急诊先锋：纽约（2023）

未来的基石是平等和机会
The future built on equality and opportunity
因为这两者的缺乏 造成了我们看到的枪♥支♥暴♥力♥
because the lack of the two feeds the gun violence that we are seeing.
拜登总统今天来到纽约 谈论枪♥支♥暴♥力♥问题
President Biden is here visiting New York today to talk about gun violence,
非常讽刺的是 他来跟我们的市长讨论预防枪♥支♥暴♥力♥
and it's pretty ironic he's here to talk to our mayor about gun violence prevention
而我们医院 现在就有两个受枪伤的孩子
and we have right now two kids in our hospital with gunshot wounds.
这个问题越来越常见了
So this is becoming an increasingly common issue, right?
每次我谈论 预防枪♥支♥暴♥力♥之类的问题时
Every time I give a talk on gun violence prevention or so on,
我总是能够引用 我们最近治疗过的一个孩子作为例证
I always have an example that I can cite as a kid that we just recently treated,
或者最近我们社区某个中枪的人
or someone in our community that was just recently shot.
这很疯狂 绝对是个大问题
So it's pretty crazy and, um, definitely, definitely a big issue,
不仅是这里 全国都一样
not only here but nationwide.
- You okay, buddy? - Woo!
你还好吗 伙计?
Somebody is mad.
有人生气了
现在我们要去查房♥
So we're just making rounds right now.
我们要看的第一个病人
And we're going to start off with the patient
是我们昨晚看过的枪伤患者
that we actually saw last night who had a gunshot wound
左侧臀部中枪 他很幸运
to his left hip and is really, really very lucky.
-阿尔弗雷德 还好吧? -很好
- Alfred, how you doing? - Good.
我们很高兴昨天不必 冲进手术室 切一条大大的切口
We're so happy that, you know, we weren't...
having to rush to the operating room and make a big cut.
-我知道我们昨天谈过这件事 -对
- I know we talked about that yesterday. - Yeah.
我要快速检查一下伤口 好吗? 就是这里
So I'm just going to have a quick look at the wound, okay? Right there.
Okay, good. It's not really bleeding that much anymore.
很好 出血已经没那么严重了
是的 昨天我能感觉到血液流出来
Yeah, no. I could feel the blood come up.
在这个位置中枪的伤者中 你绝对是我们见过的
I would say you're definitely one of the luckiest kids that we've seen
最幸运的孩子之一
with a bullet wound in this location.
-子弹卡在... -好几个地方
- The bullet is lodged-- - In several different places.
-对 -我明白 我能感觉到
- Yes. - I understand. I can feel it.
-你能感觉到? -是的 我的背部能感觉到
- You can feel it? - Yeah, I feel it in my back.
这里能感觉到 骨头的位置也能感觉到
I can feel it right here. I can feel it like where my bone is at.
是的 子弹卡在了 你的椎骨和髋骨之间
Yeah, it's literally stuck between your spine,
your vertebrae, and your pelvic bone.
It's hard to believe, but there's a lot of people who live with bullets
我知道很难让人相信 但是有很多人体内带着子弹生活
一直不知道子弹的存在 现在你会感到疼 但疼痛会消失的
and never know it's there. Now it hurts, but it's gonna go away.
我昨天本来心情很好
I was having a good day yesterday.
我走在街上 去找我的朋友们
I was walking, I was on my way to, like, to go be with my friends and stuff.
-是吗? -是的
- Yeah? - Yeah.
我戴着耳机 什么都听不见
I had my headphones in, and I couldn't really hear anything,
刚转到那条街上 突然枪声大作
and as soon as I turned toward the street, all you hear is gunfire.
我不知道枪声从何而来
I don't know where it came from.
我只知道 我的第一反应
All I know is my first instinct
是蹲下 找地方躲避 找安全的地方
was to duck and get to cover, or safety, or something.
这就是我所知道的 当我倒在地上
That's what I know. When I was on the floor,
爬到那堵墙后面时 我才知道自己中弹了
crawling to get behind the wall, that's when I knew I got hit
因为我感觉两条腿传来剧痛
because I could feel all the pain in my legs.
我看着伤口 心想“我能看见那个大洞”
And then I looked at it. I was like, "Oh, I can see the big hole."
我的裤子也裂开了
And my pants was coming apart.
然后...
And...
到处都是血
And it was just blood everywhere.
你有朋友遭受过枪♥支♥暴♥力♥吗?
You have any friends that have been affected by gun violence as well?
-我有一个朋友死了 -真的吗?
- I have one friend that died. - Really?
-是的 -这件事带给你的创伤呢?
- Yeah. - What about the trauma that comes with it?
这让你感到担心吗?
You know, is that something that worries you?
-这加重了我的伤痛 -伤痛?
- I'm just more hurt. - More hurt?
-对 -是感情上还是身体上?
- Yeah. - Like emotionally or physically?
两者都是
Like both.
What do you wanna be when you grow up?
-你长大后想干什么? -我想当演员
I want to be an actor.
-演员?不错 -对
- An actor? Nice. - Yeah.
我要去大学学习表演
I'm going to college for it.
你已经确定要去了? 太棒了 什么时候开始?
You're already going for sure? Oh, awesome. When do you start?
本来应该2月7日开始的 现在肯定要等等看了
I was supposed to start February 7th, but now I'm pretty sure I'll have to wait.
-瑞秋 -嗯?
- So, Rachel. - Yes?
-我们讨论过位置了 对吧? -对
- We went over position, correct? - Right.
一次搞定 目标是下面这个脑室
One shot, you're going to hit that ventricle down here.
我不希望你偏离目标
What I don't want you to do is miss
如果横向偏离 就会进入这个内囊
because if you miss laterally, you get into the internal capsule.
说来好笑 我当实习医生时 我有两个孩子
It's funny. When I was in my residency, I had two kids,
由于了解医学知识 对于怀孕、分娩之类的事
and knowing what you know, you get a little more anxious
你会有点紧张
about pregnancy, and deliveries, and stuff like that.
就这种疾病而言 从事医疗领域的医学生
For this kind of condition, there's an advantage to being a medical student,
具备一些优势 因为他是在了解疾病的情况下做决定
for being the healthcare field because he's making a very informed decision.
大多数时候 我会说不知情是一种福气
Most of the time, I would say there's just bliss to not knowing.
相关信息、不利的一面、各种风险 还是不知道为好
You don't want to know the information, the downside, the risk of things.
停水了吗?
They cutting down the water source here?
别紧张 最好把水费交了 宝贝
Take it easy. Better pay that water bill, baby.
来了 医生
There you go, doc.
水来了 太好了
Oh, there you go. Hell yeah.
被唐救了
- Rescued by the Don.
这是哈姆扎·基尔吉 我们要做右侧脑室-腹腔分流术
This is Hamza Khilji. We're doing a right VP shunt placement.
所有人确认是右侧
Everyone confirm right side is the correct side.
对 我也同意
Yeah, I agree too.
我们一起来正念片刻
Let's do a mindful moment together.
深呼吸三次 用鼻吸气 用嘴呼气
Take three deep breaths in through your nose and out through your mouth.
我们可以一起做
We can do it together.
嗨
Hi.
我们现在要拔掉呼吸管 好吗?
We're going to take out the breathing tube now, okay?
我们在等呼吸科医生
We're just waiting for the respiratory therapist
以便拔掉呼吸管后为他输氧
so we can give him oxygen after we take out the tube.
行吗?好的
Is that okay? Alright.
小约 这会让你咳嗽和想呕 这是正常的
Josh, this is gonna make you cough and gag. That's all normal.
我知道这种感觉很吓人 但这是正常的 好吗?
I know it's like a scary feeling, but it's all normal, okay?
你可能会呕吐
And you might throw up.
我们让你深吸一口气并且咳嗽时 你照着做就行了 好吗?
Your job is basically when we tell you, you take a deep breath in and cough, okay?
就是这样 剩下的我们会处理
That's it. We'll do all the rest.
我感觉好多了
I'm feeling a lot better.
Now that I know he's more comfortable,
现在我知道他舒服点了
他们把管子拔掉了 我感觉好多了
they took the tube out, I'm feeling a lot better.
我们帮他做好了成功的准备
We set him up to be successful,
所以我相信他会成功的
so I have a belief that he will be successful.
-好的 -我看没问题
- Okay. - I don't see a problem.
他用眼神和手势跟别人交流
He's communicating through his eyes and through his hands.
也通过点头和摇头
And he nods, and he shakes his head.
这对我来说就很好了
So that's good enough for me.
We breathe teens, 10's. 10 to 20.
我们每分钟呼吸十几次 10到20次
之前他每分钟呼吸20多次 20到30次 已经太高了
He was breathing 20's. 20 to 30, which is already high.
但现在是每分钟20次
But he's nicely breathing 20.
-好 -但是不管用 他的胸部没有起伏
- Okay. - But not work. His chest isn't heaving.
他正在经历艰难时刻
He's going through a lot of hard times at this moment.
但我向他保证 一切都会好起来的
But, you know, I assure him that things will get better.
他将有机会做自己喜欢做的事
And he will be able to do what he likes to do.
重要的第一步 成功
A big first step, success.
进步很大 小约 进步很大
Big progress, Josh. Big progress.
他是个有趣的人
He's a fun person.
他很喜欢玩和开玩笑
He likes to play and joke a lot.
你会一天天好起来的
You're gonna be okay. Day by day.
好好休息吧
Go ahead and get you some rest.
那是我的宝贝 那是我...特别的孩子
That's my baby, that's my... special child.
那是我特别的孩子
That's my special child.
儿子
Buddy.
好了 肖妮 开始吧 你很棒
Alright, Shawnee. Go for it. You're the man.
我不紧张
I'm not anxious.
Some of it's beyond my control.
有些因素不是我能控制的
所以...我采取的态度是 我已经...
So... I just take more of an attitude like I've...
能做的都做了 尽我所能做到最好了...
done everything I can to be the best I can be at doing this, and...
我认为我有能力处理这种事
I think I'm as good as it gets dealing with stuff like this.
我个人感觉你必须这样看自己
So my personal feeling is you have to feel that about yourself
不然你就会紧张
or else you're going to be anxious.
好
Okay.
谢谢
Thank you.
双极钳
Bipolar forcep.
There's a little chip of bone in.