best policy. My general strategy is to get
as much of the information out there, console them as much as I can, but if they become hysterical, get upset, tell you to shut up, tell you
to leave, never get offended because what they say in those moments that's not who they are as people, they're going through a moment
of shock, emotional shock. I'll leave them alone in the room with maybe someone watching
them a nurse or someone else but me because I'm the
one who gave the bad news, give them some time, and then come see them
once some time has gone by and pretty much every time that
I've done this conversation they apologize, we hug, I understand that they've
just lost a family member, I've gone through that
in my life with my mom. I've actually had to ask
residents to stop doing CPR on my mom, so I know what this feels like and sometimes people just
need a moment to themselves, they need to not see the person who just gave them the bad news, so it's okay to be the bad
person, leave, come back. - Transplant team's in route. I want to tell you how
fabulous you look right now. - I do? - No, I want to tell you
that but then it'd be a lie. (laughter) - You look like you've been
strapped to the bow of a ship. - So true, um, this is so true
- [Dr. Rorish] Is that so? - Interesting about the transplant team. They are a skilled set
of surgeons that come in and basically take the organs as soon as the time of death is called. Actually, um while I
was doing my training uh when I was on the surgical
unit I was one of the people that was put in a room
with the transplant team to call the time of death. You can not start to
operate on the patient taking out the organs, harvesting
the organs, what have you, until the person is completely dead, so we had to stand there
until I didn't feel a pulse and my exam was negative. There's a lot of pressure
and there there was a time where there wasn't a
pulse then he came back so I had to say well you know, wait, and it was a lot of pressure
on me being a young doctor, but I wanted to do what
was right by the patient and waited until the
heart completely stopped, the patient had no pain response, and only then did we begin
uh taking out the organs so they could save someone else's life. - Oh no, don't do that. You don't need anymore
laugh lines, believe me. - Me, have you looked at
yourself in the mirror lately? - Uh huh. - I love their relationship, it's so real - I love you so much, I
want to break you in half. - I love you so much, I
want to punch your face in. (laughter) - There was a recent article
whether or not it's okay for doctors to hug patients
and other coworkers and I thought it was insane
because if we're going to get to the state of where we're not allowed to make physical contact with people, humans crave physical contact. I'm not talking about
inappropriate physical contact, I'm talking about moments like that where you need encouragement,
where you need a hug. Even most recently I had like an eighty-four year old patient that was going through a
difficult moment in her life and I spent an hour with her in a visit, we talked about all the things going on, we treated her medical conditions, she became very emotional and
cried and asked for a hug. Of course I'm going to hug her. - Worst part is the headache. I live above the boiler
room in my building and the noise just keeps
cracking my head open. Is there anything you
can give me for that? - You're nine months pregnant, there's not a whole lot we can do other than give you Tylenol. - I've tried that, it doesn't work. - Using again? - Excuse me? - Mario. - Scars on the inside of
your arm are all track marks, right? - None of your damn business. - Bad bedside manor obviously. I've never seen a more aggressive resident in in questioning a patient. You're going to get the patient angry, whether not you're right or wrong, it could bring up old
feelings or old habits that the patient had that
can make them very emotional, they're going to disconnect, they're not going to
follow what you're saying. No one's winning here by you doing that. Shame on you, sir. - Uh, where are you from? - Norway. - Uh, center stage. Your son has a collapsed
lung we're going to help him. - How could you know that? - That the Norwegian kid can't breathe, it's pneumothorax it's
a genetic disposition. - I've never heard of that. (coughing) I'm about to have
spontaneous pneumothorax. - A Norwegian child having pneumothorax? I'm learning something from this show. I'm going to look this up afterwards. Actually, let's look this
up right now together. I'm curious what what pops up here. A significant fraction of families with familial spontaneous pneumothorax have mutations in the gene. The fact that she's just guessing that this child has pneumothorax
without a physical exam is a little crazy for me. - Diesel fumes. Oh my god. - What? - What if it's causing carbon monoxide - She lives on top of a boiler room - Carbon monoxide poisoning
can mimic flu symptoms. She said she lived above
a boiler room, right? Oh my god, Mario I could kiss you. But not really. - Common symptoms of
carbon monoxide poisoning is feeling sleepy, having
a headache, fatigue, and the treatment is breathing in oxygen. - You're not going to
like this Neal, but uh - She has to perform a C-section on a rig. Sometimes you have to be a cowboy, right? - Oh god. (water bursting) Oh. Okay. - Now, this is going
to happen very quickly. I want you to reach your hand
inside as fast as you can, carefully feel for the baby. - When? - Have you made the cut yet? - Yes. - Now.
- Now. - These are very crude instructions, but I guess in an emergence setting this is what they need to do. It feels like they're making
a rash decision here uh in doing a C-section like this with someone who's not a trained operator. There's so many mistakes that can happen. I don't know. I don't know what the right answer is. - Her, her. (baby crying) I got her. (baby crying) - How about suturing the patient back up so she doesn't bleed to death. - Hi, I'm Vanessa. - I'm Ariel. - Oh, the organs were used to save her. - Can you hear it? - Yeah, I can hear it. - Powerful moment, when you know uh you had to lose your
father but it saved uh another person's life. Code Black, in the books. This show pleasantly surprised me. I feel like all the other
shows I've watched so far were written by a Hollywood person and then a doctor contributed
some medical knowledge to it as opposed to this one, it
felt like it was written by a doctor and then a Hollywood person injected some drama into it. It was a good show. I
mean it was feel good, it was medically accurate
where it needed to be, the interpersonal
relationships were accurate. I'm excited for this show, I
think it has a lot of potential and if you guys like this
show please let me know, give me some episodes to
watch because I'm so down to watch more of Code Black. Go ahead and smash that subscribe and like button down below. As always, stay happy and healthy. (rhythmic pop music)
Thank you, hope you're enjoying it!
Thanks for the review. Really enjoyed it. Glad to see one of my favorite shows rate so well.
Another great video from the Reacts series. Keep it up! Thanks for introducing us to new shows!