驻院医生

The Resident S02E08

Part 5 Jan. 15, 2020, 12:22 p.m.

你能做点该做的事来给他检查一下吗
Can you just do the right thing and come check on him?!
你好
Hello.
好了没事的
Okay. Okay.
好了
All right.
我们会给他服止痛药...
We'll up his pain meds and...
请稍等一会
If you just, um, give me a minute.
打扰一下
Excuse me?
我有一位患有小肠梗阻的75岁男性病人
I have a 75-year-old man with a small bowel obstruction,
急诊室三区我们需要收治他
ER Bay Three. We need to admit him.
绝对不行去找外科
Absolutely not. Call surgery.
我找了他们不愿意收治
I did. They won't admit.
我也不愿意我不收治小肠梗阻患者
Neither will I. I'm not taking an SBO.
如果情况好转他可以回家
If he gets better, he goes home.
如果情况恶化他们可以进行手术
If he gets worse, they operate.
我才不会为了照顾他而收治他
I'm not going to admit him just to baby-sit.
这里需要一名医生
We need a doctor over here!
医护人员在高速公路上找到他时
Paramedics found him on the freeway
他手上还拿着吸食冰♥毒♥的工具
with a meth pipe in hand.
给他肌肉注射10毫克氟哌啶醇并检查血糖
Let's get him ten of IM haloperidol and check his blood sugar.
快去拿洗眼器
Eye station, now!
不是让你去休息一下吗
What happened to your break?!
-把他放到九区 -好
- All right, let's get him to Bay Nine. - Okay.
他还好吗
Is he all right?
他的发作越来越难控制了
His seizures are getting harder to control.
而且我们给他用的药物
And the medications we're giving him
开始影响他的肝功能了
are starting to affect his liver function.
那我现在该怎么办
So what do I do now?
我知道你很害怕佐伊
I know you're scared, Zoey,
但你需要再耐心一点
but, just-just give this a little bit more time.
不能这么做
That's not an option.
佐伊需要做出她的决定
Zoey needs to make her decision.
要尽快
Soon.
伦道夫·贝尔医生
Dr. Randolph Bell,
是查斯汀的外科主任和首席执行官
chief of surgery and the CEO of Chastain,
他已经得知了亨利的病情
has heard about Henry's case,
想和你谈谈关于迷走神经刺♥激♥器的事情
would like to talk to you about the VNS device.
正如我们所讨论过的迷走神经刺♥激♥器
As we've discussed, the VNS
是您儿子目前的最佳选择
is the best option available to your son.
我仔细看了看数据
Well, I've looked carefully at the data,
结果并不明朗
and the results aren't clear.
医生没有接受过
Doctors aren't trained
持续评估这类复杂研究的训练
to consistently evaluate this type of dense research.
但数据还是能看懂的
The man can read.
数据说明样本量并不够
And what he read said the sample size is dismal.
但是这个器械有许可证对吗
But the device has been approved, right?
是的获得了药监局的批准
It has... by the FDA.
那为什么大家都那么担忧
So then why is everyone so nervous?
-没有人担忧 -我担忧
- Everyone isn't. - I am.
大部分此类设备
A high percentage of devices are recalled
在应用到病患身上后被召回
after they've been put in patients
并造成了永久的损伤
and have caused permanent damage.
那是别的公♥司♥ 不包括科瓦蒂斯
That has happened with other companies, but not QuoVadis.
我希望还有别的风险更低的选项
I wish there were more options with less risk.
但是并没有
There are not.
你已经失去了一个儿子
You've already lost a son,
我想竭尽全力确保
and I want to do everything possible to ensure
这种事情不会再次发生
that doesn't happen again.
我强烈建议你不要选择迷走神经刺♥激♥器
I strongly recommend you do not go down this path with the VNS.
最终的决定权在你手里
Ultimately, this is your call.
但我想告诉你如果这是我的孩子
But I will tell you, if this... were my child,
我会选择植入迷走神经刺♥激♥器
I would move forward and implant the VNS.
赵医生已经做了好几例这样的手术
Dr. Chao has done several of these surgeries.
他对于迷走神经刺♥激♥器有着丰富的经验
He's highly-experienced with the VNS.
他有给儿童植入过吗
Has he implanted it in a child?
我想让这次手术万无一失
I want this to go perfectly.
我觉得自己要对他负责
I-I feel responsible.
如果数据确实有问题的话...
And if the data isn't really there...
你真的认为戈登·佩奇
You really think Gordon Page would
会生产不安全的设备吗
manufacture products that aren't safe?
干得漂亮贝尔医生
Well done, Dr. Bell.
这是历史性的一天
This is an historic day.
我相信以后还会有很多这样的时刻
The first of many, I'm sure.
等一下
Whoa. Hold up.
心脏前方停止跳动了
The front of the heart stopped moving.
是急性心脏前壁运动减退
It's acute hypokinesis of the anterior wall.
左前降支中间发生了堵塞
There's a block in the middle of the LAD.
这颗心脏发病了
The heart is having a heart attack.
快走
Yo, let's go!
华♥莱♥士♥准备好进行手术了吗
Is Wallace ready for surgery?
准备好了二号♥手术室已全身麻醉
Yes, in OR Two under general anesthesia.
很好
Good.
如果把他放回等待名单他会没命的
He'll die if we put him back on the waiting list.
这颗心脏也许并不完美但能修复好的话
This heart may not be perfect, but once we fix it,
这会是他最好的机会
it'll be his best shot.
我需要他的大隐静脉
I need to get his saphenous vein.
需要用到左侧胸廓内动脉吗
Should we use his LIMA?
打开他的胸腔需要20分钟
It'll take 20 minutes to open his chest.
你可以在五分钟之内取得大隐静脉
You can get a saphenous vein in five.
时间就是心脏
Time is heart.
给我静脉摘取工具
Get me a vein retrieval kit
给左小腿做好准备摘取大隐静脉
and start prepping the left lower leg for saphenous vein harvest.
章鱼钳
Octopus clamp.
我以为你会更快
I thought you'd be quicker.
拜托那是世界纪录
Please. That was a world record.
我从未在跳动的心脏上做过搭桥术
I've never done bypass on a beating heart.
我能协助吗
Can I assist?
还用问吗
Oh, now was that ever a question?
把镊子递给奥卡福医生
Hand Dr. Okafor the pickups.
切断大隐静脉末端
Spatulate the end of the saphenous vein,
我来做动脉切开术给我11号♥刀
and I will do the arteriotomy. #11 blade to me.
7-0血管缝线
7-0 Prolene.
小心下针
Be careful with your bites--
保持间隔相同
keep them evenly spaced out.
再快一点
A little quicker.
我在缝合主动脉
I am suturing the aorta.
这是个精细活
This is delicate work.
心脏在缺氧
The heart is losing oxygen.
不能有差池
It could not care less.
好了
Done.
有个小漏洞
There's a small leak.
看到了
Mm. I see it.
再加一针
Adding another stitch.
好了
There.
你成功了
You fixed it.
我们成功了
We fixed it.
我们把新生命的礼物送给华♥莱♥士♥吧
Shall we give Wallace the gift of a new life?
BGM: Ultraviolet by Freya Ridings
♪ No, I can't hide it ♪
♪ You're ultraviolet ♪
♪ No, I can't hide it ♪
♪ You're reading all of me, ♪
♪ you're reading... ♪
一切顺利
Everything went perfectly.
什么时候能确定有效
How long until we know if this works?
他的癫痫已经停止了
His seizures already stopped.
谢谢你
Thank you.
没事
Of course.
♪ You're ultraviolet ♪
谢谢
Thank you.
♪ You're ultraviolet... ♪
干得好贝尔医生
Well done, Dr. Bell.
对于查斯汀和科瓦蒂斯来说
Today was a good day,
今天是个好日子
both for Chastain and QuoVadis.
祝合作愉快
To a wonderful partnership.