实习医生格蕾

Grey's Anatomy S11E15

Part 4 Feb. 23, 2020, 9:20 a.m.

你要给75岁老人做5小时的手术
That is a 5-hour surgery on a 75-year-old
她还有心脏支架还需要使用抗凝剂
who has a stent and is on blood thinners.
你都没跟我商量
I can't believe you would suggest a surgery like that
怎么就建议病人做这个手术
to a patient without running it by me first.
抱歉你找我来会诊的
I'm sorry. You called me for my opinion.
我做过很多髋骨置换手术
Look, I do hip replacements all the time
有些病人年纪还比她大心脏状况更差
on far older patients with far weaker hearts.
她明显就很有活力的啊
She is clearly still active.
我觉得她心脏的问题也不大
Uh, I think her heart's in pretty good shape.
这不是你说了算
That's not your call.
好吧我们现在说的是一位健康有活力的女性
Okay, we are talking about a healthy, vibrant woman here.
她该活得更好生活质量更高
She deserves the best quality of life that we can give her.
如果她想置换髋骨这是她的决定
If she wants a new hip, that's her call.
就为了她能滚床单么有必要么
So she can get laid? Really? Really?
你觉得这件事真有那么重要
You think that's important enough
值得她冒生命危险
to risk her dying on the table?
如果她的髋骨严重受损她不能动
If her hip is so damaged that she winds up immobilized
要卧床至死
and bed-ridden for the rest of her life,
我当然觉得该这样做因为不管怎样都是要死的啊
Then, yeah, I sure do, because either way, she's dying.
好我会再仔细看看片子
Fine. I will reevaluate the images and take a closer look.
也许有其他方法呢满意了吗
Maybe there's another option. Okay?
谢谢你
Thank you.
凯普娜跟我说了那小女孩的事
Kepner told me about the little girl.
有什么我能帮忙的
What can I do? What? Can I help?
-我们正试着找气道 -冒着瘫痪的风险
- We are trying to get an airway. - By risking paralysis.
我宁愿她瘫痪的活着
I'd rather have her paralyzed and alive
也不愿她因为呼吸停止而死
than dead with respiratory arrest.
你有更好的办法吗
Do you have a better idea?
喂还在吗
H-hello? Are you still there?
露比开始吧
Ruby. Go ahead.
抬起她的下巴轻轻向前推
Lift her chin and pull it forward -- gently.
好的
O-okay.
把手♥机♥放在你妈妈的胸前
Okay, now put the phone on your mom's chest okay?
我来听听
And let me listen.
没有喘鸣了
The stridor's gone.
气道打开了但是
She opened the airway, but --
她可能还有危险
she still could be in distress.
应该还有别的情况
It's something else.
露比把头放在你妈妈
Ruby, put your head on your mom's chest
左侧胸前听
on the left side and listen.
什么也听不到
I don't hear anything.
我要听什么
What am I listening for?
呼吸声听到呼吸了吗
Breathing. Do you hear her breathing?
没有
No.
欧文
Owen.
欧文
Owen.
露比现在把耳朵
Okay, okay, um, okay, Ruby, now put your ear
贴在右侧胸前听
on the right side and listen.
有动静吗
Anything?
露比
Ruby?
她在呼吸我听到了
She -- she's breathing! I-I hear it!
可能是张力性气胸
Okay, could be a tension pneumo.
露比现在把手♥机♥放在你妈妈胸前
Mm-hmm. Ruby, um, now just push the phone into your mom's chest,
就刚才你听的地方
r-right where you were just listening.
把手♥机♥放在胸前移♥动♥
Just push the phone in and move it.
那是皮下气肿听到了吗
That's sub-q air. Do you hear that?
她需要
Mm-hmm. She's gonna need --
她需要放掉滞留的空气
she's gonna need to release the trapped air
用胸管或者别的什么
with a chest tube or something.
好
Okay.
这是唯一的办法不然她妈妈会窒息
It's -- it's the only way, or her mom's gonna suffocate.
你是说
Oh, you mean --
你要让她
You're gonna ask her to --
露比我要叫你做一件事
Okay. Ruby, I'm gonna ask you to try something.
没关系的
It's gonna be fine,
我带着你一步一步做好吗
and I'm gonna walk you through it, step by step, okay?
好的可以快点吗
O-okay, but can you tell me fast?
手♥机♥一直在响
The phone keeps beeping.
我觉得要没电了
I-I think it's running out of battery.
-你在干嘛 -我在躲人
- What are you doing here? - I am hiding out.
我们在等那个父亲的实验结果
We're waiting on the dad's labs,
但我没法呆在那听他俩
but I couldn't sit there and listen to those two
互相掐架了
bite each other's heads off anymore.
我也是
Mm. Me, neither.
布莱恩的实验结果没问题麦卡怎样
Brian's labs came back clear. How's Micah?
看起来是四级脾脏撕裂可能破裂
Looks like a grade IV splenic lac, possible rupture.
我们要准备做开腹探查术
We need to prep him for ex-lap.
什么他不行了
What? He's crashing.
-遭了 -遭了
- Crap. - Oh, crap!
他的血压降到底了
His pressure's bottoming out.
快点他室颤了我们得包住他
Hurry up! he's in v-fib. We got to bag him.
一二三
One, two, three.
轻放
Easy.
急救车呢我要用起搏器
Where is that crash cart? I need those paddles.
马上就到
Almost here.
没时间了
There's no time.
有节律了
Got a rhythm.
爱德华兹你和威尔逊去准备手术室
Edwards, you and Wilson go and prep that O.R., please.
-太神奇了 -跟你了吧
- Magical. - Told you.
什么
What?
没事
Nothing.
快点去走
Get going. Move.
露比你家厨房♥里有吸管吗
Ruby, do you guys have straws in the kitchen?
-没有 -笔呢
- No. - A pen, maybe?
-圆珠笔 -有进展吗
- A ballpoint pen? - Anything?
还没因为地震线路不通
Not yet. Lines are down because of the earthquake.
他们试着从信♥号♥♥塔三角定位
They're trying to triangulate from the cell towers.
这位母亲怎么样了
How's the mom?
等等我们有送奶昔过来
Okay. Wait! wait. We got milkshakes on the way here.
有吸管了
Got a straw!
很好我们需要你找一个
Great. Now, we're gonna need you to get a --
什么
What? What?
我不想让她做这个
I don't want to ask her to do this.
露比我们需要
Ruby, we're gonna...
我们需要你找一把刀
we're gonna need you to get a knife.
不要大的但是要尖的
Not a big one, but a sharp...
你们在做棉花糖甜点吗有没有烤肉叉
Y-you were making s'mores? Are the skewers there?
有找到一个天呐
Y-yes. Got one. Oh, god.
你想让我用这个插入她体内么
You want me to stick this into her, don't you?
露比你能做到的这能救你妈妈
Ruby, you can do this. You can. It's gonna help your mom, okay?
我们需要你找到
We just need you to find the --
第二肋间
second intercostal.
我不知道怎样向她解释这个
I don't know how to explain that to her.
等等等等
Wait, wait, wait.
露比
Um...Ruby.
摸到你妈妈的左锁骨
Okay, um, touch your mom's left collarbone,
就是从脖子发出那翅膀一样的那个
The one that looks like a wing, coming out from her neck.
用手指从那里走路
Now walk your fingers down from it.
走两步明白吗
Two steps. You got it?
-好的一二 -停
- Okay. One. Two. - Stop.
现在将手指正好滑到那个肋骨下方
Now slide your finger right underneath that rib.
然后用另一只手就在手指上方
And with your other hand, right above that finger,
将烤肉叉插入大约2.5厘米
push the skewer in about an inch.
-我做不到 -露比你可以的
- I can't do that. - Ruby, yes you can.
-万一我们错了呢 -我不会错
- What if we're wrong? - I'm not wrong.
露比你能做到
Okay. Ruby, you can do this.
她有可能会刺到她的心脏
She could puncture her heart.
她不会的露比就现在
She won't. Ruby, right now.
天呐
Oh, god.
露比插用力
Ruby, push. Hard.