驻院医生

The Resident S03E07

Part 6 Jan. 15, 2020, 10:33 a.m.

- There's too much blood. - Get suction in, damn it.
抽吸
Suction.
天啊不要
Oh, my God. No.
这和康莱德预言的一模一样
This is exactly what Conrad said would happen.
为什么她不凝血
Why isn't she clotting?
兄弟
Hey, man,
我们别无选择
we didn't have a choice anymore.
等得太久她会大脑肿胀而死
When you wait too long, her brain swells and she dies.
不解决凝血障碍就再次手术
You go back in there without correcting her coagulopathy,
她会失血过多而死
she bleeds out.
我的工作就是找出原因
It was my job to figure it out.
或许我们还是可以
Maybe we still can.
我们来确定范围
Let's work on the differential.
齐心协力
Together.
好吧
Okay.
她在出血血流不止
All right, she's bleeding. It won't stop.
为什么
Why?
-那血都去哪了 -在身体里
- And where does the blood go? - Into the body
-或者是在地面上 -现在都没有
- or onto the floor. - In this case, neither.
杰西卡不是在失去血小板
Jessica's not losing platelets.
她的身体在摧毁血小板
Her body is destroying them.
溶血血小板低
Hemolysis, low platelets,
肾功能异常发烧
renal dysfunction, fever.
-一定是血栓性血小板减少性紫癜 -天啊
- It's got to be TTP. - Oh, god.
如果她得了血栓性血小板减少性紫癜
If she has TTP,
她的血小板指数会一直下降
her platelet count will just keep dropping.
她无法凝血
She'll never clot.
这个手术会害死她
This surgery is going to kill her,
是我同意做手术的
and I gave the okay to go ahead with it.
现在我们知道是什么了
Now that we know what it is,
我们就能治疗了
we can treat it.
你要在术中
So you're gonna start plasmapheresis
给她做血浆置换吗
while she's in surgery?
他就是这么打算的
Hell yeah, he is.
赶紧的控制住那个出血点
Move faster. Get that bleeder.
我已经尽快了到处都是出血点
I'm moving as fast as I can. It's oozing everywhere.
继续输血小板
Keep hanging those platelets.
滚出我的手术室
Get out of my OR! Now!
我是外科主任
I'm chief of surgery.
查斯汀的每一台手术都是我的手术
Every OR in Chastain is my OR.
霍金斯留下
Hawkins stays.
怎么了
What's happening?
杰西卡得了血栓性血小板减少性紫癜
Jessica has TTP.
给她再多的血小板也没用
Giving her more platelets won't help.
器械护士别理他
Scrub nurse, ignore him.
-我要你跟我一起做电灼 -你来
- I need you with me on this cautery. - All you.
康莱德我来帮你建立通路
Conrad, I'll get access.
谢谢
Thank you.
你可以等我做完手术在置换血浆
You can do that plasmapheresis when I'm done.
你都不知道你说的对不对
You have no idea even if you're right,
更别提这么做有没有用
let alone if it's gonna help.
好了现在我们可以做电灼了
Okay, now we can cauterize.
现在她有机会了
Now she has a chance.
查斯汀公园纪念医院
每个人都值得最好的
贝尔医生只是想要恭喜你
Dr. Bell, just wanted to congratulate you.
恭喜什么
What for?
听说你今天签了个利润丰厚的合同
Heard you made a very lucrative deal today.
-透析医疗中心 -对
- DiaCure Dialysis Centers. - Yeah.
我们答应只用他们的换来了特♥价♥
They gave us a great price for exclusivity.
我这个新上任的副总裁应该给个赞
That deserves an "attaboy" from the new veep.
这个合同他们给了我们多少好处
What kind of kickback did they offer us for the contract?
我们为了病人安全需要的一些数据
Some data we required for patient safety,
还有他们保证会在资金上帮助我们
and they committed to help us with the money we need
填补护士的人员空缺
to fill out our nursing staff.
这超出你的职权了
Punching above your weight there.
我来决定钱用在哪
I'll make the call on where the money goes.
我想用在神经外科
I'm thinking Neuro.
巴雷特有一长串等着批款的要求
Barrett's got a laundry list of line items.
巴雷特
Barrett?
你跟凯恩医生交情好到直呼其名吗
You on a first-name basis with Dr. Cain?
我们是老交情了他帮我找的这份工作
We go way back. He's the one who got me this job.
把我从西海岸的对冲基金公♥司♥挖来的
Lured me away from a hedge fund on the West Coast.
你没有医疗领域的工作背景
You have no background in health care.
我有谋取利润的工作背景
I have a background... in profits.
这部分获利要用来聘请更多的护士
Well, this profit goes for more nurses.
这是合同的一部分
It's... it's part of the agreement.
不能反悔
It can't be undone.
以后不要再越过我做这样的交易了
No more deals like this again without my input.
我来换敷料
I'm just gonna change the dressing.
好了我们看看情况如何
All right, let's see what we have.
切口处没有太多血
There isn't very much blood around the incision.
开始凝血了
It's starting to clot.
我们再去做一个血常规
We'll get another CBC.
可以再做一个不过这是好消息
Yeah, well, we can send it in, but this is good news.
血浆置换开始起效了
The plasmapheresis is working.
她还是有可能醒不来
She still might not wake up.
而且即便她醒来
And if she does,
我们也不知道她能恢复到什么程度
we have no idea what kind of shape she'll be in.
24小时后我们会知道更多情况
We'll know more in 24 hours.
-爸等一下 -妮珂
- Hey, Dad, wait. - Oh, Nic.
我刚下班
I just finished my shift.
-你有事吗 -听着
- You need something? - Look, um...
谢谢你今天能来
Thanks for being here today.
我喜欢做义工
I love volunteering.
我知道今天早上你听说出了车祸时
I know you were scared that it was me when you heard
害怕出事的是我
about the accident this morning.
我冷落你了
I brushed you off.
对此我很抱歉
I'm sorry I did that.
我只有你了孩子
You're all I got, kid.
我们现在是奈文小队了
We're Team Nevin now.
杰西卡还是没什么变化
Still no change in Jessica.
这是什么
What's this?
透析医疗的记录
DiaCure records.
你拿到了
You got them.
对
Yeah.
比我们想的还要严重
It's worse than we thought.
服用止血素后并发症发病率升高百分之二十
20% higher complication rate with Hemopleatin.
看看这些肺栓塞病例
Look at all these PEs.
很可能就是这个药害死杰西的
This drug is probably what killed Jessie.
我觉得是
I think so.
下一步你想怎么做
What do you think the next step is?
明天我去找贝尔和红岩山医疗谈话
Tomorrow I go in to see Bell and Red Rock,
然后把这个药下架
and get this drug pulled off the shelves.
永久性的
Permanently.
你知道那么做有多危险吗康莱德
You know how dangerous that is, Conrad?
大型制药公♥司♥毫无人性
Big Pharma is ruthless.
他们会拿你开刀的
They could go after you.
他们总是抹黑检举者
They always like to discredit the messenger.
数字不会说谎
The numbers don't lie.
我们要确保杰西的情况
We'll make sure what happened to Jessie
不会发生在别人身上
doesn't happen to anyone else.
她的死可以救别人的命
Her death could save lives.
尽管这件事很可怕但今天让我开窍了
As awful as this is, I learned something today.
我真的爱她
I really love her.
直到发现可能会失去她
I don't think I realized how much
我才意识到这一点
until I thought I might lose her.
如果她醒过来我要告诉她
If she comes back to me, I'll tell her.
醒过来求你了
Please come back to me.
我们都知道你们有多相爱
We all see how much you guys love each other.
我在婚礼上抛弃了普利娅
You know, I beat myself up
对此我很自责