芝加哥急救
Chicago Med S02E19
Part 5
Jan. 23, 2020, 12:12 p.m.
- No. - Why not?
你可别说 "不能开这样的先例"
And do not say, "Because it's bad precedent."
这个先例绝对不能开
It's a horrendous precedent.
这次黑客入侵威胁到许多人的生命
These hackers are putting people's lives at risk.
患者无法得到应有的照料
They're compromising their care.
绝对不能助长这样的行为
You can't reward behavior like that.
再说 这次给了钱
Besides, you pay them now,
万一他们下次找隔壁医院
what stops them from doing it again
再用同样的招数勒索怎么办
or holding the hospital next-door hostage?
我不管隔壁医院如何
I don't care about the hospital next-door.
不能让他们赢 彼得
We cannot let them win, Peter.
你要是想坚持来硬的 我也不介意
You wanna stick to your guns, that's fine,
但到时候由你来跟董事会汇报
but you are the one who's gonna tell the board.
把消息放出去 告诉公共卫♥生♥部♥
Spread the word and notify IDPH
医院进入全员转移模式
the hospital's now on full diversion.
明白
Yes, ma'am.
接公共卫♥生♥部♥
Give me IDPH.
我们有一位胸痛患者
Yeah, I need a home for a chest pain,
一位狗咬伤患者和流感患者 谢谢
a dog bite, and a flu. Thank you.
你们有空房♥间吗
You got any room?
谢谢 拜托了
Thank you. I owe you.
莉亚 告诉所有能自理的患者
Leah, tell any walk-ins who can fend themselves
我们准备转移患者到急诊救护医院
that we'll be arranging for transport to Rush and Mercy.
懂了吗
Okay?
病理科有回复了吗
Have you heard from pathology yet?
我再给他们打一个
Let me give them another call.
谢谢
Please.
忙音 我一分钟后再试试
It's busy. I'll check back in a minute.
好
Okay.
你似乎很担心
You look worried.
是吗 这样不好
I do? That's not good.
就是...
I just...
今年太多孩子死于癌症了
I lost so many kids to cancer this year
现在只要有患者出现类似症状
that every time one comes in now, with the same symptoms,
我就 控制不住内心的恐惧
I just--I can't help but feel the fear rising in me,
我只能努力稳定情绪
and it's all I can do to control it,
这样才不会吓到家属
so that I don't scare the family.
曼宁医生 活检结果出来了
Dr. Manning, I've got your biopsy results.
病理科叫我过去了
Pathology called me in.
为什么会叫一个流行病专家过去
Why is an epidemiologist getting called in on this?
球孢子虫病
Coccidioidomycosis?
又被称为溪谷热
Otherwise known as Valley Fever,
传染性非常高
and it's highly infectious.
谢天谢地
Thank God.
你知道这种病很严重吧
You realize this is a serious illness?
对 我知道
Yes. No, yes, absolutely.
但至少不是癌症
but at least it isn't cancer.
发热和肿胀的原因是这个吗
That's what's causing the fever and the swelling?
真菌感染
A fungal infection?
孢子一般存在于土地中
Spores are typically found in soil,
主要分布在干燥区域
predominantly in desert locales.
溪谷热是大湖区的地方性疾病
Valley Fever is an endemic of the Great Lakes region.
你们最近去过西南部地区吗
Have you spent anytime in the Southwest recently?
加利福尼亚州 内华达州 亚利桑那州
California? Nevada? Arizona?
没有 德斯蒙德从来没有去过那么远
No, Desmond's never been further away from home
-最多到大急流市 -我们都没去过
- than Grand Rapids. - None of us has.
好 我们先为你儿子
Okay, well, we'd like to start your son
静脉输一些抗真菌液
on a round of IV antifungals right away.
但是我要提醒你们
But I do have to warn you,
药效很强 可能伴随着潜在副作用
it's strong medicine with the potential of side effects.
-但确实是他需要的 -谢谢各位医生
- but it is what he needs. - Thank you, doctors.
我去帮德斯蒙德治疗
I'll get started on Desmond.
请稍等
I... I'm sorry..
你儿子是我所知的第二位此病患者
but you son is the second person I've seen with this disease.
我需要你们告知所有细节
I'm gonna need a detailed history from the both of you.
这有助于我找到感染源
It could help me find the source of the infection.
能不能晚点再说
I mean, can we do this later?
我们只想去陪着孩子
We just wanna be ?with our child right now.
我们有必要尽快查清根源
It's important ?that we find this
以免别的孩子被传染
before someone else's child gets infected.
如果方便的话 我可以一个一个地谈
I can sit with you one at a time if that's better.
你去吧 陪着德斯蒙德
You go. Be with Desmond.
谢谢你
Oh, thank you.
开始 我以为只是因为镇静剂的作用
At first, I thought it was just the sedation.
但她的眼睛 她没法聚焦
You know, but her eyes-- she's just not able to focus.
我让她盯着我的手指 大概这么远
I had her fix on my finger from about this distance.
她的眼睛会来回晃到这边随机的一个地方
They dart back and forth to a random space over here.
-跟机械似的 -方波
- Almost mechanical. - A square wave .
没错
Exactly.
每次我碰到头部撞击后眼睛有问题的情况
So any time I get a--an eye thing after a fall on the head,
我就想 可能是中风 但是
I'm thinking, you know, possible stroke, but--
你的检查结果并不是
Did your work-up come back negative?
对
Yeah.
知不知道还有什么别的可能性
Any idea what else this might be?
基底神经节紊乱 正常年龄老化都有可能
Could be anything from a basal ganglia disorder to normal aging.
没有头部CT或核磁共振无法确定
It's impossible to tell without a head CT or an MRI.
也许你可以自己检查她...
You know, maybe if you just examine her yourself--
我是不是需要跟你解释"无法"的定义
Do I need to explain the definition of impossible to you?
我是神经外科医生 不是魔术师
I'm a neurosurgeon, not a magician.
去找一个可以让扫描恢复运行的人
Just find someone who can get the scans back up and running,
然后也许我们就可以正常工作了
and then maybe we can all do our jobs.
有没有什么时候能恢复网络的消息
Any word on when we might be getting our network back?
抱歉
Sorry.
你觉得他们还需要我的平板吗
You think they still need my tablet?
恐怕还需要 查尔斯医生
I'm afraid so, Dr. Charles.
查尔斯医生 关于那些病史和身体♥检♥查
Dr. Charles, hey, about those H and Ps,
17房♥的考恩布鲁斯太太
Mrs. Kornbluth in Room 17--
她被诊断为处于幻觉阶段
she was admitted experiencing hallucinations.
-好的 然后呢 -门诊时
- Okay, okay? - At intake,
她被诊断为精神病发作
it was determined that she was having a psychotic episode,
但跟她聊过之后
but after speaking with her,
我觉得她只是对安♥眠♥药♥有不良反应
I think she simply might've had an adverse reaction to Ambien.
我只想说一切都证明了
You know, this has all proven to be
这样实在太不方便了
an incredible inconvenience, I just wanna say.
我不敢相信我们病人的精神病史
I cannot believe that our patients' psychiatric histories
没有保存在一个独♥立♥的安全网络上
aren't hosted on a separate secure network,
而且健康保险便利和责任法案还不强制执行
and that HIPPA hadn't mandated that.
正在努力 也许...
Moving forward, you know, maybe...
但同时
But in the mean time, uh,
也许重新检查对我们来说有好处
it might've been beneficial for us to retrace our steps.
我现在在做一些检查 但我觉得我们也许
I am running some tests now, but I think we might be able to
今天晚一点可以让考恩布鲁斯太太出院
discharge Mrs. Kornbluth later today.
信息技术员在这儿
There's the I.T. guy.
布鲁斯
Bruce...
根据经验
Old rule of thumb,
如果你能透视袋子 检查结果就是阴性
if you can read through the bag, the test is negative.
所以腹腔没有出血吗
So there's no bleeding in the abdomen?
-没有 -这是好消息啊 对吗
- No. - Well, that's good news, right?
所以你想让我凭直觉
So you want me to crack this guy's chest open
给这个人开胸搭桥吗
and put him on bypass on a hunch?
不是凭直觉 用除外诊断法
Not a hunch. The diagnosis of exclusion.
-如果你错了呢 -他没错
- And what if you're wrong? - He's not wrong.
腹腔灌洗排除了
I mean, the DPL ruled out
子弹经过腹腔的可能性
the bullet travelling through the peritoneum,
如果它穿过了腹膜后腔
and if it went through the retroperitoneum,
那他肯定会说他背痛
then he would have reported back pain,
所以肯定有栓塞
so it had to have embolized.
崔医生 他很在行
Dr. Choi-- he knows his stuff.
他在战场上就是这么做的
It's how he does it on the battlefield.
所以我们不能把这个病人转到
So we can't just transfer this guy
别的有CT可用的创伤治疗中心吗
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