芝加哥急救

Chicago Med S07E05

Part 4 Oct. 25, 2021, 3:53 p.m.

- I'm sorry.
- I, I... I didn't mean to.
- 现在我必须重新开始。
- Now I have to start all over again.
你在数数。
You were counting.
好吧，好吧，我...再次，非常抱歉。
Okay, well, I'm... again, I'm very sorry.
你...你继续数吧。好吗？
You... you get back to that. All right?
- 米勒先生和夫人，我们刚刚拿到亚历克斯的测试结果。
- Mr. and Mrs. Miller, we just got Alex's test results back.
亚历克斯现在很稳定，
Alex is stable right now,
但扫描结果表示他的大脑正在出血。
but the scan did confirm that he is bleeding into his brain.
而且颅内压很大
And the intracranial pressure is great enough
他需要立即手术释放。
that he needs immediate surgical evacuation.
天哪。
My God.
- 等等，等等，等等。这是怎么发生的？
- Wait, wait, wait. How'd this happen?
- 是这样，他的检测结果显示
- Well, his test results came back positive
他患有一种叫做血管性血友病的出血性疾病。
for a bleeding disorder called Von Willebrand disease.
所以他的身体无法止住一个小玩具
So the impact from a small toy could've caused a bleed
撞击导致的出血。
that his body just wasn't able to stop.
- 我...我知道这信息量很大，
- I... I know this is a lot,
但是艾布拉姆斯医生会负责手术
but Dr. Abrams will be doing the surgery,
他是我们最好的。
and he's our very best.
过程应该不会那么久。
The procedure shouldn't be that long.
我会在这里随时更新情况，同时如果你有任何问题。
I'll be here for status updates or if you have any questions.
- 如果我们能得到你们的同意，
- And if we have your consent,
我们可以马上开始。
we could get started right away.
- 当然。
- 是的，当然。
- Sure.
- Yeah, of course.
做你需要做的。
- 好的。
Whatever you need.
- Okay.
那不如让我带你去一个
So why don't I take you somewhere
更舒服的地方等待吧？
that's more comfortable to wait?
- 嗯，瑞安。嘿，伙计。
- Um, Ryan. Hey, buddy.
来吧，伙计。
Come on, buddy. We're gonna take
我们起来走一走，好吗？
a little walk, all right?
- 嘿，我看到了埃莉诺的氧合
- Hey, I saw Eleanor's oxygenation
和心输出量下降。
and cardiac output are down.
你把拿到她的实验结果了吗？
Have you gotten her labs back yet?
- 拿到了，看不出什么。
- Yeah, they don't show much. Mild infiltrates
胸部x光片上有轻微浸润和一些嗜酸性粒细胞增多。
on her chest X-ray and some eosinophilia.
还是不知道怎么回事。
Still don't know what's going on.
- 我有点担心。
- I'm a little concerned.
她的一根手指和两根脚趾都变凉了。
One of her fingers and two of her toes are going cold.
可能只是血管痉挛。
Could just be a vasospasm.
- 可能是，但是...
- That could be, but...
是这样，任何动脉管路的主要缺点，
Look, the major drawback to any arterial line,
包括Vas-COM，
including the Vas-COM, is the potential
都有血栓形成的可能性。
for thrombus formation.
所以我认为我们应该把它拉出来。
So I think we should pull it out.
- 拉出来？
- Pull it out?
我的意思是，动脉血管中的血栓
I mean, thromboembolization in arterial lines
极为罕见，几乎从来没有这么快
is extremely rare, and it almost never occurs
出现过。
- 我明白。
this quickly.
- I understand.
我只是认为我们应该在安全的情况下犯错。
I just think we should err on the side of safety.
怎么了？
What?
- 发什么什么事吗？它给我们带来了很多参数。
- Is something going on? It's getting us great numbers.
保持埃莉诺的药物滴定
Keeping Eleanor's meds titrated
她的血压和心率都得到了优化。
and her pressure, and heart rate optimized.
没有它，我们只能在盲着来。
Without it, we'd just be shooting in the dark.
- 我知道。我只是想确保
- I know. I just want to make sure
我们正在适当地使用它。
- 我想我们是的。
we're using it appropriately.
- I think we are.
让我们再给它一点时间。
Let's just give it a little more time.
- 阿彻医生。
- 在。
- Dr. Archer.
- Yeah.
- 到底发生了什么？
- What the hell happened back there?
- 什么？
- What?
- 像那样屈服于布莱克医生。
- Giving in to Dr. Blake like that.
- 手术很成功，如果你不介意的话，
- The surgery was a success, and if you'll excuse me,
我还有一个急诊室需要去运作。
I have an ED to run.
- 等等，迪恩。
- Hold on, Dean.
你知道，受了那种伤，
You know, with that kind of injury,
让她保持开放是正确的做法。
keeping her open is the right thing to do.
- 布莱克医生的推理在医学上是合理的。
- Dr. Blake's reasoning was medically sound.
我的意思是，无论哪种方式我都可以争论。
I mean, I could argue it either way.
- 得了吧！
- 克罗克特...
- Come on!
- Crockett...
医院政♥治♥很像军队。
hospital politics is a lot like the military.
你付诸时间，做你该做的。
You put in your time. You do as your told.
最终你也可以成为布莱克医生。
And eventually you can rise up to become a Dr. Blake, too.
- 你好伙计。这是我的朋友，查尔斯医生。
- Hey, buddy. This is my friend, Dr. Charles.
- 嘿，亚历克斯。
- Hey, Alex.
- 我们只是在你手术前来检查你，
- We just came to check in on you before your surgery,
看看你有没有问题。
see if you had any questions.
- 这会痛吗？
- 不，不。
- Is this gonna hurt?
- No, no.
他们会给你一些药。
They're gonna give you some medicine.
它会让你入睡。
It's gonna put you right to sleep.
你不会有什么感觉。
You won't feel a thing.
- 即使他们打开我的头？
- Even when they open my head?
- 我们保证你知道的下一件事，
- Next thing you know, you're just gonna
就是在恢复中醒来。
wake up in recovery. We promise.
- 好的。
- Okay.
- 你还有什么想说的吗？
- Anything else on your mind?
- 不。
- No.
只是，当他们看我脑袋里的时候，
It's just, when they look inside my head,
他们会看到我的秘密吗？
will they see my secrets?
我认为不会。
I don't think so.
但如果你有什么想法，
But if there is something on your mind,
很多孩子告诉我，最好把它弄出来。
a lot of kids tell me that it's just better to get it out.
- 那不是瑞安的错。
- This wasn't Ryan's fault.
- 别担心。
- 瑞安没有遇到任何麻烦。
- Don't worry about that.
- Ryan's not in any trouble.
- 不，我让他做的。
- No, I made him do it.
我取笑他，而且我知道只要我够过分，
I made fun of him, and I know if I did it enough,
然后他就会非常生气来打我。
then he'd get really mad and hit me.
- 是吗？
- Yeah?
你为什么要他打你？
Why would you want him to hit you?
- 因为...
- Because...
- 因为？
- Because?
如果你受伤了，也许
If you got hurt, maybe
爸爸妈妈对你会多一点关注吗？
Mom and Dad pay a little more attention to you?
- 这太蠢了。我不应该这样做。
- It was stupid. I shouldn't have done it.
- 嘿，没关系。
- Hey, it's okay.
让我们来照顾你。好吗？
Let's get you taken care of. All right?
- 亚历克斯，不会有事的，伙计。
- Alex, it's gonna be okay, buddy.
你会好起来的。我们一会儿见。
You're gonna be fine. We'll see you in a bit.
伙计，听着，我和很多生病的孩子打交道，
Man, listen, I deal with a lot of sick kids,
但是你会怎么做呢？
but what do you do for this?
- 所以...患有多动症的孩子，控制问题，对吧？
- So... kid with ADHD, control issues, right?
随机爆发。
- 对。
Random outbursts.
- True.
- 是的，但亚历克斯知道他只有把
- Yeah, but Alex knew he could only get Ryan to lash out
瑞安逼到困境才会大发雷霆。这不是随机的。
if he backed him into a corner. That's not random.
- 那么，如果这不是多动症，我们在看什么？
- So, what are we looking at if this isn't ADHD?
- 我想可能是焦虑症。
- I think maybe an anxiety disorder.
- 又一个误诊。一周内第二次。
- Another misdiagnosis. Second in a week.
- 如果我是对的，那这个误诊
- And if I'm right, that misdiagnosis
给这个家庭带来了很多问题。
is causing this family a lot of problems.
你得快点来。
You have to come quick.
埃莉有点不对劲。
Something's wrong with Ellie.
- 埃莉诺，你能听到我说话吗？
- 是的。