驻院医生

The Resident S04E07

Part 3 May 30, 2021, 8 a.m.

我宁愿一瘸一拐地活着也不想死于
I'd rather limp and be alive than die sooner
一场手术
because of a surgery.
你的髋骨快不行了
Your hip is about shot.
我想今天就做手术
I want to do it today
因为现在你状态相对好些
because it's best that we take advantage
我们要把握这个窗口期
of this window while you're relatively well.
而且在镰状细胞危象时
Because during a sickle cell crisis,
有极高的可能出现
there would be such a high possibility
致命的血管堵塞
of a fatal blood vessel blockage
那时手术会更加危险
that a surgery would be even more dangerous.
所以罗斯让我帮助你吧
So, Rose, let me help you.
我们会竭尽全力保证你的安全
We will do everything we can to keep you safe.
我保证
That's a promise.
好了一♥期♥缝合就位
All right, first suture's in place.
进入缝合圈
Threading through the suture ring.
血压轻微下降
Slight drop in pressure.
-血容量减少 -继续输血
- Blood volume decreasing. - Keep transfusing.
一定程度的失血是常见的
Some blood loss is not atypical.
电♥话♥找奥斯汀医生
The call was for Dr. Austin.
腹部外伤伴血胸
Incoming abdominal trauma with hemothorax.
霍金斯医生亲自找你
Dr. Hawkins is requesting you personally.
康莱德很少这样
Conrad seldom does this.
这个患者一定很特殊
Whoever the patient is must be special.
所以我必须要去
Which is why I have to go.
不过这边进展不错我要出去一下
But we're fine here. I'll step out for a minute,
处理好那位病患就回来
take care of this trauma and I'll be back the moment I'm done.
出了什么事他们会问责主治医师
Anything goes wrong, they'll blame the attending.
米娜你没问题的
Mina, you got this.
男性 38岁胸腹部贯穿伤
38-year-old male with penetrating injuries to the chest and abdomen.
接诊时低血压
Initially hypotensive.
血氧饱和度急降现场插入胸管
O2 sat falling despite chest tube placed in the field.
我很久没有这么疼了
It's been a long time since I felt pain like that.
还能说话说明呼吸道通畅
You're talking, so airway's intact.
需要两个单位的O型血
We need to get two units of O-neg running.
需要一个可移♥动♥胸片尽快
We need a portable chest X-ray ASAP!
听我口令一二三
On my count. One, two, three.
胸腔积液
Hemothorax?
从左胸抽出了约750毫升积液
Drained about 750cc's in the left chest.
横膈膜可能有撕裂
It was likely a rupture to his diaphragm.
这血太多了
That's more blood than we'd like.
我得带他去手术室
I need to get him to the OR.
他的体征稳定先去做个CT吗
His vitals are stable. Stop by CT first?
好我们去做X光然后给他固定好
Yeah. We'll get X-ray then we'll pack him.
-我去通知手术室 -谢谢
- I'll let OR know we're coming. - Thank you.
你回来了
You made it.
怎么样
What's going on?
他目前体征稳定
Uh, he's stable at the moment.
我在等胸片
I'm just waiting on the chest X-ray.
好吧
Okay.
我想看看插管情况
I want to see the tube placement.
-这不太对 -除了胸管
- This can't be right. - Apart from the chest tube
和肋骨骨折看上去没问题
and a few broken ribs, looks clear to me.
说说哪里不对
Talk to me. What's wrong?
内特的胸片不该是这样的
Nate's chest, it shouldn't be clear.
-为什么 -他脊柱旁边应该有颗子弹
- Why? - There should be a bullet next to his spine and...
-但是没有 -好吧那你觉得子弹
- there isn't. - Okay, so, the bullet that you're talking about,
可能转移到其他部位了吗
you think it migrated to another place in his body?
对我得帮他们找到
Yeah, and I need to help them find it
因为内特为了救我中了枪
'cause Nate got shot saving my life.
我和内特在桑金谷
Nate and I were approaching a target
接近一个目标时
in the Sangin Valley.
被伏击了
We got ambushed.
寻找掩护
Take cover!
我们被包围了
They got us surrounded!
内特命令我们撤退
Nate ordered us to pull back.
侧翼包抄
Flank up!
但是
But...
我以为在前面的路上中枪的一名
I thought one of our Marines who got shot up
我方海军队员还活着所以
on the road ahead was still alive, so...
霍金斯留在原地这是命令
Hawkins, stay put! That's an order!
后退后退
Fall back! Fall back!
我想办法到了路上
I made my way up the road, I get there,
但是他死了
and he's dead.
我开始往回走回到队伍里
I start to head back, to regroup with my company.
但是我被突如其来的火箭炮袭击了
But I get blindsided by an RPG.
我的肩膀脱臼了膝盖骨折了
I had a dislocated shoulder, broken knee,
脖子上有弹片
shrapnel in my neck.
我以为就要死在那了
Figured this was it.
然后内特来了
And then Nate showed up.
救了我的命
Saved my life.
就是那时他的胸部中了三枪
That's when he, that's when he caught three in his chest.
但他继续走直到我们两个都回到掩体
But he kept going, made sure we both got to cover.
医生取出了两枚子弹
Doctors got two of the bullets out,
但是第三枚卡在了他的脊柱旁边
but the third was lodged near his spine
取出的风险太大
and it was too dangerous to remove.
子弹对他影响不大所以他们就没取
It wasn't giving him any trouble, so they left it there.
而现在子弹不见了
And now it's gone.
这么多年你竟然一直把这件事藏在心里
I can't believe you kept this to yourself all these years.
那是我不太光彩的时刻
It wasn't my proudest moment.
我违抗命令并且差点导致我的
I disobeyed an order and it nearly cost my commander
指挥官兼朋友丧命
and friend his life.
我很
I was...
羞愧
ashamed.
你只是在履行你的职责
You were just doing your job,
而内特回来救你也是
and so was Nate when he came back for you.
小时候我妈曾经让我练习刺绣
When I was a kid, my mom used to make me practice needlepoint.
我觉得特别烦然后跟她说
And I would get so annoyed and I would tell her
现实生活中没有人再用这个技能了
that nobody uses that skill in the real world.
我今晚要给她打电♥话♥
I'm gonna call her tonight
寻求她的原谅
and I'm gonna beg for her forgiveness.
这比刺绣难上千倍
Well, this is needlepoint times a thousand.
如果四十针不能完美协调
If all 40 sutures aren't perfectly placed,
心脏瓣膜就不能吻合
the valve won't fit
心肌就会裂开我们就得重新开始
or the heart muscle will rip, and we start over.
好了
Okay.
BGM: DYING 4 YOUR LOVE by Snoh Aalegra
♪ 'Cause I was dyin' ♪
♪ For this love, this love ♪
♪ Yeah, I was dyin' for your love, your love... ♪
完美吻合
Perfect fit.
在我准备好植入下一个瓣膜时
Now, by the time I'm ready to insert the next valve,
奥斯汀就该回来了
Austin should be here.
事实是他来不了
Actually, he won't.
刚才是奥斯汀医生的电♥话♥
That was Dr. Austin on the phone.
他处理好了霍金斯医生的病人
He took care of Dr. Hawkins' patient,
但是刚来了一个主动脉破裂的病人
but an aortic rupture just came in.
他想让我继续一个人
He wants me to keep going.
-完成 -他跟你说
- Alone. - He says to tell you
你对心脏的了解即使不比他更好
that you know this heart just as well,
也和他一样好
if not better than him.
你没问题的
You got this.
那我们继续
Then we keep going.
好的
Okay.
抽吸
Suction.
-发生什么事 -给予一升生理盐水
- What's going on? - Get me a liter of normal saline.
沃斯医生
Dr. Voss?
她心动过速低血压缺氧
She's tachycardic, hypotensive and hypoxic.
她会不会在出血
Could she be bleeding?
之前是的但很少量
She was earlier, but it was minimal
我给她输了一单位的血
and I gave her a unit of blood.
给她吸纯氧然后注射去甲肾上腺素
Let's get her on 100% FIO2 and start norepinephrine.
加油罗斯加油加油加油
Come on, Rose. Come on, come on, come on.