Good morning friends, it’s barely 8 o’clock at The Pitt, and I’ve already witnessed a sight that sticks in one’s mind, and that’s a face apparently detaching from its owner – yes, you read that right! You might wonder why and how such a thing could occur. Well, let me enlighten you: This is known as a Le Fort III fracture, where the person’s facial bones separate from their skull. A man on a scooter, ignoring safety precautions, met with an accident, leaving Dr. Langdon to piece his face back together. As if that wasn’t enough, a nurse had to remove the sweatshirt of an unconscious homeless man to provide care, only to find three rodents scurrying out. Needless to say, I share Dr. Collins’ sentiments: “absolutely not,” and we are swiftly moving on from this unsettling scene.
9 AM marks the start of a distressing scenario with the arrival of 18-year-old Nick Bradley, who was found unconscious in his bed by his parents. The duration he had been without breath remains uncertain, and his dilated pupils signal to Dr. Robby and his team that Nick is brain dead. His parents are understandably bewildered and disoriented upon arrival, and their confusion intensifies when they learn that Nick’s urine tests positive for fentanyl. Known for his good character, Nick attends college but lives at home to concentrate on his studies, making drug use highly unlikely.
Dr. Robby is mindful of the potential repercussions if he discloses the news too hastily. He orders further tests, acknowledging their inevitable outcomes, to provide some extra time for the family to come to terms with the situation. Collins criticizes him for raising false hopes, but he counters by saying, “Hope is hope.” They need space to comprehend and accept what’s unfolding before them. He could benefit from his own advice, hinting at unresolved trauma related to Adamson’s death and other events during the pandemic. Unsurprisingly, Robby chooses to disregard her concerns. Despite his compassionate nature, he is deeply saddened by this turn of events.
Perhaps Robby could use some optimism as well, given the challenging circumstances he finds himself in. The initial phase of the situation is proving to be quite daunting, and it’s only just starting. He’s dealing with the Bradleys, trying his best to support Theresa who can’t reach her son David, a high school student known to have a list of potential victims in a notebook, and on top of that, one of his elderly patients from the nursing home is near death.
Mr. Spencer has Alzheimer’s and recently contracted pneumonia, which progressed to sepsis. He had an advance directive stating he didn’t wish for machines to prolong his life, with no intubation or CPR. However, his children Helen and Jeremy, who both hold durable power of attorney, find it hard to accept their father’s situation. Despite knowing their father’s wishes and being warned about the painful process, they choose to override the directive and ask for him to be intubated. It appears that Helen is struggling to let go, while Jeremy seems to be going along with her emotional state. She justifies this as not giving up on their father, but she’s actually scared and desperate to keep him alive, even though it may not be logical. Unfortunately, there isn’t enough time to navigate all the legal procedures, so Dr. Robby has to comply with the family’s wishes (or what they believe they want), despite understanding that it might not be in their father’s best interest. This morning, Dr. Robby is experiencing some significant setbacks.
Robby consistently finds tough results and difficult decisions challenging, yet he’s well-versed in handling them. Mimicking Noah Wyle’s delivery of distressing news could be beneficial for everyone; I’d prefer him to break the bad news to me whenever necessary, using his signature Dr. Robby tone. The compassion and gentleness in his voice, though heartrending, provides both solace and motivation!
In the course of his job, Robby has become quite accustomed to certain aspects, yet we also witness a young doctor named Whitaker grappling with a patient’s death for the first time – specifically, Mr. Milton, who I had expressed concerns about earlier. Sadly, Mr. Milton is now deceased. I may not possess the empathetic skills of Dr. Rabinavitch, and that’s alright with me.
One day, Whitaker finds Mr. Milton unresponsive in the hallway when checking on him. He had been moved to make way for a more critical patient while awaiting lab test results. There is no pulse, and it’s uncertain how long he had been like this. As Whitaker initiates resuscitation efforts, Robby understands almost instinctively that Mr. Milton won’t recover. This was Whitaker’s first solo case, and the man was kind to him, making his grief palpable. He persists with compressions even when other doctors advise him to halt.
Robby realizes that this young doctor needs time to cope with the reality of the situation and suggests he administer three rounds of adrenaline (epi), but then he must stop. It’s important to note, and as medical dramas frequently emphasize, this is a teaching hospital!! Whitaker is on the brink of learning a harsh, painful lesson.
Discussing such a tragic situation: As anticipated, Nick Bradley’s tests reveal no brain stem activity, leaving Robby with no alternative but to confront the unavoidable reality. He enters Nick’s room, shutting the door behind him. We don’t catch their conversation, but we understand. We comprehend because Nick’s mother’s anguished cry for her son echoes through the ER, a sound that reverberates throughout the entire department.
In a twist of unfortunate events, Robby decides to further aggravate the situation by departing from the Bradleys and entering Mr. Spencer’s room to perform an intubation on a man whom he believes should not require such a procedure. The double whammy of inflicting harm and being powerless to rectify it is starting to wear heavily on our compassionate physician (distinct from the character in ‘The Good Doctor’). Silent and somber, Robby carries out the intubation, struggling to find any words or explanations to offer. This is a stark contrast to his usual approach of ensuring both patients and their families remain reassured.
Actually, upon reconsideration, it seems I might prefer returning to the rats after all. There was at least a good deal of laughter back then, you see?
Discharge Papers
Perhaps it’s worth considering that Dr. Mohan may need more time to attend to her patients due to their complex health issues. She is the only one who truly understands Joyce’s severe pain during sickle cell crises, and she tirelessly works to ensure Joyce receives optimal care.
What’s the current situation between Intern Trinity and our in-house surgeon, Dr. Yolanda Garcia? It appears that Dr. Garcia is somewhat brusque with most people, but there seems to be an unusual rapport between her and Trinity, even though they seem to have a contentious friendship. Is it possible that she’s showing interest in Trinity when she allows her to perform a fasciotomy on the electrocuted man, despite Dr. Robby’s concern that it might be too soon?
The blossoming guidance between Langdon and Mel has developed into something quite endearing. He soothes her when she becomes agitated following a flawless cric performance, yet struggles with stitching afterwards. Additionally, he takes care of her after things get heated with Tyler’s parents and CPS. Mel confesses that she struggles to manage and regulate her emotions effectively, often needing to step away when on the verge of an outburst. To calm herself, she recites a mantra – which happens to be the lyrics from Megan Thee Stallion’s “Savage.
I’m eager to learn more about the history between Robby and Collins. That quick moment of flirtation when Robby reacts as a cop attempts to advance on Collins (who handles it gracefully, I could use some tips) is quite entertaining. Spill the beans! It’s unfortunate that Perla and Princess aren’t around to share their insights on this!
Indeed, I must confess that when I learned Nick’s mom is portrayed by Samantha Sloyan, I found myself on an emotional journey. Many fans of medical dramas would likely recognize her from her role as Dr. Penny Blake, significantly involved in Derek Shepherd’s death on Grey’s Anatomy. Oh, just request the head CT, Penny! (She is remarkably moving as Mrs. Bradley.)
Isn’t it intriguing: Dr. McKay is wearing a tracking bracelet on his ankle, which leaves Javadi in a state of shock. However, I’m confident that our resourceful genius will uncover the secrets behind Dr. McKay’s activities sooner or later. We definitely need to find out more about this!
• Protect Myrna and her vagina at all costs!
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2025-01-10 07:54