里面有一块小骨片
这里的骨头有点多
Here the kid has a little more bone.
我需要咬骨钳 谢谢
I need a lempert, please.
这东西看起来像个…那是一把咬骨钳
This thing that looks like a– That’s a lempert.
-你好吗 何塞? -我很好
– How are you, Jose? – I’m good.
-嘿 何塞 你好吗? -我很好
– Hey, Jose. How ya doing? – Great.
-很高兴见到你 -很高兴见到你
– Good to see ya. – It’s nice to see you.
看来你正在手术…
Looks like you’re totally underway and–
是的 我本来打算 一做完就给你打电♥话♥的
Yeah, I was going to call you as soon as I was done.
-或者快做完时 -没问题
– Or when we were closing. – No problem.
戴上3D眼镜 你会看到一些很酷的东西
Put some 3D glasses on. You’ll see some cool shit.
-我戴了 非常酷 -这是外视镜
– I got ’em. It’s very cool. – This is exoscope, right?
你看血管在表面上搏动
Look at the vessel pulsing on the surface there.
-开 -很美
– On. – Beautiful.
我晚点再来找你 问问关于手术室的事
I’ll bug you later about stuff I wanted to ask about the operating rooms.
-我会打给你的 -打给我 回头见
– I’ll call you. – Give me a buzz. See ya later.
保重 何塞
Take care, Jose.
开
On.
开
On.
切腱剪
Tenotomy scissor.
-他已经穿过额叶了 对吧? -再给我…再给我一把剪子
– He’s over the frontal lobe. – Give me another scissor.
Don’t touch the pink area. He’s not over the Sylvian fissure.
他还没穿过大脑侧裂
我总是非常小心地穿过侧裂
I’m always really careful crossing the fissure.
这些剪子非常可怕
These scissors are pretty horrible.
双极钳
Bipolar.
看到肿瘤了 很多地方还在流血
There’s the tumor. A lot is still bleeding.
我们会尽量避免切断视神经 双极钳开了吗?
We try not to cut the optic nerves. Is the bipolar on?
大一号♥的双极钳 谢谢
The next size up bipolars, please.
迈克 给我紫色的…
Mike, give me my purple–
紫色那把已经打开了 18×0.6
We have the purple one on. 18 by point 6.
Oh.
– 20? – 20 by point 6.
-20? -20×0.6
-如果你想要 我们还有更小的 -我要最小的
– We have a more micro one if you want. – I want the micro-est you have.
Yes.
里面空间不大 给我一把活检钳 谢谢
Not a lot of room there, you know. Give me a biopsy forceps, please?
神经元
Four on neuron.
如果你发现我出错 就说出来
If you see me doing anything bad, speak up.
我看着呢 我不会让你出大错的
No, I got ya. I won’t let you fly into the side of a mountain.
-里面看起来不错 -对 我同意
– Looks pretty good in there. – It does. I agree.
这是你能做的最美妙的事了
One of the most beautiful things you could ever do.
我愿意免费做这种手术 每天都做 直到…
I would do this operation for free…
– …every day until…
真的 这能让我…
Seriously, it actually is for me…
我不想做别的手术了
There’s not an operation I’d rather do.
那里有个东西 脑垂体 也许是
Oh, there’s something. Pituitary. That may be it, boys.
对 我觉得你很厉害
Yeah, I think you’re good.
你知道 这很可能滑向深渊
You know, it’s like a slippery slope.
一不小心 就会进入下丘脑
A slippery slope because suddenly you get in the hypothalamus,
造成严重的内分泌失调
you just make an endocrine cripple.
肥胖症 或者激素消失 记忆受损
Obesity. Or the hormones are gone, so memory is hurt.
所以成败只在一线之间
So there is a fine line.
-我想我们结束了 -是的 我同意
– I think we’re done. – Yeah, I’m good with that.
Check all the monitoring.
查看所有监护指标
(科恩儿童医疗中心)
I’m going to be six.
我快满六岁了
是的 你要满六岁了
Yes, you will be six.
伦敦得了流感 我们一直以为是新冠
London picked up the flu, and obviously, we always think it’s COVID
因为现在有疫情 但所有人都是阴性
because that’s going on now, but everyone’s negative.
你还好吗 亲爱的?好
You okay, sweetheart? Okay.
今天她妈妈提前给我打电♥话♥ 她从上午11点就和我在一起
Today, her mom called me earlier, and she’s been with me since 11:00.
所以现在我要提前送她回去 一会儿我儿子还有一场比赛
So now I’m taking her back early, and my son has a game later.
总是在四个孩子之间来回奔波
So it’s always a juggle with four kids.
办离婚期间 我跟孩子们的关系变得紧张
My relationship, through the divorce process,
with my children has been strained.
我们正在努力改善关系 这对他们来说很难
We’re working through it. It’s tough for them.
我父母工作都很勤奋
Both my parents worked really hard.
我妈妈是护士 我爸爸是出租车司机
My mother was a nurse. My dad was a cab driver.
受他们的影响 我工作也很勤奋
So they influenced me to work hard.
但我不想变得跟我父母一模一样
But I don’t want to be like my parents totally,
uh, because times are different.
因为时代不同了
我小时候 我妈连门都不许我出 也不让我出去玩
My mom didn’t let us, didn’t let me go anywhere or hang out.
现在我却连 自己的孩子在什么地方都不知道
And now it’s like I’m wondering where the hell my kids are.
我是说 我大概知道他们在什么地方 不是在篮球场就是在健身房♥ 只是…
I mean, I know where they are, relatively. It’s either basketball at some gym, but…
只是我想知道更多
I just don’t know as much as I’d like to know.
我不是怕他们不听话
It’s not really about them being good.
我是怕他们不够成熟 会做一些蠢事 惹上麻烦
It’s about being mature enough to avoid nonsense, stay out of trouble.
我那几个儿子身材高大
And then with the size of my boys,
现在这种形势 他们看起来就像成年人
with the current climate of what’s going on, they look like adults.
但是做父母就是这样 总是免不了担心
But that’s the role of being a parent. You always worry.
分流手术就没有容易的
There’s no such thing as an easy shunt.
放置分流器时 一不小心就会出问题
You know, when you’re placing a shunt, just about anything can go wrong.
你看这里 分流系统植入器上有个孔
So basically, you’ll see here, there’s a hole in the shunt passer.
这个将进入皮下
So this is going to go under the skin,
我们将把它插入腹部 格林伯格医生所在的位置
and we’re gonna pop into the belly where Dr. Greenberg is,
拔出内部的探针
pull out this inner stylet,
然后将橙色的管子插♥进♥这里
and then the orange tube is going to slide through here.
好 这是他的锁骨
Alright, here’s his clavicle.
枕骨分流术的难点就在右边这个平面
Now, the hard part of occipital shunts is actually being in the right plane here.
他的脖子很粗
So he’s got a very thick neck.
他的头皮很结实
His scalp is really dense.
该死
Fuck.
老天 太紧了
Jeez. It is just very tight.
别管这个了 扶着他的头
Forget this. Hold the head.
-好了 -好了 太好了
– There we go. – There we go. Right. Love it.
你今天健过身了 不用去健身房♥了
You got your workout for the day. You don’t need to go to the gym.
-躲开 -好
– Watch yourself. – Yeah.
累死我了
I’m exhausted,
情绪上、体力上、精神上
emotionally, physically, spiritually.
-管子来了 -好
– There’s the tube. – Good.
他将在腹腔镜下这样做
So this is how he’s doing this laparoscopically.
现在腹部只有一个小洞
Now that’s just a tiny hole in the abdomen.
我要拔掉这根内丝
Gonna take out this inner wire.
我要把分流器取出来
I’m gonna take the shunt out.
吸
Suction.
你有脑脊液储存囊吗?
Do you have a reservoir for the spinal fluid?
-哇! -压力好大
– Whoa! – High pressure.
把这杯脑脊液拿走
Take this spinal fluid.
拿把椅子让我坐下 刺刀钳
Put the chair under me, please. Bayonet.
现在我把它抽出来
And now we just pump it.
我在抽那个瓣膜
I’m just pumping the valve.
那下面是什么器官?
What organ are we looking at underneath there?
小肠
The small intestine.
在他的余生中 这个瓣膜将调节
This valve will regulate the flow of spinal fluid
脑脊液从大脑流入腹部的速度
from the brain into his belly for the rest of his life.
好了 开始缝合
All right, we’re going to start closing.
-很好 -完美
– Good. – That was perfect.
是的 一切顺利
It was. Everything went great.
-好了 谢谢大家 谢谢 -再见
– All right, thanks, everyone. Thanks. – Bye.
瑞秋 等他醒了 给我发短♥信♥
Rachel, text me when he wakes up, thank you.
我觉得做分流手术会让医生折寿 会让你老得更快
I think shunts take years off your life. They gray you quicker.
我觉得人们低估了 做手术对体力的消耗
And I think people underestimate the physicality of surgery.
连续三、四十年反复做同样的手术
Thirty, forty years of doing the same procedure,
弯着脖子坐在那里 戴着放大镜
and we’re sitting there with our necks flexed, we’re wearing loops.
会非常累人
Uh, so it can be taxing.
我花了很多时间锻炼
I spend a ton of time exercising,
uh, stretching, strengthening my back, my neck, yoga,
拉伸 加强背部和脖子的力量 练瑜伽
还有情绪正念训练
in addition to the, obviously, emotional mindfulness training
以及其他帮助我们放松的练习
and other things to keep us relaxed.
但是受了伤就无法做手术了 所以我从不滑雪
But you can’t operate hurt, right? So I don’t ski,
运动时从不超过我跑步的速度 因为我不能拉伤前交叉韧带
I don’t do anything faster than I can run, because I can’t tear my ACL,
或者打篮球把手指弄骨折
or break my finger playing hoops.
因为那就无法做手术了
Because you can’t operate.
This is what we do.
我们会这样解乏
© 2014-2024 pabulika.com 版权所有
