03x18 - What You See Ain't Necessarily What You Get

[bunniefuu]

Let's go.

We have a 27-year-old female with severe lower abdominal pain.

Coleman, this is your patient.

She was fine until this evening.

Her roommate called the ambulance.

She's cold and clammy.

Pulse is 100 and rapid.

Blood pressure 80 over 60.

Come on, Coleman.

She's shocky.

It's obvious.

We need more information.

Have you had vaginal bleeding? Yes.

You think you're pregnant? My last period was six weeks ago.

What do you think, Coleman? I need to do a pelvic exam and pregnancy test, but right now my first diagnosis is ruptured ectopic pregnancy, so type and cross-match four units and prep the O.

R.

? Great diagnosis, Coleman.

All right, Coleman! Nice job.

Thanks, doc.

I feel better already.

Our patient, the talented and healthy Miss Sheila Davidson! Thank you! You've just had a taste of what will be happening here all week.

Using actors as standardized patients is a relatively new and innovative practice An effective tool for teaching med students the basics with no risk.

Emergency situations can be nerve-wracking, but better to k*ll an actor than a real person.

Thanks a lot, doc.

You were really good.

Thanks.

That felt great.

I had tears in my eyes and everything.

Thanks for the fast diagnosis.

Now I can make my tennis game.

Wow.

This really is a good hospital.

There'll be more standardized patients Thursday.

Miss Spencer.

When I'm directing my questions to other students, I'd appreciate if you'd respect that.

You said to treat this like a real emergency.

You wouldn't stand around waiting for some indecisive doctor to get his act together.

Well, miss big mouth rides again.

She didn't even give Coleman a chance.

She has to dominate every situation.

Ooh! That woman is arrogant, obnoxious, self-centered, patronizing And, generally, right on the money.

All the girls I loved before Oh, no.

Not again.

That were in and out my door I'm glad they came along I dedicate this song To all the girls I loved before Hey, man, you should've been there last night.

I was, in all modesty, awesome.

Where? We took over this karaoke bar You sing in front of everybody.

It's pronounced karo-key.

It means empty voice in Japanese.

Yeah, well, I know one voice that was particularly croaky last night.

Yes, you were.

Chicken! Cluck! So I didn't sing.

Some of us aren't exhibitionists.

Oh, curly! They're right.

I didn't sing because I'm a coward.

Don't you think you're overreacting a little bit? I've always been afraid to just jump in and join the fun.

This karaoke thing is last in a long line of personal wimp-outs.

I'm not going to change at this age.

I'm 30-years-old today.

I am who I am, and I'm boring.

It's your 30th birthday.

Congratulations.

Don't speak to me.

You're 18.

Hey, hey, hey.

Lift that chin right up.

So what are you doing tonight? Who knows? You don't have plans for your 30th birthday? I thought I'd just treat it like any other natural disaster.

Go home, bolt the doors, wait for further instructions.

It's comin' closer The flames are now a lickin' my body Won't you help me? I feel like I'm a slippin' away It's hard to breathe And my chest is a-heavin' I never thought I'd have this kind of performance anxiety.

Everybody sang last night? Raymond sang blue hawaiitwice.

Just a hunk-a hunk-a burnin' love Just a hunk-a hunk-a burnin' love Just a hunk-a hunk-a burnin' love Oh, a hunk-a hunk-a burnin' love I'm just a hunk-a hunk-a burnin' love You guys pick a tune yet? I don't know whether to sing a whole medley or a single show-stopping number.

Maybe she's ready.

Gosh, there's so many good songs here.

We'll get back to you.

This is ridiculous.

If I don't go up, I'll hate myself.

If I do go up, I'll humiliate myself.

I'd rather hate myself than humiliate myself any day.

For those of you who haven't taken the plunge O.

K.

, o.

K.

, this is really it.

I'm going up there.

You coming with me? It'll be a personal growth experience.

No way.

Fine.

I'll go it alone.

And now, let's all put our hands together for "Howard brickman.

" I always sing under the name Howard brickman.

Last chance for public humiliation.

Nice of you to think of me.

When you're alone and life is making you lonely You can always go When you've got worries All the noise and the hurries Seems to help, I know Get away from me.

Just listen to the music of the traffic in the city Linger on the sidewalk Where the neon signs are pretty How can you lose? The lights are much brighter there You can forget all your troubles Forget all your cares So go Downtown You little weenie, satisfied? Great.

When you're downtown Make mine a place for sure Downtown Everything's waiting for you Downtown downtown Yeah! Downtown downtown Won't go to hear 'em play a tango I'd rather hear some blues or funky ol' soul There's only one sure way to get me to go Start playin' ol' time rock 'n' roll Call me a relic Call me what you will Say I'm old fashioned Say I'm over the hill Today's music ain't got the same soul I like that ol' time rock 'n' roll Still like that ol' time rock 'n' roll That kind of music just soothes my soul I reminisce about the days of old With that ol' time rock 'n' roll Still like that ol' time rock 'n' roll That kind of music just soothes my soul No way.

No, you are not going to get me to dance the tango.

That's the old spaulding talking.

The new spaulding just cries out for castanets.

It feels really good to break out and do something completely crazy.

I never would've gotten on stage if not for you.

You never would've gotten off the stage if not for me.

True.

So thanks.

You're a good friend, doogie.

I'm glad you enjoyed your birthday.

I had a better time tonight with you than if I'd gone on a regular date.

Yeah? Yeah.

Well, thanks again for a wonderful birthday.

I don't believe it.

I don't believe you, howser.

You had her right there in the Chevy and you didn't go for it? Okay.

Yeah, that's okay.

Now she thinks you're classy.

It'll give you that edge for next time.

Vin, Carly and I are friends.

I've known her since I was 15.

What makes you sure there was anything to go for? How many times do we have to go over this? You had eye contact, right? We work together.

We have occasional eye contact.

But on this occasion we're talking 2 in the morning deserted parking lot eye contact which is an enchilada of an entirely different color.

I don't know about you, but I find those speed bumps highly erotic.

You disgust me.

Howser, once again, you are being way too analytical here.

Stop thinking! Feel, experience, sensate! There you both are, warm and snuggly Wrong.

Nobody snuggled or anything like that.

Look.

She wants you.

She's more mature.

So she won't throw herself at you like some teenage Madonna wannabe.

Her hints will be more subtle, like a tap on a shoulder, a glance in your direction.

See? See, it's a discreet dance An erotic dos-a-dos of libidinal nuance.

Mm-hmm.

No, no.

This is completely crazy.

Vinnie, I'm 18.

She's 30.

There's a 12-year age difference.

Yeah, it's unusual But it's not unheard of.

Mrs.

h.

, how are you this morning? Fine, Vinnie.

And yourself? Oh, I'm great.

Fabulous.

How's that lovely husband of yours? Oh, he's fine.

And how much older is he than you? I always forget.

A whole 15 years.

And when you first met Dr.

howser, were you ever concerned about the obvious age difference between you? At first.

Then I just stopped thinking about it.

Why? Well, other things became more important Mutual interests, compatibility, shared goals.

Age is just one factor out of many.

Yeah, that's true.

And as someone once told me, all adults are basically the same age.

Hmm.

Interesting.

Who said that? Your father.

Are you sure I'm not too jaundiced? I don't want to give away the diagnosis.

It's very subtle.

It whispers hepatitis "a.

" Don't worry, doogie.

It's a girl thing.

Right.

Now, remember that each student will examine you alone, so you can freshen up your jaundice between exams.

O.

K.

Enlarged liver tenderness on the right side.

Sclera are icteric.

And it's Angela Connor, hepatitis victim.

Keeps plants, goldfish, and boyfriend Marvin.

He has inappropriate body hair, but she loves him anyway.

Love works in mysterious ways.

In closing, the patient is clinically jaundiced, the liver is tender to palpation, sclera are icteric.

So what's your diagnosis? Hepatitis.

But she also demonstrates flank pain.

There's a mild tenderness above the spleen, a slight petechiae of the mouth and pharynx.

You sure about that? Yes.

Absolutely.

So what's your diagnosis? The physical findings are contradictory.

It could be sbe, but I'd like to check for splinter hemorrhages under the fingernails, except that she's wearing this ridiculous red nail Polish.

You're way off base.

I don't think so.

Two other students have been right.

Now, what's she got? I don't have enough information.

The patient has hepatitis "a.

" She contracted it during a camping trip.

If you'd taken a thorough history I did take a thorough history.

I knew about the camping trip, but my other findings Are incorrect.

You're wrong.

But a good doctor will learn from her mistakes.

Oh.

Doogie.

Hi.

Do you need me to help prepare any more standardized patients today? No.

We're all through.

Irritable bowel syndrome was a no-show.

O.

K.

Well, then I've got to go inventory supplies on four west.

Oh.

O.

K.

If you want me, I'll be in the supply room.

If you want me, I'll be in the supply room.

Hi, doogie.

If want me, I'll be in the supply room.

If you want me, I'll be in the supply room.

Oh, hi, doogie.

You want me? What are you doing? I think that's my line.

I'm sorry.

I'm sorry.

Um The other night, I thought the feeling was mutual.

You were attracted to me, too.

But, obviously, you aren't.

I apologize.

I better go.

I am attracted to you.

But I do have a minute.

Doogie.

Something did happen between us the other night.

When we looked at each other, there was a moment, and we both wondered what would it be like.

But it was only a moment, and that's all it can be.

O.

K.

Hypothetical.

We do get together.

We're both adults.

All adults are basically the same age, right? Would that be so terrible? No.

You're very good-looking.

You're sensitive, kind, fun to be with.

You're the perfect man for me.

But you're a boy.

I think you're saying this 'cause you're scared.

Maybe.

But I know we have a wonderful friendship, and I don't want to risk that because of a momentary attraction.

Look.

This kind of attraction will happen to you many times in your life At a party, in an elevator, with women you know, women nobody should know.

You can enjoy those connections for what they are Brief, meaningless, fun flirtations.

Let me just get this straight.

You are attracted to me.

Get out of here.

Just an honest question.

You are attracted to me.

I just can't believe I was so off.

I've got the skid marks to prove it.

I just don't get it.

The signs were all there.

No, they weren't.

You wanted it to be true so badly, you twisted reality.

I twisted reality? You seem to drop out of this faux pas altogether.

O.

K.

You're right.

I wanted it to be true.

I twisted reality.

I wanted it to be true so badly, it's like I wore blinders.

Anything that didn't fit into my scenario, I just ignored.

According to your echocardiogram and blood culture and the splinter hemorrhages under your fingernails, I can confirm a diagnosis of subacute bacterial endocarditis An inflammation of the lining of your heart.

How serious is it? We'd like to admit you and start you on I.

V.

Antibiotics.

It's a very mild case, and we caught it early, thanks to Ms.

Spencer.

So don't worry.

Try and relax.

Think of it as a free acting class with meals.

Ms.

Spencer? Ms.

Spencer? I'm sorry I overlooked your concerns at the evaluation.

I thought I already knew the diagnosis since Sheila had a physical three months ago and was healthy.

So I just tuned out what I considered to be inaccurate information.

Look, in some way, I was hoping you'd slip up.

So anything that didn't fit into my scenario, I ignored.

You don't like me, do you? You're a very talented student.

You're perceptive.

You not only have the ability to retain and synthesize information, but the confidence to act on your conclusions.

And despite your obvious personality flaws, arrogance, contempt for authority, and a monster ego, someday you'll make a great doctor.

But, no, I don't especially like you.

Well, at least you've been paying attention.