驻院医生

The Resident S03E05

Part 5 Nov. 13, 2019, 7:09 p.m.

只有一个办法可以知道
Only one way to find out.
苏珊
Hey, Susan.
有人跟你说过你走路有点奇怪吗
Anyone ever tell you you walk kind of funny?
挖苦要出院的病人这是什么样的医院啊
Insult patients who leave. What kind of hospital is this?
你的CT结果正常
Your CT was normal,
但我觉得你所有的医生都漏了某件事
but I think all your doctors missed something.
我想在你离开前做个脑部核磁共振
I'd like to do an MRI of your brain before you go.
-你在开玩笑吧 -我懂你
- You're kidding. - Hey, I get it.
你不觉得事情会有转机
You don't think things will ever change.
你光是试着勉强习惯就已经花了一辈子时间
You've spent your whole life just trying to get by.
我不能
I can't.
我不能再抱希望了
I can't hope anymore.
我已经放弃了
I am fresh out.
我们还没
We're not.
我认为我们能帮助你但你得相信我们
I think we can help you, but you got to trust us.
仅限经授权人员
-我们只需要两分钟 -我连两秒都没空
- We just need two minutes. - I don't have two seconds.
我们有个三十几岁的女性病患
We've got a female patient, 30s,
青少年时期被诊断出嗜睡症
diagnosed with narcolepsy as a teenager.
她有高血压急症我们本来以为原因是
Hypertensive emergency we thought was due
不配合服药和飞机失事
to med-noncompliance and the crash.
她的步态宽又蹒跚表明有小脑共济失调
She has a wide, staggering gait indicative of cerebellar ataxia.
因为她其实没有嗜睡症
Because she doesn't actually have narcolepsy.
她被误诊了
She was misdiagnosed.
她真正罹患的是中枢性睡眠呼吸中止症
What she really has is central sleep apnea,
由小脑扁桃体下疝畸形导致
caused by a Chiari malformation.
她需要你做手术
She needs you to operate.
我接下来五周都满了
I'm booked five weeks out.
她有镀金保险
She's got gold-plated insurance.
好我懂了
Okay, I get it.
所以你们觉得我是红岩山的某种工具
So you guys think I'm some Red Rock tool
我只在乎钱而已
who only cares about the money.
我本来可以去国内的任何一间医院先生们
I could have gone to any hospital in the country, gentlemen.
我选择了查斯汀因为我看到了
I chose Chastain because I saw the opportunity
能尽可能帮助更多人的机会
to help as many people as possible,
而且有一批工作人员支持我
with a staff who would support me,
或至少不会挡我的路
or at least stay out of my way.
像这样冲着我来不是解决问题的办法
Coming at me like this is not how it's done.
你们的病患需要我的帮助
Your patient needs my help,
我会为她动手术是因为我在乎
I will operate on her because I care,
不是因为她付得起钱
not because she can pay.
或许我们看错他了
Maybe we misjudged him.
确认她的保险状况
Check her insurance.
我是个外科住院医师
I'm a surgical resident,
这意味着我每周工作八十小时
which means I work 80 hours a week,
算上研究和准备时间更接近120小时
but it's more like a 120 with all the studying and prep.
我早上四点半前到院晚上七点之后才离开
I arrive by 4:30 a.M., leave no earlier than 7:00.
每三天就要随时待命
I'm on call every three days.
周六周日或整个周末都要工作
Work Saturday or Sunday or both.
而且我的住院医师培训还要两年
And I have two more years left of residency,
接下来还有至少好几年的专科医师培训
followed by at least another few years of fellowship,
到时我的班表只会变得更可怕
during which my schedule will only get worse.
你知道外科住院医师的薪水有多少吗
Uh... Do you know what the salary for a surgical resident is?
-还要继续说啊 -对
- Ah, there's more. - Yes.
一年五万五千美元
$55,000 a year.
即使我有时间我也付不起托儿所费用
Even if I had time, I can't afford childcare.
说完了吗
Is that all?
而且我只喜欢属于别人的小孩
And I only like children that belong to other people.
好所以
Okay, so...
你的意思是你
what you're saying is, you...
不想当我小孩的教母
don't want to be my baby's godmother.
我的意思是我是个错误的选择
I'm saying I'm the wrong choice.
我会在你做超声波时握着你的手
I will hold your hand at ultrasounds,
购买♥♥婴儿服一路上每一步都陪着你
shop for baby clothes, be with you every step of the way.
除非我死了
Unless I die.
我会尽一切努力确保你不会死
I will do everything in my power to make sure you don't.
了解
Got it.
所以我有四个止痛选项
So I have four choices for pain relief,
两个胎儿监测选项
two for fetal monitoring.
我可以选择人工剥膜
I can choose between membrane stripping
或打催产素或人工破水
or Pitocin or artificial rupture.
但如果我死了谁会照顾我的孩子
But who will take care of my baby if I'm gone?
我没办法做出想要的选择
That choice I do not get to make.
我会帮你找到其他人的
I'll help you find someone else.
阿达库我不懂为什么这件事让你这么生气
Adaku, I don't understand why this is so upsetting to you.
因为这是我们今天讨论内容里唯一一件
Because it's the only thing that we've talked about today
真正对我重要的事
that actually matters to me.
骨盆固定已完成
Pelvic fixation complete.
-咬骨钳 -咬骨钳
- Rongeur. - Rongeur.
我会很快的
I'll be quick.
我可以在等待时植入骨钉
I can insert the pins while I wait.
电钻
Drill.
注意骨钉的排列沃斯医生
Watch your alignment, Dr. Voss,
否则桡骨骨干会有间隙
or your radial shaft will be gapped.
真是幸好你在这里呢
Oh, thank goodness you're here.
出血已受到控制
Bleeding controlled.
使用腹腔真空敷料
Applying the abdominal vacuum
这样我就能让他回到重症监护室
so I can get him back up to the ICU.
我随后就好
I'm right behind you.
现在开始进行神经移植
Starting the graft now.
已经开始啦
Oh? Already?
-还要去哪里吗 -迅速与优异表现
- Got someplace to be? - Speed and performance
是可以并存的
can go hand in hand.
那你「开」的是啥
What do you drive?
杰瑞是人不是车
Jerry is a person, not a car.
如果我的动作不这么快
If I didn't move this fast,
这个人可能失去手臂的所有神经功能
this person would lose all nerve function in his arm.
杰瑞如果没有手臂就不能让手臂运动了
Jerry can't move his arms if he has no arms.
进行椎体高度恢复术
Get height restoration
如果有任何意外就呼叫我
and page me if there's any surprises.
等等你不会是要把这个男人的
Wait, you're not leaving
神经功能交给一个第三年住院医生吧
this man's nerve function to a third-year.
当然是汉娜很杰出
Of course. Hanna's extraordinary.
或许吧但我们这里不是这样做事的
She may be, but that's not how we do things here.
马上回手术台做好你的工作
Now, get back there and do your job.
他的骨盆充满了血
Uh... his pelvis is filling with blood.
我以为我们快要关闭腹腔了
I thought we were about to close.
一定是敷料撑开了血管
No, the packing must have stretched the vessels.
我刚才也修复了这里一处部份撕裂伤
I also repaired a partial tear up here earlier.
是死亡冠
Corona mortis.
-这里是死亡之冠 -出血点在闭孔动脉
- It's the crown of death. - Bleeding from the connection
与髂骨动脉之间的交通支
between the obturator and iliac arteries.
通常是致命的
It's usually fatal.
-博维电刀纱布 -给我牵引器
- Bovie. Lap. - Retractors to me.
我们得现在就控制出血
We need to control this now.
腹腔抽吸
Lap suction.
-纱布 -纱布
- Lap. - Lap.
-你一定是杰瑞的妻子 -是的
- You must be Jerry's wife. - Yes.
我是贝尔医生
I'm Dr. Bell.
在手术中你的丈夫有严重出血
During the surgery, your husband had significant bleeding.
外科医师努力止住血了
Our surgeons managed to stop it,
但他的血压下降了很长一段时间
but his blood pressure dropped for a long time.
-他没事吧 -他现在被送进重症监护室
- Is he okay? - Well, he's being moved to the ICU now.
他还活着
He's alive.
但...
But, uh...
-我们不知道他是否能够醒来 -什么
- we just don't know if he's gonna wake up. - What?
你知道吗其实我
You know, actually, I was...
我在飞机上就坐在你丈夫旁边
I was sitting beside your husband on the flight.
他嘴里一直在念叨你
He wouldn't stop talking about you.
我按了「拒接」
I hit "ignore."
他打给了我