良医

The Good Doctor S03E03

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

BGM: This Life by Vampire Weekend
♪ Baby, I know pain ♪
我是布朗医生
I'm Dr. Browne.
今天由我给你做手术
I'll be performing your surgery today.
我是布朗医生今天由我给你做手术
I'm Dr. Browne. I'll be performing your surgery today.
♪ I just thought it didn't rain in California ♪
布朗医生
Dr. Browne...
今天由我给你做手术
I'll be performing your surgery today.
♪ Baby, I know love ♪
这是个小手术
It's a very simple procedure.
手术很简单
It's a straightforward procedure.
♪ 'Cause I've never known love like this before ♪
手术很成功
It was a successful surgery.
♪ Baby, I know dreams ♪
♪ Tend to crumble at extremes ♪
手术很成功
The surgery was a success.
♪ I just thought our dream would last ♪
我们相信你会痊愈
We expect a full recovery.
♪ We're surviving, we're still living ♪
我相信你会痊愈
I expect a full recovery.
宝贝
Baby.
这个你想放哪
Where do you want this?
谢了妈放我包里就好
Thanks, Mom. Uh, put it by my bag.
我会让医院病理实验室检查的
I'll have the hospital lab run it.
进食后出现恶心和严重腹痛
Nausea and severe abdominal pain after eating.
这位病患可能要做腹腔镜胆囊切除术
This patient could need a lap chole.
那会是理想的初次手术
That would be an ideal first surgery.
先别想那么多
Let's not get ahead of ourselves.
她可能只需要胃药
She may just need an antacid.
你好米歇尔
Hi, Michelle.
你妈妈在过来的路上
I understand your mother is on her way in.
我是布朗医生
I'm Dr. Browne.
我是肖恩·莫菲医生
And I'm Dr. Shaun Murphy.
你要治好我姐姐
You need to fix my sister.
你叫什么名字
What's your name?
-蒂莎 -你好蒂莎
- Tisha. - Hi, Tisha.
我们过来就是为了
Well, that is exactly why we're here...
帮你的姐姐
to help your sister.
寄养姐姐
Foster sister.
疼痛是什么时候开始的
When did the pain start?
一小时前
About an hour ago.
当时在巴士上
It was on the bus.
我和我姐姐每天上学和放学都坐校车
My sister rides with me every day to school and back.
我和我弟弟曾经住在巴士里
My brother and I used to live on a bus.
好酷
Cool.
你以前这样疼过吗
Have you felt like this before?
有过几次
A few times.
她的右上腹部有严重的触痛
She has extreme upper-right quadrant tenderness.
符合胆囊炎症状
That's consistent with cholecystitis.
发热和白血球计数增高也符合
As is her fever and elevated white count.
你可能需要切除胆囊
Your gallbladder probably needs to be removed.
你一定很兴奋克莱尔
You must be excited, Claire.
这会是你的第一次手术
This is going to be your first surgery.
你的尿液有变色吗
Has your urine changed color?
颜色加深
Gotten darker?
听说布朗医生的首次手术可能是腹腔镜胆囊切除术
I hear Dr. Browne might have landed her first lap chole.
这病例没那么简单
It's not exactly a straightforward case.
胆管严重扩张
The duct is massively dilated,
胆囊壁发炎这块疤
the wall's inflamed, this scarring...
会影响手术视野
it's gonna limit visibility.
胆囊壁的厚度的确增加了手术难度
Well, the thickness of the gallbladder wall does pose a challenge.
你觉得呢
What do you think?
这由不得她做决定
It's not her decision.
作为主治医生得由我来决定
It's mine, as the attending.
那她也可以说说自己的看法
Doesn't mean she shouldn't offer her opinion.
我觉得梅伦德斯医生说得对
I think that, um, Dr. Melendez is right.
手术视野受限我不该
With the limited visibility, I shouldn't be...
做腹腔镜胆囊切除术才会受视野影响
Only with a laparoscopic cholecystectomy.
我觉得我们应该用别的办法
Which I don't think we should do.
即使有炎症直接开刀也可以
An open procedure would provide a clearer view
更清晰地看到
of the gallbladder and the surrounding anatomy
胆囊及周边组织结构
despite the inflammation.
我和卡莉昨晚又去约会了
Carly and I went on another date last night.
你们做了什么
What did you do?
吃晚饭看电影
Dinner, movie...
我们步行十二分钟去了一家熟食店
We walked 12 minutes to a deli
吃了点东西聊了天
and had some food and talked.
我们要去哪儿
Where are we going?
安德鲁斯要做开腹胆囊切除
Andrews is starting an open chole.
听上去你和卡莉处得不错啊
Sounds like it's going well with you and Carly.
对
Oh, yes.
她回答了我所有的问题
She answered all of my questions.
你问了几个
How many did you ask?
83个虽然有些问题有好几部分
83, although some had multiple parts.
你想要孩子吗
"Do you want to have children?
如果想那要几个什么时候要
If yes, how many and when?"
你准备在哪个地方抚养他们
"Where do you plan to raise them?
遵循哪种宗教传统
In what religious tradition?"
这些问题都挺难答啊
Those are pretty intense.
这都是好问题克莱尔都是重要话题
They're good questions, Claire, about important topics.
刚开始的时候大家经常都谈得很浅
Early on, people usually stick with lighter stuff,
像是最喜欢的电影乐队家乡什么的
favorite movies, bands, hometowns.
随便聊聊
Small talk.
往右上腹放点腹部垫
Put some LAPs in the upper-right quadrant.
安德鲁斯医生电刀
Here's the Bovie, Dr. Andrews.
约会不就是为了
Isn't the point of dating
收集信息看看对方是否合适吗
to gather information to determine compatibility?
拉开网膜
Retract the omentum.
没错
Sure.
而找出对于对方来说
Isn't that best achieved
重要的东西不才是最好的方式吗
by finding out what's important to the other person?
止血钳
Hemostats.
这是一个过程肖恩
It's a-it's a process, Shaun,
就像剥洋葱一样
like peeling an onion.
大家都更喜欢
People are more comfortable
逐渐袒露心扉
revealing their layers gradually,
而不是直接剖开内心最深处
as opposed to getting sliced right down the middle.
我听说利姆医生选你为主刀
I heard Dr. Lim selected you for the first lead.
我猜你要做胆囊切除吧
I'm guessing you drew a cholecystectomy.
纱布棒
Sponge on a stick.
你是如何下刀的
What's your approach to dissecting...
逆行还是顺行
retrograde or antegrade?
顺行
Antegrade.
在找到肝门之后
Once I've located the porta hepatis.
我觉得卡莉没事
I think Carly was comfortable.
为什么要考虑
Why does it matter
什么时候问什么样的问题
what kind of questions are asked when?
回答不才是最重要的吗
Aren't the answers what's important?
-我相信你是对的 -没错
- I'm sure you're right. - Yes.
下次约会有何计划
What is the plan for the next date?
我们没有再约
We didn't make another date.
然后我夹住胆囊底
Then I grasp gallbladder fundus
-往哪个方向提升 -向上缘
- and elevate it which way? - S-superiorly.
这很重要吗
Is that significant?
没有下次约会
No follow-up date?
倒也不是
Not necessarily.
你们约会怎么结束的
How did the night end?
晚安吻吗
Good-night kiss?
胆囊三角已经露出来了
I've exposed the triangle of Calot
胆管和动脉已经结扎完毕
and ligated the cystic duct and artery.
这时会有什么风险
What is the risk at this juncture?
-下刀时割伤肝脏 -正确
- Lacerating the liver during dissection. - Correct.
我们没接吻
We didn't kiss.
讽刺的是我刚不小心
Ironically, a complication
就向你们展示了这个术中失误