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1、抓握很好Graspisgood,但史蒂夫的体重增加得并不像我希望的那么快butStevesnotgainingweightquiteasquicklyasdlike.我白天每隔两三个小时喂他一次mfeedinghimeverytwotothreehoursduringtheday,每晚三到四次everythreetofouratnight并在中间挤奶，以增加奶量Andpumpinginbetweentoincreasemilkproduction.好吧，我建议你开始补充配方奶粉Well,mgoingtorecommendyoustartsupplementingwithformula.但每个人
2、都说“母乳最好”？Buteveryonesaysbreastisbest?母乳是理想的选择Breastmilkistheideal.现在，史蒂夫只需要一点额外的东西Rightnow,Stevejustneedsalittleextra.一些样本供你参考Somesamplestogetyoustarted.这是一款出色的产品Thisisanexcellentproduct,这将使我更容易anditwillmakeiteasierforme增加夜间喂奶次数todomorenighttimefeedings.是啊，是啊-是啊Yeah.Yeah.我以为作为联合主席Ithoughtbeingco-pre
3、sidents这意味着我们会一起做事meantwewoulddothingstogether.我的目标是Iwasaimingfor.你做一些事，我做一些事youdosomethingsandIdosomethings.有趣的是，你说的“一些事情”会给我带来更多的工作Funnyhowyoursomethingsleadstomoreworkforme.我不知道你在说什么Ihavenoideawhatyouretalkingabout.与圣约瑟医院的合作协议？TheaffiliationdealwithSanJoseMedSchool?由于护士加入了工会，我们不得不支付超额费用Wehadtocov
4、ertheoveragesbecausethenursesunionized.作为交换，我们教几个医院的学生Inexchange,weteachafewmedstudents.你不会教任何人Youwontbeteachinganyone.我将拥有无用的初生医生Iwillhavetheuselessbabydocs在部门内闲逛wanderingaroundthedepartment就像迷路的孩子拿着手术刀likelostchildrenwithscalpels.我们做了一笔好交易就是这样Wemadeagooddeal.Thatsit.这是笔划算的买♥♥卖&hearts
5、;♥Itsagooddeal.我们应该去自我介绍一下Weshouldgointroduceourselves.不，它们是小鸭子，我不会做它们的妈妈No,theyarebabyducklings,andIwillnotbetheirmommy.把他们交给肖恩和朴1.etthemimprintonShaunandPark.你好！Hi!再见Bye.你好，我是朴医生这位是医生Hi,mDr.Park.ThisisDoctor-肖恩墨菲医生Dr.ShaunMurphy.我真不敢相信真的是你I.Icantbelieveitsreallyyou.我太激动了，都快尿裤子了mjustsoexcite
6、d,mabouttopeemyself.请不要这样做Pleasedonot.当然不是你你不握手Ofcoursenot.Youre.Yourenotashaker.2012年3月有一篇摘要TherewasaMarch2012abstract不愿意握手thatdemonstratedareluctancetoshakehands可用作自闭症的诊断标记couldbeusedasadiagnosticmarkerforASD.但我喜欢紧握的感觉ButIloveagood,firmgrip.这就是自闭症称之为“谱系”的原因Thatswhytheycallitaspectrum.我们可以握一握Wecoul
7、dshake.这不要太用力Thatsnotveryfirm.这样好多了Okay.Thatsbetter.我是夏洛特卢凯提斯mCharlotteLukaitis.很高兴见到你，夏洛特Nicetomeetyou,Charlotte.我现在叫查理”，很快就叫“卢凯提斯医生”了IgobyCharliefornow,Dr.Lukaitisnsoon.距寓我的目标只有两年了Onlytwoyearsawayfrommygoal,这是我17岁时就有的whichvehadsinceIwas17,自从我看到你救人的“热搜”影片后eversinceIsawthatviralvideoofyousaving圣约瑟机场
8、的那个男孩thatboyattheSanJoseAirport使用自♥制♥的单向阀usingahomemadeone-wayvalve.那是最有型、最英雄的事Itwasthecoolest,mostheroicthing在我所见过的自闭症患者中IveeverseenfromapersonwithASD.这是非常英勇的Itwasveryheroic.我选择圣何塞医院IpickedSanJoseformedicalschool希望能策划一次与你的相遇hopingtoengineerarun-inwithyou,但后来你们医院和我的学校合作了butthenyourhosp
9、italpartneredwithmyschool,就像TaylorSwift在Mastermind中所说的那样anditslikewhatTaylorSwiftsaysinMastermind杳理Charlie.当我话太多的时候，唐会帮我DomhelpsmewhenI,youknow,talktoomuch.你好，我是多米尼克胡班克Hi,mDominickHubank.我们很高兴能有如此热心的未来医生加入我们的团队Andwerehappytohavesucheagerfuturedoctorsjoiningtheteam.未来的外科医生Futuresurgeon.我不想当外科医生Idontw
10、anttobeasurgeon,但我对轮换感到兴奋butmexcitedfortherotation.好的Okay.查理，你是我的队员Charlie,youareonmyteam.是的！,Yes!你想发表演讲吗？Wouldyouliketopresent?我很乐意dloveto.理查德谢尔福德，53岁-叫我李奇RichardShelford,53-CallmeRich.不是“利己”Notthatmwealthy.右边是理直德谢尔福德，53岁Right,RichShelford,53yearsold-不觉得自己超过了52岁Dontfeeladayover52.真有意思Thatsfunny.好吧时
11、间太长了Okay.Thisistakingtoolong.请告诉我们发生了什么Pleasetelluswhathappened.他咳得喘不过气来Hewascoughingsohardhecouldntcatchhisbreath,然后他就晕倒了，撞到了头andthenhefaintedandhithishead.咳嗽晕厥Coughsyncope.他更瘦了，也更累了He,sthinnerandwaymoretired比他上一次来看我的时候thanthelasttimehevisitedme.是的，但我没事Yeah,butmfine.只是有点冷Itsjustalittlecold.你几乎无法呼吸，
12、爸爸Youcouldbarelybreathe,Dad.嗯，胸部X光片显示多个肺部结节Um,chestX-rayshowsmultiplelungnodules淋巴结肿大andenlargedlymphnodes在肝区和纵隔区inthehilarandmediastinalareas.进行ABG、全血细胞计数、支气管镜检查GetanABG,CBC,performabronchoscopy,并将活检样本送至病理科andsendbiopsiestopath.你能使用头巾技术包扎伤口吗？CanyouapplyawounddressingusingtheTurbanTechnique?我当然可以Isu
13、recan.嘿，呃Hey,uh.我们还要多久才能离开这里？howlonguntilwecouldgetoutofhere?我的女儿，她请假陪我四处游玩Mydaughter,shetooksometimeoffworktoshowmearound.她有自己的生意Shesgotherownbusiness.在硅谷附近的几间公♥司♥担任技术顾问WorksasatechconsultantforafewcompaniesaroundtheValley.爸爸让他吹牛吧Dad.-Letthemanbrag.这是每个自豪父亲的权利没错对It,severyproudfather,s
14、right.-Yeah.请拿着这个哦Holdthis,please.-Oh.头巾包扎基本技术BasicTurbanTechniqueforheadbandaging.第一步，将两条绷带的两端打一个结Stepone,tietheendsoftwobandagestogetherinaknot.第二步，从一只耳朵开始Steptwo,startingfromoneear.病人对此表现得很好Thepatientwasagoodsportaboutit,但他的女儿并不高兴buthisdaughterwasnothappy.伤口敷料的风险很低Awounddressingisverylowstakes.是查
15、理没按教程做吗？DidCharliedoabadjobfollowingthetutorial?没有，事实上做得还不错Uh,no.Actually,thedressingwasprettydecent.但问题是，病人家属感到不舒服Butthepointis,thepatientsfamilywereuncomfortable.我觉得应该有人告诉她Ithinksomeoneshouldtellher不要再在病人面前播放如何操作的影片nomorehow-tovideosinfrontofpatients.你想的话可以你想的话可以Oh.Youcanifyouwant.我们修复了你的颅骨骨折Wewer
16、eabletorepairyourskullfracture并排出硬膜卜.大面&hearts积♥血肿andevacuatealargesubduralhematoma.真是幸运有无线网络密♥码♥吗？Luckyday.IsthereaWi-Fipassword?我得把联盟通行证拿进来IneedtogetLeaguePassinhere.事故报告说Uh,theaccidentreportsays你走到了迎面而来的汽车前面thatyousteppedrightinfrontofanoncomingcar.我只是没看到而已Ijustdidntseeit.今天是
17、个大日子Bigdaytoday.我得到了快船队的分数赔率和大球IgottheClipsandthepoints,themoneyline,andtheover.这也是六队连胜的最后一站Anditsthelastlegofasix-teamparlay我需要通过thatIneedtocomethrough.动作真大Thatsalotofaction.好吧，在游戏中拥有一些亲身经历会让生活更有趣Well,havingsomeskininthegamemakeslifemorefun.嘿，你可是“统治者”啊Hey,youreTheDominator.呃，现在只叫“统派”了Uh,justDomnow.
18、我的足球时代已经过去了Myfootballdaysarebehindme.你在对阵斯坦福大学时的那次薄饼阻挡？ThatpancakeblockyouhadagainstStanford?为75码的跑动扫清了障碍？Clearedthewayforthat75-yardrun?那场比赛让我赚了一万块Mademe10grand,thatoneplay!你为什么不参加联赛？Whyarentyouintheleague?决定要帮助别人DecidedIwantedtohelppeople而不是伤害他们insteadofhurtthem.好了，抽血检测术后血细胞比容Okay,letsdrawbloodfor
19、post-ophematocrit.一旦脑部消肿，你就可以走了Oncethebrainswellingcomesdown,youcango.你抽血了吗？Haveyoudoneablooddrawyet?这是我离开教室的第一天Itsmyfirstdayoutoftheclassroom.赌五块钱，他得了AFivebuckshegetsanA.不No.好的你去摸摸静脉AllrightYou,regoingtopalpateforavein.哦，记住，在引入针头时Oh,andremember,whenintroducingtheneedle,始终将斜面向上，将试管插入真空采样器alwaysbevel
20、upandinsertthetubeintothevacutainer.你刚刚通过了抽血术101级考试Andyoujustpassedphlebotomy101.哦，上帝啊Oh,God.你现在就可以领先五分Youcouldbeupfiverightnow.他倒下了Hewentdown.我的意思是，很难Imean,hard.额叶和顶叶看起来很清晰Frontalandparietallobeslookclear.对不起msorry.今天早上我做了举重和深蹲Ididdeadliftsandsquatsthismorning.没时间吃早餐Didnthavetimetoeatbreakfast.现在感觉
21、还好吗？Feelingokaynow?我的自尊心受到了打击，但我会没事的Myegotookahit,butllbeokay.哇哦Whoa!那是我们病人的大脑吗？Isthatourpatientsbrain?嗯你刚刚通过了解剖学101Mm.Youjustpassedanatomy101.哪个部分是前面？Whichpartsthefront?哦，说得太快了Oh,spoketoosoon.这是轴向平面Thisistheaxialplane,这意味着我们正从上往下看whichmeanswerelookingdownfromthetop.这里是颗叶和枕叶也很清楚Thesearethetemporalan
22、doccipitallobeshere.Alsoclear.你怎么知道？Howcanyoutell?我们注射了铝，而钱会渗出Weinjectedgadolinium,whichleaksout受伤部位周围aroundtheareasofinjury并使其显示在扫描时更加明亮andmakesthemshowupbrighteronthescan.这样吗？1.ikethat?是啊就像那样Yeah.Likethat.那是个肿瘤Thatsatumor,与他的脑干completelyinterwovenwithhisbrainstem以及颅神经完全交织在一起andcranialnerves并延伸至脊髓上
23、部andextendingtohisupperspinalcord.我想我们知道他为什么没看到那辆车了IguessWeknowwhyhedidntseethatcar.你正在通过喉部下降到气管Youaredescendingthroughthelarynx然后到达隆突tothetracheaandontothecarina.确定得很好-谢谢Nicelyidentified.-Thankyou.积极的肯定对自闭症患者来说是一种力量PositiveaffirmationsareempoweringforpeoplewithASD.“我的自闭症好极了”Myautismisawesome.进入支气管和
24、细支气管Ontothebronchiandbronchioles.我用TaylorSwift的记忆法你们也这样做吗？IuseTaylorSwiftmnemonics.Doyouguysdothat,too?是的No.-1do.不知道我们的情况是否一样Iwonderifoursarethesame.基本气道解剖，ITCBBBasicairwayanatomy,L,T,C,B,B.“情人奸诈羊毛衫宝贝”和“珠宝”Lover/Treacherous,Cardigan,Babe,andBejeweled.我用“坏血”来记忆支气管和细支气管一举两得IusedBadBloodforbothbronchia
25、ndbronchioles.Twoforone.嗯Mm.他会唱一首歌♥Heknowsonesong.查看支气管黏膜上的斑块1.ookatthepatchesonthebronchialmucosa.管腔变窄Theresaluminalnarrowing从肿大的淋巴结中排出fromtheenlargedlymphnodes.这绝对不是肺炎Thisdefinitelyisntpneumonia.太有型了Cool.我的第一个医学之谜Myfirstmedicalmystery.我可以呼唤墨菲医生吗？CanIpageDr.Murphy?你切割过石英台面吗？Didyouevercutquar
26、tzcountertops?是啊Yeah.我最初在一间加工厂工作Istartedoffinafabricationshop.你怎么知道的？How,dyouknowthat?切割石英会产生有毒的微尘颗粒Cuttingquartzproducestoxicfine-dustparticles嵌入你的气道和肺部thathaveembeddedinyourairwayandlungs.你得了矽肺病Youhavesilicosis.就像看魔术一样Itslikewatchingamagictrick.呃，我的医生说只是肺炎复发Uh,mydocsaiditwasjustarecurringpneumonia
27、.矽肺病往往会被误诊，直到为时已晚Silicosiscanoftenbemisdiagnoseduntilitstoolate.你需要进行双侧肺移植Youwillneedabilaterallungtransplant他需要换肺吗？Heneedsnewlungs?是的随着你呼吸功能的下降Yes.Withyourdecliningrespiratoryfunction和广泛的破坏andextensivedamage,应优先考虑对你们进行移植youshouldbeprioritizedfortransplant.但在你的余生中，你将需要全职的家庭护理Butyouwillneedfull-timeh
28、omecarefortherestofyourlife.但我一个人住在佛罗里达ButIlivealonebackinFlorida.爸爸，一步一步来Dad,onestepatatime.我觉得你应该在这里做手术Ithinkyoushouldgetthesurgeryhere,那就搬来和我一起住thenmoveinwithme.我做不到Icantdothat.当然可以Ofcourseyoucan.你的事业刚刚起步我不会给你增加负担Yourcareerhasjusttakenoff.mnotgonnaburdenyou.这不是负担你是我爸爸Itsnotaburden.Youremydad.你帮我剥
29、橙子，还当过我足球队的教练Youpeeledmyorangesandcoachedmysoccerteam.然后你供我上大学和商学院Thenyouputmethroughcollegeandbusinessschool.让我来照顾你1.etmetakecareofyou.有人正确抚养了他的女儿Someoneraisedhisgirlright.好的Okay.我们会给移植协调员打电♥话♥Wewillcallatransplantcoordinator.史蒂夫在哪里？WheresSteve?在大厅里和护士调情Downthehall,flirtingwiththenurs
30、es.我需要你给我开个多潘立酮的处方Ineedyoutowritemeaprescriptionfordomperidone.它能增加母乳分泌Itincreasesbreastmilkproduction.所有的妈妈留言板都这么说Allthemommessageboardssayso.它在任何地方都没有被批准为哺乳辅助食品Itisnotapprovedasalactationaidanywhere.加拿大和墨西哥的医生在标签外使用这种药物DoctorsinCanadaandMexicoareusingitoff-label.史蒂夫不喜欢海伦医生推荐的配方吗？DoesStevenotliketh
31、eformulaDr.Hylandrecommended?我不喜欢，肖恩Idontlikeit,Shaun.我觉得我觉得自己是个失败的母亲Ifeellike.Ifeellikeafailureasamom.但你不是失败者Butyouarenotafailure.你遵循了所有建议准则Youarefollowingalltherecommendedguidelines.事实匕你唯一没有遵守的准则是Infact,theonlyguidelineyourenotfollowing按照建议补充配方奶粉issupplementingwithformulaasadvised.肖恩Shaun.我想当妈妈已经很
32、久了Ivebeenwantingtobeamomforsolong,其中一部分原因是我的身体应该给史蒂夫andpartofthatismybodyissupposedtogiveSteve他需要的一切，而我的不会everythingheneeds,andminewont.我讨厌这样AndIhateit.请进Comein.很好你们都来了Good.You,rebothhere.伊登宝宝“品尝和观赏”活动邀请函AninvitetoBabyEden,sSipandSee.让大家正式见见她Soeveryonecanofficiallymeether穿着可爱的裙子，而不是医院的病号♥服ina
33、cutedressinsteadofahospitalgown.格拉斯曼医生要去吗？IsDr.Glassmangoing?我想是的-那我就不去了1thinkso.-ThenIdonotwanttogo.我还以为你和格拉斯已经和好了呢IthoughtyouandGlassyhadworkedthingsout.那天晚上他带走了史蒂夫HetookStevetheothernight.嗯Hmm.谁在乎他在不在？Whocaresifhesthere?只要你和那个可爰的宝宝能活下来Aslongasyouandthatgorgeousbabymakeit.不会错过的Wouldntmissit.当妈妈是不是
34、很棒？Isntbeingamomgreat?不能更棒了Thegreatest.你刚才说你觉得自己很失败Youjustsaidyoufeellikeafailure.我认为这是因为产后体力下降的缘故Ithinkthatisbecauseofapostpartumdecrease受雌激素和孕酮的影响inestrogenandprogesterone.你刚才说我荷尔蒙分泌旺盛？Didyoujustcallmehormonal?不，实际上是荷尔蒙分泌减少了-好吧No,actuallyreducedhormonal.-Okay,Shaun.该走了-这是我的办公室Timetogo.-Thisismyoff
35、ice.不要让它成为你的墓地1.etsnothaveitbeyourgravesite.啊你一定有办法的Huh.There,sgottabesomethingyoucando.我们无法安全地切除肿瘤Wecantsafelyremovethetumor而不会对脑干造成永久性损伤withoutpermanentinjurytoyourbrainstem.如果你能从手术中活下来的话Ifyousurvivethesurgeryatall.对不起我知道这很难接受msorry.Iknowitsalottotakein.但是新技术层出不穷Buttheres.theresnewtechnologyallthe
36、time.纳达尔的背伤通过干细胞治疗Nadalsbackwiththestemcells,以及巴托洛科隆andBartoloColon运动员骨伤的实验性治疗Experimentaltreatmentsonathletesorthopedicinjuries与脑外科手术完全不同arecompletelydifferentthanbrainsurgery.能否切除部分肿瘤？C-Couldyouremovesomeofthetumor?为我争取更多时间？化疗怎么样？Buymemoretime?Howaboutchemo?化疗对这种癌症无须Thistypeofcancerdoesntrespondto
37、chemo.我们确实在课堂上读过一篇关于TCR方法的论文WedidreadapaperinclassaboutaTCRapproach.有希望吗？Couldthatbesomething?只做过几次Thatwasonlydoneafewtimes,且从未涉及到脑干andneverwithbrainsteminvolvementTCRTCR.这是我最喜欢的字母Itsmynewfavoriteletters.无论他们代表什么，我们都要做这个Whatevertheystandfor,letsdothat.TCR意味着我们要锯穿你的下颌骨TCRmeanswewouldsawupthroughyourm
38、andible卜颌脱臼anddislocateyourlowerjaw.然后我们从你的口腔顶部切开Thenwecutopenfromtheroofofyourmouth到你的喉咙后面tothebackofyourthroat.这只是为了接触到肿瘤Thatsjusttoaccessthetumor.那个肿瘤与你的脑干交织在一起Thattumoriswovenintoyourbrainstem.移除它很可能会让你四肢瘫痪Removingitwouldverylikelyleaveyouquadriplegic,如果手术成功，你将无法说话或行动unabletospeakormove,ifyousur
39、vivethesurgery.好的Okay.也许这不是我的最爱Maybeit,snotmyfavorite.但让我们试试Butletstry.萨尔，你应该好好享受剩下的时光Sal,youshouldenjoyyourremainingtime.旅行Travel.与家人联络Connectwithfamily.我要和谁联络？WhoamIgonnaconnectwith?赌钱输光后被妻子赶出家门WifekickedmeoutwhenIgambledaway那些钱还是孩子的大学基金thekidscollegefund.这么多年来，他们都没跟我说过话Noneofthemhavetalkedtomefor
40、years.我要休息了Igotabreakcomingmyway.我能感觉到Icanfeelit.我们的年度报告Wevegotourannualpresentation面向管理性医疗公♥司hearts;tothemanagedcarecompanies.他们希望获得有关患者疗效的详细报告Theywantdetailedreportsonpatientoutcomes用于糖尿病老年病fordiabetes,geriatrics-好极了永远都不要安排Thatsgreat.Schedulethatfornever.不，我定在明天9点这答案不对No,vesetitfortomorrowa
41、t9:00.-Thatsthewronganswer.不幸的是，我连续接受了两次手术Unfortunately,Ihaveback-to-backsurgeries.幸好我有个拍档，可以做我不能做的事情ThankgoodnessIhaveapartnertodothethingsIcant.哦Oh.要知道，医学生是可以和住院医生一起吃饭的Youknow,medstudentsareallowedtoeatwiththeresidents.我觉得人们咀嗡的声音令人不安Ifindthesoundofpeoplechewingtobeunsettling.好吧，如果你想要一些指导Well,ifyou
42、wantsomeguidance而且你不介意听到啜饮的声音andyoudontmindthesoundofsippingnoises,乔丹和我可以带你去喝咖啡Jordanand1cantakeyouforcoffee.JHappyBirthday,DearDaddyJ哈Ha-宝贝，我一会儿打给你Uh,baby,letmecallyourightback你的胸罩在哪里买♥♥的？Wheredidyougetyourbra?我一直对蕾丝很感兴趣可以吗？Ivealwaysbeenintriguedbylace.Isitokay?现在有点忙我们能晚点在楼上谈吗？Kindofb
43、usyrightnow.Canwetalkupstairslater?你在做什么？Whatareyoudoing?只是和朋友聊聊天Justtalkingtoafriend.你叫他“爸爸”，但你♥爸♥爸在楼上YoucalledhimDaddy,butyourdadsupstairs.他是一个客户，一个常客Hesaclient,aregular.他在最后一刻给了我5000美元Hepaidmefivegrandforalast-minutesession.我很幸运，他喜欢暴露癖1.uckyforme,hesintoexhibitionism.五千？比我赚的还多Fivegr
44、and?ThatsmorethanImade挣那些钱我做了整整一个月的女招待，还包括小费awholemonthwaitressing,includingtips.人们会给性工作者小费吗？Dopeopletipsexworkers?查理，这不关我们的事，所以Charlie,thisisn,tanyofourbusiness,so.很多人都知道我是做什么的PlentyofpeopleknowwhatIdo.除了我真正的父亲Justnotmyactualfather.求你了，你什么都不能对他说Please,youcannotsayanythingtohim.当然不会Ofcoursenot.啊好消息A
45、h.Goodnews.捐献的肺刚刚可用Donorlungsjustbecameavailable.“生日快乐，爸爸”，的确如此Happybirthday.Daddy/indeed.捐赠者在楼上靠生命维持机维持生命Thedonorsupstairsonlifesupport.他的家人已经准备好撤出护理Hisfamilyisreadytowithdrawcare.我们会带你去做一些额外的检查Welltakeyouforsomeadditionaltesting,但移植手术可能明天就会进行butthetransplantcouldhappenassoonastomorrow.哇哦你需要在一楼有一间睡房♥Wow.-Youllneeda
