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EricDishman_2013S-_健康看护体系需要大家参与_
I want to share some personal friends and stories with you that I've actually never talked about in public before to help illustrate the idea and the need and the hope for us to reinvent our health care system around the world. 我要分享一些我的朋友和故事 我從來沒有公開談過 我的目的是要說明一種想法、 一種需求、一種希望 以重塑全球的醫療照護系統
personal:adj.个人的;身体的;亲自的;n.人事消息栏;人称代名词; illustrate:v.解释;加插图于;给(书等)做图表;表明…真实; reinvent:v.以新形象示人;以新形式出现; health care:n.卫生保健;
Twenty-four years ago, I had -- a sophomore in college, 24年前,我還是個大二學生
sophomore:n.(大学)二年级学生:(高中)二年级学生:
I had a series of fainting spells. No alcohol was involved . 我昏迷了好幾次,不是因為酒醉
series:n.系列,连续;[电]串联;级数;丛书; fainting:n.昏倒;v.昏倒;(faint的现在分词) alcohol:n.酒精;乙醇;含酒精饮料; involved:adj.有关的; v.涉及; (involve的过去式和过去分词)
And I ended up in student health, and they ran some labwork and came back right away , and said, " Kidney problems." 我被送到學生健康中心 做了一些檢驗後,立刻得知 是腎臟問題
right away:立刻; Kidney:n.[解剖]肾脏;腰子;个性;
And before I knew it, I was involved and thrown into this six months of tests and trials and tribulations with six doctors across two hospitals in this clash of medical titans to figure out which one of them was right about what was wrong with me. 我還沒搞清楚狀況,就開始了 六個月的檢驗、考驗和折磨 由2家醫院的6位醫生診治 這些醫界權威互相爭執 想釐清誰才正確 診斷出我的病情
tribulations:n.苦难(tribulation的复数形式); clash:v.冲突; n.冲突; titans:n.泰坦巨神;(美)大力神Ⅱ型洲际导弹(Titan的复数);
And I'm sitting in a waiting room some time later for an ultrasound , and all six of these doctors actually show up in the room at once, and I'm like, "Uh oh, this is bad news." 做完超音波後,我坐在候診室 6位醫生同時出現 我想:「糟了,一定是壞消息！」
waiting room:na.候车室; ultrasound:n.超声;超音波;
And their diagnosis was this: 醫生診斷說:
diagnosis:n.诊断;
They said, "You have two rare kidney diseases that are going to actually destroy your kidneys eventually , you have cancer-like cells in your immune system that we need to start treatment right away, 「你得了兩種罕見的腎臟疾病, 最終會讓你的腎臟壞死, 你的免疫系統中有類似癌症細胞, 必須立即治療。
diseases:n.[医]病(disease的复数);[医]疾病;[植保]病害;疾病种类; kidneys:n.[解剖]肾脏;转炉的附着物;肾形矿脉(kidney的复数); eventually:adv.最后,终于; immune system:n.免疫系统; treatment:n.治疗;疗法;对待;处理;讨论;
and you'll never be eligible for a kidney transplant , and you're not likely to live more than two or three years." 你永遠不可能符合換腎資格, 最多還能活2到3年。」
eligible for:合格;够资格; transplant:v.移植;迁移;使移居;n.移植;移居者;
Now, with the gravity of this doomsday diagnosis, it just sucked me in immediately, as if I began preparing myself as a patient to die according to the schedule that they had just given to me, 這項診斷好像世界末日 讓我立刻認定 自己就是病人 將在醫生宣判的日期死亡
doomsday:n.世界末日;最后的审判日; sucked:v.吸,吮;吸收;吞没;(suck的过去分词和过去式) patient:adj.有耐心的,能容忍的;n.病人;患者; according to:根据,据说; schedule:工作计划,日程安排
until I met a patient named Verna in a waiting room, who became a dear friend, and she grabbed me one day and took me off to the medical library and did a bunch of research on these diagnoses and these diseases, and said, "Eric, these people who get this are normally in their '70s and '80s. 我在候診室遇到另一位病人薇娜(Verna) 她成了我的好友,有天她拉著我 帶我到醫學圖書館 仔細研究我的疾病和診斷 然後說:「得到這些疾病的人, 通常都是七、八十歲,
grabbed:v.抓住;攫取;抓住,夺得;(grab的过去分词和过去式) a bunch of:一群;一束;一堆; diagnoses:n.诊断;调查分析;评价(diagnosis的复数形式); normally:adv.正常地;通常地,一般地;
They don't know anything about you. Wake up. 他們根本不了解你,醒醒吧,
Take control of your health and get on with your life." 掌握自己的健康、好好的生活！」
get on with:v.在…获得成功,于…友好相处;继续干;
And I did. 我真的這麼做了
Now, these people making these proclamations to me were not bad people. 宣告我病症的人 都不是壞人
proclamations:n.公告;宣布;宣告;公布;
In fact, these professionals were miracle workers, but they're working in a flawed , expensive system that's set up the wrong way. 他們都是仁心仁術的專科醫師 但他們在有缺陷、昂貴、錯誤的系統下工作
professionals:n.[管理]专业人员(professional的复数); miracle:n.奇迹,奇迹般的人或物;惊人的事例; flawed:adj.有缺陷的;有瑕疵的;有裂纹的;
It's dependent on hospitals and clinics for our every care need. 所有的照護都依賴醫院與診所
dependent on:依赖于;依靠; clinics:n.诊所(clinic的复数形式);
It's dependent on specialists who just look at parts of us. 依賴只看我們部分身體的專科醫師
It's dependent on guesswork of diagnoses and drug cocktails , and so something either works or you die. 依賴基於猜測的診斷以及亂槍打鳥的用藥 他不成功,你就成仁
guesswork:n.猜测;臆测;凭猜测所作之工作; cocktails:n.鸡尾酒;凉菜;混合物;(cocktail的复数)
And it's dependent on passive patients who just take it and don't ask any questions. 這系統也依賴消極的病人 默默承受、不問問題
passive:adj.被动的,消极的;被动语态的;n.被动语态; patients:n.接受治疗者,病人;(patient的复数)
Now the problem with this model is that it's unsustainable globally. 以上這種模式是有問題的 以全球來說,是無法永續的
unsustainable:adj.无法支撑的;不可证实的;不能成立的;
It's unaffordable globally. 也是無法負擔的
unaffordable:adj.买不起的;
We need to invent what I call a personal health system. 我們要發展「個人化健康系統」
So what does this personal health system look like, and what new technologies and roles is it going to entail ? 個人化健康系統是什麼？ 有哪些新技術、新角色？
technologies:n.技术;科技(technology的复数); entail:vt.使需要,必需;承担;遗传给;蕴含;n.引起;需要;继承;
Now, I'm going to start by actually sharing with you a new friend of mine, Libby, somebody I've become quite attached to over the last six months. 我現在要與各位分享 我的新朋友「利比」(Libby) 過去半年我們關係密切
attached:adj.依恋;v.重视;把…固定;(attach的过去分词和过去式)
This is Libby, or actually, this is an ultrasound image of Libby. 這就是利比也可說是利比的超音波影像
This is the kidney transplant I was never supposed to have. 是我本來永遠等不到的移植腎臟
supposed:adj.误信的;所谓的;v.认为;假设;设想;(suppose的过去分词和过去式)
Now, this is an image that we shot a couple of weeks ago for today, and you'll notice, on the edge of this image, there's some dark spots there, which was really concerning to me. 這是幾週前照的影像 請注意角落 那裡有些陰影,我很擔心
on the edge of:adv.几乎;濒于;在…边缘; concerning:prep.关于;涉及;v.影响,牵涉(某人);与…有关;涉及;(concern的现在分词)
So we're going to actually do a live exam to sort of see how Libby's doing. 我要在現場進行檢驗 看看利比的狀況好不好
This is not a wardrobe malfunction . I have to take my belt off here. 不是衣服有問題,我要脫掉皮帶
wardrobe:n.衣柜;衣橱;(英国)放置衣物的壁橱;(一个人的)全部衣物; malfunction:n.失灵;故障,功能障碍; belt:n.皮带;腰带;传动带;传送带;v.猛击;狠打;飞奔;飞驰;
Don't you in the front row worry or anything. 前排的請不要擔心
(Laughter) (笑聲)
I'm going to use a device from a company called Mobisante. 我要開始使用行動檢測公司(Mobisante) 所開發的儀器
device:n.装置;策略;图案;
This is a portable ultrasound. 叫做行動超音波
portable:adj.便携式的;手提的;轻便的;n.便携机;(尤指)手提电脑;
It can plug into a smartphone . It can plug into a tablet . 可連接手機或平板電腦
plug:n.插头;塞子;栓;v.塞住;用插头将与电源接通; smartphone:n.智能手机; tablet:n.碑;药片;写字板;小块;
Mobisante is up in Redmond, Washington, and they kindly trained me to actually do this on myself. 行動檢測公司在華盛頓州雷德蒙市 他們好心訓練我自助使用
They're not approved to do this. Patients are not approved to do this. 他們沒有獲准這麼做病人也沒獲准這麼用
approved:adj.被正式接受的,被正式认可的; v.赞成; (approve的过去分词和过去式)
This is a concept demo , so I want to make that clear. 先講清楚,這只是概念的展示
demo:v.试用(尤指软件);演示;示范;n.试样唱片;录音样带;
All right, I gotta gel up. 塗上凝膠
gel:vi.胶化;n.[物化]凝胶,胶体;
Now the people in the front row are very nervous. (Laughter) 現在前排觀眾很緊張了(笑聲)
And I want to actually introduce you to Dr. Batiuk, who's another friend of mine. 我要介紹貝謝克醫師(Dr. Thomas Batiuk) 他是我的另一位朋友
He's up in Legacy Good Samaritan Hospital in Portland, Oregon . 在奧勒岡州波特蘭市的撒馬利亞慈善醫院 (Legacy Good Samaritan)
Legacy:n.遗赠,遗产; Good Samaritan:厚道的外人;好撒玛利亚人;仁慈心善的人;好撒马利亚人; Oregon:n.俄勒冈州(美国州名);
So let me just make sure. Hey, Dr. Batiuk. Can you hear me okay? 先確認一下,貝醫生,聽得到嗎？
And actually, can you see Libby? 還有,你看得到「利比」嗎？
Thomas Batuik: Hi there, Eric. 貝醫師:嗨！艾瑞克,你好(即演講者 Eric Dishman)
You look busy. How are you? 你看起來好忙啊！你好！
Eric Dishman: I'm good. I'm just taking my clothes off in front of a few hundred people. It's wonderful. 艾瑞克:我很好,我剛脫了衣服 有幾百位觀眾在看,感覺真好！
So I just wanted to see, is this the image you need to get? 我想知道這是不是你要看的影像？
And I know you want to look and see if those spots are still there. 請幫我檢查那些陰影還在不在？
TB: Okay. Well let's scan around a little bit here, give me a lay of the land. 貝醫師:請往周圍掃描一下 我先看一下整體狀況
ED: All right.TB: Okay. Turn it a little bit inside, a little bit toward the middle for me. 艾瑞克:好的貝醫師:往裡面一點 往中間一點點
Okay, that's good. How about up a little bit? 好,很好,往上一點點
Okay, freeze that image. That's a good one for me. 停,這個影像正是我要的
ED: All right. Now last week, when I did this, you had me measure that spot to the right. 艾瑞克:上週停住時 你要我量陰影的大小
Should I do that again? 現在要做嗎?
TB: Yeah, let's do that. 貝醫師:沒錯,量一下
ED: All right. This is kind of hard to do with one hand on your belly and one hand on measuring, but I've got it, I think, and I'll save that image and send it to you. 艾瑞克:這有點難 一手在腹部,另一手還要操作 我想我作到了 我把影像存檔,再寄給你
belly:n.腹部;胃;食欲;v.涨满;鼓起;
So tell me a little bit about what this dark spot means. 請告訴我那個陰影是什麼
It's not something I was very happy about. 我不太安心
TB: Many people after a kidney transplant will develop a little fluid collection around the kidney. 貝醫師:很多人在腎臟移植後 腎臟周圍會積水
fluid:adj.流动的;流畅的;不固定的;n.流体;液体;
Most of the time it doesn't create any kind of mischief , but it does warrant looking at, so I'm happy we've got an opportunity to look at it today, make sure that it's not growing, it's not creating any problems. 大部分不會造成傷害 但是需要注意 很高興今天有機會檢查 確認沒有變大、不會造成問題
mischief:n.恶作剧;伤害;顽皮;不和; warrant:n.依据;许可证;执行令;授权令;v.使有必要;使正当;使恰当;
Based on the other images we have, 與先前影像比較
images:n.印象;声誉;形象;画像;雕像;(image的第三人称单数和复数)
I'm really happy how it looks today. 我很滿意今天的狀況
ED: All right. Well, I guess we'll double check it when I come in. 艾瑞克:我去看診時請再檢查一次
I've got my six month biopsy in a couple of weeks, and I'm going to let you do that in the clinic, because I don't think I can do that one on myself. 再幾週就要做6個月的切片檢查 我會請你幫忙 因為我沒辦法自己作切片
biopsy:n.活组织检查;切片检查法;v.活组织检查;切片检查法;
TB: Good choice.ED: All right, thanks, Dr. Batiuk. 貝醫師:沒錯艾瑞克:謝謝你,貝醫師
All right. So what you're sort of seeing here is an example of disruptive technologies, of mobile , social and analytic technologies. 好的,各位剛才看到的 是革命性的創新技術 包括行動裝置、社群、分析技術
disruptive:adj.破坏的;分裂性的;制造混乱的; mobile:n.手机;汽车;移动电话;adj.活跃的;可动的; analytic:adj.分析的;解析的;善于分析的;
These are the foundations of what's going to make personal health possible. 是未來個人化健康照護的基礎
foundations:n.基础;地基;基金会;粉底;(foundations是foundation的复数)
Now there's really three pillars of this personal health I want to talk to you about now, and it's care anywhere, care networking and care customization . 有三大支柱支撐著… 接下來要談的個人化健康照護 就是照護行動化、網路化、客製化
pillars:n.柱子;柱状物;台柱(pillar的复数);v.用柱支持(pillar的第三人称单数); customization:n.定制;[计]用户化;客制化服务;
And you just saw a little bit of the first two with my interaction with Dr. Batiuk. 剛才只匆匆一瞥前兩項 看到我和貝醫生的互動
interaction:n.[计]交互,相互作用;相互交流;干扰;
So let's start with care anywhere. 現在從第一點開始,照護行動化
Humans invented the idea of hospitals and clinics in the 1780s. It is time to update our thinking. 建立醫院和診所的構想,起源自 1780年,現在該重新思考了
update:vt.使现代化;更新;n.现代化;更新的信息;
We have got to untether clinicians and patients from the notion of traveling to a special bricks-and-mortar place for all of our care, because these places are often the wrong tool, and the most expensive tool, for the job. 我們該將醫生和病人 都要走到一棟專用 建築物進行醫療的做法中釋放出來 對醫療目的而言,這往往是錯誤的 而且昂貴的
untether:vt.解下拴牛马的绳或链; clinicians:临床医生(clinician的名词复数); notion:n.观念;信念;理解; bricks-and-mortar:传统的实体企业;
And these are sometimes unsafe places to send our sickest patients, especially in an era of superbugs and hospital-acquired infections . 對重病患者有時並不安全 尤其是這個超級細菌、 及院內感染橫行的時代
unsafe:adj.不安全的;危险的;不安稳的; especially:adv.尤其;特别;格外;十分; superbugs:n.超级病菌; hospital-acquired:医院获得性; infections:n.传染病;口腔病害(infection复数形式);
And many countries are going to go brickless from the start because they're never going to be able to afford the mega-medicalplexes that a lot of the rest of the world has built. 許多國家想直接跳過實體醫院 因為太貴了,永遠負擔不起… 已開發國家的這種大型醫學中心
Now I personally learned that hospitals can be a very dangerous place at a young age. 我個人的經驗是,醫院 對小孩來說,是個很危險的地方
personally:adv.个人;亲自;本人;就本人而言;
This was me in third grade. 這是小學三年級的我
I broke my elbow very seriously, had to have surgery , worried that they were going to actually lose the arm. 手肘嚴重骨折,需要動手術 我很怕會失去整隻手臂
elbow:n.肘;弯头;肘状物;v.用肘推;挤进;讨价还价; surgery:n.外科;外科手术;手术室;诊疗室;
Recovering from the surgery in the hospital, I get bedsores . 手術後的住院期間,我得了褥瘡
bedsores:n.褥疮;
Those bedsores become infected , and they give me an antibiotic which I end up being allergic to, and now my whole body breaks out, and now all of those become infected. 褥瘡受到感染 抗生素治療造成嚴重過敏 最後全身爆發… 全面性的感染
infected:adj.带菌的; v.传染; (infect的过去分词和过去式) antibiotic:adj.抗生的;抗菌的;n.抗生素,抗菌素; allergic:adj.对…过敏的;对…极讨厌的;
The longer I stayed in the hospital, the sicker I became, and the more expensive it became, and this happens to millions of people around the world every year. 住院越久,我病得越重 醫藥費也越高 全球每年數百萬人都是相同情形
The future of personal health that I'm talking about says care must occur at home as the default model, not in a hospital or clinic. 我講的未來個人化健康照護 是以居家照護為優先 不是目前的醫院或診所
occur:v.发生;出现;存在于;出现在; default:n.违约;拖欠;缺席;缺陷;v.违约;拖欠;缺乏;不履行;
You have to earn your way into those places by being sick enough to use that tool for the job. 你想進醫院或診所 要病到有必要的程度才行
Now the smartphones that we're already carrying can clearly have diagnostic devices like ultrasounds plugged into them, and a whole array of others, today, and as sensing is built into these, we'll be able to do vital signs monitor and behavioral monitoring like we've never had before. 現在我們用的智慧型手機 已可外接各種診斷裝置,如超音波 及其他許多裝置 智慧型手機還內建多種感測器 可進行生命跡像監測 及過去沒聽過的行為監測
smartphones:智能手机(smartphone的复数); diagnostic:adj.诊断的;特征的;n.诊断法;诊断结论; devices:n.[机][计]设备;[机]装置;[电子]器件(device的复数); ultrasounds:n.超声;超音波; plugged:v.堵塞;封堵;补充;供给;推广;(plug的过去分词和过去式) array:n.数组,阵列;排列,列阵;大批,一系列;衣服;v.排列,部署;打扮; vital:adj.至关重要的;生死攸关的;有活力的; behavioral:adj.行为的;
Many of us will have implantables that will actually look real-time at what's going on with our blood chemistry and in our proteins right now. 未來我們之中許多人可能會植入 即時監控血液中化學物質 及蛋白質的裝置
implantables:adj.可移植的,可植入的; real-time:adj.实时的;接到指示立即执行的; proteins:n.[生化]蛋白质(protein复数);
Now the software is also getting smarter, right? 軟體越來越聰明,對吧？
Think about a coach, an agent online, that's going to help me do safe self-care . 就像是線上的教練或經紀人 可幫我們安全的自我照顧
agent:n.代理人,代理商;药剂;特工;v由…作中介;由…代理;adj.代理的; self-care:n.自顾;利己;
That same interaction that we just did with the ultrasound will likely have real-time image processing , and the device will say, "Up, down, left, right, 像我剛才展示超音波的互動 未來可能會有即時影像處理 機器會指揮我上下左右
processing:v.加工;处理;审核;数据处理;v.列队行进;缓缓前进;(process的现在分词)
ah, Eric, that's the perfect spot to send that image off to your doctor." 說:「就是這個位置,影像存檔, 傳給你的醫生吧！」
Now, if we've got all these networked devices that are helping us to do care anywhere, it stands to reason that we also need a team to be able to interact with all of that stuff , 如果我們有了這些網路裝置 照護行動化就可以達成 當然,我們需要一個團隊 來進行相關互動
stands to reason:合乎道理;我们来论理; stuff:n.东西:物品:基本特征:v.填满:装满:标本:
and that leads to the second pillar I want to talk about, care networking. 這就需要我說的第二根支柱 照護網路化
We have got to go beyond this paradigm of isolated specialists doing parts care to multidisciplinary teams doing person care. 我們要突破傳統模式 也就是獨立專科醫師分別進行部分照護 進而由多科別團隊進行個人化照護
paradigm:n.范例;词形变化表; isolated:adj.偏远的; v.隔离,孤立,脱离; multidisciplinary:adj.有关各种学问的;
Uncoordinated care today is expensive at best, and it is deadly at worst. 今日缺乏協調的照護,不僅昂貴 還可能致命
Uncoordinated:adj.不协调的;不对等的;不同位的; deadly:adj.致命的;非常的;死一般的;adv.非常;如死一般地;
Eighty percent of medical errors are actually caused by communication and coordination problems amongst medical team members. 80%的醫療錯誤是因為 溝通協調問題 存在醫療團隊成員間
coordination:n.协调,调和;对等,同等; amongst:prep.在…之中;在…当中(等于among);
I had my own heart scare years ago in graduate school , when we're under treatment for the kidney, and suddenly, they're like, "Oh, we think you have a heart problem." 在念研究所時我有心驚膽顫的經驗 那時在治療腎臟 突然有人說:「你得了心臟病！」
graduate school:研究所,研究院; have a heart:v.发慈悲;
And I have these palpitations that are showing up. 接著我出現了心悸
palpitations:n.[内科]心悸(palpitation的复数);
They put me through five weeks of tests -- very expensive, very scary -- before the nurse finally notices the piece of the paper, my meds list that I've been carrying to every single appointment , and says, "Oh my gosh." 進行了5個星期檢驗 又貴又可怕－最後有位護士注意到 一張紙,我的藥單 我每次約診都帶的單子 他說:「天哪！」
finally:adv.终于;最终;(用于列举)最后;彻底地; meds:n.药物: appointment:n.任命;约定;任命的职位;
Three different specialists had prescribed three different versions of the same drug to me. 有三位專科醫師開了 相同的處方藥
prescribed:v.给…开(药); (prescribe的过去式和过去分词)
I did not have a heart problem. I had an overdose problem. 我心臟沒病,是用藥過量
overdose:n.(一次用药)过量;v.一次用药过量;
I had a care coordination problem. 是照護缺乏協調的問題
And this happens to millions of people every year. 這每年發生在數百萬人身上
I want to use technology that we're all working on and making happen to make health care a coordinated team sport. 我想用現有的科技 使健康照護成為合作的團隊運動
technology:n.技术;工艺;术语;
Now this is the most frightening thing to me. 才能解決這件讓我最害怕的事
frightening:adj.可怕的;骇人的;引起恐惧的;v.使惊吓;使惊恐(frighten的现在分词)
Out of all the care I've had in hospitals and clinics around the world, the first time I've ever had a true team-based care experience was at Legacy Good Sam these last six months for me to go get this. 我曾在世界各地的醫院及診所診治 我第一次感受到真正的醫療團隊照護 就是過去半年在撒馬利亞慈善醫院(Legacy Good Samaritan) 讓我有此感受
And this is a picture of my graduation team from Legacy. 這是我在醫院的畢業團隊照片
There's a couple of the folks here. You'll recognize Dr. Batiuk. 有好幾位,這位是貝醫師
recognize:v.认识;认出;辨别出;承认;意识到;
We just talked to him. Here's Jenny, one of the nurses, 剛和他通電話這是珍妮,其中一位護士
Allison, who helped manage the transplant list, and a dozen other people who aren't pictured, a pharmacist , a psychologist , a nutritionist , even a financial counselor , Lisa, who helped us deal with all the insurance hassles . 這是艾利森,他幫忙處理移植清單 還有十幾位不在相片中 有藥師、心理醫師、營養師 甚至還有財務顧問,麗莎 她幫我們處理所有保險事務
pharmacist:n.药剂师; psychologist:n.心理学家,心理学者; nutritionist:n.营养工作者; financial:adj.金融的;财政的,财务的; counselor:n.顾问;法律顾问;参事(等于counsellor); insurance:n.保险;保险业;保险费;保费;adj.胜券在握的; hassles:n.激战(hassle的复数);v.与…争辩(hassle的第三人称单数);
I wept the day I graduated. 我畢業那天哭了
wept:v.哭泣(weep的过去式);
I should have been happy, because I was so well that I could go back to my normal doctors, but I wept because I was so actually connected to this team. 我應該要高興,因為病已好到 可以回去看一般的醫師了 我哭是因為和團隊感情深厚
And here's the most important part. 這才是最重要的部份
The other people in this picture are me and my wife, Ashley. 照片上還有我,以及我太太艾希莉
Legacy trained us on how to do care for me at home so that they could offload the hospitals and clinics. 醫院訓練我們在家自行照護 醫院和診所就不必那麼忙碌
offload:vt.卸下;卸货;adj.卸载的;
That's the only way that the model works. 這是這種模式成功的唯一方式
My team is actually working in China on one of these self-care models for a project we called Age-Friendly Cities. 我的團隊其實在中國工作 從事自助照護模式 稱為「年齡友善城市」計畫
We're trying to help build a social network that can help track and train the care of seniors caring for themselves as well as the care provided by their family members or volunteer community health workers, as well as have an exchange network online, 我們嘗試建立社群網路 以幫助追蹤並且訓練年長者 能自已照顧自己 以及由家人提供照護 還有社區的健康照護志工 另外還有線上照護交換網站
track:n.小道;足迹;车辙;轨道;v.追踪;跟踪; seniors:n.年长者,老年人;资历较深的人(senior的复数形式); as well as:也;和…一样;不但…而且; provided:conj.假如; v.提供; (provide的过去分词和过去式) volunteer:n.志愿者;志愿兵;adj.志愿的;v.自愿; community:n.社区;[生态]群落;共同体;团体; exchange:n.交换;交流;交易所;兑换;v.交换;交易;兑换;
where, for example, I can donate three hours of care a day to your mom, if somebody else can help me with transportation to meals, and we exchange all of that online. 例如我每天照顧你媽三小時 而有人可以幫我送餐點 大家在網路上交換工作
donate:v.赠送;献(血);捐献(器官); transportation:n.运输;运输系统;运输工具;流放;
The most important point I want to make to you about this is the sacred and somewhat over-romanticized doctor-patient one-on-one is a relic of the past. 我要強調的重點是 可怕而又太理想化的 一對一醫病關係 已成為過去式
somewhat:n.几分;某物;adv.有点;多少;几分;稍微; doctor-patient:医患; one-on-one:adj.一对一的;直接对立的;adv.一对一;面对面;n.一对一的比赛; relic:n.遗迹,遗物;废墟;纪念物;
The future of health care is smart teams, and you'd better be on that team for yourself. 健康照護的未來是智慧團隊 而你自己最好就是團隊的一員
Now, the last thing that I want to talk to you about is care customization, because if you've got care anywhere and you've got care networking, those are going to go a long way towards improving our health care system, but there's still too much guesswork. 我要談的最後一件事是 照護客製化 因為照護行動化與照護網路化 要改善醫療系統,並非一蹴可幾 但現有醫療存在太多猜測
improving:v.改进;改善;(improve的现在分词)
Randomized clinical trials were actually invented in 1948 to help invent the drugs that cured tuberculosis , and those are important things, don't get me wrong. 隨機臨床實驗是在1948年發明的 用來發明治療結核病的藥 那是很重要的事,別誤會
Randomized:adj.[数]随机化的,随机的;v.使随机化;做任意排列(randomize的过去分词); clinical:adj.临床的;诊所的; tuberculosis:n.肺结核;结核病;
These population studies that we've done have created tons of miracle drugs that have saved millions of lives, but the problem is that health care is treating us as averages, not unique individuals , because at the end of the day, 這些全民研究幫忙創造了 許多新藥,救治了數百萬的生命 問題是,這種醫療照護 把我們當成平均數而不是獨立的個人 終究來說
treating:v.以…态度对待;把…看作;处理;讨论;(treat的现在分词) unique:adj.独特的,稀罕的;[数]唯一的;n.独一无二的人或物; individuals:n.[经]个人;[生物]个体(individual的复数);
the patient is not the same thing as the population who are studied. That's what's leading to the guesswork. 病人和研究的平均數並不相同 所以必須要用猜的
The technologies that are coming, high-performance computing , analytics , big data that everyone's talking about, will allow us to build predictive models for each of us as individual patients. 新科技已經來臨 電腦的高速運算、分析 大家都在講的大資料運算(big data) 可針對每個人建立預測模型 把每個人當作個別病人
high-performance:adj.高性能的;高效能的; computing:n.计算;计算机技术;信息处理技术;v.计算;求出;(compute的现在分词) analytics:n.[化学][数]分析学;解析学; predictive:adj.预言性的;成为前兆的;
And the magic here is, experiment on my avatar in software, not my body in suffering. 更神奇的是可拿我的電腦分身實驗 不必讓我身體受苦
avatar:n.电影《阿凡达》;
Now, I've had two examples I want to quickly share with you of this kind of care customization on my own journey . 我有兩個案例很快和各位分享 關於我親身經歷的照護客製化
journey:n.旅行;行程;vi.旅行;
The first was quite simple. I finally realized some years ago that all my medical teams were optimizing my treatment for longevity . 第一個很簡單,我幾年前才瞭解 我的整個醫療團隊都在為延長我的壽命而精進治療
optimizing:n.[数]优化,最佳化;adj.最佳的;v.最佳化(optimize的现在分词); longevity:n.长寿,长命;寿命;
It's like a badge of honor to see how long they can get the patient to live. 能讓病人活得更久他們就像得到榮譽徽章一樣
badge:n.徽章;证章;标记;v.授给…徽章;
I was optimizing my life for quality of life, and quality of life for me means time in snow. 那時我想改善生活品質 對我來說,生活品質就是在雪地的時光
So on my chart, I forced them to put, "Patient goal: low doses of drugs over longer periods of time, side effects friendly to skiing." 我強迫他們在病歷上寫:「病人的目標為, 長時間低劑量的用藥, 副作用不影響滑雪。」
doses:v.服药(dose的三单形式);n.[药][核]剂量(dose的复数);
And I think that's why I achieved longevity. 我想這就是我活得較久的原因
I think that time-in-snow therapy was as important as the pharmaceuticals that I had. 「雪地的時光」這項治療很重要 跟其他藥品一樣重要
therapy:n.治疗,疗法; pharmaceuticals:n.药物(pharmaceutical的复数);
Now the second example of customization -- and by the way , you can't customize care if you don't know your own goals, so health care can't know those until you know your own health care goals. 第二個客製化案例是…順道一提 如果你沒有目標,是無法客製化的 你要先有目標,醫療小組才會知道
by the way:顺便说一下; customize:vt.定做,按客户具体要求制造;
But the second example I want to give you is, 但我要說的第二個案例
I happened to be an early guinea pig , and I got very lucky to have my whole genome sequenced . 我剛好是個早期的白老鼠 我很幸運擁有完整的基因體定序
guinea pig:n.豚鼠;天竺鼠;荷兰猪;实验材料; genome:n.基因组;染色体组; sequenced:[数][计]序列;
Now it took about two weeks of processing on Intel's highest-end servers to make this happen, and another six months of human and computing labor to make sense of all of that data. 目前大約要花兩星期 用英特爾最高速的伺服器定序 再加上6個月的人工與電腦運算 以解讀所有資料
make sense of:搞清…的意思;
And at the end of all of that, they said, "Yes, those diagnoses of that clash of medical titans all of those years ago were wrong, and we have a better path forward." 最後他們說:「成功了, 醫界權威爭執多年的診斷 全都錯了, 現在有更好的方向可以邁進。」
The future that Intel's working on now is to figure out how to make that computing for personalized medicine go from months and weeks to even hours, and make this kind of tool available, 英特爾正努力,希望能找出方法 讓個人化醫療的運算 由幾個月縮短到幾週,甚至幾小時 讓更多人可使用
personalized:v.在…上标明主人姓名; (personalize的过去分词和过去式)
not just in the mainframes of tier-one research hospitals around the world, but in the mainstream -- every patient, every clinic with access to whole genome sequencing . 不僅限於全球一流的教學醫院 而能成為主流－讓每個病人、每間診所都可使用 這種完整的基因體定序
mainframes:n.大型主机(mainframe的复数形式); mainstream:n.主流; sequencing:n.[计]排序; v.[计]定序(sequence的ing形式);
And I tell you, this kind of care customization for everything from your goals to your genetics will be the most game-changing transformation that we witness in health care during our lifetime. 這種照護客製化 從個人目標到基因體定序 將是改變遊戲規則的大革命 我們有生之年就可見證到
genetics:n.遗传学; transformation:n.转变;(用于南非)民主改革; witness:n.证人;目击者;证据;v.目击;证明;为…作证;
So these three pillars of personal health, care anywhere, care networking, care customization, are happening in pieces now, but this vision will completely fail if we don't step up as caregivers and as patients to take on new roles. 健康照護的三大支柱 照護行動化、網路化、客製化 正逐步發生 但這個願景可能完全失敗,如果 醫護人員和患者不願扮演新的角色
vision:n.视力;美景;幻象;想象力;v.想象;显现;梦见; caregivers:n.照顾者;看护人(caregiver的复数);
It's what my friend Verna said: 我朋友凡恩說得好:
Wake up and take control of your health. 醒醒吧！你要主導自己的健康,
Because at the end of the day these technologies are simply about people caring for other people and ourselves in some powerful new ways. 有了這些科技 最後還是「人」在照顧別人與自己 只是運用更好更新的方法
And it's in that spirit that I want to introduce you to one last friend, very quickly. 這正是接下來我要很快介紹的 最後一位朋友的精神
Tracey Gamley stepped up to give me the impossible kidney that I was never supposed to have. 翠西甘姆利(Tracey Gamley)挺身而出,她捐出了 我本來不可能得到的腎臟
(Applause) (掌聲)
So Tracey, just tell us a little bit quickly about what the donor experience was like with you. 翠西,請很快分享一下作為捐贈者的經驗
donor:n.捐赠者;供者;赠送人;adj.捐献的;经人工授精出生的;
Tracey Gamley: For me, it was really easy. 翠西:對我來說,真的很簡單
I only had one night in the hospital. 我只在醫院住了一夜
The surgery was done laparoscopically , so I have just five very small scars on my abdomen , and I had four weeks away from work and went back to doing everything I'd done before without any changes. 手術是以腹腔鏡進行的 我的腹部只留下5個很小的疤痕 我有4個星期不能工作 之後就完全回復到我原來的生活 沒有任何改變
laparoscopically:腹腔镜的; abdomen:n.腹部;下腹;腹腔;
ED: Well, I probably will never get a chance to say this to you in such a large audience ever again. 艾瑞克:我可能再也沒有機會 在這麼多人面前對妳說…
So "thank you" feel likes a really trite word, but thank you from the bottom of my heart for saving my life. 「謝謝你！」感覺上好像老掉牙了 但我打從心底感謝妳救了我一命
trite:adj.陈腐的;平庸的;老一套的; from the bottom of my heart:真心地;从心底里…;发自内心的;天地良心;来自我心底;
(Applause) (掌聲)
This TED stage and all of the TED stages are often about celebrating innovation and celebrating new technologies, and I've done that here today, and I've seen amazing things coming from TED speakers, 在 TED 講台上 大多都是讚揚創新發明 以及新科技 這正是我剛才所做的 我也目睹了其他演講者的驚人成就
innovation:n.创新,革新;新方法;
I mean, my gosh, artificial kidneys, even printable kidneys, that are coming. 天啊！人工腎臟、列印腎臟可能都不再是夢想
artificial:adj.人造的;仿造的;虚伪的;非原产地的;武断的; printable:adj.印得出的;可出版的;
But until such time that these amazing technologies are available to all of us, and even when they are, it's up to us to care for, and even save, one another. 但在那些驚人科技實現 還有普及之前,甚至於之後 都要靠我們彼此關愛,互相救助
I hope you will go out and make personal health happen for yourselves and for everyone. Thanks so much. 希望各位今後能夠讓個人化健康照護實現 為了你,也為了每個人非常感謝
(Applause) (掌聲)