00:02:17,174
- And I get off the phone, I'm like,
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she just thanked me for telling me, I,
29
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for me telling her that she had cancer.
30
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- We kidded around,
and that's what I need.
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I need somebody that can say, "Yeah,
32
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"you're gonna need a good
glass of wine tonight."
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- If I was not using ultrasound,
34
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she came in with her
mammograms and ultrasounds,
35
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I would look at them on the viewbox,
36
00:02:32,596 --> 00:02:33,873
say, "Yeah, there's your tumor."
37
00:02:33,873 --> 00:02:35,314
But I can't feel anything,
38
00:02:35,314 --> 00:02:38,068
and the radiologist is
gonna stick a wire there
39
00:02:38,068 --> 00:02:39,694
and we'll know for sure
that we got it out.
40
00:02:39,694 --> 00:02:44,104
- She just was very sure
of what was going on,
41
00:02:44,104 --> 00:02:46,081
and what was gonna happen to me.
42
00:02:46,081 --> 00:02:48,220
- Now what I can do is
scan them in the office.
43
00:02:48,220 --> 00:02:49,293
She's here with her husband,
44
00:02:49,293 --> 00:02:50,733
they both see the pictures,
45
00:02:50,733 --> 00:02:52,132
they look exactly like the pictures
46
00:02:52,132 --> 00:02:53,823
that the radiologist took.
47
00:02:53,823 --> 00:02:55,881
And they know then that
I'm gonna take this
48
00:02:55,881 --> 00:02:59,540
to the operating room, and actually remove
49
00:02:59,540 --> 00:03:01,106
what needs to be removed.
50
00:03:01,106 --> 00:03:02,791
- Milestones are really important to me.
51
00:03:02,791 --> 00:03:05,091
Like, let's say we're
at doctor's graduation.
52
00:03:05,091 --> 00:03:07,241
- I love what I do.
53
00:03:07,241 --> 00:03:09,412
This is pretty much my life.
54
00:03:09,412 --> 00:03:10,433
- And like we were saying before,
55
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I guess I'm really just really thankful
56
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I was born in this time,
57
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that we have doctors that do what they do
58
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and medicine that does what it does.
59
00:03:18,491 --> 00:03:21,600
- The fact that I don't have
to rely on a radiologist
60
00:03:21,600 --> 00:03:23,903
allows me to just do what I need to do,
61
00:03:23,903 --> 00:03:28,070
and I think it allows me to
take better care of my patients.
62
00:03:30,757 --> 00:03:34,924
- It'd just be really
grateful that I'm still here.
63
00:03:37,740 --> 00:03:40,096
- And that gives me
actually a lot of strength
64
00:03:40,096 --> 00:03:41,749
and a lot of satisfaction to see
65
00:03:41,749 --> 00:03:44,271
what they're able to go through.
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I'm not sure I could do that.
67
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(alternative music)
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- Sometimes it's overwhelming.
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Some days we have
patients sick everywhere,
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you have to prioritize who's the sickest.
71
00:04:00,554 --> 00:04:02,496
Your way of seeing life is different
72
00:04:02,496 --> 00:04:04,476
when you have a
30-year-old, 20-year-old guy
73
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that dies almost into your hands.
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You know, when you take your
car and you go back home,
75
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you don't have the same way of looking at
76
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what you're doing or looking
at your kids or family.
77
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Dealing with patients and their families,
78
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you see them happy.
79
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You have to pronounce people dead,
80
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tell their family.
81
00:04:19,292 --> 00:04:22,670
Young people, old people,
you have to live with them
82
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these moments that are unique.
83
00:04:24,602 --> 00:04:27,944
And the arrival of bedside
ultrasound in the ICU
84
00:04:27,944 --> 00:04:31,077
or any acute care
environment is a revolution.
85
00:04:31,077 --> 00:04:32,486
But when you're at the bedside,
86
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you really wanna have an answer
87
00:04:34,425 --> 00:04:35,953
to a specific question,
88
00:04:35,953 --> 00:04:39,138
so you need to have
something that will help you
89
00:04:39,138 --> 00:04:40,336
go a bit further.
90
00:04:40,336 --> 00:04:42,941
We image the patient
and if we see something,
91
00:04:42,941 --> 00:04:43,972
or we don't see it.
92
00:04:43,972 --> 00:04:47,639
But when you find it,
that's quite a thrill.
93
00:04:48,904 --> 00:04:51,297
So, yeah, so this
44-year-old guy was in the
94
00:04:51,297 --> 00:04:53,824
emergency room, has a big heart attack.
95
00:04:53,824 --> 00:04:55,763
He has three other sick vessels,
96
00:04:55,763 --> 00:04:58,868
so we send this patient
for emergent bypass.
97
00:04:58,868 --> 00:05:00,516
He has four of them.
98
00:05:00,516 --> 00:05:01,766
He gets better,
99
00:05:02,622 --> 00:05:04,342
in the recovery room.
100
00:05:04,342 --> 00:05:07,309
He goes to the ICU, he's
doing okay initially.
101
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And then a few hours after,
102
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he started having problems
with his breathing.
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Short of breath, oxygen level going down,
104
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down, down, down,
105
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so we tried to stabilize him,
106
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but we cannot move the patient
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while they are on this
high frequency ventilation.
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So I did a bedside ultrasound
on him, of his heart.
109
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- At one point he just said to me,
110
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"Has he been on a trip recently?"
111
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- So because he has clots in the arteries
112
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of his lungs, the blood
cannot go there easily,
113
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and the oxygen level is low.
114
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And the treatment is very different
115
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than what we were doing.
116
00:05:39,533 --> 00:05:43,369
So we had the suspicion of that
with the bedside ultrasound.
117
00:05:43,369 --> 00:05:46,101
Sent him for the test,
found that he had that,
118
00:05:46,101 --> 00:05:48,700
and completely changed his therapeutics.
119
00:05:48,700 --> 00:05:52,044
Four or five days after, he
was off of the ventilator.
120
00:05:52,044 --> 00:05:54,812
He was extubated, talking to us.
121
00:05:54,812 --> 00:05:56,729
This guy has five kids,
122
00:05:57,945 --> 00:05:59,682
very charming wife.
123
00:05:59,682 --> 00:06:01,580
- And that's when I went,
just went back to the hospital
124
00:06:01,580 --> 00:06:04,136
for a monthly blood test.
125
00:06:04,136 --> 00:06:06,695
The nurse said, "You're
lucky you have Dr. Beaulieu
126
00:06:06,695 --> 00:06:07,598
"as your doctor."
127
00:06:07,598 --> 00:06:08,767
I said, "You don't have to tell me that."
128
00:06:08,767 --> 00:06:10,748
- When I saw him, two, three
weeks ago in my office,
129
00:06:10,748 --> 00:06:13,423
he was coming back from
Cuba, scuba diving.
130
00:06:13,423 --> 00:06:15,811
And I saw him, half-dead.
131
00:06:15,811 --> 00:06:18,378
One huge week with this guy
and in the outpatient clinic,
132
00:06:18,378 --> 00:06:20,890
you're like, that's worth it.
133
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(alternative music)
134
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- [Voiceover] We had a 100-year-old guy
135
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come in at around midnight last night.
136
00:06:35,312 --> 00:06:39,647
He and his wife have
been married 77 years.
137
00:06:39,647 --> 00:06:41,835
Very pleasant, friendly guy,
138
00:06:41,835 --> 00:06:45,186
with a horrible wrist fracture.
139
00:06:45,186 --> 00:06:47,302
As an anesthesiologist,
immediately when you meet someone,
140
00:06:47,302 --> 00:06:50,227
you think, what's the anesthetic
I'm gonna do with this guy?
141
00:06:50,227 --> 00:06:51,627
As I'm talking to him, I'm thinking,
142
00:06:51,627 --> 00:06:53,649
I'm running through
the options in my head,
143
00:06:53,649 --> 00:06:54,803
the more I thought, you know,
144
00:06:54,803 --> 00:06:58,186
I think my best bet here
is to give him nothing.
145
00:06:58,186 --> 00:07:00,506
And I'm just gonna block the arm.
146
00:07:00,506 --> 00:07:02,696
I want him as lucid as possible,
147
00:07:02,696 --> 00:07:04,845
and I wanna be able to wake him up.
148
00:07:04,845 --> 00:07:05,917
We went into the operating room,
149
00:07:05,917 --> 00:07:07,322
and I looked at the guy.
150
00:07:07,322 --> 00:07:09,426
Normally I would do an
infraclavicular brachial plexus block
151
00:07:09,426 --> 00:07:10,909
which goes through all the muscles,
152
00:07:10,909 --> 00:07:12,192
you're close to the lung,
153
00:07:12,192 --> 00:07:13,675
you're thinking about all those things.
154
00:07:13,675 --> 00:07:15,615
And he was kind of slouched in like this.
155
00:07:15,615 --> 00:07:16,771
So I thought, okay, this is gonna be
156
00:07:16,771 --> 00:07:18,586
a little more technically challenging,
157
00:07:18,586 --> 00:07:21,353
and I got him on the
table and took a look.
158
00:07:21,353 --> 00:07:23,624
And he, amazingly enough and thank God,
159
00:07:23,624 --> 00:07:25,933
he had this beautiful
artery that I could see,
160
00:07:25,933 --> 00:07:27,417
and gorgeous brachial plexis.
161
00:07:27,417 --> 00:07:28,988
I could see all the cords.
162
00:07:28,988 --> 00:07:32,045
So I could see it just
flooding the lateral cord.
163
00:07:32,045 --> 00:07:34,237
The posterior cord, and the lateral cord.
164
00:07:34,237 --> 00:07:35,433
You know, we did this all on the gurney
165
00:07:35,433 --> 00:07:37,583
before we even transferred
him over to the OR bed.
166
00:07:37,583 --> 00:07:39,523
Cause I asked him preop
if he had any pain,
167
00:07:39,523 --> 00:07:40,843
and he looked at me and he goes,
168
00:07:40,843 --> 00:07:43,448
"Not as long as you don't touch it."
169
00:07:43,448 --> 00:07:44,724
And I said, "Okay, don't worry about it.
170
00:07:44,724 --> 00:07:45,755
"We're not gonna touch it."
171
00:07:45,755 --> 00:07:48,015
So I didn't move him at
all, we did the block,
172
00:07:48,015 --> 00:07:50,158
I said, "Does it hurt now?"
173
00:07:50,158 --> 00:07:51,888
And he looked at me, and
the orthopedic surgeon
174
00:07:51,888 --> 00:07:53,536
was there too, and I
was like, I paid the guy
175
00:07:53,536 --> 00:07:55,307
a hundred bucks, and he goes,
176
00:07:55,307 --> 00:07:58,242
"No, feels a whole lot better now."
177
00:07:58,242 --> 00:07:59,314
And I looked him and I said,
178
00:07:59,314 --> 00:08:01,126
"You just made my day!
179
00:08:01,126 --> 00:08:02,691
"That was great!"
180
00:08:02,691 --> 00:08:05,691
(alternative music)
181
00:08:11,344 --> 00:08:13,511
- I see tragedy every day.
182
00:08:14,629 --> 00:08:17,023
You could say it's a specialty of tragedy.
183
00:08:17,023 --> 00:08:18,915
- People are sort of at death's door.
184
00:08:18,915 --> 00:08:21,271
- You've got people yelling and screaming,
185
00:08:21,271 --> 00:08:22,446
and in that type of environment,
186
00:08:22,446 --> 00:08:26,254
you've gotta tell somebody
about your personal history,
187
00:08:26,254 --> 00:08:28,149
about personal things
that you don't talk about
188
00:08:28,149 --> 00:08:30,705
with everybody every day.
189
00:08:30,705 --> 00:08:33,432
And to get somebody to talk
about those types of things,
190
00:08:33,432 --> 00:08:37,071
cause they're very important
in treating a patient,
191
00:08:37,071 --> 00:08:37,904
is an art.
192
00:08:37,904 --> 00:08:40,085
- You see the fabric of society.
193
00:08:40,085 --> 00:08:43,097
- And you see people and
how we treat each other
194
00:08:43,097 --> 00:08:43,930
in real life.
195
00:08:43,930 --> 00:08:44,786
- My neighbors always ask me,
196
00:08:44,786 --> 00:08:45,619
"Did you see anything cool?"
197
00:08:45,619 --> 00:08:46,452
I'm like,
198
00:08:47,479 --> 00:08:48,427
"I don't remember.
199
00:08:48,427 --> 00:08:50,163
"It was just a blur."
200
00:08:50,163 --> 00:08:51,192
- To save that person's life,
201
00:08:51,192 --> 00:08:53,215
I don't have time to call the radiologist
202
00:08:53,215 --> 00:08:55,485
who's probably at home at
4 o'clock in the morning,
203
00:08:55,485 --> 00:08:57,751
say, "Can you come and do
the ultrasound for me?"
204
00:08:57,751 --> 00:08:58,784
- [Chris] If you could
look right through the body
205
00:08:58,784 --> 00:08:59,653
at the organs you're interested in,
206
00:08:59,653 --> 00:09:01,142
why the heck would you not do it?
207
00:09:01,142 --> 00:09:04,065
- I'm sure he would really
be happy if he could say,
208
00:09:04,065 --> 00:09:05,384
"Dr. Saylor, why don't you do that,
209
00:09:05,384 --> 00:09:07,243
"and save the patient and let me know
210
00:09:07,243 --> 00:09:08,938
"how it turns out in the morning?"
211
00:09:08,938 --> 00:09:10,259
- [Chris] There's been a
lot of moments like that,
212
00:09:10,259 --> 00:09:13,092
with ultrasound where I say, "Wow.
213
00:09:13,941 --> 00:09:15,459
"This guy would have died."
214
00:09:15,459 --> 00:09:18,520
Or, as a physician you think to yourself,
215
00:09:18,520 --> 00:09:20,620
"I almost killed this lady."
216
00:09:20,620 --> 00:09:23,508
- But now you've got a
patient here tomorrow.
217
00:09:23,508 --> 00:09:25,943
Are you gonna be able to save
this person's life tomorrow?
218
00:09:25,943 --> 00:09:28,671
- Just the other day, I
had a tragic drowning case
219
00:09:28,671 --> 00:09:29,791
that I was involved with.
220
00:09:29,791 --> 00:09:33,958
An 18-month-old that was
found at the bottom of a pool,
221
00:09:35,094 --> 00:09:39,014
and we were able to
get her heartbeat back.
222
00:09:39,014 --> 00:09:40,043
The child did die.
223
00:09:40,043 --> 00:09:43,224
- I've gotta be just that
much better tomorrow.
224
00:09:43,224 --> 00:09:45,922
Because something else is
coming through that door
225
00:09:45,922 --> 00:09:47,149
that I may need it for.
226
00:09:47,149 --> 00:09:51,742
- As a specialty, we get it
right about 80% of the time.
227
00:09:51,742 --> 00:09:53,481
We're sort of 80%-ers.
228
00:09:53,481 --> 00:09:56,979
And a lot of people aren't comfortable
229
00:09:56,979 --> 00:09:58,594
not getting to 100%.
230
00:09:58,594 --> 00:10:00,808
And so that drives some
emergency physicians crazy
231
00:10:00,808 --> 00:10:01,641
and out of the field.
232
00:10:01,641 --> 00:10:04,021
- As a father and with many other people
233
00:10:04,021 --> 00:10:06,544
in the resuscitation
team that were parents,
234
00:10:06,544 --> 00:10:08,853
to see that sort of case,
235
00:10:08,853 --> 00:10:10,186
that was pretty,
236
00:10:12,166 --> 00:10:14,642
that was a big impact case.
237
00:10:14,642 --> 00:10:16,745
- And, at the end of the day,
238
00:10:16,745 --> 00:10:17,737
can you sit back and say,
239
00:10:17,737 --> 00:10:20,213
"I did everything I
could for that person?"
240
00:10:20,213 --> 00:10:21,536
- Within minutes, I have to then go back
241
00:10:21,536 --> 00:10:22,777
and see a sprained ankle.
242
00:10:22,777 --> 00:10:24,929
- Hopefully I have a good outcome.
243
00:10:24,929 --> 00:10:26,536
- Hmm.
244
00:10:26,536 --> 00:10:28,453
Is it more outer signs?
245
00:10:30,005 --> 00:10:32,194
It's a good amount of art.
246
00:10:32,194 --> 00:10:34,999
It's a good amount of art.
247
00:10:34,999 --> 00:10:37,416
(rock music)
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