- What do you get when you mix Uber with a Hospital? Royal Pains. Beewoop! (hip hop music) Oh, ball time. All right, good dish, good dish. Oh, oh, oh. We have a athlete that's collapsed. What are you gonna do? Check for a pulse. Call for help! Call for help, first thing
you do, call for help. - [Dr. Lawson] Alright, call 911! - Yes, he pointed the person out. - I need those two gym bags, right now. - If he- - I want some ice from those cooler, okay? Move it! - Does he have a pulse? - [Dr. Lawson] Ice, ice, bring it in! Okay, I need to ice his crotch, his armpits, and his scalp. He can't breathe. - All right we have to break this little scene down. Athlete collapses while
playing basketball. He's saying he's not
breathing, it sounds like he has no pulse. At that point, you call help, 911. Point somebody out, because
if you just yell it, hoping someone else will call
911, that may not happen. So point to someone, say, "You call 911!" and then right away
chest compressions, chest compressions, chest compressions. Don't push with your arms,
push with your upper body. Because then you could use
your weight to your advantage and not tire as quickly than
just by using your arms. When you're pushing you
want to do it to the tune of Stayin' Alive! Stayin' Alive! Ah, ah, ah, ah! All right, that was bad
singing but good effort. (tune of Stayin' Alive!) Chest, chest, chest, chest compressions. Sorry. - [Female Nurse] Aren't you
off today, Doctor Lawson? - [Dr. Lawson] I was. Status, post cardiac arrest. Got his pulse back an opened his airway. - [Female Nurse] Did
you really use gym bags for immobilization? - Yeah, can't wait to tell
him some sweaty boxers saved his neck. - So the thing with opening up his airway, if the patient is still
basically in a coma state, they can't protect their airway. That's why we do the
Glasgow Coma Scale to see whether or not the person
can protect their airway, and if they can't they
should be intubated. Because what can happen is
some secretions, whether its saliva, mucus, vomit, can
get into the mouth and then get aspirated into
the airway which will go into the lungs and that
will create a pneumonitis, which is a very serious
condition which causes serious inflammation of the
lungs an can be deadly. - [Dr. Wolf] O2 sat 80. BP 100 over 60. - Drop five of versa and 150 of sucs. - Dr. Lawson, paramedics
bringing in a 68 year old with a STEMI. - When? - Now. - A 68 year old with a STEMI means an ST-Elevation MI. And ST-Elevation is something that we look for on an EKG when someone's
having a heart attack. An MI means myocardial
infarction, just another name for a heart attack. - [Dr. Lawson] And into
the femoral artery. (machines beeping) And there's the blockage. You can finish up, I'm gonna go out. He's stable, he just needs an angio. Dr. Wolf, how's the kid? - [Dr. Wolf] The EKG shows
a third degree AV block and he's unresponsive to meds. I placed an external pacer
but I'm not getting capture. - What's his BP? - [Dr. Wolf] Hovering around 60 systolic. - All right, he needs a wire, stat. - Is Hank a cardiologist? I'm so confused. What I'm interested in here
is, this young athlete, he said he as an AV block,
which is a problem with the electricity within
the heart that can cause the heart to stop beating. He's saying that they're
trying to create capture which is when they put
a device on the outside of the chest that tries to
capture the heart's beat and reset it and give
it the proper rhythm. Now, they're not having success with that so he says, "I'm gonna put in a wire." essentially what he's
saying is he's gonna go from the internal structures and control the electricity of the heart that way. Now, we do this all
the time for pacemakers and defibrillators,
basically for all sorts of congestive heart failure and electrical anomalies of the heart. - Priority is Mr. Gardner! You'll see him all the way through. - Gardner is stable, his BP is up, his sat is 98% on two liters. The ST segments are normalizing
and his pain is gone. So, how about today we save
two for the price of one. Let's go. - I mean I totally agree with him here. Why, what does she want him to do? Babysit the other VIP patient? What good is that going to do them? If he did the procedure,
he opened up his arteries, his ST segments are
normalizing, which means that the EKG is improving,
what else is he gonna do? (smooth jazz music) Ooh! - Wow. - Still can't stop with the romance in these medical shows. With the making and the (kissing noises). Medicine is fun, we don't
need the (kissing noises). Just saying. - Let's go give that long
day of yours a happy ending. - This is a dirty show. - [Dr. Lawson] I recognized
Mr. Gardner's level of blockage, I knew it
had to be relieved and I was confident that he
would be successfully angioplastied and survive,
barring any bad luck. - Well bad luck rained
and poured, didn't it? While you had our senior
CT surgeon in another room. - To help me try to
rescue a crashing patient, I made a judgment call. - You made a mistake, a fatal one, and that's a shame, Dr. Lawson, because we all know you're the most talented physician this emergency department
has seen, and your star was only on the rise. - Was? - I know for the average
person that may watch this, and think, "Oh, that
makes sense he got fired." To me, it makes no sense at all. I have no idea what he
did wrong, it looked like he completed most
of the procedure and then left the rest of it for another doctor and then went to perform
another procedure. He didn't go home to
hang out, so I'm still flabbergasted as to why he got fired, but whatever, it's clearly
not important for the show's story line. - [Man In Black Shirt] You
really need to get out of this apartment and get
some fresh air, bro. - In Brooklyn? - Honestly it smells
so bad, it smells like moose had sex with a bucket
of Chinese food in here. Like musty. And you kind of look like
Jesus and Patrick Dempsey had a child and that
child grew older and then got really sick. - That's weird. - Look, look, look this trip is gonna get you back on your feet, I promise. - Trip? What trip? - Are you kidding? To the Hamptons! I've been telling you
about this all month! - Yeah, and all month I've
been saying, "No way." - A lot of medicine up front, a lot of no medicine in the middle. (retching) - [Dr. Silver] Clear, clear. Dr. Silver, here. When are you damn kids gonna learn how to hold your drugs? (laughing) - Concierge doctor. - [Dr. Silver] Start with some oxy? Then a little crystal? Ripped a few lines and chase a little down with champagne. Having salad, you kids call that, right? - What? Ava doesn't do drugs. - Why? Because she says she doesn't? Newsflash, pretty boy, most drug addicts are also liars. Sorry, April, we're gonna get this straight into your system. - Doctor, you may have misdiagnosed. - Oh really, who are you? - Just a concerned observer. - Well I observed nausea,
photosensitivity, disorientation, a few of the tell tale
symptoms of a opioid overdose. What are you observing? - The same symptoms you are, plus a couple you're not. Like her miotic pupils
and sludge toxidrome. - I don't understand, he
didn't even look at her eyes. How does he know what
her pupils look like? I mean, it sounds like
he has x-ray vision. He can see from across the room. Especially in a dark room,
how is he able to see a- Not buying it, Hank! - [Lifeguard] All right lookout, lookout. I've got this from here, guy. - Who are you? - I'm a lifeguard. (laughing) - Are you board certified
in clinical toxicology? - Huh? - Help me get her up, Baywatch. - I somehow doubt that this
guy's an interventional cardiologist, clinical toxicologist. How many board
certifications does he have? And they're not even ones
that go hand in hand. Like if you're an ER doctor
and you're a toxicologist, I get it, but being an
interventional cardiologist and a toxicologist, eh. Those are nice Ferraris. 360 Modena? - This isn't my blood,
it's my girlfriends. Can you come inside? - Yeah, yeah sure. - No malpractice insurance, no anything. Just oh yeah, I'm just gonna
be casually your doctor. - [Dr. Lawson] I got you! - Uh oh, fainting. Is he gonna vomit? (retching) - [Dr. Lawson] Tucker, Tucker. - He's sweating. Ooh! - [Libby] Are you okay? - Is that the seatbelt mark on his chest? (groaning) - Could have a cardiac contusion, which is a bruise of the heart. - Why didn't you tell me you're a hemophiliac? - Ooh. - Dude, my chest is killing me. - Where's your Factor VIII supply? - Bottom drawer, next to my aquarium. - So he has a bleeding
disorder that if you get into a car accident
or any kind of accident, for that matter, you start
bleeding excessively. And you're missing one
of the clotting factors, specifically Factor VIII. That's what he's talking about here. I don't know how he
knows it's specifically Factor VIII, that's really impressive. And also how he knows exactly that he's a hemophiliac. Its very impressive diagnostic skills that I feel are a little bit
past human abilities. - Stay with me pal. - I can't breathe. - Stay with me. Tucker, stay with me. Tucker, stay- (choking) Tucker. All right, jugular's up,
muffled heart sounds, minimal pulses, damn it's a bex. - What's happening to him? - I don't know what a bex is. - [Libby] What do you mean, bex? - He probably contused his heart and bled into the paracardial center. - What are you talking about? - Look at that! (horns) - His heart is being squeezed and not circulating blood to his brain. He needs the fluid drained, but because of his
hemophilia, I could kill him trying to save him. - This is actually really
similar to what happened with The Good Doctor's pilot episode, where the patient got
into also an accident and blood was pooling
around the heart and we were worried about cardiac
tamponade, where the heart's trying to beat but
there's a build up of fluid in the sac surrounding the
heart, so it has no room to beat properly, therefore,
all the vital organs are not getting enough blood supply. What complicates this case even further, I have no idea, again, how
he knows he's a hemophiliac, is that he's a hemophiliac. So if he's to do any kind
of procedure like insert a needle into the paracardial
sac and take the fluid away so that the heart can
beat properly, he can kill him because he could bleed out. (laughing) - Oh my god, this is so fake, its crazy! - He's clotting, he's clotting. Give me the pen. Okay. Tape. He's doing great, he's clotting. - Get it in. - [Dr. Lawson] Okay. Good, good. (gasping) - Its okay. - Ow, ow! - Tucker! - Just take it easy pal, take it easy. - Take it easy, I just cut
open into your heart and your ribs, you're all good
though, just take it easy. - [Libby] He saved you, he
saved you that's what he did. - What?! - Libby helped out big time. - Libby helped out?! My man, call 911. This show is really
funny, I actually enjoyed watching it as a regular show, not just as a medical drama. There's obviously some crazy, unrealistic situations that go on. But the one part that is true, is VIP Concierge Doctors are all the rage. What my goal was when I
was in medical school, was to become a VIP Concierge
Doctor, but for everybody. Make it as a low-cost option. And that's sort of coming
into existence with something known as Direct Primary Care, and I'm kind of excited about it. Click here for my three favorite videos from the last few months. As always, stay happy and healthy. (R&B music playing)
