芝加哥急救

Chicago Med S01E15

Part 6 Jan. 25, 2020, 11:23 a.m.

Okay.
通知产房♥ 我们马上过去
Call OB, tell them we're on our way.
霍斯特德你为什么抛弃我们
Halstead! Why'd you dump us?
抛弃你们是你抛弃了我
Dump you? You dumped me,
你说你要换医生的
said you wanted another doctor.
所以呢
So?
所以就给你们换了
So.
我是医生吗谁管我怎么想
Do I look like a doctor? Who cares what I think?
你是我认识的最聪明的人
You're the smartest guy I know.
我不知道你到底想怎么样
Listen, I don't know what it is you want,
但佩灵顿医生会照顾好安迪的
but Andy's in good hands with Dr. Perrington.
她知道自己在做什么
She knows what she's doing.
高中时那个坦率正直的孩子怎么了
What happened to that stand-up kid from high school?
什么
What?
我们当时很尊重你
We respected you.
那你们尊重的方式还真有意思
Funny way of showing it.
不管我们把你打倒多少次
Hey, no matter how many times we knocked you on your ass,
你都会站起来黄毛小子永远不会退缩
you always got back up. Ginger never stayed down.
我不关心其它医生
I don't care about this other doctor.
我只关心我弟弟你了解他
I care about my brother. You know him.
天啊你都还记得那次跟吉米·道尔打架
God sakes, you even remembered the fight with Jimmy Doyle.
你说他可能出现大脑出血
You said he could get a-a brain bleed?
那会害死他对吗
And that could kill him, right?
是的
That's right.
那你不该阻止这种事发生吗
Then shouldn't you stop this?
氧气水平没问题增加丙泊酚剂量
Oxygen looks good. Let's turn up the propofol.
使用抗栓塞药物
Let's administer the TPA.
等一下
Wait!
怎么了
What's going on?
我想确保对塔克先生
I want to make sure we're giving Mr. Tucker
进行合理治疗
the proper treatment.
他不是你的病人了霍斯特德医生
He's no longer your patient, Dr. Halstead.
他认为你这样会导致他脑出血
He thinks what you're doing could make his brain bleed.
抱歉你弟弟的CT显示没问题
Excuse me. Your brother's CT was clean
只有以前的水囊瘤也就是说脑出血的风险很小
except for old hygromas. That means the risk is very low.
我是跟这个病人一起长大的
I grew up with this patient
多年来他的头部受到过多次撞击
and seen him take a lot of hits to the head over the years.
水囊瘤是以前硬膜下血肿导致的
Those hygromas are indicative of old subdurals.
所以他的风险比CT结果显示的要高很多
He's at a much higher risk than his CT shows.
我们需要植入下腔静脉滤器防止以后出现血栓
We need to implant an IVC filter to prevent future clots,
但鉴于现在就有血栓了
but as far as the current clot's concerned,
我建议先等一下让他先度过危险期
I think we should hold off and let him ride it out.
霍斯特德医生是住院医生正在接受训练的医生
Dr. Halstead is a resident-a doctor in training.
我是主治医生
I am an attending physician
而且是委员会认证危重病人治疗专家
and a Board Certified Critical Care Specialist.
我跟你说你弟弟完全可以
I'm telling you, your brother is perfectly able
承受这种治疗
to handle this treatment.
不是的
He's not.
我们听霍斯特德医生的
We're going with Dr. Halstead,
听他的意见
what he says.
好
All right.
你感觉如何埃莉
How're you feeling, Ellie?
你给我用了药
You gave me drugs.
很抱歉我们当时别无选择
I'm sorry, I didn't feel like we had a choice.
这是怎么回事
And what're these?
你刚才幻觉发作了
You had what we call a delusional episode.
我疯了吗
So I'm going crazy?
不是其实我们认为
No, we actually think that it might be
这一情况与你的胃痛相关
related to your stomach pain.
因为要穿舞会礼服
Did you change your diet at all
你改变饮食了吗
in anticipation of wearing your prom dress?
改变了一点我...
Yeah, a little. I--
午餐我开始吃沙拉了
I just started eating salads at lunch.
你记得一年前你发作时
Can you remember, your last attack--a year ago--
是不是也改变饮食了吗
had you also changed your diet then?
应该是我...
I guess, I--
我当时要去佛罗里达参加排球锦标赛
I was going to a volleyball tournament in Florida,
我想穿泳衣
and I wanted to, you know, wear a bathing suit.
怎么了
Why?
我们认为你患有AIP
We believe you may have a disease called AIP,
急性间歇性卟啉病
Acute Intermittent Porphyria.
这是一种遗传病会引起严重胃痛
It's a genetic condition that causes severe stomach pain
并伴有精神病发作
along with episodes of psychosis.
碳水化合物有助于控制这一病症
Carbohydrates actually help control it,
所以我们认为你这次发病
and we think that your latest flare-up
可能是因为你最近饮食的改变
was probably helped along by your recent change in diet.
是饮食改变让我这样的吗
That's what's making me feel like this?
我们认为是的
We think so.
长远来看 AIP是可以治疗的
Long term, AIP can be treated and managed.
短期来看阿片药物有助于缓解你的疼痛
In the short term, an opiate will help to ease your pain.
阿片药物
An opiate?
你不用担心
You don't have to worry.
我们会小心控制你的用量
We will carefully manage your dosage.
只要我不变的跟我爸爸一样就行
As long as I don't turn out like my dad.
埃莉你父亲帮我们做出了这一诊断
Ellie, your father helped lead us to this diagnosis.
而且这是一种遗传病
Again, it's a genetic condition.
他可能也有这种病所以很可能
He probably has it and has very likely
他这么多年来一直在自我用药
been self-medicating all these years.
你是说因此他才成为瘾君子吗
You mean that that's why he's an addict?
其实更像是一种影响吧
Well, more like a contributing factor.
他可能跟你一样大的时候
He probably experienced the same pain that you did
也出现了类似疼痛
when he was your age,
因为没有合适的帮助或诊断
and without proper help or diagnosis,
所以他自己想办法治疗了
came up with his own way to treat it.
婴儿情况危险
Baby's in distress.
胎心过缓婴儿得不到氧气了
We've got fetal bradycardia. It's not getting oxygen.
快好了
Almost there.
婴儿窒息抽吸
Baby's apneaic. Suction.
加油加油
Come on, come on.
她看起来情况很好
She looks good.
虽然早产但很健康送去新生儿重症监护病房♥
Premature but healthy. Let's get her to the NICU.
等一下
Wait.
是个女孩
It's a girl.
你不想看看你的孩子吗
Don't you want to see your baby?
我...我做不到
I ca--I can't.
-德赛女士 -不
- Ms. Desai- - No.
拿走
Take it away.
他情况稳定了没有我们想的那么糟糕
He's stabilized. Not as bad as we thought.
可能我们不用给他用粉碎血凝块溶解剂了
Maybe we don't need to push the clot busters.
你说得对
You were right.
他没事就好
Just glad he's okay.
我先走了
Excuse me.
霍斯特德医生
Doctor Halstead.
好奇问一下你的住院期结束后
Just curious, you planning on applying for a job here
打算在这里申请工作吗
when your residency is complete?
第一选择
First choice.
我是人事委员会的如果我是你
I'm on the hiring committee, and if I were you,
我会去找其它医院的
I'd be looking for other hospitals.
里面什么情况
What's going on in there?
他们好像在庆祝
They look like they're celebrating.
是我们给埃莉进行了餐后血糖监测
Yeah. We ran a PBG test on Ellie
确认了我们的诊断
and confirmed the diagnosis.
我们也给她父亲做了
We also did one on her father,
结果显示他也有这个病
and it turns out he has it too,
但他一直不知道
but he never knew it.
她一直以来都以为他是个不关心她的
All her life she just thought he was an addict
瘾君子
who didn't care.
现在她知道了那只是他应对疾病的方法
Now she sees it was just his way of coping.
有问题吗
Any issues?
她出生时体重不到四磅
She was born shy of four pounds
而且肺部发育不健全