芝加哥急救
Chicago Med S04E13
Part 3
Jan. 21, 2020, 1:49 p.m.
But I got this body pain that I just can't seem to shake.
如果我有私人医生我就去看了 但是
If I had a regular doctor I'd go see 'em but, um,
如果你能找到个姑娘就更好了
if you could hook a girl up that'd be cool.
听我说 这里是急诊室
Okay, listen, this is an E.D.
我们需要优先处理紧急情况
We need to prioritize our emergencies.
好吧 如果这里太忙的话
Yeah, okay, well, if it's too hectic here, I mean,
你可以给我开点止疼的药吗
you could just give me something for the pain.
除非你正式检查过
Okay, no one here is going to be able to do that for you
否则没人能给你这种药
until you are formally examined.
所以你先来这边坐
So why don't you come and take a seat over here.
来吧
Go ahead.
我们会尽力帮助你 好吗
And we'll do our best to get to you, okay? All right.
谢谢你出来见我
Thank you for stepping out to see me.
-当然 -我很感激
- Of course. - I appreciate it.
好吧
Okay.
别拉着我了 西妮 好了
Need my hand back, Sydney. Okay.
-你给她量体温了吗 -37.5度 低烧
- Did you take her temperature? - 99.6. Just a bit elevated.
如果你需要的话我可以给她排个号♥
I can bump her up the triage list if you want.
不必了
Not necessary.
请告诉我这不是你的主意
Please tell me this wasn't your idea.
什么
What?
你知道不给病人治疗是很不道德的行为
You know how unethical it is denying a patient care.
像对待针线包一样对待他
Treat him like a pin cushion?
你们做的事我应该报上去
I should write you all up for what you've been doing.
你知道那个人对汉克做了什么吗
Do you know what that guy did to Hank?
他猥亵了他 伊森 频繁地
He molested him, Ethan. Regularly.
-在他们上钢琴课时 -这很糟糕
- During their piano lessons. - It's terrible.
我知道 但是轮不到我们来分发正义
I know. But it's not up to us to dole out justice.
汉克应该联♥系♥警署 提出控告
Hank should call PD. Press charges.
他做过了 但汉克和卡明斯基各执一词
He did already, but it was Hank's word against Kaminsky's
法官在庭审前
and the judge dismissed the whole thing
就驳回了整件事
before it even went to trial.
对 而且既然卡明斯基没被定罪
Yeah, and since Kaminsky wasn't even convicted
他没被作为性犯罪者登记在案
he's not registered as a sex offender.
就我们所知 他还在对其他男孩这样做
For all we know, he's still doing this to other little boys.
我知道你为什么气愤 我也气愤
Look, I get why this upsets you. It upsets me too.
但不管这个病人可能有多恶劣
But regardless of how awful this patient might be
我们在伦理上有义务
we have an ethical obligation
一视同仁地诊治他
to treat him as we would anyone else.
好吧 但没有规定要求
Fine, but there's nothing that says
我们给他度假般的体验
we have to make his stay a vacation.
我会给他提供最低限度的护理
He will get the bare minimum from me.
如果你这样觉得
Look, if that's how you feel,
也许你不负责他会更好
maybe it's better you keep away all together.
没问题
No problem.
卡明斯基先生的心电图和扫描结果
Mr. Kaminsky's EKG and scans are done.
你的检查结果为阴性
Your labs came back negative.
我没有发现任何肿瘤或损伤
I'm not seeing any tumors or lesions.
这是好事 对吧 现在我能回家了吗
That's good, right? Can I go home, now?
你需要找一位家庭医生复诊
You'll need a follow up with a primary care physician
不过看起来我们给你的拉贝洛尔起效了
but it looks like you're responding to the labetalol we gave you
所以我们有望尽快让你出院
so hopefully we can discharge you soon.
谢谢你
Thank you.
还有一件事
One last thing.
我之前没问你
I didn't ask you earlier
但高血压往往因为
but hypertension can often be made worse
工作相关的压力而恶化
by things like work related stress.
这不符合我的情况
That wouldn't apply to me
因为我一向热爱我的工作
because I've always loved my job.
-是什么工作呢 -我在我家教钢琴
- And what's that? - I teach piano at my house.
已经三十多年了
For over 30 years now.
-你有很多学生吗 -足够让我的日程满满当当
- You have a lot of students? - Enough to keep me occupied.
你上来做什么
What are you doing up here?
肋骨严重移位骨折的创伤病人
Trauma patient with severely displaced rib fractures.
而你没呼叫我
And you didn't page me?
莱瑟医生的手术耽搁了
Dr. Latham's held up in surgery
但他想让我告诉你
but he wanted me to let your know that
他看了你的病人的病历
he reviewed your patient's chart
他不认为伊塞亚先生适合做手术
and doesn't think Mr. Isiah's a good candidate for surgery.
病人艾滋病病毒阳性 感染风险太大
The patient's HIV puts him at too high of a risk for infection.
用金属固定他的肋骨是缓解他的疼痛的唯一办法
Plating his ribs is the only way to treat his pain.
莱瑟医生说你大可去问别人的意见
Dr. Latham says you're welcome to seek another opinion.
真是好极了
Well, that's just great.
你觉得呢
What about you?
你是在问我的意见吗
You're asking for my opinion now?
我知道我是你最不想帮的人
Look, I know that I am the last person that you want to help
但我们不应该因为病人艾滋病病毒阳性
but we shouldn't be afraid of surgery
就害怕手术
just because the patient has HIV.
是的
Yeah.
给你
Here.
我考虑一边用三个KLS钛板
I'm thinking three KLS titanium plates per side,
-可能最多四个小时 -好吧
- maybe four hours max. - Okay.
我空出安排就去做手术
I'll clear my schedule and do the surgery.
真的吗 谢谢你
Really? Hey. Thank you.
我不是为了你 我是为了你的病人
I'm not doing it for you, I'm doing it for your patient.
-霍斯特德医生 -怎么了
- Dr. Halstead? - Yeah?
我刚刚在外面等你
I was waiting for you outside.
抱歉 我刚刚在看病人 我们走
Sorry, I was with a patient. Let's go.
-布雷先生的检查结果 -谢谢
- Mr. Brays labs are back. - Thank you.
杰瑞德 考虑到你上次接受化疗的时间
So Jared, your liver enzymes were a little higher
你的转氨酶比预想的要高一些
than expected given when you had your last chemo treatment,
但其它各项都出人意料的好
but everything else looks surprisingly good.
那他没有危险了
So he's out of the woods?
我仍然不知道是什么导致了惊厥
Well, I still don't know what caused his seizure
但现在看来 你的生命体征是稳定的
but, um, for now, your vital signs seem stable.
听我说 如果我现在走
Listen, if I leave now,
我能赶上我的第一个发言
I can get to my first presentation in time.
我也许能刚好赶上
I might just be able to make it.
这么晚了你还要走吗
You're going to leave this late?
你得乘红眼航♥班♥了
You'll have to catch a red eye.
没关系
That's okay.
我去试试能不能改签航♥班♥
I'm gonna go see if I can reschedule my flight.
好的
Okay.
曼宁医生 你能把我的包递给我吗
Dr. Manning, can you pass me my bag, please?
就在那边
It's right over there.
好的
Sure.
-给你 -谢谢
- Here you go. - Thank you.
不客气 我一会再来看你
No problem. I'll be back to check on you soon.
血压下降
Pressure drop.
没有脉搏 他在室颤 泰瑞 开始按压
No pulse, he's in V-fib. Terry, start compressions.
这说不通 五分钟前他还好好的
Doesn't make any sense. He was fine five minutes ago.
我以为你不负责这个病人了
Thought you were staying away from this patient.
他按了呼叫按钮 这边没人
He pushed the call button. No one else was around.
-充电至200焦 -已充电
- Charge to 200. - Charged.
离手
Clear.
-还在室颤 -好吧
- Still in V-fib. - All right,
推一毫克肾上腺素 再次充电至200焦
push one milligram of epi. Charging 200 again.
-已充电 -离手
- Charged. - Clear!
他心脏停搏了 我觉得他已经死了
He's asystole. I think he's gone.
崔医生
Dr. Choi?
死亡时间 14点42分
Time of death, 14:42.
不知道我到底漏了什么 崔医生
Not sure what I'm missing here, Dr. Choi.
拉贝洛尔对病人有效
The patient responded to the labetalol
所以怎么会突然出现严重的心脏问题
so how'd he have a massive cardiac event out of the blue?
我也不知道
I'm not sure.
我一开始觉得血压飙升可能是因为
I know they're pretty rare but at first I thought
嗜铬细胞瘤 我知道这种情况非常罕见
maybe a pheochromocytoma was responsible for spiking his BP
而且我在扫描报告里也没找到任何肿瘤
but I don't see any tumors on these scans.
肯定还有什么其他原因 对吧
There must have been some other factor at play, right?
卡明斯基死时我们给他用了几剂肾上腺素
How many doses of epi did we give Kaminsky when he died?
根据病例记录 他心脏停搏前用了一剂
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