肖恩 Shaun --
你得把你的驾照给我 You need to give me your driver's license.
我不 No, I don't.
-你记得我给你做的记忆测试吗 -很清楚 - Do you remember the memory test I gave you? - Vividly.
结果证实你的记忆衰退了 Yes. It demonstrated you have a deficit.
记忆衰退意味着你不该开车 A deficit; you shouldn't be driving.
布莱兹医生也同意 Dr. Blaize agreed.
肖恩 那次测试应该是我们间的秘密 Shaun, that test was supposed to be between us;
所以我才不想在医院做 that's why I didn't want to do it at the hospital.
对 你的主治医生需要知道 Yes, your doctor needs to be informed
你所有医学检查的结果 of the results - of all your medical tests.
即使是在家做的 Even tests that are done at home.
肖恩 我开了快五十年的车 Shaun, I've been driving for like half a century.
我车技很好 知道吗 I'm an excellent driver, okay?
我不需要把我的驾照交给你 I don't need to give you my driver's license.
好吧 那我就得通知车管局了 Okay. Then I'll have to notify the DMV.
格拉斯曼医生 Dr. Glassman?
你不能通知车管局 肖恩 You're not gonna notify the DMV, Shaun.
我会的 Yes, I will notify the DMV.
肖恩 你不许通知车管局 Shaun, you will not notify the DMV.
格拉斯曼医生 Dr. Glassman,
如果你不把你的驾照交给我 if you don't give me your driver's license,
我就通知车管局 I will notify the DMV.
格拉斯曼医生 Dr. Glassman?
乔治·雷诺兹 28岁 George Reynolds, 28,
胳膊和腿突发无力 sudden onset of arm and leg weakness,
右脸下垂 说话困难 right facial droop, and trouble speaking.
CT确诊一处大脑中动脉栓塞 CT confirmed a middle cerebral artery embolism.
我预约了介入放射科 I booked us into interventional radiology.
第一次注意到症状是什么时候 乔治 When did you first notice your symptoms, George?
大概 四个半小时前 About, uh, four and a half hours ago.
等等 我怎么了 Wait, what's wrong with me?
你可能中风了 You may be having a stroke.
你每月都定期注射醋酸亮丙瑞林吗 You're on monthly injections of Lupron?
有三个月了 For three months.
这可能就是病因 That may have caused this.
你有前列腺癌吗 Do you have prostate cancer?
不 我被诊断出患有非典型增生 No. I-I was diagnosed with atypical hyperplasia.
这应该对我们要进行的治疗没有影响 That shouldn't have any effect on what we're gonna do now.
交给我们吧 乔治 We're gonna take care of you, George.
别担心 Don't worry.
这是局麻 This is local anesthetic;
你会感到有一点疼 you'll feel a pinch.
你是真正的医生吗 Are you a real doctor?
我是肖恩·莫菲医生 I'm Dr. Shaun Murphy.
有人叫你小莫吗 People ever call you Murph?
没有 No.
我要切一个小口 I'm going to make a small incision
然后就能插管让肺复张 so we can insert the tube and re-inflate your lung.
他们叫你什么 比利 What do they call you, Billy?
大坑头 火山口 三眼仔 CraterHead, Volcano, ThreeEyes...
这些算是有创意的 those are just the creative ones.
别动 Hold tight.
管子进去了 Here comes the tube...
你们真的很专业呢 You guys really know what you're doing.
没错 Yes, we do.
我们会给你的肺做个核磁共振 We'll order an MRI for your lungs.
然后会治疗你的眼眶骨折 Then we will fix your fractured eye orbit;
那就需要手术了 that will require surgery.
要不顺便把你的额头修复一下吧 What do you say we fix your forehead, too?
你们可以吗 You could do that?
-我觉得行 -我觉得不行 - I think so -- - I don't think so.
这个凹陷早就有了 It's a pre-existing condition,
并不是必须要治疗的 and it's not medically necessary.
这不会被批准的 It shouldn't be approved.
良 医
第二季 第九集
大脑中动脉血栓妨碍了整个末梢循环 The MCA clot is obstructing all distal flow.
抗雄激素并不是治疗增生的 Anti-androgens aren't indicated for hyperplasia...
他说是非典型的 He said atypical.
你觉得他在撒谎吗 You think he's lying?
也许他在变性 Maybe he's gender transitioning.
除了癌症 没有太多别的症状 Aside from cancer, there aren't many other indications.
我们先专心干好手里的活 Let's focus on what we do know.
插入导管 Feeding the catheter.
抽吸血栓 Suctioning the thrombus,
血流正在恢复 缓慢收回 and he's recanalizing. Slowly retract.
不管他为什么注射抗雄激素 Whatever his reasons are for taking anti-androgens,
希望他还有别的选择 hopefully there are options.
他要么不注射 要么就会一直中风 He either drops them or he's gonna keep having strokes.
修复前额会很贵 而且算整形 The forehead repair would be expensive and cosmetic --
这不是为了让他变好看 It's not about prettying him up;
这会让他重获新生 交新朋友 it could give him a new life, friends,
也许能少挨点打 maybe a few less beatings.
阻止打人是看守的工作 Stopping the beatings is the guards' job.
你真的一点都不同情比利吗 You really don't have any empathy for Billy?
同情心不是为了某人打架的好理由 Empathy is a bad reason to fight for someone.
如果同情心让我只想帮助 If empathy makes me only want to help patients
来自怀俄明州或是患自闭症的病人 who are from Wyoming or have ASD,
这对所有爱达荷州的非自闭症患者就很不公平 then that's very unfair to all my neuro-typical patients from Idaho.
我需要服用那些药 I need to take those drugs.
是它们造成了你的中风 They caused your stroke.
我们觉得你没有增生 We don't think you have hyperplasia.
如果你告诉我们真正的原因 If you tell us the real reason,
我敢肯定会有其他更安全的治疗措施 I'm sure there are other safer treatments --
不 没有 No, there aren't!
如果你在变性 有其他的 If you're transitioning, there are alternatives --
我告诉过你我为什么用药 I told you why I was taking the meds.
乔治 我们是你的医生 George, we are your doctors;
我们需要知道真相 we need to know the truth.
我们不会告诉别人 We're not gonna tell anyone.
我没有在变性 I'm not transitioning.
我也没得增生 And I don't have hyperplasia.
我有问题 I have problems...
在性冲动上 with my sex drive.
我知道这听着很荒谬 I know it sounds stupid,
为什么我控制不住自己 like why can't I just control myself
但是 but...
我脑子里全是这些 It's all I think about.
我只能想着这些 It's all I can think about.
我无法工作 I can't work,
无法社交 I can't socialize,
我无法正常生活 I can't have a life.
只有这些药才能让我 And those meds are the only thing
稍稍控制这种冲动 that makes it even remotely tolerable.
这些药会害死你的 They'll kill you.
住院医生们在打赌 The residents have a betting pool
你会任命谁 on who you're going to appoint.
对于要接替你外科主任职务的人 As your replacement as Chief of Surgery,
你必须做出合乎情理的决定 the decision needs to be made with decorum and expediency.
我还没有怎么仔细想 I haven't quite gotten around to analyzing --
自从你当了院长 你几乎没有时间 You've had little face time with your attendings
指导你的住院医生 since you became president.
这个你得纠正一下 You need to correct that.
我已经安排好你宣布结果的时间 I've scheduled your announcement.
你有两天时间 You've got two days.
-他在哪 -他不见了 - Where is he? - He's gone;
不遵医嘱出院了 signed out AMA.
-我试了 -多久之前 - I tried -- - How long ago?
五分钟 Five minutes...
我们为什么这么赶 Why are we in a hurry?
我刚才在为他寻找替代药物 I was researching alternative meds for him.
发现醋酸亮丙瑞林说不通 Realized Lupron didn't make any sense.
用抗雄激素来遏制性冲动 Prescribing anti-androgens for sexual urges
就像用大锤拍蚊子 is like hitting a mosquito with a mallet.
除非这些冲动是变态的 Unless they're deviant urges.
我们可能刚放走了一个儿童猥亵犯 We might've just released a child molester.
我们要报警吗 Should we call the police?
不行 We can't.
我们没有犯罪证据 We have no evidence of a crime.
利姆的赔率三比二 Lim's at 3 to 2,
梅伦德斯紧随其后 二比一 Melendez is just behind at 2 to 1,
库珀伯格是七比一 Cooperberg's 7 to 1,
如果达特林 或者任何其他人中了 and if Dartling, or anybody else comes in,
你就可以退休了 you can retire.
当安德鲁斯发现我们的病人溜了 Andrews might bail on Melendez
他可能会放弃梅伦德斯 when he finds out our patient bolted.
这就是为什么梅伦德斯赔率升到四比一了 Which is why Melendez is now 4 to 1.
同注分彩真令人兴奋[胜者平分奖池总金额] Pari-mutuel betting is very exciting.
要成为好医生需要同情心吗 Do you need empathy to be a good doctor?
不用 我觉得它反而会 No. I think it can interfere
干扰我们有效做出决定 with effective decision-making.
她这么说只是为了让你不舒服 She's just saying that to avoid hurting your feelings,
反而证实了她观点的对立面 thus making her fake point for real --
她因为同情所以撒谎 her empathy made her lie to you.
我觉得你刚才既同意了我又侮辱了我 I think you just agreed with me and insulted me at the same time.
我觉得同情很重要 I think empathy's very important...
即便会伤人 也要说出冰冷残酷的真相 Telling the cold hard truth even when it hurts,
有时这才是我们最富同情心的举动 sometimes is the most empathetic thing we can do.
正如我现在告诉肖恩这事 Which is what I'm doing for Shaun right now.
不客气 You're welcome.
我有自闭症 I have autism
这意味着我的镜像神经元有缺陷 which means I have a deficiency of mirror neurons,
导致我无法与他人产生情感共鸣 which inhibits me from emotionally trading places with people,
所以同情对我来说很难 which makes empathy very difficult.
这是否意味着我不是个好医生 Does that mean I can't be a good doctor?
不 No, it doesn't.
我们都有长处和短处 肖恩 We all have our strengths and weaknesses, Shaun.
克莱尔的长处是让大家有认同感 One of Claire's is making sure everyone feels validated.
那个变态回来了 The creep is back.
乔治又中风了吗 Is George having another stroke?
不是 No.
阴囊严重撕裂 Severe lacerations to the scrotum.
你给他止痛药了吗 Did you give him anything for pain?
四毫克吗啡 我也通知警察了 Morphine. Four milligrams. And I notified the cops;
我觉得这是起仇恨犯罪 I think it was a hate crime.
我不觉得 Yeah, I don't think so.
好了 All right.
听我的命令 On my count.
一 二 三 One, two, three.
接下来交给我们吧 We'll take it from here.
我帮他包扎并为他做准备 I'll pack him and prep him.
是你自己干的 对吧 You did this to yourself, didn't you?
我想我知道你控制不住的冲动是什么了 I think I know what kind of urges you've been having.
我不是怪物 I'm not a monster.
我从没有碰过任何人 I never touched anyone...
任何孩子 any...child.
我和我姐姐一直是好朋友 My sister and I were always best friends...
但后来她生孩子了 but then she had children.
如果我不一直吃药 If I can't keep taking the drugs...
我只能自宫 I had to do this.
家庭手术往往达不到你期待的结果 Home surgery tends to not have the results you're hoping for.
你下手很重 You did a lot of damage
但你的睾丸并未被切除 but your testicles are unscathed.
求你了 帮我切除吧 Please...finish the job.
要我说我们就切了 他是恋童癖 I say we do it; he's a pedophile.
不 他不是 No, he's not.
他自己刚承认了 He just told us he was.
他从未因冲动做出坏事 He has never acted on his urges,
而且他让我们帮忙 and he's asking us to do something
确保不再有那种冲动 to ensure he never does.
他是个好人 试图... He is a decent person trying --
我搞不懂了 I'm confused.
你想拿他怎么办 What do you want to do with him?
当正常病人 给出诊断 Treat him like a patient with a diagnosis.
让他服用抗抑郁剂 Put him on antidepressants,
介绍泌尿科医生给他 并做个精神评估 refer him to a urologist, give him a psych eval.
让专家决定他是否该被阉割 Let the experts determine if he should have a castration.
精神评估 抗抑郁剂 Psych eval? Antidepressants?
我们让病人去做心理咨询后 When we refer people for counseling,
有多少人被治愈了 how often do they get cured?
我是在找能帮助他的... I am looking to help him manage this dis--
如果他们没被治愈呢 那怎么办 And if they don't get cured, what happens?
更加抑郁 无法承受现实 辞职 They get more depressed, can't cope, quit jobs,
也许自杀 maybe kill themselves?
都不是好事 但都比不上强奸儿童 All bad, but not...rape-a-child bad.
那你打算怎么做 So what are you going to do?
从伦理上来说 我们不能为阻止犯罪 We can't ethically remove healthy organs
就切除健康的器官 for crime prevention.
我们不会为了防止偷窃癖偷东西 We don't amputate a kleptomaniac's hands
就切除他们的手 to prevent them from stealing.
手有很多用途 Hands have many purposes;
但恋童癖的睾丸只有一个作用 the balls of a pedophile have but one.
给他准备转诊并把他包扎好 Set up his referrals and patch him up.
你来富特希尔斯多久了 How long you been in Foothills?
九个月 Nine months...
少管所的日子过得很快 Time flies in Juvie.
有人来看你吗 Any visitors?
我没有带饼干来看我的奶奶 I don't have a granny bringing me cookies,
如果你是问这个 if that's what you mean.
所以同情心不是个好东西 This is why empathy is bad.
你和患者说话因为你喜欢他 You're talking to our patient because you like him,
导致他乱动 which is causing him to move,
使我们的成像不清 which is affecting our imagery.
他很害怕 He's scared.
我和他说话是想安慰他 I'm talking to him to calm him down
这对成像有利 which is improving our imagery.
我喜不喜欢他根本不重要 The fact that I like him is beside the point.
你在圣何塞长大的吗 You grow up in San Jose?
在东边 但我一有机会就出来了 East Paly...but I got out of there as soon as I could...
那时我才十五 I was 15.
你的父母还在那吗 Your parents still there?
妈妈去世了 Mom's gone...
亲爱的老爸 很可怕 Dear old Dad is...terrible.
兄弟姐妹呢 Siblings?
一个弟弟 Little brother...
他也死了 He's gone too...
变态老爹 失去弟弟 Crappy dad. Lost his brother...
我说 你不会真的 I mean, you really don't ha--
他不害怕 He's not scared.
他是喘不上气 He's short of breath
因为他的膈肌裂了 because his diaphragm is lacerated.
他的胃穿过那个裂缝 His stomach has passed through that tear
现在到他的胸腔了 and is now in his chest.
比利需要紧急手术修复隔膜 Billy needs emergency surgery on his diaphragm.
裂口从中心部分 The defect reaches all the way
一直延伸到肋边缘 from the center to the anterior costal margin.
那我们该怎么办 So what do we need to do?
分开肺下韧带 Divide the inferior pulmonary ligament
把肺部往上移动 to bring the lung upwards.
网格 Mesh.
踢他的人穿的鞋子可挺专业啊 Whoever kicked him was wearing some serious footwear.
而且等他回去后还要重新挨揍 And they'll be waiting for him when he goes back.
除非我们帮他 Unless we help him.
朴医生想修复他的额头 Dr. Park wants to fix his forehead.
「宪法」规定所有囚犯 The Constitution guarantees prisoners
享有与他人同等的医疗服务 get the same care as everyone else.
大多数普通人都负担不起整容手术 Most non-prisoners can't afford cosmetic surgery.
他会得到比多数人都好的医疗服务 He would be getting better care than everyone else.
这孩子很聪明 讨人喜欢还有礼貌 Kid is smart and personable and puts up a great front.
但他肯定很害怕 But he's scared to death.
卖大麻让他蹲了三年牢 And he got 36 months for selling weed;
而这罪名现在都已经不存在了 a crime that doesn't even exist anymore.
如果他脑门上没有这个大坑 You think his life would be anything like this
他的生活还会是这样吗 if he didn't grow up with a massive dent in his head?
抱歉 说服不了我 Sorry, I'm not convinced.
是因为你对比利没有同情心吗 Is that because you don't have any empathy for Billy?
不 是因为我同意你的观点 No. It's because I agree with you:
这手术又贵 风险大还没必要 it's expensive, risky and unnecessary.
但同情心能成为珍贵的动力 莫菲医生 But empathy can be an invaluable motivator, Dr. Murphy,
能让医生和病人间产生羁绊 that truly connects the physician with their patient.
他还在上面吗 Is he still up there?
还在 Yes he is.
我们无法为你阉割 乔治 We can't do the castration, George.
得有精神科的批准 Not without the proper psychiatric clearance.
那得等很久 That'll take forever.
只是几个月 Just a few months.
几个月就是很久 A few months is forever.
连轴看你最爱的剧 多读书 Binge watch your favorite shows, catch up on your reading.
你喜欢男人吗 雷兹尼克医生 You attracted to men, Dr. Reznick?
喜欢 成年男性 Yes. Adult men.
如果这种喜爱是不道德的 And if that were...reprehensible,
你能停止这种喜欢吗 do you think you could stop?
你根本不知道 You have no idea what it's like
活在这种想法中有多煎熬 to live with these thoughts.
我讨厌这些感情 I hate them,
我讨厌自己有这种感情 and I hate myself for having them.
但我无法阻止自己 But I can't stop them...
我很怕自己会做出不堪设想的事 and I'm afraid of what I could do.
我们马上就为你安排精神评估 We will start the process immediately.
同时给你输液 In the meantime, we'll transfuse you,
让你服用抗生素 get you on antibiotics --
不 我不接受治疗 No. I'm refusing treatment.
不要输液 不要抗生素 不要治疗 No transfusion. No antibiotics. No repair.
让这孽根腐烂吧 Let 'em rot.
我们存在共同之处 We have something in common.
我们都没有驾照 Neither of us has a driver's license.
你感觉没有驾照怎么样 How do you feel about not having a driver's license?
我很生气 肖恩 I'm pissed, Shaun.
你很生气 You feel pissed.
是的 我生气 很生气 Yes, I feel pissed. I feel very pissed
因为我被抢走了很重要的东西 because something important was taken away from me.
还是被朋友抢走的 And by a friend.
你很生气 You feel very pissed
因为你被抢走了很重要的东西 because something important was taken away from you...
还是被朋友抢走的 and by a friend.
重复我说的话可起不到什么帮助 And parroting everything I say isn't helping.
我在寻找共鸣 格拉斯曼医生 I'm finding commonality, Dr. Glassman,
调查你的情感状态 and inquiring about your emotional state,
通过复述你的话来更好地倾听你 and actively listening by restating your responses.
「外界认同有助于加强自我价值感」 "External corroboration enhances our sense of self-worth."
好吧 Okay.
我拿到驾照的第二天 The day after I got my driver's license,
你想知道我做了什么吗 you want to know what I did?
我买了一辆午夜蓝福特1963 I went out and bought a 1963 Galaxie, Midnight Blue.
1255块 1,255 bucks,
是我在加油站工作三年 every penny I earned for the past three years
赚到的所有钱 working in a gas station.
你觉得我是什么感受 How do you think that made me feel?
喜欢这种感觉 You liked it?
不 肖恩 我爱这种感觉 No, Shaun. I loved it.
你想知道为什么吗 You want to know why?
对于十六岁的少年 一辆车 Because a car to a sixteen-year-old kid
代表着独立 means independence,
代表他可以去任何他想去的地方 which means he can go wherever he wants
随时可以出发 whenever he wants.
而这种独立不会随着年龄变化 肖恩 And that doesn't change with age, Shaun,
事实上 它反而会加强 in fact, it means even more.
当你拿走我的驾照 你拿走了我的独立 When you took my license, that's what you took from me.
我不指望你能明白 I don't expect you to understand.
你不用假装懂 So you don't have to pretend.
安德鲁斯在监视你吗 Is Andrews stalking you?
太烦人了 It's annoying.
我们得团结一致抵制他 We need to stand together and tell him to back off.
我才不会跟院长说他很烦人 I'm not telling the president he's annoying.
他在侵犯我们的自主权 He's infringing on our autonomy
阻止想法的交流 and inhibiting the free flow of ideas,
两者都会阻碍我们 both of which affect our ability
给病人最好的治疗 to deliver the best patient care.
听上去好多了 That sounds slightly better.
好吧 我加入 Okay. I'm in.
-真的吗 -当然不 - Are you? - No. Of course not.
我才不想正面回击他 The last thing I'm gonna do right now is confront him,
我现在是领先的 I'm the front-runner.
虽然不是官方数据 Not according to Vegas,
我现在是三比二 I'm three to two.
我猜他们不知道你治疗致死率是我的两倍 Guess they don't know that you have double my mortality rate.
我是个创伤外科医生 I'm a trauma surgeon,
你这是把苹果和混蛋比 you're comparing apples to asshats.
我不喜欢被叫苹果 I resent being called an apple.
隔膜修复很成功 The diaphragm repair went very well.
我们已经安排好给你做眼眶骨折修复 And we've scheduled your orbital fracture repair.
我们会给你些强力止痛药助你康复 We'll get you some stronger pain meds for the recovery.
你们什么时候修复我的前额 When are you gonna fix my forehead,
让我变得像约翰·传奇 make me all John Legend?
我尽力了 比利 I tried, Billy.
对不起 I'm sorry.
我本来也没多大期望 I wasn't really getting my hopes up anyway.
我爸爸教我会如此 My dad taught me that.
他会说 「你知道吗 比利」 He'd say, "You know what, Billy?"
然后他就会正面给我一拳 And he'd just punch me in the face.
至少我觉得他让我记住了这个教训 At least, I think that was the lesson he was trying to impart.
所以你前额才会成这样吗 That's what happened to your forehead?
他是个超级棒球粉丝 He was a big A's fan.
他看每场比赛都拿着球棍 Watched every game with a bat in his hand.
2008年8月14日 August 14th, 2008,
在第十二局中他们输了 they lost in the 12th inning...
感染了 但是他的睾丸 Infection's setting in but his testicles
在多普勒上看来血流很好 still show good flow on the Doppler.
-止痛药呢 -他不肯吃 - Pain meds? - He won't take them.
他觉得那会让他昏过去 Thinks they'll knock him out
我们就能趁机进行修复 and we'll step in and repair them.
我不喜欢这样 I hate this.
我也是 Me too.
我会是个好司机 I'm going to be a good driver.
笔试部分我全对了 I got every answer correct on the written test.
除了一题 Except one
但那也是因为题目用词不当 but that was because it was improperly worded.
我跟车管局反映要重写那题 I told the DMV they need to rewrite it
他们说会考虑一下 and they said they'd take it under advisement.
很好 Great.
出发吧 Let's go.
好的 闭上双眼 Okay... let's close our eyes...
慢慢深呼吸 and take some nice, deep breaths...
做些引导联想 And how about a little guided imagery,
唤起积极的画面 to evoke positive visualizations?
好的 Okay.
想象一下停车场 Let's picture the parking lot...
周围都是车 the cars around us...
停车场入口处的黄色金属物体 the yellow steel thingy at the entrance of the parking lot
能够造成许多破坏 that could really do a lot of damage...
护柱 A bollard.
离角落约四米五远的路面减速带 The speed bump that is 15 feet from the corner
贴着「憎恶」的停车标志 with the stop sign that someone put a "Hate" sticker on
像在告诉你「别再憎恶了」 so it says "Stop Hate,"
对面就是便利店 which is right in front of the Jiff-E Mart,
门口写着「便利店 全天营业」 which says it's open "8 til Late, 24/7,"
虽然不可能是真的 因为 which can't be true beca--
很好 肖恩 That's great, Shaun.
想到很多画面啊 Super amount of visualization.
现在我们适应了周围的环境 And now that we're feeling comfortable about our surroundings,
我们可以开始驾车 we can put the car into drive,
轻轻松开刹车 ease our foot off the brake...
很好 Very nice...
睁开眼 肖恩 We can open our eyes now, Shaun.
我们在做的事太残酷了 What we're doing is cruel.
我虚心求教 布朗医生 I'm open to all options, Dr. Browne.
我需要你给我们点空间 I'm gonna have to ask you to give us some privacy.
真的吗 Really?
你想让院长 You want to throw the president of the hospital
退出医学讨论吗 out of a medical discussion?
你在干扰我的自主权 You're infringing on my autonomy
阻止思想的交流 and inhibiting the free flow of ideas,
两者都会影响我给病人最好的治疗 both of which affect my ability to deliver the best patient care.
梅伦德斯医生 Dr. Melendez.
有许多司机都没有遵守道路规则 There are many drivers not following the rules of the road.
他们忽视信号 也不检查盲点 They fail to signal, check their blind spots...
车子载的东西已超过尾灯约一米二 display a red flag when the load extends
警告信号灯都亮起来了 more than four feet past the tail lamp.
你说得对 肖恩 这是个疯狂的世界 You're right, Shaun, it's a mad world.
但你改变不了他们 But there's nothing you can do about them,
你只能关注你自己 you just got to focus on you.
关注自己吧 Yes, let's focus on me.
是的 Yes.
下一个路口右转 Let's take the next right.
准备转弯的时候 You can drive in the bike lane
你可以开进自行车车道 肖恩 when you're this close to the turn, Shaun.
不 我不能 No, I can't.
那是虚线 It's a broken line.
这就是拿道用词不当的题 That was the improperly worded question --
无论虚线实线 whether it's broken or solid,
如果离十字路口就这点距离 you can't enter the bike lane
那就不能开进自行车车道 this distance from the intersection.
我告诉过他们 I told them that it --
肖恩 你不用开这么慢 Okay, Shaun. You don't have to go so slow.
她在车道内 She's in the lane,
她不应该在车道内 she's not supposed to be in the lane.
这可是要罚款的 It's a violation carrying a fine --
-肖恩别管她 -不 - Okay, Shaun, don't worry about what she's doing -- - No.
肖恩 开进自行车车道 Shaun, you have to pull into the bike lane --
别担心她在做什么 Don't worry about what she's doing --
你不能停下 You can't just stop.
肖恩 你不能随便就停下 Shaun, you can't just stop...
肖恩 Shaun!
乔治痛得乱叫而我们却视若无睹 George is screaming in agony and we are doing nothing.
除了拿那套道德的说辞做挡箭牌 Except hiding behind ethical red tape.
那套道德的说辞就是为避免像他这样的人 Ethical red tape is there to protect people like him
犯下悔恨终生的错误而存在的 from making permanent regrettable mistakes.
还好在宣布新的外科主任之前 I'm glad we're not using it to cover our asses
我们没有用它来自保 the day before the new Chief of Surgery is announced.
我把文件签了吧 Let me sign off on the documentation.
我会注明他的阴囊已经无法修补 I'll note his scrotum is already beyond repair
外科阉割是我们的唯一选择 and surgical castration is our only option.
-我投赞成票 -不行 - I vote yes. - No.
我不会让任何人篡改医疗记录 I'm not gonna let anyone falsify medical records.
疼痛不能成为理由 恋童癖也不行 Not for pain. Not for a pedophile.
如果他的睾丸真的无法修补 Once his testes are actually beyond repair,
我们会阉割他的 we will castrate him.
所以我们就让他一直惨叫 So we're just gonna leave him there screaming;
闹得整个病区睡不着 keeping his entire unit awake?
给他换个房间 Move him.
我喜欢穿过多层骨膜做一个整齐的切口 I'd like a clean dissection through the periosteal planes
这样就能把高密度聚乙烯网滑到骨折处 so I can slip the MEDPOR mesh over the fracture.
为什么选择高密度聚乙烯网 Why do I prefer MEDPOR mesh?
它让纤维血管可以向内生长 It allows fibrovascular ingrowth
并与患者的组织相结合 and integration - of the patient's tissue.
囚犯由于精神问题请求的手术总会被批准 Prisoner surgeries are approved for psychological reasons all the time.
比如除去纹身 Tattoo removal,
变性手术包括隆胸手术 gender reassignments include breast implants;
甚至如果他笑起来很难看 hell if he had a crappy smile
我们也会以正常的咀嚼需求为由 we could justify dental work as needed
理所当然地提供牙科治疗 for proper mastication...
你曾经把一些孩子送进了少管所 You sent a few kids to Juvie?
比你想的要多 More than a few.
你感到愧疚 You feel guilty.
这可能会影响你的判断 Think that's maybe clouding your judgment?
也许 Maybe.
你也害怕在安德鲁斯做决定的关键时刻 You're afraid of ruffling Andrews' feathers
有什么变动 this close to decision day.
所以这也可能会影响你的判断 Think that's maybe clouding yours?
我们可以给比利做「隆胸手术」 We could give Billy a breast implant.
我们可以把植入物插到 We could insert it
他额骨凹陷处的分层移植物上面 over his split thickness frontal bone defect;
只需要在他的眉毛上开个小切口 it would only require a tiny incision at his eyebrow.
所以你现在支持这么做了 Now you're in favor of this?
我之前反对是因为成本太高 I was against it - because it was too expensive
没有必要而且有风险 and unnecessary and risky
但如果我们趁现在做 but if we do it now,
就不需要额外的手术 it won't require any additional surgery.
可以节省很多成本 And it'd be very economical.
他最初同意手术时的确给过我们口头许可 He did give us verbal consent when he was first admitted.
先保持麻醉状态 Keep him under.
我们得先准备好需要的东西 莫菲医生 Get what we need, Dr. Murphy.
准备好了吗 Ready or not...
告诉梅伦德斯到手术室找我们 Tell Melendez to meet us in the O.R.
出现缺血的征兆 Showing signs of ischemia;
已经有足够病例支持我们做切除手术 we have a strong medical case for removing.
利姆医生 你也支持阉割吗 Dr. Lim. You a castration fan?
现在我支持 Right now, I am.
-安德鲁斯告诉我他愿意让步 -很好 - Andrews told me he's backing off. - Great.
因为你给了他一个很不错的论据 Because you presented him with a very good argument.
-那是我的论据 -你说你不会支持我 - My argument. - Which you regurgitated to him
结果转头就转述给他了 right after you said you wouldn't back me up.
这就是所谓的领导才能吗 Call that leadership?
是的 Yes I do.
你告诉我了一个很好的论据 You presented me with a very good argument
但你自己却没有胆量把它告诉安德鲁斯 but you didn't have the guts to take it to Andrews on your own.
还有一个我不想在你手下工作的原因就是 One more reason I don't want to work under you.
你要升职并不是为了把医院变得更好 You don't want this promotion so that you can improve the hospital,
你只是想要个漂亮的头衔而已 you want it for the pretty title.
你就是沉迷于肾上腺素的刺激 You're an adrenaline junky;
你无法坚持和董事会保持联络超过两周 you won't last 2 weeks liaising with board members.
这是一条漫长而满是尘土的道路 There's a long and dusty trail
一路都是曾经低估我的人 littered with people who have underestimated me.
我们准备好了 We're ready to go.
解剖剪 谢谢 Curved tissue scissors, please.
他的收缩压是68 看看这里 His systolic is 68. And look at this.
他感染了 He's septic.
他会出现弥散性血管内凝血 He's going into D.I.C.
重新给他做化验 Rerun his labs,
准备好血小板 血浆和冷却设备 have platelets, plasma and cryo ready.
如果开始流血 他就会死 If he starts bleeding, he'll die.
我把容量从80毫升减少到了35毫升 I reduced the volume from 80 cc's to 35.
过去的24小时赔率有变化吗 Have the odds changed in the last 24 hours?
-变了一点点 -我的赔率如何 - Little. - Where am I at?
六比一 Six to one.
那我再给自己押一百 I'll put 100 on me.
他出现了严重的心动过缓 He's becoming severely bradycardic.
眼眶上的压力会导致球后血肿 The pressure on his orbit caused a retrobulbar hematoma.
如果我们不把压力释放掉 他会停止呼吸 If we don't relieve it now, he'll arrest.
钳子和剪刀 Forceps and scissors.
没有脉搏了 推注阿托品 Just lost his pulse; pushing atropine.
装一个临时的经皮起搏器 Set up a temporary transcutaneous pacemaker.
如果进行局部麻醉后对眼眶肌进行注射 If we inject the orbital muscle with local anesthetic
可能可以减轻反射 we might be able to fatigue the reflex.
就这么办 Do it.
开始心肺复苏 Starting CPR.
我希望这是解决问题的表情 I hope - that's a look of resolve.
梅伦德斯在他的住院医生面前顶撞我 Melendez stood up to me in front of his residents.
我像他这么大的时候 I did the same thing to
也对奥康纳尔做过一样的事 O'Connell when I was his age.
那利姆呢 What about Lim?
我花了很多年才培养出她那样的专注力 She has the kind of focus that took me years to develop.
还有库珀伯格 And Cooperberg,
他让我想起当年 he reminds me of me when I was --
马库斯 你一直都很优秀 Marcus. You were good.
但是没人会和你记忆中的自己一样优秀 But no one's gonna be as good as you think you were.
你曾经的弱点之一就是做决定 One of your weaknesses was decision-making.
我相信你成为院长的时候已迈过了那个坎 I trust you've gotten past that since I made you president.
继续按压 Continuing compressions
直到我捕捉到起搏器的心率 until I have capture on the pacemaker.
起搏垫已就位 Pacing pads are in position.
停止心肺复苏 Stopping CPR.
注射利多卡因 Injecting lidocaine.
我把心率设为80 I have set the rate to 80.
把心室电流增加两毫安 Increase the ventricular by two milliamps.
再增加两毫安 Increase by two more.
测到血压了 102/68 Blood pressure is responding, 102/68.
保持起搏器设置 Keep those pacer settings
我们回到正事上来 and let's get back to the main event.
他的凝血酶原时间和 Both his PT and PTT
部分凝血致活酶时间都降回去了 are coming back down,
收缩压稳定在110 监视器上无异位 his systolic is stable at 110, and no ectopy on the monitor.
弥漫性血管内凝血评分也回到了四以下 His D.I.C. Score is back under four.
他稳定下来了 He's stabilized.
球又踢回你这边了 Ball's in your court.
梅伦德斯医生 Dr. Melendez?
低睾酮水平对于心血管功能和败血症有哪些影响 Effects of low testosterone on cardiovascular function and sepsis?
可能出现急性的血管反应 Possible acute vascular response,
循环系统崩溃 circulatory collapse --
那对弥漫性血管内凝血会有什么影响呢 And what about on D.I.C.?
增加了血栓和中风的危险 Increased risk of clots and stroke.
乔治的身体现在经不起任何睾酮流失了 George's body can't tolerate any loss of testosterone right now.
要想挽救他的生命 We want to save his life,
我们就必须拯救他的睾丸 we have to save his testicles.
缝线 Sutures.
我知道怎样能让你开车了 I know how to get you to drive.
我不能开车 I can't drive.
开车就像做手术 Driving is just like surgery.
假设你正沿着马路往前开 Say you're driving down the street
突然 有人冲出了人行道 and suddenly, - somebody steps off the sidewalk,
就在你前面 right in front of you.
这就好像你正在病人的腹腔深处做手术时 Things like that must happen
会出现的任何状况 when you're deep inside someone's belly.
这根本说不通 That doesn't make any sense.
这只是打个比方 肖恩 It's an analogy, Shaun.
你能认真听我说吗 I need you to work with me just a little bit.
给我 Give me.
好吧 Okay.
意外时有发生 It would be something unexpected,
我们无法控制 out of our control,
原因也千奇百怪 而且有时很糟糕 from an aberrant source, and very bad.
就好像动脉出血 It would be analogous to an arterial bleed.
如果一辆卡车突然抛锚 妨碍了交通 How about if a truck stalls out, crippling traffic?
就好像血栓阻断了血流 于是我们绕道 A thrombus impeding blood flow, so we divert.
对 就像血栓 A thrombus, exactly.
如果你只是在沿着马路慢慢开 What if you're just cruising along
不知道从哪冒出来一辆车快速超到你前面 and a car comes out of nowhere and goes racing by?
这就像快速性心律失常 A tachyarrhythmia.
-对 肖恩 你说对了 -好棒 - Yes! Shaun, you got this. - Yes.
我带你去开那辆破车吧 So let's get you driving that hooptie.
我搞定了 亚伯特 I've got this, Albert.
手术结束了 We did the surgery;
你的循环凝血系统 your circulatory and clotting systems
已经被关闭了 were shutting down.
但切除你的睾丸有可能会让你陷入 But removing your testicles would have put you
更危险的境地 这会降低你的... at greater risk by reducing your --
你有可能会死 You would have died.
我帮你约了心理医生和泌尿科医生 I've set you up with a psychiatrist and a urologist.
他们会给你拍片子做检查 They'll screen you, get you cleared,
然后我们就能顺利完成手术了 and then we can do this the right way.
乔治 我们能做到的 George, we can get this done.
只是你不能再这么做了 You just cannot try this again.
我懂了 I get it.
要么按你们说的来 要么就没法手术 I do it your way, - or it just doesn't happen.
只是又一个十字路口 肖恩 It's just another intersection, Shaun,
跟上一个一模一样 下一个也是如此 just like the last one and just like the next one...
上一个十字路口又没有大家都冲我按喇叭 The last intersection isn't where everyone honked at me
吓得我不知所措 and made me freeze --
那天不一样 路上的司机都不一样 That was a different day, with different drivers
开车的肖恩也不是那天的肖恩了 and a different Shaun behind the wheel,
因为今天的肖恩面对这个十字路口 because today, this Shaun has a plan
心里有数 那就是... for this intersection, which is...
我会把它「解剖」开 ...I am going to dissect it.
说得没错 Damn right you are.
而今天 你要右转 And today, you're gonna turn right
你的做法是 which you will do by...
决定转弯方向 Determining laterality.
等到能够进入自行车道时转弯 And waiting until I can legally enter the bike lane.
某人刚刚转了个弯呀 Somebody just made a turn...
肖恩 Shaun!
大家都没事吧 Everybody okay?
你错了 You were wrong.
你错了 莉亚 You were wrong, Lea.
我不能开车 I can't drive.
-肖恩 我以为这样可以 -我不能开车 - Shaun, I thought I had it figured out. - I can't drive.
我 I --
手术重在操纵器械 Surgery is mechanical.
器械是可预知的 Mechanics are predictable.
开车则受人的癖好影响 Driving is subject to human foibles
也就意味着有无限的可能 which means there are limitless possibilities.
你说得对 我的比喻糟透了 You're right. My metaphor sucked.
糟得不能再糟了 It sucked very much.
因为 Because...
成为一名外科医生不止要学习操作技术 becoming a surgeon is about way more than operating.
还要学会互动 You had to learn about interacting
与老师 同事 病人和老板互动 with teachers, co-workers, patients, bosses.
与他们合作 与他们交流 Cooperating with them, communicating with them --
我很不擅长交流 I am very bad at communicating.
肖恩 你成了一名外科医生 Shaun, you became a surgeon;
这是人能做到的最难的事之一 one of the hardest things that anyone can do.
你证明了事情难以做到 And you proved that just because something is hard,
并不意味着你做不到 doesn't mean you can't do it.
看看你刚做了什么 And look what you just did.
我刚撞了一个垃圾桶 I just hit a trash can.
就是 撞的事垃圾桶而不是迎面来的车 Exactly; a trash can instead of an oncoming car
或者行人 or a pedestrian.
你做得很好 肖恩 You did great, Shaun.
那个足球就是掉落的手术剪 That soccer ball was a dropped Metzenbaum.
确实如此 I know, right?
在手术室里 我不小心掉了手术器具时 When I accidentally drop an instrument in the O.R.,
我会快速反应 降低伤害 I react quickly to minimize damage.
-没错 -是的 - Yes. - Yes.
我掉了一把手术剪 I dropped a Metzenbaum.
我能开这两破车 I can drive this hooptie.
下注就要结束了 Window's about to close.
押我的话 押十块赢一千 $10 will get you $1,000 if you want to bet on me.
大家好 Hey, everybody.
我为你们所有人感到非常的骄傲 I can't be prouder of all of you.
我们终于成长为一个卓越的手术部门 We have grown into a preeminent surgical department,
我们已得到卓越外科中心的官方认证 which has been recognized with the official designation
我们已得到卓越外科中心的官方认证 of Surgical Center of Excellence.
现在的重中之重 It's now more important than ever
就是要维持我们的高标准 that we maintain our high standards.
而这里又有如此多够格的候选人 And so, while there are many worthy candidates,
我已决定 I've decided...
自己保留该职位 to retain the title myself.
谢谢你们 Thank you.
谢谢你们 Thank you!
好 Yes!
你 Y--
你 You...
你做了 你 You did it. You --
你真的做了 You really did it.
是他的主意 It was his idea.
莫菲 你 Murph? You --
我们植入了一个小的隆胸假体 We inserted a small breast implant
来填补空缺 to fill in the depression
创造了一个更美观的外形 and create a more aesthetically pleasing contour.
-隆胸假体 -是的 - Breast implant? - Yes.
你救了我的命 You saved my life.
这是个错误 It was a mistake.
它引起了眼心反射 It caused an oculocardiac reflex
你差点就死了 and you almost died.
这是个错误 It was a mistake.
乔治 George?
为什么他监视器的警报没有响 Why didn't his monitor alarm go off?
他很稳定 我就给断开了 好让他上厕所 He was stable; I disconnected it so he could use the restroom.
-我不是... -摩根 他不见了 - I didn't -- - Morgan! He's gone!
乔治 George!
克劳飞酒吧
我永远也不会找安德鲁斯对质的 I was never gonna confront Andrews.
我是在利用你 I was playing you.
但谁他妈想到你失败了 But damn if you didn't actually make it work.
大家都失败了 It didn't work for anybody.
他耍了我们俩 他让我们彼此对立 He played us both. He set us against each other.
我想你说得对 I think you were right.
就算你只是在虚张声势 Even if you were just bluffing,
我们需要团结一致 we need to stand together.
你两天前怎么没想明白呢 Where was that wisdom two days ago?
没跟你喝酒 Still in the bottle.
你是怎么想到那主意的 How'd you come up with that idea?
你提到了隆胸手术 我就想 You mentioned breast implants and I thought --
那是他的额头 That was his forehead.
我们是给他眼睛做手术 We were operating on his eye,
当时他的额头被遮住了 his forehead was covered.
你为什么会想到这个 Why were you thinking of it?
你很关心他 You care about him;
你为他的问题感到担心 you were worried about his problem.
你同情他 You empathized with him.
我的主意差点杀了他 My idea almost killed him.
没有 No it didn't.
我在比利的抽屉里找到了这个 I found these in Billy's drawer.
三天量的止痛片 Three days of pain meds.
他假装吃药 把药片偷偷藏起来 He was cheeking them to build up a stash.
他没有夸大其词 He wasn't exaggerating.
你救了他的命 肖恩 You saved his life, Shaun.
事情不应该这样结束 This isn't the way this should have ended...
但我觉得这世界并没有 But I'm not so sure the world is a worse place
比几小时前变得更糟 than it was a couple hours ago.
你开车时越来越自在了 You almost look comfortable behind the wheel.
车座对腰部的支撑很舒服 This seat has excellent lumbar support.
但我还是非常紧张 But I am still very nervous.
我能开车了 I can drive a car.
我看得出来 I can see that.
莉亚教会了我 用了个很糟糕的比喻 Lea taught me using a very bad analogy.
管用就不能算糟糕 Nothing works like a bad analogy.
他开得很好了 He's getting pretty good;
很快就能拿到正式驾照了 won't be long before he gets his operator's.
你的下一次放疗预约在45分钟后 Your next radiation appointment is in 45 minutes.
谢谢 Thank you.
BGM: Whole Wide World (Unpeeled) by Cage the Elephant
♪ I'd go the whole wide world ♪
♪ just to find her ♪
♪ I'd go the whole wide world ♪
♪ To find out where they hide her ♪