良医

The Good Doctor S02E11

Part 3 Jan. 5, 2020, 3:41 p.m.

Unfortunately, until we know for sure,
还是要进行封闭
we're still on lockdown.
不过我会告知疾控中心
But I'll let the CDC know.
你有时间吗
Do you have a minute?
紧急吗
Is it urgent?
不太算
Not really.
小凯
Kel --
怎么了
What's up?
你为什么搬走了
Why'd you move away?
我是住院医生需要跟着工作走
I'm a resident, you go where the job takes you.
凤♥凰♥城就不需要医生吗
They don't need doctors in Phoenix?
对我来说那是个难得的好机会
This was an excellent opportunity for me.
而且不到两个小时就能飞到我不...
And it's less than a two-hour flight; I'm not --
几个月来你都有我的棒球时间表
You had my baseball schedule for months
但你只来过一次
and you came for one game
还一直在弄你的电脑
and you were on your computer the entire time.
我第二天有考试
I had exams the next day.
那你何必来呢
So why'd you bother coming?
很好
Good...
慢点
Slowly...
很好
Good...
虽然碎冰很美味
As delicious as these ice chips are,
我觉得我可以吃固体食物了
I think I'm ready for some solid food;
他们有送点饼干吗
did they send in any cookies?
莫菲医生说的很清楚放屁之前都不能吃
Dr. Murphy was very clear -- no food until you fart.
想象这是从北极直接运过来的
Just imagine they're straight from the North Pole.
-鲍勃你准备好了吗 -当然
- Bob, you ready? - Of course.
我要做骨髓提取
I'm doing a bone marrow extraction,
我还需要人来帮忙处理些血腥的东西...
and I need an extra set of hands to handle some bloody stuff...
把骨头和脂肪从干细胞中分离出来
separating bone and fat from stem cells.
谁还没被我说的话吓坏可以来帮我
Who here isn't freaked out by what I just said and can help?
埃斯特是个医生
Ester's a doctor.
你是医生吗为什么刚才不...
You're a doctor? Why haven't you --
我是兽医已经退休了
Veterinarian. Retired.
都是治病的跟我们来
Blood is blood. Follow us.
胎心还是在每分钟130到140次之间
Fetal heart rate is still between 130 and 140 BPM.
宫缩间隔为十七分钟
Contractions 17 minutes apart.
发生什么了是我的宝宝吗
What's happening? Is it my baby?
维奥拉的血压是180/100
Viola's BP is 180 over 100.
她可能有先兆子痫而且可能会癫痫发作
She may have preeclampsia and an oncoming seizure.
我们得催产
We need to induce labor.
不他不能生在这儿
No. He's not being born in here.
我们得等到隔离结束
We are waiting for quarantine to end.
你的胎盘供血不足
Your placenta isn't getting enough blood flow.
我们得让他出来
We need to get him out.
这是你第一次生宝宝
This is going to be your first baby.
我第一次接生
And mine.
开始注射支气管扩张剂
Start bronchodilators.
利姆医生能听见吗
Dr. Lim, can you hear me?
氧饱和度还在下降
O2 SATs are still dropping.
推注麻♥醉♥药♥
Push paralytics.
开始插管
Starting intubation.
喂什么情况
Hello? What's going on?
什么情况
What's going on?
利姆的氧饱和度在下降她的肺不充气
Lim's O2 SATs are crashing. Her lungs aren't inflating.
里面充满了液体和分泌物
They're filled with fluid and secretions.
-把电♥话♥拿起来 -我腾不出手
- Pick up the phone. - I've got my hands full.
维兰纽瓦快拿起电♥话♥
Villanueva, pick up the phone.
好给我看看情况
Okay, show me what's going on.
她的呼吸系统彻底衰竭了
She's in full respiratory failure.
她需要更多的肺支持
She needs more pulmonary support.
给她上双水平气道正压通气
Get her on BiPAP.
也许能争取点时间
That might buy us some time.
或者我们干脆先不管她的肺
Or we take her lungs out of the equation.
给她做体外膜肺氧合
We put her on ECMO,
在体外给血液供氧...
oxygenate her blood outside her body...
她的肺会有时间愈合
her lungs will have time to heal.
我们不能在急诊室做体外膜肺氧合
We can't do ECMO in the E.R.
我们也不应该在急诊室做
We aren't supposed to do abdominal surgery
腹部外科手术
in the E.R., either.
求你了教我怎么做
Please, walk me through it.
在她的股静脉上方找块地方做好准备
Prep an area over her femoral vein.
这太吵了
That's very loud.
能看到头部吗莫菲医生
Any crowning, Dr. Murphy?
不她的宫口只扩张了六厘米
No, she's dilated at 6 centimeters,
我还摸不到胎儿的头
and I don't feel the head.
离她羊水破了已经七个小时了
It's been seven hours since her water broke.
宝宝卡住了用奥波德氏操作法
The baby's stuck. Use Leopold's maneuvers
来确定胎儿的位置
to identify the location of the baby.
胎儿处于横位
The fetus is transverse.
他大概在朝左侧三十度的位置躺着
He's lying roughly thirty degrees to the left side.
这样宝宝生不出来
We can't deliver the baby.
什么为什么不行
What?! Why not?
我们得把宝宝转过来
We need to turn the baby.
我们得进行外部抬头倒转术
We need to do an external cephalic version.
或者进行剖腹产
Or a C-section.
我协助过几次...
I have assisted on several...
那是在手术室有经验丰富的主治医生在场
In operating rooms with an experienced attending.
我们不能在这里进行剖腹产手术
We are not doing a C-section here.
把她的床倒下去我去拿啫喱
Tilt her bed. I'll grab the gel.
好的
Okay.
所以如果...
So when...?
什么如果什么
What? When what?
他被隔离的时候我不会告诉他
I get not telling him when he's in quarantine.
他已经够忙的了但是...
He's got enough on his plate, but...
绝对不要
Never.
但是你第一次诊断出来的时候告诉他了
You told him when you were first diagnosed.
是的那是个错误
Yes, and that was a mistake.
他逼着你去做检查这救了你的命
He forced you take tests that saved your life.
不最后结果是并没有
Well, no, as it turns out, it didn't.
而且他太执着了工作都分了心
And he became so obsessed and distracted
差点害死了一个病人
that he nearly killed a patient.
他是你的朋友
He's your friend.
我是他的导师照顾我不是他的工作
I'm his mentor. It's not his job to take care of me.
一定要转动针管
Make sure you turn the needle
这样就可以从各个方向取到骨髓
so you're getting marrow from all sides.
慢点抽吸
Aspirate slower.
拉得越快越痛苦
If you pull fast, it's more painful.
坚持住鲍勃
Hang in there, Bob.
我应该受点痛苦
I deserve a little pain.
你是他爸爸你在挽救他的生命
You're his dad. You're saving his life.
我在儿子还不知道我是谁时就离开了
I took off before my son even knew who I was,
乘着破厢式货车浪迹天涯
traveled in crappy vans
住在破旧的旅馆里
to s-stay at crappy hotels
演奏着那些烂曲子
and play crappy music,
就为了赚钱买♥♥毒品
all so I could earn enough to get high.
你现在还是来了
You're here now.
我终于鼓起勇气面对他们时
By the time I got up the nerve to face them,
我前妻快死了
my ex was dying.
上帝也希望我能及时赶到救我儿子
God willing I did it in time to save my son.
梅伦德斯医生克里斯的生命体征不行了
Dr. Melendez, Chris's vitals are bottoming out.
他的分泌物和肺音都越来越差
His secretions and lung sounds are worse.
我不知道还能等多久
I don't know how much longer we can wait.
给他用左旋去甲肾上腺素准备移植
Administer Levophed, and prep him for transplant.
朴医生克里斯出现了低血压
Dr. Park, Chris's in hypotensive crisis.
-快 -我在尽快
- Go faster! - Fast as I can.
莫菲医生准备好了吗
You ready, Dr. Murphy?
是的我摸到头了
Yes. I can feel the head.
我们得往一个方向转
We need to rotate in the same direction.
深呼吸维奥拉
Deep breaths, Viola.
好的