医院革命

New Amsterdam S02E02

Part 2 Nov. 22, 2019, 10:51 a.m.

可能是你动作做错的缘故
Probably because you're doing it wrong.
你忘记舒展膝盖了
You're forgetting to extend from the knee.
你知道吗我知道一个
You know what? I know a great place
舒展膝盖的好地方
I could extend my knee into.
我倒是想看看
I'd actually love to see that,
因为照这个样子下去
because at this rate,
你不用借助拐杖走路还需要...
you'll be walking without a cane in approximately...
两亿年的时间
200 million years.
利根医生...
Dr. Ligon...
我应该告诉你不管在哪儿
you should know that I have always
你都很让人讨厌
found you to be insufferable.
不管是圣诞聚餐员工会议
Christmas parties, staff meetings,
而现在我可以很自信地说
and now I can confidently say
在复健疗法中
that same quality transfers
你还是老样子
seamlessly to your PT sessions.
而我见过80岁中风的患者
And I've seen 80-year-old stroke victims
运动能力恢复的都比你快
improve their range of motion faster than you.
我告诉你你试试
You know what? You try recovering
不吃止痛药从股骨骨折中恢复过来
from a fractured tibia with zero pain meds.
是啊我倒是希望能给你提供
Yeah, I wish I could offer you
现代医疗以外的治疗方法
something besides modern medicine,
但是你知道的我就是医生而已
but I'm, you know, just a doctor.
对了...
Actually...
等等
hold on.
什么
What?
我确实有个东西
I do have one thing
也许能帮助你消除疼痛
that might help you take your mind off the pain.
真的吗
Seriously?
但是记得还我
But I want it back.
别对它上瘾了
So don't go getting addicted to it.
作为肿瘤科的新联合主任
As the new co-chair of oncology,
我很高兴宣布每一个
I'm happy to announce that every oncology patient
新阿姆斯特丹医院的肿瘤病人
at New Amsterdam will be eligible
都有资格进行高精度靶向疗法
for precision targeted therapy.
如果你的肿瘤DNA序列
If the DNA sequence of your tumor is a match
和可实施疗法相一致的话
for the available treatment.
而我只需要签署这个文件吗
And all I have to do is sign this release?
我们会对已经记录的活组织切片进行排序
And we'll sequence the biopsy we already have on record.
这样有助于找到有缺陷的DNA的位置
Which will help us determine where the defective DNA is.
所以你们是说我的胃癌
So you're saying my stomach cancer
可能并不是真的胃癌
may not really be stomach cancer?
胃癌只是告诉我们癌症发生的地方
Well, stomach cancer just tells us where the cancer is,
并不一定就是那种癌症
not necessarily the kind of cancer.
就像车牌只能告诉你住在哪个州
Like a license plate tells you what state you live in
但是每辆车都有自己的车牌
but the numbers are specific to every car.
十分钟前我就听不懂你们在说什么了
You lost me, like, ten minutes ago.
靶向疗法人如其名
Targeted therapy is exactly like it sounds.
通过靶向癌变的基因蛋白和酶
It works by targeting the cancer's genes, proteins, and enzymes,
留下健康的细胞
leaving the healthy cells alone.
所以放疗和化疗所有的副作用
So all the side effects from radiation and chemo...
-都没有 -大大减小
- Gone. - Diminished considerably.
那有什么负面影响
So what's the downside?
-那个... -还没有测试出任何负面影响
- Well-- - There isn't a downside to being tested,
如果你正好是符合
and if you fall in the 5%
本疗法的百分之五的人群
who qualify for treatment--
百分之五
5%?
百分之五
5%?
百分之五
5%?
但这意味着化疗的大大缩短
But it means significantly less chemotherapy.
想象一下只需要两片药就能代替两小时时间
Imagine coming in for two pills instead of two hours.
但我很喜欢和夏普医生待在一起
I'd miss my Dr. Sharpe time, though.
这也意味着不用放疗
It also means no more radiation.
意味着完全治愈
It means full remission.
算我一个
Well, sign me up.
你说少做化疗我就心动了
You had me at less chemo.
瞧
See?
我们合作的多好
We make a great team.
曼尼·塔利斯 44岁校车司机
Manny Talis, 44-year-old school bus driver
右胸有痛感
with right-sided chest pain.
心率94
Heart rate 94.
血压135/80 呼吸频率14
BP 135 over 80 with resps of 14.
心电图正常
Normal EKG.
但我们在做心电图导联时发现了皮疹
But when we went to put on the EKG leads, we found this rash.
好的把他推到帘子里面
Ooh, okay, get him to curtains.
塔利斯先生好消息
Okay, Mr. Talis, good news.
我觉得你没有心脏病发
I don't think you're having a heart attack.
痛感应该是源自你胸口的皮疹
I think the pain is caused by the rash on your chest.
这叫做带状疱疹是由
It's called shingles, and it is a reactivation
引起水痘的病毒所造成的
of the virus that causes chicken pox.
你有办法减轻痛感吗
Is there anything you can do for the pain?
有布洛芬
Mm, ibuprofen.
只有这个吗
That's it?
你也可以试试这个
Oh, well, you could try this.
也许你会比我感受到更明显的疗效
Maybe you'll find it more useful than I did.
这么和你说吧我和你交换
I'll tell you what. I'll trade you.
有个孩子把这个落到车上了
One of the kids left this on the bus.
我同意换了
You're on. Okay.
我会让心脏科签署出院手续
Well, I am gonna get cardiology to sign off,
如果他们签了你就可以回家了
and if they do, then you can recuperate at home.
好的谢谢医生
All right, thank you, Doctor.
你准备通知相关部门
You're calling the appropriate department
而不是自己来做
instead of doing it all yourself?
这个守规矩的医生是谁啊
Who is this Dr. Protocol,
你把布鲁姆医生怎么样了
and what have you done to Dr. Bloom?
我进步了
Look at me evolving.
等雷诺兹医生做完手术就叫他
Just page Reynolds when he's out of surgery, okay?
好的
All right.
我使用了蛤壳切口
I use a clamshell incision.
这种切口会很好的
This incision reveals the pulmonary anatomy
显示肺部解剖结构你们看到了吗
in a spectacular fashion. You see that?
杜克你过来好好看个清楚
Now, Duke, why don't you come on over and take a better look?
过来
Come on.
看到那块组织了吗
See that tissue right there?
你来缝一下
Go ahead and throw in a couple of stitches.
让我们看看你的本事
Let's see what you got.
承认自己没准备好也没关系的
No harm in admitting you're not ready.
不我准备好了
No, I'm ready.
好吧
All right, well...
我希望你缝合得比听上去更有自信
I hope you sew more confidently than you sound.
雷诺兹医生
Dr. Reynolds.
杜克还有四秒钟
Duke, you got about four seconds
我的病人就要不行了
till my patient goes south.
开裂风险降低
Lower chance of dehiscence.
老天杜克
Damn, Duke.
你简直像台缝纫机
It's like a sewing machine.
大家仔细观察杜克的缝合
I want everyone to observe Duke's forward sutures.
看到了吗
See that?
这非常棒
That's excellent.
他们可能现在不理解
They might not get it now,
但一旦他们明白
but as soon as people see that
这能提高他们在新阿姆斯特丹医院的生活质量
this can improve their quality of life here at New Amsterdam,
我认为他们会感兴趣的
then I think they're really gonna warm to it.
但这个人画了一只手
Well, this person just drew a hand
在向你竖中指
flipping you the bird.
你在这儿
There he is.
我必须说老大做得好
I gotta say, boss, nice work.
新阿姆斯特丹医院人口普查
A New Amsterdam census,
这主意棒极了
that is just brilliant.
谢谢总算有人能理解
Thank you. Finally someone who gets it.
但医院里有一个群体
Except there is one community in this hospital