芝加哥急救
Chicago Med S02E16
Part 5
Jan. 23, 2020, 12:12 p.m.
阴♥部♥出血已经止住了
we've treated the vaginal bleeding.
那就该让她出院了
Then it's time to discharge her.
她父母又找了家疗养院
Her parents have found a new care facility,
急着想尽早把女儿安顿过去
and they're eager to get their daughter settled in.
那我们怎么知道特丽莎在那就安全了
How do we know Teresa will be safe?
我们怎么知道她不会再被侵犯了
How do we know she won't get abused again?
她已经受了那么多苦 我只是想
She has suffered so much. I just--
只想什么
Just what?
你还能做什么
What can you do?
我们都希望能多做一点
We all wish we could do more,
但我们的职责就是治好
but our job is to treat the ailment
把病人送进来的病
that brought the patient in,
仅此而已
and that's all.
该让她父母来照顾她了
It's time to give her back to her parents.
修复工作已完成 现在取下搭桥机
We've finished the repair, and now coming off bypass.
搭桥机已取下
We're off bypass.
在手术的收尾阶段 病人已经...
At the end of any surgery, when the patient has been--
肺动脉压50
Pulmonary artery pressure is 50.
-升到70了 -那左心室呢
- Coming up to 70. - And the left ventricular?
100.
我们先别激动 她可以安全度过
Well, let's not get excited. She'll ride it out.
下降了 80
It's dropping--80.
我们要重新给她旁路搭桥吗
Should we put her back on bypass?
我们 我们 我觉得我们应该 我们应
We--we-- I think we should--we--we--should--
她的心室出现早期收缩
She's throwing PVCs.
75.
肺动脉高压症越来越严重了
Pulmonary hypertension's getting worse.
肯定是术后还太窄了
Your graft has to be stenotic.
上搭桥机 莱瑟医生 我们要修复搭桥
Bypass, Dr. Latham. We need to fix the graft.
我们可以试试 肺 肺血管舒张药物
We could try a, uh--uh, pul-pulmonary vasodilator.
药物不管用 我们需要再次手术
Vasodilator's not gonna do it. We need to open her back up.
血压下降的速度很快 她快不行了
Blood pressure's dropping rapidly. We're losing her.
莱瑟医生
Dr. Latham...
-她的心博快停止了 -莱瑟医生
- She's peri-arrest. - Dr. Latham...
让开 莱瑟医生
Step away, Dr. Latham.
让开
Step away.
马蒂 再来一剂肝素 我们重新上搭桥机
Marty, re-dose of heparin. Let's get her back on bypass.
我要重新打开心脏
I'm reopening the heart.
你在这儿呢
There you are.
不如我们...
Hey, how 'bout we, um--
不如我们下班后约一个
how 'bout we hang out after work?
对 比如去吃你最喜欢的薯条什么的
Yeah, maybe go get some of your favorite fries or something.
不要了 我明白
Noah, please. I get it,
但是给我一点空间 好吗
but just give me some space, okay?
我知道你认为
So I understand that you believe that
你的诊断有误 对吗
you've been wrongfully committed. Is that right?
是的 肯定的
Yes, definitely.
以前住院过吗 南茜
Ever been hospitalized before, Nancy?
除了我妈妈拿锤子打我那晚吗
Besides for the night my mom attacked me with a hammer?
没有
No.
你想要多跟我说说你妈妈吗
You wanna tell me a little bit about your mom?
好啊 终于
I would. Finally.
南茜 你还好吗
Hi, Nancy. How are you?
还好
Okay.
我是贝克医生 南茜的精神病医生
I'm Dr. Baker, Nancy's psychiatrist.
丹·查尔斯 很高兴见到你
Dan Charles. Nice to meet you.
这位是霍斯特德医生 你应该认识里斯医生
This is Dr. Halstead, and I think you know Dr. Reese.
是的 很高兴看到我们的病人受到很好的照顾
Yes, I'm glad to see our girl here is in good hands.
-她什么时候可以出院 -她没事了
- When will she be discharged? - Oh, she's clear.
只需要取出鼻胃管
We just need to remove the NG tube,
她就可以走了
and she'll be ready to go.
好的
Good.
你介意跟我去外面聊几句吗
Do you mind? Could I get a quick word outside?
好的
Of course.
你知道南茜的母亲
Are you aware that Nancy's mother
有多次被捕记录吗
has an extensive arrest record?
不 我不知道 怎么了
No, I wasn't. Why?
好像她的诊断大多数基于
Well, it seems that she might've been committed
她母亲讲述的故事版本
largely based on her mother's version of events.
查尔斯医生 对南茜的诊断
Dr. Charles, Nancy was committed
是因为我认为她对自己和他人有威胁
because I deemed her a threat to herself and others.
我 我在想啊
I--I was just wondering
你觉得有没有那么一点可能
if you thought that there was any chance that, uh,
你的评估可能被她母亲
your assessment might've been colored by
潜在的不可靠历史所影响了
a potentially unreliable history given by the mother.
影响我评估的是对青春期精神病学
My assessment was colored by 20 years of experience
二十年的经验
in adolescent psychiatry.
而且说实话 我不喜欢被一个
And quite frankly, I don't appreciate being second-guessed
只认识我病人一个下午的医生质疑
by a doctor who's only known my patient for one afternoon.
我只是看到有偏见性诊断的可能性
I just saw the potential for a biased narrative,
想确保你已经了解所有事实了
and I wanted to make sure you had all the facts.
偏见性诊断
A biased narrative.
作为法庭指定给南茜的医生
As Nancy's court-appointed doctor,
我建议你多担心你自己的病人 查尔斯医生
I'd advise you to worry about your own patients, Dr. Charles.
你要让她出院吗
Are you discharging her?
我刚做好出院文件
I just finished the paperwork now.
-曼宁医生 -是的
- Dr. Manning. - Yes.
你昏迷的病人
Your coma patient--
鉴于她在那个疗养院收到的恶劣对待
given the abysmal treatment she received at that facility,
我不禁怀疑
I couldn't help but wonder
他们还误诊了哪些方面
what other ways they might've failed her,
所以我检查了她的医疗历史
so I reviewed her history.
有没有找到什么
Did you find anything?
恐怕没有 但我还有一个问题
I'm afraid not, but I do have one question.
你是在什么时候做的神经测试
What time of day did you perform that neuro exam?
早上 怎么了
Morning. Why?
有时候 创伤性脑损伤
Sometimes, traumatic brain injuries
会导致病人出现
result in a patient developing
不规律的睡眠和唤醒生理周期
irregular sleep/wake circadian cycles,
所以有可能特丽莎变成夜间活动了
so it's possible Teresa's become nocturnal.
我建议我们再测试一次
I suggest we try that test again.
好的
Great.
埃珍先生和埃珍夫人
Mr. and Mrs. Azen...
这位是艾布拉姆斯医生 神经外科主任
this is Dr. Abrams, Chief of Neurosurgery.
介意我们对你们的女儿多做一个测试吗
Do you mind if we perform one more test on your daughter?
新疗养院的急救车已经过来了
Well, the EMTs from her new facility are on their way.
应该很快就好
It should just take a moment.
特丽莎 如果你能听到我说话 请睁开眼
Teresa, if you can hear me, please open your eyes.
我已经问过她100万次了
I've asked her that a million times.
我知道 请再耐心等一下
I know. Just bear with me a moment.
特丽莎 如果你能听到我说话
Teresa, if you can hear me,
就左右转动一下眼睛
please move your eyes side to side.
我很抱歉
I'm sorry.
我会完成她的出院手续
I finished Teresa's discharge.
等接她的车一来...
As soon as her transportation arrives--
等一下
Hold on.
有一种症状叫闭锁综合症
There's a condition called locked-in syndrome.
如果你的女儿是这种症状的话 她是有意识的
If your daughter has it, she'd be conscious,
但她并不能左右转动她的眼睛
but she wouldn't be able to move her eyes side to side.
然而 她能...
She could, however, move them--
让我们看看
well, let's see.
特丽莎
Teresa...
我需要你为我上下动你的眼睛
I need you to move your eyes up and down for me, please.
上下
Up and down.
看到了吗
Did you see that?
那是什么
What was that?
特丽莎 如果你能听到我说话
Teresa, if you can hear me,
请你再为我上下动一下你的眼睛
please move your eyes up and down again.
天啊
Oh, my God.
我不明白
I don't understand.
你是如何把她从昏迷中唤醒的
How did you wake her from the coma?
芝加哥急救
Chicago Med
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