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1、我听说你和手术室2.0是天作之合I heard you and 2.0 are a match made in heaven.手术室2.0是个了不起的发明Well, its a remarkable advancement.我们需要一间手术室We need an ,r0.R.手术室2.0是空的2.0 is open.那里的成像更清楚Better imagings available.紧急创伤不是用来玩你那花哨玩具的时候Emergent trauma is not the time to play with your fancy toy.我和班目前的关系并不是很好Things havent be
2、en great between Ben and I.我知道他不在身边你一定很难过I know it must be hard not having him around.班？Ben?抱歉，让你等了这么久Sorry it took me so long.我怀孕前三个月大概注射了六次I probably shot up like, a half-dozen times during my first trimester. 戒毒真的很难Going cold turkey1 is really hard.我不想让任何人带走我的孩子I dont want anyone taking my baby a
3、way.喂？Hello?嘿，没关系Hey, no, no, no, no.嘿，我怎么跟你说的？Hey, what did I tell you?白天晚上都无所谓Day or night, doesnt matter.怎么了？Whats going on?你有吸毒的冲动吗？You.you having an urge to use?好Uh-huh.这个想法不错Its a good thought但那也不能替我们争取到一天的时间but that wont buy us more than a day.要是我们能找到一种长♥期♥灌注断手的方法就好了If only we c
4、ould find a way to perfuse the hand long-term.就像你说的，太可惜了Uh, like you said, its a shame.积奇，去四号♥治疗室Jackie, going to Treatment Four.知道了，这位是伊萨哥连斯Got it. This is Isaac Collins.35岁男性，车祸Fifty-three-year-old male. Motor vehicle collision.在现场可以走动拒绝上救护车、戴颈圈Ambulatory at the scene, refused board and col
5、lar.别人从后方撞上他的车He was rear-ended.但那是我的错My fault, though.脸部瘀伤是安全气囊造成的Facial bruisings from the airbag.我没有打方向灯就换车道I switched lanes without signaling.然后我猛踩刹车转弯Then I jammed on the brakes to make a turn.我太蠢了，还好是对方没事It was a bonehead move. Luckily the other guys all right.很高兴听你这么说Glad to hear it.对了，我是霍士迪医
6、生Im Doctor Halstead, by the way.生命征象？Vitals?血压有点高，150跟97Blood pressures a little high, one-fifty over ninety-seven.我有高血压Im always hypertensive.尤其是我要做透析的时候Especially when Im due for dialysis.我得了晚期肾病Ive got end stage renal disease.谢谢你告诉我，各位我数到三，一、二、三Appreciate you letting me know. On my count, folks,
7、one, two, three.谢谢你们Thanks, guys.你有装度管？See youve got a fistula?是啊，装过好几次了Yeah, been through a few of them.做了五年的透析Going on five years of dialysis.奎瓦斯医生Doctor Cuevas!伊萨Isaac.锤斯医生把好消息跟我说了Doctor Jones told me the good news!我今天一直希望能见到你I was hoping I would see you today.但不是在急症室，发生了什么事？but not in the E.D. W
8、hat happened?她是我的心理医生Shes my shrink.我其实不是，伊萨Im actually not, Isaac.你介意我告诉霍士迪医生我们是怎么认识的吗？Do you mind if I disclose to Doctor Halstead how we know each other?我和妻子萨曼莎参加了奎瓦斯医生的互助小组My wife Samantha and I attend Doctor Cuevas1 support group.适用于患有慢性疾病的病人及家属For patients and families living with chronic illn
9、ess.我们明天就不是了Which, by tomorrow, wont be us anymore.所以我才会像个疯子一样乱开车Which leads me as to why I was driving like a maniac.我接到电♥话♥ 了I got the call.我要换肾了Im getting a new kidney.恭喜Congratulations.总而言之，如你所见Anyway, as you can see, 我迫不及待想尽快赶到医院I couldnt wait to get to the hospital fast enough.但我
10、我没事But rm.Im fine.就像我跟医护人员说的一样我没有感觉到哪里断了Like I told the paramedics nothing feels broken.你说没有感觉到哪里断了也都没有哪里痛吗？Now, when you say nothing feels broken, anything feel tender?没有，我很好，真的Nah, Im good. Really.伊萨，我跟锤斯医生谈过了You know, Isaac, when I spoke to Doctor Jones,他说器官还要几个小时才会到he said that the organ wouldnt
11、 even be here for several hours. 不用着急Theres no rush.不如让霍土迪医生好好给你检查一下？Why dont you let Doctor Halstead check you out properly?我觉得脖子和背部有点痛Neck and backs a little sore, I guess.但真的没有很严重But its really not that bad.我只是不想被任何事搞砸手术I.I just dont want anything to mess up the surgery.就算你有扭伤或轻微骨折Uh, even if you
12、 have a sprain or a minor fracture, 也不会影响移植手术it shouldnt postpone the transplant.但是让锤斯医生和他的手术团队知道But better Doctor Jones and his surgical team know.这样他们就可以避免进一步加重伤害That way they can avoid aggravating any injury further.好吧，也有道理All right, yeah. Makes sense.替颈胸腰荐椎拍电脑断层扫描Lets get a C.T. of the C.T.LS. s
13、pine.抱歉让你久等了Sorry I keep you waiting.嗯Hm.我在和我的朋友聊天I was talking with my friend.没关系，洋甘菊茶No prob. Chamomile tea.蓝莓松饼，朱古力牛角包Blueberry muffin, chocolate croissant.你真贴心You are very sweet.但是我吃不下But I.I canrt eat.我的胃不舒服Uh, my stomach is in knots.1怎么了？Whats up?我朋友认为我们可能很快就失业了My friend thinks we may be out o
14、f work very soon.什么？What?是关于你们工会和医院重新谈判的事吗？Is this about your unions renegotiation with the hospital? 我知道他们打算重新敲定一份新合同I knew they were trying to Hiron out1 a new contract.但老实说，我不太清楚最新状况but I mean, honestly I havent been paying that close attention. 她说，谈判正在破裂She says talks are breaking down.双方都不让步工会可
15、能会要求进行投票That neither side will budge, and the union may ask for a vote. 投票罢♥工♥ ?A strike authorization vote?如果我连续几周If I miss work for weeks, 甚至几天不上班，那就糟了 even for days, this is not good.我要寄钱回家给我父母I send money home to my parents.但就算投票通过了But I mean, even if the vote passes? 也不代表就会进行罢&hea
16、rts江♥It doesnt mean theyre gonna strike.那只是在他们回到谈判桌之前It just.just give them more ammunition有更多谈判的筹码before they go back to the table.你知道，这些事情往往需要时间These things, you know, tend to take time.你得静观其变You gotta let it play out.我想他们会达成协议Im guessing theyre gonna make a deal.不会有事的I think its gonna be o
17、kay.她刚开始出现胎心率下降She just started having fetal heart rate decelerations以及强直性宫缩with tetanic contractions.我把催产素剂量调低了I turned down the Pit.汉娜，我好痛Hannah, it hurts so much.好，停止注射催产素Okay, stop the Pitocin.丽莎，我们来看看是不是该用力了，好吗？Liza, were gonna see if its time to push yet, okay?你能帮我屈膝吗？Can you bend your knees f
18、or me?我要进行检查Im gonna check you out.好，你只扩张了六厘米Okay, youre only about six centimeters dilated.什么？What?我们得让你趴着We need to get you onto your hands and knees,我们帮你翻身，好吗？so let us help you turn you over, okay?怎么回事？发生了什么事？Whats going on? Whats wrong?脐带正在某处被挤压The umbilical cord is being squeezed somewhere.这就是
19、导致胎儿心率下降的原因Thats whats causing the babys heart rate to drop.好痛Oh!移♥动♥体♥位♥有助于减轻压♥迫♥Moving positions can help relieve the compression.我知道I know, I know.好，我帮你检查一下All right, Im gonna check you out.子♥宫♥还是很硬Uterus is still rock hard.给她皮下注射0.25毫克特布他林L
20、ets give her point-twenty-five of terbutaline sub-Q.H丽莎，你可以躺回去了，好吗？Liza, you can lie back down now, okay?慢慢来Gently.慢一点Gentle.我们正在尝试子♥宫♥松弛剂Were trying a uterine relaxant.但如果不管用Now, if this doesnt work,我们就得进行剖腹产了were gonna need to deliver you baby via CH-section.去准备手术室吧Lets get an O.R.n
21、ready.不要，我不想要，我不No, I dont want that. I dont没关系，我们一步一步来Okay, just step at a time?我们先看看这药有没有效，好吗？Lets first see if this medicine works, okay?胎儿的心率提高了Babys heart rates coming up.太好了Thats really good.等半个小时，然后慢慢加催产素Give it about a half hour and then re-start the Pitocin slowly.但我们得先准备好手术室But lets keep a
22、n O.R. ready如果胎儿心率下降的话if the babyrs heart rate drops like that,我就要进行紧急剖腹产Im doing an emergency uCH-section.你想透过手术把洛的手固定在他的腿后面？So, you want to surgically attach Robs hand to the back of his leg?这被称为异位保存Its called ectopic banking.你看You see,为了存活，断手需要充分的血液流动what the hand needs in order to survive is ade
23、quate blood flow.他的腿能提供血液吗？And his leg can provide that?准确地说，是胫后动脉The posterior tibial artery, to be exact.胫后动脉沿着小腿的后部延伸The UP.T.A. runs along the back of the lower leg.所以你要把我的手放在腿上一周左右？So you bank my hand on my leg for a week or so?没错Thats right.然后你会把手接回我的手上，对吗？And.and then youll reattach it to my
24、arm, right?不仅仅是重新接回去More than just reattach it.使用手术室2.0Using the ”0.R2。我相信我们可以恢复I believe that we can restore手部大量的功能和感觉a remarkable amount of function and feeling.这样我就可以继续在建筑工地工作了 ？So I can keep working construction?是的Yeah.我必须要有感觉I.I gotta be able to feel,不然我就是建筑工地的负债or Im a.a liability on a constru
25、ction site.是啊Yeah, of course.好，那Okay, so, uh.well,2.0的预测模型估计，恢复部分2.Os predictive modeling estimated a eighty-five percent likelihood 或多数手部感觉的可能性为85%of regaining some or more sensation in the hand.这要经过好几个月的And thats after many, many months物理治疗和训练of physical therapy and rehab.对吧，马素医生？Right, Doctor Mar
26、cel?玛姬说得没错Uh, Maggies correct.当然，前方的路还很长Its gonna be a long road ahead, for sure.前提是你决定做手术Thats if you decide to go with the surgery.当然，还有其他选择Theres other options, of course.义肢技术有了惊人的进步Theres been incredible advancements in, uh, prosthetics.那如果保存的手术失败了呢？And thats if this banking thing doesnt work?那我
27、们再谈假肢Then we can talk prosthetics.但我想试试看But I want to give this a shot.你可以的，丽莎，加油You got this, Liza! Keep going!她为什么不出来？帮我剖腹Why isnt she coming? Just do the HC-section.来不及了Its too late for that.拜托Please.我知道你很累，但你办得到的，丽莎I know youre exhausted, but youve got this, Liza.等我数到三，我要你So when I count to thre
28、e I need you用尽全力，好吗？to give me everything youve got, okay?这是关键，看着我This is it. Look at me.， , *、 、 One, two, three.太好了Yes.你成功了，丽莎You did it, Liza.她还好吗？Is she okay?很好Yes.嗨Oh, hi.她是不是很美？Isnt she beautiful?她很完美Shes perfect.我觉得她好像需要什么你能检查一下吗？I think she needs something, can you check her again?她很好No, she
29、s fine.没关系Its okay.她哭能帮她排出肺部的积水Her crying helps the fluid get out of her lungs.但她哭个不停But she wont stop.别担心Itrs okay.她躺在你胸口的时间越长她就越能冷静下来The longer shers on your chest, the more shell calm down.把她抱走，好吗？Please just take her?-这样会很好把她抱走Its a really good idea. -Please just take her.好Okay.没关系，好There we go.
30、 Okay.嘘Sh.对不起，我只是太累了Im sorry. Im.Pm just-Im so tired.没关系Of course.你刚跑完一场马拉松You just ran a marathon.好，我们会把孩子送到育儿室Okay, well get the baby up to the nursery你可以睡一会儿，好吗？and let you sleep a bit, okay?没关系，宝贝Its okay, baby.来吧Come on.好好休息，好吗？Just rest, okay?拿到了伊萨的电脑断层扫描他在第二腰椎有压♥迫&hear性骨折Got Isaacs C.T
31、. back. He*s got a compression fracture at L two. 真不幸Uh, well thats unfortunate,但就像你说的，这不会耽误移植手术but like you said it wont delay the transplant.对吧？Right?这个嘛，你看一下，我有可能搞错Well, take a look. I could be wrong, 但在我看来骨折周围的骨头有溶解的迹象but the bone around the fracture has a lytic appearance to me.你觉得伊萨得了癌症？You th
32、ink Isaac has cancer?我认为有这种可能I think theres a possibility.溶解病变通常伴有癌细胞转移Lytic lesions are commonly associated with metastases.如果骨头已经因癌症而受损And if the bone was already damaged from cancer, 那就算是轻微的创伤也可能导致骨折then even a minor trauma could cause a fracture.好，你能自己去医院吗？Okay, can you get yourself to Med?我可以去接
33、你I can pick you up.好，很好Okay, great.那好，我去急症室找你Okay, Vil meet you in the E.D.天啊，所以班回家了？Wow, so, Ben moved back home?上周末End of last week.天啊，我很高兴听到这个消息Wow, Im so glad to hear that.就好像这片巨大的乌云散开了Feels like this huge cloud just has.just lifted.我相信ril bet.莎伦，谢谢你一直以来的支持Thanks for being a shoulder throughout
34、all this, Sharon.不客气Always.经过十多年的测试和研究The result of over a decades worth of testing and research.加夫尼芝加哥医疗中心here at Gaffney Chicago Medical Center.他们在开始帮手术室2.0打广&hearts浩♥了 ?Theyre doing infomercials for 2.0 now?积戴顿坚持的Jack Day ton insisted.但我还有个预算会议要开But, I have a budget meeting to get to.所以So.
35、好好欣赏表演吧.enjoy the show.我会的I will.在并发症发生前预测Predict complications before they happen.实时生成高度准确的图像好，但你还不确定这是溶解病变吧？Okay, but youre not sure that it*s lytic, right?也许有可能只是创伤性压♥迫&hearts性骨折？Theres still a chance it could just be a traumatic compression fracture?所以我才想安排磁力共振造影Which is why I want to get
36、 an M.R.L你知道，让我们知道是否有其他损伤You know, show us if there are other lesions,让我们更好地了解这是创伤性的还是病理引起and just give us a better idea if its traumatic or pathological.如果是病理引起And if it is pathological,那就得进行活体组织检查，伊萨that means a biopsy and Isaac今天肯定没办法进行肾脏移植is definitely not getting a kidney today.对No.真希望萨曼莎在这里，他太
37、太I wish Samantha was here. His wife.她人在哪里？Where is she?飞往西雅图的班机上要去庆祝孙女一岁生日On a flight to Seattle for their granddaughter first birthday.伊萨厌倦了他们俩都错过重要时刻Isaac got tired of both of them missing out on milestones.但是But,她出城就这么一次，他就接到了电♥话♥one time she goes out of town, he gets the call.你介意和我
38、一起告知他这个消息吗？You mind delivering the news with me?在她不在的时候，我想熟悉的面孔可能会让他感到安慰In her absence I think a familiar face might be comforting.当然可以Yeah, of course.好All right.嘿Hey.嘿Hey.你有空吗？You got a second?有Yep.好，真的值得冒险进行这个手术吗？Okay, um, is this operation really worth the risk?如果有任何东西阻碍了手或脚的血液流动If anything compr
39、omises blood-flow to the hand or the foot, 洛可能会感染并变成败血症Rob could develop an infection and become septic.但是手术室2.0会评估手术每一步的血流量But 2.0 will be assessing blood flow every step of the surgery. 以及预测术后灌注是否能维持As well as predicting if perfusion can be maintained post-op. 好，很明显，你对这项技术了若指掌Okay, clearly, you kn
40、ow this technology inside and out.但2.0从未用在这类的手术上But, its also never been used for this type of procedure.所以你要说什么？So, what are youre saying?我对洛夸大其词吗？What, I oversold Rob?不是但我认为你在2.0上投入了太多No, but I think that youve got a lot invested in 2.0,可能会有必须得用它的某种压力and maybe feel a certain pressure to use it.我不会
41、拿病人的生命当赌注Im not gonna gamble with a patients life就为了炫耀我闪亮的新玩具，玛姬just so I can show off my shiny, new toy, Maggie.你当然不会，我只是说Of course not, Im just saying.哥罗基Crockett!找到我要找的人了There*s the man Im looking for.还有别的事吗？Anything else?我不是故意把洛活护士赶走的I didnt mean to chase Nurse Lockwood away. 没关系，她得回急症室了有什么事吗？Ye
42、ah, well, she had to get back to the HE.D. Whats up?宋医生向我介绍了异位保存的手术Doctor Song briefed me on the ectopic banking case.让人印象非常深刻-是的-Very impressive. -Yeah.我的摄影师会拍下来And my videographers gonna film it.我们要把手术记录下来尽可能多吸引媒体的注意Well want to document it, and get as much press as possible.积，我不希望有人在我做复杂手术的时候Jack
43、, I dont want anybody in there taking pictures在里面拍照while Im in the middle of a complex surgery.你不会感觉到他的存在的You wont even know hes there.我会让他远离你，我保证DI keep him out of your way, I promise.在看台式教室见？See you in the amphitheater?好，我马上过去Yeah, right behind you.嘿Hey.嘿Hey.希望你不赶时间Hope youre not in any kind of a
44、hurry.电梯今天很慢Elevators taking their sweet time today.我没事，我不急着去我要去的地方I am fine. Tm not exactly anxious to get where Im going.我要和积的一个朋友见面Meeting with a friend of Jacks.他在董事会的席位已经十拿九稳了Whose seat on the Board is all but assured.天啊，医院政♥治♥,真讨厌Oh, man. Hospital politics. Yikes!是啊Uh-huh.说到这个Spe
45、aking of which.你有听说关于What.what do are you hearing about和管理工人工会的谈判进度吗？whats going on with the negotiations with the custodial workers union?莉莉安娜好像觉得双方关系变得紧张了Liliana seems to think theyre getting all tense.私下告诉你，我不认为会有罢♥工♥Between us? I.I don*t foresee a strike.我也是这么跟她说的Thats what I told her.对，罢♥：♥会对医院系统造成严重破坏Yeah. A strike would