驻院医生

The Resident S04E06

Part 5 May 30, 2021, 8 a.m.

给胎儿输血
A fetal blood transfusion?
很有风险但也是唯一的选择
It-It's risky, and it's our only option.
-为了孩子吗 -对我们必须得去做
- For the baby? - Yeah, but we have to do it.
否则孩子就保不住
The alternative is we lose her.
按照嘉比说的
Based on what Gabbi's told me,
我认为最好让你进入麻醉状态
I think it's best we put you under anesthesia.
如果你清醒着就能看见整个过程
If you're awake, you'll see it all.
而且如果稍有退缩
And if you flinch,
针头就可能扎到脐带
the needle could hit the umbilical cord.
我是个护士我不会退缩
I'm a nurse, I won't flinch.
但要是我醒来孩子不在了
But what if I wake up and our baby's gone
我却没有陪她最后一程
and I wasn't there for her?
好
Okay.
那就保持清醒
Then stay awake.
但醒着也没什么好处
But there's no upside to being awake.
不论对妮珂还是孩子且医学上没理由
Not for Nic, not for the baby, and no reason, medically,
让她受这些苦
to put her through it.
还是有个很大的理由
Well, there's one giant reason.
她想保持清醒
She might want to be awake.
谢谢你提醒比莉
Well, thank you for that, Billie.
好了告诉你我
Okay, you know what? I just...
拜托我都没法思考了
I can't even hear myself think. Please.
妮珂我们必须想清楚然后达成一致
Nic, we will sort this out and get back on the same page.
别有压力比莉能聊聊吗
Don't stress. Billie, you got a minute?
妮珂两周前被刺了
Nic was stabbed two weeks ago,
你觉得她应该眼看着往她子♥宫♥里扎针吗
and you think she needs to watch a needle penetrate her womb?
-我的想法是 -你不是她的主治医生
- What I think is... - You're not her doctor,
也不是她丈夫
you're not her husband.
你就是自以为是要做决定
This is about you being important and making the call,
而且这个决定是错的你一点没变
and the call is wrong. You haven't changed.
-但我 -没有但是
- But I... - No buts.
你该走了
You need to leave now.
实验失败了你走吧我没开玩笑
This experiment failed. Go. I'm not asking.
普瓦什
Pravesh.
什么情况
What is this?
他没有床位
He's not taking up a bed.
你真聪明但你正在给一个出院病人
I applaud the ingenuity, but you're performing a procedure
做手术呢
on a discharged patient.
他可能有正常颅压性脑积水
He might have normal pressure hydrocephalus.
如果真是这样手术能救他的命
If so, this procedure can cure him.
我们可以救他的命但我必须完成
We can give him his life back. But I need to complete
-脊椎穿刺 -我懂了不遗余力
- this lumbar puncture. - I get it. No stone unturned.
但你治的是他的烧伤
But you treated his burn.
但现在候诊室还有其他患者
Now what about the other patients
他们怎么办
who are in the waiting room right now?
如果都不能花三十分钟治好一个
What kind of hospital are we if we can't spare 30 minutes
被误诊的病人那我们还算什么医院
that might cure a patient who's been misdiagnosed?
要么给他吃药要么让他预约
Admit him to Medicine or have him make an appointment.
我不会忽视每一个病人
I won't ignore a patient.
我父亲就是这么死的
That's what happened to my father.
他现在像个患自闭症的天才
He looks like Rain Man in there.
可能损伤神经斜放钢板
Could damage a nerve. Put my plate sideways.
神经斜放钢板
Nerve. Put my plate sideways.
还有额外的血管额外的血管
And extra vein. Extra vein,
必须挑出额外的血管
always dissect extra vein.
他在复述一连串可能出错的步骤
He's reciting a litany of things that could go wrong.
所以这就是他的准备过程
So that's his process.
有趣
Interesting.
我们有四个小时连接这些动脉
We have four hours to connect these arteries
让血液注入安迪的新手里
and get blood flowing into Andy's new hands.
时间一长这双新手也就废了
Any longer, and this beautiful gift will be wasted.
准备好标记正中和尺侧
Ready to tag the median and ulnar.
随时可以开始
Raring to go.
没问题而且你速度把握得不错
I like that. And you're working at a good pace.
你也是谢谢你让我参与
So are you. Thank you for letting me
这只惯用手的移植
join you on the dominant hand.
购置材料的人没有
The damn procurement team did not
把这个裁到合适的长度
cut this one down to the right length.
好眼力
Good catch.
-太长了 -对啊
- It's too long. - Yeah.
根据我的经验再小的差距也至关重要
In my experience, even a small length issue matters.
这双手要和他一起长大
These hands will grow with him.
我可以快速测量这些钢板的长度
I can work fast to line these up properly.
好的我们要做到完美
Do it. We want this to be perfect.
好让我们来把这些指套切割到位来吧
All right. Let's cut these mittens down to size, shall we?
请进
Come in.
我来是因为董事会忽略了一个人
I'm here because the board overlooked someone
她可能是首席执行官最好的人选
who may be the best choice for CEO.
沃斯医生
Dr. Voss.
这是一个很棒的选择
That's an inspired choice.
-是时候了 -晚做总比不做强
- It's about time. - Better late than never.
姬特闯入我们的会议之后
After Kit charged into our meeting,
我们才意识到我们不需要一个保守的CEO
it became clear we don't want a safe choice for CEO.
而需要要一个大胆的开拓者
We want someone bold, trailblazing.
明天之前查斯汀要换一个新领袖
And Chastain needs a new leader by end of day.
这场手术才刚开始
Well, this operation is just getting started.
-他们整晚都出不来 -我知道
- They'll be here all night. - I know.
这场手术就是她的面试
The operation is her interview.
所以我也会整晚在这里观察
So I will be here watching it all night as well.
可以开始了
Safe to proceed.
观察脐带血管
Visualizing the umbilical vein.
给胎儿注射镇静麻醉剂
I'm going to inject the fetus with a sedative and paralytic.
不用害怕她停止活动这才是目的
Don't be alarmed when she stops moving around. That's the goal.
准备进行输血
Ready to start the transfusion.
天哪
Damn it.
-怎么了 -胎儿的心脏出现了问题
- What is it? - The baby's heart's having trouble.
输血过量胎儿的血液循环承受不住
The blood might be too much for the fetal circulation.
心率会降下来的等一等
Her heart rate's gonna bounce back. Give it a moment.
不能再给胎儿输血了
We can't give the baby any more blood.
胎儿心率正在下降
Baby's bradying down.
也许是脐带痉挛
Might be a spasm of the cord.
把她移到左侧改善子♥宫♥灌注
Let's get her on her left side to improve uterine perfusion.
听我口令一二三
On my count. One, two, three.
需要一升静脉输液
Need a liter of IV fluid.
还在下降
Baby's still bradying down.
真是个小战士
There's your little warrior.
康莱德孩子还处于麻痹状态
Conrad, the baby's still paralyzed.
希望输的血足够了
We hope the blood will be enough.
但麻药消退之前我们无法确定
But until the drugs wear off, we won't know for sure
孩子能不能保住
if she's okay or if Nic's miscarried.
没有出血液体是清澈透明的
No blood. Crystal-clear fluid.
这是什么意思
What does that mean?
没有明显感染迹象
No obvious signs of infection.
我们也称之为开香槟
This is what we call a champagne tap.
什么时候可以知道结果
When will we know if it worked?
很快脑脊液已经取得差不多了
Soon. We've taken out enough spinal fluid
看他是否会好转
to see if he gets better.
好的诺曼保持不动
Okay, Norman, you hold still, okay?
我要把针拔♥出♥来♥了
I'm gonna pull out this needle.
好了亲爱的结束了
Okay, dear, it's done.
你感觉怎么样
Okay. How do you feel?
啊感觉
Uh... I feel...
-不错 -是吗
- okay. - Yeah?
不如走几步试一下
Why don't you walk for us.
来
Here.
查斯汀公园纪念医院
对您伸出援助之手
我们在乎每个生命
卡兹夫人你想跳一曲华尔兹吗
Mrs. Katz, would you like to go waltzing?
慢慢来亲爱的
Baby steps, dear.
真不可思议谢谢你
This is incredible. Thank you.
所以医生我我真的会好起来了吗