良医

The Good Doctor S01E02

Part 4 Jan. 5, 2020, 7:39 p.m.

不确定的腹膜后肿瘤切除
Excision of an indeterminate retroperitoneal tumor.
本次手术预计不会有任何并发症
We don't anticipate any complications with the surgery.
谢谢布朗医生
Thank you, Dr. Browne.
给我十号♥刀
Ten blade.
十号♥刀
Ten blade.
我们来切除这个肿瘤吧
Let's remove a tumor.
抱歉
Excuse me.
不行
No.
可能感染了
It might be infected.
没有
It's not.
有些变色了
There is some discoloration.
他已经82岁了
He's 82 years old.
所有部位都变色了
Everything is discolored.
当我们通过肌肉层后
Once we get through the muscle layer,
要小心处理
proceed carefully.
血压120/70
Blood pressure, 120 over 70.
心率60
Heart rate 60.
她的情况稳定
She's holding steady.
我已经打开了筋膜
I've opened the facia.
你还留着你的呕吐物
You kept your puke?
对我觉得你们应该想看
Yeah, I thought you'd want to see it.
看起来就是呕吐物而已
It looks like puke.
不不不通常不是这个颜色的
No. No, no. It's not the regular color.
你的呕吐物通常都一个颜色哈
Your puke has a regular color?
对
Yeah.
看起来颜色不太正常
It is a bit of an unusual color.
我们可以化验...
We could order some...
你可以回家了
I'm sending you home.
你确定
You sure?
我能回家吗
It -- It's safe for me to go home?
我不知道该怎么说
I don't know what to say.
你会学到的
You'll learn.
从实践中
By doing.
我弟弟说有个叫肯尼的孩子
My brother said there's a kid named Kenny,
他病了他可能...
and he's sick, and there might --
你得给我们点儿钱
you should give us money.
那我有事吗
So, am I okay?
我我有事吗
Am -- Am I okay?
根据医院的相关规定
According to all hospital rules
和我收到的指示是的
and direct instructions given to me, yes.
我们需要更好的暴露视野以观察肿瘤
We need a better exposure of this tumor.
放个深层腹腔拉钩吧
Let's get the deep Balfour in here.
深层腹腔牵开器
Deep Balfour retractor
拉开腹壁
Let's get this thing open.
我就可以看清楚从哪里切除了
I've got to see where it's safe to cut.
我看这个肿瘤到处都包裹着动脉
I can't see anywhere where this tumor hasn't encased her arteries.
克莱尔你发现什么了
Claire, tell me you got something.
什么也没有
I've got nothing.
这个肿瘤比CT扫描里看到的要大得多
This tumor is way bigger than it looked on the scans.
我连她的大动脉都看不到
I...I can't even see her aorta.
这下麻烦了
That's a problem.
这是那个她父母一直在吵架的女孩吗
Is that the girl with the bickering parents?
我们不是四个小时前就让她回家了吗
Didn't we send her home four hours ago?
莫菲医生
Dr. Murphy,
梅伦德斯医生的手术需要你
Dr. Melendez needs you in surgery.
不必了
That won't be necessary.
肿瘤完全被腹主动脉包住了
The tumor's entirely encased the large abdominal arteries.
那糟透了
That's very bad.
如果它在动脉壁上
If it's in the artery walls,
要切除掉她就必死无疑
it's going to be impossible to cut out without killing her.
应该做个活检看看边缘在哪里
You should get a biopsy to determine where the margins are.
谢谢
Thank you.
不客气
You're welcome.
我还是在讽刺
I was being sarcastic... again.
我明白因为你已经知道我所说的一切
I-I see, because you are already know everything I said,
你已经送去化验室活检了吧
and you already sent a biopsy to the lab?
对因为我也是医生
Yes, 'cause I'm a doctor, too.
是的但是你需要我
Yes. But you need me?
对我需要你快点跑到化验室去催一下
Yeah, I need you to run down to the lab and hurry them along.
我是肖恩·莫菲医生
I'm Dr. Shaun Murphy.
外科住院医
I'm a surgical resident.
梅伦德斯医生送了活检样本给你们
Dr. Melendez sent you a biopsy.
什么时候可以出结果
When will the results be ready?
等我拿到结果
When I get to it.
它非常重要
It's very important.
所有结果都重要
They're all very important.
让我看看其他检查申请
Let me see the other test orders.
我可以告诉你哪个更重要
I'll tell you which ones are most important,
然后你可以按重要次序做检验
and you can do them in that order.
我会诚实公平的
I'll be honest and fair.
这不是我们的办事流程
That is not the way that it works.
去等着吧
Now go wait your turn.
再来一次
Do it again.
-给我快滚你个傻子 -我们走
- Get the hell away from me, you moron. - Let's get out of here!
等等等等
Wait, wait, wait, wait!
如果你想在生活中得到什么肖恩
If you want to get anything in life, Shaun,
你就得做一件事
there's one thing you got to do.
永远不要害怕
Never be afraid.
你才是傻子呢
You're the moron!
如果你们不做梅伦德斯医生送来的化验
If you don't do - Dr. Melendez's test right now,
我就用石头砸烂你的窗户
I will throw a rock through your window.
好吧我不想那样
Well, I wouldn't want that.
去坐吧
Go have a seat.
十五分钟后出结果
Your results will be ready in 15 minutes.
你有空吗
You got a minute?
我有个患者还躺在手术室里
I have a patient lying in the O.R.
等着化验结果
waiting for lab results,
我在这坐着想着
and I'm sitting here trying to figure out
接下来应该干嘛
what the hell I'm gonna do next,
我不喜欢任何一个选项
and I don't like any of my options,
所以是的很不幸我有空
so...yeah, unfortunately it seems I do.
好吧我们可以有空再谈
Okay, we can talk another time.
格拉斯曼跟你谈过了
Glassman talked to you?
跟自闭症医生工作我没问题
I don't have a problem with an autistic doctor.
不你只是对跟你一起工作的一个医生有意见
No, you just have a problem with one working for you.
是吗这是你对我的看法吗
Really? That's how you see me?
能不能不要掺杂个人情感
Let's not make this personal.
你在指责我的傲慢
You're accusing me of prejudice.
我是对交流有困难的医生有意见
I have a problem with the doctor who has a problem with communication.
好吧那就掺杂个人情感
Okay, let's make this personal.
你在这家医院里尊敬谁
Who do you respect at this hospital?
你和格拉斯曼
You and Glassman.
你不尊敬谁
And who do you not respect?
这会让你烦恼吗
And does it bother you
就像是你在一个错误的团队里
that it looks like - you're on the wrong team?
如果肿瘤没有侵入动脉壁
If the tumor hasn't invaded into the arterial walls,
我们可以做一个解剖面
we could create a plane of dissection.
如果是非浸润性脂肪肉瘤
Well, if it's a noninvasive liposarcoma
我们可以在外面切掉它
we can work it off from the outside.
用钝性剥离和组织钳
Blunt dissection and tissue forceps --
逐片剥离
peel it off piece by piece.
是个平滑肌肉瘤
It's a leiomyosarcoma.
太糟糕了
Well, that sucks.
对真让人悲伤
Yes, it's sad.
手术是不可能了
The surgery's impossible.
也许现在要叫醒她
Well, might as well wake her up --
告诉她还能活三个星期
let her know she has three months to live,
进行姑息治疗
offer palliative care.
手术也不是不可能
The surgery isn't impossible --
只是非常非常非常困难
just, very, very, very difficult.