So I get called with some organ offers at like midnight,
凌晨2点又有人提供器官
some more organ offers at like 2:00 a.m.
我回去睡觉 一切都很好
I go back to sleep, everything is good,
然后那条狗不停地…
and the dog does not stop having to, like–
大半夜的 那条狗的前列腺出了问题
Something happened to the dog’s prostate in the middle of the night.
不是吧?它要撒尿?
No, he has to go?
又是孩子又是狗的
Between the kids and the dog,
就像没人想让格罗斯坦家的人睡觉
it’s like nobody wants sleep to happen in the Grodstein household.
我去看看他们的情况
Let’s see how they’re doing in there.
感觉我跟格罗斯坦医生做这笔买♥♥卖♥♥吃亏了
I think I got the short end of this deal with Dr. Grodstein.
Wow. It’s a big one. Whew!
哇 好大一个
It’s the kidney, not the liver, right?
这是肾脏 不是肝脏 对吧?
希望如此 就在那里
I hope so. Right there.
不妙
That’s no good.
怎么了?
What’s wrong?
打开他会很困难
It’s gonna be very hard to open him.
肾脏上方 我用绿色标记的地方
Over the kidney where I have the green.
在手术室…
In the operating room…
吻合器
Stapler.
…捐献肾脏的主要风险是出血
…the main risk associated with donating a kidney is bleeding.
我们是在非常大的血管上
We’re doing a laparoscopic, or minimally invasive, surgery,
做腹腔镜手术 或者微创手术
on very large blood vessels.
所以只要弄伤血管 就会发生出血
So, any time you injure a blood vessel, you can run into bleeding.
我看到肾了
I can see kidney.
可以吸一下吗?吸一下
Can I have a suction, please? Suction.
快点 要非常快才行
Let’s go quick. We have to go very fast.
你看 它在搏动
You see, it’s pulsating.
但它是朝着这边搏动
But it’s pulsating and coming up this way.
-他的动脉 我不觉得…-哪里?
– His artery, I don’t think– – Where?
-就在现在的位置-对
– Right where you are. – Yeah.
那只是一根支脉朝这边脱落了大部分是往这边
A branch coming off this way, you have more of it going this way.
把剪子给我
Give me the scissors.
那我们就用Endo Catch标本袋
Then we’ll take the Endo Catch bag as well.
标本袋 你要15毫米的?好的 这是15毫米的
The bag. You want the 15? Okay, here’s a 15.
15毫米?好 我只需要这个 扶着这个
It’s 15? Okay, that’s all I need. Hold that.
请把手术灯对着我们
Turn the table light to us.
冲洗袋台 放一个加压袋
Get the bag table flush up. Put another pressure bag.
-还有冰-等等…
– And ice. – Wait…
给维尼克打电♥话♥
Can you call Winick?
好
Okay.
护士 4×4放这边
Nurse. Four by four over here.
Can I open it?
(北岸大学医院)
(莱诺克斯健康格林尼治村)
-嗨-嗨 你好吗?
– Hi. – Hi, how ya doin’?
所以你有高血压病史
So you have a history of high blood pressure.
-是的-你在吃药吗?
– Yes. – Are you taking your medications?
我以前有吃药
I used to take my medication,
但最近太忙了 总是很累
but lately I have been so busy, and I’ve been so tired,
经常开着车就睡着了
and I’ve been falling asleep behind the wheel of my car.
-天啊-随时随地都能睡着
– Oh my goodness. – Just falling asleep anywhere.
你是本地人吗?
And are you from here?
我不是本地人 我老家在阿♥拉♥巴马州
I’m not from here. I’m originally from Alabama.
阿♥拉♥巴马州
Alabama.
– Alright. Well, you have a lot going on. – Yeah.
-好的 你很忙碌-是的
我在试着放慢节奏
I was trying to slow down.
我很忙 我打三份工
Yeah.
I had so much, working three jobs,
现在我需要平静下来
so now I’m just like, I need to just calm down
试着控制住一切
and try to get everything under control.
你打三份工是因为你想…
Are you doing the three jobs because you’re just trying to…
-努力赚钱 小姐-努力挣房♥租?
– Trying to make money, miss. – Trying to keep your rent going?
对
Right.
好的 我明白
Okay. I understand.
现在的情况是 你的血压完全失控了
You know, the situation is that your blood pressure is very out of control,
而且你目前的肾功能比三♥级♥肾病还要差
but your kidneys are also slower than stage 3 at this point.
很差 这可能是高血压导致的
They’re slow, and it’s probably because of the high blood pressure.
我不是想给你上课 但你还抽烟
And I don’t want to lecture you, but in addition, you smoke.
这些因素都将继续伤害你的肾
All those things are going to essentially continue to harm your kidneys
还有高血压
and the high blood pressure. You know,
如果你不控制住血压 你将无法工作
if you don’t get this under control, you won’t be able to work,
也就无法帮助你的家人和你自己
and then help your family and help yourself.
一旦你的肾脏停止工作一旦你不吃药
Once your kidneys stop working, once there’s no medication,
不改变生活方式 不想办法改善病情
no lifestyle changes, nothing that’s going to help them,
最终你将需要做透析
you’re going to end up on something called dialysis.
一周三次 一天几个小时
It’s three times a week, several hours a day.
久而久之 你将不堪重负因为做透析需要占用大量时间
Over time, it’s very debilitating because it requires a lot of your time.
就像一份兼♥职♥工作你将去城北的莱诺克斯山
It’s like a part-time job. You’re gonna go uptown to Lenox Hill.
希望住这一次院就够了希望我们可以…
Hopefully, this is a one-time admission and we can–
你可以让病情好转 真的可以
You can turn things around. You really can.
我一周前刚满35岁没有按照我希望的方式庆祝
I turned 35 a week ago and didn’t celebrate it the way I wanted to,
所以我的好友们打算带我去旅行
so my best friends are taking me on a trip.
我还不知道去哪里但他们要带我去旅行
I don’t know where just yet, but they’re taking me on a trip.
这是个惊喜 所以你刚满35岁
– It’s a surprise. – Yeah.
So, you’re turning 35.
你还很年轻 未来的日子还长着呢
And you’re super young. You still have a lot ahead of you.
她就像个可怜的12岁小姑娘 对吧?
She’s a sad little soul in 12, huh?
你知道吗?她特别可爱
Do you know? She’s so sweet.
原来她有一大堆问题简直就是毛病缠身
Turns out she has all this stuff going on. It’s like opening a can of worms.
显然她的生活方式完全不听医生的
She’s obviously very non-compliant with lifestyle.
各种坏习惯一应俱全
Basically all the bad stuff.
就像她的成绩单上全是不及格
Like, her report card’s F, F, F all the way down.
但她又是个勤奋工作的女人
But she’s also a woman who is a hard worker,
想在纽约这种城市讨生活 这非常难
trying to keep herself afloat in a city like New York City, which is challenging.
如果有人告诉我我肾衰竭了
If somebody told me, if your kidneys shut down,
你将每周做三次透析
you’re going to dialysis three times a week,
我一定会好好保养身体 马上戒烟
I’d be like, “Forget it. I’m gonna take care of this, gonna quit smoking.”
但对有些人来说这说起来容易做起来难
But that’s easier said than done for some people.
我觉得我对她说的那番话起不了什么作用 但我希望有用
I don’t think my talk with her changed anything, but I hope it did.
很好
Very good.
好 我们离开这里
Alright, we’re out of here.
好
There we go.
好 我很好
Alright. I’m good.
(莱诺克斯健康格林尼治村)
(科恩儿童医疗中心)
好了 我们成功了 很好
All right, we made it. There you go.
楼上的心脏科在等我们吗?
Is Cardiology upstairs hanging out waiting for us?
是的
Yeah.
好 血氧是84呼气末二氧化碳为17 呼吸率40
Alright, so our sat’s 84, end-tidal 17, rate of 40,
心率113 血压正常
heart rate’s 113, blood pressure’s cooking.
Uh, we have no issues with our drips, we have code drugs.
输液没问题 我们备有心脏骤停药物
-大家对刚才的数据没问题吧?-是的
– Everybody’s good with what we went over? – Yes.
-好 鲍勃 去按住电梯-好的
– Alright. Bob, grab the elevator. – Is that alright?
他在输多巴胺、克他命芬太尼、维库溴铵
He’s on dopamine, ketamine, fentanyl, vec.
-路上不太平?-路上状况频发 是的
– Rough ride? – It was a very rough ride, yes.
我们为可能发生的状况做好了准备
We prepared for what may happen or not.
– Twenty-one, way in the back. – Way in the back.
21号♥ 在后面
值得注意的是 转运途中ST段抬高
The thing of note, ST elevations during the transport.
这让我们所有人感到担心
That’s kind of what bothered all of us.
-所以你想先做什么?-已经在做了
– What would you like to do first? – We’re doing it.
那你接下来想做什么?
Oh. So what would you like to do second?
我来帮你恢复呼气末二氧化碳因为这一直是个问题
Gonna give back your end-tidal because that’s always a problem.
让我们断开两秒钟
Let’s disconnect for two seconds.
-他摘掉帽子了 唐?-是的
– Is he off the cap, Don? – Yes, yeah.
呼吸机准备好了吗?走吧
Are you guys ready for the vent? Let’s go.
在那一刻那对父母的孩子就是我的孩子
At that moment, that parent’s child is my child.
你工作时必须非常机警拿出最好的表现
You have to be extremely sharp and be on your A-game when you’re working,
因为很多时候 你不会有第二次机会
because a lot of times you don’t get a second chance,
所以你的介入也许能挽救一条生命
so your intervention may save a life.
他喜欢用球囊呼吸器紧急转运真够呛
He likes to be bagged. The side of 68 kind of stinks.
-我觉得必须对他用球囊呼吸器-用球囊呼吸器?把呼吸器给我
– No, I think we have to bag him. – Bag him? Can I have the bag?
他在ST段抬高期间出现了心律改变
He’s had a cardiac rhythm change during what we call ST elevation,
有时这可能是心脏缺氧的表现
which sometimes could be a hypoxic heart event.
心脏缺氧可能造成心脏停止跳动
Potentially, if your heart becomes deprived of oxygen, your heart will stop.
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