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AtulGawande_2017-_想要精益求精？找个教练_
I don't come to you today as an expert. 我今天不是以專家的身分來,
I come to you as someone who has been really interested in how I get better at what I do and how we all do. 我來是因為我一直很想知道 要怎麼讓自己做得更好, 我們要怎麼做得更好。
I think it's not just how good you are now, 這件事不只關於你現在多好,
I think it's how good you're going to be that really matters. 你會變得多好才是重點。
I was visiting this birth center in the north of India. 我之前在北印度一間婦產中心
I was watching the birth attendants , and I realized I was witnessing in them an extreme form of this very struggle, which is how people improve in the face of complexity -- or don't. 觀察接生人員, 我意識到自己目睹他們 用一種很極端的方式使勁掙扎, 就是人在面對複雜情況的時候 進步的那個樣子, 或沒進步的樣子。
attendants:n.服务员;侍者,众侍从(attendant的复数); witnessing:v.当场看到,目击;是发生…的地点;见证;(witness的现在分词) extreme:adj.极端的;极度的;偏激的;尽头的;n.极端;末端;最大程度;极端的事物; improve:v.改进;改善; in the face of:面对; complexity:n.复杂性;难以理解的局势
The women here are delivering in a region where the typical birth center has a one-in-20 death rate for the babies, and the moms are dying at a rate ten times higher than they do elsewhere . 女性在這區一般產房生產 要面對二十分之一的嬰兒死亡率, 母親的死亡率比其他地方高出十倍。
region:n.地区;范围;部位; typical:adj.典型的;特有的;象征性的; death rate:n.死亡率; elsewhere:adv.在别处;到别处;
Now, we've known the critical practices that stop the big killers in birth for decades, and the thing about it is that even in this place -- in this place especially , the simplest things are not simple. 現在我們已經知道 數十年來讓嬰兒活產的關鍵措施。 但問題是即使在這裡, 尤其是這裡, 最簡單的事情都辦不到。
critical:adj.鉴定的;[核]临界的;批评的,爱挑剔的;危险的;决定性的;评论的; especially:adv.尤其;特别;格外;十分;
We know for example you should wash hands and put on clean gloves, but here, the tap is in another room, and they don't have clean gloves. 例如我們應該要洗手、戴乾淨手套, 但是這裡, 水龍頭在別的房間, 而且他們沒有乾淨的手套。
To reuse their gloves, they wash them in this basin of dilute bleach , but you can see there's still blood on the gloves from the last delivery . 為了重覆使用手套, 他們用這盆稀釋的漂白水洗, 但是大家可以看到, 手套上還有之前接生的血漬。
basin:n.水池;流域;盆地;盆; dilute:adj.稀释的;淡的;vt.稀释;冲淡;削弱;vi.变稀薄;变淡; bleach:n.漂白剂;v.(使)变白,漂白,晒白,退色 delivery:n.[贸易]交付;分娩;递送;
Ten percent of babies are born with difficulty breathing everywhere. 10% 的嬰兒出生時會呼吸困難, 不管在哪都一樣。
We know what to do. 我們知道怎麼應對。
You dry the baby with a clean cloth to stimulate them to breathe. 用一塊乾淨的布擦乾嬰兒, 刺激他們呼吸,
stimulate:v.刺激;激发;促进;激励;
If they don't start to breathe, you suction out their airways . 如果他們還沒開始呼吸, 就抽吸他們的呼吸道。
suction:n.吸;吸力;抽吸; airways:n.航空公司;广播频道;
And if that doesn't work, you give them breaths with the baby mask. 如果還不行, 就給他們戴嬰兒氧氣罩。
But these are skills that they've learned mostly from textbooks, and that baby mask is broken. 這些方法他們幾乎都在課本上學過, 但是嬰兒氧氣罩壞了。
In this one disturbing image for me is a picture that brings home just how dire the situation is. 這個畫面讓我很難受, 完全顯示出情況有多慘。
disturbing:adj.引起烦恼的;令人不安的;v.打扰;干扰;搅乱;使不安;(disturb的现在分词) dire:adj.可怕的;悲惨的;极端的;
This is a baby 10 minutes after birth, and he's alive, but only just. 這個小孩剛出生十分鐘, 他還活著, 但只剩一絲殘息。
No clean cloth, has not been dried, not warming skin to skin, an unsterile clamp across the cord . 沒有乾淨的布, 沒有被擦乾, 身體還沒完全變暖, 未殺菌的鉗子剪斷臍帶。
clamp:v.夹紧,固定住;n.夹钳,螺丝钳; cord:n.(结实的)粗线,细绳;灯芯绒裤子;v.用索子捆[绑,扎];堆积(柴薪)
He's an infection waiting to happen, and he's losing his temperature by the minute . 他可能快被感染, 每分鐘都在失溫。
infection:n.感染;传染;(身体某部位的)感染;传染病; by the minute:每时每刻
Successful child delivery requires a successful team of people. 成功接生需要一組成功團隊。
A whole team has to be skilled and coordinated; the nurses who do the deliveries in a place like this, the doctor who backs them up, the supply clerk who's responsible for 22 critical drugs and supplies being in stock and at the bedside , the medical officer in charge, responsible for the quality of the whole facility . 每個人都應該技巧熟練、合作無間, 要有能在這種地方接生的護理師, 要有能夠支援的醫生, 要有負責打點 22 種重要藥物 和醫療用品的補給員, 確保有現貨放在床邊, 要有醫務官負責 所有設備的品質。
skilled:adj.熟练的;有技能的;需要技能的; deliveries:n.[贸易]交货(delivery的复数);已交付; responsible:adj.负责的,可靠的;有责任的; stock:n.股票; v.库存; adj.老一套的; bedside:n.床边,床旁;adj.床旁的,枕边的; medical officer:n.卫生人员;卫生干事;(某机构的)专职医生; facility:n.设施;设备;特别装置;特色;场所;天资;
The thing is they are all experienced professionals . 重點是他們全都是 有經驗的專業人員。
professionals:n.[管理]专业人员(professional的复数);
I didn't meet anybody who hadn't been part of thousands of deliveries. 我碰過的每一個都接生過好幾千次。
But against the complexities that they face, they seem to be at their limits. 但是面對這複雜的情況, 他們就像已經做到極限,
complexities:n.复杂性(complexity的复数);错综复杂的事物;
They were not getting better anymore. 沒辦法做得更好。
It's how good you're going to be that really matters. 你能做得多好,才是重點。
It presses on a fundamental question. 這又涉及一個基本的問題。
fundamental:n.基础; adj.十分重大的;
How do professionals get better at what they do? 專業人員要怎麼做得更好？
How do they get great? 要怎麼做到最好？
And there are two views about this. 關於這個有兩種觀點。
One is the traditional pedagogical view. 第一種是傳統教學的觀點。
traditional:传统的,惯例的, pedagogical:adj.教育学的;教学法的;
That is that you go to school, you study, you practice, you learn, you graduate, and then you go out into the world and you make your way on your own. 就是你上學、 研讀、練習、學習、畢業, 然後出校園進入世界, 用自己的方式走自己的路。
A professional is someone who is capable of managing their own improvement . 專業人員有能力讓自己進步。
capable:adj.能干的,能胜任的;有才华的; improvement:n.改进,改善;
That is the approach that virtually all professionals have learned by. 各行各業都學過怎麼做。
approach:n.方法;路径;v.接近;建议;着手处理; virtually:adv.事实上,几乎;实质上;
That's how doctors learn, that's how lawyers do, scientists ... 醫生就是這麼學的, 還有律師也是, 科學家……
musicians. 音樂家。
And the thing is, it works. 重點是,這些方法有用。
Consider for example legendary Juilliard violin instructor Dorothy DeLay. 例如茱莉亞學院的小提琴 傳奇教師桃樂絲．狄蕾。
legendary:adj.传说的,传奇的;n.传说集;圣徒传; instructor:n.指导书;教员;指导者;
She trained an amazing roster of violin virtuosos : 她訓練過的小提琴大師 名單熠熠生輝:
roster:n.花名册;执勤人员表;逐项登记表; virtuosos:adj.技艺精湛的; n.技艺超群的人; (virtuoso的复数);
Midori, Sarah Chang, Itzhak Perlman. 五嶋綠、張永宙、伊扎克．帕爾曼。
Each of them came to her as young talents, and they worked with her over years. 每個好手在年輕時就拜師學藝, 跟著她很多年。
What she worked on most, she said, was inculcating in them habits of thinking and of learning so that they could make their way in the world without her when they were done. 她說,自己做最多的是 灌輸他們思考和學習的習慣, 如此一來他們學成後, 無需她隨侍在側, 就可以自己闖蕩世界。
inculcating:v.反复灌输;谆谆劝导;(inculcating是inculcate的现在分词);
Now, the contrasting view comes out of sports. 體育界持相反觀點。
contrasting:adj.形成鲜明对比的; v.使对比;
And they say "You are never done, everybody needs a coach." 他們說:「永遠學不完, 每個人都要教練。」
Everyone. 無一例外。
The greatest in the world needs a coach. 世界上最厲害的運動員也需要教練。
So I tried to think about this as a surgeon . 我把這件事套在外科上思考。
surgeon:n.外科医生;
Pay someone to come into my operating room, observe me and critique me. 付錢請人到我的開刀房, 觀察我、評論我,
observe:v.观察;看到;庆祝;监视; critique:n.评论文章;评论;v.写评论;对…发表评论;评判;
That seems absurd . 好像有點奇怪。
absurd:adj.荒谬的;可笑的;n.荒诞;荒诞作品;
Expertise means not needing to be coached. 專家意謂著不需再受教。
Expertise:n.专门知识;专门技术;专家的意见;
So then which view is right? 哪個觀點正確？
I learned that coaching came into sports as a very American idea. 我發現運動界開始提倡找教練 是很美式的做法。
In 1875, 1875 年的時候,
Harvard and Yale played one of the very first American-rules football games. 哈佛和耶魯對打 當時少見的橄欖球賽。
Harvard:n.哈佛大学;哈佛大学学生;
Yale hired a head coach; 耶魯聘了一位總教練;
Harvard did not. 哈佛沒有。
The results? 結果呢？
Over the next three decades, 之後三十年
Harvard won just four times. 哈佛只贏了四次。
Harvard hired a coach. 哈佛之後也請了教練。
(Laughter) （笑聲）
And it became the way that sports works. 這件事就變成體育界常態。
But is it necessary then? 但是真的有必要嗎？
Does it transfer into other fields? 其它領域也適用嗎？
transfer:n.转移;调任;调离;[体]转会球员;v.调任;调走;转学;转移;
I decided to ask, of all people, 我決定去問
Itzhak Perlman. 伊扎克．帕爾曼。
He had trained the Dorothy DeLay way and became arguably the greatest violinist of his generation. 他在桃樂絲．狄蕾門下受訓, 成為他那一代 可說是最成功的小提琴家。
arguably:v.可论证地;
One of the beautiful things about getting to write for "The New Yorker" 幫《紐約客》寫文章 最棒的一件事情是
is I call people up, and they return my phone calls. 我打給電話找人,他們會回電。
(Laughter) （笑聲）
And Perlman returned my phone call. 帕爾曼先生回了我電話。
So we ended up having an almost two-hour conversation about how he got to where he got in his career . 結果我們談了將近兩小時, 他告訴我他怎麼達到現在的境界。
career:n.职业;事业;生涯;经历;
And I asked him, I said, "Why don't violinists have coaches?" 我問他: 「為什麼小提琴家不請教練？」
violinists:n.小提琴演奏者,小提琴家;
And he said, "I don't know, but I always had a coach." 他說:「我也不知道, 但我以前都有教練。」
'"You always had a coach?" 「你以前都有教練？」
'"Oh yeah, my wife, Toby ." 「對啊,是我老婆,桃比。」
Toby:n.托比(男子名);矮胖老人形啤酒杯;
They had graduated together from Juilliard, and she had given up her job as a concert violinist to be his coach, sitting in the audience, observing him and giving him feedback . 他們一起從茱莉亞學院畢業, 她放棄當小提琴演奏家, 改當他的教練, 坐在觀眾席, 觀察他、給他意見。
observing:adj.观察的;注意的;观察力敏锐的;v.观察;遵守(observe的现在分词); feedback:n.反馈;反馈意见;回授;[电子]反馈;
'"Itzhak, in that middle section, you know you sounded a little bit mechanical . 「伊扎克,中間那段, 聽起來有點生硬。
mechanical:adj.机械的;力学的;呆板的;无意识的;手工操作的;
What can you differently next time?" 下次你可以怎麼改？」
It was crucial to everything he became, he said. 他說這件事對他的成就功不可沒。
crucial:adj.重要的;决定性的;定局的;决断的;
Turns out there are numerous problems in making it on your own. 事實證明,自己追求進步 會有很多問題。
numerous:adj.许多的,很多的;
You don't recognize the issues that are standing in your way or if you do, you don't necessarily know how to fix them. 你不會意識到卡住你的問題, 即使你知道問題, 也不見得知道該怎麼改善。
recognize:v.认识;认出;辨别出;承认;意识到; issues:n.重要议题;争论的问题;v.宣布;公布;发出;(issue的第三人称单数和复数) necessarily:adv.必要地;必定地,必然地;
And the result is that somewhere along the way, you stop improving . 結果就是成長路上的某一刻 你不再進步。
improving:v.改进;改善;(improve的现在分词)
And I thought about that, and I realized that was exactly what had happened to me as a surgeon. 我思考了這一點, 了解到那就是我身為外科醫師 所碰到的問題。
I'd entered practice in 2003, and for the first several years, it was just this steady , upward improvement in my learning curve . 我 2003 年開始行醫, 頭幾年 我在學習中一直穩定成長。
steady:adj.稳定的; v.使稳定; v.稳定地; n.关系固定的情侣; upward:adj.向上的;上升的;adv.向上; learning curve:n.经验学习曲线;
I watched my complication rates drop from one year to the next. 我看著我病人的併發率年年下降,
complication:n.并发症;复杂;复杂化;混乱;
And after about five years, they leveled out. 大概五年後 就停在那邊。
leveled:n.水平; adj.水平的; vi.瞄准; vt.使同等;
And a few more years after that, 之後又過了幾年,
I realized I wasn't getting any better anymore. 我知道自己沒有再進步了。
And I thought: "Is this as good as I'm going to get?" 我心想:「這就是我的能耐了嗎？」
So I thought a little more and I said ... 我再想了一下之後決定:
'"OK, 「好,
I'll try a coach." 我要找教練。」
So I asked a former professor of mine who had retired, his name is Bob Osteen, and he agreed to come to my operating room and observe me. 所以我問了我之前的教授, 他退休了, 叫做鮑伯．歐斯汀, 他答應我到我的手術房 觀察我。
The case -- 第一個病例,
I remember that first case. 我記得很清楚,
It went beautifully. 那個手術開得很漂亮。
I didn't think there would be anything much he'd have to say when we were done. 結束後,我覺得他不會有什麼好說的。
Instead, he had a whole page dense with notes. 但是他寫了一整張密密麻麻的筆記。
dense:adj.稠密的;浓厚的;愚钝的;
(Laughter) （笑聲）
'"Just small things," he said. 「一些小事而已,」他說。
(Laughter) （笑聲）
But it's the small things that matter. 但魔鬼藏在細節裡。
'"Did you notice that the light had swung out of the wound during the case? 「你有發現開刀的時候, 燈沒有對著傷口照嗎？
wound:n.创伤,伤口;v.使受伤;受伤,伤害;
You spent about half an hour just operating off the light from reflected surfaces." 你有半小時 用反射光動手術。」
reflected:adj.反射的;得自他人的;v.反射;思考;(reflect的过去式和过去分词)
'"Another thing I noticed," he said, "Your elbow goes up in the air every once in a while . 「我還注意到一件事,」他說, 「你的手肘三不五時會往上提。
elbow:n.肘;弯头;肘状物;v.用肘推;挤进;讨价还价; every once in a while:有时;偶然;偶尔;时而;
That means you're not in full control. 表示你沒有完全控制自己。
A surgeon's elbows should be down at their sides resting comfortably. 外科醫生的手肘應該要自然下垂。
elbows:n.弯头; v.用肘推; (elbow的第三人称单数和复数)
So that means if you feel your elbow going in the air, you should get a different instrument , or just move your feet." 如果你覺得手肘往上提, 就應該要換器具, 或是移動一下腳步。」
instrument:n.仪器;工具;乐器;手段;器械;
It was a whole other level of awareness . 這是完全不同程度的體認。
awareness:n.意识,认识;明白,知道;
And I had to think, you know, there was something fundamentally profound about this. 我當時想, 這件事從根本來看意義深遠。
fundamentally:adv.从根本上;基础地;重要地 profound:adj.深厚的;意义深远的;渊博的;
He was describing what great coaches do, and what they do is they are your external eyes and ears, providing a more accurate picture of your reality. 他說的話就是好教練做的事, 他們當你身外的眼睛和耳朵, 提供你更精確的現實。
describing:v.描述;形容;把…称为;做…运动;(describe的现在分词) external:n.外部;外观;形式;外部情况;adj.外部的;外面的;外界的;外来的; accurate:adj.精确的;
They're recognizing the fundamentals . 他們看出根本原因。
recognizing:v.认识;认出;承认;接受,赞成(recognize的现在分词) fundamentals:n.基本面;基本原理(fundamental的复数);
They're breaking your actions down and then helping you build them back up again. 他們分解你的動作, 再幫你重新組合起來。
After two months of coaching, 兩個月的訓練後,
I felt myself getting better again. 我發現自己又進步了。
And after a year, 一年之後,
I saw my complications drop down even further. 我病人的併發症案例降更低了。
It was painful . 過程很痛苦。
painful:adj.痛苦的;疼痛的;令人不快的;
I didn't like being observed , and at times I didn't want to have to work on things. 我不喜歡被觀察, 有時候我不想被逼著改掉習慣。
observed:adj.观察的;观测的;v.观察;遵守;注意到(observe的过去分词形式);
I also felt there were periods where I would get worse before I got better. 我也覺得在我進步之前, 有段時間在退步。
But it made me realize that the coaches were onto something profoundly important. 但這件事讓我了解 這些指導影響深遠,意義重大。
profoundly:adv.深刻地;深深地;极度地;
In my other work, 我的另一份工作是
I lead a health systems innovation center called Ariadne Labs , where we work on problems in the delivery of health care , including global childbirth . 主持阿里亞尼醫藥創新中心, 我們處理產房裡碰到的問題, 包含全球嬰兒出生率。
innovation:n.创新,革新;新方法; Labs:n.实验室;实验大楼;(lab的复数) health care:n.卫生保健; global:adj.全球的;总体的;球形的; childbirth:n.分娩;
As part of it, we had worked with the World Health Organization to devise a safe childbirth checklist . 其中, 我們和世界衛生組織合作 設計出一套安全生產清單。
Organization:n.组织;机构;体制;团体; devise:v.设计; n.[法]遗赠财产的遗嘱(或其中的条款); checklist:n.清单;检查表;备忘录;目录册;
It lays out the fundamentals. 清單上列出所有基本要件,
It breaks down the fundamentals -- the critical actions a team needs to go through when a woman comes in in labor, when she's ready to push, when the baby is out, and then when the mom and baby are ready to go home. 瓦解基本要件── 一連串團隊必須做的動作── 從產婦進產房來分娩、 她準備好用力推, 到嬰兒出生, 最後母子準備回家。
And we knew that just handing out a checklist wasn't going to change very much, and even just teaching it in the classroom wasn't necessarily going to be enough to get people to make the changes that you needed to bring it alive. 我們知道, 一張清單不會改變太多, 即使是在教室裡教都不見得能 讓人做出可以讓嬰兒活下來的改變。
And I thought on my experience and said, " What if we tried coaching? 我考量了我的經驗後說: 「要不要試看看找教練？
What if:如果…怎么办?
What if we tried coaching at a massive scale ?" 要不要試看看大規模找教練來做？」
massive:adj.大量的;巨大的,厚重的;魁伟的; scale:n.规模;比例;鳞;刻度;天平;数值范围;v.衡量;攀登;剥落;生水垢;
We found some incredible partners, including the government of India, and we ran a trial there in 120 birth centers. 我們找到一些很棒的夥伴, 包含印度政府, 我們在當地 120 間產婦中心測試。
incredible:adj.难以置信的,惊人的;
In Uttar Pradesh, in India's largest state. 在印度最大的行政區北方邦,
Half of the centers basically we just observed, but the other half got visits from coaches. 有一半的診所,我們單純觀察, 另一半會有教練過去。
basically:adv.主要地,基本上; other half:n.另一半(指配偶或男友,女友);
We trained an army of doctors and nurses like this one who learned to observe the care and also the managers and then help them build on their strengths and address their weaknesses. 我們訓練一批醫師和護理師,像她, 他們學習觀察產房的護理 和管理階層, 然後幫他們加強能力, 指出他們的弱點。
One of the skills for example they had to work on with people -- turned out to be fundamentally important -- was communication. 舉例來說,他們和人工作 必須有的一項技巧, 事後證明這很重要, 就是溝通。
Getting the nurses to practice speaking up when the baby mask is broken or the gloves are not in stock or someone's not washing their hands. 讓護理師練習勇於發言, 比如說,嬰兒氧氣罩壞掉、 手套庫存量不夠、 有人沒洗手。
And then getting others, including the managers, to practice listening. 然後讓其他人,包含管理階層, 練習傾聽。
This small army of coaches ended up coaching 400 nurses and other birth attendants, and 100 physicians and managers. 這一小批教練最後 訓練了四百位護理師、 接生員、 一百名外科醫生和管理人員。
physicians:n.[内科]内科医生(physician的复数);
We tracked the results across 160,000 births. 我們追蹤 16 萬名新生兒,
tracked:v.跟踪;追踪;(track的过去分词和过去式)
The results ... 結果……
in the control group you had -- and these are the ones who did not get coaching -- they delivered on only one-third of 18 basic practices that we were measuring. 在控制組的是 沒有受訓的人, 我們測量的 18 個基本要件當中, 他們只做到三分之一。
And most important was over the course of the years of study, we saw no improvement over time. 最重要的是經過多年研究, 我們在過程中沒看到進步。
The other folks got four months of coaching and then it tapered off over eight months, and we saw them increase to greater than two-thirds of the practices being delivered. 其他接受四個月訓練的人, 接下來的八個月訓練逐漸變少, 我們看見他們進步到 做到超過三分之二的基本要件。
tapered:adj.锥形的;v.逐渐变少(taper的过去式和过去分词); two-thirds:n.三分之二;三分之二的;三分之二地;
It works. 結果奏效。
We could see the improvement in quality, and you could see it happen across a whole range of centers that suggested that coaching could be a whole line of way that we bring value to what we do. 我們可以看到品質進步, 你可以看到許多診所都有成效, 這表示訓練可能是一條路, 彰顯我們專業的價值。
You can imagine the whole job category that could reach out in the world and that millions of people could fulfill . 你可以想見這能延續到世界上各行各業 能滿足上百萬人。
category:n.种类,分类;[数]范畴; fulfill:v.执行,贯彻;完成,实现;兑现;达到;起到;
We were clearly at the beginning of it, though, because there was still a distance to go. 不過我們顯然才剛起步, 還有一段路要走。
at the beginning of:在…的开始;
You have to put all of the checklist together to achieve the substantial reductions in mortality . 要把所有確認事項放在一起, 才能真的減少死亡率。
substantial:adj.大量的;实质的;内容充实的;n.本质;重要材料; reductions:n.减少;缩小;降低;减价;折扣;缩图;(reduction的复数) mortality:n.死亡数,死亡率;必死性,必死的命运;
But we began seeing the first places that were getting there, and this center was one of them because coaching helped them learn to execute on the fundamentals. 但我們開始看到第一批產房進步, 這是其中一間, 因為訓練幫他們學習從根本做起。
execute:vt.实行;执行;处死;
And you could see it here. 在這邊可以看到成果。
This is a 23-year-old woman who had come in by ambulance , in labor with her third child. 這位婦女 23 歲, 她被救護車送來, 準備生她的第三胎。
ambulance:n.救护车;
She broke her water in the triage area, so they brought her directly to the labor and delivery room, and then they ran through their checks. 她在檢傷分類區的時候羊水破了, 所以直接被送到產房, 然後醫護人員逐項確認清單。
triage:n.分类;伤员验伤分类; directly:adv.直接地;立即;马上;正好地;坦率地;conj.一…就;
I put the time stamp on here so you could see how quickly all of this happens and how much more complicated that makes things. 我在照片上標了時間, 你們就能看到這些事發生有多快, 還有事情變得多複雜。
complicated:adj.复杂的;难懂的;v.使复杂化;(complicate的过去分词和过去式)
Within four minutes, they had taken the blood pressure , measured her pulse and also measured the heart rate of the baby. 不過幾分鐘, 他們已經幫她量血壓、測脈博 和小孩的心跳。
blood pressure:n.[医]血压; measured:adj.缓慢谨慎的; v.测量; (measure的过去分词和过去式) pulse:n.脉冲;脉搏;脉率;强劲的音乐节拍;v.搏动;跳动;震动;洋溢着;
That meant that the blood pressure cuff and the fetal Doppler monitor, they were all there, and the nurse knew how to use them. 這表示血壓計和胎心儀都在這邊, 而且護理師知道要怎麼操作。
cuff:n.袖口,裤子翻边; vt.给…上袖口; vi.殴斗,拳击; fetal:adj.胎的,胎儿的; Doppler:adj.(奥地利物理学家)多普勒的;n.多普勒效应;
The team was skilled and coordinated . 這組團隊訓練有素、合作無間。
coordinated:v.使协调;使相配合;搭配,协调;(coordinate的过去分词和过去式)
The mom was doing great, the baby's heart rate was 143, which is normal. 媽媽的狀況很好, 嬰兒心跳 143 下,很正常。
Eight minutes later, the intensity of the contractions picked up, so the nurse washed her hands, put on clean gloves, examined her and found that her cervix was fully dilated . 八分鐘後,宮縮變強, 所以護理師洗手、 戴上乾淨的手套, 檢查產婦,發現她子宮頸完全張開,
intensity:n.强度;强烈;[电子]亮度;紧张; contractions:n.收缩;缩略形式(contraction的复数); cervix:n.子宫颈;颈部; dilated:v.扩大;(使)膨胀,扩张;(dilate的过去分词和过去式)
The baby was ready to come. 嬰兒準備好要出生了。
She then went straight over to do her next set of checks. 所以她直接確認下一套清單。
All of the equipment, she worked her way through and made sure she had everything she needed at the bedside. 她一一確認所有儀器 和所需物品都在床邊。
The baby mask was there, the sterile towel, the sterile equipment that you needed. 嬰兒氧氣罩、無菌布, 所有你需要的無菌用品都在。
sterile:adj.不育的;无菌的;贫瘠的;不毛的;枯燥乏味的;
And then three minutes later, one push and that baby was out. 三分鐘後,推一下寶寶就出來了。
(Applause) （掌聲）
I was watching this delivery, and suddenly I realized that the mood in that room had changed. 我看這個生產過程的時候, 突然意識到房裡的氣氛變了。
mood:n.情绪,语气;心境;气氛;
The nurse was looking at the community health worker who had come in with the woman because that baby did not seem to be alive. 護理師看著社區保健員 和產婦一起進來, 因為寶寶好像沒有活下來。
community:n.社区;[生态]群落;共同体;团体;
She was blue and floppy and not breathing. 她膚色鐵青、全身鬆軟、沒有呼吸。
floppy:adj.松软的;叭嗒叭嗒响的;懒散的,邋遢的;n.软磁碟;
She would be one of that one-in-20. 她可能會是那 20 個之中的一個。
But the nurse kept going with her checkpoints . 但是護理師繼續確認清單,
checkpoints:n.检查点集;检验点;(checkpoint的复数)
She dried that baby with a clean towel. 用乾淨的布擦乾嬰兒。
And after a minute, when that didn't stimulate that baby, she ran to get the baby mask and the other one went to get the suction. 一分鐘後, 嬰兒沒有受刺激開始呼吸, 她跑去拿嬰兒氧氣罩, 另一位去拿抽吸器。
She didn't have a mechanical suction because you could count on electricity , so she used a mouth suction, and within 20 seconds, she was clearing out that little girl's airways. 因為電力的問題, 她沒有電動抽吸器, 她用口部抽吸器, 20 秒內, 她開始清小女嬰的呼吸道,
electricity:n.电力;电流;强烈的紧张情绪;
And she got back a green, thick liquid, and within a minute of being able to do that and suctioning out over and over , that baby started to breathe. 清出綠色濃稠的液體, 可以開始不斷抽吸後一分鐘內 寶寶開始呼吸了。 寶寶開始呼吸了。
suctioning:n.吸,吸入;v.吸,吸入(suction的ing形式); over and over:反复;再三;
(Applause) （掌聲）
Another minute and that baby was crying. 下一刻寶寶就哭了。
And five minutes after that, she was pink and warming on her mother's chest, and that mother reached out to grab that nurse's hand, and they could all breathe. 五分鐘後, 粉嫩溫暖的她就在母親的懷裡, 這位媽媽伸手握住護理師的手, 她們都能呼吸了。
grab:v.攫取;霸占;将…深深吸引;n.攫取;霸占;夺取之物;
I saw a team transformed because of coaching. 我看到因為訓練,讓一組團隊改變。
transformed:v.使改变形态;使改变外观(或性质);(transform的过去分词和过去式)
And I saw at least one life saved because of it. 我看到至少因此救了一條人命。
We followed up with that mother a few months later. 幾個月後我們追蹤這位母親。
Mom and baby were doing great. 她和寶寶都很好。
The baby's name is Anshika. 寶寶叫安希卡,
It means "beautiful." 是「美麗」的意思。
And she is what's possible when we really understand how people get better at what they do. 她的存在證實了, 當我們知道如何精益求精時。 美麗成果就有可能實現。
Thank you. 謝謝。
(Applause) （掌聲）