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1、哦，你觉得你在做什么？Oh,whatdoyouthinkyouredoing?抱歉，我不觉得我们还有其他选择Sorry,Ididntfeellikewehadanotherchoice.亚曼医生，你在这里的住院医生第一年训练会是试用期DoctorAhmad,yourresidencyherewillbeonaprobationarybasis.这到底是怎么回事？Thehellsgoingon?没有通知主管就擅离岗位？Walkingoffthefloorwithoutnotifyingthesupervisor?下次就不只有警告而已Theresnotgonnabeanotherwarning.班
2、才是决定结束这段婚姻的人Benistheonewhopulledtheplugonthismarriage.别这样，玛姬Comeon,Maggie.我们现在只差临门一脚了Werealmostatthefinishline.我真的只是想接受现实Ireallyjustwanttomoveon.让我出去1.etmeoutofhere!里普利医生，我想你今天的行为有一点鲁莽DoctorRipley,whatyoudidtodaywasreckless.鲁莽？“冲动控制障碍”Reckless?Impulsecontroldisorder?你当时不是这样说的吗？Isntthatwhatyoucalledi
3、tbackthen?我是这间医院的主治医生Well,manattendingphysicianatthishospital.不要把我当成20年前你认识的那个小男孩Nottheboyyouknewtwentyyearsago.艾莎，你在这里做什么？Yo,Asher!Whatareyoudoinghere?米治，你在你好Mitch,whatare.hi.你在喝什么？Whatareyoudrinking?嗯，我.我没有Um,m.mnot.这是苏打水Thisisclubsoda.你不喝酒？Youdontdrink?我不喝Idonot.我是戒瘾的酒瘾者marecoveringaddict.我之后有时间再
4、细细告诉你这段故事Which,Iwilltellyouallaboutthatanothertime.但是现在呢？你得先走了Butrightnow?Youhavetogo.离开这里Away.你知道这里是公众场所吧？Youdorealizethisisa.apublicestablishmentright?我是在等我的约会对象m.mwaitingonadate.第一次约会Afirstdate.他随时会到，所以Andhesgonnabehereanyminute,so.-好哦-你在干嘛？不要-So.-What,no.你不行你.Did.No,you.我会紧盯着大门Igotmyeyesgluedtot
5、hedoor.他一进来我马上闪人Iwillsplitthesecondhegetshere.好吧Fine.介绍一下你的对象吧？So,whostheguy?你们怎么认识的？Howdyoumeet?他叫凯尔Hisname,sKyle.他是建筑师，我们是在交友软件上认识的.andhesanarchitect,andwemetonadatingapp.商业建筑？还是住♥宅♥?Commercialarchitecture?Residential?他公♥司♥名称是什么？What,sthenameofhisfirm?好吧，你在做什么？Okay,what
6、areyoudoinghere,huh?你感觉不像在上学前一晚会溜出门玩的类型Youdon,tseemlikethetypetoventureoutonaschoolnight.你是在委婉地说我是废青吗？Isthatyourpolitewayofcallingmealoser?不是No.因为你总是在加班、在很怪的时间Yourealwaysworkinglate,running.跑步.atsomeungodlyhours.是那些坏朋友拖我出来的Thosedegenerates,theydraggedmeout.大多是我从小学就认识的朋友Knownmostofemsincegradeschool.
7、我不知道你是芝加哥人IdidntknowyoureaChicagoboy.土生土长Bornandraised.只是离开了很多年Justbeenawayalotofyears.可以回家一定很棒吧？Mustbenicebeinghome?我想你的大情圣到了IthinkRomeohaslanded.哇，真是开球开得很漂亮哦，兄弟Whoa,thatwas.nicebreak,bro.有人可以帮我召救护车吗？Somebodycallnine-one-one!我我需要帮忙，我女朋友昏倒了I.I.Ineedhelp!Mygirlfriendjustpassedout!我们是医生Weredoctors.拜托你
8、们救救她Yougottahelpher,please.已经有人召救护车了Somebodyscallingnine-one-one.救护员应该很快就到了Paramedicsshouldbeonthewaysoon.她的呼吸慢又浅Herbreathingsslowandshallow.瞳孔呈针状Eyesarepinpoint.她怎么称呼？Whatshername?贝卡Uh,Becca.贝艮醒醒，贝卡Becca!Hey,wakeupBecca!她有服用什么东西吗？Didshetakesomething?我们需要知道才能帮她，老兄Weneedtoknowsowecanhelpher,man.快点，她吸
9、了什么？Comeon!Whatdidshetake?呃，可♥卡♥因♥,可是只吸了一口Um,coke.But.butjustahit.这是药物过量吗？Isthisanoverdose?你只吸一口怎么会药物过量？Howdoyou0.D.offjustonehit?你不会Youwouldnt.不，除非No.Unless.可♥卡♥因♥跟芬太尼混用Cocainewaslacedwithfentanyl.我的手袋里面有纳洛酮IhaveNarcaninmypurse.吧台下面挂勾上那个蓝色手袋？Uh,thebluebagun
10、derthebaronthehook?没问题，我去拿It,sokay,11.11getit.嘿，你还好吗？Hey,hey,youdoingokay?我我不.不太舒服1.Idont.I.Idontfeelsogood.你也吸了一口吗？Didyoutakeahit,too?给你-谢谢-Here.-Thanks.你没事的Youreokay.你没事的Youreokay.米治？Mitch?好Yeah.快醒来Comeon.我看不到Icantsee.欢迎回来，贝卡Uh,welcomeback,Becca.深呼吸Takeabreath.加油啊Comeon.没事的Itsokay.呼吸就对了Justbreathe
11、.添？他怎么了？Tim?Whatswrongwithhim?还有纳洛酮吗？这一剂没有用GotanymoreNarcan?Thisdidntdoit.他需要再一剂我没有-Heneedsanotherdose.-No.有人有纳洛酮吗？DoesanyonehaveNarcan?我到处问问llaskaround.气道畅通但是他没有在呼吸Airway,sopenbuthesnotbreathing.宝贝，你快点醒来-我要开始人工呼吸了-Baby,youhavetowakeup!-mgonnastartarescuebreath.不米治，等等No,no,no,Mitch,wait.你没有面罩Youdont
12、haveamask.等救护员来汉娜-Waitfortheparamedics.-Hannah.他有可能会咳血，可能会Hecouldcoughupblood,hecould.我知道风险1knowtherisks.嘿，医生，什么状况？Hey,doc,whatdowegot?疑似芬太尼药物过量Suspectedfentanyloverdose.我们已经给了一剂纳洛酮WealreadyadministeredonedoseofNarcan.宝贝，张开眼睛Baby,openyoureyes.欢迎回来Welcomeback.芝加哥警署检测了他们的药物,C.P.D.testedtheirdrugs.结果显示
13、芬太尼有阳性反应Camebackpositiveforfentanyl.最近急症室的药物过量案例持续攀升TheresbeenahugeuptickinoverdosesintheE.D.lately.是啊，其中很多案例就跟贝卡和添一样Yeah,alotofthemjustlikeBeccaandTim.消遣性毒品使用者Therecreationalusers.毫无头绪他们的药物混了芬太尼Nocluetheirdrugswerelacedwithfentanyl.我会确保他们带一些芬太尼试纸回家Illmakesuretheygohomewithsomefentanyltestingstrips.
14、谢谢你，朱丽叶Thankyou,Juliette.你的约会对象在等你Yourdateswaiting.是吗？在哪里？Heis?Where?你的6点钟方向，表现得淡定点Yoursixoclock,Justbecool.好哦，那就明天见啦Well,uh,seeyoutomorrow.好哦好哦-Yeah.-Yeah.好哦Yeah.今晚多少睡一下吧，艾莎Getsomesleeptonight,Asher.哇Wow.你，你简直是现实生活的女超人Youre,uh.you,relikeareal-lifesuperwoman.不No,no.我只是我很庆幸大家都没事mjust.mgladeveryonesok
15、ay.是啊Yeah.你想继续刚才没聊完的话题吗？So,whatdoyousaywe,um.wepickupwhereweleftoff?嗯，其实我得走了Uh,Iactually.!havetogetgoing.我明天要早起vegotkindofanearlystarttomorrow.好哦Oh.好，我明白了Yeah,getit.但是但是我真的很开心认识你，汉娜But.but!.itwasreallylovelytomeetyou,Hannah.今晚有重要约会吗？Bigplanstonight?没有No.我晚一点要参加董事会会议1.uh,gotaBoardmeetinglater.要去报告吗？G
16、ivingapresentation?不，我其实加入董事会了No,mactuallyjoiningtheBoard.哇，我一定是没看到公告Wow!Imusthavemissedtheannouncement.哦，没有公告Oh,therewasntone.是我要求的Myrequest.我不太喜欢大肆张扬Notbigonfanfare.所以董事会直接创了个席次给你？SotheBoardjustcreatedaseatforyou?这个嘛，是给医院医生的席次，所以Well,forahospitalphysician,so.但是他们询问你？Buttheyaskedyou?似乎是这样Seemsthatw
17、ay.我只是很开心我可以mjustgladIgetto,uh.为医疗人员发声toadvocateforthemedicalstaff.好哦，恭喜你Well,congratulations.你穿那套西装一定是万人迷Youmustbeverypopularwiththesuits.亚曼医生，有救护车进来DoctorAhmad!Gotanambopullingup.请去三号♥治疗室GoingtoTreatmentThree.我要上工了Dutycalls.当然Byallmeans.我们要去三号♥治疗室Weregoingtothree.收到Gotit.云斯冈萨雷斯VinceG
18、onzalez.38岁男性Thirty-eight-year-oldmale.呕吐后短暂失去意识Brieflylostconsciousnessaftervomiting.血压收缩压85,舒张压52B.P.eighty-fiveoverfifty-two.在救护车上输注了两升点滴Gavetwolitersintheambo.你好，冈萨雷斯先生Hi,MisterGonzalez.我是亚曼医生mDoctorAhmad.我是云斯It,sVince.你知道他昏过去的时候有没有撞到头吗？Doyouknowifhehithisheadwhenhepassedout?不，云斯本来就在地上No,Vincewa
19、salreadyontheground.他只是往下伏倒Hejustkindaslumpedover?而且没有很久，几秒钟而已Andhewasntoutlong,justafewseconds.谢谢你，请问你是？Thankyou.Andyouare?泰，我是云斯的丈夫Ty.mVinceshusband.我们会好好照顾他Welltakegoodcareofhim.好，听我数Okay,onmycount.、-、-One,two,three.好的，云斯，你可以往前坐起来吗？Okay,Vince,doyoumindleaningforward?我只是想从背后听诊你的肺部Ijustwanttolisten
20、toyourlungsfromtheback.双侧呼吸音清澈Clearbreathsoundsbilaterally.哦，亲爱的Oh,honey.哦，我真的很抱歉Oh,Iamsosorry.没事Itissofine.这种情形比你想象的还要频繁Happensmorethanyouthink.四毫升卓弗兰，安排腹部X光FourofZofranandaK.U.B.马上处理monit.嘿Hey.你你的头发上有沾到呕吐物You,um.youhavesomevomitinyourhair.丹尼斯华盛顿DennisWashington.你好吗？Howyoubeen?嘿，丹，你好吗？Hey,Dan.Howar
21、eyou?华盛顿医生，早安DoctorWashington,goodmorning.需要什么协助吗？WhatcanIdoforyou?我想跟进我在电子邮件里提到的那件事的后续发展IwantedtofollowuponthatmatterIemailedyouabout.哦，又寸，当然Oh,right,ofcourse.可以去我的办公室谈Wecantalkinmyoffice.我们晚点见Wellseeyoulater.星期五的医学执行委员会会议上见llseeyouattheExecMedCommitteemeetingFriday.除非我能躲过那场会OnlyifIcan,tgetoutofit.
22、你放在多士炉旁边忘了拿Youforgotitbythetoaster.不是吧Stop.我得停止把我的东西忘在你家Ivegottostopleavingmythings.嘿，我不介意Hey,Idontmind.这样我就有借口在白天的时候来看你Givesmeanexcusetocomeseeyouduringtheday.丹不知道我们的事吧？Dandoesntknowaboutus,huh?丹尼斯Dennis.我知道Iknow,Iknow,Iknow.我们暂且先不要公开Werenottellingfolksforthetimebeing.你有跟谁说吗？Haveyoutoldanyone?没有No.
23、我很困惑mconfused.我是说，如果大家知道了会很糟吗？Imean,woulditbetheworstthing?Ifpeopleknew?不No,no.当然不是Ofcoursenot.只是你你是部门的主任It,sjustthat,yourethe.yourethechiefofadepartment.而我是医院领导阶层的一员Andmamemberofhospitalleadership.但又没有禁止我们交往It,snotprohibited.莎伦，同僚随时都在约会Sharon,colleaguesdateallthetime.又不是什么大事Itsnotabigdeal.是啊，但对我来说是
24、大事Yeah,butitistome.我一直都谨守这个严厉的政策vealwayshadthisstrictpolicy不要把我的工作和感情混为一谈ofnotmixingmyworklifewithmyromanticlife,直到现在untilnow.如果你可以破例的话，我会很感激，相信我AndIappreciateyoumakinganexception,believeme.但不急Theresnorush.我们可以慢慢融合两个世界Welltakeourtimeintegratingbothworlds.此外，偷偷摸摸也满好玩的Besides,itskindafunsneakingaround
25、.有空吗？Gotaminute?我需要手术会诊Ineedasurgicalconsult.嗯Uh.病人姓名是云斯冈萨雷斯PatientsnameisVinceGonzalez.他有转移性腹部肉瘤He,sgotmetastaticabdominalsarcoma.因呕吐而被送来急症室Presentedtothe,E.D.withnausea,腹部胀气，严重腹痛abdominaldistentionandseverebellypain.这位可怜的先生什么食物都留不住,Poorguycantkeepanythingdown.好，他有任何阻塞或穿孔吗？游离液体？Okay,doeshehaveanobs
26、tructionorperforation?Freefluid?电脑断层扫描看起来没有Noton,C.T.,r但是肿瘤严重压♥迫♥他的胃Butthetumorisseverelycompressinghisstomach.所以才会吐Hencethenausea.好，但我不懂你为什么需要手术会诊？Yeah,mnotseeingwhyyouneedasurgicalconsult?我是说，如果是转移性肿瘤Imean,ifthetumorismetastatic,一定是无法手术了itmusthavebeeninoperative.正确Correct如果他没有完全阻塞，那你
27、需要我做什么？Andifhe,snotcompletelyobstructed,whatdoyouneedmefor?这个嘛，如果你可以稍微缩小这里的肿瘤的体积Well,ifyoudebulkedaportionofthetumorhere,那就能让食物通过小肠thenitwouldallowfoodtopassintothesmallintestine.喂食管也可以通过Sowouldafeedingtube.他不想要装喂食管Hedoesntwantafeedingtube.手术可以让他拥有更好的生活素质Surgerywouldaffordhimamuchbetterqualityoflife
28、.或者可能剥夺他所剩无几的时间Oritcouldcosthimwhatevertimehehasleft.我的意思是，我们讨论的是一个Imean,weretalkingaboutapatient接受多次化学治疗的病人whounderwentmultipleroundsofchemo.我想是这样，对吧？msure,right?但是没有任何并发症Withzerocomplications.他的身体健康得不得了，除了有癌症以外Hesremarkablyfitandhealthydespitethecancer.我知道这不是很迷人的手术Iknowthisisntexactlyasexysurgery.
29、你说什么？迷人的手术？Oh,begyourpardon?Sexysurgery?我很清楚外科医生不喜欢参与安宁缓和医疗Iknowsurgeonsdon,tliketogetinvolvedinpalliativecare.这个嘛，这有点太以偏概全了Well,that,squitethegeneralizationthere.好吧，让我看看Allright,let,shavealook.把病历传给我Sendmethechart.不要逞强，好吗？Dontbebrave,okay?如果我按了会痛就跟我说TellmeifithurtswhenIpush.我还好malright.好哦Okay.你的电脑断
30、层扫描看起来没有阻塞YourC.T.didntshowanobstruction,但我只是想确认butjustwantedtoconfirm.-马素医生？-是-So,DoctorMarcel?-Yeah.嗯，是这样的Uh,heresthething.我先生和我原本要在三周后飞去意大利MyhusbandandIaresupposedtoflytoItalyinthreeweeks.我祖母是波斯塔诺人MygrandmotherwasfromPositano.我一直很想去，我们就想择日不如撞Rvealwayswantedtogoandwefigurednotimelikethepresent.请教你
31、，你的日常活动还好吗，云斯？Youknow,howareyoudoingwithdailyactivities,Vince?像是更衣、做家务、开车？Thingslikedressing,housework,driving?在我开始吐出我的晚餐前吗？BeforeIstartedvomitingmysupper?我一切活动都正常Iwastotallyfunctional.我可以证明Icanattesttothat.大多时候，云斯的精神比我还好Mostdays,Vincehasmoreenergythanme.你曾经出现手术的并发症吗？Youeverhadacomplicationfromsurge
32、ry?手术后的后遗症？麻醉造成并发症？Post-operativeissues?Issueswithanesthesia?没有No.我25岁的时候割过阑尾IhadmyappendixoutwhenIwastwenty-five.但我当时没有出现任何问题But.but1didnthaveanyproblems.很好Good.真替你开心Gladtohearit.因为现在有一项手术Becausethereisasurgicaloption可以让你的肠胃系统再次恢复正常thatcouldgetyourG.I.systemworkingagain.我喜欢这个主意Ilikethesoundofthat.你
33、何不介绍一下呢，亚曼医生？Whydontyoupresentit,DoctorAhmad?既然是你的建议Sinceitwasyoursuggestion.好哦Okay.早安Morning.你昨晚还好吗？Yournightturnoutalright?结果算是非常不错的第一次约会Itactuallyendedupbeingaprettygoodfirstdate.是吗？Oh,yeah?对啊Yeah.里普利医生DoctorRipley.我们在六号♥治疗室有疑似手腕骨折的伤患WehaveapotentialwristfractureinTreatmentSix.你愿意去检杳吗？我才刚结
34、束一例病人Youmindstartingthework-up?mjustfinishingupwithapatient.幸好我满欣赏你的YoureluckyIlikeyou.暂时是这样Fornow.-谢谢，玛姬-不客气-Thankyou,Maggie.-Uh-huh.好的Okay.好的，摩尔太太So,MissesMoore,据我了解，你下车时跌倒了，对吗？Iunderstandthatyoufellgettingoutofyourcar?你介意我检查一下吗？MindifItakealook?我只是想确认有没有肿起来Ijustwanttocheckifit,sswollen.我会很小心llbeg
35、entle.彭，让她看一下吧Pam,letherlook.我的手腕没事Mywristisfine.我没有跌倒Ididntfall.什么？What?怎么回事？1dontunderstand.抱歉，亲爱的，我别无选择msorry,honey.Ididnthaveanyotherchoice.你在说什么？Whatareyoutalkingabout?我先生很抑郁，拒绝接受任何协助Myhusbandisdepressedandrefusestogetanyhelp.彭美拉Pamela!我很怕他会伤害自己AndIamsoafraidhesgonnahurthimself.听着，我很感谢你们必须尽职调查1
36、.ook,Iappreciateyouhavetodoyourduediligence.我太太提到我有自我伤害的可能性Mywifementionedthepossibilityofself-harm,所以你不能直接让我回家soyoucantjustsendmeonmyway.是啊，她跟洛活护士提到你说的话Yeah,shementionedtoNurseLockwoodacommentyoumade.是，我说了一些蠢话，像是“一觉不醒Right,Isaidsomethingstupidlikegoingtobed似乎是个辞世的好方法”andneverwakingupsoundslikeanice
37、waytogo.这样啊Huh.别这样，这只是一种普遍的说法Comeon,Iwasspeakinggenerally.我想这是个辞世的好方法，相较于被巴士撞死之类的Anicewaytogoasopposedto,Idontknow,gettinghitbyabus.好，看起来你瘦了一点？Okay,um,apparentlyyouhavebeenlosingsomeweight?我不久前才被确诊有第二型糖尿病Iwasdiagnosedwithtypetwodiabetesnotlongago.我一直对我的饮食很谨慎，规律运动vebeenprettydiligentaboutmydiet,getti
38、ngregularexercise.坦白说，我很庆幸努力付出有获得回报Frankly,mgladthehardworkspayingoff.那么保罗，描我个忙Wellthen,PaULhelpmeout.我是说.你觉得你太太为什么担心你？1mean,!.whydoyouthinkthatyourwifessoconcernedaboutyou?我得承认，我最近心情不太好1Iadmit,Ihaventbeeninthebestmoodlately.我大概比较易怒吧Myfuseisprobablyshorter.是啊Yeah.我是说，她她很担心，你变得孤僻Imean,she,s.she,sconc
39、ernedthatyouknow,youvebeenisolating.疏远她、你的朋友Withdrawingfromher,yourfriends.我最近不太想跟人来往Ihaventfeltlikesocializinglately.那你最后一次.Sowhenwasthelasttimeyouhad.我帮你省点时间，好吗？1.etmesaveyousometime,okay?我没有任何意图或欲望伤害我自己Ihavenointentionordesiretohurtmyself.听你这久说我很高兴Andmgladtohearit.所以，为了保护医院，你需要问我什么就问吧So,askmewhat
40、everquestionsyouneedtocoverthehospitalsa*.我没有自杀倾向，查理斯医生Iamnotsuicidal,DoctorCharles.彭只是无中生有罢rPamisjustmakingsomethingoutofnothing.这是她的专长Herspecialty.云斯不到一小时就要手术了WithinanhourofpostingVincessurgery,他的保险公♥司♥却拒绝这项手术hisinsurancecompanydeniedit!他们拒绝的理由是这项手术并非“医疗上必要的”Rejecteditonthegroundsofi
41、tnotbeingmedicallynecessary.还有其他替代的治疗选项Therearealternativetreatmentoptions.也就是云斯不想要的喂食管ThefeedingtubeVincedoesntwant.没错Yep.天啊，我真是受够了事先授权Man,Iamsofed-upwithprior-authorization.每个月有十儿次我的病人都被这个政策刁难Boutadozentimesamonthmypatientsgetscrewedbyit.云斯是用哪一间保险？WhatinsurancedoesVincehave?伯宁格医疗网BerningerHealthNe
42、twork.是啊，我就知道Yeah,ofcourse.最糟糕的一间保险Oneoftheworst.他们拒绝的案例比其他公&hearts词♥都多Theydenymorepatientsthananyothercompany.他们付给医生检阅者六位数的报酬Payphysicianreviewerssixfigures要他们审查病历，找理由拒绝给付tolookatchartsandfindreasonstodeny.我想我们应该在他收到保险公♥司♥的正式邮件之前先告诉他GuessWeshouldtellhimbeforehegetsaformemailfro
43、mhisinsurance.是啊Yeah.判决结果怎么样？Sowhat,stheverdict?他太太是对的吗？Ishiswifeisright?他对自己有危险？Thathesadangertohimself?这个嘛，我还不清楚Youknow,Idontknow,yet.我是说，他坚信他没有危险，对吧？Imean,hesadamantthathesnot,right?但是大约50%有自杀意念的人都会否认Butaboutfiftypercentofthepeoplewithsuicidalideationdenyit.我比较担心的是她太太的顾虑，你懂我的意思吗？mmoreconcernedbyh
44、iswifesconcern,ifthatmakessense?毕竟她处心积虑利用诡计Imean,shepulledoffaprettyelaborateruse只为了把他拖进我们医院togethimthroughourdoors.没错Exactly.所以你打算怎么做？Sowhatsthegameplan?我想再跟她深谈Iwanttotalktohersomemore.好吗？我也想再更仔细回顾Allright,Ialsowanttojustlookathismedicalhistory他的医疗史alittlemorecarefully.或者看看他是不是有门路Youknow,findoutwhat.whatkindofaccess,如果有的话，可以让他取得枪♥械♥ifany
