芝加哥急救

Chicago Med S03E08

Part 6 Jan. 23, 2020, 11:10 a.m.

Halstead, may I speak with you?
我决定不把艾斯特德转移到肿瘤科
I'm cancelling Asterid's move to Oncology.
-什么 -相反
- What? - Instead,
我会将她转移到
I'm going to find a bed for her
一所社会安全网医院里
in a safety net hospital.
芝加哥医院是一所一流的癌症中心
Med is a premiere cancer center.
-你要把她转走 -我别无选择
- You're gonna transfer her? - I don't have a choice.
她没有保险
She doesn't have insurance,
而且我知道医院不会报销
and I know the hospital won't cover the bill
她的治疗会产生的费用的
her treatments are going to generate.
她有医疗补助计划的急救承保
She has emergency coverage from Medicaid.
对不过那只能报销
Right, but that only pays for procedures
切除肿瘤相关的费用
related to removal of the tumor.
骨癌是新发现的
The bone cancer is new,
并不会立即威胁她的生命
and not immediately life-threatening.
我们不能把艾斯特德赶走
We can't throw Asterid out.
一个快捷诊所把她的肾细胞癌
A minute clinic misdiagnosed her renal cell carcinoma
错误诊断为了腰部扭伤
as a back sprain.
如果我们把她转到体制中
If we put her in the system,
她可能会再次因被忽视而延误病情
she might fall through the cracks again.
你之前动用过关系的
You have pulled strings before,
你曾经试过解决费用的事
you made the numbers work,
再做一次吧
just do it again.
你知道我们在这里谈论的费用
Do you know what kind of numbers
有多少吗
we're talking about here?
10万美元
$100,000?
20万美元
$200,000?
你难道活在梦里吗
What kind of dream world are you living in?
你想让我来通知病人吗
Do you want me to inform the patient?
不用了这件事我们会做的
No, we'll do it.
-坐在长椅上 -你好我是查尔斯医生
- Sitting in pews-- - Hi, I'm Dr. Charles.
四天前我们本来能谈一谈的
Four days ago, we could have somewhat of a conversation,
现在我不知道她有没有吃过饭
and now, I don't know if she's eaten.
我觉得杰米只是压力太大了
Between her work and school,
她要应付她的工作和学业
I thought Jamie was just stressed.
我没有意识到她会崩溃
I didn't realize she was having a breakdown.
这不是你的错
None of this is on you.
杰米
Um, Jamie?
我想现在对你做个检查你能接受吗
I'd like to examine you now. Would that be all right?
有三个人被锁在里面
Three locked up inside.
想要它的一切一切一切
Wanted everything for it, everything, everything.
一切太多了我甚至无法抱起所有东西
Everything. So much my arms can't even hold them all...
如此明显突出的去抑制现象
Clear, prominent disinhibition.
在我第一次考试后还没出现过
Hasn't let up since my first exam.
和两极性躁郁症的症状相符
Consistent with bipolar mania.
-放开我 -你看到这个了吗
- Let me go. - You see this?
在她的眼睛里
In her eyes?
什么
What?
她的虹膜周围有棕黄色的圆圈
Yellowish brown circles around her irises.
我觉得那些是角膜异常环
I think they're Kayser-Fleischer rings.
一周周一天天一周周
And weeks, days and weeks
在日历上翻过去亮光烧着了树木
flipping in the calendar, the bright light burns the trees,
树叶在下落下落停止了太多了
leaves, falling, stop falling, too many--
太多的人挤成一团
too many people crowding.
太多人了亮光烧着了树木
Too many people. Bright light burns the trees.
树叶在下落绝对是有太多的人了
Leaves falling. Entirely too many people.
你的妹妹在厨艺学校上学
Um...your sister is in culinary school.
她有没有说过什么有关铜
Has she ever said anything to you about--about copper,
使用铜锅的事
using copper pots?
有我觉得有
Yeah, I think so.
好像是说铜是最好的导热体
Something about them being the best heat conductors.
我对烹饪一点也不了解
I don't know anything about cooking.
这对你来说有用吗
Does that mean something to you?
里斯医生
Dr. Reese?
-威尔逊综合症 -那是什么
- Wilson's disease. - What's that?
是一种遗传病
It's a genetic disorder,
铜在体内累积就会发作
um, where com--copper accumulates in the body.
杰米对铜质厨具的使用
Jamie's use of copper cookware
可能加速了铜的累积
could've accelerated the buildup
因此导致了这种狂躁的症状
that led to this manic episode.
如果这是威尔逊综合症有办法可以治愈吗
If this is Wilson's disease, is there a cure?
没有不过有一种疗法可以控制发病
Um, no, but there is treatment to manage it,
她会好起来的
and she--she would get better.
谢天谢地
Oh, thank God.
里斯医生我能跟你到外面谈谈吗谢谢
Dr. Reese, could I just have a word outside? Thank you.
还有抽搐扭动蠕动扭动
And twitching. Wiggle, wriggle, wiggle...
所以你甚至没法靠近你的病人
So, you couldn't even get close enough to your patient
检查一下她的眼睛
to examine her eyes?
她太激动了
She was so agitated--
-里斯医生 -救命啊
- Dr. Reese. - Help!
没有脉搏仍在室颤充电到200
No pulse. V-fib. Charge to 200.
-充电完毕 -离手
- Charged. - Clear.
我可怜的孩子啊
Oh, my poor baby.
注射一毫克肾上腺素再充电到200
One milligram epi. Charge to 200 again.
-注射完毕充电完毕 -离手
- Epi's in. Charged. - Clear.
心脏停搏我们不能再对她电击了
Asystole. We can't shock her anymore.
我的天哪他在做什么
Oh, my God. What's he doing?
拜托拜托
Come on, come on.
她太痛苦了请停下来吧
She's suffered enough. Please, stop.
死亡时间 18点21分
Time of death 18:21.
我们在找霍斯特德医生
We're looking for Dr. Halstead.
我们来是要转移艾斯特德·摩根去县医院
Here to transfer an Asterid Morgan to County.
好的马上就来
Right, one sec.
-威尔 -怎么了
- Will? - Yeah?
他们到了
They're here.
各位跟我来
Hey, guys. Come with me.
我的病是汉娜传染给我的
I got this from Hannah?
怎么可能我喉咙不痛
How? I don't have a sore throat.
也没有发烧身上也不痛我没生病
No fever, aches, pains, I'm not sick.
你没有出现感染症状
You don't have an active infection,
不过自从你得了肺炎你就有传染性了
but since your pneumonia, you've been contagious.
十年以来都是这样
For ten years?
我在办公室上班
I work in an office,
每天和一堆人接触
cross paths with dozens of people every day,
更不用说在汤米之前的男朋友了
not to mention boyfriends before Tommy.
没人因此生病过
No one else has ever gotten sick.
我们会做一些测试
We're gonna run some tests
看看到底是什么
and find out exactly what it is.
亲爱的我真的很抱歉
Honey, I am so sorry.
不是你的错你不知道
It's not your fault. You had no idea.
而且我感觉好多了
Besides, I'm feeling better.
也就是说抗生素起作用了对吗
It means that these antibiotics are working, right?
是的
Yes.
给汉娜也输注抗生素
Put Hannah on them.
-是啊 -无论她近十年
- Yeah. - Kill whatever bug
携带的什么细菌都杀掉
she's been dragging around for the last ten years.
恐怕没那么简单
I'm afraid it's not that simple.
作为一个携带者你受到细菌的侵占
You see, as a carrier, you're colonized with the bacteria.
也就是说细菌在你体内的太多地方生存
Which means it lives in too many places in your body
抗生素很难有效
for the antibiotic to be effective.
你是说...
You mean...
我永远都得携带着这细菌
I've got this forever?
恐怕是的
I'm afraid so.
我还可能再次传染给汤米
Then I could give it to Tommy again.
在有防范措施的情况下感染的风险会降低
With precautions, the risk of reinfection can be reduced.
这不可能... 不可能是这样的
This can't be-- this can't be happening.
我们可以应对的
We can deal with it.
-好 -会有办法的
- Yeah. - We'll figure it out.
太糟心了
This sucks.
我们做了所有正确的事但还是收效甚微
We do everything right and still come up short.
好了走