芝加哥急救

Chicago Med S06E15

Part 2 Oct. 4, 2021, 6:16 p.m.

Mindy, is this the first time you've passed out
这是你第一次晕倒吗
since your diagnosis?
我只是头晕了几秒钟
I just got dizzy for a second.
-没有那么严重 -这很严重
- It's not a big deal. - Yes, it is.
上个月她确诊的时候
When they diagnosed her last month,
他们说肿瘤很小这说明肿瘤长大了吗
they said the tumor was small. Does this mean it's growing?
有可能
Well, possibly.
也可能是出血了
Or it could mean there's a bleed.
这两种情况我们都会建议做手术切除它
Either would be a reason to recommend surgery to remove it.
我不做
I'm not doing that.
但亲爱的如果病情持续恶化
But sweetie, if it's getting worse--
不
No!
没人能挖开我的大脑
No one's digging through my brain.
她上个月一直抱着电脑
She's spent the last month glued to her computer
看那些脑部手术的恐怖故事
reading horror stories about brain surgery.
那不仅仅是故事爸爸
They're not just stories, Dad.
人们从手术室出来后就变了
People come out changed.
他们会口吃抽搐忘记所有人的名字
They stutter, or have seizures, they forget everybody's names.
我会弹钢琴
I play the piano.
如果我再也不能弹琴了呢
What if I can't do that anymore?
不行
Uh-uh, no way.
好在我们进行治疗之前
Okay, before we go any further,
先做个CT看看具体情况吧
why don't we get a CT to see what we're dealing with?
然后我们再谈治疗计划
Then we can talk again and come up with a plan.
-好 -我们很快回来
- Yeah. - Uh, we'll be right back.
失陪
Excuse us.
她刚确诊时她的肿瘤医生
Her oncologist wanted to remove the tumor
就想切除肿瘤
back when she was first diagnosed.
但你也看到了跟她根本没法谈
But you can see, there's no talking to her.
有别的办法可以...
Is there any way that...
我们能强迫她做手术吗
Can we make her do it?
很抱歉但不行
Uh, I'm sorry, but no.
她已经18岁了
She's 18 years old.
她有权自己做决定
She has a right to make her own decisions.
但她还是个孩子
But she's still a kid.
她不明白会有什么后果
She doesn't understand the consequences.
我们已经黔驴技穷了不知道还能怎么办
We're at our wit's end. We don't know what else to do.
听着我知道你们有多难过
Look, I see how distressing this is,
而且也可以理解
and understandably so,
但作为父母你们只有一件事可做
but there is one thing, as parents, you can do.
什么事
Tell us.
向地检官申请临时委托书
You can apply for temporary power of attorney.
这样你们就有在她失去意识时
This will give you the ability to make medical decisions
做出医疗决定的权力
should she become unconscious.
你们要征得她的同意才能这样做
You can do it with her consent,
但利用这个让她做她不想做的手术
but using it to get a procedure she doesn't want
仍然是违背你们女儿的意愿的
would be still be circumventing your daughter's stated wishes.
但目的是挽救她的生命
With the goal of saving her life.
-好我们能商量一下吗 -当然
- Okay, can we discuss it? - Of course.
那我去预约CT
In the meantime, I'll order a CT.
妈妈要上去做超声检查了
Mom's going up for her echo now.
这是她的化验报告吗
Are those her labs?
对
Yeah.
是急性肝衰竭
It is acute liver failure.
天哪
Oh, God.
看这里
And look at this.
丙肝
Hepatitis C?
她一定无症状地携带这个病毒很久了
She must've been carrying it a long time asymptomatically,
这意味着发生了什么事
which means something happened
让病毒发作了
to push her over the edge.
你觉得是因为药物相互作用吗
Do you think it's a drug interaction?
我不知道还能是什么
I'm not sure what else it could be.
那我们只能让她停止用那个试验药
Well, we have to take her off the trial medication.
只能这样了
That's our only choice.
天哪
Oh, God.
我知道
I know.
我会让她继续服用以前的心脏药物
I'll put her back on her old cardiac meds
直到她的肝衰竭得到控制
until we can get her liver failure under control.
-然后呢 -我会查出原因的
- And then what? - I'll find something.
谢谢
Thanks.
没事
Yeah.
我发现她坐在长椅上
I found her sitting on a bench.
她说想跟你谈谈
She said that she wanted to talk to you.
谢谢麦基
Wow. Thanks, Mags.
没事
Yeah.
查尔斯医生
Hi, Dr. Charles.
拉蒙娜你好吗
Ramona, how you doing?
好很好
Good. Very good.
你吓了我一跳
You know, you gave me a real scare
就像你上次从这里逃走一样
running out of here like you did last time.
-我很高兴看到你没事 -我很抱歉
- I'm glad to see you're okay. - I'm sorry.
你根本没必要担心
There's no reason for you to worry.
那有什么事吗有什么我能帮你的吗
So, um, what's going on? What can I do for you?
其实我只想来告诉你我很好
Actually I just wanted you to know that I'm fine.
那太好了你知道吗
Oh, you know, that's great. And you know what?
我真的很感谢你来告诉我真的
I really appreciate you letting me know, I do.
我刚租了间新公♥寓♥ 而且我在上班
Yeah, I just got a new apartment, and I'm working.
虽然现在只是兼♥职♥
I mean, I'm just temping now,
但我觉得他们会让我做全职的
but I think they'll keep me on full time.
果然事情都在好转
Wow, things are, uh, really looking up.
没错
They are.
所以我想如果你有空
So I thought if you had a little free time,
也许我们能喝杯咖啡
maybe we could get a cup of coffee?
你知道吗我正在忙工作
You know what, I'm in the middle of my workday.
但我真的很想知道你现在怎么样了
But I really would like to hear about what's going on with you.
所以你觉得我们约个时间
So, um, so what do you say, I don't know,
在我办公室里
let's make an appointment, you know, meet in my office
好好谈谈如何
and have a proper chat?
我只是觉得我们可以出去走走
I just thought we could hang out.
也许我们还是约个时间更好
Probably better that we make an appointment.
我跟你说随时打我电♥话♥ 好吗
I tell you what. Call me anytime, okay?
我说真的如果我没接电♥话♥ 就留言
I mean it. If you don't get me, leave a message.
我会马上打给你好吗
I'll call you right back, okay?
-好 -很好
- Okay. - Great.
见到你真的很高兴拉蒙娜真的
Really good to see you, Ramona. Really.
我也很高兴见到你
It's good to see you too.
马塞尔医生病人来了
Dr. Marcel, incoming.
什么情况
What do we got?
去急救室 26岁男性呼吸窘迫
Baghdad, 26-year-old male in respiratory distress,
八天前进行了双肺移植手术
status-post double lung transplant eight days ago.
-詹姆斯 -你认识他
- James. - You know him?
对我是他的外科医生希拉里你好
Yeah, I was his surgeon. Hillary, hey.
出什么事了
What happened?
我们回家后第二天
He started having trouble breathing
他就开始出现呼吸困难
the day after we got home.
他的肺科医生让他继续吃药
His pulmonologist said to continue taking his meds,
但他变得越来越糟直到今天他发烧了
but he just kept getting worse until today he got a fever.
好知道了
Yeah, okay. All right.
詹姆斯我们会好好照顾你的好吗
James, we're gonna take good care of you, bud, okay?
听我口令一二三
On my count. One, two, three.
好了
There we go.
詹姆斯按十分制评分你的呼吸困难度能打几分
James, on a scale of one to ten, how hard is it to breathe?
八分可能九分
Eight. Maybe a nine.
输氧12升的情况下血氧饱和度85
O2 stats 85 on 12 liters,
而且他心跳有点快有106
and he's tachycardic at 106.
深呼吸詹姆斯
Deep breaths for me, James.
好两肺均有严重实变
Yeah, major consolidation in both the lungs.
我们做血培养电解质血常规
Let's order cultures, lytes, CBC with diff,
环孢霉素水平送他上去做胸部CT 马上
cyclosporine level and get him up for a chest CT, stat.
-收到 -让我看看你的手兄弟
- Got it. - Let me see your hands, bud.
他对新肺产生排异反应了吗