不仅有希望拯救生命 还能改善生活质量
you can hopefully not only save a life but improve quality of life,
有望让你的孩子恢复正常
and hopefully give your baby back.
这个手术很危险 我们会好好干的
It’s dangerous surgery, and we’ll do a good job.
新冠疫情延误了这家人带孩子来看病
COVID forced the family to delay their care of their baby.
另外 由于肿瘤的大小
And, in addition, there was an element of this
使孩子的病情存在独特和复杂之处
that was unique and complex due to the size of the tumor.
嘿 小朋友
Hey, buddy. Hey, buddy.
国内能做这种手术的 外科医生屈指可数
There are very few surgeons in the country that do this kind of operation.
我是为数不多的 能做这种手术的人之一
I’m one of the few people who operate on these in this way now,
我们决定把病人送到科恩儿童医院
and we decided to bring the patient to Cohen Children’s,
我平时很少在这家医院做手术
a hospital I don’t normally operate in very frequently,
但在优秀的搭档和肖恩的帮助下
but with great partners and with Shawn,
我可以高水平地完成这个手术
I’m able to do the procedure there at a very high level.
You know, doing it alone sucks.
一个人做手术很没劲
Going down any path alone, I think, sucks. It’s always good to have friends.
一个人做什么都没劲 有朋友总是好事
很好 明天我让朗格去看他
That’s good. I’ll have Langer see him tomorrow.
你看这个
Take a look at this.
这是一名医学生
This is a medical student.
他跟我上的是同一家医学院 布鲁克林的州南医学院
He goes to the same medical school I went to, downstate in Brooklyn.
这孩子23岁 他得了我们所说的“急性脑积水”
So this kid is 23. And he’s got what we call acute hydrocephalus.
他开始出现身体屈曲 严重头痛等症状
He started bending over and had severe headaches,
头痛欲裂
worst headaches of his life.
这是脊髓积液的典型表现
And that’s classic for, um, this buildup of spinal fluid.
这个脑室的脑脊液应该流向这个脑室
This ventricle has to drain into this ventricle,
然后通过非常狭窄的“苏伊士运河”
which then goes down a very narrow Suez Canal,
进入第四脑室 然后流入脊髓
then into the fourth ventricle, and then it goes into your spinal cord.
这是一个每天都在发生的动态过程
And this is a dynamic process that’s happening every day.
不知道什么原因 他的苏伊士运河
For reasons that remain unclear, his Suez Canal,
他这里的导水管关闭了
his aqueduct right here is um, closed.
造成他的大脑内压力不断上升
It’s just he’s building up pressure in his brain.
压力传导到眼睛 造成剧烈疼痛
That’s transmitted to his eyes and causing a massive headache.
-原理跟通下水道差不多 -对
– It’s like basic plumbing. – Right.
一种方案是伸下去 把那个洞变大
And so, one option is actually to go down and make that hole bigger
希望脑脊液会流走
and hope that the spinal fluid drains.
对
Right.
更安全的方案…他是医学生 我把两种方案都告诉他了
A safer approach– he’s a medical student, so I gave him both options,
他说:“这样吧 把一根导管插♥进♥这里
and he said, “You know what, just stick the catheter in this,
液体会流出去”
the fluid is going to shoot out.”
于是我紧急让他入院 以便进行减压和放置分流器
So I admitted him urgently to decompress this and put a shunt in.
…最安全的手术部位是后面这里
…the safest part to do it is back here.
我研究了一下脑室-腹腔分流术
So I actually do research on VP shunt placement,
我们了解了一下成功率…
so we’re actually looking at the success rate–
-好极了! -能够成为一个数据点 这很有意思
– Wow! That’s awesome! – It’s interesting to be a data point.
等我们完成手术后 你想跟我们写一篇论文…
When we’re all done with this and you wanna write up that paper with us…
That’d be an honor.
那我很荣幸
…你将从个人和专业两个角度看问题
…you’ll look at both personally and professionally.
-对 -好吧 手术室见
– Right. – Alright. I’ll see you inside.
如果不加处理 长时间的视乳♥头♥水肿会造成失明
If you leave this, long-standing papilledema causes blindness.
长时间的颅内压升高会造成死亡
And actually, long-standing elevated intracranial pressures can cause death.
朗格去哪儿了?
Where’s Langer, by the way?
(莱诺克斯山医院)
(科恩儿童医疗中心)
何塞·普林斯联♥系♥我们了 我得去跟他打个招呼
Jose Prince reached out. I’ve got to go say hello to him.
你见过马歇尔了吗?
Did you meet Marshall?
还没有 你好 肖恩·罗杰斯 很高兴认识你
I have not, no. How are you? Shawn Rodgers. Nice to meet you.
-很荣幸你们使用外视镜 -谢谢你今天带来设备
– Pleasure. – Excellent.
– With the exoscope. – Thank you for bringing everything today.
我告诉他了 手术台放在左边 显示屏放在右边 对
I told him set up right side surgery, left side screen. Yeah.
好 走吧
Okay, let’s go.
-你好 -你好
– How you doing? – How you doing?
I told Shawn I haven’t seen you probably since North Shore.
我跟肖恩说 我上次见到你 还是在北岸大学医院
Aww!
– There he is! – Hello!
-他来了! -嗨!
– I’m still here, look. – Oh, okay.
我还在这里 看
Dad, you can follow me over here.
孩子的爸爸跟我来这边
我们要进行安全检查 爸爸 好吗?
So we’re gonna do our safety check, Dad, okay?
好
Okay.
一会儿爸爸坐在这张椅子上睡觉
So Dad is gonna sit on the chair to go to sleep.
治疗小孩子让我很纠结
I struggle taking care of kids, you know?
I’ll be honest with you, I really enjoy it because it’s so impactful,
说实话 我很享受这个过程 因为影响重大
我不知道小儿神经外科医生 每天做这个 怎么受得了
but I don’t know how pediatric neurosurgeons do that every day.
你猜怎么着?是红色的 就像艾蒙!
And guess what? The color is red like Elmo!
艾蒙贴纸!都准备好了!
Elmo sticker! All done!
我们要跟艾蒙一起吹泡泡
We’re gonna blow some bubbles with Elmo.
谢谢!
– Thank you!
他们这样做很了不起 他们做的事太棒了
It’s amazing how they do this. What they have to do, it’s incredible.
-跟成人世界完全不同 -对
– Very different than the adult world. – Yeah.
准备好了吗?一、二、三
Ready? One, two, three.
他睡着了 爸爸 亲他一下 我们会带你出去
He’s nice and asleep, Daddy, give him a kiss and we’re gonna show you out.
好的 完美 谢谢你 爸爸
Okay, perfect. Thank you so much, Dad.
谢谢你们 谢谢
Thank you, guys, thank you.
你做得很好 谢谢
He did great. Thank you.
肖恩 我要再跟家属谈谈
Shawn, I’m just gonna go talk to family again.
– Yeah. – Want to come?
-好的 -你想跟我一起去吗?
Sure.
– You okay? – Yeah.
-你没事吧?你确定? -嗯 是的
– You sure? – Yes.
-这太让人揪心了 -是的
– It’s hard to take all this in. – Yeah.
很吓人
It’s scary and big.
You’re going to be okay, but you have to eat at home.
你会没事的 但你在家里一定要吃饭
就算不饿也要吃
You have to eat even if you don’t want to.
So you get well, okay?
这样才会好起来
家属还想让你知道 他存在萎靡不振的情况
Family members want you to know he has a failure to thrive situation.
他不吃不喝 不洗澡
He’s not eating, not drinking, not showering,
还表示不想活了
and he also expressed that he doesn’t want to live.
-他这么说? -是的 跟他儿子说的
– He said that? – Yes, he did. To his son.
麻烦你问问他的姓名和出生日期
Can you ask for first and last name, birthdate?
叔叔 你叫什么名字?
Uncle, what’s your first name?
何塞
Jose.
– Ah, perfect. – And date of birth?
-很好 -你的出生日期呢?
哪天出生的?
When was I born?
Uh…
恐怕上帝都不知道
I don’t think even God knows.
Don’t you remember which month?
你不记得是几月份吗?
– No?
不记得?
我记得是5月6日
I know its like May 6th.
哪一年?
In what year?
5月6日
May 6th…
He’s trying so hard.
他好努力地在想
It’s okay, it’s okay.
没关系
不记得没关系
It’s okay if you don’t remember.
Good afternoon. My name is Miss Cruz. I’m here to do an EKG.
下午好 我叫克鲁兹 我来为你做心电图
不一样 知道吧? 当患者是自己的亲人时 感觉不一样
It’s different, you know, it’s different when it’s a family member.
我们只能等待 看一切是否会好起来
We just got to wait to see if everything is going to be okay.
心里有点不好受 你希望自己可以留下来
A little hard because you wish you could stay here,
但现在要交给他们来照顾
but now it’s their time to render the service.
非常感谢
Thank you so much.
-你要走了? -是的 我要走了
– You’re leaving? – I’m leaving.
She’s my partner.
她是我的搭档
我们要回去工作了 去接其他人
We’re going back to work to go pick up others.
-好吧 -好
– Alright. – Alright?
Whatever you say, colonel.
你说怎样就怎样吧 上校
我们回头见 好吗?
I’ll see you later, okay?
要听话
Behave.
我一直都很听话
Like always.
现在他们要拍X光片 确保一切正常
So they’re going to do some x-rays now
and make sure that everything is okay, and hopefully he can be home by tonight.
希望他今晚就能回家
再见 杰米 谢谢 再见各位
Bye, Jamie. Thank you. See you, guys.
我们做得对 打电♥话♥给他们
We did the right thing, calling them.
现在要为下一个电♥话♥做好准备
And now just got to get ready to the next goal.
(科恩儿童医疗中心 诺斯韦尔健康)
暴♥力♥的海洋是由许多河流汇聚而成的
We have many rivers that feed the sea of violence.
我们必须为每条河筑起大坝
We must dam every river,
我们必须终结我们这座城市 和我们这个国家的枪♥支♥暴♥力♥
and we must end the gun violence in our city and in our country.
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