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And that was the message that I absorbed when I was in med school.
這就是我在醫(yī)學(xué)院時得到的信息。
I was an obsessive compulsive student.
我是一個有著強(qiáng)迫癥傾向的學(xué)生。
In high school, a classmate once said that Brian Goldman would study for a blood test.
在中學(xué)時，有個同學(xué)曾經(jīng)說布萊恩·高德曼會為了血液測驗(yàn)復(fù)習(xí)。
And so I did. And I studied in my little garret at the nurses' residence at Toronto General Hospital, not far from here.
而我的確這么做了。我在離這不遠(yuǎn)處的多倫多總醫(yī)院里護(hù)士住宅里的一個小閣樓中，完成了我的學(xué)業(yè)。
And I memorized everything. I memorized in my anatomy class the origins and exertions of every muscle,
我背下了所有東西。我背下了解剖課中提到的每一塊肌肉的起端和伸展方式，
every branch of every artery that came off the aorta, differential diagnoses obscure and common.
每一條從主動脈延伸出來的動脈的分支系統(tǒng)，以及一切鮮為人知的或者常見的鑒別診斷。
I even knew the differential diagnosis in how to classify renal tubular acidosis.
我甚至知道如何鑒別診斷不同的腎小管性酸中毒癥。
And all the while, I was amassing more and more knowledge.
在這段時間中，我積累了越來越多的知識。
And I did well, I graduated with honors, cum laude.
我的表現(xiàn)很好，并以優(yōu)等的成績畢業(yè)。
And I came out of medical school with the impression that if I memorized everything and knew everything,
當(dāng)我從醫(yī)學(xué)院出來時，我覺得我只要記下和明白了所有的東西，
or as much as possible, as close to everything as possible, that it would immunize me against making mistakes.
或者稍退一步--將近所有的東西，那我犯醫(yī)療錯誤的幾率就會微乎其微。
And it worked for a while, until I met Mrs. Drucker.
而我在一段時間之內(nèi)的確沒有犯錯。直到我遇到了Drucker女士。
I was a resident at a teaching hospital here in Toronto
我正作為一個實(shí)習(xí)醫(yī)生在多倫多工作，
when Mrs. Drucker was brought to the emergency department of the hospital where I was working.
當(dāng)Drucker女士被帶入教學(xué)醫(yī)院的急診室時。
At the time I was assigned to the cardiology service on a cardiology rotation.
當(dāng)時我正因心臟科輪調(diào)而被指派在心血管診所。
And it was my job, when the emergency staff called for a cardiology consult,
我的工作是，當(dāng)緊急救護(hù)人員需要有關(guān)于心臟的專業(yè)會診時，
to see that patient in emerg. and to report back to my attending.
在急癥室診斷病人，并在之后向負(fù)責(zé)我的主治醫(yī)生匯報(bào)。
And I saw Mrs. Drucker, and she was breathless.
當(dāng)我見到Drucker女士的時候，她的氣息已經(jīng)很微弱。
And when I listened to her, she was making a wheezy sound.
在我與她交談時，我聽到她的呼吸有喘息的聲音。
And when I listened to her chest with a stethoscope,
當(dāng)我用聽診器聆聽她的胸腔時，
I could hear crackly sounds on both sides that told me that she was in congestive heart failure.
兩邊都傳來的爆裂的聲音告訴我，這是郁血性心臟衰竭。
This is a condition in which the heart fails, and instead of being able to pump all the blood forward,
這是由于心臟在衰竭后，無法將所有的血液完全的輸送出去，
some of the blood backs up into the lung, the lungs fill up with blood, and that's why you have shortness of breath.
而導(dǎo)致部分血液回流入肺臟，肺臟里充滿了血液，而造成呼吸短促。
