时间 | 英文 | 中文 |
---|---|---|
[00:00] | The human heart is a giant muscle squeezing or contracting over 60 times each minute. That’s 3,600… | 人类的心脏是个巨大的肌肉 每分钟收缩挤压60次以上 |
[00:07] | At this point, your blood is a deep purple | 这里的血液是深紫色的 |
[00:11] | because it’s just finished dropping off oxygen for all the parts of your body. | 因为氧气刚刚被释放到身体各个部位 |
[00:17] | Come on, follow me. | 跟我来 |
[00:20] | Come on. | 过来 |
[00:28] | … | 我有个问题, 我还想去厕所 |
[00:31] | Which would you like to do first? | 你想先做哪样? |
[00:32] | The question. | 问题 |
[00:34] | – Okay. | 好的 |
[00:34] | – Where’s the bathroom? | 厕所在哪? |
[00:36] | Who knows where the bathroom is? | 谁知道厕所在哪? |
[00:38] | I do. | 我知道 |
[00:40] | Go with Ian to the bathroom. | 你陪ian去厕所 |
[00:41] | I don’t have to go. | 我不用上厕所 |
[00:42] | We’re not at school, nobody goes anywhere by themselves. | 我们不是在学校, 不能单独行动 |
[00:45] | – Why? | 为什么? |
[00:46] | – In case you get lost. | 为防止走失 |
[00:47] | Or in case somebody kidnaps us. | 或者有人绑架我们 |
[00:49] | If somebody kidnaps Ian, they’ll kidnap me, too. I want to stay with the class. | 如果有人绑架ian, 顺便就把我绑了 我想和大家在一起 |
[00:53] | Michael, go with Ian… | Michael, 陪ian去… |
[00:55] | Do you need help? | 你怎么了? |
[00:56] | I need you to find a grown-up. | 去帮我找个大人 |
[00:58] | Is the baby coming? | 小孩要出来了? |
[00:59] | – Who should I take with me? – You’re fine. | 谁陪我一起去? |
[01:01] | Go to the front desk or find a security guard. | 你没问题的, 到前台 或者找警卫来 |
[01:05] | I really have to pee. | 我要尿尿 |
[01:08] | Oh, God. | 上帝 |
[01:10] | Is the baby coming? I don’t know how to do this. | 是小孩要出来吗? 我不知道怎么办 |
[01:14] | Are you okay, Ian? | 你没事吧, ian? |
[01:15] | Yeah. Sure. | 我没事 |
[01:17] | I don’t think you are. You’re bleeding. | 我不这么觉得, 你在流血 |
[01:27] | Help! Help! | 来人! |
[02:28] | – $20. | 20块 |
[02:30] | – Call. | 跟 |
[02:31] | You’ll call anything. | 什么你都敢跟 |
[02:33] | My stack is bigger than your stack. | 我的筹码多过你 |
[02:38] | gorillas have smaller testicles than humans. | 按照相对体积来说 大猩猩的睾丸小于人类 |
[02:43] | Well, then you’d probably have an edge over a gorilla, but not over me. | 你也许可以大过猩猩 但大不过我 |
[02:47] | Reason is, primate testes’ size inversely corresponds to the fidelity of our females. | 灵长类的相对睾丸大小 与其对雌性的忠诚是负相关的 |
[02:54] | You think there might be a better time to annoy me about my wife? | 不要老拿我老婆的事呕我好不好? |
[02:57] | – I’m talking about poker. – Right. | – 我说的是扑克 – 没错 |
[02:59] | Women are evil, you’re right to drive them away. Call, fold or raise. Story time can wait. | 女人是魔鬼, 你赶走女人是明智的 跟, 扣牌还是加注, 不要废话 |
[03:03] | We’re smaller and better than chimps, | 我们比黑猩猩稍小一些 所以我们更忠诚 |
[03:06] | bigger and worse than gorillas. | 比大猩猩更大更花心 |
[03:08] | For all our rationality, our supposed trust and fealty to a higher power, | 我们的理性 把忠诚和信任置于最高境界 |
[03:13] | our ability to create a system of rules and laws, | 创造出规则和法律 |
[03:17] | our baser drives are more powerful than any of that. | 但是原始冲动大于所有的规则 |
[03:20] | We want to control our emotions, but we can’t. | 我们想控制情感, 但做不到 |
[03:24] | If we’re happy, things don’t annoy us. | 如果我们快活, 那就没什么 |
[03:27] | If, on the other hand, we’re sitting on crappy hole cards, | 但另一方面, 如果我们拿到一手烂牌 |
[03:31] | little tiny things annoy us a whole lot more. | 一点小事能让我们大为烦恼 |
[03:38] | I raise. | 加注 |
[03:40] | So, are you gonna tell me an annoying story every time I raise? | 每次我加注都要跟我讲个烦人的故事? |
[03:42] | God, that would be annoying. | 那就太过分了 |
[03:45] | I call. | 我跟 |
[03:47] | Dr. Cuddy, I got one of your patients in the ER. Ian Alston, six-years-old. | Cuddy医生? 有位病人在急诊室 Ian alston, 6岁 |
[03:51] | Oh, I know him. What’s the problem? I’m all in. | 噢, 我认识他, 什么问题? 我全押 |
[03:54] | Bloody diarrhea. Hemodynamically stable, | 泻血 |
[03:55] | but he’s been developing some coordination problems. | 血行动力稳定, 不过肢体协调有问题 |
[03:58] | It sounds like gastroenteritis and dehydration. | 好像是肠胃炎和脱水 |
[04:00] | Order fluids and I’ll take it on my service. | 先给他输液 我返班的时候处理 |
[04:02] | Bet’s to you, House. | 就看你了, House |
[04:04] | – They scan his head? – No, why would they scan… | 做过头部扫描了? |
[04:04] | Don’t play games. You gonna call? | – 没有, 为什么要扫… – 别玩花样, 跟不跟? |
[04:07] | – How’s the heart rate? – Stable. | 心率怎么样? |
[04:09] | I’m sorry. | 不好意思 |
[04:11] | House, it’s gastroenteritis. I’m not going anywhere. | House? 是肠胃炎 我不会走开的 |
[04:19] | You in or out? | 你跟不跟? |
[04:25] | I’m out. | 不跟 |
[04:30] | Stone cold bluff. | 完美的唬牌 |
[04:32] | You might want to spend a little more time paying attention to your cards | 你要多注意你的牌 |
[04:36] | and a little less time staring at my breasts. | 而不是盯着我的胸部 |
[04:39] | They don’t match either. | 它们也不成对 |
[04:40] | I’m gonna take some air. | 我出去喘喘气 |
[05:02] | Follow my finger with your eyes. | 眼睛看我的手指 |
[05:11] | How much longer will Dr. Cuddy be? | Cuddy医生什么时候会到? |
[05:13] | Well, given the number of Mojitos she’s knocking back at the party, | 从她在聚会上喝的mojitos酒的数量看 |
[05:16] | I’d say it’s gonna be at least three hours before she’s even conscious. | 她还要3小时才能回复清醒 |
[05:20] | Weren’t you at the same party? | 你也去了那个聚会? |
[05:22] | I don’t drink. | 我不喝酒 |
[05:25] | I want you to reach out and grab my cane. | 伸手抓我的拐杖 |
[05:34] | What’s wrong? | 什么问题? |
[05:35] | Your son’s brain is losing control of his muscles. | 你儿子的大脑失去对肌肉的控制了 |
[05:39] | Dr. Cuddy’s message said it was just dehydration from diarrhea. | Cuddy医生说是腹泻造成的脱水 |
[05:42] | She’s wrong. | 她错了 |
[05:45] | Is he gonna be all right? | 他会好的吧? |
[05:50] | I don’t know. | 不知道 |
[06:20] | So, were you in one of those cages? | 你在那笼子里待过? |
[06:23] | No. | 没 |
[06:25] | No, no, no, no. No, those are for tourists. | 没没没, 笼子是给游客的 |
[06:28] | You were in the water with the great white? | 你和一条大白鲨在水里 |
[06:30] | Sure, it’s no big deal. You just have to keep an eye on them. | 当然, 这有什么 注意观察就好了 |
[06:34] | If they get too close, punch them in the nose. | 如果它们太靠近 打它的鼻子 |
[06:38] | Send them on their way. | 打跑了就没事 |
[06:41] | I had you going. | 你信了 |
[06:42] | You are mean. | 坏小子 |
[06:45] | Hey. How’s that anal fissure? | 你的肛裂怎么样了? |
[06:47] | Did it heal yet? Or is it still draining? | 治好了? 还是仍在漏水? |
[06:50] | Oh, I’m sorry. I didn’t realize you’d come back for seconds. | 不好意思 我以为你不会回来了 |
[06:53] | I figured that after that girl in the stairwell you’d be done for the night. | 我以为楼梯间的那个女孩 够你今晚享受了 |
[06:56] | He’s joking. | 他开玩笑 |
[06:57] | No Adam’s apple, small hands. It’s no surprises this time. | 没有喉结, 手也小 这次应该是货真价实的了 |
[07:02] | I’ll see you later. | 迟点见 |
[07:06] | Got a case. | 有个病例 |
[07:08] | Well, you could’ve just said that. You didn’t have to screw with me. | 你可以直接说, 不用给我捣乱 |
[07:10] | If I didn’t screw with you, you’d spent the whole night thinking you might get laid, | 如果我不捣乱 你整晚都会惦记着上床 |
[07:13] | which means you’d be useless. Better to extinguish all hope. | 那样的你是无用的 还不如掐断你的希望 |
[07:16] | Get Foreman and Cameron and meet me upstairs. Stat. | 马上找foreman和cameron 到楼上找我 |
[07:25] | What’s so urgent? | 什么事这么急? |
[07:26] | Two cases, same symptoms. | 两个病例, 相同症状 |
[07:29] | What do six-year-olds and 70-year-olds have in common? | 6岁和70岁有什么相同点? |
[07:33] | Their immune systems don’t work as well. – Could be listeria. | 免疫系统都很差 可能是李氏杆菌病 |
[07:36] | – I already checked for that. | 已经查过了 |
[07:37] | Leukemia has a higher prevalence in both young and old. | 白血病在两者都高发 |
[07:39] | – So does asthma. | 哮喘也是 |
[07:41] | – No, no, no. | 不不不 |
[07:42] | They can both get diabetes. | 都能得糖尿病 |
[07:44] | No! | 不 |
[07:47] | The nearly dead and the newly bred | 将死之人和新生之人有很多共同点 |
[07:50] | have more in common with each other than with people in the middle. | 不同于青壮年 |
[07:53] | It’s weird. | 诡异 |
[07:54] | It’s kind of a circle of life thing. | 仿佛生命的循环 |
[07:56] | – This kid doesn’t have kidney failure. | 这个小孩没有肾衰竭 |
[07:58] | – He will. | 会有的 |
[07:59] | Based on this file, the kid just ate some bad food. | 根据病历, 孩子只是吃坏了 老妇人也是– |
[08:07] | – This case is 12 years old. – Yep. | 这个病例是12年前的 |
[08:09] | And this case is Cuddy’s. | 而这个是Cuddy的病人 |
[08:11] | She assigned it to me. | 她转交给我 |
[08:12] | She agrees with you that this is something more than gastroenteritis? | 她同意你的判断? 认为这不是肠胃炎? |
[08:16] | She wouldn’t have assigned it to me if she didn’t, would she? | 她要不同意我就不会转给我, 对吗? |
[08:26] | What were we talking about? | 我们在说什么? |
[08:29] | Two patients with two symptoms in common. | 两个病人, 各有两个症状相似 |
[08:31] | And five symptoms not in common. | 且有5个症状不相似 |
[08:34] | While you were all wearing your “Frankie Says Relax” t-shirts, | 你们还穿开裆裤的时候 |
[08:37] | I was treating a 73-year-old woman who went through this progression of symptoms. | 我在治疗这位73岁老妇 她经历了如下症状– |
[08:41] | The last of which was… | 最后的一项… |
[08:44] | … | 死亡 |
[08:45] | And in case any of you missed that class in med school, that one’s untreatable. | 不知道你们在医学院学过没有 这项是不可治疗的 |
[08:50] | Kid’s got the first two. | 小孩有了前两项 |
[08:52] | It took Ester an hour and 20 minutes to go from two to three. | Esther在1小时20分钟后 发展到第三项 |
[08:55] | And less than a day to make it all the way to the rear exit. | 一天之内将抵达终点 |
[08:59] | This is all because a child has some blood in his diarrhea? | 只是因为这孩子腹泻有血? |
[09:04] | Cuddy would be all over it. | 如果有丝毫理由支持坏的一面 cuddy必会全力以赴 |
[09:07] | Great. Do a colonoscopy. | 那好, 做个结肠镜 |
[09:09] | On a six-year-old kid who probably has nothing worse than some food poisoning? | 对一个很可能只是吃坏了的6岁小孩? |
[09:12] | And if you happen to find any purple papules, do me a favor and grab a slice. | 如果发现紫色丘疹 给我切一片下来 |
[09:15] | I wanna check for Erdheim-Chester. | 我要检查Erdheim-chester病 |
[09:17] | A disease that there have been, what, maybe 200 reported cases of ever? | 迄今为止只有200例的疾病? |
[09:22] | If Ester’s family had let me do an autopsy, | 如果Esther家人允许我验尸 |
[09:25] | there’d be 201. | 那就是第201例 |
[09:39] | See anything? | 发现什么? |
[09:41] | No, and I don’t expect to. | 没有, 没指望能发现什么 |
[09:45] | House usually avoids cases. | House通常不接病例 |
[09:47] | If he’s actually stealing a case from Cuddy, there’s gotta be a reason. | 如果他从cuddy处偷病例 一定有原因 |
[09:50] | It’s not the first time I’ve seen this file. | 我不是第一次见这个病历 |
[09:53] | About a month before Cameron was hired, | cameron来这里之前一个月 |
[09:55] | some trucker came in here with these symptoms. | 几个卡车司机也有相同的症状 |
[09:58] | House decided he was dying. | House认为他死定了 |
[09:59] | Two days and a spinal tap, bone marrow extraction, and three colonoscopies later, | 两天之内做了脊椎穿, 抽骨髓 三次结肠镜 |
[10:04] | we send the guy home with a bunch of painkillers and a diagnosis of a bad cheese sandwich. | 最后诊断为吃了变质起司三明治 开了些止疼药打发回家了 |
[10:09] | One of the guys who worked here before me | 有个以前在这里上班的人说 |
[10:11] | said House tried to cure Ester at least three other times. | house至少有三次试图拯救esther |
[10:15] | You know how people see the Virgin Mary in danishes and stuff? | 你知道有的人能从面包上看出圣母像? |
[10:20] | Someone died 12 years ago and House doesn’t know why. | 12年前死去的病人, House不知道原因 |
[10:23] | House sees that case now in paint peeling, in clouds, and now in this poor kid. | 这个病例一直萦绕在House的眼前 剥落的油漆里, 云彩里, 这个小孩身上 |
[10:30] | Erdheim-Chester is an abnormal growth of some of the cells that fight infection. | Erdheim-chester病是 抗感染细胞的异常生长 |
[10:34] | Is that cancer? Cos he seems okay now. | 是癌症么? 他现在看起来还好啊 |
[10:36] | The other doctor kind of scared us about that. | 另外那个医生吓死我们了 |
[10:38] | He shouldn’t have. We’re just testing. It’ll probably be negative. | 没什么可怕的 只是做个测试, 估计结果是阴性 |
[10:44] | … | 还是要做这些测试? |
[10:46] | – We need to be sure. – Isn’t there any other way? | – 我们需要确定 – 没别的办法了吗? |
[10:48] | It shouldn’t take long. All right. | 很快就好的 |
[10:52] | Those ridges look a lot like purple papules. | 那些突起看着很像紫色丘疹 |
[10:55] | They’re not purple. They’re red. Probably just blood blisters. | 这不是紫色的, 是红色 很可能只是血疱 |
[11:01] | Give me the biopsy needle. | 把活检针给我 |
[11:12] | – How long is this gonna take? – Forget it, Chase. | 这要花多长时间? |
[11:14] | Your punching out the shark story’s good, | 算了, chase, “打跑鲨鱼”的故事虽然精彩 但她不会等你的 |
[11:21] | but she’s not waiting for you. | 我们不能确认出血的原因 |
[11:23] | but we did biopsy some… – Blood blisters. | 但我们检出一些血疱 |
[11:25] | – You mean papules. | 你是说丘疹 |
[11:26] | Come on, Cameron. Who’s right? | 快点cameron, 谁是对的? |
[11:29] | Chase is. Negative for Erdheim-Chester. | Chase对了, 不是Erdheim-chester病 |
[11:33] | Let me see. | 我看看 |
[11:43] | If it’s not Erdheim-Chester… It’s exactly what we said before, | – 如果不是Erdheim-chester病 – 就是我们之前说的 |
[11:46] | a garden-variety viral gastroenteritis. Can we go back to the party? | 普通的病毒性肠胃炎 我们可以回那个派对吗? |
[11:49] | Do a kidney biopsy. | 做一次肾脏活检 |
[11:52] | Ester’s shut down in exactly… | Esther的肾脏停止- |
[11:54] | This kid is not Ester. | 这孩子不是Esther |
[11:55] | You screwed up. She died. I’m sorry. But that does not mean this kid is dying as well. | 你搞砸了, 她死了, 我很遗憾 不表示这孩子也要死 |
[11:59] | Jeez, you’re testy when you don’t get any fuzz. Come on. | 哇, 没泡到妞就这么怒 来吧 |
[12:18] | What’d the test say? | 测试结果怎样? |
[12:19] | Colonoscopy was clean. | 结肠镜正常 |
[12:21] | And the biopsy was negative for Erdheim-Chester. | 活检排除了Erdheim-chester病 |
[12:24] | So Ian’s going to be all right? It was just some sort of virus. | 这么说Ian会好的 只是病毒感染 |
[12:27] | What’s that? | 这怎么了? |
[12:29] | Urine. | 尿 |
[12:31] | Yeah, but it’s brown. | 是褐色的 |
[12:33] | Ian’s kidneys are shutting down. | Ian的肾脏失去功能了 |
[12:35] | Still think it’s not the same case? | 还说不是同个病? |
[12:54] | So, what can cause bloody diarrhea, ataxia and kidney failure? | 什么病导致泻血, 共济失调和肾衰竭? |
[13:00] | – I’ll go do a biopsy. – Forget it! | 做活组织检查 |
[13:01] | That battle’s over. | 不必了 |
[13:04] | His rising creatinine is his kidneys’ way of saying, “Go on without me.” | 不断上升的肌酐等于是说 “和你的肾拜拜吧” |
[13:08] | What explains everything? | 其它症状怎么解释? |
[13:12] | E. coli HO-157 causes bloody diarrhea and leads to Hemolytic-uremic Syndrome. | O-157大肠杆菌可以导致泻血 并导致溶血性尿毒症 |
[13:18] | Toxins from the bacteria cause his kidneys to shut down. | 细菌释放的毒素导致肾功能失常 |
[13:21] | We should start him on plasmapheresis. | 可以先给他做血透析 |
[13:22] | Clear, concise and completely plausible. | 清晰准确, 值得表扬 |
[13:26] | And exactly what I did last time. Didn’t work. – What else? | 上次我就是这么做的, 无效 还有别的吗? |
[13:30] | – Goodpasture’s Syndrome. | 肺出血肾炎综合症 |
[13:31] | Circulating antibodies cause kidney failure and bleeding. | 血液中的抗体导致肾功能失常并出血 |
[13:34] | But not the purple papules. | 但不会造成紫色丘疹 |
[13:36] | If you throw in Ester’s next symptom, brain, makes me think heavy metal toxicity. | 考虑到esther接着出现脑症状 重金属中毒也有可能 |
[13:40] | His hematocrit would have to be low. It’s at 44, and Ester’s never dropped below… – 42. | 那他的血容应该很低, 他是44 Esther也未低于 -42 |
[13:45] | – You have the file memorized? | 你把病历都背下来了? |
[13:46] | It’s my lucky number. | 这是我的幸运数字 |
[13:49] | … | 导致肾衰竭, 肠胃出血, 并能破坏大脑基底 |
[13:54] | You check Ester for that? | Esther做过这些检查? |
[13:56] | She never showed any signs of… | 她没表现出这些症状… |
[14:00] | If he has lymphoma this far advanced, we should be able to see it in his blood and brain. | 如果他的淋巴瘤发展到这个地步 从血液和大脑能得到判断 |
[14:04] | Chase, run a blood smear and immunochemistries. Foreman, get an MRI. | Chase, 做血涂片和免疫化学反应 Foreman, 安排核磁共振 |
[14:09] | – I’ll page Cuddy. | 我去呼Cuddy |
[14:10] | – No, you won’t. | 不要去 |
[14:11] | She thinks the kid has a stomachache. | 她认为孩子是肚子疼 |
[14:13] | Then she’ll come right up here and do one of two things. | 她会上来做以下两件事之一 |
[14:15] | If she agrees with me, I don’t need her. If she disagrees, I don’t want her. | 她同意我的看法, 我用不着她 她不同意我的看法, 我不想见她 |
[14:18] | Can’t handle people disagreeing with you? | 容不得别人和你意见不同? |
[14:20] | She might have a different take on this. | 她也许有不同的观点 |
[14:22] | Subordinates can disagree with me all they want. It’s healthy. | 下属可以和我意见相左, 这很健康 |
[14:25] | People who can shut me down on the other hand… | 能停我职的人, 就不能这样… |
[14:28] | Forget Cuddy. I’ll have Wilson keep her busy. | 不用管cuddy, 我会让wilson把她拖住 |
[14:37] | Keep your answers short and discreet. Is Cuddy still playing? | 回答要简短并且不着边际 cuddy还在玩牌么? |
[14:42] | The chicken is still in Piccadilly Square. | 小妞…还在皮卡迪利广场 |
[14:46] | Brilliant. She’ll never suspect that Normandy is our target. | 太好了, 她不会料到我们要攻打诺曼底 |
[14:49] | Is that House? | 是House吗? |
[14:50] | Tell him that the blinds just went to 20-40 and he’s running out of chips. | 告诉他最低下注已经升到20/40 他快没钱了 |
[14:54] | – How’s she doing? | 她玩的怎么样? |
[14:55] | – What’s going on? | 出什么情况了? |
[14:56] | The way you took off, something’s obviously… | 你走的时候, 很明显- |
[14:58] | Love to chat but got a game to play. How’s she doing? | 聊天很愉快, 但我们还有场牌要打 她玩的怎么样? |
[15:01] | The patient is on life support. | 病人还在维生器上, 我们要拔掉管子 |
[15:05] | We’re about to pull the plug. | 你拿的什么牌? |
[15:06] | Those sounds like high-dose cardio meds. | 高剂量心脏药物 |
[15:10] | Two hearts. | 两张红桃 |
[15:11] | You got the flush? | 你有顺子? |
[15:13] | Still waiting on the final labs. | 还在等化验结果 |
[15:14] | Is she drinking her seltzer? | 她在喝seltzer矿泉水? |
[15:16] | No, hydration is not a problem. | 不, 水没有问题 |
[15:19] | She’s bluffing. Push her all in. | 她在唬你, 逼她全下了 |
[15:24] | Call. Two pair. | 跟, two pairs |
[15:27] | Show me your hearts. | 让我看看你的红心 |
[15:33] | Seven of clubs. | 梅花7 |
[15:35] | Oh, dear. Sounds like I messed up. | 啊糟糕, 我搞错了 |
[15:38] | You’re gonna be stuck with her for a while. | 你得和她多纠缠一会儿了 |
[15:40] | Talk to you soon. | 再联系 |
[15:44] | Oh, yes! | 太好了 |
[15:59] | Why are you taking a picture of his head? | 为什么要拍头部的片子? |
[16:01] | We’re looking for lymphoma, but… | 我们在查淋巴瘤, 但是– |
[16:04] | So, it’s not Erdheim-something and it’s not his kidneys, but his kidneys are failing. | 不是那个Erdheim什么的病 也不是肾病, 但他的肾就是不行了 |
[16:09] | Where’s Dr. Cuddy? | 什么…哪里能找到Cuddy医生? |
[16:11] | Dr. House mentioned another case. | House医生提到了另一个病例 |
[16:12] | Is there another patient with the same thing that Ian has? | 是不是曾经有个人 和ian的病一模一样? |
[16:15] | – Not exactly. | 不尽相同 |
[16:16] | – What does that mean? | 那是什么意思? |
[16:17] | Dr. House had a patient a while back who exhibited the same symptoms as your son. | House医生以前有个病人 表现出的症状和你儿子一样 |
[16:22] | – Then you know what’s wrong? | 你知道是什么病? |
[16:24] | – No. | 不 |
[16:25] | So what do you know? | 那是什么意思? |
[16:27] | We know the likely course the disease will take. | 我们知道这个病大致的发展方向 |
[16:30] | What happened to her? | – 她的多个器官衰竭 – 她最后怎么了? |
[16:37] | She died 24 hours after her admission. | 入院24小时后死去 |
[16:47] | Mr. or Mrs. Alston, would you mind giving me a hand? | Alston先生或者太太 能不能来帮个忙? |
[16:53] | He’s having trouble sitting still. | 他总是乱动 |
[16:55] | It’s impossible to get the detail we need. | 这样不可能得到结果 |
[16:58] | So I figured he might feel more comfortable hearing your voices. | 我想你们的声音可以安慰他 |
[17:06] | Ian, honey. | Ian, 亲爱的? |
[17:09] | Just sit still. | 不要动 |
[17:11] | They’ll be done in a moment. We’re here with you. | 很快就好了, 我们就在这里 |
[17:14] | I’m scared. | 我怕 |
[17:17] | It’s okay, honey. It’s… | 没事的, 宝贝, 那只是… |
[17:18] | It’s only a big camera. It’s gonna take a picture of your head. | 是一个大照相机 他们要给你的头拍照 |
[17:23] | You love it when I take your picture at home, don’t you? Yeah. | 在家里, 你不是最喜欢我给你照相的吗? |
[17:28] | And you have to hold still for that, too, right? | 照那个相也要不动啊, 是不是? |
[17:32] | But this isn’t like that. | 这和那个不一样 |
[17:36] | I know it’s scary, Ian, | 我知道听着吓人, Ian |
[17:38] | but you can do it. | 但你可以做到 |
[17:41] | You’re getting to be so grown-up. | 你已经是个小大人了 |
[17:45] | So just hold perfectly still, just for a little bit. | 所以…只要坚持不动 一下子就好了 |
[17:51] | Mommy, are you crying? | 妈妈, 你哭了? |
[17:54] | No. No, honey, I’m just tired. | 不, 不是的宝贝 我只是累了 |
[17:59] | Okay. I’ll try. | 好吧, 我尽量 |
[18:31] | The base of his brain’s been infiltrated by a small mass. We think… – Pituitary? | – 他的大脑基底可见小块物质, 我们认为 – 垂体? |
[18:36] | – Looks that way. Explains the low blood pressure. | 看起来像 这能解释低血压 |
[18:40] | And pretty much confirms the lymphoma. | 基本符合淋巴瘤 |
[18:48] | If we’d started Ester on prednisone… | 如果我们以强的松治疗esther… |
[18:50] | Did anyone see the lymphoma? | 看见淋巴瘤了么? |
[18:53] | No, we saw a mass. The location is consistent with… | 没有, 只看见一团 位置相当靠近– |
[18:56] | Didn’t see any in the blood either. | 血液里也没见到 |
[18:58] | White blood cells show no spindling or abnormal nuclei. | 白细胞未见细长, 也没有异常核型 |
[19:00] | Nothing on immunochemistries either. It’s not lymphoma. | 免疫化学反应没发现什么, 不是淋巴瘤 |
[19:36] | house House! | |
[19:40] | It’s a train. | 那是一列火车 |
[19:42] | – We don’t know what kind of train… – Whoa. Whoa. Whoa. | 我们不知道是什么火车 |
[19:44] | – I’m thirsty. – It’s closed. | – 我渴了 – 这里关门了 |
[19:50] | It’s not now. | 没有 |
[19:58] | We got one advantage. | 我们还有一优势 |
[20:00] | We know where the tracks are going. | 我们知道病情的走向 |
[20:02] | The fact that the end of the line | 知道终点是死亡… |
[20:05] | is death is an advantage? | 这是个优势? |
[20:06] | The fact that we know is an advantage. | 只要我们知道, 就是优势 |
[20:08] | It means maybe we can get ahead of it. | 也许我们可以抢先一步 |
[20:11] | Next station is the liver. We got about 90 minutes before it gets there. | 下一站是肝脏 在此之前我们还有…90分钟 |
[20:15] | Maybe we can cut down a tree across the line just outside of town. | 也许我们可以砍倒一棵树挡住路 |
[20:19] | I’ll do an ultrasound. | 我去做超声波 |
[20:20] | No, treatment will tell us more, faster. | 不, 治疗措施告诉我们的更多, 更快 |
[20:22] | How can we start treatment if we have no idea what we’re treating for? | 不知道治什么, 怎么出治疗措施? |
[20:24] | Treat him for everything. | 所有的都治 |
[20:26] | Give him acetylcysteine, and interferon, and silymarin, | 乙酰半胱氨酸, 干扰素, 水飞蓟素 |
[20:30] | and whatever else you can think of to protect the liver. | 以及任何能想到的保肝药 |
[20:46] | What’s going on? | 发生什么事? |
[20:48] | Oh, just catching up on some TV. How’re you doing? | 随便看点电视 你怎么样? |
[20:52] | Well, thanks to your last consult, the patient has improved dramatically. | 多谢你刚才的指点 病人的病情急剧好转 |
[20:55] | Tell House the patient is about to kill the doctor. | 告诉house, 病人要杀医生了 |
[20:57] | – She says the patient… – I heard. | – 他说病人 – 听见了, 你拿什么牌? |
[21:00] | – What’ve you got? – Well, Cuddy just raised and… | cuddy刚刚加注了, 而且 |
[21:02] | – You’re paired. – What? | 你拿了对子? |
[21:03] | Nines. | 对9? |
[21:06] | How do you know? | 你怎么知道? |
[21:08] | Anything lower, you wouldn’t sound so excited. | 比这小的牌, 你不会这么兴奋 |
[21:11] | Jacks or higher, | 如果比J大 |
[21:12] | your voice sounds like Debbie from accounting is sitting in your lap. | 你的声音会变得好像 会计部的debbie坐在你腿上 |
[21:16] | Ask Cuddy if she can beat a pair of threes. | 问问cuddy她能不能大过一对3 |
[21:18] | What’s going on? If you’re gonna mess with me, | 你想干什么? 如果你想害我 |
[21:20] | wouldn’t it be more fun to do it in person? | 当面做不是更好玩? |
[21:22] | Yes, it would. | 那倒是 |
[21:24] | Can you beat a pair of threes? | 你能大过对3么? |
[21:27] | What’d she do? | 她怎么做? |
[21:28] | I left orders for PO fluids, Doctor. | 我让病人用口服液 |
[21:31] | Enough with the codes. She obviously knows it’s me. | 不要用暗语了, 她知道是我 |
[21:33] | She’s drinking her seltzer. | 她在喝seltzer |
[21:34] | … | 她停下了? |
[21:38] | … | 全押 |
[21:39] | – But… | 可是… |
[21:40] | – Just do it. | 照做就是 |
[21:42] | You couldn’t care less about this charity event. | 你对这次筹款也太热心了吧 |
[21:44] | You claim not to be messing with me. | 你说了不想害我 |
[21:45] | You’re either trying to keep me… Shut up. | – 显然, 你要么是想让我- – 闭嘴 |
[21:49] | Look, last time I wanted the game to go on. I still do. | 上次, 我希望你继续玩下去 现在仍是 |
[21:52] | It means that this time you get to win. | 也就是说, 这次必须让你赢 |
[21:54] | Hold on. | 稍等 |
[22:02] | I fold. | 扣牌 |
[22:12] | House, are you sure you’re okay? | house, 你没事吧? |
[22:46] | Meds seem to be working. Liver’s holding its own. | 药物似乎有效, 肝脏还没有出问题 |
[22:50] | Good. | 很好 |
[22:51] | – But the platelets are dropping. | 血小板在降低 |
[22:53] | – Even better. | 更好 |
[22:54] | Why? It means he’s getting sicker. | 为什么? 这表示他的病加重了 |
[22:55] | It’s new. New is good. | 这是新现象, 新的总是好的 |
[22:58] | Because old ended in death. | 因为老现象必死无疑 |
[23:04] | I can’t breathe. | 我喘不过气 |
[23:06] | Chase! Chase! | |
[23:10] | What’s happening? | 怎么了? |
[23:17] | Ian, come on. | 伊恩 来吧 |
[23:19] | Honey, just relax. | 亲爱的,放松一下 |
[23:21] | Ian, breathe. Come on, honey. Please. | 伊恩 呼吸 亲爱的 拜托 |
[23:25] | Please, honey. | 亲爱的 拜托 |
[24:19] | We had to put him on a ventilator. | 我们得给他上呼吸机了 |
[24:20] | He’s back on Ester’s path | 他又回到esther的轨道了 |
[24:23] | and we managed to make the train skip a few stations. | 我们让火车少停了几站 |
[24:26] | Which means that instead of 12 hours, he’s probably got less than two. | 说明没有12小时了 他可能只有不到2小时 |
[24:30] | Which begs the question, why? What did we do? | 引出了下面的问题 为什么? 我们做了什么? |
[24:33] | Acetylcysteine could mess with the lungs. | 乙酰半胱氨酸会破坏肺功能 |
[24:35] | Mess with them, not shut them down in 20 minutes. | 破坏, 不是在20分钟内彻底关闭 |
[24:38] | Interferon modulates the immune system. | 干扰素调节免疫系统 |
[24:40] | It could affect a cancer of the blood, like one of the leukemias. | 它可以影响血液癌细胞 就像白血病一样 |
[24:43] | It doesn’t speed them up. It slows them down. | 它不是加速, 而是减速 |
[24:45] | It slows down all 500 of them? | 所有的都减速? |
[24:47] | Anybody know where we can find an oncologist at this hour? | 谁知道这时候到哪里去找肿瘤科医生? |
[24:54] | What effects would interferon have on leukemia? | 干扰素对白血病有哪些效果? |
[24:58] | Depends on what type. Could make it better. Could make it worse. | 取决于什么类型的 可有好效果, 也可能是坏效果 |
[25:01] | A four-year fellowship to learn that. | 4年肿瘤科就学了这个 |
[25:03] | Tell House if he wants to play cards, he can get his ass back down here and play. | 告诉house, 如果他想玩牌就下来 |
[25:07] | You hear that. | 听见了? |
[25:08] | She wants me off the phone. Means she’s vulnerable. Go all in. | 她想让我挂掉, 说明她心虚 全押上 |
[25:12] | But the party’s over in less than three hours. | 可是这个聚会还有不到3小时结束 |
[25:16] | It’s over in less than two hours, | 不到2小时就结束 |
[25:18] | which means you either have three of a kind or just threes. | 说明你要么是有3张同花 或者有对3 |
[25:24] | I’m guessing threes. I bet $500. | 我猜是有对3, 我加500 |
[25:30] | – Go all in. | 全押上 |
[25:32] | – You obviously want to bust me. or I tell everybody in the building that you wear toenail polish. | 你这明显是害我 你还不如– |
[25:39] | I’m all in. | 我全押上 |
[25:43] | I’ll call. | 我跟 |
[25:45] | I’m betting you have a pair of threes, but even if you have three, | 我认准了你有对3, 不过 即使你有3个3… |
[25:52] | it’s not gonna beat trip nines. Oh! Oh! Oh, no! | 也大不过3条9 |
[26:00] | Oh, no! Oh! Oh, that’s gotta hurt. | 哦不, 哦不 不不 这下可要肉痛了 |
[26:03] | What happened? | 什么情况? |
[26:04] | I just killed two birds with one straight. Goodbye. | 我的同花顺大过1对9 |
[26:08] | Fine, keep playing. | 行, 继续玩 |
[26:09] | But I need you to recommend a good oncologist | 但你要为我推荐一个肿瘤科医生 |
[26:11] | because if I don’t get one up here in the next few minutes, I got a dead six-year-old. | 如果几分钟内还没人 这个6岁病人会死 |
[26:17] | If you need help, ask. These games are insane. | 如果你需要帮助 , 开口即可 用不着玩这些 |
[26:21] | The games have a higher success rate. | 游戏的成功率高些 |
[26:23] | Well, I don’t see anything that looks like leukemia. – You do a bone marrow biopsy? | 看不出来哪里像白血病 做过骨髓抽检么? |
[26:27] | – No time. | 没时间 |
[26:29] | Even if there is an occult blood cancer, | 如果是白血病 |
[26:30] | you wouldn’t expect interferon to make it worse. | 干扰素不会导致恶化 |
[26:33] | Certainly not this fast. | 绝对没这么快 |
[26:34] | – What would move this fast? | 什么这么快? |
[26:36] | – Autoimmune diseases. If his body’s own defenses are attacking him, | 自体免疫病 被自身的防御系统攻击 |
[26:39] | beefing them up is just gonna put fuel on the fire. | 激活免疫系统就等于火上浇油 |
[26:41] | Sarcoidosis could be in his brain and lungs. | 大脑和肺可能有结节病 |
[26:43] | No. No enlarged hilar lymph nodes on his chest x-ray. | 胸透没发现肺门淋巴结增大 |
[26:46] | The systemic nature suggests Juvenile Rheumatoid Arthritis. | 全身性症状表明可能是 少儿类风湿性关节炎 |
[26:49] | Or Kawasaki’s Disease. | 或者”川崎病” |
[26:51] | Can’t be Kawasaki’s. That doesn’t affect the elderly. | 不是川崎病, 它不出现在老人身上 |
[26:54] | This is a kid’s x-ray? | 这个…是小孩的X光 |
[26:57] | House had another patient. | House以前的一个病人… |
[27:00] | Who may or may not have had Kawasaki’s. | 她有没有川崎病难说 而这个孩子… |
[27:07] | choking off blood to his major organs, one by one. | 逐一破坏重要器官的血液供应 |
[27:11] | First the GI tract, then the kidneys, then the brain, now the lungs. | 首先是消化道, 然后肾脏 大脑, 现在是肺 |
[27:15] | Can anyone think of a reason why Kawasaki’s can’t affect the elderly, | 谁能想出来, 为什么老人不得川崎病? |
[27:20] | other than that it doesn’t? | 而不是这件事实? |
[27:26] | Nice. | 好 |
[27:26] | We can confirm with blood work. We need an ANA, sed rate… | 可以用血检确定, 自身抗体检测 沉降率– |
[27:30] | Labs will take two hours. | 化验至少要两小时 |
[27:32] | What was the old lady’s sed rate? | 老妇人的沉降率多少? |
[27:33] | Elevated, 98. | 高达98 |
[27:35] | You can’t use another patient’s labs to diagnosis Kawasaki’s disease. | 不能用另一个病人的化验结果诊断这个 |
[27:39] | Is that like a dare or something? | 这是什么禁忌么? |
[27:40] | You don’t have time to be wrong. | 没时间纠错 |
[27:42] | Fine. We’ll look for Kawasaki where he lives, | 那好, 我们到川崎病居住的地方找 |
[27:45] | Ian’s coronary arteries. | Ian的冠状动脉 |
[27:52] | This other patient, | 这个病人 |
[27:56] | the old lady, Ester? | 老妇人, 叫Esther? |
[28:03] | Have you read Moby Dick? | 你有没有听说过白鲸记? |
[28:05] | It was a book? | 是一本书? |
[28:06] | – It was ten years ago. – Twelve. | – 那是10年前 – 12年 |
[28:09] | Obsession is dangerous. | 偏执是危险的 |
[28:11] | Only if you’re on a wooden ship, and your obsession is a whale. | 只有当你坐着一条木船 而你偏执的对象是条鲸鱼 |
[28:14] | I think I’m in the clear. | 我觉得我很安全 |
[28:15] | You do realize it’s a metaphor. | 你知道这是个比喻吧? |
[28:17] | You realize the point of metaphors is to scare people from doing things | 你知道比喻的作用 就是吓唬人们不做某事 |
[28:20] | by telling them that something much scarier is gonna happen | 通过告诉他们, 如果你做了 |
[28:22] | than what will really happen. | 将会有件更恐怖的事情发生 |
[28:25] | God, I wish I had a metaphor to explain that better. | 我真希望能用个比喻更好地表达 |
[28:28] | Go back to the game. Don’t worry, I’m not gonna get eaten by witches. | 回去玩牌吧, 别担心 我不会被女巫吃了的 |
[28:36] | Coronary arteries clear. No aneurysms. | 冠状动脉没事, 没有动脉瘤 |
[28:40] | Flip the mode. Let’s see the flow. | 改变模式, 看看血流 |
[28:46] | How did that other woman die? | 那个女人怎么死的? |
[28:49] | She went into respiratory distress. | 她呼吸衰竭 |
[28:52] | – Her heart and liver were already… | 心脏和肝脏已经- |
[28:54] | – No. Did she suffer? | 不, 她疼吗? |
[28:59] | Was she in pain? | 痛苦吗? |
[29:01] | I don’t know. | 我不知道 |
[29:06] | Laminar flow. No blood clots, no ragged edges. | 血流稳定, 没有血块, 没有扰动 |
[29:10] | Damn. Shut it down. We’re just wasting time. | 该死, 关掉吧 我们在浪费时间 |
[29:19] | Look at the right atrium. | 看右心室 |
[29:21] | – That’s not Kawasaki’s. | 不是川崎病 |
[29:22] | – No. | 不 |
[29:24] | It’s small, but it’s there. | 很小, 但确实有 |
[29:26] | Ester didn’t have a mass in her heart. | Esther的心脏里没有肿块 |
[29:28] | Ian’s younger. | Ian还年轻 |
[29:29] | He can take more of a pounding. | 他不容易被打倒 |
[29:31] | Ester died before the disease reached her heart. The disease made a mass and made it fast. | Esther在疾病到达心脏之前就死了 这病造成肿块并加速死亡 |
[29:35] | – Could be bacteria. – Muscle. Connective tissue. | – 可能是细菌感染 – 肌肉 – 结缔组织 |
[29:38] | The kid can’t take any more theories. | 这孩子不能再接受猜测 |
[29:40] | Only thing we know is that whatever that mass is, | 我们只知道, 不论这肿块是什么 肯定和这病有关 |
[30:01] | I’ll shut the blinds. | 我关上百叶窗 |
[30:03] | No, let them watch. | 不, 让他们看 |
[30:04] | I do my best work on the big stage. | 有观众我的表现才好 |
[30:08] | Passing through the superior vena cava. | 穿过上腔静脉 |
[30:11] | You’re in the atrium. Pull back. | 进入心室 |
[30:15] | You’ve hit the wall of the heart. | 接触到心壁 |
[30:18] | These procedures would be so much simpler if you could do them on healthy people. | 在健康人身上做这个很简单 |
[30:23] | And out again. | 又退出 |
[30:27] | – V-fib. – Cardiac arrest. Call a code. | – 心室颤动 – 心脏停跳, 我叫人急救 |
[30:30] | Come on, paddles! – Come on. – Charge. | 快点, 电板, 快点 |
[30:36] | Clear! Code blue, ISO room. | 好了 |
[30:45] | And again. | 再来 |
[30:50] | – Nothing. – Again. | – 没反应 – 再来 |
[31:06] | You got a clock on this? | 你有表么? |
[31:08] | How much longer you gonna keep doing this? | 你这样还要多久? |
[31:10] | Clear. | 好了 |
[31:15] | Wait. I’ve got something. | 等下, 有反应了 |
[31:21] | He’s back. | 缓过来了 |
[31:29] | – What are you doing? | 你要干什么? |
[31:31] | – I’m doing what we came here to do. | 继续刚才没做完的 |
[31:33] | – It almost killed him. | 那差点要了他的命 |
[31:34] | – I know. I was right here. I need a Vacutainer. | 我知道, 我就在这里 把真空管给我 |
[31:37] | His brain’s been oxygen deprived for over eight minutes. | 他的大脑缺氧超过8分钟 |
[31:39] | There might be nothing left. He might… | 可能剩不下什么了, 你已经– |
[31:41] | Tell the parents. Where the hell is that Vacutainer? | 通知他的父母 真空管在哪里? |
[31:56] | – So, what’s he got? | 他会怎么样? |
[31:59] | – Brain damage. | 大脑损伤 |
[32:00] | Good chance. I was talking about before that. | 极有可能, 我是问在这之前 |
[32:03] | – You’re not worried about… | 你难道不担心- |
[32:04] | – Things I can’t do anything about? – I try not to. – Yeah. | 无可挽回的事, 我尽量不去担心 |
[32:06] | Things just roll off you like water off a duck. | 说的好像你可以轻松忘记 |
[32:09] | Histiocytosis. | 组织细胞增生 |
[32:11] | Very unlikely in a 73-year-old. | 不太可能在73岁病人身上 |
[32:13] | Whatever this is, it’s very unlikely. | 不管是什么, 都很蹊跷 |
[32:15] | Come on. More ideas. Let’s go, people. | 快点, 再来点主意, 加油伙计们 |
[32:17] | Genetic disorders could cause masses everywhere. Tuberous sclerosis. | 遗传病可以形成肿块 结节性硬化症 |
[32:21] | If it’s genetic, he’s had it all his life. | 如果是遗传性的, 他一出生便有 为何现在发生? |
[32:24] | – Why now? – I don’t know. It sure fits nice enough. | 不知道, 不过有可能 |
[32:26] | We haven’t ruled out leukemia yet. | 我们并未排除白血病 |
[32:28] | Or sarcoma. He could have multiple soft tissue tumors. | 或者肉瘤, 可能是多发软组织肿瘤 |
[32:31] | Or sarcoidosis. Multiple neurofibromatosis. | 或者结节病, 多发神经纤维瘤 |
[32:34] | Chondrocytomas. | 成软骨细胞瘤 |
[32:37] | How’s it going? You win? | 玩的怎么样? 赢了? |
[32:39] | I got called away by the angry parents of a patient. | 我被愤怒的家长叫来了 |
[32:42] | There are three of you here. None of you had the sense to stop him, | 你们3个人在 没一个人想到要阻止他 |
[32:45] | to pick up a phone and call me. | 没想到拿起电话找我 |
[32:47] | I told them you’d signed off. | 我告诉他们你会把病例转给我 |
[32:48] | The parents are mad because their kid is dying. It’s understandable. | 家长愤怒, 因为孩子要死了 这可以理解 |
[32:51] | But if he doesn’t die, they won’t be mad anymore. | 如果他不死, 家长就不会生气了 |
[32:54] | If he’s brain damaged, they might still be a little ticked. | 大脑损坏了, 他们照样生气 |
[32:56] | Had to do it to save him. | 我要救他就必须那样做 |
[32:57] | You had to do it to diagnose Ester. | 你那样做是为了诊断esther |
[33:00] | You may have killed a six-year-old | 你不惜杀死一个6岁小孩 |
[33:02] | because you’re obsessed with a woman who’s been dead for 12 years. | 因为你对12年前死去的一个女人不能释怀 |
[33:05] | Sometimes you lose, House! You’re not God! | 有时候你会失手, house 你不是上帝 |
[33:08] | He’s not dead yet. | 他还没死 |
[33:09] | No, but you’re done with him. It’s my case now. Go home. | 不, 这里没你事了 这是我的病人, 回你的家 |
[33:11] | Go ride your motorcycle. Go brood in a dark room. Just don’t go near Ian again. | 去飙车, 躲在小黑屋里郁郁寡欢 就是别靠近Ian了 |
[33:22] | So, anything else or is it just these seven? | 还有别的吗? 还是只有这7项 |
[33:26] | Drop it, House. She’s right. | 放手吧, house 她是对的 |
[33:28] | No, she’s not! | 不对, 你知道她不对 |
[33:32] | – You know she’s not. – We should have called her. | 我们应该叫她 |
[33:33] | I’m surprised you didn’t. | 我很惊讶你没有 |
[33:34] | You’re gonna have to find a way to let this go. We can’t go near Ian. | 无论如何你要放手了 我们不能再碰Ian |
[33:38] | We don’t need to go near him. | 我们不用碰他 |
[33:39] | We have his tumor. | 我们拿到了他的肿瘤 |
[33:42] | Well, Cuddy may be right that we screwed up the protocol. | Cuddy也许说对了 我们没有按照指南 |
[33:44] | She may be right about my screwed up obsession. | 对于我的偏执, 她也许说对了 |
[33:47] | But I’m right about the medicine. | 在医学上我是正确的 |
[33:49] | How many tests can we do with that? | 这点样本能做几个检测? |
[33:52] | Look, we cure the kid, we solve everybody’s problems. How many? | 我们治好这孩子, 就不存在任何问题 几项? |
[33:58] | Maybe two good pieces. | 两项没问题 |
[34:01] | How many okay pieces? | 最多能做几项? |
[34:03] | Three would be pushing it. | 3项已经勉强 |
[34:07] | Three tests, seven choices. | 3项测试, 7个选择 |
[34:10] | Okay, what’s first? | 好, 先做哪项? |
[34:12] | Sarcoidosis seems most likely. | 结节病似乎最有可能 |
[34:15] | Yeah. So likely that Cuddy’s gonna think of that all on her own. | 太有可能了, cuddy绝对会想起来 |
[34:18] | She’s got the kid’s whole body to play with. Let her do that test. | 整个人都在她手上 让她去做这个 |
[34:22] | What’s next? | 下一个? |
[34:23] | It’s moving too fast to be spreading. | 这么快的速度不可能是扩散 |
[34:26] | It has to be growing from something that’s already there. | 病灶肯定早就在了- |
[34:28] | Genetic disorder. Tuberous sclerosis. | 遗传病——结节性硬化症 |
[34:30] | Or it’s his immune system. Histiocytosis. | 或者是免疫系统, 组织细胞增生 |
[34:33] | Well, there are more documented cases of Histio amongst older people | 组织细胞增生的报道多集中在老人身上- |
[34:36] | than tuberous sclerosis. Let’s start with that. | 结节性硬化症则不然 从这个开始 |
[34:44] | Wing or drumstick? | 要鸡翅还是鸡腿? |
[34:47] | Gonna need a little more than that. | 需要再多点 |
[34:51] | A little more is more than a third. | 再多就超过三分之一了 |
[34:52] | If we have to repeat this test because you didn’t cut us enough… | 不给我们切够就要重复试验… |
[35:01] | I’m adding one micro liter of the immunoperoxidase. | 加入1微升免疫过氧化酶 |
[35:05] | Make it two. I don’t want House biting off our heads | 两微升, 我不想被House找麻烦 |
[35:07] | because we weren’t sure if it turned red or not. | 只因为我们不能确定显红色 |
[35:15] | That’s definitely not red. | 没有显红色 |
[35:23] | The problem could still be an abnormal cell growth It would explain the geography. | 可能还是的细胞异常增生 只不过在另一种组织 |
[35:31] | Genetic disorder is far more likely in a six-year-old. Tuberous sclerosis. | 6岁小孩更有可能是遗传病 结节性硬化症 |
[35:34] | Pretty unlikely to cause a GI bleed. | 这一般不造成消化道出血 |
[35:36] | The time course fits. | 时间序列符合 |
[35:37] | Mr. Foreman, you agree with both of them? Thanks for playing. | foreman, 你同意他们两个 你还真会玩 |
[35:40] | If we have enough tissue for two tests, why not do both? | 如果剩下的组织还能做两项 为什么不都做? |
[35:43] | Then we don’t have to think as hard. | 我们不必这么思考 |
[35:44] | Taking the pressure off the choice makes us less likely to think critically. | 摆脱做选择的压力 可以让我们更好的思考 |
[35:47] | Sarcoma is more likely to hit a six and 70-year-old. | 肉瘤在6岁和70岁人身上都是多发的 |
[35:50] | Tuberous sclerosis, it is. | 结节性硬化症 |
[35:52] | You think sarcoma is less likely? | 你认为肉瘤的几率小? |
[35:54] | It’s more likely. The test for it, on the other hand, is less reliable. | 几率大, 但是检测方法不甚可靠 |
[36:09] | Test is negative. | nestin阴性 |
[36:11] | Well, that’s okay. | 这好解释 |
[36:13] | If the tumor cells hadn’t matured, the Ki-67 protein wouldn’t have turned off. | 如果肿瘤细胞未成熟 KI-67蛋白不会消失 |
[36:18] | – What happens if we don’t solve this? | 如果我们不能解决这个 会发生什么事? |
[36:20] | – Kid dies. | 小孩会死 |
[36:21] | I mean for the next 12 years. | 我指将来的12年 |
[36:25] | Ki-67’s negative. | Ki-67蛋白阴性 |
[36:30] | And PCH antigen is negative. | PCH抗原阴性 |
[36:44] | Mighty Casey’s down to his last strike. | Mighty casey剩最后一期了 |
[36:47] | Mighty Casey struck out. | Mighty casey早就停了 |
[36:49] | Thanks a lot. I was gonna read that this weekend. | 多谢, 我本来计划这周末看的 |
[36:52] | Chondrocytoma. Connective tissue’s been in all the places we’ve been looking. | 成软骨细胞瘤 结缔组织在所有地方都有 |
[36:55] | The kid is too sick for that. We’re better off testing for sarcoma. | 孩子病的太厉害了 最好还是检测肉瘤 |
[36:58] | We would’ve seen signs of that when we tested for tuberous sclerosis. | 测结节性硬化症时 就应该看到一些指征 |
[37:00] | The tumor cells looked like muscle under the microscope. | 在显微镜下肿瘤细胞和肌细胞差不多 |
[37:03] | No, they didn’t. They looked like fat. | 不是的, 看上去像脂肪 |
[37:06] | I vote for neurofibromatosis. | 我赞成神经纤维瘤 |
[37:10] | – Why? | 为什么? |
[37:11] | – Because the other choices suck worse. | 因为其它的选择更差 |
[37:21] | Give me a minute. | 给我点时间 |
[37:52] | You want me out of here? | 你要我出去? |
[37:56] | You come up with anything? | 你查出新的东西? |
[38:01] | No. | 没有 |
[38:30] | Hey. We can talk about it tomorrow. | 我们明天再说 |
[38:40] | I… I won the poker tournament. | 我…我赢了扑克比赛 |
[38:46] | I totally played this guy, Berman, from business affairs. | 我彻底打败了商务服务部的berman |
[38:50] | I got great cards. But I don’t bet. Just call, no raises. | 我拿了好牌, 但我不声张 只跟不加 |
[38:54] | Berman pairs his king on the flop. | Berman牌面是一对K |
[38:56] | I keep calling, the river turns, | 我一直跟他, 然后看自己的底牌 |
[39:00] | I check. He can’t stand it. He goes all in. He’s sure he’s won. | 他受不了了, 全部押上 他确信能赢 |
[39:05] | I call, I flip them. | 我跟了, 亮牌 |
[39:10] | Pocket aces. | 一对A |
[39:12] | I nailed his ass. | 我把他放倒了 |
[39:23] | The aces were hiding all along. | 王牌总是隐藏着 |
[39:33] | Test him for Erdheim-Chester disease. | 测erdheim-chester病 |
[39:36] | Erdheim-Chester? That’s not even on the list. | erdheim-chester病? 它甚至不在名单上 |
[39:39] | Because we already did it. He tested negative. | 因为我们已经做过 是阴性 |
[39:42] | – So did Ester. | esther也是 |
[39:43] | – The disease lied. | 疾病会撒谎 |
[39:44] | Yeah, the tumor’s got it in for you. Diseases don’t lie. | 是啊, 肿瘤骗到你了 疾病不撒谎 |
[39:47] | Fine, it didn’t lie. It slow played us. | 好吧, 疾病不撒谎 只是慢慢地玩弄我们 |
[39:49] | We biopsied the colon, it hadn’t reached the GI tract yet. | 活检的是结肠 当时还没到达消化道 |
[39:53] | It’s there now. It’s in his liver, his lungs. | 现在它到了, 还到了肝, 肺… |
[39:56] | You want it to be there. | 我们希望它在那里 |
[39:58] | Because then you didn’t screw up 12 years ago. | 这样你12年前就不算失手了 |
[40:00] | We can’t waste our one test on the one disease we know it’s not. | 不能不能浪费样品 做一项已经排除的测试 |
[40:07] | Run the test. | 动手吧 |
[40:20] | You sure about this? | 你确定? |
[40:22] | Wait. Let me think about that. Don’t pressure me. Just run the damn test. | 等等, 我再考虑下, 别催我 赶紧开始测试 |
[40:29] | Cells look like macrophages. | 看上去像巨噬细胞 |
[40:31] | That’s a good start. | 不错的开始 |
[40:39] | Take your time, and say it loud. | 慢慢来, 大声地报出来 |
[40:51] | CD 68 positive. | Cd 68阳性 |
[41:05] | Start the treatment. | 开始治疗 |
[42:06] | So, Ester can rest peaceful now, huh? Yeah. | esther现在可以安息了? |
[42:18] | 40. $40. | |
[42:24] | You got lucky. | 你走运了 |
[42:27] | You gonna call? | 跟不跟? |
[42:29] | What I do | 我的策略… |
[42:31] | is not just based on the flip of a card. | 不光是根据牌面 |
[42:34] | You guessed. You got lucky. | 你猜的, 走运而已 |
[42:37] | It fit. | 猜中了 |
[42:38] | It could just as easily have been sarcoma or tuberous sclerosis. | 有很大可能是肉瘤或结节性硬化症 |
[42:42] | No, not just as easily. | 不, 没那么大可能 |
[42:44] | Maybe not. | 也许吧 |
[42:45] | But it wasn’t impossible. | 但不是不可能 |
[42:49] | Are you gonna call? | 你跟不跟? |
[42:53] | You know, relative to its size, | 知道吗, 根据身体的比例 |
[42:56] | the barnacle has the largest penis of any animal. | 所有动物中阴茎尺寸最大的是藤壶 |