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1、马素医生，你以相当了不起的方式拯救了纳撒尼尔的性命Doctor Marcel, you saved Nathaniefs life in spectacular fashion. 现在社群上有三千万关注者Got thirty million social media followers等着听这个故事的后续waiting to hear how this story ends.准备好迎接这一切吧Get ready for what comes next.迎接什么？Whats that?名声Fame.这到底是怎么回事？What the hell is going on?韦和云妮莎从毒贩那里买&he
2、arts;♥ 了药Will and Vanessa bought meds off a drug dealer.事情这下更复杂了Its a little more complicated than that.你想拿自己的职业冒险吗？You want to risk your own career?随便你Thats fine.别拿云妮莎的来冒险Dont risk Vanessas.艾普尔？April?你回芝加哥了吗？Are you back in Chicago?是啊，你没有结婚吗？Yeah. You didnt get married or anything, did you?没
3、有No.好，我们有空再见Well, I will see you around.（艾普尔）（我有工作，但还是得陪你喝杯咖啡等不及今晚见到你了） 你真的要求积把你的肩膀弄脱臼吗？Did you really Jack to dislocate your shoulder?当时我没有太多选择，是的Uh, didn*t have much of a choice, really.让我们来看看Lets see.什么？怎么了？What? What is it?很抱歉，这是异位妊娠Im very sorry, but it*s an ectopic pregnancy.胚胎已植入你的输卵管The embr
4、yo has implanted in your fallopian tube.这意味着什么？What does that mean?它不会回到子♥宫♥吗？Wont it move to the uterus?不No.不，甚至没有办法No, its not even viable.很不幸，你说对了Unfortunately, that*s correct.我们得在异位导致输卵管破裂前切除它We need to remove the ectopic before it can rupture the fallopian tube, 否则会危及凯特琳的性命which w
5、ould be fatal for Caitlin.好，所以我该怎么办？Okay. So, uh, what, uh.what do I have to do?好吧，我们有两种不同的选择Well, we have two different options.第一种是一种叫做甲氨蝶吟的化疗药物The first is a chemo drug called methotrexate.它阻止细胞快速分♥裂♥并结束妊娠It stops the cells from rapidly dividing and ends the pregnancy.胚胎最终会在体内重新吸收Th
6、e embryo ultimately reabsorbs back in the body它能成功解决and it successfully treats about百分之九十的异位妊娠ninety percent of ectopic pregnancies.要施打在哪里？And how do you give that?透过肌肉注射Its an intramuscular shot.通常是打在臀部或大腿Typically in the buttock or the thigh.还有其他选项吗？Whats are your other options?我们会进行手术以取出胚胎如果有必要的话
7、We would operate to remove the embryo, and if necessary, 会取出整个输卵管the entire fallopian tube.打♥针♥吧The shot.请不要动手术Please, no surgery.我们是书店的小店员，我们没有病假Were hourly workers at a bookstore. We dont get sick days. 我明白了I understand.我们只需要做一些额外的检验Well just have to do some additional labs再看结果如何，好吗？
8、and then wefll go from there, okay?先休息一下吧Try and get some rest.谢谢你Thank you.嘿Hey, hey, hey, hey, hey, hey.对不起Im sorry.不会有事的，好吗？Itll be okay, all right?看着我Look at me.彭妮露？Penelope?艾迪逊怎么样？他还好吗？Hows Edison? Is he okay?哦，他很好Oh, he*s fine.他就在隔壁He*s just next door.他需要母乳吗？我挤了一些Does he need breastmilk? I exp
9、ressed some.即使已经过了两个小时他醒来也不怎么喜欢吃饭Hes not always great about waking up to eat even if its been two hours.这样吧？我会我会转达给护士的You know what? IlL.Ill tell the nurses.我是查理斯医生Im Doctor Charles.精神科Psychiatry.也许我有产后抑郁症？Maybe I have postpartum depression?这个嘛，我不知道You know, I dont know.告诉我怎么了 ？你感觉如何？Tell me whats b
10、een going on? How you been feeling?嗯不像我自己Well, um.well, not like myself.好的Okay.我很容易哭泣I cry so easily,我的心情一团糟my moods are all over the place,而且我耳边响起了这样的声音And.and I have this ringing in my ears但我的妇产科医生说这是恢复过程的一部分but my H0.B. says its all part of the recovery process.但是-嗯-But. -Hm.但艾迪逊哭得那么大声But Edison
11、was crying so loudly,我太太累了，而且and I was so.so tired and.我知道这不是借口，但是its not an excuse, I know, but.我想了想，呃I thought about, uh.天啊God,我想过把他扔到墙上I thought about throwing him against the wall.嗯，这只是个念头，对吧？Okay. Hm, just a thought though, right?嗯Uh-huh.那么艾迪逊的爸爸有来帮忙吗？Has.has Edisons dad been around to help out
12、?其实他还没有准备好要孩子Turns out he wasnt ready for a kid.好吧，天哪，那一定很辛苦Well, gosh. I mean, thats gotta be so hard.面对这样一个改变人生的局面Facing a life-changing situation like this, 全都靠自己一个人？all.all by yourself?我妈妈第一周有跳出来帮我My mom came out for the first week, 但她必须回到俄亥俄州but she had to get back to Ohio.她离开后你们还好吗？Hows it bee
13、n since she left?嗯，很难熬Uh, hard.我的工作没有带薪产假Uh, my job doesnt have paid maternity leave, 所以我一直在家工作so Ive been working from home, you know, 每两个小时喂一次母乳时我还要忙着打电♥话♥ juggling phone calls while I breastfeed every two hours.而且没有休息时间And there are no breaks.而且无法消除脑袋里的声音And theres no time to like,
14、turn off.而他的哭声太尖锐太频繁了And his cry, like.like a screech Ititits too much.我我不行了I.I cant.我知道这是他唯一的交流方式I know its his only way to communicate但这让我咬牙切齿，我觉得我快失控了but it sets my teeth on edge and I feel like Im losing it, 所以我只是so I just.对不起Im sorry.你能不能告诉我什么Can you please just.just tell me what.你知道吗？You know
15、what?我们要我们要查明真&hearts湘♥,好吗?Were gonna.wefre gonna get to the bottom of this, okay? 我答应你I promise you.我们会的We will.好的，谢谢你Okay. Thank you.不，我来安排那个航♥班♥,我很好No, no. I will make that flight and Im fine.我的医生进来了，好吗？My doctor just walked in, okay?是的过几天见Yeah.See you in a few days.再见Goodbye
16、.很高兴见到你，萨米尔我也是-Its good to see you, Samir. -You, too.巴克里先生？Mister Baqri?我是泰勒医生是的，很抱歉-Im Doctor Taylor. -Yeah, so sorry about that.我总是有忙不完的工作My work never stops.呃，请叫我萨米尔Uh, and please, call me Samir.你遇到了什么状况呢？What seems to be the problem?嗯，嗜睡，肌痛很难确定Um, lethargy, myalgia, uh, its hard to pin down.嗯，你是
17、医生吗？Hm. Youre a physician?哦，不是Oh, no.但我和医生一起工作I work with them.萨米尔经营着咸沙社区健康基金会Samir runs the Hamsa Community Health Foundation.并在世界各地设立了诊所Sets up clinics all around the world.嗯，我收到了你的筹款电子邮件Huh, I get your fundraising emails.哦，希望不要太多Oh, hopefully not too many.我还没有退订I havent unsubscribed yet.好的，让我们看看O
18、kay, lets check this out.可以帮我开口吗？Open up?你知道，你在巴基斯坦的脊髓灰质炎疫苗接种计划You know, your polio vaccination program in Pakistan,太正了恩-incredible. -Huh.我在医学院对传染病学相当着迷I was obsessed with infectious disease in med school但他们总是把小儿麻痹症说成是过去式but they would always talk about polio in the past tense我想对我的教授大喊and I wanted t
19、o shout at my professors that.我们仍在与其抗争，是啊That were still fighting it. Right.你知道，原本几乎要根除了You know, almost had it beat.但是后来全世界放缓了脚步But then. Yes. the world took its foot off the gas,开始重新分配资金现在病情又卷土重来了started reallocating funding, and now its back and well, you know, 我们正在努力争取合作伙伴的支持we are struggling to
20、 get buy-in from our partners.只是呃对不起Its just, uh.uh, Im sorry.我还是别高谈阔论了吧I will step off of my soapbox now.不，不用道歉No, do not apologize.你正在做有意义的事Youre doing something.我也希望我能提供帮助I wish I knew how to help,这就是我进入医学界的原因its entire reason that I got into medicine.但反而But instead,我只是关掉新闻，然后吃奥利奥曲奇I just turn of
21、f the news and I eat a sleeve of Oreos.但至少现在我帮你，就是在帮更多人But you know what? At least now I can help the helper.是啊Right.那么，你有这种感觉多久了？So, how long have you felt this way?哦，几个星期？Oh, a couple of weeks?最近经常出差Ive been traveling for work a lot recently,呃，印尼、巴基斯坦、狮子山uh, Indonesia, Pakistan, Sierra Leone.我星期五去
22、了菲律宾，开设一家新诊所I leave for the Philippines on Friday, opening up a new clinic. 我去过的最奇特的地方是圣安东尼奥The most exotic place Ive ever been is San Antonio. 为了一场会议And that was for a conference.所以你对旅行没兴趣吗？So, no interest in travel?不，我很喜欢No, Id love to.但是看在我的学业和住院实习，所以But between school, and residency, it*s just.好
23、吧，让我告诉你，那并没有那么有趣Well, let me tell you. Its not always so glamorous.我整天盯着手♥机♥,吃花生酱Im glued to my phone and I survive off of peanut butter, 蛋白棒和咖啡过活protein bars and coffee.体温正常Temps normal.嗯，我没有看到任何明显的感染迹象Well, you know, Tm not seeing any obvious signs of infection 但是考虑到你的旅行历史呃 but given
24、 your travel history.uh, 我需要详细检杳你的血液I just want to cast a bit of a wide net with your blood work, 这样方便吗？ if thats okay?是的，只要能让我继续搭飞机就行Yeah, anything that gets me on a flight, Im good.呃，全血细胞计数Uh/CB.C二综合代谢检查，细菌和病毒培养物检查 bacterial and viral cultures,寄生虫卵以及痰检查0 and P and a sputum.马上来On it.我不明白I dont unde
25、rstand.你说大多数人都可以选择用药you said that most people can do the drug option.不幸的是，你的肝功能检验结果风险有点太高了Unfortunately, your liver function tests were a little too elevated, 所以你没办法做甲氨蝶吟疗法so you are not a candidate for methotrexate.有什么可以让我注射的吗？Is there something you can do so that I can get the shot?我不能做大手术I cant d
26、o a big surgery.否则我会失业几个星期Fil put me out of work for weeks.如果我们要完全剖开你的腹部，没错If we were to fully open up your abdomen, yes, 愈合会需要更长的时间the healing time would take a lot longer.幸运的是Fortunately,这是腹腔镜微创手术this procedure is laparoscopic, minimally invasive.代表我们可能今晚就能出院了Meaning we could likely send you home
27、tonight并让你在一两天后重返工作岗位and have you back at work in a day or two.好的，我想一两天应该可以Okay. I guess I can do a day or two.好的，我待会再来找你Okay. Ill see you soon.-谢谢谢谢-Thanks. -Thank you.嘿Hey.她还好吗？How*d it go?符合典型的产后症状A couple of red flags for postpartum,但我还不太敢确定but Fm not convinced yet.我是说，她提到了耳边I mean, you know, sh
28、e was talking about this ringing一直有声音响起she had in her ears.嗯，耳鸣可能是由多种原因引起的Well, tinnitus could be caused by multiple things.它可能是特发性的、源自药物治疗甲状腺功能减退或甲状腺功能亢进It could be idiopathic, medications, hypo or hyperthyroidism.我可以解决所有问题You know, I can work all of those up,但在此期间你想怎么做？but what do you want to do i
29、n the meantime?老实说吗？Honestly?我想让她和她孩子见面I want to see her with her kid.等等，查理斯医生Wait. Doctor Charles.你没有看到她刚入院的时候You didnt see her when she came in.她像是中邪了一样She was frantic.我们不能确定她会对他有什么反应We canrt be sure how shell react to him,尤其是在没有明确诊断的情况下especially without a definitive diagnosis.绝对会确保孩子的安全Absolutel
30、y gonna make sure the kid is safe.好吗？只是Okay? Its just that.我可以从他们的互动中了解到很多东西，对吧？I can learn so much from watching them interact, right?他们之间的联♥系♥How are they bonding.任何缺乏联♥系♥的异样Any warning signs of a lack of connection,如果又是发生在产后and if it is post-partum,就能帮助我衡量严重程度，对吧？it so
31、rt of helps me gauge the severity, you know?虽然我理解你的担忧While I understand your concerns,崔医生Doctor Choi,基于查理斯医生在场since Doctor Charles will be there,彭妮露有足够的能力在任何状况and Penelope had the wherewithal to ask for help发生之前寻求帮助before anything happened,我想我们可以这么做I think we should proceed.另外，我也想在场Also, Id like to
32、be present.好吧，嘿，谢谢All right. Hey, thank you.-嘿，艾卓亚-怎么了？-Hey, Archer. -Yeah?护士说腹腔镜工作站没有光纤电缆Nursing said theres no fiber optic cables for the laparoscopic tower.都去哪了 ？我必须做一个紧急异位手术Whered they all go? Ive got to do an urgent ectopic.我知道我们少了两个I know were down two.我简直不敢相信I couldnt believe it.我甚至没有犹豫Didnt
33、even hesitate.嗯，当时我的胳膊被卡住了Welt my arm was trapped uh, at the time.我觉得这是I felt it was the.继续治疗佩里先生的最佳方法the best way to continue treating Mister Perry.难怪人们称你为英雄No wonder people are calling you a hero.但你也会这么看待自己吗？But is that how you would characterize yourself?呃你知道他Uh. You know that he, um,事发几天后又紧急处理了
34、一起肺移植手术？“jerry jigged a lung transplant just days after the incident?是啊Yes.这个人有自信、有创意是医学界的未来之星Confident, creative future of medicine, this guy.这全是团队的努力It was a team effort.我敢说你可以继续和戴顿先生聊聊Look/mIm sure youd rather talk to Mister Dayton, here.该轮到我值班了And my shift is starting soon,所以so.马素医生展现了他的无私奉献精神Do
35、ctor Marcel exemplifies he kind of selfless dedication我们在加夫尼都因此感到光荣we here at Gaffney pride ourselves on.也因此吸引了大批资金And its what has attracted a new crop对本机构的慷慨投入of generous donations to this institution.那天马素医生的英勇事迹拯救了不止一个人的生命Doctor Marcefs heroics that day saved way more than just one life.这是非常无私的举动
36、又是供货的问题，不能直接开刀吗？Supply chain issues strike again. Cant you just open?不行，这明显违背了我病人的意愿No, its explicitly against my patients wishes.她需要腹腔镜She needs it to be laparoscopic.好吧Well.所以这两种选择都不理想So both options are bad.要嘛等一等Either wait it out,冒着它破裂并杀死她的风险running the risk it ruptures and kills her,或帮她转给其他医院or
37、 turf it to other hospital.或者你可以不用看屏幕Or you can go old school without video用老派方法，并盯着瞄准镜and just look straight down into the scope.这种手法现在已经失传了No ones learned how to do it that way since the Stone Age.这简直就像叫我们用一只手做手术Thats like performing surgery with one hand tied behind your back. 是啊，我够老了，好吗？Yeah, Im
38、 ancient enough. All right?我当年就是这样被训练的It*s how I was trained.好吧，这对我没有任何帮助Well, this doesnt do me any good.啊，你好，所以有什么好消息？Oh, hi. Hey, so, uh, whats the good news?我们没有看到任何感染迹象Were not seeing any signs of infection,虽然你有点贫血though you are slightly anemic.这可以解释你为什么嗜睡Which would explain your lethargy.太好了Ex
39、cellent.所以我想我服用一些铁补充剂就可以出院了吗？So I guess I can take a couple of iron supplements and be on my way? 我实际上还不太愿意让你出院Im actually not comfortable discharging you quite yet.-你刚才说我没有传染性-据我所知是这样没错-You just said Im not infectious. -Thafs true, as far as I can tell,但无法解释为什么你会缺乏铁but without a explanation for why
40、 youre deficient,我只想再做几个测试Id just like to run a couple more tests.听着，如果我没生病，那我真的得走了No, look, if Tm not sick, I really gotta get going.我还有一千通的企划电♥话♥得打更不用说Fve got like a thousand planning calls to make. And not mention,我想有些人比我更需要这张床I think theres people who need this bed more than I do,-
41、所以我萨米尔-so I. -Samir.你没事吧？You all right?是的，我没事Yeah. Tm fine.峨呃-我们回到床上吧-Pm, uh. -Lets get back on the bed.我没事Im fine.请把双腿放上来Both legs, please.泰勒医生Doctor Taylor.两条腿都有Its both legs.你知道你这样多久了吗？Do you know how long youve had this?我不知道，我我以为是徘子I dont know. I.I thought it was a heat rash.这不是贫血，是吗？This is not
42、 from the anemia, is it?我不知道I dont know.听着，有话直说吧我知道情况不妙的样子Look, dont nB.S. me, I know what bad news looks like.怎么回事？What is it?这些是瘀点，红血球细胞的分解These are petechiae, a breakdown of red blood cells.它通常与出血性疾病有关It*s usually associated with a bleeding disorder,但也可以是任何状况but could be any number of things.那么眼前
43、这是什么状况？So what are we looking at?我是说，这是自身免疫性疾病还是白血病吗？是什么？I mean is it an autoimmune disease, or Leukemia? What?直到我们做进一步的检查才会知道We dont know until we do further workup.玛姬，我需要狼疮检查自体免疫抗体♥检♥验和X光检查Um, Maggie, lets get a lupus panel, an HA.N.A.U and an x-ray.马上来On it.谢谢你Thank you.玛丽亚Maria.这位是
44、马素医生This is Doctor Marcel.抱歉让你久等了，彼斯高达小姐Apologies for the wait, Miss Piscotta.你没告诉我新闻里那个英俊的医生也来了You didnt tell me the handsome doctor from the news was coming.我看起来很狼狈I look a mess.别这么说，看来我见到了 一位王室成员啊Oh, please. Apparently, Im addressing royalty.霍士迪医生说你是意大利面女王Doctor Halstead tells me youre the, uh, q
45、ueen of pasta.唯一在美国能做出天选之面的女人Only woman in America who can make the Threads of God.哦Oh.这一切都是凭感觉Its all done by feel.这种事是讲天分的You have to have the touch.期待你出院后能去你店里坐坐Well, I look forward to stopping by once we get you patched up.所以你的血管造影显示肱动脉有损伤So your angiogram revealed an injury to the brachial artery.假性动脉瘤就像是A pseudoaneurysm like, um,从容器中推出的气球a balloon pushing out