实习医生格蕾
Grey's Anatomy S07E12
Part 3
March 1, 2020, 11:19 a.m.
Good luck with your surgery.
谢谢 阿尔特曼医生
Thank you, Dr. Altman.
她想打排球呢
Wow. A volleyball player.
从头骨上取骨意味着
Digging into her skull will tack on
她需要多恢复一年 知道吗
an extra year of healing, you know?
那也许她能在几年后打排球呢
Well, maybe she'll play in a couple of years, then.
你有考虑过他们在辛辛那提市做的那个
Well, did you consider the stem cell surgery
用尸体骨移植的干细胞手术吗
they did in Cincinnati using a cadaver bone graft?
那种手术还处于试验阶段呢
Oh, it's too experimental.
我觉得以她的年龄来说 可以考虑尝试
I think it's worth considering given her age.
我认为就她的年龄来说
I think considering her age,
最好还是用保守疗法
it's best to be conservative.
手术室见
I'll see you in surgery.
我们可以进去看看扫描结果吗
Can we, uh, go in and see the scans?
屋子很小 挤不下那么多人 老实等着吧
Pretty small room. Let's just wait.
他有串联病变
He's got tandem lesions,
第四和第五腰椎有骨折移位
a fracture translocation at L-4 and 5,
第五和第六节颈椎单侧面较高
and a unilateral jumped facet at C-5 and 6.
那是什么意思
What does that mean?
意思是说他脖子上的一个关节
It means one of the joints in his neck
被撞得移位了
was knocked out of place,
-而且背部也有损伤 -那个是你老公吗
- and he's got a broken back. - That one's your husband?
-什么 没错 -我能说 你真幸运吗
- What? Yes. - Can I just say, jackpot?
我是说 你白天有精彩的病例
I mean, you get to be at work with that all day
晚上还有帅哥拥你入怀
and go home to him at night?
我去看看他们的进展
I'm gonna go see where they're at.
我担心他的脖子
I'm worried about his neck.
我认为他颈椎损伤
I don't think he should be intubated
就不能再做气管插管了
with a cervical injury.
我可以给他做个牵引
Well I could do a little traction.
在手术前 给他的颈椎正位
Snap it back in before we do surgery.
-真是大喜日子呀 -没错
- Hell of a wedding day. - Mm.
有人说 人类一思考
They say if you want to piss off God,
上帝就发飙
just tell him your plans.
伙计 出去 出去 出去
Dude, out, out, out.
这是我见过最大的嗜铬细胞瘤了
That is the biggest pheo I've ever seen.
肾脏有浸润了吗
Is it infiltrating the kidney there?
那是 那是脾对吧
Is that -- that -- that's the spleen, right?
不 那是肝
No, that's the liver.
好吧 那这是肿瘤吗
Oh. Okay, so is that the tumor?
那是胆囊
That's a gall bladder.
-等等 真的吗 -我发誓 我现在真想死了算了
- Wait. Really? - Cross my heart. Hope to die.
核磁共振成像是反的
The image is reversed on an MRI.
刚开始看的时候是有些糊涂
It's confusing at first.
我相信杨医生肯定记得自己第一次看核磁共振成像时的样子
I'm sure Dr. Yang can remember seeing her first MRI
并且理解你的感受
and empathize.
为他人着想是住院总必备的优良品质
Empathy is a good quality for a chief resident,
-你同意吗 贝利医生 -当然同意 主任
- don't you think, Dr. Bailey? - Oh, I do, sir.
这是从脚的位置往上看的成像
This is from the feet looking up,
所以那个是肾
so that's the kidney,
那是肾上腺 那个才是肿瘤
that's the adrenal gland, and that is the tumor.
那是肿瘤吗 已经在侵蚀他的肾了
That's the tumor? It -- it's eating into the kidney.
没错 我本来还希望
Right. I was hoping
我们只要切除肾上腺就行了
we'd only have to remove the adrenal gland.
不过现在看来
But it looks like
我还得移除亨利的肾
I'm gonna have to take Henry's kidney as well.
谢博德医生会从后部对神经根部进行减压
Dr. Shepherd will decompress the nerve roots from behind,
然后我来做移植并放入固定夹板
and then I will put in a graft and a plate for stabilization.
但在此之前
But before any of that can happen,
我们要先帮你做颈部正位
we need to move your neck back into place.
-有意思 -一下就好
- Fun. - I'll be done before you know it.
先生 你还是离开为妙
Sir, you probably don't want to be here for this.
不 我要留下
No, I'm staying.
凯尔 别太过分了
Kyle, don't overdo it.
-你总是 -会有一阵
- You always-- - There's gonna be a lot of, um--
我不走 是我害他躺在这里的
I'm staying. It's my fault he's here.
我要跟他共同承受痛苦
If he's in pain, I'll be here with him.
别再赶我出去了
Stop trying to kick me out.
对 你说的没错 你应该留下的
No, you're right. You should stay.
握住他的手
Hold his hand.
-好的 -谢了
- Okay. - Thank you.
好的 布雷迪
Okay, Brady,
-准备好了吗 -好了
- you ready? - Okay.
很好 一 二 三
Okay. One, two... three.
我的肿瘤看上去有多大
So how'd my tumor look?
扫描结果还有部分没出来呢
We don't have, uh, the results from all the scans yet.
过去三年我做了十一次手术
I've had 11 operations in the past 3 years.
切除肿瘤是我的一大嗜好
I have tumors removed as a hobby.
久病成医
I know how this works.
你知道结果 但不能告诉我
You know the results, but you can't tell me.
那给我点暗示吧 比如
So give me a hint. I mean, look,
是弹珠呢 还是葡萄柚 还是像个篮球
are we talking marble, grapefruit, basketball?
韦伯医生很快就会上来讨论扫描结果的
Dr. Webber will be up shortly to discuss the results of the scan.
弗莱德 说吧 结果如何
Come on, Fred. What'd you see?
不行 他还是一年级医学院学生
No, he's a first-year med student.
他看都看不懂的
He can't even read a scan.
那他表情怎么这么纠结
Then why does he look like he's gonna piss himself?
你看他那表情 这汗出的
Look at his face. He's sweating.
-怎么回事 我活不成了吗 -不是 我的表情
- What's going on? Am I gonna die? - No, I'm not--my face...
别让我来
It--don't let me--
我真的 跟她说的一样 我假装
'cause I'm just-- like she said, pretend I'm--
闭嘴
Stop talking.
-弗莱德 你看到什么了 -没什么
- What'd you see, Fred? - Nothing.
会没事的 真的
It's gonna be okay. Truly.
-我叔叔也做了单肾切除 但他 -什么
- My uncle had his kidney removed, and he's-- - What?
-天呐 我错了 -闭嘴吧 伯顿先生
- Oh, God. I'm sorry. - Stop talking. Mr. Burton--
你们要切除我的肾吗
You have to remove my kidney?
是吗 你们要摘掉我的肾吗
Do you? Do you have to take out my kidney?
你的肾上腺瘤已经给你的肾部造成损伤
The tumor on your adrenal gland has compromised your kidney.
损伤过大 必须做切除
It's enough damage that we need to remove it.
我知道 听起来很严重
I know. It--it sounds like a lot,
但这已经是最优方案了
but it really is our best option.
能问问阿尔特曼医生的意见吗
Could we ask Dr. Altman what she thinks?
阿尔特曼医生是心胸外科的
Uh, Dr. Altman is a cardiothoracic surgeon.
这并不是她专攻的领域
This isn't her area of expertise.
我明白 但她是我的恩人
I know, but she did this amazing thing for me.
我信任她
I trust her.
如果她能参与 我会感觉好过一点
I'd feel a whole lot better if I knew that she was on board.
我还要做会诊呢
I've got a consult waiting.
很快就好 克莱夫
We'll be quick. Karev.
我们整理了一些数据
We put together some stats
针对萨拉的各种手术方案作了对比
comparing the surgical options for Sarah.
特雷彻·柯林斯综合症
骨移植替代方案
如你所见 幻灯片上列出了以萨拉的颅骨
As you can see, this slide shows the donor site morbidities
做供体可能出现的病状 下一张
associated with using Sarah's own skull. Next slide.
骨采集并发症
这张列出了使用颅骨和尸体骨各自的优劣之处
and here you can see the pros and cons of using skull bone versus cadaver bone.
显而易见 利用尸体骨的优势
You can see that the benefits of using cadaver bone
-非常明显 -把灯打开
- are really quite extensive-- - Turn the lights on.
-我们才开始说呢 -马上 开灯
- We just got started. - Lights. Now.
马克 调查结果怎样我很清楚
Mark, I know what the research says.
是可能引发移植并发症
So there's a chance of some donor graft complications.
并发症 不是
Complications? No.
你 过来
You, come here.
按你的方案手术的话
We do your procedure,
就要切开这里 和这里
we'd incise here and here.
-你干什么呢 -别动
- What's happening? - Stand still.
有可能伤及脑部 造成血肿
There's risk of hitting brain, causing a hematoma.
如果采用尸体骨呢 就可以完全避免
Or we take the cadaver route. You avoid that completely,
也就是说这些
which means all of this...
都会安然无恙
doesn't even get touched.
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