良医

The Good Doctor S04E16

Part 1 May 20, 2021, 9:18 a.m.

你说疼得很厉害
You said the pain was intense?
对两侧都很尖锐地疼
Yeah, it was sharp on both sides.
持续时间也不长
And it didn't last long?
只疼了几分钟
Just a few minutes.
那之后24小时里都没有复发吗
And nothing in the 24 hours since then?
我的产科医生说可能是圆韧带疼痛
My O.B. said it was probably round ligament pain.
有可能那其实就是生长痛
Yeah, that's basically growing pains.
你的子♥宫♥和圆韧带都在扩张
Your uterus is expanding. So do your ligaments.
胎心胎动都很正常
Normal fetal heart rate and movement.
血压正常
Your B.P. is perfect.
一切指标都很正常
Everything seems normal.
并发症和流产也是很正常的事
Complications and miscarriage are also normal.
莉亚的产科医生没有考虑到所有可能性
Lea's O.B. did not consider every possibility.
所以我们才会来这里
Which is why we're here.
肖恩列了一个清单
Shaun made a list.
我敢肯定他不排除每一个可能性
And I'm pretty sure he's not going to sleep
绝不睡觉
until every possibility is ruled out.
我把所有可能危害到
I categorized every medical complication
莉亚或胎儿的并发症都分类好了
that could negatively impact Lea or the baby
并且按病死率进行了排序
and sorted by Case Fatality Risk.
我去准备化验检查
I'll get started on the tests.
病人呼吸急促
Shortness of breath,
脉搏血氧值和呼吸率都在下降
pulse ox and respiratory rate are dropping.
她需要吸氧
She needs oxygen.
玛克辛·斯坦利 87岁
Maxine Stanley, 87 years young.
她在装饰艺术社团的鸡尾酒筹款会上
She passed out on the dance floor at a cocktail fundraiser
晕倒在舞池里
for the Art Deco Society.
是是「新艺术社团」
Art -- Art Nouveau.
她出现室颤了
She's in v-fib.
我去推救生车
Getting the crash cart.
不看她的手环
No, look at her bracelet.
那个古董莱俪手镯令人经验
The vintage Lalique? It's stunning.
另一只手腕上的那个她的医用腕带
Other wrist. Her medical bracelet.
她签过不抢救预嘱
She signed a DNR.
如果我们不抢救她会心搏停止的
If we don't do anything, she's gonna go asystolic.
我知道
I know.
-我们就不能... -不行
- But can't we just -- - No.
肾上腺素
Epinephrine?
注射肾上腺素不算非常规抢救手段
Epinephrine doesn't qualify as extraordinary lifesaving measures.
她签不抢救预嘱是有原因的
She has a DNR for a reason.
死亡时间
Time of death,
两点二十...
two twe--
她还是没有心跳但血压在上升
She still has no heartbeat, but her pressure is rising.
会是机器故障吗
Could the machines be screwing up?
全都故障吗
All of them?
她的血氧饱和度超过九十了
Her oxygen levels are climbing to over 90.
我听得到血流的声音
I'm hearing blood flow.
我还活着
I'm alive?
你们俩中哪个蠢货干的好事
Which one of you bozos did this?
良医
第四季第十六集
黛比托我把这个送给宝宝
Debbie asked me to bring this for the baby.
毛绒玩具对不到一周岁的婴儿来说不安全
Stuffed toys aren't safe for infants under 12 months old.
它们很容易引起窒息
They increase the risk of suffocation.
我会告诉她你说了谢谢的
I'll tell her you said thank you.
你应该在上班
You should be at work.
没错
Yeah.
但你没去
But you're not.
所以你来肯定是有什么事
So you must be here for a reason.
克莱尔一定给你打电♥话♥了
Claire must have called you.
她很担心莉亚
She's worried about Lea.
你说对了一半
You got some of that right.
除了莉亚很好
Except that Lea is fine.
不好的人是你这点
You're not.
肖恩你需要放轻松
Shaun, you gotta relax.
没没有哪个准爸爸能够放轻松
N-No one expecting a baby should relax.
好多事情都可能出错
There are many things that could go wrong.
好吧那孩子出生后你就能放松了吗
Okay, so after the baby's born, then you can relax?
不不能
N-no.
孩子什么能力都没有需要我们提供一切
The baby will be helpless, need us for everything.
那么一旦孩子学会了自己吃饭自己穿衣
So, once the baby learns how to feed itself and dress itself,
-你就能放松了 -不能
- then you can relax? - No.
明白我的意思了吗
Is my point becoming at all obvious?
我永远都没法放松了
That I'm never going to relax ever again?
差不多对
Kinda, yeah.
肖恩这应该是你人生中最美好的时刻
Shaun, this should be the most amazing moment of your life.
每一个为人父母的人都会这么告诉你
Every parent'll tell you the same thing.
它眨眼即逝
If you blink, you're gonna miss it,
而你却在眨眼
and you're blinking.
你你你很紧张害怕
You're -- You're -- You're nervous and you're scared
而你本该激动雀跃
when you s-should be excited.
没有早产征兆
No signs of preterm labor,
肝化验结果也排除了妊娠期黄疸的可能性
and tests on your liver ruled out obstetric cholestatis,
也不是双胎输血综合症
and it's not twin-twin transfusion,
因为你怀的不是双胞胎
because you're officially not having twins.
看来和一个医学天才生宝宝
Turns out having a baby with a medical genius
也有不好的地方
has a downside.
但如果真的有问题
But if there is a problem,
我宁愿在这里发现而不是在其他地方
I'd rather be here than anywhere else.
得好好保护这个小姑娘
Gotta take care of this little girl.
传感器绑稳了吗
Is the transducer secure?
我刚检查过怎么了
I just checked it. Why?
胎儿的心动有点过缓
Baby's heart rate is mildly bradycardic.
心率会随着人的活动而上下浮动
Um, heart rate fluctuates with activity,
你又躺了有一会儿了
and you've been off your feet for awhile.
但如果肖恩在这里的话
But if Shaun were here,
他会做一个经阴♥道♥超声
he would check a transvaginal ultrasound.
我们准备起来吧
Let's get it set up.
好消息
Good news.
你的心律失常没有造成太大伤害
The arrhythmia didn't do a lot of damage --
我有三件事不能忍♥
Three things I can't tolerate --
乳糖工装裤
lactose, cargo pants,
和我的预嘱被人无视
and my wishes being ignored.
斯坦利夫人我保证我们没有无视预嘱
Mrs. Stanley, I can assure you, we did not disregard your DNR.
那是谁干的
Then who did?
不是「谁」干的
It wasn't a "who."
你最近接受过肺癌治疗吗
You were treated for lung cancer recently?
治疗没有效果
Didn't work.
化疗只是让我吐完了我吃下去的所有正经食物
All chemo did was make me puke up any decent meal I ate.
你还接受了叶切除手术以切除肿瘤
You also had a lobectomy to remove the tumors.
他们给你的心脏装了一个东西
They implanted a cardiac device.
一个起搏器
A pacemaker.
让我不要死在手术台上
So I wouldn't die on the table.
那不是一个起搏器
It's not a pacemaker.
他们相当于在你的心脏里装了一个小泵
It's basically a miniature pump inside your heart,
如果你心脏停跳那个泵会代为运转
and if your heart stops, it takes over.
你能把它关掉吗
Can you turn it off?
那把它拿出来吧
Then take it out.
我好喜欢它
I love it.
它太大了婴儿没法吞下去
It's too big for an infant to swallow,
这意味着它危险程度中等
which means it's only moderately hazardous.
人生中大多数好东西都是这样的
Most good things in life are.
有一天我们会告诉女儿
Someday we'll tell our daughter
泰迪医生和老爸医生是怎么护她平安的
how Dr. Ted and Dr. Dad both kept her safe.
我们发现了一个问题
We have found something.
你有二型血管前置
You have Type 2 vasa previa.
也就是说胎儿的血管和脐带附着在一起
It's when the fetal blood vessels run across the cervix,
使血管极为脆弱
making them extremely vulnerable.
这些血管随时都可能破裂
Now, they could rupture at any time,
你破水时
definitely when your water breaks,
或在外力作用下一定会破裂
but also under other added stress.