良医

The Good Doctor S04E08

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

of a controlled fistula and route for drainage.
有意思但病人还是得经历漫长的恢复期
Interesting. But the patient would still have a long recovery
且有再次感染的风险还有什么
and chance of reinfection. What else?
我查到些关于内窥镜真空疗法的
I found some very interesting research
非常有意思的研究
on endoscopic vacuum therapy.
其中有关于修复食道破损的
It's under investigation for the management of esophageal leaks.
很有新意艾伦医生但有些太新了
Definitely innovative, Dr. Allen, but a little too much so.
这个想法甚至还没经过临床试验
This concept hasn't even gone through clinical trials yet,
而我们今天就要做手术了
and we need to perform surgery today.
杰克逊医生怎么不说话
Dr. Jackson, you've been quiet.
我在想是不是可以用胃底加固
I was thinking about fundic reinforcement.
我的想法是用病人自己的健康组织
My idea is to use the patient's own good tissue
来加固一♥期♥缝合
to reinforce the primary closure.
在这个病例中可以用胃组织修补
In this case, using the stomach as the patch.
就像我们用皮肤移植治疗三度烧伤一样
Like the way we use a skin graft for third-degree burns.
他有得膈膜疝的风险
Well, he'd be at risk of a diaphragmatic hernia.
我们用贲门形成术
Not if we cinch up
收紧下部食管括约肌不就行了
the lower esophageal sphincter with a fundoplasty.
肖恩莉娅说你是医生你的专业是什么
Shaun, Lea tells us you're a doctor. What's your specialty?
我是外科医生
I am a surgeon.
尽管我们中很多人很傲慢但并不全是这样
But we are not all arrogant. Though many of us are.
我还不确定那是好是坏
I'm still not sure if that's good or bad.
难吗对你来说
Is it hard? For you?
我是说这是一个困难的工作
I mean, it's a difficult job.
肖恩工作做得很出色
Shaun is excellent at his job.
那么你对疫苗有什么看法
So, how do you feel about vaccines?
天啊
Oh, my God.
因为我有点担心
Because, they worry me.
我不担心
They don't worry me.
-是吗 -真的吗
- Oh. - Really?
因为我们看了很多东西
Because we've read a lot of stuff.
尤其是自从莉亚告诉我们你的事
Especially since Lea told us about you.
疫苗不会导致自闭症妈妈
Vaccines don't cause autism, Mom.
那还不如聊聊宗教
Want to talk about religion now?
这在不该讨论的清单上
I think that that was on the list of things not to talk about.
莉亚给你写了一张清单
Lea wrote you a list?
-爸爸 -好吧
- Dad. - Well...
老实说莉亚如果我们真的无法交流
Honestly, Lea, if we're so impossible to talk to,
我们为什么要在这里
why even have us here?
痔疮手术
Hemorrhoid surgery.
-什么 -再来点酒吗
- Excuse me? - Want more wine?
我给一个癌症晚期病人
I removed a hemorrhoid
切除了痔疮
from a patient with terminal cancer.
他只有几个月的生命且无力回天
He only had a few months to live, and nothing would change that,
但手术确实让他更舒服了
but the surgery did make him more comfortable.
我建议我们今晚像做痔疮手术一样
I suggest we treat this evening like hemorrhoid surgery.
这是这是一个很好的想法
Now, that's... That's a good point.
你不必给他什么清单让他说吧
You don't have to give him any more lists. Let him talk.
我喜欢这小伙
I like this guy.
好的
Okay.
敬痔疮手术
To hemorrhoid surgery.
敬痔疮手术
To hemorrhoid surgery.
BGM: Dancing In the Moonlight by Toploader
♪ Everybody's feeling warm and bright ♪
♪ It's such a fine and natural sight ♪
我去了
I went.
♪ Everybody's dancing in the moonlight ♪
我去看心理医生了
I went to see a psychiatrist.
我我听到这个很欣慰
I'm... I'm so relieved to hear that.
就一次
Well, once.
医生说我的症状需要药物治疗
The doctor said my symptoms warranted medication,
所以之后我就再没去过
so I haven't been back since.
为什么如果你需要药物治疗
Why? If you need medication...
你为什么对你的创伤后应激障碍保密
Why did you keep your PTSD a secret?
你选择用你自己的方式
You chose to deal with your issues privately,
私下解决你的问题
on your own terms.
为什么我没有权利做同样的选择
Why am I not entitled to the same choice?
做一些自我毁灭的事
Doing something self-destructive
不是选择而是错误
is not a choice, it's a mistake.
就像我曾经那样
Just like it was when I did it.
所以我做一些你赞同的事就好
So, when I do something you agree with, it's great.
当我做了你不赞同的事
When I do something you disagree with,
-就是因为我有病 -不
- it's because I'm sick. - No.
你知道吗这就是我不想和你说话的原因
You know, this is why I don't want to talk to you,
因为这不是交流而是说教
because it's not a conversation, it's a lecture.
奥德丽
Audrey.
BGM: Celebration by Kool & The Gang
奥德丽
Audrey...
求你克莱尔让我走
Please, Claire, let me go.
不
No.
我只想回家我会没事的
I just want to go home. I'll be fine.
让我载你一程你不能这样开车
Let me give you a ride. You can't drive like this.
来吧
Come on.
我说了我很好
I said I'm fine!
不你不好
No. You're not!
♪ Celebrate good times Come on ♪
好了现在谁也别开车了你满意了吗
There! Now no one's driving home. You happy?
♪ Celebrate good times... ♪
自发性食管破裂的两大挑战
The two main challenges of Boerhaave syndrome
是及时诊断及后续进行可能的修复
are timely diagnosis followed by viability of repair,
有了这种创新的手术方法
and with this innovative surgical approach,
我想这两方面都可以做到
I think we might achieve both.
我需要结扎丝和血管闭合器
I need silk ties and LigaSure.
他胸部的感染从横膈膜漏出来
His chest infection leaked through the diaphragm
进入腹腔
into the intraperitoneal space.
胃后面有个脓肿
There's an abscess behind the stomach.
它让整个胃后壁变得脆弱
It's making the entire posterior stomach friable.
如果我们用肋间肌瓣
What if we use an intercostal muscle flap
来修补食管呢
to patch the esophagus instead?
那样会增加败血症的风险
If we do that, it raises the risk of sepsis.
病人同意承担风险
The patient signed off on risk.
-我们至少应该试试 -不是这种级别的风险
- We should at least try. - Not this level of risk.
我们得做分流手术
We need to do the diversion.
你的想法是好的别这么快就放弃了
Your idea was good. Don't give up on it so fast.
重新考虑分流手术并不意味着失败
Reverting to diversion doesn't mean failure.
我错搜成「在我附近吃肉」了
I searched "eating meat near me," which was a mistake,
不过确实跳出来一家牛排店
but I did get a recommendation for a steak house
你♥爸♥可能喜欢
your father might like.
你不用再讨好我父母了肖恩
You don't have to be nice to my parents anymore, Shaun.
我们不会再见他们了
We won't be seeing them again.
为什么
Why not?
「我们要谈谈肖恩」
"We need to talk about Shaun."
他们觉得我不够成熟
They don't think I'm mature enough
应付不了高难度的恋爱
to be in a challenging relationship.
留给我妈吧她一次性把我俩都排除出去了
Leave it to my mom, she took us both out in one shot.
你知道这很侮辱人吧对我俩都是
You do get that this is insulting. To both of us.
他们本该是世界上最爱我的人
From the people who supposedly love me most in the world.
他们不是
They don't.
不是最爱的
Not the most.
不再是
Not anymore.
莉亚...
Lea...
遇到我的人
People who meet me
通常都感到不舒服
are usually uncomfortable.
大部分时候这种感觉都不会消失
And most of the time, that doesn't go away.
那你怎么应付
How do you handle that?
我尽量耐心点
I try to be patient.
有时有用
Sometimes it works.
也许你比我更成熟
Maybe you're a more mature person than I am.
但我不确定这对我有用
But I'm not sure if that is gonna work for me.
你今早看到利姆医生了吗
Have you seen Dr. Lim this morning?
没有怎么
Uh, no. Why?
达雅的律师打电♥话♥过来
Darya's lawyer called.
-我找利姆医生 -利姆医生不在这
- I need Dr. Lim. - Dr. Lim's not here.
我不知道她今天来不来
I don't know if she'll be in today.