你的初级保健医生是对的 Your primary care doctor was right.
肿块在较小的一边 The mass is on the smaller side.
我们会用新片子再确认一下 We'll confirm with the new images,
但应该可以用药物控制住 but it should be manageable with medication.
不用做手术 No surgery needed.
我未婚夫能松一口气了 Well, my fiance will be so relieved.
他一直担心我在照片里会像弗兰肯斯坦一样 He's been worried i'll look like Frankenstein in all our photos.
还担心我可能会死 Also that I might die.
婚礼是什么时候 When's the big day?
六月 June.
你有垂体瘤 You've been dealing with wedding planning
还在筹划婚礼吗 on top of a pituitary tumor?
真该给你发个奖章 You deserve a medal.
另外我们的医疗记录系统 Our medical record system, on the other hand,
却把你归为了女性 it has you listed as female.
可能是因为宫颈刮片检查的关系 Probably because of the Pap smears.
软件显然得把跨性别者更新进去 深呼吸 Software clearly needs a trans update. Deep breath.
我帮你改好吧 省得以后麻烦了 I'll fix it so everything is correct going forward.
请确认你的性别和人称代词 Please confirm your gender and pronouns.
男性 他 谢了 Male, he/him/his. Thanks for asking.
是我们的软件太烂了 We're the ones with the messed-up software.
你早上拍的片子刚传上来了 Your scans from this morning were just uploaded.
在不到两周的时间里 肿瘤变大了一倍 In less than two weeks, the tumor's doubled in size.
BGM: Can't Take My Eyes Off You by Bob Crew, Bob Guadio
你好得令人难以置信 You're just too good to be true
让我难以移开我的目光 I can't take my eyes off of you
你就像人们向往的天堂 You'd be like heaven to touch...
34岁女性 扎拉·诺顿 34-year-old female, Zara Norton.
心动过速 神志不清 Tachycardic and delirious.
盖林医生 更新体征 Dr. Guerin, update vitals.
沃克医生 采血去做血常规和检查电解质 Dr. Wolke, draw blood for CBC and electrolytes.
我发现你停下了脚步 Now that I've found you, stay
瞳孔放大但有反应 Pupils are dilated, but reactive.
诺顿女士 你闻上去像是抽大麻了 Ms. Norton, smells like you've had some marijuana?
我刚在药房卸了一批货 Mmm-mmm. I just unloaded a shipment at the dispensary.
检查一下四氢大麻酚 Test for THC
做个全面毒理学检查 and a full tox screen.
我是个小贩 I am a peddler.
不是吸毒的 Not a user.
去做吧 Run it.
血压升高了 180/115 BP's elevated, 180 over 115.
这能解释她为什么神志不清 That could explain the delirium.
那听起来有些高 最好把药吃上 Ooh, that sound high. Better take my meds.
我从没忘过 不 See, I never miss a... Oh, no.
不 这不是 Oh, no, that's not it.
血压还在升高 210/120 BP's climbing, 210 over 120.
静脉注射1.25毫克依那普利拉 Enalaprilat, 1.25 milligrams, IV.
诺顿女士 你记得你的药叫什么吗 Ms. Norton, do you remember the name of your medication?
你可以叫我扎拉 You can call me Zara.
看到没 就写在这里 See? It say right here on the...
好了 别管药了 她没在服药 Okay, forget about the meds. She is not taking any.
这是未经治疗的慢性高血压 This is untreated chronic hypertension.
你要是错了呢 What if you're wrong?
如果她在为降压吃髓袢利尿药呢 What if she's on a loop diuretic for her pressure?
可能会造成肾衰竭的 This could cause renal failure.
她马上就要出现高血压危象了 She's heading into hypertensive crisis.
用血管紧张素受体阻断剂怎么样 What if we try an angiotensin receptor blocker?
它不会和其它药物起反应 No drug interaction.
血管紧张素受体阻断剂起效太慢了 Angiotensin receptor blockers work too slowly.
我给她打ACE抑制剂 I'm giving her the ACE inhibitor.
血管紧张素转换酶抑制剂
血压下降了 BP's going down.
干得漂亮 Nice call.
良 医
第四季 第九集
最新的预算报告 Latest budget report.
知道 我收到PDF了 Yeah, the PDF's sitting in my inbox.
我在试着当没看见 I'm trying to ignore it.
于是我来了 And thus...
你坐下了 A sit-down visit?
只是想看看你最近怎么样 Just checking in, see how you're doing.
挺好的 你呢 Okay. You?
我吗 我还在消化这一年的事 Me? I'm... recovering from the year,
和大家一样 like everybody else.
疫情大流行 病例激增 Pandemic, the surge.
你一直都坚守在岗位上 You were here for every minute of every day.
肯定累坏了吧 It must have taken a toll.
在其位谋其职 It... comes with the territory.
你不觉得心力交瘁或是心烦意乱吗 You're not, uh, stressed or distracted?
我只是累 I'm... tired.
好 那也许你该歇一阵子 Okay. Well, maybe you should take some time off.
不用 No.
但谢谢你 我没事 But thank you. I'm fine.
你看起来可不像是没事 You don't seem fine.
我的工作表现有问题吗 Are there issues with my work performance?
没有 你工作上很棒 No, you do great work.
那我就不太明白为什么我们在说这个 Then I'm not sure why we're having this conversation.
因为我担心你 Because I'm worried about you.
因为其他人也在担心你 Because other people are worried about you.
遇到些困难并不丢脸 There's no shame in struggling a little bit.
如果你太顺风顺水了 You know, what would be weird is
那才奇怪 if you didn't struggle at all.
如果你需要咨询什么人 费用由医院来出 If you need to see someone, the hospital will cover the cost.
太好了 你替我买单 Great. You'll pay my bills.
那么对我名誉的损害呢 谁买单 And the damage to my reputation, who takes care of that?
我觉得看心理医生 I don't think that seeing a therapist
不会影响你的职业生涯 will affect your career.
站着说话不腰疼 Says the white guy.
好吧 Okay.
隐私保护不是虚设的 Privacy protections are there for a reason.
不用让人知道 No one needs to know.
谢谢你的关心 Thank you for checking in.
-你感觉如何 -很好 - How you feeling? - Good.
要是能知道我怎么会在这里 就更好 Be better when I understand what landed me up in here.
你出现了急性的高血压危象 You had an acute hypertensive crisis.
我知道我血压高 Oh, I know my blood pressure's high.
我已经在吃药了 I'm already on medication for it.
你可能想知道是什么药 You probably wanna know what it is.
你包里没药 There's no medication.
我们要给你做一个超声心动图 We need to do an echocardiogram
确保你的心脏没有在这次急症中受损 to make sure your heart wasn't damaged in the crisis.
我没意见 Fine by me.
这是九折券 Here's 10% discount
在「Z&B天然」购买50美元以上商品就能用 on any purchase over $50 or more at Z & B Naturals.
Z是我 B是我的合伙人比尔 I'm Z. B is my partner Bill.
你每天在大麻堆里面 You're surrounded by pot all day, every day,
但你却从来没碰过吗 but you never touch the stuff?
怎么做到的 为什么 How? Why?
我不好这口 It's just never been my thing.
这名字对我来说太拗口了 The name always trips me up.
氯噻酮 Chlorthalidone.
是治高血压的 That's for hypertension.
好像还是满瓶 Yeah, bottle seems pretty full.
你吃了多久 How long have you been on this?
大概六个月 才重新装满的 About six months. Just refilled it.
每天都吃 Take it every day.
微笑 Smile.
歪头 Head tilt.
他也微笑 Now he smiles.
笑出声 Burst of laughter.
嗯 Yeah.
里奥·古铁雷斯 29岁 Rio Gutierrez, 29,
垂体瘤块本来可以药物治疗 pituitary mass went from manageable with meds
现在可能需要手术 to likely surgery.
所以 跟新来的放射科住院医师聊天呢 So, talking to the new radiology resident, huh?
我拿难解的扫描图询问德苏莎医生 I wanted Dr. D'Souza's opinion on an intriguing set of scans.
她很有才华 She is very talented.
你迷上她了 You're crushing on her.
没有 N... no.
我没有 我爱莉亚 I am not. I love Lea.
这两件事并不矛盾 Well, those two things aren't mutually exclusive.
古铁雷斯先生的血液中催乳素含量很高 Mr. Gutierrez's blood has high levels of prolactin.
催乳素在垂体中产生 Prolactin is produced in the pituitary gland.
可能是肿瘤分泌的 The tumor could be secreting it.
也可能是身体其他部位产生了高水平荷尔蒙 Or the tumor could be reacting to the high levels of hormones
肿瘤对其做出反应 being produced elsewhere in the body.
病人是个跨性别者 The patient is a transgender man.
做超声检查 Do an ultrasound.
探针向内推进 直到你能看见心腔 Advance the probe until you see the cardiac chamber.
扎拉可能因为肾血管疾病 Maybe Zara has secondary hypertension
患有继发性高血压 due to renal vascular disease.
她没有 她的肌酸酐是1.2 She doesn't. Her creatinine is 1.2.
肾小球滤过率正常 Her GFR is in normal range.
只是理论上不会 并不是不可能 Well, that would make it unlikely, but not impossible.
这也能解释 It'd also explain
为什么给她开的高血压药不起作用 why her prescribed hypertension meds weren't working
而你给她开了ACE抑制剂之后有所好转 and why she got better when you gave her that ACE inhibitor.
更简单的解释是 她其实没吃药 Mmm. Simpler explanation, she's not taking her meds.
瓣膜看起来正常 Valve looks normal.
我要继续下一步 做二腔观吗 Should I move on to the two-chamber view?
是的 Yeah.
我们没理由怀疑她撒谎 We have no reason to think that she's lying.
她对自己吸大麻的情况好像说的是真话 She seems to be telling the truth about her pot usage.
血液和尿液中都不含有四氢大麻酚 No THC in her blood or urine.
她绝对有其他事撒谎了 She couldn't possibly be lying about something else.
左心室厚度增加 The left ventricle is thickened,
证明没有治疗过高血压 which is consistent with untreated hypertension.
心率攀升 Heart rate's climbing.
心脏排血量在减少 Cardiac output is dropping.
每搏输出量也是 Stroke volume as well.
她出现了心源性休克 She's in cardiogenic shock.
你介意我给你做一个腹腔超声检查吗 Would you mind if I did an ultrasound on your abdomen?
因为脑肿瘤吗 For a brain tumor?
这是我的未婚夫 伊莱·辛普森 This is my fiance, Eli Simpson.
当我听到新的扫描结果时 When I heard about the new scans,
我几乎快疯了 I kind of stormed the castle.
我的英雄 My hero.
你的催乳素水平很高 Your prolactin levels are very high,
可能是肿瘤引起的 which might be caused by the tumor,
除非有别的情况提高了你的催乳素水平 unless another condition raised your prolactin,
造成了肿瘤增生 encouraging more growth.
什么情况会促进催乳素分泌 What condition boosts prolactin?
你认为我怀孕了吗 Do you think I'm pregnant?
他不可能 他在服用睾丸激素 He can't be. He's on testosterone.
除了上个月的几个星期 Except for a few weeks last month.
在我们旅行前我忘了注射激素 I forgot to take my shot before our trip.
但那也不可能 But there's no way that...
你怀孕了 You're pregnant.
你得了心源性休克 You went into cardiogenic shock
因为你的心脏没法有力地跳动 because your heart wasn't pumping adequately.
我们做了个小手术来安装一个分流泵 We did a minor procedure and installed an Impella pump,
但这只是缓兵之计 but it's a short-term solution.
我确实感到有点喘不上气 I do feel a little out of breath.
但我可能是因为看到你才这样的 安德鲁斯医生 But that might be just 'cause of you, Dr. Andrews.
诺顿女士 我已经结婚了而且我只是你的医生 Ms. Norton, I'm a married man and your doctor.
你的情况很罕见 You have a rare condition.
你心肌的某些部位 Certain parts of your heart muscle
变得异常肥厚 have become abnormally thick.
心室之间的心壁就是隔膜 So, this wall in between the chambers, that's the septum.
这是正常的样子 That's a normal one.
这是你的样子 This is what yours looks like.
这需要手术 It's gonna require surgery.
我们还需要更多化验来决定最佳方案 We're gonna run a few more tests to determine the best approach.
等等 你是我的主治医生吗 安德鲁斯医生 Wait. You gonna be my surgeon, Dr. Andrews?
我当然是 I sure will.
你们俩会跟他一起吗 And y'all two gonna be with him?
对啊 Yeah.
真是我的幸运日 My lucky day.
三个有色人种医生治疗我 Three doctors of color taking care of me.
而不是那种高高在上的医生 Doctors who won't talk down to me.
和我以前遇到的医生不一样 Not exactly what I'm used to.
你们懂我是什么意思 You guys know what I mean.
之前每次我妈妈带我去看儿科医生 My mother made me wear a suit and tie
她都会让我穿西装打领带 whenever we went to the pediatrician.
穿上最好的衣服 Put on your Sunday best
就是为了在人前表现得礼貌 just to get on the scale and touch your toes.
是啊 气死我了 我最后还是成了医生 Yeah. Made me so mad, I wound up becoming a doctor.
化验结果证实了 The testing confirmed
你的肿瘤是产生激素的催乳素瘤 your tumor is a hormone-producing prolactinoma.
你怀孕六周了 And the pregnancy is about six weeks along.
你考虑过自己是男同性恋吗 Do you consider yourself gay?
-我觉得这个问题 -当然 - I don't think that's... - Yes.
因为我就是男同性恋 Because I am gay.
但你和你未婚夫有阴道性交 But you have vaginal intercourse with your fiance.
-这就是他怀孕的原因 -墨菲医生 够了 - That is how he got pregnant... - Dr. Murphy, that's enough.
-我只是想 -我觉得你该离开 - I... I just want... - I think you should leave.
我很抱歉 I'm sorry.
他的话很不合适 That was completely inappropriate.
我们对肿瘤的治疗计划 Our treatment plan for your tumor
取决于你们对怀孕的打算 depends on your plan for your pregnancy.
所以 So...
我们讨论过孩子的事情 We've talked about kids,
但我一直以为那是很遥远的事情 but I always figured that was way down the road.
而且也不该是这样 And not this way.
我一直想领养 I always assumed we'd adopt.
我本来已经不当T了 也不再当T I'd have go off T, and stay off.
如果里奥要中止妊娠 If Rio doesn't continue the pregnancy,
然后会怎么样 then what happens?
你的激素水平会骤降 Your hormone levels would drop quickly,
这会导致肿瘤缩小 which would cause the tumor to shrink.
然后我们会用药 可能会有个小手术 After that, we'd use medication, possibly a minor surgery.
我想终止妊娠 I'd like to terminate the pregnancy.
我检查了扎拉所有的化验结果 I looked over all of Zara's labs.
所有迹象都指向 All signs point to her
她定期服用高血压药 taking her hypertension medicine regularly.
核磁共振显示心室内隔明显增厚 Her MRIs show significant ventricular septal thickness,
心脏射流严重紊乱 bad turbulence jet flow.
还有心肌水肿 There's myocardial edema, too.
用ACE抑制剂治疗不是个好主意 The ACE inhibitors were a bad call.
最终导致我们的病人心源性休克 Which eventually sent our patient into cardiogenic shock.
你为什么忽视她告诉我们的话 Why'd you ignore what she was telling us?
我根据模式化处理方式 I made a medical diagnosis
做出临床诊断 based on pattern processing
这就是医学院教的 that we're taught in med school,
它要你考虑种族 教育 which involves considering, you know, race, education,
职业 体重指数 occupation, BMI.
对我来说都是病例侧写 Always sounded like profiling to me.
没错 今天有雨 Yes, we have the rain,
但是风力更大 but more impressively, the wind.
由于风大 将产生横向雨 That rain's going to be coming in sideways.
今天一天 Just take a look at how the wind increases
风力将持续加大 as we progress throughout the day.
所以预计到今天下午 So, this afternoon, we're talking about
风力可能上升为50英里每小时 50-mile-per-hour gusts possible.
很抱歉我冒昧而来 Sorry for crashing.
放射室那边没有电视 Radiology doesn't have a TV.
你喜欢看天气预报 You like The Weather Channel?
天气预报让我很放松 I find it soothing.
一起来看吗 Would you like to join me?
同时降雨量会显著增多 And we have more intense rainfall coming through,
可能导致部分地区发生洪涝灾害 and that's going to also lead to some flood potential.
对此我们必须采取措施 All of us are going to get into the action.
考虑到山区 You got the mountains.
我能把声音调小一点 调低4格 Would you mind if I lowered the volume by four output levels?
那样就完美了 That would be perfect.
加州北部的所有地区 All the areas around here in Northern California,
以及莫德斯托 斯托克顿 萨克拉门托 Modesto, Stockton, Sacramento.
旧金山的北部地区... The northern part of San Francisco...
我觉得屏幕上的反光挺讨人厌 I find the reflection on the screen so distracting.
我赞同 So do I.
我能 Could I
这样做吗 do this?
护士让我过来 Nurse paged me.
有什么事吗 Is something wrong?
我改变主意了 I've changed my mind.
我想留下这个孩子 I want to keep the baby.
既然你准备继续妊娠 Since you're continuing the pregnancy,
那么你需要手术 摘除催乳素瘤 we'll need to surgically remove the prolactinoma.
所以你们要在他脑部动手术 So, you'll cut into his brain?
最安全方式是通过鼻腔进行手术 Our safest option is to go in through the nasal cavity
该手术称为经蝶骨手术 简称TSS in what's known as a transsphenoidal surgery, TSS for short.
比起其他手术方案 该手术创伤小 It's less invasive than our other option.
听起来还是很危险 That still sounds dangerous.
我已经做好决定了 I've made up my mind.
我有任何话语权吗 Do I get any say in this?
我们确实组建了家庭 但是我还没准备好 I'm all for us having a family, but I'm not ready to...
有孩子这事 谁都没准备好 No one's ever ready for kids.
昨天你说你从来没考虑过怀孕 Yesterday, you said that you never considered getting pregnant,
现在你却为了怀孕冒着生命危险 and now you're willing to risk your life for it.
我大概7岁时 When I was about seven,
拥有过一个小庇护所 I had this one refuge.
我把床单搭在两个椅子中间 I'd hang a quilt over a couple chairs
我带着我的两个玩具躲在其中 and hide out with my two buds,
小狐狸福克和小狮子绒绒 Foxie the Fox and Fuzz the Lion,
我曾想象着 and I'd imagine,
我是它们的爸爸 I was the dad.
它们是我的双胞胎孩子 And they were my twin little guys,
兄弟相亲 fraternal, obviously.
我们是一家人 We were a family.
变性之后 我就放下了那个梦想 When I transitioned, I put that dream aside.
至少放弃了自己生孩子的梦想 At least, as far as them coming from me.
但现在 But now...
无论我们是否准备好 whether we planned it or not,
这是我们的孩子 this is our baby.
我们多快进行手术 How soon can you do the surgery?
我会安排做图像引导核磁共振准备手术 I'll order an image-guidance MRI to get things started.
根据心脏核磁共振和心导管插入术 Based on the cardiac MRI and catheterization,
有两种治疗方案 there are two treatment options.
一种是部分切除术 就是开胸手术 Myectomy, basically open heart surgery,
另一种是室间隔酒精消融术 and alcohol septal ablation,
通过采用酒精 where we use the alcohol
杀死心肌的靶向部分 to kill targeted sections of the heart muscle.
哪一种你比较推荐呢 Well, what would you recommend?
第一种手术创伤性大 恢复更慢 The surgery is more invasive, tougher recovery,
但长期来看效果更好 but better efficacy long-term.
消融术危险系数小 The ablation is less dangerous,
但之后你可能还需要药物干预治疗 but you're more likely to need further medical interventions.
这样也算推荐 Now, you call that a recommendation?
两种方案都有利有弊 There are pros and cons to both.
你必须自己权衡 Uh, you'll need to weigh them.
你好好考虑 I'll give you some time.
你是一直想照顾别人吗 布朗医生 You always want to take care of people, Dr. Browne?
差不多 Pretty much.
我也是 Me, too.
你经营一家卖大麻的药店 Oh. Well, you run a marijuana dispensary.
并不是所有人用大麻为了吸毒 It's not all about getting people high.
可能不是 但是我想你大多数顾客 No, maybe not, but I'm guessing most of your clientele...
我的伯祖母露西曾患胰腺癌 My Great-Aunt Lucy had pancreatic cancer.
整整一年 A year, she hung on.
她都在苦苦煎熬 In agony.
大麻是唯一能够帮助她吃睡的东西 Marijuana was the only thing that helped her eat or sleep.
医生没给她开止痛药吗 Doctors didn't give her anything for the pain?
他们推荐布洛芬 They suggested ibuprofen.
你知道医生们 Now, you know doctors are 22% less likely
给黑人患者开止痛药的可能性 to give pain meds to Black patients
比给同样症状的白人患者要低22% than to white patients with the same symptoms.
我是说 你和我 我们很像 My point is, you and I, we're a lot alike.
我们都是强大的黑人女性 We're both strong, Black women
在这个世界上给自己找出路 finding our way in the world,
但其中一人比另一人更懂医药 but one of us knows more about medicine than the other.
所以我想知道 你在我的情况下会怎么办 So, I'd like to know, what would you do in my situation?
开膛心肌切除术风险更大 The open myectomy is a bigger risk
但长远来看好处更多 but offers more long-term benefits.
我已经决定了 I've made my decision.
我同意你说的 布朗医生 I'm with you, Dr. Browne.
帮我预约心肌切除术 Book the myectomy.
这是里奥·古铁雷斯的影像 给你要做的TSS Here's the Rio Gutierrez imaging for your upcoming TSS.
请放在桌上 Set that on the table, please.
我... I, um...
我注意到肿瘤在蝶鞍上扩散 I noted the tumor's suprasellar expansion
并且周围水肿 威利斯环张开 and surrounding edema and splaying of circle of Willis.
很有用 That is very helpful.
再见 莫菲医生 Bye, Dr. Murphy.
你安全了 肖恩 她走了 You're safe, Shaun. She's gone.
还没有 Not really.
德苏莎医生还在我脑海里 Dr. D'Souza is still in my brain.
我不喜欢这样 I don't like it.
我们接吻了 We kissed.
-什么时候 -什么 - When? - What?
我对她有各种想法 I have so many thoughts about her,
我还有很多问题想问里奥 and I have so many questions I want to ask Rio.
他会不会更高兴... Wouldn't he get more pleasure for...
那些问题 你不应该问他 Questions you're not supposed to ask him.
那个吻 肖恩 你们什么时候接吻的 The kiss, Shaun. When did you kiss?
昨晚 在我梦里 Last night. In my dream.
如果我不能问问题 那我怎么弄明白 If I can't ask questions, how do I understand?
我的... 我的大脑... My... My brain...
我... 我的大脑表现得和我希望的不一样 My... My brain isn't behaving the way I want it to.
我怎样让它停下来 How do I make it stop?
你被德苏莎医生吸引 You're attracted to Dr. D'Souza.
这有什么好烦的 Why does that bother you?
当我和卡莉在一起 却对莉亚有感觉时 When I was with Carly and had feelings for Lea,
意味着我应该和莉亚在一起 it meant I was supposed to be with Lea.
万一现在意味着我应该和德苏莎医生在一起呢 What if this means I'm supposed to be with Dr. D'Souza?
不会 你已经爱了莉亚好几年了 No. You've loved Lea for years.
这只是... 吸引 This is just... attraction.
但我对莉亚的爱不能把它驱走吗 But shouldn't loving Lea make it go away?
如果那样能行 亲密关系就简单多了 Relationships would be a lot easier if it worked that way.
你感到内疚 You're feeling guilty.
你带莉亚去吃顿特别点的晚餐吧 I say take Lea out for a nice dinner, something special.
然后告诉她我的动心 And tell her about my crush.
我需要让莉亚知道 I need to let Lea know.
-不 不 -你不需要 - No, definitely not. - No, you do not.
我想听听你的看法 I want to get your thoughts
关于这场TSS手术中肿瘤在蝶鞍上扩散的事 on the suprasellar extension of the tumor for this TSS.
你记得莎拉·佩珀吗 You remember Sarah Pepper?
在圣弗朗西斯区域医疗中心负责肾病学 Runs nephrology at S.F. Regional?
总是披一条披巾 Always wears a shawl?
她在上周的员工会议上崩溃了 So, during the staff meeting last week, she fell apart.
在整个部门面前尖叫 哭喊 完全疯了 Screaming, crying in front of the whole department. Totally nuts.
辛苦了一天了 Rough day at the office.
想知道你会怎样切除而不导致脑脊液漏 Wonder how you'd approach and resect without getting a CSF leak.
插一根腰椎引流管 Place a lumbar drain,
然后注入生理盐水 进行伐氏操作 then infuse saline and do Valsalva maneuver.
好 Okay.
显然 佩珀的崩溃太夸张了 Apparently, Pepper's meltdown was so over the top,
因此医院强迫她休假 the hospital forced her to take a leave.
-多久 -没说 - How long? - Unspecified.
她一直都有点疯癫 She's always been a little crazy.
据我所知 古怪和情绪化并不能算疯癫 Last I checked, eccentric and emotional didn't qualify as crazy.
谢谢你帮忙看 Thanks for taking a look.
我读到 顺性别者 I read that cisgender people
经常把变性人简单归纳为生殖器 often reduce transgender people to their genitalia,
而这样非常冒犯 and that that is offensive.
我是不是冒犯了你和里奥 Did I do that to you and Rio?
是 Yes.
对不起 I'm sorry.
里奥马上要做手术了 Rio will be going into surgery soon.
他在找你 He's been asking for you.
你没有接电话 You haven't been answering your phone.
谢谢你告诉我 Thanks for letting me know.
他也让我很困惑 He is very confusing to me, too.
里奥很努力 Rio has worked so hard,
他接受了双侧皮下乳房切除术 he had a bilateral subcutaneous mastectomy
正在接受激素替代疗法 and takes hormone replacement therapy,
但他现在选择了 but now he is choosing
最有女性特征的行为 the most female act.
里奥做的 就不是女性行为 It's not female if Rio's doing it.
好的 Y-Yes.
在他变性的过程当中 And he must have dealt with a lot of prejudice
一定需要面对很多偏见 during his transition.
我也经历过偏见 I dealt with prejudice.
我的兄弟帮助了我 他有兄弟吗 My brother helped me. Does he have a brother?
他的家人不和他讲话了 His family doesn't talk to him.
现在里奥要做脑部手术 And now Rio is having brain surgery.
他非常勇敢 He is very brave.
你可以待在这里 You can stay here.
我有个病人 扎拉·诺顿 I have a patient, Zara Norton.
我们诊断她得了肥厚性梗阻型心肌病 We, uh -- We diagnosed her with HOCM.
我看见病历了 I saw the file.
盖林医生质疑我在急诊室 Dr. Guerin expressed some concerns about
对病人做出的初始治疗 my initial handling of the case in the ER.
他觉得我因为种族而对她有刻板印象 He thinks I stereotyped her based on her race.
你觉得你有吗 Do you think you did?
她当时不行了 She was crashing.
我必须做出决定 我没有很多资料可以参考 I had to make a call. I didn't have a lot to go on.
格拉斯曼今天上午来找我 Glassman came to see me this morning.
有人告诉他我状况不稳定需要帮助 Someone told him I'm unstable and need help.
知道他是从谁那里听说的吗 Any idea where he heard that?
我去寻求帮助了 你也可以这么做 I asked for help. You can, too.
你是个住院医师 没人在乎你是否需要帮助 You're a resident. No one cares if you need help.
我得到这份工作在某种程度上 I got this job in part
是因为我的主要竞争对手 because my main competition,
一个男性 为我担保 a man, backed me.
一旦有人开始质疑我是否称职 The second anyone thinks I can't handle this --
没人会这么想的 No one is gonna think that --
如果你不停说我一团糟 他们会这么想的 They will if you keep telling them I'm a mess.
你有创伤性应激后遗症 You have PTSD.
不应该为此感到羞愧 You shouldn't be ashamed.
你刚用刻板印象诊断了一位黑人女性还好意思说我 Says the women who just profiled a Black female patient.
你对她有偏见 You judged her,
就和人们对我有偏见一样 just like people will judge me
他们会交头接耳 说我本来就有点过于紧张 and whisper that I've always been a little intense,
怪不得会让我退居二线 so no wonder I was asked to step down.
没人需要知道这些 Nobody needs to know.
确实 Exactly.
你告诉我不要紧 You tell me that it doesn't matter.
你告诉我大家会理解的 You tell me everyone will understand,
然后你又告诉我要保密 and then you tell me to keep it to myself.
我到底该不该为自己感到羞耻 Should I be ashamed, or shouldn't I be?
好了 诺顿女士 需要去做术前准备了 Alright, Ms. Norton, time to head to pre-op.
袋子里是什么药 帅哥 What's in the bag, handsome?
我得知道输进我身体里的是什么 I like to know what goes into my body.
头孢唑林 它是一种我们在手术前使用的 Uh, cefazolin. It's a prophylactic antibiotic
预防性抗生素 we give before surgeries.
有道理 Makes sense.
对了 我最初进急诊室时 Hey, what was the med y'all gave me
你们都给了我什么药 when I first got here to the ER?
依那普利 是一种血管紧张素转换酶抑制剂 Enalaprilat. It's an ACE inhibitor.
那不是治高血压的吗 Isn't that for hypertension?
但是我已经告诉你们 But I thought I already told y'all
我在吃控制血压的药了 I was on meds for my blood pressure.
你说了 You did.
这么说你们觉得我需要更多的药 So, you figured I needed more?
还是你们不相信我 Or did you not believe me?
对不起 I'm sorry.
你肯定很害怕 You must be scared.
你不应该一个人害怕 You shouldn't have to be scared alone.
我爱你 I love you.
我也爱你 I love you, too.
伊莱 Eli.
我看不见你了 I can't see you.
我就在这里 宝贝 I'm right here, babe.
你能跟着这个转动眼球吗 Can you follow this with your eyes?
它不停消失 It keeps disappearing.
你已经失去了周围视觉 You've lost peripheral vision.
肿瘤正在压迫视神经 The tumor is impinging on the optic fibers.
我们不能进行TSS手术了 We can't perform the TSS surgery.
随着肿瘤持续增大 With the tumor's continued growth,
剩下来的最优选择是开放性翼点开颅术 the best remaining option is the open pterional craniotomy.
但是它的风险更高 恢复期也更长 But it is higher risk with a lengthier recovery.
除此之外还需要考虑 All of which is on top of the potential for
对于怀孕期间性别焦虑的潜在影响 gender dysphoria during pregnancy.
这个还需要担心吗 Is that still a concern?
我想起我服用睾丸素的最初阶段 I think back to before I started taking T,
那种感觉多么糟糕 how terrible that felt.
一想到我还要从头再经历一遍那种感觉... The thought of feeling that all over again...
我们可以回到最初的计划 We could go back to the original plan.
你是说中止妊娠 You mean terminate the pregnancy?
肿瘤应该会自行缩小 The tumor should shrink on its own.
你付出很多才走到这一步 After everything you've done to get where you are in your life,
我明白想到如今 it's scary to think about
可能失去一切有多可怕 doing something that would put that at risk.
这就是我的下一步 This is my next step.
就算我很害怕 我都要迈出这一步 I'm ready to take it, even if I'm scared.
有时你不得不冒险 利姆医生 You have to take risks sometimes, Dr. Lim.
多谢 Thank you.
你不是该帮扎拉做术前准备吗 Shouldn't you be prepping Zara for surgery?
被取消了 It's canceled.
她想转院 She wants to be transferred to a different hospital.
去一所「不会因种族歧视导致她心脏衰竭」的医院 One where she won't be "Racially profiled into heart failure."
肖恩 还好吗 Shaun, you okay?
我脑子里一直有一些我不想有的想法 I am having thoughts I don't want to have.
朴和乔丹都说我不该告诉你 Both Park and Jordan say I shouldn't tell you.
但你会告诉我的 是吗 But you're going to, aren't you?
是的 Yes, I am.
我对一个同事动心了 I have a work crush.
另外 我的患者是一个怀孕的变性者 Also, my patient is a pregnant trans man --
一件一件说 肖恩 Okay, one at a time, Shaun.
你说的动心是指 About this...crush?
她是钦蒂亚·德苏莎医生 Her name is Dr. Cintia D'Souza.
她是放射科第二年住院医生 She is a second year radiology resident.
我昨晚梦见我们在住院医师休息室 Last night, I dreamed we were in the Residents' Lounge,
一起收看天气频道 接着我们开始接吻 watching The Weather Channel, and then we started kissing --
可以了 我知道了 Okay, I got it.
你生气了吗 Are you mad?
朴和乔丹是对的 我不应该告诉你 Park and Jordan were right. I shouldn't have told you.
没有 我没生气 No. I'm not mad.
只是有点吃惊 没事 A little surprised, but that's okay.
我有时也会被... I'm still attracted...
其他的男生吸引 to other guys sometimes.
不 不行 N-No.
不 什么 是谁 No. What? Who?
-这无关紧要 -谁 - It doesn't matter. - ‭Who?
好吧 就是有一位理疗师 There -- Okay, there is this one physical therapist --
别 N-No.
别说了 No.
不说了 No.
如果我们对其他人感兴趣 What if we're attracted to other people
是因为我们之间出了问题呢 because there is something wrong with our relationship?
你没打算在现实中去亲德苏莎医生吧 You're not planning on kissing Dr. D'Souza in real life?
没有 No.
或者跟她一起加班 Or working late with her,
单独在一起做X光检查 doing some X-rays alone,
然后不小心倚靠在同一个灯箱上 where you might end up leaning over the same light box --
我们已经不用灯箱了 We don't use light boxes anymore.
我也不打算和她一起加班 And I don't plan to work late with her.
那我觉得我们俩 Then I don't think either of us
都没什么好担心的 has anything to be worried about.
我要去准备翼点开颅手术 I have to go prep for a pterional craniotomy.
我是格拉斯曼医生 医院的院长 I'm Dr. Glassman, president of the hospital.
除非你是来载我去圣弗朗西斯区域医疗中心 Unless you're here to drive me to S.F.Regional,
否则你可以出去了 you can head right back on out.
对于你在急诊室的遭遇 我深表歉意 I apologize for your experience in the emergency room.
你真是十分善解人意了 That's mighty white of you.
直译为白人
我不建议您转去圣弗朗西斯区域医疗中心 I don't recommend that you transfer to S.F.Regional,
或者任何其他医院 or any other hospital, for that matter.
我肯定他们也和你们一样有豪华的设备 I'm sure they got the same fancy equipment,
光鲜亮丽的证书 same shiny sets of diplomas y'all got here,
或许还会少一些种族歧视的医生吧 and maybe a few less racist doctors.
情况似乎并非如此 Well, apparently, that doesn't seem to be the case.
我调出了100英里内 I pulled data on comparable hospitals
与我们相似的医院数据 within 100 miles,
对比了手术成功率 did numbers on surgical outcomes
以及按种族分类的患者满意度 and patient satisfaction aggregated by race.
显然 我们做得比他们都好 Apparently, we're doing well, comparatively.
你是说你的医院可能存在种族歧视现象 Your argument is that your hospital may be racially biased,
但没有其他医院的种族歧视那么严重 but it's less racially biased than these other hospitals?
是这个意思 Yeah. Pretty much.
留在圣文德医院 Stay at St. Bonaventure,
医院院长会亲自监督你的护理情况 the president of the hospital will monitor your care
一直到你痊愈出院 every step of the way.
不管怎样 For whatever it's worth,
我觉得你应该找不到比这待遇更好的了 I don't think you can do better than that.
她愿意留下 但有个条件 She's gonna stay, on one condition.
就是你退出治疗团队 That you're off the team.
朴医生 请展开大脑外侧裂 Dr. Park, please open Sylvian fissure.
蛛网膜手术刀和霍顿解剖器 Arachnoid knife and Rhoton dissector.
肿瘤可见 Tumor is visible.
一个人成为男人的要素是什么 What makes someone a man?
我原以为仅是染色体的区别 I thought it was just the chromosomes,
但事实并非如此 but that must not be it,
因此这让事情变得很复杂 which makes things confusing and difficult,
我已经知道里奥感到不适 and I know Rio was uncomfortable when he --
生活就是不适的 Life is uncomfortable.
用困境来打击你 It hits you with tough situations
你得自己扛过去 and you muscle through them.
在环窦处看到少量出血 I see a tiny bleed in the circular sinus.
用伏血凝止住 Pack it with Floseal.
跟我说说情况 Someone give me an update.
呼气末二氧化碳分压和氧饱和度下降 We got a drop in end tidal CO2 and oxygen sat.
有气胞破裂的迹象吗 See any evidence of exposed air cells?
没有 打蜡的骨边缘情况良好 No. But waxing bone edges just to be safe.
但是肿瘤挤压了蝶鞍区和蝶窦壁 But the tumor thinned the sellar floor and sphenoid wall.
导致了氧气渗入 Making it permeable to oxygen.
是空气栓塞 It's an air embolism.
血压在下降 BP's dropping.
利姆医生 我们应该怎么做 Dr. Lim, what should we do?
盐水纱布 Saline gauze,
倾斜手术台减小气压梯度 tilt the table to eliminate the negative air pressure gradient,
接上中心线导管 and place a central line.
这能阻止空气侵入 This will stop the air leak
让我们处理气泡 and allow us to access the air bubble.
插入多孔型开口导管 Inserting Bunegin air-aspirating cath.
你离上腔静脉还有两厘米 You are 2 centimeters from the superior vena cava.
抽吸右心室空气 Aspirate the right atrium
直到看不见气泡 until you don't see any more air bubbles.
干得漂亮 利姆医生 Nice save, Dr. Lim.
让我们把这个肿瘤拿出来 Let's get this tumor out.
用波茨剪 Make your transverse aortotomy
横向切开动脉 沃克医生 with Potts scissors, Dr. Wolke.
扩大肌肉切口 Extending the muscular incision
到中心室 down to the mid-ventricle.
这里是肌切除术的位置 There's the myectomy site.
异常肌束在这 There's the aberrant muscle bundle.
撤掉体外循环 Get her off bypass,
看看她有什么反应 see how she does.
心排血量怎么样 How's the cardiac output?
下降中并且不充足 Reduced and insufficient.
低排血量可能意味着我们得进一步降低隔膜 Low output could mean we need to further reduce the septum.
或者说已经降得太低了 Unless it means that we reduced it too much.
破坏了用来控制心率的 Damaged the cardiac electrical conductors
心脏电导线 that control the heart rate.
她现在有三级房室传导阻滞 She's having third-degree heart block.
恩里克是对的 Enrique's right.
我们取走了太多肌肉了 We took too much muscle.
恢复体外循环 Put her back on bypass.
我们可以用牛心包片来补充心壁 We could augment the wall with a bovine patch.
但还是没法隔离电子系统 Still wouldn't insulate the electrical system.
她还是会面临完全性房室传导阻滞的风险 She'd still be at risk of complete heart block
或者心脏骤停 and cardiac arrest.
我们可以插入双腔起搏器 We could insert a dual chamber pacer.
这样心壁就不需要传导系统 She won't need the conduction system in the wall of her heart
来控制心率 to control her heart rate.
来吧 Let's go!
开颅术做得怎么样 How was the craniotomy?
很顺利 It went well.
患者正在恢复 The patient is in recovery.
你发信息说有好消息 Your text said you have good news.
其实对于德索萨医生是坏消息 And by good news, I mean bad news for Dr. D'Souza.
有好多事能让你讨厌她 Plenty of great stuff to crush a crush.
第一个观察结果 First observation --
她闻起来像桂皮 She smells like cinnamon.
这更让人感到疑惑而不是刺激 Which is more puzzling than irritating.
其实还挺好的 所以明显没有帮助 Actually kind of nice. Which is obviously not helpful.
她整理头发的动作很奇怪 Oh, okay. She does this weird self-grooming gesture
把头发归到耳朵后面去 where she tucks her hair behind her ear.
然后还按摩自己的耳朵 And then sorta massages her ear.
这也没什么用 A-Also n-not helpful.
好吧 抱歉 抱歉 Okay. I'm sorry. I'm sorry.
好吧 在沙拉柜台 Okay. At the salad bar,
她用黄瓜钳来夹黄瓜 she used the cucumber tongs to reach for the cucumbers...
然后是西红柿 and then the tomatoes.
然后是洋葱 And the olives.
还有腌菜 And the pickles.
奥德丽·利姆 创伤后应激障碍
我能看见你了 I can see all of you.
手术怎么样 How'd -- How'd we do?
很成功 Great.
我们切除了所有肿瘤 视力恢复了 We got all of the mass, vision is restored.
你很有希望完全康复 You have every reason to expect a full recovery
并且能成功怀孕 and a healthy pregnancy.
我们要做爸爸了 We're gonna be dads.
你准备好了吗 Are you ready?
我从没做过怀孕的男人 I've never been a pregnant man before.
你永远是我认识的最好的男人 You'll always be the best man that I've ever known.
来看看你怎么样了 Came to see how you were doing.
安德鲁斯医生告诉我 Dr. Andrews told me
是你想出了救我的办法 you was the one who figured out how to save me.
但还是没有改变之前发生的事 Still don't change what went down earlier, though.
当我到了医学院 When I got to med school...
人们只看我一眼 people took one look at me
就以为自己很清楚我是谁 and they thought they knew exactly who I was.
拿助学金的黑人女孩 Black girl on financial aid.
她肯定不太聪明 She must not be that smart.
她肯定经常偷懒 She must have gotten a lot of breaks.
她可能还需要更多 She'll probably need a lot more.
我努力... And I worked...
我那么努力 I worked so hard
来证明他们错了 to prove them wrong,
我不是他们认为的那种人 that I wasn't who they thought I was,
我配得上医学院 that I deserved to be there,
我很合群 that I ...That I fit in.
你进入急诊室的时候... When you came into the ER...
又吵又闹腾 loud and messy...
我看到了 I saw...
我看到了我努力不成为的那种人 I saw everything I have tried hard not to be.
我觉得这让我很生气 And I think it made me angry.
我为此感到羞耻 And I'm ashamed of that.
我真的很抱歉 And I'm really sorry.
我以前也是那样的 I used to be that way.
但我厌倦了那么努力 But I got tired of working that hard
来让白人感到舒适 to make white people comfortable.
你们俩今晚要出去吗 You two heading out for the night?
当然 We sure are.
开颅手术怎么样 肖恩 How did the craniotomy go, Shaun?
你们切除了所有泌乳素瘤吗 Did you guys get all the prolactinoma?
对 Yes.
那是餐厅的沙拉吗 Is that cafeteria salad?
里面有腌黄瓜吗 Are there pickles in there?
你要来点吗 Did you want some?
不用了 谢谢 You know, I'm good. Thank you.
肖恩 你想... Shaun, did you...
不 谢谢 No, thank you.
这确实有助于 It does help to focus
聚焦她在沙拉吧没素质的行为 on her irresponsible salad bar practices
以及饮食偏好 and dietary preferences.
我有很多应对不适的方法 I've got a ton of strategies to manage discomfort.
我也是 So do I.
补充供给和表示和解的礼物 To replenish your supply, and a peace offering.
我都不知道我们需要和解 I wasn't aware we were at war.
看来我关于佩珀的八卦 Well, seemed like my gossip about Pepper
有点说错了 kind of landed wrong.
糟糕的一天 Bad day.
抱歉打扰了 Sorry to crash the party.
格拉斯曼医生让我给你们看这个 Dr. Glassman wanted me to show this to you two.
我让莉亚对不同指标按种族进行计算 I asked Lea to run some numbers on various metrics by race,
结果不太好 and the results are not great,
尤其是在疼痛管理方面 especially when it comes to pain management.
我们显著降低了 We are under-treating
对非裔美国人和拉丁裔患者的 African-American and Latinx patients
治疗水平 by a considerable margin.
我想我需要来点和解礼物 I think I need a little of that peace offering.
请随意 Help yourself.
还有人要吗 Anyone else?
不用了 谢谢 No. Thank you.
我也不用 Uh...me, neither.
我... I...
开始服用舍曲林了 started taking sertraline.
治疗创伤后应激障碍 For PTSD.
我很遗憾 Sorry to hear that.
你还好吗 You doing okay?
不太好 Not really.
但我在努力 But I'm...working on it.
很好 Okay.
布朗医生 干得好 Dr. Browne, good work.
谢谢 Thank you.
我向扎拉道歉了 I apologized to Zara.
她指出来 我在医学院那么努力 She pointed out I spent med school...
只是想让白人更舒服 trying to make white people comfortable.
她说得对 I mean, she's right.
不只是医学院 It wasn't just med school.
很累吧 Exhausting, isn't it?
但我们必须这么做 不是吗 But we had to do it, right?
为了走到这里 To be here?