芝加哥急救

Chicago Med S06E04

Part 3 March 16, 2021, 10:54 a.m.

What about the meds?
医院的阿司匹林卖♥♥30块一瓶
Hospital's pushing aspirin for 30 bucks a pop.
你们卖♥♥的心脏病药
Heart disease pill you're selling?
我可能要二次抵押贷款才能买♥♥得起
Bet I'd probably need a second mortgage to pay for that.
如果你合格的话
If you qualify,
制药公♥司♥会负担一切费用
the pharmaceutical company covers all costs.
这样我喜欢
I like that.
那你觉得怎么样我能帮你报名吗
So, uh, what do you say? Can I enroll you?
不抱歉太冒险了
No. Sorry, too risky.
什么你是怎么想的盖斯纳先生
What? How? Mr. Gessner.
你知道我的心脏不太好
You know, my ticker's not great,
但我现在吃的药很有效
but the pills I'm on are working.
再加上新冠一切都是未知数
COVID, though? That bug is a wildcard. I--
不不接种疫苗之前我绝不去医院
no, no, no hospitals till I've got the vaccine.
拜托别挂
Please don't hang up.
新冠病房♥是完全隔离的
The COVID ward is completely contained.
与你要来的急诊室没有任何接触
No contact with where you will be in the ED.
-嗯你当然这么说 -这是真的
- Yeah, says you. - Hey, it's the truth.
我整天都在这里感觉非常安全
I'm there all day. I've never felt safer.
好吧我想我今天下午可以过来
Okay, I guess I can come in this afternoon.
盖斯纳先生谢谢我们回头见
Mr. Gessner, thank you. I'll see you later.
干得不错
Nice job.
他差点就逃走了
He almost got away.
天太多人逃走了
God, too many of 'em have.
所以我的指标没有完成
That's why I'm behind on my quota.
艾普尔心衰患者有数百万
Millions suffer from heart failure, April.
我不知道要找到他们居然这么难
I had no idea how difficult it'd be finding them.
我不明白为什么会这样
I don't get it.
我们急诊室每天都有很多病例
We get cases in the ED every day,
更不用说心脏科了
not to mention Cardiology.
而且他们丢给了我一大堆文件
And they've thrown me a bunch of files.
不幸的是这个研究的排除标准
Unfortunately, the study's exclusionary criteria
淘汰掉了很多病人
weed out a lot of patients.
我今天上午晚点会去芝加哥国会酒店见一位
I am meeting a cardiologist at Chicago Congress
心脏病专家
later this morning,
希望他能给我几位病人
hoping he'll throw me a few patients, but--
而且我会继续向医院剩下的病人推荐
and I'll, uh, keep pitching the Med patients that are left.
我愿意帮忙
I'd like to help.
-是吗 -我在新冠病房♥时
- Yeah? - When I was in the COVID ward,
我觉得我参与了一件
I felt like I was a part of something
比我自己重要得多的事
so much bigger than myself.
我很想再次体验那种感觉
I'd like to feel that again.
我会腾出时间
I'll make time.
欢迎加入
Welcome aboard.
好
All right.
所以你就认真准备你的会面
So why don't you focus on your meeting?
我去联♥系♥医院其他的病人
And I will reach out to the rest of these Med patients.
-好吧 -好极了
- All right. - Great.
好吧
All right.
曼宁医生
Dr. Manning,
这些都是...
all this, it's...
肿瘤
Tumor.
她的腹部充满了癌细胞
Her abdomen is full of cancer.
癌症我不明白
Cancer? Um, I don't understand.
我才21岁
I'm--I'm only 21.
我应该一觉得不对就来医院的
I should've come in the moment that I felt something was off,
但我住在家里
but I live at home.
我父母都是新冠的高危人群
Both my parents are high risk for COVID.
我只是不想把病毒带回家
I just didn't want to bring it into the house.
我们理解
We understand.
你以为自己这样做是对的
You thought you were doing what was right.
我要死了吗
Am I gonna die?
没有的事
No. Hey.
我们会找肿瘤科确认一下
Look, we'll confer with Oncology,
但我认为这一块以及这一块
but I believe that this section and then this section too
都是能被切除的
are amenable to resection.
切除
Resection?
-这意味着要动手术是吗 -没错
- Um, that means surgery, right? - That's right.
我现在切除的部分越多
The more tumor I remove now,
你接下来的抗癌效果就越好
the better your position for cancer treatment later.
好的
Okay.
我知道你很害怕但你能战胜病魔的
I know you're scared, but you can win this fight.
这可真是让人印象深刻
Wow, that's impressive.
你不仅仅是洞察入微
I mean, not just the attention to detail,
能做到这点你的专注力也一定很好
but I mean, the focus that must be required to achieve that.
跟我来奉承这套认真的吗
Flattery. Really?
你可是精神科的主管
You're the head of Psychiatry.
我以为你会用更高明些的法子
I'd figured you'd use something a little more clever
来刺探我的想法呢
to get inside my head.
拜托
Oh, come on.
我们只是聊聊天而已
We're just, uh, we're just having a little chat.
好吧聊就聊吧
Okay, fine. I'll buy it.
但别再拍我马屁了
But scrap the pats on the back.
不用你说我也知道我很优秀
I know I'm good, you don't need to tell me.
你介意我坐下吗
You mind if I sit?
这风险很大
This is invasive.
肿瘤供血充足
Tumor already has a blood supply,
而且已经侵犯了临近组织
has invaded the surrounding tissues.
是的但在肝左叶附近的
Yes, but there's two clear areas of focus
是有两块明显间区的
around the left lobe of the liver
肾下极这也有
and the same with the inferior poles of the kidneys here.
我不这样认为
I don't think so.
经验之谈 CT上的内容多数是有误差的
My experience, CTs are rarely as accurate as they appear.
在片子上看这个肿瘤已经很糟了
Tumor already looks like a nightmare.
腹腔内的真实状况只会更糟
What's actually going on inside is a disaster.
恕我直言吉伦医生
Okay, look, all due respect, Dr. Gillen,
我主张手术不是为了给我简历加分
I'm not pushing to operate to boost my resume.
我是为了救伊莎贝拉的命
I want to save Isabella's life.
我也是
So do I.
但这个CT显示的状况非常糟
This CT, though, worst-case territory.
活检和进行合适的化疗
A biopsy and appropriate chemo regimen
才是安全的切入点
are the safest first step.
-将来也许会有手术的可能 -也许
- Perhaps surgery down the line. - Perhaps?
她病得很重曼宁医生
She's very sick, Dr. Manning.
如果我们早点开始治疗
If we'd been able to treat her earlier--
但我们没有
Well, we weren't.
我知道
I understand.
但在此期间她的癌症进展得太快了
And in that time, her cancer progressed too far.
所以这就完了
So that's it?
吉伦医生有她的诊断结论我有我的
Dr. Gillen has her opinion, I have mine.
进展如何
So how'd it go?
整形科医生劳里是自己整了自己吗
Did Dr. Lowry, plastic surgeon, shrink himself?
这不是他最主要的问题
Not really his priority.
那就让他住个五天吧如何
Putting him on a five-day, then?
住精神科病房♥吗为什么
A psych hold? Why?
查尔斯医生他给自己动刀了
Dr. Charles, he cut himself open.
是的因为他有身体畸形恐惧症
Yeah, because of body dysmorphia.
讽刺的是这恰恰是源自于对
Which is driven, ironically, by a desire
完美躯体的渴望而不是对自残的渴望
to perfect his body, not to hurt himself.
也许他并不是有意的
Maybe not intentionally,
但他的完美主义倾向影响了他的神志
but that perfectionism clearly clouds his judgment.
我们需要介入干预
We need to step in.
但其实
Well, the thing is,
身体畸形恐惧症不是治治就能好的
BDD isn't something that we can just fix.
托德需要对自己的身体
You know, Todd's gotta develop
建立全新的认知
an entirely new perspective on his body.
这需要时间
That's gonna take time, you know?
而你也知道像托德那样的人
You know a guy like Todd
是不会自愿去做心理咨♥询♥的
isn't gonna go to therapy voluntarily.
我们得现在就介入干预不然情况会更糟
We intervene now or this just gets worse.
我收到你的意见了