良医

The Good Doctor S04E12

Part 4 April 21, 2021, 9:04 a.m.

And that's how you screw with someone.
不
No.
你不擅长撒谎
You're not that good of a liar.
我不能和一个对我有想法的人当室友
I-I can't have a roommate who has feelings for me.
因为你开不起玩笑吗
Since when can't you take a joke?
因为我的室友挑逗我
Since my roommate hit on me.
你必须搬出去
You have to move out.
越快越好
As soon as possible.
我们决定用你的桡动脉移植
We've decided to use your radial artery for the graft.
我们已经安排了明天早上的手术室
We've scheduled an O.R. for tomorrow morning.
-好消息 -我同意
- Good call. - I agree.
你应该冒生命危险做这个手术
You should risk your life for this surgery.
你在开玩笑吗
Are you being facetious?
没有
No.
难以置信
It just boggles the mind.
你不能理解别人的意思
You can't understand what anyone means.
你不能像个成年人一样表达自己
You can't express yourself like an adult.
你就是个玩过家家的小孩
You're a child playing dress-up.
这里的所有人都陪着你玩过家家
And everyone here just plays along.
我们走吧肖恩
Let's go, Shaun.
你很不安
Y-You're agitated.
我没事
I'm fine.
你在擦杯子
You are rubbing your mug.
自闭症患者总是带着慰藉物
People with ASD often have comfort objects
以防焦虑不安
for when they become agitated.
我可以给你来点心得安
I can order you propranolol.
你要给我鲁塞卡斯·弗里德曼的
You're gonna give me the Ruseckas Freedman
自闭症评估表
ASD Diagnostic Questionnaire,
这样你才能闭嘴
and that's gonna shut your damn mouth.
好吧那个测试表只是个工具
Okay, the "Rafad-Q" is just a tool.
正式的诊断需要精神科医生给出
An official diagnosis needs to come from a psychiatrist.
我明天可能就死了
Well, since I might be dead tomorrow,
这是你次优的选择
this is your next-best option.
我会把测试表拿来
I'll get the test.
你为什么不能对别人尊重一点呢
Why can't you treat people with just an ounce of respect?
尊重是赢来的不是像发糖果那样简单
Respect has to be earned, not doled out like candy.
不这是你这样的人
No, that's just an excuse people like you use
为你垃圾行为辩护的借口
to justify your garbage behavior.
这是你这样的人
That's just an excuse people like you use
逃避现实的借口
to avoid facing reality.
我实习的时候没人尊重我
No one was respectful to me when I was a resident.
他们轻蔑而冷酷
They were dismissive and cruel.
但这点燃了我内心的火成就了今天的我
But it lit a fire and it made me the man I am today.
成为你进房♥间时带着敬意看到的人
The man that you came into my room idolizing.
不再是这样了
Not anymore.
我身体糟透了
I'm devastated.
医生应该救人性命
Surgeons deal in human lives,
不是小孩子玩过家家
not childish fantasies.
如果你想成功
If you want to succeed,
你得更像我才行
you're gonna have to be a lot more like me.
一切都好吗
Everything okay?
- 是 -手术进行得很顺利
- Yep. - Surgery went very smoothly.
现在不疼了
No pain right now.
想试一下吗
Want to take it for a test drive?
更糟了
It's worse.
侧支循环不太理想
Collateral circulation is not ideal.
我们要怎么割动脉
How are we gonna harvest the artery?
怎么了
What's going on?
我要做出多少改变才能成为医生
How much am I gonna have to change who I am to be a surgeon?
在任何方面做好或者是做到卓越
Ah, to be great -- or even good -- at anything,
我们都必须妥协
we have to compromise.
我以前总是在工作中投入太多情感
I used to get too emotionally involved in my work,
对病人是这样对所有人都是
with patients, everyone.
然后我必须学着让我自己保持距离
And I had to learn to distance myself.
是的你确实变得冷酷无情了
Yeah, you've really grown cold and heartless.
我已经做出改变我们最终都会变的
I have changed. We all end up changing.
你只是要尝试做出好的改变
You just got to try and make it a good change.
我不想做出改变
I don't want to change.
我想改变我身边的环境
I want to change what's around me.
我会想出办法的
Oh, I'll figure it out.
我相信你会的
I'm sure you will.
你是能把住货车都搞得很酷的那种人
Hey, you're the guy who makes living in a van look cool.
所以这个循环系统
So, uh, the circulation...
右边看起来更长
The right side looks like it has better length.
考虑到现在糟糕的结果
Given the poor outcome,
我们不建议现在再进行手术
we can't recommend further surgery right now.
我们建议服用六个月的止痛药
We suggest six months of pain medication
并且转诊给神经学和疼痛控制专家
and referrals to neurology and pain management specialists.
你们不建议什么手术
W-What surgery aren't you recommending?
应用脊神经后根入髓区毁损术
A DREZ lesioning.
我们会切断三叉神经
We'd cut the signal from the trigeminal nerve
到你大脑感觉区的信♥号♥♥
to the sensory areas of your brain.
但可能导致
But there's a real possibility of paralysis
一侧身体瘫痪
on one side of your body.
我想做手术
I want the surgery.
亲爱的我会帮你控制疼痛的
Baby, I'll help you manage the pain.
我会搬回来的
I-I'll move back in.
我来照顾你
I'll take care of you.
你知道我之前怎样待你的
You know how I treated you before.
我的病情只会恶化
I'm only gonna get worse.
我不会再离开你
I would never leave you again.
这就是我害怕的
That's what scares me.
我会拖累你
I'd start cutting you down,
我会变得无情
being cruel,
你却只能忍♥受
and you'd just put up with it.
我不会让这发生
I won't let that happen.
我们会准备手术室
We'll prep an O.R.
「我经常指出别人的错误」
"I frequently point out other people's mistakes."
没错
That's a yes.
「人们总是说我想太多」
"People tell me I overthink things."
只有想得少的人才那么说
Only people who underthink things.
但是好吧没错
But, fine, another yes.
「我有时会怪声怪调地说话」
"I sometimes speak in an abnormal tone."
谁会认为自己说话的语调不正常
Who thinks they speak in an abnormal tone?
当然不是
Just mark no.
还有多少问题
How many more of these?
没有了
None.
你的答案和光谱上的某个人完全一致
Your answers are fully congruent with someone on the spectrum.
不
No.
你输入错了
You keyed it wrong.
-不看我没有 -那就是别的什么
- No, look. No, I - Or something.
-看我没输错 -不给我
- Here. Look, I didn't. - No, give it to me.
-不我 -不要
- No, I -- ? - Oh! Don't!
你个粗心的蠢货
You idiot! S-Stupid, careless --
我退后了
I-I stepped back --
滚出我的房♥间
Get out of my room.
-快滚 -好
- Get out! ? - Okay.
确保我们没有影响正常的脊髓通路
Make sure we're not impacting normal spinal cord pathways.
体感正常
Somatosensories are at baseline.
血压稳定
BP's steady.
腿部和手臂脊髓诱发电位幅度降低50％
Leg and arm SSEPs at 50% decreased amplitude.
检查神经上下有无血肿
Check the cord above and below for hematoma
或者骨性压♥迫♥
or bony compression.
状况良好
Cord's fine.
推静脉输液并启动加压器
Push IV fluids and start pressors.
所以怎么回事
So, what is it?
我不知道
I don't know.
运动电位有问题吗
Any issues with motor potentials?
单边振幅下降70%
Unilateral amplitude down 70%.
神经系统就要崩溃了
We're about to get total neurological collapse.
是一个小分支动脉的血块