良医

The Good Doctor S04E08

Part 2 March 10, 2021, 11:59 a.m.

对你和你女儿都是如此
For you and your daughter.
谢谢你
Thank you.
但我想提醒你一下
But may I kindly remind you,
你们医生一次值班要多久
how long are the shifts that you doctors work?
压力大睡眠少
High stress, no sleep.
遇到重要的事你就得全力以赴
When something is important, huh, you give it all you got.
确实但我们是成年人达雅可不是
True. But we're adults. Darya's not.
对但她和同龄的女孩非常不同
Yeah, but she's very different from other girls her age.
我是说达雅她拼命工作
I mean, Darya, she works her butt off.
她赢得了我的尊...尊重
She's earned my r... respect.
你还好吗
You okay?
我感觉胸口痛
Oh, I'm feeling some kind of chest pain.
他的血氧饱和度和血压下降
His oxygen sat and pressure's dropping.
可能是心肌梗死肺部问题或主动脉瘤
Possible MI, lung problem, or aortic aneurysm.
确保呼吸道通畅
Secure his airway.
血液灌注差感觉是败血症
Poor perfusion. I think he's septic.
生命体征没有好转
And vitals aren't improving.
可能是自发性气胸
Might be a spontaneous pneumothorax
胸腔里有空气
and trapped air in his chest.
不那样胸部声音会像鼓声
No, his chest would sound like a kettle drum.
内部有积液
There's fluid in there.
给我手术刀弯曲钳和胸管
Give me a blade, curved clamp, and a chest tube.
自发性食管破裂很容易被误诊
Boerhaave syndrome is easily misdiagnosed.
叩诊技术不错
Nice catch with the percussion technique.
你可能救了这男人一命
You may have saved this man's life.
再给我点拉钩
Give me more retraction.
这些组织层糟透了
These tissue planes are terrible.
我们得清除纵隔
We're gonna have to debride the mediastinum.
食道的损伤太大修复好后
There's too much damage to repair the esophagus
会有慢性瘘管的风险
without risking a chronic fistula.
持续的胸腔渗漏
The ongoing leakage into his chest
这意味着他因感染而死
means it would just be a matter of time
将只是时间问题
before he dies from an infection.
最安全的办法是做永久食管分流
The safest approach would be to permanently divert the esophagus.
这样他下半辈子只得通过一根管道进食
And he'd have to eat through a tube for the rest of his life.
但我觉得没有更好的选择了
But I don't see a better option.
24小时后在广谱抗生素和引流管的作用下
In 24 hours, with broad spectrum antibiotics and drains,
感染能够清除并给我们更多的选择
the infection could clear and give us more options.
这为所有人赢得更多时间想出另一个绝佳的方案
Which buys everyone time to come up with another brilliant win.
她真的叫她爸爸「教练」吗
Does she really call her own father "Coach"?
他就是她的教练
He is her coach.
你怎么称呼你♥爸♥爸
What do you call your father?
-阿巴 -帕斯
- Abba. - Pass.
弗兰克
Frank.
那就是他的名字
That's his name.
你尊重什么传统吗
Do you respect any traditions?
不是那些随机的传统
Not random ones.
为什么我们要给已存在的事物创造新的标签呢
Why should we create labels for things that already have names?
这不仅是达雅怎么称呼她爸爸的问题
It's not just what Darya calls her dad,
而是他们之间的互动方式
it's how they act with each other.
他们就像同事一样
They're like coworkers.
听起来不错
That doesn't sound bad.
如果我明天是和莉亚的同事见面
If I were meeting Lea's coworkers tomorrow,
她就不会那么焦虑了
she would be much less anxious.
家人就该让你觉得焦虑
Family is supposed to make you anxious.
给父母介绍认识你的新男友这是件大事
Introducing a new boyfriend to your parents, it's a big deal.
这是一件人生大事
It's a rite of passage.
多态心室性心律失常
Polymorphic ventricular arrhythmia.
尖端扭转型室性心动过速
Torsade de Pointes.
我们需要静脉注射两克硫酸镁
We need magnesium sulfate two grams IV.
-心跳170 -她没反应
- Heart rate's 170. - She's not responding.
把除颤仪推进来
Move in the defibrillator.
-充电到100焦 -离手
- Charged to 100 joules. - Clear.
我们做错了什么吗
Did we do something wrong?
没有
No.
这很令人困惑
Which is puzzling.
第一年住院医师能犯的错是可预料的
Mistakes by first-year residents are expected,
但一个14岁孩子出现心律失常绝对是意料之外
but cardiac arrhythmia in a 14-year-old is definitely unexpected.
我正想问你要不要搭我的车
I was gonna ask if you wanted a ride,
不过如果你要加班
but if you're working late...
花了二十个小时解决这个问题
Twenty hours to figure this out.
你确定要在开车上下班路上浪费一半的时间吗
You sure you want to waste one of them driving home and back?
我一边开车一边思考
I think while I drive.
在车里和在家思考都不如在这里好
Not as well. Not in the car. Not at home.
那会感觉太舒服有太多干扰
Too comfortable, too many distractions.
最好留在这里认真工作
Better to buckle down here,
作为奖励你的同事们还可以看见你
where, as a bonus, your colleagues can see you.
我以为比起人们对医生的看法
I was under the impression that results are more important
结果更为重要
than how a doctor is perceived.
而乔丹也比你强多了
And Jordan is running rings around you there, too.
如果你不能让别人听你的结果也没有意义
Results don't matter if you can't make people listen.
所以你才不愿意做食管分流手术吗
Is that why you didn't want to perform the esophageal diversion?
你没听见我说的话
You didn't hear me?
我做的决定是为了病人好
I made a decision for the good of the patient.
现在
Now,
要靠你来证明我是对的
it's up to you to prove me right.
她有QT间期延长和偶发性心率过快
She has a prolonged QT interval and sporadic extra beats.
我会让新人们
I'm gonna get the newbies
去重新检查肾功能测试
to recheck the renal panel
再安排内分泌和遗传研究
and order endocrine and genetic studies.
我已经做过了另外还做了毒理和药物筛查
I already did. Also a tox and drug screen.
你还好吗
Are you okay?
莉亚害怕了
Lea's scared.
那么我应该做好准备
Then I should prepare myself.
她父母肯定不喜欢我的某些地方
There is definitely something about me her parents won't like.
不是的肖恩
No, Shaun.
你就是你
You are who you are.
你很棒
Who you are is great.
你这辈子都在为此做准备
You've been preparing for this your entire life.
当你第一次做重要的事情的时候
When you do something important for the first time,
比如手术你会练习
like surgery, you practice.
我应该练习和她的父母见面
I should practice meeting her parents.
怎么做呢这里可没有模拟器
Mm, how? It's not like there's a simulator
可以学习如何处理尴尬的社交互动
for learning how to navigate awkward social interactions.
有的
There is.
不过我需要披萨
But I need pizza.
BGM: Moonlight in Soho by Chucho Merchan
肖恩这是我的父母帕姆和迈克
Shaun, I'd like you to meet my parents, Pam and Mike.
您好帕姆
Hi, Pam.
您好迈克
Hi, Mike.
莉亚告诉我们你是一名医生你的专业是什么
Lea tells us you're a doctor. What specialty?
我是一名外科医生
I am a surgeon.
太遗憾了我听说外科医生都很傲慢和被高估了
What a shame. I hear surgeons are arrogant and overrated.
抱歉摩根
Morgan, I'm sorry,
你能消停一会吗
but can you just give it a rest for half a second?
我正进入角色呢请叫我帕姆
I'm in character. Please address me as Pam.
我最近读到当你睡觉的时候
I read recently that, while you're sleeping,
你每年都会不经意吃掉八只蜘蛛
you accidentally eat eight spiders every year.
是的
Yes.
我还读到有时候它们会在你胃里产卵
And I read that, sometimes, they lay eggs in your stomach,
然后你肚子里会有上千只蜘蛛
and then you can have thousands of spiders...
肖恩
Shaun.
你说过在他说错话或者说废话时
You said not to disagree with him
不要和他争辩
when he says something wrong and pointless.
我也没让你附和他
I didn't tell you to agree with him,
因为这只会让他说更多错话和废话
because that only gives him more wrong and pointless things.
好这很有用
Good. That's helpful.
我们继续吧
Let's continue.
你知道亚利桑那州没有夏令丝吗
Did you know that Arizona doesn't have Daylight Savings Time?
「夏令时」
Saving.
是「时间」的「时」而不是「丝」说不通