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00:00This program dramatizes true medical enigmas reported by the doctors themselves.
00:06The names and characteristics of the people have been altered.
00:10When we enter a hospital, we find that the doctors have all the answers.
00:16They don't have them.
00:20Help, please!
00:21What happened?
00:22She fainted during the run.
00:23I had the feeling that it was a very serious thing.
00:27True doctors.
00:29Can someone help me? He can't walk.
00:31Can you feel that I'm touching here?
00:33No.
00:34He didn't feel anything.
00:35And I was blinking him.
00:36Do you feel that I'm blinking?
00:37No.
00:38I was very lost.
00:41True cases.
00:44A series of bad things go through people's heads at a time like this.
00:48Dad, she thinks I'm pregnant.
00:50Now he's lying there, he can't even breathe.
00:53Find out what his problem is and turn to solve it.
00:56True enigmas.
00:59Help!
01:00Nis.
01:01She fainted.
01:02I don't want to die.
01:03I don't.
01:04Please, my love, turn around.
01:05He's dying.
01:14My name is Romic Zadorian and I'm an emergency medicine specialist.
01:18Each patient is different.
01:19With some we can play, with others we have to be serious.
01:22And it's never the same thing.
01:24This was a very unusual case.
01:26There was a reversal in the final diagnosis.
01:29And if we hadn't acted quickly, he could have died.
01:32Now I'm going to the dressing room for my third day of acting.
01:41And I think I'll have to take off my shirt today.
01:44This is making me a little nervous.
01:47But it's okay.
01:48I didn't know that.
01:49Do you have a scene without a shirt today?
01:51Yes, I do.
01:52What for?
01:53What do you mean?
01:54I didn't know that.
01:55I didn't know that either.
01:56It must have been last minute when the costume department brought you here.
01:59I think it's because of those two over there.
02:01Feel free.
02:02But it's been great.
02:04Wonderful.
02:05Why are you Dr. Z?
02:06What is Dr. Z?
02:07It's Zadorian.
02:08I think it's such a difficult name to pronounce that they decided to call me Dr. Z.
02:13I like it better when they call me Romic.
02:15That's all right.
02:16But they prefer Dr. Z, so let it go.
02:20This is your mark.
02:21You cross right in front of it.
02:22I'm Dr. Jamie Wells and I'm a pediatrician.
02:25One of my teenage patients told me,
02:27so you went to Yale, to medical school, just to become an actress?
02:31And I said, I'm sure.
02:32Don't you think that's what everyone should do?
02:34That's great news.
02:35You're going to give up medicine to become an actress.
02:37I think my parents would be upset.
02:41I studied a lot for this.
02:44You know, when I miss a scene, I think,
02:46Dr. Wells must have been wrong too.
02:48So it's okay.
02:49She's a rookie too.
02:51And that makes me feel better.
02:52But I didn't make a mistake.
02:53Not once.
02:54I know you didn't, because they love you here.
02:57They say, you should learn from Dr. Wells.
02:59But they didn't hire me to take off my clothes in every scene.
03:02What a story!
03:03It's because I can't speak.
03:08I'm going to show you a case I solved.
03:11It was very interesting and very deceiving at first.
03:16Come on, are you ready?
03:17Action, Jamie.
03:22Hi, Sam. Excuse me.
03:24When you're a doctor, people forget that we have other identities outside the hospital.
03:29Did you miss anything?
03:31My sanity.
03:32I don't think you'll find it in this place.
03:34We're happy to hide behind the curtains and ignore other roles.
03:38There's a million things to do before this wedding tomorrow.
03:41Wow, that's brilliant.
03:43It wasn't my first choice.
03:44It's okay.
03:45I've seen worse.
03:47I've been to 11 weddings and had to use four different shades of a horrible purple.
03:51But sometimes the best thing to do is leave our other side to flourish.
03:56Dr. Wells, there's a patient looking for you.
04:00I'm coming.
04:03What do you think, Doctor?
04:04Do you think I should find out if she's taking anyone?
04:06A day before the party?
04:08I think you've already lost that bond, my friend.
04:11Yeah.
04:13She's complaining of mild throat pain, rib pain and general discomfort.
04:17Vital signs are normal, no fever.
04:19We did blood and urine tests and they're normal.
04:21Bacterial culture?
04:22It's negative, so...
04:23Let's take a look.
04:25Children have a natural purity.
04:27They are sincere and say what they think.
04:29I appreciate these qualities and I feel that I have these qualities.
04:33That's why I chose pediatrics.
04:35It's the perfect area for me.
04:36Hi, sweetie.
04:37Okay, see you later.
04:38Bye.
04:39It's the perfect area for me.
04:40Hi, sweetie.
04:41Okay, see you later.
04:42Are you going to fall on me?
04:43This is Lee Shapiro.
04:45I know her very well.
04:46She comes all the time and always has 65 chins.
04:49What are you dying from today?
04:50A broken nail.
04:51Teenagers can be very dramatic.
04:53They say, I have a cough.
04:55Is it cancer?
04:56Do you think I'm going to die from that?
04:58And my rib hurts.
04:59But not all the time.
05:00Very strange, isn't it?
05:02She's been like this for about two weeks.
05:05Do you feel tired?
05:07A little.
05:08But I just started running.
05:10I like your uniform.
05:12The only different thing she did in the last two weeks
05:15was start running about ten kilometers a day.
05:19With the race, the tests and the science fair,
05:22I think she's demanding too much.
05:24No, that's not the problem, Dad.
05:26The problem is that today I woke up feeling bad
05:29and I thought I was going to throw up.
05:31And then my stomach started to hurt.
05:33And I didn't want to miss the training.
05:35I thought if I came here, I'd...
05:37Uh-huh.
05:38Since teenagers are very dramatic,
05:40you can lose focus and you can't let that happen.
05:43You always have to ask yourself
05:45if there's something more significant going on.
05:47You have to be able to discard and decipher a lot of information
05:50and know what the critical point is
05:52and with teenagers it's a special art.
05:54Where does it hurt now?
05:55Right here.
05:56It was kind of acute at first,
05:58but then it got kind of painful
06:00and I thought it was just a cramp, but it kept hurting.
06:03Does it hurt here?
06:04A little.
06:05Okay, lie down a little.
06:07Is it the appendix? Is that where it is?
06:09Because I heard that if it's the appendix,
06:11it can break and I could die.
06:13And it won't be a good idea because I don't want to miss the training.
06:17Yeah, and I don't want you to die.
06:19Well, excuse me, I have to go. I'll be right back.
06:21I checked your abdomen in the upper right quadrant
06:24and there was nothing too much.
06:27There was no gas, no swelling,
06:29no firmness or stiffness in the abdomen.
06:32That was a relief.
06:34Cool.
06:35So, can I run in the afternoon?
06:37No, that's not what I said.
06:39I want you to heal, I don't want you to get hurt, okay?
06:42It looked like she had costochondritis,
06:44which is the inflammation of the muscles between the ribs
06:46due to excessive exercise.
06:48It's a common complaint among children.
06:50Let's let things work out on their own.
06:52It must be a muscle tension.
06:53Shall we?
06:54I've heard of it.
06:55I think a little rest is a good idea.
06:58That's a great idea.
06:59And if she gets worse, I want to see her back as soon as possible.
07:01Okay.
07:02Okay.
07:03Let's go.
07:05What do you mean?
07:16Honey, you'll never have time to dry those nails.
07:20Can someone help me?
07:22He can't walk.
07:23Crystal, stay close to Mommy.
07:25Daddy will be fine, honey.
07:27I'll be fine.
07:28Come on, honey.
07:29We're here to see this 40-year-old man,
07:31Mr. Terrell Phillips,
07:33who fell with his wife and his daughter.
07:37Hi, I'm Dr. Zadoran.
07:39This is Dr. Wheatley.
07:40So, what happened?
07:41Was it an accident?
07:42A car accident?
07:43No, no, nothing like that.
07:45I'm having trouble moving my legs.
07:47That's all.
07:48He didn't want to show fear in front of the family
07:50because he was a very tough guy,
07:53you know, rigid and stubborn too.
07:55He didn't want to look weak
07:57because he was probably the man of the house,
08:00the great provider,
08:02and he was in that vulnerable situation
08:04in which his daughter saw him sick.
08:06He came home sick from work
08:08and had an accident in our bed.
08:10He didn't even feel what he did.
08:12He urinated involuntarily in bed
08:14and his wife was very worried.
08:16Why didn't you tell me?
08:17Shh, quiet.
08:18Are you sure you didn't get hurt
08:20in your neck or your head?
08:22Of course I have.
08:23Okay.
08:27You can push as hard as you want.
08:29Push, push, push.
08:30Nothing.
08:31Get up, get up.
08:32Also no?
08:33No.
08:34No.
08:35Feel me touching here.
08:36Close your eyes, close your eyes.
08:37Feel now.
08:38I don't feel anything.
08:39Why can't he feel?
08:40We don't know yet.
08:41It's a fracture, it's broken.
08:42Can you squeeze my fingers?
08:43He was very clear.
08:44He didn't fall.
08:45There was no trauma.
08:46Pull me in your direction.
08:48No fracture, no dislocation.
08:50He had nothing.
08:51When did it start?
08:53It started yesterday at my job.
08:59He was on the cooperative's payload platform.
09:01I imagine he carries a lot of weight,
09:03doesn't he?
09:04Repetitive effort with heavy loads
09:06can cause disc hernia.
09:08I'm going to touch your back.
09:09Tell me if you're feeling any pain, okay?
09:11Feel me touching here.
09:13He didn't feel any pain.
09:15He had no alterations,
09:16no difference in alignment or depth
09:19until the end of the spine.
09:21Now change his clothes for an ambiental.
09:23He's going to take serum too and collect blood.
09:25All right?
09:26We'll talk to you later, okay?
09:28Now try to relax.
09:29The fact that he's not feeling his legs for two days
09:32was worrying.
09:33Listen, this acute lack of sensitivity
09:35and motor functions is a little worrying.
09:37And that accident in bed,
09:39urinary incontinence,
09:41the absence of tonus retal,
09:43was even more worrying.
09:45Without a trauma,
09:46this is very difficult to explain.
09:55Hey, what's up?
09:57What do you think of a first date and a wedding?
10:00A good idea, I think.
10:01Yeah?
10:02Yeah.
10:03Oh, my God.
10:04Help me.
10:05What happened?
10:06Suddenly, Lishapil is back
10:08and it wasn't the same person I met in the morning.
10:10She fainted during the race.
10:12The biggest fear of a doctor
10:13is letting something go,
10:14especially if there's a risk of death.
10:16I have no idea what's going on.
10:18I had a feeling it was something very serious.
10:25We were in training
10:26when suddenly she doubled in pain and fell.
10:29Now my stomach is hurting and my heart is racing.
10:32My 14-year-old patient, Lishapil,
10:34came back to the hospital after a check-up,
10:36but now she was with a stiff neck,
10:38all red and feeling dizzy.
10:40How much does it hurt on a scale of 1 to 10?
10:42About 20.
10:43120 on the wrist.
10:45She ignored what I said and ran away anyway,
10:48which is a typical teenager reaction.
10:50Am I going to die?
10:52You'll be fine.
10:53I won't stop until I find out what it is, okay?
10:56Is it a sinus attack?
10:57Could be.
10:58Do you think it's a prolonged QT?
10:59And what is it?
11:00It's a kind of electrical problem in the heart.
11:02It's something we should always consider.
11:04A series of bad things
11:05go through our heads at a time like this
11:07and a very dangerous arrhythmia
11:09is called Prolonged QT Syndrome,
11:12which often leads to sudden death in children.
11:15Sometimes, when children exercise,
11:17they can get dizzy and feel nauseous.
11:19We always check this in all electrocardiograms.
11:27Mr. Phillips, have you been sick lately?
11:29No, it's been a long time since I've been sick.
11:32We treated this 40-year-old man, Terrell Phillips.
11:36He didn't have sensitivity in his legs.
11:38And with the X-rays,
11:40we hoped to get an idea of what to do with him.
11:43Did he have a headache?
11:44A change in vision?
11:45A fever or a cold?
11:46No.
11:47Any kind of weakness,
11:49it's important to understand his history
11:51because we keep imagining
11:53it's something in the brain,
11:54something in the spine,
11:55or in both.
11:56Nausea, vomiting,
11:57stomach discomfort of some kind?
11:59No, nothing like that.
12:00And does he smoke, drink,
12:02or use controlled drugs?
12:04What does that have to do with me?
12:12No.
12:13He denied having a headache,
12:15any change in vision,
12:17no loss of taste,
12:18no fever,
12:19and no cold.
12:20He denied all of that.
12:21I was lost.
12:29Let me see the electrocardiogram.
12:35The QT is 0.39.
12:37It's a normal exam.
12:38After checking Lee Shapiro's electrocardiogram
12:40and his clinical history,
12:42it was obvious to me
12:43that he didn't have prolonged QT syndrome.
12:45So it wasn't a run.
12:46Well, we're not sure about that yet.
12:48Did the pain come back, honey?
12:49A lot.
12:50It looks like it's exploding in here.
12:52Can you show me where it hurts?
12:54The description of your pain
12:55was not compatible with your exam,
12:57which can be a bad sign,
12:59especially in girls.
13:00The abdomen region
13:01can be incredibly complicated
13:03in girls.
13:04We have the genital tract,
13:05all the reproductive organs.
13:07So we need to expand our analysis
13:09and think about all the possible hypotheses.
13:12Does it hurt when I touch you?
13:14It's right here.
13:15Right here.
13:16Where does it hurt?
13:18Show me where it hurts.
13:19Up here.
13:20Now it's up here?
13:21Uh-huh.
13:22Before, Lee Shapiro complained
13:23of pain in his ribs.
13:24Now he was complaining
13:25of pain all over the right side of his abdomen.
13:27And it was changing every minute,
13:29which is very unusual.
13:30Okay, let's start over.
13:31Where exactly does it hurt?
13:33Up here.
13:34Now it's up here?
13:35Uh-huh.
13:36Are you sure?
13:37Uh-huh.
13:38Things were changing dramatically.
13:41What else could be going on?
13:47Can you feel this, Dad?
13:49Does he have any fractures?
13:50I don't see any.
13:52Yeah, but he has a degenerative
13:53joint disease.
13:55It's not uncommon for a 40-year-old man.
13:58At this point?
14:00We analyzed Terrell Phillips' radiographs
14:02and there were obvious changes
14:04that certainly pointed to a degenerative
14:06joint disease
14:08concentrated right in his spine.
14:10Well, anyway,
14:11a cartilage degeneration
14:13wouldn't cause paralysis or incontinence, would it?
14:17No, but the Queen's tail syndrome
14:18is a possibility.
14:19Think of the image of a horse's tail.
14:21And if we look at our spine,
14:23it ends in a series of filaments
14:25that look like a horse's tail,
14:27and each of these filaments
14:29corresponds to a nerve fiber.
14:31So when the Queen's tail syndrome occurs,
14:33it means there was a destruction of the nerves
14:36that lead to the legs and the pelvis.
14:39Not bad, Doctor.
14:41The Queen's tail syndrome
14:42is a serious emergency
14:44and needs to be corrected immediately.
14:46Let's follow the tests
14:47and do a resonance test.
14:48Then we'll decide.
14:49Good work.
14:50By the way, I'd like to speak
14:51to the neurosurgeon.
14:52Leave it to me.
14:53Thank you, sir.
14:55If it's not corrected immediately,
14:57it can cause paralysis.
15:03Wilson, what do I have?
15:05Trash, Piro.
15:06The urine is clear,
15:07negative for pregnancy and medicine.
15:08The electrolytes are not so good.
15:10No bleeding,
15:11but it has mild anemia and hypokalemia.
15:13Great.
15:14I don't like my hair like this.
15:15Wait, wait.
15:16Doesn't that make my face
15:17even rounder than it already is?
15:18You can talk about that outside.
15:21Potassium and iron.
15:22Sorry, guys.
15:23Hey, Tom.
15:24Sorry, okay?
15:25But I have to go.
15:26Okay.
15:27Sam, listen.
15:28Let me go, okay?
15:29Let me go.
15:33An eating disorder?
15:34Popular teenager,
15:35potassium and iron low,
15:36increased heart rate and exercise.
15:38Caffeine fan.
15:39It can be esophagitis or gastritis.
15:40Esophagitis doesn't usually cause pain
15:42on the left side of the abdomen.
15:43And a fracture in the rib?
15:45No.
15:46A person who suffers
15:47from an eating disorder
15:48can really have fractures in the bones
15:52because it will present osteoporosis
15:54at a very early age.
15:56In her case,
15:57I didn't suspect anorexia or bulimia
15:59or any other eating disorder.
16:01But there were certain things that explained
16:03why the resident thought that way.
16:05She was thin, had tachycardia,
16:07was a little dramatic in any situation.
16:09Her father said she was very determined.
16:12And these are characteristics of teenagers
16:14that tend to develop eating disorders
16:16in teenagers.
16:17At least the fingers are working.
16:19I'm still a little dizzy.
16:21Yeah, I know.
16:22Let's find a way.
16:23Mr. Shapiro,
16:24can you follow Dr. Stark
16:25to sign some papers at the reception?
16:27Is she going to be okay, Liz?
16:28She's going to be okay.
16:29I'll take good care of her.
16:30What's up, girl?
16:32Hi.
16:33Now that we got rid of your father,
16:35is there anything you want to tell me
16:36that you wouldn't say in front of him?
16:37Is he on a weird diet or anything like that?
16:39No.
16:40The coach wants me to put on a little weight,
16:42so I'm eating a lot of carbohydrates,
16:45but it's not helping at all.
16:46While I was talking to Liz,
16:48I was analyzing each part of her.
16:50I looked at the finger joints
16:51to see if there were scarring from the chronic vomiting.
16:54I looked at her skin
16:55to see if she had a thin lint called lanugo
16:57that the body develops to warm up
16:59when it's chronically malnourished.
17:01I looked at the back of her teeth
17:03when she opened her mouth
17:04to see if there was a small itch.
17:06I didn't see any of those signs in Liz.
17:08Is it making up for it in any other way?
17:15You think I eat and then throw up, is that it?
17:18You need to help me, Liz.
17:20Why hasn't all that caffeine been running lately?
17:23I thought she wasn't telling the whole truth.
17:26Hello?
17:30What's his name?
17:32Matthew.
17:40What does Matthew do?
17:42He runs marathons.
17:44Are they doing that?
17:45Are they having sex?
17:47No, we haven't done any of that yet.
17:49So you're telling me you're still a virgin?
17:51Totally.
17:52Really?
17:53Mm-hmm.
17:54With teenagers, the question is,
17:56do you always wear protection when you have sex?
17:59And they say, of course, I always do.
18:01But if you ask the following question,
18:03how many times did you forget to wear protection?
18:05They'll say, oh, about four or five times, and that's it.
18:08And I need caffeine.
18:10If I don't take it,
18:12I get all sweaty and dizzy,
18:14and I feel like I'm going to pass out.
18:17Are you feeling like that now?
18:19Mm-hmm.
18:20I was hoping your heart rate would improve after you took the serum.
18:23John, give her another liter of serum.
18:25But it didn't improve,
18:26which led me to believe there were other things going on.
18:28I started rethinking the whole clinical picture,
18:30and then the chip fell.
18:31She's restless, she's agitated,
18:33her heart is beating fast,
18:34she's eating a lot to gain weight,
18:36and she can't gain weight.
18:37I suspected that the Lychapyrus thyroid was imperative,
18:40perhaps because of Grave's disease.
18:42Grave's disease?
18:48TERREL, I CAN'T MOVE MY ARMS
18:51Very well, Mr. Phillips.
18:52As we discussed before, you will now make a resonance.
18:55You just have to sign the authorization form for the exam.
18:59It's totally non-invasive.
19:01It won't hurt at all.
19:04I can't.
19:05Terrel!
19:06Give me that, since he can't.
19:09Terry, I can't move my arms.
19:13I started feeling cold because he couldn't move his arms.
19:16I was lost.
19:17What was the problem?
19:21What do you mean you can't feel your arms?
19:23Man, this is crazy.
19:24My arms were fine five minutes ago.
19:26Mr. Phillips now couldn't move his arms,
19:28and he couldn't feel them either.
19:29And Caldequina couldn't do that.
19:31So it was something else.
19:33Can you feel me playing here?
19:35No?
19:36He had no sensitivity.
19:37I blinked, and he didn't react.
19:40You can't feel anything, Dad?
19:42Of course the wife was worried.
19:44I was worried.
19:45My colleague was worried.
19:47And I was cold.
19:48And the presence of the girl didn't make things easier.
19:51Hey, Noelle, are you busy?
19:53No, I'm fine.
19:54Can I help?
19:55Can you take care of Crystal a little bit, please?
19:58Do you want me to go to the bank?
19:59Honey, go with the nurse, okay?
20:01I'll come back to get you as soon as I can.
20:03No, I want to stay here with my dad.
20:06Please, honey.
20:08Go with the nurse.
20:10For me, okay?
20:11Thank you very much.
20:12Really.
20:15What's going on with me?
20:18Talk to me.
20:19I want answers.
20:21Dr. Zadorian, is everything okay here?
20:23I was going to explain to Mr. Phillips that, given the rapid evolution of his paralysis,
20:26we think he may have a syndrome called Guillain-Barre.
20:29And what is that?
20:31To simplify, it's when your immune system attacks, by mistake, your nervous system.
20:35Guillain-Barre is what we call ascending paralysis.
20:39It means that it starts in the fingers and goes up slowly until it reaches the chest.
20:45And it causes inflammation in the nerves and muscle weakness due to infection.
20:50But he wasn't sick before that.
20:57Let's do a lumbar pulse, and if there's a high amount of protein in the fluid...
21:01That's it, we'll have an idea if it's Guillain-Barre or not.
21:12What else, Wilson?
21:16I'm sorry.
21:17It's okay.
21:18I just...
21:19Do you want me to hold this for you?
21:21Hold this for me. I have to deliver this.
21:23Laundry just left it here.
21:25I keep scratching my nail polish.
21:27I'll just leave this. I'll be right back.
21:33Oh, shit.
21:34Damn.
21:39Shit.
21:42Thank you very much.
21:53Dr. Wilson.
21:56The thyroid levels are here.
21:58T4 in 12, TSH in .4.
22:00That's high.
22:01I suspected that Lee Shapiro's thyroid was hyperactive.
22:04And if it was, we needed to be sure it wasn't Grave's disease...
22:08which is an autoimmune problem in which the body attacks the thyroid gland...
22:12and stimulates it.
22:13Add thyroid antibodies or blood tests...
22:15and do a thyroid ultrasound.
22:17Okay.
22:18I think this will look better on the skin than on you.
22:21Well, the way it is, it won't look good on her.
22:24You did that?
22:25You're a disaster.
22:28Thank you very much.
22:29You're welcome.
22:31What's worse, having cancer or being paralytic?
22:37So, which one of the two?
22:39Did your mom give you any toys or anything for you to play with?
22:42No.
22:55No nodules, no increases, nothing in the thyroid test.
22:58Totally normal.
23:00I don't think this is going to work.
23:02Thanks for the help.
23:05How do I explain the thyroid's elevated levels?
23:08Help!
23:11What's going on?
23:14Liz?
23:15Liz?
23:17What happened?
23:18She got up to go to the bathroom and passed out.
23:20I don't want to die.
23:21You're not going to die, honey.
23:22Where's the pain? Is it back?
23:24It's right here.
23:25And all of a sudden, she was in a lot of pain.
23:27And it was in a totally different place.
23:29Do the tests again.
23:30I want something else.
23:31Do an abdominal and pelvic ultrasound.
23:33We need to have a better idea of what's going on in Liz's abdomen.
23:36Ah, normal protein in Mr. Phillips' liquid.
23:39And forget about Guillain-Barre.
23:41But there's a high rate of blood sedimentation.
23:43So there's an infection, an inflammation somewhere.
23:45It's best if the antibiotics are resolved quickly.
23:47Emergency with Terrell Pumphrey.
23:50Terrell!
23:51Terrell!
23:52Breathe, my love, please!
23:55Help my husband! Help my husband!
23:57What happened?
23:58The saturation dropped.
23:59He wasn't breathing.
24:00He was breathing only three or four times a minute.
24:02There was no good air circulation.
24:04He was sweating and in a lot of pain.
24:06We need to intubate him now and fast.
24:08I want a tube 8.0 and a syringe right now.
24:11He was dying.
24:13His wife was desperate at that time because he wasn't reacting.
24:18Why?
24:19We didn't know.
24:20Can someone get the respirator, please?
24:22I kept looking at his face and saying,
24:24Listen, we're going to intubate you.
24:26You're not breathing.
24:27You could see the fragility in his eyes, you know?
24:30Because at that time, he was putting all his trust in me
24:33and saying, Listen, I give up.
24:35All right.
24:41Mr. Phillips had what was called ascending paralysis.
24:44It progressed from the legs to the arms
24:46and then to the respiratory muscles.
24:48We intubated him to help him breathe.
24:51Your husband seemed to be...
24:53Doctor, I didn't bring my husband here to see him die.
24:56I understand.
24:57No, you don't.
24:58When you brought him here, he was still walking.
25:00Now he's lying there and can't breathe.
25:02Find out what his problem is and turn around to solve it.
25:05Okay.
25:06At that time, I didn't have an answer for my wife.
25:09We didn't have anything.
25:12She wanted to know the reason, and there we were,
25:15after so many years of training and so many years of practice,
25:18and we couldn't give her a simple explanation.
25:26Dr. Wells.
25:27Yes?
25:28I just got the blood test results from Liz.
25:31Go ahead.
25:34Liz is pregnant.
25:36What?
25:37Pregnant?
25:39She's pregnant.
25:46Liz, dear.
25:47It was unlikely that it was a false positive.
25:50She would have some kind of DST,
25:52it would be a spontaneous abortion,
25:54or an ectopic pregnancy.
25:56Where is your father?
25:58He's out there talking to the DVT.
26:01What for?
26:03We have rats.
26:05Well, I want to talk to you alone.
26:08Look at me, dear.
26:09Your blood test was positive for pregnancy.
26:12How do you explain that to me?
26:14What?
26:15No, I'm not.
26:16I told you, I've never done any of this before.
26:19She's 14 years old,
26:20and it's not impossible for a 14-year-old girl to get pregnant.
26:23You can tell me.
26:24I'm not going to judge you or get mad.
26:26I'm just worried about your bellyache.
26:28But I told you, we've never done anything like this before.
26:31We just kissed.
26:32And it never happened, okay?
26:34So you're telling me I've never had sex with this or any other boy
26:38in any moment of your life?
26:39Never.
26:40Really?
26:41Really.
26:43Dad, she thinks I'm pregnant.
26:45Tell her I'm not.
26:46I swear, I've never done any of this.
26:50What?
26:51Dad, you know I'd never do...
26:53What happened?
26:54I didn't do anything wrong.
26:57But that doesn't make sense, honey.
26:59The test was positive for pregnancy,
27:01and I'm really worried about your bellyache.
27:04I don't care why you did...
27:05I told you, we just kissed.
27:07I swear, I've never had sex in my life.
27:10I'm going out to get some coffee.
27:11I told you, Dad, I've never been close to having sex.
27:14Why don't you believe me?
27:15Because your doctor told me you're pregnant.
27:17Who should I believe, her or you?
27:19Me.
27:20You?
27:21Why did the test come back positive?
27:23I don't know!
27:24Tell me why!
27:38Dr. Wells,
27:39the test came back positive.
27:41What?
27:42So she's been pregnant for three hours?
27:45Was she pregnant here at the hospital, or what?
27:48Don't ask me.
27:49How do you explain that?
27:50There's a test that determines the presence of the pregnancy hormone,
27:53and there's another one that reveals its quantity,
27:55which helps us know how long she's been around.
27:58I remember there are certain things that can produce
28:00pregnancy results with a positive test.
28:02It must be useful.
28:03Go look it up now, okay?
28:15The results of Mr. Phillips' lumbar puncture had arrived,
28:18and I didn't see the time to find out what was going on.
28:22I did the puncture again to find Lyme antibodies,
28:25and it came back negative.
28:27With the lumbar puncture,
28:28the liquor analysis...
28:31didn't reveal a rise in protein,
28:33so Guillain-Barré was somewhat improbable,
28:36but not completely,
28:37since it couldn't be ruled out.
28:39And the antibodies for Lyme also came back negative.
28:43So it must be some kind of shock.
28:46Yeah, something in the spine region
28:47could be pressing the spinal cord.
28:49Yeah, something in the soft tissue
28:51wouldn't show up in the X-ray,
28:52like a tumor, for example.
28:54Let's do the resonance now.
28:58You're only 14, Liz.
29:00Are you crazy?
29:01We decided to do an abdominal and pelvic ultrasound on Liz Shapiro,
29:04hoping to get some results.
29:06I didn't do anything.
29:07The test says I've been pregnant for three hours, Dad.
29:09That's impossible.
29:11This is the best way to see if the organs,
29:13at least, are the normal size,
29:15with normal location,
29:17if there's active blood flow to these areas,
29:20if any tissue isn't where it should be.
29:22Why don't you believe me?
29:24I want his name.
29:26You'll keep wanting it.
29:27Very well.
29:28The gallbladder looks good.
29:30Did you see, guys? Look here.
29:32The spleen is good.
29:33The liver, too.
29:35The uterus is good.
29:37And the right ovary, too.
29:39Everything on the right side is good.
29:42What?
29:43What did you see?
29:45I can't see the left ovary.
29:47Honey, could you turn a little to my direction?
29:51There could be some kind of mass blocking the vision.
29:55What kind of mass?
29:57Well, I can't tell you yet.
29:59Now we had information that there was something on the left side,
30:03but the pain was on the other side.
30:05So what was on the left side that was causing all the pain on the right side?
30:10Unfortunately, the ultrasound is limited.
30:12We have to do a tomography to see better.
30:22Noelle, did you see? Tom is wearing my dress.
30:24No, I didn't see.
30:31Hello.
30:32Oh, how dirty.
30:34Fifty cents.
30:35Oh, no.
30:36Sixty?
30:37It's very dirty. No, no.
30:39A hundred dollars.
30:40A hundred dollars?
30:41Yes, a hundred dollars.
30:42It's very dirty.
30:43An hour?
30:44No, no.
30:45At least two hours.
30:46Two?
30:47Two hours.
30:48Look how dirty it is.
30:49It takes a long time.
30:55So we took Lee Shapiro to do a tomography
30:57and find out what was going on in his left ovary.
31:00She's not pregnant.
31:02One of the things that produces a false positive
31:04is contact with rat feces.
31:06That explains the rise in HCG.
31:08Yeah, and I told my dad
31:10I've never seen anyone so excited about having problems with rats.
31:14That brought a certain relief.
31:16But then I started to think,
31:17if it wasn't a baby,
31:18there would be something evil brewing there.
31:20Are there no sediments or stones in the biliary vesicle?
31:24The appendix seems normal.
31:27The right ovary seems fine.
31:30But...
31:31Oh, that's it.
31:32Yeah, there's definitely a mass there.
31:34My worst fear was that it was a tumor.
31:37And it would be cancerous.
31:39It looks like the size of an avocado.
31:41No wonder we didn't see the left ovary.
31:43And suddenly we see that tumor
31:45the size of an avocado
31:47obstructing the left ovary.
31:49Wait a minute.
31:51Are those teeth?
31:53Oh, my God.
31:58Now the tomography showed us
32:00that Lee Shapiro had a tumor in his left ovary.
32:08Hi.
32:09Have a seat.
32:13It looks like Lee has a tumor in his left ovary.
32:15Tumor?
32:16And I'm very worried because he's in a lot of pain.
32:18We'll probably have to do surgery right now.
32:21With a tumor this big,
32:22it's dangerous to see a rupture
32:23with the risk of septic shock and death.
32:25And what is it exactly?
32:27Is it cancer?
32:29We won't know for sure until we remove it.
32:38In the case of Mr. Phillips,
32:40he had ascending paralysis.
32:42So we did a resonance
32:44to be able to scan everything
32:46from his head to the bottom of his spine.
32:49And there was something in the spinal region.
32:53It's an epidural abscess.
32:55That explains what was pressing your spine,
32:58but it doesn't make any sense.
33:00An abscess is a form of infection.
33:02And what it does over time
33:04is grow and press,
33:06tighten the spine.
33:08And that pressure is what causes paralysis.
33:11Has he had surgery recently?
33:13No.
33:14And most spinal abscesses
33:15don't occur in injectable drug users?
33:17It's something between 40% and 50% of cases.
33:20The most important thing was to take him
33:22to the surgery room to drain the abscess.
33:25But we still didn't know what his origin was.
33:28Why did he have an epidural abscess?
33:31Why did he have an epidural abscess?
33:38Oh, come here.
33:39You'd better not play with that.
33:41Your mom wouldn't like to see you playing with that.
33:44Oh, it's okay.
33:51Hi, honey.
33:52Mom!
33:54Daddy's gonna be okay, okay?
33:56Keep thinking positive.
33:58Okay.
33:59Thank you for taking care of my daughter.
34:01I'll ask someone to pick her up.
34:04Chris, what do you think about going to the store
34:07to buy a little gift for your dad?
34:11Sit down, Mrs. Phillips.
34:16Well, uh, Sherry,
34:19there are only two reasons
34:21for someone to have this specific type of infection.
34:25Either he had a recent surgery,
34:29or...
34:31so he...
34:32Is it possible that he's using inedible drugs?
34:40No, no, no way.
34:43Terrell is a good man.
34:45That's ridiculous.
34:47No.
34:48Is it possible that he's hiding something, or...
34:51Yeah, have you ever seen anything suspicious?
34:55No.
35:01I just think he wouldn't do something like that.
35:04Well, there's always a possibility
35:06that the wife doesn't know.
35:08Well, I understand your frustration.
35:11Uh, we'll talk to you as soon as we know about the surgery.
35:16Again, thank you.
35:48Uh-huh.
36:18Uh-huh.
36:19Uh-huh.
36:21Thank you very much.
36:23Is there anyone else being operated on?
36:25My daughter.
36:26Oh, my husband.
36:28Thank you very much.
36:30You're welcome.
36:55Doctor?
36:56Mrs. Phillips?
36:57I found this.
37:00A prescription.
37:01Did you know about this?
37:02No.
37:03My husband hates going to the doctor.
37:05From what I know, he hasn't been to the doctor in years.
37:07What do you think it could be?
37:09It's a prescription for antibiotics.
37:11I'll check it out and we'll talk later, okay?
37:13Okay.
37:14Deal?
37:16This is Dr. Zadorian calling from the emergency department at Westwood University.
37:20I need information on a patient named Terrell Phillips.
37:23No, but I have his prescription right here.
37:26The other doctor said that Terrell had an abscess that was drained under excella.
37:31And that he gave him a prescription for antibiotics because he had identified signs of an infection in the skin around his abscess.
37:37So, I think now I know what happened.
37:40All right, thank you.
37:46Mr. Phillips is out of surgery.
37:48He's out of surgery.
38:13They said they were able to drain the abscess.
38:15It was all right.
38:16And now we also know where the abscess came from.
38:18And you were right.
38:19It had nothing to do with illegal drugs.
38:22I'm sorry to interrupt, but the information you took out of his wallet gave us some answers from the previous doctor.
38:29He lanceted a hole in the excella a few weeks ago.
38:38It was obvious that there was an abscess there that was drained and was healing.
38:42Even if we had seen that, it wouldn't have helped at all.
38:45It's very, very rare.
38:47And this abscess generates a bacterium called statilococcus aureus,
38:51which, if it falls into the bloodstream, can cause infections in other parts of the body.
38:56And since he didn't take the right antibiotics, they got to the spine.
39:01An abscess caused all of this? Are you serious?
39:03It happened because there was a perfect environment, the perfect bacterium, and the perfect scenario.
39:09You can see in the x-ray here how he had narrowing in the spine and infection in the bloodstream.
39:15That created the perfect environment for bacteria to reproduce.
39:18Since Mr. Phillips had a degenerative joint disease,
39:21it created an environment very susceptible to infections because there was already damage in the region.
39:27And bacteria like that. Bacteria like sick tissue.
39:30They like places where there is already damage.
39:33And we said it was nothing.
39:35Well, if you hadn't brought him right on time...
39:38Actually, if he had arrived 12 hours later at the hospital,
39:41he probably would have died right after respiratory failure.
39:45So, good luck to him for having a wife like that.
39:54I've read about hair and teeth cysts, but I think this is a fetus-in-fetus.
39:58Look, I don't think I want to know what that is.
40:00Oh, it's very bizarre.
40:01It's when an unformed twin grows inside you all your life,
40:04and when I get older, he gets hair and teeth and...
40:07Yeah, I was right. I don't even want to know.
40:14Hi, how are you?
40:16Thank God.
40:17I managed to save the left ovary, and I'm sure the tumor is benign.
40:20Alice and her father will be relieved to know.
40:22So, what's that mass?
40:24See for yourself.
40:33This can only be a game.
40:37But what is that?
40:39It's huge.
40:42We finally had the answer to Lee Shapiro's case.
40:45We have the diagnosis.
40:48I had never seen a real teratoma.
40:51It accumulates fat, hair, teeth, thyroid tissue.
40:56It's really fascinating to see.
40:59Are you sure it's not a fetus-in-fetus?
41:01No, it would look like a baby.
41:03You'd see parts of the body, like arms, legs, even organs.
41:06The first time we see a tumor like that, we ask ourselves,
41:09how did it get out of a body?
41:11The reason we can't see a mass the size of a melon is simple.
41:14There's so much going on in the abdomen,
41:16and if it's growing in there for a long time,
41:18the body will adjust the space,
41:20filling the pelvic cavity,
41:22and it's not something we can see when we examine someone.
41:25I'll take a look at Alice.
41:27Maybe it's been growing inside her since she was born.
41:37Can you feel this?
41:39And this?
41:41Good morning, everyone.
41:43This is my friend Terrell. How are you feeling today?
41:45I'm fine.
41:47Doctor, tell her it was nothing serious.
41:50I just didn't want her to worry about me.
41:53It was just a tumor.
41:55Don't tell me it wasn't serious.
41:57The doctor asked if you were sick.
41:59I don't think having a tumor is being sick.
42:02But that's not all. My love, you almost died.
42:05Next time something goes wrong, I don't want to know if it's a tumor.
42:08You better tell me.
42:10Terrell, I think you're going to be fine.
42:12You're going to recovery, and you're going to be new out there.
42:15Good luck to you. See you later.
42:17Bye.
42:18Come here. Give Daddy a hug.
42:23In the end, we realized that guy could have died,
42:26which we avoided.
42:29It was a very gratifying feeling
42:32to get out of that room and see a happy family,
42:35and a happy patient.
42:43We received the results of Lee Shapiro's biopsy,
42:46and everything was confirmed. It was benign.
42:48There was no possibility of cancer, which made me euphoric.
42:51Good news.
42:53How wonderful.
42:54I was excited to be able to tell them this,
42:56because now she could move on without worrying.
43:00It wouldn't be a problem for her in the future.
43:02What do you call that? A teratoma?
43:04Or a cystodermoid.
43:05It can grow from normal cells that already existed when we were born.
43:08How bizarre.
43:10Yeah, bizarre.
43:11And it also secretes different types of hormones.
43:13Like thyroid hormones.
43:15That's why she had symptoms of hyperthyroidism.
43:17Often, a tumor like a teratoma can secrete hormones,
43:20like thyroid hormones.
43:22That would explain why her rates were so high,
43:24and she had symptoms of that.
43:26Now that we've removed the tumor,
43:28the thyroid hormones should return to normal.
43:30We took some really cool pictures, Lee, if you want to take a look.
43:32I do.
43:33You do?
43:34I do.
43:35It was cut in half, okay?
43:37This is the inside.
43:38Okay.
43:40Oh, my God!
43:42Is that what they took of her?
43:44Yes.
43:45It's huge.
43:46It looks like a giant burrito with teeth and hair.
43:48Man, let me take a picture.
43:52All right.
43:53You can send it to me by e-mail.
43:55You can look it up on my website.
43:58You can leave it to me.
44:00She's going to celebrate her birthday, go to the ball,
44:03have a bunch of babies until she's 40,
44:05and go to medical school as your favorite doctor.
44:09Wow.
44:10I can't look anymore.
44:12I'm taking her away.
44:19Perfect.
44:21You can trust me.
44:23You haven't slept in 24 hours.
44:25Absolutely incredible.
44:33Dr. Whitley.
44:35Wow.
44:43Hello?
44:45Hi.
44:46No, I'm ready.
44:49Oh.
44:51Okay, fine.
44:53Bye.
44:56My companion.
44:58He's in bed with the flu.
45:01I know...
45:05someone who can help you.
45:07Oh, yeah?
45:09Yeah.
45:10Then get ready.
45:12Romances can happen anywhere.
45:14And, of course, it can happen in a hospital,
45:16especially when there are pretty nurses,
45:18pretty doctors, pretty attendants.
45:20That makes it an ideal place for a romance.