驻院医生

The Resident S04E03

Part 6 May 30, 2021, 7:59 a.m.

And would it come at a certain time of year?
你这么一说是的
Now that you mention it, yeah.
在冬天
In the winter.
紫癜性病变
Purpuric lesions.
肾衰竭发热
Renal failure. Fever.
再加上她被诊断为类风湿性关节炎
Combine that with her diagnosis of rheumatoid arthritis...
伊娃你得了冷沉球蛋白血症
Eva, you have a condition called cryoglobulinemia.
很罕见而且会被误诊为类风湿性关节炎
It's rare and can be mistaken for rheumatoid arthritis.
所以你的药没用
And it's why your meds never helped.
并且你总是讨厌寒冷
And why you always hated the cold.
冷沉球蛋白是血液中的蛋白质
Cryoglobulins are proteins in your blood.
它们在寒冷的时候凝结成块
They clump together during the cold,
堵在你的血管里
get trapped in your blood vessels,
就像堵车
like a-- like a traffic jam.
为什么我现在病得这么重
And why am I so sick now?
事故发生时外面很冷
It was cold outside during the accident
-而你没有保暖 -而护士
- and you weren't kept warm. - And the nurse
把你房♥间的温度调低
turned the temperature down in your room
因为你发烧
because of your fever.
这种皮疹实际上叫做「紫癜」
And this rash is-- it's actually called "Purpura."
这是由于冷沉球蛋白凝结
And it's due to the cryoglobulins clumping
在你皮肤的血管里
in the vessels in your skin.
而它们同样也会凝结在你的大脑血管里
And they're doing the same thing in your brain,
所以你才有轻微中风
which is why you had a mild stroke.
但是现在我们可以治愈你
But now we can treat you.
我们马上把血样
We're just gonna get this blood
送去化验室确认一下
to the lab, confirm it.
我们马上回来
We'll be right back.
谁让你们不等我来就开始的
Who told you to start without me?
我们总是不等凯恩医生所以
We always start without Dr. Cain, so...
这是我的手术室在我的手术室里
Well, this is my OR. And in my OR,
住院医生绝不在无人指导的情况下开刀
residents never cut unsupervised.
你们应该等我
You should have waited.
让开
Step aside.
氧饱和度和血压正在下降
O2 sats and BP are falling.
-你到底做了什么 -我们才刚开始
- What the hell did you do? - We just started
开刀一切都很顺利
the dissection. It was going perfectly.
现在的情况恰好相反
Well, this situation says otherwise.
你切的太深了刺穿了凯恩的胸膜腔
You went too deep and punctured Cain's pleural cavity.
我们需要胸科医生呼叫奥斯汀医生
We need thoracic. Page Dr. Austin.
我仍然不能控制出血
I still don't have source control.
启动大规模输血方案
Activate massive transfusion protocol.
-把摄像机弄出去 -继续拍摄
- Get the cameras out of here. - Just keep rolling.
-不要停止拍摄 -我们能处理
- Don't stop shooting. - We got this.
转为开腹
Converting to open.
按住肝脏
Hold down on the liver.
接下来呢
What next?
肝部分切除术
Partial hepatectomy.
切除他的部分肝脏会导致更多的出血
Resecting a part of his liver could cause more bleeding.
他的血容量已经少了一半
He's already lost half his volume.
他不能再失去更多了
He can't afford to lose more.
我们必须冒险并且我们必须做到完美
It's a risk we have to take, and we've got to be perfect.
牵开器
Retractors.
吻合器蓝色钉舱
Stapler. Blue load.
就在那里
There it is.
-肝静脉出血 -给我直角止血钳
- Hepatic vein bleeding. - Right angle to me.
再吻合一次蓝色钉舱
One more staple. Blue load.
结扎静脉
Ligating the vein.
出血止住了
Bleeding stopped.
打电♥话♥到血库再多要些血
Call down to the blood bank for more blood products.
吸力加大
More suction.
好了姬特交给我吧
All right, Kit, lay it on me.
张力性气胸
Tension pneumothorax.
我们实施了减压但现在他需要一根胸管
We decompressed it, but now he needs a chest tube
以及静脉修复
and a vessel repair.
你们哪个新手刺穿了凯恩的肺
Which one of you neophytes punctured Cain's lung?
我需要一个胸管手术刀
I need a chest tube. Scalpel.
-视野怎么样 -好多了
- How's the view? - Better.
我发现了出血点
I found the bleeder.
好吧通常这时候
All right, normally, this is
他应该稳定下来了
the part of the story where he stabilizes.
那他为什么没有呢
Then why the hell hasn't he?
这是哪比克拉姆重症监护室吗
What is this, Bikram ICU?
对我来说都好热
It's hot in here, even for me.
我们得给你保暖然后这台机器
Well, we have to keep you warm so this machine
可以去除你血液中的异常蛋白质
can remove the abnormal protein from your blood.
你会完全康复的
You're gonna make a full recovery.
现在你得到了正确的诊断
And now that you have a proper diagnosis,
你会觉得比之前好多了
you're gonna feel better than ever.
谢谢你
Thank you.
-嗨 -嘿
- Hi. - Hey.
所以从1到10的范围
So, on a scale from one to ten,
你有多心烦或者生气
how, um, upset/angry are you?
此时此刻我只是很高兴你没事
At the moment, I'm just glad you're okay.
我欠你一个详细的解释然后
I owe you a long explanation and...
我真的很想你
I really missed you.
我想我也有点想你
I guess I thought about you a little bit, too.
伊娃
Eva...
我找到了一份我讨厌的工作
I got a job that I hate
还有一只我喜欢的特种斗牛犬
and a special-needs bulldog that I love.
如果我们这次和你一起去会不会很疯狂
Would it be crazy if we came with you this time?
达伦这个
Darren, this...
这不能是你冲动之下做出的决定
isn't a decision you make in a moment.
相信我
Trust me.
我都经历过了你得认真决定
I've lived it. You have to be sure.
我也希望我们重新在一起
I would love for us to be together again,
但是你做不到我也可以理解
but I understand if you can't do this.
别想劝我放手
Don't try to talk me out of it.
我是认真的
I'm sure.
那是麦克劳德先生的女儿
That's Mr. McCloud's daughter.
他去世前给她打了电♥话♥
He called her before he died,
但她来得太迟了
but she came too late to see him.
-谢了 -没事
- Thanks. - Yeah.
嗨我是普瓦什医生
Hi, I'm Dr. Pravesh.
是你父亲的医生
I treated your father.
我
I'm...
我很遗憾
I'm sorry.
如果能安慰到你的话他走得很安详
If it helps, he wasn't in any pain.
我想见他一面的
I wanted to see him.
已经过去太久了
It had been too long.
我还以为总有机会
I thought there was time.
至少他打给我了
At least he called me.
我们应该说几句话的
We got to talk for a bit.
我应该道歉的
I got to apologize.
他他能联♥系♥到你我很欣慰
I'm s... I'm so glad he reached you.
我也很感激你
And I'm so grateful to you.
他说是你劝他打电♥话♥的
He said you convinced him to call.
我们总以为时间还多日子还长然后
We always think there's so much more time, and then...
意外就会发生
something happens out of the blue.
请节哀顺变
I'm so sorry for your loss.
我会请心理疏导顾问来和你聊聊
I'll send one of our counselors to come talk to you.
谢谢
Thank you.
如你所见医学是难以预测的
Well, as you've seen, medicine is unpredictable.
无论你准备得多么充分
No matter how much you prepare,
都会遇到意想不到的病例
the human body is full of surprises.
你感觉如何
How you feeling?
温暖舒服有点想抱抱你
Warm. Tingly. Like I could hug you.
这可能是止痛药的作用
Well, that could be the pain meds.
你的账号♥是什么
What's your handle?
推特
For Twitter.
-Ins -我