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1、快点Come on.本能舒适别再看着我了Stop looking at me.早餐是薄煎饼啊花生很兴奋Pancakes. The Peanut is thrilled.你穿的是我给你买♥♥的孕妇牛仔裤You are wearing the maternity jeans I bought you.你开心我也跟着开心Glad youre happy about that.你怀孕28周了Youre 28 weeks pregnant.你的体重增加了 9.8千克宝宝的位置正在下移Your weight has increased 21.5 pounds, and our
2、baby is moving lower.至少还有煎饼吃At least theres pancakes.,我们得买♥♥一辆厢型车-不我们不需要We need to buy a minivan. - No, we dont.那台大都灵没有婴儿安全功能The Striped Tomato has no infant safety features.肖恩我刚在孕妇牛仔裤前一败涂地Shaun, I just surrendered to maternity jeans,现在聊“妈妈车”不合适this is not the right time for broaching
3、the Mom-mobile.那什么时候合适？When would be the right time?太好吃了你用了酪乳？These are amazing. Did you use buttermilk?我用的希腊酸奶Greek yogurt?我等下用邮件把我的保障幼儿安全车清单发给你Ill email you my list of child-safe vehicles.我们可以在你午餐时讨论一下We can discuss it during lunch.怀孕未怀孕索尼娅贝勒？Sonja Baylor?送来的贵宾是谁？泰勒斯威夫特?她破碎的心停跳了？Whos the Code Gold
4、? Taylor Swift? Did her broken heart give out?更高级来的是罗兰巴恩斯Youd have to live here.我们会每天监测你并在胎儿接近可存活龄时Wed monitor you every day, give you prophylactic antibiotics给你用预防性抗生素和类固醇and steroids when the baby gets closer to viability.你要知道即使如此选择继续妊娠To be clear, even with all that, you may still develop仍可能引发严重子
5、♥宫♥感染最终可能导致需要切除子♥宫♥a serious uterine infection that could require a hysterectomy或引起致命的并发症or cause fatal complications.我认为应该流产I think we should terminate.如果是你的孩子What would you do.你会怎么力?if it was your baby?终止妊娠是最安全的Termination is the safest.我在问艾伦医生I was talking to Dr. Allen
6、.我会为它祈祷I would. pray on it.然后呢？And then?我想知道你会怎么做I want to know what you would do.我想我会尽力保住孩子I think I. would try to save the baby.我们必须为我们的埃丝特而战We have to fight for our Esther.在给你明确的答案之前我们需要进行活体组织检查We need a biopsy before we can give you any definitive answer.好的Okay.那什么时候做活检呢？So when do we do that?我会
7、把你介绍给另一位医生Fil give you a referral to take to another doctor.如果我想找别的医生我早找了If I wanted another doctor, I would have.我不是必须要给你治的-但你会给我治的I dont have to treat you. - But you will.你不是个会放弃的人Youre not a quitter.你努力挽婚姻You worked hard to save your marriage.你从来没在比赛中认输过You never tapped out in a fight.我一直很佩服你的坚持I
8、 always admired your persistence.也有点讨厌它And kind of hated it, too.回顾人生路Looking back at my life,我不喜欢沿途的风景I dont like the view.我伤害了I hurt.很多人a lot of people.这就是我来这里的真正原因Thats the real reason that I came here.为了得到宽恕For forgiveness.主动脉内球囊泵起作用了The intra-aortic balloon pump worked.你不需要一颗新的心脏You wont need a
9、 new heart.太棒了Great.那我什么时候可以出院？So when can I get out of here?还得一阵子Not for a few days.我们需要监测你的术后并发症We need to monitor you for post-surgical complications.你的心率升高了Your heart rate is elevated.你一直在用力吗？Have you been exerting yourself?用力的是她She did most of the exerting.我需要一千毫克左乙拉西坦和四毫克劳拉西泮快点I need 1,000 mg
10、levetiracetam and 4 mg lorazepam. Stat.罗利不会有事的吧？Is Rolly gonna be okay?罗兰癫痫发作Roland had a seizure.你最好坐下You should sit down.达莉亚在病房♥里Dalia was there.没穿衣服Naked.他们在做♥爱♥They were having sex.达莉亚和我不是一对Dalia and I aren*t together,她和罗兰才是一对she*s with Roland.这是工作的一部分Thats part of the gig.我
11、假装她是我女朋友这样罗兰的妻子就不会起疑了I pretend shes with me, so Rolands wife doesnt get suspicious. 好吧Okay.你认为是性引起的癫痫发作？You think the sex caused seizure?勃起可使心率提高百分之三十八Arousal can increase the heart rate by 38%如果他的大脑同时因此缺氧and if his brain was deprived of oxygen, 就会引起癫痫发作这意味着itd cause a seizure, which would mean他的心脏仍
12、然没有泵出足够的血液his hearts still not pumping enough blood.必须定期说谎会让你感到困扰吗？Does it bother you to have to lie on a regular basis?我并不喜欢这么做但这是一份很棒的工作所以Its not my favorite responsibility, but its a great job, so.为什么这是一份很棒的工作？Why is it a great job?我在医院的最后一天你告诉我有一天我会很幸福On my last day, you told me that one day Id
13、be very happy.但当时我很痛苦But I was miserable.我觉得自己很失败I felt like a failure.然后我遇到了罗兰他在我身上看出了一些东西Then I met Roland, and he saw something in me.这个我真的很钦佩的人全世界都钦佩的人他很看重我This guy that I really admired, that the world admired, he valued me. 而且我不介意坐私人飞机去阿姆斯特丹I dont mind flying private to Amsterdam与荷兰女王共进晚餐to ha
14、ve rijsttafel with the Queen of Netherlands.我还说你会发挥你的潜力I also said you would fulfill your potential.我现在没发挥潜力？Im not doing that?没有No.坐骨神经痛Sciatica.谢谢你提醒我我现在还是废柴一块Thanks for reminding me Im still a failure.我去给他做个B型钠酸肽测试和超声心动图看看他心脏怎么回事PH get a BNP Test and echo to check out his heart.注射生理盐水让我们到达粘膜下层Inj
15、ect saline to get us to submucosal plane.你为什么要给他治？-肿瘤在这里Whyd you stay on the case? - Theres the tumor.他是对的我对待自己的义务很认真He was right. I take my obligations seriously.取四个样品Take four samples.不是因为你有点想原谅他吗？Not because some part of you wants to forgive him?缓慢撤回示波器Withdraw the scope slowly.他不配He doesn*t dese
16、rve it.让我们从沙发开始Lets start with a sofa.让我们来看看Lets take a look.终于有人认可我的室内设计天分了Finally, somebody recognizes my interior design genius.看起来挺好It looks nice.非常好-嘿我喜欢这个买♥♥它Very. - Hey. I love this. Til take it.别啊这才是你试的第一个沙发No. This is literally the first thing youve sat on.行我再试10个但我最后还是会买&hear
17、ts;♥这个Okay, Fil sit in 10 other ones, and then 1*11 take this one.不如果你知道自己喜欢什么就坚持No. If you know you like something, stick with it.就像我的车Like my car.肖恩想买♥♥一辆厢型车Shaun wants to buy a minivan.难道你想把宝宝放进一辆75年的大都灵里？You want to put an infant in a 75 Gran Torino?不啊那样对宝宝不安全No, it*s not sa
18、fe for a baby.但But.这车 it is. 很酷啊 cool.即使我要干一份成年人的工作Even when Im going to my super grown-up job, 要穿我的女老板套装 in my lady-boss pantsuit, 但我从那辆车里出来时我还是很酷I get out of that car and Im cool.很快我将成为个普通的30多岁的妈妈开着一辆实用的车And soon, Til be just another 30-something mom in a practical car, 后排放着婴儿座椅衬衫上还有宝宝的口水 baby sea
19、t in the back and spit-up on my shirt.玛蒂的妈妈警告过我每次带娃出去的时候Maddies mom used to warn me to take two shirts都得带两件衬衫whenever I went out with the baby.我花了好久才记住I learned the hard way.为什么我明明很想要这个宝宝How do I want this baby so badly,却并不喜欢当妈妈的感觉but feel so icked out about being a mom?哪种“不喜欢”Define icked out.就是Lik
20、e.我知道-好吧形容得好I know. - Okay. Thats well said.你情绪很复杂正常人都会这样的You got mixed emotions. Welcome to the human condition. 我就买♥♥这个Im gonna take this one.她发烧了感觉很难受Her fever spiked, shes in a lot of pain.心率117胎心180Her heart rates 117. Fetal heart rate 180.母女都心动过速了Theyre both tachycardic.500毫克对乙酰氨
21、基酚开始注射氨莘西林500 milligrams acetaminophen and start ampicillin.这就是我们担心会发生的感染This is the infection we were worried about.你的宝宝活下来的可能性很小Your baby is very unlikely to survive, 而你的生命也处于危险之中and your life is in danger.我们需要立刻终止妊娠We need to terminate now.但她的心还在跳动But her hearts still beating.埃丝特只能在子♥宫&hea
22、rts;内存活Esther can only stay alive in utero.只要她还在子♥宫♥里你就会病得越来越重 And as long as shes in there, youll keep getting sicker. 我很抱歉Im so sorry.我在我们可以度过难关的Im here. We can get through this.孩子我们以后再要We can try again. 不No.你的宝宝至少还需要两周才能在子♥宫♥外存活Your baby needs at least two more weeks t
23、o be viable. 如果等那么久你可能会死And if we wait that long, you will probably die.“死亡不过是死亡而已If I perish, I perish/1 在她为家人冒生命危险之前Thats what Queen Esther said 埃丝特王后是这么说的before she risked her life for her family.索尼娅Sonja. “死亡If I perish.不过是死亡”I perish.圣博纳旺蒂尔医院B型钠酸肽测试和超声心动图显示According to the BNP test and echo, 你的
24、癫痫发作与心脏外伤无关 your seizure wasnt related to heart trauma. 我们将通过脑电波检测下你的大脑The EEG will let us assess your brain.那你来是为了什么？So whatrs your pitch?一个脑电波用不着一院之长亲自监督Hospital presidents dont supervise EEGs.你们的全球工程师计划给我留下了深刻的印象Ive been impressed by your Global Engineers Initiative.这个计划也可以运用到医学中来I think we can d
25、o the same with medicine.培训发展中国家的医生治疗他们的人♥民♥Train doctors from the developing world to take care of their people. 我为什么要选择这家医院呢？What makes St. Bons the place to do it?我们经验丰富住院医生们不是只会切囊尾和胆囊Were hands on here. Our residents dont just do appies and lap choles.在我们主治医师的指导下他们能想出复杂的治疗方法With th
26、e guidance of our attendings, they come up with complex treatments, 解开最棘手的道德困境untangle the thorniest ethical dilemmas并学习如何提供一流的患者护理and learn how to provide top-notch patient care.如果我们能培训更多来自发展中国家的住院医生If we could sponsor more residents from the developing world,等他们回国后他们就能为自己的社区服务了well send them home
27、ready to serve communities.但是我能托付生命的贾里德But Jared, who I trust with my life,却不配当这里的住院医生你炒了他wasnt good enough to be one of those residents. You fired him.你在他身上看到了我遗漏的品质You saw something in him I missed.但我现在也看到了我已经授予了他全部权限But Im seeing it now. Ive granted him full access.很场面话的回答你觉得呢他是想挣我的钱吗？Very politi
28、c answer. What do you think, has he earned my money?我在这里学到了很多I learned a tremendous amount at St. Bons.正如你所体验到的护理是一流的As youve experienced, the care is top-notch.不幸的是食物不是一流的Unfortunately, the food isnt.给达莉亚发短♥信♥让她带点阳新的猪肉包子回来Text Dalia and ask her to bring us back some of those pork buns
29、 from Yank Sing. 达莉亚进城了？Dalia went into the city?去见朋友To meet up with friends.你同意了？Youre okay with that?我为什么要反对呢？Why wouldn*t I be?确实没理由No reason.好吧让我们开始吧All right, lets start this.闭上眼睛放松Close your eyes and relax.实验室证实索尼娅患有绒毛膜羊膜炎Labs confirm Sonja has chorioamnionitis.那就加庆大霉素We should add gentamicin.
30、那会伤害婴儿的肾脏Thatll damage the babys kidneys.只有这样才能让索尼娅活下来Its our only way to keep Sonja alive.并为我们争取时间说服她终止妊娠她是在自杀Buys us time to convince her to terminate. Shes being suicidal.为孩子冒生命危险是令人钦佩的Risking your life for your child is considered admirable.但她们会母女双亡因为你给了她虚假的希望Not if youre both going to die, beca
31、use of the false hope you gave her.我只是回答了她的问题I answered her question.你是给了她许可You gave her permission.我们应该至少努力做到客观Were supposed to at least try to be objective.客观是几乎不可能的尤其是在这个问题上Objectivity is a myth, especially on this subject.我知道索尼娅正在经历极度的痛苦I know the pain Sonja*s grappling with.我也是So do I.当时我在上医学院避
32、孕了但还是怀上了I was in med schoob on birth control, and I got pregnant anyway.当时我还没准备好要孩子I wasnt ready for a kid.我很害怕I was scared.很难过And sad.但松了一口气And relieved.那只是我多年前做过的一次手术It was a medical procedure I had years ago,我现在能平静接受这事and Im at peace with it now.多数女人都能Most women are.因为那是她们自己做的选择Because it was the
33、ir choice,一个必须做的选择我也选过所以让索尼娅也自己选吧a choice you got to make and I did, too. Let Sonja make hers.我们的工作并不是帮助病人选择死亡Its not our job to help patients choose death.她的肺衰竭了Her lungs are failing.她的氧饱和度在下降体温在升高Her 02 sats are falling, fever*s climbing.插管推车Intubation cart.给她用丙泊酚和罗库澳镀Administer propofol and rocur
34、onium.我们要给你注射镇静剂然后才能插管We need to sedate you so we can intubate.这样能让你保持呼吸但唯一的方法Thatll keep you breathing. But the only way.你不能杀死她You cant kill her.埃丝特的命比我重要Esthers life before mine.索尼娅拜托答应我Sonja, please. - Promise me.我不能答应我I cant. - Promise me.安东尼Anthony.我I.我保证I promise.我爱你I love you.看下罗兰脑电图中左额叶的活动Ch
35、eck out the activity in the left frontal lobe on Rolands EEG.Better. Roland Barnes.绿色科技那家伙？The green tech guy?他被老虎袭击了 -在圣何塞？Hes attacked by a tiger. - In San Jose?在圣克鲁斯山当时他在搞动物救援At his animal rescue in Santa Cruz mountains, 礼宾医生打电♥话♥说他们正在路上concierge doc called to say theyre on the way.
36、圣何塞综合医院离他们更近啊San Jose General is much closer.他为什么来这里？-因为你Whyd he come here? - Because of you.胸壁深层撕裂伤多处肋骨骨折血气胸Deep chest wall lacerations, multiple rib fractures, hemopneumothorax. 目前情况稳定I stabilized him.但他需要立刻做CTBut he needs a CT, Stat.卡鲁医生-安德鲁斯医生Dr. Kalu. - Dr. Andrews.很高兴见到你墨菲医生Good to see you, Dr
37、. Murphy.你好贾里德Hello, Jared.著名亿万富翁和可爱的重逢？A famous billionaire and a cute reunion?这简直比看到斯威夫特还赞This is almost Swift-worthy.里奥扑克牌打得好吗？Is Leo a decent poker player?美国周刊有罗兰上周退出比赛的照片Us Weekly has photos of Roland coming out of his game last week.我的兰博是从他那赢的Won my Lambo off him.没有肝脏或脾脏外伤的迹象No sign of trauma
38、to the liver or spleen.碧昂丝为他的生日做了场私人表演？Beyonce did a private show for his birthday?那表演超棒It was awesome.发作间期尖峰Interictal spikes.幅度很小可能是偶然的Theyre very small, likely incidental.罗兰很自私占有欲极强Rolands selfish and possessive.他讨厌别人不带他玩He hates it when people have fun without him.但今天达莉亚去和朋友玩了他竟然没意见But today he
39、was fine with Dalia hanging with friends. 无私也是一种症状Being unselfish is a symptom.也许他的某处伤口感染了？Maybe one of his wounds got infected?爪子或牙齿引起的细菌性脑炎？Bacterial encephalitis from the claws or teeth?可能是轻微的水肿This could be subtle edema.再加上行为改变和发作间期尖峰Plus behavior changes and interictal spikes.听起来像脑囊虫病Sounds lik
40、e neurocysticercosis.一个绦虫囊肿-大脑中有幼虫A tapeworm cyst. - With larva in the brain.但绦虫需要几周的时间It would take a tape worm weeks才能在他大脑中完全形成幼虫和囊肿to fully form larva and cysts in his brain.而袭击发生在两天前The attack was two days ago.罗兰上次“野生动物游是两个月前Rolands last local safari was about two months ago.他掉进了一大堆老虎屎里And he fe
41、ll into a giant pile of tiger crap.我们可以用立体定向导航和水分离法We can remove the cyst and larva去除囊肿和幼虫with stereotactic navigation and hydrodissection.太赞了Awesome.你不是废柴Youre not a failure.不会吧Seriously?要猜四次？Four guesses?我两次就答对了I got it in two.你怎么了？Whats up with you?你有病人去世了？You lose a patient?相反我可能会救下一个Actually, I
42、 might save one. 乔Joe.米娅的那个乔？Mias Joe?正在等他的活检结果Waiting on his biopsy results.他们要我原谅他They asked me to forgive him.你怎么说？What*d you say?我拒绝了I refused.换做是你你也会的You wouldve, too.也许吧Maybe.但我能放下过去Im capable of letting things go.我也能放下I can let things go.我把事业放在首位就那么一天I prioritized my career for a day, 但你就是觉得不
43、可接受which you decided was unacceptable. 即使在我改变主意之后Even after I changed my mind. 你花了多长时间才原谅米娅？How long did it take you to forgive Mia?帕克医生？Dr. Park?你的检测报告好了Your diagnosis is in.这边伙计们小心点你们搬的东西有年头了Right this way. Guys, be careful. Youve got history, youre carrying.有几个台阶当心Theres a couple of steps. Be car
44、eful.谢谢伙计们右边第一扇门Thanks, guys. First door on the right.体育馆座位？Stadium seats?正宗的烛台公园体育场座位从经纪人那里买♥♥到的 Authentic, Candlestick Park stadium seats. Got them from a broker. 太酷了吧-对吧？Very cool. - Right?谢谢你给的灵感不客气Thanks for the inspiration. - Youre welcome.接下来轮到你了穿上你的外套Your turn next. Get your co
45、at.你的胃里有一个间质瘤肝上有一个小病灶You have a stromal tumor in your stomach, and a small lesion on your liver. 两者我们都可以摘除We can remove both.然后你的癌症就治愈了You*ll be cancer free.真是难以置信Thats incredible.谢谢Thank you.你明白吧？You get it, right?你这条命保住了Youre not dying.明白Yes.太了不起了This is amazing.我很感激Im so grateful.但是那不是你来这里的原因But-
46、 - Thats not why you came here.在接下来的48小时内索尼娅很可能出现多器官衰竭Sonja will likely be in multiorgan failure within the next 48 hours. 到时候埃丝特也没法活下来When that happens, Esther will not survive.但如果现在终止妊娠索尼娅是可以活下去的But if we terminate now, Sonja still can.你可以挽救你妻子的生命You can save your wifes life.全取决于你Its all up to you
47、.他说.He says.他说他做不到he says he cant do it.他必须信守诺言He needs to keep his promise.我知道该怎么做了I know what to do.抱歉兄弟Sorry, man.来啊Bring it.你还好吗？Are you okay?一条虫子在我的头骨里产卵了A worm laid eggs in my skull.是幼虫Larva.你是对的墨菲是最棒的You were right. Murphys the best.如果给你一亿美元你觉得怎么样？What would you say to a hundred million dollars?我觉得你真是太慷