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1、加夫尼芝加哥医疗中心Here at Gaffney Chicago Medical Center.要尽可能多吸引媒体的注意We*ll want to get as much press as possible.他们开始帮手术室2.0打广&hearts浩♥了 ?Theyre doing infomercials for 2.0 now?当你还小的时候,你开始有你的问题When you were a kid, you started having your problems,我没陪在你身边and I wasnt there for you.你现在在我身边了Youre here now
2、.我可以构建一个神经网络I could construct a neural network和成千上万已知的突变进行比较and compare it against tens of thousands of known mutations. 不知道你能不能教我I wonder if you might train me你说的那个新的电子病历系统on that new program you were talking about.霍士迪医生,你能帮宋医生一下吗?Dr. Halstead, can you give Dr. Song a hand?你打保龄不能靠防落坑围栏You cant play
3、 with the bumpers up.那又怎样?我不觉得尴尬啊So what? Im not embarrassed.那你要怎么变强?How are you supposed to improve?谁说我要变强的?Who said anything about improving?我是来这里喝饮料的Im here for the drinks.玛姬要请第一轮吗?Maggies buying first round?好像是这样Thats what I heard.这就是我不约你们出去的原因This is why I dont invite you two out,你们太小气了because
4、you*re cheap.班去哪了 ?You cant talk to your ex about your new crush?我觉得你搞错了I think you misread the situation.-哩-哩 八、八、-Hey. -Hey.一早安哇-Mornin*. -Whoa, whoa.这件夹克是怎么回事?Whats with the jacket?-我现在在这里工作了-是啊,我想也是-I work here now. -Yeah, that much I guessed.哇Wow.你还好吗?You all right?还好,我没睡好Yeah, I slept funny.所以
5、你负责泊车So you*re parking cars.汉娜艾莎医生帮我介绍的Hannah. Dr. Asher hooked me up.她把职缺传给我Sent over the job opening.还帮我说了好话她人真好-Put in a good word. -How considerate of her.我想要给你个惊喜Well, I wanted to surprise you.你觉得我该给她写封感谢信吗?Hey, you think I should, like, write her a thank you note? 会不会很怪?Is that weird?也许我该请她喝杯咖
6、啡Maybe Ill buy her a cup of coffee.我会帮你转达Fil pass along your regards.去忙吧Hustle up.你可不想因为在工作时间闲逛而被扣分You dont want to be written up for loitering on the job.艾卓亚医生,早Dr. Archer, good morning.你好吗? 很好-How are you? -Fine.-你为什么要这么问?-不为什么-Why would you ask me that? -No reason.你需要什么吗?要喝水或是Anything you need? W
7、ater or.我需要住院医生少说话Yeah, I need residents to talk less.嘿Hey.嘿,腹膜透析导管还好吗?-还好-Hey, howd the PD cath go? -OK.你为什么要帮辛来这里找工作?Why would you get Sean a job here?你说什么?Excuse me?这里的所有人都知道我的状况Every person in this place knows whats going on with me.你觉得他多久就会发现这件事?How long do you think itll be before he finds out
8、 the news? 等一下,他不知道你有肾衰竭吗?Wait. He doesnrt know about your renal failure?我本来打算先不说的And I had planned to keep it that way.听着,我刚让这孩子回到正轨,好吗?Listen, I just got this kid back, all right?他戒毒了,我不想让我的病情成为他的负担With his sobriety, I dont want to burden him with my stuff. 好,迪恩,很抱歉我多管闲事OK, Dean, Tm sorry if Im bu
9、tting in here;但戒毒的关键取决于你们俩都诚实以对but sobriety depends on both of you being honest.如果你真的想和辛好好相处If you really want that real relationship with Sean, 就得让他知道he needs to know.你在干涉,好吗?You are butting in, all right?等他准备好了,我就会告诉他And Ill tell him when hes ready.好,嘿OK, hey.如果你有什么需要帮忙,尽管来找我If you need a hand wit
10、h anything, Im here.我知道透析的前几晚I know that the first few nights of dialysis会很难熬can be really rough.我没有打算请保姆Yeah, Im not in the market for a nursemaid.我可以帮忙,他的血管不好找I can help. His veins roll.我可以的,谢谢你Oh, Ive got it. Thank you.他不能戴着吗?-不行,对不起-He cant keep it? -No, Tm sorry.动手术时,他什么都不能穿He cant wear anythin
11、g during surgery.嘿,丹,一切都好吗?Hey, Dan. Everything good?很好,葛云女士Yeah. Ms. Goodwin asked me to come down, 要我来看看你的病人you know, check up on your patient.就算没有该死的摄像头今天的压力也会很大Big, stressful day, even without the damn cameras. 但他似乎状态很好But he seems to be doing great, 你知道,他很正面you know, focused on the positives.看来
12、我们准备好了Welt looks like were ready to go.令人兴奋的一天,是吧?Exciting day, huh?祝你好运谢了,兄弟-Good luck. -Thanks, buddy.嘿,宽宇Hey, Kuan-yu.我是马素医生Its Dr. Marcel.准备好迎接世界了吗?Ready to see the world?我生来就准备好了I am born ready.这种精神就对了Oh, thats the spirit.很好,兄弟,太好了,好Good, buddy. Great. All right.我想请你们稍微退后Im gonna have you guys
13、step back for a moment.谢谢Thank you.我能帮忙吗?Can I give you a hand?你需要另一个包吗?Did you need an extra bag or anything?我静不下来I cant keep still.尤其是今天Worse today.担心是很正常的Perfectly normal to be worried.我天天都在变老,身体越来越虚Every day, I get older, less strong,他的情况也越来越糟and he gets worse.没错,我今天是很担心So yes, I am worried toda
14、y.但我也充满希望But I am also hopeful.很好Good.也许我现在就该进手术室了 -你知道吗?-Maybe I go into surgery now. -You know what?这恐怕是不可能的Im afraid that thats not gonna be possible.这样会违反医院规定Ifs against hospital policy.不行,我一定要进去No. No, I must be there.我很抱歉之前没跟你说清楚Im so sorry that this wasnt made clear to you earlier, 但这其实是为了宽宇的
15、安全but its actually for Kuan-yus safety.但我可以帮忙But I can be useful.也许他们有疑问,或者需要帮忙搬他Maybe they have questions or need help moving him.吴太太,照顾您儿子的人都很可靠Mrs. Wu, your son is in the best possible hands.不如我在手术室旁边Look, how about if I find you a place to wait给你找个地方等吧?right next to the operating room?你这样就能尽可能靠近
16、他That way, you can be as close as possible.这会让你感觉好一点吗?Would that make you feel better?艾卓亚医生,车祸事故,三号♥创伤室Dr. Archer, incoming MVC. Going to Trauma 3.硕克,你和他们一起去Zach, you*re going with them.高尼云逊锤斯,40岁-Court! -Vincent Jones, 40s.在切尔马克和克拉克街发生侧撞交通事故T-boned at Cermak and Clark.昏迷指数8GCS 8.血氧饱和度一直在80左右
17、徘徊Sats have been hovering in the high 80s.血压呢?105跟80-Pressure? -105 over 80.心率135Heart rates 135.好,我们走All right, lets go.我数到三就搬Get ready to transfer on my count.我们要不要找人帮忙,这样你就不用Should we get an extra set of hands so you dont have to. 不用No.准备好了吗? 一、二、三Ready? One, two, three.艾卓亚医生,你是不是Dr. Archer, are
18、you.担心你的病人就好,可以吗?Yeah, just worry about your patient, all right? 第一件事是什么?Whats the first order of business?-气道-气道,对-Airway. -Airway, right.翠妮,我需要插管设备跟快速插管用药Trint I need ET kit, RSI drugs.这边需要拍X光I need X-ray in here, please!好All right.感觉骨盆有些不稳定Feeling some instability in the pelvis.怎么这么久?-我应该快好了-What
19、 is taking so long? -I think Ive got it.-应该?-好了-You think? -Im in.呼吸听起来是双侧的Breath sounds bilateral.血氧饱和度上升,压力还是很低Sats rising. Pressure still soft.好,接下来呢,硕克?All right. Whats next, Zach?拍胸部和骨盆X光,然后做腹部超音波X-ray chest and pelvis, and then a fast.你是想救活他You want to resuscitate this guy还是让他在你下指示的时候死掉?or jus
20、t let him die while you order stuff?好,两个单位的全血Right. Two units whole blood.腹部超音波没有问题Negative fast.好,X光呢?All right. Wheres my X-ray?好了,大家退后All right, clear!让我们看看Lets see it.左侧骸骨脱位Left-sided posterior hip dislocation.-没错,然后呢?-我们要进行复位-Got it in one. And? -Well need to reduce.又回到零分了Set the scoreboard bac
21、k to zero.他需要做正电子扫描He needs a panscan.排除腔出血Rule out cavitary hemorrhage.他可能需要动手术才能复位He might need surgery before we reduce him.好,我们走吧All right, Iet*s move.要开始了Here we go.宽宇准备好了,摄像头也就位了Kuan-yus ready, and the cameras are in place.我让坐在桌子前面的那位退到后面I had the one at the head of the table moved back.你最好把他们
22、从手术室里赶出去Better if you moved them all the way out of the room. 怎么,你怕他们把你吓跑吗?What, are you afraid theyre gonna throw you off?没有什么事能把我吓跑Nothing throws me off.我只是觉得我的手术室里不该有宣传的位置I just dont think publicity has a place in my OR.我很意外你会接下这个手术Im surprised you took this case then.我想过要拒绝Well, I thought about
23、refusing,但换做是其他神经外科医生but any other neurosurgeon可能会让这个可怜的家伙瘫痪would probably paralyze the poor guy.可悲的是,到头来Now, sadly, at the end of the day, 你和我不过是在you and I are just shilling帮一个亿万富翁填满他的口袋for a billionaire padding his pockets.如果你是这么想的话,也没关系Well, if you want to look at it that way, OK.但如果没有手术室2.0就不会有这
24、场手术But this surgery never would have happened without 2.0, 如果没有积就不会有这个手术and it never would have happened without Jack.对,换句话说,都有你的份Right. In other words, your participation in it.华♥莱♥士♥小姐,我是霍士迪医生Ms. Wallace, Tm Dr. Halstead.我妈在照顾我儿子My moms looking after my son.我在试着用短讯Trying to ex
25、plain解释如何用衣服包裹一个六周大的婴儿how to swaddle a six-week-old via text.慢慢来Take your time.她会想到办法的She1! manage.就这样吧I turned out OK.你今天怎么了?So what brings you in today?哦,我要吐了Oh, here it comes.我知道了Asked and answered.你这种情况多久了 ?How long you been feeling this way?好几天了A few days now.我原本以为是食物中毒I thought maybe it was fo
26、od poisoning,但应该不会持续这么久吧?but it shouldnt last this long, right?可能是病毒性肠胃炎Could be viral gastroenteritis.肠胃炎,很快就会好Stomach bug. Easily treatable.但我们得先做些化验和静脉输液But well start with some labs and IV fluids.我还可以给你开一些治恶心的药I can also prescribe you something for nausea.非常感谢That would be much appreciated.不客气Al
27、l right.来Here we go.我做了单亲妈妈试管婴儿手术You know, I did the whole single-mom IVF thing.每个人都警告过我高龄产妇的风险Everyone warned me about the risks of a geriatric pregnancy.我不知道这种情况会持续到产后I didnt know the effects would last postpartum.我们会让你尽快康复Well, were gonna get you sorted out然后回到你儿子身边and back to your son as soon as
28、 possible.好的,全套血液检查、基本代谢指数腹部X光,再注射一升生理盐水All right, CBC, BMP, KUB, and bolus a liter of normal saline.好的谢谢你,医生-You got it. -Thanks, Doc.不客气Of course.我能请你帮我看一下吗?Hey, can I get your eyes on this?当然可以,怎么了?Yeah, sure. Whats up?40岁试管婴儿孕妇,入院的时候40-year-old IVF primip came in有恶心和呕吐,但化验结果正常with nausea and vom
29、iting, but her labs are normal.-毒理反应呢? 正常-Tox? -Clean.好,她的血压上升了,147跟92OK, yeah, her BP is up. 147 over 92.对,从入院前就这样了Yeah, been that way since intake.可能是子痫前症?-过这么久了 ?-Could be preeclampsia? -This far out?对,很少见,但有过案例Yeah, its rare, but it happens.以防万一我会检查综合代谢检查和蛋白尿fd check a CMP and PC ratio并考虑镁离子缺乏an
30、d consider mag, just in case.如果你需要,我可以帮你安排I can do the order if you want.-好,谢谢不会-Sure. Thanks. -Yeah.韦,我刚才说Hey, Will, about earlier,你和嘉丽丝you know, you and Grace.汉娜-听我说-Hannah. -No.我不应该笑你I never should have teased you.男人跟女人当然可以当朋友Obviously, men and women can be friends.好,就算我对她有兴趣OK, look, even if I w
31、ere interested in her,嘉丽丝居无定所Grace is a nomad.积带她到世界各地Jack has her all over the world.我很难和那样的人谈恋爱Its tough to start something with someone like that.知道了Yeah.化验结果出来后我会跟你说Ill let you know when these labs come back.颈胸截骨术看起来很好Cervicothoracic PSOs look good.我想是的I think so.让我们看看手术室2.0是否同意Lets see if 2.0 a
32、grees.我不需要其他意见Wheres Ben?明天是科学展览The science fair is tomorrow.他在为小苏打火山的Hes prepping the gym for a mass eruption 大规模爆发做准备of baking soda volcanoes.别担心,我约了第四个人But dont you worry, I got a fourth.是吗?谁?Oh, yeah? Who?嘿,嘉丽丝,这边Hey, Grace. Over here.听说她单身Word is shes single.干嘛,你要帮我们牵线吗?What, youre trying to se
33、t us up?没错你好-Mm-hmm. -Hi.-睡哩 八、八、-Hey. -Hey.我们要去吧台We*re hitting the bar.你要喝点什么吗?Can we get you anything?天啊,太好了Oh, my gosh, yeah.吉尼斯,或任何黑色的东西都好Guinness. Anything dark, really.黑色的东西,跟霍士迪一样Anything dark. Just like Halstead.真奇怪Go figure.好,我马上回来Well, be back in a flash.我不知道你会打保龄Didnt know you bowled.我到大学
34、毕业才知道Neither did I, until undergrad.这是我能得到的对体力要求It*s the least physically demanding gym credit I dont need another opinion.这会帮助我们,森Well, it could only help us, Sam.待命Standby.好的,手术室2.0将决定OK, so 2.0 would determine截骨术是否在理想的深度、高度和角度if the osteotomy is at the ideal depth, height, and angles 好完成矫正to achi
35、eve correction.可接受C7和T1截骨术Acceptable C7 and T1 osteotomies.可接受?这么做很完美Acceptable? Its perfect.你能解释一下这些激光对外科医生有什么帮助吗?Can you explain how those lasers are helpful for the surgeons?马素医生,你能解释一下吗?Yeah, Dr. Marcel, could you explain that?当然可以,你能挪过去一点吗?Uh, sure. Yeah. Could you move over?把你的相机对准屏幕In fact, d
36、irect your camera towards the screen there.你会看到手术室2.0会在脊椎上Youll see that 2.0 will superimpose lines叠加线条来帮助指导外科医生在哪里钻孔onto the spine to help guide the surgeon where to drill以及要移除的骨头的范围and the extent of bone to remove.艾布斯医生,我发现振幅下降了 50%Dr. Abrams, Im seeing 50% decreases in amplitude双腿的潜在危险增加了and incr
37、eased latency in both legs.要进行确认Running a motor.将诱发电位反应显示在屏幕上Put the evoked potential response on screen.马素医生,有什么问题吗?Dr. Marcel, is there a problem?我们是否要担心脊髓损伤和压♥迫♥ ?Are we concerned with cord injury and compression?是的,因为我想我们的病人的目标Yeah, rcause Im assuming that our patients goal不是瘫痪wasn
38、t to become paralyzed.提高他的平均动脉压Push his MAPs.翻转所有可逆的因素Reverse everything thats reversible.看看术中神经功能监测的变化是不是真的Find out if this IOM change is real.如果是的话,替他缝合让他下手术台做磁力共振造影And if it is, close him up and get him down for an MRI stat.磁力共振造影?不对,等一下MRI? No, hold on.我们没必要移♥动♥他手术室2.0可以做术中电脑断层扫描We
39、 dont have to move him. 2.0 can do an intraop CT.对,但看不出Yeah, which wont show me anything有没有脊髓水肿或韧带屈曲about cord edema or ligamentous buckling.但如果我能把电脑断层扫描和术中超音波结合起来But if I can merge a CT with an intraoperative ultrasound,就有你需要的一切了youd have everything youd need right here.这样就行了,我们不需要移♥动&hearts
40、;宽宇That would work, and we wouldnt have to move Kuan-yu.听着,与其在病人身上做实验Look, experiment with this thing on another patient.我更想百分百确定I want to be 100% sure.森,我们有一百个理由Sam, there are a hundred reasons不应该移♥动♥他why we should not move him.随便说一个,感染风险Pick one. Infection risk.延长麻醉的时间Prolonged time
41、under anesthesia.该死,他甚至可能会在移♥动♥后变得不稳定Hell, he could even be unstable after the move无法继续动手术to even continue surgery.那就做吧Do it.希望你是对的Lets hope youre right.不然你就会犯下终结职业生涯的错误Otherwise, youre committing a career-ending mistake to film.你真的不用任何东西吗?You sure theres nothing we can get you?-要不要吃点什
42、么?-不用-Maybe something to eat? -No.现在情况如何?How are we doing?-有进展吗? 还没有-Any updates? -Not yet.我失陪一下Oh, excuse me.那是一块可爱的石头You know, thats a lovely stone.我之前跟你儿子说话的时候就注意到了I was noticing it earlier when I was talking to your son.从河里捡的From the river.宽宇小时候找到的Kuan-yu found this as a child.又滑又亮It was smooth
43、and shiny.他认为这是宝石He thought it was a gem.那是他最后几次能活动It was one of the last times he was able to move,跟玩耍的日子to play.我做这个是为了带给他希望I made this to give him hope让他有一天能再次玩耍that one day he would play again.我答应过会帮他I promised I would help him.你确实遵守了你的诺言Well, you have certainly kept that promise.怎么了?What*s goin
44、g on?-我需要和达霞聊聊一聊什么?-I need to talk to Da-xia. -About what?出现了并发症Theres been a complication,好像是脊髓受压something about a cord compression.我需要拍下她的反应Ive got to get her point of view.现在不是时候Now is not the time.葛云女士,他们知道Ms. Goodwin, this is one of the major risks他会面临这样的主要风险they knew he was facing.从视频叙事上来说这对他们
45、的故事很重要Narratively, thafs important to their story.这件事跟故事无关Well, this is not about a story.这是个涉及真人的复杂医疗程序Its a complicated medical procedure involving real people.戴顿先生有下令I have a directive from Mr. Dayton.她签了拍摄合同She signed a contract to be filmed.我说你能拍才能拍,不是积戴顿说了算You film at my discretion, not Jack Daytons.你可以在医生提供最新情况后And you can speak to Da-xia再和达霞谈,现在不行after the doctors provide an update and not bef