芝加哥急救

Chicago Med S05E03

Part 7 Nov. 18, 2019, 10:05 a.m.

他的心跳复苏了
They got his heart back in rhythm.
你应该去陪陪他
You should go be with him.
我们需要做什么
What we need to do?
你赋予我们做出决定的权利
You give us the power to make a decision,
然后又对我们做出的决定指手画脚
and then judge us for making it?
谢帕德先生相信我我没有指手画脚
Mr. Shepard, believe me, I'm not judging anybody.
风湿科的人过来了吗
Anyone from rheumatology showed up yet?
没有
No.
继续催他们
Lean on them, okay?
再做一次化验
And run another set of labs.
-好 -又见面了
- Mm-hmm. - Oh, hey, there, again.
-欧文 -威尔
- Hi, Owen. - Hi, Will.
我们在公园里玩过以后
After we got done in the park,
我们去看了电影
we went to the movies,
然后我们想我们过来到这等妈妈下班
and then we figured we would come here and wait for Mommy.
菲利普
Hey, Phillip?
什么事
Yeah?
我不确定这里适合小孩来
Not so sure this is the best place for kids, you know?
这里会有些吓人的事也许他们没办法避开
Some scary stuff happens here that maybe they can't unsee.
是啊
Oh, yeah.
这个有道理
That's a good point.
这样就好了
There we go.
这样就不会看见什么了
Now there's nothing to unsee.
对吧
Right?
我们和你的主管说了
We told your supervisor
我们不想让你再给我们的女儿看病了
we didn't want you treating our daughter anymore.
我知道我只是想要检查最后一项
I know, I just need to check one last thing.
曼宁医生
Dr. Manning.
我要请你离开这位病人
I'll have to ask you to stay away from this patient.
我错了
I was wrong.
依托咪酯和氯♥胺♥酮♥不是一回事
Okay, etomidate and ketamine are not the same thing.
最大的区别是依托咪酯会暴露出
A big difference is that etomidate unmasks
肾上腺机能不全
adrenal insufficiencies.
而氯♥胺♥酮♥不会
While ketamine doesn't.
对
Yes.
你们看到凯莎脚上的色素斑了吗
You see the pigment spots on Keisha's foot?
这些就是一种迹象表示她的肾上腺
They are a sign that her adrenal glands
没有分泌足够的皮质醇
are not producing enough cortisol.
一百毫克氢皮质酮
100mg of hydrocortisone.
我不明白
I don't understand.
皮质醇能帮助身体缓解紧张情绪
Cortisol helps the body handle stress.
如果不够即使只是
In its absence, even the stress
被医生检查的小小紧张
of being examined by a doctor was enough
也足以让凯莎陷入昏迷
to plummet Keisha into a coma.
血压在升高
BP's improving.
她的气色回来了
Her color's coming back.
她在试着睁眼
She's trying to open her eyes.
我的宝贝女儿
Oh, my baby girl.
她太冷了
She's super cold.
我没法让她的血压升高
I'm having trouble keeping her pressure up.
你得赶快帮她缝合然后出去
You need to pack her up now and get out.
我说了不值得
I told you it wasn't worth it.
打个结搞定
A knot, and I'm done.
你在让她情况恶化马塞尔医生
You're pushing it, Dr. Marcel.
然后
And...
好了
there, done.
比我预想得要好
Looks better than I thought.
我们先暂时缝合送她上楼
Let's temp-close and get her upstairs.
打开真空海绵
Open up a vac sponge.
麦基
Maggie?
我要休息一下
I need to take a minute.
麦基
Maggs.
塞克斯顿
Sexton!
你来接手
Scrub in.
如果你想早点回去
If you need to go home early,
我非常乐意替你顶班
I'm more than willing to cover for you.
你替我顶班
You cover for me.
你才第一天上班
Your first day.
提点点建设性的批评宝拉
A little constructive criticism, Paula.
你对自己的能力太乐观了
You have an insanely inflated sense of your own capabilities.
"我拿到了证"
You know, "I'm certified doing this,
"我写了这方面的论文"
so I did my dissertation on that."
拜托
Please!
出去
Get out.
抱歉但我拒绝被这样说
I'm sorry, but I refuse to be spoken to like that.
她能挺过去吗
Is she gonna make it?
的确她流了很多血
Yeah, she lost a lot of blood,
但可以我持乐观态度
but, yeah, I'm hopeful.
知道是怎么回事了吗
Do we know any more about what happened?
受害者名叫路易莎·纳什
The victim's name is Louisa Nash.
她和袭击者是同事
She and the assailant were coworkers.
今早伯克小姐邀请路易莎去她家
This morning, Ms. Burke invited Louisa over
给她一些旧的小孩衣服
to give her some old baby clothes.
趁她不备时她迷昏了她
When her guard was down, she chloroformed her
然后强行取走了孩子
and forcibly removed the baby.
谁会做那样的事
Who would ever do something like that?
她的孩子最近死于白血病
She lost her son recently to leukemia.
或许她有点精神崩溃我也说不好
Maybe she had some sort of mental breakdown, I don't know.
我们很走运接到了关于伯克小姐的匿名举报
We were lucky, we got an anonymous tip about Ms. Burke,
帮我们及时找到了路易莎
and that helped us find Louisa in time.
嫌犯的手需要包扎
Suspect's hand needs redressing.
你们能在这处理吗
Is that something you can do here?
我来
I got it.
照顾好我的孩子好吗
Take care of my baby, okay?
告诉他我会尽快来找他的
Tell him I'll come for him as soon as I can.
这事看来很抓人眼球
This is getting to be a bit of a circus.
来我带你们走后门
Here, I'll take you out the back way.
怎么了
What's going on?
他们在撤掉生命支持设备
They're withdrawing support.
我和我妻子决定
My wife and I decided
尊重儿子的意愿
we're going to honor our son's wishes.
这样的话也许有朝一日我们还能让他回来
This way, maybe someday, we'll get our son back.
死亡时间 19点42分
Time of death, 19:42.
所以我想这可能是由于某种
So I'm thinking this might have been precipitated
潜在的疾病原因造成的
by some kind of underlying cause.
也许是艾迪生氏病
Maybe Addison's disease?
我要让内分泌医生下来给她会诊
I'm gonna have endocrinology come down and see her.
我以为我是主治医生这点已经很明确了
Thought it was clear I was gonna be the primary.
抱歉但当我意识到
I'm sorry, but once I realized
是什么导致她昏迷的时候我得快速处理
what caused her to crash, I had to act quickly.
凯莎可能会死
I mean, Keisha could've died.
有人来接我了
Oh. My ride's here.
肾上腺问题
Adrenal crisis should've been on
你最开始就该诊断出来
your differential from the start.
当时症状并不明显
It was an odd presentation.
或者是你没有想清楚
Or you just weren't thinking straight.
我要监督你往后所有的病例
I'm gonna want to oversee all your cases
直到我们可以确认
moving forward, until we know for sure
你的创伤性脑损伤没有影响到你的病人
your TBI isn't adversely affecting your patients.
你认真的吗
Are you serious?
我没有任何问题
There's nothing wrong with me.
你无权这么做
You don't have the authority.
我只是希望可以私下解决
I was hoping we could do this off-book.
否则我们可以正式找拉尼克和古德温
If not, we can formalize it with Lanik and Goodwin.
我很乐意去找他们
I'm happy to talk to them.
娜塔莉
Natalie...
这是为了保护你
It's for your own protection.
为什么我感觉你像在借机做文章
Why do I feel like you're punishing me for something else?
可以走了吗
Ready to go?
可以
Yep.