良医

我还以为他去越南禅修呢
Oh, I thought he was at a meditation retreat in Vietnam.
本来是 现在他正在走圣地亚哥之路
He was, and now he's walking the Camino de Santiago.
他就开心了
How nice for him.
我少了俩外科医师 却没人肯批准再请一个新人
I'm two surgeons down with no one to approve hiring a new one.
我需要董事会任命一名临时主席 立刻马上
I need the Board to appoint an Interim President, stat.
希望不是奥布莱恩
Just as long as it's not O'Brien.
不会的
They wouldn't.
我从一位负责董事会会议的工作人员那里听说
I heard from a staffer who covers Board Meetings
他的名字在候选人名单上
that his name's on the short list.
是最不适合这个职位的候选人
Ugh. Of the worst possible candidates for the position.
早上好 史蒂夫的照片
Good morning! Pictures of Steve.
你不用拄拐了
You no longer have your cane.
嗯 PT说我好了 很高兴见到你回来
Yeah. PT said I was ready. I'm glad to have you back.
我想加入你正在跟的病例
I would like to join your case.
他真可爱 墨菲医生 欢迎回归
He's adorable, Dr. Murphy. Welcome back
肖恩 我很高兴见到你
Shaun, I'm thrilled to see you,
但我不确定作为一个新手父亲来说
but I'm not sure this is the case where you want
这个病例适不适合你
to start as a new dad.
这是个令人激动且有挑战性的手术
It is an exciting and challenging surgery.
谢谢你们这么短时间内就能过来
Thank you for coming in on such short notice.
你们好 我是肖恩·墨菲医生
Hello. I am Dr. Shaun Murphy,
主治医师 也是个男宝的父亲
attending surgeon and father of a baby boy.
他两周大 而今天是我第一天回来上班
He is two weeks old, and today is my first day back,
但这不会影响我作为你们儿子
but that will not affect my performance
医生的专业水准
as your son's doctor.
有适合杰克的心脏这是真的吗
Is it true there might be a heart for Jack?
是的 但是心脏暂时还没准备好
Yes, but the heart isn't available yet,
而且准备好后我们也韦必能拿到
and we may not get it once it is.
我们以前也经历过这种情况
We've been through this before.
心脏暂时还没准备好是什么意思
Why isn't the heart available yet?
捐赠者家人还需要点时间
Well, the donor family is still saying
进行告别 然后才会关闭生命维持系统
their goodbyes before they turn off life support.
杰克跟捐赠者心脏完全匹配
Jack is an excellent match for the donor heart,
他的最新回声显示
and his latest echo indicates
他的心肌病和整体心脏功能
that his cardiomyopathy and overall cardiac function
都变差了 所以他应该排在名单的最前面
has worsened, so he should be at the top of the list.
我只是想多做几项测试
I just want to run some additional tests
确保他其它方面都很健康
to make sure he's otherwise healthy.
这有个问题
There is a problem.
这里有一小块划伤 应该是他指甲挠的
There is a small scratch, likely from his fingernails,
已经发展成蜂窝组织炎和脓肿
which has developed cellulitis and an abscess.
如果感染扩散并发烧
If the infection spreads and he spikes a fever,
杰克就不能接受移植手术了
Jack will be ineligible for the transplant.
我们必须马上解决这个问题
We have to lance and debride it right away.
早
Morning.
这是史蒂夫 我们的儿子 现在已经两周大了
This is Steve, our son, who is now two weeks old.
史蒂夫 这就是住在走廊尽头的那个坏脾气男人
Steve, this is the grumpy man who lives down the hall
你最爱的小毯子就是他送的
and gave you your favorite blanket.
你能猜中他的名字 肖恩深感意外
Shaun was very impressed you guessed his first name.
要试试猜下中间名吗
Wanna take a stab at the middle?
艾伦
Aaron.
我一直想要叫他鲍伊
I was lobbying pretty hard for Bowie,
既然起名为什么不用
because why not name your kid after
史上最酷的人名呢
the coolest person who every lived?
但是肖恩很坚持
But...Shaun insisted.
你有时间应该过来看看他
You should come over sometime.
你们俩可以一起发出哼唧声然后做鬼脸
You two both grunt a lot and make strange faces.
我最近事情很多 所以
I've got a lot going on, so...
我们就住隔壁 你根本就没什么事
We live next door. You have nothing going on.
你只是生气 我明白
You're mad. And I get it.
但你真的打算无视肖恩 史蒂夫和我到永远吗
But are you really gonna ignore Shaun and Steve and me forever?
你是这么打算的吗
Is that the plan?
我没有无视你
I'm not ignoring you.
而且他也很好看
And he's beautiful.
恭喜了
Congratulations.
我试过了
I tried.
吃奶的时候有发绀症状吗
Any cyanosis while eating?
昨晚她的嘴唇是有那么一丝丝发蓝
Maybe a hint of bluishness on her lips last night.
我什么都没注意到
I haven't noticed anything.
但考虑到她之前的手术和特纳综合征
But given her prior surgery and the Turner syndrome,
我觉得我们还是
I thought we should
血流量变少了
The blood flow is reduced.
看起来伊伊登的主动脉狭窄
It looks like Eden's aortic stenosis
发展得比我们预期的要快
has progressed more rapidly than we were expecting.
我们能给她服用β受体阻滞剂吗
Can we put her on beta blockers?
可以试试 但是鉴于瓣膜发育不良
We can try, but given how dysplastic the valve is,
我觉得这样用处不大
I don't think it will do much good.
你可能想多做几项医学成像 但是
You'll want to get more imaging, but...
我认为伊伊登可能很快就需要再做一次手术了
Ithink Eden's gonna need another surgery- - very soon.
心脏核磁证实瓣膜严重狭窄
Cardiac MRI confirmed severe narrowing of the valve,
梗阻和左心室功能障碍
obstruction, and Ieft ventricular dysfunction.
伊伊登需要一个新的主动脉瓣
Eden needs a new aortic valve,
否则她的心脏衰竭会越来越严重
or her heart failure will get worse.
你想用机械的还是冷冻活性同种带瓣主动脉
Are you thinking mechanical or cryopreserved homograft
来代替
for the replacement?
新生儿的机械瓣膜需要建造
Mechanical valve for a neonate needs to be built,
未来需要手术
and it will require future surgeries
还要终身服用抗凝血药
plus lifetime blood thinners.
冷冻保存的瓣膜有退化的风险
Cryopreserved valves risk degeneration down the line,
但这是一个可靠的办法
but it is a solid idea,
尤其是作为主动脉瓣置换手术的一部分
especially as part of the Ross Procedure.
可能的并发症呢
Possible complications?
主动脉瓣功能不全 肺动脉狭窄
Aortic insufficiency, pulmonary stenosis.
我们需要点时间 来讨论一下各种方宰
We can take some time, discuss the different options-
做主动脉瓣置换手术
Do the Ross Procedure.
我让亚设给她做准备
I'lI have Asher get her prepped.
你是时候进场了吧
It's time to get off the sidelines.
我不知道你在说什么
I'm not sure what you're referring to.
你是打算扔球给我吗
Are you gonna throw me a ball?
你之前也管理过医院
You've run the hospital before.
再坚持几个月没有问题
You can handle a few more months.
我是可以 但我为什么要这么做呢
I can, but why would I want to?
所以你是拒绝咯 -对
That's a no? Yes.
那就准备好迎接临时院长奥布莱恩吧
Get ready for O'Brien.
不可能
They would never.
就像是毛与巴塞尔·弗尔蒂碰面一样不可能
That's like Mao meets Basil Fawlty.
这是晦涩且过时的比喻了
Wow. That's two obscure and dated references.
他们绝对不会让奥布莱恩上的
They're never gonna move on O'Brien.
很明显 他在董事会的候选名单上
Well, apparently, he's on the Board's short list.
只要你下场 他压根没有机会
Throw your hat in the ring, he won't stand a chance.
我还是老实呆着吧 不过我会处理好的
My hat's gonna stay on my head, but I'll handle it.
好的 杰克
Jordan: Okay, Jack.
你知道自己耳朵后面有个小肿块吗
You know that little bump behind your ear?
我们得用锋利的东西戳一戳
We have to poke it with something sharp,
虽然会很痛 但这是必须的
which will hurt, but we have to do it
希望你能得到一颗新的心脏
so hopefully you can get a new heart.
抱抱熊先生来陪你咯
But Mr. Snugglepuff is here to keep you company.
亚设说墨西哥卷外卖♥♥♥车♥的菜单上加了西班牙辣香肠
Asher said the taco truck added chorizo to the menu,
好吃到爆
and it's bussin'.
找个晚上 我们应该一起点份餐吧
The next late night, we should share an order.
不是我的菜 谢谢
Not really my thing. Thanks.
确证了是片状丘疹
The sheet papoose is secure.
好 卡鲁医生 把孩子抱起来
Good. Dr. Kalu, cradle the baby.
艾伦医生 请给耳朵后部消毒
Dr. Allen, sterilize the area behind the ear.
好了 宝贝 别看
Okay, baby, don't look.
他的眼睛还没法聚集到8到12英寸
His eyes are not yet able to focus beyond 8to 12 inches.
脓肿很深
Kalu: The abscess is pretty deep.
可能需要一段时间才能痊愈
It may take a while to heal.
伤口吸液器怎么样
What about a wound vac?
我们没有那么小的
We don't have one small enough.