神迹

但我不这么看 我指的是 这病的四大难点
But I don’t believe it has to be. I’m speaking of Tetralogy of Fallot.
蓝婴
Blue babies.
是的 那些孩子 他们的心脏没有问题
Yes, these children, their hearts aren’t failing…
但通往肺部的主动脉阻塞 使他们窒息
they’re suffocating due to a blockage in the main artery to the lung.
肺动脉瓣狭窄
Pulmonary stenosis.
死亡率是百分之百
The mortality rate is 100%.
我见过数百孩子因此而发绀而死
I’ve watched hundreds of cyanotic children die.
我认为 今晚一个婴孩肯定会死
I admitted a baby tonight who will certainly die…
仅仅是因为没人有勇气
simply because no one has had the courage…
来尝试解决这种病症的外科手术
to attempt a surgical solution to this.
这也许是 个好理由
Maybe with good reason.
说得委婉些 你不能动心脏 这是基本法则
To put it mildly, you can’t operate on the heart. That’s basic.
我们没有临床验证…我的意思恰恰如此
-We don’t have clinical proof of that—My point exactly.
可能对我们来说…登顿 你得在3分钟内
-It’s possible for us—Denton, you have to stop the heart…
让心脏停止运行来进行这个复杂的手术
to perform a complicated correction within three minutes.
而那时 他们就已经死了 这些孩子就死了
By that time, they’re dead. These children are doomed.
一定有什么方法能让肺获得更多的血液
There must be a way to get more blood to the lungs.
我是说 我猜我们可以弥补心室上的缺陷…
I mean, I doubt we could repair a defect in the heart walls–
而不致于引起心室纤维颤动
Without causing ventricular fibrillation.
也许有一种方式可以避免干扰
But maybe there’s a way to avoid interfering
整个的血液循环
with the greater circulation….
如果我们只是关注肺动脉
If we focus on the pulmonary artery.
老天你到底是谁
Who on this God’s earth are you?
从聚会上带回了一些吃的 我正想法让她入睡
-Brought home some food from the party. -I’m trying to get her down.
拿着
Hold on.
好 小丫头 睡吧
Okay, girl. Now go to sleep, baby.
孩子们才上♥床♥
The girls are just getting to bed?
楼上那个2吨♥重的大胖子差点 把楼板闹穿
2-ton neighbor upstairs nearly burst through the boards.
我会解决的 解决那个胖子
-I’m gonna have to fix that. -Are you gonna fix the fat man?
当孩子们要入睡的时候 叫他不要大吵大闹
Get him to stop hollering his head off, when the girls is trying to sleep?
尝尝辣鸡蛋 它们的确不错
Try a deviled egg. They’re real good.
似乎比纳什维尔要糟糕
Seen better in Nashville.
我想回家 维维安
I want to go home, Viv.
克拉拉 我们才来这一周
Clara, it’s our first week.
是的 但你说过如果我们不喜欢这里 记得吗
Yeah, and you said if we didn’t like it, remember?
是的 我们的家人在纳什维尔
-Yes. -Our family’s in Nashville.
我们有温馨的家和好邻居 学校也不错
We had a nice home in a good neighborhood. The schools were fine.
也不是住在这种地方…
Not living in this….
就他付给你的那些薪水
I don’t know how we’re gonna make it on
我不知道怎么才能象过去那样
that paycheck he’s talking about…
而且他把你当侍者在聚会里上酒水
and he got you serving drinks at his party just to make ends meet. Come on.
要明白 当我在万德比特起步时
Try to understand. When I started at Vanderbilt…
我只是个工人 我知道
-I was a janitor. -I know.
巴诺克博士知道我能做什么 他给了我一个机会
Dr. Blalock saw what I could contribute, and he gave me a chance.
他没有要底特律那边的一个美差
And when they offered him that big job in Detroit…
因为他们让他带着我一起去
he didn’t take it because they didn’t take me.
现在我是全国最好的医学院里的
Now I’m a lab assistant to a top surgeon…
一个顶尖外科医生的实验室助手
at the number one medical school in the country.
这是个好职位 那你去读医学院的事情怎么办
-It’s a good position. -What about you going to medical school?
不必提醒我这点 我们现在有了家庭
You don’t have to remind me of that. We have a family now.
亲爱的 这是个重要的工作
Sweetheart, it’s important work.
这是个真正的机会 而且我喜欢我做的事情
And it’s a real opportunity, and I love what I’m doing.
所以酒不用在乎我的感受
So it doesn’t really matter how I feel, then, does it?
克拉拉你知道我在乎的
Clara, you know it matters.
看见那个人了吗
See that man?
那就是约翰·霍普金斯本人
That’s Johns Hopkins himself.
威廉·奥斯勒爵士
Sir William Osler…
现代美国医学之父
the father of modern American medicine.
威廉·霍斯德 乳♥房♥♥切除术的鼻祖
William Halstead, invented the mastectomy.
我带你看看其他人
Let me show you some of the others.
打搅 所有的工人在后门打卡
Excuse me. All workers punch in at the rear entrance.
他和我一起的 那也不行
-He’s with me. -That don’t make any difference.
你知道我是谁吗 不知道
-Do you know who I am? -No, sir.
巴诺克博士 首席外科教授
Dr. Blalock, Chief Surgical Professor.
抱歉 巴诺克博士 规则就是这样
I’m sorry, Dr. Blalock, but that’s the rules.
在实验室碰头维维安
I’ll meet you in the labs, Vivien.
你得先去打卡
Hey, you need to punch in first.
谢谢
Thank you.
终于来了 却是这样
I can see we’ve arrived.
他们上次用这里是什么时候
When was the last time they used this place?
把仪器搬进来之前 让人清扫一下
Have someone clean it up before they put the equipment in.
一小时后在哈尼特病房♥区见
I’ll meet you in an hour at the Harriet Lane wards.
看看陶西格博士有什么想法
Let’s see if there’s anything in this idea of Dr. Taussig’s.
打搅
Excuse me?
早上好
Good morning.
医生 哪里可以找到人来打扫实验室
Where do you think I could find someone to help us clean up the lab, Doctor?
你知道在和谁讲话吗 不清楚
-Who do you think you’re talking to? -I’m not sure.
我是维维安·托马斯
I’m Vivien Thomas,
为主持这个实验室的巴诺克博士工作
I work for Dr. Blalock, running this lab.
我是埃德加·V·海克博士…
I’m Dr. Edgar V. Hecker…
实验室主管 我需要些咖啡和面包圈
Director of Laboratories. I’d like some coffee and a doughnut.
医生
Doctor.
一定是误会了
There must be a mix-up.
听好 我不是摆架子 等着瞧
Listen, I don’t stand for insolence. We’ll see about this.
博士 知道吗 没有那么多…什么
-You know, Doctor, there aren’t many—What?
你得说大声点 我这只耳朵听力不好
You’ll have to speak up, I can’t hear too well in this ear.
你是这里不多见的女医生之一 就我看到的来说
You’re one of the few women doctors I’ve seen here.
至少他们让我进大门吧
At least they let me in through the front door.
这是稍大些孩子呆的地方
This is where we keep some of the older kids.
博士 为何他们象那样蹲着
Doctor, why do they squat like that?
一个小男孩告诉我那样呼吸顺畅些
A little boy told me that it helps him breathe better.
它阻止血液流向腿部 让它流向肺部
It cuts off the blood to the legs, pushes it up into the lungs.
他们都看起来有些青紫
They both look very cyanotic.
-他来了
Here he is now.
巴诺克博士 欢迎 抱歉来晚了
-Dr. Blalock. Welcome. -Helen, sorry.
这是萨克森家的孩子 我昨晚 向你提起过
Here is the Saxon baby I was telling you about last night.
谢谢
Thank you.
别人这么做的时候她往往会笑
She usually smiles when someone does that.
你好 萨克森夫人
Hello, Mrs. Saxon.
那是什么 那是血氧计
-What is that thing? -It’s an oximeter.
用来测血液中有多少氧气
Reads how much oxygen there is in the blood.
在里边她看起来很冷 但我无法抱抱她
She looks cold in there. But I can’t hold her.
他们说这对她不利 我甚至都 无法让她哭出来
They say it isn’t good for her. I’m not even supposed to let her cry.
当你都无法抱她时 你又如何能 让一个婴儿不哭
How do you keep a baby from crying? Especially if you can’t hold her.
当心脏增大时 你可以看见
You can see the change in the shape and the size of the vessels…
血管在形状和大小上的变化
as these hearts grow larger.
我在一些病人的心脏上做过 坏死性实验
I did necroscopies on some of my patients’ hearts.
来详细研究这种心畸形
To study the malformations in detail.
真奇怪他们能靠着这种心脏活下来
It’s amazing they could live at all with hearts like these.
哈佛的格罗斯教授说只有上帝
Dr. Gross at Harvard said only God could correct…
才能解决主动脉弓左侧的收缩性缺口
a narrowing indentation of the left side of the aortic arch.
那个论断更多地是出自哈佛而不是上帝吧
Perhaps that statement says more about Harvard than it does about God.
那个婴儿来了多久
That baby back there, how long?
半年 至多一年
Six months. A year at the very most.
那婴儿不妙 博士 你准备接手此事吗
-That’s not right. -Are you going to take this on, Doctor?
让我看看你的诊断笔记
I want to see all your diagnostic notes.
我马上去拿
I’ll get them right away.
谢谢
Thank you.
维维安 把那些书扔开
Put away the books, Vivien.
不要把时间浪费在纸上谈兵上
Let’s not waste any more time on theoretical crap.
我们从实验开始入手
Let’s start with experiments.
四个不同的问题同时出在在心脏上
Four separate defects of the heart working in combination.
分别通往两片肺叶的肺动脉
The pulmonary artery is constricted…
在分开之前 动脉太狭窄
in the main artery before the divide,
减少了对 两片肺叶的血液供应
diminishing blood supply to both lungs.
隔膜上的洞穴
And the hole in the septum…
使得废血又流回了动脉系统
causes the used blood to flow back into the arterial system…
而不是流向肺部 使得孩子们发绀青紫
instead of flowing through the lungs, turning the babies blue.
孩子的心脏娇嫩无比
A baby’s heart is delicate.
这真是个危机重重的雷区
It’s a goddamn minefield.