芝加哥急救
Chicago Med S06E14
Part 6
May 24, 2021, 3:13 p.m.
Line placement looks good...
这根胸管也不错
As does this chest tube,
但是我不记得患者需要植入胸管
though I don't remember our patient requiring one.
医生 我第一次尝试
Well, sir, when I made my first attempt
放置中心静脉时
at placing the central line,
我发现有空气从注射器中出来 所以我...
I noticed air coming out of the syringe, so I--
所以她约了一次X光 看看有没有气胸
So she ordered an x-ray to see if there was a pneumo.
-结果真的有 所以她...-我明白
- And there was, so she-- - Yeah, I understand.
实习医生泰勒 我能和你出去谈一下吗
Student doctor Taylor, can I have a word with you outside?
肖恩 我们马上回来
We'll be right back, Shawn.
植入胸管是一次正式的外科手术
Placing a chest tube is considered a surgical procedure
并且需要得到患者的首肯
that requires prior consent from the patient.
我们征求了患者的同意
We okayed it with the patient.
-"我们"是谁 -麦基和我
- "We"? - Maggie and myself.
只有持有执照的医师才可以
Consent for the procedure can only be obtained
获得进行手术的许可
by a licensed physician.
你或洛克伍德护士都没有这个资格
Neither you nor Nurse Lockwood qualify.
对不起 我不知道
I'm sorry, I didn't realize--
你行事鲁莽轻率
You acted recklessly.
在没有告知你的上级的情况下
By not notifying your supervisor,
你为我和医院都带来了风险
you put me and the ED at risk.
别担心 我来处理
Don't worry, I'll fix this.
伊森
Ethan.
听我说 凡妮莎只是遵从了我的指示
Listen, Vanessa was just following my instructions--
她是要成为医生的
She's gonna be a doctor.
在那间病房♥里发生的一切都是她的决定
What happens in that treatment room is her decision.
但这是我的错
But this is my fault.
她是个尖子生 在她的班里名列前茅
She's a top-notch student. She's head of her class.
你们在说什么呢
What are you talking about?
我之前一直在协助实习医生凡妮莎·泰勒
Student doctor Vanessa Taylor, I was assisting her.
我给了她一些错误的建议
I gave her some bad advice,
但是她靠自己解决了问题
but she solved the problem herself.
小麦 你为什么要这么卖♥♥力
Mags, why are you going so far
去帮助这个实习医生
out of your way to help this student?
求你了 伊森 再给她一次机会吧
Please, Ethan, give her a second chance.
她不应该为我的错误买♥♥单
She shouldn't have to pay for my mistake.
我会好好考虑的
I'll give it some consideration.
谢谢你
Thank you.
你为什么要去协助她
Why were you assisting her?
我和桃瑞丝换了一下岗
Doris and I just switched places for a bit.
我得去和她换回来了
I have to relieve her now.
听说 我们的病人有新情况
So I understand that we have an update on our patient?
很可惜 我们等得太久 他的阑尾穿孔了
Unfortunately, we waited so long his appendix perforated,
所以我给他割了阑尾 清洁了腹腔
so I removed it, washed his belly out,
现在他正在重症监护室里呢
and he's recovering in the ICU.
这到底是怎么发生的
How did that happen exactly?
他不再保护他的气道了
Well, he stopped protecting his airway,
所以我只能给他插管了
so I had to intubate him.
是谁给你的权力
Which then gave you the authority
给他作出医疗决策的
to make medical decisions for him?
如果我没有及时给尼尔做手术
Whoa, hey, if I hadn't come upon Neil when I did,
他早就死了
oh, he'd be dead.
他早就没气了
He'd stopped breathing.
死于阑尾炎吗
From appendicitis?
你知道这只是初步诊断吧
You know that'd be a first, right?
他得了败血症 阑尾也断裂了
He was septic. His appendix ruptured.
凭什么我要被你这样逼问
And why the hell am I getting the third degree?
你才是那个差点让
You're the one who was
一个疯子自杀的罪魁祸首
about to almost let a crazy person kill themselves!
-迪恩 别说了 -不 不行
- Dean, stop! - No, no, no.
别忘了 不管怎样
Remember, at the end of the day,
看大家相信我还是尼尔
it's my word versus Neil's--
他可觉得整个世界就是俄♥罗♥斯♥方块游戏
the guy who thinks this whole thing is a game of Tetris!
够了 迪恩 你先出去
Enough. Dean, take a walk.
谁能告诉我到底发生什么了
Someone want to tell me what's going on?
富恩特斯先生和太太
Mr. And Mrs. Fuentes.
我的艾达还好吗
Is my Ada okay?
她现在正在儿科重症监护室里使用呼吸机
She's currently on a breathing machine up in the PICU.
现在还不算完全脱离危险
Now, we're not out of the woods yet,
但我止住了她的出血
but I was able to stop the bleeding.
她活下来了
She's alive.
-没错 -感谢你 马塞尔医生
-Yeah. - Thank you, Dr. Marcel.
我很荣幸
Yeah, my pleasure.
如果我们失去了她 我都不知道该怎么办
I don't know what I would have done if we'd lost her.
她会没事的
She's gonna be all right.
希望明天我们能帮她去掉管子
Well, hopefully, we'll get her extubated tomorrow.
现在 这位特丽妮护士
In the meantime, Nurse Trini here,
她等下会送你们去儿科重症监护室
she's gonna escort you up to the PICU here in a bit.
你们能去看看她 好吗
You can see her, okay?
-谢谢你 -没事
- Thank you. - Yeah, my pleasure.
谢谢
Thanks.
-你之前在做手术吗 -是的
- You been in surgery? - Yeah.
七个月大的婴儿 枪弹伤
Seven-month-old baby with a GSW.
不过她会没事的
She's gonna be okay though.
那你呢
Are you?
没事
Yeah.
我也会没事的 谢谢你
Yeah, I'm gonna be fine. Thanks.
我想和你谈一谈
Listen, I wanted to talk to you about something,
但我有点紧张 不知道你会怎么看待这件事
but I was a little nervous about how you might take it,
虽然我知道这不是我能控制的 其实
which I know is out of my control, so--
娜塔莉 你有时间来谈一下你妈妈的事吗
Natalie, you got a minute? It's about your mom.
好的
Yeah.
-去吧 -抱歉
- Go ahead. - Sorry.
我感觉太棒了
I feel incredible.
你的手很暖
Your hands are warm,
脸上也开始有血色了
and your color is starting to come back.
我想吃个点心
I want a pastry.
我都饿死了
I am famished.
好的 我给你买♥♥一个
Okay, well, I will get you one.
-去找个座位吧 -我能自己买♥♥
- Go and take a seat. - I will get it myself.
让我体会一下重新做人的感觉
Let me feel like a normal human being again.
-好吧 我们就在那边 -好的
- Okay, well, we'll be right over there. - Okay.
太神奇了 是什么改变了
This is amazing. What changed?
在外科医生介入之前 我做了个小实验
I tried a little experiment before the surgeons weighed in.
我把她的左心室辅助装置降到了最低
I turned her LVAD as low as it could go
看看会有什么效果
to see what would happen.
然后呢
And?
她的心脏几乎不需要辅助 一样运转正常
Her heart's functioning fine with barely any assist.
其实现在这个辅助装置有点碍事了
In fact, now the LVAD's just getting in the way.
这是不是说明了
Does that mean the--
药物似乎起作用了
It appears as if the drug is working.
我们应该留她过一夜并监控指标
We should keep her overnight, monitor her,
但看起来没问题
but looks good.
我希望我能回到过去
I wish I could go back in time,
坚持让我妈妈参加药物试验
just insist that my mom signed up for the trial meds.
我们不能向肯德尔申请慈善用药的特例
We can't ask Kender for a compassionate use exemption,
谁知道他们发现后会怎么做
and who knows what they'll do when they find out.
也许他们无需知道
Maybe they don't need to find out.
给
Here.
你还剩多少药
How many pills do you have left?
也许够一周
Maybe a week's worth.
在她吃完之前 我会想办法弄到更多的
I'll try to secure more before she runs out.
威尔 我不想让你这么为难
Will, I do not want to put you in this position.
这些让我自己担心吧
Let me worry about that.
同时 我们应该和杨医生商量
In the meantime, I think we should talk to Dr. Young
把她的左心室起搏器全部取掉
about removing her LVAD altogether.
我们想试试等待移植的机会
We want to try our chances on the transplant list.
-你确定吗 -对
- Are you sure? - Yes.
娜塔莉 如果没人发现
Natalie, if we can keep from getting caught,
你妈妈可能永远都不需要移植
your mom may not ever need a transplant.
我都不知道该说什么了
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