我睡不着 I couldn't sleep.
我们应该开始每天给你量血压 We should start taking your blood pressure every day.
这样确实体贴又负责 This is very sweet and responsible.
对 我现在会担负起更多责任 Yes, I am going to try to be extra responsible now.
好 Yeah.
我们得谈谈我们想要干什么 W-we -- we have to talk about what we...want to do.
我爱你 I love you.
我想要个孩子 I want a child.
所以我想要这个孩子 So I want this child.
我也爱你 I love you, too.
我也确实想要孩子 但这事很复杂 And I do want kids, but it's complicated.
在事业发展的这个阶段要孩子合适吗 Is this the right time in my career?
我们的感情够稳定吗 In our relationship?
我是不是太年轻了 Am I too young?
我们能养得起孩子吗 Can we afford this?
我愿意现在就做出这个承诺吗 Am I willing to make this commitment right now?
我们可以开始在联名账户里存钱 We can start depositing money
用于孩子的开销 into a shared account for expenses,
而且我可以跟格拉斯曼医生谈谈 让他给你 and I can talk to Dr. Glassman about hiring you an assistant
请个助理来分担工作 to help with your workload --
肖恩 慢点 Shaun, just slow down.
我不需要你现在就回答这些问题 I-I don't need you to answer these questions now.
我只是需要思考 I just need to...think.
想清楚该怎么办 To figure out what to do.
你也需要思考 And you do, too.
钱伯斯医生 我想给你介绍我们的住院医师 Dr. Chambers, I'd like you to meet a few of our residents.
-这是... -我知道我老了 - This is Doctor -- - I know that I'm old,
但我还看得清胸牌 but I can still read name tags.
钱伯斯医生 您一个月之前就开始感觉到 Dr. Chambers, you started experiencing aches
右手疼痛吗 in your right hand a month ago?
然后是颤抖 无力 痉挛 Then tremors, weakness, spasms.
不得不中途退出上周五的肠切除手术 Had to drop out in the middle of a bowel resection last Friday.
我已经把那次手术的视频发给你了 I sent you a video of the surgery.
从你的症状看来 好像是腕管综合征 Given your symptoms, it seems that carpal tunnel --
「好像」吗 Oh, it "seems."
好吧 那问题解决了 Well, then, problem solved.
我该走了 I'll be on my way.
先生 我只想说你在海地工作的那部纪录片 Sir, can I just say that the documentary
改变了我的人生 on your work in Haiti changed my life.
正是因为它我才... It's the reason why I went into --
如果你想拍马屁 叫我「医生」而不是「先生」 If you want to suck up to me, call me "doctor," not "sir."
这里是医院 不是柯契拉音乐节 And this is a hospital, not Coachella.
如果你无法穿着得体 If you can't wear something appropriate,
至少穿得合身点 at least try something that fits.
排除自身免疫疾病 甲状腺功能减退 糖尿病 Rule out autoimmune disorders, hypothyroidism,
淀粉样变性 多发性硬化症和多发性骨髓瘤 diabetes, amyloidosis, MS, and multiple myeloma.
然后我们再考虑腕管综合征 Then we'll get back to carpal tunnel.
好 Alright.
如果您有任何问题或疑虑 If you have any other questions or concerns,
请尽管... please don't hesitate --
十二条 Twelve.
首先 我不喜欢砂纸做的毯子 First, I prefer blankets not made of sandpaper.
然后 把该死的灯光调暗 Second, dim these damn lights.
这不是在圣费尔南多谷拍色情片 This isn't some San Fernando Valley porn shoot.
-第三 -如果你列了清单 - Third -- - If you made a list,?
就没必要跟我们说一遍 you don't need to tell us.
他已经疼了九个月 He's had the pain for nine months now.
两边都疼吗 And it's on both sides?
有时是额头 Sometimes his forehead,
有时是面颊 鼻子 other times his cheeks, his nose.
而且用了极高剂量的氢可酮后疼痛仍然持续 And it's persisting through very high doses of hydrocodone.
对 药物显然没有用 Yeah, obviously, the drugs don't work.
所以我才来这里 It's why I'm here.
奥斯卡 Oscar.
这个问题很合理 It's a fair question.
听着 我很抱歉 Look, I'm sorry.
好吗 我已经看过六个医生了 Okay, I've been to six doctors now.
我无法工作 I can't work.
我甚至没法亲吻我妻子 I mean, I-I c-- I can't even kiss my wife.
我几乎笑不出来 I can hardly smile.
我会轻轻地刮一下你的面颊 I'm just gonna lightly brush your cheek.
好了 Okay.
请帮帮我 Please...help me.
我跟有线电视公司打了 I've been on the phone for like an hour
一小时电话 with the cable company --
莉亚怀孕了 Lea's pregnant.
你想要... You want to have...
对 Yes.
你高兴我就高兴 I'm glad you're happy.
你有什么疑虑吗 do you have any concerns?
有 Yes.
睡眠不足 Sleep deprivation.
但我已经开始找负担得起的夜班护士了 But I have started looking into an affordable night nurse.
还会有更大的问题 Well, there's gonna be some bigger issues.
我是说 这是 I mean, this is a...
这对任何人来说都是非常重大的时刻 This is a gigantic moment for anyone,
特别是对你来说 especially -- especially for you.
你是说 You mean...
因为我有自闭症 because of my ASD?
对 因为你有自闭症 Yeah, because of your ASD.
因为你的家庭 Because of your family.
你的工作 Your job.
我是说 I mean...
各方面 A million things.
我不想跟你说应该怎样... I don't want to tell you what -- what to --
我甚至不知道我会怎样... I mean, I don't even know what I...
一个孩子的降生 Having a child...
会改变一切 changes everything.
良 医
第四季 第十二集
鼻腔很干净 Nasal cavity's clear.
没有脓肿 面部肿瘤或鼻窦炎 There's no abscess, facial tumor, or sinusitis.
可能是听神经瘤 It could be acoustic neuroma.
却没有丧失任何听力吗 Without any hearing loss?
我们做个核磁共振看看 Let's do an MRI to check.
我们做了八次检查都是阴性 We've run eight negative tests already.
没必要再做第九次 We don't need a ninth.
我们没确诊就要一直做检查 We do the tests till we know what he has.
是纤维肌痛 It's fibromyalgia.
所以你对他疼痛的诊断是 So, your diagnosis for his pain
「没人能解释的疼痛」 is "pain that no one can explain"?
-干得好 -有些疼痛是无法避免的 - Well done. - Some pain's unavoidable.
我参加跆拳道比赛时 When I was competing in Tae Kwon Do,
他们教我们调整自己对疼痛的耐受度 they taught us to adjust our relationship to it,
学着忍受疼痛 learn to tolerate it.
这会让你更强大 It can make you stronger.
这番话真是冷酷无情 谦虚自夸 Wow. That statement has the absolute ideal ratio
大男子主义的理想配比 of heartlessness, humble-bragging, and machismo.
真棒 Bravo.
真的吗 你同意这番话 Seriously? You're pleased with that?
「大男子主义」是西班牙语 「真棒」意大利语 "Machismo," Spanish, "bravo"'s Italian.
而「谦虚自夸」还是2011年的词 And "humble-bragging"'s 2011.
我们能做得更好 不是吗 We can do better, don't you think?
也许我们没有任何发现是因为这是心理问题 Maybe we're not finding anything because it's psychological?
某种转化症 Some kind of conversion disorder?
你去做核磁共振 You do the MRI.
我跟他妻子谈谈 I'll talk to the wife.
不是内分泌问题 Negative for endocrine issues.
他有中度颈动脉狭窄的病史 He's got a history of moderate carotid stenosis.
如果有足够的斑块累积 If enough plaque builds up,
会让大脑缺氧 starves the brain of oxygen,
也许会导致他手部的问题 maybe could cause the hand problems.
生孩子 利 弊
如果有那么严重 我们早就看到中风的征兆了 If it got that bad, we'd have already seen signs of a stroke.
还有人因为我们浪费这么多资源去确认 Anyone else annoyed that we're wasting
明显是腕管综合征的诊断而烦恼吗 all these resources to confirm what's clearly carpal tunnel?
他可能是个混蛋 但他是个伟大的医生 He may be a jerk, but he's a great doctor.
如果塞拉斯·钱伯斯有医疗意见 If Silas Chambers has a medical opinion,
我们最好查清楚 we better check it out.
我觉得他不是混蛋 I didn't think he was a jerk.
安德鲁斯医生和利姆医生也会批评我们 Dr. Andrews and Dr. Lim also criticize us
也会有特殊的要求 and have particular demands.
对 他们想让我们进步 Yeah. They want us to improve.
你怎么知道钱伯斯医生不想让我们进步 How do you know Dr. Chambers doesn't?
他确实让恩里克进步了 He did improve Enrique.
没开玩笑 Not kidding.
你看着时髦了 You look snazzy.
我知道钱伯斯医生有什么病了 I know what Dr. Chambers has.
我们都很难找到你丈夫疼痛的 We're having trouble finding a physical basis
身体原因 for your husband's pain.
而且我之前问他止痛药的事时 And you defended me when I asked him
你帮我辩解过 about painkillers earlier.
几年前 奥斯卡在工地 A few years ago, Oscar was on a job site.
疯狂加班 Working crazy hours.
累得不行 He was exhausted.
他用钉枪射到了自己 He shot himself with a -- with a nail gun.
射穿了他的手掌 Right through his palm.
我们当时没有医保 We didn't have insurance,
所以我们去了个诊所 然后... so we went to this clinic, and, um...
开了类鸦片药物 Opioids?
真的很糟 Really bad.
他花了一年时间才戒掉 Took a year for him to kick.
现在 他吃的药比以前更多了 Now, um...he's taking more pills than ever.
我只要劝他寻求帮助 Whenever I talk to him about getting help,
他就会生气 he just gets mad.
我 I, uh...
我上周不得不搬出去了 I had to move out last week.
我来这里只是因为他要我来 I'm only here because he asked me to.
我觉得他是装的 I think he's faking.
你做手术的最后一天缝了113针 You threw 113 sutures in your last day of surgery.
其中有一半以上的针数 In at least half,
你的手都在非常细微的震颤 I detected a very subtle tremor.
恭喜你发现了我告诉过你的症状 Congratulations on discovering a symptom I told you about.
你伸直手腕缝针时会出现 It occurs during the part of your stitch
这种症状 而你手腕弯曲时则不会 when the wrist is straight, not when it's bent.
这不是腕管综合征 That is not carpal tunnel.
这是音乐家的肌张力障碍 It is musician's dystonia.
我每次缝合时手腕都会弯曲 My wrist flexes on every suture.
你说的是几毫秒的差异 You're talking about a difference of milliseconds.
没错 Yes, he is.
你的病症可能是因为 Your condition was probably caused
你的重复动作引起的 by your repetitive technique.
就连安德鲁斯医生也会用不同的方法缝合 Even Dr. Andrews throws sutures in varied ways.
而你从来不会 这种强迫行为 You never do. This kind of obsessive behavior
在自闭中患者中很常见 is common for those with autism.
所以 我可以... So, I can refer --
你说什么 What did you just say?
我没有自闭症 I'm not autistic.
莫菲医生没有冒犯的意思 Dr. Murphy didn't mean any offense.
他自己就患有自闭症 He himself is on the spectrum.
是吗 Oh, is he?
我还以为他攥紧双手 像个机器人一样说话 I thought his robotic voice and hand clasping
是在装模做样呢 were just charming affectations.
你真觉得我跟他有一点相似的地方吗 Do you really think I am anything like him?
我没有说 I'm not saying that --
是的 I am.
你极其有条理 You're extremely organized.
几乎不做眼神接触 You hardly make eye contact.
考虑到你在食物 毯子 And given your problems with food, blankets,
以及灯光的问题 另外你在手术期间都要带耳机 and lighting, plus the fact you wear headphones even in surgery,
你很明显有感官上的问题 you clearly have sensory issues.
我有条理 I'm organized.
难道我应该随随便便出现在手术室吗 Would you rather I show up in the O.R. and just wing it?
我对于食物和音乐有品位 I have good taste in food and music.
这也算是精神疾病吗 Now that's a mental disorder?
至于眼神接触 And as for eye contact...
好 Okay.
我不是来这里做心理咨询的 I didn't come here for a psych consult.
他只是在观察 It was just an observation about a possible reason
导致你手部症状的可能原因 for the behavior that led to your hand symptoms,
这也是我们应该讨论的 which is what we should be talking about.
物理治疗是肌张力障碍患者的推荐方案 Physical therapy is the recommended course for dystonia.
我不会在没用的治疗上投入几个月的时间 I'm not wasting months on a treatment that won't work.
我要做丘脑前腹侧核的 I want an MRI-guided ultrasound ablation
磁共振引导超声消融术 of the VO nucleus of the thalamus.
你要跳过脑部手术吗 You want to jump to brain surgery?
我会直接快进到切断脚趾 I would jump right to amputating a toe
如果这能让我重返工作 if it got me my career back.
你在想什么 What were you thinking?
你刚刚还支持了我 You just supported me.
对 因为工作不允许我在病人面前 Yes, because part of my job is not yelling at residents
冲住院医生大喊 in front of patients.
你像是看了一张模糊的核磁共振 What you did is equivalent to looking at a fuzzy MRI
就立马说病人有癌症 and blurting out a patient has cancer.
癌症是致命的 Cancer can kill you.
没有病人愿意听到这两句诊断 Neither diagnosis is one a patient is excited to hear.
准备送他去做消融术 Prep him for the ablation.
别再跟他说自闭症的事了 And do not talk to him again about autism.
他上个月已经看了六个医生了 He's seen six doctors in the last month,
拿到了三次类鸦片处方药 gotten three opioid prescriptions,
曾经有过类鸦片药物使用障碍 and he had a previous opioid problem.
典型的觅药行为 It's textbook drug-seeking.
这也是经典的傻瓜 It's also textbook "a bunch of dingbats
误诊三叉神经痛行为 missing a trigeminal neuralgia diagnosis."
他妻子同意我说的 她了解他 Mm, his wife agrees with me. She knows him.
明白你的妻子为什么会离开你了 Would explain why yours left you.
说得好 但是我妻子没有离开我 Snap. Except my wife didn't leave me,
没什么说服力 也不算聪明 so neither a good point, nor even a clever one.
安排稳态采集快速成像得要好几个小时 FIESTA imaging would take hours to set up,
还会花病人很多钱 cost the patient serious money,
结果却还是正常 and still come out negative.
因为这是标准的觅药行为 Because...it's textbook drug-seeking.
还有其他病人需要我们 We have other patients who need us.
我要送他出院了 I'm sending the discharge order.
我讨厌粑粑 I hate poop.
如果我换尿布的时候犯恶心怎么办 Like, what if I suck at changing diapers?
也许我们得从更大的问题聊起 Maybe we should start with the bigger issues
再一个一个向下解决 and work our way down.
我不是特别担心这个 This isn't at the top of my list,
但因为你是个医生 but since you are a doctor...
肖恩的自闭症是不是 Shaun's ASD -- is it...?
遗传吗 Inheritable?
有可能 Probably.
但不清楚有多大的概率 But it's unclear how much.
如果那样的话 So, even that.
我该怎么办 W-What am I supposed to do with that?
好好想想 Think it through.
假如你有个小宝宝肖恩 Let's say you have a little baby Shaun.
小小的 很真诚 Like...tiny, honest,
喜欢我的聪明小家伙 brilliant guy who adores me...
小小的衬衫 Mini button-down,
小小的蓝眼睛 teeny blue eyes...
我呢 And me?
当妈妈 A mom?
我不是说我的生活会变糟 I mean, I'm not saying my life would be worse,
但是会变得很不同 but it would just be so different
跟我之前计划的 from what I was planning.
我不是真的在计划什么 Not that I was really planning,
我只是很享受 but I am enjoying just...
生活 being.
如果你先等等呢 And so what if you wait?
我只是想确定自己做的决定是对的 I just want to make sure I'm making the right decision.
我觉得你永远没法知道 I guess you'll never really know.
我对于我的妈妈也做了很多困难的决定 I had to make a lot of hard choices about my mom.
醒来还是在想 And I still wake up wondering
我做错了哪个决定 which of them went the wrong way.
但你还是得选 But...you still gotta choose.
中脑桥没有异常信号 No abnormal signal in the mid pons.
你和朴医生在家也是这样吗 So, are you and Dr. Park like this at home, too?
当我让他从笼子里出来吃饭的时候 是的 When I let him out of his cage for meals, yes.
我们已经 Hey, we're almost --
说吧 Oh, come on.
你没收到我发的与此事无关的短信吗 Did you not get the text I didn't send about this?
如果你要这样就不要找人会诊 Don't bother asking for consults if you're gonna --
等等 Wait.
右小脑上动脉上那个是什么 What's that on the right superior cerebellar artery?
异常环状物造成压迫 An abnormal loop causing compression.
他有三叉神经痛 He has trigeminal neuralgia.
他的疼痛是真的 The pain's real.
我们能很清楚地看到 We have good visualization
目标区域 of the target area.
把超声连接到立体定向架上 Connect the ultrasound to the stereotactic frame.
生孩子的理由
点儿童套餐不会有人质疑
有借口买科学博物馆季票
有借口逃避社会责任
椎动脉
消融术是没用的 Ablation won't work.
你改变主意了吗 You changed your mind?
你不觉得他有肌张力障碍吗 You don't think he has dystonia?
他有 但那只是个症状 He does, but it's a symptom.
他的椎动脉曲线异常 His vertebral artery takes an aberrant course.
压迫了他的脊柱 It is pressing against his spinal cord.
他需要血管手术 否则他会死 He needs vascular surgery or he'll die.
这是一种从面部到大脑 It's a disorder of the nerve that carries sensation
感觉神经的紊乱 from the face to the brain.
是最痛苦的疾病之一 And it's one of the most painful conditions that exists.
而且很难诊断 And very hard to diagnose.
万幸的是朴医生同意做那些检查 Thank God Dr. Park approved all those tests.
你很痛苦 Y-you were in agony.
我 And I...
我告诉他我觉得你在撒谎 I told him I thought you were lying.
你觉得我在撒谎 You thought I was lying?
你觉得我药物上瘾了 You thought I was just being an addict.
但你还是陪我来了 And still you came here with me.
坐在我旁边 Sat at my side.
我们推荐做微血管减压术 We'd like to do a microvascular decompression.
我们会从你大脑后部进入 We'd go in through the back of your skull
放入聚四氟乙烯补片来缓和受影响的神经 and put in a Teflon patch to cushion the affected nerve.
你们要切开他的头吗 You're -- you're cutting into his brain?
这个相对来说安全 其他方案 It's relatively safe. And other options
不可能缓解疼痛 are unlikely to relieve the pain.
我会做的 Look, I-I'll do it.
谢谢你们 Uh, thank you so much.
我们想要进行椎动脉球囊闭塞试验 We want to run a vertebral artery BTO.
如果你能接受 我们会选择牺牲 If you tolerate it, then we would sacrifice the --
牺牲有缟玛瑙栓塞剂的血管 Sacrifice the vessel with onyx embolization.
我们明白你可能不喜欢这个提议 We recognize you might not love this proposal.
喜欢这个让我的手继续无力 The one in which my hand weakness remains,
毁掉我事业的提议吗 destroying my career?
你们考虑过椎体间的动脉搭桥手术吗 Did you consider vertebral-to-vertebral artery bypass
物理去除异常的动脉 with physical removal of the aberrant artery?
那会有很高的中风或者出血的风险 Mm, that would carry a very high risk for a stroke or bleed.
它能够治好肌肉障碍 让我正常工作 It would fix the dystonia and let me get back to work.
鉴于你颈动脉狭窄的病史 With your history of carotid stenosis,
你能否活下来都是未知的 it would be a coin flip whether you survive.
我能接受这些存活几率 I can live with those numbers.
不然我宁愿死去 Or, for that matter, die with them.
到三叉神经根的通道已经打开了 Corridor to the trigeminal nerve origin is open.
我移开了责任血管 I freed up the offending vessel.
聚四氟乙烯垫片 Teflon sponge.
垫片太大了 The sponge is too big.
会压迫到脑干 It'll compress the brain stem.
至少有四毫米的空间 I have at least 4 millimeters of room.
只有你说的一半 You have half that.
是 你在十五米外看得比我清楚 Yes, you have a better view 50 feet away.
他们这样已经多久了 How long have they been like this?
有一会儿了 但是情况还在恶化 A while. It's getting worse, though.
抱歉 朴 你是对的 Sorry, Park, you're right.
就像你决定要 Just like you were when you decided
送这个病人出院一样 to discharge the sick guy.
是你发明了挖苦吧 Wow, you invented sarcasm.
真了不起 Really impressive.
看看我 我也在用它呢 Hey, look at me, I'm using it, too.
朴 你误诊了 Park, you missed the diagnosis.
雷兹尼克 你违反了规定 Reznick, you ignored protocol.
不如你们俩都谦虚点 然后闭嘴 How about you both show some humility and shut up?
抱歉 Sorry.
垫子放上去了 Teflon's placed.
如果我们用大隐静脉来做搭桥呢 What if we used the saphenous vein for the bypass?
血流不够 他会休克的 Not enough flow. He'll stroke out.
那从颈动脉到椎骨远端呢 Carotid to distal vert, then?
动脉狭窄太严重了 Stenosis is too severe.
这老兄很有钱 Dude's loaded.
他到了退休的年龄 He's at retirement age.
他能教书 旅游 整天去玩 He could teach, travel, screw around all day.
为什么要我们这么做 Why is he demanding that we do this?
当你把生命奉献给 When you dedicate your life to something
赋予你意义的东西 that gives you meaning,
它就开始定义你 it starts to define you.
他的决定可能不合理 但我能理解 His decision may be irrational, but I get it.
我不觉得有什么不合理 I don't think it is irrational.
钱伯斯医生没有朋友 没有孩子 Dr. Chambers has no friends, no children,
没有家人 没有业余爱好 no family, no outside interests.
如果他不当医生 他就一无所有 If he can't be a surgeon, he'll have nothing.
我认为最佳方案是放射状移植 I think our best bet is a radial graft.
这是我能想到最好的办法 Highest flow I can think of.
有其他想法吗 Any other ideas?
好吧 我们就做放射状移植 Okay. We go with the radial graft.
我印象深刻 I'm impressed.
我当时甚至开始怀疑我是不是要失去触觉了 I was actually starting to wonder if I was losing my touch.
然后我度过了一个煎熬的下午 But then I had a dark afternoon of the soul
然后我突然意识到 and suddenly I knew it --
那只不过是烧伤 those were totally solid burns.
可能不是A+级烧伤 但A- B+最糟糕了 Maybe not A+, but A-, B+ at the worst.
所以我突然想到 你是想让我退赛 So it hit me -- your plan was to throw me off my game,
让我怀疑自己 make me doubt myself --
我迷上你了 I'm attracted to you.
我一直和这愚蠢的感觉抗争 I've been fighting this stupid feeling,
想办法找到理由 让我不再有这种感受 trying to find reasons to not...feel.
你在开玩笑吗 Are you kidding me?
是啊 Yes.
你的笑话不好笑 Your jokes were lame.
就该是这样玩弄别人的 And that's how you screw with someone.
不 No.
你不擅长撒谎 You're not that good of a liar.
我不能和一个对我有想法的人当室友 I-I can't have a roommate who has feelings for me.
因为你开不起玩笑吗 Since when can't you take a joke?
因为我的室友挑逗我 Since my roommate hit on me.
你必须搬出去 You have to move out.
越快越好 As soon as possible.
我们决定用你的桡动脉移植 We've decided to use your radial artery for the graft.
我们已经安排了明天早上的手术室 We've scheduled an O.R. for tomorrow morning.
-好消息 -我同意 - Good call. - I agree.
你应该冒生命危险做这个手术 You should risk your life for this surgery.
你在开玩笑吗 Are you being facetious?
没有 No.
难以置信 It just boggles the mind.
你不能理解别人的意思 You can't understand what anyone means.
你不能像个成年人一样表达自己 You can't express yourself like an adult.
你就是个玩过家家的小孩 You're a child playing dress-up.
这里的所有人都陪着你玩过家家 And everyone here just plays along.
我们走吧 肖恩 Let's go, Shaun.
你很不安 Y-You're agitated.
我没事 I'm fine.
你在擦杯子 You are rubbing your mug.
自闭症患者总是带着慰藉物 People with ASD often have comfort objects
以防焦虑不安 for when they become agitated.
我可以给你来点心得安 I can order you propranolol.
你要给我鲁塞卡斯·弗里德曼的 You're gonna give me the Ruseckas Freedman
自闭症评估表 ASD Diagnostic Questionnaire,
这样你才能闭嘴 and that's gonna shut your damn mouth.
好吧 那个测试表只是个工具 Okay, the "Rafad-Q" is just a tool.
正式的诊断需要精神科医生给出 An official diagnosis needs to come from a psychiatrist.
我明天可能就死了 Well, since I might be dead tomorrow,
这是你次优的选择 this is your next-best option.
我会把测试表拿来 I'll get the test.
你为什么不能对别人尊重一点呢 Why can't you treat people with just an ounce of respect?
尊重是赢来的 不是像发糖果那样简单 Respect has to be earned, not doled out like candy.
不 这是你这样的人 No, that's just an excuse people like you use
为你垃圾行为辩护的借口 to justify your garbage behavior.
这是你这样的人 That's just an excuse people like you use
逃避现实的借口 to avoid facing reality.
我实习的时候没人尊重我 No one was respectful to me when I was a resident.
他们轻蔑而冷酷 They were dismissive and cruel.
但这点燃了我内心的火 成就了今天的我 But it lit a fire and it made me the man I am today.
成为你进房间时带着敬意看到的人 The man that you came into my room idolizing.
不再是这样了 Not anymore.
我身体糟透了 I'm devastated.
医生应该救人性命 Surgeons deal in human lives,
不是小孩子玩过家家 not childish fantasies.
如果你想成功 If you want to succeed,
你得更像我才行 you're gonna have to be a lot more like me.
一切都好吗 Everything okay?
- 是 -手术进行得很顺利 - Yep. - Surgery went very smoothly.
现在不疼了 No pain right now.
想试一下吗 Want to take it for a test drive?
更糟了 It's worse.
侧支循环不太理想 Collateral circulation is not ideal.
我们要怎么割动脉 How are we gonna harvest the artery?
怎么了 What's going on?
我要做出多少改变才能成为医生 How much am I gonna have to change who I am to be a surgeon?
在任何方面做好 或者是做到卓越 Ah, to be great -- or even good -- at anything,
我们都必须妥协 we have to compromise.
我以前总是在工作中投入太多情感 I used to get too emotionally involved in my work,
对病人是这样 对所有人都是 with patients, everyone.
然后我必须学着让我自己保持距离 And I had to learn to distance myself.
是的 你确实变得冷酷无情了 Yeah, you've really grown cold and heartless.
我已经做出改变 我们最终都会变的 I have changed. We all end up changing.
你只是要尝试做出好的改变 You just got to try and make it a good change.
我不想做出改变 I don't want to change.
我想改变我身边的环境 I want to change what's around me.
我会想出办法的 Oh, I'll figure it out.
我相信你会的 I'm sure you will.
你是能把住货车都搞得很酷的那种人 Hey, you're the guy who makes living in a van look cool.
所以 这个循环系统 So, uh, the circulation...
右边看起来更长 The right side looks like it has better length.
考虑到现在糟糕的结果 Given the poor outcome,
我们不建议现在再进行手术 we can't recommend further surgery right now.
我们建议服用六个月的止痛药 We suggest six months of pain medication
并且转诊给神经学和疼痛控制专家 and referrals to neurology and pain management specialists.
你们不建议什么手术 W-What surgery aren't you recommending?
应用脊神经后根入髓区毁损术 A DREZ lesioning.
我们会切断三叉神经 We'd cut the signal from the trigeminal nerve
到你大脑感觉区的信号 to the sensory areas of your brain.
但可能导致 But there's a real possibility of paralysis
一侧身体瘫痪 on one side of your body.
我想做手术 I want the surgery.
亲爱的 我会帮你控制疼痛的 Baby, I'll help you manage the pain.
我会搬回来的 I-I'll move back in.
我来照顾你 I'll take care of you.
你知道我之前怎样待你的 You know how I treated you before.
我的病情只会恶化 I'm only gonna get worse.
我不会再离开你 I would never leave you again.
这就是我害怕的 That's what scares me.
我会拖累你 I'd start cutting you down,
我会变得无情 being cruel,
你却只能忍受 and you'd just put up with it.
我不会让这发生 I won't let that happen.
我们会准备手术室 We'll prep an O.R.
「我经常指出别人的错误」 "I frequently point out other people's mistakes."
没错 That's a yes.
「人们总是说我想太多」 "People tell me I overthink things."
只有想得少的人才那么说 Only people who underthink things.
但是 好吧 没错 But, fine, another yes.
「我有时会怪声怪调地说话」 "I sometimes speak in an abnormal tone."
谁会认为自己说话的语调不正常 Who thinks they speak in an abnormal tone?
当然不是 Just mark no.
还有多少问题 How many more of these?
没有了 None.
你的答案和光谱上的某个人完全一致 Your answers are fully congruent with someone on the spectrum.
不 No.
你输入错了 You keyed it wrong.
-不 看 我没有 -那就是别的什么 - No, look. No, I - Or something.
-看 我没输错 -不 给我 - Here. Look, I didn't. - No, give it to me.
-不 我 -不要 - No, I -- ? - Oh! Don't!
你个粗心的蠢货 You idiot! S-Stupid, careless --
我退后了 I-I stepped back --
滚出我的房间 Get out of my room.
-快滚 -好 - Get out! ? - Okay.
确保我们没有影响正常的脊髓通路 Make sure we're not impacting normal spinal cord pathways.
体感正常 Somatosensories are at baseline.
血压稳定 BP's steady.
腿部和手臂脊髓诱发电位幅度降低50％ Leg and arm SSEPs at 50% decreased amplitude.
检查神经上下有无血肿 Check the cord above and below for hematoma
或者骨性压迫 or bony compression.
状况良好 Cord's fine.
推静脉输液并启动加压器 Push IV fluids and start pressors.
所以 怎么回事 So, what is it?
我不知道 I don't know.
运动电位有问题吗 Any issues with motor potentials?
单边振幅下降70% Unilateral amplitude down 70%.
神经系统就要崩溃了 We're about to get total neurological collapse.
是一个小分支动脉的血块 It's a clot from a small branch artery.
我们检查了脊髓血管 We checked the spinal blood vessels --
在血管外面 The outside.
但电极可能损伤了脑沟动脉 But the electrode could have injured a sulcal artery.
我们要沿着脊髓背根入髓区的路径向里检查 We need to follow the DREZ pathway inward
寻找一个小血块 and search for a small clot.
从电极最后一次消融的地方开始 Start at the site of last ablation with the electrode.
太深了 It's gotta be deep.
如果她在会简单很多 This'll be easier if she's in here.
雷兹尼克医生 进来吧 Scrub in, Dr. Reznick.
我们正在为了塞拉斯的手术 We're setting up the neuromonitoring
设置神经监控系统 for Silas' surgery.
他对我发火 He's angry with me.
塞拉斯吗 Silas?
他对谁都发火 He's angry with everyone.
安德鲁斯医生说别再跟他谈自闭症的事了 Dr. Andrews said to stop talking to him about ASD.
但我还是谈了 给他做了测试 But I brought it up anyway, gave him a test,
他的杯子碎了 我不知道怎么办 his mug broke, and I don't know what to do now.
我不知道该有什么感觉 而且莉亚 I don't know what to feel. And Lea --
莉亚告诉我她怀孕了 Lea told me about the pregnancy.
因为我同时在想两件事所以才这么艰难吗 Is this hard for me because I'm dealing with both things at once?
我认为这两件事有关联 I think both things are related.
如果我的孩子 What if my child...
没有朋友怎么办 has no friends?
如果他们被人欺负了呢 What if they're picked on?
这里不是怀俄明州的小镇 This is not small-town Wyoming.
世道变了 肖恩 The world has changed, Shaun.
我没有变 I haven't changed.
我怎么 How can I...
知道他们的感受 ...know what they're feeling?
我如何宽慰他们 How can I comfort them?
我如何做一个好父亲 How can I be a good father?
记得我们第一次见面吗 Remember when we first met?
就在那 Right over there?
你很生气 You were mad at me.
是 不过你对患者的判断是正确的 Yeah. But you were right about the patient.
并且你十分固执 极度聪敏 And you were stubborn. And crazy smart.
如今的你依然如此 And you are still all of those things.
但是如果你仍然是 But if you were still just that guy
那个我在那边的门口偶遇的少年 that I met running through those doors,
你现在就不会坐在这里了 we would not be sitting here right now.
你的确改变了 You have changed.
你适应了 你成长了 You've adapted. You've grown.
你知道这有多难吗 Do you know how hard that is?
大部分人甚至不愿一试 Most people don't even try.
而你将成长为一位很棒的父亲 And you are going to grow into a great father.
不论那是何时 Whenever it happens.
慢慢垂直于我们的射频消融电极 Slowly go perpendicular at the angle of our ablation electrode.
还是看不到血栓 Still not seeing the clot.
波幅消失80% Amplitude loss at 80%.
也许不是血栓 Maybe it's not a clot.
也许是脑子上的什么东西 Maybe it's something higher up, in the brain.
不 你最初的判断是对的 No. You were right the first time.
也许它藏在某个超声波不可穿透的部分后面 Maybe it's hiding behind some ultrasound-impervious segment.
切断齿状韧带 Cut the dentate ligament.
它会有更多的横向通道 It'll get more lateral access.
完全切断韧带 Completely section the ligament.
我看到了 I see it.
移除血栓 Removing the clot.
波幅回升到正常水平了 Amplitude returning to normal baseline.
如果需要再叫我 Let me know if you need me.
我们可以 We're good.
谢谢 Thank you.
咱俩配合得不错 We did good together.
确实 We did.
不过你还是得搬出去 今晚就搬 You still have to move out, though. Tonight.
我来这里的第一天 梅伦德斯医生说 On my first day here, Dr. Melendez said
我除了抽吸液体 再也干不了别的 I would never do anything besides suction.
但后来 他让我切了我的第一个手术切口 But later, he let me make my first surgical incision.
他成为我的朋友 He became my friend.
我想念他 I miss him.
你是不是走错房间了 Are you in the right room?
有人告诉过你我需要毫无重点的故事吗 Did somebody tell you I needed pointless stories?
我以前觉得 I used to think
我想快乐 只需要成为医生就行 being a doctor was all I needed to make me happy.
这确实让我很快乐 It did make me happy.
但我意识到我想要更多 But I realized I wanted more.
而我可以得到更多 And that I could have more.
我变了 I changed.
你也可以改变 You can change, too.
但如果你死于手术就不行了 But not if you're dead from this surgery.
我已经决定了 I've made up my mind.
请你离开 Please leave.
我弟弟史蒂夫 My brother Steve,
他去世前给了我一把塑料手术刀 he gave me a plastic scalpel before he died.
它坏了 我很伤心 It broke. I was very sad.
我请你离开 I asked you to leave.
我修复手术刀之后 感觉好多了 When I fixed my scalpel, it made me feel better.
我九岁的时候父亲去世了 I was 9 years old when my father died.
我很喜欢早上和他一起喝热可可 I loved drinking hot chocolate with him in the morning.
他每次出差回来都带给我一个马克杯 He'd bring me a mug after every business trip.
他理解我 He understood me.
我妈妈不理解我 My mother didn't.
没人理解我 Nobody did.
我努力适应 但是... I tried fitting in, but...
我精疲力尽 I got frustrated.
于是我放弃了 So I gave up.
放弃家庭关系 On relationships.
放弃交朋友 On friends.
除了我擅长的一件事 其他的都放弃了 On all but the one thing I was good at.
莫菲医生 现在我太老了 And now, Dr. Murphy, I'm too old.
我有太多敌人 I've made too many enemies.
犯了太多错误 Too many mistakes.
大家忍耐我 是因为我拯救生命 People tolerate me because I save lives.
若非如此 Without that...
又会有谁在意我呢 why would anyone ever care about me?
我在意 I care.
闻起来不错 That smells good.
清淡 Bland.
意大利面配橄榄油 Mm, pasta with olive oil.
防呕吐 Kinda puke-proof.
你有没有再想想... Have you thought any more about...
想了 Yes.
我列了一个单子 I made a list.
看来我是跟你学的 I guess I've learned from you.
你写的第一条是什么 What's the first thing yours says?
我觉得我会成为一个好父亲 That I think I would be a good father...
但是我没有办法确定 but that I can't know for sure.
你会成为一个很棒的父亲 You'd make a great dad.
我写在清单里了 It's on my list.
你说得对 You were right.
这是件非常复杂的事情 It is very complicated.
但是我知道 But I do know...
我希望你幸福 莉亚 ...I want you to be happy, Lea.
我有很多理由这么做 I have so many reasons to do this.
也有很多疑虑 And so many doubts.
我只是害怕 肖恩 I'm just scared, Shaun.
但是如果我们都有很多疑虑 But if we are both having doubts,
那也许现在还不是合适的时机 then maybe now isn't the right time.
好吧 Okay.
我看我的血红蛋白稳定 I see that my hemoglobin's stable
我的白细胞数值也还行 and my white count is fine.
没错 我们刚给你写了出院单 Yeah. We just wrote your discharge orders.
这是自闭症专家的转诊单 This is a referral for an ASD specialist.
我可以自己就诊 I can look into that on my own.
谢谢你 莫菲医生 Thank you, Dr. Murphy.
也谢谢你 盖林医生 And thank you, Dr. Guerin.
欢迎回来 Welcome back.
手术成功了吗 Did it work?
试试看吧 Let's find out.
你的手好凉 Your hand's cold.
我要转走了 I'm transferring out.
去年我申请了约翰·霍普金斯大学的项目 Last year, I applied to a program at Johns Hopkins.
他们培养无国界医生 去到最需要的地方 They train doctors to travel the world, help out needy areas.
他们会招我进去 They'll let me enroll late.
听起来是个很适合你的地方 Sounds like a good place for you.
谢谢你一直是个好上级 Thanks for always being a great boss.
和好朋友 And a great friend.
肯定没有那么好 让你偷偷溜走 Can't have been that great, sneaking out like this.
事实上这是我第一次 Uh, actually, for the first time I can remember,
感到难以说再见 it felt hard to say goodbye.
你总是为他人奉献 You're always doing so much for other people.
别忘了偶尔也要为你自己打算 Please don't forget to do something for yourself every now and then.
你到底是不是在玩弄我 Were you messing with me or not?
如果我说是 你会让我留下吗 If I was, would you let me stay?
会 Yes.
我不是和你玩玩 I wasn't messing with you.
那幸好我们不再是室友了 Then I guess it's good we're not roommates anymore.
不然我就不能这么做 'Cause I couldn't do this.
这是一次性的 This is a one-time thing.
除非我改变主意 Unless I change my mind. So
所以把它当做一种动力吧 consider that an incentive.
BGM: We Get By by Mavis Staples, Ben Harper
♪ We get by on love and faith ♪
♪ We get by with a smile on our face ♪
♪ We get by with help from our kin ♪
♪ We get by through thick and through thin ♪
巴黎音乐之旅
♪ We get by ♪
♪ No matter what happens, I'll be there for you ♪
♪ We get by ♪
♪ Was just the other day ♪
♪ I heard from my old friend ♪
莉亚·德莱罗 Lea Dilallo?
♪ She was going through changes ♪
♪ Once again ♪
♪ Matters of the head ♪
♪ Matters of the heart ♪
♪ May be too early to tell ♪
♪ But it's never too late to start ♪
叫到你名字了 She called your name.
♪ We get by ♪
我一整天都在提醒自己所有的理由 I spent all day reminding myself of all the reasons
说服自己这是一个正确的决定 why this was a good idea.
但是当这个时刻真正来临 But now that it's actually happening, it...
这没有让我感觉更好 doesn't make me feel any better.
反而让我真的很难过 It just makes me feel really sad.
♪ Day by day ♪
也许现在不是合适的时机 那什么时候是呢 Maybe it's not the right time, but will it ever be?
♪ If you don't have yours ♪
♪ You sure got mine ♪
♪ We get by ♪
我 I...
♪ We get by ♪
有同样的感受 ...feel the same.
♪ In our own way ♪
♪ We get by ♪
我们真的要生下来吗 Are we really doing this?
♪ We get by ♪
♪No matter how it happens ? ♪
我们 We...
♪ I'll be there for you ♪
要有宝宝了 ...are having a baby.
♪ We get by ♪
是啊 Yes.
♪ No matter how long ♪
♪ I'll be waiting here for you ♪
♪ We get by ♪
♪ No matter what happens ♪
-好吗 -好的 - Yeah? - Okay.
好的 Okay.
♪ I'll be there for you ♪