时间 | 英文 | 中文 |
---|---|---|
[00:03] | Those are yours. | 这些是你的 |
[00:05] | We bought them together. | 是我们一起买的 |
[00:07] | Because you “Found the pattern soothing.” | 因为你觉得「样式很舒心」 |
[00:18] | I’m gonna miss you, Shaun. | 我会想念你的 肖恩 |
[00:21] | I love Carly. | 我爱卡莉 |
[00:25] | And that’s great. | 那太好了 |
[00:26] | I am so happy for you. | 我真为你感到高兴 |
[00:28] | Now you can hang the toilet paper incorrectly | 现在你想随时放错卷纸 |
[00:32] | anytime you want. | 都没人管你了 |
[00:33] | And Carly and I can go back | 我和卡莉也可以回到 |
[00:35] | to the way things were before our fight. | 我们吵架之前的状态 |
[00:38] | Well, sometimes couples need a little time to recover. | 有时候情侣间需要点时间恢复 |
[00:42] | We won’t. | 我们不用 |
[00:43] | Carly asked for you to move out. | 卡莉要你搬出去 |
[00:46] | You are moving out. | 你要搬出去了 |
[00:50] | How many kidneys do I need in my body to attend prom? | 我体内得有几个肾才能去参加毕业舞会 |
[00:53] | Ryan… | 瑞恩 |
[00:54] | Even if the surgery removes my kidney, | 即使我在手术中摘除了一个肾 |
[00:56] | it’ll be laparoscopic, | 那也是个腹腔镜手术 |
[00:57] | so my inpatient time will be seven days, tops. | 所以我最多只要住院七天 |
[01:00] | And then three more days of rest at home. | 然后在家休养三天 |
[01:02] | I can take my girlfriend to prom, right? | 我就可以带女朋友去毕业舞会了 对吗 |
[01:05] | That’s not a purely medical decision. | 那不完全是个医疗决定 |
[01:07] | I have to draw some blood. | 我需要抽点血 |
[01:09] | What are the chances Dr. Melendez might be able | 梅伦德斯医生既能摘除肿瘤 |
[01:11] | to remove the tumor but spare Ryan’s kidney? | 又能保住瑞恩的肾的几率有多大 |
[01:13] | Well, the MRI will let us know | 核磁共振结果会告诉我们 |
[01:15] | how much the chemo shrunk the tumor, | 化疗让肿瘤缩小了多少 |
[01:16] | but you shouldn’t count on it. | 但你不能抱太大希望 |
[01:18] | One chili burger, extra mustard, extra pickles. | 一个辣椒汉堡 多加黄芥末和腌菜 |
[01:22] | Hi. Morning, Mr. Cooper. | 早啊 库珀先生 |
[01:24] | I’m not sure he can have that with his surgery… | 我不确定他在术前能否吃这个 |
[01:25] | Oh, he’s fine until about 6:30 tonight. | 今晚六点三十之前都可以的 |
[01:28] | I know you. | 我认识你 |
[01:30] | Angie…Valens. | 安吉·瓦伦斯 |
[01:32] | I helped put in your chemo port. | 我帮你装过化疗用人工血管 |
[01:34] | I owe you a big thank-you. | 感谢你救了我 |
[01:36] | We met in chemo. | 我们在化疗时认识的 |
[01:38] | They should put us in a | 他们应该 |
[01:39] | public service announcement or something. | 广播一下我们的故事 |
[01:40] | Yeah… “I lost a tumor and gained a boyfriend. | 像是「干掉肿瘤 抱得男友归 |
[01:43] | Thanks, chemo.” | 感谢化疗」 |
[01:48] | James McDougall? | 詹姆斯·麦克道格 |
[01:49] | That’s who we’re here for, too. | 我们也是为他而来的 |
[01:51] | All of you can head over to Bay 4. | 你们都可以去四区 |
[01:53] | Guy saw me six months ago for a stress fracture. | 他在六个月前因骨裂来找过我 |
[01:55] | He’s a lunatic ultra-marathoner. | 他是个超级马拉松狂人 |
[01:58] | I just hope he didn’t go too hard too soon | 我希望他别训练太猛 |
[01:59] | and break it again. | 这么快又骨裂了 |
[02:07] | He didn’t break it again. | 他没有再次骨裂 |
[02:15] | 良 医 | |
[02:24] | Your GP was right to start you on ketoprofen for the swelling, | 你的家庭医生让你用酮洛芬消肿是对的 |
[02:26] | but clearly, it isn’t working. | 但显然不起作用 |
[02:28] | That’s why Drs. Murphy and Reznick | 所以莫菲和雷兹尼克医生 |
[02:29] | are going to block off some of your lymphatic channels. | 要堵住你的一些淋巴管 |
[02:31] | It should reduce production. | 应该能减少淋巴液分泌 |
[02:34] | The more pressing concern is why. | 但我们当前更担心的是病因 |
[02:36] | Have you ever had surgery on your lymph nodes? | 你以前动过淋巴结手术吗 |
[02:39] | What about cancer or radiation treatment? | 抗癌治疗和放疗呢 |
[02:42] | No. Physically, I’ve always been healthy. | 没有 我在身体方面一直很健康 |
[02:44] | Physically? | 身体方面 |
[02:45] | I was diagnosed with | 我在十六岁时 |
[02:46] | Persistent Depressive Disorder when I was 16. | 被确诊为持续性抑郁症 |
[02:49] | That’s why you got to get me back out on the road, Doc. | 所以你得让我重新回到跑道上 医生 |
[02:52] | Are antidepressants not effective for you? | 抗抑郁药对你无效吗 |
[02:55] | I mean, they help. | 它们还是有效的 |
[02:56] | But running really is key. | 但跑步才是关键 |
[02:59] | Saved my marriage and… my life. | 它拯救了我的婚姻 和我的生命 |
[03:01] | Lymphedema can be caused by an infection. | 淋巴肿大可能是由感染导致 |
[03:04] | He doesn’t have a fever. | 但他没有发热症状 |
[03:06] | Ketoprofen can suppress fevers. | 酮洛芬能退热 |
[03:08] | Let’s get some cultures | 我们去做个细菌培养 |
[03:09] | and start him on broad-spec antibiotics. | 让他开始服用广谱抗生素 |
[03:15] | As requested, your restock on enemas. | 照你说的 给你新的灌肠剂 |
[03:19] | Nice cover. | 这个幌子不错 |
[03:22] | How’ve you been feeling? | 你觉得怎么样 |
[03:23] | The methotrexate is working great. | 甲氨蝶呤很有效 |
[03:25] | No pain, no redness. | 没有疼痛 没有红肿 |
[03:27] | Stiffness, flu-like symptoms? | 浑身僵硬 类似流感症状呢 |
[03:29] | No. All good. | 没有 一切正常 |
[03:32] | How long are you planning to hide out doing RA exams | 你还要靠给别人做类风湿性关节炎检查 |
[03:35] | and clipping diabetics’ toenails? | 给糖尿病人剪脚趾甲逃避到什么时候 |
[03:38] | Dizziness, headaches, nausea? | 晕眩 头疼 恶心吗 |
[03:40] | I… Sometimes I’m a little queasy after I eat. | 我 有时候我吃完东西会有点反胃 |
[03:44] | You had to love neurosurgery. | 你曾那么热爱神经外科 |
[03:47] | How about we try to get you a medication | 给你开一种 |
[03:49] | that doesn’t irritate your stomach? | 不会刺激你胃的药怎么样 |
[03:51] | No. My hands feel great. That’s all I care about. | 不用 我的手感觉很好 别的我都不在乎 |
[03:54] | You used to open up skulls | 你曾经常做开颅手术 |
[03:56] | and poke around people’s brains. | 做着复杂的脑部手术 |
[03:58] | There’s no way this fulfills you. | 你不可能满足于此 |
[04:01] | I enjoy it. | 我乐在其中 |
[04:02] | Or, rather, I usually enjoy it. | 或者 更确切地说 我通常很享受 |
[04:06] | I’ll let you get back to it. | 我还是不打扰你了 |
[04:10] | Maybe someone out there needs an enema. | 也许有人需要灌肠 |
[04:17] | Got a measurement on the Wilms tumor? | 威尔姆斯瘤的大小确定了吗 |
[04:19] | Mm, not quite there yet. | 还需要些时间 |
[04:21] | You mentioned 7 centimeters as our limit | 你提到七厘米是我们 |
[04:24] | to doing this laparoscopically. | 做腹腔镜手术的极限 |
[04:25] | What if we pushed it to 7.2? | 如果我们提高到七点二呢 |
[04:28] | Would speed up recovery. | 可以加快恢复速度 |
[04:30] | By a few days. | 加快几天而已 |
[04:33] | Forget I brought it up. | 就当我没问 |
[04:35] | Ryan wanting to take his girlfriend to prom | 瑞恩想带他女朋友去毕业舞会的愿望 |
[04:37] | should not factor into our surgical plan. | 不应该影响我们的手术计划 |
[04:40] | Is he nuts about her? | 他很喜欢她吗 |
[04:42] | Ohh. Crazy, head over heels in love. | 简直疯狂 爱得死去活来 |
[04:45] | They both are. | 他们彼此都是 |
[04:46] | Idiots. | 白痴 |
[04:49] | I wouldn’t mind being an idiot like that again. | 我不介意再做一次那样的白痴 |
[04:52] | Though, I’m not sure I ever felt that way, | 虽然 我不确定自己是否有过这种感觉 |
[04:56] | totally happy. | 十分幸福 |
[04:57] | So therapy’s going well? | 所以治疗进展顺利 |
[05:01] | No metastasis in the lungs. | 肺部无转移 |
[05:04] | Look at that. | 看那个 |
[05:11] | Your tumor is gone. | 你的肿瘤不见了 |
[05:15] | Gone? | 不见了 |
[05:17] | How’s that possible? | 这怎么可能 |
[05:19] | The chemotherapy worked better than we expected. | 化疗的效果比我们预期的要好 |
[05:21] | Wait, like, no tumor? Zero? | 等等 没有肿瘤 一点没有 |
[05:24] | No need for surgery whatsoever? | 不需要做任何手术 |
[05:26] | That is right. | 没错 |
[05:27] | These are discharge forms. | 这些是出院手续 |
[05:32] | Both of my kidneys are taking you to prom! | 我的两个肾都能带你去舞会 |
[05:35] | Aah! Hell, yeah! | 太好了 |
[05:43] | Angie? | 安吉 |
[05:46] | – Angie! – She’s having a seizure! | -安吉 -她癫痫发作了 |
[05:50] | 2 milligrams of lorazepam and portable oxygen, stat. | 两毫克劳拉西泮和便携式氧气 快 |
[05:52] | Let’s get that under her head. | 把那个拿来垫在她头下 |
[05:57] | His lungs are filled with fluid. | 他的肺里充满了液体 |
[06:00] | I need a chest X-ray and a bedside ultrasound. | 我需要做胸部X光片和床旁超声 |
[06:03] | And page Dr. Reznick. | 呼叫雷兹尼克医生 |
[06:17] | Imaging has confirmed the reoccurrence | 影像检查证实 |
[06:20] | of your brain tumor. | 你的脑瘤复发了 |
[06:22] | What stage? | 什么阶段 |
[06:24] | Three. | 第三阶段 |
[06:27] | The best approach is surgery, | 最好的方法是手术 |
[06:29] | a wide resection of the tumor, | 大面积切除肿瘤 |
[06:30] | followed by radiation and chemo | 然后进行放疗和化疗 |
[06:32] | to encourage full remission. | 以便完全恢复 |
[06:34] | Sounds like a fun couple months. | 听起来要度过有趣的几个月 |
[06:36] | Full recovery will probably take closer to eight. | 全面恢复可能需要大约八个月的时间 |
[06:46] | We can get through this, baby, just like last time. | 我们能挺过去的 宝贝 就像上次一样 |
[06:50] | W-when will the surgery be? | 手术什么时候进行 |
[06:52] | We need to do some additional imaging, | 我们需要做一些其他影像检查 |
[06:54] | and I’d like to consult a colleague | 我还要找医生会诊 |
[06:56] | about the best surgical approach. | 找到最佳的手术方法 |
[06:58] | That’ll take a few days. | 这需要几天时间 |
[07:01] | Take your time. | 不着急 |
[07:04] | Prom? | 舞会呢 |
[07:06] | Yeah. | 对啊 |
[07:07] | Now that Ryan can go, I have to go. | 现在瑞恩可以去了 我也得去 |
[07:09] | Honey. | 宝贝 |
[07:10] | This is your health we’re talking about. | 我们谈论的是你的健康 |
[07:12] | Mom, please. | 妈妈 拜托 |
[07:15] | I just want to do this one thing like a normal kid. | 我只想像个正常孩子一样去参加舞会 |
[07:20] | Can you tell her it’s okay? | 快告诉她没问题的 |
[07:24] | We can’t. | 不行 |
[07:25] | Until we remove your tumor, | 在摘除肿瘤前 |
[07:26] | you’re at risk of potentially fatal seizures. | 你都有潜在致命癫痫发作的风险 |
[07:31] | After you’re recovered, | 等你痊愈了 |
[07:32] | you and Ryan can get all dressed up, | 你和瑞恩可以收拾得漂漂亮亮的 |
[07:34] | and we’ll go have dinner at the Grandview. Okay? | 我们一起去盛景吃晚餐 好吗 |
[07:43] | Prom sucks. | 毕业舞会没劲透了 |
[07:45] | My buddy had a fake ID. | 我兄弟弄了个假身份证明 |
[07:46] | I got so drunk in the limo that I passed out | 我在豪车里喝到断片 |
[07:48] | and never made it into the dance. | 压根没去舞会 |
[07:51] | Maybe that wasn’t everybody’s experience. | 或许不是所有人都这样 |
[07:53] | I was prom king. My date was queen. | 我是舞会国王 我舞伴是舞会皇后 |
[08:00] | I had the dress, I had the date, | 我有裙子 也有舞伴 |
[08:01] | I had the mom who got arrested. | 还有个被逮捕的妈妈 |
[08:03] | Spent the night picking her up from the drunk tank. | 花了一晚上把她从醉汉监禁室里捞出来 |
[08:05] | Did you see Park while you were there? | 你在那看见朴了吗 |
[08:08] | Go to scheduling, get Angie’s surgery set for Friday | 去安排时间 把安吉的手术安排在周五 |
[08:10] | with the best neurosurgery OR nurses. | 要最好的神经外科手术护士 |
[08:15] | Let’s go see Glassman. | 走 去看看格拉斯曼 |
[08:17] | Now I’m identifying | 现在我在检查 |
[08:18] | the submillimeter lymphatic vessels. | 亚毫米淋巴管 |
[08:20] | I need an 11-0 micro suture and a 70 micron needle. | 我需要11-0微米缝合线和70微米的针 |
[08:24] | Instead of harvesting nodes to this area, | 与其摘除这部分的淋巴结 |
[08:27] | could we redirect lymphatics away from his lymph system? | 能不能把淋巴管从淋巴系统中分离 |
[08:30] | We could. | 可以 |
[08:31] | If you identify an appropriate vessel, | 如果你能找到一条合适的血管 |
[08:33] | you can make the connection. | 就可以把二者缝合在一起 |
[08:35] | We’re clearly not dealing with an infection. | 显然不是某处有感染 |
[08:37] | There must be a blockage somewhere in his lymph system. | 他的淋巴系统中肯定哪里被堵住了 |
[08:40] | Most likely cancer. | 很像是癌症 |
[08:41] | His CBC didn’t show any abnormal cells. | 他的血常规检测显示细胞一切正常 |
[08:45] | Lymphoma doesn’t always show up. | 淋巴瘤有时候查不出来 |
[08:47] | We need to run cytology on his lymphatic fluid. | 得给他的淋巴液做细胞化学检查 |
[08:55] | It’s either gonna be nasty or very nasty, | 情况会变得糟糕或非常糟糕 |
[08:57] | depending upon how it attaches | 取决于肿瘤是如何附着在 |
[08:59] | to the thalamus and fornix. | 丘脑和穹隆上的 |
[09:01] | Which no imaging or testing can possibly determine. | 而这是做影像或检查无法确定的 |
[09:06] | So, our options are? | 我们的方案是什么 |
[09:08] | Between an endoscopic approach or an open anterior one. | 在做内窥镜或开前叶里选一个 |
[09:11] | That is correct. | 没错 |
[09:15] | I’d run a stereotactic MRI with fiducials and DTI | 我会给她做个基点立体磁共振和弥散张量成像 |
[09:20] | to gauge how close the white matter tracts actually are. | 以测量白质束具体离得有多近 |
[09:24] | You should scrub in. | 你应该刷手做手术 |
[09:26] | Another doctor can cover the clinic. | 可以找个医生顶替诊所的活 |
[09:30] | I haven’t been in an OR in over a year, | 我已经一年没进手术室了 |
[09:33] | and then, as a patient. | 后来我还成了病患 |
[09:35] | I’m not asking you to cut. | 我不是让你来主刀 |
[09:37] | But it’d be a huge value to have you there. | 但你在场会很有帮助 |
[09:41] | I appreciate that. | 谢谢 |
[09:43] | I’ll consider it. | 我会考虑的 |
[09:59] | Hello. We need to run cytology on this lymphatic fluid. | 你好 我们需要给淋巴液做细胞化学检查 |
[10:02] | I would be happy to. | 很高兴为你服务 |
[10:08] | Lea moved out this morning. | 莉亚今早搬走了 |
[10:12] | – Thank you. – You’re welcome. | -谢谢 -不客气 |
[10:14] | Can you come over tonight? | 你今晚能过来吗 |
[10:16] | Uh, that probably won’t work… | 可能不行 |
[10:18] | Or we could go to your apartment? | 或者我们去你的公寓 |
[10:21] | I can’t. | 不行 |
[10:25] | Lea said that it might take time | 莉亚说修复我们的关系 |
[10:27] | for us to recover from our fight. | 需要一段时间 |
[10:29] | But I told her that we were okay. | 但我告诉她我们没事 |
[10:31] | We are. | 的确 |
[10:33] | I made plans tonight. | 我今晚有计划了 |
[10:35] | To hang out with a friend who just got fired. | 和我一个刚被解雇的朋友聊聊 |
[10:38] | But I would love to come over tomorrow night. | 但我很想明晚去 |
[10:41] | Okay. | 好啊 |
[10:43] | I’ll put a rush on this test, too. | 这个检测我也会尽快做好的 |
[10:53] | Your lymphovenous anastomosis technique… | 你淋巴静脉吻合术的手法 |
[10:56] | I was impressed. | 让我五体投地 |
[10:58] | It’s a little early in the morning | 你这马屁拍得未免太早了 |
[10:59] | to be sucking up, Reznick. | 雷兹尼克 |
[11:00] | Not for me. I like to get a jump on things. | 没有 我是喜欢有话直说 |
[11:02] | I’m fascinated by the way you use plastic procedures, | 你在做其他外科手术时用到了 |
[11:05] | like microsurgery, in other surgical specialties. | 显微手术等整形手术法 我被惊艳到了 |
[11:08] | I thought it might make an interesting topic for a paper. | 我觉得我可能发现了一个有意思的论文选题 |
[11:11] | Want to write it with me? | 想和我一起写吗 |
[11:14] | Yes. | 好啊 |
[11:15] | Let’s talk and eat. | 我们边吃边聊 |
[11:19] | That’s not breakfast. | 早餐不能就吃这个 |
[11:22] | I’m buying. | 我请你 |
[11:24] | What publications do you want to target? | 你想选哪家出版社 |
[11:29] | Last time, Angie had bad post-op vomiting. | 上次 安吉术后呕吐严重 |
[11:30] | – Of course. I’ll make note of it… – Excuse me. | -好的 我记下来 -不好意思 |
[11:34] | She’s asleep. She needs her rest. | 她睡着了 她需要休息 |
[11:37] | I’ll wait out here until she’s awake. | 我在外面等她醒 |
[11:38] | Ryan, your immune system is weak. | 瑞恩 你的免疫系统很弱 |
[11:40] | It would be so easy for | 你很容易 |
[11:41] | you to pick up a bug and pass it to Angie. | 染上病然后传染给安吉 |
[11:43] | I haven’t been around anyone but my dad. I swear. | 我发誓 我只跟我爸爸接触过 |
[11:46] | He could wear a mask. | 他可以戴个口罩 |
[11:51] | After Angie’s surgery, we’ll see about arranging a visit. | 安吉手术后 我们会安排让你探视的 |
[11:54] | Please tell her Ryan came by. | 请转告她瑞恩来过 |
[11:59] | I’m sorry if I overstepped. | 如果我过界了 我很抱歉 |
[12:02] | I’d like to change Angie’s status | 我想把安吉的病历 |
[12:04] | to “No visitors” on her chart. | 改为「谢绝探视」 |
[12:05] | Yeah. | 好的 |
[12:14] | Please take Mr. McDougall to his room. | 请带麦克道格先生回房间 |
[12:15] | I’ll be there in a moment. | 我一会儿就来 |
[12:19] | Is that James McDougall? | 那是詹姆斯·麦克道格吗 |
[12:21] | – And the woman with him? – His wife. | -和他在一起的那个女人呢 -他的妻子 |
[12:23] | Is it cancer? | 癌症吗 |
[12:26] | No… Worse. | 不 更糟 |
[12:28] | His lymphedema is caused by a genetic mutation. | 他的淋巴水肿是由基因突变引起的 |
[12:31] | If you don’t find a medication he responds to, | 如果你不能给他找到有效的药 |
[12:33] | he’ll drown from the inside. | 他会体内窒息而死的 |
[12:38] | The mutation is on James’ ARAF gene. | 詹姆斯的序列基因发生突变 |
[12:41] | It makes an enzyme called kinase, | 产生一种叫做激酶的酶 |
[12:43] | which can cause cells to overproliferate. | 会导致细胞过度增殖 |
[12:45] | It’s a genetic condition. | 这是种遗传病 |
[12:48] | What set it off now? | 什么引起的 |
[12:50] | Probably the stress fracture. | 可能是应力骨折 |
[12:51] | Sent his immune system into overdrive, | 导致他的免疫系统过劳运作 |
[12:53] | which fired up his lymphatic system. | 刺激了他的淋巴系统 |
[12:55] | What treatment protocol targets this mutation? | 针对这种突变的治疗方案是什么 |
[12:57] | An MEK inhibitor. | 用甲基乙基酮抑制剂 |
[12:59] | The problem is, which one? | 问题是 用哪一种 |
[13:00] | There are 41 possibilities, | 有41种 |
[13:02] | each with different side effects. | 每种都有不同的副作用 |
[13:05] | Good luck. | 祝你们好运 |
[13:07] | Well, I was hoping you could stay. | 我希望你能留下来 |
[13:12] | Okay. Sure. | 好 可以 |
[13:17] | We need you to stay completely still. | 我们需要你保持不动 |
[13:20] | Not a problem. | 没问题 |
[13:23] | You okay? | 你还好吧 |
[13:26] | Ryan totally bailed. | 瑞恩彻底抛弃我了 |
[13:27] | He hasn’t come back to see me. | 他没有回来看我 |
[13:32] | If you tell her that her mom said he couldn’t visit, | 如果你告诉她是她妈不让他来探视 |
[13:34] | she’ll be pissed at her mom. | 她会生她妈妈的气 |
[13:35] | How’s that gonna help? | 这样做有什么好处 |
[13:39] | He’s probably busy catching up in school. | 他可能在学校忙 |
[13:45] | We had a pact. | 我们有约定 |
[13:47] | As long as we were together, cancer wasn’t gonna beat us. | 只要我们在一起 癌症就打不垮我们 |
[13:51] | He broke it. | 他失言了 |
[13:53] | Cancer wins. | 癌症赢了 |
[14:00] | Do you mind finishing? | 你可以自己完成吧 |
[14:13] | Imaging finished? | 造影结束了吗 |
[14:14] | Not quite. | 还没有 |
[14:15] | Mrs. Valens, Angie would really like to see Ryan. | 瓦伦斯太太 安吉很想见瑞恩 |
[14:19] | I know you’re concerned about infection, | 我知道你担心感染 |
[14:21] | but there is minimal risk. | 但风险很小 |
[14:23] | Actually… actually, none, if they do a video chat. | 实际上 如果他们只是视频聊天完全没风险 |
[14:27] | Interesting idea. | 好主意 |
[14:28] | I’ll think about it. | 我会考虑的 |
[14:32] | Angie’s depressed. | 安吉很沮丧 |
[14:34] | And studies have shown that | 研究表明 |
[14:35] | that can have a negative impact | 沮丧会对她的手术结果 |
[14:36] | on her surgical outcome. | 产生负面影响 |
[14:41] | Ryan doesn’t always improve Angie’s mood. | 瑞恩并不会一直让安吉开心 |
[14:45] | A couple of weeks ago, they had some silly fight, | 几周前 他们吵了一架 |
[14:47] | and she cried for days. | 她哭了好几天 |
[14:49] | Thank you for letting me know. | 谢谢你跟我说这些 |
[14:51] | I’m gonna do my best to cheer her up. | 我会尽力让她高兴起来 |
[14:53] | She’s a 16-year-old. | 她才十六岁 |
[14:55] | She wants her boyfriend. | 她需要她的男朋友 |
[14:57] | Yeah. | 是啊 |
[14:58] | And how smart were you when you were 16? | 你十六岁的时候有多聪明呢 |
[15:07] | Well, what about Selumetinib? | 塞卢美替尼怎么样 |
[15:09] | It’s shown promising results on related conditions. | 它治疗相关症状的效果很好 |
[15:12] | And a high occurrence of liver disease. | 也很有可能造成肝脏疾病 |
[15:15] | Binimetinib is similar, but has fewer complications. | 比尼梅替尼也差不多 但并发症少一些 |
[15:19] | Any objections? | 有人反对吗 |
[15:23] | Let’s start James on that. | 那就先给詹姆斯试试 |
[15:33] | This is exciting, working together. | 一起工作感觉太棒了 |
[15:36] | It is. | 是啊 |
[15:38] | Although, I’m used to | 但我习惯了 |
[15:40] | samples and slides instead of patients. | 面对样品和切片而不是病人 |
[15:46] | Patients can be difficult. | 病人有时候很难搞定 |
[15:49] | But you will be fine. | 但你会习惯的 |
[16:10] | Do you need something? | 你需要什么吗 |
[16:13] | I was curious how James was responding | 我只是好奇比尼梅替尼 |
[16:15] | to the Binimetinib. | 对詹姆斯效果如何 |
[16:16] | His urine output is up, | 他的尿量增多了 |
[16:18] | which suggests the lymphatic fluid… | 这表示他的淋巴液 |
[16:21] | and his potassium is a little low. | 以及钾的含量偏低 |
[16:23] | Can you…give him this? | 你能把这个给他吗 |
[16:25] | I wasn’t really… | 我不是要… |
[16:43] | Hi. I’m Dr. Lever. | 你好 我是莱瓦医生 |
[16:45] | The tumor’s abutting and possibly infiltrating | 肿瘤紧挨着甚至可能渗入了 |
[16:47] | the white matter tracts of her fornix. | 她脑穹庐的白质束 |
[16:49] | We’ll likely have to remove a section. | 所以我们很可能得切除一部分 |
[16:51] | That’ll affect her ability to form memories. | 这会影响到她的记忆能力 |
[16:53] | With a lot of neuropsych rehab, | 通过神经心理学康复 |
[16:55] | she may be able to compensate with other pathways. | 她也许能用其他的途径来弥补 |
[16:57] | Studies have shown that | 研究表明 |
[16:58] | positive attitudes lead to positive outcomes. | 积极的态度更利于得到积极的结果 |
[17:01] | You’re worried about her attitude? | 你在担心她的态度 |
[17:02] | She’s worried about young love. | 她在担心年轻人的爱情 |
[17:03] | I’m worried about what Angie is facing after surgery. | 我在担心安吉手术后要面对的事 |
[17:05] | Physical therapy, cognitive therapy, | 理疗 认知治疗 |
[17:08] | one challenge after another. | 一个接一个的挑战 |
[17:09] | And what she wants is so simple. | 而她想要的其实很简单 |
[17:14] | You want to make a sad kid happy? | 你想让一个难过的孩子开心 |
[17:17] | I guess I do. | 我想是的 |
[17:18] | Which isn’t my job, and I need to stop | 这不是我的工作 |
[17:19] | getting sucked into people’s personal issues. | 我也确实不能再卷入别人的私事了 |
[17:21] | Is there a way to do that without | 能在不让她妈妈 |
[17:22] | antagonizing the mother? | 反感的情况下做到吗 |
[17:28] | Maybe. | 可能吧 |
[17:30] | Then make her happy. | 那就让她开心点 |
[17:49] | We’ve never gotten this far before. | 我们从来没做到过这一步 |
[17:51] | No. | 没有 |
[17:52] | We haven’t. | 我们没有 |
[17:54] | And you’re okay? | 你还好吗 |
[17:56] | I am very okay. | 我非常好 |
[18:08] | Carly. | 卡莉 |
[18:24] | Okay. | 等等 |
[18:32] | Did…I do something wrong? | 我做错什么了吗 |
[18:37] | No, I’m sorry. It’s me. | 不 对不起 是因为我 |
[18:40] | You said we were okay. | 你说过我们没事 |
[18:43] | I thought we were. | 我以为没事 |
[18:45] | I-I want us to be. | 我想让我们没事 |
[18:46] | You have no reason to still be mad. | 你没有理由继续生气了啊 |
[18:48] | I’m not mad. | 我没有生气 |
[18:49] | I’m… I’m just… | 我只是 |
[18:57] | It’s Morgan. | 是摩根 |
[18:58] | The medication caused James an upper GI bleed. | 药物导致詹姆斯上消化道出血 |
[19:08] | Have you localized the source of the bleeding? | 你找到出血点了吗 |
[19:10] | Working on it. | 正在找 |
[19:11] | Seems to be coming from the antrum of the stomach. | 看起来是在胃窦 |
[19:13] | We stopped the Binimetinib. | 我们停了比尼梅替尼 |
[19:15] | On top of causing this, | 除了导致出血 |
[19:16] | it hadn’t done much to curtail the swelling. | 药物并没能消肿 |
[19:17] | Where’s Dr. Lever? | 莱瓦医生在哪 |
[19:18] | There’s the ulcerative lesion. Cautery. | 这里有一处溃疡性病损 电灼器 |
[19:24] | Zebrafish. | 斑马鱼 |
[19:26] | They’re used in medical research | 它们因为成熟得很快 |
[19:27] | because of their quick maturation, | 而被用于医疗研究中 |
[19:29] | and 84% of genes associated with human disease | 而且84%和人类疾病有关的基因 |
[19:31] | have a zebrafish equivalent. | 在斑马鱼中都有对应 |
[19:33] | You think we should do a transgenic expression | 你觉得我们应该在斑马鱼的基因组中 |
[19:37] | of James’ ARAF mutation into the zebrafish genome. | 对詹姆斯的突变基因进行转基因表达 |
[19:41] | Translation for those of us without a genetics textbook handy? | 给不清楚遗传学的我们翻译一下吧 |
[19:44] | We make mini-Jameses, as zebrafish, all with the same disorder. | 把有相同基因突变的斑马鱼当作小詹姆斯样本 |
[19:48] | Then we test every conceivable drug on those fish. | 然后在这些鱼身上测试所有能想到的药物 |
[19:51] | How long before we can start testing? | 要多久才能开始测试 |
[19:53] | If we implant the embryos now, | 如果我们现在植入胚胎 |
[19:54] | probably by late afternoon tomorrow. | 可能在明天下午晚些时候开始 |
[19:56] | Get going. | 快去做 |
[19:57] | Shaun, go with her. You have Path experience. | 肖恩 你跟她一起 你有病理学的经验 |
[20:21] | I understand no means no. | 我知道不就是不 |
[20:24] | If you don’t want to have sex, | 如果你不想做爱 |
[20:28] | I accept that. | 我接受 |
[20:30] | But I am very confused. | 但我非常困惑 |
[20:32] | So am I. | 我也是 |
[20:34] | I thought I was fine u-until I… | 我以为我没事但是… |
[20:36] | I told Lea to move out, like you wanted. | 我按照你的要求让莉亚搬出去 |
[20:41] | You said that things were okay. | 你说一切都好 |
[20:44] | They aren’t. How do I make them okay? | 但并非如此 我该怎么做才好 |
[20:47] | I can’t tell you, because I don’t know. | 我不能告诉你 因为我也不知道 |
[21:14] | When I was in chemo, | 我在做化疗时 |
[21:16] | the nurses used to force that stuff down my throat, | 护士们常常逼我喝下那些东西 |
[21:18] | so I know you’re not drinking it because of the taste. | 所以我知道你不是因为味道好才喝 |
[21:22] | It’s fast, easy nutrition. | 这是既快速又简单的营养品 |
[21:23] | That and you don’t end up puking your guts out in the bathroom. | 这样你就不会在厕所里吐了 |
[21:28] | I was president of this hospital for over 10 years. | 我在这家医院当了十多年的院长 |
[21:30] | I made a few friends, including Jack the janitor… | 我交了些朋友 比如清洁工杰克 |
[21:34] | Talks a lot, A’s fan, horrible gossip. | 话多 棒球粉丝 超级八卦 |
[21:37] | If the methotrexate is making you sick, | 如果甲氨蝶呤让你恶心 |
[21:39] | we should try another medication. | 我们应该换一种药 |
[21:43] | How can you guarantee that you’re not gonna throw up | 你怎么能保证你不会在 |
[21:46] | in the middle of your next surgery? | 下次手术中呕吐呢 |
[21:49] | It won’t happen. | 不会的 |
[21:51] | Because it only happens if I eat solid food. | 除非我吃了固体食物 |
[21:54] | And I stopped. | 而我没吃了 |
[21:57] | At least at work. | 至少上班时没吃 |
[22:10] | That is a lot of fish tanks. | 好多鱼缸啊 |
[22:12] | Forty. So we can test all of the possible medications for… | 四十个 这样我们可以测试所有可能的药物 |
[22:18] | Are you throwing a party? | 你要开派对吗 |
[22:19] | Hope so. | 希望能开 |
[22:33] | How are you doing, Shaun? | 你还好吗 肖恩 |
[22:36] | Since your father passed away? | 自从你父亲去世后 |
[22:40] | I don’t think about him very much. | 我不怎么会想起他 |
[22:48] | My mom…died recently. | 我妈妈 最近去世了 |
[22:51] | I-I don’t know if you knew that. | 我不知道你是否知道 |
[22:55] | She pops into my head all the time. | 她总是突然出现在我脑海里 |
[22:59] | Not always the nicest thoughts. | 不都是最好的画面 |
[23:08] | It’s okay not to love them. | 不爱他们也没关系 |
[23:14] | They didn’t make us who we are. | 我们的成就与他们无关 |
[23:53] | Has your mom gone home? | 你妈妈回家了吗 |
[23:56] | There is one more thing we have to deal with tonight. | 今晚我们还有一件事要处理 |
[24:02] | Come on. | 拜托 |
[24:03] | How many more sets of imaging can you possibly do? | 你到底能拍多少套片子啊 |
[24:07] | One of these is your prom dress. | 其中一套就是你的舞会礼服 |
[24:10] | I like the pink, but I think you’d look gorgeous in both. | 我喜欢粉色 但我觉得你穿这两种颜色都很漂亮 |
[24:18] | Hurry up and choose. | 赶快选择吧 |
[24:19] | Your date’ll be here soon. | 你的约会对象就快到了 |
[24:34] | All the medications are in. | 所有药物都注射完毕 |
[24:37] | Which means more waiting to see which medicine works. | 那就得花更多的时间等待 看哪种药有效 |
[24:41] | It’s hard to be patient. | 耐心等待真难 |
[24:48] | Do you think the fish control how they react to the meds? | 你觉得鱼可以控制自己对药物的反应吗 |
[24:52] | No. | 不可以 |
[24:54] | It’s just how their bodies respond. | 这只是它们身体的反应 |
[25:00] | That’s how I felt last night. | 昨晚我就是这样的 |
[25:04] | I thought I was ready for us to be together, | 我以为我准备好跟你在一起了 |
[25:07] | but my body had a different response. | 但我的身体却有不同的反应 |
[25:13] | I can’t turn that response off any more than these fish | 我不能消除这种反应 就像这些鱼 |
[25:16] | can control how their mutation reacts to the medication. | 不能控制它们的突变对药物的反应一样 |
[25:26] | Was our mutation | 我们的突变 |
[25:28] | me going to Wyoming with Lea? | 是我和莉亚去怀俄明州吗 |
[25:37] | Do you think we can find our right medication? | 你觉得我们能找到合适我们的药物吗 |
[25:55] | ♪ I found a love ♪ | |
[25:55] | BGM: Perfect by Ed Sheeran | |
[25:58] | ♪ For me ♪ | |
[26:02] | ♪ Darling, just dive right in ♪ | |
[26:06] | ♪ Follow my lead ♪ | |
[26:10] | ♪ I found a girl ♪ | |
[26:14] | ♪ Beautiful and sweet ♪ | |
[26:16] | You look amazing. | 你好美 |
[26:17] | ♪ I never knew you were the someone waiting for me ♪ | |
[26:23] | So do you. | 你也是 |
[26:24] | ♪ ‘Cause we were just kids when we fell in love ♪ | |
[26:29] | ♪ Not knowing what it was ♪ | |
[26:33] | ♪ I will not give you up this time ♪ | |
[26:40] | ♪ Darling, just kiss me slow ♪ | |
[26:44] | ♪ Your heart is all I own ♪ | |
[26:48] | ♪ And in your eyes, you’re holding mine ♪ | |
[26:54] | ♪ Baby, I’m ♪ | |
[26:58] | ♪ Dancing in the dark ♪ | |
[27:02] | ♪ With you between my arms ♪ | |
[27:06] | ♪ Barefoot on the grass ♪ | |
[27:07] | 毕业舞会 | |
[27:09] | ♪ Listening to our favorite song ♪ | |
[27:13] | ♪ When you said you looked a mess ♪ | |
[27:16] | ♪ I whispered underneath my breath ♪ | |
[27:20] | Looks like you might be feeling | 你现在看起来 |
[27:21] | a little idiotic happiness right now. | 像个幸福的傻瓜 |
[27:26] | Maybe a touch. | 或许是太感动了 |
[27:33] | ♪ No, no ♪ | |
[27:34] | Dance with a prom king? | 愿意和舞会国王跳支舞吗 |
[27:38] | ♪ You look perfect tonight ♪ | |
[27:55] | He’s tachycardic. | 他心动过速 |
[27:58] | We were talking, and then he just stopped. | 我们正说着话 他突然就沉默了 |
[28:00] | We need to do a pericardial tap. | 我们得做心包穿刺 |
[28:02] | Call the cath lab. Tell them we’re coming. | 通知导管室我们要到了 |
[28:03] | No time. We’re doing it here. | 没时间了 我们就在这里做 |
[28:05] | James, the pain in your chest | 詹姆斯 你胸部疼痛是由于 |
[28:06] | is from too much fluid around your heart. | 心脏周围有太多积液 |
[28:08] | We’re gonna put a tube into your chest to drain it. | 我们要在胸腔放置导管 排出积液 |
[28:10] | Call Shaun and Carly. Tell them we’re running out of time. | 通知肖恩和卡莉 就说我们没时间了 |
[28:15] | ♪ Will be loving you till we’re 70 ♪ | |
[28:15] | BGM: Thinking Out Loud by Ed Sheeran | |
[28:25] | ♪ And, baby, my heart could still fall as hard at 23 ♪ | |
[28:36] | ♪ And I’m thinking about how ♪ | |
[28:38] | ♪ People fall in love in mysterious ways ♪ | |
[28:43] | I brought Angie’s Bearfeet Bear. | 我把安吉的赤脚熊带来了 |
[28:45] | It always makes her feel like sh… | 这总能让她感到… |
[28:51] | It’s…prom. | 这是毕业舞会 |
[28:53] | Ryan has been wearing his mask all night. | 瑞恩整晚都戴着口罩 |
[28:57] | ♪ And I just want to tell you I am ♪ | |
[29:01] | ♪ So, honey, now ♪ | |
[29:07] | ♪ Take me into your loving arms ♪ | |
[29:11] | Don’t let her stay up too late. | 别让她玩到太晚 |
[29:13] | ♪ Kiss me under the light of a thousand stars ♪ | |
[29:19] | ♪ Place your hand on my beating heart? ♪ | |
[29:28] | Morgan called. James isn’t doing well. | 摩根打了电话来 詹姆斯情况不妙 |
[29:37] | Cross SL-327 off the list. | 把SL-327从清单上划掉 |
[29:41] | I see one… | 我看见一个… |
[29:43] | No, two tumors. | 不 是两个肿瘤 |
[30:07] | Okay. | 好了 |
[30:08] | This is my stop. | 我就送你到这里 |
[30:10] | I’ll see you after. | 待会儿见 |
[30:12] | I love you. | 我爱你 |
[30:14] | I love you, too, Mom. | 我也爱你 妈 |
[30:18] | Don’t worry. Okay? | 别担心 好吗 |
[30:21] | I got this. | 我能行 |
[30:25] | I know you do. | 我知道你可以 |
[30:35] | Okay. | 好 |
[30:42] | What if I wake up and don’t remember Ryan at all? | 如果我醒来不认识瑞恩了怎么办 |
[30:50] | Then… | 那… |
[30:52] | you’ll have the chance to fall in love with him all over again. | 你就有了重新爱上他的机会 |
[31:00] | Okay. | 好了 |
[31:14] | We’re down to five potential options. | 我们只剩五个可选项了 |
[31:17] | I don’t need five potential. I need one actual. | 我不要五个可选项 我只要一个可行的选项 |
[31:19] | There are two that best curb… | 其中两个能最有效控制… |
[31:21] | Choose one. | 选出一个 |
[31:23] | We should try Refametinib. | 我们可以试试雷法迈替尼 |
[31:27] | It caused abnormal cell growth. | 它会造成异常细胞生长 |
[31:28] | Trametinib is safer. | 曲美替尼更安全 |
[31:31] | Which doesn’t mean it’s safe. | 但不是绝对安全 |
[31:32] | Nothing’s safe. | 没有什么绝对安全 |
[31:33] | Which do you want us to do? | 你想让我们用哪种药 |
[31:40] | Trametinib. | 曲美替尼 |
[31:41] | That’s the one. | 用这个吧 |
[31:48] | Saline in. | 输入生理盐水 |
[31:49] | Advancing scope toward the third ventricle. | 窥镜推向第三心室 |
[31:52] | Claire, hold gentle pressure on the tumor | 克莱尔 我切断血液供给时 |
[31:54] | while I cut off its blood supply. | 轻轻按住肿瘤 |
[32:02] | We’ve got some significant bleeding. | 严重出血 |
[32:04] | Adjust the scope and suction. | 调整视野和抽吸器 |
[32:11] | Look higher. | 往上照 |
[32:13] | Septal vein… There’s your bleeder. | 隔静脉 这是出血处 |
[32:15] | Cauterize away. | 灼烧止血 |
[33:01] | Micro dissector. | 微型解剖刀 |
[33:08] | The tumor’s immobile. | 肿瘤无法移动 |
[33:09] | I can’t resect it without injuring the nerve tracts. | 我要切除它就会伤到神经束 |
[33:12] | She’d be comatose. | 会让她昏迷不醒 |
[33:13] | Try sharp dissection. | 试试锐解剖 |
[33:17] | – I can’t get a plane. -How bad? | -找不到平面 -有多糟 |
[33:18] | It’s completely invaded her thalamus. | 肿瘤完全侵入了她的脑丘 |
[33:20] | Thin it out with a suction aspirator. | 用抽吸器把切口变薄再切除 |
[33:30] | It’s too adherent. | 粘得太紧了 |
[33:31] | If I keep going, I’m gonna kill her. | 继续的话她会死 |
[33:35] | Any ideas? | 有什么建议吗 |
[33:58] | Tell ICU Angie will be coming sooner than we planned. | 通知重症监护室 安吉会比预计的早到 |
[34:04] | Let’s close her up. | 开始缝合吧 |
[34:22] | What next? | 接下来呢 |
[34:24] | Another round of radiation, chemo? | 再来一轮放化疗吗 |
[34:29] | Her carcinoma is | 她的癌症 |
[34:32] | unlikely to respond to those therapies. | 对这些治疗不可能产生反应 |
[34:38] | No. We have to try. | 不 我们要试试 |
[34:42] | Angie will want to fight. | 安吉会希望与病魔抗争 |
[34:43] | She’s seizing. | 她发病了 |
[34:44] | Give me lorazepam and Dilantin, stat. | 给我氯羟去甲安定和狄兰汀 马上 |
[34:46] | Phenobarb and propofol on deck. | 准备好苯巴比妥和普洛福 |
[35:10] | You’re crying. | 你在哭 |
[35:15] | Yes. | 对 |
[35:19] | Why? | 为什么 |
[35:23] | I found James on Facebook. | 我在脸书上看到詹姆斯 |
[35:27] | He and Marjorie want to go to Costa Rica. | 他和马乔里想去哥斯达黎加 |
[35:32] | Their dog is a three-legged rescue named Tripod. | 他们救助了一只三条腿的狗 叫三脚架 |
[35:40] | He’s not a slide. He’s a person. | 他不是一张无生命的图像 他是个人 |
[35:44] | He’s a good person. | 他是个好人 |
[35:45] | And he might die. | 但他可能会死 |
[35:48] | This is why I like to stay in the lab. | 所以我喜欢待在化验室 |
[35:56] | That… | 这话 |
[35:58] | Is a very dumb thing to say. | 说出来挺蠢的 |
[36:04] | If you had stayed in the lab, | 如果你当时待在化验室 |
[36:06] | James would probably be dead already. | 詹姆斯可能已经死了 |
[36:12] | Your plan with the zebrafish gave him a chance. | 你的斑马鱼计划给了他一次机会 |
[36:18] | It was a beautiful, perfect idea, | 这个漂亮 完美的想法 |
[36:23] | from a beautiful, almost perfect person. | 来自一个漂亮 近乎完美的人 |
[36:32] | Your earlobes are lopsided. | 你的耳垂大小不一样 |
[37:08] | I’m so sorry. | 对不起 |
[37:11] | We couldn’t save her. | 我们没能救他 |
[37:33] | Ms. Valens? | 瓦伦斯女士 |
[38:07] | Nice call on the zebrafish. | 斑马鱼的建议非常好 |
[38:28] | About our paper, let’s meet weekly. | 关于论文 我们每周碰一次面 |
[38:31] | I’m thinking lunch every Tuesday in the cafeteria. | 就每周二在餐厅一起吃午饭时谈吧 |
[38:34] | Perfect. | 很好 |
[38:45] | I heard about Melendez’s patient. | 我听说了梅伦德斯的病人 |
[38:51] | Yeah. | 是的 |
[39:02] | You were right. | 你是对的 |
[39:04] | I should probably try another medication for my RA. | 也许我应该尝试别的药物治我的类风湿性关节炎 |
[39:10] | I need solid food. | 我要吃固体食物 |
[39:23] | Claire? Wait up. | 克莱尔 等等 |
[39:26] | You okay? | 你还好吗 |
[39:28] | Fine. I’m just tired. | 没事 就是有点累 |
[39:32] | You did an amazing thing for Angie. | 你为安吉做的已经很好了 |
[39:34] | You gave her mother a memory that she will have forever. | 你给了她妈妈永远难忘的记忆 |
[39:37] | Well, it won’t make up for the daughter she lost. | 那也不能弥补她的丧女之痛 |
[39:40] | You’re angry. | 你在生气 |
[39:41] | I’m not. I am sad. | 我没有 我在伤心 |
[39:43] | – Who are you angry at? – I’m not. | -你生谁的气 -我没有 |
[39:45] | Are you angry at me and Glassman | 你生我和格拉斯曼的气吗 |
[39:46] | because we couldn’t save her? | 因为我们没能救她 |
[39:47] | – No! – At Angie? | -没有 -生安吉的气 |
[39:49] | No, you can’t be mad at someone for dying! | 不 你不能因为一个人死了而生气 |
[39:53] | That’s not true. You know that. | 并非如此 你很清楚 |
[39:57] | She was sick. | 她生病了 |
[39:59] | And she was trying to get better. | 而且她很努力想康复 |
[40:01] | She failed and left you alone, | 你费心费力来照顾她 |
[40:04] | after you’d spent a lifetime trying to take care of her. | 她却失败了 弃你而去 |
[40:07] | You have every reason to be mad at your mother. | 你完全有理由生你母亲的气 |
[40:11] | I hate feeling this way. | 我讨厌这种感觉 |
[40:13] | My whole life, I’ve been angry at her, | 我的一生 都在生她的气 |
[40:15] | and now it will never change. | 现在什么都没有改变 |
[40:18] | I don’t know how to stop. | 我不知道如何停止 |
[40:23] | Therapy will help. | 可以通过治疗 |
[40:26] | Time will help. | 可以让时间冲淡 |
[40:29] | There is one other thing that’s worked for me. | 还有一种方法对我有效 |
[40:44] | Did we fix our mutation? | 我们的「突变」解决了吗 |
[41:00] | That the best you got? | 你就这点本事吗 |