急诊室的故事

ER S03E11

Part 3 July 17, 2020, 11:39 a.m.

这样疼吗
Does this hurt?
看来是外科急腹症
Looks like a surgical abdomen.
我还没完成评估呢
I haven't made that assessment.
反正我已经在这了你就没必要做了
Since I'm here, you don't have to.
我需要去叫主治医师吗
Should I call for an attending?
-不用 -不用
- No. - No.
抬起来放过去
Up and over.
好了先开始静脉注射
All right, let's get an I.V. started.
我听到了点问题
I think I hear a rub.
这里可能有搏动性肿块
I may have a pulsatile mass.
准备12导联心电图拍胸片
Give me a 12-lead and a chest film.
再做一个腹部造影
Give me a cross-table abdomen.
-先做哪一个 -胸部造影
- Which one first? - Chest.
腹部造影他可能有个动脉瘤快要破裂了
Abdomen. He could have an aneurysm about to blow.
我可不想错过急性心肌梗塞
I don't want to miss an acute MI.
我也不想错过腹主动脉瘤
I don't want to miss a triple-A.
如果真的是心肌梗塞现在就该给他抗凝药
If it's an MI, he needs tPA right away.
如果是动脉瘤就必须进手术室了
An aneurysm needs to go to the O.R.
心肌问题分秒必争
Time is heart muscle.
从来没有动脉瘤在你面前破裂吗
You ever have an aneurysm blow up in your face?
两位
Hey, guys.
我已经感觉好多了
I'm feeling much better.
先生你必须躺下
Sir, you need to lie down.
你需要照X光
You need X-rays.
不我很好就是鼻子有点塞
No, I'm fine, except for a stuffy nose.
能给我打一针流感疫苗吗
Could I have a flu shot?
天哪我记起来这人了
Oh, man. I remember this dude.
每次他想搭顺风车来医院
When he wants a ride to the hospital
他就打911然后装死
he calls 911 and plays possum.
但是我有社会保险啊
But I'm on social security.
我没钱打车坐公交车又太冷了
I can't afford a cab. And it's too cold for the bus.
你来就为了扎流感疫苗
You came in for a flu shot?
如果不是很麻烦的话
If it wouldn't be too much trouble.
他归你了
He's all yours.
天哪太谢谢了
Gee, thanks.
我只是想说让我回到普外科
I'm just saying, there's no point in me
是完全没有道理的
going back to general surgery.
你已经把普外科的东西都学完了
You've learned all there is to know?
我想再去儿科轮值
I want to do another pediatric rotation.
为什么
Why?
我想做一名小儿外科医生
I want to be a pediatric surgeon.
没有基顿医生的推荐
Without Dr. Keaton's recommendation
这基本是不可能的
that's not very likely.
可我和基顿医生风格完全不同
Look, Dr. Keaton and I had stylistic differences.
不过她自己也说过我的技术非常好
She herself said that my technique was excellent.
你想跟着谁
Who would you work under?
肯纳
Kenner.
你真是走运了
Well, you're in luck.
他今晚要做一台空肠闭锁的手术去和他聊聊
He's doing a jejunal atresia tonight. Talk to him.
如果他同意带你那你就回儿科去
If he'll take you, you're back in pediatric.
好的能不能让我负责小儿外科重症监护室
Okay. Would it be possible for me to cover pedes SICU?
这样的话我就有机会
That way, I can get an opportunity
和肯纳共事了
to work with Kenner.
还有什么事吗
Anything else?
没了谢谢
No, thank you.
楚妮腰椎穿刺的托盘呢
Chuny, you got that LP tray?
在门边
By the door.
莉迪亚能请你帮个忙吗
Lydia, why don't you give us a hand.
我们也许需要人按住她
We may need to muscle her.
马克...
Uh, Mark...
你为什么不告诉我你的住址
Why won't you tell me your address?
不好意思你是谁
Excuse me. Who are you?
你是格林医生吗
Dr. Greene?
帕特·古奈特医院的法律副顾问
Pat Guinet, associate hospital counsel.
你想给这名病人做腰椎穿刺吗
You want to do a spinal tap on this patient?
没错
That's right.
她好像并不喜欢这个主意
She's not too keen on the idea.
我评估她的精神状态并不正常
Well, I've assessed her as mentally incompetent.
可我们刚刚进行了一场有条理的对话
We just had a fairly coherent conversation.
这能算是医学诊断吗
Is that a medical diagnosis?
医生她只是一个疑似病例
Look, doctor, she's clearly a borderline case.
过去我们多次被这种病人控告过
We have been sued by these patients in the past.
我试图救她的命
I'm trying to save her life
但你却大谈法律风险
and you're talking legal exposure.
没错我拿钱就是干这个的
Yeah. That's what I'm paid to do.
我拿钱是为了医治病人帮助他们康复的
Well, I'm paid to help sick people get better.
失陪了
Excuse me.
我不是想和你抬杠医生
Listen, I'm not going to wrestle with you, doctor,
不过我会在病历上写我建议你
But I'm writing on the chart you're advised against
不要在未得到这名女性同意的情况下
doing any procedure on this woman
给她进行任何治疗
without her consent
并且你和任何
and you and anyone
帮助你的人都将可能害你饭碗不保
who assists you will be putting your jobs in jeopardy.
去做一个精神评估
Get a psych consult.
看看他们是否都认为她神志不清
If they agree she's incompetent
让她等着先去救治其他人
put her on a hold and proceed.
在评估结果出来前都不要动她
Until then, don't touch her.
再来一针就好
Just one more stitch.
你有没有考虑
So, have you given any more thought
参与我的研究
to participating in my study?
我有很多文书工作需要补齐
I've got a lot of paperwork I need to catch up on.
不会花费你很多时间的
It won't take much time--
每隔几个小时抽15分钟就好
It's just 15 minutes every couple of hours.
如果我们忙起来这就不太可能了
If we get busy, that could be a problem.
但目前为止都挺闲的
It's been slow so far.
我艾滋病阳性不会影响实验结果吗
My being hiv-positive won't skew the results?
一点都不会影响
Won't make a bit of difference.
今晚是我能收集数据的最后一晚了
Tonight's my last night to collect data
而且如果我...
and if I... ow!
我的结果就是不完... 就是毫无价值的了
My findings will be incom... well, worthless, really.
不过如果你真地那么忙
But if you're too busy
我尊重你的决定
I respect your decision--
就像我一如既往尊重和支持你的决定一样
just as I've always respected and supported your decisions.
我需要做什么
What would I have to do?
他得分了
He scores!
我们总算有一个真患者了吗
We finally get a bona fide patient?
是啊但我们不准碰她
Yeah, but we're not allowed to touch her.
我想再要条毯子还有零食
She asked for another blanket and a snack.
原来我们这不是医院而只是提供床位加早餐
So we're not a hospital-- we're a bed-and-breakfast.
精神科的人下来了吗
Did Psych come down?
还没有
No, not yet.
再催一次我在休息室等
Try again. I'll be in the lounge.
你要给失踪人员查询局打电♥话♥吗
You call missing persons?
是啊不过目前没有人找她
Yeah, but so far, no one's missed her.
有辆轮椅没刹车
We got a wheelchair with no brakes
还有三个输液架摇摇晃晃的
and three I.V. stands that are wobbling.
这些东西该怎么处理
What are we supposed to do with them all?
丑八怪
Ugly...
这位不是我最喜欢的贼吗
Well, if it isn't my favorite thief.
我都把钱包还你了
Hey, you got your wallet back.
那我妈妈的银器呢
What about my mother's silverware?
我发誓我没拿
I didn't take it, I swear.
查理你是要我叫保安轰你
Charlie, do I have to call security
还是自己走
or you going to leave by yourself?
不听我说你得帮帮我
No. Listen, man, I need some bread.
我说真的
No, I'm serious.
有个男的比我卖♥♥淫
There's this dude trying to pimp me,
我不愿意
and I don't want to...
他说我得给他一百块
He says I got to pay him 100 bucks
不然他就杀了我
or he's going to kill me.