驻院医生

The Resident S03E16

Part 4 June 20, 2020, 5:03 p.m.

And I can't, in good conscience, send you to a party like this.
我的团队可以马上让你焕然一新
My team can get you into something amazing immediately.
行好吧
Okay. Fine.
你的胸围是多少 38
What's your chest measurement? 38?
至少42
42, at least.
你就是38
You're a 38.
谁邀请了007
Who invited 007?
今晚你最好拿出最佳水准霍金斯
Well, you better bring your A game tonight, Hawkins,
因为我可没有闹着玩
'cause I ain't messing around here.
我看得出来
I can see that.
怎么回事
How did this happen?
我的病人是著名的时装设计师
My patient is a famous fashion designer,
而且还有几分像仙女教母
and, as it turns out, part fairy godmother.
再加上米娜横加嫌弃
And you mix that with Mina's very aggressive comments
我租来的礼服就这样了
about my rental tux, and voilà.
好的
Yeah.
你看上去很精神
Well, you look good, man.
-怎么了 -她刚拍完X光
- What happened? - Well, she just got back from an X-ray.
-我正要带她做内窥镜检查 -帮我止痛
- I came to take her for the endoscopy. - Oh, make it stop.
注射四毫克吗♥啡♥
All right, let's get four of morphine.
我的手按下去更痛
Does it hurt more when I push my hand in
-还是放开更痛 -放开更痛
- or when I take it away? - When you take it away.
反跳痛僵直
Rebound tenderness. Guarding.
急腹症我看一下X光片
Surgical abdomen. I'll check the X-rays.
-隔膜下有空气 -她穿孔了
- Air under the diaphragm. - She's perforated.
这这是什么意思
Wh-What does that mean?
意思是我们要跳过内窥镜检查
It means we're skipping the endoscopy.
你需要立即做手术找诺兰来
You need surgery now. Get Nolan.
不不不不我不行我不能一个人去
No. No, no, no, no. I can't, I can't go alone..
没有人陪我
I have no one.
-我会孤独死去的 -你不会死的吉玛
- I'm gonna die alone. - You're not gonna die, Gemma.
-我不会让你死的 -普瓦什医生
- I will not let that happen. - Dr. Pravesh,
请你陪着我
please stay with me.
我很害怕
I'm so scared.
我不会离开你的
I'm not gonna leave you.
我保证
I promise.
好吗我就在这里
All right? I'm right here.
我收到你的呼叫了有什么需要
I got your page. What do you need?
她的血氧饱和度在80多
Her O2 sats are in the 80s.
-要给她插管 -我喘不上气
- We need to intubate. - I can't breathe.
我需要药和气道工具包
Hey. I need meds and an airway kit.
请你们帮帮她
Please just help her.
她的麻痹正在迅速恶化
Her paralysis is progressing rapidly.
她不能自主呼吸了
She's not gonna be able to keep breathing on her own.
-是什么导致了麻痹 -我们不知道
- What's causing the paralysis? - We don't know.
好的
Got it.
好了没事的玛丽
All right, it's gonna be okay, Mary.
这个能让你睡着好吗
This is gonna put you to sleep, all right?
没事的
All good.
好的开始准备好了吗
Okay, here we go. Ready?
好的
Yep.
-天啊 -你一直都不相信她
- Oh, my God. - You never believed her.
对不起我不知道
I'm so sorry. I didn't know.
-好了吗 -好了
- Got it? - Got it.
好插管成功
All right, the tube's in.
-她暂时稳定了 -暂时
- She's stable, for now. - For now?
你是说她可能会恶化吗
You-you mean she could get worse?
我们会尽力想办法
Not if we can help it.
我先在胃底开一个切口
I'll begin with an incision in the gastric fundus.
10号♥刀
10-blade.
有没有硬闯皇家舞会的诀窍
Got any tips on crashing a royal ball?
别闯
Don't.
视频来电
娜丁·苏埃马特
我知道我迟到了
Hey. I know. I'm late.
对不起娜丁
I'm sorry, Nadine.
-我的病人需要我 -我明白
- My patient needed me. - I understand.
只是
It's just...
客人陆续来了
people are starting to arrive.
按照传统你应该在我身边
Traditionally, you'd be by my side.
我会尽快赶到那里
I will be there as soon as I can.
我向你保证这个手术很简单
Look, I promise you, this is a straightforward procedure.
-我很快就能过去 -什么鬼
- I'll be out of here in no time. - What the hell?
这是
Is that...?
一个巨大的胃形毛团
A giant, stomach-shaped hairball.
娜丁我得挂了
Nadine, I have to go.
你还好吧
You good?
我觉得我嘴里有头发
I think I got hair in my mouth.
我以前听说过
I've heard about this before,
但我从来没见过这么严重的食毛症
but I've never seen such a severe case of trichophagia.
吉玛在吃自己的毛发
Gemma's eating her own hair?
这就可以解释为什么她没有眉毛了
That would explain the no eyebrows.
这个梗阻这么大
An obstruction this big,
她吃的不仅仅是眉毛
she's been eating more than just her eyebrows.
而且这还没完
And that's not all of it.
一定有一整条
There must be a-a tail.
从胃部开始延伸穿过幽门
Extends from the gastric body, beyond the pylorus,
直到十二指肠
into the duodenum.
-这是长发公主综合症 -看来是的
- It's Rapunzel syndrome. - Yeah, it appears so.
我们得把缠绕在肠道里的毛发解开
We have to untangle the hair that has wound itself
才能把它们取出来
through the intestines to extract it.
对还要修复肠道里的所有损伤
Yes, repairing whatever damage we need to along the way.
听起来很复杂
Sounds complex.
你应该打电♥话♥告诉你的公主
You should call your princess and let her know.
这手术要花不少时间
This is gonna take a while.
窦性心动过缓骤停增加
Sinus bradycardia with increasing pauses,
最长五秒
up to five seconds.
化验结果没问题
Labs are pristine.
脊椎穿刺结果呈阴性
The spinal tap came back negative.
影像上什么都没有
Nothing on imaging.
但她的麻痹发展得太快了
But her paralysis is moving so fast.
她可能会窦性停搏
She could go into sinus arrest.
把除颤仪给她贴上以防万一
Let's put the pads on her, just in case.
把急救车推到床边准备好
Let's keep the crash cart bedside, ready to go.
这根本不合理
This doesn't make any sense.
她来的时候症状还不明确
When she came here, her symptoms were so vague.
呼吸衰竭然后
Respiratory failure and...
现在心脏也不行了
and now her heart.
-我们肯定漏掉了什么 -嗯
- We're missing something. - Mm-hmm.
只是血氧感测太敏感了
It's just the pulse ox. It's been finicky.
指甲油有时候也会导致
Nail polish can sometimes prevent the pulse ox
血氧感测读数不准
from giving an accurate reading.
等等
Wait.
米氏线
Mees' lines.
有时会在化疗或肾衰竭病人身上出现
Sometimes found in chemotherapy patients or ones in renal failure.
或是接触重金属的病人
Or when exposed to heavy metals.
玛丽的血检结果出来了
Mary's blood levels are back.
她体内的重金属是铊
The heavy metal in her blood is thallium.
-什么 -好消息是
- What? - Good news is,
服用普鲁士蓝[亚铁氰化铁] 配合透析治疗
with some Prussian blue and dialysis,
-我们可以治好她 -坏消息是
- we can treat her. - The bad news is
铊元素在自然界中含量极低
thallium is not a naturally occurring element.
可能是有人故意让她接触的
Someone could be giving it to her intentionally.
有人给玛丽下毒
Someone's poisoning Mary?
谁
Uh, who?
一个不仅有渠道
Someone with access and...
还能接近玛丽的人
proximity.
苏珊的丈夫心里装的全是
Susan married a man who's way more invested
自己的亲生女儿
in his daughter than he is her.
也许她不能忍♥受了
So maybe she couldn't take it?
她确实希望玛丽离开家
She does want her out of the house.
铊在美国是非法的