芝加哥急救

Chicago Med S08E22

Part 5 July 18, 2023, 3:17 p.m.

我的天啊，是真的，我就知道
Oh, my God. It's true. I knew it.
知道什么？
Knew what?
她出轨了
She's having an affair.
出轨？
Having an affair?
你看到她离开房♥间去接电♥话♥吧
You saw how she left the room to take a phone call.
这不是第一次了
I mean, it's not the first time.
她一直都很神秘，很冷漠
She's been so secretive, so distant.
并不一定代表她有外遇
Doesn't necessarily mean she's having an affair.
查理斯医生，如果我抓住軚盘的时候
Dr. Charles, what if when I grabbed the wheel
是某种潜意识的行为呢？
it was some kind of a subconscious thing?
就像，你知道，也许在内心深处，我想要…
Like, you know, maybe deep down I wanted...
我可以跟你保证，弗雷德，你的情况
I can assure you, Fred, that your condition
完全是神经系统的问题，好吗？
is entirely neurological. OK?
不是心理因素，这不是下意识的行为
No psychological element. Nothing subconscious about it.
就这样
End of story.
好
OK.
我们还在等救护车来接你
We're still waiting on the ambulance to transfer you.
我又打了一通电♥话♥去催
I just put another call in.
谢谢
Thank you.
疼得更厉害了吗？
Is the pain getting worse?
对，痛死了
Yes. Terrible.
那你躺平
Why don't you lie on your back
我来检查一下你的胃
and let me check your stomach?
好
OK.
天啊
Oh.
好
OK.
好，准备好了吗？
OK. Ready?
好
OK.
好
OK.
你只能待在这里，我马上回来
You're not going anywhere. I'll be right back.
好
OK.
-艾卓亚医生？-嗯？
-Dr. Archer? -Yeah?
莎拉马龙，她在发烧跟呕吐
Sarah Malone, she's febrile, she's vomiting,
血压很低
and her BP's soft.
她的肠很可能完全扭曲了
She's most likely fully torsed.
在肠道坏死之前，她现在就需要做手术
She needs an operation now before her intestine becomes necrotic.
等救护车来到这里
And by the time the ambulance gets here
再转诊的话…
and she's transferred, admitted...
她可能就死了
She could die.
没时间了
Not gonna wait.
好，我们就在这里动手术
All right. We'll have the operation here.
好，但是她的保险怎么办？
OK. But what about her insurance?
她可能会欠下一辈子的债
She could be in debt for the rest of her life.
除非我们私下动手术
Unless we do the surgery off the books.
当然，这意味着积戴顿的
Of course, that means Jack Dayton's
盈利性医院不会有任何收益
for-profit hospital won't be reimbursed.
我没有意见
Can't say I have a problem with that.
好，但要怎么进行？
OK, but how? How?
我们不能带她去主要手术室
We can't take her to the main OR.
我就在她的治疗室开刀吧
I'll just do it in her treatment room.
只能这样了，好吗？
That's all. OK?
你现在用你远近驰名的说服能力
Now you use your renowned powers of persuasion.
去帮我找麻醉师吧，好吗？
Get me an anesthesiologist. OK?
-谢谢你，艾卓亚医生 -快去找麻醉师
-Thank you, Dr. Archer. -Just, find an anesthesiologist.
-动作快 -好
-Come on. -OK.
好
OK.
好，我现在要把肠子从疝气囊里抽出来
OK. I'm now freeing up the bowel from the hernia sac.
警告
Warning.
已经进行全皮层小肠切开术
There has been a full thickness small bowel enterotomy.
手术室2.0，我没有伤到肠道
2.0, I have not injured the intestine.
请重新评估
Please re-evaluate.
请保护伤口免受严重污染
Protect the field from gross contamination.
评估损伤，并决定，要进行初步修复还是切除
Assess damage and decide between primary repair versus resection.
不对，这个影像是错误的
No, that image is not correct.
2.0，我重复一遍，我没有进行切肠
2.0, I repeat, I have not cut into the intestine.
肠子是完整的
The bowel is intact.
如果你不解决穿孔问题
If you do not address perforation,
有百分之百的机会，病人会感染败血症
there is a 100% chance patient will become septic.
好，大家听好了，没有肠穿孔
OK, everyone. There is no perforation of the bowel.
没有任何并发症
No complications of any kind.
手术室2.0要么搞错了目标，要么就是传感器故障
2.0 is either off target or its sensors are malfunctioning.
宋医生，你能让我们从画面上
Dr. Song, would you please show the gallery
直接看到现场状况吗？
direct view of the field?
马上来
Coming up.
好
OK.
正如你们所见
As you all can see,
没有任何肠穿孔
there is no perforation of the bowel whatsoever.
立即修复肠穿孔
Repair bowel perforation immediately.
马素医生，我要把它关掉吗？
Dr. Marcel, should I shut it down?
-好 -死亡概率，90%
-Yes. -Chance of mortality, 90%.
各位先生、各位女士，我向你们保证
Ladies and gentlemen, I can assure you all
戴顿先生没有生命危险
Mr. Dayton is not at risk.
这个手术我已经做过几百次了
This is a procedure I've performed hundreds of times.
就算没有手术室2.0，我也可以轻而易举完成
I can easily proceed without 2.0.
继续处理疝气
Continuing to reduce the hernia.
-太好了，你在这里 -怎么了？
-Great, there you are. -What's up?
我在想你能不能来陪我开刀
Uh, I wondered if you'd come spot me in a surgery.
剖腹手术
Laparotomy.
陪你？
Spot you?
对
Yeah.
我…觉得有点不舒服
I'm, uh... I'm feeling a little wobbly.
我是妇产科医生，你记得吧？
I'm an OB, remember?
你不想找外科住院医师吗？
Don't you want a surgical resident?
不行，现在的情况很不寻常
No. See, the circumstances are unusual.
如果高层发现了这件事，我们可能都会被解雇
If admin were to find out about this, we'd probably get fired.
哇，你真会鼓励人
Ooh, what an incentive.
我认为这件事很重要
I take it that this is important.
这可以救人一命
It would save the patient's life.
这就是我们在这里的原因吧？
Kinda why we're here, right?
这肯定是乙状结肠扭转
It's definitely sigmoid volvulus.
牵引器
Alpha retractor.
好，可以吗？
All right. Yeah?
可以
Yeah.
帮我解开乙状结肠
Help me untwist the sigmoid.
好了
There we go.
-好了吗？-好了
-Got it? -Yeah.
看起来还可以
That looks viable.
对，但是乙状结肠很软
Yeah, but the sigmoid is really floppy.
对，只是需要切除，然后…
Yeah, it just needs to be resected, and, uh...
重新连结
and re-anastomosed.
-艾卓亚医生？-没事
-Dr. Archer? -Yeah.
我只是…让我坐一会儿，好吗？
No, I just... for a second let me sit down, will you?
好
OK.
汉娜，你可以接手吗？
Hannah, you could take over?
-当然可以 -好
-Absolutely. -All right.
麦蒂，病人还好吗？
Marty, how's the patient?
她非常干燥，但注射了两升林格氏液
She was bone dry, but after two liters of Ringer's
和一升白蛋白后，她的尿量足够了
and one of albumin, she's making adequate urine.
好，很好
OK, great.
我们来切除这个乙状结肠
Let's get this sigmoid resected.
珍妮丝
Janice.
查理斯医生
Dr. Charles.
很抱歉我刚才那样离开
I'm sorry that I ran out like that.
你还好吗？
Is everything OK?
事实上，我刚和我的医生通电♥话♥
Actually, I just spoke to my doctor,
我收到了好消息
and I got some very good news.
就是他传信息给你的？
Oh, that's who texted you?
对
Yes.
我几周前做了个活体组织检查
I had a biopsy a couple of weeks ago,
结果是阴性
and I just found out that it's negative.