Remember how I said you get good at spotting the fakers?
Whitaker
Yeah.
He's exhibiting every sign of opiate withdrawal. Eyes dilated, tearing, skin has piloerection and goosebumps. Hypertension, tachycardia. Agitation, restlessness, perspiration. He's checking every box.
Whitaker
Right, but he said he doesn't take drugs and seldom drinks alcohol, so...
That's exactly what he would want you to believe if he was drug-seeking.
Whitaker
Wow. You're good.
Whitaker
So how do we treat him?
By getting him to admit his opiate usage.
Whitaker
Right. How do we do that?
By being smarter than the patient.
Whitaker
Got it. He said he isn't an addict, so why give him an opiate agonist to treat his withdrawal symptoms?
Because I don't believe him. And I know this will work. Then once he feels better, we can get him to admit to his addiction and treat him long-term.
["Code Triage, Emergency Department now." over Public Address system]
We're locking down the hospital and setting up a command center in Administration. We'll coordinate logistics, supplies, communication.
Unclear, but initial reports are not good.
The night shift is gonna be here soon, but we are gonna need more help, especially from Surgery and Anesthesiology.
MCI group text and email went out to everyone, including Transport and Environmental Services.
OK, good. [to Dana] Hey, everyone's gonna want to come in to help. Keep enough in reserve. Tell them to come in eight hours later to give us a break. And can you try and reach Jake?
Surgery's got to call in the cavalry. We're gonna need all 25 ORs.
Ahead of you. Four ORs are prepped and staffed, and we're working on getting the rest up and running.
What about disaster supplies?
Every patient in the ER needs to go up. Beds or no beds, they'll get better care in an upstairs hallway than ignored down here.
Whitaker
There's a whole wing that's empty on the eighth floor. I don't know if that's...
But no nurses to staff it.
No comment on that one. Waiting room and Triage can go to Family Medicine Urgent Care. And we should turn off the TVs. We don't need to cause any extra panic.
The cafeteria will handle the family members and survivors.
Keep the press out of here.
Gladly. Call me directly if you need anything else.
Whitaker
What are you doing?
Whitaker
Are you crazy? Did Abbot approve this?
He said, do what you have to do. Attendings are all tied up. If I can blow up a balloon in the aorta, it'll stop the bleeding.
Whitaker
It'll cut off the blood supply to half her body.
I'll only go in a few inches, zone three, below the kidneys, until she gets up to the OR. Glove up, Huckleberry.
Whitaker
Okay, you're gonna need an ultrasound, X-ray.
Whitaker
Have you done this before?
It's a central line. I just need to hit the femoral artery like that. Piece of cake. All right, guidewire, then introducer sheath.
Whitaker
What was that you were reciting?
It's called the Shema prayer. It's a declaration of faith in God. I lived with my grandmother when I was little, and she and I used to recite it every morning.
Whitaker
"Even youths grow tired and weary, "and young men stumble and fall. "But those who hold hope in the Lord "will renew their strength and soar on wings like eagles." It's Isaiah 40. I was an undergrad theology major.