医院革命

New Amsterdam S02E12

Part 3 Feb. 27, 2020, 10:18 a.m.

I'm just more interested in the tangible.
-古德温医生你听说了吗 -听说什么
- Hey, Dr. G, did you hear? - Hear what?
他们刚才说我的癌症在好转
They just told me I was in remission.
这太神奇了吧
What are the odds, huh?
-大麦克太神奇了 -抱一个
- Big Mike, that's amazing. - Give me some.
-介意我坐过来吗 -当然不介意请坐
- You mind if I sit in? - No, man, please.
登录失败
链接无效
简直太荒谬了
This is ridiculous.
难以置信
Unbelievable.
好好听我说
Okay, okay, listen up.
我们已经切断了与病人互动的屏幕
I mean, we have already cut screens from patient interactions.
我们并不需要电脑
We don't need computers.
我们需要的是我们的智慧
All we need is our wits
和一些纸
and some paper.
好了来吧
All right, come on.
我们开始吧
Let's do this.
由于我不能把处方用邮件发给药店
Since I can't email prescriptions to the pharmacy,
出院的病人怎么拿到药
how are discharged patients gonna get their meds?
你可以写下来或许就写在这张便签上
You'll write them down. Maybe here on this pad.
我们应该怎么称呼这个神奇的发明
And what shall we call this amazing invention?
这个写处方用的便签呢
This pad on which we write prescriptions?
他腹痛
Um, he's got abdominal pain.
还有呢
And?
通常在我打输入这一症状之后
Usually the computer tells me what comes next
电脑会告诉我接下来怎么做
after I type in the symptom.
你是认真地跟我说我的一位住院医生
Are you seriously telling me that one of my residents
不知道怎么治疗肚子痛吗
doesn't know what to do about a tummy ache?
行了这太荒谬了
Okay, this is ridiculous.
难道这整栋楼都没有一支
How is there not a single working pen
-能写的笔吗 -给试试这支
- in this entire building? - Here, try this one.
-病人来了 -好了我们要开始了
- Incoming! - All right, now we're in business.
好好学着点
Watch and learn.
伙计们什么情况
All right, fellas, what do we got?
53岁男性
53-year-old male
抱怨说胸口有压♥迫♥痛
complaining of crushing substernal chest pain.
你叫什么名字先生
Okay, what's your name, sir?
伊凯卡·纳马考卡阿洛哈内里
Ikaika Namakaokealohahaunele.
结尾是「A」还是「E」
With an "A" Or an "E"?
我从小就很胖
Ever since I was a kid, I was big.
到我20岁的时候已经170公斤了
By the time I was 20, I was about 375 pounds.
我几乎走不了路
I could barely walk.
那一定很令人沮丧
That must've been frustrating.
人们会说是我没有努力减肥
People'd say I wasn't trying hard enough to lose the weight.
我胖都是我的错
That it was my fault I was so fat.
那真是...
That's--
肥胖不是意志力的问题
obesity is not a willpower issue.
不是的
It's not.
我原来也胖过
I've, um, you know-- I've been there.
所以你懂
So you know.
没错
Yeah.
当时我的一位医生告诉我肥胖是一种疾病
Then one of my doctors told me obesity was a disease.
-没错 -而且它和其他疾病一样
- Yeah. - And like any other disease,
-是可以被治愈的 -对没错
- it could be treated. - Yeah, that's correct.
我当时准备好了去尝试所有办法
Well, I was ready to try damn near anything.
所以我开始吃这这种药
So I started taking this medication,
然后我开始掉体重感觉更健康了
and I started losing weight, and I felt healthier.
是真的
I really did,
但他们从来没跟我说过皮瓣的事
but they never told me about these skin flaps.
不是说我有多爱以前的身体
Wasn't like I loved my body before,
但那至少是我的身体
but at least it was my body.
现在这样让我觉得我穿着一件外套
This makes me feel like I'm wearing an extra coat.
人们注视我的目光比我胖的时候还要多
People stare at me more now than they did when I was fat.
露易丝你有没有想过自残
Louise, do you ever think about hurting yourself?
可以做手术的
Hey, there are-- there are surgeries.
你知道的吧
You know that right?
可以切除多余的皮肤
Where they remove the excess skin--
我满脑子都是这个手术但太贵了
It's all I think about, but it costs a fortune,
我的保险不会报销这就是我现在的生活
and my insurance won't pay for it, so this is my life now.
不不是这样的我不会放弃你的
No, no, that is not the case. I'm not giving up on you.
好吗你也别放弃
Okay? Don't you either.
-海伦嗨 -嗨
- Helen, hey. - Hi.
你有没有患者
Did any of your patients
进入卡斯特罗医生的二♥期♥临床试验
get into Dr. Castro's Stage Two trial?
只有一个
Only one.
我的患者中符合条件的一个都没进
Not a single one of my eligible patients got in.
-没有 -昌治医生的患者也是
- None? - None of Dr. Shoji's either.
如果现在卡斯特罗医生得到政♥府♥资助
Now if Dr. Castro's gotten government funding
40名患者上哪去找这些患者呢
for 40 patients, where are they coming from?
我大老远从芝加哥飞来就为了这个
I flew all the way from Chicago for this?
-萨姆拜托 -抱歉只是
- Sam, come on. - Sorry, it's just--
你♥爸♥爸还在这里想和我们说话
Your father's still in there trying to talk to us.
-想和我们交流 -但他不在
- Trying to communicate with us. - But he's not.
为什么你看不出来他已经不在了
I mean, why can't you see that? He's gone.
妈我知道你有多希望爸爸还在这里
Mom, we know how badly you want Dad to still be here.
我们也很想他但这些只是无意识的动作
We miss him too, but these are just involuntary movements.
此时此刻
I mean, at this point
我们都在做无意识的运动
we're all doing involuntary movements.
你不是一直在这里
You haven't been here.
你们两个在这里的时间都太少
Neither of you have been here enough
看不出这和之前有什么不同
to see that these are different.
有什么不同吗
Are these different?
没有
No.
我爸爸有出任何...叫什么来着
Does our father show any signs of--what is it?
大脑高级功能的迹象吗
Higher brain function?
没有
No.
而且你在14年前告诉我们
And you told us 14 years ago
要宣称一个人还活着
that it takes more than a beating heart
光是心脏跳动还不够所以我爸还活着吗
to declare someone alive, so is my father alive?
他没有大脑皮质功能
He has no cerebral cortical function,
所以我得说不
so I would have to say no.
你听到他说的了妈求你了
You listen to him, Mom? Please?
他在14年前就说过刚才又说了一遍
He told us this 14 years ago. He just said it again.
我们还要被困在这个
How much longer do we have to be stuck at this
永无止境的苏醒中多久
never-ending wake?
萨姆是对的妈妈
Sam's right, Mom.
这看起来太真实了
It looked so real.
我们都想让这成真但这不会成真的
We all want it to be real; it just isn't.
会发生
What would
什么呢如果我们
happen if we were to, uh...
让他走
...to let him go?
如果我们拔掉他的饲管
If we were to remove his, uh, feeding tube,
他的身体会失去营养
his body would be deprived of nutrients,
几天之内他的器官就会衰竭
and within a few days his organs would start to fail,
但我向你保证他不会感到任何痛苦
but I assure you that he would not experience any pain or suffering.
脉搏血氧值为90%
Pulse ox is 90%.
50毫升生理盐水 24度备用
50 mils normal saline at 24 degrees standing by.
初始支气管肺泡灌洗结果显示出
Initial BAL results show
充满脂质的巨噬细胞与热化学灼伤一致
lipid laden macrophages consistent with hot chemical burns.
基本和化学战一致
Basically the same as chemical warfare.
-有什么想法 -一时想不出什么
- Any ideas? - Not off the top of my head.
我们看看疾控中心如何建议
So let's see what the CDC recommends.
你上次不得不查阅治疗指南是什么时候
When's the last time you had to look up a treatment guideline?
我不知道当了实习生之后再没看过
I don't know. Not since I was an intern.
好疾控中心本周建议在这里
All right, the, uh, CDC recommends this week, let's see here--
「排气口设置小潮气量以及加强呼气末正压通气」
"Vent settings with low tidal volumes and high P.E.E.P."
那最多只能拖延一下
That's temporizing, at best.
我们现在都是凭感觉
Well, we're all flying blind here.
我去找一台
Let me try to locate a,
前蛋白转化酶枯草杆菌蛋白酶9型调制器
uh, PCSK9 modulator.
这应该能减轻一点炎症
A dose or two might knock down some of the inflammation.
-依据是什么 -像我说的