良医

The Good Doctor S01E04

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

脓已经排出但肿胀并未消除
The gland's evacuated, but the swelling's not going down.
心率和血压正常
Heart rate and BP are stable.
能再亮点吗
Can I get a little more light, please?
-该死 -怎么了
- Damn. - What is it?
肿胀没有消除是因为脓肿下有肿瘤
The swelling isn't going down because there's a mass beneath the abscess.
不只是压♥迫♥着外阴神经
And it's not just pressing on the pudendal nerve --
已经完全包围了
It's totally engulfed it.
情况很糟
That's bad.
非常糟糕
Very bad.
已经做完了吗
You're done already?
我们已经设法排净脓肿
We were able to drain the abscess.
我已经觉得好多了
I already feel better.
这只是止痛药的效果
That's only because of the pain meds.
之所以痛感非常强烈
The reason the pain was so severe
是因为这并非只是脓肿
was because it wasn't just an abscess.
下面长了一个会阴肌瘤
There's perineal myoma underneath.
那是什么
What's that?
是一种纤维瘤
A fibroid tumor.
没有癌变但是它包围了神经
It's not cancerous, but it is wrapped around the nerve.
我们得切除肿瘤
We need to remove the tumor,
但这样必须切除神经
but to do that, we will have to sever the nerve.
你的生殖器官会失去所有感觉
You'll lose all feeling in your genitals.
非常遗憾
I'm so sorry.
我就知道
I knew it.
是上帝在惩罚我
God's punishing me.
不绝非如此
No, absolutely not.
这只是随机生长的...
This is just a random growth...
你信教吗
You're religious?
是的
Yes.
至少以前信
Or at least I used to be.
很久未感念过上帝了
I haven't thought about God in a really long time.
但生病住院后...
But being in here...
你确定不要我们帮你联络父母吗
You sure you don't want us to call your parents?
不我没办法面对他们的脸
No. I couldn't bear to see the look on their faces.
尤其是爸爸
Especially my dad's.
父母就是如此为你分忧
Well, that's what parents are for.
让你不必自己承担一切
So you don't have to do these things alone.
你能告诉你父亲你是个妓♥女♥吗
Could you tell your father you're a whore?
你是犯过错但那都过去了
You made a mistake. That is all.
-患者生命体征 -稳定
- Patient vitals? - Stable.
-胚胎呢 -稳定
- Fetus? - Stable.
很好
Okay.
准备好了吗
Is everybody ready?
手术刀
Knife.
拉钩
Retractor.
好的
Okay.
切入子♥宫♥
Cutting into the uterus.
经食管超声心动图显示前壁机能减退
T.E.E. is showing anterior wall hypokinesis.
收缩压90 给我漂浮导管
Systolic pressure 90. Get me a Swan.
静脉注射功能降低她心脏病突发了
I.V. function is decreasing. She's having a heart attack.
马上缝合切口
I need you to close the incision.
-马上持针器 -快去拿荧光镜
- On it. Needle driver. - Get a fluoroscope in here!
我要对她进行球囊反搏
I'm gonna prep her for a balloon pump.
芭芭拉
Barbara?
手术时产生了并发症
There was a complication during surgery.
血块堵塞了你的心脏动脉
A blood clot blocked an artery in your heart.
我们及时处理了
We were able to catch it in time.
我的孩子呢
And my baby?
胚胎稳定
The fetus is stable.
我们打开子♥宫♥前你心肌梗塞了
The M.I. happened before we opened the uterus.
这么说我们又回到原点了吗
So, we're right back where we started?
你刚刚心脏病发作
You just had a heart attack.
我不在乎
I don't care.
现在没有选择了
There is no other option now.
如果不结束妊娠胚胎会死在子♥宫♥内
If we don't terminate and the fetus dies in utero,
产生的血块会击垮你的心脏和大脑
the resulting clots will overwhelm your heart and brain.
所以我们更要再试一次
Which is exactly why we need to try again.
你在说什么
What're you talking about?
你得切除肿瘤
You need to remove the tumor.
你之前求我别做手术
You begged me not to do the surgery before.
之前我以为我能说服她
I thought I could talk her out of it then.
现在我知道我不能
Now I know I can't.
你要是不做她就会死
Either you do it, or she dies.
此前如果我们被起诉
Before, if we got sued,
他们至少有个人站在我们这边
we'd at least have one of them on our side,
但现在他们达成一致了
but now, with them both aligned --
他们能起诉我们不动手术吗
Can they sue us for not operating?
他们可以争辩我们放弃治疗
They could argue that we abandoned care.
我们还在提供治疗
We're still offering care.
只不过不是他们想要的治疗
Just not the care that they want.
这都怪你
Which is your fault.
如果你一开始没给她希望
If you hadn't offered her hope to begin with,
也许我们还能说服她
we might have been able to reason with her.
切口周围有多疼痛
How's the pain around the incision?
满级十级的话五级疼痛
5 out of 10.
我会加大剂量
I'll up the dosage.
心绞痛吗
Any chest pain?
没有心脏感觉很好
No. My heart actually feels fine.
好的
Good.
如果她不想结束妊娠我们也无能为力
If she doesn't want to terminate, there's nothing we can do.
我们就送她回家等死吗
So we just send her home to die?
那是她的决定
It is her decision.
我们可以告诉她我们进行胚胎手术
We could tell her we were going ahead with the fetal surgery.
但等她被麻醉...
But once she's under --
我就当作你没说过这句话
I'm gonna pretend you never said that.
如果那是救她的唯一机会
If it's the only chance to save her life --
这正是我想说的
This is exactly what I'm talking about.
你不会骗要自杀的人来阻止他跳楼吗
You wouldn't lie to convince a suicidal person to climb down off the ledge?
故意隐瞒患者一场重大外科手术
Knowingly lying to a patient about a major medical surgery --
好了够了
Okay, okay! Hey!
欺骗患者是一回事
Lying to a patient is one thing.
未经他们同意而进行手术
Performing surgery without their consent --
是缺乏职业道德并且违法的
It's unethical and illegal.
还很疯狂
And insane.
我只是...
I just...
我不想这么做
I don't want to do this.
我们还有其他选择
It's not our only option.
你要我再尝试做胚胎手术吗
You want me to attempt the fetal surgery again?
如果只有这个办法能救她
If it's the only way to save her life.
第一次的话只有这个办法能救她
The first time, it was the only way to save her life.
但经历了第一次后第二天再心脏病发作
But a second heart attack one day after the first
-她会死 -也许不会
- will kill her. - Maybe not.
抱歉打扰了但...
I am so sorry to interrupt, but I...
我有个主意
I have an idea.
如果我们在她自杀之前先杀死她呢
What if we kill her before she kills herself?
我们会停止你的心脏
We'll stop your heart
在手术期间使用分流机代替
and put you on a bypass machine for the duration of the surgery.
如果你的心脏没有跳动
You can't have a heart attack
你就不会心脏病发作
if your heart's not beating to begin with.
解决了这台手术最大的危险
It takes the most significant danger off the table.
但血块不是仍会危及她的大脑吗
But aren't the clots a danger to her brain, as well?
这不能完全排除所有风险
This doesn't completely eliminate every risk,
但能解决最大的风险
but it does reduce the biggest one.
谢谢
Thank you.
我们明天一早就动手术
We'll do it first thing in the morning.
你修了我的水槽
You fixed my sink!
你知道现在几点吗
Do you know how to tell time?
你修了我的水槽
You fixed my sink!
不用客气走开吧
You're welcome. Now go away.
那不在清单上
It was not on the list!