良医

The Good Doctor S01E18

Part 3 Jan. 5, 2020, 7:42 p.m.

或者至少你不应该告诉他
Or at least you shouldn't have told him.
他的凝血因子依旧没有工作
His coagulation factors are still off.
挤压伤不是问题
Crush trauma isn't the issue.
他的毒理学检查是阴性
And his tox screen came back clean.
-也不是因为嗑药 -我们并不能确定
- It's not drugs, either. - We don't know that.
他输了太多血
He's had so many transfusions,
他血管里的血和他来时的血不一样了
the blood in his veins isn't the same blood he came in with.
药物可能还在他的器官里造成...
The drugs could still be in his organs causing --
我知道你不想认为
I get that you don't want to think
这可能是由你朋友造成的但我们必须...
that this could be caused by your friend, but we have to --
这孩子是从兄弟会捉弄活动上来的喝得烂醉
The kid came directly from a frat hazing, hammered.
他没嗑药的几率有多大
What are the odds he wasn't on drugs?
我们应该开始注射咪唑安定
We should start IV midazolam
用碳酸氢钠中和...
and sodium bicarbonate to counteract --
那是服用了安♥非♥他♥命♥的治疗方法
That's the treatment for amphetamines.
如果你的判断是错的
If you're wrong,
可能会导致心律失常危及生命
that could cause a fatal arrhythmia.
我会弄明白他嗑了什么药的
I'll find out what drugs he's on.
你就准备通过问来弄明白吗
You're going to find out by asking?
布莱克之前对我挺坦诚
Blake was honest with me before.
当你不是承认罪行的时候
It's a lot easier to be honest
坦诚会容易得多
when you're not confessing to a crime.
在这件事上我们没有太多选择
We don't have a lot of choice in the matter.
不是那样的
That's not true.
谢谢
Thanks for doing this.
没什么
Yeah, no worries.
我第一眼看到你的时候就注意到你被划伤了
Noticed it was cut when I first saw you.
觉得应该处理一下
Figured it should get cleaned up.
我能抽点血吗
Is it all right if I draw some blood?
只是想确保
Just want to make sure
你没有毒素和感染
you don't have any toxins or infections.
好
Sure.
所以
So,
护士说卡登有弥漫性血管内凝血
the nurse said that Caden has DIC.
你知道那是什么吗
Do you know what that is?
简单说就是他的身体
Well, in short, his body is clotting
同时在凝块和出血
and hemorrhaging at the same time.
如果我们找不到原因
If we can't figure out what's causing it,
他就会死
he'll die.
按住三秒
Just hold that there for me.
好了
All done.
布莱克兄弟你肯定嗑了什么
Blake, buddy, you're on something.
你的瞳孔扩张
Your pupils are dilated,
你在20℃的房♥间汗如雨下
and you're sweating in a 68-degree room.
现在我可以把这个交给警♥察♥
Now, I can hand this over to the cops
或者你可以告诉我卡登到底嗑了什么
or you can tell the truth about what Caden's on.
摇♥头♥丸♥
Molly.
如果你直接问我的话我会和你说实话的
I would've told you the truth if you'd asked.
抱歉
I'm sorry.
你有时间谈谈吗
You have time to talk?
肖恩告诉你了
Shaun told you.
是的
He did. Yeah.
我更希望是你亲口告诉我
I wish I would've heard it from you.
对不起
Yeah, I'm sorry.
-我们是朋友 -我明白
- We're friends. - I get it.
-我想在你身边陪你 -怎么你在生我的气
- I want to be there for you. - What, are you mad at me?
是的
Yes.
我应该陪着你的
I'm supposed to be there for you.
干什么要干什么握住我的手吗
To do what? To do what exactly? Hold my hand?
是的如果需要的话
Yes, if that's what's needed.
好我只想静静好吗
Okay, well, what I need is to be left alone, okay?
你告诉了肖恩
Well, you told Shaun,
那可真明智
so that was a brilliant strategy.
好了好了我明白
Okay, okay, I get it.
蠢蠢蠢蠢好了吧
Stupid, stupid, stupid, stupid, okay?
有时候当人们知道自己要死了时
Sometimes when people are told they are dying,
他们会做蠢事
they do stupid things!
有时候他们身边的人会做蠢事
Sometimes people around them do stupid things!
肖恩让你过来的
Shaun told you to come here
想劝我做更多影像对吗
to try to convince me to get more imaging, right?!
亚伦你不能放弃
Aaron, you can't stop fighting.
-曼蒂不会让你放... -别
- Maddie wouldn't have wanted you to stop -- - Don't,
别别你敢
don't, don't, don't you dare.
你敢
Don't you dare.
你要说什么
What are you gonna say, huh?
曼蒂是个斗士
That Maddie was a fighter?
她从不放弃
That she never quit?
我很遗憾
I'm sorry.
谢谢
Thank you.
你应该去做个弥散张量成像
And you should get the DTI.
不为你
Not for you.
你已经接受了你的诊断
You've accepted your diagnosis.
但肖恩没有
Shaun hasn't.
他需要接受
He needs to.
尼尔
Hey, Neil.
我听说你的一个案子出现了并发症
I heard there was a complication in one of your cases.
卡登·赫里
Caden Hauley?
是听说还是你在监控所有莫菲的案子
Heard or have you been monitoring all of Murphy's cases?
我监控我部门的所有案子
I monitor all my department's cases.
弥漫性血管内凝血的18岁患者
18-year-old with DIC.
知道是什么导致的吗
Any idea what set it off?
有并发症
Complications happen.
他来的时候就状况很糟
The kid was in pretty bad shape when he got to us.
我还想知道你为什么同时做了两台手术
I'm also wondering why you were in two surgeries at once.
你留下三个无人看管的新手住院医生
You left three first-years unattended?
你知道我们总是这么做的
You know we do this all the time.
如果不这样的话我们无法有效运转
We couldn't function efficiently if we didn't.
我希望卡登能渡过难关
I hope Caden pulls through.
你这么快就预约到了
You got a very quick appointment.
我有后门肖恩
I have connections, Shaun.
你为什么听杰西卡的不听我的
Why did you listen to Jessica but not me?
杰西卡也很聪明
Well, Jessica's pretty smart, too.
是但她和你说什么了
Yes, but what did she tell you?
我觉得现在不太适合谈这个
I don't think this is a good time.
什么时候合适
When is a good time?
我还有很多要向你学习的地方
I have a lot to learn from you,
如果你要死了就只剩下不到两年的时间学习了
and if you're dying, less than two years to learn.
不好意思让你们久等了
Sorry to keep you waiting.
你的影像有点意外
There were some surprises on your images.
之前的诊断是不正确的
The previous diagnosis was incorrect.
在你的脑桥上有多形性成胶质细胞瘤
You have a Glioblastoma Multiforme located in your pons.
我想不用我来告诉你
I'm sure I don't need to tell you this,
但这是最具侵略性的脑癌
but it's the most aggressive form of brain cancer.
我们估计还有约三到四个月的时间
We estimate three, maybe four months.
等你准备好了
I can have my assistant get in touch with you
我会让我的助手联♥系♥你给你介绍治疗师
to refer you to a therapist when you're ready.
他还是有低血压血液稀薄
He still has low blood pressure and thin blood,
也就是说对摇♥头♥丸♥的治疗没有起效
which means the treatment for the MDMA didn't work.
所以摇♥头♥丸♥不是问题所在
So the Molly wasn't the problem?
肯定没有帮到他但我们觉得他...
It certainly didn't help him, but now we think he --
最好的可能是卡登细菌感染了
Our best guess is Caden has a bacterial infection.
谢谢
Thanks.
弥漫性血管内凝血
DIC?
怎么了
What happened there?
我们还不确定
Uh, we're not sure yet.
他入院时就病得不轻
He was pretty sick when he came in.
有时候就是会出现并发症的
I guess sometimes complications just happen.
挺会讲话的
Interesting choice of words.
和梅伦德斯医生跟我说的居然如出一辙
Eerily similar - to what Dr. Melendez said to me.
是的他在讨论鉴别诊断的时候说过
Yeah, he said it during a differential.