The baby was found to have a hole in the diaphragm,
膈肌上有个洞
before being born, in an ultrasound.
我看到胸腔的这个位置有一大块肝脏
I’m seeing quite a bit of the liver here in the chest,
这些灰色的洞中全是肠子
and all of the intestines here in these gray holes.
心脏完全被推到了胸腔的另一侧
And the heart has been pushed completely out of the chest to the other side.
所以我们今天的任务 是把这堆东西全都推回到腹腔
So our job today is going to be to push all of this back into the belly
给予心脏和肺脏 存活和正常工作的空间
and give the heart and the lungs the room they need to live and function,
以便有朝一日我们能够参加她的婚礼
so that we can get to some day seeing her at her wedding.
说“再见 妈妈爸爸 我马上回来”
Say, “Bye, Mommy, Daddy. Be back soon.”
一会儿见 好吗?
See you soon, okay?
急救车99 创伤通知待定 预计八分钟后到达
Medic 99. Trauma notification TBD, ETA is eight minutes.
我有一个11岁的男孩 在车祸中头部受伤
I have an 11-year-old male with a head injury, secondary to an MVA.
他的额叶有一个很大的血肿
He has a large frontal lobe hematoma.
他看起来昏昏欲睡 但是意识清醒 神志正常
He appears lethargic but is alert and oriented.
让我看看肿的地方
Let me see your bump.
不要闭上眼睛
You gotta keep your eyes open.
他现在意识不清
He’s… He’s not, like, alert.
Like…
We think that, you know, he needs immediate care.
我们认为他需要立即接受抢救
It’s a kid, and you want to make them feel safe, and it’s scary for them.
他还是个孩子 你希望他们感到安全 这一切对他们来说很可怕
在他们看来 这一切非常混乱
All this is like chaos in their head,
所以我们总是 想方设法让他们保持冷静
so we always, you know, try to keep them calm,
但不管你费多少口舌 向他们解释这种情况
but it doesn’t matter how much you explain the situation to them,
他们还是受不了 警笛声、警♥察♥和各种人
they’re not going to be okay with all the sirens and police and people,
陌生人靠近他们
strangers coming up to them.
我在尽可能平安到达
I’m trying to get there safe,
同时希望他不会有事
and hopefully, you know, he’s going to be okay.
你要尽量保持清醒 因为你可能有脑震荡 好吗?
You gotta try to stay awake because you might have a concussion, okay?
保持眼睛睁开
You gotta keep your eyes open.
你做得很好 你没事
You’re doing good, you’re alright.
(北岸大学医院)
詹妮弗由于 暴发性肝功能衰竭而陷入昏迷
Jennifer went into coma as a result of fulminant liver failure,
她的肝脏出了故障 罢♥工♥了
where your liver just shuts off and stops working.
她现在正躺在手术台上
She’s on the operating room table right now.
如果无法尽快为她做移植 她的颅内压力就会上升
If you cannot transplant her fast enough, then pressure will build up in her head,
她的大脑会形成脑疝
and her brain can herniate out of her skull,
到那时候 患者就无法恢复了
and patients don’t recover from that.
他们要么遭受终生脑损伤 要么死掉 死掉的可能性更大
They either have lifelong brain damage, or more likely they just die.
幸运的是 我们找到了一个肝脏
Luckily, we found a liver.
时间一分一秒流逝 我们在和时间赛跑
And the clock has really already started, and it’s a race against time.
-祝你今天一切顺利 -谢谢
– Have a good day. – Thank you.
我们要去另一个州把器官取回来
We’re going to another state to bring an organ back.
器官捐献者的故事从来都不美好
There’s never a good donor story.
总是很不幸 这次的捐献者是脑死亡
It’s always somebody that unfortunately, in this case,
it’s somebody that, unfortunately, that– that is brain dead.
家属很有勇气
And the family was courageous
也很有爱心 想把死者的器官捐给他人
and caring enough to say that they want to donate organs to somebody else.
这位女士恶化得太快了
This lady’s sick. She just went down the tubes quickly.
没错 现在35岁以下的器官捐献者中
Yeah. Now, the percentage of donors under age 35
死于吸毒的比例高达75%?远高于死于创伤的比例
who are narcotics is 75%? I mean, it’s way more than trauma.
国内吸毒和酗酒的人数绝对在上升
People been home, and drugs, alcohol definitely on the up.
Yeah.
So, you know, we make triumph out of adversity.
所以我们是在逆境中取得胜利
(莱诺克斯山医院)
(救护车入口)
说到大脑 它固定在坚硬的头骨中
When you talk about the brain, it’s fixed in a rigid skull.
这是一个盒子 规则很简单
This is a box. And we have a very simple rule.
盒子里只有三样东西 脊液、大脑和血液
There’s only really three things in the box.
Spinal fluid, brain, and blood.
其中任何一样增加 你仍在这个固定的盒子中
And if any one of those increase in any way,
you’re still in this fixed box.
Good morning.
一般来说 脑瘤的病情比较急迫
Brain tumors, in general, tend to be urgent,
患者往往命悬一线 他们在承受压力
meaning that those patients are under extremis, they’re under pressure.
我们必须把肿瘤取出来 因为他们的大脑内可能存在高压
We have to take that tumor out because they may be having pressure in the brain,
迫切任务自然是立刻对患者进行治疗
and the urgency is making sure that patient starts treatment right away.
丹尼斯医生
Dr. Dennis.
布克瓦尔 很高兴见到你
Boockvar, pleasure, as always.
-伙计 -看起来不错
– My man. – Looking good.
-你昨晚怎么样?-还不错 睡了一会儿
– How was your night? – It was good, yeah, got some rest.
-睡着了 冥想了很久 感觉很好 -你冥想时做什么?
– Slept, meditated a lot, feeling good. – What do you do for meditation?
我有空时会练气功 做各种动作
Um, well, I do Qigong when I have time to kind of do the movements.
Um, I do have breathing exercises, I pray a little bit, and things like that.
我会练习吐纳 偶尔做做祷告 诸如此类的
我们会在手术室做正念冥想
Well, we’ll be doing some mindfulness in the operating room.
我们每次手术前都会做 所以我们会给你时间做冥想
We do it right before every case, so…
– Oh, I appreciate that. – …we’ll give you an extra mindful moment.
非常感谢
I appreciate that so much.
今天全世界都将为你祈祷 马科斯
You got the whole world praying for you, Marcos, today.
– I appreciate that. – Okay.
这是为了马科斯 他会很感激的
This is for Marcos. He’ll appreciate this.
-一个大好人 -天底下最好的人
– Really nice guy. – The nicest.
好事做尽
Does all the right things,
偏偏得了也许是最可怕的人类癌症
and gets perhaps the worst of human cancers that exist.
太没天理了
Just terrible.
(科恩儿童医疗中心)
我只是不明白为什么 枪♥支♥太危险了
I just don’t understand why. Guns is very dangerous.
You know.
这就是他们会对你做的事
This is what they can do to you, you know?
当时他跟朋友在一起
He was with friends.
据我所知 是一次聚会
To my knowledge, it was a gathering.
目前还没有线索 如果只是飞车枪击…
Still have no information, if it’s just a drive-by…
我现在只知道这些
It’s all I know at this moment.
如果你能帮忙照顾小约 我可以把你也介绍给他的妈妈
If you can help take care of Josh, I can introduce you to the mom too.
好的
Yep, yep.
他身中多枪
So he’s got multiple gunshots,
病情刚刚稳定下来 腹部有个开口
was initially stabilized, and has an open abdomen.
也许可以缝合了 如果还不行 你可以看看
Maybe he’s ready for closure. If not, you can take a look.
需要我就说一声 我可以过去
If you need me, just let me know and I can pop over.
Okay.
-夏洛特 情况还好吗?-是的 给他打了镇静剂了
Charlotte, you think we’re good?
Yeah. He’s already sedated.
好的 我去跟他妈妈谈谈
Okay. I’ll just talk to the mom.
嗨 我们打算打开已经打开了的腹部
Hi, Mom. The plan is to open up the abdomen that’s already open,
把敷料取出来 把血迹冲洗干净
but take off the dressing, wash out all the blood, look at the stomach,
检查一下胃、肝脏和横膈膜 确保修补的部位完好无损
the liver, the diaphragm, make sure the repairs are all intact.
如果还有出血点 就处理一下
If there’s any extra bleeding, take care of it,
因为我们知道腹部引流管有血流出来
because we do know there’s blood coming out of the drain from the belly,
我们想确保没有遗漏什么
so we want to make sure we’re not missing anything,
然后重新敷上敷料
and then reapply that dressing.
他会渡过难关的 我们见过大量的枪伤
He’s gonna pull through. We’re seeing crazy amounts of firearm injury
遍布全市 所以他会渡过难关的
you know, throughout the city, so he’s gonna pull through.
-他是个斗士 -没错 我们会好好照顾他的
– He’s a fighter. – He is, he is.
We’ll take good care of him.
约书亚身中多枪
Joshua suffered multiple gunshots.
他正在与死神搏斗
And he’s now fighting for his life.
很多时候 子弹不会留在体内
A lot of these bullets don’t remain in the body,
它们击中各种器官后穿出身体
they kind of hit all your organs and then exit.
通常都是这样
That’s typically what we see.
在一个不断受到
How do you live in a society
这种暴♥力♥威胁的社会中 你将如何生活?
where you’re at constant risk for this type of violence?
这里和这里有枪伤
There’s a bullet wound here and here, right?
横膈膜损伤是在这里
This is where the injury to the diaphragm happened,
这是脾脏、肝脏、胃
the spleen, liver, stomach.
其他地方也有多处枪伤
Multiple bullet wounds everywhere else as well.
感染太严重了 对吧?感染太严重了
They’re too infected, no? They’re too infected.
我们把孩子送到急诊室的时候 他的母亲在那里等他
When we brought the kid to the ER, his mother was waiting there for him.
他一下子就感觉好多了
That immediately made him feel better.
回到救护车以后 你会准备接下一个任务
When you go back to the ambulance, you get ready for the next call,
但你总是忍♥不住会想 刚才那个病人怎么样了?
but then you’re always thinking about, “I wonder what happened to that patient.”
我们不知道结局如何 不知道他们是否回家了
We don’t get to see the results, like if they went home.
如果病人是孩子 做决定时总是很艰难
When it comes to kids, you know, it’s always a difficult call.
他们太脆弱了
They’re so vulnerable.
总是让你感到于心不忍♥
It always touches, you know, like, a part of your heart.
尤其是现在
Especially now.
-你脸色很难看 你没事吧?-我没事
– You look really pale, are you okay? – I’m okay.
要是有事 你最好告诉我
You better tell me if you’re not okay.
我没事 我觉得你就是想给我打点滴
I’m okay. Just, I feel like you just want to start an IV on me.
没错 我想赶快给你补液
I do. I just wanna hydrate you real quick.
-是吗?-是的
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