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PeterWeinstock_2016X-_栩栩如生的模拟演练使得实际的手术更为安全_
What if I told you there was a new technology that, when placed in the hands of doctors and nurses, improved outcomes for children and adults, patients of all ages; reduced pain and suffering, reduced time in the operating rooms, reduced anesthetic times, had the ultimate dose-response curve that the more you did it, the better it benefitted patients? 想像这会怎样── 交给医生和护士使用, 它能改善儿童、成人, 它能降低病人的痛苦, 缩短手术的时间, 减少麻醉的次数, 获得最佳的剂量反应曲线; 这技术被用得越多, 患者的获益就越大。
What if:如果…怎么办? technology:n.技术;工艺;术语; in the hands of:由…掌握;在…掌握中; improved:adj.改良的:v.改进:改善(improve的过去分词和过去式) outcomes:n.结果;成果;后果;出路;(outcome的复数) patients:n.接受治疗者,病人;(patient的复数) anesthetic:adj.麻醉的;感觉缺失的;n.麻醉剂,麻药; ultimate:adj.最终的;极限的;根本的;n.终极;根本;基本原则; dose-response:un.剂量反应;剂量疗效反应;反应关系; curve:n.曲线;弯曲;曲面;弧线;v.(使)沿曲线移动;呈曲线形; benefitted:适合于...(benefit的过去式和过去分词);对...有利;有益于...;
Here's a kicker : it has no side effects, and it's available no matter where care is delivered. 意料之外的是:它不但没有副作用, 且可用于任何治疗。
kicker:n.踢者;爱发牢骚的人;喷射器;
I can tell you as an ICU doctor at Boston Children's Hospital, this would be a game changer for me. 身为波士顿儿童医院 加护病房的医生, 我认为局面会全然改观。
Boston:n.波士顿(美国城市); changer:n.转换开关装置;改变者(change的名词形式);
That technology is lifelike rehearsal . 我说的科技是
lifelike:adj.栩栩如生的;逼真的; rehearsal:n.排演;预演;练习;训练;叙述;
This lifelike rehearsal is being delivered through medical simulation . 用逼真的医学模拟来练习。
simulation:n.仿真;模拟;模仿;假装;
I thought I would start with a case, just to really describe the challenge ahead, and why this technology is not just going to improve health care but why it's critical to health care. 我先举个实例 来确切说明医学所面临的挑战, 为何这技术不但会改善医疗, 并且是不可或缺的。
describe:v.描述;形容;把…称为;画出…图形; health care:n.卫生保健; 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;
This is a child that's born, young girl. 这是一个刚出生的小女孩。
'"Day of life zero," we call it, the first day of life, just born into the world. 我们称为「生命的首日」, 她降生到这世界的第一天。
And just as she's being born, we notice very quickly that she is deteriorating . 她一出生, 我们立刻发现她的健康状况
deteriorating:v.退化,恶化(deteriorate的ing形式);
Her heart rate is going up, her blood pressure is going down, she's breathing very, very fast. 她的心跳加速, 呼吸非常急促。
blood pressure:n.[医]血压;
And the reason for this is displayed in this chest X-ray. 这张 X 光片显示病因。
displayed:v.陈列;展出;展示;显露(display的过去分词和过去式)
That's called a babygram, a full X-ray of a child's body, a little infant's body. 我们称之为婴儿图像 (babygram), 是婴儿全身的 X 光片。
As you look on the top side of this, that's where the heart and lungs are supposed to be. 图片的上半 是心脏和肺脏应该在的位置;
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)
As you look at the bottom end, that's where the abdomen is,and that's where the intestines are supposed to be. 下半是腹部和小肠应该在的位置。
abdomen:n.腹部;下腹;腹腔; intestines:n.[解剖]肠(intestine的复数);内脏;下水;
And you can see how there's sort of that translucent area that made its way up into the right side of this child's chest. 看这块半透明的区域, 一直延伸到右上方婴儿的胸腔,
translucent:adj.透明的;半透明的;
And those are the intestines -- in the wrong place . 那是错位的小肠。
in the wrong place:不合适的地方;
As a result , they're pushing on the lungs and making it very difficult for this poor baby to breathe. 小肠推挤肺部, 使得这可怜的婴儿难以呼吸。
As a result:结果;
The fix for this problem is to take this child immediately to the operating room, bring those intestines back into the abdomen, let the lungs expand and allow this child to breathe again. 解决之道是马上为她动手术, 把小肠移回腹部, 让她肺的空间扩大, 能够恢复呼吸。
expand:v.扩张;使膨胀;详述;发展;张开,展开;
But before she can go to the operating room, she must get whisked away to the ICU, where I work. 但在手术之前, 必须先火速送她进我的加护病房。
whisked:v.搅打,搅动;匆匆带走;迅速送走(whisk的过去分词和过去式)
I work with surgical teams.We gather around her, and we place this child on heart-lung bypass . 我和手术团队围绕着她, 为她接上体外心肺循环机 ,
surgical:adj.外科的;外科手术的; heart-lung:人工心肺机; bypass:vt.绕开;忽视;设旁路;迂回;n.旁路;[公路]支路;
We put her to sleep, we make a tiny little incision in the neck, we place catheters into the major vessels of the neck -- and I can tell you that these vessels are about the size of a pen,the tip of a pen -- and then we have blood drawn from the body, we bring it through a machine, it gets oxygenated , and it goes back into the body. 上麻醉药, 在脖子上切个小口, 把导管伸入脖子的主动脉内。 这些血管的尺寸只有笔尖那么细。 我们抽出她的血液, 导入一台机器,充氧, 再送回体内。
incision:n.切口;雕刻,切割;切开; catheters:n.导尿管,尿液管(catheter的复数形式);医用导管; vessels:n.血管(vessel的复数);船舶;容器; tip:n.小窍门,小费;v.给…小费;使倾斜; oxygenated:adj.氧化的;充了氧的;充满氧气的;v.使氧合(oxygenate的过去分词);充氧;
We save her life, and get her safely to the operating room. 我们挽救她的性命, 把她安全送进开刀房。
Here's the problem: these disorders -- what is known is congenital diaphragmatic hernia -- this hole in the diaphragm that has allowed these intestines to sneak up -- these disorders are rare. 问题在此: 她罹患的病 被称为「先天性横膈疝气」, 隔膜上有个洞使肠子得以向上移位, 是种罕见的疾病。
disorders:n.无秩序,混乱; v.[电子]扰乱(disorder的单三形式); congenital:adj.先天的,天生的;天赋的; diaphragmatic:adj.隔膜的;横隔膜的; hernia:n.[中医]疝气;脱肠; sneak:v.溜; n.鬼鬼祟祟的人; adj.暗中进行的;
Even in the best hands in the world, there is still a challenge to get the volume -- the natural volume of these patients -- in order to get our expertise curve at 100 percent. 即使是世上最优秀的外科医生 也难以累积足够的经验, 因为患者的数目太少, 医师难以练到百分之百的技术曲线。
volume:n.体积;容积;音量;响度;一册;合订本 expertise:n.专门知识;专门技术;专家的意见;
They just don't present that often. 很难遇到这种病例。
So how do you make the rare common? 那么,怎样变罕见为常见呢？
Here's the other problem: in the health care system that I trained for over 20 years, what currently exists,the model of training is called the apprenticeship model. 另外还有一个问题: 我服务了二十多年的医疗系统, 现行的训练模式称为「学徒模式」,
currently:adv.当前;一般地; apprenticeship:n.学徒期;学徒身分;
It's been around for centuries. 已有数百年的历史。
It's based on this idea that you see a surgery maybe once, maybe several times, you then go do that surgery, and then ultimately you teach that surgery to the next generation. 学徒模式的基本概念 是先看别人做一次或数次的手术, 然后自己动手术; 最终再把这技术传承给下一代。
surgery:n.外科;外科手术;手术室;诊疗室; ultimately:adv.最终;最后;归根结底;终究;
And implicit in this model -- 其实说白了,
implicit:adj.含蓄的;暗示的;盲从的;
I don't need to tell you this -- is that we practice on the very patients that we are delivering care to. 相信大家也能想得到, 学徒模式是一面开刀、一面练习。
That's a problem. 这是个大问题。
I think there's a better approach . 我认为有更好的方法。
approach:n.方法;路径;v.接近;建议;着手处理;
Medicine may very well be the last high-stakes industry that does not practice prior to game time. 医疗很可能是最后一门 不先训练就实作的高风险行業了。
high-stakes:adj.高风险; prior:adj.先前的; n.(小隐修院)院长; v.居先;
I want to describe to you a better approach through medical simulation. 让我阐述医疗模拟这个好办法。
Well, the first thing we did is we went to other high-stakes industries that had been using this type of methodology for decades. 我们先参观其他已经使用这方法 数十年之久的高风险行業,
methodology:n.方法学,方法论;
This is nuclear power . 核电厂。
nuclear power:na.核大国;
Nuclear power runs scenarios on a regular basis in order to practice what they hope will never occur . 核电厂会定期演习, 练习和防范不乐见的未然;
scenarios:n.情节;脚本;情景介绍(scenario的复数); occur:v.发生;出现;存在于;出现在;
And as we're all very familiar , the airline industry -- we all get on planes now, comforted by the idea that pilots and crews have trained on simulators much like these, 还有大家熟悉的航空業。 现今大家搭机都很放心, 因爲机师和机组人员
familiar:adj.熟悉的;常见的;亲近的;n.常客;密友; airline:n.航空公司; simulators:n.模拟器;假装者,模拟者;
training on scenarios that we hope will never occur, but we know if they did, they would be prepared for the worst. 他们知道要如何应对 但愿永不发生的紧急状况; 万一不幸发生了, 我们有信心他们能应变。
In fact, the airline industry has gone as far as to create fuselages of simulation environments, because of the importance of the team coming together. 事实上,航空業甚至直接打造机舱模拟情境, 因为整体团队的运作至关重要。
as far as:至于…; fuselages:n.[航]机身(飞机);
This is an evacuation drill simulator. 这是模拟的疏散演习。
evacuation:n.疏散;撤离;排泄;
So again, if that ever were to happen, these rare, rare events, they're ready to act on the drop of a dime . 我重申,一旦发生罕见事故, 他们能够瞬间应变。
dime:n.一角硬币;
I guess the most compelling for me in some ways is the sports industry -- arguably high stakes. 我猜,最吸引我目光的 还是高风险的体育行業。
compelling:adj.引人入胜的; v.强迫; (compel的现在分词) arguably:v.可论证地;
You think about a baseball team: baseball players practice. 我认为棒球队球员练习
I think it's a beautiful example of progressive training. 是个渐进训练的好例子。
progressive:adj.进步的;先进的;开明的;稳步的;n.进步人士;开明人士;改革派;
The first thing they do is go out to spring training. 他们先进行春季训练。
They go to a spring training camp,perhaps a simulator in baseball. 春训用的可能是棒球模拟器,
They're not on the real field, but they're on a simulated field, and they're playing in the pregame season. 不是实体球场,而是模拟的球场。 他们打季前赛,
simulated:adj.假装的; v.假装; (simulate的过去式和过去分词) pregame:adj.比赛前的;
Then they make their way to the field during the season games, and what's the first thing they do before they start the game? 然后在正规赛季进入棒球比赛场。 开赛前他们先做些什么呢？
They go into the batting cage and do batting practice for hours, having different types of pitches being thrown at them, hitting ball after ball as they limber their muscles , getting ready for the game itself. 先在击球练习区挥棒几个小时; 面对各式球路 一次又一次挥棒暖身, 为真正的比赛做准备。
pitches:pitch的变形; limber:adj.柔软的;敏捷的;vt.使柔软;将接在前车上;vi.做准备活动; muscles:n.肌肉(muscle的复数);
And here's the most phenomenal part of this, and for all of you who watch any sport event, you will see this phenomenon happen. 最不凡的部分, 所有看球赛的人 都会看到这现象:
phenomenal:adj.现象的;显著的;异常的;能知觉的;惊人的,非凡的; phenomenon:n.现象;杰出的人;非凡的人(或事物);
The batter gets into the batter's box, the pitcher gets ready to pitch. 打者进入打击区, 投手准备投球,
batter:n.击球手;面糊(煎料);面糊(用于做糕饼);击球员;v.连续猛击;殴打; pitcher:n.投手;大水罐;
Right before the pitch is thrown, what does that batter do? 就在球被投出之前, 打者做什么动作？
The batter steps out of the box and takes a practice swing. 打者离开打击区 练习挥棒。
He wouldn't do it any other way. 打者必定这样做。
I want to talk to you about how we're building practice swings like this in medicine. 告诉你 我们如何为医疗行業建立练习系统, 建造打击练习区,
We are building batting cages for the patients that we care about at Boston Children's. 建造打击练习区, 建在波士顿儿童医院里。
I want to use this case that we recently built. 我用最近建的案例说明:
recently:adv.最近;新近;
It's the case of a four-year-old who had a progressively enlarging head, and as a result, had loss of developmental milestones , neurologic milestones , and the reason for this problem is here -- it's called hydrocephalus . 这个四岁儿童的头部逐渐涨大, 以致发育不如预期, 错失了脑神经发育的里程碑。 问题出在这里: 「脑积水」。
progressively:adv.渐进地;日益增多地; developmental:adj.发展的;启发的; milestones:n.里程碑;时间表; neurologic:adj.神经病学的; hydrocephalus:n.[内科]脑积水;
So, a quick study in neurosurgery . 快速简介脑神经外科手术的做法。
neurosurgery:n.[外科]神经外科;
There's the brain, and you can see the cranium surrounding the brain. 这是大脑, 颅骨包围着大脑,
cranium:n.颅;[解剖]头盖;
What surrounds the brain, between the brain and cranium, is something called cerebrospinal fluid or fluid, which acts as a shock absorber . 在大脑和颅骨之间流动的 是「脑脊液」, 它的作用是缓冲撞击力。
cerebrospinal:adj.[解剖]脑脊髓的; fluid:adj.流动的;流畅的;不固定的;n.流体;液体; shock absorber:n.阻尼器;
In your heads right now, there is cerebrospinal fluid just bathing your brains and making its way around. 此刻你的大脑 浸泡在头骨里的脑脊液里, 脑脊液绕着大脑流动,
bathing:n.游泳,畅游;v.给…洗澡;洗澡;(bath的现在分词)
It's produced in one area and flows through, and then is re-exchanged. 在一个地方产生脑脊液, 流动,然后再循环,
And this beautiful flow pattern occurs for all of us. 每个人的脑脊液都美妙地流动着。
occurs:v.重现(occur的第三人称单数);
But unfortunately in some children, there's a blockage of this flow pattern, much like a traffic jam . 但不幸有些孩子的脑脊液 塞住不流动, 就像交通壅塞那样。
unfortunately:adv.不幸地; blockage:n.堵塞,堵塞;封锁;妨碍; traffic jam:n.堵车;交通阻塞;
As a result, the fluid accumulates , and the brain is pushed aside. 结果脑脊液积聚, 脑被挤到一边,
accumulates:vi.累积;积聚;vt.积攒;
It has difficulty growing. 难以生长,
As a result, the child loses neurologic milestones. 孩子因此脑神经发育迟缓,
This is a devastating disease in children. 这是种毁灭性的儿童病。
devastating:adj.毁灭性的; v.毁灭; (devastate的现在分词) disease:n.病,[医]疾病;弊病;vt.传染;使…有病;
The cure for this is surgery. 治疗方式是动手术。
The traditional surgery is to take a bit of the cranium off, a bit of the skull , drain this fluid out, stick a drain in place, and then eventually bring this drain internal to the body. 传统手术是取下一小块颅骨, 一小块头骨, 安装一条引流管排出脑脊液, 引流到身体的内部。
traditional:传统的,惯例的, skull:n.头盖骨,脑壳; drain:v.排水;流干;喝光,耗尽;n.排水;下水道,排水管;消耗; eventually:adv.最后,终于; internal:n.内脏;本质;adj.内部的;里面的;体内的;(机构)内部的;
Big operation. 这是个大手术。
But some great news is that advances in neurosurgical care have allowed us to develop minimally invasive approaches to this surgery. 好消息是神经外科医疗 已经进步到
neurosurgical:神经外科的; minimally:adv.最低限度地;最低程度地; invasive:adj.侵略性的;攻击性的; approaches:v.靠近,接近; n.方式,方法,态度;
Through a small pinhole , a camera can be inserted, led into the deep brain structure , and cause a little hole in a membrane that allows all that fluid to drain, much like it would in a sink. 相机可通过小针孔 进入深层的脑结构, 在脑膜上开个小孔引流脑脊液, 就像让水槽排水一样。
pinhole:n.针孔;小孔; structure:n.结构;构造;建筑物;vt.组织;构成;建造; membrane:n.膜;薄膜;羊皮纸;
All of a sudden , the brain is no longer under pressure, can re-expand and we cure the child through a single-hole incision. 转眼间,脑部不再受压, 能够伸展, 开一个小切口就能治疗这孩子。
All of a sudden:突然地,出乎意料地; re-expand:再膨胀;
But here's the problem: hydrocephalus is relatively rare. 但问题是: 脑积水相当罕见,
relatively:adv.相当程度上;相当地;相对地;
And there are no good training methods to get really good at getting this scope to the right place. 没有好的训练方法能让我们 娴熟地把镜头摆放在正确的位置。
scope:n.能力; v.仔细看;
But surgeons have been quite creative about this, even our own. 对此外科医生相当有创造力,
surgeons:n.外科医生;(surgeon的复数) creative:adj.创造性的;
And they've come up with training models. 他们发明了训练模型。
come up with:提出;想出;赶上;
Here's the current training model. 这是目前的训练模型。
(Laughter) （笑声）
I kid you not. 我可没开玩笑。
This is a red pepper , not made in Hollywood; it's real red pepper. 这是个红椒,不是好莱坞做的, 而是真正的红椒。
red pepper:红辣椒,辣椒;
And what surgeons do is they stick a scope into the pepper, and they do what is called a "seedectomy." 外科医生把镜头伸入红椒, 进行所谓「椒籽切除术」。
(Laughter) （笑声）
They use this scope to remove seeds using a little tweezer . 他们用镜头和小镊子摘除红椒籽,
tweezer:vt.用镊子钳;n.镊子;钳子;
And that is a way to get under their belts the rudimentary components of doing this surgery. 那是学会基本手术操作的方式。
belts:n.皮带(belt的复数);带子;v.用皮带等围绕;用带扎牢(belt的三单形式); rudimentary:adj.基本的;初步的;退化的;残遗的;未发展的; components:n.部件;组件;成份(component复数);
Then they head right into the apprenticeship model, seeing many of them as they present themselves, then doing it, and then teaching it -- waiting for these patients to arrive. 接着他们直接进入学徒模式, 观摩多次临场的手术, 然后亲自动手,接着传授, 等待着新的患者。
We can do a lot better. 我们有更好的方式。
We are manufacturing reproductions of children in order for surgeons and surgical teams to rehearse in the most relevant possible ways. 如今我们复制病童, 让外科医生和手术团队 以最接近实况的方式一再练习。
manufacturing:n.制造业;工业;v.制造;生产(manufacture的现在分词); reproductions:n.[古]复制品(reproduction的复数); rehearse:v.排练;预演;演习; relevant:adj.相关的;切题的;中肯的;有重大关系的;有意义的,目的明确的;
Let me show you this. 让我来展示。
Here's my team in what's called the SIM Engineering Division of the Simulator Program. 这是我的团队, 模拟计划的模拟工程团队。
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) Division:n.师;分配;分开;分歧;
This is an amazing team of individuals . 团队的每个人都很了不起。
individuals:n.[经]个人;[生物]个体(individual的复数);
They are mechanical engineers; you're seeing here, illustrators . 有机械工程师, 和这里看到的绘图师。
mechanical:adj.机械的;力学的;呆板的;无意识的;手工操作的; illustrators:n.插图画家(illustrator的复数形式);
They take primary data from CT scans and MRIs, translate it into digital information, animate it, put it together into the components of the child itself, 他们把电脑断层 转成数字资讯, 做成动画, 整合做成儿童自身的器官。
translate:v.翻译;被翻译;被译成;(使)转变; digital:adj.数字的;手指的;n.数字;键; animate:vt.使有生气;使活泼;鼓舞;推动;adj.有生命的;
surface-scan elements of the child that have been casted as needed, depending on the surgery itself, and then take this digital data and be able to output it 根据手术本身的需求, 事先已扫描儿童的器官, 连同数据输出到
elements:n.要素;基本部分;少量;一群;(element的复数) output:n.(人、机器、机构的)产量;输出;输出功率;输出量;v.输出;
on state-of-the-art , three-dimensional printing devices that allow us to print the components exactly to the micron detail of what the child's anatomy will look like. 最先进的三维列印机, 把儿童的器官列印出来, 细节精确到微米的程度。
state-of-the-art:adj.最先进的;已经发展的;达到最高水准的; three-dimensional:adj.三维的;立体的;真实的; devices:n.[机][计]设备;[机]装置;[电子]器件(device的复数); micron:n.微米(等于百万分之一米); anatomy:n.解剖;解剖学;剖析;解析;
You can see here, the skull of this child being printed in the hours before we performed this surgery. 这里看到的是 儿童的头骨 在手术前数小时被列印出来。
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)
But we could not do this work without our dear friends on the West Coast in Hollywood, California. 如果没有西岸加州好莱坞的伙伴们
West Coast:n.美国西海岸(尤指加利福尼亚州);
These are individuals that are incredibly talented at being able to recreate reality. 这些是特别擅长重制现实的人。
incredibly:adv.难以置信地;非常地; recreate:vt.再现;再创造
It was not a long leap for us. 这不算是我们的大跃进。
leap:n.跳越;跳跃;跳高;骤变;v.跳;跳跃;跳越;猛冲;
The more we got into this field, the more it became clear to us that we are doing cinematography . 在这个领域了解得越多就越清楚, 我们是在拍片,
cinematography:n.电影艺术;
We're doing filmmaking , it's just that the actors are not actors. 在制作电影。 但不由演员演出,
filmmaking:n.制片,电影摄制;
They're real doctors and nurses. 而是如假包换的医生和护士。
So these are some photos of our dear friends at Fractured FX in Hollywood California, an Emmy-Award-winning special effects firm. 这些照片来自任职于加州好莱坞 Fractured FX 的好朋友们, 那是个获得艾美奖的特效公司。
Fractured:v.(使)断裂,折断,破裂;(使)分裂;(fracture的过去式和过去分词) special effects:特效;
This is Justin Raleigh and his group -- this is not one of our patients -- 这是贾斯汀·罗利和他的队友, 那可不是我们的病人,
(Laughter) （笑声）
but kind of the exquisite work that these individuals do. 而是他们的精湛作品。
exquisite:adj.精致的;细腻的;优美的,高雅的;异常的;剧烈的;n.服饰过于讲究的男子;
We have now collaborated and fused our experience, bringing their group to Boston Children's Hospital, sending our group out to Hollywood, California and exchanging around this to be able to develop these type of simulators. 我们现已融合双方的经验, 邀请他们团队到波士顿儿童医院, 也送我们的人去加州好莱坞, 交流和开发这类的模拟器。
collaborated:v.合作;协作;通敌;勾结敌人;(collaborate的过去分词和过去式) fused:adj.装有熔断器的;v.(使)融合,熔断(fuse的过去分词和过去式)
What I'm about to show you is a reproduction of this child. 下面向大家展示这孩子的复制模型。
You'll notice here that every hair on the child's head is reproduced . 可以看到孩子的每根头发都被复制了。
reproduced:v.重现(reproduce的过去分词);再生产;生育;adj.再生的;重制的;
And in fact, this is also that reproduced child -- and I apologize for any queasy stomachs, but that is a reproduction and simulation of the child they're about to operate on. 事实上,这也是复制的孩子。 若看了不舒服,我道歉。 那是为他们要动手术的孩子 所做的模型和模拟。
queasy:adj.呕吐的;不稳定的;催吐的;
Here's that membrane we had talked about,the inside of this child's brain. 这是我们先前说过孩子的脑膜。
What you're going to be seeing here is, on one side, the actual patient, and on the other side , the simulator. 这里看到的一边是真实的病患, 另一边是模拟的。
on the other side:另一面;在另一边;
As I mentioned, a scope, a little camera, needs to make its way down, and you're seeing that here. 如我先前说的 在脑膜上开个小洞
It needs to make a small hole in this membrane and allow this fluid to seep out. 在脑膜上开个小洞 排出脑脊液。
seep:vi.漏;渗出;n.小泉;水陆两用的吉普车;
I won't do a quiz show to see who thinks which side is which, but on the right is the simulator. 我不考你们哪边真,哪边模拟。 右侧是模拟的。
quiz:n.小测验;知识竞赛;v.盘问;查问;询问;
So surgeons can now produce training opportunities, do these surgeries as many times as they want, to their heart's content , until they feel comfortable. 现在创造了训练的机会, 让医生可以重复做无数遍的手术, 直到他们满意、有信心之后,
surgeries:n.外科手术(surgery复数); content:n.内容,目录;满足;容量;adj.满意的;vt.使满足;
And then, and only then, bring the child into the operating room. 才为孩子动手术。
But we don't stop here. 不只这样,
We know that a key step to this is not just the skill itself, but combining that skill with a team who's going to deliver that care. 我们知道关键不局限于手术的技巧, 而在结合手术团队和技巧。
Now we turn to Formula One. 现在我们转看 一级方程式赛车的例子。
Formula:n.公式; adj.(赛车)方程式的(指赛车要符合规定的体积,重量及汽缸容量等);
And here is an example of a technician putting on a tire and doing that time and time again on this car. 技师安装轮胎, 一而再、再而三换车胎。
technician:n.技术员;技师;(艺术、体育等的)技巧精湛者; time and time again:一次次;一次又一次;多次;不断地;
But that is very quickly going to be incorporated within team-training experiences, now as a full team orchestrating the exchange of tires and getting this car back on the speedway . 很快纳入整个团队的训练中, 群策群力换车胎, 群策群力换车胎, 把车送回赛道。
incorporated:adj.合并的; v.合并; orchestrating:v.精心安排;编配或创作管弦乐曲;策划;密谋;(orchestrate的现在分词) exchange:n.交换;交流;交易所;兑换;v.交换;交易;兑换; speedway:n.高速公路;(摩托车或汽车的)赛车跑道;机器脚踏车的竞赛场;
We've done that step in health care, so now what you're about to see is a simulated operation. 在医疗领域我们也这么做。 接下来看模拟手术。
We've taken the simulator I just described to you, we've brought it into the operating room at Boston Children's Hospital, and these individuals -- these native teams, operative teams -- are doing the surgery before the surgery. 把我刚才描述的模拟手术训练 带进波士顿儿童医院的手术室里, 本地手术团队的这些人 正在进行手术前的模拟手术。
described:v.描述;形容;把…称为;做…运动;(describe的过去分词和过去式) native:adj.本国的;土著的;天然的;与生俱来的;天赋的;n.本地人;土产;当地居民; operative:adj.有效的;运转着的;从事生产劳动的;n.侦探;技工;
Operate twice; cut once. 练习两次; 实切一次。
Let me show that to you. 请看。
(Video) Surgical team member 1: You want the head down or head up? （影片）手术团队成员之一: 头放低还是放高？
Could we have the scissors back, please? 请把剪刀拿回来好吗？
scissors:n.剪刀;v.剪断;删除;(scissor的第三人称单数和复数)
Peter Weinstock: It's really amazing. （彼得·万斯托克）真的很棒。
The second step to this, which is critical, is we take these teams out immediately and debrief them. 接下来是关键的第二步: 立刻请团队出来听简报。
debrief:vt.盘问;听取报告;
We use the same technologies that are used in Lean and Six Sigma in the military , and we bring them out and talk about what went right, but more importantly,we talk about what didn't go well, and how we're going to fix it. 用和军方一样的 「精实六标准差」, 讨论哪里做得好, 更重要的是知道哪里做得不好 以及要如何改正。
technologies:n.技术;科技(technology的复数); Lean:v.前俯(或后仰):倾斜:adj.肉少的:难以赚钱的:贫乏的:n.瘦肉: Sigma:n.希腊文第十八个字母; military:adj.军事的;军人的;适于战争的;n.军队;军人;
Then we bring them right back in and do it again. 然后让他们立刻回手术室再做一次。
Deliberative batting practice in the moments when it matters most. 是紧要关头的刻意击球练习。
Deliberative:adj.审议的;慎重的;
Let's go back to this case now. 回到这个病例。
Same child, but now let me describe how we care for this child at Boston Children's Hospital. 同一个孩子, 现在描述我们在波士顿儿童医院 如何护理这个孩子。
This child was born at three o'clock in the morning. 这孩子在凌晨三点出生。
At two o'clock in the morning, we assembled the team, and took the reproduced anatomy that we would gain out of scans and images , and brought that team to the virtual bedside , to a simulated bedside -- 在凌晨两点, 我们就集合医疗团队, 把用扫描和影像所复制的解剖结构 及团队送到虚拟病床, 也就是模拟的病床。
assembled:v.聚集;集合;收集;装配;组装;(assemble的过去分词和过去式) images:n.印象;声誉;形象;画像;雕像;(image的第三人称单数和复数) virtual:adj.[计]虚拟的;实质上的,事实上的(但未在名义上或正式获承认); bedside:n.床边,床旁;adj.床旁的,枕边的;
the same team that's going to operate on this child in the hours ahead -- and we have them do the procedure . 几个小时后同一团队 要为这孩子动手术, 先让他们操作模拟一遍。
procedure:n.步骤;手术;(商业、法律或政治上的)程序;
Let me show you a moment of this. 请看其中的片段,
This is not a real incision. 不是真的切口,
And the baby has not yet been born. 婴儿尚未出生。
Imagine this. 想像一下,
So now the conversations that I have with families in the intensive care unit at Boston Children's Hospital are totally different. 如今我与孩子的家人 在波士顿儿童医院加护病房的对话 和以往截然不同。
intensive care:n.(医院里的)特别护理病房;重症监护;
Imagine this conversation: "Not only do we take care of this disorder frequently in our ICU, and not only have we done surgeries like the surgery we're going to do on your child, but we have done your child's surgery. 想像这对话: 「我们不仅常在加护病房医这种病, 不仅曾多次做过 将要为令郎／令嬡进行的手术, 而且,我们已为他／她手术过了,
frequently:adv.频繁地,经常地;时常,屡次;
And we did it two hours ago.And we did it 10 times. 两个小时前做了十回。
And now we're prepared to take them back to the operating room." 我们已准备好进行真正的手术。」
So a new technology in health care: lifelike rehearsal. 新的医疗技术: 栩栩如生的模拟医学演练,
Practicing prior to game time. 赛前的练习。
Thank you. 谢谢。
(Applause) （鼓掌）