良医

The Good Doctor S04E09

Part 5 March 10, 2021, noon

I am having thoughts I don't want to have.
朴和乔丹都说我不该告诉你
Both Park and Jordan say I shouldn't tell you.
但你会告诉我的是吗
But you're going to, aren't you?
是的
Yes, I am.
我对一个同事动心了
I have a work crush.
另外我的患者是一个怀孕的变性者
Also, my patient is a pregnant trans man --
一件一件说肖恩
Okay, one at a time, Shaun.
你说的动心是指
About this...crush?
她是钦蒂亚·德苏莎医生
Her name is Dr. Cintia D'Souza.
她是放射科第二年住院医生
She is a second year radiology resident.
我昨晚梦见我们在住院医师休息室
Last night, I dreamed we were in the Residents' Lounge,
一起收看天气频道接着我们开始接吻
watching The Weather Channel, and then we started kissing --
可以了我知道了
Okay, I got it.
你生气了吗
Are you mad?
朴和乔丹是对的我不应该告诉你
Park and Jordan were right. I shouldn't have told you.
没有我没生气
No. I'm not mad.
只是有点吃惊没事
A little surprised, but that's okay.
我有时也会被...
I'm still attracted...
其他的男生吸引
to other guys sometimes.
不不行
N-No.
不什么是谁
No. What? Who?
-这无关紧要 -谁
- It doesn't matter. - Who?
好吧就是有一位理疗师
There -- Okay, there is this one physical therapist --
别
N-No.
别说了
No.
不说了
No.
如果我们对其他人感兴趣
What if we're attracted to other people
是因为我们之间出了问题呢
because there is something wrong with our relationship?
你没打算在现实中去亲德苏莎医生吧
You're not planning on kissing Dr. D'Souza in real life?
没有
No.
或者跟她一起加班
Or working late with her,
单独在一起做X光检查
doing some X-rays alone,
然后不小心倚靠在同一个灯箱上
where you might end up leaning over the same light box --
我们已经不用灯箱了
We don't use light boxes anymore.
我也不打算和她一起加班
And I don't plan to work late with her.
那我觉得我们俩
Then I don't think either of us
都没什么好担心的
has anything to be worried about.
我要去准备翼点开颅手术
I have to go prep for a pterional craniotomy.
我是格拉斯曼医生医院的院长
I'm Dr. Glassman, president of the hospital.
除非你是来载我去圣弗朗西斯区域医疗中心
Unless you're here to drive me to S.F.Regional,
否则你可以出去了
you can head right back on out.
对于你在急诊室的遭遇我深表歉意
I apologize for your experience in the emergency room.
你真是十分善解人意了[直译为「白人」]
That's mighty white of you.
我不建议您转去圣弗朗西斯区域医疗中心
I don't recommend that you transfer to S.F.Regional,
或者任何其他医院
or any other hospital, for that matter.
我肯定他们也和你们一样有豪华的设备
I'm sure they got the same fancy equipment,
光鲜亮丽的证书
same shiny sets of diplomas y'all got here,
或许还会少一些种族歧视的医生吧
and maybe a few less racist doctors.
情况似乎并非如此
Well, apparently, that doesn't seem to be the case.
我调出了100英里内
I pulled data on comparable hospitals
与我们相似的医院数据
within 100 miles,
对比了手术成功率
did numbers on surgical outcomes
以及按种族分类的患者满意度
and patient satisfaction aggregated by race.
显然我们做得比他们都好
Apparently, we're doing well, comparatively.
你是说你的医院可能存在种族歧视现象
Your argument is that your hospital may be racially biased,
但没有其他医院的种族歧视那么严重
but it's less racially biased than these other hospitals?
是这个意思
Yeah. Pretty much.
留在圣文德医院
Stay at St. Bonaventure,
医院院长会亲自监督你的护理情况
the president of the hospital will monitor your care
一直到你痊愈出院
every step of the way.
不管怎样
For whatever it's worth,
我觉得你应该找不到比这待遇更好的了
I don't think you can do better than that.
她愿意留下但有个条件
She's gonna stay, on one condition.
就是你退出治疗团队
That you're off the team.
朴医生请展开大脑外侧裂
Dr. Park, please open Sylvian fissure.
蛛网膜手术刀和霍顿解剖器
Arachnoid knife and Rhoton dissector.
肿瘤可见
Tumor is visible.
一个人成为男人的要素是什么
What makes someone a man?
我原以为仅是染色体的区别
I thought it was just the chromosomes,
但事实并非如此
but that must not be it,
因此这让事情变得很复杂
which makes things confusing and difficult,
我已经知道里奥感到不适
and I know Rio was uncomfortable when he --
生活就是不适的
Life is uncomfortable.
用困境来打击你
It hits you with tough situations
你得自己扛过去
and you muscle through them.
在环窦处看到少量出血
I see a tiny bleed in the circular sinus.
用伏血凝止住
Pack it with Floseal.
跟我说说情况
Someone give me an update.
呼气末二氧化碳分压和氧饱和度下降
We got a drop in end tidal CO2 and oxygen sat.
有肺泡破裂的迹象吗
See any evidence of exposed air cells?
没有打蜡的骨边缘情况良好
No. But waxing bone edges just to be safe.
但是肿瘤挤压了蝶鞍区和蝶窦壁
But the tumor thinned the sellar floor and sphenoid wall.
导致了氧气渗入
Making it permeable to oxygen.
是空气栓塞
It's an air embolism.
血压在下降
BP's dropping.
利姆医生我们应该怎么做
Dr. Lim, what should we do?
盐水纱布
Saline gauze,
倾斜手术台减小气压梯度
tilt the table to eliminate the negative air pressure gradient,
接上中心线导管
and place a central line.
这能阻止空气侵入
This will stop the air leak
让我们处理气泡
and allow us to access the air bubble.
插入多孔型开口导管
Inserting Bunegin air-aspirating cath.
你离上腔静脉还有两厘米
You are 2 centimeters from the superior vena cava.
抽吸右心室空气
Aspirate the right atrium
直到看不见气泡
until you don't see any more air bubbles.
干得漂亮利姆医生
Nice save, Dr. Lim.
让我们把这个肿瘤拿出来
Let's get this tumor out.
用波茨剪
Make your transverse aortotomy
横向切开动脉沃克医生
with Potts scissors, Dr. Wolke.
扩大肌肉切口
Extending the muscular incision
到中心室
down to the mid-ventricle.
这里是肌切除术的位置
There's the myectomy site.
异常肌束在这
There's the aberrant muscle bundle.
撤掉体外循环
Get her off bypass,
看看她有什么反应
see how she does.
心排血量怎么样
How's the cardiac output?
下降中并且不充足
Reduced and insufficient.
低排血量可能意味着我们得进一步降低隔膜
Low output could mean we need to further reduce the septum.
或者说已经降得太低了
Unless it means that we reduced it too much.
破坏了用来控制心率的
Damaged the cardiac electrical conductors
心脏电导线
that control the heart rate.
她现在有三♥级♥房♥室传导阻滞
She's having third-degree heart block.
恩里克是对的
Enrique's right.
我们取走了太多肌肉了
We took too much muscle.
恢复体外循环
Put her back on bypass.
我们可以用牛心包片来补充心壁
We could augment the wall with a bovine patch.
但还是没法隔离电子系统
Still wouldn't insulate the electrical system.
她还是会面临完全性房♥室传导阻滞的风险
She'd still be at risk of complete heart block
或者心脏骤停
and cardiac arrest.
我们可以插入双腔起搏器
We could insert a dual chamber pacer.
这样心壁就不需要传导系统
She won't need the conduction system in the wall of her heart
来控制心率
to control her heart rate.
来吧
Let's go!
开颅术做得怎么样
How was the craniotomy?
很顺利
It went well.
患者正在恢复
The patient is in recovery.
你发信息说有好消息
Your text said you have good news.
其实对于德索萨医生是坏消息
And by good news, I mean bad news for Dr. D'Souza.
有好多事能让你讨厌她
Plenty of great stuff to crush a crush.
第一个观察结果
First observation --
她闻起来像桂皮