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1、那个男孩今天差点就死了Thatboyalmostdiedtoday.我认为医院应该停用伊索麦朵IthinkthehospitalshouldpullExsomadex.我们这里不是这样处理事情的lt,snothowthingsworkhere.这个议题的意义不只是一个病人Thisisbiggerthanjustonepatient.我很佩服你扭转了你的人生Iamimpressedwithhowyouturnedyourlifearound.名列第一的?也许是少年监狱?Topofthelist,maybeCountyJuvenile?毕竟你得克服很多难关Youhadalottoovercome.
2、你会忘东忘西,伯特Youreforgettingthings,Bert.我们先跟神经科医生约诊1.etsmakeanappointmentwithaneurologist.你们两个编造出这个谬论,你们就能得到我的钱Thetwoofyouarecookingupthisnonsensesoyoucangetmymoney.我会接受检查,免得免得你再来烦我llgettested,justtogetyouoffmyback.太好了Oh,good.你来了Youmadeit.你在暗中监视我吗?Areyouspyingonme?你在我工作的地方有约诊Youhaveanappointmentatmyplac
3、eofemployment.我只是想把事情排开陪着你Ithoughtdmakemyselfavailabletoyou.听着1.ook.你如果会紧张我也可以理解.Iunderstandifyourenervous.我不紧张,我跟你说过我没事,莎伦mnotnervous,Itoldyoumfine,Sharon.我不需要该死的保母看着我做每件事1dontneedadamnbabysitterwatchingmyeverymove.这样吧,如果你那么排斥,那我就不管你了Youknowwhat,ifyoufeelthatstronglyaboutit,llbackoff.但要让孩子知道医生怎么说Ju
4、stletyourchildrenknowwhatthedoctorsays.-谢谢-请享用-Thanks.-Enjoy.嘿,我想要来个Hey,uh,lldoa.早安Goodmorning.嘿,早安Hey,goodmorning.你要喝点什么吗?Getyouanything?哦,不用,我在家就泡好咖啡了Oh,no,Imakemycoffeeathome.我对我的咖啡比较要求mbougieaboutmycoffee.是这样吗?Oh,isthatso?麻烦给我一杯中杯手冲黑咖啡Uh,lldoamediumdripblack,please.1射谢Thankyou.我显然不太要求mdecidedlyu
5、n-bougie.不,我听说你把你的好品味,留给奇怪的鸡尾酒No,Ihearyoureserveyour.yourrefinedtasteforweirdcocktails.你是指我的萨泽拉克?YoureferringtomySazerac?你去纽奥良讲这种话试试看GotoNewOrleansandsaythat.钱给你Thereyougo.零钱不用找了,谢谢Keepthechange.Thankyou.你错rYouweresaying?亚曼医生DoctorAhmad.马素医生DoctorMarcel.我有一些消息,你们听了一定会很开心Ihavesomenewsmsureyoullbeglad
6、tohear.医院决定暂停使用Thehospitalhasputatemporaryhold伊索麦朵,等到ontheuseOfExsomadexpending完成全面性的安全查核athoroughsafetyreview.太棒了Thatsamazing.我还以为IthoughttheDrug药物与处方集委员会不打算采取行动andFormularyCommitteewerentgonnatakeaction.他们本来没有Theywerent.但是有一位董事会成员极力要求,埃弗雷特占土Butattheurgingofoneofourboardmembers,EverettJames,委员会决定推&
7、hearts;翻♥他们的决定theCommitteedecidedtoreversetheirdecision直到食品药物管理局厘清问题untiltheF.D.A.sortsitout.太好了Great.-好的-谢谢你,葛云女士-Allright.-Thankyou,MissGoodwin.不客气Yourewelcome.看看你1.ookatyou.我一直以为组织惯性Ialwaysthoughtinstitutionalinertia代表我们败局已定,但我们成功了meantweweredeadinthewaterbutwedidit.是你成功了Youdidit.恭喜Congrat
8、ulations.听我数,三、二、一Onmycount,three,two,one.卢卡斯,别担心Hey,Lucas.Wevegotyou.我需要照X光,单一枪伤?Ineedanx-ray!SingleG.S.W.?就我目前所知是这样AsfarasIcouldtell.我在背后没看到任何伤口1didntseeanythinginthesack.但是血止不住Butcouldntstopthebleeding.血压一直往下掉,心率110B.P.,sfalling.Ratesone-ten.输注-单位的0型阴性血Hangaunitof0-neg.米高,胸腔X光Mike,chestx-ray.好Yep
9、.好,听我数,我们两个交换,三、二、一Okay,onmycount,let,sswapplaces,three,two,one.对,是锁骨下动脉Yeahthat,sthesubclavianartery.谢谢你,高尼,这里交给我们吧Thanks,Courtney.Wegotthis.远离Clear!没错,子弹F在锁骨后面Yeah,bulletsretainedbehindtheclavicle.我我没办法呼吸I.Ican,tbreathe.好,你尽量保持清醒Okay,juststaywithus.我们得想办法止血Wegottagetthisbleedundercontrol.用止血钳吗?Cla
10、mp?没办法找到适合的角度夹上去Wontbeabletogetanangleonit.给我一条导尿管Getmeafoleycath.-用来处理枪伤?-快点-Foragunshot?-Comeon.我会插入导尿管拦住血流llinsertthefoleytocapturethebleed,把气囊充气andwhenweinflatetheballoon就能拖延时间itlltemporize.帮我们争取一点时间Buyussometime.好Yeah.血压还是偏低但稳定B.P.sstilllowbutstable.呼叫创伤科,请他们开一间手术室,我们走吧Pagetrauma.Havethemopenan
11、0.R.Letsgo.要来点提神饮料吗?1.ittlepickmeup?不用,我已经有一杯了,谢谢Oh,no,Ialreadyhaveone.Thankyou.是预防性准备Itsprophylactic.我想你需要第二轮Figuredyoudneedasecondround毕竟你又在值班室过夜了afterspendinganothernightintheon-callroom.你怎么知道我睡在那里?How,dyouknowIslepthere?你在梳刚起床的一头乱发Yourebrushingyourbedhair.你还好吗?Areyouokay?自从离婚之后Youvebeenspendinga
12、lotoftimeintheE.D.你待在急症室的时间很长sincethedivorce.因为家里再也不像家了Becausethehousedoesntfeellikehomeanymore,我觉得自己在那里好似陌生人andIfeellikeastrangerthere.玛姬Maggie.我需要助手Ineedanassist.好,马上来Yep,rightbehindyou.谢谢你的咖啡Thanksforthecoffee.不客气Yeah.你好,我是艾卓亚医生Hello,mDoctorArcher.这位是洛活护士ThisisNurseLockwood.你们早安Morning,morning.听说
13、你的回肠造口有点问题?Ihearyourehavingsometroublewithyourileostomy?我是黛,这是我儿子,加列Deb.It,smyson,Caleb.医生你好-你好-Hey,doc.-Hi.我敢说是脱垂了Prettysureitsaprolapse.又一次Again.可以让我看一下吗?Huh?Youmind?抱歉,我知道很恶心Sorryknowitsnasty.不用担心,我们没那么脆弱Dontworry.Werenotsqueamishhere.没错Yeah.绝对是脱垂了Yeah,it,sdefinitelyprolapsed.你说这以前发生过?Yousaythish
14、ashappenedbefore?卷次他偷溜出门打篮球的时候Everytimehesneaksofftoplaybasketball.你在冬天的时候带我来芝加哥YoutookmetoChicagointhewinter.不然你希望我怎么打发时间?Whatelsedoyouexpectmetodoforfun?不要跑出门还伤害自己Notrunoffandhurtyourself.我们是从奥克兰来玩的WerevisitingfromOakland.现在发炎太严重,没办法处理Well,itsstilltooinflamedtomanipulaterightnow,但是我们可以缓解肿胀,洒一些but,
15、uh.wecanreducetheswellingwithsome.糖Sugar.我想就是这样处理Ifiguredthatwasthecase.是啊,现代医学的奇迹Yeah,miraclesofmodernmedicine.我还想安排一些实验室检直Ialsowannaordersomelabs?全套血液检查、基本代谢指数,和腹部电脑断层扫描A,C.B.C,andanabdominal,C.T,.没问题,医生Yougotit,doc.我可以问吗?这里还看到另一道疤痕CanIask,Iseesomeotherscarshere,allright?有些是手术疤痕,但其他的Somearesurgica
16、lbuttheothers.加列秋天的时候被开了两枪Calebwasshottwotimesinthefall.天啊Oh,myGod.我家那里常发生入室抢劫1.ottacarbreak-inswheremfrom.有一次演变成枪战,我被流弹波及OneturnedintoashootoutandIcaughtacoupleofstrays.我很遗憾Sorrytohearthat.但你看起来恢复得还不错Youseemtobedoingwell.他是坚强的孩子Hesatoughkid.在球场上也很强Toughonthecourt,too.在我装上回肠造口之前,是加利福尼亚最强的后卫Oneoftheb
17、estguardsinCaliforniabeforethis.等你接受造口关闭术之后Wellafterthereversalprocedure,你马上就能回到球场上了youllbebackonthecourtinnotime.不重要了Wontmatter.我们的小儿外科医生,戴维斯医生DoctorDavis,ourpediatricsurgeonbackhome,说加列还要再等十个月saidCalebhastowaitanothertenmonths.到时候夏天就结束了,大学球探也离开了Bythenthesummer,sgoneandsoareallthecollegescouts.我们先处
18、理好眼前的问题,好吗,亲爱的?Whydontwefocusongettingthroughthisfornow,okayhon?你愿意让我们联♥系♥,你们的外科医生吗?Dowehaveyourpermissiontocontactyoursurgeon?取得加列的病历记录?TogetCalebsmedicalrecords?当然可以Ofcourse.-好的-与此同时,先别乱跑-Okay.-Well,inthemeantime,sittight.我们去安排一些检直Weregonnagetthesetestsgoing我很快就回来看你andthenllbebacktoc
19、heckonyoushortly.谢谢Thankyou.沙利文先生,医生很快就过来看诊MisterSullivan.adoctorwillbewithyousoon.我们只是需要你先躺卜.♥床♥Wejustneedyoutogetinthebed.好,只是你们两个至少退后六尺Fine!Just.justbothofyougivemesixfeet!好哦Okay.好的,先生Okay,sir.好Okay.我会给你空间,没问题mgivingyouspace.It,sfine.早安,安妮塔Morning,Anita.这公早就这公失控?Earlystarttothemadne
20、ss?有人报案说有酒吧斗殴Gotacallaboutabarfight.到现场接到这位万人迷,罗伯特沙利文Pickedupthischarmer,RobertSullivan.我不想量生命体征1dontwantanyvitals.我什么都不想量,我不想要量血压Idontwantanything.IdontwantanyP.P.他还在酒醉,不愿意安静下来Hesstillintoxicatedandwouldntsettledown,所以我跟他说,要么送医包扎他的伤口soItoldhimitseitherthehospital不然就是去酒鬼监禁室forhisinjuriesorthedrunkta
21、nk.-算他聪明-是啊-Well,noidiot.-Yeah.而且他很坚持要送他来芝加哥医院AndhewasadamantaboutbeingbroughttoMed.说他认识这里的医生Saidheknowsadoctorhere.他有说是谁吗?Hesaywhichone?他一直说“里普”HekeptaskingforRip.“里普,?ForRip?-我只是要量你的脉搏-我不想量什么心跳-Ijustneedtotakeyourpulse.-IdontwantanyB.P.Ms.一下子就好我什么都不要-Ijustwantasec.-Iwantnothing.嘿,沙利文先生,你还好吗?Hey,Mi
22、sterSullivan,howyoudoing?你又是哪位?Whothehellareyou?我是查理斯医生mDoctorCharles.南茜只是想要量你的生命体征Youknow,Nancysjusttryingtogetyourvitals,确保你没事,只要两秒钟就好makesureyoureokay,taketwoseconds.不用,我好得很No,malreadygood.我好极了Ifeelgood.里普在哪里?我要找里普Where,sRip?1wannatalktoRip.你是说里普利医生吗?DoyoumeanDoctorRipley?去找他来就对了Justgethim.南茜,我们先
23、让沙利文先生静一静Nancy,lets,uh,giveMisterSullivanalittlespace.去呼叫里普利医生AndpageDoctorRipley.好Okay.谢谢Thankyou.创伤科来电Hey,traumacalled.锁骨下修复很顺利Subclavianrepairwentsmoothly.病人一切平安Patientsdoingwell.好,谢啦,翠妮Good.Thanks,Trini.嘿,你呼叫我Hey,1gotyourpage.什么事?Whafsup?你认识五号♥治疗室这位先生吗?Oh,areyou,uh.areyoufamiliarwiththisg
24、entlemaninfive,here?嗯什么名字去了Misteuh.沙利文先生?罗伯特沙利文?MisterSullivan?RobertSullivan?认识Yeah.这位先生太超过了Gentlemanispushingit.怎么了?-扯入酒吧斗殴被揍了-顿-Whathappened?-Gotbangedupinabarfight.坚持要送来芝加哥医院,因为你InsistedonbeingbroughttoMedbecauseofyou.不让任何人治疗他Wontletanybodyelsetreathim.我不要No.至少让我量你的体温Attheveryleast,Ineedyourtemp
25、erature.不要No.好极了Great是啊Yeah.他一直要我们找“里普”HekeepsonaskingforRip.是啊Yeah.对沙利跟我以前常常Uh,SullyandI,usedto,uh,一起在街上鬼混,在我离开芝加哥之前runthestreetstogetherbeforeIleftChicago.是吗?Oh,yeah?你诊治你的老朋友没问题吧?You.youokaytreatinganoldbuddy?我可以请别人来Icanfindsomebodyelse.我们没那么熟,应该不会有什么问题Werenotthatclosesoitshouldntbeaproblem.谢啦Than
26、ks.好Okay.我不想跟你对话了Idontwannahavethisconversationwithyou.先生,你不能离开Sir,yourenotgoinganywhere.嘿,终于出现啦Hey!Thereheis!好的,不要那么大声,沙利Allright,let,skeepitdown,Sully.就跟你说我认识他吧ItoldyouIknewhim.我来就好,谢谢Igotthis.Thankyou.感谢老天ThankGod.终于可以放松一下了Canfinallyrelax.你想都别想Donteventhinkaboutit.天啊,警♥察♥可能也会把我丢进监牢J
27、eez,copmightaswellhavedroppedmeoffatjail.如果你-直这样闹,那就还是有可能发生Stillanoptionifyoukeepactingthisway.跑来这里为难每个人Showinguphere,givingeverybodyahardtime.大清早在酒吧斗殴?搞什么鬼,沙利?Andabarfightatthecrackofdawn?Whatthehell,Sully?嘿,有人在说我的公牛队的坏话Hey,someguysweretalkingdownonmyBulls,我回嘴了,他们却开不起玩笑,所以我们就去外面解决andIretortedandthe
28、ycouldnttakeajoke,sowehandleditoutside.是哦,看起来是他们解决了你Yeah,looksliketheyhandledyou.他们还伤到你哪里?Whereelsedidtheygetya,?被喑算了几拳Couplecheapbodyshots.更不用提你的下巴Nottomentionyourjaw.但我还是很帅mstillasexsymbol,though.对方就比我惨多了Cantsaythesameforhimandhisboy.他们承受了我的铁拳Theywereonthereceivingendofthis.看起来像是我们惯称的拳击手骨折1.ooksli
29、kewhatwecallaboxersfracture.听起来是好消息Hm,likethesoundofthat.不得不说,你终于学会用你的手,真让我刮目相看Gottasay,mimpressedyoufinallylearnedhowtouseyourhands.以前就应该好好用你的手Couldveusedthembackintheday免得我还要忙着救你,以防你被揍扁whileIwasbusysavingyoufromgettingyoura*kicked.还会说笑话嘛Stillgotjokes.看你这样穿着高级的白袍,顶着美男发型Fancywhitecoatandaprettyboyha
30、ircut,但至少你的幽默感还在butatleastyoukeptyoursenseofhumor.有点呼吸短促吗?Alittleshortofbreaththere?只是咳嗽而已,应该是放假的时候感冒了JustalittlecoughIpickedupovertheholidays.让我听听看1.etmetakealisten.深呼吸Deepbreath.好的,保险起见,我要安排血液检验和X光Allright,mgonnaorderbloodworkandax-raytobesafe.我只是想检查我的手,现在你却要推销我更多?Oh,Ijustwantedmyhandlookedatbutno
31、wyouretryingtoupsellme?穿上病人袍,不要乱跑Justputthegownonandstayput.马上有人会进来帮你照胸腔和手的X光Someonellbebysoontoimageyourchestandhand.还有不要为难人家And,urn,dontgivethemahardtime.喉咙看起来还好Throatdoesn,tlookthatbad.你已经这样多久了,阿德瑞娜?Howlonghaveyoubeenfeelingthisway,Adriana?几个礼拜了吧?说不准Afewweeks?Hardtosay.我一直在旅行,所以时间感有点混乱Beentraveli
32、ngalotsomysenseoftimeisouttawhack.去了哪些好玩的地方吗?Anywherefun?中西部酒店大会巡回赛壮游GrandtouroftheMidwestshotelconventioncircuit.我办了一场桌游展Iorganizetabletopandboardgamecons.总之,我还以为这只是又一次展览咳Anyway,Ithoughtthiswasjustanothercon-cough.就是在满是玩家的宴会厅里Youknow,somethingyoupickup会被传染的病,可是whenyourestuffedinaballroomfullofgamer
33、sbut.可以呼吸一下吗?Canyoubreatheforme?那样会痛Thathurt.你的肺听起来的确有点罗音Yourlungsdosoundalittlejunky.意思是里面有很多痰Justmeansthatthere,salotofphlegm.有可能是流感、冠状病毒病或肺炎造成Couldbefromflu,Covidorapneumonia我们要先做一些检查确认才能知道病因butwewontknowuntilwerunafewteststobesure.我才刚打过疫苗,但肺炎?天啊Ijustgotmyshots,butpneumonia?Wow.交给我们吧Welltakegoodc
34、areofyou.先从胸腔X光开始1.etsstartwitha,uh,chestx-ray,全套血液检查、基本代谢指数,拭子检验冠状病毒病、流感和链球菌C.B.C.,B.M.P.fswabsforCovid,fluandstrep,安排胸腔和颈部电脑断层扫描andputinaC.T.forchestandneck.-好哦-我很快就回来-Okay.-llbebacktocheckonyousoon.嘿,我只是想再确认,关于电脑断层扫描的医嘱Hey,Um,IjustwantedtodoublecheckonthoseCATscans.我们不用先等胸腔X光的结果吗?Shouldntwewaitfo
35、rthechestx-rayfirst?这样似乎有点躁进Itseemsaggressive.老实说,我不确定这会否只是感染Honestly,mnotevensurethatthisisjustaninfection.但是检查结果出来的时候还是呼叫我吧Butpagemewhenthosetestsareback.好,没问题Yeah,yougotit.洒一点糖Thereyougo.你真的很擅长这个Yourearealproatthis.我也没想过我会擅长这个,但谢啦It,snotaskillIplannedonmasteringbut,thanks.加列,黛Caleb.Deb.好消息,你的实验室检
36、验报告都正常Goodnews.Yourlabscamebacknormal.真是太好了,宝贝Oh,thatsgreat,hon.看起来你的脱垂Well,itlookslikeyourprolapse消肿的速度并没有如我们所愿hasntreducedasquicklyaswedlike.也许是因为持续充血的关系It,sprobablybecauseOfpersistentcongestion.根据我看到的状况,还有加列最新的电脑断层扫描So,basedonwhatmseeinghereandCalebslatestC.T.我想接着进行造口关闭术会比较好Ithinkitwouldbebetteri
37、fwewentaheadwithyourreversalsurgery.你说什么?等等,什么意思?-Excuseme?-Waitwhat?说实话,我建议越快进行越好Truthfully,myrecommendationwouldbetodothisassoonaspossible.你的意思是我可以摆脱这东西?就在今天?YouretellingmeIcangetridofthisthing?Like,today?我应该可以帮你安排在几个小时后手术Ishouldbeabletogetyouonthescheduleinafewhours.没错Yeah.动手术吧1.etsgo!妈,我们可以打电&he
38、arts;话♥给马克教练Mom,wecancallCoachMark.跟他说我今年夏天可以在战士队打球TellhimmrunningwiththeSoldiersthisSummer.这是好消息Thisisgoodnews.方便借一步说话吗?CanIspeakwithyouforamoment?我不明白Idontunderstand.你你不能在病房♥把脱垂复位吗?You.youcantreducetheprolapsebedside?这个嘛,我应该可以Well,Iprobablycan,但我想这时候,长♥期♥来看,手术应该是更好的解决方法
39、butIthinksurgeryisthebetterlong-termsolutionatthispoint.加列已经手术完几个月,他的复原状况很好Calebisseveralmonthsoutandhisrecoveryisgoinggreat.他的检验报告显示他很健康,很强壮His,uh,labsindicatethathe,shealthy,hesstrong.恕我直言,戴维斯医生,从一开始就是他的医生Allduerespect,DoctorDavishasbeenwithussincedayone.但我们才认识你多久,两小时?Weveknownyouforwhat,twohours?
40、艾卓亚医生在这方面经历丰富DoctorArcherhasalotOfexperiencewiththis.我们的医生坚持要我们等Ourdoctorwasadamantwewait.再加上加列所有的手术ThatwithallofCaleb,ssurgeries,沾黏需要时间才能消退,我们才能关闭造口theadhesionsneededtimetobreakdownbeforewecoulddothereversal.那是很周全的计划Thatwasasolidplan.不过However,加列的脱垂复发Calebsrecurringprolapses会令他更有可能再次脱垂couldmakeitmo
41、relikelyforhimtoprolapseagain.有可能导致最后的修复更棘手Andpossiblymaketheeventualrepairmorechallenging.你们又不能确定Youdon,tknowforsure.我不会用我儿子的健康来交换Iwonttrademyson,shealthforthat.我知道你希望等到回家再处理1knowyouwannaholdoffuntilyougethome,但我很乐意跟你的小儿外科医生沟通butdbehappytospeakwithyourpediatricsurgeon.就像我说的1.ikeIsaid,戴维斯医生认为加列最好再等等
42、DoctorDavisbelievesCalebisbetteroffwaiting,所以除非他有不同看法,不然我都不想再讨论手术的事了sountilhesaysotherwise,mnotdiscussingsurgeryanyfurther.我可以请你帮我看个东西吗?CanIgetyoureyesonsomething?当然,Course.直接跳到电脑断层扫描啊?Skippedrightto,C.T.scans,huh?病人到院时出现典型的感染迹象Patientcameinwithclassicsignsofaninfection.但是又有呼吸短促和胸痛butwiththeshortnes
43、sofbreathandchestpain,我担心这是败血性肺栓塞Iwasafraidthatitwasasepticpulmonaryembolism.我知道这不太可能Knowthatsalongshot.不,完全正确,你看No,youwere,onthemoney.Look.绝对是一个小小的肺栓塞Definitelyasmall,P.E.你看这个颈部的电脑断层扫描Checkoutthisneck,C.T.我不确定自己看到什么mnotsureexactlywhatmlookingat.扁桃腺周围脓疡,浸润渗入颈静脉Peritonsiliarabscesswithinfiltrationint
44、othejugularvein.拭子检验结果是什么?Whatdtheswabcomebackas?链球菌Strep.这样啊Hm.这是雷米尔氏症,对吧?ThisisLemierre1SSyndrome,isn,tit?我只有在书上看过veonlyreadaboutit.颈部有感染的血块,没错Infectedbloodclotintheneck,yeah.非常罕见Veryrare.非常危险Verydangerous.这样很多问题都说得通了Explainsalot.感染是从喉咙开始Infectionstartsinthethroat,扩散到颈部,血块顺流向下spreadstothejugular,startsthrowingclotsdownstream.好,我们需要尽快,让你的病人接受抗凝血药Okay,we,uh.weneedtoanticoagulateyourpatientASAP.开始帮病人输注肝素Sogoaheadandstartheronaheparindrip,以防原有的