芝加哥急救

Chicago Med S07E05

Part 5 Oct. 25, 2021, 3:53 p.m.

- Eleanor, can you hear me?
- Yeah.
- 好的。
- 握紧我的手。
- Okay.
- Squeeze my hand.
- 发生了什么？她为什么会这样？
- What's happening? Why's she like this?
- 短暂性脑缺血发作，一个小中风。
- She had a TIA, a mini-stroke.
给她上阿司匹林和氯吡格雷
Start her on aspirin and clopidogrel
然后给她的头部做个核磁共振检查。
and call for an MRI of her head.
- 中风？什么...？为什么？
- A stroke? What... what? Why?
- 因为她正在形成血栓。是她血管里的
- 'Cause she's forming thrombi. They're blood clots
血块，有一个进入了她的大脑。
in her vessels, and one's travelled to her brain.
天哪。
My God.
- 拿个缝合工具包。我们必须把Vas拉出来。
- Get a suture kit. We have to pull the Vas out.
- 我叫哈默医生来。借过一下，哈尔特先生。
- I'll call Dr. Hammer. Excuse me, Mr. Halt.
她在放射科。
- 不不不。
She's up in radiology.
- No, no, no.
每过去一分钟
Every minute that passes
就会增加她中风的风险。
increases her risk of a major stroke.
我们必须现在取出来。
We have to pull it right now.
- 嘿，你还好吗？
- Hey, you okay?
- 不，我今天把一切都搞砸了。
- No. I screwed everything up today.
- 我看了亚历克斯的记录。
- I saw Alex's notes.
血管性血友病？你不可能知道的。
Von Willebrand disease? You couldn't have known.
- 我本可以早点安排那些实验的。
- I could've ordered those labs earlier.
- 但这没有关系。
- But it doesn't matter.
结果还是一样。
The outcome still would've been the same.
听着，你总是希望你能
Look, you're always gonna wish that you could've done
更早的采取某些措施。
something earlier.
这是成为一名好医生的一部分。
It's part of being a good doctor.
- 亚历克斯还在做手术，麦基。
- Alex is in surgery, Maggie.
他的脑子里正在流血。
He's bleeding into his brain.
- 这不是你的错。
- Which isn't your fault.
- 你拔了我病人的Vas-COM？
- You pulled my patient's Vas-COM?
- 她有短暂性脑缺血发作。
- She had a TIA.
Vas-COM很可能是源头。
The Vas-COM was most likely the source.
- 你又不知道。可能是狼疮，
- You don't know that. Could've been lupus,
心内膜炎，甚至白血病。
endocarditis, even leukemia.
而现在我们没有办法监视她了。
And now we have no way to monitor her.
- 她随时都有可能再次中风。
- She could've had another stroke at any minute.
我...我该怎么做？
What... what was I supposed to do?
- 她是我的病人，威尔。
- She's my patient, Will.
你至少应该先问过我。
You at least should've asked me.
- 等你下来的时间...
- By the time you got down here...
我不会冒这个险的。
- 不，你害怕
I'm not taking that chance.
- No, you were afraid
我会不同意，我会阻止你。
that I would disagree and that I'd stop you.
- 不。
- No.
- 还是医学院的老威尔，
- It's the same old Will from med school,
总是认为你知道的更好。
always thinking that you know better.
- 史蒂薇，不是这样的。
- Stevie, that's not what this was about.
- 你就是这么告诉自己的。
- You tell yourself that.
- 嗨。
- Hi.
不知道你还记不记得今天早上见过我。
I don't know if you remember me from this morning.
我是你的外科医生，马塞尔医生。
I'm the surgeon on your case, Dr. Marcel.
你感觉如何？
How you feeling?
- 就像我被车撞了一样。
- Like I got hit by a car.
- 好吧，你刚刚做了大手术，
- Well, you did just have major surgery,
但是，进展顺利，
but, it went well,
我想你每天都会感觉好一点。
and I imagine you will feel a little better each day.
- 给你。
- Here you go.
布莱克医生说慢慢来。
- 谢谢，迪娜。
Dr. Blake said to go slow.
- Thanks, Dina.
- 冰片。我妈妈爱上了他们。
- Ice chips. My mom is in love with them.
坦率地说，我认为它们的吸入风险
Frankly, I think they're just as much
和液体一样大。
- 吸入风险？
an aspiration risk as liquids.
- Aspiration risk?
什么，你...你也是医生吗？
What, are you a... you a doctor, too?
- 完成了医学院第三年的一半。
- Made it halfway through a third year of med school.
可以。
Okay.
- 意识到我是为我妈妈做的，不是为了我。
- Realized I was doing it for my mom, not for me.
我猜你现在已经见过她了？
I'm assuming you've met her by now?
- 认识了她，是的。
- Made her acquaintance, yeah.
- 她试图参加手术？
- She try to scrub in?
你怎么猜到的？
How'd you guess?
我了解我妈妈。
I know my mom.
- 在我从医学院退学后
- She didn't talk to me for six months
她已经六个月没跟我说话了
- 哇，这很糟糕。
after I quit med school.
- Wow, that's rough.
- 不。
- No.
我掌控自己生活的那一天？
The day I took control of my life?
是我走过最好的一步。
Best move I ever made.
- 无论如何，我应该让你休息一下。
- Anyway, I should let you get some rest.
嗯，享受你的冰片，我过会再回来看你。
Um, enjoy your ice chips, and I'll check back later.
等一下，你从医学院出来后做了什么？
So wait, what did you end up doing after med school?
- 渎职律师。
- 医疗方面的？
- A malpractice lawyer.
- Medical?
你妈妈一定很骄傲。
Your mom must be very proud.
- 米勒先生和夫人，我有最新情况要告诉你们。
- Mr. and Mrs. Miller, I have an update for you.
- 马上回来，伙计。
- Be right back, buddy.
- 所以，他们...他们刚刚结束
- So, look, they're... they're just finishing up
了手术。
in surgery now.
所有迹象表明手术是成功的。
All indications are that the procedure was a success.
亚历克斯做得很好。
And Alex is doing great.
- 天啊，真的吗？
- 非常感谢。
- My God, really?
- Thank you so much.
听着，斯科特医生和我在今天的手术之前
Listen, Dr. Scott and I talked to Alex
跟亚历克斯谈过
before the procedure today.
我知道你现在有很多事情要做，
And I understand that you have a lot on your plate right now,
但我...我也认为跟你分享这场
but I... I also think it's important that I share
对话是很重要的。
this conversation with you.
好的。
Okay.
- 所以...所以他告诉我们的是
- So... so what he told us is that
他今天激怒了瑞安。
he provoked Ryan into this outburst today.
他感觉很糟糕。
He feels terrible.
我认为他正在寻求一些关注。
I think he is looking for some attention.
但令我担心瑞安的是...这对我来说意味着
But where Ryan's concerned... What this means to me
这不是一次冲动的爆发。
is that it wasn't an impulsive outburst.
这不是...不是随机的。
It wasn't... it wasn't random.
还有我今天观察到的其他一些事情
And that and a couple other things I've observed today
让我相信很有可能
are leading me to believe it's very possible
是...是你儿子被误诊为多动症
that... that your son has been misdiagnosed with ADHD
而我们可能面对的是
and that we were probably looking
某种焦虑症。
at some kind of anxiety disorder instead.
- 等等，你在说什么？
- Wait, what are you talking about?
看看他。他都不能好好坐着。
Look at him. He can't sit still.
- 但是米勒先生，这是...在数数，对吧？
- But Mr. Miller, it's... it's the counting, right?
打拍子。
The tapping.
我认为他通过自我安抚
I think that he's self-soothing
来帮助自己应对这些焦虑的感觉。
to help him cope with these feelings of anxiety.
当它停止运作的时候，
And when that stops working,
我认为他感觉像被逼到了角落里，
I think he feels backed into a corner,
然后就有了战斗或逃跑的情况。
and then you have a fight-or-flight situation.
- 那么，阿得拉怎么说？
- Well, what about the Adderall?
他的医生说这会有所帮助。
His doctor said that would help.
- 如果他真的患有多动症，它会起作用。
- If he actually had ADHD, it would be working.
但事实并非如此，对吧？我认为对瑞安而言，
But it's not, right? I think that in Ryan's case,
这实际上对他不利
it's actually working against him
只会加剧这些焦虑感
and serving to only intensify these feelings of anxiety
到了他们经常出现的地步
to the point where they're often,
坦白说，这是难以承受的。
frankly, unbearable.
- 查尔斯医生，伙计，看，我...我...
- Dr. Charles, man, look I... I...