芝加哥急救
Chicago Med S02E04
Part 2
Jan. 23, 2020, 12:08 p.m.
肠阻塞 就算是一部分
Bowel obstructions, even partial ones,
也会危及生命
can become life-threatening situations.
不清除阻塞我们不能让你离开
We can't discharge you until it's cleared.
-现在不疼了 -我懂
- It doesn't hurt anymore. - Look, I understand,
但你的检验结果依旧不正常
but your output is still too high.
-让我检查一下 -不要
- Let's see if I can feel any-- - No!
我不喜欢被人碰
I just--I don't like to be touched.
这有事吗
How we doing in here?
再配合治疗一段时间
Give the tube a little more time.
我保证会尽快让你回家的
I promise we'll get you home as soon as possible.
他被发现晕倒在街上
He was found passed out on the street.
腹部X射线现实他的肠子有大量粪便
AB showed a massive stool in his bowel.
-晕倒 -没错
- Wow. Passed out? - Yeah.
-那一定很严重了 -开始清除阻塞了
- It must have been pretty bad. - It's starting to clear,
但他自从到这之后 开始变得好斗忧虑
but he's been combative, fearful ever since he got here.
-你想要我会诊吗 -是的 他不愿意跟我说话
- You want a consult? - Sure. He won't talk to me.
看 也许他和
Oh, look, there's somebody
有些人交流起来更容易
he might have an easier time relating to.
你把这叫降压农场
You call this the vent farm?
黑色幽默使人理智
Dark humor keeps you sane
如果你要在这待一会的话
if you're gonna spend some time here.
很高兴见到你
Hey, good to see you.
-所以所有昏迷患者都被送到这来了 -是的
- So this is where all our comatose patients go? - Mm-hmm.
很多人都没有亲人了
A lot of these people didn't have anyone.
他们只是被安排了一个社工
They just got appointed a case worker
让他们继续活着
who decided to keep them on life support.
另一些有家人的还抱有微小的希望
Others have families that are still holding out hope.
不管怎样 他们都...
Either way, they're just--
没有什么可以做的是吗
Nothing that can be done, right?
医学上是没了
Nothing medically.
那又如何 我们来这查细菌培养结果吗
So what, we're here to check some culture results?
-不是 -宣布某人死亡吗
- Nope. - Pronounce someone dead?
-也不是 -那我们在这干嘛
- Uh-uh. - So what are we doing?
我们来这涂指甲油
We're here to paint some nails.
发生什么事了吗
What's going on?
你还记得我的癌症患者海莉·克莱恩吗
You remember my cancer patient, Haley Cline?
-一个很甜美的孩子 -记得
- Sweet, young girl? - Yeah.
这个出现在她的细菌培养报告中
This just showed up in her cultures.
天哪 多粘菌素耐药肠杆菌
Oh, God, colistin-resistant Enterobacter.
事实上她几乎不能对抗感染
She can barely fight off infection as it is.
现在她被一种有抗药性的超级细菌感染了
Now she has an antibiotic-resistant super bug?
这真是个坏消息
This is really bad news.
-娜塔莉 这比你想的还糟糕 -什么意思
- Natalie, it's worse than you think. - What do you mean?
他是埃里克·蒂尔曼 刚入院
This is Eric Tillman, just came in.
他也被这种细菌感染了
He has CRE too.
同样的细菌 真的吗
The same bug? Are you serious?
实验室刚确认了
Labs just confirmed it.
所以我们有可能爆发疫情
So we could be looking at an outbreak
还可能无药可医
that might not have a cure.
硅胶手套
禁止通行
禁止通行
霍斯特德医生 曼宁医生 这位是罗宾·查尔斯
Dr. Halstead, Dr. Manning, this is Robin Charles,
我们流行病科的新成员
the newest member of our epidemiology department.
-很高兴认识你 -班里的顶尖学生
- Pleasure. - Top of her class,
杜邦奖学金获得者 而且她恰好是
DuPont Scholar, and she just happens
查尔斯医生的女儿
to be Dr. Charles's daughter.
怎么说呢 裙带关系依旧存在
What can I say? Nepotism is alive and well.
听说我们有多粘菌素耐药肠杆菌感染病例
So I hear we've got colistin-resistant Enterobacter?
-两个患者 -他们是在这里感染的吗
- In two patients. - Did they catch it in this hospital?
我不这么认为
I don't think so.
我们之前没有感染病例
There's no record my patient's ever been here.
现在有了 这说明
Well, he's here now, which means
这所有免疫功能低下的患者都有危险
every immunocompromised patient in this place is at risk.
我们拿到最终的细菌培养敏感测试结果了吗
Do we have final culture sensitivities yet?
-还在等 -我要和你们病人的
- We're still waiting. - I'll need to talk to
每一个联♥系♥人谈话
every one of your patient's contacts,
了解详细病史
get detailed histories,
找出这些人之间的联♥系♥
find out what the connections between these people are.
保持联♥系♥
I'll be in touch soon.
实际上 等等
Actually, um, wait.
我觉得是我的错
Uh, I think it's my fault.
海莉三天前来住过院
Haley was here three days ago.
我没有诊断出来
I missed the diagnosis.
你不能确定
You don't know that.
她离开后也可能一样容易感染
She could have just as easily contracted it after she left.
我看了记录 你完全照章办事
I saw her records. You treated her exactly how you should have.
那如果她被感染了 然后被我送回城里
Well, what if I sent her back into the city with an infection
她再传染给埃里克 谁知道还有多少人
and she gave it to Eric and who knows how many others?
娜塔莉 这城市有几乎三百万人
Natalie, it's a city of almost 3 million people.
这可能就是巧合
This could all just be a coincidence.
说实话 我不相信巧合
Actually, I don't believe in coincidences.
抱歉 保持联♥系♥
Sorry. I'll be in touch.
亲爱的 这是杰夫·克拉克
Hey, honey. This is Jeff Clarke,
大四医学生
fourth-year med student,
虽然长得有点粗糙
little rough around the edges,
不过这年头来帮忙的人不好找
but it's so hard to find good help these days.
你好呀
Hi.
你怎么认识她的
How do you know her?
那天很晚了她自己一个人来了急诊室
She came into the ED late one night alone,
动脉瘤破了 大出血
burst an aneurysm, massive hemorrhage.
等我们开始救助 已经太晚了
By the time we got her, we knew it was too late.
她一直叫我陪她说话 我就陪了
She kept on asking me to talk to her, so I did.
当时我母亲刚过世
Thing is my mother had just passed...
我小时候她哄我睡觉的时候
And when she used to put me to sleep as a kid,
总是会叫我 麦麦基
she used to call me Maggie-Pie
好像出自一首讲鸟儿的童谣
from a nursery rhyme about a bird,
我也不知道 也许辛迪之前听过那首歌♥
and I don't know, maybe Cindy had heard that rhyme before.
她肯定是看到了我的名牌
She must have seen my nametag, I--
因为她在弥留之际 抓着我的手
'cause in her last moment she squeezed my hand...
也叫了我一声麦麦基
And she called me Maggie-Pie too.
芝加哥警署查了 她没有亲属
Anyway, CPD looked, but there was no family,
没有朋友 没人来照顾她
no friends, no one to speak for her,
所以就送来了这里
so they brought her here.
我现在每周都会来看她
Now I check in on her every week,
跟她讲我的生活
tell her what's going on with my life.
我也不知道
I don't know.
我觉得她似乎一脚踏在这个世界
I figure she's got one foot in this world
而另一只脚踏在我妈妈的世界
and, uh, another in the next where Mom is.
为什么一个19岁的孩子会有肠梗阻
So why would a 19 year old have a bowel obstruction?
好问题 其他测试结果都显示正常
Good question. All his other tests are normal.
-可能是压力大吧 -有可能
- It could be stress, right? - Could be.
精神压力有很多种表现形式
Stress can present a hundred different ways.
可你觉得不是因为压力吗
But you think it's something else?
不知道 要靠你问清楚了
Don't know. That's what you're gonna find out.
你好
Hi.
我叫莎拉·里斯 我可以进来吗
I'm, uh, Dr. Reese, Sarah. Can I come in?
-我真的想走 -这我不怪你
- I really want to leave. - I don't blame you,
但是你似乎还得在这里待一会儿
but it sounds like you're gonna be here a little bit longer,
要不我们聊聊吧
so maybe we could talk?
我坐在这里吧 可以吗
Or I could just sit here. Is that okay?
-为什么 -不知道
- Why? - I don't know.
我就是觉得你可能希望有人陪着
I just thought you might want some company.
你是芝加哥本地人吗
Are you from Chicago?
我来这里五年了
I've been here five years.
我老家在康涅狄格州
I'm from Connecticut,
到现在我都很讨厌冬天
and I still totally dread the winter.
我以为自己知道什么叫冷
I mean, I thought I knew what cold was,
但是这里的冷
but this is, like,
是《国家地理杂♥志♥》《冰冻星球》那种冷
"National Geographic," "Frozen Planet" cold.
我会随身带着暖手贴
I carry around those hand warmer pads
就怕眼皮冻住睁不开
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