良医

The Good Doctor S04E18

Part 2 July 17, 2021, 10:02 p.m.

我从没感觉这么好过
I've never felt better.
至少让我再做些检查
At least let me do some additional tests
确保这种疗法没有任何副作用
to make sure there aren't any adverse side effects.
好
Sure.
我总是愿意接受新信息
I'm always open to new information.
早上好需要帮忙吗
Good morning. How can I help you?
我们是来优胜美地溪露营的
We're here to camp at Yosemite Creek.
好你们有预约吗
Great. You have a reservation?
预约
Reservation?
营地必须预约
Campsites are reservation only.
不对
That's not true.
有27个先到先得的营地
There are 27 first come, first serve campsites.
早上六点有27个营地
There were 27 campsites at 6:00 A.M.
但到6点45分它们就被占满了
By 6:45, they were all taken.
请你们掉头回去吧
I'm gonna need you to turn the car around.
不行我们一定要野营
No, we need to go camping.
先生我理解您不高兴但是
Sir, I understand you're upset, but...
不你你什么都不知道
No. You... You don't understand at all why...
肖恩没关系
Shaun, it's okay.
我们可以去别的营地
We'll find another place to camp.
谢谢你
Uh, thank you.
拉紧了
Tighten up.
从外往里来
Now work from the outside in.
切除所有脉管增生
Eliminate any arterial feeders.
本来可以简单很多
This would be a lot easier
如果他们七年前就同意让我手术
if they'd let me do this seven years ago.
这不能怪他们
It's not their fault.
他们害怕让十二岁的孩子动手术
They're scared of surgery for their 12-year-old child.
他们傲慢又固执
They're arrogant. And stubborn.
你怎么那么安静
You're quiet.
不好意思
Sorry.
我在想我自己的父母
I was actually thinking about my own parents.
迈尔斯觉得我们应该解决过去的问题
Miles thinks that we should "deal with the past"
这样我们之间才会没有隔阂
so that there's not a barrier between us.
现在一切都挺好的
Things have been going pretty good.
何必破坏现状呢
And why mess with success?
我同意
I agree.
涉及到父母的事有时候
When it comes to parents, some things,
事实上大多数时候都最好闭口不谈
in fact, many things, should just be left unsaid.
你跟父母都已经断了往来了
Says the guy who doesn't have a relationship with his.
对因为我提起了那些该闭口不谈的话题
Yeah. Because I said things that should have been unsaid.
我同意迈尔斯
Well, I agree with Miles.
那样的谈话不会轻松
It's not gonna be an easy conversation,
但是
but...
伤口置之不理只会变得更严重
Wounds that aren't treated get worse.
她的气管插管里有血
There's blood in her ET tube.
肯定是呼吸道出血了
Must be a bleeder in the airway.
拉紧伤口
Retract the wound.
研究表明用裸盖菇素
The research on psilocybin
治疗抗药型抑郁很有前景
for drug-resistant depression is promising.
肺部顶点看起来很健康
Apex of the lungs look clear.
「有前景」和「证明有效」差远了
There's a big difference between "promising" and "proven."
更别提一个是专家开♥发♥的药物
Not to mention a drug made by professionals
一个是随便什么人在地下室种出来的蘑菇
versus some guy growing mushrooms in his basement.
你是我认识的人里最不相信
You're the most skeptical guy I know
另类疗法的但你却认同这个
about alternative medicine, but this you agree with?
我不惊讶
I'm not surprised.
不惊讶朴是个彻头彻尾的伪君子吗
That Park's a total hypocrite?
不惊讶你们意见相左
That you two disagree.
你们就没有意见相同的时候
You never agree on anything.
我觉得你们就是
I think you just...
喜欢吵来吵去
Enjoy arguing with each other.
你得放大点看
You need to get closer.
能放大左肺下叶那里吗
Can you focus on the left inferior lobe?
-那是什么 -病变
- What is that? - A lesion.
真菌病变
A fungal lesion.
这不叫野营这叫车尾营
This isn't camping. It's tailgating.
这里有树
There's trees,
有可以扎帐篷
a place we can pitch a tent
和生火的空地
and build a fire.
一股汽油的味道
It smells like gasoline.
我觉得是他们的发电机漏了
I think their generator might have a leak.
多适合在旁边生火啊
Just what you want right next to a campfire.
这里看得到湖
We have a view of the lake.
挺漂亮的不是吗
It's pretty, isn't it?
是啊
Yeah.
由于出血我们不得不停止激光手术
We had to abort the laser surgery due to a bleed,
不过她现在已经清醒稳定了在术后恢复
but she's conscious and stable now in post-op recovery.
畸形脉管已经长进肺上叶太深
The AVM infiltrated too deep into the upper lobe of the lung
没法用激光烧蚀了
to ablate with the laser.
我们只能摘除她的锁骨
We'll have to go back in and remove her collarbone
再进行更深入的手术
for better access.
还要再做一次手术
Another surgery?
摘除她的骨头
To remove her bone?
我们清除掉畸形血管后会放回去的
We'll put it back after we excise the AVM.
锁骨恢复期间她需要一直佩戴固定带
She'll have to wear a brace until the bone heals.
动脉畸形的形态多变
Vascular malformations are chameleons.
很难分辨哪里开始是畸形血管
It's hard to tell where abnormal blood vessels end
哪里又是正常血管
and normal ones begin.
你们今天早上做评估的时候
You were all a lot more confident
态度要比现在肯定得多
in your assessment this morning.
我们想带女儿回家
We want to take our daughter home.
-没错 -现在就走
- Yeah. - Now.
很抱歉这不可能
I'm sorry. That's not possible.
激光手术使畸形脉管变得很脆弱
The laser surgery caused weakening in the AVM,
随时都可能再次出血
which means it could rebleed at any time.
好吧
Okay.
好吧
Okay.
你很幸运要是再晚一周来体♥检♥
You're lucky. If you scheduled your physical a week later,
你的肝和肺就要衰竭了
your liver and lungs would be failing.
那手术之后呢
And after the surgery?
我的抑郁怎么办
What about my depression?
这种疗法在要你的命你还打算继续做吗
You're asking if you can continue a treatment that's killing you?
开始打裸盖菇素针之前
Before I started the psilocybin injections...
我过得很痛苦
I was miserable.
我吃不下睡不着
I-I couldn't sleep, I barely ate.
我没法再回去过那种黑暗的日子
I can't bear to face that darkness again.
我不知道裸盖菇素是真的有用
I don't know if it's the psilocybin
还是起了安慰剂作用或是因为别的什么
or placebo effect, or something else neither of us understands,
但如果你曾找到过光明
but if you found the light once...
你一定能再次找到它
You can find it again.
来
Okay.
这火生得真好
It's a nice fire.
我把柴火堆成了圆锥帐篷型
I used the Teepee method.
我打算采用开胸和中线开腹手术
I'm thinking open thoracotomy and midline laparotomy.
我们可以做一个很小的开刀手术
We might be able to use minimally invasive scope surgery
来切除大块的病变其余部分
to get the big lesions and attack the rest
在术后用抗真菌药物治疗
post-operatively with anti-fungals.
没效果的吧
More like minimally effective.
还是积极些把病变部分一次性都取出来
Better to be aggressive, take them all out at once.
那样手术会很大恢复会很痛苦
That's a huge operation with a long, painful recovery.
他的病变范围就是很大
He has a huge problem.
病变看起来已经延伸到肝脏后面了
This lesion looks like it extends behind the liver.
你是高级外科住院医师
You're the senior surgical resident.
你要开始做这些决定了
You need to start making these calls.
我不这么认为
I'm not so sure about that.
抱歉但是我质疑朴医生
I'm sorry, but I question Dr. Park's objectivity
面对雷兹尼克医生时的客观性
when it comes to Dr. Reznick's ideas.
面对的是谁不重要
I don't care where an idea comes from,
我也不喜欢你这样指控我
and I don't appreciate you accusing me...