对不起 我吵醒你了吗? Sorry, did I wake you?
是啊 Yes.
宝宝压着我的膀胱 The baby's pressing on my bladder,
所以我每晚大概要尿78次尿 so I have to pee approximately 78 times every night.
既然我们都醒着 我们就来谈谈孩子的名字吧 We can talk about baby names since we are both awake.
我总是想着一个名字...凯莉 I keep coming back to one name... Kelly.
这让我想起了凯莉钳 It reminds me of a Kelly clamp.
每当我抱着我们的儿子时 And I will think about grasping onto tissue
我就会想要抓住组织或血管 or vessels every time I'm holding our son.
艾迪生呢? What about Addison?
艾迪生墨菲 Addison Murphy.
艾迪生是一种疾病的名字 Addison is the name of a disease.
我会担心我们儿子 分泌的皮质醇和醛固酮不够 I'll worry our son is not producing enough cortisol or aldosterone.
你可以继续睡了 反正我又要去尿尿了 You can go back to sleep, I have to go pee again anyway.
早上好 有人想吃煎饼吗? Good morning. Pancakes, anyone?
它们不仅仅是普通的煎饼 They are not just ordinary pancakes.
它们是荷兰婴儿煎饼 They are Dutch baby pancakes,
也被称为俾斯麦饼、荷兰泡芙 甚至是“那种煎饼” also known as Bismarcks, Dutch puffs, and even Hootenannies.
-我查了一下 -没错 - I looked it up. - That is correct.
它们是在烤箱里烤的 不是油炸的 我起得很早 They're baked in the oven not fried. I was up early.
对不起我频繁上厕所让您睡不着了 Sorry if my frequent bathroom trips kept you up.
别傻了 你怀着孩子呢 Don't be silly. You're making a human.
谢谢 Thank you.
凯莉和艾迪森出局了 我不反对 So, Kelly and Addison are out, I don't disagree.
孟乔森呢? How about Munchausen?
-肖恩... -还是帕金森? - Shaun... - Or Parkinson?
我们的卧室谈话是私密的 Our bedroom conversations are private.
全部吗? All of them?
我们又没说什么 It's not like we were talking about--
没关系 Never mind.
吃饭吧 Let's eat.
圣何塞校董事会的一个朋友联系了我 A friend on the San Jose schoolboard reached out,
他们正在找人给高中生做一系列 they're looking for someone to give a series of online talks
关于医学职业的在线讲座 to high schoolers about careers in medicine.
特别针对有色人种的年轻女性的 Specifically to young women of color.
-太好 -我觉得你是完美的人选 - That's great. - I thought you'd be perfect.
哦 Oh.
那不是我期待的反应 That wasn't the reaction I was expecting.
也许图克斯医生可以做到? Maybe Dr. Tooks can do it?
图克斯是位妈妈 Tooks is a mom,
这些高中生在她身上 看不到自己的影子 these high schoolkids don't see themselves in her.
-肯定还有别人 -没有 - There's gotta be someone else. - There isn't.
美国只有2%的外科医生是黑人 Only 2% of surgeons in the U.S. are black.
不要害怕走到聚光灯下 Don't be afraid to step into the spotlight.
我不害怕 我只是很忙 I'm not afraid, I'm just very busy.
好的 只需要几个小时的时间 Okay. It'll only take a couple hours of your time.
“你相信自己是什么 你就是什么” 这是真的... "If you can see it, you can be it" is a real thing...
成为别人眼中的那个人不是我的责任 It's not my responsibility to be the one they see.
好吧 Okay.
内森在生日派对上 Nathan hit his head on the trampoline frame
把头撞到蹦床架上了 at his birthday party.
额头上起了个包 但看起来没事... He got a bump, but he seemed fine...
爸爸呢? Where's daddy?
我跟你说过 他在上班帮助别人 过几天就回来 好吗 I told you, he's at work helping people. He'll be back in a few days, okay.
两天后会不会出现脑震荡? Is it possible to develop a concussion two days later?
让我们看看能不能查出是怎么回事 Let's see if we can find out what's going on.
内森 你的小狗叫什么名字? Nathan, what's your puppy's name?
帕奇斯 Patches.
我能用这盏灯查看帕奇斯的眼睛 确定他没事吗? Can I look into Patches' eyes with this light? Make sure he's okay?
或者你可以查查看? Or you can do it?
看这里就行 Just look in here.
你能把这个捡起来给医生吗? Can you pick this up and give it to the doctor?
我不能 爸爸呢? I can't. Where's daddy?
你能跟我击掌吗 伙计 Can you give me a high five, bud.
好的 现在双手击掌 Good. Now high ten.
怎么了?这是脑震荡吗? What is happening? Is this a concussion?
不是脑震荡 It's not a concussion.
你儿子中风了 Your son is having a stroke.
-你迟到了 -不 我没有 - You are late. - No, I'm not.
现在是早上八点零一分 It's 8:01 am.
现在确实是 It-- It is now.
但我敢肯定 当我走进门时 时间还是八点钟 But I'm sure it was still 8:00 when I walked through the door.
你剪头发了吗? Were you getting your hair cut?
没有 No.
你又吸毒了? Are you using drugs again?
没有 No.
你在观察期 我对你要负责 You are on probation and I am responsible for you.
复吸的常见的迹象包括忽视责任 Common signs include ignoring responsibilities
和行事隐秘 and secretive behavior.
我保证 我是干净的 I promise, I'm clean.
如果你愿意 我可以尿在杯子里 I'll pee in a cup if you want.
好吧 Okay.
我要去协助朴医生了 I'm going to assist Dr. Park.
如果你的尿样检测没有问题 你就可以参加这台手术 You can join the case if your sample comes back clean.
我甚至都没有迟到 I wasn't even late.
既能帮助年轻的多元化的女性 A chance to help young diverse women
又能拍院长马屁的机会? and kiss the hospital president's ass at the same time?
这个问题只有一个答案 There's only one answer to that
“可”开头 “以”结尾 and it starts with a "y" and ends with a "yes."
-那没用 -我知道 但我坚持我的观点 - That didn't work. - I know. But I stand by my point.
我们还不够忙吗? Aren't we busy enough?
为什么我有额外的作业 因为我有更多的黑色素? Why do I have extra homework because I have more melanin?
为什么我的伊奶奶给我发短信? And why is my Grandma E texting me?
你不应该把它看作家庭作业 You shouldn't think of it as homework
也不应该把它当成一种负担 and you shouldn't think of it as a burden.
你不该以为你知道我是什么样的人 You shouldn't think you know what it's like to be me.
明白了 Point taken.
搞什么...? What the...?
好吧 我们能把注意力 放在病人身上吗? Okay, can we just focus on our patients, please?
昆克 你来了 Quinque, there you are.
伊奶奶?您在这里做什么? Grandma E? What are you doing here?
我听说他们这里有医生 I was told they have doctors here.
我胸闷 呼吸急促 脚踝肿胀... I've got tightness in my chest, shortness of breath, swollen ankles--
您没在奥克兰看过医生吗? Didn't you see your doctors in Oakland?
那些白痴说我的腹水是“肝硬化” Those idiots said my ascites indicated "cirrhosis of the liver"
就好像我喝醉了一样 like I'm some kind of drunk.
我想凭借我的家族关系 I figured with my family connections,
我可以在这里得到一流的护理 I could get top- shelf care here.
我不能参与您的任何... I can't be involved in any of your--
但是我可以 But I can.
很高兴见到您 伊奶奶 我是沃克医生 Delighted to meet you Grandma E, I'm Dr. Wolke.
好的 乔丹宝贝 你留下来看着这位小男生 Okay, Jordan baby, you stay and keep an eye on little mister here.
他可能会想靠自己的帅气蒙混过关 He might try to skate by on his good looks.
您能向后靠靠吗? Can you lean back for me?
乔丹 你从来没有提到过有个妹妹 Jordan, you never mentioned having a sister.
看 我喜欢他 See, I like him.
颈静脉扩张伴颈静脉压升高 Distended jugular veins with increased JVP.
有库斯毛氏迹象和脉搏反常 Kussmaul's sign and Pulsus paradoxus.
也许我现在不那么喜欢你了 Maybe I don't like you so much now.
她确实有胸部放疗史 She does have a history of chest radiation.
-心包的回声亮度 -那是什么意思? - Echo-brightness of the pericardium. - What does that mean?
心脏周围的囊发炎并且有钙沉积物 The sac around your heart is inflamed and there are calcium deposits.
奶奶? Grandma?
-脉搏微弱 -我们在她心跳停止之前做点什么吧 - Faint pulses. - Let's do something before she arrest.
为心包切开术准备手术室 Set up an O.R. STAT for a pericardiotomy.
不 瑞克 留在那里 我保证我能搞定 No, Rick, stay. I promise I've got this.
抱歉打扰了 我们准备好了 Sorry to interrupt. We're ready.
您能和我丈夫谈谈吗? Can you please talk to my husband?
当然了 Of course.
我是朴医生 This is Doctor Park.
一个四岁的孩子怎么会得中风? How does a four year old end up with a stroke?
头部外伤是主要原因之一 Head trauma is one of the main causes.
我觉得我现在应该上飞机了 但琳达让我留下来 I feel like I should get on a plane now, but Linda's telling me to stay.
-你有多远? -我在阿拉巴马州 - How far are you? - Alabama.
龙卷风过后 仍有人失踪 We still have people missing after the tornado ripped through.
我不能告诉您如何区分轻重缓急 I can't tell you how to prioritize.
我希望在您来之前让您儿子好起来 I'm hoping to make your son better well before you could get here.
谢谢 Thank you.
我们没事 We're okay.
反正你过几天就会回来的 留在那里继续帮忙吧 And you'll be back in a few days anyway. Just stay and keep helping.
好的 Okay.
清除血肿 Evacuating the hematoma.
我在气象频道上看到 I saw on the Weather Channel
阿拉巴马州的龙卷风是过去三年里 that the Alabama tornado was the 15th to reach a four
第十五次达到 增强藤田级数四级的龙卷风 on the Enhanced Fujita scale in the last three years.
这次灾难共造成116人死亡 Together they have caused 116 fatalities.
幸运的是 我们有像他父亲那样的人 他们迎难而上 Luckily we have people like his Dad who run towards a crisis.
但他和他儿子也面临危机 But he also has a crisis right here with his son.
他走的时候还不知道 He didn't know that when he left.
我没看到出血的迹象 I'm not seeing an active bleeder.
在这个切除腔内 有一个富血管化的脑实质 There is a hyper-vascularized brain parenchyma in this resection cavity.
大口径血管都比正常的小 The major named vessels are all smaller than usual,
看起来伤痕累累 and look scarred in.
出血不是撞到头造成的 The hemorrhage was not from hitting his head.
这孩子和他的大脑 比我们想象的还要糟糕 This boy and his brain are even sicker than we thought.
照亮胸骨牵开器 Lighting the sternal retractor.
那她为什么叫你K女王呢? So why does she call you Queen K?
是五的意思 It's Quinque.
拉丁语是五的意思 因为我是六个孩子中的老五 Latin for five because I'm the fifth child of six.
她叫你弟弟老六吗? Does she call your little brother Sex?
请集中注意力 别杀了我的奶奶 Please focus so you don't kill my grandmother.
烧灼胸骨骨膜边缘 Cauterizing the edges of the sternal periosteum.
她太迷人了 She's so charming.
为什么你没有这些基因? Why didn't you get any of those genes?
魅力是一个非常复杂的 女人的众多层面之一 Charm is one of many layers of a very complicated woman.
从我出生那天起 伊奶奶 就像教官一样管教着我 Grandma E drove me like a drill sergeant from the day I was born.
确保心包与胸膜和横膈膜分离 Ensure the pericardium is free from both the pleurae and the diaphragm.
15号刀片 15 blade.
我需要一个新的15号刀片... I need a new 15 blade...
发生什么事了? What's happening?
我刺不破它 从没见过这么严重的限制性心包炎 I can't pierce it. Never seen constrictive pericarditis this severe.
已经完全钙化了 It's completely calcified.
你奶奶有所谓的椰子心 Your grandma has what's known as coconut heart.
您儿子患有一种罕见的自体免疫疾病 叫做原发性中枢神经系统血管炎 Your son has a rare auto-immune disorder called Primary CNS vasculitis.
这导致他整个大脑的血管发炎 It's causing inflammation of his blood vessels throughout his brain.
好吧 下一步怎么办? Okay. What are the next steps?
环磷酰胺输液 Cyclophosphamide infusions.
那是化疗 That's chemo.
我母亲患乳腺癌的时候就化疗 My mother had that when she had breast cancer
她头发掉光 呕吐 嘴巴上全是疮 and she lost her hair, threw up, got sores all over her mouth.
如果不加以治疗 情况会更糟 Letting this go untreated is far worse.
反复发作的脑出血 可能是大面积中风 Recurrent brain bleeds, possibly large territory strokes.
这些可能是致命性的 They could be fatal.
内森要接受某种免疫抑制治疗 Nathan will be on some form of immunosuppression
一辈子 his whole life.
对不起 I'm sorry.
谢谢医生 Thank you, Doctor.
怎样才能在不刺破椰子的 情况下掰开椰子呢? How do you crack a coconut without puncturing what's underneath?
缩窄性心包炎 Constrictive pericarditis.
请不要再说椰子了 这是我奶奶而且情况很严重 Please stop saying coconut. It's my grandmother and it's serious.
不是你的患者 Not your case.
我只是在吃零食 想帮忙 I'm just having a snack and trying to help--
我们需要集思广益 We need ideas.
左前胸廓切开术和心包部分切除术 Left anterior thoracotomy and partial excision of the pericardium.
避免胸骨感染似乎是最安全的途径 Avoid sternal infection and seems likely the safest route.
这将需要更多的手术 It'll require more surgeries.
请别参与 Please go away.
等等 你有什么建议? Wait, what are you advocating for?
完全清除 Complete removal.
胸骨正中切开术可以让我们 A median sternotomy gives us
清楚地看到从膈神经 到膈神经的病变心包 clear access to the diseased pericardium from phrenic nerve to phrenic nerve.
这太冒险了 It's way too risky.
完全清除能修复她的心脏 Complete decortication fixes her heart.
彻底地 Completely.
你这是在提倡大范围高风险手术 You're advocating for an extensive, high-risk surgery.
与此同时 部分切除 Meanwhile, partial removal
为你70岁的奶奶提供了 一个可能在她的余生中 offers your 70-year-oldgrandmother a shot at full health
保持完全健康的机会 for what likely amount to the rest of her life.
难道不该让病人自己决定吗? Shouldn't you let the patient decide?
不 如果不是可行的选择 我是不会提出来的 No. I don't present something if it's not a viable option.
我认为这是可行的 I think it is viable.
她的外科医生没有提出来 Her surgeon doesn't.
乔丹 好好当一个孙女吧 Jordan, go be a granddaughter.
如果我没有成为一名外科医生 我想我会成为一名作家 If I hadn't become a surgeon, I think I would've been a writer.
你从没告诉过我 你奶奶在马库斯书店工作 You never told me your grandmother worked at Marcus Books.
我该这么做吗? Was I supposed to?
我只是个低级职员 I was just a lowly clerk.
当我听说他叫马库斯时就想到了 It came up when I heard his name was Marcus.
身处文化地标的中心 There is nothing lowly
并没有什么卑微的 about being at the center of a cultural landmark.
我的温恩阿姨曾经带我去参加 托尼莫里森 My Auntie Winn used to take me to author readings
和玛雅安杰洛...作家读书会 by Toni Morrison, Maya Angelou...
而您每天都在那里 and you were there everyday.
我可能拿过饼干给你 I probably served you some cookies.
-您见过詹姆斯鲍德温吗? -见过 - Did you ever meet, James Baldwin? - I did.
好的 她可能需要休息一下了 Okay. She can probably use some rest.
是的 一点没错 Yes, absolutely.
如果您需要什么 伊芙琳女士 您知道去哪找我 If you need anything at all, Ms. Evelyn, you know where to find me.
-谢谢 马库斯 -好的 女士 - Thank you, Marcus. - Yes, ma'am.
马库斯书店 哇! Marcus Books. Wow!
那很奇怪 That was weird.
不会比你拒绝参加 他的指导计划更奇怪吧? Not as weird as you refusing to do his mentorship program?
让咱们聊聊您的事吧... Let's talk about you...
还有您的心脏 and your heart.
您的心包已经变硬了 可能是癌症治疗造成的 Your pericardium has become hardened, likely from your cancer treatments.
那么现在怎么了? So what happens now?
林医生决定部分切除 Dr. Lim has decided on a partial removal.
你认为是最好的方案吗? And you think that's best?
乔丹杰奎琳艾伦 你看着 跟我说实话 Jordan Jacqueline Allen, you look at me and you tell me,
如果你认为这是最好的方案的话 if you think it's best.
哇 你们花了好长时间才到家? Wow, it took you guys a while to get home?
我们出去吃饭了 因为丽娅以为... We went out to dinner. Because Lea thought that--
您为什么在地板上?高脚椅怎么了? Why are you on the floor? What's with the high chairs?
我在回家的路上去了好市多 I stopped at Costco on the way home.
没想到有好多种葡萄酒可以选 Surprisingly diverse selection of wines.
这里有一瓶开着的 如果你们想喝的话 There's an open bottle if you guys want--
尽管可能已经空瓶了 Although that might be empty.
危险! Danger!
我记得酒 您醉了吗? I remember wine. Are you drunk?
没有 也许有一点 No. Maybe a little.
我是宝宝专家 危险! I'm baby-proofing. Danger!
您还好吗? Are you okay?
哦 你们得蹲下来检查一下 Oh, you guys got to get down here and check this out.
从宝宝的角度来看 这地方是个该死的死亡陷阱... From the baby's perspective, this place is a fricking death trap...
对尼古拉斯来说 暂时用这个名字 for Nicholas. Place holder name.
我们可以叫他尼克或者尼基 We can call him Nick, Nicky.
我喜欢尼基 I like Nicky.
您为什么要买三把高脚椅? Why did you buy three high chairs?
一个是给你的礼物 另外两个我会拿回去 危险! One's a gift for you, and the other two I'll take back. Danger!
那可能很危险 That could be dangerous.
您不用给我们买任何东西 You don't have to buy us anything.
我还给你们买了一个保姆摄像头 I also got you a nanny cam.
这是...这是个泰迪熊 It's-- It's-- It's a teddy bear,
但你们不会相信里面有个摄像头 but you wouldn't believe there is a camera inside.
那很实用... 也很可爱 That is very practical... and cute.
好的 我们一年内都不需要 高脚椅和婴儿防护用品 Okay. We will not need a highchair or baby proofing for a year.
我们不会给我们儿子取名 尼克、尼古拉斯或尼基 And we'll not name our son Nick, Nicholas or Nicky,
或者其他类似的名字 or any variation thereof.
好的 Okay.
这很有道理 但你们会想要这个 That's fair enough but you're going to want this,
这是斯波克博士写的 一本关于育儿的书 it's a book by Dr. Spock on parenting.
当年大家都读过这本书 Everyone read this book back in the day,
他是如此受欢迎 他竞选了总统 he was so popular, he ran for president.
危险 Danger.
我去睡觉了 I'm going to bed.
是的 但是 在宝宝出生 Yeah, but-- You're going to want to read this
你变得筋疲力尽前 你要读读这本书 before the baby comes and you get exhausted.
我已经筋疲力尽了 Already there.
危险! Danger!
你在想什么? What were you thinking?
在想我奶奶应该吃些 美味的玛芬蛋糕吗? My grandmother deserved the good muffins?
她只会同意做完全清除手术 She'll only agree to complete decortication,
她不应该知道这件事 which she shouldn't know about.
你不能给病人提供一个 You do not present a patient with an option
我认为不安全甚至不可行的选择 that I've deemed unsafe and wouldn't even perform.
-这是不可接受的 -你是对的 - It's unacceptable. - You're right.
我觉得你的计划有点保守... I felt like your plan was a little conservative--
你是住院医生 You are a resident,
你对我的决定有什么看法无关紧要 your feelings about my decisions are not relevant.
-我会告诉她我错了 -并说服她我是对的 - I'll tell her I was wrong. - And convince her I'm right.
或者给她找另一家医院 Or find her another hospital.
好的 女士 Yes, ma'am.
您的玛芬蛋糕准备好了 Your muffins are ready.
他对化疗的反应如何? How's he handling the chemo?
你还好吗 伙计? You doing okay, bud?
内森 你能回答朴医生的问题吗? 一切都好吗? Nathan, can you answer Doctor Park, please? Is everything okay?
不 No.
你说得对 不好 You're right. It's not okay.
好吧 那些不是玩具 Okay, those aren't toys.
我们还好吗 妈妈? We okay, mom?
他生日收到了几十个新玩具... He's got dozens of new toys for his birthday...
他不应该用药瓶建造城堡 he shouldn't have to be building castles with pill bottles.
对不起 I'm sorry.
你不应该一个人承担这一切 You shouldn't be trying to do all of this alone.
我丈夫正在拯救生命 我不能拖他后腿 My husband is saving lives. I can't pull him away from that.
我可以 I can.
把你的手机给我 Give me your phone.
嗨 瑞克 我是朴医生 Hi Rick, Doctor Park.
您还好吗? You okay?
是的 我很好 Yeah. I'm fine.
但你不是很好 But you are not.
发生了什么事? What happened?
我不该质疑林医生的手术建议 I was wrong to question Dr. Lim's surgical advice.
她是最棒的 She is the best.
我希望有一天能成为她 I hope to be her someday.
如果她认为部分切除心包 And if she thinks the partial removal of the pericardium
是最好的做法 那么我同意她的做法 is the best course of action, then I agree with her.
好的 Okay.
那我就这么做 Then that's what I'll do.
但是你为什么一开始 反对她的建议呢? But why did you go against her advice in the first place?
我觉得我需要做额外的事情 I felt like I needed to do extra.
成为英雄 To be a hero.
为什么? Why?
从小您就告诉我要加倍努力 Since I was little, you told me I had to work twice as hard,
比其他人加倍优秀 be twice as good as everybody else.
这么多年过去了 After all these years,
我仍在努力达到您的要求 I'm still striving to be good enough for you.
我现在明白那是很大的压力了 Now see that's a lot of pressure.
但这是世界对你我这样的人的要求 But it's what the world requires from people that look like you and me.
我爸爸什么时候来? When is my daddy coming?
你爸爸要上飞机了 他很快就会回来 Your daddy is getting on a plane, he's gonna be back soon.
但是现在 我们必须 看看药物是否有效 好吗? But now, we have to see if the medicine is working, okay?
如果有效 我可以不再吃药吗? If it is, can I stop taking it?
我很抱歉 你仍然需要吃药 I'm so sorry. You still need it.
我讨厌吃药 I hate it.
我知道 I know.
我们来玩个游戏 比如捉迷藏 好吗? Let's play a game, like hide and seek, okay?
来 躺下 Here, lie down.
你可以进入隧道 You get to go in the tunnel.
保持安静 这样没人能找到你... And stay very still so nobody can find you...
等安全了 我会回来接你 听起来不错吧? I'll come back and get you when the coast is clear. Sound good?
你对他很好 You are very good with him.
开始成像 Starting the imaging.
谢谢 Thanks.
内森 你会听到一些砰砰声 这只是机器的声音 Nathan, you're about to hear some banging. It's just the machine
但记住要保持不动 好吗? but remember to stay really still, okay?
我会的 I am.
再努力一点 好吗 伙计? Try a little harder, okay, bud?
运动伪影 我们可能得给他注射镇静剂 Motion artifact, we might have to sedate him.
那些不是伪影 Those are not artifacts.
他没有中枢神经系统血管炎 而是患有烟雾病 He does not have CNS Vasculitis, he has Moyamoya disease.
那是什么鬼东西? What the heck is that?
狭窄的颈动脉 正在减少流向他大脑的血液 A narrow carotid artery is reducing blood flow to his brain.
这片区域 看起来像一团烟雾? This area here, looks like a puff of smoke?
这就是烟雾症在日语中的意思 That's what moyamoya means in Japanese,
一堆新的、微小的血管已经形成 A bunch of new, tiny vessels have developed
以避开堵塞 to circumvent the blockage,
但是因为血管不正常 所以很容易出血 but because the vessels are abnormal, they're prone to bleeds.
我们可以通过非常有趣的 脑部手术来解决这个问题 We can fix the problem with a very interesting brain surgery.
所以你们用多余的化疗 错误治疗了我们的儿子 So now that you're done poisoning our son with chemo that he didn't need,
我们还应该信任你们 让你们打开他的头骨? we should trust you to crack open his skull?
我们会用一个小的开颅手术 We will use a small craniotomy to access--
我明白你为什么感到沮丧 I get why you're frustrated.
烟雾病很罕见 而且出了名的难诊断 Moyamoya is rare and notoriously hard to diagnose.
很多孩子接受过更久多余的化疗 Many kids get chemo they don't need for a lot longer.
我们希望明天 能为内森做第一次脑部手术 We're hoping to do Nathan's first brain surgery tomorrow.
他需要不止一次手术? He needs more than one?
什么是脑部手术? What's brain surgery?
嘿 Hey.
这就是我们要让你变得更好的方式 It's how we're going to make you all better.
不用化疗了? No more chemo?
不再化疗了 No more chemo.
你会在这里吗? Are you going to be here?
我的飞机被取消了 伙计 My plane got cancelled, buddy,
但听我说 我保证 我会尽快到达那里 好吗? but look, I promise I'm going to be there as soon as I can, okay?
帕奇斯也能做脑外科手术吗? Can Patches get brain surgery, too?
不能 帕奇斯是一个毛绒玩具 它没有大脑 No. Patches is a stuffed animal, it does not have a brain.
我刚刚尿在我们的浴缸里了 I just peed in our bathtub.
格拉斯曼必须得走 Glassman has to go.
-嘿! -对不起! - Hey! - Sorry!
新手医生 First years.
你又迟到了 You are late again.
拜托 只是一分钟 C'mon. Like one minute.
上次... Last time...
你昨天的药检呈阴性 Your drug test from yesterday was negative,
你没有吸毒 那么是什么导致你迟到呢? you are not using. So what is causing your tardiness?
听我说 我很抱歉 Look, I'm sorry.
我一直做得很好 I've been doing really well.
以及我做得这么好的原因 And the reason I'm doing so well
是我每天的互助会议 is my daily meeting.
让我保持清醒 那有点远 还有早上的交通 Sets my mind right. It's kinda far. And there's morning traffic.
支持非常重要 Support is very important.
守时也是如此 And so is punctuality.
我要绘制一个复杂的双管血管搭桥图 I'm going to map a complex double-barrel vascular bypass.
-该死 -那是你第六次杀死我奶奶了 - Dang it. - That's the 6th time you've killed her.
咬骨钳不管用 需要再多一点动力 It wasn't working with the rongeur, need little more power.
-还有正确的扭矩 -这让人安心 - And the right torque. - That's reassuring.
别再徘徊了 去看看病人吧 Stop hovering and go visit, visitor.
说服伊芙琳艾伦不做手术之后 Convincing Evelyn Allen to do a surgery,
又说服她做手术 这有点困难 after convincing her not to, was a little bumpy.
请详细说明 Details, please.
我借此机会解释 I took the opportunity to explain
她给我的压力有多大 how much pressure she's put on me,
她借此机会再次让我觉得自己不够格 and she took that opportunity to make me feel inadequate once again.
我从来没有认为 你是一个缺乏自信的人 I've never thought of you as someone who lacks for confidence.
假装成功直到你成功为止 Fake it till you make it.
你是顶级外科科室之一的住院医师 You're a resident in one of the top surgical programs.
你已经成功了 You've already made it.
我只看到我还有差距 All I see is the ground I've still got to cover.
怎么样了? How's it going?
还没准备好 Not ready for primetime.
这个STA解剖结构 是理想的供体血管可以绕过阻塞 This S.T.A. anatomy is ideal as a donor vessel to bypass the blockage.
所以我们将在这里 重新引导头皮血管进入大脑 So we'll reroute the scalp vessel into the brain here.
给你一点小贴士 下次有孩子问 Gonna give you a little tip. Next time a child asks
你是否能给他的毛绒动物做手术 if you could do surgery on his stuffed animal
好让他不那么害怕时?就说可以 so that he feels less scared? Say yes.
我只是告诉他事实 I was only telling him the truth.
大脑中动脉的这个分支 看起来像是一个理想的受体 This branch of the middle cerebral artery looks like an ideal recipient.
你快当爸爸了 孩子是没有逻辑的 You're about to be a father. Children are illogical.
我们可以放置临时夹子来控制血管 We can place temporary clips for vascular control,
然后用10-0脯烯 将STA与MCA吻合 and then anastomose the STA to the MCA using 10-0 prolenes.
我小时候很有逻辑 I was very logical as a child.
我不喜欢别人跟我说话时 把我当成傻子 I did not like being talked to like I was dumb
我也绝对不喜欢被人骗 and I definitely did not like being lied to.
那里的那个孩子觉得如果他的斑点狗 That child there felt that if his Dalmatian
和他一起经历了这可怕的事情 went through this scary thing with him,
他会不那么害怕 he would be less scared.
如果你能接受另一个人的所思所想 If you can embrace another person's thought process,
那会让关系更紧密 it can strengthen the relationship.
丽娅认为她不应该在浴缸里尿尿 Lea thinks she should not have to pee in the tub,
我理解 which I understand.
不要绑架我奶奶 No kidnapping my grandmother.
我让他绕着这层转一圈 我需要换个环境 I asked him to do a lap around the floor, I needed a change of scenery.
好吧 您转完圈了 现在回到您的病房吧 Well, you had your lap, now back to your cell.
谢谢你带我奶奶参观 跑步男 Thanks for the tour, Speedy.
跑步男? Speedy?
今天早上我在这里冲刺 I was sprinting through here this morning.
我迟到了 I was late.
本周第二次 Second time this week.
闹钟止闹按钮是最误事的 Snooze buttons are the devil's plaything.
我今天早上实际上 参加了一个匿名戒毒互助会议 I was actually at a Narcotics Anonymous meeting this morning.
我每天都去 I go every day.
“互相忏悔并且为对方祷告 "Confess your sins to each other and pray for each other
好让你痊愈” so that you may be healed."
《雅各书》 5:15-16 James 5:15-16.
但愿如此 Amen to that.
对你有好处 年轻人 Good for you, young man.
-肯定有更近距离的会议地点 -我试过更近距离的... - There's got to be a closer meeting. - I've tried the closer one...
强硬派的管理层认为 The hardliners who run it think
穿西装打领带是保持清醒的关键 that wearing a suit and tie is key to staying sober.
在医院这里组织你自己的会议 Start your own meeting, here at the hospital.
按你自己的想法来 你再也不会上班迟到了 Set your own tone, and you're never late for work again.
不 我没有资格当领导 No, I'm not qualified to be a leader.
没有这样的事 No such thing.
领导人领导 就这么简单 Leaders lead, simple as that.
您很烦人 You are annoying.
好吧 肖恩 我也很高兴见到你 Well, nice to see you too, Shaun.
不是对我 是对丽娅 Not to me, but to Lea,
我想让我们的关系保持牢固 and I want to keep our relationship strong.
她觉得您的存在占据了我们的公寓 She feels your presence has taken over our apartment
她想要回自己的空间 and she wants her space back.
我的婴儿保护措施太过分了 I overstepped with the babyproofing.
-还有名字的建议 -还有史波克博士的事 - And suggesting names. - And the Dr. Spock thing.
还有更多 保姆摄像头 And there's more, the nanny cam.
好吧 Okay, okay. Okay.
想想你的孩子和未来 这很有趣 It's was fun, thinking about your baby, and the future.
也许这是很好的消遣 Maybe it has been a nice distraction.
是的 Yes, it was.
自从您的房子被烧毁后您就需要它 Which you've needed since your house burned down
而且您没有地方住 and you have no place to live.
是的 谢谢 肖恩 Yes, thank you, Shaun.
格拉斯曼医生 您不完全是我的家人 Dr. Glassman, you are not exactly my family.
我理解 我知道 肖恩 I get it. I know, Shaun.
但我认为您是孩子的爷爷 But I consider you to be the baby's grandfather.
哇 Wow.
谢谢 Thank you.
我从没想过你会这么看我 I never thought that would happen for me.
谢谢 Thank you.
您可以留下 我会告诉丽娅 她会改变主意的 You can stay. I will tell Lea and she will change her mind.
不用了 我要走了 No, no, no. I'm going to go.
去哪里? Where?
我不知道 I don't know.
要我给您拿本杂志吗? Can I get you a magazine?
不用 谢谢 No, thank you.
枕头这么放可以吗? Are your pillows positioned okay?
好吧 你又来了 Okay, you're doing it again.
怎么了? What?
你从小就这样 The thing you've doing since you were little...
当你需要帮助的时候 just fussing over people...
你就会对别人过分关心 when it's you that's in need.
好的 来吧 跟我说说 Okay, c'mon. Tell me.
您刚见过佩雷斯医生了 You just met Dr. Perez,
您那么好还那么支持他 and you were so nice and supportive.
您知道我等您对我说 Do you know how long I've waited for you to say
“干得好”或者“哇 你是个医生” 等了多久吗? "Good job" to me. Or "Wow, you're a doctor."
你知道丽贝卡克拉姆勒是谁吗? Do you know who Rebecca Crumpler is?
不知道 No.
她是第一位黑人女医生 She was the first black female doctor.
当我读到她的故事时 我想成为像她那样的人 And when I read about her, I wanted to be just like her.
但遗憾的是 在你上医学院之前 But unfortunately, I didn't know who she was either
我也不知道她是谁 until you were in med school.
昆克...从你上幼儿园开始 Quinque... I've been impressed by you
我就对你寄予厚望 since you were in kindergarten.
奶奶 Grandma.
-怎么回事? -她呼吸困难 - What's going on? - She's having trouble breathing.
她有低血压 She's hypotensive.
颈静脉扩张加剧 心脏衰竭 Jugular vein distension is increased, her heart is failing.
告诉我你已经练习过了 Tell me you got through a practice run.
我们推迟了手术 这样我们就能多练习了 We were postponing the surgery so we could practice more.
与毒瘾作斗争?
你在贴什么? What are you hanging?
那是... It's a...
显然您能看懂 You can read obviously.
可以吗?对不起 我应该先和您说清楚 Is this okay? I'm sorry, I should have cleared it with you first.
是的 你应该先说清楚 Yes, you should have.
因为我就会告诉你 用六楼的小会议室 Because I'd have told you to use the small conference room up on six.
楼上更安静 房间里有百叶窗 It's quieter up there, and the room has blinds,
帮助你保持“匿名”的感觉 to help with the "anonymous" part.
谢谢 Thanks.
我是朴医生 This is Park.
我得飞到旧金山去 我现在正在叫出租车 I had to fly to San Francisco, I'm just grabbing a cab now.
你能等我到那儿再做手术吗? Can you hold the surgery until I get there?
我们不能 如果他再出血... We can't. If he hemorrhages again...
或者 你能让他接电话吗? Or, can you put him on the phone?
他已经打了镇定剂 He's already sedated.
但如果这是我跟他说话的 But what if this was my last chance
最后机会呢? to talk to him?
我会像医治自己的儿子一样医治内森 I'll treat Nathan like my own son.
我保证 I promise.
谢谢 Thank you.
尝试穿刺心包 Try to puncture the pericardium
抓住边缘 这样我们就可以开始剥壳了 and grab an edge so we can start to peel the shell.
施加更大的压力 Apply more pressure.
我们可能需要另一种工具来刺穿它 We may need another tool to pierce it.
让我们试试咬骨钳 Let's try the rongeur.
心肌穿孔 Perforation of the myocardium.
手动填塞孔 脱脂棉缝合线 Manually tamponading the hole. Pledgeted sutures.
心包钙化太严重了 The pericardium's just too calcified.
它粘附在心肌上 It's adhering to the myocardium.
那么我们该怎么办? So what do we do?
修复穿孔 之后 我愿意接受各种建议 Repair the perforation, after that, I'm open to ideas.
我们可以给她做旁路手术 We could put her on bypass.
一点一点轻轻剥去钙化的心包 Gently peel off the calcified pericardium bit by bit,
-然后修复损伤 -在桶上戳洞 - and repair damage as we go. - Poking holes in a bucket
希望我们能在 水漏出来之前把它们堵上 and hoping we can plug them before the water leaks out.
我有个主意 I have an idea.
-继续说 -这叫做华夫饼手术 - Go ahead. - It's called the Waffle procedure.
我发现了一项新的研究 它说 I found a novel study, it said
密集钙化斑块可以 被划分成多个交叉阴影的部分 dense calcified plaques can be scored into multiple cross hatched sections.
根本不需要去除? No removal at all?
没错 外壳留在原位 Exactly. The shell stays in place,
但心脏在跳动时有扩张和收缩的空间 but the heart has room to expand and contract as it beats.
死亡率? Mortality rate?
低于8% Under 8%
跟我说怎么做 Talk me through it.
好的 超声波手术刀 Okay. Ultrasonic scalpel.
首先切开钙化的心包 Start by incising the calcified pericardium.
ICG血管造影看起来很好 ICG angio looks great.
佩雷斯医生 您可以做硬脑膜闭合术 Doctor Perez, you may do the dural closure,
然后更换颅骨瓣 then replace the skull flap.
在我们关闭之前... Before we close...
我们比计划提前了 为什么不在他的另一个大脑半球 We're ahead of schedule. Why not go ahead with the bypass
-做旁路手术呢? -那不是手术方案 - in his other hemisphere? - That is not the plan.
同时进行双侧手术 有改变脑流量的风险 Simultaneous bi-lateral surgery risks altering brain flow,
可能会导致另一次流血 it could cause another bleed.
但也许有办法降低这种风险 But maybe there's a way to reduce that risk.
这种等待对父母来说简直是地狱 一直都知道他们儿子的大脑... The wait will be hell on the parents, the whole time knowing their son's brain--
父母的压力与医学无关 The parents' stress is not medically relevant.
我知道 肖恩 但是请... I know, Shaun, but please...
你能想到别的办法吗? Can you think of any other way?
(STA-MCA旁路手术 血流更快修复更快)
(脑膜-硬脑膜-动脉-血管合并 血流更慢 恢复更安全)
左侧脑膜-硬脑膜-动脉- 血管合并的风险 An encephalo-duro-arterio-synangiosis of the left side
相对较低 would be relatively low risk.
我们现在可以放心地做了 We could safely do that now.
谢谢 Thank you.
瑞克 琳达! Rick, Linda!
手术很顺利 The surgery went well.
她醒了 很准时 There she is, right on schedule.
您感觉如何? How do you feel?
就像我可以呼吸一样 Like I can breathe.
这么长时间以来第一次 For the first time in a long time.
替我感谢林医生 Thank Dr. Lim for me.
我会的 I will.
某人太得意了 Somebody's all puffed up.
你做了什么... You did something...
手术团队有点卡住了 The surgical team got a little stuck.
我只是给了他们一个新想法 I just gave them a new idea.
干得好 Good job.
哇 你是医生 Wow, you're a doctor.
哇 好吧 你现在说得有点过分了 Wow, okay. You're laying on a little too thick now.
看起来不错 你感觉怎么样? Looking good. How are you feeling?
还好 Okay.
你能和我击掌吗? Can you give me a high five?
击双掌? High ten?
好样的 Good job.
好小子 Good boy buddy.
帕奇斯呢? Where is Patches?
他就在这儿 He is right here.
你确实给他做了脑部手术 You did do the brain surgery on him.
没有 我只是在他头上 绑了绷带让你感觉好点儿 No. I just put bandages on his head to make you feel better.
我确实感觉好点儿了 I do.
不好意思 这里要开会了 I'm sorry, there's a meeting.
我知道 匿名戒毒互助会 对吧? I know. N.A. right?
是的 Yeah.
我花了几分钟才鼓起勇气进来 Took me a few minutes to get the courage to come in.
只有我们两个来了 对不起 It's just us. Sorry.
两个或更多人聚集的地方... Where two or more are gathered...
请坐 Have a seat, please.
嗨 我是丹尼 而且... Hi. I'm Danny. And...
我是个瘾君子 I'm an addict.
快到演讲时间了 Almost show time.
别这么说 您让我紧张 Don't say it like that, you make me nervous.
做你自己 这已经足够了 Be yourself. That's more than enough.
大家好 Hi, everybody.
你们有那么多人 There's so many of you.
这真是太好了 That's so good to see.
我是乔丹艾伦医生 I'm Doctor Jordan Allen,
我是圣文德医院的 第三年外科住院医师 and I'm a third year surgical resident at St. Bonaventure Hospital.
格拉西在哪儿? Where's Glassy?
他不会再和我们住一起了 He will not be staying with us anymore.
-他搬出去了? -是的 - He moved out? - Yes.
我们谈了谈 觉得这样最好 We had a talk and decided it was best.
你告诉他我在抱怨他了吗? Did you tell him I was complaining about him?
是的 Yes.
肖恩 我现在感觉糟透了 Shaun, now I feel horrible.
你不需要 You don't need to.
他在走廊的尽头 找到了一间空置的公寓 He found a vacant apartment just down the hall.
在这栋楼里? In this building?
-是的 -他是我们的隔壁邻居? - Yes. - He's our next-door neighbor?
我们隔壁邻居的隔壁邻居 Our next-door neighbor's next-door neighbor.
字幕翻译: 何卓