良医

The Good Doctor S03E09

Part 2 Jan. 5, 2020, 2:53 p.m.

友好提醒大多数人的第一次
Fair warning -- - the first time for most people
都很糟糕
is kind of awful.
你的第一次很糟糕吗
Your first time was awful?
这个问题不适合问同事
Not an appropriate question to ask a colleague.
不过每个定律都有例外
Although, there's an exception to every rule.
你的爱人看什么书准备的
Which books did your lover read to prepare?
没有血块没有出血
No clots, no bleeds,
没有闭塞没有卵圆孔未闭
no occlusions, no P.F.O.
怎么
W--
她没有中风
She didn't have a stroke.
她癫痫发作了
She's having a seizure.
紧急关闭
推注安定剂
Pushing diazepam.
她必须要去厕所
She had to use the restroom.
她的膀胱胀大
Her bladder is distended.
膀胱肿大挤压到的东西就是癫痫发作的原因
Whatever it's pressing against must be causing these attacks.
CT显示她有两处盆腔病变
CT shows she has two pelvic lesions,
化验结果显示儿茶酚胺含量激增
and labs show elevated levels of catecholamines.
我们给她的止疼药可能使她的膀胱肿大
The pain meds we gave her could have distended her bladder,
而膀胱就在其中一个肿瘤边上
which is abutting one of the tumors,
引发了第二次发作
setting off her second attack.
那第一次呢
But what set off the first one?
性♥交♥
Sexual intercourse.
另一个肿瘤在阴蒂上
The other tumor appears to be within her clitoris.
随着时间推移渐进影响可能使其不稳定
Progressive impact may have destabilized it over time.
现在她癫痫发作的频率会更多
And now she's at risk of having more seizures.
性♥爱♥会害死这个女人
Sex could kill this woman.
他稳定下来了血液里没有摇♥头♥丸♥了
He's stable, and the MDMA is out of his system.
我们可以继续移植主动脉了
We're good to go back in and graft the aorta.
我们正面临失血以及
We're just getting caught up with blood loss
体液复苏的问题
and fluid resuscitation.
做血管内支架是侵入性最小的
An endovascular stent is minimally invasive.
这个选项比做移植好
It is a better option than a graft.
但支架可能会造成凝血
But a stent could clot off
因为我们不能用血液稀释剂
because we won't be able to give blood thinners.
他的肝脏仍然有出血的风险
His liver is still a bleeding risk.
那我们先用支架碰碰运气吧
Let's take our chances with the stent.
我们可以速战速决让他回到重症监护室
We can be in and out and have him back in the ICU,
然后在那里专心让他恢复
where we can focus on his recovery.
我不想没得到允许就进行下一步
I do not want to proceed without consent.
再过几个小时他也不会恢复意识
He won't regain consciousness for another couple of hours.
我们不应该等那么久
We shouldn't wait that long.
问问她妻子她马上就到了
Get it from his wife. She's on her way here now.
我们可以摘除肿瘤
We can remove the tumors,
但这也意味着必须摘除
but it means we also have to remove
你大部分的阴♥道♥和阴蒂
most of your vagina and clitoris.
你还可以生育
You can still have children.
通过剖腹产不会影响你的子♥宫♥或卵巢
Via C-section. It won't affect your uterus or ovaries.
那性生活呢
What about sex?
你将无法发♥生♥关♥系♥或
You won't be able to have intercourse
体验性高♥潮♥
or experience an orgasm.
这不合理
I-it doesn't make sense.
我已经有性行为五年了
I've been sexually active for five years.
没有任何病症发作
Never had any attacks.
我们怀疑肿瘤休眠了一段时间
We suspect the tumor's been dormant for some time.
如果我不做手术呢
What if I don't have the surgery?
再次发作的几率是多少
What are the odds of another attack?
这涉及到很多变量
There are many variables involved,
包括性♥爱♥的频率持续时间
including frequency, duration,
体♥位♥和阴♥茎♥大小
sexual position, penis size --
大约2%
About 2%.
每次吗
Each time?
每次
Each time.
夫妇每年平均发生52次性行为
On average, couples have sex 52 times per year,
意味着在接下来的三年里
which means in the next three years,
你的致命脑缺血发作的几率
your chance of having a life-threatening attack
大大超过95%
is well over 95%.
我想我们还是碰运气吧
I think we'll take our chances.
你们俩可以单独谈谈
You should talk it over between yourselves,
或者找个咨♥询♥师
perhaps with a counselor --
情况我已经了解了
I understand the situation.
我不想做手术
I don't want the surgery.
我马上就过去
I'll catch up.
没在研究会议上见到你
Missed you at the research meeting.
我在做手术开颅手术
I was in surgery. Craniotomy.
现在我还有两个会诊跟捐赠者见面
Now I have two consults, a meeting with a donor,
还要主持医院的会
and a hospital chair meeting.
好吧别忘了吃东西
Well, don't forget to eat something.
弱者才需要食物
Ah, food is for the weak.
也只有弱者才会等这部电梯
So is waiting for this elevator.
我们没事吧
Are we okay?
当然
Yeah.
对不起我只是很忙
Sorry, I'm just busy.
我们建议用支架
We're recommending the stent.
虽然有凝血的风险但比移植侵入性小
It risks clotting, but it's also less invasive than the graft.
做移植修复效果更持久
The graft would be a more permanent repair,
但出现手术并发症的可能性也越大
but there's greater chance of surgical complications.
我只能信任你们对吗
I have to trust you, right?
爸爸的病会好吗
Is Dad gonna be okay?
当然亲爱的
Oh, absolutely, darling.
我们会好好照顾你♥爸♥爸
We're gonna take good care of your dad.
他很快就能回家了好吗
He'll be home before you know it, okay?
好
Okay.
谢谢
Thank you.
如果我们不做手术就让她回家她会死的
If we send her home without the surgery, she'll die.
这可不好说
We don't know that.
剥夺一对相爱的年轻夫妇的性生活
And taking away sex from a young couple in love?
这是毁灭性的
That's devastating.
死亡也一样
So's death.
一对夫妇花在性生活上的时间有多少
How much time does a couple actually spend having sex?
每周19分钟包括前戏
19 minutes per week, including foreplay.
剩下的时间才是真正的感情生活
The rest -- - that's the real relationship.
撇去行为本身不说
Forget the act itself.
性♥爱♥是在感情关系中获得
Sex is crucial to the happiness
幸福和满足的关键因素
and satisfaction of a relationship.
性♥爱♥也是有破坏性的
Sex is destructive.
会让人说谎变成骗子和白♥痴♥
It turns people into liars and cheaters and idiots.
它可能会是一段关系的开始
It might start relationships,
但大多数情况下它会让人们伤心欲绝
but more often than not, it rips them apart.
她听到了毁灭性的消息
She got devastating news
然后想都不想就做了个情绪化的决定
and made an emotional decision without thinking it through.
至少我们可以让她找人咨♥询♥
The least we can do is get her counseling.
当你给她诊断结果时她有没有提出需要咨♥询♥
Was she offered counseling when you gave her the diagnosis?
没怎么提但她当时还沉浸在...
Briefly, but she was still reeling from the --
那就结了
Then it's over.
等她的情况稳定了让她出院
When she's stable, discharge her.
谢谢
Thank you.
对粉色的心和紫色的星星
Yeah, the pink heart and purple star...
你感觉怎样
How are you feeling?
医生他很好
Hi, Doctor. He's doing great.
你好我是布朗医生
Hi. I'm Dr. Browne.
你的主动脉有一处撕裂
You had a tear in your aorta,
但我们用支架稳定住了
but we stabilized it with a stent.
在可以给你用血液稀释剂之前
Until we can give you blood thinners,
你会有凝血风险
you'll be at risk of a clot,
所以我们会密切监测你
so we'll be monitoring you closely.
但现在一切看起来都很完美
But right now, everything is looking absolutely perfect.
轻点
Gentle.
看小蛋糕
See, Cupcake?
我没事了
It's all good.
你昨晚为什么不回家