良医

The Good Doctor S03E02

Part 6 Nov. 13, 2019, 1:57 p.m.

causing the same symptom.
是因为第一次手术
We only know about the second condition
我们才知道有第二个病症
because of the first surgery.
治疗方案是钡灌肠
Treatment protocol is a barium enema,
但不适合布雷登这个年龄的孩子
but not for someone Braden's age.
空气灌肠可能有用
An air enema might work.
除非肠子破了
Unless the intestine's torn.
摩根重新调整视野
Morgan, reposition the scope
以便更好地观察肠套叠部位
to get a better look at the intestinal wall
周围的肠壁
around the intussusception site.
肯定有太多的肿胀和水肿了
There's too much swelling and edema to be sure.
考虑到感染的风险我们没时间查证了
With the risk of infection, we don't have time to find out.
你要给他开腹了
You're gonna have to open him up.
应该你来
You should.
坎特雷尔夫妇已经明确表示了
The Cantrells made their wishes clear.
那是在我让他们认为你犯错了的时候
Well, that's when I made them think you'd erred,
而你没有
which you did not --
不是过于谨慎
not on the side of caution...
完全没有
not at all.
我们一起做手术
We do the surgery together.
谁来主刀
Who's the lead?
我觉得你知道
I think you know.
滥用职权吗
Pulling rank?
没错
Absolutely.
作为外科手术主任我指定你
As Chief of Surgery, I designate you.
这就像个拼图
It's like a puzzle.
你来固定动脉
You secure to the artery,
这样血管就不会延伸到静脉
then the vessel just won't quite stretch to the vein.
你可以移♥动♥受体血管
You could mobilize the recipient vessel.
再说一遍布朗医生
Repeat that, Dr. Browne.
移♥动♥受体血管使其松弛
Mobilize the recipient vessel to create more slack.
你又见卡莉了
You saw Carly again.
怎么样
How was it?
不速之客
Inconvenient.
但就算她突然造访
But despite her intrusion,
我还是能专注在治疗上
I was still able to concentrate on medicine.
那不是突然造访是个约会
That wasn't an intrusion. That was a date.
那只是散步
It was walking.
跟与你彼此喜欢的人一起散步
Walking with someone you like who likes you, too,
就是不算约会的约会
is a non-date date.
我有过的最好的约会
Some of the best dates that I have had
没有鲜花没有餐厅预约只是...
did not involve flowers and restaurant reservations. Just...
两个人坐在沙发上一起吃着薯片
sharing a bag of chips and sitting on a couch.
固定好了
Secured.
松开血管钳
Remove clamps.
血液在移植物中间流动
Blood flow to and from graft.
我们开始处理胸肌皮瓣
Let's move on to the pectoralis flap.
血压在下降
Blood pressure's dropping.
好的心率上升
Okay. Heart rate is up.
静脉注射肾上腺素一毫克
Push IV fluids, give epinephrine 1 milligram,
开始静滴
then start a drip.
这里有肠壁穿孔
There's intestinal wall perforation.
能修复吗
Repairable?
组织损伤得太多了
There's too much tissue damage.
感染
Infection?
没有腹膜炎的征兆
No sign of peritonitis,
但我们得切除这段小肠
but we'll need to remove this section of bowel.
-心动过速了 -血压过低
- He's tachy. - Hypotensive.
继续注射升压素和抗生素
Push vasopressors and antibiotics.
检查血气分♥析♥仪的红细胞压积
Check an iSTAT hematocrit,
术前气骨导差注射两单位浓缩红细胞
ABG. Give two units PRBCs.
我没有看到任何大出血
I don't see any major bleeding.
推送更多补液再补充一次强心剂
Push more fluids, start an inotrope.
用多普勒检查碰过的所有血管是否有血栓
Check all vessels we worked on for clots with the Doppler.
好的
Okay.
颈动脉有大血栓
Large clot in the carotid.
重新钳紧
Clamps back on,
实施颈动脉切开
performing carotid arteriotomy.
想办法吸出血栓
Will try to aspirate out the clot.
拿着肝素在旁边待命
Stand by with heparin.
颈动脉血栓清除
Carotid clot removed.
脑电图好了
EEG looking good.
继续胸肌皮瓣剥离
Resuming pectoralis flap dissection.
干得好各位
Good work, everybody.
来说点什么
Go ahead, say something.
对你能讲话
Yeah, you can talk.
一开始或许不能说太多...
Maybe not too much at first...
要让下巴有一个恢复的机会
give the jaw a chance to heal.
谢谢
Thank you.
我代表我们大家不用谢
On behalf of all of us, you're very welcome.
那个被搭讪时被你解救的女生在这里
The woman who was being accosted when you intervened is here.
她没事吧
Is she all right?
她不是作为病人来的
She's not here as a patient.
她一直...等着见你
She's been... waiting to see you.
行吗
Okay?
你好
Hello.
我真抱歉发生了这种事
I am so sorry this happened.
我也是.
Me too.
你看起来…
You look...
等肿胀消退时他会看起来好很多
When the swelling goes down, he'll look a lot better.
没关系
It's okay.
我的脸从没带给我过好运
My face was never my fortune.
为什么你会这么做
What made you do it?
你为什么插手
Why did you step in?
我不知道
I don't know.
你当时需要帮助
You needed help.
对了我叫
Olivia, by the way.
乔希
Josh.
我们留你俩认识下
We'll let you two get acquainted.
对我来说谁第一个做主刀手术并不重要
It didn't matter who got the first lead surgery -- to me.
但最近我注意到了
But it's recently been brought to my attention
对你们中的一些人来说有多重要
how much it might mean to some of you.
似乎我忘了这个决定有多重要
Seems I'd forgotten how important this decision is
因为这是你们梦寐以求多年的机会
when you've been dreaming about it for years.
你们都是优秀的候选人每个人都是应得的
You're all excellent candidates, each deserving,
也都会轮到你们
and will all get your turn.
先从布朗医生开始
Starting with Dr. Browne.
太棒了
Yes!
谢谢
Thank you.
-恭喜 -谢谢
- Congratulations. - Thanks.
刚才那是什么鬼
What the hell was that?
我只是为一个同事感到高兴
I was happy for a colleague.
你不是为了让自己获胜才去竞争
You weren't campaigning for you to win.
是为了让我输才做的
You were campaigning for me to lose.
你就那么讨厌我吗
Do you dislike me that much?
我只是不想让你作为首席住院医师来监督我
I just wouldn't want you supervising me as Chief Resident.
要你是老板简直是噩梦
You'd be a nightmare of a boss.
肖恩
Shaun.
利姆医生认为我为这个病患
Dr. Lim thought my motives for fighting this hard
这么努力的动机是判断失误
for this patient were miscalculated.
她是对的
She was right.
我们不该救他的脸吗
We shouldn't have saved his face?
我们资源有限而且更加局限的是
We have limited resources, and we're even more limited
以人的能力来决定谁是值得救的
in our personal capacity to determine who is deserving,
所以我们才选择去平等对待每一个人
so we make a choice to treat everyone the same.
那你为什么要对这个病患不一样
So why did you treat this patient differently?
因为我很生气
Because I was angry.
我牺牲了自己去救你
I made a sacrifice to save you.
我失去了工作遭受了大越级的降职
I lost my job, I took a substantial demotion.
我觉得我是个傻瓜
And I thought I was a fool.
代价太高了