芝加哥急救

Chicago Med S02E09

Part 5 Jan. 23, 2020, 12:10 p.m.

-谢谢 -不客气
- Thank you. - Yeah.
查尔斯医生
Dr. Charles.
能说句话吗
speak with you a second?
-什么事 -是这样我...
- What's up? - Yeah, so, my--
我那心脏病人梅根·斯科特
my heart patient Meghan Scott--
没听见她有什么消息
I hadn't heard anything,
所以移植评估有什么新进展吗
so is there something going on with the transplant eval?
我知道你很清楚我们不应该
Well, I know you know that we're not supposed
讨论这些事但私下告诉你
to be talking about this, but unofficially,
她的成瘾史让她具有很高风险
her history of addiction makes her very high risk.
我知道她的过往
Wh-- I understand her history,
可我们现在在谈的是她的未来
but we're talking about her future here.
关键问题就是她的未来啊
Well, her future's precisely the issue.
抱歉罗德斯医生但是
I'm sorry, Dr. Rhodes, but the--
但是审查程序容忍♥度非常低
the clearance process-- it's unforgiving.
不是不是查尔斯医生你也仅仅
No, no, no, no. Dr. Charles, you spent what,
跟她聊了一小时吧
All of an hour with her?
我认识梅根和她女儿布里亚已经几个月了
I've known Meghan and her daughter Bria for months now.
你是在受控环境下认识她的
You've known her within a controlled environment.
开刀手术
The invasive surgery,
使用鸦♥片♥制剂的止痛措施
the powerful opiates for pain management,
严格的用药日程
the rigorous medication schedule,
和接连不断的检查
the constant check-ups
确保她不会排斥植入器官
to make sure she's not rejecting the organ.
所以你拿着个检查清单就确定了她的命运了吗
So you're gonna seal her fate with a checklist, then?
她得不到心脏移植就会死
She doesn't get a heart, she dies.
她只有半年最多一年的寿命了
She's looking at six months, maybe a year.
你真的以为我不知道这些吗
Do you honestly think that I don't know that?
决定再难做也要有人来做罗德斯医生
Someone's got to make the tough decisions here, Dr. Rhodes.
希望你不要干扰我的工作
I'd thank you to let me do my job.
羊水指标看起来正常
Amniotic fluid level looks okay.
颈半透明度也正常
Same with nuchal translucency.
胎儿心率180 健康强劲
Fetal heart rate is 180, nice and strong.
太好了好小子
Aw, yeah, that's a boy.
你好啊小伙子是块当后卫的料
What's up, little man? Already looking like a linebacker.
我倒觉得她是个科学家
she looks like a scientist to me.
李医生怎么了
Dr. Lee? Something wrong?
12周胎儿下巴到头顶的最佳宽度应该是26毫米
At 12 weeks, optimal crown chin length is 26 millimeters.
而你的胎儿是23毫米
Your fetal measurement is 23.
在正常范围内吗
Is that still within the normal range?
在是在不过还是偏低
Yes, but on the low end.
应该密切关注这一点
Something we need to keep an eye on.
数值过低意味着什么
Low measurement-- what does it mean?
主要是有发育成无脑儿的风险
The main concern is anencephaly,
神经管畸形会导致大脑
a neural tube defect that can cause the brain
发育不正常
to develop abnormally.
是因为我的肺结核药物吗
Is it because of my TB meds?
有可能但还不能确定
Possibly. We can't really know for sure.
她说肺结核药物可能会影响孩子发育
She said the TB meds could possibly be affecting the baby.
这并不意味着...
That doesn't mean--
我知道
I know.
但如果真的有影响呢
But what if they are?
你不能断药啊
You can't stop taking them.
所以我们该怎么办
So, where does that leave us?
你看你才怀了12周
Look. You're 12 weeks.
如果我们考虑...
If we're considering--
不考虑
We're not.
艾普尔
April,
我也不想这样
it's not what I want either,
但如果这危及到你的健康
but if your health is in question,
危及到我们孩子的生活质量那我
the quality of life of our baby is threatened, I--
我们必须要明白
we need to understand
等过了14周情况会更危险更复杂
this gets riskier, more complicated after 14 weeks.
塔特我是天主教♥徒♥
Tate, I am Catholic.
艾普尔这也是我的孩子
April, it's my baby too.
难道我还没有发言权了吗
Don't I at least get to discuss this?
我不会堕胎的
We are not terminating this pregnancy.
所以我需要做多久的化疗
So how long would I have to do chemo for?
这得让肿瘤科医生来定了
That's up to the oncologist.
一般来说一个疗程为期一到四周
Generally, it's given in cycles between one and four weeks long
然后休息一段时间
followed by a period of rest.
要几个疗程
How many cycles?
平均四到六个
On average, four to six.
那副作用呢网上列了几千种
What about side effects? The Internet lists thousands.
这完全取决于泰德的身体反应
It all depends on how Ted's body reacts.
但是确实副作用有很多
But yes, the side effects can add up.
而且因为胆石性胰腺炎
And because of the gallstone pancreatitis,
副作用可能还会加剧
they may even be exacerbated.
听上去很糟糕
Well, all of this sounds awful.
如果手术会怎么样
what am I looking at with surgery?
通过胸廓切开术清除肿瘤
Removal of the mass via thoracotomy.
我会打开你的胸腔移除肿瘤
I'll open your chest and peel away the growth
不管它长在哪里
from whatever it's attached to.
但是我的胆囊炎几个...几个小时前
But my pancreatitis-- a few--a few hours ago
做胆囊手术还很危险
it was too dicey for gallbladder surgery.
现在怎么又可以了
How is it okay with all of this?
你的心脏功能受损
Your cardiac function is compromised.
我们的首要任务是预防心脏衰竭
Preventing heart failure has to be our chief concern.
爸爸我不知道我该怎么办
Dad, I don't know what I'm gonna do.
我感觉如果我现在做错了决定
I feel like if I make the wrong decision right now
我就会...我就会死
I'm gonna-- I'm gonna die.
你们现在就要答案吗
Do you need an answer right now?
泰德我理解这个决定很艰难
Ted, look, I understand this is all overwhelming,
但你病得很重
but you're very sick.
我们越早开始反击...
The sooner we start fighting back--
应急性放疗
Emergency radiation.
是的只做一次目的在于稳定
Yeah, a single dose intended only to stabilize
你肺里的肿瘤
the mass in your lung.
这样能多争取几天时间让胰腺炎减轻
It'll give the pancreatitis a few more days to heal,
也能给你和你♥爸♥爸多一点时间
and it'll give you and your dad more time
决定疗法
to decide on a treatment.
如果之后我还是选择手术
And if I still choose surgery after,
也会更安全一点对吗
it'll be safer, right?
理论上是这样
Theoretically, yes.
我什么时候能做放疗
When can I do it? The radiation.
今天我会安排放疗的专家
Today. I will set it up with the radiation oncologist.
你准备就站在那里看着还是想进来
You gonna just stand there staring, or are you gonna come in?
我擦不掉这个讨厌的咖啡印...
I can't get this frickin' coffee ring off of--
你想说什么
what's on your mind?
我知道你有预约
I know you have reservations,
但我一直在看
but I've been reading
其他人是怎么通过非主流的方式
about how others have managed addiction
控制成瘾的
in unorthodox ways.
可以冥想梅根已经在做了
There's meditation. Meghan already does that.
预测你的弱点
Predicting your weak spots.
她还跟有负面影响的朋友断绝往来
She's cut off friends that were bad influences.
这些方法的问题在于
The problem with these techniques is
他们都是各自努力
that they're all solo endeavors.
梅根需要的是戒瘾协会的支持
What Meghan needs is the support of a sober community.
但没有他们她也很成功
But she's been successful without one.
她有布里亚
And she's got Bria,
这是她戒酒的主要原因
all the reason in the world to stay sober.
还不够
Won't be enough.
我治疗成瘾已经超过二十年
I've been treating addiction for over 20 years.
相信我我知道我在说什么
And trust me. I know of what I speak.
大概十四年前我弟弟输掉了他的战斗
My brother lost his battle with addiction about 14 years ago.
对不起
I am sorry.
我跟你一样希望梅根成功
I want Meghan to succeed just as badly as you do.
但每当我看着她我...
But I look at her, and I--
我就能看到我弟弟
I see my little brother.