良医

The Good Doctor S04E06

Part 4 March 10, 2021, 11:59 a.m.

我觉得这与本无关
I don't think this is about Ben.
你有没有明知道能救
Have you ever lost a patient
却没有救活的病人
you knew you could have saved?
新冠最严重的时候
When covid was at its worst,
我们不得不取消所有非紧急手术
we had to cancel all non-urgent procedures.
一位患有心脏病的年轻妈妈
A young mom with a heart condition was
病情比我想得要更紧急
more urgent than I thought.
没等我把她的手术提上日程她就死了
And she died waiting for me to put her on the schedule.
你是怎么度过的
How do you get past that?
因为这项工作就是这样
You get past it because that's the job.
你会永远记得
You will always remember it.
也最终不会再受午夜梦回的折磨
And you will eventually stop reliving it.
你又怎么能确定
How can you be so sure?
因为做不到的话你就不能成为医生
Because if you don't, you can't be a surgeon.
我很肯定你就是一名医生
And I'm pretty sure you're a surgeon.
我该回去工作了
I should get back to work.
放入窥镜
Insert the speculum.
撑开子♥宫♥颈
Now dilate the cervix.
开始抽吸
Begin suction.
开始在子♥宫♥内慢慢抽吸
Begin gentle suction in the uterus.
有问题吗
Is anything wrong?
没事的
You're okay.
艾伦医生接下来交给我
Dr. Allen, I can take it from here.
别担心快结束了
Don't worry. We're almost done.
你不会有事
You're gonna be just fine.
你根本不知道那女人在经历什么
You have no idea what that woman was going through,
你还雪上加霜
and you made it worse for her.
我知道我没...
I know. I didn't...
在进手术室之前
You had an opportunity to opt out
你有机会退出
before you walked into that room,
但你同意了做手术
but you agreed to do the procedure,
你承担起了对那个病人的责任
you took on an obligation to that patient,
结果你没做到
and you failed her.
如果你再出现这样的情况
If you ever do anything like that again,
我就要把你从我的项目开除
I will have you removed from my program.
也许你应该先清洗一段时间的便盆
Maybe you should be cleaning bedpans for a while.
希望那项工作没有道德障碍
Hopefully there's no moral objection to that.
为什么我的桌子上有成人玩具
Why are there adult toys on my desk?
我听人说大羊驼很好
I've heard good things about the Llama,
但网上的评论并不都是准确的
but online reviews aren't always accurate.
你有特别喜欢的吗
Do you have a favorite?
这是送给莉亚的
They're for Lea.
你最喜欢哪个克莱尔
Which one do you like the most, Claire?
有证据显示创伤会改变大脑的运作方式
Evidence suggests that trauma changes the way the brain works.
过于活跃的杏仁体会加剧人们
An overactive amygdala can heighten someone's response
对情绪刺♥激♥的反应包括恐惧
to emotional stimuli, including fear.
我想我们应该考虑给本做杏仁体消融术
I think we should consider amygdala ablation for Ben.
这太疯狂了
That's crazy.
而且根本不在我们的考虑范围内
And completely outside the scope of our care.
我们是
We're s...
我们是外科医生
We're surgeons.
我们解决生理问题而不是心理问题
We fix physiological problems, not mental ones.
这就是生理问题
It is a physiological problem.
他的大脑功能不正常
His brain isn't functioning properly.
如果这些反应是肿瘤造成的
If it was a tumor that was causing these reactions,
你会毫不犹豫地切除它
you wouldn't hesitate to remove it.
但他没有肿瘤
But there is no tumor.
你是要给他的大脑造成伤害
You're talking about inflicting damage on his brain.
他术后可能会中风
He could suffer a stroke
或昏迷或者彻底醒不过来
or come out in a coma or not come out at all.
如果你用立体定向激光的方法
If you use a stereotactic laser approach
而不是开颅手术
rather than an open craniotomy,
就会大大降低风险
you would greatly reduce the risks.
这不是你的病例
This is not your case!
你不能因为不想做分配给你的事
You cannot jump into this one
就直接跳到这一个病例
because you don't want to do the one assigned to you,
教住院医师是你的任务而不是我的
which is to teach, which you've made my problem
就像选莉亚的生日礼物是你的问题而不是我的一样
just like you made Lea's birthday gifts my problem.
你得成熟点承担些责任
You need to grow up and accept some responsibility.
我去年也被诊断为创伤后应激障碍
I was diagnosed with PTSD last year.
我基本上没告诉任何人
I kept it mainly private.
梅伦德斯真的帮我渡过了难关
Melendez really helped me through it.
有朋友依靠真的很好
It was nice to have a friend to lean on.
所以如果你需要朋友...
So if you need one...
我觉得
I feel
不在状态
off.
觉得跟世界脱节了
Disconnected.
觉得我好像喘不过气来
Like I can't catch my breath.
但
But
这和工作是一起的
it comes with the job.
我会克服的
I'll get over it.
是本
It's Ben.
本
Ben.
没人会伤害你
No one is gonna hurt you.
你又在闪回了
You're having a flashback.
我知道我在哪里
I know where I am.
自从我回到家后
Every day since I came home,
我每天都觉得好像有怪兽在追我
I've felt like there's a monster chasing me.
我尽量不让它追上
I try to outrun it
但结果却伤害了我最爱的人
but I end up hurting the one I love the most.
我对周围的所有人都是个威胁
I'm a threat to everyone around me.
不本你只是需要帮助
No, Ben, you just need help.
什么都没用
Nothing helps.
我不能微笑也不能大笑
I can't smile. I can't laugh.
我除了痛什么都感觉不到
I can't feel anything but pain.
我让周围的所有人
I make everyone around me
都很痛苦
suffer.
本
Ben.
有个手术可能会有帮助
There's a surgery that may help.
我想参与杏仁体消融术
I would like to scrub in on the amygdala ablation surgery.
露丝说你觉得不堪重负需要...
Rose said you're feeling overwhelmed and need...
我不想再听到那个女人说的任何话
I don't wanna hear any more things that woman has said.
你的工作是指导你的住院医师
Your job is to supervise your residents.
你为什么在这里而不在指导他们
Why are you here instead of doing that?
你说过你会教我指导他们
You said you were going to supervise my supervision,
但你没有
but you didn't.
你接手了我的病例
You took over my case.
我不知道我该学什么怎么学
I don't know what I was supposed to learn or how.
进来吧
Scrub in.
莫菲医生告诉亚舍探针的位置
Dr. Murphy, walk Asher through the probe placement
以及到杏仁体的路线
and trajectory to the amygdala.
我会教你指导他们
I will supervise your supervision.
好将探针垂直插入大脑皮层表面
Okay, insert the probe perpendicular to the cortical surface.
住手你的方向偏了
Stop! You're off course.
照这个路线插下去
On the current trajectory,
你会穿过脉络膜动脉的分支
you will penetrate a branch of the choroidal artery
造成脑出血
and cause a hemorrhage.
离探针远点
Step away from the probe.
你的工作是教学而不是接手
Your job is to teach, not take over.
将探针向下调整一毫米
Adjust the probe one millimeter inferiorly.
避开你右边的颞角
Avoid the temporal horn on your right.
我在图像导引上看不到它
I can't see it on the image guidance.
把你看到的告诉亚舍
Tell Asher what you see.
它应该指向Y轴上的六点钟方向
It should point toward your six o'clock on the Y axis.
你必须去感觉它
You have to feel it.
那个
The...
脑实质边沿的组织面是光滑的
The tissue plane along the parenchyma is smooth.
感觉应该就像在滑行
It should feel like gliding.
你已经到杏仁体了
You've reached the amygdala.
准备进行激光热消融术
Ready to begin thermal laser ablation.