芝加哥急救

Chicago Med S09E03

Part 4 Feb. 11, 2024, 8:31 p.m.

女士
Ma'am.
女士，你不能这样
Ma'am, you can't do that!
女士
Ma'am.
好的
Okay.
这会有点冰冰凉凉的感觉
This is gonna feel a little cold.
好吗？
Okay?
你就是汉娜艾莎？
You're Hannah Asher?
你认识这位女士吗？
Do you know this woman?
呃，不认识
Um, no.
你希望我带她离开吗？
Do you want me to remove her?
你敢碰我试试看
I'd like to see you try.
好，等一下，大家等一下
Okay, hold on. Hold on a second.
我是汉娜艾莎医生
I'm Doctor Hannah Asher.
有什么问题吗？
Is there a problem?
问题？
A problem?
这个嘛，你昨天晚上跟我先生约会
Well, you went on a date with my husband last night,
所以没错，我们的确有大问题
so, yeah, we've got a problem.
云斯，我们已经向你的保险公♥司♥提起上诉了，好吗？
Vince, we're submitting an appeal to your insurance company, okay?
我们经历过上诉的过程
We've been through the appeals process.
云斯的医生一开始怀疑有哪里不对劲的时候
When Vince's doctor first suspected something was wrong,
他想安排电脑断层扫描
he ordered a "C.T."
保险公♥司♥起初不愿意核准
Insurance wouldn't approve it initially.
他们说没有足够的证据显示这项检查是必要的
Said there wasn't "sufficient evidence" to warrant it.
他们花了三个月时间才授权
It took them three months to finally get it authorized.
了解
Yeah.
谁知道那段时间肿瘤长大了多少？
Who knows how much the tumor grew in that time?
云斯
Vince,
我知道你极力避免使用喂食管
I know you were trying to avoid a feeding tube.
不
No.
我不要喂食管
No feeding tube.
听着，我们可以放一根暂时的
Look, we could place a temporary one.
不
Nope.
如果没有喂食管的话…
Without a feeding tube...
我就没有时间了
I'm gonna lose time.
我明白
I understand that.
你有可能几个礼拜内就过世了
You could die in weeks.
甚至可能短短几天
Possibly days.
我们刚得知一切已经束手无策
When we first got the news that nothing more could be done,
这个疾病是末期的时候
that this was terminal,
我们想出一句座右铭，告诉自己进入接下来这个阶段的态度
we came up with a motto for how we were gonna approach this next phase.
素质重于时间，对吧？
Quality over time, right?
不要喂食管
No feeding tube.
好吧
Okay.
你先好好休息
Get some rest.
我晚一点再回来，好吗？
Be back in a bit, okay?
嘿，谢啦
Hey, thanks.
我会去跟使用审查的专家谈谈
Uh, I'm gonna talk to Utilization Review specialists.
看能不能加快上诉的程序
See if I can expedite the, uh, appeal process.
你真的认为那会有多大影响吗？
You really think that's gonna make much of a difference?
值得一试
Worth a shot.
我昨晚的确有出去约会，但不是跟已婚人士
I did go out last night, but it wasn't with anyone that was married.
好了，各位
All right, guys.
别看了，表演结束了，好吗？
Come on, "show's over," huh?
我是跟凯尔出去
I went out with Kyle.
凯尔？
Kyle?
对啊
Yeah.
对，就是他
Yeah, that's him.
他的名字是尼克邓
His name is Nick Dunn.
他不是建筑师，而是总承包商
He's not an architect. He's a general contractor.
所以…天啊
So, oh, God.
那是…
It's...
你真的不知道他已婚了？
You really didn't know he was married?
不知道，我发誓
No. I swear.
我…
I...
我要杀了他
I'm gonna kill him.
这个嘛，我…
Well, I...
他怎么可以这样对我？
How could he do this to me?
我肚子里还怀着我们的孩子
I'm carrying our child!
实在太糟糕了，我同意
It's absolutely terrible, I agree.
我是说，我就知道有些事情不对劲
I mean, I knew something was up.
我还以为那只是新手爸爸的焦虑，你懂吗？
I thought it was just new dad jitters, you know?
绝对不可能，我从来没想…哦
In a million years, I never...oh.
你还好吗？
You okay?
我想我刚刚破水了
I think my water just broke?
你现在怀孕几周？
How many weeks are you?
38周
Thirty-eight.
我想让你接上监测器
I would like to get you on a monitor.
不
No.
不…我要去找我自己的医生
No, no, no. I'm going to see my own doctor.
嘿…深呼吸，跟着我深呼吸
Hey, hey, hey. Breathe. Breathe with me.
我知道要怎么深呼吸
I know how to breathe!
怎么会这样？
This can't be happening.
可以麻烦你把膝盖弯起来吗？
You put your knees up for me, please?
你会有轻微的压♥迫♥感
You're gonna feel a little bit of pressure.
好
Okay.
好的，泰莎，你的子♥宫♥颈已经完全扩张了
Okay, so Tessa, you are fully dilated.
什么？
What?
对，也就是说没有时间
Yep, which means there is no time
可以到楼上或等你的医生来了
to move upstairs or wait for your doctor.
不…我不能在这里生小孩
No, no, no. I can't have my baby here.
急症室拥有分娩所需的所有设备
The" E.D." is fully-equipped for deliveries.
不，我不能让你接生，抱歉
No, I can't have you deliver my baby, I'm sorry.
听好，我可以理解我不是你的第一人选
Look, I get that I'm not your first option.
事实上，我可能是最不得已的人选
In fact, I'm probably your last.
但是我是拥有专科执照的妇产科医生
But I am a board-certified "O.B.G.Y.N."
我接生了数以百计的宝宝
And I've delivered hundreds of babies,
如果我们一起合作，我可以让你的宝宝顺利诞生
and I will get yours out safely if we work together.
好，改变计划
Okay, change of plans.
泰莎现在已经要分娩了，所以我们要在这里接生
Tessa's ready to deliver now, so we're gonna do it here.
哦，好
Oh. Okay.
对，再帮我找一位护士来，一张产台，再找一位医生来
Yep, get me another nurse, a delivery table, and grab another doctor.
只要有空的人都可以
Whoever's available.
我们也许需要多个人手帮忙
We'll maybe need an extra set of hands.
我们可以的，好吗？
We got this. Okay?
好
Okay.
现在是什么情况？
Where we at?
总而言之？
Long and short of it?
保罗很抑郁，但他的自杀风险偏低
Paul is depressed, but his risk of suicide is low.
我找不到任何他试图伤害自己的证据
Couldn't find any evidence of any kind of intent to harm himself.
好吧，那我就去准备他的出院文件
All right, so I'll get his discharge paperwork ready.
你想要安插精神科转诊吗？
Do you want to include a psych referral?
我跟你说，玛姬，我其实还不打算让他出院
You know, Mags? I'm actually not quite ready to discharge him.
好哦？
Okay?
是这样的，听我说
Here's the thing, right?
他六个月前被诊断为急性第二型糖尿病
He gets diagnosed with sudden-onset type two diabetes six months ago,
没有家族史，体重指标偏低
no family history, low "B.M.I."
好吗？
All right?
而我们都很清楚，当你确诊为第二型糖尿病
And we all know that when you get diagnosed with type two,
你不会…你不会体重下降
you don't...you don't lose weight.
不，体重会上升
No, you gain weight.
-对 -对吧？
-Right. -Right?
再加上急性的抑郁，也一样
And then there's this sudden-onset depression, again,
没有家族史，对吧？
no history, right?
没有触发因子
No triggers.
我只是在想我们是不是漏掉了什么
I'm just wondering if we're not missing something.
你懂吧？是不是有潜在的医疗问题
You know? Some underlying medical condition.
你想要…安排一套实验室检验吗？
Do you want to, uh, order a set of labs?
先从全套血液检查和综合代谢检查开始吧
Let's start out with a "C.B.C." and a "C.M.P."
我要去翻查文献
And I'm gonna dig in the literature.
看我能不能找出一些共同点
See I can't find some kind of "common thread."