良医

The Good Doctor S04E15

Part 4 May 20, 2021, 9:17 a.m.

-他有多用力有在更加使劲吗 -是的
- How hard? Is it getting firmer? - Yeah.
上劳拉西泮加大丙泊酚剂量
Ativan. Increase propofol,
我们要做个CT 还有脑电图
and we need a C.T. and an E.E.G.
他局灶性癫痫发作了
He is having a focal seizure
发作于左脑
which is originating in the left side of the brain,
但左边大脑没有受损这很奇怪
which wasn't the damaged side, which is very strange.
弹片一定是移位了
The bullet fragment must've migrated.
没有取出来是个错误
It was a mistake to leave it in.
他癫痫了
He's seizing.
他明确说过如果不取出子弹
This is exactly what he said wouldn't happen
也不会发生癫痫
if we left the bullet in.
明确说过
Exactly.
我相信他会有办法的
I'm sure he'll figure out what to do, and--
您有谁的消息
Who do you have news for?
蒂拉洛女士
Ms. DiLallo?
是好消息吗
Good news?
没什么
Oh, it's nothing.
你有权开心
It's okay for someone to be happy.
我怀孕了
I'm expecting.
检查结果一切都好
And all's good.
我在平安夜生的孩子
I gave birth on Christmas Eve.
所有的护士都在唱圣诞颂歌♥
All the nurses were singing carols.
肯尼开玩笑说
Kenny joked that the only thing missing
就差三位智者了
were the three wise men.
真是做作又荒谬
It was hokey and ridiculous.
但也很神奇
But it was magical.
伊森早产了三周
Ethan was three weeks premature.
我们在享受最后一个愉快的周末
We were having just one last fun weekend,
我们的二人世界但伊森大概不乐意
the two of us, and I guess Ethan didn't like that idea,
所以我在一间汽车旅馆里生下了他
so I gave birth in a motel room
离我的产科医生十万八千里
300 miles from my OB.
我们给打扫房♥间的人留了一大笔小费
Left a really good tip for housekeeping.
这太奇怪了
It's very strange.
我的决定错了
I was wrong.
这非常非常奇怪
It's...very, very strange.
不你没有错
No, you weren't.
弹片没有移♥动♥
The fragment's still stable in location,
没有压♥迫♥大脑中动脉没有新的出血点
no severe compression on MCA, no new bleeds.
那说明我们漏了什么别的
That just means we missed something else.
那里
There.
做左丘脑深处
Deep in the left thalamus.
我没有错
I wasn't wrong.
我没有错
I wasn't wrong.
是你的错
You were.
你没注意到这里
You missed it.
不不我没有错
No. No, I wasn't wrong.
哪里还有弹片的话我一定会注意到的
I would've noticed another fragment.
看
There.
八小时前那里什么都没有
There was nothing there eight hours ago.
好吧所以...
Okay, so...
它是新出现在这个位置的
it's just new to this location,
也就是说它移♥动♥过了
which means it's moving.
根据它的移♥动♥路径
And based on its trajectory,
它会造成更多的伤害
it's gonna cause a lot more damage.
它的位置比另一个弹片深很多
It's much deeper than the other.
因此我们够不到
So we can't get to it.
我们没法穿过
We can't go through the water
男孩的脑积水引流系统
drainage system of the boy's brain
因为那意味着
because that would mean having to puncture
必须穿透丘脑室壁
the ventricular wall at the thalamus,
我们也不能在磁共振引导下追踪损伤途径
and we can't follow the injury pathway using MRI guidance
因为子弹里有金属不能做磁共振
because the metal in the bullet rules out the MRI.
-我们也不能... -肖恩肖恩
- And we can't-- - Shaun, Shaun, just--
你是一名神经外科医生好吗
You are a neurosurgeon, okay?
你能发现我漏了什么
You will know what I have missed.
你觉得你没有漏掉任何细节是吗
You don't think you missed anything?
是的
No.
那就是没有
Then you didn't.
好吧那...
Okay, then...
伊森很可能会死
Ethan is probably going to die.
好吧
Okay.
这个患者不一样是吗
This one's different, huh?
因为他是个孩子
Because he is a child?
没错没错因为他是个孩子
Yeah, yeah, because he's a child.
不对
No.
我以前也有没救过来的孩子
I've lost children before.
肖恩每个父母都有一个任务
Shaun, every parent has one job,
就是让他们的孩子好好活着
and that's to keep their kid alive,
保护他们免于世间的灾难
to keep them from all the horrors in the world.
或许...
And maybe...
由于你没法保护伊森
because you can't protect Ethan,
你认为...
you think...
那不合理
That's not rational.
对那...
No, it's--
为人父母的代价太不合理了
It's not rational, the price of parenthood.
但你知道吗是值得的
But you know what? It's worth it.
如果它让我觉得沮丧觉得不理智
If it makes me upset and irrational,
那它听起来不是很值得
it doesn't sound like it's worth it.
这不是你的真心话
You don't mean that.
我向你来请教关于伊森的手术建议
I came here to ask for your surgical advice about Ethan,
结果你给我的建议都是关于我的情绪
and all you've given me is emotional advice about me.
没错
Yeah.
因为我能给的只有这些
Because that's all I got.
凯兰七岁开始踢足球
Kellan started playing soccer when he was 7.
他非常喜欢那件球衣
He loved that jersey so much.
每晚穿着球衣入睡不让我们洗
Wore it to bed every night. Wouldn't let us wash it.
后来他把葡萄汁洒到了球衣上
Then he spilled grape juice on it.
很大一块紫色污渍
A big purple stain.
我冲他发火了
And I got angry at him.
在孩子面前我总是会有点那样
I always get a little like this with kids.
我觉得没有我
You know, I think maybe Shaun and Lim
肖恩和利姆也能把手术做得很好
can handle it fine without me.
如果躺在重症监护室里的是凯兰
If it was Kellan in that ICU,
他的医生要放弃他就因为医生的孩子
how would you feel if his doctor bailed on him
十年前弄洒了葡萄汁你会怎么想
because his kid had spilled grape juice 10 years earlier?
没错对你来说很残酷
Yeah, it's brutal on you.
但他们要承受的残酷是你的百倍
About a hundredth as brutal as it is on them.
所以你赞同拜登的一切理念
So, you agree with Biden on every single issue?
不当然不了
No, of course not.
但我赞同不止一项
But I agree with him on more than one.
你赞同多少
How many?
你的底线是什么
Where's the line?
每一票都是妥协
Every vote is a compromise.
我们支持自己觉得重要的事
We support the things we think are important,
然后合理化那些不太重要的
and...rationalize the things that aren't.
不幸的是「妥协」成了一个贬义词
Unfortunately, compromise has become a dirty word,
挺讽刺的鉴于它是民♥主♥的本质
which is ironic since that's the essence of democracy,
而且我离开祖国也是由于缺乏妥协
and the lack of compromise is why I left home.
他的左脚好冰
His left foot is cold.
没有脉搏
It's pulseless.
这里有脉搏
I got a pulse here.
他手腕和脚踝之间一定有什么问题
Something's happening between here and you.
有脉搏
Good.
这里没有
Nothing.
有
Good.
没有
Nothing.
没有
Nothing.
问题出在腘动脉一定是有血栓掉落了
It's his popliteal artery. He must've thrown a clot.
我们得立即处理不然最好结果也是截肢
We have to fix this now or he loses the leg at best.
伊森的癫痫是因为另一块碎片
Ethan's seizures were caused by a different fragment