芝加哥急救

Chicago Med S01E10

Part 5 Jan. 25, 2020, 11:22 a.m.

你为什么给我的病人开维他命K
Why did you administer vitamin K to my patient
还问都不问我一下
without consulting me?
他的凝血速度很慢
His clotting was slow.
这是符合规范的
It's standard protocol,
而且我觉得你说的是我们的病人吧
and I think you mean our patient.
你的规范可能已经造成了肺栓塞
Your protocol may have caused a pulmonary embolism.
你没依据可别说这话
You have no grounds to say that.
任何事情都可能会发生
Any number of things could've happened.
他已经和自己的血管病变抗争了好几年了
He has been battling his vasculopathy for years.
你现在是说他随时都在等死咯
Oh, so now he was a ticking time bomb?
我不是这个意思
That's not what I said,
你要是有认真听我说话就知道了
and if you had listened, you'd know that.
我听得一清二楚
I heard you loud and clear.
你觉得自己没做错那蒂姆呢
You thought nothing was wrong, and where is Tim now?
我离开的时候他还好好地
He was stable when I left him.
你最好想好了再说话
You better think about what you're saying right now.
小娜维他命K使他失去了一个凝块
Nat, that vitamin K made him throw a clot.
你不知道
You don't know that.
要不是你乱插手他还好好地
If you hadn't interfered, he'd still be here.
不这不关我的事
No, this is not about me.
这都是因为你和你在詹妮弗·贝克
This is about you and the mess that you made
拒绝心肺复苏时硬给她做心肺复苏惹出的乱子
when you resuscitated Jennifer Baker against her DNR.
就算你把这事怪在我头上也不能弥补你做的错事
Well, blaming me for this is not gonna make that right.
我呼叫了你两次
Hey, I paged you twice.
你不是应该在做手术吗
Shouldn't you be operating?
患者心脏病发作心脏病医师正给他做脉瓣置换
No, the patient arrested. Cardiologist is doing a TAVR,
我就得了空想我们可以一起吃点什么
and I had a minute and figured we might grab a bite to eat.
坐
Sit.
可能我错过了什么
I--you know, maybe I'm missing something.
我刚给唐尼提出了
I-I just--I pitched Downey
至少四个解决方案对吧
at least four solutions, right?
他没一个满意
Not one bullet hit its mark.
有时候我觉得我就是那个人
You know, half the time, I feel like I'm the chosen one.
其他时候我觉得自己让他失望了
The other half, I feel like I'm failing him.
我就是不懂他在想什么
I just can't get a read on the guy.
你介意我们聊点别的什么吗
Mind if we talk about something else?
是不是有什么我们应该谈一谈
Is there something we should be talking about,
因为我有种感觉
'cause I get the feeling--
见鬼我得走了
Damn, uh...I gotta go.
听着一会儿我们接着聊好吗
Look, we'll pick this up later, okay?
好啊
Yeah.
通常颅内感染是由于
Often, brain infections are caused
鼻窦和耳内的炎症所引起的
by inflammation in the sinuses and in the ears.
你的耳朵没问题
Your ears look okay.
你一直知道自己想做一个医生吗
Always know you wanted to be a doctor?
是的
Yes.
也不是
And no.
小时候我对解剖学很感兴趣
As a kid, I was intrigued by anatomy,
解剖青蛙在显微镜下面
dissecting frogs and looking at their organs
看它们的器官
under the microscope.
但我现在在急诊室里面
But here I am in the E.D.
我从没想过我会和人打交道
I never thought I'd be dealing with people
尤其是在他们最艰辛的时候
in their most difficult times.
你呢
And you?
冰球
Hockey...
冰球它...
Hockey is... Well, it's so...
-暴♥力♥了吗 -是的
- Vicious? - Well, yeah.
是啊
Yeah.
我不理解
I don't understand
怎么有人会不顾自己失去一嘴牙的危险去比赛
how someone could risk all of their teeth for a game.
我爸爸是职业选手
My dad played pro,
我还没会走路就已经会滑冰了
and I was skating before I could walk.
即使我想换个工作
Even if I wanted a different career,
我也觉得不合适
nothing else would feel right on me.
我猜是没法逃避自己内心吧
Guess you can't escape who you are.
你鼻子里有点干血
You've got a little dried blood in your nose,
但有可能是因为摔倒引起的
but it's probably just because of the fall.
不我今早流鼻血流的
Oh, no, I had a nosebleed this morning.
经常如此
I get 'em all the time.
经常吗
All the time?
是没什么大不了的
Yeah, it's no big deal.
可以张嘴让我看一下吗
Can I take a look in your mouth, please?
好的
Okay.
我马上回来
I'll be right back.
-古德温女士 -什么事
- Ms. Goodwin? - Yeah?
我的值班表我不想和霍斯德特医生
My schedule--I would like to be on different shifts
-一起轮班 -是吗
- than Dr. Halstead. - Oh?
我觉得这对病人是最好的
I think it's in the best interest of our patients.
不是私人恩怨
It's nothing personal.
听起来却是私人恩怨你们俩闹别扭了
It sounds personal. You two at odds?
这么说都算客气了
That's putting it mildly.
就算我想我也不能
Listen, I couldn't honor your request
同意你的请求
even if I wanted to.
医院在被审查
With the hospital under scrutiny,
霍斯特德医生的任何变动
any changes with Dr. Halstead
都有可能被认为是有罪
could be interpreted as culpability.
尘埃落定前就这样了
It's status quo until the dust clears.
当我面对一条恶犬
You know, when I'm faced with a snarling dog,
我试着提醒自己
I try to remind myself
是出于自卫
it's self-preservation
让他露出獠牙
that's making him show his teeth.
鼻窦和耳朵没有感染
Sinuses and ears were clear of infection,
但布莱特经常流鼻血
but Bret gets frequent nosebleeds,
从小就这样
has since he was a kid,
口腔有血管扩张现象
and he's got dilated vessels on the inside of his mouth.
你觉得是遗传性出血性毛细血管扩张症
You're thinking HHT?
很少见但符合症状
It's rare, but it fits the symptoms.
好的去做个胸腹部断层扫描
Okay, let's get a CT chest and belly
-看看结果如何 -好的
- and see what comes back. - Okay.
里斯干得不错
Reese, good call.
没有异物
No sign of foreign bodies.
外部检查无异常
No abnormalities in my external exam.
你怎么看
What's your theory?
肺栓塞
Pulmonary embolism.
他心力衰竭被送到急救室
He came into the E.D. with mild CHF
几个小时后死亡
and was dead in a couple hours.
我要从胸部开始
I'm gonna start with the chest then.
肺栓塞不会有这么多血
A pulmonary embolism wouldn't manifest this much blood.
帮我吸血
Give me some suction.
绝对不是肺栓塞把手给我
Definitely not a PE. Give me your hand.
摸到了吗
You feel that?
摸到洞了吗
You feel the hole?
主动脉动脉瘤破裂他不可能活下来
Ruptured aortic aneurysm. He didn't stand a chance.
所以我错了
So I was wrong.
你或是其他人都无计可施
Nothing you or anyone else could've done.
是
Yeah.
上去拦截他
Just go at him right there...
布莱特
Hey, Bret.
库伯先生库伯太太布莱特
Mr. And Mrs. Cooper, Bret,
我们拿到胸部断层扫描报告了
we got our chest CT back.
何不坐下说
Why don't we have a seat?
好的
Okay.
好
Okay.
布莱特得了一种
Bret has a condition
叫遗传性出血性毛细血管扩张症的病也叫HHT
called hereditary hemorrhagic telangiectasia or HHT.
HHT 那是什么
HHT? What's that?
没事的儿子
Hey, hey, it's okay, son.
它会导致身体各处的血管
It causes the blood vessels in different parts of the body
纠缠成脆弱的束叫做动静脉畸形
to form fragile bundles called arterial venous malformations.
这些畸形有时会让细菌渗入到血液
These AVMs can sometimes allow bacteria to seep into the blood