芝加哥急救

Chicago Med S03E07

Part 3 Jan. 23, 2020, 11:10 a.m.

That baby's going home with somebody else.
我们却让莉安和他熟悉然后再抱走他吗
We let LeAnn bond with him, and then just rip him away?
我们帮助她的机会基本上都已经消失了
Any chance we have of helping her...pretty much gone for good.
查尔斯医生我们在说的可是孩子的性命
Dr. Charles, we're talking about an infant's life.
这我知道但我就是在想
I'm aware of that, but I just think that
我们应该更全面地考虑这个问题
we should take a beat and look at all sides of this.
打断一下曼宁医生
Excuse me, Dr. Manning.
儿保部的人正在赶来
DCFS is on their way.
他们找了一些备选的寄养家庭
They've got some foster parents
可能会有兴趣
that might be interested
照顾你的病人
in caring for your patient.
好不过请他们再给我一点时间
Good. Um, just have them give me a little bit of time.
好吗孩子现在还不太稳定
Okay? Um, the baby's not stable yet.
-我尽量 -谢谢
- I'll do my best. - Thank you.
你好啊莎伦
Oh, hey, Sharon.
你好伯特
Hello, Bert.
丹普西女士怎么样了
Uh, how's Miss Dempsey doing?
但愿我们能尽快出院
Well, hopefully, we'll be out of here soon.
霍斯特德医生正在治疗
Dr. Halstead's on top of it.
那就好
Well, that's good.
你最近还好吗
And how are you doing?
我吗你懂的就那样
Me? I'm, you know, the same:
将就着过尽量帮帮她
hanging in there, trying to help as best I can.
我想肯定不容易
Well, I'm sure it isn't easy.
确实
No, it isn't.
眼看着她一天天恶化下去
Watching her get a little worse every day
一些日常小事越来越艰难
and struggling with the things
明明几周之前还十分轻松
that were easy just a few weeks ago and...
总之我该回去了
Anyhow, I... I should get back.
好
Yeah.
你回来上班之后
Once you return to work,
我们一天轮两班
we'll round twice a day,
每天早上进行表格审核
do a chart review every morning,
你每天下午观摩集体治疗
and you'll observe group therapy every afternoon.
你说的观摩是我也得进去吗
By "Observe," Do you mean I will be sitting in?
不用我们有单面镜房♥间
No, we have a one-way mirror.
我并不支持把住院医师当廉价劳力的理念
I don't believe in using house staff as cheap labor.
你先请
You first.
住院实习的时间应该用来观摩
Residency is a time to watch
和吸收
and absorb.
好吧不过说到治疗
Okay. Uh, though, speaking about therapy,
我最近读了埃里克森的理论
I've been reading up on Erikson's theories
策略性互动这种方法我觉得很有趣
for strategic interaction, and it's an interesting take,
从病人个人的力量入手
focusing on a patient's, uh, personal strengths,
而不是他们的病理征状
rather than their pathologies.
互动策略确实很有趣不过
Yes, interactional therapy is interesting, but
你应该把你余下的停职期用来
you should spend the rest of your suspension
学习这些
learning these.
这是什么
What are they?
治疗算法
Treatment algorithms
是我们面对过的最常见的七种情况
for the seven most common conditions we see.
但这些都是流程图
But these are flow charts.
还怎么进行个性化治疗
How do you individualize the therapy?
第三步
Step three.
病人对药物反应是否良好
Is the patient responding to medication?
是或否
Yes, no.
周四下午我们开文献报告会
Thursday afternoons, we do journal club.
欢迎你来旁听
You're welcome to listen in.
-什么情况 -老旧危楼
- What happened? - Building's condemned.
本不应该住人
Supposed to be empty,
但我们听见里面有人
but we thought we heard somebody inside.
原来是有人蹭房♥住名字叫加里
Turned out to be a squatter. Guy's name is Gary.
他的左腿上
He's got a big chunk of concrete
压着好大一块水泥
compressing his left leg
还有一段钢筋穿透了他的下腹
and a piece of rebar straight up through his groin.
我们做了包扎但他出了不少血
We got pressure on it, but he's bleeding pretty bad.
止血之后你们能救他出来吗
If we stop the bleed, can we get him out?
-难说 -副队
- Hard to say. - Hey, Lieutenant!
-怎么了 -那水泥块是承重块
- Yeah? - Uh, the concrete's a bear.
没法用气袋撑起来
We can't use the bags on it,
但我们也许能用
but we might be able to
气錾来敲碎它
break it up with the air chisel.
小心我们还没清出一条道路来
Be careful. We haven't been able to clear a path yet,
我们得小心钻过去
so we're gonna have to sneak through.
-当心头 -好的
- Watch your heads. - Yeah.
我们来了加里
Ah, here we go, Gary.
这位是罗德斯医生
We got Dr. Rhodes
还有贝克医生
and Dr. Bekker.
加里
Now, Gary,
我们会治好你的好吗
we're gonna take good care of you, all right?
好了这就对了
All right. Hey, you're okay.
好再做一轮测试
All right, draw up another round of labs,
-再注射一克万古霉素 -好的
- and hang a gram of vanco. - Yep.
丹普西女士
Hey, Ms. Dempsey.
抗生素没管用是不是
The antibiotics aren't working, are they?
确实没有
No, they're not,
而细菌很有可能
and it's possible the bacteria
已经从你的肺部扩散到了血液里
has spread from your lungs into your blood.
败血症
Sepsis.
我也在查资料
I've been reading.
是的
Yes.
我希望接下来要用的新抗生素
Now, I'm hoping this new antibiotic we're starting
能够扭转局面
will turn things around,
但你也知道核上性麻痹
but, as you know, the supranuclear palsy
让你的免疫系统不那么管用了
makes your immune system less effective,
所以也有可能在药物生效之前
so there's also a chance before we get there
你的肺就已经先不行了
your lungs will start to give out.
如果到了那一步
Now, if it comes to that,
我就需要给你插管了
I am gonna have to intubate you.
然后给我上呼吸机吗
And put me on a ventilator?
是
Yes.
不过希望只是暂时使用
But hopefully, it's only temporary,
感染一消除就可以取下来
until we can clear the infection.
好吗
Okay?
你坚持住
Hang in there.
我过一会儿就来看你
I'll be back to check on you in a few minutes.
霍斯特德医生
Dr. Halstead?
我不想上呼吸机
I don't want that ventilator.
我知道这听起来很吓人
I understand this sounds daunting,
但正如我所说就算到了那一步
but like I said, if it comes to that,
我们也可能很快就取下呼吸机
we may very well be able to get you off it again soon.
但也可能取不下来了
Or you may not.
我知道这会是什么结局
I know how this all ends.
莱拉
Lyla,
如果你的肺崩溃了而我们又没插管
if your lungs fail and I don't intubate,
你会死的
you'll die.
我知道
I know.
好吧
Okay.
克劳福德女士
Ms. Crawford?
我说了我不想谈了
I told you, I don't want to talk.
我不是来讨论戒毒的
Uh, I'm not here to discuss detox.
我是想谈谈你的孩子
I want to talk to you about your baby.
怎么了
What about it?
是个男孩
He's a boy,
他受到了海♥洛♥因♥的影响
and he's withdrawing from heroin.
不吃东西不睡觉
He's, um, not eating, not sleeping.
呼吸和心跳不规律并不理想
Breathing and heartbeat aren't quite as regular as we'd like.
那就给他吃药啊
So give him some medicine.
我们一直在这样做
Well, we have been, but...
但是事情并不这么简单
it is not quite that simple.
好吧