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1、马素医生的无私奉献Doctor Marcel exemplifies the selfless dedication是我们加夫尼董事会引以为豪的典范we here at Gaffney pride ourselves on.这个男人充满自信又有创意他是医学界的未来Confident, creative, future of medicine, this guy.你有没有想过如果他们没有逼我们You ever wonder what it would have been like if they hadnt把云妮莎送给人领养会是怎样？made us put Vanessa up for adop
2、tion?我跟格兰说得很清楚And I made it very clear to Grant我没兴趣和他复合that I am not interested in reconnecting with him.你觉得有必要这样跟他说You felt the need to tell him that.我不想造成任何误会I didnt want there to be any confusion.萨米尔要我加入他的团队Samir offered me a spot on his team.到菲律宾？In the Philippines?这是我的使命This is my calling.都这么多年
3、了，15年Its been a while. Fifteen years.过了这么久如果你还有什么话想对我说的If you have anything that you want to say to me after all this time, 我愿意尽力好好听你说fd like to try my best to listen.不客气No problem.才怪，少来了No, come on. Come on.我刚不是跟你说了吗？Thats what Fm talking about.早安，伊芬Morning, Ethan.早安，汉娜Morning, Hannah.她是数学家，对吧？Math
4、ematician, right?对，流体力学是她的强项Yeah, top on her field, fluids and mechanics.事实上，她下个月要到奥斯陆领阿贝尔奖In fact, shers being awarded The Abel Prize in Oslo next month.哇Wow.萨夫，你能想到过去儿个月她的行为有什么变化吗？Seth, can you think of any changes to her behavior in the last few months?有，大概一个月前开始的Yeah, it started like about a mon
5、th ago.她很混乱又很激动She was confused, agitated.嗯Huh.嘿，硕克Hey, Zach,你有没有把完整的代谢分♥析♥报告写进去？did you include a complete metabolic panel?还有一定要拍头部的电脑断层扫描Lets also make sure we get that head C.T. too.遵命Yes, sir.她不会有事吧？Hey, shes gonna be all right, right?听着，我们一定会查个水落石出的，好吗？Look, we*re absolutely gonna
6、 get to the bottom of this, all right?在我们开始下一步之前Probably just a good idea等待一些测试结果to wait for some of these test results可能会是个好主意before we start looking at next steps.好，有什么怀孕并发症需要我们注意的吗？Uh. Okay, any pregnancy complications we should know about?除了一些莫名的食欲之外Besides some bizarre cravings,其他都还算顺利ifs been
7、relatively smooth,但我我不得不说我今天身体痒到要疯了but I.I just have to say Im like, itching like crazy today.如果你没有我才担心呢fd be worried if you werent.在这个阶段，你的荷尔蒙分泌旺盛At this stage your hormones are running wild瘙痒在足月妊娠中是完全正常的and itching is totally normal in a full-term pregnancy.是你带她来的吗？Hey, are you the guy that brough
8、t her in?保安要把你的车拖走了Securitys about to tow your van.什么？What?嘿，吉士，对不起，谢谢你Hey, Gus, sorry! Uh, thanks again!好All right.我想做个检查fd like to do an exam.玛雅，你想要我们联♥系♥谁呢？Maya, anyone youd like us to call?可惜没有Unfortunately not.我在春天搬来这里上学Um, I moved down here for school in the spring.我的家人都在纽约And al
9、l of my familys up in New York.孩子的父亲呢？And the baby*s father?我们分道扬镶了Not in the picture.好Okay.我喜欢你的袜子Oh, I love your socks.谢谢Thank you.你能把脚后跟放在脚蹬上吗？Can you put your heels more in the stirrups?很好All right.你知道，我本来不打算那么早知道孩子的性别的You know, I was gonna hold off on the sex of the baby 但我只坚持了 15周but I only ma
10、de it to week fifteen.我等不及要见她了I just couldn*t wait to meet her.我有个好消息，玛雅，你不用再等了Well, Ive got good news, Maya, your wait is over.你的子♥宫♥ 口已经扩张了六厘米Youre about six centimeters dilated这代表这个小女孩今天就要出生了which means this little girl is coming today.我的天啊Oh, my God.恭喜你，玛雅Congrats Maya.好了All right,
11、现在我要给宝宝做个超声波检查now Im going to do an ultrasound to check on the baby, 好吗？okay?好Okay.玛雅，看来宝宝胎位不正So, Maya, it appears your babys breech.什么这是什么意思？What does.what does that mean?意思是她的头朝向了错的位置It just means that her heads facing the wrong direction. 她不会有事吧？Uh, shes gonna be okay, right?不会，这种事很常见Oh, yes, thi
12、s is very common.只是我们得进行剖腹产It just means we need to deliver via uCu-section.你是说动手术吗？You mean like surgery?对，不过别担心Yes, but dont worry.手术非常安全It is totally safe.如果你想要的话你整个过程都可以保持清醒And you can be with us and awake the entire time if you want.-好-好-Yeah, okay. -Okay.嘿，朵莉丝？ 是-Hey, Doris? -Yeah.我们需要一间复合手术室C
13、an we open up the Hybrid OR?好Yeah.里-哩 八、八、-Hey. -Hey.你的刷手服是哪来的？Whererd you get the scrubs?我自己洗衣服I do my own laundry.每天晚上吗？Every night?每天晚上，就是因为这样Every night. For precisely this reason.这是海军的习惯吗？Is that some kind of Navy thing?他们是这样训练你的？The way you were trained?我身边站着一群王牌骑警Fm flanked by a bunch of Dudl
14、ey Do-Rights.太棒了Awesome.伊芬？凯？有病人来了Ethan? Kai? Incoming!高尼？你要去创伤部Courtney? Youre going to Baghdad!报告情况，高尼Talk to me, Court.36岁的犯人Uh, thirty-six-year-old inmate,右颈前外侧被刺伤stabbed in the anterior lateral right neck in County.直接按压止住了出血Bleeding stopped with direct pressure.气管插管中，路上注射了琥珀胆碱和依托咪酯，昏迷指数三Intubat
15、ed en route with sux and etomidate. G.C.S. Three.好，看来已经没有在出血了All right, looks like theres no active bleeding.准备抬他上♥床♥Lets get him ready for a transfer.大家都准备好了吗？Everybody ready?准备好了吗？Ready?一、二、三One, two, three.心率94,血压130跟87Heart rate ninety-four. HB.P.H one-thirty over eighty-seven.血氧饱和
16、度百分之百Sats one hundred percent.双侧都有呼吸音，给他接上呼吸机Breath sounds are bilateral. Lets get him on a ventilator.我听说有个从库克郡来的犯人？Uh, did I hear something about an inmate coming in from Cook County?谁替我拍张X光片Someone get me an x-ray.没错，脖子上被捅了一刀Yeah, shanked in the neck.你会喜欢这个巧合的Oh, you1! love this coincidence.他姓艾卓亚
17、His last names Archer.辛艾卓亚Sean Archer.是啊,这世界真小Yeah, its a small world.是啊Yeah.不晓得这家伙惹到谁了Wonder who this guy pissed off.已经止血了No active bleeding.不过脖子上有个大血肿Big old hematoma in the neck though.来，给我看看Here, let me look at that.X光机来了X-rays here.等一下Hold.等等，我摸到东西了Hold on. Tm feeling something in here.再拍个颈部X光片
18、Lets get a neck x-ray as well.确保没有异物残留Make sure theres no retained foreign body.嘿，迪恩Hey, Dean.现在不是时候Not now. Not now.云妮的测试结果出来了Renees test results.甲状腺功能良好Thyroid function is good.没有内分泌问题电脑断层扫描也没问题No endocrine problem. C.T. head is clean.对，也没有家族精神病史Yeah, no family history of mental illness, either.你知
19、道吗？ 不知道-You know? -Nope.到目前为止So far anyway,云妮的思觉失调还没有办法解释no organic explanation for Renees psychosis.那我们该怎么办？So where does that leave us?耐心等待Wait.她服用什么免疫抑制剂？What immunosuppressant is she on?.他克莫司.该死-Tacrolimus. -Oh, crap.怎么了？What?环抱素梅有用吗？Cyclosporine wouldnt work?移植前我们就试过了Well, we tried that pre-tra
20、nsplant,但云妮对同级的所有东西都过敏but Renee was allergic to everything in that class.他克莫司是我们最后的选择The tacrolimus was our last option.你为什么这么问？Why do you ask?我们怀疑云妮的思觉失调是由免疫抑制剂引起的We suspect that Renees psychosis is being caused by the immunosuppressant为了保护她的新肾她一直在服用免疫抑制剂that shes been taking to protect her new kid
21、ney.他克莫司吗？你确定？Her tacrolimus? Are you sure?我们已经排除了所有其他可能性Weve just about ruled out every other possibility.但手术是十个月前的事了But the surgery was ten months ago.虽然听起来很奇怪As strange as it might sound,但这样的反应甚至会发生在手术几年后reactions like this can occur even.even years after surgery.那我们应该让她停药，对吧？So, we should just t
22、ake her off her meds then, right?我也希望能这么简单就解决，萨夫I wish it were that easy, Seth.但要是没有免疫抑制剂But, without the immunosuppressants,云妮的身体就会排斥新肾脏Renees body will reject the new kidney.过了这么久还会？After all this time?很遗憾地，就是这样Unfortunately, yes.那我们要怎么力、？So, what are we supposed to do?下一步就是要试看看抗精神病药Well, the next
23、 step would be to try an antipsychotic.有种叫奥氮平的药，我想让她试着There*s a drug called olanzapine that I would like to start her服用小剂量，看看是否有帮助on a small dose of and see if that helps.嘿，萨夫？Hey, Seth?别担心Don*t worry.我们会控制好情况的，好吗？We*re gonna get this under control, okay?该死Damn.看来刀柄断在了他脖子上Looks like the shank must h
24、ave broken off in his neck.好，我们能送他进手术室吗？All right, can we get him up to the O.R. please?你们还站在这里做什么？What are you standing around here for?动作快啊Just do it.跟手术室说我要做颈部探查，好吗？Tell the O.R.n that Im bringing up a neck exploration, okay?- 迪恩？-等一下- Dean? -Yeah, one second.不好意思Uh, sorry.能帮他解开手铐吗？Can we get the
25、 shackles off him?他哪也去不了Hes not going anywhere.- 可以吗？ 迪恩听我说- All right? -Dean, Dean. Hey, Dean.- 到底有什么事？ 迪恩，辛在坐牢？-What is it? -Dean, Seanrs in jail?我上次问你，你说他在西部Last time I asked, you said he was out west.到底是怎么回事？Whats going on?说来话长It*s a long story.好吗？我答应你，我会跟你解释清楚的Okay? I promise I will get you cau
26、ght up.- 我保证好- I promise. -Okay.但我现在得去准备手术But I gotta go scrub now.我不能站在这里I cannot stand here.尼尔今天在创伤科值班Neils on-call in trauma today.让他动手术吧，他是最厉害的了Lets let him operate. Hes as good as it gets.这可是我儿子，伊芬This is my son, Ethan.所以你才不该动这个手术Exactly why you shouldnt be doing this surgery.拜托，兄弟，你知道我是对的Come
27、on, man, you know Fm right.好吧，嘿All right, hey.别担心Don*t worry.我会一直陪在辛旁边的，好吗？Ill stay with Sean the whole time, all right?好-好-Yeah. -All right.我认为我们还有这个预算I do think we have room in the budget for that.所以如果各位看一下So if you take a look at.对不起，莎伦Im sorry, Sharon.你叫我什么？莎伦？Uh, excuse me. Sharon?费特在接下来的一个小时左右
28、会跟董事会通电♥话♥Freds on a call with the board for the next hour or so.我有什么能帮你的吗？Is there something I can help you with?我不知道米查姆先生是否听说了Well, I dont know if Mister Meacham has heard or not,但我们今天没有收到刷手服but we didnt get our delivery of scrubs today.费特知道，是的Fred is aware, yes.也许你该叫他出来Maybe you sho
29、uld ask him to come out.这能算是紧急情况吗？Is this really an emergency?年轻人Young man,刷手服对于保持手术室的完整性至关重要scrubs are critical in maintaining the integrity of our operating rooms. 我们还有手术服吧？We still have surgical gowns, correct?那你要他们里面穿什么？And what do you expect them to wear underneath?他应该知道我们的员工和病人不只会陷入危险He should
30、 know that besides putting our staff and patients at risk, 我们还可能会被起诉were opening ourselves up for potential lawsuits.我们应该取消所有非急需外科手术直到这个问题得到解决We should cancel all elective surgeries until we iron this out.这对损益表会有很大的影响That would be a big hit to the Pn and L.所以我才会来找米查姆先生Thats why Im here to see Mister
31、 Meacham.会议一结束我就给打到你办公室Fil call your office as soon as this breaks up,葛云小姐Miss Goodwin.谢谢Thank you.请看六-Ta-da. -Six, six.什锦果仁？Trail mix?这是云妮莎的最爱Vanessas favorite.里面有菠萝干和巧克力的那种The kind with dried pineapple and chocolate in it.我还给她写了张小纸条And I wrote her a little note, too.哦Aw.我希望她知道我们有多想她I hope she know
32、s how much we all miss her.嘿，我要先去洗澡Hey, Im gonna hit the showers.我买♥♥杯果汁给你喝Fil grab you a juice.谢谢Thanks.你们俩好像处得很好You two seem to be getting along.啊，不是那样的，我们只是朋友Ah, its not like that. Were just friends.你说了算If you say so.那你呢？What about you?你和艾普尔还好吗？How are things with April?嗯，说实话Hm, to
33、be honest,第二次容易多了its much easier the second time around.就好像我们把所有该大吵的事都吵完了Its like we got all the big arguments out of the way.那太棒了啊Thats great.是啊，你知道，到头来Yeah, you know, it turns out.我们一直都走在同条路上.we were walking down the same path this entire time 只是彼此不知道而已and just didnt know it.我觉得汉娜和我I think with Ha
34、nnah and L我们很久以前就分道扬镶了our, uh.our paths diverged a long time ago.至少在健身房♥有人看到你了Well, at least you got someone to spot you in the gym.硕克，有病人来了Zach, we got incoming!你要去三号♥治疗室You*re going to Treatment Three.好如果她不知道If she doesnt,等她收到这个包裹的时候就知道了she will by the time she gets this package.嗨，亲爱
35、的Hey sweetie.班？你来这里干嘛？Hey Ben? What are you doing here?我有个学生从攀爬架上摔了下来A student of mine fell off the jungle gym.救护车说他们要把她送来这里The ambo said they were taking her here.她叫米拉霍洛威Names Mira Holloway?哦对，她在四号♥治疗室Oh, yeah, shes in Treatment Four.跟我来Come on.-医生看起来跟米拉差不了几岁她被照顾得很好-Doctor looks no older tha
36、n Mira. -Oh, shes in good hands.别担心Dont worry.葛云小姐，我们只能穿这个吗？Miss Goodwin, is this really all we got?我很抱歉，是的Im sorry, yes,这是最好的选择了its the best we have.-有点痒-这样就可以了-Its kinda itchy. -Yeah, theyre fine.我们将就一下吧Well make do.你为什么那样看着我？Why are you looking at me like that?没什么，我只是担心你Ifs okay, I was just worri
37、ed about you.云妮，你还好吗？Renee, how are you doing?你能告诉我你现在感觉如何吗？Can you, um.can you tell me how youre feeling right now? 我来这里多久了 ？How long have I been here?你早上就来了，你摔了一跤Since this morning. You had a fall.你原本跟奥斯陆要开视像会议You had the Zoom with Oslo,但我重新安排时间了but I had it rescheduled.奥斯陆？Oslo?阿贝尔奖The Abel Prize
38、.下个月要颁奖给你Theyre handing it out next month.真不错Thats nice.你知道吗？You know what?萨夫，我觉得我们应该让你太太休息一会儿Seth, I think we should let your wife rest for a little bit.云妮，我们几分钟后就回来，好吗？Renee, well be back in just a few minutes, okay?她怎么了？What*s wrong with her?这个嘛，奥氮平已经让她严重麻痹了Well, the olanzapine has pretty severel
39、y obtunded her. 麻痹？Obtunded?我很抱歉Uh, Tm sorry.这代表她对刺♥激♥的反应会比较慢It just means that shes slower to react to stimuli.这是一种常见的副作用Its not an uncommon side effect.但这种情况只是暂时的吧？But this is gonna wear off, right?重点是，萨夫，只要他克莫司起作用The thing is； Seth, is that when the tacrolimus is in play, 就像这种副作用一样l
40、ike it is with this side effect that the pharmacology 药物反应会变得更微妙just becomes a lot more delicate.如果降低剂量呢？But we can lower the dose?这已经是最低剂量了Shes already had the lowest dose坦白说，她的影响已经非常明显了and frankly her affect is just extremely pronounced already.我是不是有看过阿立哌嘤的Did I read somewhere that aripiprazole镇静效
41、果比较没那么好？has a less sedative effect?这样会比较好吗？Uh, would that work better?你知道，在这个节骨眼上，值得一试You know, at this point, its worth a try.不如我们让她体内系统先排掉奥氮平So why dont we let the olanzapine clear her system再给她一些阿立哌嘤and then give her some aripiprazole看看情况会不会好转？and see if we get to a better place?天啊，这衣服快把我逼疯了God,
42、this suit is driving me nuts.可不是嘛Tell me about it.我流了超多汗Im nschvitzingH like crazy.嘿，我看到宝宝了Hey, I can see the baby.就快好了，玛雅Almost there, Maya.胎儿横位背朝下Baby flipped to transverse back down.什么这是什么意思？What.what does that mean?意思是她有点卡住了Just means shes a little stuck.只不过要多花点时间Its just gonna take a bit longer
43、.拿绷带剪扩大子♥宫♥切口Grab the bandage scissors and extend the uterine incision.迪恩？-怎么了？-Hey Dean? -Yeah?看来又有一个犯人要过来了Looks like we got another prisoner coming in.什么？What?创伤部Baghdad.德克尼曼，37岁男性Deke Niemann. Thirty-seven-year-old male,胸、腹和背部有钝器创伤blunt trauma to the chest, abdomen and back.他跟狱警发生了肢
44、体冲突Ended up in a physical confrontation with a correction officer.那些混♥蛋♥用警棍打我Bastards got me with a baton!切尔马克把这名病患转诊过来Cermak transferred this one over.这是他们拍的X光片我去把档案上传Heres the x-rays they took. -1,11 pull these up.来，听我指挥Here, on my count.一、二小心一点，天啊One, two. Easy, man!-痛死了 一等一下，我们得重新替
45、他上铐-That hurts! -Hold on. We have to recuff him.X光片上传了X-rays up!左侧血气胸Hemopneumothorax on the left.准备插胸管的工具，准备铺巾Get a chest tube tray. Prep and drape.输入一百单位芬太尼和两单位咪♥达♥喋♥仑♥Push a hundred of fentanyl and two of versed.你有个同事说要注意这家伙One of your co-workers trucked this guy up pretty good.完全可以理解Totally justified.他手里拿了武器He had a weapon in his han