医院革命

New Amsterdam S02E15

Part 3 April 19, 2020, 9:43 a.m.

因为遇到珍妮那天是我一生中最美好的一天
Because the day I met Jenny was the best day of my life...
之后的每一天都更好了
And every day since has been better.
我知道这很疯狂
Look, I know that this is insane, okay?
相信我
Believe me.
我也理解为什么你看不到希望
And I can understand why you can't see a way through it,
但我无法想象回不到以前的样子
but I can't imagine not going back to how we were.
回到家没有你
Not coming home to you--
如果你觉得不可能
If you think it's impossible,
你现在就看着我的眼睛跟我说
and you can look me in the eye and tell me right now
你已经不爱我了
that you don't love me anymore,
那我就取消婚礼
then I will call off the wedding.
你知道我爱你
You know I love you...
但只有爱是不够的
But love just isn't enough.
就是不够的不是吗
It isn't enough, is it?
我是来终结阿片类药物流行的
Hi, so, uh, I'm here to end the opioid epidemic.
好
Okay.
所以半数的服药过量都发生在
So half the ODs occur
进入急诊室三个月之内
within three months of a visit to the emergency room,
主要用于阿片类药物过量中毒或阿片药成瘾的诊断
但如果我们开纳洛酮but if we prescribe suboxone--
就可以控制阿片类药物戒断症状
We could manage the symptoms of opioid withdrawal
-而无致死风险 -没错
- without the risk of fatality. - Exactly.
我们需要缉毒局的治疗行为豁免
We'll need a Treatment Act Waiver by the DEA,
就算这样每个有执照的医生每次只能
and even then, each licensed doctor's only allowed
-治疗三十名患者 -谁有执照
- to treat 30 patients at a time. - So who's all licensed?
-在你眼前 -真的吗
- You're looking at her. - Really?
这种情况今天就要改变
Well, that has to change. Today.
为了让所有人都拿到执照
To get everyone licensed,
他们需要参加全天的培训课程
they'll need to go on an all-day training course.
好叫来所有的医生主治医师
Sure, okay, grab all the doctors, attendings,
还有住院医生让他们去参加考试
and residents and have them take that test,
所有人通过之前不准回来
and nobody comes back until they pass.
那就意味着关闭急诊室
That would mean shutting down ED.
对那就关掉吧
Yeah, so shut it down.
-不行麦克斯 -行
- No, Max. - Yes.
你想让我给公共卫♥生♥部♥打电♥话♥
You want me to call the department of public health,
重新安排救护车暂停本院的一级创伤状态
re-route all ambulances, suspend our Level I Trauma status,
并且转移大量正在接受治疗的患者
and potentially move a multitude of patients
并且转移大量正在接受治疗的患者
who are already being treated?
-这是个好计划 -麦克斯
- That's a great plan. - Max!
简直闻所未闻这样会上新闻的
That's unheard of. It would make the news!
-而且布兰特利 -会喜欢的去
- And Brantley-- - Will love it! Go!
桥墩上的密会
A secret rendezvous on the pier?
我们这是见面还是练习侦查技术
Are we catching up or practicing our spy craft?
奥德拉
Audra.
很抱歉偷偷摸摸约你见面
I'm sorry for all the cloak and dagger,
但我遇到个难题恐怕是个秘密
but I have a dilemma, and I'm afraid it is a secret.
怎么了
What's up?
这涉及到卡斯特罗在医院外进行的国卫院试验
It involves the NIH trial that Castro's running out of New Amsterdam.
-你遇到什么难题 -我不太确定
- What's your dilemma? - I'm not entirely sure.
还不确定
Not yet.
你是担心试验存在方案偏离吗
Are you concerned there's been a protocol deviation?
因为这可能会危及你们医院所有的国卫院资助
Because that could jeopardize all NIH funding at your hospital.
这可是数亿美元的资金
We're talking hundreds of millions of dollars.
这就是为什么我要和你私下谈
Which is why I needed to speak with you off the record
撇开你国卫院的身份
without your NIH hat on.
我没有太多细节可讲
I don't have a lot of details.
我只是想帮助我的一个患者
I'm simply trying to help one of my patients that's involved.
你听说过卡斯特罗的试验
Have you heard of any significant side effects
有什么显著的副作用吗
from Castro's trial?
她什么都没报告
She hasn't reported anything,
但她应该立即记录任何不良反应
but she's supposed to document any adverse reactions immediately.
你的患者在服用试验药物还是安慰剂
Is your patient on the protocol or the placebo?
-我不知道 -你得去弄明白
- I don't know. - Well, you have to find out.
这是验证的唯一方法
It's the only way to verify.
但这意味着要违反双盲原则
But that would mean violating the double-blind.
你可以直接问卡斯特罗
You can ask Castro directly.
是那会很尴尬
Yeah, that would be, um--awkward.
实在不行就绕开她
Then go around her if you have to.
你得知道患者服用的是安慰剂还是试验药物
You need to know if the patient is on the placebo or the drug.
如果是试验药物
And if it's the drug--
我们会进行更深入的讨论
We have a bigger conversation.
不知道你有没有听说
Uh, not sure if you've heard,
国家公共电台和纽约第一频道都在关注我们
but both NPR and New York One are buzzing about us.
-因为你关闭了急诊室 -没错
- Because you shuttered the ED? - That's right.
都是头条新闻都关注阿片类药物流行问题
Both lead stories, both focused on the opioid epidemic.
我们将有更多拿到纳洛酮执照的医生
You know, we're gonna have more licensed suboxone doctors
比国内任何医院都多
in this hospital than any other hospital in the country.
完美可你觉得我关心吗
Wonderful. You want a cookie?
-什么 -我没让你呼吁关注
- What? - I didn't ask you to raise awareness,
我让你解决问题
I asked you to solve the problem.
然而医院外面有数百万人在受苦
But instead you're handing out detox drugs
而你却在发放戒毒药物
while millions of people outside the hospital are suffering.
我不在医院外面工作
I don't work outside the hospital.
不你在院外工作当你想的时候
Yes, you do. When you want to.
在理发店测量血压
Blood pressure testing in barber shops?
去保险代理人的办公室找他们
Chasing down insurance agents in their offices?
行了麦克斯跟你对话的人是我
Come on, Max! It's me you're talking to.
人们正在死去
People are dying.
做到更好
Do better.
凯西送他去泌尿科
Casey, Casey. Get him situated in Urology.
别让他们把他推走
Don't let them pawn him off.
患者来了
Incoming!
卡罗琳·沃纳 20岁晕倒在时代广场
Carolyn Werner, 20, fell in Times Square.
看起来像是桡尺骨骨折
Looks like a radial/ulna fracture.
-血压120 -好不用说了
- BP 120 over-- - Okay, let me stop you
她状况稳定只有手臂受伤吗
right there--she is stable with an isolated injury to the arm?
-对 -掉头
- Yeah. - Turn her around
-送她去浸信会 -你是认真的吗
- and take her to Baptist. - Are you serious?
我们以为重新派遣消息是误发的
we thought dispatch was mistaken.
不是我们关门了
No. We are closed.
你指望我拿这么多病患怎么办
What the hell am I supposed to do with all these?
我说不好斯金医生
I don't know, Dr. Skein.
他们收治在你名下所以...治疗他们
They are patients admitted to your care, so...tend to them?
二十个病人
20 people?
你做的...不管你在做什么
You've clogged every bed in my department
你让我的部门病床爆满了
with this--this-- uh, whatever you're doing.
我们在努力解决阿片类药物危机
We are trying to solve the opioid crisis.
一个你有份参与造成的危机
A crisis you helped cause.
我是个皮肤科医生
I'm a dermatologist.
我承认你们的情况很难处理
I will admit that your situation is difficult.
但我的工作不是去评判
but is not my job to judge
你们的关系是对是错
whether your relationship is right or wrong.
在我看来很明显你俩是非常真心地相爱的
What is very apparent to me is the love between you two is very real.
如果你们想它是值得去争取的
And if you want, worth fighting for.
但有一个不能改变的事实
There is one inconvertible truth.
你们绝不能生育孩子
Biological children can never be an option.
你认为孩子是我们担心的吗
You think kids are what we're worried about?
我都无法直视他
I can't even look at him.
因为这个新的信息
Because this new information
改变了你看待他的方式吗
has changed the way you see him?
那算是好消息
Well, good news there.
亲密关系是可以经受变化的
Relationships can survive change.
实际上几乎所有亲密关系都必须经受变化
In fact, almost all of them have to.
这又不是他突然增肥20磅那种事
This isn't like he's suddenly gained 20 pounds.
确实不是听着我能理解
No, um-- Look, I get it.
但生活仍要继续而你要做出调整
But life goes on, and you adjust.
亲密关系也需要做出调整不然就会结束
Relationships adjust too, or they end.
如果内心发生的改变难以逾越那便只能如此
If change is insurmountable in the heart, then that's it,
一切都结束了
show's over.
但你俩的情况并非如此
But that is not the case with you two.