良医

The Good Doctor S06E17

Part 3 March 22, 2023, 12:13 p.m.

我建议做大动脉双调转重建术
I'd recommend
the double switch reconstruction.
将血流重定向到右心室
Redirect blood flow
to the right ventricle.
卡特的心率和心脏检查
我收到电子版了
- I have Carter's BMP and cardiac labs.
- I received them digitally.
但纸质版还是很有用的
But the hard copies
are always appreciated.
你俩吵架了吗?
没有
- Trouble in paradise?
- Everything's fine.
他俩在被动攻击彼此
They're in this passive-aggressive fight.
我们没吵架
你都不跟我说话哪吵得起来
- We're not fighting.
- That would require you talking to me.
你们可以选择不说
You don't have to share.
但这里可是有两个离过婚的人
But you do have two divorcees
而且很可悲我们有丰富的经验
with a sadly ample amount
of experience between us.
你们中有人和前任联♥系♥了?
Was one of you in contact with an ex?
在不告诉你的情况下
接受了其他州的工作?
Took an out-of-state job
without including you?
在一些重要的事上杰罗姆骗了我
Jerome lied to me
about something important.
我没骗你
故意不说就是欺骗
- I didn't.
- Omission is still a lie.
没那么简单
你早该告诉我的
- Not that simple.
- Should've told me.
我想告诉你的
但你没有
- I wanted to.
- You didn't.
我害怕你的反应
I was afraid of how you'd react.
但你是对的
But you're right.
这从来不该是秘密
没有什么可隐瞒的
It never should have been a secret.
There's nothing to hide.
我是艾滋病毒阳性
I'm HIV positive.
多亏了服用药物
多年来我的病毒载量低于检测量
Thanks to my meds, my viral load
has been undetectable for years.
我的病毒测不出来
I'm poz undetectable.
我不会传播病毒的
I can't transmit the virus.
你应该去和他谈谈
You should go talk to him.
我还有工作要做
I have work to do.
给家属介绍下大动脉双调转术
Present the double switch surgery
to the family.
如果他们同意手术我来做
这就去
- If they agree, I'll scrub in.
- On it.
不行
怎么一下从起搏器变成重建心脏了?
No. How did we get from a pacemaker
to reconstructing his heart?
这个手术可能听起来很吓人
The procedure may sound drastic,
但能降低他患心力衰竭的风险
but it will reduce his risk
of developing heart failure.
我们不能先只给他装心脏起搏器吗
Can't we give him the pacemaker
如果将来情况恶化再进行手术?
and do the surgery
if the problem gets worse?
等他出现心力衰竭的迹象后
再重建就晚了
When he shows signs of heart failure,
it'll be too late for the reconstruction.
我们得现在就治好他
轮不到你做决定
- We should fix it now.
- This isn't your decision.
现在你还在因为我17岁犯的错怪我?
You're still making me pay for mistakes
I made when I was 17?
还有18岁、19岁、20岁...
我已经回来两年了
- And eighteen, nineteen, twenty--
- I've been back for two years.
如果你不给我机会
我怎么真正当妈妈呢?
How can I be a mother
when you won't give me a chance?
妈妈?
E妈妈?我不太舒服
Mama? Mama E? I don't feel good.
没事宝贝我在呢
亲爱的怎么了?
- It's okay, baby. I'm here.
- Honey, what's wrong?
我的胸口痛
心率40 血压73/45
- My chest hurts.
- Heart rate is 40bpm. BP 73/45.
我们得在他病情恶化前尽快做出决定
We need a decision soon
before his condition deteriorates.
我想为之前的事情道歉
我太不专业了
I wanted to apologize for earlier.
It was unprofessional.
用不着道歉...你其实可以不说的
You have nothing to apologize for...
and no duty to disclose.
不可检测等于不会传播
Undetectable equals untransmittable.
我很感激你这么说
I appreciate you saying that.
给阿舍一点时间
他是个医生
- Give Asher some time.
- He's a doctor.
他知道他没有任何危险
He knows there was never any risk to him.
人们的理智和情感
What people know
and how it makes them feel
往往是有很大差别的
are often two very different things.
这么多年你已经接受自己了阿舍也需要一个接受的过程
You've had years to process your status.
Allow Asher to process it too.
请不要说“我早说过了”
嘴上不说心里说
- Please do not say "I told you so."
- I won't. But I'm gonna think it.
你好像有点被宠坏了
You seem a little spoiled.
你不了解我
You don't know me.
你家有钱
你不用努力工作就能获得一切
You come from money and you
haven't had to work hard for anything.
你从医学院毕业了太棒了
You made it through med school.
Bravo to that.
你被踢出了这个医院
You got kicked out of this program,
但获得了一份照顾亿万富翁的工作
but landed on your feet
taking care of a billionaire.
然后你厌倦了
大家又张开怀抱欢迎你回来
And when you got tired of that,
you were welcomed back here.
你开着你的豪车
带着老想法回到医院
You come in with your fancy car
and your old tricks
心想着“我是个外科医生”
但你不是目前还不是
and think, "Ta-da. I'm a surgeon."
But you're not. Yet.
你是新来的
肖恩是老板我有资历
You're the new kid.
Shaun is the boss and I have seniority.
你应该听肯德里克的谦虚点
You should've listened to Kendrick.
Be humble.
我只想向肖恩和大家证明我属于这里
I just want to prove that I belong here...
to Shaun, to everyone.
但你是对的
我知道
- But you're right.
- I know.
图像的分辨率仍然不够高
The image is still not
high enough resolution.
你完成重新成像了吗?
Have you finished redoing the imaging?
是的一步一步照着规则来的但图像还是不清晰
Yes, and I followed all the protocols,
but the image still doesn't look clear.
图像很清晰...但雅拉的诊断有误
The image is clear...
but Yara's diagnosis was incorrect.
她没得妥瑞症她有脑瘤
She does not have Tourette's.
She has a brain tumor.
我没有妥瑞症?
I don't have Tourette's?
对是因为下丘脑错构瘤你的抽动不是抽动
No. You have a hypothalamic hamartoma.
Your tics aren't tics.
而是由大脑肿瘤引起的癫痫发作
They are gelastic seizures
caused by the tumor in your brain.
瘤?是癌症吗?
这个肿瘤不是癌性的
- Tumor? Does that mean cancer?
- The tumor is not cancerous.
伽玛刀放射手术
应该可以阻止它生长并治好癫痫
But a Gamma Knife radiosurgery should stop
it from growing and treat the seizures.
能让我不再癫痫发作吗?
Will it stop this?
短时间内不行
也可能一直不行
- Not immediately.
- And possibly not at all.
如果到时候没效果还有其他选择
There are other options you can consider
if you don't see improvement.
或者也可以现在就考虑其他选择
Or we could consider them now.
切除肿瘤可以让癫痫发作立刻停止
A successful resection
could stop the seizures immediately.
那个手术有风险
但那样我就可以回学校了
- That procedure is risky.
- But that means I can go back to school.
我可以学习开车可以照顾好自己
I could learn how to drive,
take care of myself.
妈妈拜托我只是想做个正常人
Mommy, please. I just want to be normal.
切除肿瘤可能导致中风
Tumor resection can cause stroke,
部分瘫痪、学习障碍、脑膜炎
partial paralysis,
learning deficits, meningitis.
伽玛刀要安全得多
The Gamma Knife is much safer.
雅拉对不起我不能...
你可以