时间 | 英文 | 中文 |
---|---|---|
[00:08] | 加夫尼芝加哥医院 医院大门 | |
[00:13] | I asked you to plant one bug then walk away. | 我就让你放一个窃听器后就别管了 |
[00:16] | But no, you couldn’t do that. | 但你都做不到 |
[00:17] | Hell, you don’t seem to get it. | 你怎么就不明白呢 |
[00:18] | As a physician, I have a responsibility– | 作为医生 我的职责是… |
[00:20] | I’m so tired of hearing that. | 这话我听腻了 |
[00:22] | After the MRI fiasco, Ray Burke said | 在核磁共振的闹剧之后 雷·伯克 |
[00:24] | he was done with you and still you called him. | 让你别再找他 但你还是给他打电话了 |
[00:26] | Well, I need to speak to him about his MRI results. | 我得和他谈谈他的核磁共振结果 |
[00:29] | I’m concerned. | 我很担心 |
[00:30] | Concerned how? | 担心什么 |
[00:32] | There are some subdural hematomas | 他的两侧颈动脉都有些 |
[00:34] | and plaques in both his carotids. | 硬膜下血肿和血小板 |
[00:37] | It could mean he’s at risk for a stroke. | 说明他有可能中风 |
[00:38] | Could? | 可能 |
[00:39] | I can’t make a diagnosis without more of a work-up. | 没有更细致的检查 我无法下结论 |
[00:41] | That case, there’s nothing to report to Ray about. | 这样的话 你无需向雷交代什么 |
[00:44] | We could have nailed that scumbag a week ago | 如果不是因为你搞砸了 我们一周前 |
[00:46] | if you hadn’t screwed things up. | 就能逮捕这个人渣 |
[00:48] | No more calls. | 别再打电话了 |
[00:49] | I can’t just walk away. | 我不能袖手旁观 |
[00:51] | You can and you will. | 你可以 你也会这么做 |
[00:54] | It’s over, Dr. Halstead. | 结束了 霍斯特德医生 |
[00:56] | Hey, you made this mess when you took Ray’s kickback. | 你拿雷的回扣时 就铸成了大错 |
[01:00] | This is on you. | 都怪你 |
[01:06] | Will, who was that woman? | 威尔 那个女人是谁 |
[01:08] | Oh, just a drug rep. | 一个医药代表 |
[01:10] | They just won’t leave me alone. | 他们不停地来烦我 |
[01:12] | Really? I’ve never seen her before. | 是吗 我从没见过她 |
[01:13] | So, listen, the DJ texted me. | 听着 DJ给我发信息了 |
[01:16] | The wedding’s only three weeks away. | 三周后就要举行婚礼了 |
[01:17] | We haven’t given him a song list. | 我们还没把歌单给他 |
[01:18] | What was she pushing? | 她在推荐什么 |
[01:20] | The drug rep. | 那个医药代表 |
[01:21] | Oh, just some calcium channel blocker. | 就是些钙通道阻滞剂 |
[01:24] | So about the DJ… | 关于DJ的事 |
[01:26] | – It’s Maggie. – Yeah, me too. | -是麦基 -我也收到了 |
[01:32] | Father and daughter hit and run victims. | 父女二人是肇事逃逸的受害者 |
[01:34] | This is Abigail Jones, two years old. | 这是阿比盖尔·琼斯 两岁 |
[01:36] | GCS nine, blunt head trauma with lacerations. | 昏迷指数9 钝器头外伤并有撕裂 |
[01:38] | IO line in the left leg. | 输液管在左腿上 |
[01:40] | Abigail, it’s gonna be okay. | 阿比盖尔 一切都会好的 |
[01:42] | – Where’s the father? – En route. | -父亲在哪 -在路上 |
[01:44] | Other ambo was trying to get an airway | 我们离开现场时 |
[01:45] | when we rolled away from the scene. | 其他救护人员正在为他插管 |
[01:47] | They were in crosswalk. They had the signal. | 父女俩在人行道上 绿灯亮着 |
[01:49] | Car plowed right through them. | 车径直冲向他们 |
[01:52] | Let’s transfer on my count: One, two, three. | 听我的口令把她抬上去 一 二 三 |
[01:59] | Abigail? Abigail? | 阿比盖尔 阿比盖尔 |
[02:01] | She’s unresponsive. I need to intubate. | 没有反应 我得插管 |
[02:03] | Broselow tape. | 给我儿童急救尺 |
[02:03] | And a chest X-ray. | 和胸片仪 |
[02:07] | Just about 12 to 14 kilos. | 大约十二到十四千克 |
[02:09] | Yellow drawer. | 黄色抽屉 |
[02:11] | Four etomidate. 20 of sux. | 四单位麻醉剂 二十单位司可林 |
[02:12] | BP 100 over 70. | 血压100/70 |
[02:14] | Heart rate 136. | 脉搏每分钟136 |
[02:16] | Sats 88. | 氧饱和88 |
[02:21] | X-rays in place. Nat, tell us when. | X光就位 小娜 好了告诉我们 |
[02:23] | All right, I’m in. | 插进去了 |
[02:26] | Go. | 照吧 |
[02:31] | Clear. | 离手 |
[02:33] | Right side’s whited out. | 右侧胸腔全是血 |
[02:34] | Chest tube. | 胸管 |
[02:35] | Ultrasound. | 超声仪 |
[02:38] | Sats down to 80. | 氧饱和下降到80 |
[02:45] | Fastscan’s negative. No blood in the belly. | 快速扫描呈阴性 没有内出血 |
[02:51] | Tubes in. | 胸管进去了 |
[02:52] | Sats coming back up. 100%. | 氧饱和回升 到100了 |
[02:54] | BP and heart rate’s stabilizing, as well. | 血压和脉搏也稳定了 |
[02:58] | Pupils are reactive but sluggish. | 瞳孔有反应但移动缓慢 |
[03:00] | Heads up, paramedics are coming in with the father right now. | 注意 急救人员现在带着父亲来了 |
[03:04] | You go take him. I’ll finish this. | 你去照顾他 这里我来 |
[03:07] | Marc Jones, 32. | 马克·琼斯 32岁 |
[03:08] | GCS 3, intubated in the field. | 昏迷指数3 当场插管 |
[03:10] | Suspect a C-spine injury. | 怀疑是颈椎受伤 |
[03:12] | There’s a step off on the back of his neck. | 他脖子后部有处错位 |
[03:13] | All right. Let’s transfer him. | 好 我们把他抬上去 |
[03:16] | One…two…three. | 一 二 三 |
[03:20] | – Thank you, Cesar. – Yep. | -谢谢 塞萨尔 -不客气 |
[03:29] | Good breath sounds bilaterally. | 双边呼吸音正常 |
[03:33] | BP 88 over 58. Heart rate 120. | 血压88/58 脉搏每分钟120 |
[03:35] | Should we start a neo bag? | 给他再挂一包吗 |
[03:37] | Yes, titrate to a pressure of 110. | 没错 滴注到血压恢复110 |
[03:38] | Need a chest X-ray and an ultrasound. | 还需做胸片和超声波 |
[03:40] | Yep. | 收到 |
[03:45] | Oh, my God. | 我的天 |
[03:47] | Dr. Halstead. | 霍斯特德医生 |
[03:49] | Hold on. | 等等 |
[04:17] | How’s the little girl? | 小女孩怎么样了 |
[04:18] | Her vitals are stable and no long bone fractures. | 她的体征正常 没有长骨骨折 |
[04:21] | But CT Head shows diffuse intraparenchymal bleeding. | 但头部CT显示有慢性脑实质出血 |
[04:24] | And what did neuro say? | 神经科怎么说 |
[04:25] | I just got off the phone with them. | 刚和他们通完电话 |
[04:27] | They put in a pressure monitor, | 他们放置了一个血压检测仪 |
[04:28] | and they agreed with me to treat | 也同意我 |
[04:29] | with hyperventilation and mannitol | 用过度通气与甘露醇进行治疗 |
[04:30] | to reduce the intracranial pressure. | 以减轻颅内压的方案 |
[04:32] | And what about the father? | 那父亲呢 |
[04:34] | Intubated but unresponsive without sedation. | 已插管 但无镇静反应 |
[04:36] | – So, a brain injury? – I’m not sure. | -脑损伤吗 -我不确定 |
[04:39] | Pupils are equal and reactive, so that’s a good sign. | 瞳孔对称且有反应 这是个好迹象 |
[04:41] | We’re just waiting on scan results to see | 我们在等扫描结果 |
[04:43] | how bad the injuries are. | 看看伤势有多严重 |
[04:44] | Look, Marc’s stable now, but what if he goes downhill? | 听着 马克现在稳定 但如果他情况恶化了呢 |
[04:47] | He’s wearing a lot of ink. | 他身上有很多纹身 |
[04:48] | Is this “Do No Resuscitate” a legit advanced directive? | 这个”不要抢救”能当作合法的病人要求吗 |
[04:51] | The hospital’s got a team of lawyers trying to figure that out. | 医院的律师团正在讨论这个问题 |
[04:54] | What about his family? | 他的家人呢 |
[04:55] | Do they know if he meant it or not? | 他们知不知道这纹身是否他的本意 |
[04:57] | We’re looking for them too. | 我们还在寻找他的家人 |
[04:58] | It seems it’s just Mr. Jones | 但现在看来只有 |
[05:00] | and his daughter, Abigail, in the world. | 琼斯先生和他女儿阿比盖尔 |
[05:02] | He had on a wedding ring. There’s no wife? | 他戴着婚戒 没找到妻子吗 |
[05:03] | There was, Melinda. Legal found an obituary. | 以前有 叫梅琳达 律师找到了讣告 |
[05:06] | She died last year. Ovarian cancer. | 她去年因卵巢癌去世了 |
[05:09] | If his wife had to be intubated | 如果他妻子的最后时光 |
[05:11] | and wasn’t able to get off the vent, | 只能在呼吸机上度过 |
[05:12] | seeing her like that could be why he got that tattoo. | 看到她痛苦的样子可能是他纹身的原因 |
[05:16] | Yeah, maybe that’s what he was feeling then, | 也许当时他是那么想的 |
[05:18] | but what about now? | 但现在呢 |
[05:19] | He’s all Abigail has. | 阿比盖尔只剩下他了 |
[05:20] | I can’t see him not wanting us to do everything | 我觉得为了阿比盖尔 |
[05:22] | in our power to keep him alive for her. | 他会让我们尽全力救他 |
[05:24] | Well, the truth is, we don’t know | 事实上我们并不知道 |
[05:25] | why Mr. Jones got the tattoo or how he feels about it now. | 琼斯先生纹身的目的和他现在的想法 |
[05:28] | So, let’s not jump to conclusions until we have real facts. | 我们先别忙着下结论 除非我们有真凭实据 |
[05:33] | And in the meantime? | 那同时呢 |
[05:34] | While the hospital does their due diligence, | 同时医院在做他们的背景调查 |
[05:37] | err on the side of life. | 宁可犯错也要以生命为重 |
[05:39] | Thank you. | 谢谢 |
[05:46] | Keegan and I have been neighbors for a few months. | 从我几个月前搬回来 |
[05:48] | Since I moved back. | 基根和我一直是邻居 |
[05:49] | I’m only here ’cause Vicki talked me into it. | 只是因为维琪劝我 我才来的 |
[05:52] | At this point, I’ve given up on doctors. | 现在 对医生我完全没有指望了 |
[05:55] | Whoa, no, no, no. No more scratching. | 不行 不能挠了 |
[05:57] | I can’t help it. It’s been three years. | 我忍不住啊 已经三年了 |
[06:00] | Three years. Never stops. | 三年了 一刻都没有停止过 |
[06:02] | And it started with a MRSA infection? | 是从金黄葡萄球菌感染开始的 |
[06:03] | The antibiotics to treat it. | 是用来治疗感染的抗生素 |
[06:05] | Linezolid. Side effect was pruritus. | 利奈唑胺 副作用是瘙痒 |
[06:07] | – Bad itch, huh? – Mm, the worst. | -瘙痒得厉害 -是 难忍 |
[06:09] | Everywhere. And I mean everywhere. | 到处都痒 真的 到处都痒 |
[06:13] | But the reaction went away | 但是她停止用药以后 |
[06:14] | when she stopped taking the pills. | 反应就停止了 |
[06:16] | Except for right here, | 除了这个地方 |
[06:17] | and it is killing me not to scratch it right now. | 不让我挠简直要了我的命 |
[06:19] | The itch never lets up? | 瘙痒从来没有减轻过吗 |
[06:21] | In the shower? When you’re sleeping? | 洗澡的时候 睡觉的时候 |
[06:23] | Never. | 没有 |
[06:24] | I’ve used toothbrushes, pencils, even steel wool once. | 我用过牙刷 铅笔 有次甚至是钢丝球 |
[06:28] | Nothing stops the itch. | 根本止不住 |
[06:31] | Easy, Keegan. Keegan. | 别 基根 基根 |
[06:32] | – Stop. – I know it’s hard. | -别动 -我知道这很难 |
[06:34] | Just try not to scratch. | 努力不要挠 |
[06:36] | All right, I’m gonna clean it out | 我来清洗一下 |
[06:37] | and apply some steroid cream. | 然后上些类固醇膏 |
[06:39] | Should help calm it down. | 应该能缓和一下 |
[06:42] | That won’t do anything. | 那不会有任何效果的 |
[06:43] | I’ve tried creams and antihistamines, acupuncture. | 我试过药膏 抗组胺剂 针灸 |
[06:47] | I’ve seen dozens of doctors, dermatologists, allergists. | 看过好多医生 皮肤科专家 过敏科专家 |
[06:50] | Nothing helps. | 什么都没用 |
[06:52] | I–I just can’t stop. | 我就是停不下来 |
[06:55] | D–don’t. Don’t. Don’t. Don’t. | 不行不行不行 |
[06:56] | – Doesn’t that hurt? – All I feel is the itch. | -难道你不疼吗 -我就是觉得痒 |
[06:59] | It’s all day, every day. | 每分每秒 无时无刻 |
[07:00] | Please just find it and cut it out. | 求求你 找出原因把它治好 |
[07:03] | Okay. | 好 |
[07:04] | Let’s get a full set of labs and go from there. | 我们先做全套的化验 然后从那开始 |
[07:09] | I’ll be back with the results. | 我拿到结果再过来 |
[07:13] | No more scratching. | 千万不能再挠了 |
[07:14] | Thank you. | 谢谢 |
[07:20] | I’ve never seen anything like this. | 这种情况我从来没遇到过 |
[07:22] | She’s down to the muscle. | 她完全停不下来 |
[07:23] | And she was serious about trying everything. | 而且她真的是试过所有的方法 |
[07:25] | I looked inside her medicine cabinet, | 我看过她的药品柜 |
[07:26] | it’s like a pharmacy. | 感觉跟药房一样 |
[07:28] | I tried to help her, but she didn’t serve, | 我想帮她 可是因为她没服过役 |
[07:30] | so I can’t bring her to the VA. | 所以我没办法带她去退伍军人医院 |
[07:32] | How much do you know about Keegan outside of the itch? | 除了瘙痒以外 你对基根了解多少 |
[07:35] | Is she… | 她 |
[07:36] | Crazy? | 疯了 |
[07:38] | I don’t think so, but an itch for three years… | 我不觉得 可是一个三年的瘙痒 |
[07:41] | Yeah. | 就是 |
[07:43] | I’m gonna get psych involved. | 我会让精神科参与的 |
[07:45] | Thanks for bringing her in. | 谢谢你把她送来 |
[07:46] | – Thanks. – Yeah. | -谢谢 -没事 |
[07:52] | So, Vicki’s here. | 维琪来了 |
[07:55] | She just brought in a patient. | 她送个病人过来 |
[07:59] | This is the only hospital in Chicago? | 整个芝加哥就我们这一家医院吗 |
[08:03] | You trying to tell me something? | 你想说什么 |
[08:07] | No. | 没什么 |
[08:10] | Okay. | 那好 |
[08:14] | April, I appreciate you covering for me | 艾普尔 非常感谢你每次在我 |
[08:17] | every time I’m in the Hybrid OR. | 去混合手术室时帮我照顾这边 |
[08:19] | Of course I don’t expect you to know | 当然 我不能指望我学过的 |
[08:20] | everything that I’ve learned, | 你都会 |
[08:21] | so I made a reference guide for you. | 所以我做了个参考指南给你 |
[08:24] | Well, I haven’t had any problems. | 我没什么应付不了的啊 |
[08:26] | Well, not yet, but it’s good to be prepared. | 现在没有 但是有备无患啊 |
[08:28] | 《护士长业务与责任规范》 麦基·洛克伍德 | |
[08:29] | “Obligations and Proficiencies of the Charge Nurse.” | 《护士长业务与责任规范》 |
[08:33] | People don’t realize how complex the job can be. | 大家不知道这工作会有多复杂 |
[08:36] | How many pages is this thing? | 这玩意有多少页 |
[08:38] | Is there a PowerPoint presentation to go with it? | 有配套的幻灯片演示吗 |
[08:41] | Is that gonna be a problem? | 有什么问题吗 |
[08:43] | No problem. | 没有 |
[08:47] | Vicki brought in the patient. | 维琪送来了个病人 |
[08:49] | Vicki. Your–uh–your friend, Vicki? | 维琪 你朋友 维琪 |
[08:51] | – Former friend. – Yeah. | -前任 -是的 |
[08:53] | Keegan. I’m Dr. Charles. | 基根 我是查尔斯医生 |
[08:55] | How you doing? | 你怎么样 |
[08:57] | 查尔斯医生 精神科 | |
[08:59] | Of course. The shrink. | 当然了 精神病医生 |
[09:01] | Look, this isn’t because of feelings, | 这个不是我的感觉的问题 |
[09:04] | and it’s not OCD. | 也不是强迫症 |
[09:05] | I don’t have delusional parasitosis | 我既没有寄生虫妄想症 |
[09:07] | or a conversion disorder. | 也没有转换障碍 |
[09:09] | And the itching didn’t start after my dad died | 瘙痒既不是在我父亲去世以后 |
[09:10] | or my boyfriend left me. | 也不是我男朋友把我甩了以后出现的 |
[09:13] | Look, I’m not insane. | 我没疯 |
[09:14] | My head just itches and I want it to stop. | 我就是脑袋瘙痒 我想让它停下来 |
[09:18] | Okay. | 好吧 |
[09:19] | Well, let’s try to make that happen. | 我们努力把它弄好 |
[09:21] | Really? | 真的吗 |
[09:22] | Usually docs are writing me a referral so I’ll leave. | 一般来说医生给我个转诊证明 我就走了 |
[09:26] | Well, you came to us for help, so we’re gonna help ya. | 你来寻求帮助 所以我们会帮助你 |
[09:28] | Just for now though, do you think you can | 现在嘛 你能不让 |
[09:30] | keep your hand away from the wound? | 你的手去碰你的头吗 |
[09:31] | I can’t help it. | 我忍不住 |
[09:33] | Okay. | 好吧 |
[09:34] | So Dr. Choi told me that you’ve tried OTC’s, | 崔医生说你试过非处方药 |
[09:38] | prescriptions, host of home remedies. | 处方药 还有很多偏方 |
[09:40] | How ’bout bupivacaine? | 试过布比卡因吗 |
[09:42] | What’s that? | 是什么 |
[09:43] | A local anesthetic. | 局部麻醉 |
[09:45] | Five mil should do it. | 五毫升就好了 |
[09:47] | I’d like to apply a little bit to the area. | 我想在病灶用一点 |
[09:49] | If it provides relief, it would suggest that | 如果有改善 |
[09:51] | the problem might lie in your cutaneous nerve endings. | 就说明问题可能出在你的皮肤神经末梢上 |
[09:54] | And that would help suggest a treatment plan going forward. | 而这就有助于制订接下来的治疗方案 |
[09:57] | Then stop talking and get to it. | 那就别啰嗦了 赶快来吧 |
[09:59] | You’re gonna feel a pinch. | 会有一点点疼 |
[10:01] | Do it. | 来吧 |
[10:05] | Okay. | 好的 |
[10:08] | It feels different. | 感觉不太一样 |
[10:10] | Different how? | 怎么不一样 |
[10:11] | Better. | 有改善 |
[10:13] | I mean, it tingles a little, but it itches less. | 有点刺痛 但是不那么痒了 |
[10:16] | Hmm. That’s a good start. | 这是好现象 |
[10:19] | Yeah. | 是的 |
[10:20] | We’ll check on you in a bit. | 我们过会儿再来看你的情况 |
[10:27] | So, anesthetic should provide relief | 麻醉应该可以缓解 |
[10:29] | for like, three or four hours. | 三到四个小时 |
[10:31] | Itch doesn’t come back, then set her up | 如果瘙痒不再发作 给她处理一下 |
[10:32] | with some topical patches to take home. | 开些局部贴片就可以回家了 |
[10:34] | Sounds good. | 听起来不错 |
[10:37] | Mannequins? | 服装模特 |
[10:38] | Look, I was a department store latchkey kid. | 我曾经是一个在百货公司乱逛的带钥匙儿童 |
[10:40] | So, I took what I could get. | 所以 遇上谁就是谁了 |
[10:42] | Jenny was basically my first girlfriend. | 詹妮基本上算是我的初恋女友 |
[10:43] | Which is why I am such a good kisser. | 所以我吻技了得 |
[10:46] | I don’t think I know how to feel about this. | 我不知道该怎么理解这句话 |
[10:48] | On the one hand, it’s very disturbing. | 一方面 可能会让我不太开心 |
[10:50] | On the other, I should probably be thanking Jenny | 另一方面 我可能应该感谢詹妮 |
[10:52] | for those years of practice. | 对你多年的训练 |
[10:54] | Hold on. It wasn’t years, okay? | 打住 没有多年 好吗 |
[10:56] | Dr. Rhodes–was looking for you. | 罗德斯医生 我一直在找你 |
[10:59] | I wanted to tell you before you got the memo. | 在你拿到备忘之前我想先告诉你 |
[11:02] | The Hybrid Room will be used | 在需要的时候 混合手术室 |
[11:03] | for general surgeries when needed. | 也会用于一般的手术 |
[11:06] | General surgeries? | 一般手术 |
[11:07] | Appendectomies, gall bladders– | 阑尾切除术 胆囊手术 |
[11:09] | So, everything but trauma, which is why | 除了创伤都有对应的手术室了 |
[11:11] | we built it in the first place. | 这才是我们建立它的初衷 |
[11:12] | Look, the Hybrid Room was expensive. | 混合手术室造价高昂 |
[11:15] | It came in over budget. | 大大超出预算 |
[11:16] | Using it when we can will help balance the books. | 能用就用有助于达到收支平衡 |
[11:19] | You mean, pad them? | 你是说 用来创收 |
[11:20] | Well, profit’s not a bad thing. | 当然 利润是个好东西 |
[11:22] | Ms. Goodwin, this is Chicago. | 古德温女士 这里可是芝加哥 |
[11:23] | We get six traumas before lunch. | 我们在午饭前就来了六个创伤患者 |
[11:25] | What are those patients supposed to do? | 那些病人该怎么办 |
[11:26] | I don’t know, take a number? | 我不知道 拿号排队吗 |
[11:28] | Well, your displeasure is noted, Dr. Rhodes. | 好吧 罗德斯医生 我收到你的反对意见 |
[11:33] | And overruled. | 并且驳回 |
[11:36] | When does all this start? | 什么时候开始 |
[11:38] | Today. | 今天 |
[11:40] | In fact, Dr. Lanik will take the lead. | 事实上 拉尼克医生会负责这件事 |
[11:47] | This is a terrible idea. | 真是个糟糕的主意 |
[11:50] | It’s gotta be Gwen Garrett. | 肯定是格温·加瑞特的主意 |
[11:54] | Let it go. | 别管了 |
[11:56] | This isn’t a hill to die on. | 天又不会塌下来 |
[12:04] | Damn it! | 该死 |
[12:05] | Call Dr. Charles. | 呼叫查尔斯医生 |
[12:08] | Keegan, stop. Don’t scratch. | 基根 停下 别抓了 |
[12:09] | Oh, the itch is back and it’s worse than before. | 又开始痒了 比之前更严重 |
[12:11] | You have to stop scratching. | 你必须停止抓挠 |
[12:12] | Oh, then you have to tie me down. | 那你只能把我绑起来了 |
[12:15] | – Five milligrams of diazepam. – On it. | -五毫克安定 -马上 |
[12:17] | I can’t live like this anymore. | 我真的受不了了 |
[12:19] | I’d rather be dead. | 我宁愿去死 |
[12:21] | What happened? | 什么情况 |
[12:24] | Oh, God. | 天哪 |
[12:27] | She scratched through to her skull. | 她已经抓到头骨了 |
[12:43] | How’s Abigail? | 阿比盖尔怎么样了 |
[12:44] | Fighting. How’s the dad? | 还在坚持 她爸爸呢 |
[12:48] | Scans are back. | 扫描结果出来了 |
[12:48] | CT brain revealed no bleeding, | 脑部CT显示没有出血 |
[12:50] | and there’s no obvious brain trauma. | 也没有明显的脑部创伤 |
[12:52] | Well, that’s good news. | 那是好消息啊 |
[12:54] | Yeah, except the CT C-spine | 是的 除了颈椎CT显示 |
[12:57] | revealed a subluxation at C3 on 4. | 在第三和第四个颈椎之间有半脱位 |
[13:00] | MRI confirmed? | 做核磁共振确认了吗 |
[13:01] | Complete spinal cord transection. | 已经做了脊髓横断检查 |
[13:03] | He’s paralyzed from the neck down. | 他从颈部以下瘫痪了 |
[13:06] | I’m sorry. | 我很遗憾 |
[13:08] | I just spoke with Jay. | 我刚才和杰聊过了 |
[13:09] | PD caught the driver who hit them. | 警察已经抓到了撞他们的司机 |
[13:12] | He blew through a red light because he was texting. | 他因为在发短信所以闯了红灯 |
[13:15] | BP’s spiked, 146 over 94. | 血压飙升 146/94 |
[13:18] | Heart rate’s down, 54. | 心率下降到54 |
[13:21] | Cushing’s Reflex. | 这是库欣反射 |
[13:22] | Her intracranial pressure is worsening. | 她的颅内压正在恶化 |
[13:24] | She needs more hyperventilation. | 她需要增加通气量 |
[13:25] | Get her off the vent. | 帮她把呼吸机取下来 |
[13:29] | Heart rate’s still dropping. | 心率还在下降 |
[13:30] | 47. | 到47了 |
[13:31] | Two milligrams of atropine. | 两毫克阿托品 |
[13:37] | It’s in. | 注射完毕 |
[13:38] | Come on. Come on. | 加油 加油 |
[13:41] | Heart rate’s coming back up. 49…. | 心率开始恢复了 49… |
[13:44] | 51… 51… | |
[13:45] | Come on. Come on. | 加油 加油 |
[13:48] | Come on, Abigail. | 加油 阿比盖尔 |
[13:55] | Dr. Rhodes, you’re gonna bag that. | 罗德斯医生 你得给他上气囊 |
[13:56] | Yep. Talk to me. | 来了 什么情况 |
[13:58] | James Brice, 24. | 詹姆斯·布莱斯 24岁 |
[13:59] | GCS 7. Hypotensive. | 七度昏迷 血压极低 |
[14:01] | Intubated en route. Belly’s distended. | 途中进行了插管 腹部肿胀 |
[14:03] | What happened? | 发生了什么事 |
[14:04] | He was putting in storm windows for the nursery. | 他爬上去关托儿所的防风窗 |
[14:06] | He fell off the ladder. | 然后从梯子上摔下来了 |
[14:07] | At least 20 feet. | 梯子至少有六米多高 |
[14:08] | I was worried the baby would be cold this winter. | 我担心冬天宝宝会着凉 |
[14:10] | It’s okay. Don’t worry. | 没事的 别担心 |
[14:11] | It’s not your fault. Maggie? | 不是你的错 麦基 |
[14:13] | I got her. | 有我在 |
[14:13] | Mrs. Brice, why don’t you come with me, | 布莱斯太太 你跟我过来 |
[14:15] | and let the doctors work, okay? | 让医生做他们的工作 好吗 |
[14:16] | He keeps trying to die on us. | 他好几次差点死在路上 |
[14:18] | All right. On my count. | 好 听我口令 |
[14:19] | One, two, three. | 一 二 三 |
[14:27] | Good breath sounds on the left and the right. | 左边和右边的呼吸音都很好 |
[14:29] | Let’s get a chest X-ray. | 我们做个胸部X光 |
[14:30] | Field IV is blown. We don’t have access. | 现场静脉滴注的位置肿了 没地方插针 |
[14:32] | All right. | 好 |
[14:34] | Ava, can you get a line in? | 艾娃 你能插根导管吗 |
[14:36] | Give me a kit. | 给我个工具包 |
[14:39] | X-ray’s up. | X光准备好了 |
[14:40] | Everybody clear. | 所有人离手 |
[14:43] | Looks good. | 看起来不错 |
[14:46] | Belly’s hard as a rock. Give me a Fastscan. | 腹部像石头一样硬 给我快速扫描仪 |
[14:56] | It’s full of blood. | 里面全是血 |
[14:57] | I need to get in there and find the bleed. | 我需要开腹找到出血点 |
[15:02] | We’ll use the Hybrid OR. | 我们要用混合手术室 |
[15:04] | We can make it upstairs. | 我们可以到楼上做 |
[15:04] | There are operating rooms available. | 那里有空着的手术室 |
[15:06] | There’s also one right across the ED. | 穿过急诊室就有一个手术室 |
[15:07] | – Much closer. – Connor, Goodwin just to you– | -比楼上近得多 -康纳 古德温刚… |
[15:09] | I know what she said. | 我知道她说了什么 |
[15:10] | Find Maggie. Have her page my team. | 去找麦基 让她呼叫我的团队 |
[15:13] | It’s probably CT looking for you. | 可能是心胸科那边找你 |
[15:14] | I got this. | 这里有我就行了 |
[15:15] | You’re going to get yourself into trouble. | 你会给自己惹上麻烦的 |
[15:17] | I can’t worry about that now. | 管不了那么多了 |
[15:18] | Get James ready to go. | 让詹姆斯准备好走 |
[15:22] | Lanik. I’m taking the Hybrid OR. | 拉尼克 我要用混合手术室 |
[15:24] | My patient is on the table. | 我的病人现在在手术台上 |
[15:26] | His gall bladder can wait. Bring him back next week. | 他的胆囊可以等 让他下星期再来 |
[15:29] | I’m not your resident, Connor. | 我不是你的住院医生 康纳 |
[15:30] | You can’t order me around. | 你不能命令我 |
[15:32] | Is your patient about to die? Because mine sure is. | 你的病人是快死了吗 我的病人肯定是 |
[15:39] | Get Dr. Lanik’s patient out and | 送拉尼克医生的病人出去 |
[15:40] | re-prep the room for mine. | 为我的病人重新准备手术室 |
[16:00] | Natalie. | 娜塔莉 |
[16:01] | I just need a moment. | 我只想一个人待会 |
[16:03] | Yeah, of course. | 好 |
[16:08] | All right. Thank you. | 好的 谢谢你 |
[16:10] | April, I’m getting pulled into surgery. | 艾普尔 手术室需要我 |
[16:13] | Okay, I’ll hold it down out here. | 好的 这里交给我 |
[16:15] | Oh, and I’ve got a delivery of NG Tubes, Hep Locks, | 一会还有鼻胃管 肝素阀 |
[16:17] | and ABD Pads coming in. | 和腹部垫的送货 |
[16:18] | I called it in late last night. | 我昨晚订的 |
[16:20] | I’ll double check the order against the invoice, | 我会对比检查订单和货单 |
[16:21] | make sure it’s all there. | 确保东西齐全 |
[16:22] | All right. Oh. | 好的 |
[16:23] | And it’s payroll week, so it means that you have– | 这周要发工资 所以你要… |
[16:26] | All the nurses need to sign off on their timecards. | 需要所有护士签字确认她们的考勤卡 |
[16:28] | Maggie, you’re driving me crazy. | 麦基 你要把我逼疯了 |
[16:31] | If anything happens, I’ll handle it. | 发生什么事我都能处理 |
[16:33] | Okay, and you’ve got the reference guide | 好 而且你有我写的 |
[16:34] | that I wrote, so we’re all good. | 参考手册 所以没问题 |
[16:37] | All good. Good, good, good. | 没问题 没问题 |
[16:43] | You want some company? | 你想要人陪吗 |
[16:44] | I get it if you’d rather be alone. | 如果你想自己待着我也能理解 |
[16:46] | No, I’m glad to see you. | 不 见到你我很高兴 |
[16:49] | How’s Marc? | 马克怎么样 |
[16:50] | No change. Still unconscious. | 没有变化 仍在昏迷中 |
[16:54] | Abigail was only two. | 阿比盖尔才两岁 |
[16:57] | And now she’s gone. | 现在她不在了 |
[16:59] | All because some guy couldn’t look away from his phone. | 就因为有个家伙盯着手机 |
[17:05] | But maybe something good could come from all of this. | 但也许这一切也能有些好处 |
[17:08] | I mean, all these kids waiting for transplants. | 这么多孩子等着移植 |
[17:11] | There are so few pediatric donors | 儿科捐献者太少了 |
[17:13] | in comparison to the thousands of children in need. | 而需要移植的孩子成千上万 |
[17:17] | Abigail could be an organ donor. | 阿比盖尔可以捐献器官 |
[17:20] | As a minor, you know, she’s gotta get | 她是未成年人 你知道得有 |
[17:21] | a parent or guardian to sign off before she can donate. | 一名家长或监护人签字同意才能捐献 |
[17:24] | Yeah, I know that. | 我知道 |
[17:25] | And if Goodwin can’t track down any of her other family, | 如果古德温找不到她的其他家人 |
[17:28] | then all that’s left is her father. | 就只剩下她的父亲了 |
[17:33] | Do you think Marc will wake up? | 你觉得马克会醒过来吗 |
[17:37] | I’ve seen patients in worse shape turn around. | 我见过状况更糟的病人好转 |
[17:50] | Well, that’s a new one. | 这还是头一次见 |
[17:50] | Usually I have to cut them open myself to get to the brain. | 一般来说我得亲自开颅才能看到大脑 |
[17:53] | So, what do you think? | 你怎么想 |
[17:54] | Well, for whatever reason, | 不管因为什么原因 |
[17:56] | the cutaneous nerves in that part of her scalp went haywire. | 她头皮那块区域的皮神经失控了 |
[17:58] | Makes them always feel itchy, so she keep scratching. | 导致一直感到瘙痒 所以她忍不住挠 |
[18:00] | There a fix? | 有治疗办法吗 |
[18:01] | Yeah, surgery. | 有 手术 |
[18:02] | Sever the nerve. | 切断神经 |
[18:03] | No more feeling, no more itching. | 没有感觉 没有瘙痒 |
[18:05] | And no more scratching. | 不会挠了 |
[18:06] | Yeah, and possible serious, irreversible side effects. | 还有可能出现的严重不可逆转的副作用 |
[18:10] | Facial paralysis, blurred vision. | 面部瘫痪 视力模糊 |
[18:11] | Worst case, she ends up in a wheelchair. | 最坏的情况 她可能会坐上轮椅 |
[18:13] | I’m not cutting her open in an alley, Daniel. | 我又不是在巷子里给她开刀 丹尼尔 |
[18:15] | The risks you’re describing are dwarfed by the reward. | 你说的风险比起回报完全可以忽略 |
[18:17] | – Yeah, we hope. – What do you suggest? | -但愿如此 -你有什么建议 |
[18:19] | Twice a week counseling sessions? | 每周两次心理咨询吗 |
[18:21] | Of course, we’d have to put a cone around her neck | 当然了 我们还得在她脖子上套个套 |
[18:22] | to keep her from scratching. | 免得她挠 |
[18:23] | Sam, all those years of scratching, those nerves are shot. | 萨姆 挠了那么多年 神经已经麻痹了 |
[18:26] | There’s nothing left to go haywire. | 不可能还有什么失控 |
[18:28] | Dr. Charles, if that were the case, | 查尔斯医生 如果是这样 |
[18:29] | Keegan shouldn’t feel anything. | 基根应该什么感觉也没有 |
[18:30] | Let alone an itch. | 更不要提瘙痒了 |
[18:31] | If those nerves were active, | 如果神经没断 |
[18:33] | that anesthetic would have provided relief for hours. | 那么麻醉剂应该能缓解瘙痒几个小时 |
[18:35] | – It didn’t. – You only used 5 mil. | -但是没有 -你只用了五毫克 |
[18:37] | – It wasn’t enough. – I agree. | -量不够 -我同意 |
[18:38] | The anesthetic didn’t work for long, but it did work. | 麻醉剂有效时间不长 但是有效 |
[18:40] | Proves the nerves are involved. | 证明与神经有关 |
[18:41] | Great, we have a majority. Not that I care. | 好极了 多数赞同 虽然我不在乎 |
[18:43] | – We done? – Sam? | -说完了吗 -萨姆 |
[18:45] | All I’m saying, I don’t think operating is gonna do a damn thing. | 我只是想说 我认为手术完全没用 |
[18:49] | Thanks for you input. | 谢谢你的意见 |
[18:50] | But the last time I checked, I was the neurosurgeon. | 但据我所知 我才是神经外科医生 |
[18:53] | Put her on the schedule. | 给她安排手术 |
[18:56] | Isn’t surgery supposed to be the last option? | 手术不应该是最后的选择吗 |
[19:00] | Dr. Charles, she scratched into her skull. | 查尔斯医生 她挠到了颅骨了 |
[19:10] | What happened? | 怎么回事 |
[19:12] | He suddenly went into v-fib. | 他突然就室颤了 |
[19:13] | Shocked him multiple times and then he went asystolic. | 电击了数次 然后心脏停搏了 |
[19:15] | Another round of epi. | 再来一针肾上腺素 |
[19:21] | It’s in. | 推进去了 |
[19:23] | Check for a pulse. | 检查脉搏 |
[19:27] | Nothing. | 没有脉搏 |
[19:29] | Come on, Marc. | 加油 马克 |
[19:32] | Don’t you give up. | 不许放弃 |
[19:37] | Pulse is back. Sinus tach. | 脉搏恢复 窦性心跳过速 |
[19:40] | He’s back. | 他活过来了 |
[19:42] | All right. | 好了 |
[19:43] | Prep him to move. | 准备转移 |
[19:44] | I’ll call ICU, tell them we’re sending him up for cooling. | 我去告诉重症监护室我们要送他上去 |
[19:49] | How long was he asystole? | 他心脏停搏了多久 |
[19:51] | Almost ten minutes. | 将近十分钟 |
[19:53] | What’s your boyfriend thinking? | 你男友在想什么 |
[19:55] | This guy’s not waking up. | 他醒不过来了 |
[20:13] | Hey, is your ulcer getting worse? | 你的溃疡加重了吗 |
[20:16] | Today’s not helping. | 今天很难熬 |
[20:18] | Yeah. | 是啊 |
[20:20] | So, I looked at the Paramedic’s report from the accident scene. | 我看了急救人员的事故现场报告 |
[20:24] | Marc was down at least five minutes before help arrived. | 在救助到达前马克至少心脏停搏了五分钟 |
[20:27] | And after this last code it was almost ten. | 刚刚这次将近十分钟 |
[20:30] | I mean, that’s almost 15 minutes with no oxygen. | 加起来是将近十五分钟的缺氧 |
[20:32] | I know. | 我知道 |
[20:33] | Increases the chances | 加大了 |
[20:34] | the brain function he has is now compromised. | 他脑功能受损的几率 |
[20:36] | But we won’t know if that’s the case until he wakes up. | 但直到他醒来前我们都不能确定 |
[20:39] | You think he really will? | 你真的认为他会醒来 |
[20:40] | After he coded? | 这次抢救后还会醒来 |
[20:41] | I don’t know. | 我不知道 |
[20:45] | Maybe it’s time to start thinking about | 也许是时候开始考虑 |
[20:47] | honoring his advanced directive. | 履行他的预嘱 |
[20:50] | Advanced directive? | 预嘱 |
[20:51] | Nat, it is a tattoo, not a legal document. | 小娜 那是个纹身 不是法律文件 |
[20:54] | It might be a proxy to one. | 可能是代替品 |
[20:56] | And what if Marc does have the paperwork to back it up? | 而且如果马克真的有文件支持呢 |
[20:58] | I mean, it could be at home in a file or in a safety deposit box. | 文件可能在家里 可能在保管箱 |
[21:02] | If something binding exists, | 如果真的有具有法律效应的东西 |
[21:03] | the hospital’s lawyers will find it, | 医院的律师会找到的 |
[21:05] | and I’ll obey whatever it says. | 我肯定会履行 |
[21:06] | But until then, it’s just a tattoo, | 但在那之前 这只是一个纹身 |
[21:07] | and one of many. | 他有不止一个纹身 |
[21:08] | Will, Abigail’s organs are still healthy. | 威尔 阿比盖尔的器官仍然健康 |
[21:12] | But they won’t be viable for long. | 但活力保持不了多久了 |
[21:14] | Without Marc or any family to consent, | 没有马克或家人的同意 |
[21:16] | we can’t donate them. | 我们不能捐献它们 |
[21:18] | But if we honor his tattoo and we let him go, | 但如果我们履行他纹身的指示 放弃救治 |
[21:21] | then the hospital can petition | 然后医院可以申请 |
[21:22] | to become Abigail’s legal guardian, | 成为阿比盖尔的法定监护人 |
[21:24] | and we can make the decision | 这样我们就有权决定 |
[21:26] | to donate her organs before they go to waste. | 在浪费之前捐献出她的器官 |
[21:29] | Natalie, you are asking me to let Marc die. | 娜塔莉 你的意思是让马克死 |
[21:31] | I can’t do that. | 我做不到 |
[21:33] | Well, if by some miracle he does wake up, | 就算有奇迹发生 他醒过来了 |
[21:36] | it’ll be to brain damage, paralysis, | 也会有大脑损伤 瘫痪 |
[21:38] | and the loss of his daughter. | 还有失去女儿的痛苦 |
[21:40] | So, please help me understand | 所以 告诉我 |
[21:43] | why you won’t even consider this. | 你为什么不考虑一下 |
[21:44] | I have a responsibility to my patients | 我要对我的病人负责 |
[21:46] | to do everything I can to save their lives. | 我要尽我所能来拯救他们的生命 |
[21:48] | Anything less, then I am failing them. | 否则我就是辜负他们 |
[21:54] | Okay. | 好吧 |
[22:04] | He’s losing blood faster than I can replace it. | 他失血的速度比输血速度快 |
[22:06] | Massive bleed from behind the liver. | 肝后大量出血 |
[22:09] | There must be a hole in the vena cava. | 腔静脉一定破了个洞 |
[22:13] | Long Allis clamps. | 长夹钳 |
[22:20] | Damn it, this isn’t working. | 该死 这不管用 |
[22:22] | I can’t reach the tear without making it worse. | 我摸不到撕裂处 |
[22:24] | All right, Maggie, get your hands in here. | 麦基 把手伸进去 |
[22:28] | Push on these packs. Press hard. | 使劲按住这些包 |
[22:29] | All right. | 就这样 |
[22:31] | That’ll buy us some time. | 这会为我们争取点时间 |
[22:32] | Call Dr. Lanik, get him in here. | 打给拉尼克医生 让他过来 |
[22:34] | I don’t care what he’s doing. | 我不管他在干什么 |
[22:35] | Just make sure he’s scrubbed up and ready to work. | 让他自己清洗然后准备工作 |
[22:37] | Give me an 8 ET tube and a sternal saw. | 给我一个八英寸的管子和一个胸骨锯 |
[22:40] | Sternotomy? | 要做胸骨切开术吗 |
[22:42] | You’re gonna open up his chest? | 你要给他开胸吗 |
[22:43] | I gotta get to the bleed somehow. | 我得止住出血 |
[22:46] | Hey, got your page. | 收到你的呼叫了 |
[22:47] | Come on in. | 请进 |
[22:49] | Dr. Abrams is in surgery right now. | 艾布拉姆医生在做手术 |
[22:50] | As soon as he’s done, Keegan’s next. | 他做完了之后就是基根 |
[22:54] | – What’s all this? – It’s an experiment. | -这是什么 -是个实验 |
[22:57] | For what? | 什么实验 |
[22:58] | Well, you don’t think that | 你不认为 |
[23:00] | Keegan can experience her itch without cutaneous nerves. | 基根不用皮肤神经就能感到痒 |
[23:03] | And I do. I think I can prove it. | 但是我相信 而且我能证明 |
[23:08] | Have a seat. | 请坐 |
[23:12] | Okay. | 好吧 |
[23:14] | So, can you take your left arm | 你能把你的左臂 |
[23:16] | and put it on the other side of the partition here? | 放在搁板的另一边吗 |
[23:21] | Thank you. | 谢谢配合 |
[23:23] | So, is this like a magic trick? | 这是在变魔术吗 |
[23:25] | Yeah, kinda. | 算是吧 |
[23:29] | Okay, so I’m gonna start to brush your real hand | 我将同时用刷子 |
[23:34] | and the fake hand simultaneously. | 刷你的真手和假手 |
[23:36] | But I just want you to look at the fake hand. | 但我需要你盯着假手 |
[23:38] | Okay? | 行吗 |
[23:39] | Whatever you say. | 都听你的 |
[23:41] | So, amputees sometimes still feel | 截肢者缺失的肢体 |
[23:45] | the missing limb, right? | 有时仍会感到疼痛 对吗 |
[23:46] | Yeah. A phantom limb. | 是的 幻肢 |
[23:48] | The nerves are transmitting confusing signals. | 神经在传递迷惑人的信号 |
[23:51] | Or do amputees still feel missing limbs because | 或者截肢者能感觉到缺失的肢体 |
[23:54] | the brain is just assuming that it’s still there? | 是因为大脑假设它还在 |
[23:57] | ‘Cause if that were the case, the nerves would be irrelevant. | 如果是这样的话 神经就无关紧要了 |
[24:00] | Right? | 对吗 |
[24:02] | So, you’re suggesting Keegan’s got a phantom itch? | 所以 你是说基根有幻觉性瘙痒吗 |
[24:05] | Her brain is telling her it’s there, even though it isn’t? | 她的大脑告诉她还在 但其实已经不复存在了 |
[24:08] | Yeah. | 没错 |
[24:09] | Just like amputees perceive a limb that used to be there. | 就像被截肢者感觉到曾经存在的肢体一样 |
[24:13] | Keegan still perceives an itch that she got three years ago | 基根感觉到了三年前 |
[24:16] | from a drug reaction. | 药物反应时候的瘙痒 |
[24:17] | I mean, the brain’s basically playing a trick on her. | 大脑其实是在捉弄她 |
[24:20] | Interesting theory. | 有趣的理论 |
[24:23] | Where are you going with all this? | 你要用这个证明什么 |
[24:24] | That’s not your hand. Right? | 这不是你的手 对吗 |
[24:26] | But the more you stare at it, | 在我刷你的真手同时 |
[24:28] | while feeling me brush your real hand, | 你越盯着它看 |
[24:30] | the more your brain might start to blend them together. | 你的大脑越会把他们混在一起 |
[24:33] | Well, I guess I can buy that. | 这我能认可 |
[24:35] | Yeah. | 没错 |
[24:37] | Very powerful, the connection between what we see | 我们看到的和感觉到的之间的联系 |
[24:40] | and what we feel. | 非常强大 |
[24:43] | But Dr. Charles, I still know which one’s my arm. | 但是查尔斯医生 我知道哪个是我的手 |
[24:45] | Huh. Do ya? | 是吗 你知道吗 |
[24:56] | Uh, for a second there– | 有那么一秒钟 |
[24:57] | You felt the hammer. | 你感觉到了锤子 |
[24:59] | Yeah, I did. | 没错 我感觉到了 |
[25:03] | Well, and we both know there aren’t | 你我都知道 |
[25:06] | any nerve endings in this thing, right? | 这东西里没有神经 对吧 |
[25:09] | Amazing the tricks the brain can play on us. | 大脑捉弄我们的把戏真神奇 |
[25:14] | Keegan. Keegan, wait. | 基根 基根 等等 |
[25:17] | I’ve changed my mind. | 我改主意了 |
[25:17] | I don’t think you should have surgery just yet. | 我不认为你现在该做手术 |
[25:19] | Oh, here we go. | 开始了 |
[25:20] | What crazy idea has Dr. Charles talked you into? | 查尔斯医生告诉你了什么疯狂的想法 |
[25:23] | It may not be a nerve problem. | 可能不是神经问题 |
[25:25] | It could be a perception problem. | 这可能是感知问题 |
[25:27] | In fact, I’m not sure your itch is real. | 事实上 我不认为你的瘙痒是真的 |
[25:29] | Not real? Are you two serious? | 不是真的 你们认真的吗 |
[25:31] | Look at me. | 看看我 |
[25:32] | I have to be tied to the bed | 我必须要被绑在床上 |
[25:33] | so I don’t scratch a bigger hole in my head. | 才能阻止我在脑袋上挖出一个更大的洞 |
[25:36] | If surgery will work, I have to do it. | 如果手术管用的话 我必须要做 |
[25:38] | But what if it doesn’t? | 如果不管用呢 |
[25:39] | What if you wake up and nothing’s changed? | 如果你醒来什么都没变呢 |
[25:41] | It has to work. | 它一定管用的 |
[25:43] | Because I can’t live like this anymore. | 因为我不能再这么活着了 |
[25:44] | I want my life back. | 我想过以前的生活 |
[25:46] | Surgery will give it to you. | 手术会让你好起来的 |
[25:48] | All right, let’s go. | 我们走 |
[25:50] | Wait, Keegan. Wait, wait. | 等等 基根 等等 |
[25:52] | The brain can change. It responds to experience. | 大脑可以改变 它对以前的经历有反应 |
[25:54] | It’s called neuroplasticity. | 这叫做神经可塑性 |
[25:56] | Three years ago, a drug reaction created | 三年之前 药物反应创造了 |
[25:59] | a chronic itch that you can’t seem to satisfy, | 一种你似乎无法满足的慢性瘙痒 |
[26:01] | because it rewired your brain. | 因为它重新连接了你的大脑 |
[26:03] | No surgery is gonna fix that. Trust me. | 没有手术能修复这个 相信我 |
[26:05] | Daniel. | 丹尼尔 |
[26:06] | Please. Please, Keegan. | 拜托 拜托 基根 |
[26:08] | Let me try something before you go under the knife. | 在你做手术之前让我试试 |
[26:11] | It’s been three years. | 都三年了 |
[26:13] | What can you do for me that no other doctor has tried? | 你能做什么其他医生做不到的吗 |
[26:17] | A trick. | 一个把戏 |
[26:24] | What the hell is going on? | 发生了什么 |
[26:26] | I was told you needed help with a liver bleed. | 我听说你们需要止住肝出血 |
[26:27] | Retro-hepatic cava tear. | 肝后隧道静脉撕裂 |
[26:29] | Can’t fix anything until I control the bleed. | 在止住出血之前没法干别的 |
[26:31] | I’m gonna do that with an atrial caval shunt. | 我要做心房腔静脉分流术 |
[26:34] | You gotta be kidding. | 你在开玩笑吧 |
[26:35] | Nope, I’m gonna snake an ET tube | 没有 我要顺着他的心脏 |
[26:37] | down his heart and bypass the tear. | 给他插管 避开撕裂处 |
[26:39] | What, you couldn’t think of a riskier move? | 你想不到更冒险的举动了吗 |
[26:41] | Atrial caval shunts have an abysmal success rate. | 心房腔分流术成功率极低 |
[26:44] | Yep, I’m aware. | 没错 我知道 |
[26:46] | Then you also know that he’s cold and coagulopathic. | 那你也清楚他体温较低 并有凝血障碍 |
[26:49] | So, if you don’t pack him up, | 所以如果你不把他缝好 |
[26:50] | and get him up to the ICU to be warmed, | 送到楼上重症监护室回暖 |
[26:52] | he’s gonna die here on this table. | 他会死在这张手术台上 |
[26:53] | At least this gives him a shot. | 至少他还有个机会 |
[26:54] | If we send him up to the ICU, | 如果我们把他送到楼上重症监护室 |
[26:56] | he bleeds out and dies for sure. | 他一定会失血过多而死 |
[26:58] | Scissors and ET tube. | 剪刀和内插管 |
[27:01] | If you cut into that heart, there is no going back. | 如果你对他的心脏切下去 就不能反悔了 |
[27:03] | Yeah, I know. | 是 我知道 |
[27:05] | Don’t do it. | 别这么做 |
[27:12] | God damn it. | 该死 |
[27:14] | You kick me out of here | 你把我从这里赶出去 |
[27:15] | only to force me to help you kill this guy. | 就为了让我帮你杀了这个人吗 |
[27:17] | You’re a prick, Rhodes. | 你这个蠢货 罗德斯 |
[27:20] | Yeah, maybe. | 是啊 也许吧 |
[27:32] | If her father doesn’t wake up, | 如果阿比盖尔的爸爸醒不过来 |
[27:34] | what happens to Abigail’s organs? | 那她的器官会怎么样 |
[27:37] | They’re no good to anyone. | 谁都拿不到 |
[27:46] | Ms. Goodwin, can I speak to you about something? | 古德温女士 我能跟你谈谈吗 |
[27:54] | Could’ve driven a truck through this hole. | 这个洞大得能开卡车 |
[27:55] | He never would have survived in the ICU. | 他活不到重症监护室 |
[27:58] | This is the right call. | 这是正确的选择 |
[27:59] | Don’t act like you didn’t get lucky as hell. | 别搞得好像你没仰仗自己运气好 |
[28:03] | Let’s finish this up. | 我们收尾吧 |
[28:10] | What do I do? | 我该做什么 |
[28:11] | I don’t know how long I can go without scratching. | 我不知道我能坚持多久不去挠 |
[28:13] | Okay. | 好 |
[28:13] | I want you to look at your reflection | 我要你盯着自己痒的地方 |
[28:15] | and scratch the non-itchy side of your head. | 然后挠头的另一边不痒的地方 |
[28:20] | In the mirror, the image is gonna be reversed. | 在镜子里 画面是反的 |
[28:22] | It’s gonna look like you’re actually | 看起来就像是你确实在 |
[28:23] | scratching the itchy side. | 挠痒的那一面 |
[28:25] | Oh, I see it. | 我明白了 |
[28:28] | But how is scratching this side of my head | 但是为什么在这边挠 |
[28:29] | gonna make the itch go away on the other side? | 也会让另一边的痒好转 |
[28:31] | Keegan, trust me. | 基根 相信我 |
[28:32] | We know that you’ve been feeling this thing. | 我们知道你一直深受其扰 |
[28:34] | But I just want you to consider the possibility that maybe, | 但我希望你考虑一下这个可能性 |
[28:38] | just maybe that this itch isn’t real. | 也许这个痒并不是真的 |
[28:40] | And no amount of scratching is gonna satisfy it. | 永远没法挠得爽 |
[28:43] | Well, then what the hell am I doing? | 那我到底该怎么做 |
[28:44] | Giving your brain new visual input | 给你的大脑新的视觉输入 |
[28:47] | to the override the experience you had three years ago, | 以覆盖三年前的经历 |
[28:49] | so it can begin to rewire itself. | 让它能够重连 |
[28:52] | Okay, you’re losing me. | 好吧 我听不太懂 |
[28:54] | By feeling yourself scratch one side of your head | 你感觉你在挠头的这一边 |
[28:56] | while you’re seeing yourself scratch the other, | 实际上你在挠另外一边 |
[28:59] | your brain will be tricked. | 你的大脑就被唬住了 |
[29:00] | And realize something’s not right. | 然后会意识到有哪里不对劲 |
[29:02] | Now, hopefully, that experience will force you | 幸运的话 这种体验能迫使你 |
[29:05] | to perceive a new reality. | 感知一种新的现实 |
[29:07] | A reality in which the itch doesn’t exist. | 在这个现实中 痒不存在 |
[29:11] | So you say, but nothing’s changing. | 虽然你们这么说 但没用 |
[29:14] | And I feel stupid. | 我觉得自己很蠢 |
[29:16] | The exercise is designed to confuse your brain, | 这种练习本就是设计来迷惑你的大脑的 |
[29:18] | so don’t worry about that. | 所以不要担心 |
[29:19] | Just keep scratching. | 继续抓就好了 |
[29:22] | Like this? Harder? Softer? | 这样吗 更用力一点 还是轻一点 |
[29:25] | – Just like you’re doing. – Yes. | -照常就好 -好 |
[29:27] | Be patient. | 耐心一点 |
[29:30] | Give it a chance. | 给它一个机会 |
[29:34] | Keegan, we’ll be just outside. | 基根 我们就在外面 |
[29:37] | You’re doing great. | 你做得很好 |
[29:44] | How long are we gonna let her keep scratching? | 我们要让她一直挠多久 |
[29:48] | She’s been dealing with this for what, three years? | 她已经这样多久了 三年是吗 |
[29:50] | I mean, honestly Ethan, | 老实说 伊森 |
[29:52] | I don’t know how long it might take. | 我不知道需要多久才行 |
[29:54] | If it takes. | 前提是可行 |
[29:55] | The phantom itch theory makes sense, | 瘙痒幻觉理论是有道理 |
[29:58] | but it’s still just a theory. | 但只是理论 |
[29:59] | I just really don’t wanna give her any false hope. | 我不想再给她任何错误的希望了 |
[30:03] | Dr. Charles. | 查尔斯医生 |
[30:05] | Something’s definitely happening. | 有变化 |
[30:08] | The itch, it’s less. | 痒感减弱了 |
[30:15] | Okay. | 好 |
[30:19] | All right, I’ll be back in five. | 好 我五分钟内回来 |
[30:20] | I’m gonna run these over to sterile processing. | 我要把这些送去无菌处理 |
[30:30] | Hey. Have you seen April? | 你看到艾普尔了吗 |
[30:31] | – I wanted to check in on her. – Nope. | -我想问问她进展 -没有 |
[30:33] | She’s probably putting out a fire somewhere. | 她可能去哪救火了 |
[30:35] | That girl is on it. | 她可以的 |
[30:37] | So, things went well while I was in surgery? | 所以我在手术室时 没出什么乱子吧 |
[30:39] | Yeah, didn’t even realize you were gone. | 对 都没意识到你不在 |
[30:44] | That’s great. | 太好了 |
[30:45] | Yeah. | 是啊 |
[30:51] | Dr. Halstead, could I have a moment? | 霍斯特德医生 能和你谈谈吗 |
[30:54] | Of course. | 当然 |
[30:55] | An emergency ethics committee was formed to evaluate | 我们成立了一个紧急伦理委员会来评估 |
[30:58] | Marc Jones’ current condition and future prognosis. | 马克·琼斯的现状和未来预后 |
[31:02] | Wait, was formed? Who asked for that? | 等等 成立了 谁要求的 |
[31:04] | Between his spinal cord injury | 基于他的脊髓损伤和 |
[31:06] | and the high probability for irreparable brain damage, | 高概率的非可逆性脑损伤 |
[31:10] | the committee concluded with reasonable medical certainty | 委员会以合理的医学确定性得出结论 |
[31:13] | that he has no quality of life. | 他将不会有任何生活质量可言 |
[31:16] | No. | 不 |
[31:17] | Listen, the hospital will honor | 医院尊重 |
[31:21] | Mr. Jones’s tattoo as an advanced directive. | 琼斯先生的文身为预嘱 |
[31:24] | If he codes again, you will not resuscitate. | 如果他再次病危 你无需抢救 |
[31:28] | I cannot just walk away. | 我没办法袖手旁观 |
[31:30] | I’m sorry, but it’s over, Dr. Halstead. | 抱歉 但结束了 霍斯特德医生 |
[31:39] | I wanna talk to you. | 我想和你谈谈 |
[31:47] | An emergency ethics committee? | 紧急伦理委员会 |
[31:49] | What, I don’t bow down to your decision on my patient, | 我不屈服于你对我病人的决定 |
[31:52] | so you go over me to Goodwin and bench me? | 所以你去找古德温女士来压我吗 |
[31:54] | You forced my hand. | 你逼我的 |
[31:55] | I tried talking to you. You shut me down. | 我想和你谈 但你拒绝了我 |
[31:57] | Because you’d already decided Marc should die. | 因为你已经决定马克该死了 |
[32:00] | He has a tattoo across his chest that says, | 他胸口有个文身写着 |
[32:02] | “Do Not Resuscitate.” | “不要抢救” |
[32:03] | We don’t know that’s how he feels. | 我们不能确定这是他的想法 |
[32:05] | We don’t know he doesn’t. | 我们也不能确定不是 |
[32:07] | But what I do know is that if we don’t act now, | 但我知道如果我们现在不行动 |
[32:09] | we will lose Abigail’s organs. | 我们就会失去阿比盖尔的器官 |
[32:11] | Those are children’s lives in our hands. | 我们还有很多孩子的生命要救 |
[32:14] | No, don’t turn this on me. | 不 别拿这个来绑架我 |
[32:15] | Don’t guilt me into thinking that I’m the bad guy. | 别让我有负罪感 觉得自己是坏人 |
[32:17] | You don’t think I know the stakes of this case? | 你以为我不知道这个病人的胜算吗 |
[32:19] | I am sick of everyone telling me what I can | 我受够了所有人都在告诉我能做什么 |
[32:22] | and what I cannot do. | 不能做什么 |
[32:23] | I am just trying to save my patients. | 我只是想要救我的病人 |
[32:26] | What are you talking about? | 你在说什么 |
[32:27] | Who is everyone? | 所有人是谁 |
[32:31] | You betrayed me. | 你背叛了我 |
[32:33] | How can I ever trust you? | 我要怎么相信你 |
[32:35] | How can I trust you? | 我要怎么相信你 |
[32:38] | In the past, you have let patients go | 以前 你知道没希望了 |
[32:40] | who you knew were hopeless. | 就会任病人逝去 |
[32:42] | But you know what? It is more than that. | 但你知道吗 不仅是这件事 |
[32:43] | No, look at me. | 不 看着我 |
[32:44] | It is more than that. | 不止这件事 |
[32:46] | You have been acting strange for weeks. | 你已经好几个星期怪怪的了 |
[32:48] | And this morning, | 还有今天早上 |
[32:49] | that ridiculous story about a drug rep, really? | 那个医药代表的拙劣谎言 认真的吗 |
[32:56] | Well then, here we are. | 看看我们现在 |
[32:57] | And about to get married. | 而且我们还准备结婚 |
[33:06] | – Maggie. – Yep. | -麦基 -在 |
[33:07] | Thanks for approving my PTO for next month. | 谢谢你批准我下个月的带薪休假 |
[33:11] | I didn’t think there was a way to make it happen. | 我原本以为这是不可能的 |
[33:13] | Oh, yeah. Sure. | 是啊 好 |
[33:17] | April. | 艾普尔 |
[33:19] | Did you sign off on Monique’s paid time off for next month? | 你同意了莫妮克下个月的带薪休假吗 |
[33:22] | Yeah. | 是的 |
[33:23] | Saw her request had been siting there for three weeks. | 我看到她的申请已经搁着三个星期了 |
[33:25] | I hate it when I put in for vacation times and nothing happens. | 如果是我 也会很反感请了假但迟迟没回应 |
[33:28] | It takes a long time because someone’s always asking for PTO. | 时间久是因为有些人总是要请带薪假 |
[33:31] | Especially Monique. | 尤其是莫妮克 |
[33:33] | She took eight days off last month. | 她上个月休了八天 |
[33:35] | Well, her sister is pregnant, on bed rest and needs help. | 她姐姐怀孕了在休养 需要人照顾 |
[33:38] | So, how could I say no? | 所以 我怎么能拒绝呢 |
[33:40] | – What? – Lisa. | -什么 -丽莎 |
[33:42] | I’m talking to you. | 我在和你说话 |
[33:43] | I have a system for handling PTO’s. | 我有一套处理带薪休假的系统 |
[33:45] | You can’t take time off if you’re out of vacation. | 如果你没假了就不能再请了 |
[33:47] | Monique was out. | 莫妮卡没假了 |
[33:49] | Doris gave her some of hers. | 桃瑞丝把她的匀给她了 |
[33:51] | Oh, my God. You let them swap? | 天哪 你还允许她们调假 |
[33:54] | Doris said she wasn’t gonna use them. | 桃瑞丝说反正她也用不上 |
[33:56] | No sense letting them gather dust. | 没必要放着积灰 |
[33:57] | You know what’s gonna happen now? | 你知道现在情况是怎样吗 |
[33:58] | I’m gonna get hammered with requests from nurses | 我会受到其他想调假的护士的 |
[34:01] | who wanna swap days. | 多重打击 |
[34:02] | – Thanks a lot. – You know what? | -谢谢 -你知道吗 |
[34:04] | You don’t like the way I handle things | 我是在帮你忙 |
[34:06] | when I’m doing you a favor… | 而你不喜欢我做事的方式 |
[34:08] | A favor? | 帮我忙 |
[34:09] | This is a privilege. | 这是殊荣 |
[34:13] | Give your privilege to someone else. | 那把你的殊荣给其他人吧 |
[34:43] | Time of death, 19:22. | 死亡时间 19点22分 |
[34:55] | There, he’s gone. | 好了 他死了 |
[34:57] | You won. | 你赢了 |
[35:05] | I was about to give up, | 我原本要放弃了 |
[35:07] | but then there was this moment. | 但突然奇迹发生了 |
[35:09] | Look at me, I’m not scratching. | 看看我 我不挠了 |
[35:12] | I am so happy for you. | 我为你高兴 |
[35:14] | Dr. Choi, I can keep these mirrors, right? | 崔医生 我能留着那些镜子吧 |
[35:17] | It’s so much better. | 我好多了 |
[35:19] | Of course. And keep it up. | 当然 留着吧 |
[35:21] | Over time, they should fade away completely. | 再过段时间 就能痊愈了 |
[35:24] | Excuse me. | 失陪了 |
[35:26] | Dr. Charles, surgery would have been a mistake. | 查尔斯医生 手术确实会是个错误的选择 |
[35:29] | Good call steering her away. | 正确的决定救了她 |
[35:31] | Yeah, but, you know, I certainly understood | 是啊 但其实 我很理解 |
[35:32] | her desperation for relief. | 她迫切想解脱的心情 |
[35:36] | Do you know that scientifically, | 你知道在科学意义上 |
[35:37] | itching is ranked as one of the most distressing sensations | 痒被列为人能体会到的 |
[35:40] | a human being can experience? | 最痛苦的感觉之一吗 |
[35:42] | Really? | 真的吗 |
[35:46] | You know what, Dr. Charles, maybe it’s not a good idea, | 查尔斯医生 也许这不是个好主意 |
[35:50] | but some itches you just have to scratch. | 但有些痒是非挠不可的 |
[35:56] | Vicki. | 维琪 |
[36:03] | What do you say we go for a run? | 我们一起去跑步吧 |
[36:05] | Like old times? | 跟以前一样 |
[36:07] | Sure. | 好 |
[36:09] | Call me sometime. | 找时间约 |
[36:10] | My shift’s over. | 我下班了 |
[36:14] | How ’bout now? | 不如就现在吧 |
[36:18] | Okay. Let’s do it. | 好 一起去吧 |
[36:27] | Okay, look, my way isn’t the only way. | 我的方式不是唯一的方式 |
[36:31] | You’re doing a good job. | 你做得很好 |
[36:33] | Thanks. | 谢谢 |
[36:35] | And I confess, it sucks when you realize | 我承认 发现自己能被人取代 |
[36:37] | that you can be replaced. | 这种感觉很不好受 |
[36:40] | Yeah, I know. | 是啊 我知道 |
[36:51] | Wanna get a drink? | 要一起喝一杯吗 |
[36:54] | Maybe two? | 两杯也行 |
[36:58] | Yeah. | 好吧 |
[37:08] | Oh, Sam. | 萨姆 |
[37:09] | You’ll be happy to hear that Keegan’s feeling much better. | 基根感觉好多了 你也为她高兴吧 |
[37:12] | Oh, your smoke and mirrors? | 你的烟和镜子吗 |
[37:14] | Temporary fix. | 暂时治好了 |
[37:16] | She’ll be back here in six weeks to get that surgery. | 她六周后就会回来说要动手术的 |
[37:19] | Well, that’s the way you see it, | 那是你这么想 |
[37:21] | I, uh, I guess I see it a little differently. | 我可不这么想 |
[37:24] | Until next time, Daniel. | 再见 丹尼尔 |
[37:26] | Good night. | 晚安 |
[37:36] | An atrial caval shunt. | 心房腔静脉分流术 |
[37:39] | My cowboy. | 太迷人了 |
[37:42] | Dr. Rhodes. | 罗德斯医生 |
[37:44] | Three operating rooms upstairs were open. | 楼上有三间手术室空闲 |
[37:47] | You could have treated your patient in any one of them. | 你可以在任何一间治疗你的病人 |
[37:50] | Maybe, but I didn’t want to risk him dying in transit. | 也许吧 但我不想冒他在转移中死掉的风险 |
[37:53] | That is why we have a Hybrid OR. | 所以我们才成立了混合手术室 |
[37:56] | The gall bladder surgery you interrupted, | 你打断的胆囊手术 |
[37:59] | I’m rescheduling it for tomorrow. | 我重新安排到明天 |
[38:00] | In the Hybrid OR. | 在混合手术室里 |
[38:02] | Ms. Goodwin, this idea to repurpose my room | 古德温女士 重新定位我的手术室 |
[38:05] | is misguided and reckless. | 这个想法既愚蠢又鲁莽 |
[38:07] | Your room? | 你的手术室 |
[38:08] | Well, the board is considering closing your room | 董事会在考虑关闭你的手术室 |
[38:12] | unless it starts proving its worth. | 直到它开始证明自己的价值 |
[38:14] | That’s why I’m gonna make sure it is always earning money. | 所以我才想要确保它能赚钱 |
[38:18] | Great. Then I’m gonna keep fighting back, | 好 那我会继续反抗 |
[38:20] | because I’m not gonna let Gwen Garrett | 因为我不会让格温·加瑞特 |
[38:22] | turn the Hybrid OR into an ATM. | 把混合手术室变成取款机 |
[38:24] | Gwen Garrett has nothing to do with this. | 格温·加瑞特与此无关 |
[38:26] | I decided to put general surgeries in there. | 是我决定在那里做普通手术的 |
[38:30] | So you pull this little stunt again, and I’ll show you the door. | 所以你要是再搞这一出 我就让它关门 |
[38:38] | I don’t care what she says. | 我才不管她说的 |
[38:40] | I saved his life. I’d do it again. | 我救了他的命 我还会这么做 |
[38:43] | Come here. | 来 |
[39:01] | We’re a lot alike, you know. | 我们很相似 |
[39:03] | You’d do anything to get what you want. | 你会为了得到自己想要的不惜一切 |
[39:10] | You’re that bad, huh? | 你这么急不可耐吗 |
[39:12] | I’m that bad. | 我就是急不可耐 |
[39:38] | Abigail’s organs are off to recipients. | 阿比盖尔的器官给接受者了 |
[39:43] | That’s good. | 很好 |
[39:58] | Maybe you want this back? | 也许你想把它要回去 |
[40:15] | No, I don’t. | 不 我不想 |
[40:22] | Natalie, I wanna marry you. | 娜塔莉 我想和你结婚 |