芝加哥急救

Chicago Med S01E16

Part 6 Jan. 25, 2020, 11:24 a.m.

到处暗藏危机
Snakes in the grass.
旁路搭桥藏在疤痕组织中
Bypass grafts are buried in the scar tissue,
很难看到
tough to see.
轻一点
Soften your grip...
慢慢来
an--and go slow.
-我看到了 -好
- I see it. - Mm-hmm.
左前降支旁路搭桥近端假性动脉瘤
Proximal pseudo-aneurysm of the LAD bypass graft.
插管使用人工心肺机
Let's cannulate and get him on the pump
我们进行修复
so we can do the repair.
不我不需要人工心肺机
No, I don't need the pump.
只要缝合修复一下就好了
It just needs a single repair stitch.
我可以在跳动的心脏上完成
I can do it on the beating heart.
-8-0缝合线 -缝合线
- 8-0 suture. - Suture.
心电图显示局部缺血标准温度升高
EKG's ischemic. STs elevation.
假性动脉瘤破裂
Pseudo-aneurysm's ruptured.
他在出血给我8-0缝合线
He's bleeding. 8-0 suture to me.
-我这里角度更好 -罗德斯医生
- I've got the better angle. - Dr. Rhodes.
是我答应做这台手术的我不能失去他
I pushed for the surgery. I can't lose him.
我让你看得更清楚一点
I'll get you better exposure.
那里
There.
现在缝第二针
Going to put a second stitch in now.
不要碰到搭桥
Don't back-wall the graft.
出血停止了心电图改善
Bleeding has stopped and EKG's improving.
血压情况良好
Pressure's good.
搞定了
We're out of the woods.
还没有
Not yet.
我想检查一下其它搭桥
I want to check his other bypass grafts.
要是以后再出问题
Something goes wrong in the future,
不会有人给他进行第三次手术了
no surgeon's gonna open his chest a third time.
淋巴瘤
Lymphoma.
我得了癌症
I have cancer?
下面要做活检确定肿瘤类型
The next step is a biopsy to determine exactly which kind.
但我才26岁
But I'm only 26.
我每天都去健身
I go to the gym every day.
我不抽烟
I don't smoke.
我知道
I know.
这不公平
It's not fair.
但我没感觉到生病
But I don't feel sick.
那是因为我们发现得早
Well, that's because it was caught early.
现在我们有充分的时间进行治疗
You have time to get way ahead of this.
淋巴结在这里对吗
The lymph nodes are around here, aren't they?
一个月了邦莫一直想咬我
Boomer's been nipping at me for a month.
一直想咬这里
Always right there.
你觉得他知道吗
Do you think he knew?
可能
Maybe.
有些狗好像确实可以闻到癌症的出现
It seems some dogs can smell cancers,
即使是在很早的阶段
even in the very early stages.
对他不是想袭击你
Yeah, he wasn't attacking you.
他是想保护你
He was trying to protect you.
麦基 4号♥治疗室那边怎么回事
Maggie, what's going on with Treatment 4?
-我们都没地方... -我知道
- We don't have the space for this- - I know, I know.
都一整天了
It's been all day.
霍斯特德医生环境服务的人还没有来
Dr. Halstead, environmental services hasn't shown up yet.
我都不知道他们什么时候会来
I can't even get an estimate as to when they will.
我亲自去找他们
I'll go see them in person.
逼不得已我拉也拉一个人过来
I'll drag someone down here if I have to.
把他们叫来干活
Knock some heads.
我需要那间治疗室
I need that room back.
他怎么样
How's he doing?
还行
Well.
那就好
Good.
你怎么样
How are you doing?
作为神经科学家
As a neurologist,
路易体痴呆症是我最大的噩梦
Lewy Body Dementia was my worst nightmare.
我见过太过病例
I'd seen so many cases,
所以我想
and I'm wondering
这是否影响了我的诊断
if it influenced my diagnosis.
医学啊
Medicine, you know.
是不完美的科学
Imperfect science.
可人类仍然在运用这一科学
Practiced by human beings, no less.
整整四年我们本可以做CT的
Four years we could have been doing CTs,
但是我已经有了答案所以就想
but I had an answer, so there was no reason
没理由继续让他的大脑暴露在辐射中
to continue radiating his brain.
我劫持了内森的自我意志
I robbed Nathan of his mind.
我把他囚禁了
I imprisoned him.
我花光了我们的积蓄
I drained our savings.
浪费了我们在一起的时间
Squandered our time together,
浪费掉了我们再也回不去的时间
time that we can never get back.
我要怎么告诉他我做的事
How am I gonna tell him what I've done?
他永远不会原谅我
He's never gonna forgive me.
你丈夫会原谅你的劳拉
Your husband's gonna forgive you, Laura.
这你一定要相信我
I want you to trust me on that.
恕我直言
Your struggle,
你该担心的
if I may,
是想办法自己原谅自己
is figuring out how you're gonna forgive yourself.
生命体征稳定
Vitals are stable.
心电图情况良好
EKG looks good.
克利夫兰医学中心有句格言
Cleveland Clinic has an axiom.
对健康的心脏进行紧急手术
Emergency surgery on a healthy heart?
可以
Yes.
对修复过的心脏再进行修复
Redo surgery for a repaired heart?
可以
Yes.
对修复过的心脏进行紧急手术
Emergency surgery for a repaired heart?
不可以
No,
因为大部分情况下
because overwhelmingly,
病人会死在手术台上
those patients die on the table.
那我也无能为力
I couldn't do nothing.
我怀疑你是自尊心作祟而不是利他主义
I suspect it was ego more than altruism.
伟大的外科医生
Great surgeons
会权衡利弊
know the balance.
你很自信
You're confident,
而不是自大
not arrogant.
我喜欢这点罗德斯医生
I like that, Dr. Rhodes.
今天干得漂亮
Nice job today.
乖乖
You're good. You're good.
乖
Good boy.
乖
Good boy.
不要从上面
Don't come from above.
从前面让他看到你
Come from the front so he can see you,
先伸出手背来
and hold out the back of your hand first.
-好 -来伙计
- Okay. - Come on, buddy.
-是这样吗 -对
- Yeah? - Yeah.
真乖
Hey, there.
你听说过那个关于狗的那个故事吗
Did you ever hear that origin story about dogs?
伊甸园里开始动物和人和谐相处
In Eden, humans and animals got along,
连说的语言都一样
even spoke the same language,
但是亚当和夏娃犯下罪恶上天把他们逐出时
but when Adam and Eve sinned and God drove them out,
动物和人之间出现了一条很大的鸿沟
a great chasm opened up between people and animals.
鸿沟越来越大最后一刻
And as the chasm grew wider, at the very last moment,
一条狗跳过鸿沟来陪伴人类了
a dog leaped across it to be with us.
这是个好故事
That's a great story.
对
Yeah.
进来
Come in.
古德温女士我能跟你说几句话吗
Ms. Goodwin, can I talk to you for a moment?
快点现在是鉴定委员会事情处理最后冲刺阶段
Quickly, I'm on the homestretch with JCAHO,
我不想现在放松警惕
and I don't want to let up now.
我知道我说话的分量不大
I know my voice isn't official,
但我想为威尔说句好话
but I'd like to put in a good word
把目前还空着的急救室主治医生的位子给他
for Will regarding the open ED attending position.
是吗
Really?