- Before I hit play, I wanna let you know
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I recently partnered with them on a cooking video.
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Since we filmed that video, I've become
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So I wanna extend their offer.
The first hundred people who click the link
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It's healthy ingredients, that are
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The recipes are already pre-planned for you,
so for someone like me who is a novice chef
and doesn't really know how to cook,
it makes the process a lot easier.
I always say, the most important thing
is to be in charge of your health,
and one of the major ways to do that
is to know what goes into your body.
(intro music)
I was probably four years old when this show came out.
So a lot has changed in medical practice.
But I think it's gonna be kind of cool
to show how we've evolved in our medical practices.
The colors are accurate.
It looks like this could have been filmed today.
I think that probably has something to do
with the fact that hospitals haven't been updated
in decades in their appearance.
- You ain't seen nothin' yet.
- It's never a good idea to take the cap
off the syringe with your mouth.
'Cause what if it flicks off and then
you end up stabbing yourself in the face.
Not a good idea.
I get sometimes in a trauma situation people do it,
there's no rush to be had here.
So take it off with your hands,
throw it in the sharps bin,
make sure you don't stab somebody and get a needle stick.
- Your hand is still attached.
Not by much, but it's gonna be okay.
- Never a fan of promising patients results.
I understand in a trauma situation
you need to calm people down,
because when you calm them down heart rate drops,
and you have a better chance of survival.
But, I just wouldn't give false promises,
I would say, you know, we're taking great care of you,
we're working on saving your hand.
The best thing you can do for us right now is to relax.
- Let's go people, that's a shockable rhythm.
- Clear.
- He just literally put one of the
paddles on the top of her chest,
and the other one what looked like
on her like abdomen to shock her.
That's not the way you do it,
you have to do it on the chest area.
- I can't stand it!
- I'll give you something for the pain, just hold on.
Notify the orthopaedic we have an open fracture.
Give him tetanus and diamorphine right away!
- The reason why they say specifically open fracture,
that means that your bone has broken
and has penetrated out of your skin.
So that's dangerous for two reasons.
Number one, high chance of infection
because you have an open wound.
Second, because sometimes the bone can put pressure
on your blood vessels, and therefore
cause something known as claudication.
Which means that you're not getting
enough circulation to a part of the body,
and then that area can swell and it can be
very dangerous and you need emergen surgery for that.
And then on top of it, you could obviously lose
a lot, a lot of blood, because you have
an open fracture that you need to get closed and reduced.
- Come on back to us.
Come on, baby.
- I don't know where his hands are in that scene.
Just because you're seeing the electrical activity
look good on the monitor, you have to feel for the pulse.
If you don't feel the pulse, that can just be
pulseless electrical activity.
It means that the heart has rhythm,
and the electricity is there but the heart's
not completely beating properly
to get the blood flow going throughout your body.
Patient's still in cardiac arrest.
It means you have to keep going with your
advanced cardiac life support.
- Carna had a heart attack,
and we were unable to revive him.
I'm sorry.
- Bastard!
You bastards!
You're sorry?
- I sort of get what this patient's going through.
I mean, I've lost family members before.
But it's also inappropriate to be physical
with any healthcare professional.
Doctor, nurse, PA, anybody.
The one thing that Zdogg does a really good job on,
you could check out his channel,
he also makes really good medical videos.
He stands up for healthcare worker abuse.
And we really need to put more attention to that
because it's contributing to doctors burning out,
nurses burning out, increasing rates
of suicide in the healthcare profession field,
because, while this patient lost his one father
and he's acting this way, it's understandable.
But this doctor's gonna see, 20 30 patients like this,
and if they all do this, you're not gonna last
a very long time practicing, especially
if you're working five six days a week.
Oh, paper charts.
I haven't touched a paper chart in ages.
- You work 36 hours on 18 off,
which is 90 hours a week, 52 weeks a year.
For that, we are paid $23 739 before taxes,
and we also have to make the coffee?
- My heart is breaking.
- Residents nowadays make somewhere in the range of,
I would say 40 to 65 000, depending where
your program is, what kind of program it is.
Now there's hour restrictions in place, where,
interns especially can only work 16 hour shifts at a time.
You have to have a certain amount of hours
in between your shifts, there's weekly caps.
As I mentioned in my Grey's Anatomy review video,
the Libby Zion Law in New York State
started this trend of instituting hourly caps on residents,
and it spread to all 50 states at this point.
- [Pager] Dr Green, your wife is waiting in the cafeteria.
- Dammit.
- We still have pagers, and sometimes
you can send them messages to your phones.
But the reason they were trying
to reduce the amount of pagers overhead
is to allow patients to rest and sleep.
If you think about it, who's in the hospital?
Sick people.
People who need to get better.
How do they get better?
Through rest, because body heals itself.
If you constantly have pages going on overhead,
it's very difficult for a patient to sleep.
- Oh now, would you look at this?
That's the first tailored white coat I've ever seen.
- This is really funny.
So, Noah Wyle, this actor.
People tell me all the time how much I remind them of him.
- I probably get that more than I get
the whole McDreamy thing, even though
the McDreamy thing's a running joke,
but people say I look so much like him.
This first comment that I see of them
is them making fun of the fact
that he has a tailored white coat.
And I actually have a white coat that's very fitted,
and my nurses and my colleagues
always make fun of me, like, ooh,
look at Doctor Mike with his fancy white coat.
I just think it's important to look professional, clean,
and you know, suited up as a doctor.
You know, you work hard, you wanna
preserve this image of professionalism.
So I don't think it's a bad thing.
And I know they're gonna pick on him 'cause,
I've experienced people picking me about it.
- It's an Angiocath with a 16 needle.
You need a large for in case they are bleeding
and you need to transfuse them.
Do you know how to start an IV?
- Actually no.
- I thought you were third year.
- I am, but all I've done is dermatology and psychiatry.
- As a medical student, in your first two years
you're pretty much in a classroom
and just learning the curriculum,
everything you need to know about the human body.
- In your third year, you start doing
your clinical rotations, especially your cores.
Family medicine, internal medicine, surgery.
It's not unusual for a third year
to come in and not know how to do an IV.
And generally, they're trained by either
senior students, or young residents or interns.
It's scary, being on your rotation for the first time.
The way that I came about it, and I had some success,
was that I came very very excited to learn.
And I wanted to learn how to do IVs,
and I wanted to learn how to do procedures.
And anything that somebody would let me do,
or let me watch, or let me practice,
I would be the first to volunteer.
I wouldn't try and steal opportunities from other people,
'cause I don't wanna be a gunner.
And a gunner's a person who tries to,
put other people down, or get themselves ahead at all costs.
Even if it hurts someone else.
Wasn't one of those people.
But I was very motivated.
And if you're a medical student,
and you wanna shine on rotations, be motivated.
- Okay ma'am, we are gonna push on the next one, okay?
One, two, three.
- The best way to deliver a baby is during the contractions,
you should tell the patient to push,
and you want them to hold the pressure
for the push as much as possible.
And then if there's time, they can exhale,
gather their strength, and push again
while the contraction is going on.
Pushing while the contraction is not going on
is not ideal because the uterus
is not contracting the baby out.
Therefore you're not gonna have
any real success in getting the baby out.
And is that a newborn baby.
It's a very large baby, you could tell.
So now what we do in the hospitals, is,
if the baby's crying, and the baby's breathing,
the first thing we do is right away
put the baby on the mom's breast.
That has shown the best results.
Bonding with the baby is very important.
It calms the mother down, it calms the baby down,
it's one of the things that we're
really pushing in all the major hospital systems.
- Nice and red.
He has otitis media, you'll be fine.
- Otitis media is a very common ear infection
in young children, it's when the middle ear
becomes infected with usually a bacterial infection.
You do need antibiotics for it because
it can actually spread to the local tissues, to the bone.
There's a part of the skull called the mastoid process
and you can get mastoiditis there.
It can be very dangerous, especially
when a baby's so young and fragile,
especially in the early days of life.
- Everyone has a family, Mark.
My wife wants to shop, kids grow up.
You go to private school, college.
You gotta think about that.
Now, the office for our next associate is here.
- The constant dilemma for ER physicians
is that you often work very long hours.
The hours that you do work are very stressful.
You're seeing a lot of patients.
There's a high stress rate in this
type of job because you never know
what kind of patients you're gonna get.
What this doctor's essentially offering Dr Green
is to leave the ER, work as an outpatient physician.
Where he would have a little bit more flexibility,
a little less stress, better lifestyle,
but he's not practicing the type of medicine
he seems to wanna practice, and he dreamed of practicing.
So it's always a decision that
I see my colleagues struggle with
that do they want the intense excitement
of working in an ER setting, or do they want
something more suitable to their lifestyle,
that they can start a family, be attentive to their family,
have a more set schedule with weekends off.
If you are really passionate about a specific field
of medicine, you can't imagine doing anything else.
So I can totally see Dr Green saying no to this
and saying I would prefer to work in the stressful ER
because that's where his passion lies.
- Are you afraid to tell me the truth?
- Your history of coughing blood,
weight loss, and this x-ray, is suggestive of cancer.
But the diagnoses has not been confirmed,
and it may very well be something else.
And none of us should jump to any conclusions until we know.
That's what I think.
- How long do I have?
- Six months to a year.
- No doctor could look at an x-ray
and from the x-ray just make a guess
of how long a patient has from life expectancy standpoint
without a biopsy, bronchoscopy, without a CAT scan even.
What she was doing in the first place was correct,
you have to tell them that what you suspect it to be,
give your differential, explain the next step in treatment,
but not to give him a life expectancy.
That's wrong.
It's gonna be inaccurate.
- You told me how long has it been
since you had your last period?
- I don't know.
- Just think back.
Tell me roughly.
- It was after Christmas.
- Okay.
So it's been a few months?
- I guess so, I haven't really paid attention.
- And you've had sexual intercourse?
- Yes.
- Dr Carter?
What you have is an ectopic pregnancy
and she needs to be scheduled for ultrasound and surgery.
Right away.
- What is going on right now?
He asked her when her last period was,
she said she wasn't sure, maybe a few months ago.
He asked if she had sexual intercourse, she said yes.
And he just makes a diagnoses of an ectopic pregnancy
without doing a physical exam?
This is just, this is so inaccurate.
You may suspect an ectopic pregnancy
from doing a physical exam, and getting a full history,
but you don't diagnose someone with that.
That's just, it's wild.
She could have so many other things.
She could have, because it's left lower side
in abdominal pain, it could be
something with her stool, she could have a lot of gas,
she could have diverticulitis,
obviously not so common in her age group.
Even sometimes appendicitis, which normally happens
on the right side, can present with
lower left side in abdominal pain.
She could also have a cyst in her ovary
that could be causing discomfort.
So to just say that she has an ectopic pregnancy
from that, oh my god that's so wrong.
- You people standing around for, huh?
- Do the arterial stick.
She got a Babinski?
- Yeah.
- So, a Babinski Reflex is when you stroke the bottom,
or the sole of the foot with a sharp object.
Not a very sharp object, with like a pointy object,
like the back of a reflex hammer.
And if you stroke upwards, the toes in an adult
are supposed to flex downwards
as if they're grabbing the object.
If they extend away, and the big toe goes up,
that's actually a sign of central nervous system damage.
And in times of an overdose,
that could be a very bad predictive sign.
- How did this happen?
- He fell out of his crib.
- I mean, he was crying all night, so I brought him here.
- I bet he's been crying, when did he fall?
- I don't know.
I don't want to get into trouble.
- Ma'am, your son has multiple contusions --
- He's not my son.
- You know, whatever!
- So, a young child with multiple bruising,
multiple contusions, is very suspicious
for child abuse, and it would need to be
screened by children or family services.
Another thing that makes this suspicious
about child abuse is fractures in
different stages of healing.
Also a child that is scared to talk
in front of their parents.
Could be an early sign, speak in front
of their parents, could be an early sign.
Because they're hiding how they got their injuries
and lying to you to try and cover up for their family.
A very unfortunate common death in children,
especially young infants, like six months of age,
three months of age, is Shaken Baby Syndrome,
where after crying for a very long period of time,
frustrated parents will shake their baby very hard
to get them to stop and actually cause
severe spinal and or brain damage,
which causes the baby to stop breathing and die.
It's horrible when this happens.
I've seen this happen.
So that's why I always screen my parents,
my parents, my patients who are parents,
to find out how they're doing in raising their child,
if there's any symptoms of depression,
if they are overly stressed out
because then I try and get them help,
and give them some stress management techniques
and really tell them what to do
in case that they're feeling these emotions creep in
so they don't make a horrible mistake like that.
- He was standing.
Blocking traffic.
But he's got that smell, so I thought I'd check.
- You did the right thing.
We've got a diabetic ketoacidosis, let's go.
- Very commonly, folks who are
in diabetic ketoacidosis, which means
that their blood sugar is so high,
their blood is become acidotic and,
all the functions, all the cellular processes
that go on in your body, start collapsing,
and breaking down, and you can die
from diabetic ketoacidosis, and what this
police officer is saying is you got that smell on him
is 'cause you have a very fruity aroma
when you're going through diabetic ketoacidosis.
It's a very distinct smell that if you've smelled it before
you know exactly what the police officer's talking about.
That feeling when you go to sleep,
and you know you have couple hours
to nap when you're on call, oh my god
those are the most precious hours
'cause your eyes are just closing.
And you're just exhausted, but it feels so good,
even like 30 minutes of sleep, it's really important
to prevent you from going crazy.
- [Woman] 6:30, Dr Green.
- And it really does feel like that.
You slept 10 seconds and it's been two hours.
ER is a classic, it's well-written, it's well-produced.
I really could see myself binge-watching this show.
I mean, I watched this show when
I was like eight nine years old,
but now being a doctor, it's cool watching this
and learning how they did certain things
back in the '90s, what problems they had.
So if you wanna binge this show,
it's actually available on Hulu right now.
Like I always say, if you have any recommendations,
or you have some questions, jump into the comment section.
'Cause you know I respond, if not down there,
in my monthly Responding to Comments video.
As always, stay happy and healthy.
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