03x05 - Episode 5

[bunniefuu]

Chaos can't take over. From now on,
it's full triage.

We don't have beds.

Hospitals must take them.

We're doctors, here for you.

Dispatch told me
you had room for him.

They're wrong.

The old function testing unit.

With no room,
I put a patient there.

- Who has the old Alzheimer?
- Mrs. Jeanin?

Brun wants me
to transfer a patient aged 89.

I can say I found a place

and we bring her here by ERV.
On the sly.

- How do we organize the duty roster?
- I can start.

sh*t.

Anyone there?

Avicenne wouldn't take him.

His fit has lasted 3 days now.

We'll take care of him.

Your cardiologist called me,
worried he hasn't seen you in 2 years.

I monitor myself and I'm fine.

I want you to do another test.

I can't replace Arben right now.

Brun needs you to examine his daughter.
Her stomach hurts.

Replace me with Arben.

I'll rest a second, then I'll go.

I think she's pregnant.

Ectopic pregnancy.

Brun has to know.

Shut up!

Hurry, give him the shot!

Let him sit up!

Stop.

Chloé, stop.

OK, you win!

Calm down! Can you hear me?

- I can't breathe.
- Sir, I'm doing my best.

INTERNS

"IT'S LIKE TETRIS." - OLIVIER BRUN

Excuse me.

Feeling better?

Yes.

I feel I fought all night.

I'll leave you with Rachid.

- Call me if needed.
- No worries.

Thanks.

- See you later.
- OK.

I like it when he's quiet.

- Sugar?
- Without for me.

Without? This is with.

I'm pricking you.

- Are you OK?
- Yeah.

That's really nasty.



- Want a coffee too?
- Yeah.

- No sugar, right?
- Thanks.

So what do we do?

Take them back to the ER.

And tell Brun what?

I don't care.

I'm done with the California.

OK, things screwed up.

With the door open and a phone,
you'd have been OK.

And if you'd come to take over.

You didn't. No one came.

Anyhow, that's not the problem.

The California's the problem.

Maybe Brun will understand.

No, he won't.

He has nothing to offer,
leading to this.

What do you say?

It was a nice try.

But it's no solution.

In a crisis,
there's no right solution.

I'll carry on.

I'll handle the California.

Excuse me!

Why bring them here?

We were told to.

Who told you?

The care home.

Some went to Bondy or Gennevilliers.

- We were told Poincaré.
- You were?

You were all told that?

- All good.
- Need my health card?

Just the number.
If I have it, that's fine.

Will it take long?



The oldies was you?

- What?
- The oldies downstairs.

The oldies? No.

Lazare?

Come here, please.

Alright, hold the line.

Did you accept the oldies?

What?



We took no one.
We're swamped here.

We'll do a relief triage.

Instead of this one?

On top of this one.

A fourth triage?

Exactly.

Third, fifth, I've lost count.

No need to say it.

Yes, I'm sorry.

Larouchi!

If you take patients,
let me know.

What?

I'm on my reports.
I don't take anyone before leaving.

- Going home?
- Yes, my shift's over.

Seen the mess here?

I've done 12 hours,
the legal maximum.

If you say so.

Excuse me.

I cut my holiday to help.

Don't push it.

Where do we put them?

Who?

The care home lot.

We've nowhere free.

Is this a joke?
I never accepted them.

So who did?

Did you accept the oldies?

No idea what you mean.

I have no responsibilities here.

And I take none.

So no one accepted


We can't take decisions like that.

Did you ask Simoni?

Simoni...

You accepted the oldies?

No, Wagner did. Why?

Will Wagner see to them?

Why do you get so mad?

Because we're too swamped for them.

And I decide who we take!

Come with me.

Is Wagner here?

I haven't seen her.

Where are you going?

- To see Muriel.
- Got an appointment?

Are you serious?

How can you and Manuel
accept 10 oldies

in my unit
without telling me?

Do others decide for my unit now?

The home's taking them back later?

They just need IV rehydration
while their AC is fixed.

It was a hot night.

What? It's true.

Just rehydrate them.

It's not just rehydrating them.

Realize the extra workload
for my teams?

Do I tell you how to run your units?

Is your daughter OK?

Yes, she's OK.

She's in gynecology.

With Marouni?

That's good.

Lucky you had the unit and staff
for her last night.

That was harsh.

Maybe.

I'll leave you.

It's like a new triage, but permanent.

Here, as usual, surname, first name,

colored folders, etc.

Triage will be between the walkway
and the corridor, OK?

For example,
ma'am, were you triaged?

There, she's all good.

From this point, they can go.

The new arrivals, likewise.

We triage them, they go,

and those left in the corridor,

we re-triage them
and see what to do with them.

Do we triage or treat them?

It depends on their condition.

- Have you explained?
- Yes, all good.

OK, it's triage.

But how does it work?

- It's not complicated.
- No, it's simple.

I'll explain. Triage 1

on the walkway
with Stella and Lazare.







That's what I explained.

- No.
- Yes.

Fast medicine, like.

Exactly, spot on.

Got that?

In fast medicine,
medicine is a word too many.

Dorothée...

- How many left?
- 3.

Arben, what about this one?

- To the left.
- Arben!

- Yes?
- What is this?

- We're doing our best.
- It's like Tetris.

Beds to one side,
and clear the corridor.

Rachid, on the left from there.

Keep the corridor free.

How many left?



We'll see to them after.

Laura! Arben!

Come with me.

Rachid, Diakité, come on.

OK, Dorothée?

Test CBC, electrolytes, that's all.

Hydrate them on drips.
Don't overdo it.

Get the other 3.

Nothing here...

I have the staircase comma,
the spatulas...

The spectacle...

Try to stay calm.

I'll take over.

The flies!

What's wrong, sir?

It's the...

"strapulet"!

Calm down. Look at me.

Can you tell me where it hurts?

I don't understand a word.
What's wrong?

"Varme"...

You threw up?

You threw up?

Alright.

Breathe. Calm down.
I'll listen to your heart.

I'm "rexpirating’’ the "frex"...

I'll sit you up.

I "externate" the permanence
of the fragmentation...

I arrive from the château

Cornelian...

Lie down.

Staircase.

I'll come back, sir.

The "marises"...

Ma'am?

- Yes?
- Did you bring Mr. Besse?

Yes, I did, I'm his home help.

Do you understand him?

No, I don't understand a word.

No one does since his stroke.

Not even his family?

He has no family, actually.
Only me.

When I arrived today, he wasn't well.

I was afraid, so I brought him here.

Did I do right, ma'am?

Yes, we'll look after him
and keep you posted.

Can I say goodbye?

Of course.

Sir...

Thank you.

You're welcome.

I can't find a vein.

- Try the other arm.
- No vein either.

The elbow, then.
Can we do that?

OK, try the elbow.

I give him saline solution?

He's at 170/70.
Saline or glucose 5?

Roll him onto his side.


Just a vasovagal syncope.

And your hand?

- He cut himself.
- I cut myself.

With what?

The bread-knife.

Rest, Hugo will replace you.

- No, I'll be fine.
- Sure?

I'm good.

You're going to rest. Lie down.

Alright?

OK there?

Can I go?

Stay with him.

Weird, after a good night.

Rest and I'll replace you, OK?

Thanks.

The comma of the trousers.

Alright.

Good. Climb on here, please.

On the little step here.

Nice and slowly, on the little step.

Mind how you go.

Just let me turn your head.

That's it.
Shoulders like this. Very good.

Keep still.
I'll turn my light on.

I'll be over there.

It's the annex of the bread

last week!

Not a heart attack?

No, his ECG is normal.

Sir, inflate your chest
and hold your breath, OK?

Does he understand?

I don't think so.

It's Wernicke's aphasia.

Keep still!

Is that a button?

It could be a coin too.

Sir...

We saw you swallowed something
that's stuck in your esophagus.

We'll try to remove it, OK?

No, sir, don't get upset.

Don't worry.

I'll look after you.

Don't worry, come with me.

Put your shirt back on.

Sir, let's turn over.

There, very good.

Thank you.

Hugo?

- What?
- His diaper was full.

He has a huge rash,

with sores on his elbows and heels.

They need protective dressings.

It'll take ages to do everyone.

We rehydrate them.

Nothing else.

We can't leave them like this.

Are you managing?

They haven't been washed.

Not to mention diapers
several days old.

In this heat, they bruise easily.

OK, ma'am, lower your arm.

- Souleymane...
- Yes.

- What's it like?
- Hell.

They're a mess.

We can't just rehydrate them.
Their hygiene is...

Totally appalling.

Disgusting, you mean.

Call a spade a spade.

How appalling?

They haven't been changed or washed,
they have rashes,

sores on their heels and backs...

Mycosis too.
Nearly all bedridden.

It's always the same.

We need backup.

I don't have any backup.

My EVS workers and nurses
are all busy.

There's no backup.

Is that clear? There is none.

Laura should be at home.

She worked all night.

She can't be on duty again.

It's OK, Martine,
I don't mind.

I don't care.

What?

I don't care you don't mind.

I mind.

Crazy doctors working non-stop

and fainting like Arben,

who cares!

But not my nurses, dammit!

Let me by.

Right...

I'll find backup.

Thanks.

I'll talk to her.

She'll refuse, don't insist.

Just a nurse and an EVS worker.

Impossible.

You decide now?

No, but when she's unavailable, yes.

We need help to pull through.

We're all understaffed.
It's hard for everyone.

- Let me in.
- I can't.

Sorry to bother you, but I need
a nurse and an EVS worker for the day.

Muriel?

Can you hear me?

Does it work?

Yes, it works.

Muriel, can you hear me?

Go away and let us work.

My whole arm hurts.

- How long now?
- A week.

- On medication?
- Fred?

Here.

- I file them?
- Yes. Give me greens and blues.

Take these.

- Here.
- Thanks.

Alyson!

- Has David sped up?
- Yes.

Are you eating?

David?

Come here a second.

You've been an hour.
Not fast enough.

It's a big thing.

Male, 40, suspected botulism.

Botulism?

Heard of it?

Botulism is really rare.

So?

Hold on.

Smell this.

- Well?
- It stinks.

Of what?

Rotten fish. That stuff's rotten.

It smells of botulinum toxin.

Try to speed up anyway.

Mrs. Montagner, Marie?

You swallowed a fruit stone?

A coin?

A button?

A button like this?

A thermometer?

You can't do that.
Don't break equipment.

Comma in lettuce.

Kids, not adults, swallow batteries.
Was it deliberate?

No, he has huge psychomotor problems.

It's stuck just above the cardia.

And?

It won't descend.
The inflammation is blocking it.

How long now?

No idea. This morning.

In 2 hours, you risk a lithium leak,
and that's nasty.

Can I bring him now?

What?

Can I bring my patient now?

Impossible. It's Wednesday.

No endoscopists today.

No endoscopists?

Tuesdays and Thursdays.

- They're not here now.
- And you?

I'm no use either,
it's only my second semester.

No endoscopy training.

So what do you do?

I'm an intern.

Gastroenterology
isn't just endoscopies.

You should transfer him.

Thanks for the advice.

Don't waste time.

I'll make no promises.

If it's busy, I can't help.

You see?

Forget it.

- Where's the endoscope?
- Inside.

No, they're operating, we can't go in.

We can't go in?

Hello.

I'll bring it back.

You're a pain in the a*s.

Sorry, excuse us.

Help me.

Arben?

- Hello?
- It's me. Feeling better?

- I'm OK.
- Not at the hospital?

I went out.

I need help for an endoscopy.

I can't do endoscopies.

OK, but you know how
and it's urgent.

The guy has a lithium battery
stuck above his cardia.

The gastric team?

Not here today,
and a transfer would be too long.

Everything OK?

Arben...

I really can't.

We've done endoscopies.

Remember Drobert's esophageal varices?

I won't do that anymore.

I've been regularized
and can only do certain things.

I have to go.

- Who is it?
- Me.

Breathe.

It sounds OK.

Let me hear.

I hear whistling and wheezing.

No more than usual.

I'll increase my diuretics anyway.

I'm tired.

Leaving already?

Sit down.

I have some good news.

I'm moving down south.
To Carpentras.

I know a doctor there.
An old colleague from Tirana.

He'll help you find work.

No.

I have to get back to Poincaré.

You won't take care of me?

Of course I will,

but you're fine here
and I'm not far.

No, you have to leave with me!

Well?

What?
Sardine paste smells of sardines.

Unlikely.
What's up with him?

Slight facial paralysis,
stomach ache.

It's not a lot.

It began 4 hours

after eating canned food,
like botulism.

He has nausea,
stomach pains, neuro signs.

That ticks a lot of boxes.
And...

CRP 4 times the norm.

- It's not homemade.
- Exactly.

- 50% of cases are with commercial stuff.
- In France?

- What?
- That's in France?

No idea.

Like I said, get more proof.

Declaring botulism to the RHA
is serious.

Just send him home.

If it worsens, he comes back.

I agree.

I think we can wait a bit.

"Wait"? That's not how I do medicine.

We always opt for precaution.

Normally, but nothing's normal.

He comes back if it worsens, period.

He's irresponsible.

I'm sorry, but...

He's not totally wrong.

OK, but I'll do medicine the way I want.

Is it a bad time?

No, go ahead.

I have suspected botulism
in sector 4.

Botulism? Are you sure?



but Brun wants him discharged.

Botulism is pretty rare.

I know that.

But it's risky to let him go.

Maybe he could go to the California.

No.

- Sorry?
- No, I won't take him.

Why not?

The California is over.

I run it alone now.

Alright.

David!

Familiar with endoscopies?

A bit. It depends. Why?

A foreign body in the esophagus.
A lithium battery.

Sure?
Lithium batteries are rare.

Where exactly?

Just above the cardia.

- Good general condition?
- Yes.

- How old is he?
- 62.

Any history?

Just aphasia.

Could you do it?

Who? Me?

I've never done an endoscopy.

Sorry.

Lie on your side to do your back.

Brun pisses me off.

Why can't he wash them?

It's not my job to wash them.

It's not washing, it's caring.

Is it Laura and Rachid's job?

Stella, look at this.

He has a huge pressure ulcer.

Jesus!

- Can we have a word?
- Of course.

- Are the oldies OK?
- No.

Their care home seems a bit negligent.

No hygiene, malnourished,
all with bed sores.

We should run tests.
Vitamins, toxins...

X-rays too for the bruises.

I understand.

We'll always find something.

Average age of 90,
ultra-medicated,

multiple pathologies –
results will be bad.

We do nothing?

Won't you take a look?

Seen the corridors?

Sorry, I can't.

It'll soon be over. Stay focused, OK?

I'll lubricate the probe.

I'll insert it slowly.
Don't try to speak.

Look down and breathe calmly.

Simply relax.

Stay focused on my voice.

Stay with me, OK?

There. Try to gulp

as if swallowing the probe.

- Stay calm.
- That's it.

It's descending.

We're near the battery.

- Breathe...
- Hold on, I got it wrong.

- I'll withdraw.
- Don't move.

- Breathe.
- Don't move, sir.

It'll hurt.

Hold my hand.

To the right, there's a bend.

Go on, turn to the right.

Turn...

I'm doing my best, Chloé.

Try not to move.

Where's the battery?

- Breathe calmly.
- That's it.

We're there.

I see it.

Don't move now.

It's OK, sir, we've found it.

Open it.

A bit of blood.

More to the left.

- There?
- Close it.

Close it!

Want to try?

I'm doing my best.
I'm not used to this.

- Tell me when.
- Careful.

Need help?

It's OK, hold my hand.

Dr. Bascha's here.

Stay calm, sir, nearly there.

Keep breathing calmly.

Grip my hand.

Close it.

Focus on your breathing.

Close it.

- Nearly there.
- Be brave, sir.

There. Keep breathing, sir.
It's almost over.

Laura, got Mrs. Gaulec's tests?

Yes, 2 more tricyclics
and 5 anemic on the CBC.



And creatine 4 times normal.

Look at this.

Mrs. Guérin.

Laura, you saw Kaminski?

Well?

It's horrendous.

Look.

What's it like?

Benzo traces,

untreated fractures,
rhabdomyolysis...

Iron-deficiency anemia, urinary infection,
kidney failure, vitamin deficiency – the lot.

Can I see?

Seen this?

Mrs. Viera's pelvic x-ray.

That's not neglect, it's abuse.

What's going on?

The oldies' tests.

Are you OK, sir?

No?

Breathe in deeply.

You have a fever.

No, I'm OK.

- Tell me.
- It hurts here.

The pain's here?

Thank you, doctor.

Thank you.

Come with me.

Alright.

I agree with you.

We can't send them back
in this state.

But they can't stay in the corridor.

So I'm opening Simoni's rooms
in sector 2.

To care for them with dignity.

As you know, that's ill*gal.

But...

adapting can mean breaking rules.

I'll take responsibility.
It's my decision.

I'll face the consequences.

So will we.

No.

I'll face the consequences alone.
Does everyone agree?

Excuse me...

Could my suspected botulism case
get a room too?

You kept him?

Yeah.

I've launched a botulinum toxin test.

We'll put him in a room too.

Do you know where the keys are?

Martine must have them.

I bet she took them home.

Can anyone pick a lock?

Shine the light so I can see
the small latch inside.

Can you do it?

No idea, I managed it once.

Really go for it.

Stop, you'll jam the scissors.

- Get closer.
- You know how?

It's logical.

Scissors won't work.
Give me the tweezers.

Give it a kick.

No way, that's a crazy idea.

- You'll smash it.
- What a macho!

Trust her, she's done it before.

- I'm not a macho.
- You are.

Turn it the other way.

I can manage.

Come on, give her some air.

Thank you.

Who's the best?

Bring the first 4 gurneys here,
the others there.

I'll get my botulism.

The second one.

Take that one.

We're all machos for her.
Am I a macho?

Bullshit.

Let's get started, please.

We'll have the meeting now.

You've been told? Good.

Let's get started.

Hello. No one's here.

Excuse me...

Know about the meeting?

Aren't they here?

- Hello.
- Hi.

- No one's here?
- They're coming.

- No phones, please.
- Thanks.

- Let's try to do this quickly.
- All set.

All here?

Larouchi's coming.

Start anyway.

Alright.

I'm not accusing anyone.

But, as the admin manager,
I need to understand.

Why make that decision?

- For the patients.
- What?

For the patients.

You can't open up beds.

I did my job.

No need to hospitalize them.

The home was taking them back.

Opening my rooms
without my agreement is forbidden.

With or without.

Sorry. How's it going?

You were in Bali, right?

Come in.

Go on.

With or without your agreement,
it's forbidden by ministerial decree.

Emotions play no role in medicine.

We rank priorities,
and hospitalizing the elderly illegally

is irresponsible.

What's responsible?

I don't agree.

They were in such a state,
one day was too short.

We're still treating them now.

Keeping them was only humane.

You shouldn't have accepted them.

You're making us pay
for accepting them?

Not at all.

- And the botulism?
- What?

Why illegally hospitalize a guy
for botulism

when he has no symptoms?

The test was negative.

If you suspect it, you do tests.

I'm sorry,
you lost me at botulism.

We're losing track.

No, it's clear.

We do medicine.

We defend our principles.

You were here too?

No, but I'd have done the same.

We all have principles.

My principle is to respect labor law.

My staff are being forced to work illegally.

Like doctors.

We don't get the same pay.

What?

If we stuck to the rules,
nothing would happen.

I do neo-natal.
Why am I here?

I don't know why you're here, Lazare.

But I know you need to rest.

We agreed to stay.

We talked about that.

I made my decisions alone.
I assume full responsibility.

So, Muriel,
what do we do with these patients?

We send them back?

You want me to look bad?

We don't have the staff
or the facilities.

So they go back to the care home.

We send them back?

And I have to handle it?

You're ER chief.

You'll handle it.

Thank you, everyone.

Is your daughter OK?

She's OK.

It's not easy, but she's OK.

Thank you.

And you?

Me...

We saved those oldies from drowning
and now throw them overboard.

I can't do that.

I can't do it.