良医

The Good Doctor S05E04

Part 4 Nov. 3, 2021, 9:59 a.m.

Mom?
她在吐♥血♥
She's puking up blood!
腹部肿胀板状腹反跳痛
Distended, firm, rebound tenderness.
她肠穿孔了我们得送她回手术室
Her bowel's perforated. We gotta get her back to the OR.
我错了
I was wrong.
你妈妈在用呼吸机
Your mom is on a ventilator,
朴医生在给她做体外膜肺氧合
and Dr. Park is placing her on ECMO.
这将为她的血液提供氧气
It will oxygenate her blood
因为她的肺已经不工作了
now that her lungs are no longer working.
你妈妈现在昏迷不醒她没有生存意志
Your mom is unconscious, and she has no living will.
根据加州法律你有权利为她做
By California law, you have power of attorney
所有的医疗决定
over all her medical decisions.
他有明显的利益冲突
He's got a clear conflict of interest.
-他想要移植 -他们想要的是一样的
- He wants the transplant... - They want the same thing.
她说我复述一遍「我不允许」
She said, and I quote, "I'm not gonna allow it."
她宁愿死你觉得这有任何歧义吗
She'd rather die. You finding ambiguity in any of that?
她优先考虑的是儿子的幸福而非自己的
Her priority was her son's happiness, not her own.
做移植手术
Do the transplant.
所以你就判定她为了自己
So, you're just gonna decide she was wrong
为了她儿子所做的事是错的吗
about what she wanted for herself? For her son?
我没有
I'm not.
她的代理人她的儿子来决定
Her proxy is. Her son is.
你们最好希望这行得通
And you'd better hope this works.
我们得按莫菲医生之前的计划来
Uh, we need to do Dr. Murphy's plan from before.
右侧结肠切除术
The right hemicolectomy?
我们已经失去了机会
We missed our chance.
现在我们必须做全结肠切除术
Now we have to do a full colectomy
并切除大部分小肠
and a resection of most of the small bowel.
这是唯一可以防止再次发生肠穿孔的办法
It's the only way to prevent another perforation
这会要她的命
that would kill her.
但我读过一个病例报告他们用促动力药
But I read a case report where they're using prokinetics
和胆碱酯酶抑制剂来
and.... and acetylcholinesterase inhibitors
增强孩子们的肠动力
to strengthen motility in kids.
这可能有用但不足以克服
That could help, but it wouldn't be enough
未来的肠梗阻带来的压力
to overcome the pressure from future obstructions.
我们就是要减小压力
We just reduce the pressure!
我是说我们可以上下都装上管子
I mean, we can put, uh, tubes above and below.
我没听明白
I'm not following.
-因为这不合理 -肖恩让他说
- Because it makes no sense. - Shaun, let him talk.
上下抽吸
Suctioning above and below
不会减轻局灶性肠梗阻带来的负担
wouldn't reduce the burden of a focal obstruction!
别跟我说我哪里错了
Don't tell me what I'm getting wrong!
帮我找到治疗方法
Help me find a way to do this!
看这是受影响的肠道
Look, this is the affected part of the bowel.
停下停下
Stop it. Stop it.
请你停下停下
Please, stop it! Stop it!
停下停下
Stop it! Stop it!
我在尽力帮你的女儿
I am trying to help your daughter!
莫菲医生你必须离开
Dr. Murphy, you need to leave.
不我没必要离开他才要离开
No, I do not need to leave. He does!
他让我们用利妥昔单抗使她病情恶化
He made us give her Rituximab, and it made her sicker!
你为什么会在这里你根本不是医生
Why are you even here? You are not a doctor!
马上出去肖恩
Get out of here now, Shaun.
马上
Now.
莫菲医生的方式不妥但他是对的
Dr. Murphy was inappropriate, but he was right.
让我去告诉她吧
Let me be the one to tell her.
我们可以用4-0普理灵缝线手工缝合
We could hand-suture with a running 4-0 prolene.
不软骨部分要用间断缝合
No, we need interrupted sutures for the cartilaginous portion.
好端端吻合术
Okay. End-to-end anastomosis.
支气管大小不匹配
Bronchial sizes don't match up.
行望远镜式套入缝合
Fine. Telescoping technique.
-不 -为什么
- No. - Why not?
不知道我就是...
I don't know. I just...
不喜欢这样
Don't like it.
你要干什么
What are you doing?
我显然感受到了要确保
I'm obviously feeling some pressure
移植手术安全完成的压力而且...
to make sure the transplant comes off safely, and...
对这是你做的唯一合情合理的事
Yes, that's the only thing you've been doing that makes sense.
跟这个病例有关的其他事
Everything else on this case,
你都处理得不公平情绪化
you've been unfair, emotional.
-对不起 -这...
- I'm sorry. - This...
这跟你没关系
This has nothing to do with you.
-我不... -闭嘴
- I... I don't... - Just shut up.
我情绪化是因为...
I've... I've been emotional because...
我激素失调而我激素失调
I'm hormonal, and I'm hormonal
是因为我...
because I...
我总是偷偷溜出去
I've been sneaking off
在屁♥股♥上注射
and injecting my butt
超高剂量的人绒毛膜促♥性♥腺♥激♥素♥和排卵针
with insane amounts of HCG and Gonal-F,
这让我觉得自己完全像个疯子
which is making me feel like a total lunatic.
你在冻卵
You've been freezing your eggs.
你为什么不告诉我
Why didn't you tell me?
用来活跃气氛吗
Like an icebreaker?
「我知道我们刚刚在一起
"I know we just got together.
你知道吗我这两个月都在取卵」
"Guess what, I'm two months into egg retrieval"?
我甚至不...
I'm not even, uh...
我甚至不确定自己是否想要孩子
I'm not even sure I want kids, or...
是否能做个称职的妈妈
Whether I'd even be a decent mom.
我肯定不是最无私的人
I'm certainly not the most unselfish person.
而且谁能说
And, uh, who's to say
我会做出比吉娜更明智的选择
I'd make better choices than Gina?
谁知道会不会有人为我辩护
Who knows if anyone would ever defend me?
我该走了
I should go.
你怎么样
How you doing?
糟透了
Very badly.
我被印在广♥告♥牌上还被踢出了一个病例
I have been put on a billboard and kicked off a case.
好我跟安德鲁斯医生谈过了
Yeah, well, I spoke with Dr. Andrews,
这事不会记录在你的档案里
and there's not gonna be a note in your file
或者其他文档里
or anything like that.
其他的事怎么样
What about this other stuff?
嗯萨伦给了我48小时
Yes, Salen gave me 48 hours.
我明天早上要去跟她谈
I'm going to talk to her tomorrow morning.
你打算说些什么
What are you gonna say?
我有30个要点
I have 30 bullet points.
也许我们应该把这些过一遍
Maybe we should talk these through?
也许得删掉几个
Maybe narrow them down a little?
肖恩
Shaun?
我知道我给那女孩提供的治疗方案是对的
I know I was right about that girl's treatment.
但我无论说什么都无法说服她父亲
But nothing I said convinced her father.
我只会让他生气而她却病得更重
I just made him mad. She just got sicker.
而且
And...
我知道我说这广♥告♥牌是个错误也是对的
I know I'm right that this billboard is a mistake.
但我觉得我也无法说服萨伦
But I think I won't be able to convince Salen, either.
我一直都知道自己是对的
I keep knowing I'm right,
但我无法改变任何人的想法
but I can't change anyone's mind.
打扰一下伙计们
Excuse me, fellas.
抱歉各位能让我们单独聊会吗
Sorry, guys. Can we have the room for just one minute?
谢谢你们
Thank you.
没有任何理由没有
There is no justification, none,
要暴露员工的个人医疗记录
for exposing an employee's personal medical records.
把广♥告♥牌拿下来
Take the billboard down.
这能制♥造♥话题为人们提供谈资
It's noisy. Makes people talk.
对你想过这有多让人难过吗
Yeah, about how awful it is.
还有可能违法
It's also possibly illegal.
你为什么要宠着肖恩
Why are you coddling Shaun?
就没人照顾我的多动症
Nobody made accommodations for my ADHD.
这也很难过
That was hard,
但它让我变得更强大更聪明更神通广大
but it made me stronger, smarter, more resourceful.
我们有不同的问题也有不同的优势
We have different problems and different strengths,
但我知道如果你继续护着他
but I know if you keep patronizing him,
会适得其反