| 时间 | 英文 | 中文 |
|---|---|---|
| [00:02] | He is not sick. | 他根本没病 |
| [00:04] | Dr. Riley is throwing up. He obviously can’t lecture. | 莱利医生呕吐不止 很明显没法讲课 |
| [00:07] | You witnessed the spew? Or you just have his word for it? | 你亲眼看见他吐了 还是他说的 |
| [00:10] | I think I’m coming down with a little bit of the clap. | 我感觉自己得了淋病 |
| [00:11] | I may have to go home for a few days. | 可能得回家休息几天 |
| [00:13] | Dr. Riley doesn’t have a history of lying to me. | 莱利医生从没对我撒过谎 |
| [00:16] | You said this is the fifth time he’s missed a class this year. | 你说过这是他今年第五次不上课了 |
| [00:18] | Either he’s dying or he’s lying. | 要么他是病入膏肓 要么就是撒谎 |
| [00:20] | I’ll give you two hours off clinic duty. | 我免你两个小时的门诊 |
| [00:22] | Fine. I’ll have Cameron do it. | 好 我让卡梅隆去 |
| [00:23] | She loves inspiring the inspired. | 她最喜欢传道授业解惑 |
| [00:25] | – You’ll do it. – Why is it always me? | -得你去 -为啥老是我 |
| [00:28] | Because the world hates you. | 因为你人缘差 |
| [00:29] | Or because it’s a class on diagnostics. | 或者因为这是节诊断课 |
| [00:31] | Pick whichever reason feeds your narcissism better. | 看哪个答案更满足你的自恋心理 |
| [00:35] | I’m not doing it. | 老子不干 |
| [00:48] | You’re supposed to stop me. Renegotiate. | 你该拦住我 重新谈判的 |
| [00:51] | And you were supposed to keep on walking. | 而你该继续往前走 |
| [00:53] | Sorry. Guess we both screwed up. Go on. Do it again. | 抱歉 咱俩都没按规矩来 再来 |
| [00:57] | I’ll do the lecture for four hours off clinic. | 我去上课 免我四小时的门诊 |
| [01:00] | Two. I know you’d rather spend a couple of hours | 两小时 我知道你宁愿花几小时 |
| [01:03] | listening to yourself than listening to patients. | 听自己说话 也不愿在这儿问诊 |
| [01:07] | Class starts in 20 minutes. | 20分钟后开课 |
| [01:12] | Dr. House, there’s a patient. | 豪斯医生 有病人找你 |
| [01:13] | I’m outta here. Take it up with Cuddy. | 我得要走了 有事儿找卡迪 |
| [01:15] | Greg. | 格雷戈 |
| [01:22] | Hi, Stacy. | 史黛西 |
| [01:26] | How ya doin’? | 你好吗 |
| [01:28] | How am I doing? | 你问我好吗 |
| [01:31] | The last five years have been like– | 过去这五年就好像… |
| [01:35] | You ever see those Girls Gone Wild videos? | 你有没看过《美女也疯狂》[成人影片] |
| [01:37] | Your life’s been like that? Or your life’s been spent watching them? | 你就那样活着 还是你就靠看那片活着 |
| [01:46] | I have missed you. | 我很想你 |
| [01:49] | Is that why you’re here? | 所以你才来的吗 |
| [01:56] | I need your help. | 我是来找你帮忙的 |
| [02:08] | – Who am I looking at? – My husband. | -这是谁的病历 -我丈夫的 |
| [02:15] | Who is suffering abdominal pain and fainting spells. | 病人感觉腹痛 并伴有间歇性晕眩 |
| [02:20] | No sign of tumors, no vasculitis. | 没有肿瘤 也不是血管炎 |
| [02:23] | Could be indigestion. | 可能是消化不良 |
| [02:26] | Or maybe a kidney stone. Little one can pack a lot of wallop. | 或是肾结石 小小一颗就会很痛苦 |
| [02:30] | Did you think I wasn’t going to get married? | 你以为我不会结婚 是吗 |
| [02:34] | Not to someone so poorly endowed. | 至少不是跟身体这么差的 |
| [02:36] | This guy’s pancreas is pathetic. | 这家伙胰脏太烂了 |
| [02:43] | There is no kidney stone, no indigestion. | 不是肾结石 也不是消化不良 |
| [02:46] | Three hospitals, five doctors– Not one of them found anything. | 换了三家医院五个医生都查不出病因 |
| [02:49] | Maybe there’s nothing to be found. | 也许本来就没什么病 |
| [02:51] | Right. You suddenly trust doctors, | 是啊 就好比你会突然信任医生 |
| [02:53] | love puppies and long walks in the rain. | 喜欢宠物和雨中散步 |
| [02:54] | Walks are out. | 我的腿没法散步 |
| [02:57] | I was around you long enough to know when something’s not right. | 相处久了 对方有不对劲自然知道 |
| [03:00] | Mark’s had personality changes. He’s acting strange, disconnected. | 马克性情大变 行为古怪没有连贯性 |
| [03:04] | Interesting. | 有意思 |
| [03:06] | Means there’s either a neurological component, | 就是说不是神经问题 |
| [03:08] | or he’s having an affair. | 就是有了外遇 |
| [03:10] | No affair. No nothing. He’s sick. | 没有外遇 什么都没有 他就是病了 |
| [03:14] | I know you’re not too busy. You avoid work like the plague. | 我知道你不太忙 你躲工作跟躲瘟疫似的 |
| [03:17] | Unless it actually is the plague. | 除非真有瘟疫 |
| [03:19] | – I’m asking you a favor. – I’m not too busy. | -我请你帮忙 -我是不太忙 |
| [03:26] | But I’m not sure I want him to live. | 但不确定想不想救他 |
| [03:31] | It’s good seeing you again. | 很高兴再见到你 |
| [04:25] | Three guys walk into a clinic. | 有三个人来看门诊 |
| [04:28] | Their legs hurt. What’s wrong with them? | 都说腿疼 会是什么病 |
| [04:35] | I’m not gonna like you, am I? | 你知道我不待见你的 是吧 |
| [04:37] | The most likely cause of leg pain is muscle strain. | 腿疼最可能的原因就是肌肉劳损 |
| [04:39] | Apply heat and rest affected areas. | 热敷并放松疼痛部位 |
| [04:42] | Statistically, you’re right. Very good. | 统计学上说 你说得对 很好 |
| [04:44] | My experience, | 以我的经验 |
| [04:45] | over half of leg pain is musculoskeletal, | 半数以上腿疼都是骨骼肌系统问题 |
| [04:48] | generally from excessive exercise, | 一般是由于过度锻炼引起的 |
| [04:50] | Twelve percent is varicose veins brought on by pregnancy, | 12%是因怀孕导致静脉曲张而引起的 |
| [04:54] | and most of the rest is the result of vehicular accidents. | 其余大部分都是交通事故 |
| [04:57] | I said three people. That’s six legs. | 三个人 就有六条退 |
| [05:00] | So you’ve got three hurt jogging, two in collisions, | 所以其中三条是运动过度 两条是交通意外 |
| [05:03] | and one of the legs is pregnant. | 还有一条是因为怀孕 |
| [05:06] | What were they doing when pain presented? | 疼痛发生时 他们都在干什么 |
| [05:08] | – I have no idea. – You didn’t ask? You didn’t take a history? | -我不知道 -你没问病史吗 |
| [05:11] | Of course. But all that told us is what they said happened. | 当然 但所知的仅限于病人自述 |
| [05:16] | Person “A”, farmer, says he was fixing a fence. | 病人甲 农夫 说他当时正在修栅栏 |
| [05:22] | Tightness in the ankle, loss of muscle control. | 突然脚踝疼痛 肌肉失去控制 |
| [05:27] | Person “B”, volleyball practice. | 病人乙 排球运动员 |
| [05:35] | Coach figured it was a pulled muscle. | 教练认为是肌肉拉伤 |
| [05:38] | And “C”, we’ve got Carmen Electra golfing. | 病人丙 卡门·伊莱克特拉正在打高尔夫 |
| [05:43] | – Yes! – Whoa. You treated the Baywatch chick? | -好球 -你治过《海滩护卫队》里的妞吗 |
| [05:47] | The Baywatch thespian. And no. | 应该说是《海滩护卫队》的演员 没 |
| [05:51] | I gotta disguise the identity of each of the patients, | 我得假设每个病人的身份 |
| [05:53] | and I got tired of using the middle-aged man. | 我厌倦了总拿中年男子举例 |
| [05:55] | Carmen seemed like a pleasant alternative. | 卡门看来是个不错的选择 |
| [05:59] | Also, she’s apparently quite the golfer. | 而且 她高尔夫也打得不错 |
| [06:01] | In less than two hours, one of these three… | 在接下来两小时内 三人中的一个… |
| [06:04] | will be tossed out of the hospital | 将被扔出医院 |
| [06:06] | because they were faking it to score narcotics, | 因为他是装病来骗麻醉剂的 |
| [06:08] | and one will be very close to death. | 一人将生命垂危 |
| [06:13] | Any guesses on which is which? | 猜得出是谁吗 |
| [06:17] | Okay, I say we start with the farmer. | 好吧 先从农夫讲起 |
| [06:22] | Did you hike to the fence, and how far? | 你徒步走到栅栏的吗 有多远 |
| [06:25] | Yes. It’s about a half a mile from my farmhouse. | 是的 离我的农庄差不多半英里 |
| [06:29] | Where is the pain localized? | 哪儿疼 |
| [06:31] | It started just above my ankle, and it’s radiating up. | 从脚踝开始 往上都疼 |
| [06:35] | So, what should we do first? | 那么 我们该先做什么 |
| [06:37] | Family history? | 问家族病史 |
| [06:38] | Indicative of leg pain? That’s a very short list. | 腿疼的病史 这可不多 |
| [06:41] | Any history of bone cancer, | 家族中有无骨癌 |
| [06:42] | osteogenesis imperfecta or multiple myeloma? | 成骨不全或多发性骨髓瘤病史 |
| [06:46] | Could be a blood issue. | 可能是血液问题 |
| [06:47] | We should run a C.B.C. and a D-Dimer. | 应做全血球计数和血浆D二聚体检测 |
| [06:50] | And get an M.R.I. | 再做个核磁共振 |
| [06:51] | M.R.I. or a PET scan? | 核磁共振还是PET扫描 |
| [06:53] | If the problem’s vascular, he’s better off– | 要是血管的问题 最好… |
| [06:54] | Sorry. Thanks for playin’. | 抱歉 谢谢参与 |
| [06:57] | Patient’s dead. You killed him. | 病人已死 你们害死的 |
| [07:01] | We had no time to run any tests. There was nothing we could do. | 根本没时间做检测 我们也无能为力 |
| [07:03] | You had time to look at the leg. | 至少有时间看看病人的腿 |
| [07:11] | I thought we were starting with the farmer’s case first. | 不是说先从农夫讲起吗 |
| [07:13] | We are. But if we’re gonna look at a leg– | 没错 不过要看腿的话… |
| [07:17] | I need you to take off your pants. | 你得脱了裤子 |
| [07:48] | Puncture. | 有创伤 |
| [07:49] | – Snakebite. – That would be my guess. | -蛇咬的 -我也会这么猜 |
| [07:51] | Farmer didn’t know he’d been bitten by a snake? | 农夫不知道自己被蛇咬吗 |
| [07:53] | That’s what he said. | 他是这么说的 |
| [07:54] | Sudden shooting pain, tall grass. Never saw a thing. | 突感刺痛 高茎草地 什么都没看见 |
| [07:58] | – What kind of snake? – You want me to tell you | -是哪种蛇 -你想让我 |
| [08:00] | what kind of snake it was from the shape of the hole in the leg? | 单凭腿上的创口就说出是哪种蛇吗 |
| [08:02] | How are we to know what kind of antivenom to use | 不知道是哪种蛇的话 |
| [08:04] | if we don’t know what kind of snake it is? | 怎么能确定用哪种抗蛇毒血清 |
| [08:05] | Oh, there are people to find those things out. | 会有人去找答案的 |
| [08:08] | Shouldn’t we wait for the Humane Society or something? | 难道不该等动物保护协会之类的吗 |
| [08:11] | Guy might only have a couple of hours. | 那人可能仅剩几小时可活了 |
| [08:20] | And while we wait for the Humane Society to show up, | 等动物保护协会派人来的同时 |
| [08:24] | what say we check in on the volleyball player. | 不如先去看看排球运动员的情况 |
| [08:28] | You have tendinitis. | 你有肌腱炎 |
| [08:31] | How old is this person? | 这人多大年纪 |
| [08:33] | I mean, | 我是说 |
| [08:33] | it’s not really a 40-year-old man on a girls’ volleyball team, right? | 不会真有40岁中年男人混在女排队里的吧 |
| [08:37] | It’s a leg. A leg is a leg is a leg. | 看的是腿 腿就是腿 |
| [08:39] | Well, I was just worried that– | 我只是担心… |
| [08:40] | Would you worry about her more if she was younger? | 她要是再年轻点 你是否会加倍担心 |
| [08:44] | Obviously, we should care about all our patients, | 当然我们该关心所有病人 |
| [08:46] | no matter what age– | 不管多大年纪… |
| [08:48] | Yeah, right. I saw the way you were looking at Carmen. | 对 我看到你盯着卡门那小样了 |
| [08:51] | She’s mine. Stay away. | 她是我的 离她远点 |
| [08:54] | – Would you operate on your mother? – Of course not. | -你会给你妈妈动手术吗 -当然不 |
| [08:58] | I’d be too nervous. Couldn’t be objective. | 我肯定会太紧张 不能客观处理 |
| [09:01] | Then why are you so anxious to treat every patient like they’re family? | 那为什么都急于视患者如家人般对待 |
| [09:05] | The actual patient is 16. | 实际的病人16岁 |
| [09:07] | Here’s what happens when doctors care too much. | 医生关心过多 就会这样 |
| [09:11] | I need to know everything about you. | 告诉我你所有的情况 |
| [09:15] | I went back three generations. | 我追溯了其家族三代 |
| [09:17] | No history of cancer, Parkinson’s or any other degenerative condition. | 无癌症 帕金森或其他病变史 |
| [09:20] | But there’s this boy at school, | 但她们学校有个男孩 |
| [09:22] | and he’s on the boys’ volleyball team. | 是校排球队的 |
| [09:23] | They made out at a party, and now he won’t call her back. | 在派对上俩人好上了 从此再没联系过她 |
| [09:25] | And this friend of hers at school said | 她一个同学说 |
| [09:27] | this boy didn’t like her and never did. | 那男孩从没喜欢过她 |
| [09:29] | You got all this from an examination of the knee? | 让你去检查她的膝盖 你就问回来这些 |
| [09:31] | I think she’s depressed. | 我觉得她很抑郁 |
| [09:32] | She doesn’t have tendinitis? | 她没有肌腱炎吗 |
| [09:33] | – She has tendinitis. – She’s depressed about having tendinitis? | -有肌腱炎 -那她是因此而抑郁吗 |
| [09:35] | She’s depressed for the same reason that she has tendinitis. | 她抑郁的原因跟患肌腱炎的原因一样 |
| [09:38] | – Not the boy? – No, the boy’s a jerk. | -不是那男孩? -不 那男孩是个混蛋 |
| [09:39] | She knows that, and yet she’s depressed. | 她自己清楚但仍很抑郁 |
| [09:41] | I found a nodule. | 我发现个小瘤 |
| [09:43] | Ahh. Problems with the thyroid gland– causes depressed mental state… | 是甲状腺问题 引发情绪抑郁 |
| [09:48] | can cause inflammation of the tendons. | 也可以导致肌腱发炎 |
| [09:50] | I’ll run the tests. | 我会去做测试 |
| [09:53] | So because she took such an extreme interest, | 这么说 正是因为她的极度关注 |
| [09:55] | she found out that the person had a thyroid condition. | 才能发现那人甲状腺有问题 |
| [09:58] | No. Because she took such an interest, she discovered a tiny nodule… | 不对 因为关注 她发现个极小的瘤 |
| [10:03] | which in reality signified nothing but gave us no choice… | 本来无关紧要 却让我们别无选择 |
| [10:06] | but to put a person with tendinitis through an expensive and painful test. | 让肌腱炎病人去做又贵又痛的检测 |
| [10:18] | Here’s how a well-adjusted doctor handles a case. | 真正处理得当的医生 会这样看病 |
| [10:27] | Can I put my pants back on now? | 现在我能穿上裤子了吧 |
| [10:29] | I’d rather you didn’t. | 最好不要 |
| [10:30] | Which Carmen Electra is this? | 这是哪位卡门·伊莱克特拉 |
| [10:32] | The first one. The golfer. | 开始那位 打高尔夫的 |
| [10:35] | Then why isn’t she wearing pants? | 那她为什么没穿裤子 |
| [10:39] | You have decreased reflexes in your patellar tendon. | 你膝盖肌腱的反射能力下降 |
| [10:43] | – Anyone? – Slipped disc. | -谁能来说下 -椎间盘突出 |
| [10:45] | Could be. How bad does it hurt? | 有可能 有多痛 |
| [10:48] | – It hurts really, really bad. – Yeah? | -真的很痛很痛 -真的 |
| [10:51] | It doesn’t seem real. Is she the one faking? | 看起来不像真的 她是装病的那位吗 |
| [10:54] | Oh, for God’s sake. | 看在上帝份上 |
| [10:55] | She’s here to play into my fantasy, | 请她来是为了满足我的幻想 |
| [10:58] | not ’cause she’s Meryl Streep. | 又不是因为演技 |
| [11:02] | Fine. | 好吧 |
| [11:03] | What the hell is wrong with me! | 我到底得了什么病 |
| [11:06] | Do something! | 快帮帮我 |
| [11:09] | Too much pain to be a slipped disc. | 这么疼不像是椎间盘突出 |
| [11:11] | Could be herniated and impinging the nerve root. | 内容物疝出 压迫到了神经根 |
| [11:13] | Or it could be referred pain from his groin. | 或者是腹股沟区牵涉痛 |
| [11:15] | Sir, are you getting pain anywhere else? | 先生 还有其他部位疼痛吗 |
| [11:19] | He’s curling. It’s not the back. | 他蜷着身子 肯定不是后背疼 |
| [11:21] | – Sir, where are you getting pain? – Help me! | -先生 你哪里疼 -救救我 |
| [11:23] | He’s not gonna tell us anything if we don’t get him out of pain. | 不先帮他止疼 什么都问不出来 |
| [11:26] | Give him 50 milligrams of Demerol. | 给他注射50毫克杜冷丁 |
| [11:27] | We have no history. He could be allergic. | 没有他的病历 会过敏的 |
| [11:29] | What do I do? | 我该怎么办 |
| [11:31] | We can’t diagnose him while he screams. | 他不停叫疼 无法诊断 |
| [11:33] | Better than killing him with painkillers. That– | 总比止痛药过敏致死的好 那就… |
| [11:44] | Apparently he’s not allergic. | 显然他没过敏 |
| [11:47] | Thank you. I feel a lot better now. | 谢谢 我感觉好多了 |
| [11:55] | We screwed up. | 我们搞砸了 |
| [11:57] | No. You did exactly what his attending did. | 不 你们做了主治医师该做的 |
| [12:00] | – And that was the proper way to handle the case? – Yeah. | -那就是得当的诊断方式吗 -对 |
| [12:02] | The guy used him as a dealer. | 那人显然把这当毒品用 |
| [12:04] | You’re gonna see a lot of drug-seeking behavior in your practice. | 你们以后会见识更多装病骗麻醉剂的 |
| [12:07] | There’s a reason– It works. | 原因只有一个 这么做见效 |
| [12:10] | Meanwhile, back on the farm– | 现在 回到农场 |
| [12:18] | Yeah. Timber rattlesnake. | 没错 是粗鳞响尾蛇 |
| [12:21] | Four vials of the CroFab antivenom. | 准备四瓶CroFab抗蛇毒血清 |
| [12:25] | – Hey, how ya doin’? – All right. | -你好 感觉如何 -还不错 |
| [12:27] | Thank you. This will start making you feel better really fast. | 谢谢 注射以后很快就会好的 |
| [12:39] | He’s having an allergic reaction. Bag. | 他有过敏反应 呼吸器 |
| [12:44] | Paddles and epi. | 心脏起搏器 |
| [12:46] | – His heart’s fine. – It’s not gonna stay that way. | -他的心脏没问题 -很快就会有 |
| [12:50] | Paddles! | 心脏起搏器 |
| [12:58] | What say we take five, | 不如休息五分钟 |
| [13:00] | get some coffee, go pee. | 喝点咖啡 方便方便 |
| [13:12] | You didn’t think she was gonna get married? | 你以为她不会结婚吗 |
| [13:15] | She asked me the same question. | 她也这么问我 |
| [13:20] | And… what? You’re not gonna treat him? | 怎么 不准备给他治吗 |
| [13:26] | There’s probably nothing wrong with him. | 很可能他什么病都没有 |
| [13:28] | Oh, sure, that makes sense. | 当然 那也说得通 |
| [13:30] | She’s just using the old sick husband routine… | 她只是利用丈夫生病这样的老桥段 |
| [13:32] | as an excuse to get back in touch with you. | 当做重新接近你的借口 |
| [13:35] | You think this is easy for her? | 你觉得这对她来说容易吗 |
| [13:37] | The only reason she’d be anywhere near you is | 她再次靠近你的唯一原因 |
| [13:39] | if she was desperate. | 只能是别无选择了 |
| [13:40] | So I should help her because she hates me? | 难道因为她恨我 我就该帮她吗 |
| [13:42] | She doesn’t hate you. She loves you. | 她并不恨你 她深爱你 |
| [13:45] | She just… can’t stand to be around you. | 她只是无法留在你的身边 |
| [13:55] | Uh, Dr. House? | 豪斯医生 |
| [13:57] | It’s been almost six minutes. | 已经休息了将近六分钟了 |
| [14:08] | Found him. | 找到了 |
| [14:11] | The volleyball player… | 那排球运动员 |
| [14:14] | was responding to the anti-inflammatories as you’d expect in a case of tendinitis. | 诊断为肌腱炎 注射抗炎药后见效 |
| [14:19] | Whoa, whoa, whoa, whoa, whoa. What about the snakebite guy? | 等下 被蛇咬的那位呢 |
| [14:22] | I don’t really care about the volleyball player. | 我对排球运动员那例不是很感兴趣 |
| [14:24] | What if I told you the volleyball player had a sudden massive stroke? | 要是我说排球运动员突然重度中风呢 |
| [14:28] | – Really? – No. | -真的吗 -没有 |
| [14:30] | But that would make you interested, right? | 但这样你就会感兴趣了 是吗 |
| [14:32] | What if her T-4 came back low? | 要是她的甲状腺水平再次降低呢 |
| [14:35] | It’s not quite as interesting, but it has the benefit of being true. | 这本不是好事 但真的话反而能引起医生兴趣 |
| [14:37] | You said the thyroid biopsy was a wasted test. | 你说过甲状腺活检只是徒劳 |
| [14:40] | No, I didn’t. I said she put a person | 不 我没这么说 我只是她说让一名 |
| [14:43] | with tendinitis through an expensive and painful test. | 患肌腱炎的病人去做又贵又痛苦的检查 |
| [14:46] | Apparently, the patient had tendinitis and a thyroid condition. | 很显然 病人既有肌腱炎又有甲状腺问题 |
| [14:49] | We’re gonna start you on thyroxine. | 给你用甲状腺素 |
| [14:51] | It’ll make you feel better and level your moods. | 能让你病情好转 平复情绪 |
| [14:55] | Thank you. | 谢谢 |
| [15:07] | – So that’s it? – You were right the first time. | -就这样吗 -你之前是对的 |
| [15:11] | Snakebite guy’s way more interesting. Gross, actually. | 被蛇咬的病例更有趣 其实是恶心 |
| [15:18] | The patient responded to epinephrine, | 用肾上腺素后见效 |
| [15:21] | and the allergic reaction was arrested. | 不再过敏 |
| [15:23] | Unfortunately, the patient continues to deteriorate. | 不幸的是 病情仍持续恶化 |
| [15:26] | Maybe the snake wrangler was wrong about the type we caught. | 也许不是我们抓的那种蛇咬的 |
| [15:28] | He faxed us the venom test. | 毒液测试报告传真过来了 |
| [15:30] | Confirmed. It’s a timber rattlesnake. | 确认是粗鳞响尾蛇 |
| [15:33] | No, it’s not. Notice the volume? | 不对 不是的 注意到毒液量那栏吗 |
| [15:36] | I skimmed over that and the gender and the coloring. | 我大致浏览了性别和颜色 |
| [15:39] | Jumped right to the name of the snake. | 就直接跳过去看蛇的种类了 |
| [15:41] | Two hundred milligrams. Our guy got bit less than four hours ago. | 两百毫克毒液 病人是不足四小时前被咬的 |
| [15:45] | There’s no way a snake regenerates that much venom that quickly. | 蛇不可能在短时间内重新生成这么多毒液 |
| [15:48] | We’re supposed to know how fast snakes make their venom? | 我们还得知道蛇生成毒液的速度吗 |
| [15:51] | No. Unless you’ve got a patient bit by one. | 不必 除非你的病人被蛇咬了 |
| [15:54] | Then it might be helpful. | 这类知识就有用了 |
| [15:56] | So what do we do now? | 那我们现在该怎么办 |
| [15:57] | He must have been bitten by a different snake. We go back and find it. | 他肯定是被其它蛇给咬了 回去再找吧 |
| [16:01] | Or you go online, and you find | 或者上网 就能查到 |
| [16:03] | there’s only three poisonous snakes common in New Jersey: | 新泽西只有三种常见毒蛇 |
| [16:05] | the copperhead, timber rattler and the coral. | 铜头蛇 粗鳞响尾蛇和珊瑚蛇 |
| [16:07] | Copperhead and timber rattler | 而我们给病人注释的抗蛇毒血清 |
| [16:10] | both respond to the antivenoms we gave the guy. | 对铜头蛇和粗鳞响尾蛇都有效 |
| [16:11] | So we give him the antivenom for the other one? | 那应该给他注射另一种抗蛇毒血清吗 |
| [16:14] | Is that a question? | 你这是在问我 |
| [16:15] | We can’t just blindly give him another antivenom, | 绝对不能盲目再给他用抗蛇毒血清了 |
| [16:17] | especially after the first one almost killed him. | 尤其是在第一种差点害死他后 |
| [16:19] | You said only three types of poisonous snakes commonly found in New Jersey. | 你说新泽西就三种常见毒蛇 |
| [16:23] | – Well, what if this is an uncommon one? – Very good. | -那万一是不常见的呢 -很好 |
| [16:26] | – We gotta find the right snake. – No need. | -还是得找到到底是哪种 -没必要了 |
| [16:28] | Odds are by the time you get back, | 很可能等我们回来 |
| [16:30] | the autopsy results will tell you what kind of snake it was. | 验尸报告自然会告诉我们是那种蛇 |
| [16:32] | But you said– | 但你说… |
| [16:34] | So we do give him the antivenom for the other one? | 所以还是得给他再用其他血清 |
| [16:37] | Again, was that a question? | 再说一次 你是在问我吗 |
| [16:39] | I asked what you would do. | 是我在问你们啊 |
| [16:40] | It seems unfair for you to ask me what you would do. | 你把问题扔回给我 好像有失公允 |
| [16:43] | Who gives the guy the other antivenom? | 谁选择给他用另一种抗蛇毒血清 |
| [16:48] | And who goes looking for the snake? | 谁选择继续去找蛇 |
| [16:51] | I assume that one choice kills him, the other one saves him. | 我觉得这两个选择 一个杀人 一个救人 |
| [16:54] | That’s usually the way it works | 在腿部中毒变黑的情况下 |
| [16:56] | at the leg-turning-black stage. | 通常只有这两种方法 |
| [16:58] | So half of us killed him, and half of us saved his life. | 所以我们可能杀了他 也可能救了他 |
| [17:02] | – Yeah. – We can’t be blamed for– | -对 -但不该以此谴责我们… |
| [17:05] | I’m sure this goes against everything you’ve been taught, | 我知道这跟你们所学是相违背的 |
| [17:08] | but right and wrong do exist. | 但对错之分确实存在 |
| [17:11] | Just because you don’t know what the right answer is– | 仅仅因为你自己不知道哪个是对 |
| [17:13] | maybe there’s even no way you could know what the right answer is– | 或者根本没办法知道哪个是对 |
| [17:15] | doesn’t make your answer right or even okay. | 这样并不会让你的答案变对 |
| [17:18] | It’s much simpler than that. | 其实事情远没那么复杂 |
| [17:20] | It’s just plain wrong. | 不过是个低级错误 |
| [17:25] | We gave the guy the antivenom. | 我们给他用了抗蛇毒血清 |
| [17:27] | What if I’m allergic again? | 万一我再过敏呢 |
| [17:29] | That’s why these people are here. | 所以这么多医生站在这 |
| [17:31] | If you have a reaction, | 一旦你有过敏反应 |
| [17:32] | we’re ready to do whatever’s necessary… | 我们会及时采取必要措施 |
| [17:34] | to ensure your airways stay open and your heart keeps beating. | 确保你气道保持通畅 心脏继续跳动 |
| [17:37] | My wife’s on her way in. Can’t this wait? | 我妻子正在赶来 就不能等等再治吗 |
| [17:40] | I’m sorry. It can’t. | 抱歉 等不了 |
| [18:14] | – It hurts again. – He came back? | -我腿又疼了 -他又回来了吗 |
| [18:18] | On average, drug addicts are stupid. | 通常来说 吸毒的人都很蠢 |
| [18:22] | – I’d call the cops. – Good for you. | -要是我就报警 -很好 |
| [18:25] | A lot of doctors wouldn’t risk their careers on a hunch. | 大部分医生都不会用职业生涯赌这一把 |
| [18:28] | It’s not a hunch. I mean, I know he wants drugs. | 这不算赌 我明知道他是来骗毒品的 |
| [18:30] | Well, even drug addicts get sick. | 但吸毒的人也有可能生病 |
| [18:32] | Actually, for some reason, | 事实上 出于某种原因 |
| [18:35] | they tend to get sick more often than non-drug addicts. | 他们比不吸毒的更常生病 |
| [18:39] | Luckily, you don’t have to play your hunch. | 幸运的是 你不用赌这一把 |
| [18:43] | There’s a faster way. Actually, there are several. | 有种更快的解决之道 事实上有好几种 |
| [18:45] | My preference is urine testing. | 我更倾向于给他验尿 |
| [18:47] | But you already know he has drugs in his system. | 但你已经知道他会有毒品反应了 |
| [18:49] | That’s not what I’m testing for. | 我不是想检测的这个 |
| [18:51] | We’re gonna put this hard rubber tube up your urethra and into your bladder. | 我们会将这根硬橡胶管通过尿道插入你的膀胱 |
| [18:55] | It may be a little uncomfortable. | 可能会有点不舒服 |
| [18:57] | Shouldn’t I be getting some sort of anesthetic? | 难道不该给我来点什么麻醉剂吗 |
| [19:01] | We’re concerned about allergic reactions today. | 不麻醉 今天我们很怕有过敏反应 |
| [19:11] | If the guy can handle a rod in his penis | 如果这人能忍受塑胶管插在鸡鸡里 |
| [19:14] | for half an hour, he’s really sick. | 半小时之久 那他肯定是真病了 |
| [19:16] | Or he’s really jonesing. | 或者他毒瘾真的有够重 |
| [19:18] | There’s easier ways to get ahold of drugs. | 还是有很多简单办法能搞到毒品的 |
| [19:20] | Other hospitals, for example. | 比如说 去其他医院 |
| [19:25] | The volleyball player is not responding to treatment. | 对排球运动员的治疗并不见效 |
| [19:31] | At least we think it’s not working… | 至少我们不认为有效 |
| [19:32] | on account of the fact that she’s getting worse. | 事实上 她的病情恶化了 |
| [19:35] | – Can you still hear me? – No. | -还能听到我说话吗 -听不到 |
| [19:38] | – A little! – Not really! | -能听到一点 -听不清 |
| [19:42] | Well, if you can’t hear me, how do you know what I asked? | 听不到 怎么知道我问什么 |
| [19:45] | I’m sorry. What did I do? | 抱歉 哪儿弄疼你了吗 |
| [19:47] | I don’t know. It really hurts. | 不知道 但真的很疼 |
| [19:50] | I promise to be very careful. | 我保证非常小心 |
| [19:51] | – Susan– – Not her real name. | -苏珊 -那不是她真名 |
| [19:54] | Susan, I barely touched you. | 苏珊 我根本就没碰你 |
| [19:58] | – It hurts so much! – I’m sorry. | -实在太疼了 -抱歉 |
| [20:00] | I have to get this blood. Just hold on. | 我一定得抽血 再坚持下 |
| [20:02] | Hypersensitivity to touch. | 接触感觉过敏 |
| [20:04] | Her calcium up? | 体内钙离子含量过高吗 |
| [20:06] | Lab over 16. | 检查结果超过16 |
| [20:07] | Question is why. Likely suspects. | 问题是为什么 可能原因 |
| [20:09] | Parathyroid adenoma. | 副甲状腺瘤 |
| [20:10] | – Kidney problems. – Vit “D” intoxication. | -肾脏问题 -维生素D中毒 |
| [20:11] | – Hyperthyroid. – Caused by our treatment? | -甲状腺机能亢进 -是由治疗引起的吗 |
| [20:14] | Can you please slow down? | 能否慢点讲 |
| [20:21] | The adenoma is most likely. | 最有可能的是腺瘤 |
| [20:25] | Check her P.T.H., phosphorus | 检查其甲状旁腺素 体内磷含量… |
| [20:27] | and ionized calcium. | 和钙离子含量 |
| [20:30] | And do a technetium sestamibi. | 再做司他比锝检测 |
| [20:33] | Okay, that’s enough about the volleyball player. | 好了 排球运动员就讲到这里 |
| [20:36] | – What’s up with the farmer? – What farmer? | -那农夫现在怎么样 -什么农夫 |
| [20:40] | Snakebite guy. | 被蛇咬的那位 |
| [20:42] | Oh, right. You guys don’t know about him. | 对了 你们并不知道他 |
| [20:44] | He doesn’t get bitten until three months after | 他是在排球运动员入院三个月后 |
| [20:47] | we treat the volleyball player. | 被蛇咬伤来就诊的 |
| [20:48] | Luckily, it’s been well established that time is not a fixed construct. | 幸运的是 已经确认时机并未完全延误 |
| [20:52] | His condition is not improving. Double the dosage. | 病情没有改善 给他双倍剂量 |
| [20:55] | – Already did. – There’s another antivenom. | -已经加了 -还有种血清 |
| [20:57] | – It’s not as effective, but– – Already tried it. | -可能并不有效 但… -已经试过了 |
| [20:59] | The first stuff, the stuff he was allergic to. | 第一种用的就是 但他过敏 |
| [21:01] | Gave it to him with high-dose steroids. | 同时用高剂量的类固醇 |
| [21:03] | – Nothing’s working. – What does it all mean? | -都没有效果 -这些能说明什么 |
| [21:06] | – Wrong snake? – We tried every other antivenom we had. | -不是那种蛇吗 -已经试遍了所有的血清 |
| [21:09] | We’re too late? | 是病情延误太久吗 |
| [21:11] | Yep. He’s dying. His wife’s here. | 对 他就快死了 他妻子赶到了 |
| [21:14] | Finally found a babysitter. Who wants to let ’em know? | 她总算找到保姆看孩子了 谁去告诉他们噩耗 |
| [21:19] | – Actually, I’m kidding. – He’s not dying? | -其实我在开玩笑 -他不会死吗 |
| [21:22] | Oh, yeah, he’s dying. But there’s no wife and kid. | 不 他是快死了 但并没有妻儿 |
| [21:25] | Which is great. | 这太好了 |
| [21:27] | Makes the breaking-the-news thing way easier. | 让宣布病人死亡这事更省心了 |
| [21:31] | Oh, yeah. One more piece of news. | 对了 还有个消息 |
| [21:39] | The drug addict is peeing blood. | 吸毒的那家伙开始尿血了 |
| [21:47] | How do they teach you how to tell someone that they’re dying? | 他们是怎么教你们向家属宣布噩耗的 |
| [21:55] | It’s kind of like teaching architects how to explain | 就像教建筑师怎么跟人解释 |
| [21:57] | why their building fell down. | 他们造的房子为何倒塌一样 |
| [22:00] | Do you role-play and stuff? | 练习时会分角色扮演吗 |
| [22:02] | Yeah. One of us gives the bad news, | 对 一人去通知死亡 |
| [22:05] | and one of us gets the bad news. | 另一人则扮演家属 |
| [22:06] | What do you have to do to get an “A” in You’re Dying 101? | 那怎么做才能在这门课上拿个优秀呢 |
| [22:10] | They grade you on gentleness and supportiveness? | 他们会依照你们的亲切度和支持度打分吗 |
| [22:14] | Is there a scale for measuring compassion? | 有没有个衡量同情的标准 |
| [22:20] | This buddy of mine– | 我有个朋友 |
| [22:22] | I gotta give him 10 bucks every time someone says thank you. | 每次有人感谢他 我都恨不得给他十块钱 |
| [22:26] | Imagine that. This guy’s so good, | 想象下 他实在太好人了 |
| [22:30] | people thank him for telling ’em that they’re dying. | 即使宣布死亡 人们还是会不住感谢他 |
| [22:38] | Needs brown. | 还差棕色 |
| [22:40] | I don’t get thanked that often. | 我可没收到那么多感谢 |
| [22:43] | You’re dying. | 你快死了 |
| [22:46] | In a few hours. | 就剩几个小时了 |
| [22:50] | There’s nothing we can do except deal with the pain. | 除了帮你止痛 我们已无能为力了 |
| [22:54] | Well, I need to go home. | 我得回家 |
| [22:56] | You’re not going home. | 你不能回家 |
| [23:00] | But my dog. What will happen to my dog? | 但我的狗呢 我的狗以后怎么办 |
| [23:10] | Her neck looks clean. No adenoma. | 颈部没有病变 没有腺瘤 |
| [23:12] | Wait, wait, wait. The guy’s dying, and all he cares about is his dog? | 等下 那家伙快死了 却只关心他的狗吗 |
| [23:19] | Any of you guys go the dog route in your improv sessions? | 在你们角色扮演中 有没人遇到过狗狗这回事 |
| [23:24] | It’s a basic truth of the human condition that everybody lies. | 人类的真理就是 人人皆会说谎 |
| [23:30] | The only variable is about what. | 唯一的不同是 说什么谎 |
| [23:34] | The great thing about telling someone they’re dying… | 告诉某人他快死了 最大的好处就是 |
| [23:36] | is that it tends to focus their priorities. | 让他更易聚焦于自己最在乎的事 |
| [23:40] | You find out what matters to them. | 你就能找出他们最关心的问题 |
| [23:43] | What they’re willing to die for. | 他们愿意为之付诸一切的事 |
| [23:48] | What they’re willing to lie for. | 他们不惜为之说谎的事 |
| [23:50] | You must have a neighbor who– | 你肯定会有邻居照顾… |
| [23:52] | Neighbors don’t like him. | 邻居们都不喜欢它 |
| [23:55] | So the Humane Society will take him in and find him a home. | 那动物保护协会的会接管 让它安家 |
| [23:57] | No, they won’t. Yeah, but maybe my aunt– | 他们才不会 对了 也许我姨妈… |
| [24:04] | It wasn’t a snakebite, was it? | 那不是蛇咬的 是吗 |
| [24:09] | I said I don’t remember bein’ bit. | 我说过我不记得被咬过 |
| [24:11] | Sure you do. Just not by a snake. | 你当然记得 只是不是蛇咬的 |
| [24:14] | I assume that Cujo bit one of your neighbors a while back. | 估计前阵子你家恶犬就咬过邻居 |
| [24:19] | You tell me that he bit you, and I gotta report it. | 一旦你说是它咬的你 我肯定会上报 |
| [24:22] | Cujo’s got a record. He gets the chair. | 你家恶犬已经有不良记录了 肯定会被处死 |
| [24:28] | The good news is you might just live. | 好消息是你应该死不了了 |
| [24:31] | The bad news is your dog’s gonna die. | 坏消息是你的狗非死不可 |
| [24:34] | Guy risked his life to save this thing? | 他就为了救这玩意不惜玩命 |
| [24:39] | I’ll hold him. You swab the mouth. | 我来制住它 你去它嘴巴里采样 |
| [24:42] | I think I’ve got a better grip here. You go for the mouth. | 我觉得我制住它比较好 你去采样 |
| [24:46] | All right. I’m odds. | 好吧 猜拳决定 |
| [24:48] | – You serious? – One, two, three! | -真的? -1 2 3 |
| [24:50] | Damn. | 见鬼 |
| [24:53] | I don’t care if he’s scratching your nads off, you don’t let go. | 我可不管它会不会抓坏你衣服 别松手 |
| [24:55] | Just do it! | 快动手 |
| [25:01] | I say we let the guy die. | 不如就让那人死了算了 |
| [25:03] | – I got his head. Just do it. – Got it. | -我抓住它头了 快动手 -好了 |
| [25:10] | What would you call that? | 这是什么颜色 |
| [25:13] | It’s tea-colored, right? | 是茶色 对吧 |
| [25:16] | The guy we thought was just after the drugs– | 我们认为单纯为骗毒品而来的那人 |
| [25:20] | What’s the differential diagnosis for urine that’s tea-colored? | 尿样呈茶色的话 鉴别诊断是什么 |
| [25:25] | Kidney stone. | 肾结石 |
| [25:27] | – Kidney stones would cause what? – Blood in urine. | -肾结石会导致什么 -尿血 |
| [25:31] | – What color is your pee? – Yellow. | -你的尿是什么颜色的 -黄色 |
| [25:34] | – What color is your blood? – Red. | -你的血呢 -红色 |
| [25:35] | What colors did I use? | 我刚用了哪几种颜色 |
| [25:38] | Red, yellow and brown. | 红 黄还有棕色 |
| [25:40] | And brown. What causes brown? | 就是棕色 什么会导致棕色尿 |
| [25:42] | Waste. | 体内垃圾 |
| [25:43] | Which means the kidneys are shutting down. Why? | 也就是说他肾脏不工作了 为什么 |
| [25:45] | Trauma. | 外伤 |
| [25:46] | None that his history would indicate. | 他的病历中并未提及 |
| [25:47] | Could be damage done by the self-injection of the Demerol. | 可能是因私自注射杜冷丁引起的 |
| [25:49] | – Treatment? – Heat and rest– | -治疗方式 -热敷及放松… |
| [25:51] | – Other possible causes? – Infection. | -还有其他可能原因吗 -感染 |
| [25:53] | Start him on antibiotics. What else? | 开始给他用抗生素 还有呢 |
| [25:56] | – Come on! Come on! – I-I don’t know. | -快 快点想 -我 我不知道 |
| [26:00] | You’re useless. But at least you know it. | 真没用 不过至少还有自知之明 |
| [26:03] | Blood tests show elevated creatine kinase. | 血检结果显示肌酸激酶超高 |
| [26:05] | – What does that tell you? – The trauma diagnosis was right. | -这说明什么 -外伤的诊断是正确的 |
| [26:08] | He takes it easy for a few days, he’ll be fine. | 放松休息几天就会没事的 |
| [26:09] | You sure? | 你确定? |
| [26:10] | The elevated C.K. rules out infection– | 肌酸激酶超高就排除了感染的可能 |
| [26:12] | You know what’s worse than useless? | 知道什么比没用更糟吗 |
| [26:14] | Useless and oblivious. | 没用 迟钝 |
| [26:17] | What are they missing? | 他们遗漏了什么可能 |
| [26:20] | It’s kind of hard to think when you’re in our face like– | 你脸板成那样 让我们很难思考 |
| [26:23] | Yeah? | 是吗 |
| [26:23] | You think it’s gonna be easier when you got a real patient really dying? | 你觉得面对垂危病人会更容易吗 |
| [26:26] | What are you missing? | 你们到底遗漏了什么 |
| [26:28] | Muscle death. | 肌肉坏死 |
| [26:34] | Not your case. | 跟你无关 |
| [26:35] | Nothing wrong with a consult. | 大家一起讨论肯定不是坏事 |
| [26:40] | Dying muscle leaks myoglobin. It’s toxic to the kidneys. | 肌肉坏死会释放肌红蛋白 对肾脏有毒 |
| [26:44] | Brilliant. | 聪明 |
| [26:47] | M.R.I. his leg. See what’s killing it. | 给他腿部做核磁共振 看到底什么情况 |
| [26:56] | Why is the girl getting the M.R.I.? | 为何要给那女孩做核磁共振 |
| [26:58] | Because the neck scan revealed nothing, | 因为她颈部扫描未发现任何甲状腺瘤 |
| [27:00] | and her doctor’s way more obsessive than she thinks she is. | 而她的医生 比她自己想象得强迫症更加严重 |
| [27:03] | But you said the guy needed the M.R.I. | 但你说那人需要做核磁共振 |
| [27:04] | Because Dr. Cameron back there said muscle death. | 那是因为卡梅隆告诉你们他是肌肉坏死 |
| [27:07] | Not one of you said it. Not one of this guy’s doctors said it. | 你们可没人这么说 他的医生也没人发现 |
| [27:11] | They gave him bed rest | 他们就让他卧床休息 |
| [27:13] | and antibiotics, just like you guys would have. | 跟你们一样给他用抗生素 |
| [27:15] | – Did he get better? – No. | -那他病情好转了吗 -没有 |
| [27:18] | – How long– – Three days. | -多久才… -三天 |
| [27:21] | It is in the nature of medicine that you are gonna screw up. | 这就是医学的自然规律 你们可能会搞砸 |
| [27:25] | you’re gonna kill someone. | 也可能会害死病人 |
| [27:28] | If you can’t handle that reality, pick another profession. | 没法面对这一事实的话 趁早转行 |
| [27:31] | Or finish medical school and teach. | 或者读完医学院就去教书 |
| [27:35] | Three days before they thought it might have been muscle death? | 他们用了整整三天才想到可能是肌肉坏死? |
| [27:38] | No, three days before the patient | 不 是病人三天后 |
| [27:40] | suggested it might have been muscle death. | 自己想到可能是肌肉坏死 |
| [27:46] | The M.R.I. revealed an osteosarcoma. | 核磁共振结果显示是骨肉瘤 |
| [27:50] | A cancerous tumor on your femur. | 你大腿骨上有个癌变的肿块 |
| [27:54] | It needs to be removed surgically. | 需要手术摘除 |
| [27:55] | With chemo, she has an excellent chance of survival. | 再经化疗 她生存几率很高 |
| [27:59] | But I have to warn you– | 但我必须提醒你 |
| [28:01] | depending on how large the tumor is and how ingrained it is, | 医生将根据你肿瘤的大小和顽固程度 |
| [28:07] | the surgeon may need to amputate your leg. | 决定是否需要截肢 |
| [28:11] | I’m sorry. | 我很抱歉 |
| [28:14] | It’s okay. | 没事的 |
| [28:22] | Dogs’ mouths are pretty filthy, | 狗的口腔很脏 |
| [28:24] | but they have natural antibodies to fight off most of the stuff. | 它们有天生抗体 可消灭大部分细菌 |
| [28:26] | We don’t. That’s why dog bites can be so nasty. | 但我们没有 所以被狗咬很危险 |
| [28:29] | Lab tests of your dog’s saliva revealed a type of strep bacteria. | 检测结果显示你家狗唾液中含有链球菌 |
| [28:33] | It’s commonly known as the flesh-eating disease. | 这种病通常被称为坏死性筋膜炎[噬肉病] |
| [28:37] | We need to operate immediately to remove the damaged tissue. | 必须马上手术 切除坏死组织 |
| [28:40] | We may need to remove the leg. | 可能得截肢 |
| [28:51] | – The M.R.I. revealed a problem. – No kidding. | -核磁共振显示有问题 -开什么玩笑 |
| [28:55] | I’m sorry none of your doctors found it earlier. | 抱歉你的医生没尽早查出问题 |
| [28:57] | I am personally gonna oversee your treatment from now on. | 我个人自此将全程监督你的治疗情况 |
| [28:59] | You’re gonna cut me open, aren’t you? | 你们会让我动一堆手术 是吧 |
| [29:04] | We may need to remove the leg. | 可能需要截肢 |
| [29:17] | His M.R.I. showed that the leg pain | 他的核磁共振结果显示 |
| [29:19] | wasn’t caused by the self-injection. | 腿疼并非私自注射而导致 |
| [29:22] | It wasn’t caused by an infection. | 也不是感染引发的 |
| [29:27] | It was an aneurysm that clotted… | 动脉瘤内血栓形成 |
| [29:31] | leading to an infarction. | 导致的梗死 |
| [29:33] | My God, you were right. It’s House. | 天哪 你猜对了 正是豪斯自己 |
| [29:38] | We have to do the surgery. | 一定得动手术 |
| [29:40] | The necrotic tissue has to be removed. If there’s too much– | 坏死组织必须手术切除 如果太多的话… |
| [29:44] | I don’t care what you find. | 我不管你们发现了什么 |
| [29:46] | It may become necessary in order to save your life. | 为了救你 这些都是必要措施 |
| [29:49] | I like my leg. | 我喜欢自己的腿 |
| [29:50] | I’ve had it for as long as I can remember. | 自我记事起 他们就跟着我 |
| [29:53] | Greg, I love your leg as much as you do. | 格雷戈 我跟你一样喜欢你的腿 |
| [29:56] | They’re not cutting it off. | 绝对不能截肢 |
| [30:02] | The patient made the right choice. | 病人作出正确的选择 |
| [30:05] | Tell a surgeon that it’s okay to cut a leg off, | 告诉医生 截肢也可以 |
| [30:08] | and he’s gonna spend the night polishing his good hacksaw. | 他将抛光自己腿上的钢架度过漫漫长夜 |
| [30:11] | Right. Surgeons could care less about saving limbs. | 对 医生对保全病人四肢根本毫不在乎 |
| [30:14] | Of course they care about their patients. | 医生当然关心病人权益 |
| [30:16] | They just care about themselves more, | 只是关心他们自己更多而已 |
| [30:18] | which is not an unreasonable position. | 这种立场也不是不能理解 |
| [30:21] | Trying to maximize the tissue you save… | 保留越多的组织 |
| [30:23] | also maximizes the chances of something going wrong, | 风险越大 |
| [30:26] | which means you’ve gotta be extra careful, | 这意味着你得格外小心 |
| [30:29] | which is such a pain in the ass. | 这真是太讨厌了 |
| [30:32] | Amazing advances have been made. Kids with prosthetic legs… | 医学界已经有了非凡进步 装了义肢的孩子们 |
| [30:36] | are running the hundred-meter dash in 12 seconds. | 百米冲刺可以跑进12秒内 |
| [30:38] | Yeah, they’re just not as pretty. | 是啊 只是看着不太美观而已 |
| [30:42] | Do a bypass. Restore the circulation. | 做个旁路 让血液恢复流通就好 |
| [30:45] | – Amputation is safer. – For you or me? | -截肢更安全 -对你还是对我 |
| [30:48] | – The blockage of blood flow– – Four-day blockage. | -血流的阻塞…-已经阻塞了四天 |
| [30:51] | Yes. It caused muscle cell death. | 对 导致肌肉细胞坏死 |
| [30:54] | When those cells die, they release cytokines and potassium. | 细胞坏死会释放细胞因子和钾 |
| [30:57] | And if you restore the blood flow instead of just lopping it all off, | 一旦血液恢复流通 而不把坏死组织切除的话 |
| [31:00] | then all that crap gets washed back into my system. | 这些都会重新流回我的身体系统中 |
| [31:02] | The cytokines could cause organ failure. | 细胞因子可能导致器官衰竭 |
| [31:04] | The potassium could cause cardiac arrest. | 而钾可能导致心脏骤停 |
| [31:06] | On the other hand, I may just get the use of my leg back. | 但另一方面 我可能能保住我的腿 |
| [31:10] | – The postoperative pain alone will – – I’ll get through it. | -光是术后的疼痛就…-我可以忍受 |
| [31:13] | I understand the risks. You’re in the clear. | 风险我都明白 你也清楚 |
| [31:15] | Go schedule an O.R. | 安排旁路手术吧 |
| [31:23] | God, you’re an idiot. | 老天 你个白痴 |
| [31:26] | I think I’m more of a jerk. | 我觉得我更像个混球 |
| [31:28] | I’m not being glib, and I’m not being cute. | 我不想跟你耍嘴皮子 也不会装可爱 |
| [31:31] | I don’t want you to kill yourself. | 只是不想你害死自己 |
| [31:34] | I’m not gonna die. | 我不会死的 |
| [31:36] | Oh, I feel completely reassured. | 这下我还真放心了 |
| [32:08] | More suction. | 再吸干净点 |
| [32:54] | Inserting now. | 现在插入 |
| [33:22] | They gotta up the morphine. | 让他们加大吗啡用量 |
| [33:24] | Doctors say they can’t. | 医生说不行 |
| [33:26] | Doctors recommended bed rest and antibiotics. | 医生还曾推荐卧床休息和使用抗生素呢 |
| [33:29] | They screwed up. | 他们之前是错了 |
| [33:30] | It doesn’t mean they’re wrong this time. | 但不意味着这次也错了 |
| [33:31] | Sure doesn’t mean they’re right. | 当然也不意味着这次就对了 |
| [33:32] | – Morphine will kill you. – I can handle it. | -吗啡会害死你的 -我能熬过去的 |
| [33:35] | You’re in pain. You’re not thinking right. | 你疼痛难忍 不能正确思考 |
| [33:37] | That’s why I need the damn morphine! | 所以我才需要那该死的吗啡 |
| [33:39] | I’ll talk to them. | 我去跟他们说 |
| [33:45] | Oh, my God. How much longer is the pain gonna last? | 上帝啊 他还得这样疼多久 |
| [33:47] | It depends on how much muscle cell death there was. | 得看肌肉细胞坏死的数量 |
| [33:50] | He could be right. | 他可能是对的 |
| [33:51] | He could come out of this with almost full use of his leg. | 他可能可以不用截肢就挺过去 |
| [33:53] | Or? | 或者呢 |
| [33:55] | He could be in pain for the rest of his life. | 或者可能余生都这么痛苦 |
| [34:01] | There’s a third option… surgically. | 还有第三种选择 动手术 |
| [34:04] | A middle ground between what we did and amputation. | 是目前情况和截肢间折中的办法 |
| [34:10] | He’s not big on middle ground. | 他不喜欢折中 |
| [34:14] | Yeah. | 是啊 |
| [34:40] | Nurse? Nurse! | 护士 护士 |
| [34:44] | I need more calcium gluconate. | 再帮我挂葡萄糖酸钙 |
| [34:46] | You just had five m.l.’s. | 你已经挂了五袋了 |
| [34:47] | The Q.R.S. is getting wider. | 报告显示心电图QRS波变宽 |
| [34:49] | My potassium is rising. | 钾含量一直在增加 |
| [34:50] | – I’ll talk to your doctor. – Well, you better make it fast, | -我这就去找医生 -你最好快点 |
| [34:52] | ’cause I’m about to go into cardiac arrest. | 因为我的心脏快骤停了 |
| [34:54] | You give me the dose, or I go into wide complex tachycardia. | 快帮我挂 不然心动过速会更严重 |
| [34:58] | – I could get in trouble– – Listen, it’s not a narcotic! | -我会有麻烦的 -听着 这又不是麻醉剂 |
| [35:01] | I’m not looking for a buzz. You got about 20 seconds. | 我不是在跟你讨价还价 你还有20秒 |
| [35:11] | I was wrong. | 我错了 |
| [35:19] | – What do you got? – Wide complex tachycardia. | -什么情况 -心动过速 |
| [35:22] | – You diagnosed– – He did. | -是你的诊断 -他自己做的诊断 |
| [35:23] | – Defibrillator. – Paddles. | -准备心脏除颤器 -心脏除颤器 |
| [35:26] | – Charge. – Clear. | -充电 -让开 |
| [35:32] | The patient was technically dead for over a minute. | 病人心脏停跳超过一分钟 |
| [36:11] | He’s back. | 他活过来了 |
| [36:19] | Do you think he was dead? | 你认为他经历了死亡吗 |
| [36:22] | Do you think those experiences were real? | 你认为濒死体验是真实的吗 |
| [36:26] | Define “real”. They were real experiences. | 何谓”真实” 体验是真实发生的 |
| [36:31] | What they meant– | 他们说的是… |
| [36:34] | Personally, I choose to believe that the white light people sometimes see, | 我个人选择相信 人们常说的 |
| [36:37] | the visions this patient saw, | 这位病人见也到的 那道白光 |
| [36:41] | they’re all just chemical reactions | 只是大脑停止时 |
| [36:43] | that take place while the brain shuts down. | 所发生的化学反应 |
| [36:45] | You choose to believe that? | 你选择相信这个 |
| [36:48] | There’s no conclusive science. | 科学研究从不会有尽头 |
| [36:50] | My choice has no practical relevance to my life. | 我的选择对我的生命没有影响 |
| [36:53] | I choose the outcome I find more comforting. | 我只是选择更令人欣慰的结果 |
| [36:56] | You find it more comforting to believe that this is it? | 而你觉得这个说法更令人欣慰 |
| [37:00] | I find it more comforting to believe that this… | 我觉得相信人世不是一场单纯的试验 |
| [37:04] | isn’t simply a test. | 更令我欣慰 |
| [37:12] | How bad is the pain right now? | 现在有多痛 |
| [37:15] | It’s bad. | 非常痛 |
| [37:16] | It’s not getting any better. | 根本就没好转 |
| [37:17] | If you were right, the pain would be subsiding. | 如果你对的话 疼痛会减少 |
| [37:20] | – You’d be getting better. – It’s just taking longer. | -你也会慢慢好转 -只是时间长点 |
| [37:23] | No, it’s not. | 不 不是的 |
| [37:25] | We’ve gotta let ’em cut the leg off. | 本该让他们帮你截肢的 |
| [37:31] | It’s my leg. It’s my life. | 这是我的腿 是我的人生 |
| [37:36] | Would you give up your leg to save my life? | 如果需要你截肢救我一命 你会吗 |
| [37:39] | Of course I would. | 当然 |
| [37:39] | Why do you think your life is worth less than mine? | 那你怎么会认为你的命不如我的值钱 |
| [37:44] | If this were any other patient, what would you tell them to do? | 如果是其他病人 你会怎么跟他们说 |
| [37:52] | – I would say it’s their choice. – Not a chance. | -我会说让他们自己选择 -不可能 |
| [37:56] | You’d browbeat them | 你会恐吓他们 |
| [37:57] | until they made the choice you knew was right. | 直到他们作出你认为对的选择 |
| [38:00] | You’d shove it in their face that it’s just a damn leg. | 你会冲他们嚷嚷 这只是条该死的腿 |
| [38:05] | You don’t think you deserve to live? | 你觉得自己不该活下去吗 |
| [38:09] | You don’t think you deserve to be happy? | 觉得自己不该得到幸福吗 |
| [38:13] | Now let them cut off your leg. | 让他们截肢就好了 |
| [38:19] | I can’t. I can’t. | 我做不到 做不到 |
| [38:23] | I’m sorry. | 抱歉 |
| [38:32] | The pain alone is gonna kill you. | 光是疼就能把你疼死 |
| [38:35] | I know. I know. | 我知道 我知道 |
| [38:42] | I need you to talk to the doctor. | 帮我去跟医生说下 |
| [38:53] | He change his mind? | 他改主意了吗 |
| [38:55] | No. | 没有 |
| [38:58] | He’s asked to be put in a chemically induced coma… | 他要求对他进行化学昏迷 |
| [39:01] | so that he can sleep through the worst part of the pain. | 让他能在疼痛最严重的时候 一路睡过去 |
| [39:06] | We can do that. | 我们可以这么做 |
| [39:10] | What happens after he’s in the coma? | 他昏迷之后会怎么做 |
| [39:13] | We’ll obviously monitor his condition closely, | 当然会严密监视他的情况 |
| [39:16] | and if he can get through the next 48 hours | 如果在接下来48小时内 |
| [39:18] | without another cardiac incident– | 心脏没有其他状况 |
| [39:19] | I meant, I’m his health care proxy. | 我是他的健康医疗代理 |
| [39:22] | I get to make medical decisions for him if he’s not able to. | 他不能做决定期间 我可以代理 |
| [39:28] | You should talk to him about what he wants to do. | 你该跟他谈谈他想怎么做 |
| [39:30] | I know what he wants. | 我知道他想怎么做 |
| [39:31] | But if he’s out, it’s my call, right? | 但在他昏迷期间 我就能做主 对吗 |
| [39:51] | You’ll be out in less than a minute. | 你会在一分钟内昏迷 |
| [39:58] | Thank you. | 谢谢 |
| [40:07] | I’ll see you when I wake up. | 等我醒来后再见 |
| [40:12] | We’ll go golfing. | 我们去打高尔夫 |
| [40:17] | I love you. | 我爱你 |
| [40:22] | I love you too. | 我也爱你 |
| [40:26] | I’m sorry. | 对不起 |
| [40:32] | You’ve got nothing to be sorry about. | 你没什么好道歉的 |
| [40:53] | The middle ground you were talking about– | 你之前说过的折衷选择 |
| [40:55] | We go in, take out the dead muscle. | 进行手术 切除坏死肌肉 |
| [40:58] | There’s still some risk of reperfusion injury, but– | 还是会有一些伤害的风险 但… |
| [41:02] | Give me the forms you need signed. | 给我需要签名的表格 |
| [41:08] | You’re saving his life. | 你这是在救他的命 |
| [41:11] | He won’t see it that way. | 他不会那么想的 |
| [41:31] | Because of the extent of the muscle removed, | 由于切除肌肉的范围太大 |
| [41:36] | the utility of the patient’s leg was severely compromised. | 病人腿部功能严重受损 |
| [41:40] | Because of the time delay in making the diagnosis, | 由于确诊时间延误太久 |
| [41:44] | the patient continues to experience chronic pain. | 病人持续遭受慢性剧痛 |
| [41:54] | – She had no right to do that. – She had the proxy. | -她没权利那样做 -她有代理权 |
| [41:57] | She knew he didn’t want the surgery. | 她明知他不想动手术 |
| [41:58] | She saved his life. | 她是为了救他的命 |
| [41:59] | We don’t know that. Maybe he would’ve been fine. | 这点没人知道 也许他会好转 |
| [42:01] | It doesn’t matter. It’s the patient’s call. | 没关系 这是病人的选择 |
| [42:03] | The patient’s an idiot. | 那病人是个白痴 |
| [42:06] | They usually are. | 病人通常都是 |
| [42:09] | Do you have a buzzer or something? | 有定时器之类的吗 |
| [42:11] | What time does this class end? | 这课什么时候结束 |
| [42:12] | Twenty minutes ago. | 二十分钟前 |
| [42:20] | I’m not doing this again. | 我再也不干这个了 |
| [42:23] | And this guy is not the world’s greatest dad. | 这家伙不是个好爸爸 |
| [42:26] | Not even ranked. | 排名都够不上 |
| [42:28] | Who the hell lets their kids play with lead-based paint? | 哪个好爸爸会给孩子用含铅的颜料 |
| [42:31] | That’s why he’s always sick. | 怪不得他总生病 |
| [42:32] | Find him some plastic cups, and the class is all his again. | 帮他另找几个塑料杯 这门课就还给他了 |
| [43:04] | Stacy, it’s Greg. | 史黛西 我是格雷戈 |
| [43:06] | I’ve got an opening in my calendar for 10:00 tomorrow morning. | 我明早十点有空 |
| [43:10] | Make sure your husband isn’t late. | 务必让你丈夫别迟到 |