芝加哥急救

Chicago Med S08E10

Part 3 April 5, 2023, 10:19 a.m.

I would never wish Crohn's disease on my worst enemy.
胃管肯定堵塞了
The gastric tube is definitely clogged.
你猜对了，洛伊
You called it, Roy.
这是过去三个月里第四次了
That's the fourth time in the last three months.
是啊，你有冲洗过胃管吗？
Yeah. You flushing it out?
我用过温水
I've used warm water,
气泡水、苏打水
seltzer, soda,
除了通乐，我什么都用过了
everything short of Drano.
那好吧，我们把管子加大一点
OK, well, let's upsize the tube a little bit.
拜托，马素医生这只是暂时的解决办法
Come on, Dr. Marcel. It's a temporary solution.
肯定有比这音乐管游戏更好的方法
There's got to be something better than this game of musical tubes.
我知道你很难受，洛伊
Yeah, look, I get that you're frustrated, Roy,
但我们得想办法让你得到营养
but we got to get you nutrition somehow.
你不明白
You don't understand.
我受不了了
I can't take this.
我需要吃东西
I need to eat something.
听我说，很遗憾，进食已经不可能了
Look, sadly, that's not possible anymore
因为你的食道狭窄
because of your esophageal strictures.
你没办法吞咽食物
You won't be able to get the food down.
那我能动手术吗？
What about my surgical options?
我在网络上看到有方法能切除并替换食道
I read online you can remove and replace my esophagus.
我们可以动这种手术吗？
Can we do something like that?
这个嘛，如果要动手术，我需要
Well, if I do that, I'll need to replace it
重建一个新的食道
by reconstructing a new esophagus
从你的胃或肠的一部分来替代
from a part of your stomach or intestine.
但这是个复杂的手术
But it's a complicated procedure,
尤其是对你来说
especially for you.
听我说，这些年来你动了很多手术
Look, you've had a lot of surgeries over the years,
留下的疤痕组织让你很难
and all of that resulting scar tissue makes it very difficult
找到有用的肠子
to find a piece of intestine that can work.
但你可以试试看吧？
But you could try, right?
手术里有太多可能失败的因素
Too much can go wrong.
还会比现在这样更糟吗？
How much worse can it be than this?
你怕你会害死我？
You worried you might kill me?
我受不了要这样过日子了
I can't stand the idea of having to keep living like this.
我是认真的
I'm serious.
我不知道我还能撑多久
I don't know how much longer I could go on.
我知道了，洛伊
I hear you, Roy.
好吧，这样吧…
All right, well...
让我考虑一下，好吗？
let me have a think on it, OK?
杜普雷医生，早安
Dr. Dupre, morning.
你能帮我建档吗？
Can you input that for me?
马素医生，我无意间听到
Dr. Marcel, I couldn't help but overhear
你在讨论像艾弗刘易斯
you discussing what sounded to be like an Ivor Lewis operation
替腹部有不良反应的局部性肠炎患者的手术
on a Crohn's patient with a hostile abdomen.
你在偷听吗？
Eavesdropping much?
我不是故意的
Not intentionally.
听着，我很乐意为手术提供2.0服务
Look, I would love to offer 2.0 services for the operation.
谢谢，但我跟他说了
Thanks, but I told him
我们不会动手术
we're not gonna go the surgical route.
洛伊的局部性肠炎和之前手术的黏连
Roy's Crohn's disease and adhesions from prior surgeries
让他动手术的风险非常高他不适合手术
make him a very high risk and poor surgical candidate.
我认为这是利用2.0成像的完美案例
I think this is the perfect case to take advantage of 2.0's imaging.
如果2.0会给外科手术带来革命性的变化
If 2.0 is gonna revolutionize surgery,
这正是它应该用于的病例
this is exactly the kind of case it should be used on.
洛伊的情况很不稳定
You know, Roy's situation is very precarious.
我不相信2.0能带来改变
I'm not convinced 2.0 can make a difference.
我理解你有疑虑
I understand your reservations,
但你不认为这值得一试吗？
but don't you think it's worth exploring?
你一定是索菲亚的爸爸
You must be Sophia's dad.
我是格连伊士曼，不好意思，我迟到了
Glen Eastman. I'm sorry I'm late.
我住在洛歇尔，我已经尽快赶过来了
I live out in Rochelle. Got here as soon as I could.
我很高兴你来了，我是霍士迪医生
I'm glad you made it. I'm Dr. Halstead.
我拿到化验报告了
I have your lab results.
我去外面等
I'll step outside.
不用，教练，请留下来
No, Coach, please stay.
你就像是我们的家人，仙蒂
You're basically family, Cindy.
在过去的几年，她对索菲亚的生活
She's been a wonderful influence in Sophia's life
产生了巨大的影响
over the past few years,
尤其是因为我住得很远
especially since I live so far away.
那好
OK.
好消息是你的化验报告和心电图都很正常
Well, the good news is your labs and EKG came back normal.
知道是什么引起的吗？
Any idea what did cause this then?
还不清楚，但我想给索菲亚
Not yet, but I'd like to test Sophia
做个布鲁格达氏综合征的测试
for something called Brugada syndrome.
这是种非常罕见的疾病会导致心律失常
It's a very rare disorder that causes arrhythmias
或心率不整
or irregular heartbeats,
尤其会发生在
especially if someone who has it
过度劳累的情况下就像你今天游泳一样
overexerts themselves like you did swimming today.
听起来很严重
That sounds serious.
在最糟糕的情况下
In the very worst cases,
这种疾病会导致心脏完全停止跳动
it can cause the heart to stop altogether.
但有治疗方法可以防止这种情况发生
But there are treatments that will prevent that from happening.
所以我想再做一次心电图
That's why I'd like to do another EKG.
但这次，我想用一种
But this time, I'd like to administer a medication
叫普鲁卡因胺的药，如果索菲亚真的
called procainamide that will trigger an irregular EKG result
患有布鲁格达氏综合征就会导致心电图异常
if Sophia does in fact have Brugada Syndrome.
我们不得不做吧？
We've got to do it, right?
这样才知道到底有没有
So we know either way.
好，我马上叫护士替你准备
All right, I'll have a nurse get you set up right away.
班顿的电脑断层扫描
Brandon's CT.
他有二级脾裂，没有出血
He's got a grade 2 splenic crack with no blush.
好，你有什么建议？
All right. What's your recommendation?
追踪他24小时内的血红蛋白
Track his hemoglobins over the next 24 hours.
我认为只要有保持稳定
As long as it remains stable,
就没有必要动手术
I don't see any need for surgical intervention.
他还通过了自主呼吸测试
He also passed a spontaneous breathing test.
很好，我们来拔管吧
Good. Let's extubate.
来吧
Here you go.
班顿，我们现在要取出你的气管插管，好吗？
Brandon, we're gonna remove your endotracheal tube now, OK?
好了，班顿，我把带子松开
All right, Brandon, I'm just gonna loosen the strap.
好，慢慢来
There you go. Nice and easy.
呼吸
Breathe.
做得很好
Good job.
蒂芬妮还好吗？
Is Tiffany OK?
蒂芬妮？
Tiffany?
我太太，他们有送她来这里吗？
My wife. Did they bring her here?
我听不懂
I don't understand.
她在车上吗？
Was she in the car?
对
Yes.
她怀孕了
She's pregnant.
要生了
In labor.
她人在哪？
Where is she?
我刚才问过现场的当地消防部门了
Just spoke to the local fire department on the scene.
恐怕他们没在那里找到其他人
I'm afraid they didn't find anyone else there.
什么？
What?
不可能，我…怎么会…你在说什么？
No, I... what are... What are you saying?
班顿，你确定
Brandon, are you sure
你没有记错吗？
you're not misremembering what happened?
我没有胡说
I'm not making this up.
她就坐在我旁边
She was sitting right next to me.
我可以证明，我…我的手♥机♥呢？
I can prove it. Just... where's my phone?
好
OK.
你们看，地图上的点就是她的手♥机♥
Look, this dot on the map is her cell phone.
就在55号♥州际公路旁边
That's right by Interstate 55.
我就是在那里出车祸的吧？
That's where I crashed, right?
好，既然如此，我自己回去找
OK, I'll go back there myself if I have to.
班顿，你的情况不适合出院
Brandon, you're in no shape to leave the hospital.
交给我们处理，你坐好
We're gonna get on top of this. You just sit tight.
拜托你了
Please.
她长这样