医院革命

New Amsterdam S01E09

Part 2 Nov. 27, 2019, 1:17 p.m.

接着头脑风暴
Keep thinking.
替工薪阶层好好出口气
Kick some ass for the working class!
潘塔基医生联♥系♥你了吗
Did you hear from Dr. Panthaki?
没有我想和你说的不是试验的事
No, this isn't about the trial.
布鲁姆医生让我为一位血液病患者做会诊
Dr. Bloom asked me to consult on a hematology patient.
结果发现她在本院接受过心脏移植手术
Turns out that she was a heart transplant recipient here,
27年前
27 years ago.
然后呢
And?
她的病历上记载着其心脏捐赠者是
Her file says that she received her heart
「卢娜·古德温」
from a "Luna Goodwin".
你妹妹
Your sister.
她快不行了
She's fading fast.
我们已经输了两包带压力袋的
We've already infused two units of packed red cells
红细胞血但她的计数净值还是负值
with a pressure bag but she's still net negative.
我想给她用血浆增量剂
I would give her a plasma expander,
但她的红细胞压积已经太少了
but her hematocrit's already in the toilet.
用了反而让她情况更加危险
I mean, that's just gonna make it crash even more.
普通的生成与破坏机制
The usual production - destruction algorithm
好像不太适用
doesn't seem to apply to her.
从血库再拿两单元血
Let's order up two more units from the blood bank
并开两条大口径静脉通路
and let's get a second large bore IV line.
将她调整成头低脚高的位置
Give me a little trendelenburg.
我能做些什么
How can I help?
血都往这去了
That's where all the blood is going.
莎拉的右大腿
Sarah's right thigh.
那她为什么会流血
Why is she bleeding in the first place?
没找到出血点
There's no localized source.
没有伤口撕裂动脉瘤破裂吗
No cuts, lacerations, blown arterial aneurysm?
是的看上去所有器官都在慢慢出血
No, every organ just seems to be oozing blood.
部分凝血活酶时间查了吗
Elevated PTT?
刚过正常范围
It's barely out of the normal range.
但考虑到这点
Yeah, but put that together
再加上她大量出血的原因
with why she's bleeding so much.
获得性血友病吗
Acquired hemophilia?
她的八号♥抑制因子不起作用
Her clotting factor eight isn't working.
所以她才血流不止
That's why she's bleeding.
很罕见但的确能解释病情
Rare, but it would explain it.
很好
That's good.
我好渴
I'm really thirsty.
她很渴能给她拿点水吗
She's thirsty. Can we get her some water, nurse?
先等等
Let's hold off on that.
马德森女士我...
Ms. Madsen, I--
我做过心脏移植手术
I had a heart transplant.
我最近一次复查时医生说
At my last check-up my doctor said
环孢菌素水平很低
that my cyclosporin levels were low
我很担心我的身体对心脏出现了排异反应
and I've been worried that my body's rejecting my heart.
可能是这个原因吗
Could that be causing this?
但这解释不了出血
That wouldn't explain the bleeding.
不过能解释为什么出血
But it might explain why the bleeding's
让你病得这么重
been making you so sick.
我的病究竟有多严重
How sick am I?
获得性血友病是种很严重的病
I'm afraid acquired hemophilia is quite serious.
但我们能治好好吗
But we're gonna fix it, okay?
护士们现在会带你去重症监护室
Nurses are gonna take you up to ICU right now.
我们马上开始治疗你会没事的
We're gonna start treatment and you're gonna do great.
谢谢
Thank you.
你还好吗
Are you okay?
血一旦止住了
Once the bleeding is stabilized
就做一个移植心脏的活检
get me a transvenous heart biopsy.
告诉我一切关于心脏的信息
Tell me everything you can about that heart.
麦克斯
Max.
建立账户
你打字好快
You type so fast!
好像「战争游戏」里的马修·布罗德里克
Like Matthew Broderick in "WarGames."
不知道你说的是啥玩意儿
No idea who or what that is.
好了你现在有推特帐户了
Boom. Now you're on Twitter.
格拉蒂斯
推特新用户
看这个是我
See? That's me right there.
账号♥是@ShayMyName2018
@ShayMyName2018?
是啊我知道这名字很傻
Yeah. Silly name, I know.
有2.7万个关注
You have 27,000 followers?
是啊很疯狂对吧
Yeah. Crazy, right?
从我刚开始变性时他们就关注我了
They've been following me since the beginning of my transition.
这是个真实存在的群体
It's a--it's a real community.
他们支持我
They support me.
-让我保持真我 -我都不知道
- Keep me real. - I had no idea.
是啊他们很期待我去做隆胸手术
Yeah, they can't wait for me to get top surgery.
现在我们就等弗罗姆医生
Now we're just waiting for Dr. Frome
能尽职尽责攻克难关了
to, you know, do his thing.
你不明白
You don't understand.
我们爱谢伊
We love Shay.
从他最初开始变性时我们就大力支持
We have been supportive of his transition from the beginning.
新发型新衣服
The new haircut, the new clothes.
还有荷尔蒙阻断剂
Even the hormone blockers.
我们从未拒绝过一次也没有
We never pushed back, not once.
但手术那是永久性的啊
But surgery? It's so permanent.
你们也知道
Well, you know, um...
隆胸手术是
Top surgery is
对变性男士来说是最能有性别认同感的手术
the most common gender-confirmation surgery for trans men.
如果身体性别与心理性别不符
Having a body that doesn't reflect your gender...
那会令人非常焦躁不安
That can be deeply unsettling.
当然我们明白
Of course. We know.
-只是 -好吧我就直说了
- It's just-- - Okay, I'm just gonna say it.
他还没到能开车的年龄
He's not even old enough to drive a car.
他还不能看限制级影片
He's not old enough to get into R-rated movies,
他还没到能够决定对自己实施
and he's not old enough to decide on his own
永久性手术的年龄
to get permanent surgery.
没事的没事的
It's okay, it's okay.
这里就是我们能够吐露心声的地方
This is exactly where we can talk about all of this.
不如你们告诉我一些
So why don't you guys tell me
谢伊出柜之前的生活状态吧
a little bit about Shay before he came out?
很艰难
It was hard.
他一直很焦虑
He was anxious all the time.
有时他甚至下不了床
Sometimes he had trouble getting out of bed.
那他公开宣布变性之后呢
What about after he started to socially transition?
他开始有了笑容
He started smiling.
交到了朋友
Making friends.
当他开始使用荷尔蒙阻断剂之后
And when he started the hormone blockers
他说自己第一次感觉身心合一
he said he felt like himself for the first time.
是的
Yeah.
我的宝贝14岁了却从未有过身份认同感
My baby was 14 and he had never felt like himself.
我们现在也心怀感激
And we're grateful he does.
但当我们拒绝他做手术后
But when we said no to surgery,
你知道他干了什么吗
you know what he did?
他在推特上发起了「赞助我」众筹
He threw a GoFundMe on Twitter
让关注他的人出钱
to ask his followers to pay for it.
而那些人也真的给钱了
And they did.
他在这个群体中能发声我们感到骄傲
We're proud that he is a voice for a community.
但他还是个孩子
But he's just a kid.
我们的孩子
Our kid.
请告诉他他不能做这个手术
Please tell him he can't do this.
我明白你们的纠结
All right, I-I understand that you are overwhelmed.
但自从谢伊变性以来他的状态变佳
But the positive changes in Shay since transitioning
这是不可否认的
are undeniable.
而情感上的变化呢
And emotionally?
我觉得现在最重要的情感
I gotta say, I think the emotions that matter most here
就是他的情感所以
are his. So...
我会批准对他的手术进行一个医学评估
I am going to approve a medical evaluation for surgery.
我儿子戒酒一整年了
My son has been sober for a year.
那真是太好了
Oh, that's terrific.
他表现出极强的毅力