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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 the nurses' residence at Toronto General Hospital, not far from here.
而我的确这么做了。我在离这不远处的多伦多总医院里护士住宅里的一个小阁楼中，完成了我的学业。
And I memorized everything. I memorized in my anatomy class the origins and exertions of every muscle,
我背下了所有东西。我背下了解剖课中提到的每一块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.
每一条从主动脉延伸出来的动脉的分支系统，以及一切鲜为人知的或者常见的鉴别诊断。
I even knew the differential diagnosis in how to classify renal tubular acidosis.
我甚至知道如何鉴别诊断不同的肾小管性酸中毒症。
And all the while, I was amassing more and more knowledge.
在这段时间中，我积累了越来越多的知识。
And I did well, I graduated with honors, cum laude.
我的表现很好，并以优等的成绩毕业。
And I came out of medical school with the impression that if I memorized everything and knew everything,
当我从医学院出来时，我觉得我只要记下和明白了所有的东西，
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--将近所有的东西，那我犯医疗错误的几率就会微乎其微。
And it worked for a while, until I met Mrs. Drucker.
而我在一段时间之内的确没有犯错。直到我遇到了Drucker女士。
I was a resident at a teaching hospital here in Toronto
我正作为一个实习医生在多伦多工作，
when Mrs. Drucker was brought to the emergency department of the hospital where I was working.
当Drucker女士被带入教学医院的急诊室时。
At the time I was assigned to the cardiology service on a cardiology rotation.
当时我正因心脏科轮调而被指派在心血管诊所。
And it was my job, when the emergency staff called for a cardiology consult,
我的工作是，当紧急救护人员需要有关于心脏的专业会诊时，
to see that patient in emerg. and to report back to my attending.
在急症室诊断病人，并在之后向负责我的主治医生汇报。
And I saw Mrs. Drucker, and she was breathless.
当我见到Drucker女士的时候，她的气息已经很微弱。
And when I listened to her, she was making a wheezy sound.
在我与她交谈时，我听到她的呼吸有喘息的声音。
And when I listened to her chest with a stethoscope,
当我用听诊器聆听她的胸腔时，
I could hear crackly sounds on both sides that told me that she was in congestive heart failure.
两边都传来的爆裂的声音告诉我，这是郁血性心脏衰竭。
This is a condition in which the heart fails, and instead of being able to pump all the blood forward,
这是由于心脏在衰竭后，无法将所有的血液完全的输送出去，
some of the blood backs up into the lung, the lungs fill up with blood, and that's why you have shortness of breath.
而导致部分血液回流入肺脏，肺脏里充满了血液，而造成呼吸短促。
