良医

The Good Doctor S04E14

Part 2 April 21, 2021, 9:05 a.m.

这是你没有生孩子的原因吗
Is that why you don't have children?
肖恩你永远不该问一个女性那样的问题
Shaun, that is not something you should ever ask a woman.
是我先提起来的
I brought it up.
我没有有意地做出那样的选择
I never consciously made that decision.
但一路以来我做的许多小选择
But along the way I made a bunch of small ones
导致我把工作放在了组建家庭之前
that put my job in front of having a family,
而且我也不后悔
and I don't regret it.
但大部分男人不用做这种选择让我很生气
But it does piss me off that most men don't have to choose.
活动股骨近端然后铰孔粗锉
Mobilize the proximal femur, then ream and rasp.
琴的血压骤降
Jean's pressure just tanked...
血压6♥4♥/38
6♥4♥ Over 38.
加快输液上升压药
Push fluids, start pressors.
心率低至42次每分钟
Heart rate's low at 42,
窦性心动过缓
sinus bradycardia.
她术前检查一切正常没有心脏病史
Her pre-op tests were all normal. She has no cardiac history.
如果她有血栓掉落心率应该过速
If she threw a clot, she'd be tachy.
检查是否有隐性出血
Check for any occult bleeding.
我做一个经食道超声
I'll get the transesophageal echo.
没有出血
There is no bleeding.
做个十二导联心电图上肌钙蛋白
Check a twelve-lead, start troponins.
血压稳定了
Her B.P. Is stabilizing.
切除骨刺放髋臼杯向后外侧拧紧螺丝
Remove osteophytes, place cup, direct screws posterolaterally.
她的血压不应该出现下降
Her pressure should not have dropped,
我们也不知道为什么血压又回升了
and we don't know why it came back up.
不是因为输液和升压药或自发性逆转或...
It wasn't the fluids and pressures or spontaneous reversal or...
我们要在血压再一次下降前
We need to finish her hip arthoplasty
完成她的髋关节置换手术
before she bottoms out again.
然后没错
And then yes,
我们需要找出血压下降的原因
we need to figure out why it happened in the first place.
推进针头
Go ahead and advance the needle.
你有在和谁约会吗
Are you seeing anybody?
不这要开始变得奇怪了吗
Oh, no. Is this about to get weird?
-不我不 -注射荧光剂
- No, I... No. - Taking a fluoro shot.
你通常只约一个人
Do you usually one person exclusively
还是同时约会好几个人
or are you seeing a few people at once?
-小心不要刺穿胸膜腔 -具体一点
- Careful not to breech the pleural space. - Define your terms.
「约会」是指一起吃晚餐还是约来打炮
Does "date" mean "have dinner with" or "meet up for sex"?
我不是很确定
I'm not entirely sure.
如果到了会一起吃饭的地步
By the time there's food involved,
我更偏向只和一个人约会进入血肿
I prefer to be exclusive. In the hematoma now.
我什么都吸不出来
I'm not able to aspirate anything.
那不只是血肿和血栓
That's not just clot and blood.
那是一个肿块
It's a mass.
直径约五厘米
It's about five centimeters across,
实心不易滑动
firm, nonmobile.
很稠密
It's very dense.
做个活检
Get a biopsy,
不过看起来像是乳腺癌
but that looks like breast cancer.
如果她的心脏可能有问题
If there might be a problem with her heart,
她还应该给心脏增加负担吗
she should be putting strain on it?
如果我要心脏病突发
If I'm gonna have a heart attack,
这里是最合适的地方
this is the best place for it.
一点不错
That is exactly right.
你妈妈很可能没事
It's very likely your mom is fine--
血压下降可能只是麻醉反应
that the blood pressure drop was just a reaction the anesthesia.
你是一位非常成功的飞行员
You're a very successful pilot.
这因为你是女性而更艰难了吗
Was that harder because you are a woman?
对我来说表现杰出给了我优势
For me, standing out was a plus.
让我获得关注
It got me noticed.
这并不总是好事
Mm, that's not always a good thing.
是海军部队
It's the Navy.
给我定的标准比给男兵定的高吗没错
Was the bar higher for me than the guys? Yeah.
但压力是让你进步的机会
But pressure's just an opportunity to get better.
你母亲很鼓舞人心
Your mother is very inspiring.
是的她的确很鼓舞人心
Yes...she is.
需要的话我可以加快速度
I can go harder if you need me to.
好的请吧
Yes, please.
我没有乳♥房♥♥
I don't have breasts.
怎么会得乳腺癌
How can I have breast cancer?
你有乳腺组织
You have breast tissue,
虽然在男性中很罕见但这的确会发生
and while it's rare in men, it does happen.
活检发现了一处恶性肿瘤
The biopsy has identified a particularly aggressive tumor.
但好消息是我们发现得早
But the good news is we caught it early.
那接下来呢
W-what's next?
抱歉
Sorry.
配对成功
莎拉发来一条消息
配对成功
坎迪丝309发来一条消息
萨曼莎发来一条消息
配对成功
配对成功
我们建议手术取出肿瘤
We're recommending surgery to remove the mass.
然后进行化疗
Followed by chemotherapy.
我们不认为会造成长♥期♥的
We don't believe there'll be any long-term
-体能降低或... -能保留我的移植物吗
- loss of strength or-- - Can I keep my implants?
手术时能绕过移植物吗
Like, will they be able to work around them?
-有可能 -但是可能很小
- It's possible. - But highly unlikely.
治疗结束后健美先生还是得保持健美
At the end of this, the Body gotta look like the Body.
不然我会失去赞助商
Otherwise, I'll lose my sponsors,
失去职业生涯
my career.
肿瘤切除术很合理考虑到...
A lumpectomy makes sense considering--
如果我们让患者把外表
If we want to let the patient prioritize his appearance
置于健康之前
over his health.
他需要做乳腺切除
He needs a mastectomy.
你还会那么轻蔑吗如果患者
Would you be that dismissive if our patient
是一位女性想要保留...
was a woman choosing to preserve her--
今天某人人气很高啊
Someone's popular today.
都是约会软件的提醒
They're all dating app alerts.
一张头像能带来的人气提升真是令人惊讶
It's amazing what upgrading a profile pic can do.
你得把密♥码♥设定得更复杂些
You should vary your password more.
你哪里来的这张照片
Where'd you get this photo?
我拍了留作私用的
I took it for personal use.
不过我很高兴让它为你打开
But I'm happy to let it be your introduction
线上约会世界的大门
to the world of e-dating.
飞吧肌肉麻雀
Fly, muscular sparrow.
飞吧
Fly.
-这张照片简直... -这叫作
- This photo's such a-- - The words you're looking for
「饥渴陷阱」不谢
are "thirst trap," and you're welcome.
放松放松
Relax. Relax.
现在你享受着伴侣的抚慰
While you are under the soothing touch of your partner,
让我们来讨论一下分娩计划
let's discuss birthing plans.
好吧也许你可以别那么用力
Okay, maybe just a little less pressure.
-像这样吗 -不是
- Like this? - Uh, not really.
记住你对自己的分娩负责
Remember, you are in charge of your birthing experience.
你分娩的方方面面都是你自己的决定
Every aspect of your labor is your decision,
从你去医院开始
starting with when you head to the hospital.
行了停下吧行了
Okay, maybe just stop. It's okay.
我推荐道格拉斯的4-1-1原则
I recommend what doulas call the 4-1-1 rule.
你等到宫缩间隔四分钟
You wait until contractions are four minutes apart
至少持续一分钟的时候
and last for one minute for at least --
间隔五分钟会更安全
Five minute intervals is safer.
这是一种观点墨菲医生
That's one opinion, Dr. Murphy,
这是为在医院享受等待过程的母亲们准备的
for mothers who enjoy waiting at the hospital.
一旦你宫缩了清楚地告诉你的伴侣
Once you arrive, clearly instruct your partner
和你的医生你想要什么
and your doctor of what you want.
不医生需要负责分娩
No. The doctor needs to be in charge.
如果有并发症怎么办
What if there is a complication?
也许应该让她来说
Maybe just let her talk.
对不起
Sorry.
你的羊水破了之后
After your water breaks,
为了之后的工作你要让自己更强大
fortify yourself for the work ahead.
冥想或者提前选好一首歌♥
Be that with meditation or a pre-selected song
能让你放松的歌♥ 或者清淡的零食