匹兹堡医护前线（2025）

The Pitt S01E11

Part 2 May 20, 2025, 4:18 p.m.

我肯定会把分诊处打理得妥妥帖帖
Chairs is about to be my bitch.
所以这都是因为那次争吵吗
So, D... is--is this all about the fight?
什么争吵
What fight?
罗比和朗登在储物柜那里大吵了一架
Robby and Langdon got into it at the lockers.
场面很难看非常难看
Shit was flying. Literal shit.
你们俩够了别再说了
That's enough from you two. Not another word.
（要出大事了）
再嚼舌头你们两个假期都来加班
Keep it up! You'll both be working the holidays!
（我就说吧）
（你也许是对的）
什么情况
What have we got?
39周孕妇羊水破了能看到宝宝的头
39 weeks, crowning after a SROM.
你好孩子妈我是主治医生罗宾纳维奇医生
Hi, Mom. I'm the attending. I'm Dr. Robinavitch.
我是娜塔莉但我不是孩子的妈妈
I'm Natalie, but I'm not the mom.
发生什么了 -你来得正是时候
What's happening? - You got here just in time.
我们是孩子的爸爸娜塔莉是我最好的朋友和代♥孕♥母亲
Uh, we're the dads. Natalie's my best friend and surrogate.
我们都教四年级甚至共用教室
We both teach fourth grade and even share classrooms.
同一个房♥间同一个子♥宫♥
Same room, same womb.
我们一直劝她别再这么说
We've been urging her to stop saying that.
我拿到了待产包让我把手♥机♥上的分娩播放列表调出来
I've got the prenatal bag, and let me pull up the birthing playlist on my phone.
是时候了
It's time.
去他妈的碧昂丝我不需要音乐
Fuck Beyoncé. Fuck her.
我可以接手
I can take this.
不用
No.
我来吧 -加油柯林斯医生
I got it. - Go, Dr. Collins.
好的娜塔莉
Okay, Natalie.
下次宫缩时我们很有可能成功分娩
Good chance we'll deliver on the next contraction.
抽吸球囊准备好了
Bulb suction is ready.
好了头出来了
Right. Head is out!
很好休息一下在下一次用力之前喘口气
Nice. Take a break. Catch your breath before the next one.
好了这次我需要你更用力一些
All right. I'm going to need another big push from you.
我可以的
You got this.
三二…
Three, two...
这是谁
Who do we have in here?
伊万普格利西 55岁
Ivan Pugliesi, 55, has experienced
经历了一天的腹部痉挛呕吐和腹泻
a day of abdominal cramps, vomiting, and diarrhea.
无发热室速124 高压192低压100
Afebrile, tachy at 124, BP 192 over 100.
我是莫汉医生 -我是医学生维塔克
I'm Dr. Mohan. - I'm Student Doctor Whitaker.
很高兴认识你们
Nice to meet you guys.
我本想打电♥话♥给我自己的医生但我来自纽约
Um, I would have called my own doctor, but I'm from New York.
你们两个孩子去过那里吗 -我从没去过纽约
You two kids ever been out there? - Oh, I've never been to New York.
来到匹兹堡是我第一次离开内布拉斯加州
Coming to Pittsburgh was my first time leaving Nebraska.
你要在城里待多久
Uh, h-how long are you in town?
只待到周一我女儿要结婚了
Just till Monday. My--my daughter's getting married.
她是我的宝贝也是我唯一的女儿
She's my baby and the only girl.
恭喜你 -谢谢
Congratulations. - Yeah, thanks.
人们都说做父母的不该偏心但是…
Uh, you know, they say you're not supposed to have a favorite kid, but--
我是独生女所以我生下来就是父母最爱的孩子
I'm an only child, so I was born the favorite.
维塔克 -我是四个孩子中最小的
Whitaker? - Oh, uh, youngest of four.
我父母能记得我的名字我就很开心了
I'm just happy when my parents remember my name.
不我是说你有什么问题要问病人吗
No, I meant, do you have any questions for the patient?
能给我一些止痛药吗
Hey, can I just get something for the pain, you think?
等我们做完评估
As soon as we're done with this assessment.
我们只想尽职尽责地完成工作
We just want to do our due diligence.
你得过肠道疾病吗
Any intestinal disease in your past?
溃疡胆结石一般胃病做过手术吗
Ulcers, gallstones? General stomach ailments? Surgeries?
没有都没有
No. No, nothing.
肠鸣音正常 -谢谢
Good bowel sounds. - Thank you.
腹部柔软没有痛点
Abdomen's soft. Nothing focal.
你还有别的不适吗
Anything else bothering you?
我的背快疼死了坐四个小时的车就会这样
Uh, you know, my back is killing me. Four-hour car ride will do it.
我上次扭伤时
I mean, the last time I tweaked it,
他们给我注射了吗♥啡♥ 效果还不错
I think they gave me, um-- they gave me morphine, and-- and that worked pretty good.
你抽烟吗 -不抽
Do you smoke? - No.
喝酒吗
Drink alcohol?
一个月一两次吧我不是酒鬼
Uh, once, twice a month. I'm not a big drinker.
有吸毒史吗药丸或注射都算
Any recreational drugs, either pills or by injection?
镇静剂迷幻剂止痛药
Tranquilizers, hallucinogens, painkillers?
以上都有
Uh, all of the above.
我开玩笑的我不吸毒从来没有
Yeah. I'm kidding. No, no drugs, never.
那你平时都做些什么呢
And what do you spend your time doing?
我是精算师做风险管理和数据打交道
I'm an actuary. It's risk management, stats.
基本上就是坐办公室的工作
It's pretty much a desk job.
我抽了瓶枢复宁治疗恶心 -从四单位开始然后重复…
I pulled Zofran for the nausea. - Start with 4, repeat PRN.
什么就这样
What, and that's it?
现在我们要开始做一些血液检查
For now, we're going to start with some blood tests.
我们很快就会回来看你
We'll be back soon and check in on you.
好吧
All right. Fine.
你觉得是什么问题
What do you think we should be looking at?
有一系列严重的疾病和情况需要鉴别诊断来排除
A big differential of pretty serious stuff to rule out.
你有什么计划
So what's your plan?
除了枢复宁之外做全血计数和全套代谢功能检查
Besides Zofran, CBC, CMP,
还有静脉注射吗♥啡♥ 或者CT
IV fluids, morphine, maybe CT.
化验项目和静脉注射的判断是对的但不要打吗♥啡♥
Good on labs and IV fluids, but no morphine.
用可乐定和肌肉松弛剂来缓解症状
Treat his symptoms with Clonidine and muscle relaxants.
如果他是…
What if he's--
听着我今天真的不能再失去病人了
Look, I-I really can't lose another patient today.
还记得我说过你会慢慢学会如何发现冒牌货吗
Remember how I said you get good at spotting the fakers?
是的
Yeah.
他表现出了所有阿片类药物戒断的迹象
He's exhibiting every sign of opiate withdrawal.
瞳孔扩大流泪皮肤出现立毛和鸡皮疙瘩
Eyes dilated, tearing, skin has piloerection and goosebumps.
高血压心动过速
Hypertension, tachycardia.
烦躁坐立不安出汗每一项都符合
Agitation, restlessness, perspiration. He's checking every box.
好吧但他说他不吸毒很少喝酒所以…
Right, but he said he doesn't take drugs and seldom drinks alcohol, so...
如果他是为了毒品而来的他就是故意那么说好让你相信他
That's exactly what he would want you to believe if he was drug-seeking.
哇你真厉害
Wow. You're good.
谢谢
Thanks.
我确实很厉害
I am.
那我们要怎么治疗他 -让他承认他服用了阿片类药物
So how do we treat him? - By getting him to admit his opiate usage.
好怎么做 -比病人聪明
Right. How do we do that? - By being smarter than the patient.
明白了
Got it.
再用力一次 -你前两次也是这么说的
Another big one. - You said that the last two times.
肩难产
Shoulder dystocia.
头缩回去了 -这叫乌龟征
The head's pulling back. - That's called the turtle sign.
多纳休你能打给产科护士
Hey, Donahue, can you call an L and D nurse
让她把胎儿监护仪拿下来吗
and ask her to bring down a fetal monitor, please?
发生什么事了
What's going on?
宝宝的肩膀可能卡在你的盆骨上了
Baby's shoulder might be a little stuck on your pelvic bone.
你不用担心
It's nothing for you to worry about.
下次用力的时候我们试试别的办法
We'll just try something different on the next push.
准备好了吗
Ready?
我们大家都做一次深呼吸吧所有人
Why don't we all take a deep breath, huh? Everybody.
再来一次爸爸们也要做吸气
One more time. Dads too. And in.
如果你想跟他过万圣节就直说吧
If you want him for Halloween, just say it.
我想跟他过万圣节以及在那之前的所有节日
I want him for Halloween and everything until then.
感恩节给我吧 -好吧
Give me Thanksgiving. - Fine.
你可以庆祝美洲原住民被天花消灭
You can celebrate bringing smallpox to wipe out the Native Americans.
受伤的人是我一点同情不会要你命的
You know, I'm the one who's hurt. A little sympathy wouldn't kill you.
你带着我们儿子做了蠢事
You broke your ankle doing something stupid
摔断了脚踝
with our son.
我需要手术 -他没戴头盔查德
I need surgery. - He wasn't wearing a helmet, Chad.
如果他摔倒撞到头怎么办
What if he had fallen and hit his head?
他没有 -是但有这个可能
He didn't. - No, but he could have.
你知道看着孩子死去是什么感觉吗
Do you know what it's like to watch a child die?
又来了
Oh, here we go.
你知道有多少孩子因为家长的一个愚蠢错误
You know how many kids come in here who are messed up because of one stupid
被送来这里吗
parental mistake?
你知道我绝不会让儿子出事
You know I would never let anything happen to our son.
那就付诸行动
Then act like it.
做个成年人你是他的父亲不是他的朋友
Be a grown-up. You're his father, not his friend.
对你是他的母亲不是我妻子
Yeah, and you're his mother, not my wife.
你认为…