And it wasn&#39t because of my attending he was a doll.而这也不是因为我的主治；他人非常好。He talked to the family, and I&#39m quite sure that he smoothed things over and made sure that I didn&#39t get sued.他和那家人好好的谈过。我确定他为了确保我没有被控告而替我打了圆场。And I kept asking myself these questions. Why didn&#39t I ask my attending?但我仍

It&#39s a system in which there are two kinds of physicians -- those who make mistakes and those who don&#39t,在这个制度当中，只有两种人 -- 犯错的不犯错的，those who can&#39t handle sleep deprivation and those who can, those who have lousy outcomes and those who have great outcomes.可以调适睡眠不足的和不可以忍受的，以及那些有着糟糕的结果和有着优秀的结果的。

And two days later I came to do my next emergency shift, and that&#39s when my chief asked to speak to me quietly in her office.两天后，又轮到我在急诊室值班。那时我的主任要我去她的办公室里私下谈谈。And she said the three words: Do you remember?她说了那三个字： 记得吗？&quotDo you remember that patient you saw with the sore throat?&quot“记得吗？那位你看过

And that was the message that I absorbed when I was in med school.这就是我在医学院时得到的信息。I was an obsessive compulsive student.我是一个有着强迫症倾向的学生。In high school, a classmate once said that Brian Goldman would study for a blood test.在中学时，有个同学曾经说布莱恩·高德曼会为了血液测验复习。And so I did. And I studied in my little garret at

But each time, they were gnawing at me, eating at me.但每当我想到这两起病例，那种感觉都会折磨啃噬我。And I&#39d like to be able to say to you that my worst mistakes only happened in the first five years of practice as many of my colleagues say, which is total B.S.而我也希望我可以告诉你，我造成的最严重的错误只发生在了我开始行医的前五年，像我众多的同事所称一般。但这完全是扯淡。Som

Now let&#39s take this back into my world of medicine where I&#39m a lot more comfortable,现在让我们回到我的世界，医疗领域。这个领域我比较熟悉，or perhaps a bit less comfortable after what I&#39m going to talk to you about.但我接下来要说的却让我有些困扰。Suppose you have appendicitis and you&#39re referred to a surgeon who&#39s batting 400 o

I think we have to do something about a piece of the culture of medicine that has to change.我觉得在当今的医学文化中，有一部份文化必须要开始改变。And I think it starts with one physician, and that&#39s me.而这个改变可以从一个医生开始，那就是我。And maybe I&#39ve been around long enough that I can afford to give away some of my false prestige to

What they need is an environment to be able to do that.他们只是需要一个场合来吐露心声。What they need is a redefined medical culture.他们需要的是一个重新定义的医学文化。And it starts with one physician at a time.从一位又一位个别的医生开始。The redefined physician is human, knows she&#39s human, accepts it, isn&#39t proud of making mistakes,重新定义过的

And that wasn&#39t a difficult diagnosis to make.这不是一个困难的诊断。I made it and I set to work treating her.作出诊断后我开始着手帮她治疗。I gave her aspirin. I gave her medications to relieve the strain on her heart.我开给了她阿司匹林，并给了她一些可以减轻她心脏负担的药物。I gave her medications that we call diuretics, water pills, to get her to pee

So I signed the discharge papers, and an ambulance came, paramedics came to take her home.我在出院单上签了名， 一辆救护车来后急救人员将她送回了家。And I went back to my work on the wards.之后我回到了我在诊所的工作。All the rest of that day, that afternoon, I had this kind of gnawing feeling inside my stomach.在接下来的一天中， 那天下午， 我的肠胃有着一种翻滚的感觉。Bu

And I was shocked and shaken to the core.我震惊不已， 吓得不得了。And I went through this roller coaster, because after they stabilized her, she went to the intensive care unit, and I hoped against hope that she would recover.之后我的心情便像是做着云霄飞车一般， 因为当他们将她的情况稳定下来后， 便将她送进了加护病房， 我在绝望中希望她能够醒过来。And over the next two or

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