芝加哥急救

Chicago Med S04E04

Part 3 Jan. 21, 2020, 1:47 p.m.

她有内出血
She's bleeding internally.
我们得把她立即送去手术室控制病情
We need to get her up to surgery now to control it.
但她不会有事的吧
She'll be okay though, right?
-曼宁医生 -你好
- Doctor Manning. - Hi.
琳达你的检查检测结果来了
Linda, your labs came back.
好不了的感冒淤伤和瘀点
The cold you can't shake, the bruising and petechiae,
再加上你的脾脏...
and now your spleen--
都是原发性骨髓纤维化导致的
they're from Primary Myelofibrosis.
这是一种白血病
It's a type of leukemia.
我的天啊
Oh, my God.
白血病
Leukemia.
是癌症
That's cancer.
是但这种病是有治疗办法的
It is. There are some medications that treat the disease,
不过副作用也可能会很强烈
but the side effects can be extreme
而且治疗结果无法保证
and the results are unproven.
不过还有一种办法可以治愈
There is one treatment that can offer a cure.
干细胞移植
It's a stem cell transplant.
移植
Transplant?
那肯定有名单吧
There's a list, right?
我肯定排到队尾了
I'll be at the bottom.
不是不是
No, no.
心脏啊肺之类的器♥官♥移♥植♥有排队名单
There are lists for organs like hearts and lungs.
是因为这些器官来自已故捐赠者
Because they come from deceased donors,
因此供应量有限
there's a limited supply.
但干细胞可以由活人捐献
But stem cells come from living donors.
所以只要符合捐血条件的
So anyone able to give blood
应该就可以捐献干细胞
can likely also give stem cells.
因此选项有很多
There are a lot of options.
你瞧亲爱的我们一定可以的
See, baby, we're gonna beat this.
谢谢你曼宁医生
Thank you, Doctor Manning.
没事
Of course.
那我联♥系♥血液科让他们开始准备吧
I'll call hematology to get things started, okay?
谢谢你
Gracias.
血压仍然很低体温较高 38.8度
BP's still low, temp's ticked up, 102.
还跑了三趟厕所
And three trips to the bathroom.
我离了冰袋都不行
I couldn't even keep down ice chips.
抱歉我也希望能查明病因
I'm sorry. I wish I had an answer.
但你的血液指标都在正常范围内
All your blood work was within normal limits.
CT显示你的卵巢确实有囊肿
And the CT did show a cyst in your ovaries,
但也不是什么少见的情况
but that's not uncommon.
是啊我姐姐也有同样的情况
Yeah, my sister has the same thing.
-你的脖子疼 -有点僵
- Your neck hurt? - Stiff.
头疼吗
Headache?
时断时续的
Off and on.
要做脊椎穿刺吗
Set up for a lumbar puncture?
那不是要在脊椎上扎针吗治流感的
Isn't that a spinal tap? For the flu?
病情可能已经发展成了脑炎或脑膜炎
It's possible that it's evolved into encephalitis or meningitis.
我发誓以后每一针流感疫苗我都打
I will never skip another flu shot, I swear.
有什么人可以帮你联♥系♥一下吗
Is there someone we can call for you?
不必了我的闺蜜们来了只会闹
No, my girlfriends, they'll bring drama
我现在嫌烦
I don't need right now.
汉克·博伊特来电
那你姐姐呢
What about your sister?
她和我父母在外州住
She and my parents live out of state.
没事我开了播客
It's okay, I've got my podcasts,
就算我上厕所他们也能听见
and they can actually go with me into the bathroom.
那就让他们好好陪你吧
They might make better company, then.
看来安定起作用了
I see the Valium's helping.
我试着来回走走放松一下
I'm trying to move around a little, loosen things up.
那是我的CT结果吗
Those my CT results?
是扫描显示脊椎退行性病变和疤痕组织
Yes, scans show spinal degeneration and scar tissue
从L3延伸到L5
at L3 through L5.
我们怀疑这是慢性病不是今天疼痛的原因
We suspect it's chronic and not the cause of today's pain.
-可能是结构问题所以 -你想做核磁
- That's likely structural, so... - You want an MRI.
然后把扫描结果和我两年前手术
Compare it to the scan taken when I had surgery
留下的伤疤进行比对看有没有异样
two years ago to see if anything's different.
都忘了你熟悉流程
Forgot. You know the drill.
所以我知道核磁共振不会比CT显示更多结果
Yeah, so I know an MRI won't show anything more than the CT.
你们会给我一些低级的肌肉放松药
You'll give me some low grade muscle relaxer,
还会建议我接受理疗
recommend physical therapy,
但那些药一点用都不管
but those meds won't do anything
还不如儿童感冒药好使
more than a baby aspirin.
我是律师
And I'm a lawyer,
是阿斯特-考德威-戴维斯律所的合伙人
a partner at Astor, Caldwell and Davis.
我没时间躺在地板上做臀桥
I don't have time to lie on the floor doing pelvic bridges
听私教给我上课
with some glorified trainer.
不如你们直接开处方给我管用的药
So how about you just write me a script for what will work?
诺科10-325s
Norco 10-325s,
然后咱们各忙各的去
then we can all get on with our lives.
我去和药房♥谈谈
I'll talk to the pharmacy.
我收回
I take it back.
我认为诺雅比我的老教练厉害多了
I think Nora's got the edge over my old coach.
你在干什么
What are you doing?
在伊利诺伊州处方数据库搜索诺雅的名字
Running Nora's name through the Illinois prescription database.
看看她是不是被标注的医院常客
See if she's flagged as a frequent flyer.
你认为她可能是想骗药
You think she's just trying to score pills?
-假装疼痛 -可能
- Faking her pain? - Maybe.
极力躲避核磁共振而且要求
Dodging an MRI and then immediately
开药特别急迫看着就像骗子
pressing for meds reeks of a con job.
诺雅·布莱克无搜索结果
她没登记过
She's not on file.
但这并不意味着我们了解了全部情况
Still doesn't mean we're getting the whole story.
那我们该怎么办
So what do we do?
诺雅在东慈爱做的背部手术
Nora had her back surgery at East Mercy.
联♥系♥他们
Call over there.
问问那边她来找我们是不是因为被他们断药了
See if she's only coming to us because they cut her off.
-塞萨尔 -里基·格兰顿 19岁
- Cesar. - Ricky Glendon, 19.
被公交撞了昏迷指数5 当场插管
Hit by a bus. GCS 5, intubated on scene.
血压过低无明显长骨变形
Hypotensive, but no obvious long bone deformities.
腹部硬得像石头麦基
Belly's hard as a rock. Maggie?
我来紧急创伤室准备好了
I got you. Baghdad's ready.
好了送进去
All right, let's get him in.
好了听我口令
All right. On my count.
一二三
One, two, three.
做超声
Give me the ultrasound.
快速扫描有结果
Fast scan's positive.
腹部有积液
There's free fluid in the belly.
得开腹了
I need to get in there.
在混合手术室做吧麦基你自己选
We'll do it in the hybrid O.R. Maggie, decision time.
来不来参与手术
You on my team or no?
-我来 -好
- I'm in. - Good.
呼叫麻醉科召集其他人
Page anesthesia, assemble the others,
把混合手术室准备好
and prep the hybrid O.R. for surgery.
收到艾普尔
Copy that. April.
接诊台交给你了
Take over the AD?
-你放心去 -好的
- As long as you need. - All right.
杰你在哪儿给我回电
Jay, where are you? Call me back.
来趟医院更好
Better yet, stop by the hospital.
没事吧
Everything okay?
没事就是杰和我
Uh, yeah, just... you know Jay and I,
还在争论爸爸的东西怎么处理
still arguing over Dad's stuff.
真的吗我以为帕特没有多余的身外之物
Really? I thought Pat didn't hold on to anything.
他没有只是些以前的棒球卡
Yeah, he didn't. These are old baseball cards.
今早博伊特找你有什么事吗
So what was all that with Voight this morning?
好神秘
So secretive.
没什么他想听听我的意见
Nothing, uh... he wanted a curbside diagnosis
因为他不相信自己的医生
because he doesn't trust his own doctor.
他挺麻烦的
He's a pain in the ass.
他确实应该参考他人的意见
He should get a second opinion for that.
明白了吗屁♥股♥痛[麻烦]
Get it? Pain...in the ass.
是啊真好笑
Oh, yeah. That's funny.