芝加哥急救

Chicago Med S07E06

Part 3 Nov. 13, 2021, 1:10 p.m.

And here is your large green tea with extra honey, Dr. Charles.
谢谢你，奥利维亚
Thank you, Olivia.
查尔斯医生，你有时间吗？
Dr. Charles, do you have a minute?
当然，有什么事吗？
Yeah, of course. What's going on?
嗯，我的，嗯，我妈妈早些时候来了
Uh, my, uh, my mom came in earlier.
我想你看见了。是的，我看见了
I think you saw. Yeah, I did.
嗯，我希望你能和她谈谈
Yeah, I was hoping that you might talk to her.
她有耐甲氧西林金黄色葡萄球菌感染
She has a MRSA infection,
但她并不想治疗
but she won't get treatment for it.
哦，天哪
Oh, boy.
嗯，她总是这个样子
Yeah, she's always been this way.
我甚至没法说服她吃降压药
I can't even get her to commit to taking her blood pressure medication,
更不用说静脉注射抗生素了
much less intravenous antibiotics.
这是令人沮丧的，对吧
Frustrating, right?
嗯
Yeah.
她和我讲话总不在一个频道上
She and I kinda speak a different language.
这也是我希望你可能有更好的机会
It's kinda why I was hoping that you might have
来改变她的想法
a better chance of changing her mind.
我很乐意试一下
Happy to give it a shot.
还有其它的我需要知道的吗？
Anything else you think that I should know?
你很快就会见识到你面对的是什么
You'll see pretty quickly what you're up against.
好吧，只是，你知道
Okay, it's just, you know,
我只是不想盲目给人治病，仅此而已
don't wanna be flying blind, that's all.
我妈妈和我之间，很复杂
It's complicated, my mom and I.
在我记事的时候我爸爸就离开了
My dad left before I could even remember.
我在一幢又一幢公♥寓♥里度过了童年
We spent my childhood bouncing from apartment to apartment.
有时候为了省下个月的房♥租
Sometimes leaving in the middle of the night
大半夜就得离开
to avoid paying the last month's rent.
相当混乱啊
Pretty chaotic.
是，那时候我以为这是正常的
Yeah, at the time I thought it was normal.
我知道的就这些
It was all I knew.
而且她想给我们一个家
And she wanted to make a home for us.
她也试着做了
She really tried.
她就是走不出自己的路
She just couldn't get out of her own way.
这…这是什么意思？
How--how do you mean?
她没法保住工作
She couldn't hold down a job.
她会对老板出言不逊，然后被解雇
She'd mouth off to a boss, get fired.
嗯。她开始喝酒
Right. She started drinking.
开始嗑药
Started using.
我们最后流落街头。哦，天哪
We wound up on the street. Oh, man.
我很确定她有某种未确诊的精神疾病
I'm pretty sure she has some undiagnosed mental illness.
嗯。你会看到的
Right. Yeah, you'll see.
我完全理解这对你来说有多残酷
I thoroughly appreciate how absolutely brutal this must be for you.
我也明白如果我宣布你妈妈不称职
And I also get how it might really simplify your ability
可能会简化你治疗她的能力
to treat your mom if I were to declare her incompetent.
如果需要的话
If that's what it takes.
但你也知道为了让我剥夺病人的决断能力
But you also know that in order for me to take away a patient's decisional capabilities,
他们只需要满足一套非常具体的标准
it's--they just have to meet a very specific set of criteria.
我只是…我只是不想让你抱太大希望，好吗？
I just--I just don't want you to get your hopes up, okay?
但我很高兴能和你妈妈说话，
But I'm only too happy to speak to your mom,
我真的很感激你告诉我的所有细节
and I--I really appreciate all the detail you give me, okay?
谢谢你。不客气
Thank you. You bet.
这是个孤立的尺骨骨折
It's an isolated fracture of the ulna,
但打石膏一个半月后应该就会好起来了
but it should heal up just fine after about a month and a half in a cast.
好消息是，西沃恩，你可以选石膏的颜色
The good news is, Siobhan, you get to pick the color.
你最喜欢什么颜色？紫色
What's your favorite color? Purple.
你知道，我总是忘记紫色是由哪两种颜色组成
You know, I always forget what two colors make purple.
我知道是蓝色和…
I know it's blue and---
红色。呃，对
Red. Ah, okay.
我们这有个紫色专家，
We got a purple expert, y'all.
好像脑雾已经消散了
It seems like the brain fog has lifted.
所以现在已经没问题了。谢天谢地
So there's no problem there. Thank God.
我是想问问西沃恩的过去
I did wanna ask about Siobhan's history.
我在电子医疗记录上看到差不多一年前
I saw in the electronic medical records that she landed
她去了东慈医院的急诊室
at East Mercy's emergency room about a year ago.
那是另一场可怕的事故
That was another terrible accident.
西沃恩有时候就是会不注意
Siobhan just doesn't pay attention sometimes.
她有时候一头雾水
Her head's in the clouds.
我们从杂货店进来
We'd come inside from the grocery store.
当时下着雨，我在卸货，
It had been raining, and I was unloading the groceries,
我把伞落在厨房♥瓷砖上了
and I--I left my umbrella on the kitchen tile.
我最后到那的时候，下面有一滩水
And when I finally went there was this puddle of water underneath and--
我们能想到的就这些
That's all we can think of.
我…我以为我把它们清理掉了
I--I thought that I cleaned it up,
但我猜我一定漏掉了什么
but I guess I must have missed some and--
是，她那时也做了CT
Yeah, she had a head CT then too.
是啊，她摔倒了，后脑勺撞…撞在厨房♥台子上了
Yeah, she--she fell and hit--hit the back of her head on the kitchen counter.
最后缝了四针
It took four staples to...
但就像我们说的，西沃恩总是笨手笨脚的
But like we said, Siobhan's always been kind of clumsy.
那西沃恩，你怎么看呢？
And what do you think, Siobhan?
你笨手笨脚吗？
Are you clumsy?
我猜我已经摔倒很多次了
I guess I do fall down a lot.
我们的骨科住院医生马上来给西沃恩打石膏
We'll have an orthopedic resident coming soon and cast Siobhan's arm.
我们会保证他带来紫色的石膏带
And we'll go make sure he brings his purple casting tape.
给儿童和家庭服务部打电♥话♥
Call DCFS.
等等，你说什么？
Wait, what are you talking about?
有一些十分可疑的伤
There's a pattern of suspicious injuries.
是，但是他们解释了发生了什么
Yes, but they explained what happened
而且西沃恩也证实了
and--and Siobhan confirmed it.
你认为她会说什么？
What do you think she's gonna say, huh?
如果说我在之前当警♥察♥的时候学会了什么
If there's one thing I learned from my days at CPD,
那就是故事听起来越复杂
is that the more convoluted the story sounds,
就越有可能是假的
the more likely it is not true.
是，但就凭我们看到的一点就给儿家部打电♥话♥？
Yes, but to call DCFS on that with what little we saw?
你知道这会对那对父母造成什么影响吗？
Do you know what it could do to those parents?
你打不打，你不打我打
If you won't call them, I will.
不是，我…
No, I--
如果一个适当的临床评估能得出双相情感障碍的诊断，我不会感到惊讶
I wouldn't be surprised if a proper clinical evaluation would yield a bipolar diagnosis.
但现在她有能力
But right now she has capacity.
即使她拒绝给自己治疗？
Even if she refuses to take care of herself?
但这并不妨碍她自己做医疗决定
It doesn't disqualify her from making her own medical decisions.
如果这次这会害死她呢？
What if it kills her this time?
她好像意识到了风险
She seems to be aware of the risk.
我并不想在征求你的意见之前建议你这么做，
I didn't wanna suggest this before running it by you first,
但有一种药片形式的抗生素在对抗耐甲金黄葡萄球菌方面取得了一些成功。
but there is a pill form of antibiotics that's had some success with MRSA.
利奈唑胺，我知道，但她不会坚持治疗的
Linezolid, I know, but she'll never stick to the regimen.
你知道，这次可能会有不同
You know, could be different this time.
为什么？
Why?
比如，她的降压药，
Well, for instance, with her blood pressure medication,
对吧，她不会吃的
right, that she won't take,
我们身体上没有高血压
we don't experience high blood pressure physically.
但你妈妈，她发了高烧
But your mom, she has a high fever.
她的胳膊肿了。她很痛苦。
Her arm is swollen. She's in lot a of pain.
有可能她的身体症状会迫使她采取行动
It's possible that her physical symptoms could compel her to act.
如果不行呢？
And if they don't?
不幸的是，她必须要做这个决定
Unfortunately, it's her decision to make.
我会和她谈谈的，我看看我能做什么
I'll talk to her. I'll see what I can do.
谢谢你。不客气
Thank you. Of course.
那个无名氏怎么样了
So how's our John Doe?
CT显示脑部非常肿胀
Well, head CT is really tight
严重的缺氧损伤
brain is very swollen, bad anoxic injury.
我是说，预后并不好
I mean, the prognosis is not good.
警署有消息吗？
Any word from CPD?
只有指纹查不出任何记录
Only that his prints didn't turn up any records.
哦，那现在呢
Oh. So what now?
肯定有人在外面找这个可怜的人
There's gotta be somebody out there looking for this poor man.
让我们给他们个机会跳出来
Let's give 'em a chance to come out of the woodwork.
好
Right.
我正找你呢
Just the man we're looking for.
哦，你来了
Oh, there she is.
听说你今天出院了