实习医生格蕾

Grey's Anatomy S18E04

Part 2 Oct. 29, 2021, 3:28 p.m.

今天将成为你们职业生涯中难忘的一天
Today is gonna be a day that you will remember for the rest of your careers.
每个人都要完整进行一台腹腔镜胆囊切除术
Each one of you is gonna perform a lap chole start to finish...
独♥立♥完成
On your own.
今天你们就是主治医生
Today, you will be attendings.
- 什么 - 天啊
- What?! - Oh, my God!
他没开玩笑
He's serious.
这就是Webber教学法
Welcome to the Webber Method.
我后悔了
I take it back.
什么
What?
你不能去明尼苏达州
You can't go to Minnesota.
这个人疯了
This man has lost his damned mind.
- Hunt 什么情况 - Roy Davis 60岁
- Hunt, what's going on? - Roy Davis, 60
咯血后晕厥
experienced syncope after an episode of hemoptysis.
血压160/100 心动过速
BP is 160 over 100, and he's tachycardic.
需要马上拍胸片
Gonna need chest films ASAP.
Roy
Roy.
胸片结果肯定不乐观
They won't show anything good, I can promise you that.
Roy 有我在
Roy, I'm here.
他和我一样都有肺纤维化
He has the same thing I have... Pulmonary fibrosis...
更严重
More advanced.
你最好赶紧走不要待在这
Listen, I know you'd rather chew gravel than hang out here
我不会走的
I'm staying.
创伤一室准备好了
Trauma 1 is open.
好的送进去
Okay, let's get him inside!
你在大厅等
You stay in the lobby.
有消息后马上通知你
I'll update you as soon as I can, okay?
Niki 宫口开五公分了宝宝今天就会出生
Niki, you are 5 centimeters dilated and having this baby today.
恭喜你
Congratulations.
太早了我还没准备好
But it's too early. I'm not ready.
而且今天是我们恋爱一个月纪念日
And today's our one-month anniversary.
哇哦今天是好日子呢
Wow! It's a special day all around.
- 爸爸是谁 - 不是谁就是一♥夜♥情♥
- Who's the dad? - No dad. Just a hook-up.
我们有过性生活很多
We had sex. A lot of sex.
我和孕妇有过很多性生活
I had a lot of sex with a pregnant woman.
都一样的
It works just the same.
但这打破我的道德底线了
Okay, but, like, I'm pretty sure that's outside of my moral code.
你为什么不告诉我
Why didn't you tell me?
看我这样子我以为你知道呢
Look at me. I thought you knew.
我还以为你是...
I just thought you were...
好了你叫Dustin对吧
Okay. Dustin, right?
Niki有医生照顾
Niki is in good hands.
你出去走走找点冰块吧
Why don't you take a breather, go find some ice chips?
给她送过来
For her, not you.
Niki你还好吗
Niki, are you okay?
我胸口很疼
My chest really hurts.
Wilson 做心电图检测主要指标
Okay, Wilson, let's get an EKG and vitals.
好的
Right.
深呼吸
Breathe.
很好
Good.
这样一来可以同时进行多台手术
Okay, now, this system of concurrent surgeries will allow us
让有经验的住院医生主刀
to put experienced residents in the OR as leads
主治医生轮流到不同手术室指导
and then attendings can rotate in and out
从而实现效率最大化
for maximum efficiency.
我不喜欢
I don't like it.
你看这里
Look. If you look here
腹腔镜胆囊切除手术一般需要45分钟
the average lap chole lasts what... 45 minutes?
但最关键的步骤只需要...
But the most critical part only lasts...
- 5-10分钟 - 正确
- 5 to 10. - Exactly.
如果每位主治医生依照安排流转
Which means, if each attending rotates according to the schedule
我们就可以去每一间手术室
we can be in each and every OR...
指导最关键的步骤
At precisely the moment we need to be.
是的
Yes.
我还是不喜欢
I still don't like it.
Bailey 这就是解决当前最大挑战的方案
Bailey, this is the answer to our biggest challenge right now.
应对医生短缺问题
The physician shortage.
这只是腹腔镜胆囊切除手术
And it's lap choles.
又不是移植手术或者胰十二指肠切除术
It's not transplants and Whipples.
听着这一代住院医生
Look, this generation of residents...
他们没办法进行大量手术观摩
They don't have a thousand hours to watch us operate
因为他们已经超负荷工作了
while we work them to the bone.
他们需要用巧劲而不是用蛮力
I mean, they want to work smarter, not harder.
这也是没办法
And who would blame them?
我不需要创新教学方式
I don't need generation education.
我需要病人活着
I need patients not to die.
我已经说了很久了
I've been saying for a long time that
要让住院医生走出实验室走进手术室
we need to get the residents out of the lab and into the OR.
Bailey 你觉得呢
What do you say, Bailey?
今天有12台胆囊切除准备好了吗
You ready to do 12 lap choles today?
需要有三位主治医生参加
Look, the system only works with three attendings.
我们都要参与才行
We all have to be on board.
我的天好吧那就做吧
God help us. Fine. Let's do it.
你不会后悔的
You won't regret it. Okay.
那都是后话了
Let's not go that far.
Hayes
Hayes.
有空吗请你简单做一次儿科会诊
Do you have a quick second for a pediatric consult?
你可是腹壁移植手术名人必须有空
For Grey's award-winning abdomen? Sure.
14岁的小朋友
A 14-year-old kid
在酒店附近的公园踢足球
plays soccer in a park near our hotel.
最近有些呼吸困难
Seemed to be getting extra winded the other day.
脚踝有些浮肿
His ankles look a little swollen.
会有什么问题吗
Is that anything?
有可能也有可能没事
Could be. Or not.
抱歉我必须要亲自检查
I'm sorry. I'd have to examine him myself
才能有更肯定的答复
to tell you anything more definitive.
就怕你这样说
I was afraid you'd say that.
你怎么认识Noah的
So, how'd you meet Noah?
他躲医生就像躲瘟神一样
He avoids doctors like the plague.
我最近给他和他儿子看过病
I treated him and his son recently.
是哦那场车祸
Ah, the accident.
把树撞坏了
That tree will never be the same.
车也坏了
Or the car.
Noah就像我儿子一样
Noah's the closest thing I have to a son.
第一次见到他他还是长痘的新兵
Met him when he was a pimple-faced recruit
都还没有变声
whose voice had barely dropped.
我看着他长大结婚
I watched him grow up, get married
有了Danny
have Danny.
你见过Heather了吗
Have you met Heather yet?
他老婆吗还没呢
His wife? No, not yet.
我很爱他但说实话能娶到她真是幸运
I love Noah, but he punched above his weight on that one.
出结果了
The scans are up.
该死
Oh, man. Damn it.
看到那个结节了吗
See that nodule there?
肺癌
Lung cancer.
可能是早期
Probably an early stage
但是他有肺纤维化
but since he's also got pulmonary fibrosis...
治疗的机会并不多
Might as well be terminal.
都是因为美军没能妥善处理垃圾
All because the U.S. military couldn't be bothered to properly dispose of its trash.
怎么不说话了肯定是好消息吧
Lotta silence out there. Must be good news, huh?
CT结果正常化验结果也很好
CT's negative, labs look good.
她没有癫痫病史吗
She has no history of seizures?
如果有的话我会不告诉你吗
You don't think I would have told you if there's a history of seizures?
也没有家族史吗
No family history?
一样的回答
Same answer.
好吧工作例行提问
Okay, but it is my job to ask the questions.
我懂但是请问有价值的问题
No, I get that, but maybe just ask smarter questions.
- 你还好吗 - 不要问我我不是病人
- Are you okay? - No, I'm not the patient.
问问跟病人相关的要紧问题吧
Ask smarter questions about my patient.
- Addie... - 不对这样不行
- Addie... - No. Just no, no, no.
我是Montgomery医生你是Shepherd医生
I'm Dr. Montgomery. You're Dr. Shepherd.
这是我们的病人她多次流产
And we are fixing this woman who's lost so many pregnancies