芝加哥急救

Chicago Med S06E07

Part 5 March 16, 2021, 10:56 a.m.

让我们及时发现了肿瘤
because it allowed us to find the tumor
没有使其继续增大
before it grew larger.
那现在怎么做
So what happens now?
我们带罗恩去做手术我来切除瘤块
We take Ron into surgery, and I remove the mass.
希望淋巴结没有受到太大的影响
Hopefully, the lymph nodes are minimally involved.
对
Yeah.
同时我们要确定肿瘤治疗方案
In the meantime, we'll loop in Oncology.
手术后你可能要开始
You know, after surgery, you may need to start
做一个疗程的化疗可能还要放疗
a course of chemo, maybe radiation.
谁能想到肺炎还能是好事呢
Who knew pneumonia could be a good thing?
真的有必要这样吗
All this really necessary?
别担心一眨眼的时间
Oh, don't you worry, we'll have you
你就能重新站起来
back on your feet in a jiffy.
查尔斯医生看看你的平板
Dr. C, check your iPad.
理查德·科恩的毒检刚刚出来
Richard Cohen's tox screen just came in,
-还有他女儿来了 -谢谢你汉克
- and his daughter's here. - Thanks, Hank.
据你所知
So as far as you know,
你♥爸♥没有精神病史
your dad has no history of mental illness?
-没有从来没有 -好
- No. Never. - Right.
他的检查显示他的精神状态
His test did not indicate a physical cause
不是身体原因所以更有可能是
for his mental state, which makes it much more likely
药物引发的
that it was chemically induced.
也就指向了这些东西
Um, which brings us to these.
不是吧
Oh, no.
就算做了毒检
Yeah, even with a tox screen,
我们也无法辨别大部分药片的成分
we weren't able to identify most of them,
我希望你也许
and I was hoping that you might be able
-能帮我们弄清楚 -我知道一些
- to help us out with that. - Some of them.
是我爸自己的混合药物
It's my dad's own cocktail.
婆罗米菲尼布特左旋肉碱
Uh, Brahmi, Phenibut, L-Carnitine,
吡拉西坦银杏
piracetam, ginkgo.
他总会加些东西所以我不知道还有什么
He's always adding more, so I don't know what else.
这样啊所以都是些
Uh-huh. So those are supplements
人们认为能益智的物质
that supposedly have a nootropic effect.
能提高认知能力
They increase cognitive function.
你觉得你♥爸♥是不是担心
Do you think your-- your pop might be worried
他自己智力在下降
that he's losing his faculties?
不会我父亲是个非常聪明的人
No. My father's a brilliant man.
他22岁就拿到了博士学位
He got his PhD when he was 22.
但是他总想提升自己的心智
But he's always looked to improve his mental capacity.
他说这些很安全
He said these were safe.
但是理论上来说和他的其它所有药物
Theoretically, but you know, when taken together
混在一起服用
with all of his other medications,
有可能会导致
it is possible they could have caused,
精神错乱
you know, a psychotic break.
-什么精神病 -我知道这个词很可怕
- What? Psychotic? - I know it's a scary word,
但其实它只是幻觉的另一种
but it's really just another medical term
医学上的叫法我给他服用了点东西
for delusion, you know, and I've given him
让他镇静下来
something to calm him down,
等他的身体把这些东西排掉
and when these leave his system,
应该会有所改善
we really should see a change.
他大部分的幻觉
You know, most of his delusions
都是关于一个叫梅森的人
have been focused on somebody named Mason.
你知道是谁
Do you know who that is
或者为什么他害怕他吗
or why he might be afraid of him?
毫无理由啊
There's no reason at all.
梅森博士是他以前的同事
Dr. Mason was a colleague.
他是我爸的上一任系主任
He was chair of the department before my dad.
但他一年前得了动脉瘤
But he had an aneurism a year ago.
梅森博士已经死了
Dr. Mason is dead.
请及时向我报告崔医生的情况
Please keep me posted on Dr. Choi's condition,
在住院部给他安排好了病房♥
and let me know when they get him a room
就告诉我
on the medical floor.
艾布拉姆斯医生如果我越界了非常抱歉
Dr. Abrams, I'm really sorry if I overstepped.
越界真会轻描淡写
Overstepped. That's a generous assessment.
艾布拉姆斯医生怎么了
Dr. Abrams. Something wrong?
已经解决了
I've handled it.
请告诉我
Please. Tell me.
他指导我怎么用支架
He's coaching me on a stent--
这本身就是一种侮辱
which is insulting in and of itself--
但是接着他竟敢给我推销
but then he has the temerity to try to upsell me
新的脊柱内镜
on a new spinalscope.
他在手术过程中给你推销
He tried to upsell you during an operation?
我知道他是你儿子
Look, I-- I know he's your son,
但我没办法接受他再来我的手术室
but I can't say that I would welcome him back to my O.R.
我刚刚拿到约翰逊太太的血检结果
I just got Mrs. Johnson's blood work back.
她确实在吃药
She's on the medication.
你打算怎么办
What are you gonna do?
我只能叫维诺尼正式公开她
I'm gonna have to let Virani officially unblind her.
他们可能会关闭这个试验
They'll probably stop the trial.
很遗憾
I'm sorry.
嗯
Yeah.
约翰逊太太有情况
It's Mrs. Johnson.
6号♥诊室呼叫
-她怎么了 -她出现了抽搐
- What's wrong with her? - She's having a seizure.
5毫克安定
5 of Ativan.
为什么会这样
Why's this happening?
很有可能是钠离子过低
Likely from low sodium.
导致大脑发生肿胀
It causes swelling of the brain.
你不能做点什么吗
Can't you do something for her?
相信我我们都在尽最大努力
Believe me, we're trying.
我们什么都试过了利尿剂生理盐水
Everything we've done-- diuretics, hypertonic saline--
她的钠离子水平不应该还这么低啊
her sodium shouldn't still be this low.
临床试验中只有她有这种症状
Nobody else is having symptoms like this in the trial.
我到底漏掉了什么
What am I missing?
只有一种可能了
There is one possibility.
我想要送你的妻子去做一次脑CT
With your permission, I'd like to send your wife
需要你的允许
for a CT scan of her head.
不如和维诺尼医生说一下情况
What about talking to Dr. Virani?
-咱们先做这个 -你确定吗
- Let's do this first. - You sure?
我确定约翰逊先生你是否允许
Yes. Mr. Johnson, do I have your permission?
约翰逊先生
Mr. Johnson.
如果你觉得有用的话那就做吧
If you think it'll help, yes.
告诉放射科我们马上到
Let Radiology know we're coming up.
怎么样
Well?
这是约翰逊夫人的扫描结果
This is Mrs. Johnson's scan.
好的
Okay.
这里有个下丘脑病变
And this is a hypothalamic lesion.
-这是个肿瘤 -虽然很小
- A tumor. - I mean, it's small,
但是它压♥迫♥了脑垂体
but it's pressing on the pituitary.
这就是她钠离子水平过低的原因
Which explains her low sodium.
也引发了她的癫痫
That's what caused her seizure.
并不是临床试验的药物引起的
And not the trial medication.
如果她有使用药物的话
If--if she's on it.
这对咱们来说真是大好消息
This is great news for us.
那约翰逊夫人怎么办
But what about Mrs. Johnson?
一旦我们解决了病变的问题
Once we correct the lesion,
她的脑垂体机能应该就能恢复正常了
pituitary function should go back to normal.
所以我们不用对她进行公开
So we won't need to unblind her.
不用我觉得没必要
No. I don't think it's necessary.
真是松了一口气
I mean, that is such a relief.
恭喜
Congratulations.
这次还真是有惊无险
This was an incredible catch.
好的已经止住血了
All right. Got the bleeding under control.
病理科说切除肿块的边缘干净
Path says the margins are clean on the resected mass.
那个4级肿块如何了
Where are we with the level 4 nodes?
我想要进行缝合
I'd like to wrap this up.
稍等我刚收到了消息
Hold on. I just received something.
他们看到了癌细胞是未分化的细胞
They're seeing cancerous, undifferentiated cells.
看起来像腺棘癌
Adenosquamous in appearance.
该死的