芝加哥急救

Chicago Med S06E10

Part 4 April 13, 2021, 9:23 a.m.

Mr. Norris is ex-military.
三个月前才从阿富汗回来
Just back from Afghanistan three months ago.
我们都知道
And we all know how complicated
回归平民生活有多复杂
those transitions back to civilian life can be.
但在我看来
But for what it's worth,
他没有显出施暴者的特征
he's not throwing off an abusive profile for me.
看看这个
Well, take a look at this.
这是她在东慈爱医院的诊疗记录
Those are her medical records from East Mercy.
上个月她去了两次
She's been there twice in the last month
胸腔上有挫伤鼻子流血
for bruising in her rib cage and a bloody nose.
她被施暴了
She's being abused.
这是一小时内她第三次呼救
It's third time she's coded in an hour.
胎儿让她的心脏
The fetus is putting
承受太多的负担
too much strain on her heart.
我们没法接生她才22周大
We can't deliver. She's only 22 weeks.
我们得按照程序来
We have to stick with the playbook
寄希望于大剂量用药
and hope the higher dose of meds works.
-或者我们试试其他的 -什么呢
- Or we try something else. - Now what?
-丁卡因 -你在逗我吗
- Tetracaine. - Are you kidding?
我们应该用它注射
We should give it as an infusion,
阻断钠离子通道重设她的心率
block her sodium channels, and reset her rhythm.
这只有几次先例
It's only been tried in a handful of cases.
没有硬数据
There's no hard data.
是的这很前沿但或许会成功
Yes, it's cutting edge, but it could be a home run.
或者会引发心搏停止置她于死地
Or it could cause asystole and kill her.
我明白但我们不能继续这样
I understand, but we can't keep going like this.
我们对她做的每次电击
Each shock we give her
都会增加胎儿心律不齐的几率
increases the chance of fetal arrhythmia.
我也想保护胎儿
I wanna protect the fetus as well,
但我们的职责是先考虑患者
but our duty is to our patient first.
-伊森 -你已经造成很大的损失了
- Ethan-- - You've already done enough damage as it is.
我们继续用药
We're sticking with the meds.
我知道我很笨手笨脚
I know, I'm such a klutz.
一次是我在健身房♥绊倒了摔在了杠铃上
One time I tripped at the gym and landed on some weights.
还有一次撞上了门
And the other time, I ran into a door.
布莱恩陪你一起去了诊疗室吗
Did Brian go to the ED with you?
我很难为情没有告诉他
I didn't tell him. I was embarrassed.
你们似乎很亲密
Huh. You guys--you seem so close.
我不知道你为什么难为情
I don't get why you'd be embarrassed.
这是怎么了
What is going on?
艾米丽如果你有话想和我们说
Look, Emily, if there is anything you wanna tell us--
等等你们是不是在暗示
Wait, you're not suggesting
这些伤和他有关系
that he had anything to do with this?
这三次伤情
All three injuries have happened
都是布莱恩从军队退役后发生的
since Brian's been back from deployment.
布莱恩是个好男人
Look, Brian is a good man.
他是个经历过战争的好男人
He's a good man who went through combat.
我想你知道人会...
And as I'm sure you know, people can--
他们可能会带着某些问题回来
they can come back with issues.
这对他来说不容易
Well, it wasn't easy for him.
他当时见到的
What he saw there.
但他现在回来和我在一起了这才是最重要的
But what matters now is that he's back and we're together.
好吧但无论他在那里经历了什么
Okay, but no matter what happened to him over there,
如果他伤害了你这也是不行的
it is not okay if he's hurting you.
你根本不知道自己在说什么
You don't know what you're talking about.
艾米丽我们只是想
Emily, please. We're just--
我觉得你们应该走了
I think that you should leave.
我好吧
Look, I-- okay.
她在保护他
She's protecting him.
典型的受虐妇女综合征
It's classic battered woman syndrome.
很有可能但我不确定
You know, very possible, but I don't know.
有些情况还是不对劲
Something still-- it's just not adding up.
这些受伤和就诊的记录
All of these ER visits, all these injuries,
都是在清晨发生的
are taking place very early in the morning.
好吧那就是在上午施暴
Okay, so they fight in the morning.
但如果他没有施暴呢
But what if he's not fighting her at all?
如果他是在和别人动手
What if he's fighting with something else,
而她正好在场呢
and she just happened to be there?
小娜难怪他不记得
Nat, no wonder he can't remember
这些抓痕是怎么造成的了
where these scratches come from.
我觉得这可能是在他睡着的时候发生的
I think that this might all be happening when he's asleep.
你怎么证明呢
How do you prove that?
我有办法了
I have an idea.
你们弄丢了子弹
You lost the bullet?
我们没弄丢这叫弹头栓塞
We didn't lose it. It's called a bullet embolism.
通过你血管上的弹孔
It got pulled through the hole in your vein
转移到了肝部
and traveled up to the liver.
就堵在血管里
It's lodged inside the vessel there.
天哪这不可能
迈赫迪先生我们也不希望这样
Look, Mr. Mehti, this is not what we wanted.
但我们会处理好的好吗
But we're gonna get this taken care of, okay?
不过既然你今天已经接受过麻醉了
However, since you've already been put to sleep today,
我想等两天再重新给你动刀做手术
I do wanna wait two days before opening you back up again.
-两天 -没错
- Two days? - Yeah.
看我就说不该来你一次次地让我失望
爸爸我们得按他们说的做
安静
你们单独谈吧
I'll give you guys some space.
-马塞尔医生 -怎么了
- Hey, Dr. Marcel. - Yeah?
我代我爸爸道个歉
Look, I'm sorry about my father.
-没关系 -如果能让你好受点
- Oh, it's okay. - Well, if it helps,
他其实是冲我发火
his anger's actually directed at me.
别担心
Don't worry about it.
他放弃了一切来到美国
He gave up everything to come to America,
为了给我机会
to give me opportunities.
我做了什么坚持成为一名音乐家
What do I do? I insist on being a musician.
他说我永远养活不了自己
He says I'll never earn a living.
他讨厌我的音乐
He hates my music.
他的失望远远比一颗子弹要多
His disappointment's over a lot more than a bullet.
我理解你
I understand you.
你不用担心我的感受
And you don't have to worry about my feelings.
我们会治好你父亲好吗
Let's just get your father fixed up, okay?
-好 -那就行
- Yeah. - All right.
-马塞尔医生 -怎么了
- Dr. Marcel? - Yeah?
我不想插手但我无意间听到你们谈话
I don't mean to butt in, but I overheard you talking,
我觉得有个办法可以避免在做一次手术
and I think there's a way you could avoid another surgery.
-怎么样 -我有一个新型的内窥镜装置
- How's that? - I've got this new endoscopic device
用于安撞人工心脏瓣膜的
to deploy artificial heart valves.
它通过延伸机械手指释放瓣膜
It extends mechanical fingers to release the valve.
你觉得可以逆向操作
You think that it could work in reverse?
没错抓出子弹
Exactly. Just grab the bullet.
但这还没有被批准
But it's not approved for that.
必须在批准范围之外使用是吗
This would have to be off-label, right?
是的
It would.
但如果你想避免再做一次手术
But if you're trying to avoid an open surgery...
好吧
Right.
这主意其实很不错
It's actually a pretty good idea.
好吧就这么办
All right. Let's do it.
麦基问你需不需要
Maggie's just wondering if you would need
别人替你一会
someone to cover for you.
不用我一会就下去
No, I'll be down in a minute.
你没事吧
Hey, you okay?
如果这害他丢了一条腿或是更糟呢
What if I cost this man his leg, or worse?
艾普尔别陷入这种情绪
April, don't get caught up in that.
我相信你肯定已经竭尽所能了
I'm sure you did everything possible.
她怎么样
How's she doing?
还是会时不时地心动过速
Still in and out of v-tach.
伊森给了她标准用药
Ethan's giving her the standard meds,
这或许是最好的选择
which maybe is for the best.
但你有更好的想法
But you have something better in mind?
丁卡因
Tetracaine.
风险很高说不定没用
It's risky, and may not even work.
但我们怎么能