良医

The Good Doctor S04E03

Part 3 March 10, 2021, 11:58 a.m.

因为蚂蚁不关心政♥治♥ 球队
Because ants don't care about politics, sports teams,
或其他任何人们为之疯狂的东西
or anything else people get so savage about.
雄性蚂蚁是从未受精的卵发育而成的
Male ants develop from unfertilized eggs,
这意味着它们没有父亲也不能有儿子
which means they don't have a father and can't have sons.
但它们有外祖父和外孙
But they do have grandfathers and can have grandsons.
有意思
Interesting.
而且令人费解
And confusing.
是我的心理作用还是那些医生在看着我们
Is it just me, or are those doctors watching us?
他们是申请住院医师的新人
They're the new resident applicants.
他们来了所以朴克莱尔和我
They're here so Park, Claire, and I
可以帮利姆医生评估他们
can evaluate them for Dr. Lim.
那他们为什么都站在那里
So, why are they standing over there?
朴在跟凯兰视频聊天
Park had a video chat with Kellan,
而我在跟你吃真正的午餐
and I had a real lunch with you.
肖恩你不能在吃饭时让他们就站在那里
Shaun, you can't just have them stand there while you eat.
做个好老板的一部分就是要做个好主人
Part of being a good boss is being a good host.
你得把他们介绍给别人
You need to introduce them to people.
比如我快
Like me. Right now.
请过来吧
Come here, please.
艾伦医生伦德伯格医生盖林医生
Dr. Allen, Dr. Lundberg, Dr. Guerin,
这是我女朋友莉亚
this is my girlfriend, Lea.
她现在负责信息技术部门
She runs the IT department now.
好了
Okay.
很高兴见到大家请跟我们一起吃吧
Nice to meet you all. Please join us.
肖恩一直跟我说起你们
Shaun's been telling me all about you.
我没有
N... no. I haven't.
我希望肖恩没有对你们太苛刻
So, I hope Shaun's not being too hard on you.
没有他很好
No, he's been great.
而且我们旁观的病例真的很有趣
And the case we're observing is really interesting.
我们要用盐水填充的假体矫正一位
We're correcting a 17-year-old girl's tuberous breasts
17岁女孩的结节性乳♥房♥♥
with saline implants.
艾伦医生跟安德鲁斯医生说这不道德
Dr. Allen told Dr. Andrews it was unethical.
他很生气
He got mad.
我没说这不道德我只是...
I didn't say it was unethical. I just...
我觉得我不该干涉
I suppose I shouldn't have interfered.
好吧我不知道什么是结节性乳♥房♥♥
Well, I don't know what a tuberous breast is,
但我觉得假体没有人们想的那么好
but I think implants are way overrated.
那是因为你的胸部很美
That's because your breasts are excellent.
谢谢
Thank you.
正如我所想的
That's exactly my point.
我没有那么大
Mine aren't huge,
但每一个近距离接触过它们的人
but every guy who's ever seen them up close and personal
都异常兴奋
has been thrilled.
我就是这样
I definitely was.
你身体的每个部位都让我异常兴奋
I am thrilled by every part of your body.
抱歉怪我信息量太大
Sorry. My bad. Total TMI.
我甚至不介意你的喉音
I'm not even bothered by your adenoidal voice.
除了在电♥话♥里和妈妈说话的时候
Except when you talk to your mom on the phone.
但是我戴上了耳机
But I just put on headphones.
至少你们知道他会是一个很诚实的老大
At least you'll know he'll be a totally honest boss.
切口向上延伸
The incision's extended superiorly
以方便做心房♥切开术
to meet the atriotomy,
-然后心房♥间隔膜被打开 -牵开器
- and then the inter-atrial septum is opened up. - Retractor.
使用卡彭蒂尔牵开器便于看到二尖瓣
A Carpentier retractor is used to visualize the mitral valve.
这样就可以清楚的看到肿瘤
That will allow a clear view of the tumor.
麻烦关掉对话频道
Can we turn the channel?
解说有点烦人了
Color commentary's getting a bit annoying.
随着右心房♥打开
With the right atrium opened obliq...
布朗那组怎样有哪些杰出人才吗
How's Team Browne? Any early standouts?
杰克逊有点胆小但却很聪明
Jackson's a bit timid, but smart.
沃克挺热情
Wolke is definitely enthusiastic.
而你的首要候选人
And your star recruit is...
很自以为是
pretty full of himself.
我找外科医生是根据他的经验来看
I'm looking for surgeons, and according to his recs,
他得能像专家一样解剖和缝合
he can dissect and suture like a pro.
我以为你也在寻求我们的意见
I thought you were also looking for our input.
他在每个顶尖科目中都排名第一
He's ranked first by every top program.
你真的觉得他们都错了你是对的
You really think they're all wrong and you're right?
那么你为什么干这行
So, what brings you all to the biz?
我在高中时做过重建高级心脏生命支持手术
Had my ACL reconstructed in high school,
在大学时做过回旋肌手术
both my rotators in college.
我喜欢救死扶伤
I love the idea of fixing people,
帮助人们做到最好
helping them be the best they can be.
外科医生是有上帝情节的人对吧
Surgeons are the ones with the God complex, right?
我有上帝情节
I have that.
我一生都在讲依地语研究犹太法典
I spent my life speaking Yiddish and studying the Talmud,
不刮我两侧的头发
and not shaving the sides of my hair,
因为天上会有人在意
because someone up there supposedly cares.
但是我意识到
Uh, but then I realized
天上没有人
no one's up there.
没人在意
No one cares.
没有更高等的仁慈之力会拯救我们所以
No benevolent higher power is going to save us, so...
我们需要互相拯救
we have to save each other.
你有什么高见吗
Can you top that?
-没有 -努力想想
- Definitely not. - Try anyway.
你的聪明毋庸置疑还从哈佛拿到了双学位
You're obviously smart. You've got two degrees from Harvard.
我父母都是哈佛校友所以
My parents are Harvard alums, so...
我相信这在我入校时帮了忙
I'm sure that helped me get in.
贬低自己不会帮助你被录用
You're not gonna get hired by undermining your own...
出问题了
Something went wrong.
好像是他们割破了肺动脉
Looks like they nicked a pulmonary artery.
不如果是的话布朗会抽吸
No. If they had, Browne would be suctioning
而不是利姆把她的手伸进去
instead of Lim reaching in with her hands.
他们现在在做什么
What are they doing now?
什么也没做
Nothing.
我们要接触到肿瘤
We can't access the tumor
就不得不破坏整个心脏流出道
without compromising his entire cardiac outflow tract.
按照我的建议怎么样从正中进胸
What about going in the way I suggested? The median sternotomy.
肿瘤太靠后了我们得给他缝合
The tumor's too far back. We need to close him up.
质子束辐射对心脏危害太大
Proton beam radiation would be too toxic to the heart.
免疫疗法也是
So is immunotherapy.
我们不能通过手术接触到整个肿瘤
We can't access the entire tumor surgically,
我们无法杀死肿瘤而让他的心脏安然无恙
and we can't kill it without killing his heart along with it.
如果我们切掉我们能接触到的部分
What if we cut out the parts we can access
然后剩下的部分化疗试试呢
and try our luck with chemo on what's left?
静脉注射阿霉素和异环磷酰胺可能减缓肿瘤生长
IV doxorubicin and ifosfamide might slow the growth,
这能再给他几个月的时间
give him a few more months.
我不会让我的病人带着几个月的寿命回家
No, I'm not sending my patient home with just a few extra months.
聊胜于无
It's better than nothing.
进行心脏移植呢
What about a transplant?
不行
Not an option.
心脏肿瘤这病没法获批
Heart tumors are a contraindication.
如果我们移植他自己的心脏呢
What if we transplant his own heart?
如果我们把它从胸膛整个取出来
If we take it totally out of his chest,
我们就可以接触到心脏后部
we'd have access to the posterior heart.
就可以切除肿瘤
We could excise the tumor,
修复它留下的缺口
fix the defect it left behind,
-然后把它放回去 -太酷了
- and then put it back in. - Cool.
一点也不酷
Not cool.
至少一个正常的心脏移植
At least with a normal heart transplant,
你会得到一个健康的心脏
you'd be getting a healthy heart.
她的想法保留了摘除心脏的风险
Her idea keeps the risk of removing the heart,
但增加了植入一个
and adds the risk that the heart we'd be putting back in
已经严重受损心脏的风险
has just been severely compromised
因为肿瘤被切除了
having had a tumor cut out of it.
他还年轻心脏没被肿瘤入侵的部分
He's young, and the part of his heart not infiltrated
仍旧健壮
with tumor is strong.
做下心脏核磁共振看看
Do a cardiac MRA and see
肿瘤是否入侵了冠状动脉
if the tumor's infiltrated the coronary arteries.
如果没有的话摩根的想法是可行的
If it hasn't, Morgan's idea could work.