kgg

I understand what you're saying, but if he had even an inkling that she was an alcoholic, wouldn't he then be more likely to call 911 right away? I honestly think Diane put up such a good front and she fooled so many people.

But why be okay with her driving his kids if he knew she was an alcoholic? I only recently saw this doc and this is my theory: I really do think something happened to set her off and she was determined to commit suicide, and - given how she grew up without her mother - she was going to take her kids with her. Given the fact that so many of her acquaintances describe her as as very concerned with appearances and fairly controlling, I believe something happened that threatened to fracture that, and it was unacceptable to her, so she made the decision to smoke weed and down vodka in a very short period of time to basically numb herself so she could commit suicide. I think she went to the gas station for Tylenol (and apparently Tylenol specifically - not ibuprofen) because a Tylenol overdose is deadly. If she were in pain - toothache, migraine - ibuprofen tends to be the better pain reliever. I think she wanted that to be part of her cocktail to help give her the courage to commit suicide. The whole alcoholic thing - I'm honestly torn. I think her blood alcohol level was around double the legal limit, plus there was quite a bit of undigested alcohol sitting in her stomach. I remember reading somewhere on Reddit that if she were a true alcoholic, twice the legal limit BAL wouldn't disorient her as much as it was someone who was a more social drinker. Maybe she did have a problem with alcohol, but I don't think this was her typical. If she was an alcoholic, she clearly didn't want anyone to know and took great strides to hide things. She downed a lot of alcohol in a short period of time - and then she died. This seems so deliberate.

When I get blank stares after I ask people to clarify, I've started adding, "Does it last as long as a commercial, a TV show, or a movie?" Someone once told me, "A long commercial. Like...a Nationwide commercial."

Right??? In what world does any surgeon do this? Send something to path from the other ovary during the operation. I'm always flabbergasted that they fail to get OBGYN involved. Every other ED is like, "Problem with your lady parts? Someone page OB!" And discussing stem cell transplants does not happen in the ED, at least not by ED docs! There are literally hematologist/oncologists who specialize in this very area. Because it takes special knowledge. I don't know why I keep hate watching this show.

SO MANY things were wrong with the premature baby storyline. It's almost funny how bad it was. My beef with this show and high-risk pregnant women continues as they refuse to get OB involved the moment a pregnant woman with severe issues is wheeled through the door. Unless the baby was halfway out, she would be taken straight to Labor & Delivery and people who actually know what they're doing would talk to the pregnant woman and her husband regarding what will happen, any possible interventions, etc. In situations like this, there are some parents who are adamant very early on about not intervening given these circumstances. Most - if there is time - would get an emergency NICU consult so questions can be answered. Resuscitating a 23 weeker with all hands on deck is typical nowadays (unless parents refuse). Maybe small hospitals without resources don't regularly intervene when it comes to 23 weekers, but that is not the norm. As for 22 weekers, more and more hospitals are offering the parents intervention at that age of gestation. So this woman delivered in the freaking ED and they just...whisked the baby en caul away? I did not understand that. They were clearly surprised it was moving so it's not like they had planned to take it to the NICU for resuscitation. So they were just taking it away to be cruel? And once you cut the cord, you are suffocating it in the sac. The fluid isn't magically protecting it when the cord isn't delivering oxygenated blood because it was cut. It made no sense. The parents didn't want it to suffer, wanted it to pass. So why put it in a warmer and take it to the hallway? Awful. And then what the hell were they doing in the NICU? How was the baby "holding on" when he wasn't intubated?!?!?! You don't wait even ten or 15 minutes to take action after these kids are born. The moment they are out, you need to establish an airway and access (via the umbilical vein and one of the arteries). He wasn't getting oxygen or glucose in that period between birth and when they started resuscitating him. So even if he may have had a CHANCE initially right after birth, waiting however many minutes for the mom to deliver the placenta and come to the NICU would have killed the baby. The fact that the birth, resuscitation, and death took place solely in the hands of these two idiots is ridiculous.

Just started watching this episode. I'm about 15 minutes in and I can't get over how Alicia's voice sounds *just* like Jordan Peele's character "Meegan."

So true. They have to own it. I wish Dr. Now emphasized (maybe he does and we don't see it) that these changes are not just to prepare for surgery, but will be lifelong. Maybe a cooking class would help for these people? Although a lot of them have at least a month-long stay in the hospital where they are forced to eat just that food - so they know what they SHOULD be eating.

Like many of you, I started the episode rooting for her. She came off as intelligent and earnest...at first. When she started making all-or-none statements, like threatening to end her conversation with Dr. Now if he mentioned getting on a plane again, I knew she was just another jerk who wanted all the control. This show has been going on for how long? EVERYONE knows you have to show you can lose weight before you get approved for the surgery. How are they all surprised? How? And what bugs me the most is when people lose weight in the hospital, it means they have LIVED the 800 or 1,200 calorie a day diet, so they can't plead ignorance when they go home and gain it all back. Were you ever given a whole can of whipped cream while you were in the hospital? No? Then maybe lay off of it when you're at home trying to lose weight. Janine wasn't as bad as Penny - who is, though? - but she definitely had that air of "I know better than you." She's going to go to her grave "knowing."

Thanks for that summary! I think I missed a huge chunk of the first season so the barista stuff is news to me! I didn't know that she matched into pathology. Once you match, it's really hard to up and leave your program - and harder still to transition to another one, especially before you are supposed to start. When a med student certifies their rank list, they're basically signing a contract that says "I will work at any place I put on my rank list." But that's probably the least egregious mistake this show makes.

Absolutely! Although, once she has the surgery, she is no longer a patient in the emergency department. I don't get why Natalie was interacting with her after the surgery and telling her the results. It's bizarre. She's a surgery patient now and surgery owns her. Surgery would have told her about the appendix and you can bet the farm that any surgeon would matter-of-factly explain she had a tubal ligation. Because it's the truth. I don't get how this show doesn't understand that these are basics. The Reese story was silly - but I was relieved it wasn't a gun. I don't think Rhodes being a jerk to her earlier re: Robin helped the matter. And is it bad I ended the episode wanting to see more of Reese's apartment? It seemed so cutely decorated. The Robin leaving part was explained, I thought, fairly well. I'm sure this leaves the path open for Rhodes to play the field with that South African surgeon - however I hope they don't go there. She's the pits.

Just catching up on this season now and I don't know why I keep hate-watching this show. It isn't even worth it! The pregnant patient that Manning and Halstead took care of - anything beyond stabilizing the arrhythmia is NOT an ED issue. How on earth do they not consult OB the moment they notice the fetus is growth restricted? (And I call BS on him scanning her so lightening fast and doing measurements coming to a gestational age determination but whatever.) Nutrition is not an issue that they are going to tackle in the ED, let alone her psych issues related to withholding food. In the ED, you stabilize the arrhythmia and get the proper people involved (Maternal Fetal Medicine and possibly Cards and *eventually* nutrition once she is out of the woods). ALSO - and I'm assuming they have some kind of medical professional advising them so there is no excuse for this - when you are dealing with a fetus that has symmetrical growth restriction, you MUST consider an infectious cause (TORCH infections - something every medical student has had to memorize) or a chromosomal abnormality. You can't just jump to malnutrition. Malnourished fetuses (and malnourished infants for that matter, as well), tend to be asymmetrically small - weight drops off first, then height, then head circumference LAST. So a fetus not getting proper nutrients would be measuring small but with an asymmetrically large head because that is the last thing that is preserved. That being said, if she is starving herself for the entirety of her pregnancy, HC would drop off as well, but out of proportion to length and estimated weight. Worst of the worst is that Manning attempted to give her IV nutrition (probably just dextrose and electrolytes - not something that is going to magically plump up the fetus and an aggressive fluid regimen is not something I would start on anyone who may have compromised cardiac function) after the woman specifically said no. Was the patient nuts? Absolutely. But her body, her choice until you get the proper people involved (OB, psych, nutrition), NOT a pediatric ED fellow (which I am assuming Manning is. I can't remember exactly). It's all just bad medicine, plain and simple.

I think what set Dr. Now off was the fact that his mother was escalating everything and diagnosing him with sepsis. She labels him as sick, he believes it, and then it sets his progress back. I'm a doctor, and I've never yelled at a lay family member of a patient for suggesting labs, etc., but I understand his frustration. I've seen sepsis many, many, many times. It can start out subtlety and go downhill quickly, so it's important to look for it. Dr. Now and his team seem to act quickly enough for patients who are ill. I'm assuming the team who initially evaluated Sean found him to have a normal blood pressure, no fever, no obvious nidus of infection. His complaints of aching all over make me think he had a viral infection causing some myalgias (the aches and pains we feel when we get sick). We don't have a timeline from when he was admitted until when Dr. Now saw him, but ideally for those you fear have sepsis, it's important to have fluids and antibiotics going sooner rather than later. It seems like they did a "rule out," meaning they grabbed blood cultures and started antibiotics pending those blood cultures.

Just watched this episode...what the hell is up with Manning? Didn't the kid have delays? Autism? Kids on the spectrum (and kids in general) can have Mary frickin' Poppins as their nanny and some of them still will have issues with food. And what a BS apology. Sorry, but a vitamin deficiency - especially in the setting of delays/behavioral issues - does not warrant attitude from a doctor to a patient's parent. Basic dietary history should come up during well child checks, and should be addressed then as well. So it's not just on the mom. Also, am I the only person who didn't get a fake baby in high school? Granted, no one in my high school had a baby, but still, is that really a thing?

That is just heartbreaking.

Home schooling and cyber school are two different things (I had to learn a lot of this for my old job). Home schooling has been around forever. Different states have different standards/regulations. Some have almost none and others have quite a few. If I remember correctly, Florida has almost none and Pennsylvania has quite a few. In some states, you don't need a high school diploma to teach your kids at home. There is a very powerful home schooling lobby (they are vicious). The Duggars home school, for example, for religious reasons. Cyber schools (aka online charter schools) are different. There are different cyber school companies, and each has their own curriculum. If a student cannot be in a "brick and mortar" school (for most kids I have encountered, it's more of a "does not want to" situation), then the school district will pay for them to be cyber schooled. There are different methods of cyber schooling - some are virtual classrooms where kids have to be in front of the computer at a set time every day and there are others that are basically "do at your own pace," where they read on their own and complete assignments and pretty much have little or no interaction with any teacher. There's no way to take a good inventory of home schooling because each household approaches it differently and there isn't much regulation. Cyber schooling, however, is a different story. Kids who are taken out of school and tasked to learn at home via cyber schooling are underperforming compared to their peers in actual schools (http://www.mcall.com/news/local/mc-cyber-charter-schools-study-20151027-story.html). And these cyber schools are raking in TONS of money without being held accountable. If a kid fails a grade in cyber school, the cyber school doesn't give back the money the school district has paid them. Each district is different, but I've seen kids fail cyber school for two years running and then get put back in "brick and mortar" schools - so when they should be entering 9th grade, for example, they're repeating 7th grade for the third time. School districts will fork over tax payer money to these private companies and then money that could have been allocated to actual school programs to benefit school programs is cut. Sorry, I'll get off my soapbox now. If Bayley is doing anything, it's an online charter school. I don't think Lisa is sitting down with her every day at the kitchen table and teaching her algebra.

I hope not. That poor kid. Maybe she can live with her grandfather and finish high school. She did seem less accepting of her living situation compared to most kids on this show.

When you take a crap in your bed and your teenage daughter has to clean it up - if that's not your bottom, you are bottomless. He MUST be getting something out of this. I think the price of not being mobile, the price of the indignity of having to be taken care of like a baby does not outweigh getting to lay in bed all day and do his drug of choice: food. I've seen so many Intervention episodes where people who had nice, comfortable homes end up living in a crack house or on the street because of drugs. It's the same thing - the cons of lack of safe shelter, lack of security, lack of health care are not enough to keep people away from drugs. The high is too much of a lure. And we know that for some drug addicts, they will never recover. I think James is one of those people.

I think there are a few important things: Joe had not been bed bound for years. James apparently hurt his ankle or leg and that was the end of his mobility. Joe also had a job for years. James didn't work for almost 2 decades - because of a poor economy? Because of his weight? Because he is lazy? (Probably the last one.) Even though Joe looked older, I'm pretty sure he was in his early or mid-30's. James was a decade older. I think the biggest thing, though, was that James had a live-in enabler.

That reminds me of the Friends episode where Ross screamed: "I grew up with Monica! If you didn't eat fast, you didn't eat at all!" But seriously, I don't buy that there wasn't enough food. He clearly gained weight during that period. If he could overeat to that extreme and the other seven human beings not starve to death, then there was enough food. He probably just didn't like that he couldn't have extra portions, because by then he was clearly used to getting them.

Oh my goodness, that sounds wonderful! I think we cut corners to save time and end up paying more. A couple of months ago, I had to fork over almost $2,000 for a car repair. Spending that kind of money in one sitting is irksome to me. So I started bringing my food to work (including my coffee) and not ordering out. It's amazing how it all adds up! I was spending at least $15/weekday during the day and then another $60 or so a week in takeout. In fewer than 4 months, I'll be able to save that much just from not spending it on outside food. I also find that I make better food choices when I have to take the time to go to the grocery store and plan and prep meals.

Penny could sit up in bed and was at least nice to the firemen who hauled her ass from place to place. And I can't believe I've uttered any positive words about Penny.

Oh, I totally agree she is part of the problem, but abused women tend to move from one abuser to another. Just like an abused woman would lie to the cops about how she got a black eye, Lisa is lying to Dr. Nowzaradan about what he's eating. These bed-bound people can bully from their beds. It's kind of fascinating how much power they can hold over their families. Even the nice one who was in the Air Force - her niece said early on in the episode how she could be not so nice if the junk food on her list wasn't purchased. However, the niece ended up being an awesome drill sergeant, so that behavior was stopped immediately. James and Lisa would both be better off if she walked away. But that's not going to happen unless she wises up.

Holy crap, he is awful! A few stray observations: Lisa is most likely getting paid by the government to be his "caretaker." In some bizarre way, it behooves them both for him to remain disabled and her to remain his caretaker. It is guaranteed income. The kids - so...am I missing something or did he have two kids with Lisa when he was in his early 20's and then let her raise them with her abusive husband? James is painting himself to be Lisa's knight in shining armor - and I think that's part of his hold over her - but he is just as abusive. I feel like Bailey is the only one who sees how worthless he is. She needs to just separate herself from that toxic situation and live her life. The catheter: I am really curious to know what kind it was. It can't be a condom catheter because his penis HAS to be buried at this point and there's no putting one on if all you've got is what looks like a little belly button where your penis should be. If it's a typical catheter inserted into the urethra, it would need to be changed frequently. If it's a suprapubic catheter, I wonder why they've resorted to that. Some kind of urethral injury? People with buried penises can pee. They just can't aim. I am seriously dubious about the claim that he has never seen a nutritionist. For anyone who admits him to the hospital, a nutrition consult is going to be a reflex order. But let's say he never saw a nutritionist - he spent at least two months total hospitalized strictly for weight loss, and was eating an 800 calorie diet. He knows what 800 calories/day looks like and tastes like. And clearly they got a list of no-no foods and Lisa read it. He just didn't care. At all. Sitting up in bed - what an accomplishment! That was more of a work-out for the people lifting him. My heart is out to the EMTs who are charged with moving this barnacle from place to place. It is dangerous, hazardous work. I don't think James is worth it. I really don't. Lisa, Bailey, and James' father would be better off if James died. I don't even feel bad saying that.

What a pleasant lady! And her family was great, too! The weird thing is that she could have been spared the awful, 5 day trip if she had just limited her intake in Seattle. The woman dropped >100 pounds before surgery! These trips seem so dangerous and so hard on everyone involved. But I guess it's not good TV if they get it in gear before they meet Dr. Now.

She was bad, but not Penny bad. I think her willingness to get up and walk and also her admitting that she is a crappy mom (or non-mom) is what puts her above Penny. But she was pretty damn insufferable, threatening to put her mother in a sketchy nursing home (as if her mother will be the invalid first) and bitching at the son she didn't raise for eating in front of her. I agree with everyone upthread who mentioned she seemed stunted. She came a cross less emotionally developed than her teenage children (and less articulate and less bright).