良医

The Good Doctor S04E19

Part 3 July 17, 2021, 10:02 p.m.

你有没有过感觉想吐
Do you feel like you might throw up?
有时候
Sometimes.
有时候
"Sometimes."
但她在说谎是经常这样
But she's lying. It's always.
她还发烧伴有呕吐
She has fevers, too, and throws up.
我要摸摸你的腹部你能躺在床上吗
I need to feel your abdomen. Can you lie on the bed for me?
妈妈她要摸摸你的腹部
She has to feel your stomach, Mom.
躺下
Lie down.
好吧
Okay.
加尔扎女士我觉得你有胆结石
Ms. Garza, I think you have gallstones.
我们得做些检查
We will have to run some tests,
但你可能需要动手术
but it is likely that you will need surgery.
妈妈医生认为你有胆结石
Mom, the doctor believes you have gallstones.
他们得做检查来验证
They need to do a test to be sure,
但你需要手术
but you need surgery.
不不不做手术
No, no. Not surgery.
我来这是接受药物治疗
I came here for medicine.
你跟我说了他们会给我开药的
You told me they were gonna give me medicine.
别倔了听医生的
Don't be stubborn. Do what the doctor says.
如果她不想做手术她来这干嘛
If she doesn't want surgery, why is she here?
我跟她说你们会给她开些有用的药
I told her you would have pills that would help her.
我告诉她在她来之前我不会吃东西
I told her I wouldn't eat until she came.
我得工作
I have to work.
我得照顾你
I need to take care of you.
她说她不能失去工作
She says she can't miss work.
她得照顾我
She needs to take care of me.
我需要你准确地翻译
I‐I need you to translate accurately.
我妈妈从前也病得很重
My mother was very sick, too.
她妈妈从前也病得很重
Her mother also was very sick.
她想瞒着她的病痛
And she tried to hide her pain,
但是孩子们能看得出人受苦的时候
but children know when people are suffering ‐‐
尤其是他们的母亲
especially their mothers.
她想瞒着她的病痛
She tried to hide her pain,
但是孩子们能看得出人受苦的时候
but kids know when people are suffering.
尤其是他们的母亲
Especially when it's their mother.
如果你照顾不好你自己
You can't take care of your daughter
你也无法照顾好你的女儿
if you do not take care of yourself.
如果你照顾不好你自己
You can't take care of your daughter
你也无法照顾好你的女儿
if you don't take care of yourself.
你看过巴斯蒂安的档案了吗
Did you review Bastion's file?
等待待定否
做双额钻孔
Doing a bifrontal trepanation
重建颅底
and reconstructing the skull base
可以预防脑疝
could prevent brain herniation.
脑脊液泄漏的风险是多大
What about risk of CSF leak?
用颅周皮瓣做多层硬脑膜成形术
It reduces with a multilayer duraplasty
可以减少风险
using a pericranial flap.
我对病人说五句话
I say five sentences to a patient.
你说五个字
You say five words.
一个护士要我把这个给你
A nurse wanted me to give this to you.
因为医学术语没什么用
Because medical jargon does nothing
但是能吓到他们并浪费我们的时间
but scare them and waste our time.
他们关心的是我们能帮上忙吗
All they care about is, can we help ‐‐
能还是不能
yes or no?
否
巴斯蒂安
你儿子的心脏瓣膜损坏
Your son's heart valves are damaged.
你儿子的心脏瓣膜损坏
Your son's heart valves are damaged.
可能是因为他去年的风湿热
It's probably the result of his rheumatic fever last year.
可能是因为
Probably as a result
他去年的风湿热
of the rheumatic fever he had last year.
因为他心脏的缘故
Because of his heart,
我们不能切除他的肝肿瘤
we can't remove his liver tumor.
这样手术的风险会很大
I‐it makes the surgery too risky.
我很抱歉
I'm very sorry.
因为他心脏的缘故我们不能切除他的肝肿瘤
Due to his heart, we can't remove the tumor in his liver
因为这样手术的风险会很大
because it makes the surgery very risky.
我们很抱歉
We are very sorry.
谢谢医生
Thank you, Doctor.
不我很抱歉
No, I'm sorry.
我们不能给你儿子做手术
W‐we can't do the operation on your son.
我不确定他
He ‐‐ I'm not sure he ‐‐
但你至少试过了
But you tried.
谢谢你的尝试
Thank you for trying.
上帝保佑你
God bless you.
一切都会好起来的
Everything's gonna be okay.
别担心
Don't worry.
否待定
里昂·卡斯蒂洛 22岁男性
León Castillo. 22‐year‐old male.
无法补救的巨大脐疝
Large, non‐reducible umbilical hernia.
他是他妹妹们的唯一的依靠
He's the sole provider for his siblings ‐‐
他的妹妹们没有个人信息他们与这无关
No personal details. They're irrelevant.
两个孩子的生计都依赖他
Two children's survival depends on his.
我觉得有关系
Seems relevant to me.
决策只需要基于医疗数据
Decisions need to be based on medical data alone.
这不能变成一场比惨大会
This can't turn into a contest of whose life is more tragic.
不然赢家就太多了
There would be too many winners.
不做手术
Without surgery,
疝气很有可能勒死他
the hernia's at a very high risk for strangulation.
手术很快很简单
It's a fast, simple procedure,
他几乎肯定会完全康复
and he will almost certainly have a full recovery.
手术后他可能再活十五年
From a surgery he could survive another 15 years without.
用生物假体替换瓣膜
Replacing the valve with a bioprosthetic
意味着他永远不需要服用血液稀释剂
means he won't need to be on blood thinners forever.
但他可能需要后续手术
But he'll probably need follow‐up surgeries
更换替件
to replace the replacement.
这家伙是个运动员一个足球明星
Well, this guy's an athlete, a fútbol star.
这有什么关系
Is that relevant?
当然有关系因为他的心脏状况很好
Yes, because his underlying cardiac health is excellent.
他可以完全康复
He should make a full recovery.
不幸的是他的牙齿不健康
Unfortunately, his dental health isn't.
他有蛀牙他很有可能患心内膜炎
He has cavities, which puts him at high risk for endocarditis,
这会导致阀门劣化
which would contribute to valve deterioration.
全腹结肠切除术
A total abdominal colectomy
让她有八到九♥成♥的机会完全康复
offers her an 80% to 90% chance at full recovery.
否则就完全恢复健康没有并发症
Otherwise healthy, no complicating factors.
肿瘤可以通过超声引导手术切除
The tumor could be removed using ultrasound‐guided surgery.
但她无法接受术后化疗和放疗
But she has no access to post‐op chemo and radiation.
肿瘤是球状的局部的
The mass is round, localized.
没有扩散迹象
No signs of infiltration in the adjacent structures.
复发的可能性很小
Minimal chance of recurrence.
前提是全部切除
If you get all of it.
她上周刚结婚
She just got married last week...
雷兹尼克医生
Dr. Reznick.
这与医学有关
...which is medically relevant,
因为研究表明
because studies have shown
乐观的人长♥期♥预后更好
optimistic people have better long‐term prognosis.
她充满了希望
And she is full of hope.
这有个男孩
There's a boy.
他需要毯子
He needs blankets.
能给我毯子吗
Blankets, please?
那边
There.
谢谢
Thank you.
请关门
胆结石间歇性阻塞胆管
The gallstones are intermittently blocking the bile duct,
可能导致上升性胆管炎败血症甚至死亡
which could lead to ascending cholangitis, sepsis, and death.
她可能对药物有反应
Her condition might respond to medication.
不不太可能
No, it's extremely unlikely
考虑到她的严重症状
given how advanced her symptoms are.
但她有不手术的选择
But she has a non‐surgical option.
巴斯蒂安没有
Bastion doesn't.
他能活到十二岁真是个奇迹
It's a miracle he made it to 12.
如果不做手术他活不到十五岁