良医

没关系
It's okay.
蛆虫
Maggots.
直接用抗生素不是更好吗
How are those better than just using antibiotics?
蛆虫清理坏死组织的速度更快
Maggots work faster to clear necrotic debris
它们的唾液和其他消化分泌物
on account of the antimicrobial nature
还有抗菌的特性
of their saliva and other digestive secretions.
把那些虫子放在我宝宝身上安全吗
It's safe to put those bugs on my baby?
幼虫而已 -这些是医用蛆虫
Larvae. - These are medical maggots.
已经经过了特别消毒
They've been specially disinfected.
绝对安全
It's completely safe.
在这种情况下 就算是我儿子史蒂夫 我也会用蛆虫
I would use maggots on my son, Steve, in this situation.
虽然不太可能有这种情况
That is unlikely to happen,
但我举这样的例子是为了让你放松
but I hope the parallel puts you at ease.
那就干吧
Go ahead.
你想喝点咖啡吗
You want some coffee?
我在办公室还有一些蛋白质棒
Or I have a stash of protein bars in my office.
不用了 谢谢
I'm fine, thanks.
如果你想吃点什么 去就好了
But if you want something, go ahead.
你的家人为什么来这里
What's your family here for?
心脏移植 希望是给我们的儿子杰克的
A heart transplant, hopefully, for our son, Jack.
他多大了
How old is he?
12周
12 weeks.
我的女儿伊登11周大了
Oh. My daughter, Eden, is 11 weeks.
她现在正在做心脏手术
She's having heart surgery right now.
我会为你们祈祷的
Y'all will be in my prayers.
这是杰克的第一次手甫吗
Is this Jack's first surgery?
他还做过其他手术
He's had other procedures,
但这次是他第一次做心脏直视手术
but this would be his first open heart surgery.
还不一定呢
If it happens.
如果能做上 我建议术后使用比萘芬乳膏
When it happens, I recommend Biafine cream for post- op.
它含有一种叫做三乙醇胺的天然化合物
It contains a natural compound called trolamine.
对伊登的恢复很有帮助
It really helped with Eden's recovery.
你女儿做了几次手术
How many surgeries has your daughter had?
一次 七周的时候做的
Uh, one. At seven weeks.
伊登和我都是老手了
Eden and I are old hands.
你们都是非常坚强的女士
You're two very resilient ladies.
我是凯特·皮尔斯 这是我丈夫欧文
I'm Kate Pierce. This is my husband, Owen.
我是摩根雷·茨尼克
Morgan Reznick.
我是亚历克斯·帕克
Alex Park.
你能不能
Would you like to...
你可以的 来吧
Yeah! You can do itl Come on.
这就对了 你成功了
Oh! There you go! You got it! You got it!
你成功了
You got it!
嗨 爸爸 重回工作岗位感觉怎么样
Hi, Daddy. How is it being back at work?
我刚在一个比史蒂夫大几个月的婴儿身上放了蛆
I just applied maggots to a baby a few months older than Steve.
是史蒂夫吗
Is that Steve?
他应该去睡觉了
He is supposed to be asleep.
他的俯卧训练做得不错
Mm. He's doing well with tummy time.
你昨天说他有点落后进度
And you mentioned yesterday he was behind,
所以我想应该再加几分钟
so Ithought I'd add a few extra minutes.
不 不
No, no.
俯卧训练不应该占用他的睡眠时间
Tummy time should not be extended into his sleep window.
你没有收到应用提醒吗
Did you not get the app alert?
他7分钟前就有应该睡觉了
You are seven minutes into nap time.
没有收到 我可能错过了
Nope. I guess I missed it.
睡眠时间不足会使他过度疲劳
Delaying his nap could make him overtired
也可能影响他下一次进食
or delay his next feeding.
时间安排很重要
The schedule is very important.
我知道了 肖恩 只是几分钟而已
I know, Shaun, I know. It's just a few extra minutes.
八分钟了 这可不算少 都好久了
Eight minutes. That is not a few. It is several.
我该让史蒂夫躺下来了
Uh, I should go put Steve down.
再见
Bye- bye.
好吧
Okay.
我们不得不中止手术
We had to abort the procedure.
伊登其中一个双尖肺动脉瓣
Eden has a bicuspid pulmonary valve.
与主动脉之间的组织连接太少了
There wasn't enough tissue to attach it to the aorta.
我们还观察到瓣膜有泄露
And we observed leaking at the valve.
她心脏衰竭的速度比我们想象的还要快
Her heart is failing even faster than we thought.
很抱歉
I'm so sorry.
我们下一步怎么办
What's our next move?
蛆虫起作用了
Oh. The maggots worked!
杰克宝宝的感染已经清除
Baby Jack's infection has cleared,
心脏已经在来的路上了
and the heart is on its way here.
伊登有两个瓣膜有病变
Eden has two bad valves
并且心力衰竭在快速恶化
and rapidly progressing heart failure.
我们只有一颗供移植的心脏 但有两个婴儿都需要
We have one donor heart and two babies who need it.
我们来决定哪个宝宝能得到这颗心脏
It's up to us to decide which baby gets this heart.
杰克已经等了三个月了
Jack has been waiting for three months.
移植手术是他唯一的选择
A transplant is his only option.
他可以用心室辅助器 直到找到合适的心脏
He could go on a VA. D. until another heart is available.
那可能需要几个月的时间
Kalu: That could take months.
心室辅助器不适合杰克 因为
And a V. A. D. isn't a good option for Jack because of the
摩根 摩根
Morgan. Morgan.
你不能进来 你们两个都不行
You can't be here. Neither of you.
我哪也不去
I can't be anywhere else,
要么你找人给我打镇静剂 要么
so either someone should sedate me or...
也不是不行
Well, that can be arranged.
我和帕克待在这并不是什么问题
It's only a problem that Park and I are here
除非干扰了你们的决定 你们自己做决定就好
if we influence your decision, so don't let us.
我什么也不会说的
I won't say a word.
卡鲁医生
Dr. Kalu?
至于杰克的心室辅助器 他体重过轻
as far as the V. A. D. for Jack, he's underweight,
所以并发症的风险很高
so a high risk of complications,
还可能感染 出血 中风
infections, bleeding, stroke.
这对伊登来说也不是一个好办法
It's not a great option for Eden, either.
我们等机械替代瓣膜的时候 伊登可以
Eden can go on ECMO while we're waiting
先用体外膜肺氧合
for mechanical replacement valves.
体外膜肺氧合是有风险的 尤其是对患有特纳综合征的婴儿
ECMO has risks, especially for a baby with Turner syndrome.
持续的时间越长 并发重症的
And the longer she's on it, the greater the risk
风险就越大
of serious complications.
可能等不及瓣膜来了
The valves may not get here in time.
不说两句吗 墨菲医生
Care to weigh in, Dr. Murphy?
基于体型和血型 杰克和伊登
Jack and Eden are equally good matches to the donor heart
与捐赠的心脏都配型成功了
based on size and blood type.
还有别的吗
Anything else?
直说吧 肖恩
It's okay, Shaun.
没有了这颗心
Without this heart
杰克就会天折
Jack will die.
伊登没有这颗心 也可能死亡
Eden may also die without it.
但她还有别的选择
But she has other options.
虽然有风险的 但仍然有选择
They are risky, but they are options.
那颗心应该给杰克
Jack should get the heart.
今晚我们就给伊登做体外膜肺氧合
We'll put Eden on ECMO tonight.
我会联♥系♥艾伯特
And Ill contact Abbott
尽快拿到1毫米瓣膜
about getting the 15- millimeter valves ASAP.
嘿 很抱歉 我们今晚改约好吗
Hey. I'm sorry. Can we rain- check tonight?
我累坏了 杰罗姆答应过
I'm exhausted, and Jerome promised
我们一起看一部精彩的犯罪电影
that we could watch a nice crime procedural.
有时候忙了一周需要好好放松
Sometimes you need a case of the week.
是的
Yeah.
我最喜欢的
Mmm! My favorite!
一份切达牛腩加淡酱
One cheddar brisket with mild sauce
这样小史蒂夫下次吃饭才不尝不出辣味
so little Steve's next meal doesn't burn his mouth.
你真是救苦救难 我饿死了
You are a treasure. I am starving.
谢谢
Thank you.
可怜的伊登 不得不做体外膜肺氧合了
Poor Eden, having to go on ECMO.
还有可怜的摩根和帕克
And poor Morgan and Park.
已经耗一天了
It's...been a day.
佩雷斯不在 你还好吗
And how are you holding up? Without Perez?
在家里或工作中发生的每件事
Everything that happens, at home or at work,