实习医生格蕾
Grey's Anatomy S08E22
Part 6
Feb. 29, 2020, 7:35 p.m.
是啊 可是和好朋友在男厕所
Yeah, well, so is having premarital sex
发生婚前性行为也不合规矩啊
in the men's room with a really good friend,
不过就这么自然的发生了
but that just happened, so...
我在过去的十年里都被
You know, I have been surrounded by scientists
科学家包围着
for a decade now,
这影响了我对于与上帝的关系的感觉
holding back my feelings about my relationship with god
因为我害怕被嘲笑
'cause I was afraid of being laughed at
被议论 或者被认为不够格做医生
or judged or considered less of a doctor.
我在逃避
I was hiding,
觉得承认对上帝的爱
ashamed to admit that I love him,
承认他是我唯一在意的关系很丢人
that his is the one relationship I count on.
现在 我却不确定了
And now-- now I'm not sure
不知道我是搞砸了
if I just screwed that up
还是把自己从条条框框中解脱出来了
or freed myself from its limitations. I...
我唯一确定的是
The one thing I know for sure, though, is...
我不会再逃避了
I think I'm done hiding.
凯普娜医生 我们问你的问题
Dr. Kepner, we asked you a question.
哦 我会做姑息性内镜下支架置入
Yes, I would do a palliative endoscopic stenting.
如果这个失败了病人还活着并且有疼痛感
If that failed and the patient was still alive and having pain,
我会做胆肠短路术
I would do a biliary-enteric bypass.
再之后我会
After that, I might...
女性 30岁 三♥级♥烧伤
A 30-year-old female comes in with third-degree burns.
你已经检查了她的气道并开始扩容
You've checked her airway and started fluid resuscitation
用5%的葡萄糖生理盐水
with D-5 N.S. fluids.
其实我会用乳酸林格氏液来扩容
Actually, I would use L.R. for fluid resuscitation,
而不是生理盐水
not N.S.
盐水里有太多的氯化物
Uh, saline has too much chloride,
并且容易引起病人酸中毒
and that could cause acidosis in my patient.
好
Okay.
所以你开始给病人输一公升乳酸林格氏液
So you've started your patient on a liter of L.R.
多谢协助 贝利
Thanks for assisting, Bailey.
嘿 尼克曾经国家地理
You know, Nick did
做过一次很大的宣传活动
a big spread in "National Geographic" once
在加尔各答为孤儿女孩开的学校
On this school for orphan girls in Calcutta,
他给他们送去了好多照相机
and he--he sent them a bunch of cameras.
好像是宝丽来
I think that it was Polaroids.
所以他们就不用花钱洗相片了
So they wouldn't have to pay for the film to get processed...
结果 好几个女孩
But anyways, you know, a couple of those girls
都真的成为了摄影师
actually became photographers.
很专业的那种 很酷是不是
Like professionals. Isn't that amazing?
我们没有要杀掉你的朋友
We're not going to kill your friend.
什么 我知道 我就是说说
What? I know. I'm just--I'm saying...
他是不是也搭救流浪狗啊
Hey, does he save puppies, too?
不要挖苦 专心点
Less sarcasm. A little more focus.
哦 天哪
Oh, shoot.
我们今天应该
We were supposed to
带零食去日托所的
bring snack today to the day care
-给所有的孩子们 -今天
- for all the kids. - Today?
嗯 那个精神科的妈妈问我能不能和她换
Yeah, that mom from psych asked if we would switch with her,
我说可以 然后我就忘了
and I said we would, and then I forgot.
你得把这些写下来
You need to write this stuff down. I--
我知道 我知道 对不起
I know. I know. I am so sorry. I...
真对不起
Sorry.
你没忘是不是
You didn't forget snack today, did you?
没有 我是看到血管上有转移灶了 看这个
No, I'm seeing mets in the vessels. Look at this.
我擦 如果这里有
Damn. And if they're here...
那就全身都有了
They're gonna be everywhere.
颞肌已经萎缩了
The temporalis muscle is atrophied.
格蕾医生 这是为什么
Any idea why, Dr. Grey?
缺乏使用
Uh, lack of use?
因为骨头没了所以没有地方接了
It had nowhere to attach since the bone was gone.
是的 现在已经用不了这块肌肉了
That's right. It's too late for this muscle.
它已经错失机会了
It's missed its chance to attach.
我们为什么要谈到颞肌
Why are we talking about the temporalis?
教学的好机会啊 斯隆医生 不要打岔
Teachable moment, Dr. Sloan. Stay out of it.
一旦你把脂肪注入到查理的颞骨里
Once you inject the fat into charlie's temple,
肌肉就会
the muscle will--
还说肌肉
Again with the muscle?
是的 曾经健康的肌肉
Yeah, the once healthy muscle
会慢慢萎缩直至消失
will slowly wither to nothing.
无依无靠的
All alone,
被厚厚的脂肪包围住
surrounded by a thick layer of fat.
讲得很精妙啊 谢博德医生
Very crafty, Dr. Shepherd.
收到你的意思了
Message received,
清晰又洪亮
loud and clear.
他们有零食
They had snack.
现在我无缘无故弄来两磅草莓
And now I have 2 pounds of strawberries for no reason.
泰迪为什么在这
Why--why is teddy here?
亲爱的
Oh, honey.
我们做了断层扫描
We did a pet-scan, and, um...
尼克有硬膜内转移灶
Nick has intradural mets.
已经转移到淋巴结了
They've spread into his lymph nodes.
心脏里都有
They've even gone into his heart.
他有个心脏肿瘤 看起来
He has a cardiac tumor, which looks like
已经侵入右心室了
it might have invaded into the right ventricle.
到了这一步
At this point,
我们真是没有什么办法了
there's very little that we can do.
我会考虑是不是克罗恩病
I-I would be concerned about Crohn's disease
但也不排除是消化性胃溃疡
but differential diagnosis could be P.U.D.,
溃疡性结肠炎 或者阑尾炎
ulcerative colitis, or appendicitis.
格蕾医生
Dr. Grey?
对不起 我忍♥不住了
I'm sorry. I can't--
我会放置瘘内窥镜
I'd locate the fistula endoscopically,
然后注射纤维蛋白胶
then inject fibrin glue.
那脓疮呢
What about an abscess?
脓疮怎么了
What about it?
你很显然已经把它排除掉了
Well, apparently, you have ruled it out.
就是觉得有点 太随意了 不是么
It just feels a bit... cavalier, doesn't it?
你说是就是
If you say so.
我仍然不能理解
I'm having a hard time understanding
为什么我明明可以用内窥镜还偏要开刀
why I would open her up when I could treat it endoscopically.
杨医生 回答我的问题
Precisely my question, Dr. Yang.
我已经处理这种情况好几次了
I've treated this condition a dozen times.
我处理了好几千次了
And I a thousand times.
如果你坚持开刀
If you would rather I open her up
做十二指肠切除术
and do tube duodenostomy,
也行
that's... fine, too.
伤害比较大 不过也行
It's more invasive, but fine.
嗯
Mm-hmm.
格蕾医生
Dr. Grey.
格雷医生 我们要暂停了
Dr. Grey, we're gonna have to call this.
你可以明年再来考
You can take the exam again next year.
我们不会算你不及格
And we won't--we won't count this as a failure
-请你... -好了 你们是医生
- so please-- - Okay, you're doctors.
会连这点呕吐都对付不了吗
You can't handle a little vomit?
格蕾医生 真的没关系
Dr. Grey, it-- it's really okay--
我会采取经腹手术来进行修补
I would repair it with an abdominal approach,
减少疝内容物的体积
reduce the size of the hernia contents,
切除气囊 闭合裂孔
excise the sac, close the hiatus,
为抗返流和胃固定做一个松弛尼森手术
and perform a floppy Nissen for antireflux and gastropexy.
还是问点别的吧
But ask me something else,
因为我十二岁时就知道这题的答案了
because I've known that answer since I was, like 12 years old.
松弛尼森术事实上是我母亲发明的
My mother practically invented the floppy Nissen.
继续出问题吧 不要手下留情
So keep them coming, but don't go easy on me.
好吧 一名四十岁男性的
All right. A 40-year-old man presents
左颞叶出现可疑病变
with a suspicious lesion on his left temporal,
送往医院...
sent in by his in--
色素性病变吗
Pigmented lesion?
你似乎认为自己稳操胜券
You seem awfully sure of yourself.
不好意思 这是一个考题吗
I'm sorry. Is that a question?
实习医生格蕾
Grey's Anatomy
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