驻院医生

The Resident S02E23

Part 2 Jan. 15, 2020, 12:26 p.m.

这地方是我如今的真爱
This place is my main squeeze these days.
你知道这很可悲吧
You're aware that's pathetic.
成年男性年龄不明
Adult male. Age unknown.
在皮德蒙特公园发现了他
Found him in Piedmont Park.
-送到二号♥ -昏迷指数11
- Put him in two. - GCS 11,
血压95/60 血糖82
BP 95/60, blood sugar 82,
左臂可能骨折
possible broken left arm,
-另有一些小刮碰和瘀伤 -好的
- minor scrapes and bruises. - Okay.
再开一个大口径静脉通路再挂一升生理盐水
Let's start another large bore IV and hang another liter of normal saline.
-一二三 -一二
- One, two, three. - One, two...
好了
Okay.
能告诉我们你的姓名吗先生
Can you tell us your name, please, sir?
有身份证吗
I.D.?
没有钱包和手♥机♥
No wallet. No phone.
好吧
Okay.
破的衣服
Torn clothes.
指甲下有污垢
Dirt under his fingernails.
他可能是流浪汉
He could be homeless.
先生请告诉我们你的姓名
Sir, your name, please.
给他做肝功能检查凝血检测毒品尿检
Okay, let's add LFTs, coags, UTox,
阿司匹林和扑热息痛浓度以及血液酒精浓度检查
aspirin/acetaminophen levels, and a blood alcohol level.
联♥系♥社工
Page social work.
看看他们认不认识他
See if they recognize him.
如果不认识就让他们联♥系♥当地的收♥容♥所♥
If not, have them call local shelters,
看看有没有失踪或符合特征的人与此同时
see if anyone's missing or fits the description, while we try
对他进行镇痛处理
to get his pain under control.
我会安排X光检查
I'll order an X-ray
让沃斯医生来检查一下他的手臂
and get Dr. Voss to take a look at that arm.
作为器♥官♥移♥植♥协调员你肯定很有成就感吧
Must be very rewarding to be a transplant coordinator.
是的但也很泄气
It is, but it's frustrating.
我们需要更多的捐献者伸出援手
We need more donors to step up.
有太多死于等待器♥官♥移♥植♥的病人了
Too many people die waiting for an organ.
我最害怕这会发生在我妹妹身上
That's my biggest fear with my sister.
她的透析效果好吗
How is she doing on dialysis?
不太好
Not well.
她现在处于早期心力衰竭
Um, she's in early heart failure.
导致了很多问题
It's causing a lot of problems.
一个新的肾会对她的心脏有帮助
A new organ could help her heart.
是啊但我们等不了几年的时间了
Yeah. But we can't wait years to get one.
打扰一下
Excuse me.
你好欢迎来到查斯汀
Hi. Welcome to Chastain.
-需要帮助吗 -可能需要
- Can I help you? - Yeah, maybe.
我是来找一位医生的
I'm looking for a doctor.
她叫希拉·斯穆克
Her name is Shira Smook.
希拉·斯穆克
Shira... Smook.
查斯汀公园纪念医院
医生名录
希拉·斯穆克
希拉·斯穆克麻醉师
她是麻醉科的
Okay. Anesthesiology.
需要我呼叫她吗
Would you like me to page her?
不用了麻醉科
Nah. Anesthesiology.
我自己打电♥话♥告诉她我来了
I'll call her myself, tell her I'm here.
她的血压下降了所以他们不得不中止透析
They had to abort dialysis because her pressure dropped.
你的血氧饱和度有点低
Your SATs are a little low.
拜托你帮帮我妮珂
Please...please make it stop, Nic.
我们会竭尽全力的抬高点应该会好受些
Gonna do our best. This should help.
现在的首要任务
First order of business
是更换你的心脏用药
is to switch up your heart medication
这样你才能耐受透析
so you can tolerate dialysis.
好了我和妮珂要去讨论一下我们的选项
All right, Nic and I need to discuss our options.
然后我马上回来
Then I'll be right back.
没事的
It's gonna be okay.
等我一会儿
Just give me a sec.
颈静脉压升高
Elevated JVP.
我还发现了肝颈静脉回流的迹象
And I saw signs of hepatojugular reflux.
她的心力衰竭在不断加重
Her heart failure is getting worse,
比预计的更迅速
more rapidly than we expected.
简直是场灾难
This is a disaster.
治疗双重器官衰竭很棘手
Treatment of dual organ failure is challenging,
但并非不可能
not impossible.
单是心力衰竭就足以要了杰西的命
Heart failure alone could kill Jessie.
她需要一个新的肾
She needs a new kidney.
要尽快
Soon.
有过肾脏移植改善心脏功能的病例
There are cases where that alone improves heart function.
她可能十年内都不需要进行心脏移植
She might not need a new heart for ten years.
你父亲仍是最符合情理的捐献者
Your father's still the most logical donor.
他在本地而且匹配
He's here. He's a match.
凯尔拒绝捐献
Kyle refused to donate.
而且我现在找不到他他失踪了
And now I can't find him. He's disappeared.
我一次又一次地打他电♥话♥
I-I've called him over and over again.
所以我让我爸帮忙找他
Which is why I asked my dad to try and track him down.
他让他的私♥家♥侦♥探♥去找他
He put his private investigator on him,
告诉了我一个地址
and now I have an address.
你想知道吗
You want it?
难熬
Trying,
熬...伙计
i-ingman...
完蛋了
Dad bum.
这是表达性失语症
He has expressive aphasia.
他明白我们说的话但他无法说话
He knows what we're saying, but he can't speak.
可能是摔断手臂的时候撞到了头
Maybe when he fell and broke his arm, he hit his head.
还是找不到家属也没有代理人告知他的身份
Still no kin we can find, no proxy to tell us who he is.
握紧我的手握紧我的手
Squeeze my hand. Squeeze my hand.
好了就是这样
All right. There you go.
现在已经排到字母S了吗
We're up to the letter "S" now?
姓名向日葵1号♥
我们称他为「向日葵1号♥」
We're calling him Sunflower One.
不是针对你我的朋友
Nothing personal, my friend.
我们不清楚病人的身份时就以花来命名他们
When we can't identify patients, we name them after flowers.
对
Yeah.
他需要做CT
He needs a CT.
贝尔一直在加强对这里的控制
Bell's been tightening the screws down here.
他对我说的原话是
He told me, and I quote,
白金级医疗是为那些有白金信♥用♥卡♥的人准备的
"Platinum care is reserved for those with platinum credit cards."
我们不是每时每刻都在努力绕开贝尔的限制吗
Since when do we do anything but try to work around Bell?
草...
Her...
草药
herb.
草药
Herb.
考虑到他的年龄以及被发现时的情况
Given his age and how he was found,
他可能患有痴呆症这样的话这...
he might have dementia. In which case, this...
就是他的基线
is his baseline.
我们要照顾好他
We need to take care of this man.
不论他是不是流浪汉
Whether or not he's homeless,
不论他有没有医保
or whether or not he's insured.
如果存在潜在的病情
If there is an underlying diagnosis,
比如脑出血或肿瘤
like a brain bleed or a tumor,
治疗不及时可能导致不可逆的损伤甚至是死亡
delay could cause irreparable damage, even death.
CT是最低限度的标准治疗
At the bare minimum, a CT is standard of care.
很好
Good.
检查结果出来了告诉我们
Let us know when we have the results.
然后再看情况
Take it from there.
绝对是二度Ⅱ型心脏传导阻滞
So it's definitely a type 2 second-degree heart block.
所以我才会头晕
Which explains my dizziness.
电脉冲信♥号♥♥没法穿过你的心脏
Electrical impulses aren't getting through to your heart.
植入心脏起搏器的手术
How serious is the surgery to...
-复杂吗 -就是个小手术老兄
- implant a pacemaker? - Oh, it's no big deal, bruh.
很快就能做完一小时后你就会重获新生
Quick procedure; in an hour, you'll be a new man.
很好谢谢
Good. Thank you.
除此之外一切都还好吗
So, otherwise... everything okay?
你似乎心情很好
You seem to be in good spirits.
好得不能再好了
Man, I have never been better.
说真的我幸福极了
Seriously, on top of the world.
-真好 -是啊