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Good, really good, maybe an all-star.
خوب، خیلی خوب. شاید حتی منتخب.
en-fa
Do you know what they call a 400 baseball hitter?
Čo potom 400-bodový pálkar?
en-sk
That's somebody who hit, by the way, four times safely out of every 10.
E cineva care lovește în siguranță în 4 din 10 cazuri.
en-ro
Legendary -- as in Ted Williams legendary -- the last Major League Baseball player to hit over 400 during a regular season.
Legendás -- olyan Ted Williams szintű legendás. Ő volt az amerikai profi baseball-liga utolsó olyan játékosa, aki 400 fölött ütött egy szezonban.
en-hu
Now let's take this back into my world of medicine where I'm a lot more comfortable, or perhaps a bit less comfortable after what I'm going to talk to you about.
Сега нека се върнем към моят свят на медицината, където се чувствам много по-комфортно или може би малко по-некомфортно след това, за което смятам да говоря.
en-bg
Suppose you have appendicitis and you're referred to a surgeon who's batting 400 on appendectomies.
נניח שיש למישהו דלקת תוספתן והוא הופנה למנתח ש"חובט" בהצלחה 400 בניתוחי תוספתן.
en-he
(Laughter) Somehow this isn't working out, is it?
(웃음) 좀 문제가 있어 보이지 않습니까?
en-ko
Now suppose you live in a certain part of a certain remote place and you have a loved one who has blockages in two coronary arteries and your family doctor refers that loved one to a cardiologist who's batting 200 on angioplasties.
Agora suponhamos que vivem num certo local mais remoto e que têm uma pessoa querida que tem duas artérias coronárias impermeáveis e o vosso médico de família a refere a um cardiologista que "bate 200" em angioplastias.
en-pt
But, but, you know what?
いや でも いいお知らせです
en-ja
She's doing a lot better this year. She's on the comeback trail.
Оваа година ѝ е многу подобро.
en-mk
And she's hitting a 257.
Jest znów na topie i odbija 257.
en-pl
Somehow this isn't working.
ありえないことです
en-ja
But I'm going to ask you a question.
Pitaću vas sada nešto.
en-sr
What do you think a batting average for a cardiac surgeon or a nurse practitioner or an orthopedic surgeon, an OBGYN, a paramedic is supposed to be?
你们认为, 一位心脏外科医生,或一位职业护理师, 一位骨科外科医生 妇产科医生或急救人员的 “击球率” 应该是多少?
en-zh-cn
1,000, very good.
1000, muy bien.
en-es
Now truth of the matter is, nobody knows in all of medicine what a good surgeon or physician or paramedic is supposed to bat.
Але насправді в медицині ніхто не знає, яким має бути показник для хорошого хірурга, терапевта чи парамедика.
en-uk
What we do though is we send each one of them, including myself, out into the world with the admonition, be perfect.
Quello che però facciamo è spedirli tutti, me incluso, là fuori con questo avvertimento: sii perfetto.
en-it
Never ever, ever make a mistake, but you worry about the details, about how that's going to happen.
Asnjëherë kurrë, kurrë mos të bëjë gabim, por ju shqetësoheni për detaje, për atë se si do të ndodhë.
en-sq
And that was the message that I absorbed when I was in med school.
Dhe ky ishte mesazhi që unë absorbova kur isha në shkollën e mjekësis.
en-sq
I was an obsessive compulsive student.
Я з головою занурився у науку.
en-uk
In high school, a classmate once said that Brian Goldman would study for a blood test.
مرة في الثانوية احد الزملاء قال ان برايان قولدمان سيدرس فحص الدم.
en-ar
(Laughter) And so I did.
(smeh) I to je tačno.
en-sr
And I studied in my little garret at the nurses' residence at Toronto General Hospital, not far from here.
Dhe kam studiuar në dhomën time të vogël në rezidencën e mjekëve në Spitalin e Përgjithshëm në Toronto, jo shumë larg nga këtu.
en-sq
And I memorized everything.
Dhe kam memorizuar gjithëcka.
en-sq
I memorized in my anatomy class the origins and exertions of every muscle, every branch of every artery that came off the aorta, differential diagnoses obscure and common.
Tôi học thuộc trong lớp giải phẫu điểm bắt đầu và hoạt động của từng bó cơ, từng nhánh của từng động mạch tách ra từ động mạch chủ, những căn bệnh phức tạp, cả hiếm gặp và thông dụng.
en-vi
I even knew the differential diagnosis in how to classify renal tubular acidosis.
Conoscevo perfino le diagnosi differenziali per classificare l'acidosi tubulare renale.
en-it
And all the while, I was amassing more and more knowledge.
و تمام مدت، دانسته های بیشتر و بیشتر انباشته می کردم.
en-fa
And I did well, I graduated with honors, cum laude.
Y me iba muy bien; me gradué con honores.
en-es
And I came out of medical school with the impression that if I memorized everything and knew everything, or as much as possible, as close to everything as possible, that it would immunize me against making mistakes.
Y egresé de la escuela de medicina con la impresión de que si memorizaba todo, entonces sabría todo, o lo más posible, cercano al todo, porque así me inmunizaría de los errores.
en-es
And it worked for a while, until I met Mrs. Drucker.
To je i bilo tako neko vreme, dok nisam upoznao gospođu Druker.
en-sr
I was a resident at a teaching hospital here in Toronto when Mrs. Drucker was brought to the emergency department of the hospital where I was working.
Pôsobil som ako asistujúci lekár v univerzitnej nemocnici tu v Toronte, keď na pohotovosť doviezli pani Druckerovú.
en-sk
At the time I was assigned to the cardiology service on a cardiology rotation.
그당시 전 심장과에서 순환근무를 하고 있었지요.
en-ko
And it was my job, when the emergency staff called for a cardiology consult, to see that patient in emerg.
И беше моя работа, когато от спешното потърсят кардиолог за консултация, да се видя с пациента в спешното
en-bg
and to report back to my attending.
et de faire un compte-rendu à mon superviseur.
en-fr
And I saw Mrs. Drucker, and she was breathless.
Assim, vi a Sra. Drucker e ela estava com falta de ar.
en-pt
And when I listened to her, she was making a wheezy sound.
E mentre la ascoltavo, faceva un sibilo.
en-it
And when I listened to her chest with a stethoscope, I could hear crackly sounds on both sides that told me that she was in congestive heart failure.
وعندما كنت استمع الى صدرها بسماعة الطبيب، وكنت أسمع أصوات مكسره على الجانبين وعرفت حينها انها تعاني من فشل القلب الاحتقاني.
en-ar
This is a condition in which the heart fails, and instead of being able to pump all the blood forward, some of the blood backs up into the lung, the lungs fill up with blood, and that's why you have shortness of breath.
이것은 심장기능 상실시 심장이 모든 혈액을 심장밖으로 뿜어내지 못해서 일부 혈액이 폐로 역류하여 폐에 혈액이 차서 호흠하기 힘들게 되는 거죠.
en-ko
And that wasn't a difficult diagnosis to make.
Nie była to trudna do postawienia diagnoza.
en-pl
I made it and I set to work treating her.
e vendosa dignozën dhe vendosa ta trajtoj.
en-sq
I gave her aspirin. I gave her medications to relieve the strain on her heart.
Je lui ai donné de l'aspirine et des médicaments pour soulager la tension au cœur.
en-fr
I gave her medications that we call diuretics, water pills, to get her to pee out the access fluid.
Podal som jej diuretiká, a teda tablety na vymočenie nadbytočnej tekutiny.
en-sk
And over the course of the next hour and a half or two, she started to feel better.
E num período de uma hora e meia ou duas, ela começou a sentir-se melhor.
en-pt-br
And I felt really good.
그래서 저는 기분이 정말 좋았는데
en-ko
And that's when I made my first mistake; I sent her home.
그것이 제가 처음으로 실수를 저지른 순간이었죠. 전 그녀를 퇴원시켰지요.
en-ko
Actually, I made two more mistakes.
De fato, cometi mais dois enganos.
en-pt-br
I sent her home without speaking to my attending.
L'ho dimessa senza parlarne con il mio supervisore.
en-it
I didn't pick up the phone and do what I was supposed to do, which was call my attending and run the story by him so he would have a chance to see her for himself.
我没有做我照着我应该做的, 拿起电话打给我的主治并让他看一下这个案例, 给他一个亲自见见这名病患的机会。
en-zh-cn
And he knew her, he would have been able to furnish additional information about her.
그는 그 환자를 알았기 때문에 그녀에게 추가적인 정보를 줄 수 있었지요.
en-ko
Maybe I did it for a good reason.
Talvez eu tenha feito isso por uma boa razão.
en-pt-br
Maybe I didn't want to be a high-maintenance resident.
Talvez eu não quisesse ser um residente que necessita de assistência constante.
en-pt-br
Maybe I wanted to be so successful and so able to take responsibility that I would do so and I would be able to take care of my attending's patients without even having to contact him.
也许我太想 可以独当一面, 可以不需要 和我的主治沟通 便照顾好他的病患。
en-zh-cn
The second mistake that I made was worse.
Το δεύτερο λάθος που έκανα ήταν χειρότερο.
en-el
In sending her home, I disregarded a little voice deep down inside that was trying to tell me, "Goldman, not a good idea. Don't do this."
Al enviarla a su casa, no presté atención a una voz en mi interior que me decía: "Goldman, no es una buena idea.
en-es
In fact, so lacking in confidence was I that I actually asked the nurse who was looking after Mrs. Drucker, "Do you think it's okay if she goes home?"
Ne čini to." Toliko sam bio nesiguran da sam na kraju pitao sestru koja je pazila g-đu Druker: "Da li je OK da je pustimo kući?"
en-sr
And the nurse thought about it and said very matter-of-factly, "Yeah, I think she'll do okay."
dhe infermierja mendoi për këtë dhe tha "Po mendoj se ajo do të jet mirë."
en-sq
I can remember that like it was yesterday.
Tôi nhớ rõ mọi sự như ngày hôm qua vậy.
en-vi
So I signed the discharge papers, and an ambulance came, paramedics came to take her home.
Donc j'ai signé les formulaires, et une ambulance est arrivée, et les ambulanciers sont venus la chercher.
en-fr
And I went back to my work on the wards.
Un es atgriezos pie saviem pienākumiem palātās.
en-lv
All the rest of that day, that afternoon, I had this kind of gnawing feeling inside my stomach.
Tërë pjesën tjetër të asaj dite, atë mbrëmje, Kam pasur një lloj brejtje brenda stomakut tim.
en-sq
But I carried on with my work.
ale kontynuowałem pracę.
en-pl
And at the end of the day, I packed up to leave the hospital and walked to the parking lot to take my car and drive home when I did something that I don't usually do.
Aan het einde van de dag pakte ik mijn spullen en liep naar de parkeerplaats om in mijn auto te stappen toen ik iets deed wat ik normaal niet doe.
en-nl
I walked through the emergency department on my way home.
Tôi đi qua phòng cấp cứu trên đường về nhà.
en-vi
And it was there that another nurse, not the nurse who was looking after Mrs. Drucker before, but another nurse, said three words to me that are the three words that most emergency physicians I know dread.
Und dort sagte eine anderen Krankenschwester, nicht der Schwester die nach Frau Drucker gesehen hatte, sondern einer anderen drei Worte zu mir und diese drei Worte fürchten die meisten Notfallärzte, die ich kenne.
en-de
Others in medicine dread them as well, but there's something particular about emergency medicine because we see patients so fleetingly.
医療に関わる者は皆 この一言を恐れますが 救急医療ではさらに特別な一言です なぜなら次から次へと患者を診るからです
en-ja
The three words are: Do you remember?
Die drei Worte lauten: Erinnern Sie sich?
en-de
"Do you remember that patient you sent home?"
"Czy może pamiętasz pacjentkę, którą posłałeś do domu?"
en-pl
the other nurse asked matter-of-factly.
zapytała mnie wprost pielęgniarka.
en-pl
"Well she's back," in just that tone of voice.
« Eh bien, elle est de retour », avec ce ton-là.
en-fr
Well she was back all right.
Revenise.
en-ro
She was back and near death.
Era tornata e in fin di vita.
en-it
About an hour after she had arrived home, after I'd sent her home, she collapsed and her family called 911 and the paramedics brought her back to the emergency department where she had a blood pressure of 50, which is in severe shock.
Zhruba hodinu potom, co přijela domů, co jsem ji poslal domů, zkolabovala a její příbuzní zavolali 911 a záchranáři ji přivezli nazpět na pohotovost kde jí naměřili krevní tlak 50, což odpovídá velkému šoku.
en-cs
And she was barely breathing and she was blue.
Un viņa tik tikko elpoja un bija zila.
en-lv
And the emerg. staff pulled out all the stops.
응급실 의료진 모두가 최선을 다했습니다.
en-ko
They gave her medications to raise her blood pressure.
ata i dhanë medikamente për t'ia rritur tensionin e gjakut.
en-sq
They put her on a ventilator.
Stavili su je na ventilator.
en-hr
And I was shocked and shaken to the core.
Byłem w szoku i cały się trząsłem.
en-pl
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.
E continuei nessa montanha russa, porque depois que a estabilizaram, ela foi para o centro de cuidados intensivos, e eu esperava contra a expectativa que ela se recuperaria.
en-pt-br
And over the next two or three days, it was clear that she was never going to wake up.
Và trong hai hay ba ngày sau đó, mọi sự rõ ràng là bà không bao giờ tỉnh dậy nữa.
en-vi
She had irreversible brain damage.
Mala totiž nezvratné poškodenie mozgu.
en-sk
And the family gathered.
De familie kwam bijeen.
en-nl
And over the course of the next eight or nine days, they resigned themselves to what was happening.
在接下来的八到九天里, 他们慢慢的接受了这件事实。
en-zh-cn
And at about the nine day mark, they let her go -- Mrs. Drucker, a wife, a mother and a grandmother.
وفي خلال تسعة ايام تركوها تذهب -- السيدة دانكر, زوجة, أم وجدة.
en-ar
They say you never forget the names of those who die.
Dizem que você nunca esquece os nomes daqueles que morrem.
en-pt-br
And that was my first time to be acquainted with that.
Vtedy som to okúsil po prvý raz.
en-sk
Over the next few weeks, I beat myself up and I experienced for the first time the unhealthy shame that exists in our culture of medicine -- where I felt alone, isolated, not feeling the healthy kind of shame that you feel, because you can't talk about it with your colleagues.
在接下来的几个星期内, 我无比的沮丧, 并第一次经历了 那种在医学文化中存在的 危险的羞愧感 -- 我觉得孤单无助。 这不是那种健康的羞愧感, 因为你不能和你的同事提起讨论它。
en-zh-cn
You know that healthy kind, when you betray a secret that a best friend made you promise never to reveal and then you get busted and then your best friend confronts you and you have terrible discussions, but at the end of it all that sick feeling guides you and you say, I'll never make that mistake again.
Tudják, azt az egészséges fajtát, amikor elárulod a legjobb barátod féltve őrzött titkát és lebuksz, és a barátod szembesít vele, és szörnyű szóváltásba keveredtek, de a végén az a rettenetes érzés elvezet oda, hogy azt mondod, soha többé nem követem el ezt a hibát.
en-hu
And you make amends and you never make that mistake again.
Próbálod jóvátenni, és nem követed el többé azt a hibát.
en-hu
That's the kind of shame that is a teacher.
Ce genre de honte vous apprend quelque chose.
en-fr
The unhealthy shame I'm talking about is the one that makes you so sick inside.
Cái loại hổ thẹn không lành mạnh tôi nói về là loại khiến cho bạn nôn nao trong lòng.
en-vi
It's the one that says, not that what you did was bad, but that you are bad.
Az nem azt mondja, hogy amit tettél, az rossz, hanem hogy te vagy a rossz.
en-hu
And it was what I was feeling.
E era o que eu estava a sentir.
en-pt
And it wasn't because of my attending; he was a doll.
Nebolo to mojím nadriadením, ten bol skvelý.
en-sk
He talked to the family, and I'm quite sure that he smoothed things over and made sure that I didn't get sued.
Ha parlato alla famiglia, e sono certo che ha sminuito le cose in modo che non venissi citato in giudizio.
en-it
And I kept asking myself these questions.
و من مدام از خودم این سوالات رو میپرسیدم
en-fa
Why didn't I ask my attending? Why did I send her home?
De ce nu am întrebat supervizorul?
en-ro
And then at my worst moments: Why did I make such a stupid mistake?
A v najhorších chvíľach dokonca: „Prečo som urobil tak hlúpu chybu?"
en-sk
Why did I go into medicine?
Защо се захванах с медицина?
en-bg
Slowly but surely, it lifted.
Yavaş yavaş da olsa bu yararlı oldu.
en-tr
I began to feel a bit better.
Začal som sa cítiť lepšie.
en-sk