实习医生格蕾

Grey's Anatomy S13E18

Part 1 Jan. 26, 2020, 11 a.m.

我母亲的阿兹海默症恶化的那段时间
When my mother's Alzheimer's got bad,
有一天我在整理她的账单
I was going through her bills,
其间我发现了一个记事本
and I found a notepad.
上面写着
Written on it were the words
"重要提示告诉梅瑞狄斯不要"
"Important -- tell Meredith not to..."
然后就没了
And that was it.
她最终也没写完那句话
She never finished that sentence.
到底告诉梅瑞狄斯不要做什么呢
Tell Meredith not to what?
不要喝太多酒
Not to drink too much?
不要爱抚陌生的狗狗
Not to pet strange dogs?
不要付出真心
Not to give her heart away?
不要把草坪上的洒水器开着不关
Not to leave the sprinklers on?
那段时间我们没怎么聊天
We didn't exactly talk a lot in those days.
我很后悔我多希望当时多和她聊聊
I regret that. I wish we had.
我还以为之前你说你和科亨医生
I thought you said you and Dr. Cohen
在进行乳腺切除时把病灶都清理干净了
had clean margins in the mastectomy.
没错我们确实清理干净了
Yeah, we did.
但之后最新的扫描结果显示
But then, a spot showed up on the latest scans
胸廓这里出现了一个阴影
alongside the chest wall here.
-所以你根本没清理干净 -可能什么也不是
- So you didn't. - It could be nothing.
或者可能是上次手术遗留的
Or it could be leftover cells
未清除的且在继续蔓延的癌细胞
that weren't taken out and kept growing.
-麦琪 -抱歉我
- Maggie! - I'm sorry. I --
-你们继续说吧 -再次进入手术室前
- Keep going. - We don't know what it is, really,
我们真的不知道那是什么
until we get in there.
没错我会进行一次扩大局部切除手术
Yeah, I'll do a wide local excision,
仔细查看一下那片区域切除病灶
explore the area, remove anything I find.
我们可能需要做个肌瓣悬吊
We may need to do a muscle flap
来修补下病灶切除后胸廓缺失部分
just to cover the defect,
不过这个手术很简单
but simple.
明天就做手术
Tomorrow.
不行我们打算下周进行手术
No, we're thinking next week.
不必须是明天
No, it has to be tomorrow,
最迟后天
The next day at the latest.
我们应该等她身体再恢复一段时间
We should let her get stronger first.
她现在身体状态很好
She is strong.
我们不想再等到癌细胞像之前那样扩散开来了
And we don't want it to spread past what it already has.
当然不希望这种情况发生但这是个大手术
Of course we don't, but it's a big surgery, so --
我知道我扛得住
Yeah, I can handle it.
我很好
I'm fine.
我想尽快接受下一次手术
I want the next surgery as soon as you can do it.
情况如何
How'd it go?
谢谢
Thank you.
我觉得挺好的
Okay, I think.
她之前进行的放疗导致了一些组织纤维化
Her radiation caused some fibrosis,
给手术增加了一些难度
which made things a little tricky.
我反正是希望能再等她恢复一周再进行手术
I would've preferred to have waited another week.
我也是希望等到下周
I wanted to wait too.
抱歉之前那件事我还没来得及跟进
I'm sorry. I haven't followed up on the the thing.
共进晚餐吗
Dinner?
并不是我不想
It's not because I don't want to.
只是我
It's just that I...
我理解我是说你知道的如果
Sure, I mean, you know, if...
最近发生太多事了
There's a lot going on.
最近发生太多事了
There is a lot going on.
总有一天能成行的
It'll happen...sometime.
总有一天
Sometime.
我先进去了
I better get in there.
吓死我了
God.
你睡不着吗
You can't sleep?
完全清醒各种睡不着
Wide awake, all hours.
这把椅子是唯一能让我的胃和背
This chair's the only place my stomach and back
感到舒坦的地方所以
can get comfortable, so...
你怎么也起来了
What are you doing up?
我有三个孩子根本捞不到觉睡
I have three kids. I don't sleep.
当妈真不容易
Motherhood.
我一直想再要个孩子
I always wanted more kids
这样麦琪就能有个妹妹或者弟弟
so Maggie could have a sister or a brother.
她从家里搬出去的时候我很担心
I was worried when she wanted to move out here.
她之前在波士顿过得很开心
She was happy in Boston,
但是
but...
我真的很高兴她认识了你
I'm really glad she found you.
你刚说你的胃疼得很不舒服是吗
You said your stomach is bothering you?
见鬼
Damn it.
理查德
Richard?
你准备怎么跟她们说
What are you gonna say?
你确定是癌细胞转移吗
You're sure it's a met?
病灶就在经流肝脏的胆管上
It's right where the bile drains from your liver,
这也解释了你为什么会胃痛
so that would explain your pain.
你是说我身体里又出现了新肿瘤吗
You're saying I have another tumor?
不是她说的是原来那颗肿瘤的癌细胞
No. No, she's saying that cells from the original tumor
转移扩散到了其他区域
have traveled and grown in another place.
转移到了肝上吗
In my liver?
-是的 -有可能
- Yes. ? - Maybe.
我知道这对你们而言还难以接受
So, I know this is a lot to take in.
你们俩不如今晚先休息
So why don't the two of you, um, take the night,
我们明天再详细
and we can meet again in the morning
讨论下这事好吗
and discuss it further, okay?
我们现在就可以讨论啊
We're here now.
但是我只是想表达
But I just meant that...
你能用腹腔镜微创手术移除病灶吗
Can you remove it laparoscopically?
-什么 -现在这个情况那样做
- What? - ?Well, that would be better
比再来一次开胸手术更合理对吗
than an open procedure at this point, right?
这样也不需要中断化疗
Then we wouldn't have to stop her chemo regimen,
除非你有其他手术方案
unless you have a different surgical plan.
你想出去讨论一下吗
Would you like to discuss this outside?
不我们讨论的是我妈妈的治疗方案
No, no. We're discussing my mother's treatment.
-我们可以和她一起讨论 -好的
- We can discuss it with her. ?- Okay.
戴安一般来说对于这种侵略性癌症
Diane, typically with aggressive cancers,
我们只会在原发区域进行手术
we only operate where the original tumor began --
就你而言也就是你的乳腺
in this case, it was your breast.
除非肿瘤转移到了其他区域
Unless the cancer spreads beyond that,
不然再进行手术是没有实际疗效的
surgery is not curative.
但这样能防止出现后续的疼痛和并发症
But it could prevent further pain and complications,
如果癌细胞转移或者继续蔓延
which there will be if the met keeps growing
这种情况就会发生
or spreads even further.
我们会通过其他治疗手段来防止这种情况发生
And we would work to prevent that using other options.
是啊给她输更多化疗药物
Sure, pump her with more chemo.
刚才你还担心
Well, a second ago, you were worried
要停掉她的化疗
about stopping her chemo.
你就摘除这个转移肿瘤就行了
Just take out the met!
你是在让我做一个...
You're asking me to perform a procedure...
你几乎无法在扫描片子上看到
You can barely see it on the scan.
不仅会给她带来疼痛
...that will not only cause her pain,
还让她面临多种并发症风险的手术
but put her at risk for many complications.
这是我母亲
It's my mother!
我想让你跳出标准和典型的思考方式
I'm asking you to think beyond the standard and typical.
我想让你以一个专业外科医生的角度
And I'm asking you to listen to yourself as a surgeon,
-听听你刚才说的 -天哪够了
- who should know better -- Oh, good God, enough!
你们两个都闭嘴我都听不见自己的思考了
Both of you -- I can't even hear myself think.
妈妈我们只是我们需要一个
Mama, we just -- we need one --
你是想说
Are you saying
你不能做手术
that you can't do the surgery
-来摘除这个 -转移的肿瘤
- to remove the, um... - the met.
你能做吗
Can you do it?
我能做但我的意思是我不会做的
I can, but I'm saying that I won't
因为从专业的角度来讲
because, in my professional opinion,
我认为这不是个好主意
I think it's a terrible idea.
梅瑞狄斯如果你不做这个手术就可以走了
Meredith, if you won't do the surgery, you should go.
我们会找一个愿意做的外科医生
We'll find another surgeon who will.