John Langer, David’s brother, called me at 5:00 on this day.
我心都碎了
It broke my freaking heart.
万幸的是 他的大脑完好无损
Thankfully, his brain is perfect.
他的脊髓看起来还好 中间这里
His spinal cord looks good, and right here in the middle,
存在先天性狭窄
he has some congenital narrowing.
他的脊髓受到了挤压
He kind of pinched his cord.
他的头猛地后仰 这里受到了压♥迫♥
So when he whipped his head back, this kind of crunched down.
现在这里有炎症 当你这样做时
Now he’s got inflammation here. Basically, when you do that,
这叫做中♥央♥脊髓综合症 这会切断信♥号♥♥
it’s called the central cord syndrome, and you can actually stop the signals,
从大脑传导到四肢的运动和感觉信♥号♥♥
motor and sensory, that go from your brain to your extremities.
无论如何 他需要解除 那个部位受到的压♥迫♥
Either way, he needs to have that released and relieved,
所以他需要做椎板切除及融合术
so he’s going to need a laminectomy infusion.
好的 朗格医生 什么事?
Yes, sir. Dr. Langer, what happened?
我需要用点吗♥啡♥
I need to take a little morphine.
-增加药物? -知道了
– More medication? – I got it.
好 我们来了
Okay, we’re coming.
如果只是切除这些骨头 给他所需的空间
If you just took off these bones and gave him the room that he needs,
脊髓所需的空间…
basically for his spinal cord…
他应该能完全康复 我希望如此
he should be full strength, is my hope.
We’re all done. We’re gonna get you out.
做完了 我们把你抬出来
大卫的工作是做人类最复杂的手术
Now, David does the most complex surgery in humankind.
他是个微血管外科医生 对人的大脑动手术
He’s a microvascular surgeon in the human brain,
需要把血管缝在一起
and he’s gotta tie blood vessels together.
这需要最细的缝合线
And so that takes, you know, the finest suture,
最细的线 操作最精细的器械
the finest threads, holding the finest, um, instruments.
我的工作容易多了 我是使用较大的器械
It’s much easier to do what I do, which is take bigger instruments
切除脑肿瘤 他要使用最精细的器械
and take out brain tumors. He’s gotta use the finest instruments.
所以可能要用三到五个月 他才能恢复缝线的能力
So even if it takes three months, four months, five months,
he’s got to be able to sew.
At least I’ll have someone to snowshoe with now.
至少现在有人陪我穿雪鞋了
纽约州规定 所有医疗人员都要接种疫苗
New York State states that every healthcare worker has to be vaccinated,
现在的法律规定
and the way that the laws are working now dictates that
不接种疫苗就不能照料患者
you can’t take care of patients without vaccination.
现在团队中 好像只有我没有接种疫苗了
I think I’m the only one part of the team not vaccinated.
我最后一次在急诊室上班是周四 今天是我最后一天在天空健康上班
My last day in the ER was Thursday. My last day at SkyHealth is today, so…
I’m not gonna cry though.
但我是不会哭的
我正处于事业的黄金期 我喜欢这份工作 我觉得很舒服
Right where I’m in the prime of my career, where I like where I am, I’m comfortable.
我必须做出这个决定 并承担相应的后果
You know, I have to make this decision and the consequence to it.
诺斯韦尔中心呼叫天空健康
Northwell Center SkyHealth,
我们接到一个 来自佩孔尼克湾医疗中心的患者…
I have a patient coming in from Peconic Bay Medical Center…
你听到了吗?
You got it?
This is going to be a STEMI rescue. Patient’s on an Impella and BiPAP,
诊断为ST段抬高型心肌梗死 患者使用了心室辅助装置和呼吸机
心脏监护仪和静脉点滴
cardiac monitor and a couple drips.
收到 听起来病人很不稳定
Copy. It sounds like the patient’s unstable.
移♥动♥患者时一定要异常小心
Let’s make sure that we move the patient very carefully.
油门和开关 环境因素?
Throttles and switches. Environmental considerations?
准备就绪
Ready when you are.
诺斯韦尔中心天空健康一号♥
– Northwell Center SkyHealth One,
13点21分起飞 载员四人
skids up at 13:21 with four souls on board.
(天空健康)
(卡茨妇女医院)
-准备好了吗 亲爱的? -好了
– Ready, my love? – I’m ready.
-好 -好吧
– Okay. – Alright.
我们决定做剖腹产
We decided that we’re going to do the C-section
因为胎位的原因
because of the position of the baby.
If he’s not able to come out without any help,
如果他没有帮助就生不出来
他们将不得不把他的肩膀弄脱臼
they’re going to have to dislocate his shoulder.
我知道我得顺应现实 做好手术准备
I know I just got to let it go and get ready for the surgery.
现在我只想想着
And I just want to think on that moment
第一次见到孩子的面容的时刻
when I’m going to see my son’s face for the first time.
这就是我期待的
That’s what I’m looking forward to.
麻烦按一下三楼
Um, hit three, please?
Are you okay?
你没事吧?
Yes?
嗯?
再过一会儿 我们就能见到我们的孩子了
Later on, we’re going to see our baby.
我希望我当时没有想着别的事
I wish I wasn’t having other things going through my brain,
因为这通常不是最佳状态
because it’s not usually optimal.
但是到了床边 别的事情都被推到了一边
But once you get at the bedside, everything else gets pushed out the way.
你好 我是劳拉护士 什么情况?
Hi. My name is Laura, I’m one of the nurses. What’s going on?
这位先生52岁 昨晚午夜左右入院
This gentleman, 52-year-old male, came in around midnight last night,
救护车送来的 症状是呼吸困难和腹痛
brought in by ambulance, for respiratory distress and abdominal pain.
他没有家人或朋友
He doesn’t have any family or any friends.
他没有家人?好可怜
He doesn’t have family? Aw, poor baby.
他担心“我怎么从这里回家?”
“How am I supposed to get home from here?” He was concerned about that.
我们以为他没有保险 所以没有继续看医生
We were thinking he didn’t have insurance so he didn’t follow up with doctors.
结果是他不知道如何预约
But it’s more of he didn’t know how to set up the follow-up appointments.
-所以他可能需要社工帮忙 -对
– He might need a little social work. – Yeah.
他的药吃完了 一直没有买♥♥药
So his medications ran out, and he never got them refilled.
真可怜
Oh, poor thing.
由于停药 他最后来到了这里
Because he stopped those medications, he ended up in here.
一、二、三
One, two, three.
好
Okay.
舒服吗?很好
Comfy? Good.
你怎么样 柯蒂斯?感觉哪里疼吗?
– How you doing, Curtis? – Tank can go right in here.
Are you having any pain?
有什么不舒服吗?
Any discomfort?
他受不了呼吸面罩
He’s not tolerating the BiPAP mask.
我需要你做几次深呼吸
I want you to take some deep breaths in and out.
暂时不要把心思放在谈话上 好吗?
Try not to focus on talking for a couple of seconds. Okay?
可以把之前我给你的包给我吗?
Can I have that bag that I gave you earlier?
你盯着心室辅助装置 一会儿我来 两秒钟
You just watch that Impella, and then I’ll deal with that. Two seconds.
好 我们得走了
Okay. We got to go.
– Rotor RPM? – 100%
-旋翼转数? -100%
-油门和开关? -正常
– Throttles and switches? – Clean.
-门? -关好了
– Doors? – Secure.
诺斯韦尔中心天空健康一号♥ 我们起飞了
Northwell Center SkyHealth One. We are skids up.
-佩孔尼克 前往南区 -再按一次
– Peconic, en route to the South Side. – Hit it one more time.
Something’s going on with this thing.
这东西出问题了
把它取下来 我们给他 用一会儿非再吸入型面罩 好吗?
Just take it off. We’ll give him a non-rebreather for a minute, okay?
我们去重症监护室 我们得走了 赶紧上去
We’re going to the medical ICU. We need to go, get up there now.
我们从佩孔尼克送一个病人过来
We have the transfer coming from Peconic.
飞行途中遇到了一些问题 但我们都解决了
A couple of hiccups in the air, but we have everything.
都准备好了吗?一、二、三 很好
Everybody ready? One, two, three. Awesome.
Curtis, good luck, okay? It was a pleasure meeting you.
柯蒂斯 祝你好运 好吗? 很高兴认识你
我忘了拿头盔了 我得跑回去 不知道我是怎么了
I left my helmet. I had to run back. I dunno what’s wrong with me.
我心不在焉的
My brain was elsewhere.
-你好 -嗨 朗格医生
– Hello, you. – Hi, Dr. Langer.
– Good morning, Dr. Langer. – How are you?
-早上好 朗格医生 -你好吗?
你好吗?
How are you?
-我得把监护仪重新接上 好吗? -好
– Gotta put you back on our monitor, okay? – Okay.
我得把这些重新接到导线上 好吗?
I’m just going to put these back on the leads, okay?
摘掉他的口罩
Take his mask off.
-嘿 大卫 我是加里·吉安戈拉 -嗨 加里
– Hey, Dave. Gary Giangola. – Hi, Gary.
-你怎么样 伙计? -我没事 还撑得住
– How you doing, buddy? – I’m okay. Hanging in there.
好的 撑住 回头见 好吗?
Alright. Hang in there. I’ll see you later, okay?
嘿 朗格医生 今天我是照顾你的护士 好吗?
Hey, Dr. Langer. I’m going to be your nurse today, okay?
好的
Sure thing.
-早上好 朗格医生 -早上好
– Good morning, Dr. Langer. – Good morning.
我叫马文 我是这里的护工 我来帮你量体温
I’m Marvin, I’m one of the PCA’s up here. I just gotta grab your temperature.
我把这个放在这里 需要止疼药的话 按一下就行了
I’m going to leave this just in case you need pain meds. You click it, right?
-知道了 -是吗?好
– I got it. – Yeah? Okay.
哪个是呼叫护士的?
And which is the nurse call?
-护士呼叫按钮… -我不想把两者搞混
– The nurse call button– – I don’t want to confuse the two.
It’s okay if you do, right?
搞混了也没关系
她怎么还不来?见鬼
– Where is she, goddamn it?
算了
Forget about it.
我很高兴你的幽默感还在 朗格医生
I’m so happy you still have your sense of humor, Dr. Langer.
还在
That I have.
你知道 是在莱诺克斯做手术
You know, the decision whether to have surgery here at Lenox
还是去没人认识他的地方做 这是个艰难的决定
or go somewhere else where there is more anonymity is a tough decision
因为…这个团队是你组建的
because… you built this team.
你清楚哪个外科医生医术好
You know who’s a good surgeon.
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