良医

The Good Doctor S03E17

Part 1 April 2, 2020, 9:29 a.m.

韦斯·基勒 49岁
Wes Keeler, 49,
四天前右上臂被仙人掌扎破
pricked in the upper right arm by a cactus four days ago.
体温39.1度
Temp 102.5.
伤口严重感染
Wound is seriously infected.
他是泰耶山野营旅行的领队
He was leading a camping trip on Mount Thayer.
我们不能把他们留在山上
We couldn't leave 'em up there alone.
血压89/51 心动过速
BP's 86/51. Tachycardic.
呼吸急促微弱
Rapid, shallow breathing.
败血症的迹象
Signs of sepsis.
你们要给他截肢吗
You gonna have to cut his arm off?
我会没事的
I'll be fine!
我们需要立即给伤口做清创
We need to debride the wound stat!
肖恩我一直在找你
Shaun, I've been looking all over for you.
你想吃点早餐吗
Hey, uh, h-how about getting some breakfast?
吃点煎饼
Some pancakes?
不我不饿
No. I'm not hungry.
好吧
Okay.
那今晚来我这吃晚饭
How about coming over for dinner tonight?
黛比要做千层面吗
Is Debbie making lasagna?
她可以做
She could.
不了谢谢
No, thank you.
好吧肖恩
Okay, Shaun.
你能停下跟我谈谈吗
Can we just stop and -- and talk for just a minute?
你为什么为什么不回我信息
Why are-- aren't you, uh, responding to my texts?
你在难过吗
Are you upset?
-你难过是因为莉亚吗 -对
- Are you sad because of Lea? - Yes. Yes.
我非常难过
I am very sad.
但会没事的
But it will be okay.
对当然会没事的
Yeah, of course it'll be okay.
我还是要跟莉亚在一起
I'm still going to be with Lea.
等等什么
Wait. What?
她说她爱我
She said she loves me.
她也给了你一百个
She also gave you a hundred reasons
-不能和你在一起的理由肖恩 -对
- why she can't be with you, Shaun. - Yes. Yes.
她给了我很明确的理由
She gave me very specific reasons
为什么我们不能在一起
why we can't be together,
但我也克服了其他挑战
but I've overcome other challenges...
-不肖恩这不 -成为好医生好朋友
- No, Shaun, it's not -- - ...to become a good doctor, a good friend.
这与克服挑战无关
it's not about overcoming challenges.
这与你无关
It's not about you.
这是因为莉亚
It's about Lea.
我走两步就要摔倒
I can't take two steps without falling down.
是平衡问题还是身体虚弱
Is the issue balance or weakness?
都是
All of the above.
疲惫晕眩头重脚轻头疼
Fatigue, dizziness, light-headedness, headaches,
偶尔恶心
occasional bouts of nausea.
那你什么时
And when d--
五年前就在我女儿出生后
Five years ago, just after the birth of my daughter.
一天内或一个月内
And there's no discernible fluctuation
都没有可辨波动
based on time of day or time of the month.
体温36.7 血压111/78
Temp 98.2. BP 111/78.
等我站直后就会降到80/50
That'll drop to 80/50 when I'm upright.
我不喝酒不抽烟也不吸毒
I don't drink, smoke, or take drugs.
我过去十年都没有境外旅游
I haven't traveled outside of the country in the last 10 years.
而且没有相似症状的家族病史
And there's no family history of a similar condition.
你之前经历过问诊
You've been through this before.
十七次算上西雅图的自然疗法就是十八次
17 times. 18 if you count the naturopath in Seattle.
但我不算
Which I don't.
没人能确诊我
No one has been able to give me a diagnosis.
我们需要做心电图压力测试
We need to do an EKG and stress test,
胸部腹部和盆骨CT
get a CT of your chest, abdomen, and pelvis.
不用麻烦了
Let me save you some time.
这是五年间的检测化验扫描报告
Five years' worth of tests, labs, scans, reports...
我的所有病史
...my entire medical odyssey.
有意思了
Fun.
良医
第三季第十七集
准备一下休息室
Set up in the lounge
把这些再多复印几份
and get me copies of each of those --
克莱尔
Claire!
达什天哪
Dash. Oh, my God!
你怎么来了
Why are you here?
你改了电♥话♥
Uh, you changed your number.
对说来话长
Right. Um, it's a long story.
达什你还记得梅伦德斯医生莫菲医生吧
Uh, Dash, you remember Dr. Melendez, Dr. Murphy?
当然
Yeah, of course.
你们让我的妻子多活了六个月
Uh, you gave my wife six more good months.
我们想过把猫的名字换成你们的
We considered renaming our cat after you.
那就太愚蠢了猫记得住自己的名字
That would have been foolish. Cats remember their names.
请节哀我们已经竭尽全力了
Sorry for your loss. Wish we could've done more.
你俩叙叙旧吧
Let you two catch up.
由于对你肝和肾脏潜在的危害
I think the infection spread quickly
我觉得感染扩散得很快
because of the underlying damage to your liver and kidney.
我们需要继续给你用静脉注射抗生素
We'll need to keep you on a prolonged course of IV antibiotics.
你们听到了吗
Hey, you hear that, guys?
丙肝和海♥洛♥因♥可没有听上去那么有趣
Hep C and heroin aren't as much fun as they sound.
虽然其中一个比另一个更有趣
Although one was more fun than the other...
片刻而已
for a while.
他们有什么地方可以去吗
Don't they have somewhere else to go?
没什么地方
Not likely.
他们大部分人都好多年没见自己父母了
Most of them haven't seen their parents in years,
所以和我在一起
so they're with me --
高危青少年的生存训练项目
survivalist training program for at-risk youth.
我们更喜欢称为「潜力尚未发挥的青年」
We prefer "Young adults with unrealized potential."
我本来应该教这些年轻人责任感
I'm supposed to be teaching these yahoos responsibility and...
以及正确决策
good decision-making.
真是个好榜样
Hell of an example.
他有新的杂音了
He's got a new murmur.
血压下降了
BP's dropping.
韦斯我们得看看你的心脏
Wes, we need to take a look at your heart.
韦斯感染又扩散了
Wes, the infection's spread.
伤到了你的主动脉瓣
It's damaged your aortic valve.
你需要紧急手术
You need emergency surgery.
爱丽丝·戈特弗里德
病症排除病症可能病症
血管炎呢
What about vasculitis?
或自主神经机能障碍
Or dysautonomia?
两者都会出现虚弱和疲惫
Both are consistent with weakness and fatigue.
她的颞动脉活检结果是阴性
Her temporal artery biopsy was negative.
排除了血管炎
That rules out vasculitis.
我看到了关于自主神经机能障碍的信息
And I thought I saw something about dysautonomia in here.
自主神经机能障碍有十五种不同病因
There are 15 different causes of dysautonomia.
已经排除了七种
Seven have been ruled out.
其他的与爱丽丝的症状不相符
The rest are inconsistent with Alice's symptoms
或没有确定性的诊断测试
or have no definitive diagnostic test.
你和利姆医生做了这么多年朋友
How did you make Dr. Lim fall in love with you
你是怎么让她爱上你的
after you had been friends for so long?
我猜那是问你的
I assume that's directed at you.
我觉得你不能让别人爱上你肖恩
I don't think you make anyone fall in love with you, Shaun.
而是日久生情
It unfolds naturally over time.
这不对
That's not true.
每个人一开始都不爱你
Everyone starts off not loving you.
然后你说或做一些事让对方爱上你
Then you say and do things that make them love you.
或不爱那就是爱情存在的意义
Or not. That's the point of romance.
但如果你们已经是朋友
But romance is harder
那爱情就会来得更加困难
if you're already friends with the person.
你无法隐藏自己的弱点
You can't hide the less attractive parts of yourself.
这也能是优势
It can be an advantage.
你已经知道怎样会惹他们生气
You already know what pisses them off.
非常正确
That's very true.
肖恩
Shaun...
卡莉说只想和你做朋友吗
did Carly tell you she just wants to be friends?