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MitchellKatz_2018P-_美国医疗保健系统假设了我们什么_
A few years ago, 几年前,
I was taking care of a woman who was a victim of violence . 我曾接待过一个 遭受暴力对待的女士。
victim:n.受害人;牺牲品;牺牲者; violence:n.暴力;侵犯;激烈;歪曲;
I wanted her to be seen in a clinic that specialized in trauma survivors. 我想让她去专门治疗 创伤幸存者的诊所。
clinic:n.诊所;临床实习;(医院的)门诊部;门诊时间; specialized:adj.专业的; v.专门研究(或从事); (specialize的过去式和过去分词) trauma:n.[外科]创伤(由心理创伤造成精神上的异常);外伤;
I made the appointment myself because, being the director of the department, 我亲自为她预约, 因为作为这个部门的主管,
appointment:n.任命;约定;任命的职位;
I knew if I did it, she would get an appointment right away . 我知道如果我去, 她会立刻得到预约。
right away:立刻;
The clinic was about an hour and a half away from where she lived. 诊所离她住的地方大约 有一个半小时的路程。
But she took down the address and agreed to go. 她记住了地址并约定了会去。
Unfortunately , she didn't make it to the clinic. 但遗憾的是,她没有出现。
Unfortunately:adv.不幸地;
When I spoke to the psychiatrist , he explained to me that trauma survivors are often resistant to dealing with the difficult issues that they face and often miss appointments . 当我和精神病医生谈话时, 他向我解释说, 创伤幸存者通常拒绝处理 他们遇到的困难, 并常常错过预约。
psychiatrist:n.精神病学家,精神病医生; resistant:adj.抵抗的,反抗的;顽固的;n.抵抗者; 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) appointments:n.约会;预约;约定;任命;委任;职位;(appointment的复数)
For this reason, they don't generally allow the doctors to make appointments for the patients . 因为这个原因, 他们通常不让医生为病人预约。
generally:adv.通常;普遍地,一般地; patients:n.接受治疗者,病人;(patient的复数)
They had made a special exception for me. 他们特地为我开了绿灯。
exception:n.例外;异议;
When I spoke to my patient, she had a much simpler and less Freudian explanation of why she didn't go to that appointment: her ride didn't show. 当我跟我的病人交谈时, 她对为什么没能赴约 有个简单得多, 而且不那么弗洛伊德式的解释: 带她去的车没出现。
Freudian:adj.佛洛伊德的;佛洛伊德学说的;n.相信佛洛伊德学说的人;
Now, some of you may be thinking, "Didn't she have some other way of getting to that clinic appointment?" 现在,你们有些人可能在想, “她没有别的办法去诊所吗？”
Couldn't she have taken an Uber or called another friend? 她不能打个优步或 叫另一个朋友送她去吗？
Uber:adj.最好的;?超级的;n.Uber(公司品牌名)优步;
If you're thinking that, it's probably because you have resources . 如果你那样想, 这可能是因为你有资源。
resources:n.[计][环境]资源; v.向…提供资金(resource的第三人称单数);
But she didn't have enough money for an Uber, and she didn't have another friend to call. 但她并没有足够的钱打优步, 也没有另一个朋友可以叫。
But she did have me, and I was able to get her another appointment, which she kept without difficulty. 但她却有我, 我能够让她得到另一个预约, 并且可以毫不费力地保持。
She wasn't resistant, it's just that her ride didn't show. 她不是不愿意, 只是她的车没有出现。
I wish I could say that this was an isolated incident, but I know from running the safety net systems in San Francisco, Los Angeles, and now New York City, that health care is built on a middle-class model that often doesn't meet the needs of low-income patients. 我希望我能说这是一个孤立的事件, 但我从旧金山、洛杉矶 和现在的纽约市 运行的安全网络系统中知道, 医疗保健是建立在 中产阶级模式之上的, 这种模式往往不能满足 低收入患者的需求。
isolated:adj.偏远的; v.隔离,孤立,脱离; safety net:n.安全保障;为防止人摔落而设置的安全网; health care:n.卫生保健; middle-class:adj.中产阶级的;中层社会的;
That's one of the reasons why it's been so difficult for us to close the disparity in health care that exists along economic lines, despite the expansion of health insurance under the ACA, or Obamacare . 这就是为什么我们很难 缩小医疗保健方面存在的 经济差距的原因之一, 尽管平价医疗法案,也叫奥巴马医改, 扩大了医疗保险。
disparity:n.不同;不一致;不等; economic:adj.经济的,经济上的;经济学的; despite:prep.尽管,不管;n.轻视;憎恨;侮辱; expansion:n.扩张;膨胀;扩展;扩大; insurance:n.保险;保险业;保险费;保费;adj.胜券在握的; Obamacare:奥巴马医改计划;
Health care in the United States assumes that, besides getting across the large land expanse of Los Angeles, it also assumes that you can take off from work in the middle of the day to get care. 美国的医疗保健假设, 除了可以跨越广阔的洛杉矶, 它还假设你可以在中午离开工作 去看医生。
United:adj.联合的; v.联合,团结; (unite的过去分词和过去式) assumes:v.假定;采用;承担;呈;(assumes是assume的第三人称单数) besides:adv.此外;而且;prep.除…之外; expanse:n.宽阔;广阔的区域;苍天;膨胀扩张;
One of the patients who came to my East Los Angeles clinic on a Thursday afternoon presented with partial blindness in both eyes. 有个周四的下午,一位病人来到 我在东洛杉矶的诊所, 他的双眼出现了部分失明的症状。
partial:adj.部分的;不完整的;片面的;有偏见的;
Very concerned , I said to him, "When did this develop?" 我非常担心地对他说, “这种情况是什么时候出现的？”
concerned:adj.有关的;关心的;v.关心;与…有关;(concern的过去时和过去分词)
He said, "Sunday." 他说,“星期天。”
I said, "Sunday? 我说,“星期天？”
Did you think of coming sooner to clinic?" 你想过早点来诊所吗？”
And he said, "Well, I have to work in order to pay the rent." 他说,“我得工作才能支付租金。”
A second patient to that same clinic, a trucker , drove three days with a raging infection , only coming to see me after he had delivered his merchandise . 第二病人来到同样的诊所, 一个卡车司机, 带着严重的感冒开了三天车, 只能在他交付完货物后才来见我。
trucker:n.卡车司机;从事货车运输业者; raging:adj.愤怒的,狂暴的;v.发怒,恼火(rage的现在分词); infection:n.感染;传染;(身体某部位的)感染;传染病; merchandise:n.商品;货品;相关商品;v.推销;(运用广告等)销售;
Both patients' care was jeopardized by their delays in seeking care. 这两名病人的健康都因 延误求医而受到损害。
jeopardized:v.冒…的危险;危及;危害;损害;(jeopardize的过去式和过去分词) seeking:v.寻找;寻求;谋求;争取;(向人)请求(seek的现在分词)
Health care in the United States assumes that you speak English or can bring someone with you who can. 美国的医疗保健假设你会说英语, 或者你可以带一个会说英语的人。
In San Francisco, I took care of a patient on the inpatient service who was from West Africa and spoke a dialect so unusual that we could only find one translator on the telephonic line who could understand him. 在旧金山,我在住院部 照顾过一个病人, 他来自西非,并且说 一种不常见的方言, 我们只能在电话系统上 找到一个翻译 可以听懂他。
inpatient:n.住院病人;住院的; dialect:n.方言;地方话;土话; telephonic:adj.[通信]电话的;用电话传送的;电话机的;
And that translator only worked one afternoon a week. 那个翻译一周只工作一个下午。
Unfortunately, my patient needed translation services every day. 遗憾的是,我的病人 每天都需要翻译服务。
Health care in the United States assumes that you are literate . 美国的医疗保健假设你有文化。
literate:adj.受过教育的;精通文学的;n.学者;
I learned that a patient of mine who spoke English without accent was illiterate , when he asked me to please sign a social security disability form for him right away. 我在一个说地道英语的病人 请我马上为他签署一份 社会保障残疾表格时, 才知道他是文盲。
accent:n.口音;重音;强调;特点;重音符号;v.强调;重读;带…口音讲话; illiterate:adj.文盲的;不识字的;没受教育的;n.文盲; social security:n.社会保障金(政府定期向贫穷、失业、患病等人发放); disability:n.残疾;无能;无资格;不利条件;
The form needed to go to the office that same day, and I wasn't in clinic, so trying to help him out, knowing that he was the sole caretaker of his son, 表格需要在当天交到办公室, 而我当时不在诊所, 所以为了帮助他解决, 知道他是他儿子的唯一监护人,
sole:n.鞋底; adj.仅有的; v.给(鞋)换底; caretaker:n.看管者;看门人;守护者;adj.临时代理的;
I said, "Well, bring the form to my administrative office. 我说,“好吧,把表格带到 我的行政办公室。
administrative:adj.管理的,行政的;
I'll sign it and I'll fax it in for you." 我会签字并传真给你。”
He took the two buses to my office, dropped off the form, went back home to take care of his son ... 他坐了两趟公共汽车到我的办公室, 留下表格, 回到家照顾他的小孩…
I got to the office, and what did I find next to the big "X" on the form? 我回到办公室,在表格大大 的“X”旁边我发现了什么？
The word " applicant ." 写着“申请人”。
applicant:n.申请人(尤指求职、进高等学校等);
He needed to sign the form. 他需要在表格上签字。
And so now I had to have him take the two buses back to the office and sign the form so that we could then fax it in for him. 所以现在我不得不让他乘坐 两趟公交回到我的办公室, 再签字,这样我们就可以传真给他。
It completely changed how I took care of him. 这完全改变了我关照他的方式。
I made sure that I always went over instructions verbally with him. 我确保我总是和他一起 仔细口头检查指南。
verbally:adv.口头地,非书面地;用言辞地;
It also made me think about all of the patients who receive reams and reams of paper spit out by our modern electronic health record systems, explaining their diagnoses and their treatments , 这也让我想起所有的病人, 他们会收到我们现代 电子健康记录系统吐出的大量文件, 用于解释他们的诊断和治疗,
reams:n.大量的文字(或写作);v.不公平地对待;欺骗;(ream的第三人称单数和复数) electronic:adj.电子的;电子器件的;电子设备的; diagnoses:n.诊断;调查分析;评价(diagnosis的复数形式); treatments:n.治疗;疗法;对待;处理;讨论;(treatment的复数)
and wondering how many people actually can understand what's on those pieces of paper. 我想知道有多少人能够真正理解 这些纸上写的是什么。
Health care in the United States assumes that you have a working telephone and an accurate address. 美国的医疗保健假设你 有一部能用的电话 和一个准确的地址。
accurate:adj.精确的;
The proliferation of inexpensive cell phones has actually helped quite a lot. 廉价手机的普及 确实帮了大忙。
proliferation:n.增殖,扩散;分芽繁殖; inexpensive:adj.廉价的;不昂贵的;
But still, my patients run out of minutes, and their phones get disconnected . 但我的病人手机仍然会欠费, 然后就联系不上了。
run out of:用完; disconnected:adj.分离的; v.切断(煤气、水或电的供应); (disconnect的过去式和过去分词)
Low-income people often have to move around a lot by necessity. 低收入者经常不得不搬家。
move around:v.走来走去;绕着…来回转;
I remember reviewing a chart of a woman with an abnormality on her mammogram . 我记得我看过一个乳房X光检查中 出现异常的女性的图表。
reviewing:v.复查;重新考虑;反思;评论;(review的现在分词) abnormality:n.异常;畸形,变态; mammogram:n.乳房X线照片;
That chart assiduously documents that three letters were sent to her home, asking her to please come in for follow-up . 那张图表详细记录了 有三封信已经寄到她家, 请她来跟进。
assiduously:adv.刻苦地;勤勉地; come in for:受到;接受;得到; follow-up:adj.后续的;增补的;n.随访;跟进;后续行动;
Of course, if the address isn't accurate, it doesn't much matter how many letters you send to that same address. 当然,如果这个地址不准确, 你寄多少封信过去 那个地址都不重要。
Health care in the United States assumes that you have a steady supply of food. 美国的医疗保健假设 你有稳定的食物供应。
steady:adj.稳定的; v.使稳定; v.稳定地; n.关系固定的情侣;
This is particularly an issue for diabetics . 这对糖尿病患者来说尤其是个问题。
particularly:adv.特别地,独特地;详细地,具体地;明确地,细致地; diabetics:n.糖尿病,糖尿病患者;
We give them medications that lower their blood sugar . 我们给他们药物降低他们的血糖。
medications:n.药;药物;(medication的复数) blood sugar:n.血糖;
On days when they don't have enough food, it puts them at risk for a life-threatening side effect of hypoglycemia , or low blood sugar. 在他们没有足够食物的日子里, 这会让他们面临低血糖 或低血糖副作用的生命威胁。
life-threatening:adj.威胁生命的; side effect:n.副作用;附带后果; hypoglycemia:n.低血糖症;血糖过低;
Health care in the United States assumes that you have a home with a refrigerator for your insulin , a bathroom where you can wash up, a bed where you can sleep without worrying about violence while you're resting. 美国医疗保健假设你家里 有冰箱可以储存你的胰岛素, 有浴室可以洗漱, 有床可以睡觉, 休息时无需担心暴力。
insulin:n.[生化][药]胰岛素;
But what if you don't have that? 但如果你没有这些呢？
what if:如果…怎么办?
What if you live on the street, you live under the freeway , you live in a congregant shelter, where every morning you have to leave at 7 or 8am? 如果你住在街上, 住在高速公路下面, 或者住在集体避难所, 并且每天早上7点或8点 就必须离开哪里呢？
freeway:n.高速公路; congregant:n.(会议)召集人;聚会者;
Where do you store your medicines? 你在哪里储存你的药物？
Where do you use the bathroom? 你在哪里使用你的浴室？
How do you put your legs up if you have congestive heart failure ? 如果你有充血性心力衰竭, 你怎么抬腿？
congestive:adj.充血的,充血性的; heart failure:n.心力衰竭;
Is it any wonder that providing people with health insurance who are homeless does not erase the huge disparity between the homeless and the housed? 为无家可归者提供医疗保险 并没有消除他们 和被安置者之间的巨大差距, 这有什么奇怪的吗？
erase:vt.抹去;擦除;vi.被擦去,被抹掉;
Health care in the United States assumes that you prioritize your health care. 美国医疗保险假设你以看病为重。
prioritize:v.按重要性排列;划分优先顺序;优先处理;
But what about all of you? 但你们所有人呢？
Let me assume for a moment that you're all taking a medication. 让我假设一个场景, 你们都需要服药。
Maybe it's for high blood pressure . 也许是为了治疗高血压。
blood pressure:n.[医]血压;
Maybe it's for diabetes or depression . 也许是为了治疗糖尿病和抑郁症。
diabetes:n.糖尿病;多尿症; depression:n.沮丧;洼地;不景气;忧愁;
What if tonight you had a choice: you could have your medication but live on the street, or you could be housed in your home but not have your medication. 如果你今晚有个选择: 你可以服药,但要生活在街上, 或者你可以住在家中,但不能服药。
Which would you choose? 你会怎么选？
I know which one I would choose. 我知道我会选择哪个。
This is just a graphic example of the kinds of choices that low-income patients have to make every day. 这就是低收入病人每天 面临选择的一个例子。
graphic:adj.形象的;图表的;绘画似的;
So when my doctors shake their heads and say, "I don't know why that patient didn't keep his follow-up appointments," 所以当我的医生摇头并说, “我不知道为什么那个病人 没有遵守他的跟进预约,”
'"I don't know why she didn't go for that exam that I ordered," “我不知道为什么 他没来参与我预定的检查,”
I think, well, maybe her ride didn't show, or maybe he had to work. 我想,可能是因为他的车没有出现, 或者他不得不工作。
But also, maybe there was something more important that day than their high blood pressure or a screening colonoscopy . 但同样,也许那天有 比高血压或结肠镜检查 更重要的事情。
colonoscopy:n.结肠镜检查;
Maybe that patient was dealing with an abusive spouse or a daughter who is pregnant and drug-addicted or a son who was kicked out of school. 也许这个病人面对的是 一个有虐待倾向的配偶, 或者是一个怀孕且吸毒成瘾的女儿, 或者是一个被学校开除的儿子。
abusive:adj.辱骂的;滥用的;虐待的; spouse:n.配偶;vt.和…结婚; pregnant:adj.怀孕的;富有意义的; drug-addicted:吸毒上瘾的;吸毒成瘾的;
Or even maybe they were riding their bicycle through an intersection and got hit by a truck, and now they're using a wheelchair and have very limited mobility . 或者甚至是他们的汽车 经过十字路口时 被卡车撞到了, 现在他们只能坐着轮椅,行动不便。
intersection:n.交叉;十字路口;交集;交叉点; wheelchair:n.轮椅; limited:adj.有限的; n.高级快车; v.限制; (limit的过去分词和过去式) mobility:n.移动性;机动性;[电子]迁移率;
Obviously, these things also happen to middle-class people. 显然,这些事情也会 发生在中产阶级身上。
But when they do, we have resources that enable us to deal with these problems. 但当它们发生时, 我们有资源来应对这些问题。
enable:v.使能够;使有机会;使成为可能;使可行;
We also have the belief that we will live out our normal lifespans . 我们也相信我们会活到正常寿命。
lifespans:n.寿命;预期生命期限;预期使用期限;
That's not true for low-income people. 这对于低收入群体则不现实。
They've seen their friends and relatives die young of accidents, of violence, of cancers that should have been diagnosed at an earlier stage. 他们见过他们的朋友和亲戚 因事故, 暴力, 或本该在早期就能诊断出来 的癌症而死去。
relatives:n.亲戚;亲属;同类事物;(relative的复数) cancers:n.癌; (Cancers是cancer的复数) diagnosed:v.诊断(疾病);判断(问题的原因);(diagnose的过去分词和过去式)
It can lead to a sense of hopelessness , that it doesn't really matter what you do. 这会导致无助感, 这真的跟你怎么做没有关系。
hopelessness:n.绝望,无望;不抱希望;
I know I've painted a bleak picture of the care of low-income patients. 我知道我描绘了一幅低收入 病人惨淡的画面。
bleak:adj.阴冷的;荒凉的,无遮蔽的;黯淡的,无希望的;冷酷的;单调的;
But I want you to know how rewarding I find it to work in a safety net system, and my deep belief is that we can make the system responsive to the needs of low-income patients. 但我想让你们知道我认为 在安全的网络系统中 工作是多么值得, 并且我深信我们 可以让这个系统 去响应低收入病人的需求。
rewarding:adj.有益的;值得做的;报酬高的;v.奖励;奖赏;给以报酬;(reward的现在分词) responsive:adj.响应的;应答的;回答的;
The starting point has to be to meet patients where they are, provide services without obstacles and provide patients what they need -- not what we think they need. 起点必须是到达病人所在的位置, 无障碍地提供服务, 并且提供病人所需要的—— 而非我们认为他们需要的。
starting point:n.出发点;基础; obstacles:n.障碍;障碍物;阻碍;(obstacle的复数形式)
It's impossible for me to take good care of a patient who is homeless and living on the street. 我不可能照料好那些 无家可归或流落街头的人。
The right prescription for a homeless patient is housing. 无家可归的病人最好的药方是住房。
prescription:n.处方;药方;医生开的药;开处方;
In Los Angeles, we housed 4,700 chronically homeless persons suffering from medical illness, mental illness, addiction . 在洛杉矶, 我们收容了4700名患有疾病、 精神疾病和毒瘾的长期无家可归者。
chronically:adv.长期地;慢性地;习惯性地; mental:adj.精神的;脑力的;疯的;n.精神病患者; addiction:n.瘾;嗜好;入迷;
When we housed them, we found that overall health care costs, including the housing, decreased . 当我们为他们提供住处时, 我们发现整体的医疗保健成本, 包括住处在内, 降低了。
overall:v.全部; n.外套; adj.全面的; decreased:v.减少,减小,降低;(decrease的过去分词和过去式)
That's because they had many fewer hospital visits, both in the emergency room and on the inpatient service. 那是因为他们去医院的次数少了, 不管是急诊室还是住院部。
emergency room:n.急诊室;
And we gave them back their dignity . 我们还给他们了尊严,
dignity:n.尊严;高贵;
No extra charge for that. 不需要额外的费用。
extra:adj.额外的:n.额外的事物:adv.额外:另外: charge for:索价,要价;为…收费;
For people who do not have a steady supply of food, especially those who are diabetic, safety net systems are experimenting with a variety of solutions, including food pantries at primary care clinics and distributing maps of community food banks and soup kitchens. 对没有稳定食物供给的人, 尤其是那些糖尿病患者, 安全保护网络 正在实验多种解决方案, 包括初级保健诊所的食品分发, 以及社区食品银行和 热汤供点的分发地图。
especially:adv.尤其;特别;格外;十分; variety:n.多样;种类;杂耍;变化,多样化; pantries:n.餐具室;食品室;食品储藏室; clinics:n.诊所(clinic的复数形式); distributing:v.分发;分配;分销;使散开;使分布;分散;(distribute的现在分词) community:n.社区;[生态]群落;共同体;团体;
And in New York City, we've hired a bunch of enrollers to get our patients into the supplemental nutrition program known as "food stamps" to most people. 在纽约, 我们雇用了一群登记者 来让我们的病人加入 补充营养援助计划, 即为多数人所知的“食物券”。
a bunch of:一群;一束;一堆; supplemental:adj.补充的(等于supplementary);追加的; nutrition:n.营养,营养学;营养品;
When patients and doctors don't understand each other, mistakes will occur . 当病人和医生无法理解彼此时, 错误就会出现。
occur:v.发生;出现;存在于;出现在;
For non-English-speaking patients, translation is as important as a prescription pad . 对于母语非英语的病人, 翻译就如同处方笺一样重要,
non-English-speaking:不讲英语的;不说英语的;非讲英语国家; pad:n.软垫,护垫;便笺本;爪垫;肉掌;v.填充,覆盖,保护;蹑手蹑脚地走;做黑账;
Perhaps more important. 可能更加重要。
And, you know, it doesn't cost anything more to put all of the materials at the level of fourth-grade reading, so that everybody can understand what's being said. 要知道,将所有的材料 按四年级阅读水品书写 并不会增加多少成本, 这样每个人都能理解 上面说的是什么。
But more than anything else, I think low-income patients benefit from having a primary care doctor. 但更重要的,我认为低收入病人 会受益于初级护理医生。
Mind you, I think middle-class people also benefit from having somebody to quarterback their care. 提醒各位一下,我认为 中产阶级也会受益于 有人管理他们的医疗。
quarterback:n.橄榄球的四分卫; vt.(以四分卫)指挥进攻; (橄榄球中)担任四分卫;
But when they don't, they have others who can advocate for them, who can get them that disability placard or make sure the disability application is completed. 但当他们没有时, 他们有其他人可以为他们争取, 他们可以得到残疾的证明 或确保残疾申请完成。
advocate:v.拥护;支持;提倡;n.支持者;提倡者;辩护律师;出庭辩护人; placard:n.海报,标语牌;招贴;vt.张贴,悬挂;公布;张贴公告于;vi.张贴公告; application:n.应用;申请;应用程序;敷用;
But low-income people really need a team of people who can help them to access the medical and non-medical services that they need. 但低收入人群真的需要 一个团队来帮助他们 获取他们所需的医疗 和非医疗资源。
non-medical:un.非药性的;无需住院天数;
Also, many low-income people are disenfranchised from other community supports, and they really benefit from the care and continuity provided by primary care. 同样,很多低收入人群缺乏 其他社区的支持, 他们确实会受益于初级护理 及护理的连续性。
disenfranchised:v.剥夺(某人)的权利(尤指选举权);(disenfranchise的过去分词和过去式) continuity:n.连续性;一连串;分镜头剧本; provided:conj.假如; v.提供; (provide的过去分词和过去式)
A primary care doctor I particularly admire once told me how she believed that her relationship with a patient over a decade was the only healthy relationship that that patient had in her life. 一位我尤其欣赏的初级护理医生, 曾经告诉我,她相信她与一个病人 长达10年的关系 是这个病人在她一生中 唯一的健康关系。
The good news is, you don't actually have to be a doctor to provide that special sauce of care and continuity. 好消息是,你不必 非得成为一个医生, 就能提供那种特别的关怀和连续性。
sauce:n.酱;调味汁;讨厌的话(或举动);v.给…加滋味;(俚)对…说冒昧话;
This was really brought home to me when one of my own long-term patients died at an outside hospital. 当我的一位长期病人 在一家医院外去世时, 我才真正意识到这一点。
long-term:adj.长期的;从长远来看;
I had to tell the other doctors and nurses in my clinic that he had passed. 我需要告诉诊所里 的其他医生和护士, 他去世了。
But I didn't know that in another part of our clinic, on a different floor, there was a registration clerk who had developed a very special relationship with my patient every time he came in for an appointment. 但我不知道的是, 在我们诊所的其他地方, 在不同的楼层, 有一个登记员, 他跟这个每次来挂号的病人 也发展了一段非常特别的关系。
registration:n.登记;注册;挂号;
When she learned three weeks later that he had died, she came and found me in my examining room, tears streaming down her cheeks, talking about my patient and the memories that she had of him, the kinds of discussions that they had had about their lives together. 当她三周后听到他去世的消息时, 她来到我的检查室找我, 眼泪顺着她的脸颊流下, 她讲起我的病人和她对他的回忆, 他们曾经一起讨论的那些话题。
My patient had a hard life. 我的病人生活艰难。
He was by his own admission a gangbanger . 他承认自己是个混混。
admission:n.入场费;进入权;招供;门票费; gangbanger:n.青少年犯罪团伙成员;
He had spent a substantial amount of time in prison. 他在监狱里呆了很长一段时间。
substantial:adj.大量的;实质的;内容充实的;n.本质;重要材料;
He suffered from a very serious illness. 他曾遭受一种非常严重疾病的折磨。
He was a drug addict. 他是瘾君子。
But despite all that, he rarely missed a visit, and I like to believe that was because he knew at our clinic that he was loved. 尽管如此,他却很少错过 跟医生的预约, 我相信那是因为他知道 他在我们诊所是被爱的。
rarely:adv.很少地;难得;罕有地;
When our health care systems have the same commitment to low-income patients that that man had to us, two things will happen. 当我们的医疗保健系统 对低收入病人拥有 像那个病人对我们同样的承诺时, 两件事会发生。
commitment:n.承诺;投入;保证;许诺;
First, the system will be responsive to the needs of low-income people. 首先,医疗系统能够响应 低收入病人的需求。
It will speak their language, it will meet their schedules, it will fulfill their needs. 它会说他们的语言, 它会顺应他们的日程安排, 它会满足他们的需求。
fulfill:v.执行,贯彻;完成,实现;兑现;达到;起到;
Second, we will be providing the kind of care that we went into this profession to do -- not just checking the boxes, but really taking care of those we serve. 第二,我们会提供 我们进入这个行业 所要做的护理—— 不仅只是检查表格, 而是真正照顾这些我们所服务的人。
profession:n.行业,职业;业内人士;同行;
Thank you. 谢谢。
(Applause) （鼓掌）