芝加哥急救

Chicago Med S08E05

Part 3 April 5, 2023, 10:18 a.m.

If we call PD, they're gonna ask Devon a lot of questions
我的名字可能会被提及
and my name could come up.
云妮莎，外面只要有毒品
Vanessa, as long as there's a bad batch out there,
就会有人吸毒过量
someone else could OD.
对，你说得对，我们联络芝加哥警署
No, you're right. We call CPD.
如果我早知道戴文有涉毒
If I would've known Devon was involved in hard drugs,
我绝不会建议去找他
I would've never suggested going to him.
嘿，我知道
Hey. I know.
我觉得他们可能在交往
I think they might be a thing.
别多管闲事，朵莉丝
Keep walking, Doris.
慢慢来…
Easy, easy.
算你走运，我帮你把他力气耗尽了
You're lucky I tired him out for you.
是啊，你用脸和肋骨攻击他的方式
Yeah, the way you went at him with your face and ribs,
让我印象深刻
that was impressive.
就连笑都会痛，好吗？
Even smiling hurts, all right?
因为你的下巴肿了，让我看看你的肋骨
'Cause your jaw's swollen. Let me see your ribs.
好，交给我…
All right, I got it. I got it. I got it.
好
All right.
皮肉伤？
Flesh wound?
对，没错，好大一片
Oh, yeah, yeah. Nice one.
嘿，硕克，交给你了
Hey, Zach, do a work up.
不行，他第一年当住院医生，不行
No, no. First year resident, no, no.
-我不这么认为 -嘿，来吧
-I don't think so. -Hey, come on.
我们这里是教学医院，迪恩
We're still a teaching hospital, Dean.
今天已经够漫长了，好吗？
It's already been a day, okay?
帮我拍个肋骨X光片
Just order me x-rays for my ribs
下巴要拍电脑断层扫描，好吗？
and a CT for my jaw, will you, please?
好，没问题，兄弟
Yeah, you got it, man.
嘿
Hey.
天啊
Ooh, man.
我上楼接生结果错过了好戏
I go upstairs to deliver a baby and miss all the action.
你还好吗？
How you doing?
-死不了 -很好
-I'll live. -Okay.
如果你需要什么，就跟我说
If you need anything, I'm around.
好
All right.
这是纳撒尼尔入院时的胸部X光片
This is Nathaniel's chest x-ray from when he was admitted.
左胸有血气胸
The left chest had a hemopneumothorax.
不过，右胸没有大碍，基恩
The right chest, however, was okay. Gene.
这是他30分钟前的胸部X光片
Now, his chest x-ray from 30 minutes ago.
天差地远
Night and day.
等等，这是36小时内发生的吗？
Wait, this happened in 36 hours?
我也吓了一跳
It caught me by surprise too.
是啊
Yeah.
-彼得 -很抱歉打断你
-Peter. -I'm sorry to interrupt.
彼得，发生什么事了？
Peter, what's going on?
纳撒尼尔允许医院
Nathaniel has given permission for the hospital
与戴顿先生分享他的医疗信息
to share his medical information with Mr. Dayton.
我知道这不合乎传统但那地铁是我盖的
Now, I know this is unorthodox, but I built that train.
纳撒尼尔，他跟了我很多年
Nathaniel, he's been with me for years
我的团队不仅仅是员工
and my team, they're more than just employees.
他们就跟我家人一样
They may as well be family.
法律部门签了字
Legal signed off on it.
好的，彼得，谢谢你
Okay. Peter, thank you.
双侧多处大小肺叶的实质化病变
Bilateral multi-lobar consolidation.
-很深的疤痕跟发炎 -这是什么意思？
-Heavy scarring, inflammation. -Which means?
他的肺坏了
His lungs are destroyed,
但这么严重又这么快，怎么会？
but this much damage this fast, how?
-我唯一能想到的是… -火车的电池
-Only thing I can think of... -Train's batteries.
嗯
Mm-hmm.
他被困在列车长车厢时
From when he was trapped in the conductor's compartment.
隧♥道♥里很潮湿
The tunnel was full of moisture.
泄漏的锂离子电池加上湿气？
Leaky lithium ion batteries plus moisture?
氢氟酸
Hydrofluoric acid.
高腐蚀性又有毒
Highly corrosive, toxic.
-纳撒尼尔吸入了氢氟酸 -有什么解决方法？
-Nathaniel inhaled it. -So what's the fix?
只有肺移植
At this point, a lung transplant.
我马上把纳撒尼尔列入名单
I'll put Nathaniel on the list immediately.
同时，我会停掉呼吸器，改用人工肺
In the meantime, I'd like to get him off the vent and onto ECMO.
减轻他肺部的压力
Take some pressure off his lungs.
恐怕无法使用人工肺
I'm afraid ECMO's not an option.
我们导管不够
Tubing shortage.
在货到之前，机器都无法使用
The machine's down until the shipment arrives.
什么时候会到货？
When will that be?
可能要两三天吧？
Maybe two days, three?
一般人都能靠呼吸器活好几周
People spend weeks on ventilators.
有时候更久，对吧？所以也许我们不会有事
Sometimes longer, right? So maybe we're in good shape.
不是这样的
We're not.
纳撒尼尔的肺伤得太严重了
Nathaniel's lungs are so injured,
呼吸器几乎起不了作用，我只能在
the vent's barely doing the job and I've only got a little
不造成进一步损伤的情况下稍微调整一下设备
wiggle room with the settings without risking further damage.
就算有呼吸器，我们的状况也不妙
Even with the vent, we're sinking.
发烧变得更严重了
Fever notched up a bit.
虽然我一直躺着，但我已经筋疲力尽了
I've just been laying here, but I'm spent.
你的身体在奋战
Your body's at war.
不幸的是，我还不知道它在对抗什么
Unfortunately, I don't know yet what it's fighting against.
化验和扫描都没有结果吗？
The labs and scans didn't show anything?
无法帮助判断
Nothing definitive.
肝脏和脾脏轻度肿大
A mild enlargement of the liver and spleens,
淋巴结肿大、全身肠道炎症
swollen lymph nodes, global intestinal inflammation.
全部都是病毒症状
So all viral symptoms,
但没有指向一个特定的方向
but not pointing in a specific direction.
布洛克，你有大量的疫苗接种史
Brock, you've got an extensive vaccination history.
我看到有强制要求的腮腺炎、麻疹、德国麻疹
I see the requirements like mumps, measles, rubella.
也有非强制的流感和冠状病毒疫苗
Some optionals like flu and COVID,
但也有一些
but there are a few that are
只适用于国际旅行的疫苗
only for international travel.
你最近有出国吗？
Have you left the country recently?
没有，从来没有
No. Never.
我来自芝加哥
I'm from Chicago.
我…高中毕业后我就一直在佐治亚州
I... I've been in Georgia since graduating high school.
先待在亚特兰大南部，然后搬到海边
First the south of Atlanta then near the coast.
我最近才搬回家
I just recently moved back home.
我们应该考虑传染病吗？
Should we bring in infectious diseases?
我可以找个人来看看但如果没有旅游史的话
I could call a fellow, but if there's been no travel
我想她也不会有什么新的想法要补充
then I don't think she'll have anything new to add.
那我们接下来该怎么办？
Where do we go from here then?
进行更多化验
More labs.
血液跟大便培养、本抗体测定
Blood and stool cultures, a mono spot test,
但我一定会给你用
but I'll definitely put you on
经验性广效抗生素
empiric broad-spectrum antibiotics.
希望能让你退烧
Hopefully, we can get that fever down.
所以我们的神秘病人…
So our mystery patient...
脑电图和电脑断层扫描都是阴性
EEG and CT, both negative.
他没有癫痫或中风
He didn't have a seizure or stroke.
毒理也呈阴性，所以不是毒品
Tox also negative, so not drugs.
他的电解质有点紊乱
His electrolytes were a little off,
但我不信他会失忆
but I'm not buying amnesia.
我也不信
No, me neither.
输液刚换了第二袋
I just hung a second bag of fluids.
他看起来比刚进来时反应灵敏多了
He seems more alert than when he came in.
-谢谢，南茜 -很好
-Thank you, Nancy. -Good.
你还好吗？
How you doing?
又是我们，查理斯医生和奎瓦斯医生
It's Dr. Charles and Dr. Cuevas again.
-你记得我们刚刚见过吗？-稍微记得
-Do you remember us from before? -Kind of.
你知道你在哪吗？
Do you know where you are?
好像是医院急症室
Uh, looks like the hospital. Emergency room.
嗯，你知道你是谁吗？
Mm-hmm. And do you know who you are?
哈里斯，我是哈里斯贝维尔
Harris. I'm Harris Bevel.
-你多大了，哈里斯？-28岁
-And how old are you, Harris? -28.
你住在哪？
And where do you live?
瑞格利维尔，在棒球场附近