芝加哥急救

Chicago Med S08E05

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

You're welcome.
嘿
Hey.
经验性抗生素没有发挥作用
The empiric antibiotics aren't doing anything.
他的体温还在升高，现在呼吸困难
His fever's still ticking up, and now he's having trouble breathing.
-他肚子还痛吗？-更痛了
-And his belly pain? -It's worse.
最新的化验有什么结果吗？
Is there anything in the latest labs?
没有，本抗体测定呈阴性
No. Mono test was negative.
血液培养到目前为止没有异常
The blood cultures are unremarkable so far,
但他的淋巴球指数偏高
but his lymphocytes were on the high side.
你觉得是淋巴癌
You're thinking lymphoma.
我已经想了一整天
It's been in the back of my mind all day.
我只是不想直接跳到最糟的选项
I just didn't want to jump straight to the worst option.
我还是不懂
Well, I still don't.
他的血清率和C反应蛋白都很高
His sed rate and CRP are high.
炎症指标升高可能是自身免疫问题
Rising inflammatory markers could point to an autoimmune issue.
川崎氏病？
Kawasaki disease?
川崎氏病主要影响儿童
Kawasaki primarily affects children
通常会有明显的皮疹
and often presents with a tell-tale rash.
布洛克没有这种症状
That wasn't one of Brock's symptoms.
不过也不排除这种可能性
Doesn't rule it out, though.
可能只是一种变异
It could just be an odd presentation.
你知道吗？你说得对
You know what? You're right.
我不认为是川崎氏病但你给了我一个想法
I don't think it's Kawasaki, but you've given me a thought.
我想再做一个测试
I want to run one more test.
好，我很满意
Okay, I like it.
透析机上的动脉和静脉导管
Arterial and venous tubing from a dialysis machine.
人工肺的泵、充氧器、气体和热交换器
Pumps, oxygenator, gas and heat exchanger from an ECMO.
围床的碎片
Bits and pieces of an enclosure bed
跟附加的塑胶外壳
and added plastic for the housing.
虽然不豪华，但我认为这样行得通
It's not fancy, but I think it's gonna work.
你没有信心
You're not sold.
我不喜欢这里
I don't like the housing.
太脆弱了，这里必须更坚固
It's too flimsy. It's got to be stronger.
不能裂开，也不能垮掉
It can't tear. It can't collapse.
毕竟这是用来固定供体肺的
I mean, this is what holds the donor lungs.
对，肺
Yeah, the lungs,
很珍贵
they're precious.
必须被好好对待
They have to be treated as such.
被轻轻托住
Cradled.
像新生儿一样
Like a newborn.
恒温箱怎么样？
How about an incubator?
对，嘿，亚力士，给我一个恒温箱
Yeah. Hey, Alex, baby floor. Get me an incubator.
供体肺已经到了
Donor lungs have arrived.
太好了，我们来看看
Great. Let's take a look.
谢谢
Thank you.
天啊
Oh, geez.
它的形状比我想象的更糟
It's worse shape than I thought.
是啊，但七、八小时的灌注和通气…
Yeah, but seven, eight hours of perfusion and aeration...
我抱持谨慎乐观态度
I'm cautiously optimistic.
机器还要多久才能准备好？
How long until the machine is ready?
五分钟，准备好供体肺
Five minutes. Prep the donor lungs.
莎伦
Sharon.
我们急症室出了点状况
We have a situation in the ED.
我真不敢相信你把医院
I cannot believe you put this hospital
置于这种法律危险之中
in that kind of legal jeopardy.
也不顾自身安全
And yourselves.
你们要全力配合这些警探
You are to fully cooperate with these detectives.
懂不懂？
Is that understood?
好
Okay.
到底是怎么回事？
What the hell is going on?
韦和云妮莎自作主张
Will and Vanessa went rogue.
情况不妙
It's bad.
-他们跟毒贩买♥♥药 -搞什么…
-Bought meds off a drug dealer. -Wha...
就是那个家伙
That guy.
你现在的疼痛程度有多少，一到十分？
What's your pain level now, one through ten?
35分
Uh, 35.
静脉注射芬太尼没有效果
IV fentanyl isn't doing it.
管路没问题
The line's working fine.
我复位过数十个下巴
I've reduced dozens of jaws.
我治疗过成千上万的肋骨骨折
I've treated thousands of broken ribs.
止痛药对那些病人有用也应该对我有用吧？
Pain meds help those patients, they should be helping me, yeah?
来，给我看看我的病历
Here, let me see my chart, please.
这是在开玩笑吗？
Are you kidding me?
马上叫艾莎医生过来
Get Dr. Asher in here now.
哦，嘿
Oh, hey.
我在精神科替哈里斯
So I was able to free up a bed in the psych unit
腾出了一张床，所以没问题了
for Harris, so that's good.
太好了，因为我认为他的心悒
That's great, because I think his depression
源自于童年创伤后压力症
stems from childhood PTSD.
真的吗？
Really?
你还记得几周前克拉克街的枪击案吗？
Do you remember a couple weeks ago that shooting on Clark Street?
记得，那个穿防弹衣的家伙
Yeah, that guy with all the body armor.
带了两千发子弹…
Like, 2,000 rounds of ammu...
出事地点就在瑞格利维尔哈里斯说他住那里
That was at Wrigleyville where Harris says he lives.
结果一切正好发生在
And it turns out that all went down
哈里斯的公♥寓♥大楼前面
in front of Harris' apartment building.
天啊
Oh, my God.
所以，他…看到了整个过程？
So he, like... He saw the whole thing?
他听到了
He heard it.
我刚和他在图森的姐姐聊过
I just talked to his sister in Tucson,
她说他把自己锁在公♥寓♥里
and she said that he locked himself in the apartment
躲在衣橱里
and laid low in the closet.
虽然他没有遭遇任何危险
So he was never in danger,
但显然从那天起，他就不对劲了
but apparently since that day, he's just been off.
是啊，今天早上他说“外面很危险
Yeah, this morning he said, "It's dangerous outside.
你必须要有个藏身之处”
You always need to find a hiding spot."
说到大规模枪击事件
Talking about mass shootings.
嗯
Mm-hmm.
我六年级的时候第一次
I was in sixth grade when I had my first
参加了主动射击训练，就我的经验
active shooter drill, and speaking from experience,
真的很可怕
they're terrifying.
因此，我们有理由认为，这个事件
So it's reasonable to think that this incident
引发了一些根深蒂固的恐惧
triggered some deep-rooted fears
导致了他现在的状况
that led us to where we are now.
我的意思是，在我那个年代你知道，有空袭演习
I mean, in my day, it was, you know, it was air raid drill
为了防止该死的核战争
in case of nuclear frickin' war.
-蹲下掩护，知道吗？-你的病人
-Duck and cover, you know? -Your patient.
哈里斯贝维尔不见了
Harris Bevel, he's gone.
-什么？-我去打电♥话♥给其他急症室
-What? -I'm gonna call the other EDs
看他会不会出现在别间医院
and see if he shows up at one of them.
我去联♥系♥芝加哥警署要他们去他的公♥寓♥巡一下
I'll reach out to CPD, ask them to do a welfare check at his apartment.
我去找保安，以防有人看到他离开
I'll call security in case somebody saw him leave.
-好 -你用药不足…
-All right. -You underdosed...
你用药不足，过来这里
You underdosed me. Come here.
过来这里
Come here.
好，我身高6英尺，体重180磅
All right, I'm 6 foot, 180.
对我来说，合理的芬太尼剂量
The healthy, responsible dose of fentanyl for me
是150，你只给了我25
would be 150mics. You gave me 25.
我很抱歉
I'm so sorry.
我是下巴脱臼和肋骨骨折不是被纸割到
I got a dislocated jaw and broken ribs, not a papercut.
我来处理，剂量150，我去拿药
I'll fix it. 150mics. I'll put in the order.
快去
Do it.
现在连医生都要开始吵架了吗？
Now the doctors are fighting with each other?
我只想回家，拜托你了
I just want to go home, please.
对不起，纳撒尼尔，我知道你不舒服
I'm sorry, Nathaniel. I know you're uncomfortable.
“绝不气馁”
"Never say die."
就是要有这种精神
That's the spirit.
我马上回来
I'll be right back.
呼吸器没有用
Vent's not cutting it.
供体肺只灌注了四个小时
Donor lungs have only been perfusing for four hours.
-够久吗？-必须够