The Good Doctor《良医》第六季第十八集完整中英文对照剧本

前情提要PreviouslyonTheGoodDoctor...来俱乐部的还是来上班的？Goingtothecluborwork我还得花点时间才能适应早班Theseearlycallsneedsomegettingusedto.棕色牵开器.没有棕色牵开器BrownRetractor.-NobrownRetractor.我好像把它放在你的托盘上了IthoughtIputitonyourtray.卡鲁医生不是你的同级Dr.Kaluisnotyourpeer.他是你的员工你是他的老板Hesyouremployeeyourehisboss.我不打算给贾里德特殊待遇IdonotplantogiveJaredspecialtreatment.如果我看到了对你们俩都不好AndifIseeititwontbegoodforeitherofyou.我没想要特殊待遇Imnotexpectingspecialtreatment.我也不喜欢被当作实习生对待Idontappreciatebeingtreatedlikeanintern.安德鲁斯医生说他会根据你的表现来评判我的表现Dr.Andrewsisjudgingmyperformanceoffyours而你的表现并不好anditisnotgood.你开着你的豪车带着老想法回到医院Youcomeinwithyourfancycarandyouroldtricks心想着〃我是个外科医生”但你不是andthink“Ta-da.Imasurgeon.11ButyouYenot.我想证明我属于这里IwanttoproveIbelong.我在术后检查雅拉时发现你只缝了八针WhenIcheckedYarapost-opInoticedyouonlyusedeightsutures而且她还有一点出血你应该缝十针的andshehadasmallbleed.Youshouldveusedten.格拉斯曼医生关闭了帽状腱膜和缝合Dr.Glassmanclosedthegaleaandskin.格拉斯曼医生少缝了两针？-应该是的Dr.Glassmanskippedtwosutures-Guessso.你昨天早上儿点起床的？Ifwedontstopthespasmshecouldhavepermanentbraindamage.未来发生漏斗部痉挛的可能性非常高Thechanceofafutureinfundibularspasmisveryhigh.法洛四联症修复手术的风险会变大Tetrepairsurgerywillbemuchmorerisky.达芙妮肺部的压力非常高PressureinDaphneslungsiscriticallyhigh根本不是常规的扁桃体切除术Notaroutinetonsillectomyatall.穿刺房hearts;间隔Puncturingtheatrialseptum.右心在减压Rightheartisdecompressing.给一氧化氮以放松和扩张血管Givenitricoxidetorelaxanddilatethevasculature.她的呼吸暂停确实对她的肺血管造成了影响Herapneareallydidanumberonherpulmonaryvessels.难怪她笨拙又健忘Nowondershesclumsyforgetful.几十年来她一直在睡眠中缺氧Shesbeensleepingoxygen-deprivedfordecades.但她依然不该是她女儿的责任Stilldoesn*tmakeherherdaughtersresponsibility.你想让凯兰放弃自己的生活来照顾你吗？WouldyouwantKellantoputhislifeonholdtotakecareofyou当然不想他放弃自己的人生但我不觉得过度关心父母Nothiswholelifeno.ButIdontthinkbeingoverly-devoted是孩子的缺点拔掉导管istheworstqualityinakid.Removethecatheters.我们家六个孩子我是唯一的女孩爸妈工作很辛苦Iwasoneofsixgrowingup.Onlygirl.MomandDadworkedalot.所以从幼儿园起我就变成了大家的第二个妈妈SoIwasbasicallysecondmomsincekindergarten.我爰我的兄弟们Ilovemybrothers.但如果你要一直照顾别人buttheresalotyoumissouton就会错过很多ifyoureallaboutcaringforsomeoneelse.她室性早搏次数很多也许是电解质问题？ShesthrowingalotofPVCs.Maybeanelectrolyteissue血压在下降心率172BPisdroppingheartrate

172.几乎没有脉搏她心动过速了除颤仪电极板Barelygettingapulse.Shesinv-tach.Defibpaddles.（建议除颤）（放电中）血压和心率稳定BPandheartratestabilizing.进行新的化验胸部X光检查、心电图检查GetanewchemistrychestX-rayEKG.我们需要了解她的心脏还有什么问题Weneedtolearnwhatelseisgoingonwithherheart.请不要弄乱我的材料Pleasedonrtdisturbmymaterials.这是什么材料？Whicharewhatexactly格拉斯曼医生犯了一个不同寻常的手术错误Dr.Glassmanmadeanuncharacteristicsurgicalerror.我在确定是单次错误还是形成了模式Iamdeterminingifitwasananomalyorpartofapattern.格拉斯曼一定会对此感到很高兴Glassmanmustbepleasedaboutthat.他不会你是在讽刺Heisnot.Youarebeingsarcastic.绩效考核是标准做法对医生和患者都有好处Performancereviewisastandardpracticebenefitsdoctorsandpatients.我发现了过去四个月的另外三个错误Ivenotedthreeadditionalerrorsfromlastfourmonths.我觉得没形成模式-瘢痕组织上的硬膜撕裂Idontseeapattern.-Duraltearonscartissue用尼龙线连续缝合而不是单乔缝合线这算错误？closingwitharunningnyloninsteadofMonocryl.Thatamistake格拉斯曼医生一直用皮下单乔缝合Dr.GlassmanhasalwaysusedsubcutaneousMonocryl.这些只算变化小失误Thesearevariationsminormissteps.仔细阅读任何外科医生四个月的报告Porethroughfourmonthsofanysurgeonsreports你都会发现这样的差异•不会andyoullfinddiscrepancieslikethis.-No.会的•我的不会Yes.-Notinmine.那倒有可能•没错Thatsprobablytrue.-Yeah.如果你没找到模式也许是因为没有模式Ifyourenotfindingapatternmaybeitsbecausethereisntone.我的病人醒了Mypatientisawake.这是否意味着你们做不了四联症修复术？DoesthismeanyoucantdotheTetrepair有一种药物普hearts;蔡hearts;洛hearts;尔hearts;可以显着降低Theresamedicationpropranololthatllsignificantlyreducetherisk在手术过程中再次痉挛的风险ofhavinganotherspasmduringsurgery.但是由于长hearts;期hearts;新冠你可能会面对一些罕见副作用ButcauseofyourlongCOVIDyoureatriskforsomeraresideeffects.这些副作用严重吗？-严重Aretheyserious-Yes.不全严重比如恶心、呕吐、肌肉酸痛Notsomelikenauseavomitingmuscleaches.但其他的比如低血糖或视觉…Butotherssuchashypoglycemiaorvisual—开始用普hearts;蔡hearts;洛hearts;尔hearts;的话Startwithpropranolol.也很有可能不会有副作用Goodchanceyouwontexperiencethesideeffects.但我们需要密切关注你Butwe*llneedtokeepacloseeyeonyou.排在她前面的那些患者是否也是患有糖尿病的老年人？Andarethosepatientsaheadofheralsoseniorswithdiabetes不要挂断电hearts;话hearts;否则我会亲自去找你解决这事DonothanguporIllheaddowntodothisinperson.我会等待Filwait.嗨Hey.我听说有家新开的葡萄牙餐厅很棒ThereisagreatnewPortuguesespotIreadabout.周五或周六晚上七点我俩订个双人桌怎么样？IcanmakereservationsforusFridayorSaturdayat7:00这两天我都要加班自从贝克和林恩离开后我一直很忙Imworkingadoublebothdays.BeenhecticsinceBakerandLinhleft.两名旅行护士周一会来上班•我要的是注册护士TwotravelersarestartingMonday.-1needstaffnurses.他们技术高超Theyrehighlyskilled.这不重要旅行护士只会扰乱工作流程Doesntmatter.Travelnursesdisruptworkflow无法建立长hearts;期hearts;关系dontbuildlong-termrelationships.我们现在没资源雇佣常驻员工Wedonthavetheresourcesforpermanentstaff.你刚雇了个全职住院医生来替代新近才离职那个Youjusthiredanewfull-timeresidenttoreplacesomeonewholeftrecently.那是利姆的部门ThatwasLimsdepartment.好好极了我这就让她下去Yes.Great.Tmsendingherdown.对不起我们稍后再谈？•当然Sorry.Welltalklater-Ofcourse.所以你在看我会不会吐？SoyourewatchingtoseeifIthrowup或昏厥、抽搐、肌肉痉挛Orfaintseizeorhavemusclespasms.你知道吗在新冠之前我的大脑YouknowbeforeCOVIDmybrainwas.我研究进化模式基因的・・・Ididevolutionarypatternsgenetic...基因如何结合在一起howgenesgotogether.序列Thesequence.现在我的大脑连刷牙顺序都搞不清Nowmybraincanthandlethesequenceofbrushingmyteeth.我的注意力我的工作记忆所有的…Myfocusmyworkingmemoryallofthe...天啊・・・Ohmy...还有管控功能Theexecutivefunction.时灵时不灵的Itsnotalwayshappening.请呼叫沃尔克医生来观察她你留下来等他来了再走PleasepageDr.Wolketomonitorherandstayuntilhecomes.把你的手推到我的手上Pushyourhandagainstmine.管控功能的错误形成了模式Thepatterniserrorsinexecutivefunction.我正在处理事情•你的脑癌可能已经复发了Iminthemiddleofsomething.-Yourbraincancermayhavereturned.所有错误都跟管控功能有关•肖恩Allerrorstiedtoexecutivefunction.-Shaun.储存程序记忆的背外侧前额叶皮层Specificallyproceduralmemoryinthedorsolateralprefrontalcortex是复发性神经胶质瘤的常见部位acommonsiteforarecurrentglioma这都证明你的癌症已经复发whichstronglysuggestsyourcancerhasreturned.我上次的扫描结果完全清晰Mylastscancamebackcompletelyclear.我很好•上次扫描是六个月前Imfine.-Lastscanwassixmonthsago.这些错误来自过去四个月你需要再次扫描Theseerrorsarefromlastfourmonths.Youneedanotherscan.证据非常有说服力-事实并非如此Theevidenceisverycompelling.-Itsnot.我进行的复杂的手术Iperformcomplexsurgeries比这医院中的任何其他医生都要多moresothananyotherdoctoronthisstaffbytheway.所以百分比会导致Sothepercentageswoulddictate我可能会犯更多无关紧要的小错误thatImightmakemoreminorandirrelevantmissteps；如果你非要说那些算错误的话ifthatswhatyouwannacallem.错误率增加了Therateoferrorshasincreased.是的因为我处理的病例更棘手YeahcauseItakeontoughercases.都是别人处理不了的Theonesnooneelsewill.不行你需要再做一次核磁共振•肖恩No.YouneedanotherMRInow.-Shaun我要做的是回到病人身边而你需要记住下次先敲门whatIneedistogetbacktomypatientandyouneedtoknockfirstnexttime.“树木变绿了”Itsthegreeningofthetrees.轮到我了Myturn.试图做我的认知练习Tryingtogetmycognitiveexercisesin.你在背什么？Whatreyoumemorizing是阿达利蒙的《承受》里的一首诗ItsapoemfromTheCarryingAdaLimon.这个诗集主要讲的是Thecollectionismostlyabout.本该拥有却未能拥有的生活nothavingthelifeyouthoughtyoudhaveIguess.我刚读的那首是关于春天的TheoneIwasjustreading.itrsaboutspringcoming.“关于不放弃的建议”InstructionsonNotGivingUp.听起来很有用-可惜我不能一下子读完Soundsuseful.-ToobadIcantreaditallatonce.我刚读完俳句Ivejustgraduatedfromhaikus.在我生病之前我甚至从没想过要看一首诗NevereventhoughttolookatapoembeforeIgotsick.没有耐心也没有时间Didnthavethepatienceforitorthetime.但现在我只能读诗了ThatsbasicallyallIreadnow.也开始写作了就当是…Startedwritingtooaskindofa...创造性疗法creativetherapy.白三叶草的遗传变异Therewasakindofpoetry其实也像一首诗tothegeneticvariationsinwhiteclovertoo.我愿意付出任何代价.・・rdgiveanythingto...你的血压在下降心率在上升Yourbloodpressuresdroppingheartratesclimbing.我头晕•我来检查你的血糖Imdizzy.-Checkingyourglucose.她癫痫发作了抢救车快点Sheshavingaseizure.Crashcartnow.我们以为是你的心脏问题但其实是肾脏问题Wethoughtitwasyourheartbutitsakidneyissue.你的肾动脉变窄了Narrowingofyourrenalarterieswhichwasexacerbated肺动脉高压引起的肾功能衰竭加剧了你的肾动脉变窄bythepulmonaryhypertensioncausingkidneyfailure.这是睡眠呼吸暂停导致的吗？•我们认为是的Thisiscauseofmysleepapnea-Webelieveso.Yeah.她能做移植手术吗？我可以做个测试看看我是否匹配CanshegetatransplantIcandoatestseeifFmamatch.不幸的是你的其他健康问题导致做不了移植Unfortunatelyyourotherhealthconcernsruleoutatransplant.但是肾动脉旁路术可以让你的肾脏自行愈合Butarenalarterybypasswouldallowyourkidneystohealontheirown.但有并发症的风险有些相当严重Theresriskofcomplications.Somequiteserious.但如果成功了你就可以过上充实、独hearts;立hearts;的生活Butinsuccessyoucouldliveafullindependentlife.有多严重我可能会死？ButseriousasinIcoulddie有些并发症可能是致命的Somecomplicationscanbefatal.但风险相对较低Buttheriskisrelativelylow.还有其他选择吗？Arethereotheroptions可以透析Welltheresdialysis但在你的余生中你每周需要进行多次透析butyoudneedmultiplesessionsaweekfortherestofyourlife.那样风险较小但我觉得我一个人不行ThatslessriskybutIdontthinkIcouldhandleallthatonmyown.妈如果你选透析我就留在圣何塞MomifyouwanttochoosethedialysisIllstayinSanJose.对不起Imsorry.我不想留下你•用不着说抱歉Idontwanttokeepyou.-Youhavenothingtobesorryfor.原来这段时间你一直在生病、挣扎我却总说你YouknowallthistimeyouvebeensickandstrugglingandIjudgedyou.可是你的新工作怎么办Butyournewjob.那只是一份工作Itsjustajob.所以你用来让我的手术更安全的药Sothemedicationyougavemetomakemysurgerysafer实际上会增加我的风险吗？willactuallymakeitmorerisky没错Thatsright.但如果没有这种药物我很有可能会再次四联症发作ButwithoutthatmedicationImmuchmorelikelytohaveanotherTetspell.是的而且可能比上次更严重Yesandpossiblymoreseverethanthelasttime.脑雾我所有的症状都会更糟吗？Brainfog；allmydeficitscouldgetworse可能永远好不了？Forpossiblyforever是的Yes.但如果我们不做四联症修复你的心脏可能会突然停跳ButifwedontdotheTetrepairyourheartwillstopatsomepoint.我已经失去了我的头脑Ivealreadybeenthroughlosingmythoughts我的整个自我mywholeself.我不能再那样了Icantdothatagain.找个别的办法来做我的心脏手术Findanotherwaytofixmyheart.有了按照我们原来的想法直接做手术Newidea.Wegobacktotheoldideaandjustdothesurgery.这是不可能的我们必须找个办法即解决四联症Itsanonstarter.WeneedtopresentawaytohelpherTet又不引发四联症的症状withouttriggeringherTet.要想促进血液流动可以做经皮瓣膜和心室中膈缺损闭合ApercutaneousvalveandVSDclosurecouldhelpwithbloodflow.这涉及心脏导管会导致肌肉痉挛Thatinvolvescathetersintheheartwhichwouldcausethemuscletospasm.好的是时候使用施展肖恩大hearts;法hearts;了Allright.ItstimeforsomeWWSMD.无论你和杰罗姆在私下做什么…WhateveryouandJeromedoonyourowntimeis—〃肖恩墨菲会怎么做”WhatwouldShaunMurphydo（肺动脉瓣主动脉瓣）（右侧三尖瓣房hearts;室瓣）分流器怎么样能改善血液流动WhataboutashuntItwouldimprovebloodflow.可以给她几个月时间让她继续她的认知恢复Buyafewmonthstocontinuehercognitiverecovery.当她感觉心脏好点的时候也许她会让我们修复她的心脏Whenshefeelsbetteraboutherheartmaybesheletsusfixherheart.在那之前四联症可能会要了她的命HerTetwouldlikelykillherbeforethat.但是分流器不会引发症状她应该能接受Butplacingashuntwonttriggeraspellmakingitsomethingshedactuallyaccept.我跟她说Filtakeittoher.我只能待45分钟然后我就要继续看格拉斯曼医生的手术视频了Icanstayonly45minutes.HavetoreviewDr.GlassmansORvideos.你不是看过了吗？■之前没找神经胶质瘤复发的线索Didntyoudothat-Notforgliomarecurrencesymptoms.我要找新证据让他去做核磁共振Newevidencewillconvincehimtogetascan.你今天看了儿个月的数据了放松下明早你脑子会更清醒Youbingedmonthsofdatainoneday.Youllhaveaclearerheadinthemorning.所以现在我们唱唱卡拉OKUntilthenhereweare.Karaokerager.真棒•确实棒我们有个歌hearts;单Yay.-Itisnyayn.Wehaveasonglist.而且贾里德是我们的朋友他刚回医院还邀请我们一起庆祝PlusJaredsourfriend.Hejustmovedback.Celebrationisinorder.那我明早再看视频Iwillreviewthevideosinthemorning.听起来很疯狂Soundsprettywildinthere.因为也许Becausemaybe你会成为拯救我的人Youregonnabetheonethatsavesme毕竟Andafterall我只是在热身Iwasjustwarmingup.人都去哪了？•有很多食物Whereiseveryone-Thereisalotoffood.是的我预定的你们是最先到的YeahIhaditcatered.Yourethefirsttoarrive.最后一秒放鸽子的有摩根、帕克、阿舍和丹尼AndsofarlastminuterainchecksfromMorganParkAsherDanny.还有杰罗姆AndJerome.所以只有我们四个人Soitsjustusfour.这意味着所有这些零食Whichmeansthatallthesesnacks和歌hearts;曲单归我们独享了andsongbindersareforus.是的人少正好可以讨论症状Yes.Thelowturnoutistheperfectopportunitytodiscusssymptoms.在你最近和格拉斯曼医生一起手术时InyourrecentsurgerieswithDr.Glassmandoyourecallobserving有注意到任何hearts;平hearts;衡问题、颤抖或运动无力吗？anybalanceissuestremorsormotorweakness这听起来是个完美的选择Thatsoundsliketheperfectoption.什么时候可以进行分流手术？Howsooncanyoudotheshuntprocedure我会尽量安排在明天Illtrytoscheduleitfortomorrow.我自己也度过了奇怪的一年Ivehadastrangeyearmyself.十一个月前我遭到袭击腰部以下瘫痪ElevenmonthsagoIwasattackedandparalyzedfromthewaistdown.我以为它是永久性的几乎每个人都这样认为Ithoughtitwaspermanent.Almosteveryonedid.起初我满脑子都是要能重新走路Atwhattimedidyouwakeupyesterdaymorning老样子五点半怎么了？Theusual5:

30.Why午餐时你吃了一份科布沙拉AtlunchyouhadaCobbsalad.摄入了450卡路里你没蘸酱吧？450caloriesingested；assumingyoukeptitdown没有•你洗桑拿了吗Yes.-Didyouuseasauna剧烈运动或者腹泻过吗？engageinrigorousexerciseand/orexperiencediarrhea没有都没有你问这些做什么？NoIdidn*tdoanyofthosethings.Whatswiththequestions你在昨天的开颅手术中犯了个错误Youmadeanerrorinyesterdayscraniotomy.我正在尝试评估会对注意力产生负面影响的各种因素Imtryingtoevaluatevariousfactorsthatwouldnegativelyimpactfocus.我犯了个错误？Imadeanerror缝合你只用了8针但伤口的大小需要缝10针Youclosedwithonlyeightsutures.Thesizeofthewoundrequiredten.我们需要弄清楚为什么…Weneedtofigureoutwhy-为什么要搞清楚为什么两针而已WhydoweneedtofigureoutwhyTwosutures.就这么一次不值一提Itsablip.Itfsnotathing.这可能是种会引起麻烦的模式所以需要关注…Itcouldbepartofatroublingpatternneedingattention-肖恩手术很成功对吧？病人的治疗效果很好ShaunthesurgerywasasuccessrightThepatienthadagreatoutcome.没什么模式Thereisnopattern.再见Goodbye.我是一名外科医生我属于这里FmasurgeonandIbelonghere.我是一名外科医生我属于这里ImasurgeonandIbelonghere.你是一名外科医生你属于这里Youareasurgeonandyoubelonghere.AtfirstallIwantedwastowalkagain.我准备冒着生命危险找回原来的我Iwasreadytoriskmylifetogetbacktotheoldme.但随着时间的推移我开始欣赏我的新生活ButastimewentonIstartedtoappreciatemynewlife.我的新自我Mynewself.我开始了一段新的关系要是没这段经历这根本不可能发生Istartedanewrelationshipthatwouldnthavehappenedotherwise.在许多方面我的生活得到了改善Inmanywaysmylifeimproved.你知道你是走进来讲这个故事的吧？Yourecognizeyouwalkedintotellmethisstory在知道生命没有危险后我才同意做手术的IonlyagreedtodothesurgeryonceIknewmylifewasntatrisk.即便如此当时我也有疑虑AndeventhenIhaddoubts.我喜欢自己后来的样子我想留住她IlikedwhoIdbecome.Iwantedtoholdontoher.我不会.・・Imnot...再一次…losingmymind...失去我的理智alloveragain.在我看来你不像失去理智的人Youdon*tstrikemeassomeonewhoslosthermind.（《诗集:承受》艾达利蒙）这包括血栓切除术在二月份你协助…Thatcoversthethrombectomy.InFebruaryyouassisted-好了我要利用我的孕妇特权了Okay.Implayingthepregnantladycard.我们该走了肖恩•好吧WeregoingShaun.-Okay.谢谢再见Thankyou.Goodbye.我也该走了Ishouldheadouttoo.明天早班Earlymorning.也许你该想怎么当好首年住院医生Maybefocusonbeingafirstyearresident而不是把派对策划写进自己的简历里beforeaddingpartyplannertoyourresume.可能我有点用力过猛了Thecateringmayhavebeenabridgetoofar.是的Yeah.我有个漂泊的童年Ibouncedaroundgrowingup.在不同的学校、城市、国家atdifferentschoolscitiescountries.但无论我们在哪里Butwhereverwewere我父母都有一座大房hearts;子所以我很会办派对myparentshadabighouseandIknewhowtothrowaparty.所以办派对总让我觉得自己融入了ClosestIgettofeelinglikeIfit.我猜旧习难改吧OldhabitsdiehardIguess.融入需要时间Fittingintakestime.但我从来没有融入过任何地方ButIneverhaveanywhere.也许不是每个人都能找到自己的位置Maybenoteveryonefindstheirplace.达芙妮感染了我们该走了Daphneisgettingseptic.Wehavetogo.早上好.早啊Morning.-Hello.你不能喝•我每天可以喝355毫升Youshouldnothavethat.-Tmpermitted12ouncesaday.专家同意的Expertsagree.是的但那是我凌晨三点半煮的YesbutthatwasbrewedwhenIwokeupat3:30a.m.你看完视频了？•是的并整合了观察结果Youmakeitthroughthevideos-Yesandintegratedtheobservations卡鲁和艾伦医生昨晚就神经胶质瘤可能的症状提出了建议DoctorsKaluandAllenmadelastnightregardingpossiblegliomasymptoms.我现在准备去和格拉斯曼医生说IamnowreadytopresentDr.Glassman修订后的证据都是非常有说服力的withtherevisedevidencewhichisverycompelling.幸运的是抗生素对你的感染有用Thankfullyyourinfectionisrespondingtotheantibiotics.感染出现在你的透析口附近Theinfectionstartedaroundyourdialysisport这很容易再次发生thatcouldeasilyhappenagain.肾动脉旁路术也是一种选择Therenalarterybypassisstillanoption.太危险了Itstoorisky.败血症也很危险Soissepsis.谢谢你医生但我觉得活下来就好ThankyoudoctorbutFilsettleforbeingalive.你不该这么觉得Youshouldnt.你值得更有质量的生活Youdeservemorethanthat.我知道你一生都感到恶心、困Iknowyouvehadawholelifeoffeelingsickandstuck一直在恶性循环andrepeatingthesameoldbadpatterns.但你的过去并不能决定你的未来Butyourpastdoesnothavetotellyourfuturewheretogo.你可以选条不同的道路选择成为不同的人Youcanchooseadifferentpathandwhoyouregoingtobeonit.而你的女儿也可以有选择权Andletyourdaughterdothesame.春天的布拉格很美Pragueisbeautifulinthespring.（请查看有新证据的修订材料以便我们进行讨论肖恩）我们已经安排了今天下午的分流器放置术Wevescheduledashuntplacementforthisafternoon.那昨晚你说的故事呢？■那是我的想法但这是你的决定Andthatwholespeechlastnight-1standbyitbutitsyourdecision.我一直在等待旧我回来Ivebeenwaitingfortheoldmetocomeback.但那个人可能已经不存在了andthatpersonmaynotexistanymore.所以…And...也许我应该接受事实maybeIshouldbeokaywiththat.做四联症修复术吧DotheTetrepair.松开近端夹具Releasingtheproximalclamp.达芙妮怎么改变主意了？WhatmadeDaphnechangehermind艾伦医生知道怎么直击人心Dr.Allenhasawayofgettingthroughtopeople.血流看起来受阻移植物中有扭结Bloodflowlooksobstructed.Theresakinkinthegraft.我们可以重做但可能还会这样Wecouldredoit.Butmostlikelyithappensagain.我们可以不把旁路固定在主动脉上Wecouldanchorthebypassoffoftheaortainstead.在那个角度扭结的可能性较小Atthatanglelesschanceofakink.行得通Thatcouldwork.延长切口-胸骨锯Extendingtheincision.-Sternalsaw.开始胸骨切开术Startingthesternotomy.血氧降到786502droppedto

78.Sixty-five.四联症发作了SheshavingaTetspell.给她500毫升液体推注和纯氧Giveher500ccfluidbolusand100%oxygen给小剂量以增加肺血流量Givingamini-bolustoincreasepulmonaryflow.血氧降到5045Oxygensatson

50.Forty-five.加油加油Comeoncomeon.给她更多的氧气和麻醉剂Givehermoreoxygenanduptheopiates.显示不出来了Ithasstoppedregistering.（血氧饱和度］血氧饱和度上升了02isrising.心率正在稳定Heartratesstabilizing.她严重缺氧时间过长Shewasinprolongedgrosshypoxia.这可能会放大认知缺陷Thatcouldextendcognitivedeficits.或更糟orworse.那只有等她醒了才能知道了Wewontknowuntilshewakes.在她再次出现症状前先给她搭桥Letsgetheronbypassbeforeshehasanotherone.好的Okay.庆祝成功的肾动脉旁路手术Toasuccessfulrenalarterybypass.干杯由睿智而有说服力的医生发表的感人演讲促成Cheers.Facilitatedbyamovingspeechfromawiseandpersuasivesurgeon.多亏了某人提出的手术方案Withagreatsurgicalsavebyaguy现在某人该吃点绝妙的玉米饼了whosabouttohavesomelifechangingtacos.好吧Okay.我的天啊这也太好吃了吧OhmyGod.Okaythisisamazing.太赞了•我说吧水产玉米粒玉米饼Itsamazing.-Toldyou.Blue.Corn.Tortilla.我可能会爱上吃这个Icouldgetusedtothis.你脸上有生菜Youhavesomelettuce.这里不是另一边Here.Nomirrorimage.好了没？-没有Now-No.不许笑Nolaughing.你说得对我得严肃点No.Right.Veryseriousmatter.来让我来Hereletme.看还有There.Just.我们该走了Weshouldgo.是的Yeah.得早点回去准备达芙妮的术后治疗WeneedtogetbackearlyforDaphnepost-op.是的对Yeahright.旁路手术很顺利术后检查结果看起来很好Thebypasswentsmoothlyandpost-oplabslookgood.可以期待完全康复Weexpectafullrecovery.妈你感觉如何？HowareyoufeelingMom我能呼吸了Iambreathing.仿佛我这辈子第一次呼吸一样Kindoffeelslikethefirsttimeinmylife.扁桃体切除术后的肿胀已经消退Thepost-opswellingfromthetonsillectomyhasgonedown.你终于可以毫无阻碍地呼吸了You*refinallybreathingwithoutanyobstruction.你需要记好自己该吃的药Youneedtostayontopofyourmedications后续记得复诊还要看一些饮食指南andfollow-upvisitsobservesomedietaryguidelines.但这些都写在出院计划上了Butthedischargeplanlaysitallout.我会帮你记着的妈FilbetheretohelpMom.不No.不用你Youwont.你得去过自己的生活Youneedtoliveyourownlife.但我会和你视频通话的ButIwillacceptFaceTimecalls.等我康复了我就去看你AndonceIrecoverIllcomevisit.听说春天的布拉格很美IhearthatPragueisbeautifulinthespring.听起来不错啊Itsoundslikeaplan.格拉斯的事情进展不顺利？ThingsnotgowellwithGlassy他退回了文件还附上了一张便条Hereturnedthefileswithanote说他没有看这些文件也不打算看sayinghedidnotlookatthemanddoesnotintendto.太遗憾了Imsorry.让他自己看这些文件可能是错误的Itprobablywasamistaketoleavethemforhimtoread.我会重新整理文件然后去他的办公室和他一起看Filreorderthefilesandgotohisofficetoreviewwithhim.他不想看这些文件Hedoesntwanttoseethem.但他还不知道新的证据呢Buthedoesn*tknowaboutthenewevidence.也许他不想知道Maybehedoesntwanttoknow.癌症幸存者得带着不确定性生活…Cancersurvivorshavetolivewithanuncertainty-知道总比不知道好Knowingisbetterthannotknowing.如果他还没准备好看这些你就不能强迫他Ifhesnotreadytolookatthisyoucantforcehim.也许他害怕了肖恩我想也许你也害怕了MaybehesscaredShaun.AndIthinkmaybeyourescaredtoo.我们要生孩子了We*reabouttohaveababy.你快当爸爸了Youreabouttobeadad.我觉得你在担心家人而格拉斯曼也是我们的家人AndIthinkyoureworriedaboutfamilyandGlassmanisapartofthat.但如果你继续逼他Butifyoukeeppushingyouriskdamaging你生命最重要的关系之一可能会变坏oneofthemostimportantrelationshipsinyourlife.嗨-嗨Hey.-Hey.我一直在想我们不能继续这样一起喝咖啡了IvebeenthinkingandIneedabreakfromourcoffees.达理希Dalisay.我也不认为一起吃晚餐是个好主意Idon*tthinkdinnersagoodideaeither.即使我们对医院业务有不同的看法Sowehaveadifferentpointofviewabouthospitalbusiness.但这不会改变我对你的感觉ThatdoesntchangethewayIfeelaboutyou.无论上班下班我都是我OnorofftheclockTmthesameperson.对我来说如果你不重视护士的工作Tomeifyoudontvaluewhatthenursesdo不把我们视为可投资的资源而是可削减的项目enoughtotreatuslikearesourcetoinvestinnotalineitemtobecut.那你能有多在乎我？Howmuchcanyoucareaboutme老实说如果你真那么想Andtobehonestifthatisyourpointofview我可能以后都不会那么敬重你了itundercutstherespectIhaveforyou.哈珀路易斯德克兰1994年3月30日HarperLouiseDecraneMarch30th

1994.你知道自己为什么在这里吗？Anddoyouknowwhyyourehere为了治疗我的心脏Formyheartissues.我四联症又发作了吗？IhadanotherTetspelldidntI我们需要进行更多测试但是你的语言和记忆似乎完好无损Wellneedtoconductmoretests.Butyourspeechandmemoryseemintact至于你的心脏我们期待能完全康复andwithregardtoyourheart；weexpectafullrecovery.随着时间的推移你也可能恢复全部认知能力Andwithtimeyoumayrecoveryourfullcognitiveabilitiesaswell.可能吧Maybe.但现在我只专注于此刻ButfornowIlljustfocusonbeinghere.“真正让我着迷的是树变绿了“Itsthegreeningofthetreesthatreallygetstome.当白色和太妃糖的冲击Whenalltheshockofwhiteandtaffy让人行道上布满了善后的五彩纸屑leavethepavementstrewnwiththeconfettiofaftermath叶子来了theleavescome.耐心地步履蹒跚地patientplodding.无论冬天多么难熬我们都会长出一层绿色的皮肤agreenskingrowingoverwhateverwinterdidtous.回归到继续生活的奇怪想法中去areturntothestrangeideaofcontinuousliving；尽管我们一团糟悲伤又空虚”despitethemessofusthehurttheempty.肖恩怎么了？Shaunwhat丽认为因为我要当爸爸了LeathinksthatbecauseIamgoingtobeadad我很担心我的家人Iamworriedaboutmyfamily.然后呢Okay.她还认为你很害怕Shealsothinksyouarescared.我不害怕肖恩我很好ImnotscaredShaun.Tmfine.她说如果你不想做扫描我应该放手ShesaysifyoudontwanttodothescanIshouldletitgo.她…She...是对的isright.很好谢谢Good.Thankyou.但我害怕Iamscared.格拉斯曼医生Dr.Glassman.我请求你去做核磁共振Iamaskingyoutodothescan.因为・・・Because...数据和证据是可靠的thedataandtheevidencearesound.而且因为…Andbecause...当我即将成为父亲时我实在不想失去我的父亲itwouldbehardtolosemyfatherjustasIamabouttobecomeone.就当为了我做核磁共振吧Dothescanforme.肖恩我会做的ShaunIlldothescan.“好吧那么我接受‘TinethenIlltakeit/树似乎在说一片光滑的新叶像拳头一样展开到开阔的池塘thetreeseemstosay.Anewslickleafunfurlinglikeafisttoanopenpond.俄全盘接受Tiltakeit我一直在想象镜子里的你Ijustkeepimaginingyouinthemirror比如你有特雷西罗斯的头发likeyouhavethehairofTraceeEllisRoss还有碧昂斯的神态-不要羞辱我的自我调节andtheswagofBeyonce.-Donotshamemyself-care.自我肯定是有研究支持的Affirmationsarebackedbyresearch.功能性磁共振成像显示自我肯定能造成大脑的积极变化FMRIevidenceshowsacorrelationwithpositivechangesinthebrain.我刚刚准备好了一个惊喜Ivejustputthefinishingtouchesonasurprise.请鼓掌Drumrollplease.不鼓也行那准备好你们的歌hearts;单Ornot.Wellgetyoursonglistsready因为你们都被正式邀请参加becauseyouareallofficiallyinvitedto“星光卡拉OK晚七点至无穷晚”“StarKaraoke.7:00p.m.untilquestionmarkquestionmark.无穷晚啊看来是个派对It*sgonnabeapartywhenthere*sdoublepunctuationinvolved.就想放松下也想多了解你们一点Justthechancetounwindgettoknowyouallbetter.听起来很有趣谢谢•你就等着惨败吧Soundsfun.Thanks.-Preparetobedestroyed.我的《爱人如你》绝了MySomeoneLikeYouslays.谁能去骸骨脱臼患者的外科会诊Needasurgicalconsultforapatientwithadislocatedpatella.抱歉急诊有约SorryER.那就是你俩了一号hearts;房hearts;Youtwoareit.RoomOne.胸痛是什么时候开始的？Whendidthechestpainsstart星期二早上是第一次同时感觉到呼吸急促IfirstnoticeditTuesdaymorningalongwithshortnessofbreath.你在服用任何药物吗？Areyoutakinganymedications在吃药中间换过儿次药Istartedwithonethenswitchedafewtimes.这些都是用于治疗多动症的-还有脑雾TheseareusedtotreatADHD.-Andbrainfog.我患有长hearts;期hearts渐冠刚开始服用月瓜法辛ImaCOVIDlonghaulerandIjuststartedGuanfacine和N.乙酰半胱氨酸可能总算能有点效果了andN-acetylcysteine；whichmayactuallybehelpingfinally.你第一次感染是什么时候？Whenwasyourinitialinfection八个月前一开始像轻微流感后来越来越糟Eightmonthsago.Justfeltlikeamildflu.Butthenitgotworse.像是有人把糖蜜倒在了我脑子上likesomeonepouredmolassesonmybrain.我做过认知疗法Ivedonecognitivetherapy记忆练习都没用memoryexercises.Stillam.为了好起来什么法子我都试过WhateverIcandotogetbackinthefield.哪个？■三叶草Whichone-Clover.我是进化生物学家Imanevolutionarybiologist.我一直在研究白三叶草如何适应环境变化Ihavebeenstudyinghowwhitecloveradaptstoenvironmentalchanges.我现在是无限期休假AndImonindefiniteleave.请先保持安静Pleasestoptalkingnow.皮肤发青氧气含量低心率加快Bluishskinlow02levelsrapidheartrate.并且呼吸越来越吃力可能是肺栓塞Andincreasinglylaboredbreathing.Possiblepulmonaryembolism.马上预定胸部CT血管造影和超声检查OrderachestCTAandechostat.我得走了Ihavetogo.这个你用得上有个大文件我发了一半到你的打印机上Youwillneedthis.Isentonehalfofahigh-volumeordertoyourprinter.这些是格拉斯曼的手术报告？•过去三个月的所有报告TheseareGlassmansopreports-Forthelastthreemonths.一到三月的在这十到十二月的在帕克和我的办公室打印JanuarytoMarch.OctobertoDecemberisprintinginParksandmyoffice.所以你向我的打印机发送了一百次手术报告的打印请求？Soyousentreportsforlike100surgeriestomyprinter没有是176次手术共473页No.176surgeries.473pages.我已经发邮件让运营部来给你换墨盒了Iveemailedoperationstoreplaceyourtoner.很多部分都要彩打Manyelementsareincolor.你要这么多文件干嘛？Andwhyexactlydoyouneedallofthis确定他的错误是否是“就这么一次Tofindoutifhismistakewasablip.这是我第二次膝盖脱臼了SecondtimeIvedislocatedmyknee.第一次好像是几个月前？FirstwasafewmonthsagoIthink那次是脚踝扭伤Thatwasthesprainedankle.上次脱臼是去年Thedislocationwaslastyear.你的核磁共振显示没有相关的骨骼或韧带损伤YourMRIshowsnoassociateddamagetobonesorligaments.她还一直说头晕Shesalsobeencomplainingaboutdizziness脚踝肿胀可能与更年期有关swollenanklesmaybemenopauserelated.雷茨尼克医生想用激素替代疗法Dr.Reznickwantsheronhormonereplacementtherapy.奥瑞恩坚持要我做个彻底的检查OrioninsistedIgeteverythingcheckedout然后她再搬到8000公里外自己住beforesheleavesandmoves6000milesawaytolivealone.因为新的工作下周我要去布拉格ImmovingtoPraguenextweekforanewjob.你可以随时来看我妈妈AndyoucanvisitmeanytimeyouwantMom.膝盖受伤了可去不了Notwithabustedknee.在使用激素替代疗法前TomoveforwardwithHRT我需要确认你过去五年的所有用药情况Ineedtoconfirmallyourmedicationsoverthelastfiveyears.有种紫色三角形的Therewasapurpletriangleone.但去年我就没用了还有种像橙子的Buttheytookmeoffthatlastyear.Andanorange-shapedone.我来跟你说吧Illreviewitwithyou.我们看看你膝盖的活动情况请躺下Weneedtoseehowyourkneersmoving.Laybackplease.卡鲁医生你来检查吧GoaheadwiththeexamDr.Kalu.我以为我只能旁观■这是膝盖检查IthoughtIdobserve.-Itsakneeexam不是多韧带重建notamulti-ligamentreconstruction.你上次告诉我不要以为自己什么都知道YoutoldmelasttimenottoassumeIknoweverything.这本来就是你该做的工作Thisisjustmakingmedoyourjob.听起来像是呼吸暂停的征兆检查下她的扁桃体Thatsoundedlikeanapneicspell.Checkhertonsils.加西亚女士？Ms.Garcia我是不是又睡着了？DidIfallasleepagain是的Yes.我可以快速看一下你的嘴吗？CouldItakeaquicklookinyourmouth扁桃体相连Kissingtonsils.扁桃体太大了它们碰到并阻塞了你的呼吸道Theyresoenlargedtheyretouchingandobstructingyourairway引起严重的呼吸暂停你需要马上进行扁桃体切除术causingsevereapnea.Youneedatonsillectomyrightaway.没有肺栓塞但有多种心脏问题Nopulmonaryembolismbutmultiplecardiacissues肺动脉瓣严重狭窄severenarrowingofthepulmonicvalve右心室肥厚下室之间有一个开口hypertrophiedrightventricleanopeningbetweenthelowerchambers.这组缺陷看起来像法洛四联症但…ThissetofdefectsalmostlookslikeTetralogyofFallotbut-就是法洛四联症Itis.她患有第四种畸形主动脉骑跨Shehasthefourthmalformation.Overridingaorta.我还从未在成人身上见过法洛四联症IveneverseenTetinanadultbefore.她怎么活到现在的？Howisshestillalive等一下我现在必须把所有东西都写下来Hangonasec.Ihavetowriteeverythingdownnow.法洛四联症几乎都是在婴儿期就被诊断出来了Tetisalmostalwaysdiagnosedininfancy.但你是个特殊情况医生没查出来Doctorsmisseditinyourcase.你的情况太罕见了Youhaveararepresentation.流入左心室的流量增加Therightventricleobstructionisbalanced平衡了右心室的阻塞byanincreasedflowintotheleftventricle.新冠造成的损害破坏了这种平衡这个病毒可能救了你的命DamagefromCOVIDdisruptedthebalance.Thevirusmayhavesavedyourlife.未确诊的法洛四联症患者很少能活过童年VeryfewundiagnosedTetpatientssurvivepastchildhood.只有百分之二的人活到了40岁Amere2%makeitto

40.我会在某个时候突然死掉吗？Iwouldvejustdroppeddeadatsomepoint很有可能Itsverylikely.我们可以分两次来消除这种风险Wecanremovethatriskwithtwoseparateprocedures.首先我们将关闭为了补偿您的心脏缺陷Firstwellclosetheextravesselsthathaveformed而形成的额外血管tocompensateforyourheartdefects.然后我们会做手术来修复这些缺陷Thenwerlldoasurgerytorepairthosedefects.这个病和我的新冠长hearts;期hearts;症状有关吗？IsitpossibletheTetisconnectedtomylongCOVIDsymptoms心脏手术能治愈我的头雾…Couldfixingmyheartclearupmyhead-脑雾吗？Thebrain不能我很抱歉NoImsorry.你抢到桌子了Yousnaggedourtable.打败了霍克斯和努涅兹抢到的•你是冠军啊BeatHawksandNuneztoit.-Youreachampion.一杯生杏仁淡奶加了半份代糖OneSplendahalfsugarintherawlightalmondmilk.现在谁是冠军？Nowwhosthechampion我有东西给你■真的吗？Ihavesomethingforyou.-Really一份承认双方关系的协议Anagreementacknowledgingaconsensualrelationship.我马库斯安德鲁斯想带你达理希维拉纽瓦去约会LMarcusAndrewswouldliketotakeyouDalisayVillanuevaonadate.作为医院院长我已经签署了AndashospitalpresidentIvealreadysignedit.这太浪漫了Thisissoromantic.把笔给我Givemethepen.这周末一起吃晚饭？■让我看看Dinnerthisweekend-Letmesee.病房hearts;需要我对不起Imneededontheward.Sorry.以后再说？-没问题Lockitdownlater-Sure.冰咖啡？-不用Icedcoffee-Imgood.那热咖啡呢？Howabouthotcoffee为了纪念达芙妮扁桃体切除术成功InhonorofDaphne*ssuccessfultonsillectomy.我买hearts;hearts;了几杯给你选Igotafewoptions.那是拿铁吗？Isthatalatte就是个常规的扁桃体切除术Itwasaroutinetonsillectomy.那可是异常大的扁桃体还好她女儿把她送过来了Thosewereunusuallylargetonsils.Goodthingherdaughterbroughtherin.难道你觉得达芙妮该继续呼吸不畅？YouthinkDaphnewasbetteroffnotbreathing我认为不该由女儿来确保妈妈看医生Idontthinkitsadaughtersjobtomakesuremomgoestothedoctor.是达芙妮ItsDaphne.心率飙升她缺氧了■将氧气调到最大Heartratesspikedshe*shypoxic.-Turnupoxygentomax.右心室和心房hearts;有响亮杂音Loudmurmurrightventricleandatrium.呼吸暂停造成的慢性损伤增加了压力Chronicdamagefromapneacouldhaveincreasedthepressure导致右心衰竭causingrightheartfailure.血压下降了一带她去导管室BPsdropping.-Gethertothecathlab.放置弹簧圈栓塞Positioningcoilingsystem.还需要关闭两条血管Twovesselslefttoclose.部署弹簧圈Deployingthecoil.她的血氧饱和度在下降Her02satsaredropping.她的漏斗部肌肉正在收缩她有法洛四联症的症状了Herinfundibularmuscleisclampingdown.SheishavingaTetspell.给去氧肾上腺素和纯氧Givephenylephrineand100%oxygen.这是我见过的第一个真人案例Ihaveneverseenoneinpersonbefore.我们需要将血液输送到肺部给她输液并增加麻醉剂用量Weneedtomoveblooduptothelungs.Giveherabolusanduptheopiates.如果不制止痉挛她可能会有永久性的脑损伤。