芝加哥急救

Chicago Med S07E07

Part 4 Nov. 21, 2021, 4:34 p.m.

我真的不想和一个
and I really don't want to be associated
有潜在缺陷的产品扯上关系
with a potentially defective product.
所以我猜我想知道的是
So I guess what I'm wondering
你觉得是瓦西监视仪本身的问题
is do you think it was the Vas-COM itself,
还是库珀医生可能的失误？
or was Dr. Cooper possibly at fault?
大家好啊，最近怎么样啊？马特
Hey guys, how's it going? Matt.
你好，马特
Hello, Matt!
我正在跟威尔说我有多高兴并且
Um, I was just telling Will over here how excited I am
稍后你们俩一起去招待套房♥
to have you both at the hospitality suite later.
1202房♥间，一定会很好玩的
Room 1202. It's gonna be a blast.
有开胃饼和蟹腿。听起来不错
There's canapés and crab legs. It sounds fantastic.
我想我还是先走一遍吧
I think I'm gonna walk the floor though first.
霍斯特德，开始吧。坐在副驾驶上
Halstead, let's do this. Ride shotgun with me.
遵命，长官。再见，杰莎
Yes, sir. See you later, Jessa.
拜拜
Yeah.
所以说，杰莎在质疑我
So, Jessa's questioning my decision-making
对埃莉诺的决定吗？
in regards to Eleanor's care?
我不会介意的
I wouldn't take it personally.
我很确定她是在保护她的老板
I'm sure she's just protecting her employer.
这就好。我，嗯…
That's okay. I, um...
我已经第二次质疑自己了
I've been second-guessing my decisions myself.
哦，是吗？
Oh, yeah?
如果你是一瓶龙舌兰
If you were a bottle of tequila,
你会躲在哪里？
where would you be hiding right now?
好极了
Great.
谢谢你们这么快就回信
Thank you for responding so quickly.
我保证会很简短的
I promise to be brief.
过去几周，我们已经看到了
Over the past few weeks, we've seen an uptick
使用瓦西监控仪的病人
in patient complications in regards
并发症的数量正在增加，
to the Vas-COM cardiac monitor,
其中包括最近一个悲剧的死亡
including a recent tragic death.
因此，即刻实行，
So, starting immediately,
医院将暂停使用瓦西监控仪
the hospital will discontinue the use of the Vas-COM
直到它们被证明是十分安全的
until it can be proven to be totally safe.
真是错误的时间
About damn time.
我们对瓦西监控仪引起的并发症的数量肯定吗？
Are we sure about the math on this one?
也许我们看到瓦西监控仪有更多的问题
Maybe we're seeing more problems with the Vas-COM
但那可能是
but that might be
因为使用的次数比之前多得多
because there's a lot more being used than ever before.
完全正确
Exactly.
我现在有11个病人在心脏恢复期使用它
I have 11 in use right now in cardiac recovery.
我应该怎么做？全都置换出来吗？
Like, what am I supposed to do? Swap them out?
是的。用回瓦西监控仪之前的设备
Yes. Return to the methods and devices before Vas-COM.
这完全是倒♥退♥
That'd be going backward.
你不能那样绑住我们的手
You can't tie our hands like that clinically.
我相信你能做得到
I'm confident you'll make do.
提前感谢你们的遵守
Thank you all in advance for your compliance.
就是这样
Yep.
再加两磅，慢慢来
Adding another two pounds. Take it slow.
我们不想在现在的情况下
We don't want to damage the ligaments
再损伤韧带
any more than they already are.
好了。再拍一张片子
All right. Let's get another image.
离手
Clear.
好了，对齐的话看起来更好
Okay, alignment looks better.
应该减少绳索的压力
Should reduce pressure from the cord.
哦，太好了，你没杀了他
Oh, good, you didn't kill him.
医院一直找不到
The hospital has been unable to find
任何法定年龄的近亲
any next of kin of legal age
代表丹尼尔斯先生做出决定，
to make decisions on Mr. Daniels' behalf,
所以法律说现在是我们该怎么做的时候了
so the law says it's now our call on how to proceed.
我们有什么办法？
So, what are our options?
考虑到他的颈椎受伤
Well, given the injury's to his c-spine,
我们唯一的选择是颈椎前路椎间盘切除和融合
our only option is an anterior cervical discectomy and fusion.
稳定对内森来说是最快的复苏之路
Stabilization is the quickest road to recovery for Nathan.
哦，真好。我很高兴得到你的赞同
Oh, good. I'm glad I have your approval.
几个小时后开始做手术
I've got an OR opening up in a few hours.
我会让我的团队把他转移到那
I'll have my team transfer him up there then.
等等，脐带肿胀怎么办？
Wait, what about the cord swelling?
你们可以从后面解压，改善血流
You could decompress it posteriorly, improve flow.
不，伤的很彻底
No, the injury's complete.
解压不会恢复不存在的功能
Decompression won't restore function that isn't there.
但我们都知道肿胀可以掩盖不完全损伤。
But we both know swelling can mask an incomplete injury.
更积极的方法可能会恢复
A more aggressive approach could restore
他的运动功能。内森又能走路了
his motor function. Nathan could walk again.
你没有结合他严重受伤的情况
Not according to his ASIA results.
这个人几乎没有任何功能可以恢复
The man's got virtually no function left to restore.
不过，我们应该征求EJ的意见
But still, we should get EJ's input
看看这是不是他们两个想要的
and see if this is what either of them would want.
这孩子才15岁
Kid's 15 years old.
欢迎你告诉他我们在做什么，
So, you're welcome to inform him as to what we're doing,
但我们不是在进行民♥意♥测验，哈默医生
but we're not conducting a straw poll here, Dr. Hammer.
就这么定了
The decision's been made.
都准备好了，马塞尔医生。好
All set for you, Dr. Marcel. Okay.
我不能把它放在后面
I can't get it to lay posteriorly.
也许我们可以把胃向左推
Maybe I can push the stomach to the left more.
肝还是太大了
Liver's still too large.
我有更多的空间切除更多的组织
Well, I--I've got more room to resect more tissue.
看起来没那么多空间
Not much, from the looks of it.
我能做到的
I can make it work.
但愿如此
Let's hope so.
泰勒医生，我听说你给阿斯特里德做了脊椎穿刺了吗
Dr. Taylor, did I hear that you gave Astrid a spinal tap?
我只想确定我们不是在看多发性硬化症
I just wanted to make sure we weren't looking at MS.
我想我们早就谈过了
I thought that we covered that earlier.
所有的实验结果都出来了
Oh, and all the labs are back.
都是成阴性
They're negative across the board.
好了，官方结果。不是多发性硬化症？
Okay, so it's official. No MS?
它仍然不排除神经方面的问题
It still doesn't rule out something neurological.
麦基，我想再做一次核磁共振
Maggie, I want to order another MRI,
但要和之前形成对比
but this time with contrast.
好吧，等等。听着，凡妮莎
Okay, wait. Look, Vanessa.
这位年轻的女士，她经历了一场创伤事件
This young lady, she's been through a traumatic event.
对吧？她现在很脆弱
Right? She's in a vulnerable place.
而现在我们花了两个小时把管子
And now we've spent the last couple of hours sliding her
插♥进♥去又拔♥出♥来♥
in and out of metal tubes,
把针扎在她的背上
sticking big needles in her back.
她的父母正在讨论让他做出承诺
Her parents are talking about having her committed.
我只想确定这个诊断是正确的
I just want to make sure that this diagnosis is correct.
我为你试图
And I applaud your drive
搞清楚这里发生了什么的努力鼓掌
in trying to figure out what's going on here.
但我也鼓励你把她看作
But I also would encourage you to think of her as,
嗯，怎么说呢，更多的作为一个人看待
I don't know, more as a human being
而不是你能得分的测试题
and less maybe as a test you're gonna get graded on.
我是说，我觉得这…在这方面
I mean, I think it's--it's just important
取得平衡非常重要
to strike a balance there. Okay?
行吧。那好，谢谢你
Yeah. Great. Thank you.
麦基，她清醒后呼我。谢谢你
Mags, page me once she becomes lucid. Thank you.
你是说，他会瘫痪？
You mean, he's going to be paralyzed?
完全瘫痪？
Like totally paralyzed?
听着，EJ，我知道这很难
Look, EJ, I know this is difficult.
但重要的是，在认知上
But the important thing is that cognitively,
你父亲应该完全康复了
your father should make a full recovery.
他不能走路，还有骑自行车
He won't be able to--to walk, or--or ride his bike,
甚至不能自己吃饭
or even eat on his own.
他不会想这么生活的
He wouldn't want to live like that.
还有别的办法
There's got to be another way.
其实，还有另一个选择
Actually, there is another option.
如果我们把你父亲的脊柱融合在一起
If we fuse your father's spine
然后通过椎板切除术，
and then decompress the spinal cord
给脊髓减压
with a procedure called a laminectomy,
他就有可能恢复一些
there's a chance that he could regain some