急诊室的故事

ER S02E19

Part 4 March 14, 2020, 9:27 p.m.

我拍教育视频设备租赁广♥告♥
I do educational tapes, equipment rentals.
什么钱我都赚
I'll take your money any way I can.
麻烦你镜头拉近到中景麦克斯
Would you zoom into a medium shot now, Max.
你的眼睛怎么样了
How's your eye?
没事了
Oh, fine.
形象不错啊
Nice profile.
你真的不想上电视吗
You sure you won't go on the air?
我不想推广你的生发产品
I wouldn't feel right plugging your hair growth products
因为我自己并不相信它能有效
since I don't believe in them myself.
你比大部分男人
Well, you're more secure
都靠谱多了
than most men.
你身材不错啊平时锻炼吗
You look like in pretty good shape. You exercise?
跑步俯卧撑之类的为什么问这个
Run, push-ups. Why?
我要在全国范围内
I'm just about to go national
推广一种新的健身脚踏车
with a new exercycle, and I haven't found
目前还没找到合适的代言人
a pitchman yet.
你有兴趣吗
You, uh, interested?
他脐周疼痛
He's had periumbilical pain
在右下腹的位置
localized to the right lower quadrant.
反跳痛压痛反胃伴有呕吐
Rebound, guarding, nausea and vomiting.
白细胞计数是多少
What's his white count?
9000 我认为是阑尾炎
9,000. I'm thinking appendix.
阑尾通常在低一点的位置
Appys usually present a bit lower
不过也有例外
but they can fool you.
带他上来吧
Let's take him up.
可以让我来做手术吗
Can I do the procedure?
本顿允许你做阑尾手术吗
Does Benton let you do appys?
我们谈过这件事了
We've talked about it.
好吧凡事总有第一次嘛
Well, there's a first time for everything.
肯纳利先生我们将带您去手术室
Mr. Kennerly, you're going to the O.R.
您不需要担心
But there's no reason to worry.
一定会没事的
Everything's going to be fine.
-你给她做完清理了吗 -是的
- You clean her out yet? - Yeah.
我还得排出脓肿
I've still got to drain the abscess.
她心跳过速 180了
She's tachy. 180.
体温40度
Temp's 104.
我去拿冷却毯
I'll get a cooling blanket.
我有些紧张了皮特
This is making me nervous, Peter.
坚持住
Just hold on.
-皮特隔壁是你那位医学生吗 -什么
- Peter, isn't that your med student next door? - What?
那边是什么情况
What's going on over there?
另一台阑尾炎手术
Another appendix.
坏事成双啊
When it rains it pours.
麻烦来个人把百叶窗拉上
Somebody close those blinds.
第五次心律失常
Run of five.
时间很紧迫皮特
Your time's about up, Peter.
拜托再给我两分钟
Come on. Just give me two minutes.
太晚了
Too late!
-她室颤了 -糟糕
- She's fibrillating. - Damn it.
除颤仪充到200
Charging at 200.
-不要这样啊 -离手
- Don't do this to me! -Clear.
在心脏病发作后心脏会释放出三种酶
There are three enzymes that are released by the heart
肌酸激酶同工酶
after a heart attack
天门冬氨酸氨基转移酶以及乳酸脱氢酶
C.K.-M.B., A.S.T. and L.D.H.
通过绘制这几种酶的变化曲线
by graphing the levels of each enzyme, we can determine
我们可以判断出你在今早四点左右
that you had your heart attack back here
心脏病发作了
at approximately 4:00 this morning.
谢谢你医生
Oh, thank you, doctor.
就是她
She's the one.
苏珊
Susan.
怎么了凯瑞
Yes, Kerry?
有一位护士提醒我
One of the nurses alerted me
埃塞尔要违背医嘱出院
that Ethel was about to sign out A.M.A.
以她的情况这可能会害了她
Which, in her condition, might well have killed her.
我觉得为了救她一命最好多迁就她些
I thought it best to indulge her in order to save her life.
好主意
Good thinking.
我知道与不好说话的患者打交道会让人很崩溃
I know it's frustrating dealing with difficult patients,
但你有些
but you have a tendency
太易怒和固执了
to become anger-locked and inflexible.
谢谢你指明了这一点
Thank you for pointing that out.
如果你觉得自己陷得太深
If you feel yourself getting dug in
可以和我聊聊
just call me.
我会帮你的
I'm here to help.
牵开器
Retractor.
让腹内斜肌暴露出来
Let's expose the internal oblique.
可以帮我做下抽吸吗
Can I have some suction?
好切开吧
Good. Now cut it open.
好了
I'm in.
把手伸入腹膜
Now put your hand in the peritoneum
探查一下直到找到阑尾
and feel around until you find the appendix.
好了
I got it.
好的检查下吧
Okay. Let's see.
好吧这真是我见过的
Well, that is the pinkest
最粉♥嫩♥ 最健康的阑尾了
most healthy appendix I've ever seen.
但他所有的症状都符合啊
But he had all the symptoms.
症状是会骗人的
Uh-huh. They can fool you.
既然都做到这一步了...
Well, as long as we're here...
最好不要
Better not.
另外我好像发现了
Besides, I think I see
造成肯纳利先生腹痛的罪魁祸首
the cause of Mr. Kennerly's bellyache.
是什么
What?
回肠末端处有一根牙签
Toothpick in the terminal ileum.
如果你夹住后面的金色流苏
I think if you pull on the gold tassel
它会滑出来的
it'll slide right out.
祝贺你卡特医生
Congratulations, Mr. Carter
你完成了自己的第一次牙签移除手术
on your first toothpick-ectomy.
开始冲洗吧
Now let's start irrigating.
门多萨先生
Mr. Mendoza.
怎么了
Yes?
你妻子的手术结束了但她的病情很严重
Your wife is out of surgery, but she's very sick.
她的阑尾在我移除之前就破裂了
Her appendix burst before I could remove it
细菌侵入了她的血液系统
and, uh, the bacteria invaded her bloodstream.
我们给她用了抗生素以对抗感染
We're giving her antibiotics to fight the infection.
我希望她能挺过去
I expect her to pull through it.
你是说她可能会去世吗
Are you saying she could die?
有这种可能性
It's a possibility.
我们刚来的时候
When we first came in
为什么不说这是阑尾炎
was there no way to tell that it was the appendix?
症状和患者自述都表明了更像是食物中毒
Well, the symptoms and the story suggested food poisoning.
我们都没有见到医生
That woman sent us home
那女人就让我们回家了
without ever seeing a doctor.
她咨♥询♥了医生
She consulted a doctor...
是医生同意你妻子出院的
who ordered your wife discharged.
怎么会发生这种事
How could this happen?
那个孩子怎么样了
How's the kid doing?
还是老样子
Oh, the same.
我可以去看看
Think I could take a peek in there
把这个给他吗
give him this?
当然可以
Yeah. Sure.
你自己画的吗
Did you draw that yourself?
是的
I did.
他去哪了
Where is he?
我不知道杰瑞米
I don't know. Jeremy?
天啊
Oh, man.
杰瑞米
Jeremy?
不要啊
Oh, no.
杰瑞米
Jeremy!
杰瑞米
Jeremy!
你见到那个小孩了吗
Hey, have you seen the kid?
哪个小孩
What kid?