驻院医生

The Resident S03E20

Part 4 June 20, 2020, 5:04 p.m.

I'll be back.
看来你有结果了
You look like you have news.
我们成功了
We have a hit.
太好了
That's great.
不过实验室里成功的方法在病人身上
But what works in the labs can be starkly different to
效果却可能截然不同
what works in a person.
对但这是一次机会姬特
True. But it's a chance, Kit.
是
Yes.
这是机会
Yes, it is.
厉害
Nice.
什么
Excuse me?
他不能放弃
He can't give up.
2004年莎莎舞星球大赛
-这家伙有天赋 -嗯
- The man has a gift. - Mm-hmm.
你发现了什么
What'd you find?
看到没就在他病情恶化到发生室颤前
See? Just before he degenerates into V fib...
先是室速发作
The rhythm started at V tach.
这就是说我们可以采用消融术
Which means we could ablate it.
你觉得消融术能行吗
Do you think it would work?
那要看是谁来操作
In the right hands.
他很幸运他的舞蹈造诣深厚
And luckily, the man's prowess on the dance floor
论娴熟优雅他的舞蹈仅次于我的医术
is second only to my own dexterity and grace.
我猜这就意味着
I assume that means
我该安排他进导管室了
I should get him on the cath lab schedule.
没错我们这就去给他点好消息
Yes. Now let's go give him the good news.
谢谢
Thanks.
你感觉怎么样德瑞克
How are you feeling, Derek?
我身体发热体虚无力
Weak. Really hot.
我的背有点痛
My back hurts a bit.
我怎么了
What's going on?
你发高烧血压有点低
You have a high fever and your blood pressure's a little low.
但我们在给你治疗
but we're working on it.
我们有个方案不过并不轻松
We have a plan, but it is gonna be tough.
我们不是只用一种药物去对抗真菌
Instead of using one drug to fight the fungus,
我们会用一组药物
We are using a combination.
伏立康唑两性霉素
"Voriconazole, amphotericin".
他的肾刚开始恢复
His kidneys are just starting to recover.
我知道
I know.
而且我不能保证这些药会起效
And I can't promise you these drugs will work.
甚至短期内可能会让你感觉更糟糕
They could even make you feel worse in the short-term.
我化疗都挺过来了这次也没问题
I've been through chemo. I can handle this.
好
Okay.
还有件不是很有趣的事
There is one more not particularly fun thing.
我们想直接消灭真菌
W-We want to attack the fungus directly.
所以我们要把药物直接注射进你的眼睛
So we're gonna inject the meds into your eyes.
等等你说什么
Wait, what?
不疼的
It won't hurt.
用这个就不会疼这是麻药
Not with this. It's numbling Medicine.
没事
It's okay.
我准备好了来吧
I'm ready. Do it.
现在你要把蘑菇切块
Now, you're gonna want to chop those mushrooms...
米格尔
Miguel.
我们有希望了
We come with hope.
我和奥卡福医生已经
Dr. Okafor and I have familiarized ourselves
对你心脏的情况了如指掌
with the intimate details of your heart,
我们有个可行方案供你选择
and we'd like to suggest a viable option
能让你重新穿上舞鞋
to return you back to your dancing shoes.
这个方案叫做消融术
It's a procedure called ablation.
我们会用些导管刺穿主动脉血管
We'll thread catheters through the main artery
插入腹股沟静脉血管
and vein in your groin
然后用高温
and then burn away the part of your heart
烧掉导致心跳异常的那部分心脏
that's been causing the abnormal rhythm.
你们说我的心脏衰弱
You tell me my heart is weak.
但还要烧掉一部分来修复它
And you want to fix it by burning bits away.
米格尔
Miguel,
如果手术进行顺利
if this goes as well as expected,
你就不会再出现致命性心律失常
it means no more lethal arrhythmias.
不会再晕倒
No more collapsing.
我们看了一段你跳舞的视频
We saw a video of you dancing.
2004年的锦标赛
2004 championship.
我得第二名的那年吗
The year I came in second?
第一名舞弊
I was cheated, you know.
不管是第一还是第二你都是真正的大♥师♥
Second place, first place, you are a true master.
如果这个治疗方案见效
And if this procedure works,
那么你就可以继续跳舞
it means you can continue dancing,
不再被电击不再担惊受怕
without shocks and without fear.
医生
Doctors...
我的心脏交给你们了
my heart is in your hands.
我需要最不会拖后腿的器械护士
I need the least incompetent scrub nurses.
不要史黛丝她总是掉东西不要那个大嗓门
Not Stacey, she drops things. Not the crier.
让坎迪斯来她我能接受
Get me Candace. I don't mind her.
还有谁可以谁比较靠谱
And someone else. Who doesn't suck?
阿贾克斯很好
AJax is excellent.
他还行让他来
He's passable. Get him.
告诉楚我需要他多备点血
Tell Chu I'll need some extra blood on hand
再去做一组血常规和凝血检测
and send off another set of CBC and coags.
不要给我出现任何意外
I don't want any surprises.
那边疯狂的质量把控是怎么回事
What's with the manic quality control over there?
他对这台手术格外关心
Think he cares more about this one.
四号♥手术室不行
OR Four is not gonna work for me.
我要去五号♥手术室
I need my case in OR Five
在新的神经外科楼
in the new neurosurgery building.
手术室排班表
五号♥手术室好像已经有安排了
Mm, looks like OR Five is taken.
现在没了
Not anymore.
五号♥手术室
硬膜下积脓引流术预定凯恩医生
贾丝廷人不错
Justine seems pretty great.
她对你依然很重要是吧
She still means a lot to you, doesn't she?
没什么人比她更重要
Few people have meant more.
那些药物没有用
So... the drugs aren't working.
去甲肾上腺素已经上调到十二单位了
Norepi is up to 12 mics.
他的尿量在减少
His urine output is trailing off.
已经输完液了吗
The fluid has gone in already?
-全部四升 -化验结果怎么样
- All four liters. - Anything on the labs?
酸中毒加重乳酸上升
Worsening acidosis. Increased lactate.
-是感染性休克 -没错
- He's in septic shock. - Yeah.
德瑞克
Derek...
我是霍金斯医生能听到我说话吗
it's Dr. Hawkins. Can you hear me?
发生了什么
What is... going on?
他神志越来越不清楚
His delirium is worsening.
我们可能需要为他重新插管
We may need to re-intubate him.
谢谢
Thanks.
我忍♥不住在想如果凯恩医生没有来查斯汀
I can't stop thinking, if Cain had never come to Chastain,
德瑞克就不会是现在这个样子
Derek wouldn't be in this situation.
红岩山毁了我爱的一切
Red Rock is destroying everything I love.
如果可以的话我会把它付之一炬
I would burn it all down, if I could.
你去休息吧姬特呼吸一下新鲜空气
Take a break, Kit. Get some air.
我会陪着德瑞克的
I'm gonna stay with Derek.
造影完成
Mapping complete.
快速诱导
Rapid pace to induce.
-给除颤仪充电 -不别动
- Charge the defibrillator. - No, stop.
他现在心率过速血压也不稳定
He's in V tach with an unstable pressure.
在我们消融时我们希望他心率过速
We want him in V tach while we ablate.
我知道但是他的血压只有50而且还在下降
I know, but his pressure's 50 and dropping.
-他还能撑多久 -直到我说完事了
- How long can he tolerate this? - Until I say so.
现在不是你慌乱的时候奥卡福
Now is not the time to lose your cool, Okafor.
我一点也不慌乱
Hmm. My cool is intact.
很好
Excellent.
开启消融电流
Ablation current on.
关闭
Off.
血压降到40了
Pressure's down to 40.
开启电流