芝加哥急救

Chicago Med S07E04

Part 6 Oct. 25, 2021, 3:53 p.m.

Let me just check something, let me just check something.
啊。看看这个
Ah. Look at this.
电缆有问题，看见了吗？
Cable's got a kink in it. See that?
请给我一份新的好吗？当然
Can I have a new one, please? Yeah.
肯定是在从手术室出来的路上被床栏杆卡住了
Yeah, must have snagged on the bed railings on the trip from the O.R.
哦，是啊
Oh, yeah.
中心动脉压11，问题解决
CVP of 11. And problem solved.
真是千钧一发啊
That was a close shave, yeah?
是啊。解决了就好
Yeah. Glad it worked out.
是的，急诊室见
Yeah. See you back in the E.D.
一会见
Yeah. All right.
帮帮我
Help me!
帮帮我，请帮帮我
Please. Help me, please.
库马尔先生，我在这。你怎么了？
Hey, Mr. Kumar, I'm here. What's going on?
我的背，我的背着火了
My back. My back is on fire.
好吧。放射科医生说支架可以缓解疼痛
Okay. Radiologist said that the stent would ease the pain,
但它更疼了，更疼了
but it's worse, it's worse.
我的腿也麻了
And my legs are numb.
腿麻了
They're numb. Okay.
我没法移♥动♥它们。好吧，我们会想办法的
I can't move them. Okay, we're gonna figure this out.
这不可能是动脉瘤
No way this is an aneurysm.
我需要给他做个核磁共振。哎呦
I need an MRI. Ow!
该死的，我就知道
Damn it. I knew it.
主动脉内层肿瘤
Tumor in the inner layer of the aorta.
它阻塞了几条通往脊椎的穿孔血管。
It's occluding several perforating vessels
没有足够的血流
to the spine. It's not getting enough blood.
解释了为什么他的腿麻木了
Explains why his legs went numb.
看起来血液已经渗进了主动脉壁
Looks like blood's leaking into the wall of the aorta.
如果它继续压♥迫♥血管--
If it keeps compressing the vessels--
他的腿会从麻木变成瘫痪
His legs will go from numb to paralyzed.
那个肿瘤要出来了
That tumor's gotta come out.
罗兰没有精神分♥裂♥症？
Roland doesn't have schizophrenia?
我不相信他有
I don't believe he does.
和他谈完话，看完他的测试结果
After talking with him, looking at his test results,
从斯科特医生这了解了更多的病史
getting more medical history from Dr. Scott,
我认为更合适的诊断应该是
it's my belief that the more appropriate diagnosis
双相情感障碍
would be bipolar disorder.
但另一个精神科医生说--错了
But the other psychiatrist-- Was wrong.
但他非常肯定。说他以前见过这个病例
But he was so sure. Said he'd seen it before.
精神病学远非一门精确的科学
Psychiatry is far from an exact science.
不幸的是，研究确实表明
And unfortunately, research does show
非裔美国人，尤其是男性
that African Americans, particularly males,
被误诊为精神分♥裂♥症的远远多于白人
are misdiagnosed with schizophrenia far more than whites.
我们被认为是危险的，
We're perceived as dangerous,
所以我们得到了符合这种看法的诊断
and so we get a diagnosis to match that perception.
这就是为什么给罗兰开了这么大剂量的药？
This why the dosage on Roland's meds was so high also?
因为他被认为是个威胁？
Because he was assumed to be a threat?
非常有可能
It's very likely.
高剂量也可能加剧了
And that high dose also probably contributed
我认为他确实患有的这种病的病情
to exacerbating the condition that I think that he actually has.
今天的事本来可以避免的
Today could have been avoided.
我非常抱歉
I'm so sorry.
有什么方法能让事情变好吗？
Is there a way to make things right?
我们要重新做一个完整的评估
We do a complete reassessment, okay?
新的药物，正确的剂量，治疗
New meds. The right doses. Therapy.
我知道一家诊所
I know of an outpatient clinic
而且我认为罗兰会有回应的
that I think that Roland would really respond to.
好吗？
Okay?
我让你们俩谈一分钟
I'm gonna leave you two for a minute.
谢谢你。不客气
Thank you. Of course.
你怎么看
What do you think?
我觉得他也在罗兰身上看到了我们所看到的东西
I think he sees the same thing in Roland that we see.
你怎么想的？听从查尔斯医生的建议？
What do you say? Follow Dr. Charles' advice?
异常？我不明白
An anomaly? I don't understand.
根据你的医疗记录
According to your medical records,
我们有理由质疑你原来的肿瘤
we have reason to question whether your original tumor
是否是间变性星形细胞瘤
was in fact anaplastic astrocytoma.
我们看到一份病理报告
We came across a pathology report
显示可能是毛细胞星形细胞瘤
that suggests it might be pilocytic astrocytoma.
好吧，这有什么区别？
Well, what's the difference?
前者是恶性的，后者是良性的
Anaplastic is malignant. Pilocytic is benign.
所以我可能没得癌症？
So I might not have cancer?
我们也不清楚
We don't know.
原来的肿瘤已经没有组织可以检查了
There's no tissue left from that original tumor to examine.
为了做出最新的诊断，我们需要测试新的样本
对最近的复发进行活检
Biopsy the latest recurrence.
在1991年，技术只允许我们分♥析♥肿瘤组织
In 1991, technology only allowed us to analyze the tumor's tissue.
今天，我们能够解剖它的分子结构
Today, we're able to dissect its molecular structure.
识别会更加精确的
Identification will be exact.
就算如此，我还是有可能得癌症
Even so, I might still have cancer.
我越来越怀疑事实并非如此。为什么？
More and more I'm suspecting that that is not the case. Why?
因为你还活着
Because you're alive.
患有间变性星形细胞瘤的人
People with anaplastic astrocytoma
都没你活的时间长
simply don't live as long as you have.
好吧
Okay.
好吧，做活检吧
Okay, do the biopsy.
我猜是马塞尔医生吧
Dr. Marcel, I presume. Yeah.
希姆斯医生，心胸外科
Dr. Simms, cardiothoracic surgery.
很高兴见到你
Pleasure.
放射科跟我说了病人的情况
Radiology filled me in on the patient.
主动脉肿瘤。嗯
Aortic tumor. Mm-hmm.
不错的诊断
Nice call.
我听说，从一开始就不顾导管室
From the get go and despite the cath lab, I hear.
虽然中间有点曲折，但是，
Yeah, it wasn't a straight line, but, uh,
我们又回到正轨了
we're back on track now.
我很感激你能抢先一步，但接下来就交给我了
I appreciate the head start, but I'll take it from here.
我想是我来做手术。。
Uh, I assumed I would perform the surgery.
我明白，但这是心血管手术
I understand, but this is a cardiovascular procedure.
不是创伤手术，有点超出你的能力范围
Not a trauma. Little out of your lane.
我知道那是什么，我也有这个能力
I'm aware of what it is, and I have the skills.
也许吧，但你没有证书
Maybe, but you don't have the credentials.
你是个普通外科医生，不是专家
You're a general surgeon, not a specialist.
我只想搞清楚一点
I just want to make something very clear,
库马尔先生是我的病人
Mr. Kumar is my patient.
马塞尔医生
Dr. Marcel.
你真的想在一场
Do you really want to waste time
你赢不了的争论上浪费时间吗？
fighting an argument you're not going to win?
你可以在观察室看
You're free to watch from the observation room.
哇偶。这视野多开阔
Wow. What a view.
你几乎能看见整座城市
You can almost see the entire city.
然而，这是医院里最适合独处的地方
And yet, it's the best spot in the hospital to be alone.
今天早上的排练不太顺利
Rehearsal didn't go well this morning.
好吧…
Okay...
所以我接受了库珀医生的微妙建议
So I flirted with the subtle suggestion
去破坏阿彻博士的中心动脉压监视器
from Dr. Cooper to sabotage Dr. Archer's CVP monitor.
破坏？好吧
Sabotage? Yeah.
这样瓦西监视仪就能扭转乾坤
So that the 瓦西监视仪 could save the day.
所以我差点就去做了
And I came this close to doing it.
但你没有
But you didn't.
但我害怕我做了
But I'm afraid I could've.
听着，在过去
Look, in the past,
每次你做出不明智的举动
every time you've acted injudiciously,
你总是把病人的最大利益放在心上，
you've always kept your patient's best interest
我知道你总是这样
at heart, and I know you always will.
谢谢
Thanks.
霍斯特德医生
And Dr. Halstead...
如果这让你难以承受
If this ever gets to be too much for you,
告诉我，我会把这整件事都停下来
tell me, and I'll put a stop to the whole thing.
良性的？
Benign?
所以一直以来，我都没得过癌症？
So all this time, I never had cancer?
没有
No.