良医

The Good Doctor S03E19

Part 4 April 2, 2020, 9:29 a.m.

Making initial midline incision to posterior neck.
移开那根木条需要点时间
It's gonna take some time before we can move that bar.
好的
That's fine.
在你们开始前我得先确定孩子的受伤情况
We need to get a sense of the kid's injuries before you do anything.
我得下去检查一下
I need to get under there and take a look.
跟我来
Follow me.
哮喘和粉尘吸入
Asthma and dust inhalation.
雪上加霜
Bad combination.
深呼吸
Take deep breaths.
再高点
Higher.
再高点
Higher.
到她肺部的位置
Where her lungs are.
-明明是你在听 -就是这
- You're the one that can hear them. - There.
再用力
Deeper.
我在努力但不行
Trying. Just can't.
可能是因为你的肺部过度换气
That's probably because your lungs are hyperinflated.
开始用沙丁胺醇和氧气进行雾化治疗
Start nebulizer albuterol and oxygen,
每分钟八升
eight liters per minute.
你为什么在用熟石膏
Why are you using plaster of Paris?
你让我给她的手臂打石膏但没说...
You told me cast her arm. You didn't tell me...
用玻璃钢
To use fiberglass,
可以事半功倍
which takes half the time and is twice as effective?
我不知道还得教你常识
I wasn't aware that I had to instruct you on common sense.
贱♥人♥
Bitch.
我能跟利姆医生通话吗拜托
Can I speak to Dr. Lim, please?
肖恩你在哪里
Shaun, where are you?
我找到位女士肩部和腿部都被刺穿了
I found a woman with shoulder and leg impalements.
我想拉她的肩膀
I'm going to extract the shoulder,
但把她的腿拉出来可能会切断胫后动脉
but freeing the leg could sever the posterior tibial artery.
听着不妙啊
That sounds bad.
你会死的
You would die.
是什么把腿刺穿的
What's the leg impaled on?
看着像钢筋
Mm, it appears to be steel rebar.
我们会派个消防员下去
We'll send down a firefighter.
他们一把钢筋锯断就会拉她上来
Once they've sawed through the rebar, they'll transport her up.
别把这个频道关掉让我知道你的情况
And keep this channel open so I can hear you.
他们找到莉亚了吗
Have they found Lea?
没有他们还在搜索
No. They're still searching.
好吧
Okay.
亚伦你这里弄完以后能回急诊室吗
Hey, Aaron, can you head back to the ER when you finish here?
除非你可以接手第三手术室里那根
Not unless you can take the transected aorta
切断的动脉
being prepped in OR 3.
我在第二手术室有个心肌挫伤和
I got a myocardial contusion and
心包填塞手术要做
tamponade in 2.
吊扇砸在了那家伙胸口
Ceiling fan fell on this guy's chest.
那回头见
See you on the other side.
好
Yeah.
-出血了 -血管钳
- We've got a bleed. - Clamp.
硬物撕裂了
The hardware tore a muscular branch
她的右侧椎动脉的肌支
of her right vertebral artery.
不进行抽吸我找不到出血点
I can't find the bleed without suction.
我看到了
I see it.
她的生命体征平稳但失血太多
Her vitals are stable, but she's lost too much blood.
要给她输血我们才能继续手术
We can't keep cutting till we give her a transfusion.
查查所有本地医院和血库
Check all local hospitals and blood banks.
看看谁能马上给我们提供O型阴性血
See who can get us O-negative, stat.
也许还有其他方法可以给她输血
There might be another way to transfuse her.
当时我十六岁坐在我爸车上
So, I'm 16, in my dad's car,
兜里有一包毒品
a dime bag in my pocket,
一个警♥察♥走过来了
and a cop approaching.
你被捕了吗
Did you get arrested?
让我把故事讲完
Hey, let me tell the story.
应该有起因经过结尾
It's got a beginning, middle, and end.
-我想知道结尾 -知道来龙去脉会更精彩
- I want the end. - It's better with the middle.
我们摇下车窗
We, uh, roll down the window,
一团烟雾正好飘到了警♥察♥脸上
and the cop is hit with a cloud of smoke.
她让我们下车
She makes us get out,
搜了我俩的身搜查了整辆车
pats us both down, searches the whole car...
我很快回来
I'll be right back.
等等拜托拜托别吊我胃口
Oh, wait. Come on, come on. Don't leave me hanging.
拜托
Come on.
她什么都没找到
She didn't find anything.
好吧
All right.
我们的身体会做出些惊人的事
Our bodies can do amazing things,
甚至能藏♥毒♥
even hide dime bags.
胡扯不可能当时你是在抽那包毒品吗
Holy crap! No way! Did you still smoke it?
我很快回来
I'll be right back.
哥们你肯定在抽
Oh, man, you did!
情况有多糟
How bad is it?
他的脊椎断了
His spine's been severed.
他流了很多血
He's lost a lot of blood.
股动脉没有脉搏
No femoral pulses.
双腿冰凉
His legs are ice cold.
那根木条基本上交叉阻断了他的腹主动脉
The bar's basically cross-clamping his abdominal aorta.
我们把那根木条抬起来他就会大出血
He's gonna bleed out when we lift the bar.
对
Yeah.
不我们一定可以做些什么
No, there's gotta be something we can do.
我们可以趁还来得及把他爸爸找来
We can get his dad here before it's too late.
注射五毫升丁哌卡因
Inject five CCs bupivacaine,
等二十分钟然后拔♥出♥来♥
wait 20 minutes, then pull it out.
你来找我是为了让哮喘病人出院吗
You here for me to discharge our asthmatic?
不是她变得更严重了
No, she's gotten worse.
而且她还在抱怨背痛
And she's complaining about back pain.
她说她在地震时摔倒了
She said she fell during the earthquake.
所以会背痛
Symptom explained.
那些缝合线得缝得再密点
Those sutures need to be closer together.
在她的雾化器里加上布地♥奈♥德♥
Add budesonide to her nebulizer.
这能帮助她呼吸
That should help her breathing.
我想她可能怀孕了
I think she might be pregnant.
呼吸急促再加上背痛
Shortness of breath plus back pain
可能是尿路感染肾结石或者怀孕导致的
could be UTI, kidney stones, or pregnancy.
尿检排除了尿路感染和肾结石
Urine dip ruled out UTI and kidney stones.
所以她的症状和地震无关
So her symptoms have nothing to do with the earthquake?
是有可能
It's possible.
你怎么能又慢又马虎
How can you be both slow and sloppy?
这是我第一次缝线
This is my first time doing sutures.
快弄好我就可以让他出院了
Finish up so I can discharge him.
别再胡乱猜测了
Stop with the zebra hunting.
给她用点布地♥奈♥德♥ 清理下床位
Put her on budesonide and clear the bed.
我让你帮助我不是替我思考
I asked you to be my hands, not my brain.
雷兹尼克医生
Dr. Reznick.
我受够贱♥人♥计划了这三年我受够了
I'm over the bitch plan, after three years of it.
我们在危机时刻
We're in crisis.
你想借此在安德鲁斯医生面前
That you are using to rehabilitate
修复你的形象和声誉没问题
your reputation with Andrews, which is fine.
但别再伤害帮助你的人了
But stop biting the hands that are your hands.
你在做什么
What are you doing?
给仪器消毒
Sterilizing the instrument.
你有认识的癌症患者吗
Do you know someone with cancer?
我很好奇为何你会参加为癌症研究的募捐活动
I'm curious why you were at a fundraiser for cancer research.
为了一个男人
I was there for a man.
一个既没有癌症也不想跟我在一起的人
One without cancer or any interest in being with me.
我前男友是慈善机构的董事会成员
My ex-boyfriend is on the board of the charity.
你为什么想见你前男友
Why did you want to see your ex-boyfriend?
我想...
I guess...
我是希望他能意识到他还爱着我
I hoped he'd realize he was still in love with me
求我复合
and beg me to take him back.
很聪明对吧
Clever, huh?
我懂
I understand.
我还是想让莉亚做我的女朋友
I still want Lea to be my girlfriend.
但她不这么想吗