芝加哥急救

Chicago Med S08E18

Part 5 April 18, 2023, 11:39 a.m.

他向我保证，他从没想过
who assured me he never even considered
要让自己瘫痪
trying to paralyze himself.
也许他只是从没讨论过而已
Well, maybe he just never discussed it.
-迪恩 -干嘛？
-Dean. -Yeah?
就算他是故意摔下来的
Even if the fall were intentional,
我们也不能强迫他动手术
we still can't force a surgery on him.
是不行，但法♥院♥命令可以
No, but a court order could.
但我们没有理由向法官请♥愿♥，对吧？
But we don't have the grounds to petition a judge, right?
因为他有能力
Because he competent.
我也不喜欢这样，好吗？
I don't like it either, okay?
但他有权拒绝手术
But he has the right to refuse the surgery.
好吧，算了
Okay, all right.
你又再一次让我的病人
And once again, you're keeping my patients
得不到他们需要的治疗
from getting the care they need.
嘿，这是怎么回事？
Hey, so what gives?
你在说什么？
What are you talking about?
你没看到你的行事历上
You didn't see this impromptu board meeting
有个临时董事会议吗？
added to your calendar?
我是说，你知道这是怎么回事吗？
I mean, do you have any idea what this is about?
我根本不知道有这场会议
I didn't even know it was happening.
好吧，这是一个临时会议
Okay, well, it's an impromptu meeting
有整个董事会，还有高层，好吗？
with the entire board, plus C-suite, okay?
我是说，那肯定不是好事
I mean, that can't be good.
听着，我也不喜欢被人突袭
Look, I don't like being blindsided either,
但不要这么悲观
but don't get all fatalistic.
这个嘛，我去问积的时候
Yeah, well, when I talked to Jack about it,
他不肯透露任何细节，只叫我别担心
he wouldn't share any details, and he told me not to worry.
这让我很担心
That makes me worry.
你和他的律师
Well, you're in fairly regular contact
不是有固定保持联络吗？
with his lawyers, aren't you?
看看他有没有处理什么重要的文件
Well, see if he has any significant filings in motion,
我打个电♥话♥给佐治
and I'll put a call out to George.
也许他会有情报
Maybe he has some intel.
佐治？
George?
对，托马斯医生我们最新的董事会成员
Yeah, Dr. Thomas, our newest board member.
是啊，我都不知道
Oh, yeah, I didn't realize
你和佐治这么亲密
that you and George were getting so chummy.
我去找点别的事来多管闲事
I'll go find some other business to stick my nose into.
红灯
Red light.
红灯！中情局找到我了！
Red light! The CIA's found me!
信♥号♥♥在移♥动♥
The signals are moving!
他们随时会出现
They're gonna be here any minute.
-我们回床上去，好吗？-不好了
-Let's get back in bed, okay? -Oh, no.
他们亮起红灯
They flash the red lights
就是要把你像老鼠一样逼入绝境
when they got you cornered like a rat.
这是他们接手的信♥号♥♥
That's their signal to move in!
玛姬，我需要你帮忙
Maggie, I could use a hand.
-完蛋了… -贝林
-No, no, no, no. -Baylin.
贝林，我需要你冷静下来
Baylin, I need you to calm down.
深呼吸…我需要你呼吸
Breathe. Breathe. I need you to breathe.
我现在就把这些灯关了
These light, I'm turning them off right now.
-我去把灯关掉 -对不起
-I'm turning them off. -Yeah, I'm sorry!
-我得走了 -贝林
-I have to go! -Baylin.
-贝林… -他们会把我杀了！
-Baylin. Baylin. -They're gonna kill me!
保全，马上阻止他离开
Security, stop him from leaving right now.
把查理斯医生找来
Page Dr. Charles.
放开我…
Let me go! Let me go!
我得走了，拜托
I gotta go, please.
看来我们的老朋友，贝林
Looks like our old buddy, Baylin,
几周前停药了
went off his meds a couple weeks ago.
好消息是，他同意在精神病房♥
Good news: he's agreed to check into the psych ward
住几天直到他恢复正常
for a couple of days until he gets back on regimen.
太好了
Great.
所以这些就是他发作的原因吗？
So these are what set him off?
再说一次为什么要装这个？
And why were they installed again?
为了让病人更舒服
To make patients more comfortable.
积戴顿真是天才，必须把灯拆了
The genius of Jack Dayton. They got to go.
嗯哼
Mm-hmm.
玛姬，我听说了
Maggie, I heard what happened.
所以你会明白我为什么要把灯拆掉
So you'll understand why I want the lights removed.
选红色是个错误
Red was a poor color choice.
我今晚会把灯光调中性一点
I'll reprogram the lights to something more neutral tonight.
我要把灯拆掉，嘉丽丝
I want them gone, please, Grace.
不是重新编程，是拆掉
Not reprogrammed. Just gone.
你同意监测急诊室的噪音级别
You agreed that monitoring noise levels in the ED
对病人的护理很重要
is important for patient care.
而我做得非常好
And I do a damn good job of it.
我没有说你做得不好
I'm not suggesting that you're not.
我不需要任何协助
I don't need any assistance.
好消息，你所有的化验结果都很正常
So good news. All your labs came back normal.
你的血沉有轻微升高
Your ESR was mildly elevated,
但没什么好担心的
but that's nothing to be concerned about.
什么是血沉？是测试什么的？
What is ESR? What does it test for?
红血球沉降速率
Erythrocyte sedimentation rate.
测量体内的炎症活动
It measures inflammatory activity in the body.
-我的有升高了？-一点点
-And mine's elevated? -Mildly.
升高的原因有很多
And it can be elevated for a number of reasons.
我是说，像踩到脚趾头这样的事就会升高
I mean, something like stubbing your toe will do it.
如果你有…那叫什么…
What if you have... What is it called...
-巨细胞… -动脉炎
-Giant cell... -Arteritis.
对，你的血沉会升高吗？
Right. Would your ESR be elevated then?
会，但会比你的要高多了
Yes, but much higher than yours.
高多少？
How much higher?
我记得通常会是50或以上
Off the top of my head, I believe, typically 50 or above.
-我的是31 -没错
-And mine was 31. -Correct.
你见过血沉低于50的病人患有巨细胞动脉炎吗？
And you never see GCA in a patient with an ESR below 50?
确实有类似的病例
There have been cases, similar ones,
但那些病人都有你没有的症状
but those patients all had symptoms of the condition you do not have.
你更有可能是头痛障碍
Uh, it's far more likely you have a headache disorder.
我怀疑是偏头痛或丛发性头痛
I suspect migraines or cluster headaches.
我想把你介绍给一位专家…
I'd like to refer you to a specialist...
等一下，你的系统说如果是巨细胞动脉炎
Whoa, your system says here, if it is GCA,
应该马上治疗，以防止…
it should be treated right away to prevent...
视力下降或中风？
vision loss or a stroke?
我可能要几周后才看得到专家
It could be weeks before I see a specialist.
艾莉西亚诊断巨细胞动脉炎的黄金标准
Alicia, the gold standard for diagnosing GCA
是做颞动脉活检
is a temporal artery biopsy.
神经外科医生在你的太阳穴上开一个切口
Neurosurgeon makes an incision above your temple
取出你的一部分血管
and removes a piece of your blood vessel.
外科医生？
A surgeon?
对，我们说的是真正的手术
Yes, we're talking about an actual procedure here.
但我全程都不会有知觉吧
But I'd be out for the whole thing.
他们会替我麻醉吧？
They put me to sleep, right?
不会，这只能在局部麻药下配合轻度镇静使用
No, it's only used with light sedation under local anesthetic.
你会全程醒着
You'd be awake the whole time.
听我说，我知道头痛让人很不舒服
Look, I know headaches are extremely frustrating
你想知道原因，但我们还是
and you want answers, but let's start
先让你纾缓一下吧
with giving you some relief.
我会开翠普登给你，这是一种药物…
I'm gonna put you on triptan. It's a class of drug used...
我不会感到有任何纾缓
I'm not gonna feel any relief
在我确定这不是巨细胞动脉炎之前
until I know definitively this isn't GCA.
艾莉西亚，只是你的症状太少了…
Alicia, it's just you have so few of the symptoms...
你说过当病人的表现
You said misdiagnoses happen
不典型时，就会出现误诊
when a patient's presentation is atypical.
我要做活检
I want the biopsy.
莎拉，我真的希望你能考虑留下来
Sarah, I really wish you'd reconsider staying.
让我送他去上学
Just let me get him to school.
如果我还是不舒服，我就马上回来
If I have another spell, I'll come right back.
哦
Oh!
等一下，我羊水破了吗？
Wait. Did my water just break?