 That is the most insane thing I've ever heard in my life. This is the worst example of interventional radiology I have ever seen portrayed on TV. Welcome back to the channel, everybody. For those of you who are new around here, my name is Michael, aka Dr. Cellini, and I'm a board-certified diagnostic and interventional radiologist in New Jersey. Now I got a ton of comments on one of my last videos about how there is an interventional radiology scene or scenes in Chicago Med Season 7 Episode 11. And I haven't seen this episode, but I thought I might as well react to it if there is some interventional radiology stuff going on here. So hopefully there's more than like a split second because that would be kind of a waste of a video, but I guess we'll find out together. Let's go. All right, so by the way, I have really no idea what Chicago Med is even about. I've never seen an episode in my life. So this will be episode number one for me. And I'm starting off at Season 7 Episode 11. So I'm going to have no idea what's going on. But nonetheless, let's look for some interventional radiology stuff. I missed. I missed again. Whatever. Here. Wow, I forgot. You know, it's been a while. I used to watch these shows all in med school. If you've seen that video where I did how I stayed motivated in med school, I probably did that video like two years ago. I used to watch Grey's Anatomy all the time and this, I forgot how dramatic it is. So dramatic. So that lady, no idea what happened to her. She looks like she has a rip worn infection going on in her leg. But that's a weird spot for young patients to have surgery. I guess we'll find out more. I'm very excited now. That's what it is. That's why I was like, a young woman wouldn't have surgery on their hips or their bottom. So that explains it. A lot of women, especially in New York City that we saw when I worked with plastic surgeons, my first year residency, they would do revisions where they would actually go in and remove a lot of like silicone injections from women's bottoms because they would go to like Columbia or Mexico or whatnot and get these just random injections of who the heck knows what. They'd be multi hour surgeries and they would erode through the skin kind of like this one. It happens more than you would think in the United States. But right now she's in subject shock. The first 24 hours are critical. Understand. Did something go wrong with her surgery? Accepted shock means she is having a reaction to the bacteria in her blood system causing her blood pressure to drop, which may need to be artificially kept elevated by pressers such as Norepi or epinephrine. I'm surprised she's not in the ICU setting by now. It's imperative to start antibiotics and fluid immediately in these patients. She should be shipped up to the ICU for close monitoring. What people don't realize is especially emergency medicine physicians, they have to play like detectives almost because these kind of scenarios happen all the time and you have to read people and read their relationships and their interactions between each other. And it's way more than just practicing medicine. You really have to be a detective, kind of feel out what's going on. And this is why you never be replaced by AI, especially in emergency medicine, because there are just too many things that you can't train artificial intelligence to do. You can't train artificial intelligence to read people how the situation is a little weird and all that stuff. So this raises some red flags. You have to do a little more investigation before you get to the bottom of this and any emergency medicine physician, nurse, tech, et cetera, comment below because I know you have to do this all the time. You can definitely see that it's exceedingly rare, but it can happen. When you inject silicone into your butt, it can migrate into the vessels and go into your heart and into your lungs causing a pulmonary embolism, which can cause respiratory distress and cardiac collapse. Now the IR has got me thinking here because I haven't seen any IR yet and we're like halfway through this episode where they might be doing a pulmonary embolectomy here, which again is what I do. We'll see what happens. What? I don't think there was. Let me go back. Now she does have bilateral breast implants. So I guess she has breast implants and gluteal implants. These are the breast implants right here. Now she just mentioned that the patient has an embolus in her right ventricle, which I don't see. This is a silicone embolus in her right ventricle, partially obstructing the outflow tract. So you couldn't really see the outflow tract there barely, but there was no obstruction. So basically they just showed a CT of the heart with no pulmonary embolism. Classic. That is the most insane thing I've ever heard in my life. Serious CTs. Let me rewind here. So we do pulmonary embolectomy. We advance a very large catheter, like besides my thumb, through the right atrium, through the right ventricle, through the tricuspid valve, into the pulmonary arteries, it can cause arrhythmia as we have this huge tube sitting in the tricuspid valve, not allowing it to open and close like it should. So you can see how that could cause a bad arrhythmia. And we've had many patients not do well from the arrhythmia. And it's just a risk of this procedure. But it's kind of one of those things where if you don't do anything, they could die. If you do something, they're most likely not going to die, but there's always a risk that they could. So this is one of the situations I have never done a serial CT dieted thrombectomy. I don't think that's possible because you really need to watch your catheter real time because you could cause some serious damage to the heart if you do not. About to thread the wire. You sure we don't need radiology? No, it's okay. I can see where you are. First of all, there's no radiologists reading these CTAs. Secondly, there's no interventional radiologists performing these procedures. You can't just have some random person performing this procedure. Like first of all, how do you even get access into the venous system to begin with? Okay, go slow and steady. You've got 10 centimeters until you're at the right ventricle. But I don't even see anything. Threading the wire. Also, what the heck is that? That's not even a real sheet that we use. He's also threading a catheter without the wire, which is fundamental step number one of what not to do. So I think what he has, they're using an actual insulator. That's what we use to inflate balloons when we're doing angioplasties and stuff. And that's what he has in his hand right there. I think and he's rotating it. I mean, this doesn't make any sense. Also, he's just sitting there getting radiated by that tube. This is so stupid. This is like really downplaying my profession. I'm a little disappointed with this. Okay, five degrees to your right, then inflate. Sounds like 71, pressure's dropping fast. The weird thing about this is I think they keep showing that CT scan and there's like a little glob, but it's actually in the left ventricle, not the right ventricle. So I don't know who made this. Why do they not hire me for this? So he has the syringe on the sheath and the stopcock is closed to the sheath side, which means he's literally doing nothing. He's also injecting air and it's just flowing out the top of that stopcock and doing zero things. I guess he was injecting saline. Either way, it's doing nothing. I don't even, what did he do there? So there was a glob of silicone sitting in the left ventricle boat. Let's, that's besides the point. They're sitting in the right ventricle, flew into the pulmonary outflow track and he what grabbed it and pulled it backwards. So what now it's just sitting in the heart. He didn't do anything, but what I'm so confused right now. So all he did was just pull a glob of silicone from the pulmonary outflow track to the right ventricle or into the right atrium. I'm so, he did nothing and that silicone can just go right back up where it was at any time. This is the worst example of intermissional radiology I have ever seen portrayed on TV. So I don't know why they, why do they not just call me? They can email me. I would have done a free consultation for this show. Maybe they'll call me next time. All right. So that officially concludes this video, Chicago meds, season seven, episode 11. I am a little upset at the way they portrayed interventional radiologists. That was one of the worst procedures I've ever seen performed. It made no sense. It was completely medically inaccurate. So again, why did they not consult physicians? I guess they don't really care, right? Most people don't know what the heck is going on and it's all for dramatic purposes. But you know, it hurts my heart to see something like that and see our field portrayed in such a way. So yeah, I'll leave it at that. A little disappointed. That's how I feel about this episode. So the first episode of Chicago Med ever watched, I'm disappointed. Please do better next time. As always, gently press that subscribe button, join my channel if you want to and follow me on Instagram and tick tock if you don't already. And I'll see you all on the next video. Bye.