良医

The Good Doctor S04E12

Part 3 April 21, 2021, 9:04 a.m.

小小的蓝眼睛
teeny blue eyes...
我呢
And me?
当妈妈
A mom?
我不是说我的生活会变糟
I mean, I'm not saying my life would be worse,
但是会变得很不同
but it would just be so different
跟我之前计划的
from what I was planning.
我不是真的在计划什么
Not that I was really planning,
我只是很享受
but I am enjoying just...
生活
being.
如果你先等等呢
And so what if you wait?
我只是想确定自己做的决定是对的
I just want to make sure I'm making the right decision.
我觉得你永远没法知道
I guess you'll never really know.
我对于我的妈妈也做了很多困难的决定
I had to make a lot of hard choices about my mom.
醒来还是在想
And I still wake up wondering
我做错了哪个决定
which of them went the wrong way.
但你还是得选
But...you still gotta choose.
中脑桥没有异常信♥号♥♥
No abnormal signal in the mid pons.
你和朴医生在家也是这样吗
So, are you and Dr. Park like this at home, too?
当我让他从笼子里出来吃饭的时候是的
When I let him out of his cage for meals, yes.
我们已经
Hey, we're almost --
说吧
Oh, come on.
你没收到我发的与此事无关的短♥信♥吗
Did you not get the text I didn't send about this?
如果你要这样就不要找人会诊
Don't bother asking for consults if you're gonna --
等等
Wait.
右小脑上动脉上那个是什么
What's that on the right superior cerebellar artery?
异常环状物造成压♥迫♥
An abnormal loop causing compression.
他有三叉神经痛
He has trigeminal neuralgia.
他的疼痛是真的
The pain's real.
我们能很清楚地看到
We have good visualization
目标区域
of the target area.
把超声连接到立体定向架上
Connect the ultrasound to the stereotactic frame.
生孩子的理由
点儿童套餐不会有人♥质♥疑
有借口买♥♥科学博物馆季票
有借口逃避社会责任
椎动脉
消融术是没用的
Ablation won't work.
你改变主意了吗
You changed your mind?
你不觉得他有肌张力障碍吗
You don't think he has dystonia?
他有但那只是个症状
He does, but it's a symptom.
他的椎动脉曲线异常
His vertebral artery takes an aberrant course.
压♥迫♥了他的脊柱
It is pressing against his spinal cord.
他需要血管手术否则他会死
He needs vascular surgery or he'll die.
这是一种从面部到大脑
It's a disorder of the nerve that carries sensation
感觉神经的紊乱
from the face to the brain.
是最痛苦的疾病之一
And it's one of the most painful conditions that exists.
而且很难诊断
And very hard to diagnose.
万幸的是朴医生同意做那些检查
Thank God Dr. Park approved all those tests.
你很痛苦
Y-you were in agony.
我
And I...
我告诉他我觉得你在撒谎
I told him I thought you were lying.
你觉得我在撒谎
You thought I was lying?
你觉得我药物上瘾了
You thought I was just being an addict.
但你还是陪我来了
And still you came here with me.
坐在我旁边
Sat at my side.
我们推荐做微血管减压术
We'd like to do a microvascular decompression.
我们会从你大脑后部进入
We'd go in through the back of your skull
放入聚四氟乙烯补片来缓和受影响的神经
and put in a Teflon patch to cushion the affected nerve.
你们要切开他的头吗
You're -- you're cutting into his brain?
这个相对来说安全其他方案
It's relatively safe. And other options
不可能缓解疼痛
are unlikely to relieve the pain.
我会做的
Look, I-I'll do it.
谢谢你们
Uh, thank you so much.
我们想要进行椎动脉球囊闭塞试验
We want to run a vertebral artery BTO.
如果你能接受我们会选择牺牲
If you tolerate it, then we would sacrifice the --
牺牲有缟玛瑙栓塞剂的血管
Sacrifice the vessel with onyx embolization.
我们明白你可能不喜欢这个提议
We recognize you might not love this proposal.
喜欢这个让我的手继续无力
The one in which my hand weakness remains,
毁掉我事业的提议吗
destroying my career?
你们考虑过椎体间的动脉搭桥手术吗
Did you consider vertebral-to-vertebral artery bypass
物理去除异常的动脉
with physical removal of the aberrant artery?
那会有很高的中风或者出血的风险
Mm, that would carry a very high risk for a stroke or bleed.
它能够治好肌肉障碍让我正常工作
It would fix the dystonia and let me get back to work.
鉴于你颈动脉狭窄的病史
With your history of carotid stenosis,
你能否活下来都是未知的
it would be a coin flip whether you survive.
我能接受这些存活几率
I can live with those numbers.
不然我宁愿死去
Or, for that matter, die with them.
到三叉神经根的通道已经打开了
Corridor to the trigeminal nerve origin is open.
我移开了责任血管
I freed up the offending vessel.
聚四氟乙烯垫片
Teflon sponge.
垫片太大了
The sponge is too big.
会压♥迫♥到脑干
It'll compress the brain stem.
至少有四毫米的空间
I have at least 4 millimeters of room.
只有你说的一半
You have half that.
是你在十五米外看得比我清楚
Yes, you have a better view 50 feet away.
他们这样已经多久了
How long have they been like this?
有一会儿了但是情况还在恶化
A while. It's getting worse, though.
抱歉朴你是对的
Sorry, Park, you're right.
就像你决定要
Just like you were when you decided
送这个病人出院一样
to discharge the sick guy.
是你发明了挖苦吧
Wow, you invented sarcasm.
真了不起
Really impressive.
看看我我也在用它呢
Hey, look at me, I'm using it, too.
朴你误诊了
Park, you missed the diagnosis.
雷兹尼克你违反了规定
Reznick, you ignored protocol.
不如你们俩都谦虚点然后闭嘴
How about you both show some humility and shut up?
抱歉
Sorry.
垫子放上去了
Teflon's placed.
如果我们用大隐静脉来做搭桥呢
What if we used the saphenous vein for the bypass?
血流不够他会休克的
Not enough flow. He'll stroke out.
那从颈动脉到椎骨远端呢
Carotid to distal vert, then?
动脉狭窄太严重了
Stenosis is too severe.
这老兄很有钱
Dude's loaded.
他到了退休的年龄
He's at retirement age.
他能教书旅游整天去玩
He could teach, travel, screw around all day.
为什么要我们这么做
Why is he demanding that we do this?
当你把生命奉献给
When you dedicate your life to something
赋予你意义的东西
that gives you meaning,
它就开始定义你
it starts to define you.
他的决定可能不合理但我能理解
His decision may be irrational, but I get it.
我不觉得有什么不合理
I don't think it is irrational.
钱伯斯医生没有朋友没有孩子
Dr. Chambers has no friends, no children,
没有家人没有业余爱好
no family, no outside interests.
如果他不当医生他就一无所有
If he can't be a surgeon, he'll have nothing.
我认为最佳方案是放射状移植
I think our best bet is a radial graft.
这是我能想到最好的办法
Highest flow I can think of.
有其他想法吗
Any other ideas?
好吧我们就做放射状移植
Okay. We go with the radial graft.
我印象深刻
I'm impressed.
我当时甚至开始怀疑我是不是要失去触觉了
I was actually starting to wonder if I was losing my touch.
然后我度过了一个煎熬的下午
But then I had a dark afternoon of the soul
然后我突然意识到
and suddenly I knew it --
那只不过是烧伤
those were totally solid burns.
可能不是A+级烧伤但A- B+最糟糕了
Maybe not A+, but A-, B+ at the worst.
所以我突然想到你是想让我退赛
So it hit me -- your plan was to throw me off my game,
让我怀疑自己
make me doubt myself --
我迷上你了
I'm attracted to you.
我一直和这愚蠢的感觉抗争
I've been fighting this stupid feeling,
想办法找到理由让我不再有这种感受
trying to find reasons to not...feel.
你在开玩笑吗
Are you kidding me?
是啊
Yes.
你的笑话不好笑
Your jokes were lame.
就该是这样玩弄别人的