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KevinJones_2015X-_为什么好奇心是科学与医药的钥匙？_
Science. 科学。
The very word for many of you conjures unhappy memories of boredom in high school biology or physics class. 这个词对于你们中的很多人来说,召唤了对于高中生物 或是物理课堂的苦闷记忆。
conjures:v.变魔术;变戏法;(conjure的第三人称单数) boredom:n.厌倦;令人厌烦的事物; biology:n.(一个地区全部的)生物;生物学;
But let me assure that what you did there had very little to do with science. 但是我向你们保证,你们在那时经历的 与科学是大相径庭的。
assure:vt.保证;担保;使确信;弄清楚;
That was really the "what" of science. 那只是科学“是什么”。
It was the history of what other people had discovered. 那是前人发现的历史记载。
What I'm most interested in as a scientist is the "how" of science. 我对于成为一名科学家最感兴趣的地方 是科学的“为什么”。
Because science is knowledge in process . 因为科学的知识是正在探寻中的。
process:v.处理;加工;列队行进;n.过程,进行;方法,adj.经过特殊加工(或处理)的;
We make an observation , guess an explanation for that observation , and then make a prediction that we can test with an experiment or other observation. 我们进行观察,对观察提出一种设想原因, 做一种可以通过实验或是 其他观察论证的假设。
observation:n.观察;观测;监视;(尤指据所见、所闻、所读而作的)评论; prediction:n.预报;预言;
A couple of examples. 举些例子。
First of all , people noticed that the Earth was below, the sky above, and both the Sun and the Moon seemed to go around them. 首先,人们注意到了大地在脚下,天空在头顶, 太阳和月亮都看似围绕着它们在移动
First of all:adv.首先;
Their guessed explanation was that the Earth must be the center of the universe. 他们提出的设想是 地球一定是宇宙的中心。
The prediction: everything should circle around the Earth. 预测即为:一切都是围绕着地球运动的。
This was first really tested when Galileo got his hands on one of the first telescopes , and as he gazed into the night sky, what he found there was a planet, Jupiter , with four moons circling around it. 当伽里略着手于第一台望远镜, 望向天空的时候,这件事第一次 被真正测试了, 他发现的是一颗行星,木星, 周围还有四颗卫星环绕着它。
telescopes:n.望远镜; v.套叠; (telescope的第三人称单数) gazed:vi.凝视;注视;n.凝视;注视; Jupiter:n.[天]木星;朱庇特(罗马神话中的宙斯神);
He then used those moons to follow the path of Jupiter and found that Jupiter also was not going around the Earth but around the Sun. 之后,他又利用这些卫星去跟踪木星的轨道 发现木星也不是围绕地球运动的 而是围绕太阳运动的。
So the prediction test failed. 所以说这个假说测试就失败了。
And this led to the discarding of the theory that the Earth was the center of the universe. 这就导致了地球是宇宙的中心 这个理论被推翻。
discarding:v.丢弃;打出(discard的ing形式);
Another example: Sir Isaac Newton noticed that things fall to the Earth. 另一个例子:艾萨克·牛顿爵士注意到了东西都是向地面坠落的。
Newton:n.牛顿(英国科学家);牛顿(力的单位);
The guessed explanation was gravity, the prediction that everything should fall to the Earth. 设想原因是引力, 预测是万物都会落向地面。
But of course, not everything does fall to the Earth. 但是当然,并不是所有东西都落向地面的。
So did we discard gravity? 但是我们就抛弃引力吗？
No. We revised the theory and said, gravity pulls things to the Earth unless there is an equal and opposite force in the other direction. 不。我们重新改写理论,说引力将万物拉向地面, 除非事物还受到大小相同方向相反的力的作用。
revised:v.改变;修改;复习;温习;(revise的过去分词和过去式)
This led us to learn something new. 这引领我们学到了新的东西。
We began to pay more attention to the bird and the bird's wings, and just think of all the discoveries that have flown from that line of thinking. 我们开始更多的关注鸟儿和它们的翅膀, 想一想从那条思路 引出的一系列发现。
So the test failures, the exceptions, the outliers teach us what we don't know and lead us to something new. 所以那些测试的失败,意外,异常值 给我们传授了未知,引领我们去发现新的东西。
outliers:n.[分化]异常值;离群值;离开本体的东西;局外人(outlier的复数);
This is how science moves forward. This is how science learns. 科学就是这样不断前行。科学就是这样不断学习。
Sometimes in the media , and even more rarely , but sometimes even scientists will say that something or other has been scientifically proven. 有的时候在媒体当中,甚至更罕见的, 有时甚至科学家们会说 这个或是那个已经被科学证明了。
media:n.媒体;媒质(medium的复数);血管中层;浊塞音;中脉; rarely:adv.很少地;难得;罕有地; scientifically:adv.系统地;合乎科学地;学问上;
But I hope that you understand that science never proves anything definitively forever. 但是,我希望你们能够明白,科学从不能证明任何东西, 永远都不可能。
definitively:adv.决定性地;最后地;
Hopefully science remains curious enough to look for and humble enough to recognize when we have found the next outlier, the next exception ,which, like Jupiter's moons, teaches us what we don't actually know. 希望科学始终保持那种好奇感 让我们去探寻, 和那种谦逊感, 当我们发现下一个异常值, 下一个特例, 就像木星的卫星那样的东西的时候, 教会我们那些我们并不了解的东西。
curious:adj.好奇的,有求知欲的;古怪的;爱挑剔的; humble:adj.谦逊的; vt.使谦恭; recognize:v.认识;认出;辨别出;承认;意识到; exception:n.例外;异议;
We're going to change gears here for a second. 我们要在这里变换一小会儿主题了。
gears:n.[机]齿轮,[机]传动装置(gear的复数形式); v.以齿轮连起,安排(gear的三单形式);
The caduceus , or the symbol of medicine, means a lot of different things to different people, but most of our public discourse on medicine really turns it into an engineering problem. 墨丘利的节杖,或者说是医药的象征, 对于不同的人,有着不同的意义, 但是我们的普遍公共医学论述 却将它转变为了一个工程问题。
caduceus:n.墨丘利的节杖(医学的标志);使者杖; symbol:n.象征;符号;标志; discourse:n.论述;谈话;演讲;vi.演说;谈论;讲述;vt.说出;演奏出; engineering:n.工程;工程学;v.密谋策划;设计制造;改变…的基因;(engineer的现在分词)
We have the hallways of Congress , and the boardrooms of insurance companies that try to figure out how to pay for it. 我们的国会长廊, 还有保险公司的董事会都试图找到支付它们的途径
hallways:n.(美)走廊;门厅(hallway的复数); Congress:n.国会;代表大会;会议;社交; boardrooms:n.董事会会议室;(boardroom的复数) insurance:n.保险;保险业;保险费;保费;adj.胜券在握的;
The ethicists and epidemiologists try to figure out how best to distribute medicine, and the hospitals and physicians are absolutely obsessed with their protocols and checklists , trying to figure out how best to safely apply medicine. 伦理学家和流行病学家 试图找到如何更好分配药物的方法, 医院和医生们却完全沉迷于 他们的协议和清单, 试图找到更安全应用药物的方法。
ethicists:n.伦理学家; epidemiologists:n.流行病学家(epidemiologist的复数); distribute:v.分发;分配;分销;分散; physicians:n.[内科]内科医生(physician的复数); absolutely:adv.绝对地;完全地; obsessed:v.使痴迷;使迷恋;使着迷;(obsess的过去式和过去分词) protocols:n.协议; v.拟定议定书; checklists:n.清单(checklist的复数); apply:v.申请;涂,敷;应用;适用;请求;
These are all good things. 这些都是好事。
However, they also all assume at some level that the textbook of medicine is closed. 但是,他们也都在 一定程度上假定了 医学教科书是封闭的。
assume:v.承担;假定;采取;呈现;
We start to measure the quality of our health care by how quickly we can access it. 我们就开始以我们能多快速的得到医疗服务 来衡量我们的医疗质量。
health care:n.卫生保健;
It doesn't surprise me that in this climate, many of our institutions for the provision of health care start to look a heck of a lot like Jiffy Lube . 在这种风气下,许多机构 为寻求医疗服务,开始大批搜寻润滑油的行为,
institutions:n.机构;慈善机构;风俗习惯,制度;(institution的复数) provision:n.规定;条款;准备;[经]供应品;vt.供给…食物及必需品; Jiffy:n.一会儿,瞬间; Lube:n.润滑油(等于lubrication);
(Laughter) （笑声）
The only problem is that when I graduated from medical school, 唯一的问题是,当我从医学院毕业的时候,
I didn't get one of those little doohickeys that your mechanic has to plug into your car and find out exactly what's wrong with it, because the textbook of medicine is not closed. 我并没有得到那个像是你的机械师 一插进你的汽车里就能知道 车子哪里出问题的小窍门, 因为医学课本 并非是封闭的。
doohickeys:n.窍门;小玩意;装置; mechanic:n.技工,机修工;adj.手工的; plug:n.插头;塞子;栓;v.塞住;用插头将与电源接通;
Medicine is science. 医药是科学。
Medicine is knowledge in process. 医药是正在进程中的知识。
We make an observation, we guess an explanation of that observation, and then we make a prediction that we can test. 我们先观察现象, 然后猜测现象背后的解释, 之后我们作出一个能够被测试的假设
Now, the testing ground of most predictions in medicine is populations. 当下,我们在医药领域大多数的测试场地就是 群体。
testing ground:n.(新思想、新方法的)试验场;(机器等的)试验场; predictions:n.预测,预言(prediction复数形式);
And you may remember from those boring days in biology class that populations tend to distribute around a mean as a Gaussian or a normal curve . 然后也许你还记得在那些无聊的生物课上 关于群体倾向于呈现 围绕平均值的 高斯或是正态分布曲线。
boring:adj.无聊的;令人厌烦的;n.钻孔;v.使厌烦;钻孔;(bore的现在分词) curve:n.曲线;弯曲;曲面;弧线;v.(使)沿曲线移动;呈曲线形;
Therefore, in medicine, after we make a prediction from a guessed explanation, we test it in a population. 因此,在医药领域, 在我们用一种可能的原因作出预测之后, 我们就在群体中测试它。
That means that what we know in medicine, our knowledge and our know-how , comes from populations but extends only as far as the next outlier, the next exception, which, like Jupiter's moons, will teach us what we don't actually know. 这就意味着,我们关于医药学习的知识, 我们的所有知识, 都来自于群体, 而只有当达到下一个异常值的时候, 下一个特例, 我们的知识才会扩张, 它们教会了我们并不了解的东西。
know-how:n.诀窍;实际知识;专门技能; extends:v.使伸长;扩大;扩展;延长;使延期;(extend的第三人称单数) as far as:至于…;
Now, I am a surgeon who looks after patients with sarcoma . 现在,我是一名外科医生, 正在寻找肉瘤病人。
surgeon:n.外科医生; patients:n.接受治疗者,病人;(patient的复数) sarcoma:n.[肿瘤]肉瘤,恶性毒瘤;
Sarcoma is a very rare form of cancer . 肉瘤是一种极其罕见的癌症。
cancer:n.癌症;恶性肿瘤;
It's the cancer of flesh and bones. 是骨与肌肉的癌变。
flesh:n.肉;肉体;v.喂肉给…;发胖;
And I would tell you that every one of my patients is an outlier, is an exception. 然后我会告诉你,我的每一位病人都是异常值, 都是特例。
There is no surgery I have ever performed for a sarcoma patient that has ever been guided by a randomized controlled clinical trial, what we consider the best kind of population-based evidence in medicine. 我为这些肉瘤患者做的手术,没有任何一个是对照着, 临床实验案例,就是那些我们认识中最适合医药的 以群体为基础的实验证据,没有任何一个是被其指导着完成的。
surgery:n.外科;外科手术;手术室;诊疗室; performed:v.表演;执行;履行;演出;工作,运转(好/不好)(perform的过去分词和过去式) 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; population-based:基于人群的; evidence:n.证据,证明;迹象;明显;v.证明;
People talk about thinking outside the box, but we don't even have a box in sarcoma. 人们总说要跳出定式思维, 但是在肉瘤病症上,我们没有定式。
What we do have as we take a bath in the uncertainty and unknowns and exceptions and outliers that surround us in sarcoma is easy access to what I think are those two most important values for any science: humility and curiosity . 当我们沐浴在关于肉瘤的,环绕我们的, 那些未知,不确定,特例,异常值中的时候, 我们所拥有的,是我眼中对于任何一种科学, 最重要的两种价值观: 谦逊和好奇心。
uncertainty:n.不确定,不可靠; humility:n.谦卑,谦逊; curiosity:n.好奇,好奇心;珍品,古董,古玩;
Because if I am humble and curious, when a patient asks me a question, and I don't know the answer, 因为如果我是谦逊的,好奇心强的, 当病人询问我问题的时候, 如果我不知道问题的答案,
I'll ask a colleague who may have a similar albeit distinct patient with sarcoma. 我就会去询问有着相似的, 尽管是不同的肉瘤病人的同事。
colleague:n.同事,同僚; albeit:conj.虽然;即使; distinct:adj.明显的;独特的;清楚的;有区别的;
We'll even establish international collaborations . 我们甚至会建立国际间的合作。
establish:v.创立;设立;建立;确立;使立足;查实; collaborations:n.协作(collaboration的复数);
Those patients will start to talk to each other through chat rooms and support groups. 那些病人也会开始在聊天室和支持团体中 互相交流。
It's through this kind of humbly curious communication that we begin to try and learn new things. 是通过这种谦逊的,好奇的交流过程, 我们开始去尝试并学习新的知识。
humbly:adv.谦逊地;卑贱地;低声下气地;
As an example, this is a patient of mine who had a cancer near his knee. 作为例子,这是我的一位病人 他在膝盖附近长了一个肿瘤。
Because of humbly curious communication in international collaborations, we have learned that we can repurpose the ankle to serve as the knee when we have to remove the knee with the cancer. 正因为那种在国际合作中谦逊的 好奇心驱使的沟通, 我们学习到了如果必须在移除肿瘤的同时移除膝盖, 那么我们可以用踝关节代替膝关节的位置。
repurpose:vt.改换意图;重新目的化;
He can then wear a prosthetic and run and jump and play. 这样他就可以带着假肢跑,跳,玩耍了。
prosthetic:adj.假体的;非朊基的;
This opportunity was available to him because of international collaborations. 是国际间合作 给了他这样的机会。
It was desirable to him because he had contacted other patients who had experienced it. 这也是他所希望的, 因为他与经历过这些的其他病人联系过了。
desirable:adj.令人满意的;值得要的;n.合意的人或事物; contacted:v.联系,联络(如用电话或信件)(contact的过去分词和过去式)
And so exceptions and outliers in medicine teach us what we don't know, but also lead us to new thinking. 所以在医药领域的特例与异常值 教会了我们那些不了解的东西,同时也引发了我们作出新的思考。
Now, very importantly, all the new thinking that outliers and exceptions lead us to in medicine does not only apply to the outliers and exceptions. 现在,非常重要的是, 所有这些在医药领域关于异常值和特例的新的思考 并非只能运用于那些特例的情况中。
It is not that we only learn from sarcoma patients ways to manage sarcoma patients. 我们从肉瘤病人身上学习到的, 并非仅仅是治疗肉瘤病人的方法。
Sometimes, the outliers and the exceptions teach us things that matter quite a lot to the general population. 有的时候,这些异常情况, 这些特例, 也教会了我们一些,对大众同样十分重要的事情。
Like a tree standing outside a forest, the outliers and the exceptions draw our attention and lead us into a much greater sense of perhaps what a tree is. 就像是身处树林之外的一棵树, 这些外围的,特例般的存在,吸引了我们的注意力, 并能够引领我们得到一个,像是“树是什么”,这种更为宏观的认识。
We often talk about losing the forests for the trees, but one also loses a tree within a forest. 我们经常说,树木们失去了森林, 但是,我们也会 失去森林里的树木。
But the tree that stands out by itself makes those relationships that define a tree, the relationships between trunk and roots and branches,much more apparent . 那些独自站立的树, 它们同样,甚至以一种更加明确的方式 定义了树木的概念,树干,树根与树枝间的联系。
define:v.定义;使明确;规定; apparent:adj.显然的;表面上的;
Even if that tree is crooked or even if that tree has very unusual relationships between trunk and roots and branches, it nonetheless draws our attention and allows us to make observations that we can then test in the general population. 即使那颗树是弯曲的, 或者甚至它的树干,树根与树枝 之间的联系是非同寻常的, 它吸引了我们的注意力, 让我们作出了观察, 然后能够在普试群体中进行测试。
crooked:adj.扭曲的;弯曲的;不直的;v.(手指或手臂)弯曲;(crook的过去分词和过去式) nonetheless:adv.尽管如此,但是; observations:n.观察,观察值;观察结果;(observation的复数形式); in the general:通常,一般;
I told you that sarcomas are rare. 我告诉过你们了,肉瘤是罕见的。
They make up about one percent of all cancers . 它们只在所有癌症中占有1%
cancers:n.癌; (Cancers是cancer的复数)
You also probably know that cancer is considered a genetic disease . 你也许还知道癌症是一种基因疾病。
genetic:adj.基因的;遗传学的; disease:n.病,[医]疾病;弊病;vt.传染;使…有病;
By genetic disease we mean that cancer is caused by oncogenes that are turned on in cancer and tumor suppressor genes that are turned off to cause cancer. 基因疾病是指癌症是由于 原癌基因的触发和 抑癌基因的失效所诱发的。
oncogenes:n.[遗][肿瘤]致癌基因(oncogene的复数); tumor:n.肿瘤;肿块;赘生物; suppressor:n.抑制器;消除器;
You might think that we learned about oncogenes and tumor suppressor genes from common cancers like breast cancer and prostate cancer and lung cancer, but you'd be wrong. 你也许会认为我们是从那先常见癌症, 像是乳腺癌,前列腺癌, 肺癌中,发现原癌基因与抑癌基因的, 但是,那样想你就错了。
prostate:adj.前列腺的;n.[解剖]前列腺;
We learned about oncogenes and tumor suppressor genes for the first time in that itty-bitty little one percent of cancers called sarcoma. 我们是从那些极少数的,1%的肉瘤中 第一次的, 学习到了原癌基因和抑癌基因的。
itty-bitty:adj.极小的(等于itsy-bitsy);
In 1966, Peyton Rous got the Nobel Prize for realizing that chickens had a transmissible form of sarcoma. 1966年,佩顿·劳斯获得了诺贝尔奖 他发现了鸡群中一种 传染性的肉瘤。
Nobel Prize:n.诺贝尔奖; transmissible:adj.能传送的;能透射的;可传达的;
Thirty years later, Harold Varmus and Mike Bishop discovered what that transmissible element was. 三十年之后,哈罗德·瓦尔姆斯与麦克·毕晓普发现了 那种传染性的因子究竟是什么。
Bishop:n.主教;象; element:n.元素;要素;原理;成分;自然环境;
It was a virus carrying a gene, the src oncogene. 那是一种病毒 它携带一种基因, 那就是肉瘤原癌基因。
Now, I will not tell you that src is the most important oncogene. 现在,我不会说肉瘤原癌基因是最重要的原癌基因。
I will not tell you that src is the most frequently turned on oncogene in all of cancer. 我也不会告诉你 肉瘤原癌基因是最常见的原癌基因。
frequently:adv.频繁地,经常地;时常,屡次;
But it was the first oncogene. 但是,它是第一个被发现的原癌基因。
The exception, the outlier drew our attention and led us to something that taught us very important things about the rest of biology. 那个特例,那个异常值, 它吸引了我们的注意力,并引领了我们, 教会了我们关于整个生物领域重要的东西。
Now, TP53 is the most important tumor suppressor gene. 当下,肿瘤抑制蛋白p53是最重要的抑癌因子。
It is the most frequently turned off tumor suppressor gene in almost every kind of cancer. 它是最常见的失效而引发各种肿瘤的 抑癌基因。
But we didn't learn about it from common cancers. 但是我们并不是从一般的癌症当中发现它的。
We learned about it when doctors Li and Fraumeni were looking at families, and they realized that these families had way too many sarcomas. 是当李医生和弗劳梅尼医生 在关注家庭史过程中, 发现有些家庭患肉瘤病人概率远高于其他家庭时
I told you that sarcoma is rare. 我告诉过你们了,肉瘤很罕见。
Remember that a one in a million diagnosis , if it happens twice in one family, is way too common in that family. 记住,百万分之一的诊断率, 如果在同一个家庭中出现两例, 那就已经远高于其他家庭了。
diagnosis:n.诊断;
The very fact that these are rare draws our attention and leads us to new kinds of thinking. 就是因为它们十分罕见的特性, 吸引了我们的注意力, 并引发了我们作出新的思考。
Now, many of you may say, and may rightly say, that yeah, Kevin, that's great, but you're not talking about a bird's wing. 你们中的很多人可能会说, 或者现在正在说, 嗯,凯文,这听起来不错, 但是你所说的并非是鸟的翅膀,
rightly:adv.正确地;恰当地;公正地;合适地;
You're not talking about moons floating around some planet Jupiter. 或者是卫星围绕着木星漂行。
This is a person. 这是一个人。
This outlier, this exception, may lead to the advancement of science, but this is a person. 这种特例,这种异常值,也许会引领我们科学的进步, 但是,这是一个人。
advancement:n.前进,进步;提升;
And all I can say is that I know that all too well. 而我能说的只是, 我太了解了。
I have conversations with these patients with rare and deadly diseases . 我与这些患有罕见的,致命的疾病的患者交流过。
deadly:adj.致命的;非常的;死一般的;adv.非常;如死一般地; diseases:n.[医]病(disease的复数);[医]疾病;[植保]病害;疾病种类;
I write about these conversations. 我记录下了我们的对话。
These conversations are terribly fraught . 这些谈话都是极度令人担忧的。
fraught:adj.担心的,忧虑的;充满…的;
They're fraught with horrible phrases like "I have bad news" or "There's nothing more we can do." 它们充满了那些可怕的短语 像是“我有一个坏消息”或是“我们已经尽力了”
horrible:可怕的,极讨厌的,
Sometimes these conversations turn on a single word: " terminal ." 有的时候,这些对话就带来了一个词: “晚期。”
terminal:n.终端;航站楼;终端机;航空终点站;adj.晚期的;不治的;致命的;患绝症的;
Silence can also be rather uncomfortable. 沉默也是同等的令人难受的。
Where the blanks are in medicine can be just as important as the words that we use in these conversations. 医药中的空白和我们在这些 对话中用语的间隙, 是同等重要的。
What are the unknowns? 什么是未知的？
What are the experiments that are being done? 有哪些实验是正在做的？
Do this little exercise with me. 和我一起做一个小练习。
Up there on the screen, you see this phrase, "no where." 在屏幕上,你可以看到这个短语,“没有地方“
Notice where the blank is. 注意一下间歇的地方。
If we move that blank one space over "no where" 如果我们移动一格那个空隙, “没有地方”
becomes "now here," 就变成了“现在在这”
the exact opposite meaning, just by shifting the blank one space over. 正好是相反的意思, 仅仅是移动一个空格。
shifting:adj.不断移动的;流动的;v.转移;赶快;快速移动;变换;(shift的现在分词)
I'll never forget the night that I walked into one of my patients' rooms. 我永远不会忘记走进 我的一位病人房间的那个夜晚。
I had been operating long that day but I still wanted to come and see him. 虽然一整天都在做手术, 我还是想要过去看看他。
He was a boy I had diagnosed with a bone cancer a few days before. 他是个孩子,在几天前被诊断出了骨癌。
diagnosed:v.诊断(疾病);判断(问题的原因);(diagnose的过去分词和过去式)
He and his mother had been meeting with the chemotherapy doctors earlier that day, and he had been admitted to the hospital to begin chemotherapy. 他和他的妈妈在那天早些时候,见了负责他的化疗医生, 他被允许进入医院开始化疗。
chemotherapy:n.[临床]化学疗法;
It was almost midnight when I got to his room. 当我进入他的房间的时候,已经是将近午夜了。
He was asleep, but I found his mother reading by flashlight next to his bed. 他睡着了,但是我发现他的妈妈 还在他的床边, 在灯光下阅读着。
She came out in the hall to chat with me for a few minutes. 她出来和我在走廊里聊了几分钟。
It turned out that what she had been reading was the protocol that the chemotherapy doctors had given her that day. 结果得知她在阅读的是当天 化疗医生给她的一份 协议书。
She had memorized it. 她记住了里面的内容。
memorized:v.记忆;记住(memorize的过去分词和过去式)
She said, "Dr. Jones, you told me that we don't always win with this type of cancer, but I've been studying this protocol, and I think I can do it. 她说,“琼斯医生,你告诉我们, 我们并不是总能战胜 这种癌症, 但是我很仔细的研究了这份协议,我认为我们能做到的。
I think I can comply with these very difficult treatments . 我认为我们可以应对这些非常困难的治疗
comply:vi.遵守;顺从,遵从;答应; treatments:n.治疗;疗法;对待;处理;讨论;(treatment的复数)
I'm going to quit my job. I'm going to move in with my parents. 我要辞掉我的工作。我会搬去和我的父母一起住。
quit:v.离开;放弃;停止;使…解除;n.离开;[计]退出;adj.摆脱了…的;已经了结的;
I'm going to keep my baby safe." 我要保护我的孩子。”
I didn't tell her. 我没有告诉她。
I didn't stop to correct her thinking. 我没有纠正她的想法。
She was trusting in a protocol that even if complied with, wouldn't necessarily save her son. 她正在相信一份协议书, 即使遵守了, 也不一定能挽救她的儿子。
complied:v.遵照(comply的过去式和过去分词); necessarily:adv.必要地;必定地,必然地;
I didn't tell her. 我没有告诉她。
I didn't fill in that blank. 我没有填补那个空隙。
But a year and a half later her boy nonetheless died of his cancer. 但是一年半之后, 她的儿子还是死于了癌症。
Should I have told her? 我应该告诉她吗？
Now, many of you may say, "So what? 现在,你们中的很多人可能会说,“那又怎样？”
I don't have sarcoma. 我有没有得肉瘤。
No one in my family has sarcoma. 我们家也没有人得肉瘤。
And this is all fine and well, but it probably doesn't matter in my life." 好吧,这也许是事实, 但它可能根本不会出现在我的人生中。”
And you're probably right. 你说的没错。
Sarcoma may not matter a whole lot in your life. 肉瘤也许与你的人生毫无关系。
But where the blanks are in medicine does matter in your life. 但是那些存在于医药中的空白, 是影响你的人生的。
I didn't tell you one dirty little secret. 我没有告诉你们一个肮脏的小秘密。
I told you that in medicine, we test predictions in populations, but I didn't tell you, and so often medicine never tells you that every time an individual encounters medicine, 我告诉了你们,在医药领域,我们在人群中进行测试, 但是我没有告诉你们的是, 在很多情况中,药物不会告诉你 每当一个个体 遇见药物,
individual:n.个人;有个性的人;adj.单独的;个别的; encounters:v.遭遇(encounter的第三人称单数);邂逅;n.遭遇战(encounter的复数);相见;
even if that individual is firmly embedded in the general population, neither the individual nor the physician knows where in that population the individual will land. 即便是那个个体深信自己隐藏于普试人群当中, 个体或是医生都不会知道, 实验最后降临在谁的头上。
embedded:adj.嵌入式的;植入的;内含的;v.嵌入(embed的过去式和过去分词形式);
Therefore, every encounter with medicine is an experiment. 都是一次实验。
You will be a subject in an experiment. 你就是那个实验中的 被实验者。
And the outcome will be either a better or a worse result for you. 而实验结果既可能是好的,也可能是不好的。
outcome:n.结果,结局;成果;
As long as medicine works well, we're fine with fast service, bravado , brimmingly confident conversations. 只要药物起作用, 我们就能满足于这种快速的服务, 自满的,充满自信的谈话。
As long as:conj.只要;长达;如果;既然; bravado:n.虚张声势;冒险; confident:adj.自信的;确信的;
But when things don't work well, sometimes we want something different. 但是当事情进展不顺利, 有时我们就希望得到不同。
A colleague of mine removed a tumor from a patient's limb . 我的一个同事从一位病人的身上摘下了一个肿瘤。
limb:n.肢,臂;分支;枝干;v.切断…的手足;从…上截下树枝;
He was concerned about this tumor. 他很担心这个肿瘤。
concerned:adj.有关的;关心的;v.关心;与…有关;(concern的过去时和过去分词)
In our physician conferences , he talked about his concern that this was a type of tumor that had a high risk for coming back in the same limb. 在我们的研讨会上,他谈论了自己的担忧, 这是一种,有着极高的 原位复发率的肿瘤。
conferences:n.会议(conference的复数形式);
But his conversations with the patient were exactly what a patient might want: brimming with confidence . 但是他与病患的交流 却完全是病患想听到的那种: 充满自信。
brimming:v.(使)满,盛满;(brim的现在分词) confidence:n.信心;信任;秘密;adj.(美)诈骗的;骗得信任的;
He said, "I got it all and you're good to go." 他说:“我已经把它搞定了,你已经可以出院了。”
She and her husband were thrilled . 她和她的丈夫为此十分兴奋。
thrilled:adj.非常兴奋; v.使非常兴奋; (thrill的过去分词和过去式)
They went out, celebrated, fancy dinner, opened a bottle of champagne . 他们离开了,庆祝了,美妙的晚餐,还开了一瓶香槟。
fancy:n.幻想; adj.想象的; v.想象; champagne:n.香槟酒;香槟酒色;
The only problem was a few weeks later, she started to notice another nodule in the same area. 唯一的问题就在于几周之后, 她开始注意到在同一片区域的另一个结节。
nodule:n.小结;小瘤;节结;
It turned out he hadn't gotten it all, and she wasn't good to go. 结果表明他没搞定肿瘤,她也还不能出院。
But what happened at this juncture absolutely fascinates me. 但这个时候发生的事,我却觉得十分有趣。
juncture:n.接缝;连接;接合; fascinates:vt.使着迷,使神魂颠倒;vi.入迷;
My colleague came to me and said, "Kevin, would you mind looking after this patient for me?" 我的同事找到我,并说, “凯文,你愿意帮我照顾这个病人吗？”
I said, "Why, you know the right thing to do as well as I do. 我说:“为什么,你和我一样,知道该怎么做啊。
as well as:也;和…一样;不但…而且;
You haven't done anything wrong." 你没做错任何事情。”
He said, "Please, just look after this patient for me." 他说,“求你了,就帮我照看一下这个病人吧。”
He was embarrassed — not by what he had done, but by the conversation that he had had, by the overconfidence . 他感到脸红— 不是为他所做的, 而是为他所说的, 为他的过度自信。
embarrassed:adj.尴尬的;窘迫的;v.使...局促不安;(embarrass的过去分词和过去式) overconfidence:n.自负;过分相信;
So I performed a much more invasive surgery and had a very different conversation with the patient afterwards. 所以我又做了一个更加侵入性的手术 在之后与病患做了一个截然不同的对话。
invasive:adj.侵略性的;攻击性的;
I said, "Most likely I've gotten it all and you're most likely good to go, but this is the experiment that we're doing. 我说,“最可能的情况是,我已经完全切除了, 你应该可以走了, 但是这是我们的一个实验。
This is what you're going to watch for. 这是你需要继续观察的。
This is what I'm going to watch for. 这也是我需要继续观察的。
And we're going to work together to find out if this surgery will work to get rid of your cancer." 然后我们会一起努力,来探寻手术是否 成功解决了你的癌症。“
I can guarantee you, she and her husband did not crack another bottle of champagne after talking to me. 我可以向你们保证,在这次谈话后,
guarantee:n.保证;担保;保证人;保证书;抵押品;v.保证;担保; crack:v.使破裂;打开;变声;n.裂缝;声变;噼啪声;adj.最好的;高明的;
But she was now a scientist, not only a subject in her experiment. 但是,她却变为了一名科学家, 而不仅仅是实验中的实验对象。
And so I encourage you to seek humility and curiosity in your physicians. 所以,我鼓励你们去 在你们的医生那儿,
seek:v.寻求;寻找;谋求;
Almost 20 billion times each year, a person walks into a doctor's office, and that person becomes a patient. 每年大概有200亿次, 当一个人走进医生的办公室, 然后出来时就变成了一名患者。
You or someone you love will be that patient sometime very soon. 你和你所爱的人很快也会变成那个患者。
How will you talk to your doctors? 你会如何和你的医生们说？
What will you tell them? 你会告诉他们什么？
What will they tell you? 他们会告诉你什么？
They cannot tell you what they do not know, but they can tell you when they don't know if only you'll ask. 他们不能告诉你 他们也不确定的事, 但是他们也可以告诉你他们不知道, 只有当你问的时候。
So please, join the conversation. 所以,请你们加入谈话当中吧。
Thank you. 谢谢。
(Applause) （掌声）