良医

The Good Doctor S05E11

Part 3 March 23, 2022, 8:56 a.m.

I wanted my birthstone, sapphire.
但我们买♥♥不起所以我爸爸给我做了这个
But we couldn't afford it. So my dad made me this.
他称这是一个占位符
He called it a placeholder.
这真的很贴心
That's really sweet.
核磁共振成像是一个强大的磁铁
An MRI is a powerful magnet.
它将破坏你的口香糖包装环
It will destroy your gum-wrapper ring,
而且可能会烧伤你的手指
and it could burn your finger.
保证你不会丢失它？
Promise you won't lose it?
我保证
I promise.
好的
Okay.
她的主动脉瓣受损
She damaged her aortic valve.
我们需要把她开启
We'll need to open her up.
CP 旁路一般不是脑出血的好追兵
CP bypass is generally not a good chaser to a brain bleed.
她需要一个功能性阀门
She needs a functional valve.
你需要想办法给她一个
You'll need to figure out a way to give her one
而不把她变成一个植物人
without turning her into a vegetable.
我带你来是为了你的专业知识
I brought you here for your expertise.
还是你想让我为你弄清楚？
Or would you rather I try to figure it out for you?
举手投足让别人来做
Throwing up your hands and making someone else
解决问题不是领导
solve the problem is not leadership.
我猜我们不是在谈论心脏瓣膜
I'm gonna guess we're not talking about a heart valve.
当Ethicure集团接手后
When Ethicure took over,
你就这样走出去走向天堂
you just walked out, headed for Paradise.
我知道你正在经历一个艰难的时刻
I know you were going through a rough patch,
但我们在这里也经历了这种情况
but we were going through it here, too.
而你却不屑于站出来
And you didn't bother to step up
直到它成为肖恩的一个问题
until it became a problem for Shaun.
你想让我为我
You want me to apologize
对肖恩的承诺道歉？那是不可能的
for my commitment to Shaun? That's not gonna happen.
我绝不会要求你这样做
I would never ask you to do that.
我只是没有意识到我们其他人对你来说
I just didn't realize how little the rest
是多么的不重要
of us matter to you.
我可以插入一个主动脉泵来支持她的心脏
I can insert an aortic pump to support her heart.
这应该为我争取一些时间来修复她的阀门
That should buy me some time to fix her valve.
胸部的创伤损坏了她的肺动脉分支
The chest trauma damaged a branch of her pulmonary artery.
血已经止住了
The bleeding has stopped,
但她的动脉随时都可能重新出血
but her artery could re-bleed at any time.
我们怎么去到这里呢？
How do we get to it?
它被重要的器官所包围
It's surrounded by vital organs.
切开胸腔从近端到远程肝脏进行解剖
Thoracotomy, dissect from proximal to distal hilum,
隔离容器并重建容器
isolate the vessel, and reconstruct the vessel.
对于一个小伤来说这是个大手术
That's a big surgery for a small injury.
这几乎和重新破裂的风险一样大
It's almost as risky as a re-rupture.
我们需要一个更安全的计划
We need a safer plan.
我没有
I don't have one.
我需要时间来搞清楚
I need time to figure it out.
我需要 24 小时监测她的情况
I'll need to monitor her around the clock
以防她再次出血
in case she bleeds again.
看起来伊斯拉与莫菲医生
Looks like Isla's getting some QT
毕竟还是得到了一些 QT
with Dr. Murphy after all.
我们完成了吗？
Are we done?
我很无聊
I'm bored.
你的朋友是哪位？
- Who's your friend?
- 她不是我的朋友她是我的病人
- She's not my friend. She's my patient.
刘艾拉 10 岁女性
Isla Liu, 10-year-old female
患有节段性分支的假性动脉瘤
with a pseudo-aneurysm of a segmental branch
左肺动脉的
of the left pulmonary artery.
我需要密切监视她
I need to monitor her closely
以确保她不会失血过多
to make sure she does not bleed out.
这是我的未婚妻莉亚
This is my fiancee, Lea.
她是信息科技部的负责人
She's Head of the I.T. Department.
我需要你和她谈谈
I need you to talk to her
当我想出如何修复她时
while I figure out how to fix her.
她说了很多
She talks a lot.
我是的
I do.
你的戒指呢？他说你是他的未婚妻
Where's your ring? He said you were his fiancee.
我向他求婚
I proposed to him,
这只是一时兴起的事情所以没有戒指
and it was a spur of the moment kinda thing, so no ring.
非常现代嗯
- Very modern. - Mm.
我约了我的上一个男朋友但没有成功
I asked out my last boyfriend, but it didn't work out.
你的婚礼是什么时候？
When's your wedding?
我们没有订日子你选了一个蛋糕吗？
- We don't have a date. - Did you pick a cake?
我姨妈吃的是红丝绒它真的很好
My aunt had red velvet. It was really good.
而且她的长袍超级长他们称之为「火车」
And her gown was super long. They call it a train.
你有一个这样的东西吗？
Do you have one of those?
「火车」会导致绊倒和骨科伤害
Trains can lead to tripping and orthopedic injuries.
我不想要一件有裙裾的衣服
I don't want a dress with a train.
你没有蛋糕没有戒指
You have no cake, no ring,
没有礼服也没有日子？
no dress, and no date?
我们有一个蛋糕
We have a cake.
那你怎么是他的未婚妻？
Then how are you his fiancee?
这不就是男朋友和女朋友吗？
Isn't it just, like, boyfriend and girlfriend?
什么是 I.T.？
What's I.T.?
嗯 I.T 代表「信息科技」
Well, I.T. stands for "information technology,"
所以我和很多计算机打交道
so I work with a lot of computers.
增加 P-8 的流量给她的心脏做个 CT
Increase the flow to P-eight and get a CT of her heart.
我们需要准确的阀门测量
We need exact valve measurements.
得到了一些好消息
Got some good news.
我使布莱恩的手臂恢复了血流
I restored blood flow to Bryan's arm.
你本该截肢的
You were supposed to amputate.
我没有开启他的胸部
I didn't open his chest.
我从锁骨下重建了他的血管
I rebuilt his vessels from under the clavicle.
仍然有一个大的组织缺陷
Still got a large tissue defect,
但我可以用纤维覆盖
but I can cover that with a tissue flap.
我认识一个很好的神经外科医生
I know a great neurosurgeon
负责神经修复
for the nerve repairs.
还要做手术吗？他可能会再次出血
More surgery? He could bleed again.
我可以处理这个问题
I can handle that.
那么潜在的
And what about the potential
针对输血后的凝血问题？
for post-transfusion clotting issues?
切除他的手臂是唯一的方法
Removing his arm is the only way
以保证我们拯救他的生命
to guarantee we save his life.
失去两个肢体将是毁灭性的打击
Losing two limbs would be devastating.
为了避免一个相对较小的风险付出太高代价
It's such a high cost to avoid a relatively small risk.
但对那个小女孩来说这并不小
But it's not small to that little girl,
你可以成为孤儿为你自己的自我服务
whom you could orphan to serve your own ego.
相当严厉的评估
Pretty harsh assessment,
特别是考虑到我刚刚
especially considering I just rescued you and our colleagues
从你的自杀任务救了你和我们的同事
from your suicide mission.
你想为在最后可能的时刻找到
You want a medal for finding your moral compass
你的道德指南针而获得奖章吗？
at the last possible moment?
在关键时刻我在那里
I was there when it counted.
你听从她的吩咐甚至在孩子死后也是如此
You did her bidding, even after the baby died,
然后利用这种情况
and then leveraged the situation
所以你就出来负责了
so you came out in charge.
我是负责人
I am in charge.
我在拯救这个人的手臂
I'm saving this man's arm.
你现在是在从儿童偷窃吗？
Are you stealing from children now?
这东西一直在这里
This stuff's been in here
从我住院的第一年开始
since my first year of residency.
你不是应该参加同行评审吗？
Aren't you supposed to be in peer review?
我被这个外伤案件缠住了
I'm tied up on this trauma case.
我想你可能想为我旁听一下
I thought you might want to sit in on it for me.
法伯医生在领导它
Dr. Farber's leading it.
执行行动委员会主席
Chair of the Executive Ops Committee.
如果有一天你想经营一家医院...
If you want to run a hospital one day...
得走了
Gotta go.
但感谢你对我的思念
But thanks for thinking of me.
怎样才能切除假性动脉瘤？
How can I resect a pseudo-aneurysm
而不切断上叶的血流？
without cutting off blood flow to the upper lobe?
动脉搭桥呢？