It seems like he caught RSV,
心脏病大大加重了病情
which made it much worse with his cardiac conditions.
所以现在病情危重
So he’s extremely sick and critical at this time.
之前这个孩子在其他医院
This baby was at an outside hospital.
看样子那所医院的医生到了束手无策的地步
I guess they came to a point where they were unable to manage the patient,
觉得患者需要接受他们无法提供的治疗
and they felt the patient needed care they were incapable of.
所以他们联♥系♥我们转院
So at that point, they contacted us, uh, for transfer.
我们认为孩子在科恩中心能得到更好的救治
We decided the child could benefit from coming to Cohen’s.
-准备好让他出来了吗?-是的
– You have him ready to come out? – Yeah.
往后推
Roll him back.
Just lay back. Don’t lift up your head.
躺下 别抬头
-把他推出来-我会的
– Push him out. – I will.
来吧
Go ahead.
我一直很喜欢照顾别人
I’ve always loved taking care of others.
我一直很珍视这份工作
That’s always something that I’ve really valued.
有人在如此短的时间内将生命托付给你
For someone to entrust you in such a short period of time,
这让我感到无比谦卑
you know, that’s a very humbling experience.
这是一名56岁的男性名叫乔纳森·卡尔
This is a 56-year-old male. His name is Jonathan Carr.
He does have a GI bleed.
他确实是消化道出血
这是给他输的第二袋血了 所以 是的
This is the second unit of blood that’s being given, so yeah.
而且他那一侧有瘘管
And he has a fistula on that side,
所以每周一、周三和周五都要做透析
so he gets dialysis every Monday, Wednesday, Friday.
他周一发生过一次心跳骤停
He did sustain a cardiac arrest on Monday.
你的呼吸怎么样?
How’s your breathing?
呼吸很困难 因为…我的胸部
Well, it’s very hard to breathe because… my chest.
我希望医护怎样跟我母亲说话我就会怎样跟病人说话
I do try to talk to them like I would want my mother to be spoken to.
我明白把我最爱的人托付给别人的感觉
I know what it’s like to trust people with someone that I love the most.
五年前我妈妈病了
Like, my mom was sick five years ago,
很不幸 她去世了
and unfortunately she passed away.
我还记得把她托付给别人时我是什么心情
I remember what it felt like to entrust somebody with her.
放轻松
Just relax.
他们会好好照顾你的 好吗?
They’re gonna take good care of you, okay?
我觉得这很疯狂
I thought it was crazy,
因为我的预产期就在
because my due date is actually
她的忌日的一周后
a little bit more than a week after her passing,
我觉得这不是巧合
and I don’t think it’s a coincidence.
我觉得她和上帝是以这种方式告诉我
I think that was her and God’s way of telling me,
“你再也不用那样煎熬了”
“You wouldn’t have to suffer again like that,”
我终于可以跟她团聚了不过是以另一种方式
and that I would finally be reunited with her but in a different way.
我可能不会举办迎婴派对之类的活动
I’m probably not going to do like a baby shower or anything.
我不想用这种事麻烦别人
Like, I don’t want to burden people with that kind of thing,
而且我知道我妈妈无法出席
and I know my mom can’t be physically present,
有时候这会让人更难受
like, sometimes it makes it harder.
所以…如果不举办 也许会…
So… sometimes it’s easier just not to…
just not to do it.
好受一些
– You are too much. – All the best to you, sir.
-你太滑稽了-祝你一切顺利 先生
– Alright, thank you. – You’re welcome.
-好 谢谢-不客气
-你平时会尿尿吗?你会尿尿吗?-不
– Do you make urine? Do you pee? – No.
-你最后一次尿尿是什么时候?-该死 我不记得了
– When is the last time you peed? – Shit, I can’t remember.
Uh…
– A couple years ago. – Couple years ago the last pee?
-几年前吧-最后一次尿尿是几年前?
我们将拔掉导尿管到时候你会恨我的
We’ll take out the catheter and you’ll hate me…
因为你会从没有尿变成两秒钟尿一次
…because you’re gonna go from not peeing to peeing every two seconds.
虽然麻烦 不过是好事
It’s a good problem to have.
好了 朋友 祝你前往巴哈马群岛旅途顺利 好好享受
Alright, my friend, have a good trip to the Bahamas. Enjoy.
– Okay. – When you’re done, off dialysis, alright?
做完手术就不用透析了 对吧?
好了 插好管子 然后我们开始
Alright, so some lines go in, and then we start the dance.
我是一名肾科医生的儿子就是看肾病的医生
I’m the son of a nephrologist, which is a kidney doctor.
确认时间 11点09分
Time of verification, 11:09.
所以当我的朋友们跟着父亲去看喷气机队比赛的时候
So when all my friends were going with their dads to Jets games,
我会去透析中心
I was going to dialysis centers
看我爸爸照顾肾病晚期患者
and watching my dad take care of patients with end-stage kidney disease.
我还清楚地记得 有一次跟他在车上
I remember very distinctly being in the car with him,
他打电♥话♥给一个病人
and he made that phone call to a patient
告诉对方即将为他做肾移植手术
to tell them they were getting a kidney transplant.
他异常激动 兴高采烈的
He was getting very emotional, he was excited.
他照顾这个病人20多年了
He had taken care of this patient for upwards of 20 years.
那一刻我意识到
And I realized at that point,
器♥官♥移♥植♥有可能改变接受移植者的生命
this transplant had the opportunity to change this recipient’s life.
从此我就立志要干这个我迷上了这一行
I thought, “I got to be involved with this.” I was hooked.
(捐献者手术室)
好
Okay.
准备好就开始吧
We’re ready when you are.
我们要做腹腔镜下左肾供体摘除术
We’re doing a laparoscopic left donor nephrectomy.
我们已经分别和共同核对过患者的身份
We have independently collectively identified the patient
包括姓名和出生日期不符之处均已消除
by name and date of birth, and resolved all discrepancies.
-确认?-确认
– Confirmed? – Confirmed.
我们先把肾脏露出来 这是肾
Now, we’re starting to expose the kidney. This is kidney.
我们移开了肠子 移开了大肠
We moved the bowel, we moved the large intestine,
现在露出了肾脏
and now we’re exposing the kidney.
肾脏周围有一大块脂肪垫
And the kidney is surrounded by a big pad of fat.
肾脏供体摘除术
The operation of donor nephrectomy
是医学界唯一的
is the only operation in medicine that is done
对患者完全没有好处的手术
for no benefit to the patient at all.
他不是病人 他是个健康的人
He is not a patient, he’s a healthy guy.
所以这台手术违背了医学院教给我们的原则
So this operation defies what they teach us in medical school,
“不要造成伤害”因为这种手术一定会造成伤害
that “don’t do harm,” because this is an operation that carries harm anyway.
你会捐肾给亲戚吗?
Would you donate a kidney to a relative?
会
Yes.
你会捐肾给朋友吗?
Would you donate a kidney to a friend?
I don’t think so.
我想不会
我想我也不会
I think that’s what I would also do.
不捐给朋友?
Not a friend?
我没有朋友
– I don’t have friends. – I thought we were.
我以为我们是朋友
40?很好 现在是87至90
Forty? It’s great. We’re doing 87 to 90 sat.
比刚才好
Better than what we had.
等一下 我把这个收起来
Hang on. So, I’ll take this.
我们在他的左股动脉开了一个口以便推注药物
We have an open port in his left femoral if we need to push drugs.
-还有一个10毫升的注射器-好
– Also, a 10cc syringe. – Okay.
我们还在他的右手留置了一根外周静脉输液管
We also got a PIV that’s open in his right hand.
把注射笔放在手边备用
If your Epi is around, just in case.
好
Yeah.
有这个就够了 希望用不上
Okay. That’s the only thing we’re going to need. Well, I hope not.
接下来我们要决定
So, the next thing we need to decide.
Uh…
如果出现心跳骤停就送他去最近的医院
Full code, if it occurs, get him to the closest hospital.
-好-好
– Okay. – Okay.
Blood pressure’s going.
血压在上升
血压66和53呼气末二氧化碳为17 呼吸率39
Pressure’s 66 over 53. End-tidal 17, 39.
心率109 血氧饱和度88
Heart rate’s 109. Sat is a whopping 88.
-你接上气罐了吧?-接到我的主气罐?
You’re connected to the tank? Oh, to my main?
我可以给五毫升等效剂量五毫升注射器
I could do five mil equivalence, five mil syringe.
丹 从这条路我们也可以送到塞奥西特
So, from this way, Dan, our other diversion would be Syosset,
那家医院非常小
which is a very small hospital.
我只是在分享计划
I’m just sharing the plan.
好
Okay.
下一步是普莱恩维尤沿这条路走不远就是
Next step would be Plainview, a little further down the road.
但除此之外 我们得去科恩中心
But other than that, we have to end up in Cohen’s.
你好 儿科 需要帮助吗?
Hello, Pediatric Unit. Can I help you?
嘿 我要送一个生病的孩子回去
Hey, I’m coming back with a sick child. Uh…
形势不乐观我可能要停在急诊室门口
Looking pretty rough. I might need to stop at the ER.
我大概15分钟后通知你
I’ll let you know in about 15 minutes.
如果他心跳骤停我们将送到你们那里
If he codes, we’re going to stop with you.
我们在给他用球囊呼吸器因为他用不了呼吸机
We’re actually bagging him because we cannot ventilate him.
对 你能开快点吗?
Yeah, you got a little more diesel therapy in there?
坐稳了
Hold on to your hats.
天啊
Oh, my God.
不 真的 等一下 她开车像个疯子
No, really, hold on. She drives like a maniac.
嘿 我是唐纳德
Hey, it’s Donald.
你能在十分钟后到后门见我吗?
Can you meet me at the back door in 10 minutes?
看样子他可能会心脏骤停
It looks like he might code.
我在午夜接到提供器官的电♥话♥
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