良医

The Good Doctor S06E08

Part 3 Feb. 9, 2023, 11:56 a.m.

还在下降
Still dropping.
你有做抗血小板抗体♥检♥查吗？
You do an anti-platelet antibody?
正在等结果
Waiting on results.
再预定一次红细胞输血提高她的血细胞比容
Order another PRBC transfusion to get her hematocrit up.
强♥奸♥检测包有进展吗？
Any progress on the rape kit?
她不愿意提这个
She won't talk about it.
我觉得不能怪她
I can't blame her.
那是一项侵入性检查
It's an invasive process that proves
只能证明一件她不记得的可怕的事
a horrible thing she doesn't remember.
她的大脑可能不记得了但她的身体记得
Her brain may not remember, but her body does.
将来有一天她很可能会想起来
And chances are eventually, it'll come back.
我们不应该尊重她的意愿吗？
Shouldn't we respect her wishes?
我们不想让她重温遭人侵犯的感觉
Don't want her to feel assaulted again.
否认不能改变事情已经发生的事实
Denying it doesn't change it
是托妮灰色警报
It's Tony. Code Gray.
不要求你了住手
No, please, please. Stop.
她尖叫着醒来还拔掉了输液管
She woke up screaming and pulled out her IV.
离我远点
Just stay away from me.
我只是想帮你
Just want to help you.
托妮你没事了
Tony, you're okay.
我们都陪着你
We're here with you.
那不是真的
It's not real.
你能和我一起呼吸吗？
Can you breathe with me?
好的
Okay.
你没事了
You're okay.
你现在没有危险
You're not in danger now.
我做了一个噩梦
I had a nightmare.
她的病号♥服
Her gown.
我得看看你的伤口
Let me look at that.
好吗？
Okay?
脾脏修复失败了
The spleen repair didn't work.
（三）
在你的职业生涯中你已经移除了五块常规海绵
Over the course of your career, you've removed five routine sponges
比该地区任何一位外科医生都要多
that is higher than any surgeon in the region.
那是我简历上的长项就排在杂耍下面
Special skill on my resume, right under juggling.
我的病人体内遗留了一条手术巾
My patient has a retained towel
导致了多器官受累的败血症
that has caused sepsis with multi organ involvement.
我想向你咨♥询♥手术事宜
I would like a surgical consult.
找你们科主任吧
A request for your department head.
利姆医生说我应该自己解决这个问题
Dr. Lim said I should tackle the problem on my own.
有意思
That's interesting.
她说得对
She is right.
我是主治医生
I am an attending.
但你在遗留手术器械方面的经验对这个病例有帮助
But your RSI experience would be helpful on this case.
我会看的
I'll take a look.
维拉纽瓦护士
Nurse Villanueva.
格温的手术怎么还在我的日程上？
Why is Gwen's surgery still on my schedule?
她因为换了外科医生而恐慌
She panicked over a new surgeon.
她想要… -告诉她
She wants-- -Tell her
那位医生很厉害从我的轮班日程上删除她
she's in great hands with Dr. Annanian, take her off my rotation.
不行
No.
你说过你会给她做手术
You said you'd do the surgery.
如果你不做自己去说吧
You tell her you won't.
微创手术怎么样？
What about a minimally invasive surgery?
将手术巾剪开通过一个小孔
Cut the towel, remove it in pieces
逐片取出 -行不通
through a single port. -Won't work.
从它附着的地方看被感染的组织使她处于高风险中
Where it's attached, infected tissue puts her at high risk.
大刀阔斧地全部切除
And aggressive gross total resection
被手术巾入侵的器官和感染的坏死组织
of organs invaded by the towel, plus infected, necrotic tissue
是长♥期♥生存的最佳选择…
is the best option for long term survival…
手术有大出血的风险我们必须切除她的子♥宫♥
Procedure risks major bleeds. We'd have to remove her uterus.
她们正打算生孩子她要受孕
They're planning a family. She is to carry the baby.
如果她死了那也生不了孩子
That will also be impossible if she is dead.
说得委婉一点
It's elegantly put.
病人的妻子来了吧？
The wife of the patient is here, right?
向她解释各种选项看她想如何进行下去
Explain the options to her, see how she wants to proceed.
她们在她上次手术前发生了争执
They had an argument before her last surgery.
她肯定不想让她的妻子做决定
She won't be pleased with her wife making that decision.
去找她谈谈吧
Just go talk to her.
我们知道你为什么出血了
We know why you're bleeding.
你患上了免疫性血小板减少症
You have a condition known as ITP.
你的免疫系统正在破坏你的血小板
Your immune system is destroying your platelets.
你们能治好吗？
Can you fix it?
有药物可以治疗
There's medication to help.
我们必须切除你的脾脏
We must remove your spleen.
为什么不在之前的手术中切除呢？
Why didn't you do that during my earlier surgery?
还不知道你有免疫性血小板减少症
We weren't aware of your ITP.
创伤可以触发这种病
It can be triggered by trauma.
免疫性血小板减少症让我们的方法变复杂了
The ITP complicates our approach.
通常我们会通过腹部切除脾脏但是
Usually we'd remove your spleen through your abdomen, but…
那有大出血的风险
that risks a catastrophic bleed.
我们可以通过最小切口经阴♥道♥切除你的脾脏
We can remove your spleen vaginally with minimal incisions.
出血风险比较小
Less risk of bleeding.
好就这么办
Okay, let's do it.
我希望你能在手术前做一个强♥奸♥检测包
I hope you'll allow a rape kit before the procedure.
我已经告诉你了不行
I already told you, no.
经阴♥道♥手术会毁掉性侵犯的所有证据
The trans vaginal approach will destroy all evidence of the sexual assault.
不做
No.
我不在乎
I don't care.
没有检测包你就没有证据
Without the kit, you'll have no proof.
你说得对
You're right.
我相信我确实遭遇了可怕的事
I believe that something terrible happened to me.
但我要不要选择大海捞针都不会改变这个事实
But that is true whether or not I go chase down the Boogieman
有用的
It could help.
怎么做都没用
Nothing will help.
不要让做这件事的人逍遥法外
Don't let whoever did this get away with it.
他已经逍遥法外了
He already has.
做了强♥奸♥检测包也不能让我回到强♥奸♥之前
Doing a rape kit is not going to unrape me.
开始手术吧
Go ahead with surgery.
我们需要你来做决定
We need your decision.
有没有办法在不切除子♥宫♥的情况下进行全切术？
Is there a way to do the total resection without removing her uterus?
没有
No.
她一生都梦想着怀孕生子
She's dreamed of being pregnant her whole life.
我没办法替她选择
I can't choose for her.
你可以
You can.
我们明白这有多难选
We understand how difficult this is.
她永远不会原谅我 -她会的
She'll never forgive me. -She will.
她显然是爱你的
It's obvious she loves you.
她把现在的事归咎于我
She blames me for what's happening.
如果我夺走她
If I take away her chance
生育的机会…
to carry a child…
你说得对
You are right.
你选择全切术她就会失去子♥宫♥
You choose gross resection, she loses her uterus.
她很可能永远不会原谅你
It is likely she will never forgive you.
但那都不相干这是你的决定
But that is irrelevant. It is your decision.
你必须做决定
You have to make it.
不管接下来会发生什么
Whatever happens next.
做全切术吧
Do the total resection.
好久没在这里见到你了
Haven't seen you here for a while.
我都忘了人际关系可以吞噬自♥由♥支配的时间
Forgot how relationships can eat into discretionary time
听起来不像是抱怨
Doesn't exactly sound like a complaint.
的确不是
It's not.
肖恩来找我咨♥询♥手术事宜了
Shaun came to me with a surgical consult.
你的遗留手术器械记录
Your RSI record.
很聪明 -他来找我是因为你把他打发走了
Smart. -Did it because you sent him away.
主任的工作职责包括赋权他们的主治医生
Part of the chief's job is to empower their attendings
找到自己的解决方案
to find their own solutions.
听起来他做到了
Sounds like he did.
有很多方法都能赋权主治医生
A lot of ways to empower an attending.
我选择了其中之一
And I chose one.
因为你还在生气？