| 时间 | 英文 | 中文 |
|---|---|---|
| [00:06] | I’m incising the uterine wall. | 我在切子宫壁 |
| [00:08] | You’re doing great, really great. | 你表现很好 非常好 |
| [00:11] | It’s gonna be okay. | 会没事的 |
| [00:13] | You promise? | 你保证 |
| [00:16] | – Baby’s out. – Umbilical clip. Suction. | -宝宝出来了 -脐带钳 抽吸 |
| [00:19] | Please — | 求你们 |
| [00:20] | can I see my daughter? | 我能看看我女儿吗 |
| [00:22] | Yes. | 可以 |
| [00:23] | Of course. | 当然 |
| [00:27] | Sorry. | 抱歉 |
| [00:28] | We’ll need to get her into surgery. | 我们需要对她进行手术 |
| [00:30] | We’ll take good care of her. | 我们会照顾好她的 |
| [00:45] | Your New Chief is fashionably late. | 你的新主任很时髦地迟到了 |
| [00:48] | Our Chief. | 是我们的 |
| [00:50] | Just because I endorsed Dr. Han to the Board | 虽然是我向医委会介绍的韩医生 |
| [00:52] | doesn’t mean I don’t have any concerns. | 但不意味着我一点担忧也没有 |
| [00:54] | Connections like Dr. Han’s come at a premium | 请韩医生这样的人代价高昂 |
| [00:56] | and, he assures me, will be well worth it | 鉴于我们目前在医委会面临的困境 |
| [00:58] | given our current predicament with the Medical Board. | 他向我保证雇他是物有所值 |
| [01:00] | I’m not just worried about the money. | 我不仅是在担心钱 |
| [01:03] | When you pay that much, | 当你付如此高工资 |
| [01:04] | they tend to think they’re worth it. | 他们容易自以为是 |
| [01:07] | Makes a person think they don’t have to show up | 他们就会连自己的欢迎早午餐会 |
| [01:09] | for their own welcome brunch. | 都懒得现身 |
| [01:23] | The baby’s bowel protrusion | 宝宝的肠突出 |
| [01:24] | seemed less severe on the prenatal imaging. | 在产前影像诊断里看上去没那么严重 |
| [01:27] | And it’ll have to wait | 而我们得先解决 |
| [01:28] | until we’re done with her heart problem. | 她的心脏问题才能轮到肠子 |
| [01:30] | Now that I’m in here, her septum looks more like Swiss cheese. | 我现在能看到她的隔膜和瑞士奶酪一样都是洞 |
| [01:37] | Page the on-call neonatal cardiac surgeon. | 呼叫新生儿心脏外科值班医生 |
| [01:39] | That won’t be necessary. I’ll scrub in. | 没有必要 我来就好 |
| [01:42] | And who are you? | 请问你是 |
| [01:44] | I’m Jackson Han. | 我是杰克森·韩 |
| [01:45] | Your new Chief of Surgery. | 你们的新外科主任 |
| [02:04] | Echo probe, please. | 给我回波探头 |
| [02:07] | And let’s turn that music on. | 让我们来放点音乐 |
| [02:13] | Advance the delivery sheath. | 传送鞘管往前点 |
| [02:18] | It’s in the patient’s heart, Dr. Murphy. | 在患者心脏里 莫菲医生 |
| [02:19] | I think the music is a little distracting. | 我觉得音乐有点让人分神 |
| [02:22] | I feel the same way about operating without music. | 做手术没有音乐才让人分神 |
| [02:26] | I’ll take a longer sheath, | 我来用一根长一点的 |
| [02:28] | and Dr. Murphy will need some forceps. | 而莫菲医生需要夹钳 |
| [02:36] | 5-second rule. | 五秒内捡起还能用 |
| [02:41] | It was a joke. | 我开个玩笑 |
| [02:46] | What about her bowels? | 她的肠子怎么了 |
| [02:47] | Why isn’t Dr. Lim inserting it into the abdomen right now? | 为什么利姆医生现在不把它放进腹腔 |
| [02:50] | There is not enough room. | 空间不够 |
| [02:53] | There’s — there’s not enough room | 如果要放进去 |
| [02:55] | without increasing abdominal pressure, | 不升高腹腔压是不可能的 |
| [02:57] | which would critically decrease blood flow to the bowel. | 这会导致肠道血流量锐减 |
| [03:00] | According to what hemodynamic principle… | 根据哪个血流动力学原理 |
| [03:03] | Dr. Browne? | 布朗医生 |
| [03:04] | Vascular impedance — blood flow is driven | 血流阻力 血流是由 |
| [03:06] | by the force induced by the pressure gradient. | 压差驱动的 |
| [03:08] | And how do you calculate it? | 该如何计算 |
| [03:13] | I-I’d have to look it up. | 我得去查一下 |
| [03:16] | 8 times L.Nu. divided | 八乘血管长度和血液粘滞性 |
| [03:18] | by Pi.R.4. | 除以圆周率乘半径的四次方 |
| [03:19] | Very good, Dr. Murphy. | 很好 莫菲医生 |
| [03:21] | That’s also why this occluder won’t work. | 所以这个封堵器用不了 |
| [03:23] | It won’t hold up against the huge pressure gradient in her heart. | 它扛不住她心脏内部的巨大压差 |
| [03:26] | Is there a fix? | 有解决方案吗 |
| [03:27] | Long-term, I don’t have one. | 我现在没有长期的方案 |
| [03:29] | Right now, I need umbilical tape and PE tubing. | 现在把脐带胶布和PE管给我 |
| [03:39] | You’re making a pulmonary artery band. | 你在做肺动脉束带 |
| [03:42] | That should buy us some time | 这样能争取点时间 |
| [03:43] | to come up with a plan before we lose this baby. | 想到办法救这个婴儿 |
| [03:53] | Lab technician to O.R. 6. | 检验技术员请到第六手术室 |
| [03:59] | You canceled my hernia repair? | 你取消了我的疝气修补术吗 |
| [04:01] | With no advance notice. Sorry about that. | 没有提前通知你 真是不好意思 |
| [04:04] | But so great to meet you. | 但很高兴见到你 |
| [04:06] | Jackson Han. | 我是杰克森·韩 |
| [04:07] | – Neil Melendez. – Oh, I know. | -尼尔·梅伦德斯 -我知道 |
| [04:08] | You did great work on that piggyback heart transplant. | 你那个背驮式心脏移植做得很不错 |
| [04:12] | I need a consult on Minesh Goyal. | 我需要你去给米那什·戈雅尔做会诊 |
| [04:14] | He’s the founding CEO of a company — | 他是一家公司的创始首席执行官 |
| [04:15] | – What’s his diagnosis? – He doesn’t have one. | -他的诊断结果是什么 -没有 |
| [04:18] | He’s here for a full physical, complete diagnostic workup. | 他是来做全面诊断检查的 |
| [04:22] | I have a long-standing Executive Wellness — | 我有一个长期的高管健康… |
| [04:24] | I’m a surgeon, not an internist. | 我是外科医 不是内科的 |
| [04:27] | I don’t do preventative medicine. | 我不做预防医学 |
| [04:28] | No matter how rich the patient is. | 不论患者多有钱 |
| [04:32] | You know what’s great about rich patients? | 你知道有钱患者的好处是什么吗 |
| [04:34] | They allow us to treat poor patients. | 他们让我们能治疗贫穷的患者 |
| [04:37] | Also, I promised Minesh the very best. | 并且我向米那什保证给他最好的医生 |
| [04:39] | So, really, who else am I gonna get? | 所以我还能找谁呢 |
| [04:43] | Dr. Johansen to pre-op. | 约翰森医生请去手术准备室 |
| [04:48] | BP’s 110 over 70. | 血压高压110 低压70 |
| [04:51] | Uh, Jackson — Dr. Han — | 杰克森 韩医生 |
| [04:53] | says great things about you. | 说了你很多好话 |
| [04:57] | That’s very kind. | 谢谢 |
| [04:59] | Normal EKG, optimal BMI, | 心电图正常 体质指数很好 |
| [05:02] | heart and lungs sound good. | 心脏和肺都没有问题 |
| [05:03] | Any reason you’re worried enough about your health | 有什么原因让你忧心到 |
| [05:05] | to endure an entire day of tests? | 能忍受一天的各种检查呢 |
| [05:07] | I’m not worried. | 我并不是担心 |
| [05:11] | Knowledge is power. | 知识就是力量 |
| [05:13] | Whenever I enter a new market, | 每次我进入新市场 |
| [05:14] | I learn everything I can about the landscape — | 我都尽力了解这个领域的方方面面 |
| [05:17] | consumer needs, target market, competitors. | 消费需求 目标市场 竞争者 |
| [05:20] | You’re aware your body isn’t a business. | 你知道你的身体并不是公司吧 |
| [05:23] | I know I sound like a rich lunatic | 我知道我听上去像是个有钱的疯子 |
| [05:25] | with fantasies about controlling every aspect of my life. | 妄图掌控我生活中的每一个方面 |
| [05:29] | And I guess I kind of am. | 我猜我算是吧 |
| [05:35] | My dad was in good shape, too. | 我父亲也曾经保养得很好 |
| [05:38] | Until he dropped dead on his daily jog. | 直到他猝死于每日都进行的慢跑中 |
| [05:53] | Dr. Markiel, please come to the mental health unit. | 马奇埃尔医生请到心理健康科 |
| [06:15] | I’m Larry Childs. | 我是拉瑞·查兹 |
| [06:16] | I’d shake your hand, but, you know, | 我想跟你握个手 但是 |
| [06:18] | no functioning immune system. | 我的免疫系统已经挂了 |
| [06:20] | – Aaron. Hi. – Good to meet you. | -我叫亚伦 你好 -很高兴见到你 |
| [06:23] | What flavor cancer do you have? | 你得了哪味癌症啊 |
| [06:26] | – What flavor? – Yeah. | -哪味 -对啊 |
| [06:28] | Glioma. | 神经胶质瘤 |
| [06:29] | Shut the front door. | 不是吧 |
| [06:31] | Brain or spine? | 脑部还是脊椎 |
| [06:33] | – Brain. – Dude — | -脑部 -老兄 |
| [06:35] | we’re tumor twins. | 咱俩是肿瘤双胞胎啊 |
| [06:36] | Wh-What do they have you on? | 他们给你用了什么药 |
| [06:39] | Vincristine. I hear that’s intense. | 长春新碱 我听说药效很强 |
| [06:41] | My doc thought it would wipe me out. | 我的医生认为这药能干掉我 |
| [06:43] | You doing okay or longing for death? | 你恢复有望还是想着赶紧死 |
| [06:46] | I am hanging in there. Thank you. | 我撑着呢 谢谢 |
| [06:48] | I’m on my third round of temozolomide. | 这是我用替莫唑胺的第三轮了 |
| [07:01] | I’ve seen you in here a few times. | 我在这看到过你几次 |
| [07:05] | I’ve seen you in here a few times. | 我在这看到过你几次 |
| [07:07] | You kind of keep to yourself, huh? | 你喜欢独来独往 对吧 |
| [07:10] | Yeah. | 嗯 |
| [07:11] | Well, I’m happy to introduce you around. | 我很乐意介绍一下大家 |
| [07:13] | It’s a really friendly group. | 大伙都很友好 |
| [07:14] | I’m okay. Thank you. | 不用了 谢谢 |
| [07:15] | You have a support group you go to? | 你有互助小组吗 |
| [07:18] | I do not. | 没有 |
| [07:20] | Everyone needs a cancer community. | 所有人都需要有个癌症小圈子 |
| [07:56] | And try to hold still. | 尽量别动 |
| [07:59] | Thank you. | 谢谢你 |
| [08:01] | For bringing us in. | 让我们参与 |
| [08:02] | This is the new Chief’s patient. It’s a great opportunity. | 这是新外科主任的病人 是个绝佳机会 |
| [08:04] | Or it’s a bunch of pointless tests. | 或一大堆无用的检查 |
| [08:09] | Uh, for which I thank you. | 但我依然感谢你 |
| [08:11] | Tell us about Dr. Han. | 跟我们说说韩医生 |
| [08:13] | He’s direct, charming, | 他说话直接 有魅力 |
| [08:15] | very sure of himself. | 非常自信 |
| [08:17] | Big ego. | 很自负 |
| [08:23] | There’s nothing wrong with an ego if you can back it up. | 自负没什么 只要有能力 |
| [08:26] | And Dr. Han’s arterial switch technique | 韩医生的动脉转位技术 |
| [08:28] | is performed all over the world. | 普及到了世界各地 |
| [08:30] | The tests aren’t all pointless. | 这些检查不全是毫无意义 |
| [08:32] | Way to stand firm, Park. | 好一个见风使舵 朴 |
| [08:33] | No, look at the monitor. | 不 看屏幕 |
| [08:35] | He has a tumor. | 他有肿瘤 |
| [09:02] | Percy’s stable? | 珀西稳定了吗 |
| [09:04] | We’re naming her Persephone. | 我们打算给她起名珀西芬 |
| [09:07] | Yes. I put in a central line for nutrition. | 是的 我开了一条中心静脉输送营养 |
| [09:10] | Percy is stable right now. | 珀西现在稳定了 |
| [09:11] | We’re looking for solutions to her problems. | 我们正在寻找治疗方案 |
| [09:14] | W-wh-why does… | 为什么 |
| [09:17] | Why does she have all these birth defects? | 为什么她会有这些先天缺损 |
| [09:19] | Diane. | 戴安 |
| [09:21] | We spoke to our obstetrician. | 我们跟产科医生谈了 |
| [09:22] | She said these defects can happen for no reason, right? | 她说这些先天缺损可能找不到原因 对吗 |
| [09:27] | That’s true. | 没错 |
| [09:28] | Over 50% have no known cause. | 有五成多的缺损原因未知 |
| [09:33] | I was taking paroxetine for clinical depression. | 我之前服用帕罗西汀治疗临床抑郁症 |
| [09:38] | And you went off the meds | 但你一发现自己怀孕 |
| [09:39] | as soon as you found out you were pregnant. | 就马上停药了 |
| [09:41] | She was five, six weeks at most. | 她那时最多怀孕五六周 |
| [09:43] | My OB told me studies show | 我的产科医生说研究表明 |
| [09:45] | antidepressants are safe to take during pregnancy. | 怀孕期间可以服用抗抑郁症药物 |
| [09:47] | But is that true, | 这是真的 |
| [09:49] | or is she protecting me? | 还是她在保护我 |
| [09:53] | There was a study that associated paroxetine | 有一项研究表明帕罗西汀和 |
| [09:56] | with these kinds of defects. | 这种先天缺损有关 |
| [09:57] | It is a possibility. | 有这个可能 |
| [10:12] | You can’t tell whether it’s cancerous or benign? | 你无法确定肿瘤是恶性还是良性的 |
| [10:14] | Not until we do the biopsy, | 做了活检才能有定论 |
| [10:15] | which I’ve scheduled for later. | 已经约了一会做活检 |
| [10:17] | We’ll know what’s going on by the morning. | 早上就会知道结果 |
| [10:21] | Good. | 好 |
| [10:22] | That’s good. | 很好 |
| [10:26] | Maybe you’d like to call someone? | 你想给谁打电话吗 |
| [10:29] | A family member, a friend? | 家人或朋友 |
| [10:31] | I’ll worry when I know it’s cancer. | 等确定是癌症我再担心 |
| [10:43] | We could use a transcatheter route | 我们可以用经导管路线 |
| [10:45] | and patch each hole individually. | 分别修复每个洞 |
| [10:49] | Her heart’s the size of a walnut. | 她的心脏只有核桃那么大 |
| [10:50] | It’s too small to maneuver inside. | 太小了无法在里面操作 |
| [10:53] | A single large patch to close the holes | 用一个大的补丁堵上所有洞 |
| [10:55] | would withstand the pressure. | 就能承受住压力 |
| [10:56] | Yes. | 没错 |
| [10:59] | It would also block electrical conduction, | 还能阻断导电 |
| [11:02] | causing deadly arrhythmias. | 造成致命性心律失常 |
| [11:04] | Dr. Murphy… | 莫菲医生 |
| [11:07] | did you tell the mom that she caused her baby’s birth defect? | 你是不是告诉那个母亲是她造成了孩子的先天缺损 |
| [11:10] | No. I said that her antidepressants could have. | 不是 我说可能是她的抗抑郁药 |
| [11:15] | Why did you tell her that? | 你为什么说这个 |
| [11:17] | It’s the truth. | 这是事实 |
| [11:19] | And is that relevant to her current medical situation? | 这与她现在的身体状况有关联吗 |
| [11:23] | No. | 没有 |
| [11:26] | And how did you think that answer would make her feel? | 你觉得你的回答让她有什么感受 |
| [11:29] | What did you think would happen? | 你觉得会发生什么 |
| [11:33] | The mother is devastated. | 母亲悲痛欲绝 |
| [11:35] | The father is furious. | 父亲气疯了 |
| [11:36] | I would be, too. | 换了我也会 |
| [11:38] | Shaun is a resident. | 肖恩只是住院医师 |
| [11:39] | Residents make mistakes. | 住院医师会犯错 |
| [11:42] | Managing these parents’ emotional concerns | 管理这些病人的情绪 |
| [11:44] | is as much a part of this job as operating on their daughter. | 以及给他们的女儿做手术都是这份工作的一部分 |
| [11:48] | Social cues are hard for Shaun, | 肖恩不太懂社交信号 |
| [11:50] | but we’ve been working with him — | 但我们一直在帮助他 |
| [11:51] | You should be focused on your own shortcomings, | 你应该注意改进自己的缺点 |
| [11:53] | like retaining the formula for vascular impedance. | 比如记住血流助力计算公式 |
| [11:57] | Dr. Han. | 韩医生 |
| [12:01] | We could patch each individual hole in the heart | 如果能切开心室 我们就可以 |
| [12:03] | if we cut open the ventricle — | 单独修复心脏的每个洞 |
| [12:05] | Don’t change the subject, Dr. Murphy. | 别转移话题 莫菲医生 |
| [12:07] | I didn’t, Dr. Han. | 我没有 韩医生 |
| [12:08] | We were talking about the baby. | 我们之前在谈论婴儿的手术方案 |
| [12:11] | Really? | 真的吗 |
| [12:13] | You don’t see a difference in the nature of your discussion | 你不知道在我进来前和进来后你们的讨论 |
| [12:15] | before I arrived and after? | 发生了本质性的变化吗 |
| [12:19] | We were talking about the baby. | 我们之前在谈论婴儿的手术方案 |
| [12:28] | They tried the approach you suggested at L.A. Children’s. | 洛杉矶儿童医院尝试了你说的方案 |
| [12:31] | The baby died a week later. | 婴儿一周后去世了 |
| [12:33] | The suture line didn’t hold, and the cardiac wall ruptured. | 缝合线撑不住 心脏壁破裂 |
| [12:36] | Keep looking. | 接着找 |
| [12:37] | Dr. Murphy, | 莫菲医生 |
| [12:40] | do not talk with those parents again. | 别再和那对父母说话了 |
| [12:46] | I’ll walk with you. | 我跟你一起 |
| [12:51] | You’re pretty tough on my residents. | 你对我的住院医师很严格 |
| [12:53] | Rebuking them in public, | 在公共场合指责他们 |
| [12:54] | pimping them with questions during surgery. | 在手术时用问题为难他们 |
| [12:56] | Shame-based learning isn’t my style. | 羞辱式学习不是我的风格 |
| [12:58] | I’ll bear that in mind. | 我会记住 |
| [13:00] | But this isn’t about my treatment of “the residents.” | 但这不是我对待医师的问题 |
| [13:02] | You’re concerned about Dr. Murphy. | 你担心莫菲医生 |
| [13:04] | Well, a lot of doctors have less than ideal bedside manner. | 很多医生对病人的态度都不太理想 |
| [13:07] | – He’s young. – Would you ever have said | -他还年轻 -你作为住院医 |
| [13:08] | something like that to a patient as a resident? | 或是作为医学生时 |
| [13:10] | As a med student? | 会对病人说这样的话吗 |
| [13:12] | And Murphy doesn’t even understand he did anything wrong. | 而莫菲甚至都不明白他到底做错了什么 |
| [13:14] | Shaun has hard-wired differences | 肖恩对于事物的感知 |
| [13:16] | – in the way he perceives things. – Exactly. | -和常人大不一样 -正是 |
| [13:18] | No matter how hard he works, | 不管他多么努力 |
| [13:19] | no matter how hard you try and help him, | 不管你多么努力地帮助他 |
| [13:22] | his limitations are not going to change. | 他的局限性不会改变 |
| [13:25] | He’s going to continue to inflict them on our patients | 他会继续以多样性和包容性的名义 |
| [13:28] | all in the name of diversity and inclusion. | 给我们的病人带来伤害 |
| [13:33] | Shaun deserves to be here. | 肖恩有能力留在这 |
| [13:36] | Once you see what he’s capable of, you’ll agree. | 一旦你看到他的能力 你会认同的 |
| [13:39] | I look forward to being proven wrong. | 我期待被证明我是错误的 |
| [13:47] | Stay seated for 20 minutes. | 再坐二十分钟 |
| [13:48] | Don’t want you passing out in the lobby. | 不希望你在大堂里昏倒 |
| [13:50] | I know, I know. Thank you. | 我知道 我知道 谢谢 |
| [13:57] | This disease changed my relationships, | 这种病改变了我的关系 |
| [13:58] | changed my priorities, changed… | 改变了我生活的重点 改变了 |
| [14:01] | who I am. | 我是谁 |
| [14:03] | Cancer is an identity. | 癌症是一种身份 |
| [14:04] | Cancer is cellular mutation. | 癌症是细胞突变 |
| [14:06] | The people in this room are my people. | 这个房间里的人都是我的人 |
| [14:08] | What are you? 20 years old? I’m triple your age. | 你多大 20岁 我是你的三倍 |
| [14:11] | I don’t think you’re my “people.” | 我不认为你是我的同类 |
| [14:13] | The last time I hung out with my law-school friends | 上次我和法学院的朋友出去玩 |
| [14:15] | epic fail. | 史诗般的失败 |
| [14:16] | The fact that you use the phrase “epic fail,” | 你用「史诗般的失败」这个词 |
| [14:18] | kind of case in point. | 完全证实了我的说法 |
| [14:19] | They’re all focused on what firm they’re gonna land at, | 他们关注的都是要去什么公司上班 |
| [14:21] | and I’m all about whether… | 而我只想知道… |
| [14:23] | Candice’s leukemia is responding | 新的化疗方案对 |
| [14:25] | to her new chemo regimen. | 坎迪丝的白血病有没有作用 |
| [14:27] | By the way, she has this peppermint oil | 顺便说一句 她的薄荷油 |
| [14:28] | that is great for headaches. | 对头痛很有效 |
| [14:35] | I know that look. | 我知道那种表情 |
| [14:37] | Here, here. | 给 给 |
| [14:43] | Got you, brother… | 有我呢 兄弟 |
| [14:45] | whether you like it or not. | 不管你喜不喜欢 |
| [14:51] | Show me where we are. | 现在什么情况 |
| [14:53] | That angle runs pretty close to the sacral nerve roots. | 这个角度非常接近骶神经根 |
| [14:57] | How are we doing? | 情况如何 |
| [14:58] | Tumor’s abutting the iliac artery. | 肿瘤贴着髂动脉 |
| [15:00] | I’m trying not to disrupt the entire blood supply | 我在想办法不阻碍他下半身的 |
| [15:02] | to his lower body. | 全部血液供应 |
| [15:03] | Dr. Han, I’m Morgan Reznick. | 韩医生 我是摩根·雷兹尼克 |
| [15:05] | I really enjoyed your article on Myotomy | 我很喜欢你那篇婴儿 |
| [15:07] | for infantile hypertrophic pyloric stenosis. | 先天肥厚性幽门狭窄肌切开术的文章 |
| [15:11] | I appreciate the thorough research behind your sucking up. | 我很欣赏你为了拍马屁做的功课 |
| [15:14] | And you are? | 你是 |
| [15:16] | Alex Park. | 亚力克斯·朴 |
| [15:17] | Park, you were a cop. | 朴 你以前是警察 |
| [15:20] | Medicine as a second career, good stuff. | 医学作为第二职业 不错 |
| [15:22] | Tends to bring a fresh perspective. | 会带来新的视角 |
| [15:27] | I hit an artery. Take the needle. | 我碰到动脉了 拿着针 |
| [15:30] | Blood’s pooling in the pelvis. | 血液在涌向盆腔 |
| [15:31] | – Should we open him up? – No. | -我们要开刀吗 -不 |
| [15:32] | Prep the femoral artery. Get me an art cath set. | 准备股动脉 给我一套动脉导管 |
| [15:34] | Presure is dropping. | 血压在下降 |
| [15:35] | Platinum coil. | 铂金弹簧圈 |
| [15:44] | Nice save. | 干得漂亮 |
| [15:46] | Next time, don’t hit the vessel. | 下次不要碰到血管 |
| [15:49] | There is no next time. | 没有下次了 |
| [15:51] | The biopsy’s too dangerous. | 活检太危险了 |
| [15:59] | It is likely that it’s a benign notochord cell tumor. | 很有可能是良性脊索细胞瘤 |
| [16:02] | They look like chordomas, | 那看起来像是脊索瘤 |
| [16:03] | but they’re harmless and way more common. | 但是无害的 而且更常见 |
| [16:05] | But you don’t know. | 可是你不知道 |
| [16:07] | Since we can’t do the biopsy, no. | 因为我们不能做活检 所以不知道 |
| [16:10] | This is the problem with broad testing. | 这就是全身检查的问题 |
| [16:13] | Everyone has abnormalities. | 每个人都有异常的地方 |
| [16:14] | Most of them are nothing. | 大多不是什么问题 |
| [16:16] | But when we do find them, | 但当我们确实发现问题时 |
| [16:17] | we have to make some tough choices. | 我们必须做出艰难的选择 |
| [16:21] | So, what exactly is my tough choice? | 那我的艰难选择到底是什么呢 |
| [16:25] | We could remove the tumor. | 我们可以切除肿瘤 |
| [16:27] | This is a very risky surgery. | 这是一个非常危险的手术 |
| [16:29] | There’s a chance of paralysis or worse, | 有瘫痪或更坏的可能 |
| [16:31] | you may not make it off the table. | 你可能下不了手术台 |
| [16:33] | Or you do nothing. | 或者就不做手术 |
| [16:35] | We’d continue to monitor it, | 我们可以继续观察 |
| [16:37] | do imaging every few weeks. | 每隔几周做一次成像 |
| [16:38] | But chordomas move very quickly. | 但是脊索瘤转移得很快 |
| [16:40] | By the time any change showed up on imaging, | 一旦影像出现任何变化 |
| [16:42] | it’s most likely metastasized throughout your body. | 很可能是全身转移 |
| [16:47] | So it probably isn’t cancer, | 所以这可能不是癌症 |
| [16:50] | but if it is and I wait, then I’ll die. | 但如果是癌症而我等着 那我就会死 |
| [16:54] | That’s true. | 是这样的 |
| [16:55] | And if I don’t wait and I get the surgery, | 如果我不等 直接做手术 |
| [16:59] | then there’s a good chance I’ll die. | 那我很有可能会死 |
| [17:01] | Yes. | 是的 |
| [17:08] | I’m gonna need to think this over. | 我得好好考虑一下 |
| [17:25] | This is the May Annals of Neonatal Surgery. | 这是五月份出的《新生儿手术记录》 |
| [17:29] | I just finished March. I need to read April now. | 我刚看完三月的 我现在得看四月的 |
| [17:32] | Oh, I have April, Shaun. | 我在看四月 肖恩 |
| [17:34] | No. | 不 |
| [17:35] | No, you’re supposed to be reading | 不 你应该去看 |
| [17:37] | New Approaches in Neonatal Surgery. | 《新生儿外科新思路》 |
| [17:40] | Claire has the British Journal of Neonatology. | 克莱尔那有《英国新生儿学杂志》 |
| [17:51] | Shaun… | 肖恩 |
| [17:53] | I think maybe you should be quiet around Han for a little while. | 我觉得韩在的时候你或许应该安静一点 |
| [17:59] | But then how will I answer his questions? | 可是我怎么回答他的问题呢 |
| [18:03] | Direct questions, absolutely answer. | 直接的问题 当然回答 |
| [18:06] | Otherwise, outside of the O.R., | 否则 在手术室外 |
| [18:09] | you should stay out of his way. | 你应该避开他 |
| [18:13] | If someone had convinced Shaun to do that with Dr. Melendez, | 如果有人说服肖恩这样对梅伦德斯医生 |
| [18:16] | he would still be on suction. | 他现在还在做抽吸的工作 |
| [18:22] | Code blue. NICU, Bed 4. | 蓝色警报 新生儿重症监护室4号床 |
| [18:30] | O2 SATs dropped and central venous pressure shot up. | 氧饱和度下降 中心静脉压升高 |
| [18:32] | The Pulmonary Artery Band is failing. | 肺动脉带在衰竭 |
| [18:34] | – Eight of dopamine. – Let’s get a mask on her. | -注射八个单位的巴胺 -给她上呼吸机 |
| [18:36] | She won’t last much longer. We need other options. | 她坚持不了多久 我们需要想其他办法 |
| [18:38] | I’ll update the parents. | 我去通知父母 |
| [18:41] | Let’s get her on full cardiac support. | 给她上全套心脏支持系统 |
| [18:59] | What have you got? Anything? | 你查到什么了吗 |
| [19:01] | This Cleveland group | 这个克利夫兰的团队 |
| [19:02] | repaired a bowel protrusion using enterolysis. | 用肠溶解术修复肠突出 |
| [19:05] | I could cut out this excess inflammatory tissue | 我可以切除多余的炎症组织 |
| [19:08] | and segment of bowel atresia. | 以及部分肠道闭锁 |
| [19:09] | Might make her intestines small enough to fit. | 或许能让她的肠子小到可以放进去 |
| [19:11] | Promising. | 有希望 |
| [19:13] | Given the size of her abdomen, | 因为她腹部空间太小 |
| [19:14] | I need to remove a lot of bowel. | 所以我得截掉一大段肠道 |
| [19:15] | There’s a good chance she wouldn’t be able to absorb food. | 她很有可能无法吸收食物 |
| [19:18] | We’ll have to find the right balance. | 我们必须找到一个恰当的平衡点 |
| [19:20] | It’s our only workable plan. | 这是唯一可行的方案 |
| [19:22] | Best bet on the heart is to cut through the ventricle, | 最好的办法是切开心室 |
| [19:24] | like Murphy suggested. | 就像莫菲建议的那样 |
| [19:26] | you were concerned about the suture line holding. | 你担心的是缝合线的支撑强度 |
| [19:29] | Well, I still am. | 没错 我还在担心 |
| [19:30] | Hopefully, horizontal mattress sutures will work. | 希望水平褥式缝合法能起效 |
| [19:32] | They should be able to withstand the tension at the suture line. | 它们应该能承受得住缝合线的拉力 |
| [19:35] | There’s still a risk of an aneurysm forming | 还是有在下面的组织中 |
| [19:38] | in the tissue underneath. | 形成动脉瘤的风险 |
| [19:42] | Dr. Lim? | 利姆医生 |
| [19:44] | I have an idea I’d like to share, | 即使韩医生没有问我问题 |
| [19:47] | even though Dr. Han didn’t ask me a question. | 我也有个想法想分享一下 |
| [19:54] | Yeah, go ahead, Shaun. | 好 说吧 肖恩 |
| [19:56] | If we go in through the atrium, | 如果我们从心房穿进去 |
| [19:57] | we wouldn’t have to worry about the suture line… | 就不用担心缝合线的问题… |
| [19:59] | It’s the same issue we discussed. | 这个问题我们已经讨论过了 |
| [20:01] | There’s not enough room inside the baby’s heart | 婴儿的心脏内部没有足够的空间 |
| [20:03] | to stitch the patches in the place. | 可以把补丁缝上去 |
| [20:05] | Oh, we don’t need to, Dr. Han. | 我们不需要这样做 韩医生 |
| [20:07] | We can make a plug | 我们可以做个塞子 |
| [20:08] | small enough for her heart… | 小到跟她的心脏相符… |
| [20:10] | a PTFE disc with a stem like a mushroom. | 带有茎部的聚四氟乙烯阀瓣 像个小蘑菇 |
| [20:12] | Then we can insert the stem through one of the holes | 然后我们把它的茎部插入其中一个洞里 |
| [20:14] | until the disc presses against the wall, | 直到这个阀瓣贴在心脏外壁上 |
| [20:16] | covering all the holes. | 把所有洞都覆盖住 |
| [20:19] | L-like a stopper in a bathtub. | 就像浴缸里的塞子 |
| [20:22] | Yes. | 没错 |
| [20:23] | The higher pressure on the left side of her heart | 她左侧心脏的受到的压力更大 |
| [20:25] | would keep it in place. | 这样就可以把塞子固定住 |
| [20:27] | We wouldn’t even need to stitch. | 我们都不用缝针了 |
| [20:30] | Great idea. | 好主意 |
| [20:32] | We should take this to the parents. | 我们应该去跟她父母谈谈 |
| [20:33] | Great idea for the heart. | 是治疗心脏的好主意 |
| [20:35] | But we need to tell them that our current plan | 但是还是得告诉他们目前 |
| [20:38] | for the abdominal repair | 修补腹部的方案 |
| [20:39] | is considerably more of a long shot. | 风险还是相当高的 |
| [20:41] | And that fixing the heart takes an option off the table. | 而且修补心脏让我们又少了一个选择 |
| [20:45] | Withdrawing care. | 也就是撤除治疗 |
| [20:56] | You can’t move that card. | 你不能动那张牌 |
| [20:59] | Excuse me? | 什么意思 |
| [21:00] | Who cheats at solitaire? | 谁玩单人纸牌会作弊 |
| [21:01] | You’re literally only cheating yourself. | 你其实是在欺骗自己 |
| [21:03] | Again. | 又一次 |
| [21:04] | Good morning, Larry. | 早上好 拉瑞 |
| [21:05] | Is it a macho thing? | 这样就是有男子气概吗 |
| [21:07] | Like a real man should be able to make it through | 真男人就不能被贴上癌症患者的标签 |
| [21:09] | without leaning on a label or the people who go with it? | 也不需要人陪 只能靠自己挺过去吗 |
| [21:14] | Embracing cancer as an identity | 把拥抱癌症作为自己的人物设定 |
| [21:16] | is the last thing any one of us should be doing. | 是我们这种人最不应该做的事情 |
| [21:18] | It underscores everything horrible right now. | 这样会更加凸显所有可怕的事情 |
| [21:22] | We’re in a daily battle for our lives. | 我们每天都在为活下去而斗争 |
| [21:24] | I see no value in dwelling on that. | 整天纠结这些事情没有任何意义 |
| [21:31] | Candice is late. | 坎迪丝迟到了 |
| [21:33] | Which means either her niece forgot to pick her up. | 可能是她侄女忘记去接她了 |
| [21:37] | Again. | 又一次 |
| [21:38] | Or she got some bad news. | 也可能是她病情恶化了 |
| [21:41] | Or she’s already dead. | 或者她已经死了 |
| [21:46] | We are in a daily battle. | 我们每天都在战斗 |
| [21:51] | I’d rather have some company. | 但我宁愿有人陪伴 |
| [22:09] | I spoke to my mother and brother, | 我已经跟我的母亲和兄弟谈过了 |
| [22:11] | and they both think I shouldn’t do the surgery. | 他们都觉得我不应该做手术 |
| [22:14] | Apparently they’re more scared of your surgical skills | 显然他们更害怕的是你的手术技能 |
| [22:16] | than they are of this tumor. | 而不是那个肿瘤 |
| [22:19] | And where do you stand? | 那你怎么看 |
| [22:20] | I need numbers. | 我需要数据 |
| [22:23] | Please. | 请坐 |
| [22:28] | The stats on something like this, it — | 关于类似情况的统计数据 |
| [22:31] | there are a lot of variables. | 有很多变数 |
| [22:32] | What are the odds I make it through the surgery | 那我手术成功 没有并发症的几率 |
| [22:35] | without any complications? | 有多大 |
| [22:37] | It’s a challenging procedure. | 这个手术很有挑战性 |
| [22:39] | Zero complications, I’d say 80%. | 我觉得有八成把握没有并发症 |
| [22:44] | But it is very unlikely this tumor is malignant. | 但是这个肿瘤很有可能不是恶性的 |
| [22:47] | Give me a number. | 给我具体数据 |
| [22:50] | About 5% chance it’s a chordoma. | 它是脊索瘤的可能性只有百分之五 |
| [23:00] | The numbers agree with your family. | 从这个数据来看你家人的意见是对的 |
| [23:02] | So do I. | 我也同意 |
| [23:12] | I’ve always been more comfortable with action than inaction. | 我一直都喜欢主动采取措施而不是坐以待毙 |
| [23:19] | I want you to do the surgery. | 我想让你来做这个手术 |
| [23:25] | Certainty comes at a price. | 要确定一件事是要付出代价的 |
| [23:35] | She’ll be able to get off the life support machines? | 她有可能撤掉生命维持系统吗 |
| [23:38] | If everything goes well, yes. | 如果一切顺利 没错 |
| [23:40] | She’ll have a strong heart. | 她会有一颗强大的心脏 |
| [23:41] | How soon can you do it? | 多快可以做手术 |
| [23:45] | You should know we feel less confident | 你们应该知道我们对于她肠道治疗的 |
| [23:47] | about our plan for her bowel. | 方案还不是很有信心 |
| [23:50] | The chance of failure is quite high. | 失败的可能性非常高 |
| [23:52] | How high? | 有多高 |
| [23:53] | I put it at 90% that the repair won’t work. | 我觉得有九成的可能修补不会起效 |
| [23:56] | Which would lead to irreversible malnutrition. | 这可能会导致无法复原的营养不良 |
| [23:59] | Your daughter would slowly starve to death over months. | 术后的几个月你女儿可能会慢慢饿死 |
| [24:03] | Right now, her body is working very hard | 现在 她的身体正在努力地 |
| [24:06] | just to stay alive. | 活下去 |
| [24:10] | If we were to turn off the machines… | 如果我们关闭生命维持系统 |
| [24:13] | Turn off the machines? | 关闭生命维持系统 |
| [24:17] | She would pass quickly. And peacefully. | 她很快就会平静地离开 |
| [24:21] | If the heart surgery is a success, | 如果心脏手术成功 |
| [24:23] | that won’t be an option. | 那就不用担心了 |
| [24:28] | Why not try to fix the bowel first | 那为何不先尝试修复肠道 |
| [24:29] | to see if it works? | 看看是否起效呢 |
| [24:30] | We won’t know if the bowel is viable | 因为在心脏手术成功之前 |
| [24:32] | until after the heart is. | 我们都无法知道肠道是否存活 |
| [24:35] | We have to do the surgery. | 我们必须做手术 |
| [24:38] | But if this doesn’t work, she could starve to death. | 但是如果失败 她会饿死的 |
| [24:40] | It’s worth the risk… | 这值得冒险… |
| [24:41] | It’s not our risk. It’s hers. | 这不是我们在冒险 而是她 |
| [24:43] | So, instead, you’re ready to give up on our daughter? | 所以 你就准备放弃我们的女儿了吗 |
| [24:46] | I mean, it’s like we’re right back at the ultrasound. | 就像当初我们一起站在超声波图像前 |
| [24:49] | We decided together to continue this pregnancy. | 一起决定 带她来到这个世界 |
| [24:51] | So this is as much my fault as it is yours. | 所以这件事你和我一样有错 |
| [24:53] | My fault? | 这是我的错吗 |
| [24:55] | Because of the medication? | 就因为那些药物 |
| [24:59] | I cannot turn off that machine. | 我不能关闭生命维持系统 |
| [25:03] | Your guilt is stopping you from admitting what we need to do. | 你的负罪感在阻止我们做该做的事 |
| [25:05] | My guilt has nothing to do with this. | 我的负罪感与这件事无关 |
| [25:08] | – I am fighting for my daughter. – So am I. | -我在为我女儿争取 -我也是 |
| [25:13] | Since the parents can’t agree, the decision | 既然父母的观点无法达成一致 |
| [25:15] | about the baby’s care will be made by a judge | 那将由一位法官根据我们的意见 |
| [25:18] | who will rely on our recommendation. | 为婴儿的治疗做出决定 |
| [25:21] | So we make the choice, | 所以我们做决定 |
| [25:22] | but the parents live with it? | 父母听之任之吗 |
| [25:26] | Well, maybe that’s a good thing. | 也许那是件好事 |
| [25:30] | For parents to have to decide between | 父母不得不在 |
| [25:32] | letting their daughter die | 眼睁睁看着女儿死去 |
| [25:34] | or fighting for her life, knowing she may suffer horribly, | 和痛苦对抗病魔间抉择 |
| [25:37] | maybe it’s better if we carry that burden. | 也许让我们担起这份重任更好 |
| [25:42] | Dr. Lim? | 利姆医生 |
| [25:44] | Your decision would be? | 你的决定是什么 |
| [25:47] | Take her off life support. | 关掉生命维持系统 |
| [25:49] | The odds are stacked against the bowel repair working. | 肠道修复可能对她不利 |
| [25:51] | Those numbers reflect the general population of doctors. | 那些数据反应的只是普通医生 |
| [25:54] | I think Dr. Lim and I are better than that. | 我认为利姆医生和我能够做得更好 |
| [25:57] | We can beat the odds. | 我们可以逆转局势 |
| [26:06] | One of the things I’m not going to miss | 作为外科主任 |
| [26:07] | about being Chief of Surgery | 我不喜欢的一点 |
| [26:10] | is being responsible for choices like this. | 就是得为这样的抉择负责任 |
| [26:15] | Dr. Han, it’s your department — | 韩医生 你的部门 |
| [26:17] | it’s your call. | 由你来决定 |
| [26:27] | You’ve been here all night? | 你一整晚都在这吗 |
| [26:29] | I’ve been working on a case | 我一直在和新任的外科主任 |
| [26:30] | with the new Chief of Surgery, Dr. Han. | 韩医生进行一桩手术 |
| [26:33] | – How’s that going? – Not very well. | -进展得如何 -不太顺利 |
| [26:35] | He plays music in the operating room. | 他在手术室放音乐 |
| [26:37] | Oh, geez. One of those. | 天哪 又是这种人 |
| [26:39] | And he says I need to focus on | 他还说我需要集中注意在 |
| [26:40] | our patients’ emotional needs. | 我们病人的情感需求上 |
| [26:43] | Well, that’s a tough assignment for you. | 这任务对你来说挺困难 |
| [26:52] | You ever wish you had, you know, | 你有没有想过结交 |
| [26:55] | friends, co-workers on the spectrum? | 患有自闭症的朋友 同事 |
| [26:58] | Not usually. | 并没有 |
| [27:00] | But maybe Dr. Han wouldn’t notice me as much | 也许韩医生不会太注意到我 |
| [27:03] | if I weren’t the only doctor with ASD. | 如果我不是唯一一个患自闭症的医生 |
| [27:08] | There’s this kid in chemo, | 有个在化疗的孩子 |
| [27:10] | just obsessed with having cancer. | 痴迷于患癌 |
| [27:13] | It’s all he talks about. | 他一直在谈论癌症 |
| [27:14] | He wants to be friends with everybody in the ward. | 他想和病房里的每个人都做朋友 |
| [27:16] | That’s very smart of him. | 他非常聪明 |
| [27:18] | Speigel et al showed an increase in overall survival | 《明镜周刊》等杂志发现乳腺癌病患 |
| [27:21] | and quality of life measures in breast cancer patients | 如果结识了其他同病相怜的人 |
| [27:23] | who formed social bonds with others battling the disease. | 那他们的存活率及生命质量都有所上升 |
| [27:27] | What should I do about Dr. Han? | 我该怎么应对韩医生 |
| [27:32] | I don’t know. | 我不知道 |
| [27:34] | just do your work, | 做好你的本职 |
| [27:36] | be a good surgeon, be an excellent surgeon. | 成为好的外科医生 杰出的外科医生 |
| [27:39] | Over time, he’ll forget about the autism. | 时间久了 他就忘记自闭症这事了 |
| [27:41] | Why would that happen? | 为什么会这样呢 |
| [27:42] | He’ll see that you have the skill, you have dedication. | 他会发现你的专业水平 你的奉献精神 |
| [27:45] | I have autism. | 我有自闭症 |
| [27:47] | It’s part of who I am. | 我生来如此 |
| [28:00] | The judge…? | 法官 |
| [28:01] | Accepted our recommendation | 接受了我们的提议 |
| [28:03] | and ruled in favor of surgery. | 并同意手术 |
| [28:06] | Thank you, Doctor. | 谢谢你 医生 |
| [28:13] | Okay, Percy. | 好了 珀西 |
| [28:17] | Momma loves you. | 妈妈爱你 |
| [28:21] | I love you, Percy. | 我爱你 珀西 |
| [28:58] | Should we remove more bowel? | 我们还要再移除些肠道吗 |
| [29:00] | That would take us to the ilium. | 那样会接触到髂骨 |
| [29:02] | She won’t gain enough weight to thrive. | 她的体重会达不到健康的标准 |
| [29:04] | Her abdominal muscles are tight | 她腹部的肌肉太紧实了 |
| [29:06] | from developing around an empty cavity. | 没法建一个空腹腔 |
| [29:10] | They’re cinched around her tummy like a corset. | 它们就像束腰一样缠着她的肚子 |
| [29:13] | What if we unbuttoned it? | 如果我们解开它呢 |
| [29:14] | Released the muscle | 释放肌肉 |
| [29:15] | and increased the abdominal circumference. | 扩大腹部范围 |
| [29:17] | Those muscles are part of her abdominal wall. | 这些肌肉是她腹腔壁的一部分 |
| [29:19] | Not if we separate the layers — | 但如果我们将层与层分开 |
| [29:21] | create a plane between the skin and the muscle. | 在皮肤与肌肉之间建一个平面 |
| [29:25] | You good if Murphy and I start on the heart? | 如果我和莫菲从心脏开始你没问题吧 |
| [29:28] | Dr. Browne, you’re with me on the abdomen. | 布朗医生 你和我负责腹腔 |
| [29:32] | Clearing the field. | 清理手术区域 |
| [29:33] | Han is on the call schedule next weekend. | 韩下周要值班 |
| [29:35] | Maybe Carmen will switch with me so I can cover with him? | 也许卡曼能和我换班好让我替他的班 |
| [29:37] | Or maybe you shouldn’t try so hard. | 也许你可以别这么拼命 |
| [29:41] | Retractor. | 牵引器 |
| [29:43] | Some of us don’t have a cool former career — | 我们有些人并没有体面的前职业 |
| [29:45] | or an easy-going, mellow demeanor. | 也并不开朗成熟 |
| [29:47] | People are never gonna crowd in my corner | 人们永远不会 |
| [29:48] | because I’m just so likable. | 因为我很讨喜就拥护我 |
| [29:49] | Well, you could try being nice to them. | 你可试试对他人友好点 |
| [29:51] | – Well, this is easier. – There it is. | -这简单多了 -就是这 |
| [29:56] | Does it look like cancer? | 看上去像癌症吗 |
| [29:58] | It’s not labeled. | 光看可看不出来 |
| [29:59] | We’re all gonna have to wait for the pathologist’s report. | 我们需要等病理报告 |
| [30:03] | Probe. | 探针 |
| [30:10] | The artery is in the way. | 有动脉挡住了 |
| [30:12] | We can’t get at the tumor without him bleeding out. | 要碰到肿瘤肯定会弄破动脉 |
| [30:19] | We’re gonna have to take it from the back. | 只能从背面入手了 |
| [30:20] | – But the S1 nerve root — – Is something he can live without. | -但S1神经根 -可有可无 |
| [30:24] | Dissecting scissors. | 解剖剪 |
| [30:29] | Pledget anchor. | 包扎锚点 |
| [30:46] | The plug is in position. | 塞子已就位 |
| [30:47] | You ready to test the bowel repair? | 准备好检验肠道修复得如何了吗 |
| [30:50] | Let’s take her off cardiac support. | 关掉心脏维持装置 |
| [30:52] | Dr. Murphy, it was your idea. | 莫菲医生 这是你的主意 |
| [30:54] | You do the honors. | 由你来 |
| [31:06] | Abdominal pressure is normal. | 腹腔压正常 |
| [31:09] | The intestines are perfusing. | 肠道在蠕动 |
| [31:15] | Pulmonary pressure’s spiking. | 肺压在上升 |
| [31:17] | Prostacyclin and nitric oxide — | 前列环素和氧化氮 |
| [31:18] | we need to get her lung pressure down. | 我们需要让她的肺压下降 |
| [31:19] | Oxygen SATs are dropping. | 血氧饱和度在下降 |
| [31:21] | No response to pulmonary vasodilators. | 对肺部血管扩张剂无反应 |
| [31:23] | Now the heart’s too strong. It’s overpowering her lungs. | 心脏跳动太强 给肺部施加很大压力 |
| [31:26] | She needs to go back on cardiac support. | 她需要心脏维持装置 |
| [31:36] | Persephone won’t starve to death… | 珀西芬不会饿死 |
| [31:40] | but she will drown in her own fluids. | 但会因积液过多而死 |
| [31:57] | I’ll talk to the parents. | 我去跟父母说 |
| [31:59] | May I come? | 我可以一起吗 |
| [32:12] | Now that Persephone’s heart is pumping at full power, | 珀西芬的心脏跳动太强 |
| [32:14] | her lungs are overwhelmed. | 她的肺部正在衰竭 |
| [32:18] | The humane thing to do | 最人道的方法就是 |
| [32:19] | is to turn off the machines and let her go. | 关掉所有仪器 让她离去 |
| [32:23] | No, I-I can’t… | 不 我不可以 |
| [32:25] | I can’t give up on her. | 我不可以放弃她 |
| [32:30] | Because you fought for her | 因为自从她出生以来 |
| [32:33] | every minute since she was born. | 你每分钟都在为她而战 |
| [32:35] | Before that, when you were taking your medication | 在那之前 当你在服用 |
| [32:37] | for the depression, | 抗抑郁药的时候 |
| [32:38] | you were fighting to keep going | 你为了继续活下去而战 |
| [32:41] | so you could bring her into the world. | 这样她才能出生 |
| [32:59] | But letting go of Percy is not giving up on her. | 但是让珀西走不是放弃她 |
| [33:04] | It’s listening to what her body is telling us. | 而是听从她的身体告诉我们的信息 |
| [33:11] | She’s hit her limit. | 她已经到达极限了 |
| [33:30] | Okay. | 好了 |
| [34:06] | I want Persephone to look as good as possible | 为了珀西芬的父母 我想让她 |
| [34:08] | for the parents. | 尽可能好看些 |
| [34:15] | Let’s turn off cardiac support. | 关掉心脏维持装置 |
| [34:22] | Ventilator. | 呼吸器 |
| [34:25] | Let’s take a minute. | 替她祷告一分钟吧 |
| [35:10] | Check valve. | 止回阀 |
| [35:16] | Every time the heart contracted, | 每一次心脏收缩 |
| [35:18] | blood went into the opposite side of the heart | 血液就会进入心脏的另一侧 |
| [35:20] | and raised lung pressure. | 提升肺部压力 |
| [35:22] | The hole reduced the pressure when it got too high | 当压力过大时 那个洞能降低压力 |
| [35:25] | because it allowed backflow. | 因为它允许返流 |
| [35:26] | But our repair of the defect blocked this backwards flow. | 但我们修复缺口 阻止了那个返流 |
| [35:30] | What if we made it so she still had a heart defect, | 如果我们能让她在需要的时候 |
| [35:32] | but only when she needed it? | 仍然保留有一个心脏的缺陷呢 |
| [35:34] | It’d be like an unlatched door in the wall of the heart. | 就像在心脏壁上开一个没拴上的门 |
| [35:38] | When the pressure gets too high on the right side, | 当右侧的心脏过高 |
| [35:40] | the door swings open, releasing the pressure on the lungs. | 这个门就会打开 减轻肺部的压力 |
| [35:43] | The rest of the time, it stays shut. | 其余时候则保持关闭 |
| [35:45] | It should reduce lung pressure by a third. Is that enough? | 那应该能减少三分之一的压力 够用吗 |
| [35:48] | It depends on how high | 那取决于 |
| [35:49] | her pulmonary vascular resistance is. | 她的肺血流阻力有多高 |
| [35:51] | PVR is pulmonary artery pressure | 肺血流阻力等于肺动脉压减去肺毛细血管楔压 |
| [35:53] | minus wedge pressure divided by cardiac output times 80. | 除以心排血量再乘以八十 |
| [36:08] | The last time I saw my doctor, | 上次我去见医生时 |
| [36:09] | he told me I had six months to live. | 他跟我说我还能活六个月 |
| [36:12] | He also told me I should marry an accountant | 他还跟我说我应该和一个会计结婚 |
| [36:14] | and move to North Dakota. | 搬去北达科他州 |
| [36:15] | You don’t say. | 不是吧 |
| [36:17] | When I asked if it would help my cancer, | 当我问他那对治好我的癌症有没有帮助 |
| [36:19] | he said no, | 他说没有 |
| [36:20] | just make the six months seem much longer. | 只会让这六个月看起来更长 |
| [36:26] | What’s the difference between a Neo-Nazi and cancer? | 癌症和新纳粹主义分子有什么区别呢 |
| [36:29] | Cancer doesn’t discriminate. | 癌症不区别对待每个人 |
| [36:34] | I knew a guy once — | 我认识一个人 |
| [36:36] | his Zodiac sign was Cancer. | 他的星座是巨蟹[癌症] |
| [36:38] | It was really ironic how he died. | 这让他的死法看起来很讽刺 |
| [36:44] | how’s that? | 为什么呢 |
| [36:44] | He was eaten by a giant crab. | 他被一个巨大的螃蟹吃了 |
| [36:47] | Oh, geez. | 天呐 |
| [36:52] | Aaron, glioma. | 亚伦 神经胶质瘤 |
| [36:54] | Candice, leukemia. | 坎迪丝 白血病 |
| [36:57] | Gin rummy or blackjack? | 玩金拉米纸牌还是21点纸牌 |
| [36:58] | How fast do you want to take my money? | 你想多快赢走我的钱 |
| [37:00] | Blackjack. | 21点 |
| [37:01] | Cut ’em. | 切牌吧 |
| [37:15] | Did you get it all? | 你都取出来了吗 |
| [37:20] | Yes. | 是的 |
| [37:21] | Totally clear margins. | 边缘都很清楚 |
| [37:23] | But the only way to achieve that | 但是为了做到这个 |
| [37:25] | involved removing the nerve that controls your left foot. | 不得不移除控制你左脚的神经 |
| [37:29] | Rehab and an advanced orthotic may help, | 康复治疗和矫形器也许有用 |
| [37:32] | but you will walk with a limp. | 但你只能跛着一条腿走路了 |
| [37:35] | Final pathology will let us know if it was worth it. | 最终病理检查会告诉我们这个代价是否值得 |
| [37:42] | I’ll let you know when it comes in. | 结果出来的时候我会告诉你的 |
| [37:46] | It doesn’t matter anymore. | 不重要了 |
| [37:51] | It’s not like you can put the tumor back in. | 反正那个瘤也放不回去了 |
| [38:09] | Is she… okay? | 她还好吗 |
| [38:12] | She still has a surgery or two in her future, but, yes. | 她还有一两个手术要做 但是还好 |
| [38:16] | She’s gonna be great. | 她会恢复的 |
| [38:22] | Can I hold her? | 我能抱抱她吗 |
| [38:23] | I think that would be very nice. | 我觉得那对你们来说 |
| [38:26] | For both of you. | 都非常好 |
| [38:43] | Hi, angel. | 我的天使 |
| [38:47] | Oh, my baby. | 我的宝贝 |
| [38:53] | Come hold her. | 来抱抱她 |
| [39:01] | You were fighting for her, too. | 你也为她而战了 |
| [39:08] | She’s beautiful. | 她多漂亮啊 |
| [39:18] | Nice work. | 做得好 |
| [39:21] | Thank you. | 谢谢 |
| [39:24] | She’s beautiful. | 她很漂亮 |
| [39:27] | Listen to her. | 你听她的声音 |
| [39:39] | Thank you. | 谢谢 |
| [39:46] | Minesh’s biopsy results? | 米那什的活检查结果 |
| [39:59] | You don’t want to know if we wasted our time | 你不想知道我们是不是在浪费时间 |
| [40:00] | almost killing him? | 还差点杀死了他 |
| [40:02] | Can’t put the tumor back. | 反正肿瘤也放不回去了 |
| [40:20] | Hello, Dr. Han. | 你好 韩医生 |
| [40:23] | You take the bus, too? | 你也坐公车啊 |
| [40:25] | No, Shaun. | 不 肖恩 |
| [40:27] | I just wanted to talk to you. | 我只是想和你谈谈 |
| [40:32] | You really do have remarkable diagnostic skills. | 你确实有着不凡的诊断能力 |
| [40:36] | I have to admit, you’re an asset to this hospital. | 我必须得承认 你是这家医院难得的人才 |
| [40:39] | Yes, I am. | 我也觉得 |
| [40:44] | I spoke to the Residency Director of Pathology. | 我和住院病理部主任谈过了 |
| [40:48] | And we both agree you’ll be a great fit there. | 我们都觉得你很适合待在那里 |
| [40:53] | I’m a surgical resident. | 我是个外科住院医师 |
| [40:57] | As a pathology resident, | 作为病理住院医师 |
| [40:59] | you’ll touch cases and lives | 你能接触到 |
| [41:01] | across all the medical departments. | 所有医疗部门的病例和病患 |
| [41:05] | It’s an opportunity for you to help patients | 这对你来说是个好机会 |
| [41:07] | without having to deal with patients. | 能帮助病患 但不用和病患打交道 |
| [41:11] | Given your difficulties with communication and social cues, | 鉴于你在沟通和理解社交信号上的困难 |
| [41:15] | I think it will be a much better fit. | 我觉得这对你更合适 |
| [41:18] | No, thank you. | 不了 谢谢你 |
| [41:21] | I have been working very hard | 我花了很大功夫 |
| [41:24] | at my communication skills. | 来提高我的沟通能力 |
| [41:27] | Hard work isn’t enough. | 光努力是不够的 |
| [41:30] | You have to do the job. | 你必须完成好工作 |
| [41:34] | I am a surgical resident. | 我是个外科住院医师 |
| [41:40] | You were. | 曾经是 |
| [41:43] | And you’re gonna do great work in pathology. | 你在病理部门会很出色的 |