驻院医生

The Resident S04E12

Part 3 July 28, 2021, 1:03 p.m.

Like this.
没什么比教年轻住院医生重要事务
Nothing more satisfying than teaching the important stuff
更让人心满意足的了
to young residents.
今天不顺
The day isn't going great.
我跟猛禽一起做手术搞砸了
I messed up in the OR with Raptor,
他又朝我吼来着
and he yelled at me, again.
你导致病人死亡了吗
Did you kill someone?
- 没 - 那就甭担心
-No. -Then don't worry about it.
我不喜欢被羞辱
I don't like to be humiliated.
我保证他不是针对你
It wasn't about you, I promise.
他现在压力很大家务事
He's under a lot of pressure right now, a family thing.
相信我他现在这个状态是有原因的
Believe me, he's on a razor's edge for a good reason.
抱歉
I'm sorry.
医院总裁在这儿干嘛呢
So what's the hospital's CEO doing in here, anyway?
今天对我来说也是具有挑战性的一天
Bit of a challenging day on my end, as well.
当你无计可施的时候
The supply room is a known resource
补给室是个好去处
when you're at your wit's end.
安静私密枕头还多
It's quiet, private, lots of pillows.
好了跟我来我给你换个手术室
Come on, come with me. I'll get you into another OR.
奥斯丁医生可不是切斯汀唯一优秀的外科医生
Dr. Austin isn't the only fine surgeon at Chastain.
沃斯医生
Dr. Voss?
有机会的话我想和您一起工作
I would love to work with you sometime.
只要我没被炒鱿鱼会有机会的
Well, if my ass isn't fired shortly, we'll arrange it.
来吧
Come on.
嘿辛迪怎么了你呼我
Hey, Cindy. What happened? You paged?
她体温升高 37度8
She has an elevated temp. 100.1.
- 而且心动过速 - 对的
-And she's tachy. -Yeah.
嘿萝丝
Hey, Rose?
现在感觉怎么样
Can you tell me how you're feeling?
累有点热
Tired, a little hot.
给她打一克醋氨酚
Let's give her a gram of acetaminophen
和一升乳酸林格氏液
and bolus her a liter of lactated ringers.
好的
Okay.
哪儿都不疼
It doesn't hurt anywhere.
不像之前能感觉到疼
It's not like a pain I've felt before.
但我并不舒服
But I don't feel good.
不会是基因疗法的原因吧
It couldn't be the gene therapy, could it?
目前还不清楚
I don't know yet.
我们会给你输液再订一套血液培养液
We'll give you some fluid and order a set of blood cultures.
我还以为没什么能吓到我了
I thought there was nothing left that could scare me.
不管发生什么我们都会处理好的
Whatever happens, we'll manage it.
不是那意思
It's not that.
我知道生病是什么样
I know what it is to be sick.
但希望的感觉
But hope?
当我按下那个按钮时
When I pressed that button,
我感受到了希望
it's what I felt.
我已经很久没有这种感觉了
And I haven't felt that in so long.
我不想失去它
I don't want to lose it.
65岁男性昏厥腹部创伤
65-year-old male with syncope and blunt abdominal trauma.
好的把他送到二号♥室
IRVING: All right, let's put him in Bay Two.
血压90/50 心跳130 心律不齐
BP 90/50, heart rate 130 and irregular.
血氧饱和度95%
02 sat 95%.
我从椅子上摔下来了那又怎样
PETE: I fell on a chair. So what?
我还以为你俩今天不用看病人呢
I thought you two were spending a day away from sick people.
计划不如变化
Well, best-laid plans...
- 一二三 - 三
-One, two, three. -Three.
这样不会有好下场的
Nothing good can come of this.
说什么来着
- -Told you.
我会安排心电图和实验室检查
I'll order an EKG and labs.
湿啰音升到中段
Crackles halfway up.
- 立刻做X光检测 - 好的
-I need an X-ray stat. -Yeah.
- 也许需要插管 - 好的
-And I might have to intubate. -Okay.
皮特
- -CONRAD: Pete,
这说明有问题我们得治好它
this isn't good, and we have to fix it.
右上部轻压有疼痛感反馈
Tenderness and guarding in the right upper quadrant.
糟了自♥由♥流体
Damn it. Free fluid.
他脱离监控期间擅自服用了血液稀释剂
He's on blood thinners that weren't being monitored.
导致现在腹腔出血不止
And now he's bleeding into his abdomen.
威利医生已经带了三名住院医了
Dr. Wylie already has three residents.
对我告诉过你我不想干这活
BILLIE: Yep. And I told you I didn't want the gig.
我需要你也只有你能陪我练垒球
I need you and only you, for a softball.
带上动脉瘤夹 7号♥手术室 15分钟后
Aneurysm clip, OR 7, in 15 minutes.
威利医生
Dr. Wylie?
我不参加了
I'm gonna have to pass.
凯恩医生要我过去
Dr. Cain has requested me.
嘿萝丝怎么样了
Hey. What's going on with Rose?
体温上升
Elevated temps.
心动过速
She's tachycardic.
血压下降
Her blood pressure is dropping.
我叫了肿瘤医生来会诊
I called in her oncologist to examine her.
- 情况如何 - 药物起作用了
-How is she? -Responding to fluids.
暂时稳定
Stable for now.
如果这是细胞源发性
If this is a systemic inflammatory reaction
全身炎症反应我们会帮她顶过去
from the cells, we support her through it,
她很快就会好起来
and she should improve soon.
好的我会密切关注她
Okay. I'll keep an eye on her.
好我得去看别的病人了
Okay, I have to see another patient,
如有任何变化都告诉我
but tell me if anything changes.
谢谢
Thank you.
伊如果你不坐下
Yee, if you don't sit down...
你的癌症越来越严重
Your cancer is getting worse.
等下一步治疗方案一出来我就坐
When we know the next steps, I'll sit.
- 那之前 - 你♥爸♥冷静不下来
-So, until then... -Your father has zero chill.
- 看得出来 - 现在
-Tell me about it. -And at the moment,
我也无能为力
-mine is in limited supply, too. -
你好卡罗尔伊很高兴见到你们
Hello, Carol. Yee. Lovely to see you.
奥立佛医生不用客套了
Okay, Dr. Oliver, we can dispense with the niceties.
- 有人都要死了 - 没错
-We're dying here. -Literally.
- 卡罗尔 - 我长话短说
-Carol. -OLIVER: This will be short
是好消息
and very sweet.
很高兴的告诉各位
I am happy to say
卡罗尔因癌症突变
that Carol's cancer has a mutation
使她有资格接受靶向治疗
that qualifies her for targeted therapy.
谢谢
Thank you.
听到了吗妈
AUSTIN: You hear that, Ma?
太不可思议了
This is incredible.
传统的化疗手段较之前已经改进许多
Conventional chemo is better than it used to be,
但仍是个钝器
but it's still a blunt tool.
靶向治疗方式正如其名
Targeted therapy is exactly what the name says.
只攻击癌症细胞内协助其
It attacks only the changes in the cancer cells
生长扩散的那部分且不伤害正常细胞
that help it grow and spread while sparing your normal cells.
对我而言意味着什么
And what does this mean for me?
我知道这并不代表治愈但
I mean, I know it's not a cure, but...
你仍会处于癌症四期
OLIVER: You still have stage IV cancer,
但我们在争取时间
but we are buying time.
癌症终会复发
The cancer will eventually come back,
但届时可能就会有新的更好的治疗方案
but by then, we could have new and even better treatments.
妈妈
Mom.
妈妈这是好事
Mom, this is great news.
CT结果显示肝脏三♥级♥缺血
So, the CT you ordered showed a grade III liver lac.
- 他最近的血红蛋白数值是多少 - 12.2
-What's his most recent hemoglobin? -NIC: 12.2.
第二份检测结果应该很快就出来了
The second one should be back any minute.
你知道他昏倒的原因吗
Any guesses why he passed out in the first place?
- 不知道太突然了 - 不合理
-No idea. It was so abrupt. -BELL: Doesn't make sense.
是什么导致了呼吸衰竭
So, what accounts for the respiratory failure?
也不知道
It's all a mystery.
心电图和超声波
His EKG and echo show evidence
显示他右侧心脏劳损导致严重的肺动脉高压
of severe pulmonary hypertension with right-sided heart strain,
但那是一年前的片子了
and that's all new from a year ago.
我们之前以为是肺栓塞
We thought it could be a P.E.,
但他一直服用血液稀释剂