芝加哥急救

Chicago Med S06E09

Part 3 April 13, 2021, 9:23 a.m.

看看好吗
and take a look, okay?
好了
All right.
我们看看
Now let's look.
好
Okay.
你的胎盘盖住了子♥宫♥颈
Well, your placenta is covering your cervix.
蒂昂这可能是你出血的原因
Tionne, it's probably what caused the bleeding.
-宝宝没事吧 -看起来是的
- Is the baby okay? - It appears so, yes.
但我现在要看看里面
But I'm gonna take a look inside now
看看出什么事了好吗
and see what's going on, okay?
好
Okay.
谢谢
Thank you.
蒂昂你出血又严重了
Tionne, you're bleeding heavily again.
我们得送你去手术室
We need to get you to the operating room.
-手术室 -对
- The operating room? - Yes.
你得做手术才能把宝宝生下来
You need surgery to deliver your baby.
要把我的肚子切开吗
And cut me open?
这对你的宝宝是最好的好吗
It's what's best for your baby, okay?
蒂昂我们可以打电♥话♥给谁吗
Tionne, is there anyone that we can call?
现在应该陪着你的人
Someone that should be here with you right now?
我妈妈在南部照顾我外婆
Um, my mom's taking care of my grandma Downstate.
她要明天才能赶到这里
She can't get here till tomorrow.
麦基能陪我吗
Can Maggie come with?
这样我没醒的时候就有人陪着宝宝
So someone's there for the baby while I'm asleep?
你会没事的蒂昂
You're gonna be fine, Tionne.
好
Okay.
这张片子可以看出有双边浸润
This picture's showing some bilateral infiltrates.
我搞不懂了他到底有没有肺炎
I'm confused. Does he have pneumonia or not?
当然现在还没完全发展成肺炎没有
Certainly not full-blown pneumonia at this point, no.
你看到他的手指和脚趾尖了吗
Did you see the tips of his fingers and toes?
看到淤青程度了吗
How blue they're getting?
扫描显示
The scan's showing
他身体里有多处炎症
he has a lot of inflammation in his body.
可能会影响到他的血液循环
It could be affecting his circulation.
如果我挺不过去
If I don't make it through this,
把我的十字架给孩子
give my cross to the baby.
赫克托别这么说
Hector, don't talk like that.
我们提高他的给氧量给他戴上氧气面罩
Let's up his oxygen, get a mask on him.
赫克托
Hey, Hector.
要我说你应该是有感染
If I had to guess, you've got some kind of infection,
所以我们会先
so we're gonna start you
给你开些广谱抗生素
on some broad-spectrum antibiotics,
看看效果如何
see what effect they have.
与此同时我们会仔细检查一下你的血液
And in the meantime, we'll take a closer look at your blood,
搞清楚到底怎么回事好吗
try to get our arms around what's going on, okay?
没事的
It's okay.
有些事不对劲崔医生
Something's not adding up, Dr. Choi.
从他的症状看肯定是肺炎
His symptoms say pneumonia for sure,
但他没有持续地咳嗽
but he's not producing a steady cough
而且他的白细胞计数完全正常
and his white count's totally normal.
还有那个肿得厉害的耳朵
And then there's that crazy ear thing?
很抱歉我多管闲事了但我喜欢疑难杂症
I'm sorry to be a buttinsky, but I love a tricky diagnosis.
-可以让我看看吗 -当然
- You mind if I take a look? - Sure.
你觉得可能是跟艾滋病毒相关的综合征吗
You think maybe it's an HIV-related syndrome?
我们做个化验才能明确排除
Let's test to definitively rule it out.
还要扫描他的腿部
Also scan his legs.
看看有没有深静脉血栓的迹象
See if there's any signs of DVT.
如果是肺栓塞你们刚才扫描时
Well, you'd have seen them on the scan
就应该看到了
if it was a pulmonary embolism, now.
我觉得这位年轻的德斯克医生说到点子上了
Now, I think young Driskell here is on to something.
他的耳软骨发炎了对吗
His inflammation of the ear cartilage, yeah?
崔医生认为最可能是皮疹
Well, Dr. Choi thinks it's most likely a rash
或者感染的症状
or a reaction to the infection.
也可能是整个病情的关键
Well, or it could be the key to this whole thing.
有人说如果你听到蹄声就会想到马
You know, they say if you hear hoofbeats, think horses.
但如果我是你德斯克医生
But if I were you, Dr. Driskell,
我就会注意是不是斑马
I'd be on the lookout for zebras.
可能是结节病或者外周血管炎
Maybe sarcoidosis or peripheral vasculitis?
我会先观察观察迪恩
I'm gonna hold off on that, Dean.
看看抗生素起不起效
Give the antibiotics a chance to take effect.
如无必要勿增实体
Occam's razor and all.
在我们去寻找斑马前
I wanna check off all the boxes
我要查清所有可能性
before we go hunting for zebras.
这当然也是一种可行的方案
That's certainly a viable strategy as well.
阿彻医生
Dr. Archer?
CT室刚送来了你要的4号♥治疗室的扫描件
CT just sent over the scans you requested for Treatment 4.
谢谢谢谢
Ah, thank you, thank you.
如果我越界了很抱歉
And I apologize if I overstepped.
好请稍等
Okay. Could you hold on, please?
查尔斯医生等等
Dr. Charles, wait.
我正和东慈爱医院通话
I am on the line with East Mercy.
出问题了
There's a problem.
我不会给她治疗的
I'm not treating her.
拉蒙娜·戴维斯一直以来都是个麻烦
Ramona Davis has been trouble for a long time.
-经常去吗 -是的
- Frequent flier? - Yes.
过去一年每两三周就来一次
Every two, three weeks for the past year.
她过来坚持只让我给她治疗
She shows up, insists that only I treat her.
她一直缠着我
She's obsessed with me.
上周她来了
Last week, she came in.
她说她的手失去了知觉
She claimed she lost feeling in her hands,
但很明显她是装的
but it was clear she was making it up.
这是第一次
And was this the first time
她在编造症状吗
it seemed like she was faking symptoms?
这是我第一次拆穿她
First time I called her on it.
她发飙了指控我治疗失当
She flipped out, accused me of malpractice,
威胁要控告我控告医院
threatened to sue me, the hospital.
情况非常紧张
It got pretty intense.
这可能解释了
You know, that might explain
为什么她来的时候脚上扎了钉子
why she showed up with a nail in her foot.
如果她今天真的跟你编了这些事
I mean, if she had actually made it over to you today,
你没办法说那也是她装的
there's no way you could say she was making that up.
-打扰一下布里奇斯医生 -我要走了
- Excuse me, Dr. Bridges. - Look, I've gotta run.
我希望拉蒙娜能得到她所需要的帮助
I hope Ramona gets the help she needs,
但我没办法帮她
but I can't be the one to give it to her.
完全理解
Completely get it.
谢谢你打来医生
Thank you for your time, Doctor.
我去取消救护车
I'll cancel the ambo.
如果你是对的她用钉子伤了自己
So if you're right and she injured herself with the nail,
你可以把她收进精神科
then you can put her on a psych hold.
但即使强制控制她也可以拒绝手术
But even on a hold, she could still refuse surgery.
是的她还有决策能力对吗
Yeah, she still has decisional capacity, right?
好吧
Okay.
但我们要说服她留下做手术
But we gotta convince her to stay and have the surgery.
她有生命危险
Her life is at stake.
迪恩
Dean,
达尔比说你让她出院了
Darby says you're discharging her?
我给她开了增强法莫替丁的处方
I wrote her a script for extra-strength Pepcid,
鉴于她现在的情况
see how she fares.
你介意我看一下CT吗
You mind if I take a look at the CT?
看到了吗
See?
这和超声波的结果没有两样
Nothing here tells a different story than the ultrasound.
在我看来胆囊还是受感染的
Still seems to me that the gallbladder is infected.
我不同意
Well, I disagree
我想让病人免于手术
and I'm just trying to spare the patient an operation.
如果她需要做手术呢
Well, what if it's an operation that she needs?
或许有必要听听外科医生的建议
Maybe a second opinion from a surgeon is warranted?
我恰好也是专业认证的外科医生
Well, I also happen to be a board-certified surgeon myself,
但非常感谢你的关心曼宁医生
but thanks very much for your input, Dr. Manning.
先走一步
Excuse me.
什么样的医生会拒绝治疗一个病人
What doctor refuses to treat a patient?
我父亲是名医生他竭尽全力
My dad is a doctor and he went out of his way