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doctor-reacts-to-the-good-doctor-viral-surgeon-meme-episode

Doctor Reacts To The Good Doctor | Viral Surgeon Meme Episode

the most viral part of the good doctor I am a surgeon feels weird saying viral cuz it has nothing to do with the virus but let's watch these episodes let's get started hello Dr Han you take the bus too no Sean I just wanted to talk to you that's one thick scarf it looks borderline uncomfortable I spoke to the residency director of pathology and we both agree you'll be a great fit there are they trying to get him away from going into the surgical field and instead go into pathology I mean there's value in that because there's less patient interaction but I feel like his skills in Reading human behavior okay maybe he is better as a pathologist I'm a surgical resident as a pathology resident you'll Touch cases and lives across all the medical departments it's an opportunity for you to help patients without having to deal with patients he could also have a really good place in Interventional Radiology known as IR where there are procedures performed so you still have some patient interaction it's slightly surgical something to consider Sean I am a surgical resident you were and you're going to do great work in pathology people switch residencies all the time and actually from surgery is a very common swap to other fields because surgery is unique it's demanding and it doesn't mean that those people aren't good doctors or they failed it's about finding the specialty that's right for you lifestyle wise skill-wise passion wise and initially when you start many people have the wrong impression of what the field will ultimately be like through the generous support of St Bonaventure Foundation we've been able to transport Kenny and his mother from their home in Mississippi we appreciate you allowing us to share your case as an educational opportunity for our St the neurofibroma started as a small bump near the base of the spine so neurofibroma is usually a non-cancerous tumor meaning that it's not malignant it's benign and the only time we really intervene with them is if they start causing symptoms due to their size or position wow okay that's a very big size I'm curious to know if that's ever even been recorded I mean that's like the size of a human and it it's almost the shape of a liver which is kind of interesting it encircled his abdomen and grew to over 100 lb but why did it grow to this size why didn't anyone act on it blood supply becoming so intertwined with the patients it was deemed inoperable but we've been able to come up with an Innovative surgical plan that will allow us to slowly peel the tumor off the front and back of his torso in one piece and give Kenny his life back now there are conditions called neurofibromatosis type one where people can actually through a genetic mutation with some of their protein genes actually have a bunch of different neurofibromas throughout their body but I don't know that they have one that can become that big I think it's more of a a quantity versus a size I am going to need 60 units of type B positive packed red blood cells H for o 60 you operating on a hemophiliac elephant our patient has a 200 lb neurofibroma cool there's more blood in the tumor than the patient so we're going to have to follow massive transfusion protocol those are the different types of neur fibromas by the way that we're popping up there's like spinal there's muscular there's dermal dermal seems to be the more common type that's obviously not dermal I could do some research on Cell Salvage techniques cancer is a risk but if we Mendes has put together a pretty big team so we have everything we need I feel bad for sea but to some degree she's right because when you have too many cooks in the kitchen things get complicated mistakes get made too many people mixing around no one knows who's in charge very very messy situation can arise Shawn is being punished for mistakes that Han thinks he might make in the future he's not punishing him he just saved his ass okay Kenny the MRA is going to help us map the blood supply to the tumor MRA is basically a form of MRI that's looking at blood flow through the Dy put into the arterial system the blood vessels you'll be able to see where that blood goes and where it's distributed and where you can make safe incisions in we should take a stand meaning what stage a walk out how much do one of these bad boys cost anyway about 3 million but it's worthless unless you stop talking yeah when you talk or move during an MRI you develop something known as motion artifact on the scan where because there's a little bit of a delay in between each image you could actually see blurring and it becomes very difficult to make out what you're looking at and mistakes could be made it's not good that works for Jeff Bezos and Bill bich I'm not talking about your leadership lecture I'm talking about this it's such an extravagant image I've never seen anything like that we expected the tumor to grow since the last scans but not to this extent blood vessels that I thought we'd be able to quickly cauterize are now thicker than my thumb thick blood vessels are problematic because as soon as you make an incision to cut out the tumor you get massive bleeding and because this tumor create a lot of neovascularization where it literally released these factors called endothelial growth factors it created its own blood supply fat tumors they all behave in this very unique way where they actually start sucking life from you that is why many of our patients who are advanced in their cancer staging actually look CTIC where they look so skinny and worn down really the cancer starts taking away the calories it starts using the calories for its own growth it redirects blood towards the tumors it's impossible to remove the tumor without causing you to bleed to death no I don't care how risk you it is but then if it continues to grow he's also going to die you have to make a decision here Kenny as long as your heart remains healthy you basically will be too whoa how can you make that prediction if this thing starts growing and it's growing at the speed where he's like in just a few days the blood vessels became thicker than my thumb what's going to happen in a matter of years in five years this thing could be three times the size of any other human at which point he will start suffering those ill effects want to be treated I want to be cured I want my life back I always thought all I had to do was get enough money or find the right doctors but if you're telling me there's no hope I've never seen in a hospital where a patient has to cry and advocate so hard for their case that it will then change the doctor's mind like it feels like the medical necessity should change the doctor's mind not whether or not the patient becomes emotional she's always trying to one up us Morgan she's not staying late because she wants to research she's staying late so that Han can see she's staying late that's just who she is don't take it personal and my dad's a Taekwondo grandmas coached Me growing up he always used to say only you can beat you I did Taekwondo for8 years certainly other people could have beat me besides me but you know I tried You' think if you're selling Boba you'd have straws wide enough to get the balls throughou them I can't believe you drink that stuff it's like putting gummy bears in a drink is she going to try and clot the blood vessels I got an idea if we embolize the larger blood vessels to the tumor before surgery we can I just don't understand why they didn't think about this before why is she having to Bob a brainstorm here I'm not a surgeon and yet I figured this out this should reduce hemorrhaging during surgery and allow us to excise the tumor without you bleeding out I also don't understand why they can't embolize the tumor if they're embolizing and destroying the blood vessels to the tumor that can actually cause the tumor to necrose at which point it would start getting smaller and fade and then you could operate on it I don't understand why you have to do it in this order just need to get a few more branches off the aort and we're done well done Dr Brown this feels like it's the easiest decision to have made why did Dr Brown like every other doctor should be ashamed of themselves what's his estimated blood loss about 8 and 1 12 lers well that's a lot there's only like four to five in a human the entire human body typically only has 5 1/2 L of blood thanks Sean for factchecking me in real time let's get 30 more units on prpc he's like you said four to 5 it's actually 5 to six  add cryo fresh frozen plasma and platelets to that so the unique thing is you see those pads we frequently use those for dabbing and getting control of bleeders but we count those very meticulously when we bring them out and then when we put them back there have been many instances of them being left inside patients he's crashing he's ventilating fine we've got no immediate blood loss or hemorrhaging it looks like distributive shock I need satat labs and initiate shock resuscitation for some reason he's having fluid go into different spaces throughout his body causing a low blood pressure but if you give more fluids essentially you create more Demand on his heart uh more fluid entering his lungs and creating a bigger problem he's got a high white count and what looks to be a systemic pro-inflammatory cyto release putting off the blood supply to the tumors is causing post imization syndome interarterial lidocaine 130 Mig of methy predonisolone start antibiotics should we be trying to reverse the embolization restore blood flow to the tumor so this is uh kind of similar what happens when a patient loses circulation to let's say an injured limb if after a while the body part starts dying and then you reperfuse the dying portion the body comes in you get massive inflammatory response you get massive electrolyte imbalances and it can actually kill the person when you remove the thing that's crushing them so reperfusing a dead or damaged organ can actually be quite problematic and this is essentially what's happening with this tumor right now page Dr Murphy no do not paage Dr Murphy I get it you like him but we don't have time for an audition I'm trying to save my patient's life my patient which means it's my call I am also trying to save your patient's life so I'm urging you to stop wasting time now we've cut away almost half that's all we can do right now so let's remove it and give him a chance to live and fight another day why can't you do both you can walk and chew gum at the same time can't you surgeons call Sean and continue on with the procedure if you clamp the aorta it could lower the blood flow to the tumor enough to slow the release of the cyto Kines clamping the aorta will kill the intestines kidneys and legs maybe you could do a bypass not if we release the clamp every 10 minutes give it just enough blood to stop the cyto kindes but not so much that he bleeds to death oh I don't know this this sounds awful remember when you're clamping off the aorta you're also clamping off all the blood flow to the lower portion of the body which includes vital organs thank you for the consult Dr Murphy I don't know if that's good advice care to do the honors let's take it up they made this procedure I mean it's complicated granted all the intricacies of the size of the tumor the blood flow but they made it sound way more complicated than it actually was it's a tumor you clamp off the arteries you cut them you move on with your life like I don't understand what the issue is here you're still going to need some skin and soft tissue grafts but the Heart part done your prognosis is excellent thank y'all so much am I taking this thing home in a glass bottle y'all got something that big he's just being a smartass I'm surprised he's that lucid after a surgery usually uh patients are really groggy especially after that huge amount of blood loss I am not leaving your office until you reinstate me what are you doing Sean do you think ordering me to do something will change my mind I am a surgeon and the viral meme was Bor I am a surgeon I am a surgeon I am I am a surgeon I am a surgeon Dr H I am a surgeon I am a surgeon I am a you are [Applause] the you know part of reading social cues which is something those who are diagnosed with autism struggle with at times is um inability to read contextual cues which often times actually help us learn to manage our emotions better that's why a lot of times children who are diagnosed late or not diagnosed with the correct condition can actually develop behavioral issues because they don't have the checks and balances that their classmates or peers might have because they are able to read contextual cues they are able to use social guidance to keep ourselves in check that's not to say what others think about us is always right but we as humans have evolved to think alongside the group to use group ideology to use others actions to guide our own and when you're not able to read social cues that makes the process a lot more difficult especially when dealing with difficult moments like traumatic ones maybe even as traumatic as this Dr Murphy may not communicate like you do he may not communicate like I do but make no mistake he does communicate and he inspires but I didn't fire Dr Murphy because he doesn't Inspire I fired him because he was irrational unprofessional couldn't calm down he couldn't control himself I mean it's kind of fair feedback like I can't even hate on the guy just as you have the power to fire someone under your supervision so do I you're going to fire me to save d Murphy that's mad drastic just be like yo we want to keep the guy can you can you bring him back can we mediate the situation you don't have to fire him so did he get fired yeah sea gets rehired I feel like Shawn has trouble falling asleep but here are evidence-based ways of how to fall asleep faster click here to check that out and as always stay happy and [Music] healthy

Dr.

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