新编临床医学英语

新编临床医学英语第1期:病患的问题与诉求Unit?1?Text?A?Internal?Medicine?and?Today's?Internist第1单元文章A?内科与内科医生Questions/Pleas?of?the?Patient病患的问题与诉求How?can?I?find?a?good?doctor?"我如何找到一位良医？How?can?I?find?a?good?doctor?whom?I?can?afford?"如何能够碰到一位价格亲民的医生？How?can?I?find?a?good?doctor?who?cares?about?me?as?a?person?〃又如何能够遇见一位把我当成“人”看待的医生？How?can?I?find?a?good?doctor?who?will?take?the?time?to?listen?and?understand?"如何找到一位能够花时间倾听我的诉说，了解我的名医？People?who?need?medical?care?ask?these?questions?throughout?the?world?every?day.每天，全球有许多病患都在询问这些问题。They?ask?them?because?they?face?a?health?care?system?that?is?scientifically?complex,organizationally?overloaded,?and?generally?not?oriented?to?the?patient?as?a?person.他们之所以问这些问题，是因为他们所面对的医疗保健体系技术深奥、机构臃肿，而且一般都没有意识到病人首先是一个“人”。When?an?individual?first?becomes?ill,?regardless?of?the?symptoms,?he?or?she?needs?mostsomeone?who?seems?to?say,如果有人生了病，不管症状如何，他们最希望听到的是："I?am?a?good?doctor；I?charge?a?reasonable?amount?for?my?services；I?care?about?you，thepatient?and?I?will?take?the?time?to?listen?and?understand."“我是医生；我只收取亲民价格，我关心病患，我将倾听你的诉求，理解你。”A?prominent?teacher/physician?in?a?major?medical?center?taught?his?students?to?listen?to?thepatient?and?he?will?tell?you?what?is?wrong,?and?he?will?tell?you?what?he?needs".主要医疗中心的知名学者/内科医生都会教授学生要学会倾听，病人会告诉你哪里不舒服，也将会告诉你他们的需求。Having?found?a?physician?who?answers?so?profoundly?to?their?needs,?some?patients?areextremely?grateful?but?most?are?utterly?overwhelmed.有些内科医生完全满足了病患的需求，有些患者表现出了极大的感激之情，但是绝大部分都激动不已。With?the?discovery?of?that?relationship,?the?difference?between?a?superb?technician?and?a?truephysician?really?becomes?evident?to?the?patient.有了这层关系之后，专业技师和内科医生的区别在病患面前展露无遗。That?physician/teacher?was?a?scholarly?gentleman?with?deep?scientific?insight?and?an?activeand?stimulating?clinical?and?research?practice.内科医生/教授都是学术人才，他们对学科有着科学的深刻见解，并活跃在临床和研究领域中。Unfortunately?he?developed?crippling?rheumatoid?arthritis?in?the?midst?of?his?career.但是，他们在工作期间不幸患上了风湿性关节炎。Beyond?question,?his?own?disease?sensitized?him?to?the?complex?mix?of?expectations,?needs,fears,毫无疑问，他自身的疾病使他对病人交织着期待、需要、恐惧和感激的复杂心情十分敏感，and?appreciation?that?patients?feel?when?facing?a?physical-mental?trial?while?at?the?same?timelooking?forthat?perfect?physician?to?help?them.这是患者们在经历身心煎熬、同时又盼望有那么一位德高望重的名医能给他进行诊治时所共有的感觉。Patients?flocked?to?this?doctor，not?just?for?his?accurate?diagnoses,?his?correct?therapies,?oreven?his?warmth,患者都去找这样的医生看病，并不是因为他们准确无误的诊断，正确的治疗方法，甚至是所给予的温暖，but?for?the?intellect?he?expressed?and?the?sheer?joy?of?living?that?he?extended?in?everyencounter?with?another?human?being.而是他们所散发的智慧之光，以及他在面对每一个“人”时所展现的喜悦之情。He?had?a?Shakespearean?grasp?of?the?qualities?of?being?human?and?an?uncommon?ability?totransmit?love?and?respect?for?his?fellow?human?beings.他既能像莎翁那样对人性特点有着深刻的了解，又身具异秉能把关爱和尊重传递给全人类。He?exhibited?the?ideal?all?physicians?should?emulate.他展现了所有内科医生应该展现的最理想的一面。Many?readers?know?a?physician?with?these?characteristics?all?should?seek?to?know?one?and?todevelop?their?own?professional?persona?so?that?human?qualities?are?not?lost?to?technicalacumen.许多读者都认为拥有这些特征的内科医生都应该去了解，并培养自己的职业形象，只有这样，人类的本质才不会在技术面前甘拜下风。1.be?oriented?to?面向,本句中的?them?是指上句的?these?questions.原文：They?ask?them?because?they?face?a?health?care?system?that?is?scientifically?complex,organizationally?overloaded,?and?generally?not?oriented?to?the?patient?as?a?person.?他们之所以问这些问题，是因为他们所面对的医疗保健体系技术深奥、机构臃肿，而且一般都没有意识到病人首先是一个“人”。2.in?the?midst?of：在…中，在…当中原文：Unfortunately,?he?developed?crippling?rheumatoid?arthritis?in?the?midst?of?his?career.但是，他们在工作期间不幸患上了风湿性关节炎。3.beyond?question?的意思是“毫无疑问地”；sensitize?sb?to?sth?意思是“使某人对某事敏感起来”。原文：Beyond?question,?his?own?disease?sensitized?him?to?the?complex?mix?of?expectations,needs,?fears,?and?appreciation?that?patients?feel?when?facing?a?physical-mental?trial?while?atthe?same?time?looking?forthat?perfect?physician?to?help?them.毫无疑问，他自身的疾病使他对病人交织着期待、需要、恐惧和感激的复杂心情十分敏感。这是患者们在经历身心煎熬、同时又盼望有那么一位德高望重的名医能给他进行诊治时所共有的感觉。4.rheumatoid?arthritis?风湿性关节炎例句：The?study?was?also?too?short?to?show?whether?TwHF?can?slow?the?joint?damage?causedby?rheumatoid?arthritis.这项研究时间也太短，不能显示雷公藤是否能减缓由风湿性关节炎引起的关节损伤。第2期:好医生的科学和技术专业背景THE?SCIENTIFIC?AND?TECHNOLOGIC?BACKGROUND?OF?A?"GOOD?DOCTOR"“好医生”的科学和技术专业背景Since?Flexner?issued?his?famous?report?in?1910,?American?medical?education?has?striven?towardthe?development?of?a?strong?scientific?base.自从1910年弗莱克斯纳的着名研究报告问世以来，美国的医学教育致力于培养深厚的科学基础。This?intellectual?prerequisite,therefore,has?become?an?integral?part?of?premedical,undergraduate,?graduate,?and,?indeed,?continuing?medical?education.所以，以学术知识为前提的教育就成为了医学预科、本科生、研究生以及继续医学教育的主要组成部分。Biomedical?science?is?fundamental?to?understanding?disease,?making?diagnoses,?developingnew?therapies,?and?appreciating?the?complexities?and?contributions?of?new?technologies.生物医学是掌握病情、作出诊断、研究新型治疗方法的基础，同时它还是研发新技术的基础。Physicians?cannot?be?satisfied?with?simply?knowing?that?a?certain?form?of?therapy?works?80?to90?per?cent?of?the?time.内科医生不能够只满足于掌握某领域治疗方法的80-90%。They?must?understand?the?basic?physiology?and?pharmacology?of?any?approach?they?use.他们必须对所应用的生理学和药物学的基本疗法了如指掌。They?must?possess?the?intellectual?tools?to?follow?reports?of?current?research?in?medicaljournals他们必须能够利用学术方法来掌握医学杂志的最新研究成果，so?that?they?can?continue?to?grasp?the?newest?and?latest?approaches,?no?matter?howcomplicated?the?field?may?become.不管该领域变得多么复杂多变，他们都能够掌握最新的治疗方法。That?is?why,?in?a?textbook?of?medicine?like?this,?strong?emphasis?is?given?to?how?things?work,what?goes?amiss?when?pathologic?processes?ensue,这就是为什么像这样的医学教科书要着重强调事物的运作方法，以及在病理过程中所出现的差错，and?what?effect?a?given?therapy?has?in?correcting?that?defect.以及特定治疗方法对纠正差错所带来的影响。We?seek?to?create?within?the?minds?of?our?readers?a?yearning?for?a?greater?depth?ofunderstanding?and?a?continuing?commitment?to?stay?at?the?frontier?of?scientific?knowledge.我们希望我们的读者能够从内心有着更加深入的了解，并继续处在科学的最前沿。These?are,?in?fact,?among?the?hallmarks?of?a?professional?in?any?scientific?field.事实上，任意科学领域专业都包含了这些特点。We?are?moving?into?an?era?when?pharmacotherapeutic?agents?are?no?longer?merely?wonders?oforganic?chemistry,?but?increasingly?often?are?biologic?products.当今时代，药剂已经不仅仅是有机化学的奇迹，它也逐渐变成了生物制品。Some?of?these?are?isolated?from?nature?others?are?developed?by?recombinant?DNAtechnology.许多产品已经脱离自然，有些是DNA技术重组的产物。On?the?horizon?is?the?availability?of?a?true?replacement?or?supplement?for?defective?ordeficient?biochemical?constituents?of?the?body.我们即将要面对的是真正能够替代或是能够补充生物化学成分中不足的产品。No?physician?can,?with?intellectual?honesty,?use?these?new?classes?of?agents?without?fullyunderstanding?their?action,?their?meaning,?and?their?potential?side?effects.任何一位有学术诚信的医生都不会在没有充分了解这些新型药剂的功能、作用以及潜在副作用的情况下就使用它们。The?diagnostic?and?therapeutic?contributions?and?potential,?in?clinical?situations,ofbiocompatible?prosthetic?devices,?nuclear?magnetic?resonance?spectroscopy,通过一系列的发展（还没有被确认），诊疗对未来临床中的生物兼容性假肢器官、核磁共振谱、high-frequency?laser?beams,?and?so?on?through?developments?not?yet?conceivedappreciated?only?by?the?mind?that?is?disciplined?in?fundamental?science.高频激光等所作出的贡献只有在基础科学中才能得以实现。1.per?capita?每人，按人口（计算）例句：The?United?States?spends?more?per?capita?on?health?care?than?any?other?nation?in?theworld.美国是全球个人医疗开销最大的国家。2.Medicaid?plan?医疗补助制度例句：With?the?passage?of?the?Medicare?program?for?the?elderly?and?the?Medicaid?plan?for?thepoor?by?Congress?in?1965,?1965年，美国国会通过了补助老人的退休医疗福利，以及补助穷人的穷人医疗补助，3.dental?care?牙齿护理例句：Your?smile?depends?on?simple?dental?care?habits,?such?as?brushing?and?flossing.自信的笑容取决于简单的牙齿护理习惯，如刷牙和使用牙线。4.cost-efficient?有成本效益的例句：It?also?helps?the?architect?manage?resources?in?a?very?cost-efficient?manner.?它还有助于架构师采用一种非常具有成本效益的方式来管理各种资源。第3期:THE?ORGANIZATION?AND?FINANCING?OF?TODAY'S?MEDICINE当代医疗制度与资金投入Patients,?as?well?as?their?representatives?in?government,?industry,?and?managed-careorganizations,?are?concerned?about?the?rising?cost?of?medical?care.政府、产业、管理型医疗保险代表以及病患都对不断增加的看病价格给予了高度关注。The?total?bill?for?health?care?in?America?now?rises?at?a?rate?of?about?10?per?cent?per?year,?anincrease?that?seems?to?continue?unabated.在美国，医疗开销以每年10%的价格增长，而这一趋势还将继续下去。Federal?legislation?instituting?diagnosis-related?groups?(DRC's)?has?clearly?moderated?the?riseof?hospital?costs,?but?physician?costs?continue?to?rise?at?an?ever-increasing?rate.联邦立法已经开设了诊断相关组，并已经降低了医院开销，但是内科医生的开销仍然在不断增加。Every?student?of?medicine?should?ask?if?this?is?realistic.每一名医学学生都在问这是不是真的。Is?it?sustainable??Is?it?defensible?是可持续性的？还是有可解决的办法？What?will?be?the?limits?范围到底在哪？Patients?already?ask,“Can?I?really?afford?the?best?doctors?in?the?most?prestigious?practices,?inthe?most?famous?medical?centers?”病患在问，“我能去最好的医疗中心，最好的科室，找最好的医生看病吗？”“Can?I?afford?to?be?referred?to?a?subspecialist?”我有钱去看那些专业医师吗？“Can?I?afford?to?be?out?of?work?and?in?the?hospital?”我能支付得起不上班在医院看病的开销吗？“Can?I?afford?to?pay?my?rising?insurance?premiums?”“我有钱支付不断增长的保险吗？”“How?much?deductible?on?my?insurance?can?I?afford?”“保险中的扣除条款我能支付得起多少？”Worse?yet,?an?increasing?number?of?patients?have?to?make?choices?between?seeking?medical?anddental?care?and?getting?food,?clothing,?shelter,?and?other?essentials?of?daily?living.更糟糕的是，有许许多多的病患不得不在看病，看牙和基本日常生活之间做出选择。These?issues?have?become?major?concerns?in?American?households?and?clearly?represent?one?ofthe?most?disturbing?weaknesses?in?our?economy,这些问题已经成为美国家庭关心的主要问题,并且是美国经济中最令人担心的薄弱环节，of?which?now?nearly?12?per?cent?(?by?annual?gross?national?product)?is?devoted?to?health?care,up?from?8?per?cent?in?1975.医疗费用所占每年国民生产总值的比例已由1975年的8%增加到现在的12%。Over?the?last?two?to?three?decades?it?has?been?a?goal?of?the?United?States?to?promote?everincreasing?quality?and?cost-effectiveness?of?health?care?for?all.在过去的二三十年中，美国的目标就是要为全体民众提供质量高，成本高效益的医疗制度。Unfortunately,?we?have?failed?miserably.不幸的是，我们遭遇了惨败。The?USA?spends?more?per?capita?on?health?care?than?any?other?nation?in?the?world.美国是全球个人医疗开销最大的国家。Yet?in?the?major?indices?of?health?our?population?ranks?nineteenth！但是在主要医疗指数上，美国民众排在了第19位！At?the?same?time?we?continue?to?see?a?wasteful?maldistribution?of?physicians?both?by?specialtyand?geographically?and?a?growing?number?of?medically?indigent?and?medically?uninsured?peoplein?our?nation.与此同时，无论在专业还是在地域上，内科医生的分配不合理，没有保险，没钱看病的人数还在不断增加。Somehow,?the?costs?of?what?we?are?trying?to?achieve—even?though?the?goal?is?commendable—?are?not?being?placed?in?proper?perspective?by?the?medical?profession,?health-care?managers,and?representatives?of?the?people?in?order?to?provide?suitable?care?for?all.尽管我们要实现的目标值得赞扬，但是我们要实现的看病价格并没有得到医疗人士、医疗卫生监管人士、以及代表的认真对待。Unfortunately，in?the?present?system?the?real?needs?of?the?populace?are?not?always?met?byaffordable?services.不幸的是，就目前的制度而言，大众所能够支付得起的医疗费用无法满足人们的要求。At?the?same?time,?overutilization?of?medical?services?may?be?the?very?engine?that?drives?up?thetotal?cost?of?health?care?delivery.与此同时，医疗服务的过度使用或许也是增加医疗费用的引擎。With?the?passage?of?the?Medicare?program?for?the?elderly?and?the?Medicaid?plan?for?the?poor?byCongress?in?1965,1965年，美国国会通过了补助老人的退休医疗福利，以及补助穷人的穷人医疗补助，we?had?hoped?as?a?nation?that?we?were?moving?toward?a?more?just?and?efficient?system.我们希望美国的医疗系统能够变得更加公正，更加有效。In?fact,?the?opposite?has?been?the?trend.但是事实上，我们却背道而驰。This?societal?goal?must?now?be?readdressed?reformulated,?and?restructed?in?terms?of?modernneeds,就社会需求来讲，我们应该通过重组来实现社会目标，reflecting?fairly?and?fully?measured?cost-benefit?ratios?for?every?form?of?medical?service.全面反映医疗服务的成本与效益比例。1.per?capita?每人，按人口（计算）例句：The?United?States?spends?more?per?capita?on?health?care?than?any?other?nation?in?theworld.美国是全球个人医疗开销最大的国家。2.Medicaid?plan?医疗补助制度例句：With?the?passage?of?the?Medicare?program?for?the?elderly?and?the?Medicaid?plan?for?thepoor?by?Congress?in?1965,?1965年，美国国会通过了补助老人的退休医疗福利，以及补助穷人的穷人医疗补助，3.dental?care?牙齿护理例句：Your?smile?depends?on?simple?dental?care?habits,?such?as?brushing?and?flossing.自信的笑容取决于简单的牙齿护理习惯，如刷牙和使用牙线。4.cost-efficient?有成本效益的例句：It?also?helps?the?architect?manage?resources?in?a?very?cost-efficient?manner.?它还有助于架构师采用一种非常具有成本效益的方式来管理各种资源。第4期:Medical?professionals?often?attribute?overutilization?to?patient?behavior.医疗专业人士经常将过度使用归罪于病患的行为。In?fact,?however,?physicians?control?70?per?cent?of?health?expenditures.但是，事实上，医护人员却掌控者70%的医疗支出。A?few?patients?with?hypochondriasis,?for?example,?may?visit?physicians?too?often,例如，少数患有疑病症的病患会经常就医。and?many?older?patients?may?seek?medical?help?at?times?when?a?friendly,?reassuring?chat?istheir?real?desire,许多老年患者有时也会寻求医疗帮助，他们希望能够得到友好，舒心的交谈，but?in?the?final?analysis?utilization?of?the?health?care?system?is?in?the?hands?of?physicians.归根结底，医护系统的利用问题掌控在医护人员手中。Ironically,?although?physician?competence?is?often?equated?to?mastery?of?expensivetechniques?and?technologies,具有讽刺意味的是，虽然医术常常等同于掌握价格高昂的仪器设备和科技手段，physicians?are?actually?at?their?professional?best?when?listening?to?the?patient?and?respondingto?what?they?hear?and?see?with?medicine?most?comprehensive?armamentarium.但医生达到炉火纯青境地，往往是在能够倾听患者心声并应用最先进的医疗设备对他们听到、看到的患者状况采取相应措施的时候。Overutilization,?when?it?occurs,?is?thus?most?likely?to?be?our?fault?as?physicians.当出现过度使用问题时，医护人员是最有可能出错的。Our?responsibility?as?professionals?is?to?be?absolutely?certain?that?our?errors?in?this?directionare?driven?by?well-founded?concern?for?the?health?of?our?patients,作为专业人士，我们的责任就是要坚决确保这些错误是建立在对病患健康的关心之上，not?by?the?financial?interests?of?our?practices?or?the?hospitals?where?we?work.而不是建立在经济效益或是医院之上。Individual?physicians,?then,?must?take?a?personal?and?professional?interest?in?the?control?ofhealth?care?costs?not?only?because?it?is?right?for?the?nation,?but?because?it?is?right?for?thepatient.对于个体医护人员来说，他们必须从专业角度和个人角度来对医疗费用产生兴趣，这不仅对国家有益，还将有益于病患。In?our?litigious?society,?a?legalistically?defensive?approach?to?medical?practice?has?become?tooprevalent.在我们这个喜欢诉讼的社会里，有关医疗的法律保护方法就变得非常普遍了。The?conditions?that?engender?this?tendency?must?be?altered.我们必须对这一趋势进行纠正。Physicians?must?use?all?of?their?diagnostic?skills?to?focus?on?the?very?best?approach?to?medicaldiagnosis?and?therapy医护人员必须使用其所有的诊断技能来关注医疗诊断和理疗方法，and?to?steer?away?from?unnecessary?use?or?repetition?of?expensive?procedures?such?ascomputed?tomography,?magnetic?resonance?imaging,?and?cardiac?catheterization.并避免不必要的使用，或是重复价格昂贵的诊治，例如计算机体层摄影、核磁共振成像或是心导管插入术。The?physician?must?use?intellect?scientific?knowledge?and?analytical?skillsto?best?serve?thepatient?without?inundating?the?system?with?unnecessary?costs医生必须运用智慧（包括科学知识和分析能力）来为病人提供最佳服务，既不要给医疗保健体系增加不必要的费用，and?the?patient?with?a?financial?burden?he?simply?cannot??to?bear.也不要给病人造成不必要的、无法继续承受的经济负担。1.take（an）interestin对……发生兴趣例句：We?takeinterestin?yourcannedgoodsandwishtohavethecatalogues.我们对你方的罐头食品有兴趣，希望能收到目录。2.onthefinalanalysis归根结底例句：Nowadays,thecompetitionoftechnologyandstrengthisthecompetitionofhumansandhumancapital?onthefinalanalysis.当今世界科技和实力的竞争，归根到底是人的竞争，是人力资本的竞争。3.steerawayfrom避开例句：Wewantedtomakeacleanbreakfromactressesand?steerawayfrom?blondesandcleansethepalette.我们不想再用女演员代言，也不想要金发女郎，我们重新做出选择。4.financialburden财政负担例句：Bearingthe?financialburden?ofcommercialandinvestmentarbitrationsisdifficultforanycountry,butmostespeciallysoforasmallcountrylikeUruguay.承担商业和投资仲裁决定的财政负担对任何国家都很艰难，对于乌拉圭这样的小国来说更是如此。第5期:Costscanbecontrolledonlyifphysiciansareconvincedoftheneedandarewillingtoparticipateinprovidingthisvitalservice.只有医护人员能够真正明白这些需求，并愿意参与到提供重大服务上来，价格才能够得到控制。Oneaspectofthiscontrolisattentiontovariouspossiblemeansofhealthcarefinance,控制价格的其中一个方面就是要重视各种卫生保健,includingprepaidplans,preferredproviderorganizationshealthmaintenanceorganizations,andothermanagedcaresystems.包括重点服务计划、优先医疗服务提供者组织、健康维护组织以及其他管理式医疗系统。Allofthesemustbecarefullyexploredwithaviewtomakinghealthcareaccessiblewhereitismostneeded.为了让最需要医疗保障的民众接受到该服务，我们必须对这些系统进行细致地探究。Clearly,multipletoolsandprogramsmaybenecessary,buttheyshouldnotbethrustuponthepatientsimplytosatisfydoctrinesoffreeenterprise.显然，这些措施和项目或许是不可或缺的，但是不能够仅仅是为了满足自由主义的信条而将其强加于病患身上。Toprovidethebesthealthcareinafiniteeconomyweneedsystemsthatprovidesuchcareinthemostefficientway,regardlessofthepaymentscheme.为了在有限的经济体中提供最好的医疗保障，不论支付计划如何，我们需要利用最有效的措施来提供医疗服务Anotheraspectofourcost-controljobistosupportandparticipateinresearchonoutcomes,在这项成本控制工作中，另一个方面就是要参与到对支出的研究上来，aimingtowardsystematicevaluationofcost-effectivenessofthemedicalprocedureswechooseinthelightofalltheinterestsofourpatient.考虑到病患的利益，我们的目的就是要对医疗程序的成本效益进行系统的评估。Forexample,wedonotknowwhytreatmentofprostatichypertrophyismorecommonlymedicalinsomepartsofthenation,surgicalinothers.例如，我们不知道为什么有些地区对会利用内科的方式来治疗前列腺增生，有的地方会利用手术的治疗方式。Whydoestheincidenceofcaesareansectionsvarysowidely?为什么实施剖腹产的范围会如此之广？Thecostsandbenefitsofcoronaryangioplastyversusbypasssurgeryremainobscure.冠状动脉成形术和心脏搭桥手术的成本和效益仍然不明确。Everyyearbillionsofdollarsarespentasaresultofclinicaldecisionsthatmayhingeontheseorsimilarissues.每年，政府都会在相似的临床问题上花费数十亿美金。Physiciansmustinvolvethemselvesintheprocessesofchangewithaneyefirsttotheindividualpatientandthentosociety.内科医生必须亲身参与到变革的过程中来，这么做首先是为了病患，其次这也有利于社会。1.with?a?view?to?为了要例句：Time?after?time,?he?read?such?sentences?as:“Please?cause?an?investigation?be?made?witha?view?to?ascertaining?the?truth.马弗里克一次又一次看到这样的句子：“敬请以查明事实真相为宗旨，展开一番调查。”2.be?thrust?on?把…强加于例句：Specific?challenges?will?be?thrust?on?Mrs?Clinton?from?Day?1.希拉里从第一天开始就会面临具体的挑战。3.in?the?light?of?根据例句：They?will?adjust?their?bequests?in?the?light?of?yours.他们将根据你的赠予调整自己的遗产分配。4.hinge?on?靠...转动例句：Somewhat?surprisingly,?the?answer?turns?out?to?hinge?on?what?you?mean?by?best?andwhat?you?mean?by?long-run.有些令人惊讶的是，答案取决于在你看来最好的和长期的是一个什么概念。第6期:THOSE?WHO?CARE那些关爱病患的医生"How?can?I?find?a?good?doctor?who?cares?about?me?as?a?person?"如何找到一位拿病患当“人”看的医生？When?speaking?of?caring,?one?has?to?define?specifically?what?is?meant.说到关爱，人们不得不将其明确定义。A?physician?can?diagnose?and?prescribe?in?a?technically?correct?and?scientific?but?insensitiveway?and?the?patient?may?be?made?better?even?cured.医生在确诊病患时能够保证在技术和科学上的准确性，但是却不添加个人感情，患者能够在这种情况下有所好转，或是得到治愈。On?the?other?hand,?when?the?patient?asks?the?question,"Does?my?physician?really?care?〃另一方面，当病人问道：我的医生真的关心我吗？the?patient?means,?Does?it?matter?to?the?physician?what?happens?to?me?病患的意思是：“我的情况对医生来说重要吗？Does?my?doctor?show?sensitivity?and?compassion?beyond?the?mere?technical?qualities?ofmedicine?〃医生是否仅仅超越了技术层面而展现出同情和敏感。It?is?in?this?sense?that?we?address?ourselves?to?the?nature?of?those?who?care.我们正是要从这一层面去了解那些医护人员的本质。It?may?seem?odd?to?talk?about?caring?as?a?skill,?but?in?a?real?sense?it?is?just?that.把关爱当做一种技能来讨论似乎有一些奇怪，但是事实就是这样。Those?involved?in?the?education?of?students?realize?that?at?least?some?forms?of?compassionhave?to?be?learned.那些接受了医学教育的学生意识到他们至少要习得某些形式的同情。The?developing?physician?must?see?such?traits?in?action?in?order?to?acquire?and?apply?them?ininteraction?with?patients?and?their?families.为了在与病患和家属的沟通中获得并应用这种同情，成长中的医生必须将这些特点付诸行动。Sometimes?this?involves?learning?how?to?demonstrate?compassion.有时，这些要涉及到如何展现同情心。Kahlil?Gibran?has?taught?us,"You?give?but?little?when?you?give?of?your?possessions?it?is?whenyou?give?of?yourself?that?you?truly?give."纪伯伦教导过我们：“给予财产算不上给予，只有当你献出自己，那才算是真正的给予。”Giving?of?ourselves?with?ease,?with?grace,?and?with?meaning?is?for?most?of?us?an?acquired?skill.轻松，完美的献出自己，这对于我们大多数人来说是一种习得的技能。Sometimes?it?involves?a?deep?sense?of?reawakening?within?to?bring?out?an?innate?sensitivityand?compassion?that?perhaps?has?not?expressed?itself?since?childhood.有时，这包括内心深处的苏醒，并迸发出自从童年时期就没有表现过的同情和敏感。At?other?times,?learning?to?care?may?involve?a?complete?transformation?of?behavior?andattitudes?toward?people,?particularly?those?who?are?not?from?our?own?cultural?background.在其他时候，学习关爱或许要把对待他人的行为和态度进行全面的改变，特别是对那些拥有不同文化背景的人。Many?believe?that?the?greatest?responsibility?in?medical?education?today?is?to?fostercompassion?within?the?student?of?medicine.许多人相信当今医学教育中最重要的是将同情心渗透到医科大学学生的心中。To?receive?medical?care,?patients?must?trust?their?bodies?and?their?very?lives?to?physicians,?andso?to?be?in?an?honest?position?to?give?medical?care，physicians?must?earn?such?radical?trust.为了获得关爱，病患必须对自己的身体有着足够的信心，并能够将自己的生命交到医生手中，那么医生就完全能够给予关爱，医生必须获得百分百的信任。Mere?technical?treatment?of?disease?does?not?suffice.仅仅是对于疾病的技术治疗是不能够满足的。Patients?must?be?able?reasonably?to?believe?that?their?physicians?care?about?them?in?anextraordinarily?personal?way.病患必须合理地相信，他们的医生从个人层面对他们非常关心。This?exchange?of?care?for?trust,?while?not?identical?to?friendship?or?love,?is?equally?binding.这种用关爱换取信任同样相互关联，这与友情和爱完全不同。From?it?develops?an?interdependence?that?is?far?from?unwholesome?rather,?it?potentiates?careand?promotes?healing.这种造成的相互依赖远远不会对身心造成伤害，反而这会增强关爱，提高治愈率。Our?late?twentieth?century?sophistication?and?technologic?orientation?have?too?often?cost?uswarmth,?humor,?and?humanity,?leaving?us?in?social?isolation.20世纪晚期以复杂和技术为目的的医疗经常让我们失去了温暖、幽默以及仁慈，并让我们被社会所孤立。We?do?far?better?as?professionals?to?err?on?the?side?of?being?human?with?our?patients?than?totry?to?play?deus?ex?machina,?the?god?from?the?machine.作为专业人员，我们对待病人要人性化，这么做即使犯些小错也比扮演冷冰冰的解围之神要好。1.identical?to/with：与…完全相同的例句：His?appearance?was?identical?to?his?mother,?Anyone?could?identify?that?he?was?herson.他的面容和母亲是同样的。任何人都可以识别他是她的儿子。2.in?a?position?to?do?能够作某事例句：The?people?you're?in?a?position?to?do?something?nice?for,?even?if?they've?got?no?abilityto?reciprocate.你能做一些力所能及的事情的人，哪怕他们有没有能力来报答。3.acquired?skill?习得的技能例句：Failing?to?recognize?that?speaking?is?an?acquired?skill.没有认识到演讲是一个可以后天习得的技巧。4.happen?to?发生于例句：Yes,?it?could?happen?to?any?of?us,?but?yesterday?it?happened?to?.是的，这可能发生在我们任何一个人身上，但是昨天却发生在他们身上了。第7期HE?SOCIAL?RESPONSIBILITIES?AND?HUMANISTIC?QUALITIES?OF?"THE?GOODDOCTOR"“好医生”的社会责任和人道主义素质The?patient?says,"Take?charge,?make?me?well,?help?me?feel?comfortable,?show?me?compassion?listen?to?my?problems?and?I?will?give?you?trust."病患称：“负责任，治好病，舒适感，同情心，倾听我的诉求，我将信任你。”Dag?Hammarskjold?reminds?us?of"the?humility?which?comes?from?others?having?faith?in?you".哈马舍尔德提醒我们“要谦虚，谦虚来自于别人对你的信任”。The?natural?outcome?of?this?giving?and?receiving?of?trust?is?that?the?physician?must?acceptsome?degree?of?obligation?to?the?patient.信任别人和得到信任的自然结果是医生必须要承担一些对病患的义务。Of?course,?the?patient,?if?able,?keeps?some?responsibility?for?the?healing?process,?but?thephysician?must?be?willing?to?answer?the?patient's?needs,当然，如果病患可以的话，他们也需要在治疗过程中承担一些责任，但是医生必须愿意满足病患的需求。however?demanding,?however?changing,?however?at?times?unreasonable?or?falsely?perceived.尽管这样的要求过高，变动性较大，有时还会是不合理的，或是不正确的需求。Generalists?in?internal?medicine?undertake?a?long-term?commitment?to?a?patient's?care.内科医生对病患所承担的责任需要持续很长一段时间。They?are?reminded?daily?that?this?commitment?continues?beyond?a?particularly?insightfuldiagnosis?or?the?completion?of?an?endoscopic?procedure；他们每天都会被提醒，这些责任超越了某一类高深的诊断，或是完成一次内镜检查；that?the?patient?still?needs?care?when?the?numbers?are?back?from?the?most?recent?cardiaccatheterization就是当病人完成最常见的心导管插手术，or?when?the?final?stitch?is?completed?in?a?complex?procedure?and?the?patient?is?rolled?from?theoperating?suite.或是完成了复杂手术的最后一针，就算病人从手术室中推出来，他们仍需要呵护。The?internist?continues?to?care?for?and?nurture?the?patient?through?the?whole?process?ofhealing?in?a?way?that?requires?enormous?skill?in?close?personal?interaction.内科医生在全部治疗过程中都会继续对病患进行关爱和呵护，而这种关爱方式需要人际交流中的诸多技能。1.long-term?长期的例句：You?should?also?have?long-term?goals,?not?only?for?your?business?but?for?your?owncareer.同时，你也应该为你的职业生涯设定一个长期的目标，而不仅仅是为了眼前的工作。2.care?for?关心例句：Lily?spent?years?caring?for?her?sick?uncle.莉莉照顾了她生病的叔叔好多年。3.endoscopic?procedure?内镜检查例句：It?is?usually?done?in?the?hospital?or?an?endoscopic?procedure?room.通常结肠镜检查是在医院或专门的内镜检查室内进行。4.internal?medicine?内科例句：The?study?was?published?on?Monday?in?the?Archives?of?Internal?Medicine.这项研究在星期一发表在内科医学档案上。第8期HELP?WITH?FAMILY?INTERACTIONS了解家庭关系The?woman?who?comes?into?her?physician's?office?with?a?history?of?fatigue,listlessness,inability?to?sleep,?and?irritability?may?be?describing?the?early?symptoms?of?amorbid?disease.进入医生办公室的这位女性患者拥有疲劳史，精神萎靡，并患有失眠症和烦躁症，这位病患或许还会描述她疾病的早期症状。She?may,?however,?be?showing?signs?of?depression?secondary?to?her?inability?to?cope?anylonger?with?an?alcoholic?husband,或许，由于她无力应对酗酒的丈夫，with?a?teenage?son?addicted?to?cocaine,or?with?an?elderly?mother?for?whom?she?must?care.吸毒成瘾的孩子，以及她必须要照顾的老母亲而显出抑郁状态。The?wise?physician?considers?organic?pathology?but?also?realizes?that?presenting?symptomsmay?be?only?part?of?what?is?really?troubling?the?patient.睿智的医生认为应该运用器官病理学的方法来治疗，但是医生又意识到目前所展现的症状或许仅仅是烦恼病患的一部分。This?requires?an?unusual?sensitivity?and?an?ability?to?pursue?in?a?cautious,?understanding,andcareful?way?and?to?listen?to?the?concerns?and?needs?the?patient?describes--traits,?again,?thatcan?and?must?be?developed?and?practiced.这就需要医生非常敏感并且能小心谨慎、善解人意、细致入微地去探寻并倾听病人的忧虑和需求,医生的这些能力能够且必须加以完善和实践。The?physician's?role?is?to?help?the?patient?understand?the?connections?between?unpleasantsituations,?emotional?disturbances,?and?organic?symptoms.医生的角色就是要帮助病患了解不良状况、情绪困扰以及身体症状之间的联系。Sometimes?patients?are?helped?simply?by?understanding?those?relationships?and?being?awarethat?the?doctor?appreciates?them?and?reassures,?listens?with?a?sympathetic?ear,?and?seldomadvises?in?a?direct?way,?but?does?express?concern.有时候，帮助病人只需要让他们知道这三者之间的关系并意识到：医生了解他们，愿意安慰和倾听他们，很少直言相劝、却能表达关心之情。In?earlier?days,?when?most?medical?care?was?delivered?at?home,?the?physician?was?quickly?madeaware?of?living?situations?and?family?interactions,if?he?or?she?did?not?already?know?the?entirefamily?and?their?circumstances.早些时候，当时绝大多数医生都会在病人家中进行医护治疗，如果医生并没有完全了解病患的家庭和环境状况，那么医生也会很快察觉到病患的生活状况以及家庭关系。Today?when?the?patient?comes?to?the?office,?generally?alone?and?certainly?out?of?socioeconomiccontext,?it?is?much?more?difficult?to?perceive?what?is?going?on.如今，病患来到医生的办公室，通常病患会独自一人来，完全无法得知病患的社会经济背景，医生就很难做出正确的判断。The?physician?must?exercise?a?much?greater?degree?of?skill?and?understanding?in?exploringfamily?interrelationships?during?a?history?and?physical?examination?or?in?an?even?shorter?visit.通过既往史，体检甚至是通过简短拜访的方式，医生必须要提高他们了解家庭关系的技能。1.addicted?to?上瘾例句：He?became?addicted?to?drugs.?他已吸毒成瘾。2.medical?care?医疗护理例句：So?far,?however,?two?panels?of?government?experts?who?have?looked?at?the?issue?havenot?found?significant?impediments?to?research?or?medical?care?caused?by?gene?patents.?可是到目前为止，关注该案的两个政府专家小组还没有发现基因检测专利制度对医学研究和医疗护理方面明显的障碍。3.physical?examination?体检例句：A?careful?history?and?physical?examination?were?obtained,?but?there?was?no?obviousreason?for?the?patient's?problem.?也得到了一份详细的病史和身体检查，但是没有任何明显的证据表明病人患有该疾病。4.sympathetic?ear?同情心例句：Women?need?a?sympathetic?ear.?女士们需要一位具有同情心的听众。第9期HELP?WITH?OBTAINING?NECESSARY?ADDITIONAL?PROFESSIONAL?SERVICES帮助病患获得必要的额外专业服务The?warm?and?intimate?relationship?that?any?patient?seeks?is?not?one?that?a?typical?patient?canhave?with?many?physicians?at?the?same?time.病患所需要的亲密关系并不是哪位病患能够在同一时间与多位医生所拥有的。The?internist?must?demonstrate?a?variety?of?skills,?attitudes,?and?abilities?and?a?store?ofdiverse?information?that?allows?him?or?her?to?be?the?patient's?health?care?manager?as?well?as?hisconfidant,?keeping?in?mind?that?the?average?patient?does?not?understand?the?system?ofmedical?referrals?for?subspecialty?consultation.内科医生必须具有各种技能、观点、能力和丰富的信息。这会让他们既成为病人健康的管理者也成为患者的知心人。他们还要时刻牢记，普通病人对分科就诊和转诊这套制度并不了解。An?oncologist/internist?recently?described?for?me?how?she?weaves?the?fabric?of?health?caremanagement?for?a?patient?who?has?been?referred?with?a?positive?biopsy?for?a?malignant?disease.一位肿瘤医师/内科医生最近对我说她是如何为病患建立医疗管理的，这名病患因恶性病接受了活性切片检查。In?this?situation?the?oncologist?has?to?view?herself?as?the?captain?of?a?rather?complicated?ship.在这种情况下，肿瘤医师不得不将自己看成是一艘大船船长。She?has?to?talk?with?the?referring?physician，obtain?the?biopsy?slides,?have?them?re-read?byher?own?consulting?pathologist,?and?review?them?herself.她需要与转诊医师进行沟通，获取切片，请病理学家再次分析，之后自己审查。She?then?has?to?review?the?chart?and?the?radiographs?with?a?consulting?radiologist?and?decide,given?al