余小舫2022-03-04 13:31
外科格言与引语集萃（147）
——外科教学（2）
图/文 余小舫
1．A physician"s life is a constant and losing battle against obsolescence
—— Mark M Ravitch, 1910-1989
【译文】医生生涯就是一场不断与落伍叫阵并最终败给它的持久战。
【点评】尤其在信息大爆炸的今天更是如此。
2．It is very difficult to slow down. The practice of medicine is like heart muscle contraction… it’s all or none.
—— Béla Schick,1877-1967
【译文】医学实践就像不停收缩的心肌，要么全有，要么全无，慢下来是非常困难的。
3. I failed in the primary Fellowship examination of the Royal College – I was … inadequate in the ordeal of exposure to the savagely searching questions asked by experienced and sometimes rather alarming surgeons, who wanted to know how much a frightened young man could reproduce, from his only partially trained memory, of details of topographical anatomy, much of which had seemed to him to be of little or no practical importance.
—— Geiffrey Keynes, 1887—1982
【中文】我在皇家学院的初级专科医生培训考试中不及格——我……经受不住那种折磨人的提问，那些外科医生经验丰富、有时甚至相当令人恐惧，问题残忍，不断纠缠。他想知道，一个受了惊吓的年轻人，凭他那仅有的部分记忆训练，能复述多少结构解剖学的细节，其中大部分内容对他来说似乎完全不重要或者没有什么实际意义。
4. Probably in the not far distant future we will crawl out of our old methods of education, as a snake sheds its skin, and reorganize a new plan.
—— Charlie Mayo 1865-1939
【中文】也许在不久的将来，我们将从旧的教育方法中爬出来，就像蛇蜕皮一样，并重新构建一个新的计划。
【点评】近一百年过去了，好像还没爬出来。
5. The most essential part of a student’s instruction is obtained, as I believe, not in the lecture room, but at the bedside.
—— Oliver Wendell Holmes 1809–1894
【译文】我认为，学习最重要的部分不是在课堂上，而是在床边。
6．It might….. be of singular advantage to young surgeons, particularly before they begin an operation to go through every part of it attentively in their own minds to consider every possible accident which may happen and to have the proper remedies at hand in case they should; and in all operations of delicacy and difficulty to act with deliberation.
—— John Jones, 1729-1791
【译文】对年轻外科医生而言，有一种特别能受益的学习方法是，尤其是在他们做手术之前，在自己脑海中聚精会神地模拟一遍每一个步骤，考虑到每一种可能的意外，并准备好随手可及的、适当的补救措施，以备不时之需；此外，须深思熟虑地应对每一台棘手的手术。
【点评】无论这台手术是否由你主刀，如果能养成这种手术前进行心与手的“模拟演练”的习惯， 将非常有助于年轻外科医生的进步。
7. I would suggest the plan of reading not less than one hour a day.
—— Will. Mayo 1861-1938
【中文】我建议每天阅读不应少于1小时。
8. Cultivate methodic habits of study.
—— Will. Mayo 1861-1938
【中文】需培养有条理的学习习惯。
【点评】在这个碎片化阅读盛行的年代，应该重新掂量一下这句话的分量。
9. As we have become more and more dependent upon the laboratory and special investigations in making our diagnosis, we have gradually lost that faculty of clinical observation which enabled these early clinicians to make an accurate diagnosis in the more common diseases almost with a glance at the patient.
—— Will. Mayo 1861-1938
【中文】随着我们越来越离不开实验室和特别仪器检查的结果来做诊断，我们逐渐失去了临床观察能力，而这种能力常常能让早年的临床医生几乎一眼就能对很常见的一些疾病做出准确的诊断。
10. The mental effect on the patient is good, the practical knowledge to yourself is better, and if you avail yourselves of all the means of physical diagnosis and repeated examinations, the number of unsolved cases will be surprisingly small.
—— Will. Mayo 1861-1938
【中文】如果你充分利用物理诊断和亲自反复检查病人，不仅能搞清楚绝大多数病人的诊断，而且能给患者留下良好的印象，增长自己的实践经验。
11. Above all things, let me urge upon you the absolute necessity of careful examinations for the purpose of diagnosis. My own experience has been that the public will forgive you and error in treatment more readily than one in diagnosis, and I fully believe that more than one-half of the failures in diagnosis are due to hasty and unmethodic examinations.
—— Will. Mayo 1861-1938
【中文】首先，我想强调的是，为了获得正确的诊断绝对有必要进行详细的体格检查。据我的经验，与你在治疗方面的错误相比公众更不能原谅你的诊断错误。我完全相信，超过一半的诊断失误是因为匆忙行事和缺乏系统的体检。
12. Errors of judgment in student days were made harmless by the care and attention of your teachers. From now on you will have no such check upon your actions, and your mistakes will be costly because they concern the health and happiness, if not the life, of individuals.
—— Will. Mayo 1861-1938
【中文】学生时代的错误因你老师的细心和明察得到了及时化解。从现在开始，你的行为将不再有人帮你把关，你将为你的错误付出代价，因为它们关系到一个人的健康和幸福，即使不会丧命。
一
