时间 | 英文 | 中文 |
---|---|---|
[00:01] | Your primary care doctor was right. | 你的初级保健医生是对的 |
[00:02] | The mass is on the smaller side. | 肿块在较小的一边 |
[00:04] | We’ll confirm with the new images, | 我们会用新片子再确认一下 |
[00:06] | but it should be manageable with medication. | 但应该可以用药物控制住 |
[00:08] | No surgery needed. | 不用做手术 |
[00:10] | Well, my fiance will be so relieved. | 我未婚夫能松一口气了 |
[00:13] | He’s been worried i’ll look like Frankenstein in all our photos. | 他一直担心我在照片里会像弗兰肯斯坦一样 |
[00:16] | Also that I might die. | 还担心我可能会死 |
[00:18] | When’s the big day? | 婚礼是什么时候 |
[00:19] | June. | 六月 |
[00:21] | You’ve been dealing with wedding planning | 你有垂体瘤 |
[00:22] | on top of a pituitary tumor? | 还在筹划婚礼吗 |
[00:26] | You deserve a medal. | 真该给你发个奖章 |
[00:27] | Our medical record system, on the other hand, | 另外我们的医疗记录系统 |
[00:29] | it has you listed as female. | 却把你归为了女性 |
[00:32] | Probably because of the Pap smears. | 可能是因为宫颈刮片检查的关系 |
[00:34] | Software clearly needs a trans update. Deep breath. | 软件显然得把跨性别者更新进去 深呼吸 |
[00:36] | I’ll fix it so everything is correct going forward. | 我帮你改好吧 省得以后麻烦了 |
[00:39] | Please confirm your gender and pronouns. | 请确认你的性别和人称代词 |
[00:41] | Male, he/him/his. Thanks for asking. | 男性 他 谢了 |
[00:43] | We’re the ones with the messed-up software. | 是我们的软件太烂了 |
[00:45] | Your scans from this morning were just uploaded. | 你早上拍的片子刚传上来了 |
[00:56] | In less than two weeks, the tumor’s doubled in size. | 在不到两周的时间里 肿瘤变大了一倍 |
[01:03] | You’re just too good to be true | 你好得令人难以置信 |
[01:06] | I can’t take my eyes off of you | 让我难以移开我的目光 |
[01:08] | You’d be like heaven to touch… | 你就像人们向往的天堂 |
[01:10] | 34-year-old female, Zara Norton. | 34岁女性 扎拉·诺顿 |
[01:12] | Tachycardic and delirious. | 心动过速 神志不清 |
[01:14] | Dr. Guerin, update vitals. | 盖林医生 更新体征 |
[01:15] | Dr. Wolke, draw blood for CBC and electrolytes. | 沃克医生 采血去做血常规和检查电解质 |
[01:19] | Now that I’ve found you, stay | 我发现你停下了脚步 |
[01:21] | Pupils are dilated, but reactive. | 瞳孔放大但有反应 |
[01:23] | Ms. Norton, smells like you’ve had some marijuana? | 诺顿女士 你闻上去像是抽大麻了 |
[01:25] | Mmm-mmm. I just unloaded a shipment at the dispensary. | 我刚在药房卸了一批货 |
[01:28] | Test for THC | 检查一下四氢大麻酚 |
[01:29] | and a full tox screen. | 做个全面毒理学检查 |
[01:30] | I am a peddler. | 我是个小贩 |
[01:31] | Not a user. | 不是吸毒的 |
[01:33] | Run it. | 去做吧 |
[01:34] | BP’s elevated, 180 over 115. | 血压升高了 180/115 |
[01:37] | That could explain the delirium. | 这能解释她为什么神志不清 |
[01:38] | Ooh, that sound high. Better take my meds. | 那听起来有些高 最好把药吃上 |
[01:40] | See, I never miss a… Oh, no. | 我从没忘过 不 |
[01:44] | Oh, no, that’s not it. | 不 这不是 |
[01:45] | BP’s climbing, 210 over 120. | 血压还在升高 210/120 |
[01:46] | Enalaprilat, 1.25 milligrams, IV. | 静脉注射1.25毫克依那普利拉 |
[01:48] | Ms. Norton, do you remember the name of your medication? | 诺顿女士 你记得你的药叫什么吗 |
[01:50] | You can call me Zara. | 你可以叫我扎拉 |
[01:52] | See? It say right here on the… | 看到没 就写在这里 |
[01:55] | Okay, forget about the meds. She is not taking any. | 好了 别管药了 她没在服药 |
[01:56] | This is untreated chronic hypertension. | 这是未经治疗的慢性高血压 |
[01:58] | What if you’re wrong? | 你要是错了呢 |
[01:59] | What if she’s on a loop diuretic for her pressure? | 如果她在为降压吃髓袢利尿药呢 |
[02:01] | This could cause renal failure. | 可能会造成肾衰竭的 |
[02:03] | She’s heading into hypertensive crisis. | 她马上就要出现高血压危象了 |
[02:05] | What if we try an angiotensin receptor blocker? | 用血管紧张素受体阻断剂怎么样 |
[02:07] | No drug interaction. | 它不会和其它药物起反应 |
[02:08] | Angiotensin receptor blockers work too slowly. | 血管紧张素受体阻断剂起效太慢了 |
[02:10] | I’m giving her the ACE inhibitor. | 我给她打ACE抑制剂 |
[02:16] | BP’s going down. | 血压下降了 |
[02:18] | Nice call. | 干得漂亮 |
[02:35] | Latest budget report. | 最新的预算报告 |
[02:37] | Yeah, the PDF’s sitting in my inbox. | 知道 我收到PDF了 |
[02:39] | I’m trying to ignore it. | 我在试着当没看见 |
[02:41] | And thus… | 于是我来了 |
[02:45] | A sit-down visit? | 你坐下了 |
[02:46] | Just checking in, see how you’re doing. | 只是想看看你最近怎么样 |
[02:48] | Okay. You? | 挺好的 你呢 |
[02:49] | Me? I’m… recovering from the year, | 我吗 我还在消化这一年的事 |
[02:53] | like everybody else. | 和大家一样 |
[02:54] | Pandemic, the surge. | 疫情大流行 病例激增 |
[02:56] | You were here for every minute of every day. | 你一直都坚守在岗位上 |
[02:58] | It must have taken a toll. | 肯定累坏了吧 |
[03:00] | It… comes with the territory. | 在其位谋其职 |
[03:02] | You’re not, uh, stressed or distracted? | 你不觉得心力交瘁或是心烦意乱吗 |
[03:06] | I’m… tired. | 我只是累 |
[03:09] | Okay. Well, maybe you should take some time off. | 好 那也许你该歇一阵子 |
[03:12] | No. | 不用 |
[03:15] | But thank you. I’m fine. | 但谢谢你 我没事 |
[03:22] | You don’t seem fine. | 你看起来可不像是没事 |
[03:28] | Are there issues with my work performance? | 我的工作表现有问题吗 |
[03:30] | No, you do great work. | 没有 你工作上很棒 |
[03:31] | Then I’m not sure why we’re having this conversation. | 那我就不太明白为什么我们在说这个 |
[03:33] | Because I’m worried about you. | 因为我担心你 |
[03:36] | Because other people are worried about you. | 因为其他人也在担心你 |
[03:39] | There’s no shame in struggling a little bit. | 遇到些困难并不丢脸 |
[03:42] | You know, what would be weird is | 如果你太顺风顺水了 |
[03:44] | if you didn’t struggle at all. | 那才奇怪 |
[03:47] | If you need to see someone, the hospital will cover the cost. | 如果你需要咨询什么人 费用由医院来出 |
[03:51] | Great. You’ll pay my bills. | 太好了 你替我买单 |
[03:53] | And the damage to my reputation, who takes care of that? | 那么对我名誉的损害呢 谁买单 |
[03:58] | I don’t think that seeing a therapist | 我觉得看心理医生 |
[04:00] | will affect your career. | 不会影响你的职业生涯 |
[04:03] | Says the white guy. | 站着说话不腰疼 |
[04:08] | Okay. | 好吧 |
[04:11] | Privacy protections are there for a reason. | 隐私保护不是虚设的 |
[04:13] | No one needs to know. | 不用让人知道 |
[04:15] | Thank you for checking in. | 谢谢你的关心 |
[04:33] | – How you feeling? – Good. | -你感觉如何 -很好 |
[04:35] | Be better when I understand what landed me up in here. | 要是能知道我怎么会在这里 就更好 |
[04:37] | You had an acute hypertensive crisis. | 你出现了急性的高血压危象 |
[04:40] | Oh, I know my blood pressure’s high. | 我知道我血压高 |
[04:41] | I’m already on medication for it. | 我已经在吃药了 |
[04:42] | You probably wanna know what it is. | 你可能想知道是什么药 |
[04:44] | There’s no medication. | 你包里没药 |
[04:47] | We need to do an echocardiogram | 我们要给你做一个超声心动图 |
[04:49] | to make sure your heart wasn’t damaged in the crisis. | 确保你的心脏没有在这次急症中受损 |
[04:51] | Fine by me. | 我没意见 |
[04:53] | Here’s 10% discount | 这是九折券 |
[04:54] | on any purchase over $50 or more at Z & B Naturals. | 在「Z&B天然」购买50美元以上商品就能用 |
[04:57] | I’m Z. B is my partner Bill. | Z是我 B是我的合伙人比尔 |
[05:01] | You’re surrounded by pot all day, every day, | 你每天在大麻堆里面 |
[05:02] | but you never touch the stuff? | 但你却从来没碰过吗 |
[05:04] | How? Why? | 怎么做到的 为什么 |
[05:05] | It’s just never been my thing. | 我不好这口 |
[05:11] | The name always trips me up. | 这名字对我来说太拗口了 |
[05:12] | Chlorthalidone. | 氯噻酮 |
[05:14] | That’s for hypertension. | 是治高血压的 |
[05:15] | Yeah, bottle seems pretty full. | 好像还是满瓶 |
[05:17] | How long have you been on this? | 你吃了多久 |
[05:18] | About six months. Just refilled it. | 大概六个月 才重新装满的 |
[05:19] | Take it every day. | 每天都吃 |
[05:26] | Smile. | 微笑 |
[05:28] | Head tilt. | 歪头 |
[05:30] | Now he smiles. | 他也微笑 |
[05:33] | Burst of laughter. | 笑出声 |
[05:37] | Yeah. | 嗯 |
[05:45] | Rio Gutierrez, 29, | 里奥·古铁雷斯 29岁 |
[05:46] | pituitary mass went from manageable with meds | 垂体瘤块本来可以药物治疗 |
[05:49] | to likely surgery. | 现在可能需要手术 |
[05:50] | So, talking to the new radiology resident, huh? | 所以 跟新来的放射科住院医师聊天呢 |
[05:54] | I wanted Dr. D’Souza’s opinion on an intriguing set of scans. | 我拿难解的扫描图询问德苏莎医生 |
[05:58] | She is very talented. | 她很有才华 |
[06:00] | You’re crushing on her. | 你迷上她了 |
[06:02] | N… no. | 没有 |
[06:03] | I am not. I love Lea. | 我没有 我爱莉亚 |
[06:05] | Well, those two things aren’t mutually exclusive. | 这两件事并不矛盾 |
[06:09] | Mr. Gutierrez’s blood has high levels of prolactin. | 古铁雷斯先生的血液中催乳素含量很高 |
[06:12] | Prolactin is produced in the pituitary gland. | 催乳素在垂体中产生 |
[06:14] | The tumor could be secreting it. | 可能是肿瘤分泌的 |
[06:15] | Or the tumor could be reacting to the high levels of hormones | 也可能是身体其他部位产生了高水平荷尔蒙 |
[06:17] | being produced elsewhere in the body. | 肿瘤对其做出反应 |
[06:20] | The patient is a transgender man. | 病人是个跨性别者 |
[06:25] | Do an ultrasound. | 做超声检查 |
[06:28] | Advance the probe until you see the cardiac chamber. | 探针向内推进 直到你能看见心腔 |
[06:32] | Maybe Zara has secondary hypertension | 扎拉可能因为肾血管疾病 |
[06:34] | due to renal vascular disease. | 患有继发性高血压 |
[06:35] | She doesn’t. Her creatinine is 1.2. | 她没有 她的肌酸酐是1.2 |
[06:37] | Her GFR is in normal range. | 肾小球滤过率正常 |
[06:39] | Well, that would make it unlikely, but not impossible. | 只是理论上不会 并不是不可能 |
[06:41] | It’d also explain | 这也能解释 |
[06:42] | why her prescribed hypertension meds weren’t working | 为什么给她开的高血压药不起作用 |
[06:44] | and why she got better when you gave her that ACE inhibitor. | 而你给她开了ACE抑制剂之后有所好转 |
[06:46] | Mmm. Simpler explanation, she’s not taking her meds. | 更简单的解释是 她其实没吃药 |
[06:48] | Valve looks normal. | 瓣膜看起来正常 |
[06:50] | Should I move on to the two-chamber view? | 我要继续下一步 做二腔观吗 |
[06:52] | Yeah. | 是的 |
[06:53] | We have no reason to think that she’s lying. | 我们没理由怀疑她撒谎 |
[06:55] | She seems to be telling the truth about her pot usage. | 她对自己吸大麻的情况好像说的是真话 |
[06:57] | No THC in her blood or urine. | 血液和尿液中都不含有四氢大麻酚 |
[06:59] | She couldn’t possibly be lying about something else. | 她绝对有其他事撒谎了 |
[07:02] | The left ventricle is thickened, | 左心室厚度增加 |
[07:04] | which is consistent with untreated hypertension. | 证明没有治疗过高血压 |
[07:08] | Heart rate’s climbing. | 心率攀升 |
[07:11] | Cardiac output is dropping. | 心脏排血量在减少 |
[07:12] | Stroke volume as well. | 每搏输出量也是 |
[07:14] | She’s in cardiogenic shock. | 她出现了心源性休克 |
[07:19] | Would you mind if I did an ultrasound on your abdomen? | 你介意我给你做一个腹腔超声检查吗 |
[07:22] | For a brain tumor? | 因为脑肿瘤吗 |
[07:23] | This is my fiance, Eli Simpson. | 这是我的未婚夫 伊莱·辛普森 |
[07:27] | When I heard about the new scans, | 当我听到新的扫描结果时 |
[07:28] | I kind of stormed the castle. | 我几乎快疯了 |
[07:31] | My hero. | 我的英雄 |
[07:33] | Your prolactin levels are very high, | 你的催乳素水平很高 |
[07:34] | which might be caused by the tumor, | 可能是肿瘤引起的 |
[07:35] | unless another condition raised your prolactin, | 除非有别的情况提高了你的催乳素水平 |
[07:37] | encouraging more growth. | 造成了肿瘤增生 |
[07:39] | What condition boosts prolactin? | 什么情况会促进催乳素分泌 |
[07:43] | Do you think I’m pregnant? | 你认为我怀孕了吗 |
[07:45] | He can’t be. He’s on testosterone. | 他不可能 他在服用睾丸激素 |
[07:48] | Except for a few weeks last month. | 除了上个月的几个星期 |
[07:50] | I forgot to take my shot before our trip. | 在我们旅行前我忘了注射激素 |
[07:53] | But there’s no way that… | 但那也不可能 |
[07:54] | You’re pregnant. | 你怀孕了 |
[08:09] | You went into cardiogenic shock | 你得了心源性休克 |
[08:11] | because your heart wasn’t pumping adequately. | 因为你的心脏没法有力地跳动 |
[08:13] | We did a minor procedure and installed an Impella pump, | 我们做了个小手术来安装一个分流泵 |
[08:17] | but it’s a short-term solution. | 但这只是缓兵之计 |
[08:18] | I do feel a little out of breath. | 我确实感到有点喘不上气 |
[08:20] | But that might be just ’cause of you, Dr. Andrews. | 但我可能是因为看到你才这样的 安德鲁斯医生 |
[08:23] | Ms. Norton, I’m a married man and your doctor. | 诺顿女士 我已经结婚了而且我只是你的医生 |
[08:27] | You have a rare condition. | 你的情况很罕见 |
[08:28] | Certain parts of your heart muscle | 你心肌的某些部位 |
[08:30] | have become abnormally thick. | 变得异常肥厚 |
[08:32] | So, this wall in between the chambers, that’s the septum. | 心室之间的心壁就是隔膜 |
[08:35] | That’s a normal one. | 这是正常的样子 |
[08:38] | This is what yours looks like. | 这是你的样子 |
[08:41] | It’s gonna require surgery. | 这需要手术 |
[08:43] | We’re gonna run a few more tests to determine the best approach. | 我们还需要更多化验来决定最佳方案 |
[08:47] | Wait. You gonna be my surgeon, Dr. Andrews? | 等等 你是我的主治医生吗 安德鲁斯医生 |
[08:49] | I sure will. | 我当然是 |
[08:51] | And y’all two gonna be with him? | 你们俩会跟他一起吗 |
[08:53] | Yeah. | 对啊 |
[08:55] | My lucky day. | 真是我的幸运日 |
[08:57] | Three doctors of color taking care of me. | 三个有色人种医生治疗我 |
[09:00] | Doctors who won’t talk down to me. | 而不是那种高高在上的医生 |
[09:02] | Not exactly what I’m used to. | 和我以前遇到的医生不一样 |
[09:04] | You guys know what I mean. | 你们懂我是什么意思 |
[09:06] | My mother made me wear a suit and tie | 之前每次我妈妈带我去看儿科医生 |
[09:07] | whenever we went to the pediatrician. | 她都会让我穿西装打领带 |
[09:10] | Put on your Sunday best | 穿上最好的衣服 |
[09:11] | just to get on the scale and touch your toes. | 就是为了在人前表现得礼貌 |
[09:13] | Yeah. Made me so mad, I wound up becoming a doctor. | 是啊 气死我了 我最后还是成了医生 |
[09:19] | The testing confirmed | 化验结果证实了 |
[09:20] | your tumor is a hormone-producing prolactinoma. | 你的肿瘤是产生激素的催乳素瘤 |
[09:23] | And the pregnancy is about six weeks along. | 你怀孕六周了 |
[09:26] | Do you consider yourself gay? | 你考虑过自己是男同性恋吗 |
[09:30] | – I don’t think that’s… – Yes. | -我觉得这个问题 -当然 |
[09:32] | Because I am gay. | 因为我就是男同性恋 |
[09:35] | But you have vaginal intercourse with your fiance. | 但你和你未婚夫有阴道性交 |
[09:38] | – That is how he got pregnant… – Dr. Murphy, that’s enough. | -这就是他怀孕的原因 -墨菲医生 够了 |
[09:40] | – I… I just want… – I think you should leave. | -我只是想 -我觉得你该离开 |
[09:52] | I’m sorry. | 我很抱歉 |
[09:53] | That was completely inappropriate. | 他的话很不合适 |
[09:57] | Our treatment plan for your tumor | 我们对肿瘤的治疗计划 |
[09:59] | depends on your plan for your pregnancy. | 取决于你们对怀孕的打算 |
[10:02] | So… | 所以 |
[10:07] | We’ve talked about kids, | 我们讨论过孩子的事情 |
[10:08] | but I always figured that was way down the road. | 但我一直以为那是很遥远的事情 |
[10:14] | And not this way. | 而且也不该是这样 |
[10:16] | I always assumed we’d adopt. | 我一直想领养 |
[10:20] | I’d have go off T, and stay off. | 我本来已经不当T了 也不再当T |
[10:24] | If Rio doesn’t continue the pregnancy, | 如果里奥要中止妊娠 |
[10:27] | then what happens? | 然后会怎么样 |
[10:29] | Your hormone levels would drop quickly, | 你的激素水平会骤降 |
[10:30] | which would cause the tumor to shrink. | 这会导致肿瘤缩小 |
[10:32] | After that, we’d use medication, possibly a minor surgery. | 然后我们会用药 可能会有个小手术 |
[10:38] | I’d like to terminate the pregnancy. | 我想终止妊娠 |
[10:43] | I looked over all of Zara’s labs. | 我检查了扎拉所有的化验结果 |
[10:45] | All signs point to her | 所有迹象都指向 |
[10:46] | taking her hypertension medicine regularly. | 她定期服用高血压药 |
[10:49] | Her MRIs show significant ventricular septal thickness, | 核磁共振显示心室内隔明显增厚 |
[10:53] | bad turbulence jet flow. | 心脏射流严重紊乱 |
[10:56] | There’s myocardial edema, too. | 还有心肌水肿 |
[10:59] | The ACE inhibitors were a bad call. | 用ACE抑制剂治疗不是个好主意 |
[11:01] | Which eventually sent our patient into cardiogenic shock. | 最终导致我们的病人心源性休克 |
[11:08] | Why’d you ignore what she was telling us? | 你为什么忽视她告诉我们的话 |
[11:11] | I made a medical diagnosis | 我根据模式化处理方式 |
[11:13] | based on pattern processing | 做出临床诊断 |
[11:15] | that we’re taught in med school, | 这就是医学院教的 |
[11:16] | which involves considering, you know, race, education, | 它要你考虑种族 教育 |
[11:21] | occupation, BMI. | 职业 体重指数 |
[11:24] | Always sounded like profiling to me. | 对我来说都是病例侧写 |
[11:34] | Yes, we have the rain, | 没错 今天有雨 |
[11:35] | but more impressively, the wind. | 但是风力更大 |
[11:37] | That rain’s going to be coming in sideways. | 由于风大 将产生横向雨 |
[11:39] | Just take a look at how the wind increases | 今天一天 |
[11:41] | as we progress throughout the day. | 风力将持续加大 |
[11:42] | So, this afternoon, we’re talking about | 所以预计到今天下午 |
[11:44] | 50-mile-per-hour gusts possible. | 风力可能上升为50英里每小时 |
[11:46] | Sorry for crashing. | 很抱歉我冒昧而来 |
[11:48] | Radiology doesn’t have a TV. | 放射室那边没有电视 |
[11:52] | You like The Weather Channel? | 你喜欢看天气预报 |
[11:55] | I find it soothing. | 天气预报让我很放松 |
[11:58] | Would you like to join me? | 一起来看吗 |
[12:01] | And we have more intense rainfall coming through, | 同时降雨量会显著增多 |
[12:04] | and that’s going to also lead to some flood potential. | 可能导致部分地区发生洪涝灾害 |
[12:06] | All of us are going to get into the action. | 对此我们必须采取措施 |
[12:09] | You got the mountains. | 考虑到山区 |
[12:10] | Would you mind if I lowered the volume by four output levels? | 我能把声音调小一点 调低4格 |
[12:16] | That would be perfect. | 那样就完美了 |
[12:18] | All the areas around here in Northern California, | 加州北部的所有地区 |
[12:19] | Modesto, Stockton, Sacramento. | 以及莫德斯托 斯托克顿 萨克拉门托 |
[12:21] | The northern part of San Francisco… | 旧金山的北部地区… |
[12:32] | I find the reflection on the screen so distracting. | 我觉得屏幕上的反光挺讨人厌 |
[12:38] | So do I. | 我赞同 |
[12:51] | Could I | 我能 |
[12:55] | do this? | 这样做吗 |
[13:41] | Nurse paged me. | 护士让我过来 |
[13:44] | Is something wrong? | 有什么事吗 |
[13:47] | I’ve changed my mind. | 我改变主意了 |
[13:51] | I want to keep the baby. | 我想留下这个孩子 |
[13:57] | Since you’re continuing the pregnancy, | 既然你准备继续妊娠 |
[13:59] | we’ll need to surgically remove the prolactinoma. | 那么你需要手术 摘除催乳素瘤 |
[14:02] | So, you’ll cut into his brain? | 所以你们要在他脑部动手术 |
[14:05] | Our safest option is to go in through the nasal cavity | 最安全方式是通过鼻腔进行手术 |
[14:07] | in what’s known as a transsphenoidal surgery, TSS for short. | 该手术称为经蝶骨手术 简称TSS |
[14:11] | It’s less invasive than our other option. | 比起其他手术方案 该手术创伤小 |
[14:15] | That still sounds dangerous. | 听起来还是很危险 |
[14:17] | I’ve made up my mind. | 我已经做好决定了 |
[14:18] | Do I get any say in this? | 我有任何话语权吗 |
[14:23] | I’m all for us having a family, but I’m not ready to… | 我们确实组建了家庭 但是我还没准备好 |
[14:25] | No one’s ever ready for kids. | 有孩子这事 谁都没准备好 |
[14:27] | Yesterday, you said that you never considered getting pregnant, | 昨天你说你从来没考虑过怀孕 |
[14:30] | and now you’re willing to risk your life for it. | 现在你却为了怀孕冒着生命危险 |
[14:36] | When I was about seven, | 我大概7岁时 |
[14:39] | I had this one refuge. | 拥有过一个小庇护所 |
[14:43] | I’d hang a quilt over a couple chairs | 我把床单搭在两个椅子中间 |
[14:45] | and hide out with my two buds, | 我带着我的两个玩具躲在其中 |
[14:49] | Foxie the Fox and Fuzz the Lion, | 小狐狸福克和小狮子绒绒 |
[14:53] | and I’d imagine, | 我曾想象着 |
[14:55] | I was the dad. | 我是它们的爸爸 |
[14:59] | And they were my twin little guys, | 它们是我的双胞胎孩子 |
[15:02] | fraternal, obviously. | 兄弟相亲 |
[15:06] | We were a family. | 我们是一家人 |
[15:10] | When I transitioned, I put that dream aside. | 变性之后 我就放下了那个梦想 |
[15:14] | At least, as far as them coming from me. | 至少放弃了自己生孩子的梦想 |
[15:16] | But now… | 但现在 |
[15:21] | whether we planned it or not, | 无论我们是否准备好 |
[15:24] | this is our baby. | 这是我们的孩子 |
[15:32] | How soon can you do the surgery? | 我们多快进行手术 |
[15:34] | I’ll order an image-guidance MRI to get things started. | 我会安排做图像引导核磁共振准备手术 |
[15:46] | Based on the cardiac MRI and catheterization, | 根据心脏核磁共振和心导管插入术 |
[15:49] | there are two treatment options. | 有两种治疗方案 |
[15:50] | Myectomy, basically open heart surgery, | 一种是部分切除术 就是开胸手术 |
[15:53] | and alcohol septal ablation, | 另一种是室间隔酒精消融术 |
[15:55] | where we use the alcohol | 通过采用酒精 |
[15:56] | to kill targeted sections of the heart muscle. | 杀死心肌的靶向部分 |
[16:00] | Well, what would you recommend? | 哪一种你比较推荐呢 |
[16:02] | The surgery is more invasive, tougher recovery, | 第一种手术创伤性大 恢复更慢 |
[16:05] | but better efficacy long-term. | 但长期来看效果更好 |
[16:07] | The ablation is less dangerous, | 消融术危险系数小 |
[16:09] | but you’re more likely to need further medical interventions. | 但之后你可能还需要药物干预治疗 |
[16:14] | Now, you call that a recommendation? | 这样也算推荐 |
[16:15] | There are pros and cons to both. | 两种方案都有利有弊 |
[16:18] | Uh, you’ll need to weigh them. | 你必须自己权衡 |
[16:20] | I’ll give you some time. | 你好好考虑 |
[16:22] | You always want to take care of people, Dr. Browne? | 你是一直想照顾别人吗 布朗医生 |
[16:24] | Pretty much. | 差不多 |
[16:26] | Me, too. | 我也是 |
[16:28] | Oh. Well, you run a marijuana dispensary. | 你经营一家卖大麻的药店 |
[16:31] | It’s not all about getting people high. | 并不是所有人用大麻为了吸毒 |
[16:33] | No, maybe not, but I’m guessing most of your clientele… | 可能不是 但是我想你大多数顾客 |
[16:36] | My Great-Aunt Lucy had pancreatic cancer. | 我的伯祖母露西曾患胰腺癌 |
[16:41] | A year, she hung on. | 整整一年 |
[16:44] | In agony. | 她都在苦苦煎熬 |
[16:46] | Marijuana was the only thing that helped her eat or sleep. | 大麻是唯一能够帮助她吃睡的东西 |
[16:50] | Doctors didn’t give her anything for the pain? | 医生没给她开止痛药吗 |
[16:53] | They suggested ibuprofen. | 他们推荐布洛芬 |
[16:55] | Now, you know doctors are 22% less likely | 你知道医生们 |
[16:58] | to give pain meds to Black patients | 给黑人患者开止痛药的可能性 |
[17:00] | than to white patients with the same symptoms. | 比给同样症状的白人患者要低22% |
[17:04] | My point is, you and I, we’re a lot alike. | 我是说 你和我 我们很像 |
[17:08] | We’re both strong, Black women | 我们都是强大的黑人女性 |
[17:09] | finding our way in the world, | 在这个世界上给自己找出路 |
[17:10] | but one of us knows more about medicine than the other. | 但其中一人比另一人更懂医药 |
[17:13] | So, I’d like to know, what would you do in my situation? | 所以我想知道 你在我的情况下会怎么办 |
[17:22] | The open myectomy is a bigger risk | 开膛心肌切除术风险更大 |
[17:24] | but offers more long-term benefits. | 但长远来看好处更多 |
[17:29] | I’ve made my decision. | 我已经决定了 |
[17:34] | I’m with you, Dr. Browne. | 我同意你说的 布朗医生 |
[17:36] | Book the myectomy. | 帮我预约心肌切除术 |
[17:45] | Here’s the Rio Gutierrez imaging for your upcoming TSS. | 这是里奥·古铁雷斯的影像 给你要做的TSS |
[17:48] | Set that on the table, please. | 请放在桌上 |
[17:54] | I, um… | 我… |
[17:56] | I noted the tumor’s suprasellar expansion | 我注意到肿瘤在蝶鞍上扩散 |
[17:58] | and surrounding edema and splaying of circle of Willis. | 并且周围水肿 威利斯环张开 |
[18:02] | That is very helpful. | 很有用 |
[18:07] | Bye, Dr. Murphy. | 再见 莫菲医生 |
[18:11] | You’re safe, Shaun. She’s gone. | 你安全了 肖恩 她走了 |
[18:12] | Not really. | 还没有 |
[18:15] | Dr. D’Souza is still in my brain. | 德苏莎医生还在我脑海里 |
[18:17] | I don’t like it. | 我不喜欢这样 |
[18:19] | We kissed. | 我们接吻了 |
[18:21] | – When? – What? | -什么时候 -什么 |
[18:22] | I have so many thoughts about her, | 我对她有各种想法 |
[18:24] | and I have so many questions I want to ask Rio. | 我还有很多问题想问里奥 |
[18:27] | Wouldn’t he get more pleasure for… | 他会不会更高兴… |
[18:28] | Questions you’re not supposed to ask him. | 那些问题 你不应该问他 |
[18:30] | The kiss, Shaun. When did you kiss? | 那个吻 肖恩 你们什么时候接吻的 |
[18:31] | Last night. In my dream. | 昨晚 在我梦里 |
[18:35] | If I can’t ask questions, how do I understand? | 如果我不能问问题 那我怎么弄明白 |
[18:39] | My… My brain… | 我的… 我的大脑… |
[18:41] | My… My brain isn’t behaving the way I want it to. | 我… 我的大脑表现得和我希望的不一样 |
[18:44] | How do I make it stop? | 我怎样让它停下来 |
[18:49] | You’re attracted to Dr. D’Souza. | 你被德苏莎医生吸引 |
[18:52] | Why does that bother you? | 这有什么好烦的 |
[18:56] | When I was with Carly and had feelings for Lea, | 当我和卡莉在一起 却对莉亚有感觉时 |
[19:00] | it meant I was supposed to be with Lea. | 意味着我应该和莉亚在一起 |
[19:03] | What if this means I’m supposed to be with Dr. D’Souza? | 万一现在意味着我应该和德苏莎医生在一起呢 |
[19:06] | No. You’ve loved Lea for years. | 不会 你已经爱了莉亚好几年了 |
[19:08] | This is just… attraction. | 这只是… 吸引 |
[19:13] | But shouldn’t loving Lea make it go away? | 但我对莉亚的爱不能把它驱走吗 |
[19:18] | Relationships would be a lot easier if it worked that way. | 如果那样能行 亲密关系就简单多了 |
[19:23] | You’re feeling guilty. | 你感到内疚 |
[19:24] | I say take Lea out for a nice dinner, something special. | 你带莉亚去吃顿特别点的晚餐吧 |
[19:27] | And tell her about my crush. | 然后告诉她我的动心 |
[19:30] | I need to let Lea know. | 我需要让莉亚知道 |
[19:31] | – No, definitely not. – No, you do not. | -不 不 -你不需要 |
[19:34] | I want to get your thoughts | 我想听听你的看法 |
[19:35] | on the suprasellar extension of the tumor for this TSS. | 关于这场TSS手术中肿瘤在蝶鞍上扩散的事 |
[19:37] | You remember Sarah Pepper? | 你记得莎拉·佩珀吗 |
[19:38] | Runs nephrology at S.F. Regional? | 在圣弗朗西斯区域医疗中心负责肾病学 |
[19:41] | Always wears a shawl? | 总是披一条披巾 |
[19:42] | So, during the staff meeting last week, she fell apart. | 她在上周的员工会议上崩溃了 |
[19:46] | Screaming, crying in front of the whole department. Totally nuts. | 在整个部门面前尖叫 哭喊 完全疯了 |
[19:49] | Rough day at the office. | 辛苦了一天了 |
[19:51] | Wonder how you’d approach and resect without getting a CSF leak. | 想知道你会怎样切除而不导致脑脊液漏 |
[19:56] | Place a lumbar drain, | 插一根腰椎引流管 |
[19:57] | then infuse saline and do Valsalva maneuver. | 然后注入生理盐水 进行伐氏操作 |
[20:00] | Okay. | 好 |
[20:00] | Apparently, Pepper’s meltdown was so over the top, | 显然 佩珀的崩溃太夸张了 |
[20:03] | the hospital forced her to take a leave. | 因此医院强迫她休假 |
[20:06] | – How long? – Unspecified. | -多久 -没说 |
[20:09] | She’s always been a little crazy. | 她一直都有点疯癫 |
[20:12] | Last I checked, eccentric and emotional didn’t qualify as crazy. | 据我所知 古怪和情绪化并不能算疯癫 |
[20:15] | Thanks for taking a look. | 谢谢你帮忙看 |
[20:23] | I read that cisgender people | 我读到 顺性别者 |
[20:24] | often reduce transgender people to their genitalia, | 经常把变性人简单归纳为生殖器 |
[20:27] | and that that is offensive. | 而这样非常冒犯 |
[20:30] | Did I do that to you and Rio? | 我是不是冒犯了你和里奥 |
[20:32] | Yes. | 是 |
[20:35] | I’m sorry. | 对不起 |
[20:39] | Rio will be going into surgery soon. | 里奥马上要做手术了 |
[20:43] | He’s been asking for you. | 他在找你 |
[20:45] | You haven’t been answering your phone. | 你没有接电话 |
[20:48] | Thanks for letting me know. | 谢谢你告诉我 |
[20:53] | He is very confusing to me, too. | 他也让我很困惑 |
[20:56] | Rio has worked so hard, | 里奥很努力 |
[20:58] | he had a bilateral subcutaneous mastectomy | 他接受了双侧皮下乳房切除术 |
[21:01] | and takes hormone replacement therapy, | 正在接受激素替代疗法 |
[21:03] | but now he is choosing | 但他现在选择了 |
[21:06] | the most female act. | 最有女性特征的行为 |
[21:10] | It’s not female if Rio’s doing it. | 里奥做的 就不是女性行为 |
[21:16] | Y-Yes. | 好的 |
[21:18] | And he must have dealt with a lot of prejudice | 在他变性的过程当中 |
[21:22] | during his transition. | 一定需要面对很多偏见 |
[21:23] | I dealt with prejudice. | 我也经历过偏见 |
[21:25] | My brother helped me. Does he have a brother? | 我的兄弟帮助了我 他有兄弟吗 |
[21:29] | His family doesn’t talk to him. | 他的家人不和他讲话了 |
[21:36] | And now Rio is having brain surgery. | 现在里奥要做脑部手术 |
[21:43] | He is very brave. | 他非常勇敢 |
[21:45] | You can stay here. | 你可以待在这里 |
[21:52] | I have a patient, Zara Norton. | 我有个病人 扎拉·诺顿 |
[21:54] | We, uh — We diagnosed her with HOCM. | 我们诊断她得了肥厚性梗阻型心肌病 |
[21:57] | I saw the file. | 我看见病历了 |
[21:58] | Dr. Guerin expressed some concerns about | 盖林医生质疑我在急诊室 |
[22:01] | my initial handling of the case in the ER. | 对病人做出的初始治疗 |
[22:05] | He thinks I stereotyped her based on her race. | 他觉得我因为种族而对她有刻板印象 |
[22:10] | Do you think you did? | 你觉得你有吗 |
[22:13] | She was crashing. | 她当时不行了 |
[22:14] | I had to make a call. I didn’t have a lot to go on. | 我必须做出决定 我没有很多资料可以参考 |
[22:19] | Glassman came to see me this morning. | 格拉斯曼今天上午来找我 |
[22:22] | Someone told him I’m unstable and need help. | 有人告诉他我状况不稳定需要帮助 |
[22:25] | Any idea where he heard that? | 知道他是从谁那里听说的吗 |
[22:28] | I asked for help. You can, too. | 我去寻求帮助了 你也可以这么做 |
[22:30] | You’re a resident. No one cares if you need help. | 你是个住院医师 没人在乎你是否需要帮助 |
[22:33] | I got this job in part | 我得到这份工作在某种程度上 |
[22:35] | because my main competition, | 是因为我的主要竞争对手 |
[22:36] | a man, backed me. | 一个男性 为我担保 |
[22:39] | The second anyone thinks I can’t handle this — | 一旦有人开始质疑我是否称职 |
[22:41] | No one is gonna think that — | 没人会这么想的 |
[22:42] | They will if you keep telling them I’m a mess. | 如果你不停说我一团糟 他们会这么想的 |
[22:45] | You have PTSD. | 你有创伤性应激后遗症 |
[22:47] | You shouldn’t be ashamed. | 不应该为此感到羞愧 |
[22:48] | Says the women who just profiled a Black female patient. | 你刚用刻板印象诊断了一位黑人女性还好意思说我 |
[22:54] | You judged her, | 你对她有偏见 |
[22:55] | just like people will judge me | 就和人们对我有偏见一样 |
[22:58] | and whisper that I’ve always been a little intense, | 他们会交头接耳 说我本来就有点过于紧张 |
[23:01] | so no wonder I was asked to step down. | 怪不得会让我退居二线 |
[23:07] | Nobody needs to know. | 没人需要知道这些 |
[23:11] | Exactly. | 确实 |
[23:15] | You tell me that it doesn’t matter. | 你告诉我不要紧 |
[23:17] | You tell me everyone will understand, | 你告诉我大家会理解的 |
[23:19] | and then you tell me to keep it to myself. | 然后你又告诉我要保密 |
[23:21] | Should I be ashamed, or shouldn’t I be? | 我到底该不该为自己感到羞耻 |
[23:25] | Alright, Ms. Norton, time to head to pre-op. | 好了 诺顿女士 需要去做术前准备了 |
[23:30] | What’s in the bag, handsome? | 袋子里是什么药 帅哥 |
[23:32] | I like to know what goes into my body. | 我得知道输进我身体里的是什么 |
[23:35] | Uh, cefazolin. It’s a prophylactic antibiotic | 头孢唑林 它是一种我们在手术前使用的 |
[23:37] | we give before surgeries. | 预防性抗生素 |
[23:39] | Makes sense. | 有道理 |
[23:41] | Hey, what was the med y’all gave me | 对了 我最初进急诊室时 |
[23:42] | when I first got here to the ER? | 你们都给了我什么药 |
[23:45] | Enalaprilat. It’s an ACE inhibitor. | 依那普利 是一种血管紧张素转换酶抑制剂 |
[23:48] | Isn’t that for hypertension? | 那不是治高血压的吗 |
[23:51] | But I thought I already told y’all | 但是我已经告诉你们 |
[23:52] | I was on meds for my blood pressure. | 我在吃控制血压的药了 |
[23:55] | You did. | 你说了 |
[23:56] | So, you figured I needed more? | 这么说你们觉得我需要更多的药 |
[24:02] | Or did you not believe me? | 还是你们不相信我 |
[24:17] | I’m sorry. | 对不起 |
[24:22] | You must be scared. | 你肯定很害怕 |
[24:24] | You shouldn’t have to be scared alone. | 你不应该一个人害怕 |
[24:29] | I love you. | 我爱你 |
[24:31] | I love you, too. | 我也爱你 |
[24:37] | Eli. | 伊莱 |
[24:40] | I can’t see you. | 我看不见你了 |
[24:42] | I’m right here, babe. | 我就在这里 宝贝 |
[24:44] | Can you follow this with your eyes? | 你能跟着这个转动眼球吗 |
[24:49] | It keeps disappearing. | 它不停消失 |
[24:50] | You’ve lost peripheral vision. | 你已经失去了周围视觉 |
[24:52] | The tumor is impinging on the optic fibers. | 肿瘤正在压迫视神经 |
[24:54] | We can’t perform the TSS surgery. | 我们不能进行TSS手术了 |
[25:01] | With the tumor’s continued growth, | 随着肿瘤持续增大 |
[25:03] | the best remaining option is the open pterional craniotomy. | 剩下来的最优选择是开放性翼点开颅术 |
[25:07] | But it is higher risk with a lengthier recovery. | 但是它的风险更高 恢复期也更长 |
[25:11] | All of which is on top of the potential for | 除此之外还需要考虑 |
[25:13] | gender dysphoria during pregnancy. | 对于怀孕期间性别焦虑的潜在影响 |
[25:15] | Is that still a concern? | 这个还需要担心吗 |
[25:19] | I think back to before I started taking T, | 我想起我服用睾丸素的最初阶段 |
[25:22] | how terrible that felt. | 那种感觉多么糟糕 |
[25:26] | The thought of feeling that all over again… | 一想到我还要从头再经历一遍那种感觉… |
[25:32] | We could go back to the original plan. | 我们可以回到最初的计划 |
[25:37] | You mean terminate the pregnancy? | 你是说中止妊娠 |
[25:40] | The tumor should shrink on its own. | 肿瘤应该会自行缩小 |
[25:45] | After everything you’ve done to get where you are in your life, | 你付出很多才走到这一步 |
[25:50] | it’s scary to think about | 我明白想到如今 |
[25:51] | doing something that would put that at risk. | 可能失去一切有多可怕 |
[25:57] | This is my next step. | 这就是我的下一步 |
[26:00] | I’m ready to take it, even if I’m scared. | 就算我很害怕 我都要迈出这一步 |
[26:06] | You have to take risks sometimes, Dr. Lim. | 有时你不得不冒险 利姆医生 |
[26:18] | Thank you. | 多谢 |
[26:19] | Shouldn’t you be prepping Zara for surgery? | 你不是该帮扎拉做术前准备吗 |
[26:22] | It’s canceled. | 被取消了 |
[26:23] | She wants to be transferred to a different hospital. | 她想转院 |
[26:27] | One where she won’t be “Racially profiled into heart failure.” | 去一所「不会因种族歧视导致她心脏衰竭」的医院 |
[26:39] | Shaun, you okay? | 肖恩 还好吗 |
[26:44] | I am having thoughts I don’t want to have. | 我脑子里一直有一些我不想有的想法 |
[26:47] | Both Park and Jordan say I shouldn’t tell you. | 朴和乔丹都说我不该告诉你 |
[26:51] | But you’re going to, aren’t you? | 但你会告诉我的 是吗 |
[26:55] | Yes, I am. | 是的 |
[26:57] | I have a work crush. | 我对一个同事动心了 |
[26:59] | Also, my patient is a pregnant trans man — | 另外 我的患者是一个怀孕的变性者 |
[27:01] | Okay, one at a time, Shaun. | 一件一件说 肖恩 |
[27:03] | About this…crush? | 你说的动心是指 |
[27:06] | Her name is Dr. Cintia D’Souza. | 她是钦蒂亚·德苏莎医生 |
[27:07] | She is a second year radiology resident. | 她是放射科第二年住院医生 |
[27:09] | Last night, I dreamed we were in the Residents’ Lounge, | 我昨晚梦见我们在住院医师休息室 |
[27:12] | watching The Weather Channel, and then we started kissing — | 一起收看天气频道 接着我们开始接吻 |
[27:14] | Okay, I got it. | 可以了 我知道了 |
[27:17] | Are you mad? | 你生气了吗 |
[27:19] | Park and Jordan were right. I shouldn’t have told you. | 朴和乔丹是对的 我不应该告诉你 |
[27:22] | No. I’m not mad. | 没有 我没生气 |
[27:24] | A little surprised, but that’s okay. | 只是有点吃惊 没事 |
[27:31] | I’m still attracted… | 我有时也会被… |
[27:33] | to other guys sometimes. | 其他的男生吸引 |
[27:36] | N-No. | 不 不行 |
[27:37] | No. What? Who? | 不 什么 是谁 |
[27:39] | – It doesn’t matter. – Who? | -这无关紧要 -谁 |
[27:41] | There — Okay, there is this one physical therapist — | 好吧 就是有一位理疗师 |
[27:45] | N-No. | 别 |
[27:47] | No. | 别说了 |
[27:48] | No. | 不说了 |
[27:53] | What if we’re attracted to other people | 如果我们对其他人感兴趣 |
[27:57] | because there is something wrong with our relationship? | 是因为我们之间出了问题呢 |
[28:02] | You’re not planning on kissing Dr. D’Souza in real life? | 你没打算在现实中去亲德苏莎医生吧 |
[28:05] | No. | 没有 |
[28:06] | Or working late with her, | 或者跟她一起加班 |
[28:09] | doing some X-rays alone, | 单独在一起做X光检查 |
[28:11] | where you might end up leaning over the same light box — | 然后不小心倚靠在同一个灯箱上 |
[28:14] | We don’t use light boxes anymore. | 我们已经不用灯箱了 |
[28:21] | And I don’t plan to work late with her. | 我也不打算和她一起加班 |
[28:23] | Then I don’t think either of us | 那我觉得我们俩 |
[28:25] | has anything to be worried about. | 都没什么好担心的 |
[28:39] | I have to go prep for a pterional craniotomy. | 我要去准备翼点开颅手术 |
[28:49] | I’m Dr. Glassman, president of the hospital. | 我是格拉斯曼医生 医院的院长 |
[28:52] | Unless you’re here to drive me to S.F.Regional, | 除非你是来载我去圣弗朗西斯区域医疗中心 |
[28:54] | you can head right back on out. | 否则你可以出去了 |
[28:57] | I apologize for your experience in the emergency room. | 对于你在急诊室的遭遇 我深表歉意 |
[29:00] | That’s mighty white of you. | 你真是十分善解人意了[直译为「白人」] |
[29:05] | I don’t recommend that you transfer to S.F.Regional, | 我不建议您转去圣弗朗西斯区域医疗中心 |
[29:08] | or any other hospital, for that matter. | 或者任何其他医院 |
[29:10] | I’m sure they got the same fancy equipment, | 我肯定他们也和你们一样有豪华的设备 |
[29:12] | same shiny sets of diplomas y’all got here, | 光鲜亮丽的证书 |
[29:14] | and maybe a few less racist doctors. | 或许还会少一些种族歧视的医生吧 |
[29:18] | Well, apparently, that doesn’t seem to be the case. | 情况似乎并非如此 |
[29:21] | I pulled data on comparable hospitals | 我调出了100英里内 |
[29:24] | within 100 miles, | 与我们相似的医院数据 |
[29:26] | did numbers on surgical outcomes | 对比了手术成功率 |
[29:29] | and patient satisfaction aggregated by race. | 以及按种族分类的患者满意度 |
[29:34] | Apparently, we’re doing well, comparatively. | 显然 我们做得比他们都好 |
[29:41] | Your argument is that your hospital may be racially biased, | 你是说你的医院可能存在种族歧视现象 |
[29:45] | but it’s less racially biased than these other hospitals? | 但没有其他医院的种族歧视那么严重 |
[29:49] | Yeah. Pretty much. | 是这个意思 |
[29:52] | Stay at St. Bonaventure, | 留在圣文德医院 |
[29:53] | the president of the hospital will monitor your care | 医院院长会亲自监督你的护理情况 |
[29:56] | every step of the way. | 一直到你痊愈出院 |
[29:59] | For whatever it’s worth, | 不管怎样 |
[30:01] | I don’t think you can do better than that. | 我觉得你应该找不到比这待遇更好的了 |
[30:13] | She’s gonna stay, on one condition. | 她愿意留下 但有个条件 |
[30:17] | That you’re off the team. | 就是你退出治疗团队 |
[30:29] | Dr. Park, please open Sylvian fissure. | 朴医生 请展开大脑外侧裂 |
[30:31] | Arachnoid knife and Rhoton dissector. | 蛛网膜手术刀和霍顿解剖器 |
[30:35] | Tumor is visible. | 肿瘤可见 |
[30:39] | What makes someone a man? | 一个人成为男人的要素是什么 |
[30:43] | I thought it was just the chromosomes, | 我原以为仅是染色体的区别 |
[30:45] | but that must not be it, | 但事实并非如此 |
[30:47] | which makes things confusing and difficult, | 因此这让事情变得很复杂 |
[30:50] | and I know Rio was uncomfortable when he — | 我已经知道里奥感到不适 |
[30:52] | Life is uncomfortable. | 生活就是不适的 |
[30:54] | It hits you with tough situations | 用困境来打击你 |
[30:55] | and you muscle through them. | 你得自己扛过去 |
[30:57] | I see a tiny bleed in the circular sinus. | 在环窦处看到少量出血 |
[31:00] | Pack it with Floseal. | 用伏血凝止住 |
[31:08] | Someone give me an update. | 跟我说说情况 |
[31:09] | We got a drop in end tidal CO2 and oxygen sat. | 呼气末二氧化碳分压和氧饱和度下降 |
[31:11] | See any evidence of exposed air cells? | 有肺泡破裂的迹象吗 |
[31:13] | No. But waxing bone edges just to be safe. | 没有 打蜡的骨边缘情况良好 |
[31:17] | But the tumor thinned the sellar floor and sphenoid wall. | 但是肿瘤挤压了蝶鞍区和蝶窦壁 |
[31:21] | Making it permeable to oxygen. | 导致了氧气渗入 |
[31:25] | It’s an air embolism. | 是空气栓塞 |
[31:27] | BP’s dropping. | 血压在下降 |
[31:32] | Dr. Lim, what should we do? | 利姆医生 我们应该怎么做 |
[31:56] | Saline gauze, | 盐水纱布 |
[31:58] | tilt the table to eliminate the negative air pressure gradient, | 倾斜手术台减小气压梯度 |
[32:00] | and place a central line. | 接上中心线导管 |
[32:03] | This will stop the air leak | 这能阻止空气侵入 |
[32:04] | and allow us to access the air bubble. | 让我们处理气泡 |
[32:06] | Inserting Bunegin air-aspirating cath. | 插入多孔型开口导管 |
[32:10] | You are 2 centimeters from the superior vena cava. | 你离上腔静脉还有两厘米 |
[32:15] | Aspirate the right atrium | 抽吸右心室空气 |
[32:16] | until you don’t see any more air bubbles. | 直到看不见气泡 |
[32:28] | Nice save, Dr. Lim. | 干得漂亮 利姆医生 |
[32:31] | Let’s get this tumor out. | 让我们把这个肿瘤拿出来 |
[32:33] | Make your transverse aortotomy | 用波茨剪 |
[32:34] | with Potts scissors, Dr. Wolke. | 横向切开动脉 沃克医生 |
[32:37] | Extending the muscular incision | 扩大肌肉切口 |
[32:39] | down to the mid-ventricle. | 到中心室 |
[32:41] | There’s the myectomy site. | 这里是肌切除术的位置 |
[32:44] | There’s the aberrant muscle bundle. | 异常肌束在这 |
[33:11] | Get her off bypass, | 撤掉体外循环 |
[33:13] | see how she does. | 看看她有什么反应 |
[33:27] | How’s the cardiac output? | 心排血量怎么样 |
[33:30] | Reduced and insufficient. | 下降中并且不充足 |
[33:32] | Low output could mean we need to further reduce the septum. | 低排血量可能意味着我们得进一步降低隔膜 |
[33:36] | Unless it means that we reduced it too much. | 或者说已经降得太低了 |
[33:38] | Damaged the cardiac electrical conductors | 破坏了用来控制心率的 |
[33:39] | that control the heart rate. | 心脏电导线 |
[33:41] | She’s having third-degree heart block. | 她现在有三级房室传导阻滞 |
[33:43] | Enrique’s right. | 恩里克是对的 |
[33:44] | We took too much muscle. | 我们取走了太多肌肉了 |
[33:47] | Put her back on bypass. | 恢复体外循环 |
[33:48] | We could augment the wall with a bovine patch. | 我们可以用牛心包片来补充心壁 |
[33:50] | Still wouldn’t insulate the electrical system. | 但还是没法隔离电子系统 |
[33:52] | She’d still be at risk of complete heart block | 她还是会面临完全性房室传导阻滞的风险 |
[33:54] | and cardiac arrest. | 或者心脏骤停 |
[33:58] | We could insert a dual chamber pacer. | 我们可以插入双腔起搏器 |
[34:01] | She won’t need the conduction system in the wall of her heart | 这样心壁就不需要传导系统 |
[34:04] | to control her heart rate. | 来控制心率 |
[34:08] | Let’s go! | 来吧 |
[34:14] | How was the craniotomy? | 开颅术做得怎么样 |
[34:16] | It went well. | 很顺利 |
[34:17] | The patient is in recovery. | 患者正在恢复 |
[34:22] | Your text said you have good news. | 你发信息说有好消息 |
[34:25] | And by good news, I mean bad news for Dr. D’Souza. | 其实对于德索萨医生是坏消息 |
[34:27] | Plenty of great stuff to crush a crush. | 有好多事能让你讨厌她 |
[34:31] | First observation — | 第一个观察结果 |
[34:33] | She smells like cinnamon. | 她闻起来像桂皮 |
[34:39] | Which is more puzzling than irritating. | 这更让人感到疑惑而不是刺激 |
[34:41] | Actually kind of nice. Which is obviously not helpful. | 其实还挺好的 所以明显没有帮助 |
[34:45] | Oh, okay. She does this weird self-grooming gesture | 她整理头发的动作很奇怪 |
[34:48] | where she tucks her hair behind her ear. | 把头发归到耳朵后面去 |
[34:52] | And then sorta massages her ear. | 然后还按摩自己的耳朵 |
[34:54] | A-Also n-not helpful. | 这也没什么用 |
[34:56] | Okay. I’m sorry. I’m sorry. | 好吧 抱歉 抱歉 |
[34:59] | Okay. At the salad bar, | 好吧 在沙拉柜台 |
[35:01] | she used the cucumber tongs to reach for the cucumbers… | 她用黄瓜钳来夹黄瓜 |
[35:06] | and then the tomatoes. | 然后是西红柿 |
[35:11] | And the olives. | 然后是洋葱 |
[35:14] | And the pickles. | 还有腌菜 |
[35:59] | I can see all of you. | 我能看见你了 |
[36:06] | How’d — How’d we do? | 手术怎么样 |
[36:08] | Great. | 很成功 |
[36:09] | We got all of the mass, vision is restored. | 我们切除了所有肿瘤 视力恢复了 |
[36:11] | You have every reason to expect a full recovery | 你很有希望完全康复 |
[36:15] | and a healthy pregnancy. | 并且能成功怀孕 |
[36:20] | We’re gonna be dads. | 我们要做爸爸了 |
[36:25] | Are you ready? | 你准备好了吗 |
[36:29] | I’ve never been a pregnant man before. | 我从没做过怀孕的男人 |
[36:33] | You’ll always be the best man that I’ve ever known. | 你永远是我认识的最好的男人 |
[36:50] | Came to see how you were doing. | 来看看你怎么样了 |
[36:52] | Dr. Andrews told me | 安德鲁斯医生告诉我 |
[36:53] | you was the one who figured out how to save me. | 是你想出了救我的办法 |
[37:00] | Still don’t change what went down earlier, though. | 但还是没有改变之前发生的事 |
[37:09] | When I got to med school… | 当我到了医学院 |
[37:14] | people took one look at me | 人们只看我一眼 |
[37:15] | and they thought they knew exactly who I was. | 就以为自己很清楚我是谁 |
[37:18] | Black girl on financial aid. | 拿助学金的黑人女孩 |
[37:22] | She must not be that smart. | 她肯定不太聪明 |
[37:24] | She must have gotten a lot of breaks. | 她肯定经常偷懒 |
[37:28] | She’ll probably need a lot more. | 她可能还需要更多 |
[37:34] | And I worked… | 我努力… |
[37:37] | I worked so hard | 我那么努力 |
[37:40] | to prove them wrong, | 来证明他们错了 |
[37:42] | that I wasn’t who they thought I was, | 我不是他们认为的那种人 |
[37:43] | that I deserved to be there, | 我配得上医学院 |
[37:45] | that I …That I fit in. | 我很合群 |
[37:54] | When you came into the ER… | 你进入急诊室的时候… |
[37:58] | loud and messy… | 又吵又闹腾 |
[38:03] | I saw… | 我看到了 |
[38:05] | I saw everything I have tried hard not to be. | 我看到了我努力不成为的那种人 |
[38:14] | And I think it made me angry. | 我觉得这让我很生气 |
[38:22] | And I’m ashamed of that. | 我为此感到羞耻 |
[38:27] | And I’m really sorry. | 我真的很抱歉 |
[38:32] | I used to be that way. | 我以前也是那样的 |
[38:37] | But I got tired of working that hard | 但我厌倦了那么努力 |
[38:38] | to make white people comfortable. | 来让白人感到舒适 |
[38:56] | You two heading out for the night? | 你们俩今晚要出去吗 |
[39:01] | We sure are. | 当然 |
[39:03] | How did the craniotomy go, Shaun? | 开颅手术怎么样 肖恩 |
[39:06] | Did you guys get all the prolactinoma? | 你们切除了所有泌乳素瘤吗 |
[39:10] | Yes. | 对 |
[39:12] | Is that cafeteria salad? | 那是餐厅的沙拉吗 |
[39:16] | Are there pickles in there? | 里面有腌黄瓜吗 |
[39:19] | Did you want some? | 你要来点吗 |
[39:20] | You know, I’m good. Thank you. | 不用了 谢谢 |
[39:23] | Shaun, did you… | 肖恩 你想… |
[39:25] | No, thank you. | 不 谢谢 |
[39:32] | It does help to focus | 这确实有助于 |
[39:33] | on her irresponsible salad bar practices | 聚焦她在沙拉吧没素质的行为 |
[39:36] | and dietary preferences. | 以及饮食偏好 |
[39:37] | I’ve got a ton of strategies to manage discomfort. | 我有很多应对不适的方法 |
[39:41] | So do I. | 我也是 |
[39:48] | To replenish your supply, and a peace offering. | 补充供给和表示和解的礼物 |
[39:52] | I wasn’t aware we were at war. | 我都不知道我们需要和解 |
[39:55] | Well, seemed like my gossip about Pepper | 看来我关于佩珀的八卦 |
[39:57] | kind of landed wrong. | 有点说错了 |
[40:00] | Bad day. | 糟糕的一天 |
[40:01] | Sorry to crash the party. | 抱歉打扰了 |
[40:03] | Dr. Glassman wanted me to show this to you two. | 格拉斯曼医生让我给你们看这个 |
[40:07] | I asked Lea to run some numbers on various metrics by race, | 我让莉亚对不同指标按种族进行计算 |
[40:11] | and the results are not great, | 结果不太好 |
[40:14] | especially when it comes to pain management. | 尤其是在疼痛管理方面 |
[40:15] | We are under-treating | 我们显著降低了 |
[40:17] | African-American and Latinx patients | 对非裔美国人和拉丁裔患者的 |
[40:19] | by a considerable margin. | 治疗水平 |
[40:22] | I think I need a little of that peace offering. | 我想我需要来点和解礼物 |
[40:24] | Help yourself. | 请随意 |
[40:25] | Anyone else? | 还有人要吗 |
[40:26] | No. Thank you. | 不用了 谢谢 |
[40:30] | Uh…me, neither. | 我也不用 |
[40:38] | I… | 我… |
[40:42] | started taking sertraline. | 开始服用舍曲林了 |
[40:45] | For PTSD. | 治疗创伤后应激障碍 |
[40:49] | Sorry to hear that. | 我很遗憾 |
[40:52] | You doing okay? | 你还好吗 |
[40:56] | Not really. | 不太好 |
[40:59] | But I’m…working on it. | 但我在努力 |
[41:04] | Okay. | 很好 |
[41:09] | Dr. Browne, good work. | 布朗医生 干得好 |
[41:14] | Thank you. | 谢谢 |
[41:42] | I apologized to Zara. | 我向扎拉道歉了 |
[41:47] | She pointed out I spent med school… | 她指出来 我在医学院那么努力 |
[41:52] | trying to make white people comfortable. | 只是想让白人更舒服 |
[41:58] | I mean, she’s right. | 她说得对 |
[42:00] | It wasn’t just med school. | 不只是医学院 |
[42:05] | Exhausting, isn’t it? | 很累吧 |
[42:09] | But we had to do it, right? | 但我们必须这么做 不是吗 |
[42:12] | To be here? | 为了走到这里 |