864: Chicago Hope - This American Life
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00:00 00:00 Transcript Share This American Life Life Partners How to Listen Episodes Recommended About Overview Staff Announcements Fellowships Jobs Music Make Radio On The Road FAQ Submissions Merch Contact Us Our Other Shows Merch Follow Us Life Partners Subscribe to our newsletter Full episode Toggle Audio and Transcript Sync Transcript | Episode #864 | July 18, 2025 864: Chicago Hope Note: This American Life is produced for the ear and designed to be heard.
00:00 00:00 文字记录 分享此 美国生活 生活伙伴 如何收听 剧集 推荐 关于 概述 员工公告 奖学金 工作 音乐 在路上制作电台 常见问题解答 提交 商品 联系我们 我们的其他节目 商品 关注我们 生活伙伴 订阅我们的时事通讯 整集 切换音频和文字记录同步 文字记录 | 内容第 864 集 | 2025 年 7 月 18 日 864：芝加哥希望 注：《This American Life》是为耳朵而制作的，旨在让人们听到。
If you are able, we strongly encourage you to listen to the audio, which includes emotion and emphasis that's not on the page.
如果可以的话，我们强烈建议您收听音频，其中包括页面上没有的情感和重点。
Transcripts are generated using a combination of speech recognition software and human transcribers, and may contain errors.
文字记录是使用语音识别软件和人工转录员结合生成的，可能包含错误。
Please check the corresponding audio before quoting in print.
请在印刷版引用前检查相应的音频。
Prologue: Prologue Ira Glass From WBEZ Chicago, it's This American Life.
序言：序言 来自 WBEZ 芝加哥的 Ira Glass，这就是美国生活。
I'm Ira Glass.
我是艾拉·格拉斯。
A couple of years ago, one of our producers put together this story that just got too big for our show.
几年前，我们的一位制片人整理了这个故事，但这个故事对我们的节目来说太大了。
It couldn't be contained in an hour or two hours.
不可能一两个小时就可以控制住。
And so it spun out into its own podcast series called The Retrievals.
因此它衍生出了自己的播客系列，名为“The Retrievals”。
It was a big hit.
这是一个很大的打击。
Maybe you heard it.
也许你听到了。
Our coworkers at Serial at The New York Times produced it.
我们在《纽约时报》连续剧的同事制作了它。
Anyway, now that producer, Susan Burton, is back with a story that is just as compelling.
不管怎样，现在制片人苏珊·伯顿带着一个同样引人入胜的故事回来了。
And they have released it as season two of The Retrievals.
他们已将其作为《检索》的第二季发布。
At first, I heard drafts of this months ago.
起初，我是几个月前听到的草稿。
And I am very excited that we can present one of the episodes for you today.
我很高兴我们今天能为您展示其中一集。
I have to say, one of the things that I really like about this story is that by the end, it turns out to be surprisingly hopeful.
我不得不说，我真正喜欢这个故事的一件事是，到最后，它竟然充满了令人惊讶的希望。
She also invented this way to tell a radio story I have never heard anybody try.
她还发明了这种方式来讲述广播故事，我从未听过有人尝试过。
I hope you like it.
我希望你喜欢它。
I think you'll like it.
我想你会喜欢的。
The story takes place in a hospital's labor and delivery unit.
故事发生在医院的待产科。
And there's some description in here of medical procedures.
这里有一些医疗程序的描述。
And things don't go well.
但事情并不顺利。
Just a heads-up.
只是一个提示。
Here's Susan.
这是苏珊。
6:00 AM in Chicago.
早上 6:00 抵达芝加哥。
Of course, the shot starts at the lake.
当然，镜头是从湖边开始的。
Camera pans over the water and the magnificent buildings rise from the shoreline, twinkling in the dawn light.
镜头平移在水面上，宏伟的建筑从海岸线上拔地而起，在黎明的光芒中闪烁。
We continue across the city, still bird's-eye view, over the grid, over the elevated tracks and wide highways, coming to rest in a western suburb.
我们继续穿过城市，仍然鸟瞰整个城市，越过电网、高架轨道和宽阔的高速公路，最后在西郊停下来。
Drop down to a brick bungalow where, inside, a woman, late 30s, moves softly past the bedrooms where her children sleep and steps out the front door to meet the morning.
来到一栋砖砌平房，里面有一个 30 多岁的女人，轻轻地走过她孩子们睡觉的卧室，走出前门迎接早晨。
Wind chill of 20 below.
风寒20度以下。
She hurries to a minivan.
她赶紧走向一辆小型货车。
And as she pulls away from the curb, we see the streets frosted with salt, the moon shining high and hard.
当她驶离路边时，我们看到街道上结满了盐霜，月亮高高地照耀着。
And we see her work ID where she keeps it on the center console.
我们可以看到她的工作 ID，她把它放在中控台上。
The words "BOARD CERTIFIED RN" and her name in all caps.
“BOARD CERTIFIED RN”字样和她的名字全部大写。
This is Mindy Figueroa.
这是明迪·菲格罗亚。
Mindy says she was made to be a nurse.
明迪说她生来就是为了当一名护士。
I think I was just born to be in healthcare.
我想我生来就适合从事医疗保健行业。
Like, as a kid, my sister would find all the dolls and the ballet slippers at the Dollar Tree, like, section.
就像，小时候，我姐姐会在美元树之类的区域找到所有的娃娃和芭蕾舞鞋。
But I always got the doctor kit, the stethoscope, the little syringe.
但我总是带着医疗包、听诊器、小注射器。
Always, always, always.
永远，永远，永远。
So it was just always a thing.
所以这一直是一件事。
Mindy was the first one in her family to go to college.
明迪是家里第一个上大学的人。
Her parents came to this country undocumented, from Mexico, worked factory jobs, earned citizenship.
她的父母从墨西哥无证来到这个国家，在工厂工作，获得了公民身份。
Mindy paid her way through school, got her degree, started out at a small hospital, and after a few years, transferred up to a big one-- UI Health at the University of Illinois at Chicago.
明迪自费完成了学业，获得了学位，从一家小医院开始工作，几年后，转到了一家大医院——伊利诺伊大学芝加哥分校的 UI Health。
She works on the labor and delivery floor, with patients about to have babies.
她在待产区工作，照顾即将生孩子的病人。
I've been told many, many times that as soon as I walk in the room, they know I like my job.
很多很多次，当我走进房间时，他们就知道我喜欢我的工作。
And I love coming to work.
我喜欢来上班。
And I feel like they feel that.
我觉得他们也有这种感觉。
So I walk in a room and good morning, my name is Mindy.
所以我走进一个房间，早上好，我的名字是明迪。
I will be here until 7:00 PM.
我会在这里待到晚上 7:00。
We watch this happen, Mindy stepping cheerfully into a labor room, her face framed by two neat braids.
我们看着这一切发生，明迪高兴地走进产房，她的脸被两条整齐的辫子围着。
And then we carousel through shots of Mindy at work-- Mindy strapping a fetal monitor to a patient's belly, Mindy at the nursing station holding a plastic pillow up like show and tell, her colleagues doubled over in laughter, Mindy, her face grave, bursting through the door of the OR.
然后我们轮流播放明迪工作时的镜头——明迪把胎儿监护仪绑在病人的肚子上，在护理站，明迪举着一个塑料枕头，像表演和讲述一样，她的同事们笑得弯下腰来，明迪一脸严肃地冲进了手术室的门。
Mindy loves the intimacy of labor and delivery.
明迪喜欢分娩时的亲密感。
And that adrenaline, that switch from, it's calm to now it's time to run.
肾上腺素从平静转变为现在是跑步的时候了。
And also, I mean, I just like blood, in general.
而且，我的意思是，总的来说，我只是喜欢血液。
[LAUGHS]
[笑]
Yes.
是的。
And everyone on the unit knows it.
单位里的每个人都知道这一点。
If there is a hemorrhage, if there is heavy bleeding, they know I am the person.
如果有出血，如果有大量出血，他们就会知道我就是那个人。
I like to weigh it.
我喜欢掂量一下。
I like to quantify the blood.
我喜欢量化血液。
I like to clean it up.
我喜欢把它清理干净。
Blood clots coming out of after delivery and we're pushing on their belly and it's almost like popping a pimple.
产后血凝块流出，我们按压他们的腹部，几乎就像挤痘痘一样。
Like, OK, let's get it out of there to prevent more bleeding.
就像，好吧，让我们把它从那里取出来防止更多的流血。
And I feel like I'm really good at recognizing when we're trending towards too much blood.
我觉得我真的很擅长识别我们何时会流血过多。
Because I am actually watching.
因为我确实在看。
I watch every birth.
我注视着每一次出生。
I watch every C-section.
我观看每一次剖腹产。
Like, I don't sit and chart.
就像，我不会坐下来绘制图表。
As soon as the incision starts, I watch it.
切口一开始，我就会观察。
Because it's just intriguing to me.
因为这对我来说很有趣。
I've been doing this for 14 years.
我已经这样做了 14 年。
And it still amazes me that there's an incision on an abdomen, but there's a baby there.
令我惊讶的是，腹部有一个切口，但那里有一个婴儿。
So I watch every delivery.
所以我每次送货都会看。
This story is going to be about one of those deliveries that Mindy watched, one that changed things for her and for her hospital.
这个故事将讲述明迪目睹的一场分娩，这场分娩改变了她和她的医院的一切。
There are more than 2,000 deliveries a year at UIC.
UIC 每年交付超过 2,000 件。
It's a public hospital, not a fancy one.
这是一家公立医院，不是豪华医院。
And it's located right in the middle of the city, in the medical district.
它位于市中心的医疗区。
Establishing shot of the hulking building, dawn breaking open the sky above.
拍摄这座巨大建筑的镜头，黎明破晓，天空破晓。
A humble hospital in Chicago, a hard-working nurse, a delivery with stakes-- how could we not tell this like a medical drama?
芝加哥一家简陋的医院，辛勤工作的护士，带着赌注的分娩——我们怎么能不把这当作一部医疗剧来讲述呢？
A medical drama, its emphasis is on the world inside the hospital, on the heart and the heroism of the people who work there, on their relationships with one another, on how their interactions with patients are shaped by their own stories.
一部医疗剧，它的重点是医院内部的世界，医院工作人员的内心和英雄主义，他们彼此之间的关系，以及他们自己的故事如何塑造他们与患者的互动。
But what happens in a hospital also reverberates outside.
但医院里发生的事情也会在外面引起反响。
And on this show, we're going to see that too.
在这个节目中，我们也将看到这一点。
Because this delivery that Mindy watches, it doesn't just change things at UIC.
因为 Mindy 观看的这次交付不仅改变了 UIC 的事情。
It could change things for the entire country.
它可能会改变整个国家的情况。
And now let's pull back, get the whole hospital in the frame, and end the opening credit sequence with this image, this boxy building on the subzero morning.
现在让我们退一步，将整个医院纳入画面中，并用这张图片结束片头，这栋四四方方的建筑位于零下的早晨。
But we know that behind that imposing facade, it's warm.
但我们知道，在这宏伟的外表背后，却是温暖的。
We're already invested in the human drama inside.
我们已经投入到了里面的人性戏剧中。
Black screen.
黑屏。
Susan Burton's story continues.
苏珊·伯顿的故事还在继续。
Stay with us.
留在我们身边。
It's This American Life.
这就是美国生活。
Susan Burton picks up where she left off.
苏珊·伯顿从她上次停下的地方继续说道。
The action of the episode begins with Mindy in a nearly empty elevator.
本集的情节始于明迪在几乎空无一人的电梯里。
Closer to 7:00 AM, change of shift, you can barely fit, it's sardines.
接近早上 7:00，换班，你几乎无法适应，这是沙丁鱼。
But Mindy's early today.
但明迪今天来得很早。
She's almost always early.
她几乎总是早到。
She's the one who will have cleaned the break room by the time her coworkers arrive.
当她的同事到达时，她会打扫休息室。
At UIC, your coworkers have your back.
在UIC，你的同事会为你提供支持。
Mindy could say this about all of the nurses on her crew.
明迪可以这样评价她团队中的所有护士。
One of those nurses is Clara Hochhauser.
克拉拉·霍赫豪瑟（Clara Hochhauser）就是其中一位护士。
We see her emerging from the locker room in gray scrubs and a scrub coat.
我们看到她穿着灰色手术服和磨砂外套从更衣室出来。
Not everyone wears a scrub coat, but Clara does because it has better pockets and because it covers her tattoos.
不是每个人都穿磨砂外套，但克拉拉却穿，因为它有更好的口袋，而且可以遮盖她的纹身。
Clara has large, wise eyes, as if she sees more than other people.
克拉拉有一双充满智慧的大眼睛，仿佛她比其他人看得更远。
She's a natural at nursing, but it wasn't obvious that it was where she would wind up.
她天生擅长护理，但目前还不清楚她最终会从事护理工作。
I am, like, a high school dropout.
我就像一个高中辍学者。
I really did not do well with school.
我在学校确实表现得不好。
And long story short, I just was like, never mind, I'll get my GED.
长话短说，我当时想，没关系，我会拿到 GED 的。
And I started working.
我开始工作。
And I worked in a coffee shop.
我在一家咖啡店工作。
One day, Clara got a massage, and then she became a massage therapist.
有一天，克拉拉接受了按摩，然后她成为了一名按摩治疗师。
And she found the clients she liked best were the pregnant clients.
她发现她最喜欢的客户是怀孕的客户。
So then she decided to become a midwife.
于是她决定成为一名助产士。
But after finishing her degree, she just wanted to start working.
但完成学业后，她只想开始工作。
And as a nurse, she could do that sooner.
作为一名护士，她可以更快地做到这一点。
She started as a mother-baby nurse and eventually switched to labor and delivery.
她最初是一名母婴护士，最终转向分娩。
She never thought she would have her own kids.
她从来没有想过自己会有自己的孩子。
I definitely never planned on having children.
我绝对没有计划要孩子。
I definitely always felt like, ooh, emotionally, a little dysfunctional family.
我确实总是感觉，哦，在情感上，一个有点功能失调的家庭。
Yeah.
是的。
Clara Hochhauser I identified, like, purely as a lesbian.
克拉拉·霍克豪瑟 (Clara Hochhauser) 我认为她纯粹是一名女同性恋。
I was not able to conceptualize what it meant to be bisexual.
我无法概念化双性恋意味着什么。
That wasn't an option.
那不是一个选择。
It's either you were gay or you weren't gay, you know?
要么你是同性恋，要么你不是同性恋，你知道吗？
Yeah.
是的。
Clara Hochhauser And not that you can't have babies with women.
Clara Hochhauser：并不是说你不能和女人生孩子。
But just all the things, I just thought, no, no, no, no, I love little babies, but I do not want to be a parent.
但只是所有的事情，我只是想，不，不，不，不，我爱小婴儿，但我不想成为父母。
And then Clara got divorced from her wife.
然后克拉拉和她的妻子离婚了。
She met a guy.
她遇到了一个男人。
They got married.
他们结婚了。
Suddenly, Clara understood she didn't have to be, as she puts it, a perfect, magical, special person to have children.
突然，克拉拉意识到，她不必像她所说的那样，成为一个完美、神奇、特别的人才能生孩子。
She was 40.
她40岁了。
With her husband, Clay, she did IVF, and soon she was pregnant with twins.
她和丈夫克莱一起进行了试管受精，很快就怀上了双胞胎。
I was incredibly excited and could not believe that two embryos took when-- you know?
我非常兴奋，简直不敢相信两个胚胎在什么时候——你知道吗？
Yeah.
是的。
Clara Hochhauser It just all seemed surreal.
克拉拉·霍赫豪瑟（Clara Hochhauser） 这一切看起来都超现实。
Like, I can't believe it worked the very first transfer.
就像，我不敢相信第一次转移就成功了。
But I, of course, was really nervous about the outcome because I see firsthand all the time the ways in which pregnancies can go sideways.
但当然，我对结果感到非常紧张，因为我一直亲眼目睹怀孕可能会出现问题的方式。
And there are no guarantees that anybody goes home with a baby at the end.
并且不能保证任何人最终都能带着孩子回家。
So it was just like another layer of worry.
所以这就像另一层担忧。
Clara would go home with her babies.
克拉拉会带着她的孩子回家。
That's not where this story is going.
这不是这个故事的发展方向。
She would also be delivering at UIC herself.
她还将亲自在伊利诺伊大学芝加哥分校 (UIC) 授课。
On a medical drama, when the healthcare provider becomes the patient, it's a twist.
在医疗剧中，当医疗保健提供者变成患者时，这是一个转折。
But this isn't a twist.
但这并不是一个转折。
It's our premise.
这是我们的前提。
We don't know how this matters yet, but it will.
我们还不知道这有多重要，但它会。
It matters that this patient is not a visitor, that she's not someone who leaves, but someone who stays.
重要的是，这位病人不是访客，她不是离开的人，而是留下来的人。
A twin pregnancy at age 40-- there was definitely a chance that Clara would need a C-section, but she wanted to avoid it.
40 岁怀上双胞胎——克拉拉肯定有可能需要剖腹产，但她想避免这种情况。
I wanted so badly to have a vaginal delivery.
我非常想要阴道分娩。
I did not want to have surgery.
我不想做手术。
But because I was older, because I'm a bit fat, I just was like, oh god.
但因为我年纪大了，因为我有点胖，我就想，天啊。
Clara also wanted to avoid delivering in the operating room.
克拉拉还想避免在手术室分娩。
Typically, if you're having twins, you can labor in a labor room, but you have to deliver in the operating room, even if you're delivering vaginally.
通常，如果您怀的是双胞胎，您可以在产房分娩，但即使您是阴道分娩，也必须在手术室分娩。
It's a safety thing, just be in the right room if something goes wrong.
这是一个安全问题，如果出现问题，请呆在正确的房间里。
But Clara really did not want this.
但克拉拉确实不想这样。
But the idea of having to deliver in the operating room was horrifying to me.
但必须在手术室分娩的想法让我感到恐惧。
I was just terrified of the OR, more or less.
我或多或少只是害怕手术室。
How come?
怎么会？
Clara Hochhauser Um, delivering in the operating room always just seems so awful to me.
Clara Hochhauser 嗯，在手术室里分娩对我来说总是那么糟糕。
I don't know.
我不知道。
It's this really narrow, metal table.
这是一张非常狭窄的金属桌子。
Uh-huh.
嗯嗯。
Clara Hochhauser You're flat on your back.
Clara Hochhauser 你平躺着。
You're not restrained, but where are you going to go?
你不受约束，但你要去哪里？
You've got an epidural.
你已经接受了硬膜外麻醉。
You're gonna be hooked up to more monitors.
您将连接更多的显示器。
You know?
你知道？
Like, it takes away any of that just safety and autonomy, you know?
就像，它剥夺了任何安全和自主权，你知道吗？
Yeah.
是的。
One of the things Clara did want was for Mindy, her coworker, to take pictures of the birth.
克拉拉确实想要的一件事是让她的同事明迪为分娩拍照。
So I have a side hustle, like a photography-- it's a hobby.
所以我有一个副业，比如摄影——这是一种爱好。
But I take our coworker's birth pictures.
但我拍了我们同事的出生照片。
Mindy's always taken pictures.
明迪总是拍照。
Back in college with the little cameras you'd hang on your wrist.
回到大学时，你的手腕上挂着小相机。
Eventually she got a camera with a big lens that attached and taught herself how to use it from YouTube.
最终，她得到了一台带有大镜头的相机，并从 YouTube 上自学了如何使用它。
And then one of my nursing friends was pregnant.
然后我的一位护理朋友怀孕了。
And she's like, will you take some pictures of me pregnant?
她说，你能给我拍一些怀孕的照片吗？
She's like, I don't like to go to places.
她就像，我不喜欢去一些地方。
And so I took a few of her and made them black and white.
所以我拍了一些她的照片，把它们做成黑白的。
And they were exceptional.
他们非常出色。
And I was like, huh.
我当时想，嗯。
And then when she had her baby, she's like, can you take pictures of my baby?
然后当她生了孩子后，她问，你能为我的孩子拍张照片吗？
And she paid me.
她付钱给我。
And I was like, you don't have to pay me.
我当时想，你不必付钱给我。
But she paid me like $200.
但她付给我大约200美元。
And I was like, [GASPS], that's a lot of money.
我当时想，[喘气]，那是很多钱。
Like, no, I'm not a professional.
就像，不，我不是专业人士。
And it just took off from there.
它就从那里起飞了。
Yeah.
是的。
Do you take, like if somebody's having a cesarean, would you take a picture of the surgical field?
你会想，如果有人进行剖腹产，你会拍一张手术区域的照片吗？
Yes.
是的。
Yeah.
是的。
I'll take a picture of the bloody canister.
我会拍一张血淋淋的罐子的照片。
And I do ask.
我确实问了。
I do ask how graphic I can get.
我确实问我能得到怎样的图形。
Because I will literally take a picture of turd coming out, you know?
因为我真的会拍一张粪便出来的照片，你知道吗？
Yeah.
是的。
Mindy Figueroa I will photograph it all because I am not squeamish.
Mindy Figueroa 我会把这一切都拍下来，因为我并不拘谨。
But there's people who are like, that's too much.
但也有人觉得，这太过分了。
Or if they're doing skin to skin and it's a beautiful photo, I make sure I cover the nipple so that they can use that photo.
或者，如果他们正在进行肌肤接触并且这是一张漂亮的照片，我会确保遮住乳头，以便他们可以使用那张照片。
Yeah, I just gauge who they are.
是的，我只是判断他们是谁。
How graphic are we doing?
我们做得怎么样？
And I think Clara was one of those who's like, let's do it all.
我认为克拉拉是那些喜欢“让我们一起做这一切”的人之一。
Susan Burton On April 19, 2022, Clara arrived at the hospital for a scheduled induction, which is when you get drugs to start your labor.
苏珊·伯顿 (Susan Burton) 2022 年 4 月 19 日，克拉拉 (Clara) 抵达医院进行预定的引产，此时您将获得药物以开始分娩。
Now, we flashback to see her on that day.
现在，我们回想起那天见到她的情景。
She and her husband, Clay, are crossing the street from the staff garage.
她和丈夫克莱正从员工车库过马路。
Clara's purposeful, leading the way.
克拉拉目标明确，一路领先。
Clay's just passed the bar, is going into criminal defense, did an internship advocating for victims of police brutality.
克莱刚刚通过了律师资格考试，即将进入刑事辩护领域，并做过一份为警察暴行受害者辩护的实习生。
It matters that you know something about Clay so that he's a little more than just the cut-out husband, more than just the husband watching the main event.
重要的是你对克莱有所了解，这样他就不仅仅是一个被淘汰的丈夫，不仅仅是一个观看主要赛事的丈夫。
At the employee entrance, Clara badges in.
在员工入口处，克拉拉入场。
I was coming in.
我正要进来。
I was scheduled for an evening induction.
我被安排参加晚上的入职培训。
And so I thought, yeah, I like that.
所以我想，是的，我喜欢这样。
I like those evening inductions.
我喜欢那些晚上的引导。
So I'll come in at night after dinner.
所以我晚上吃完晚饭就进来。
And I'll get the initial stuff and then go from there.
我会得到最初的东西，然后从那里开始。
On the fourth floor, Clara enters her labor room, Room 5, the best one.
在四楼，克拉拉进入了她的产房，即最好的 5 号房。
That's where they try to put you if you're a staff member.
如果你是一名工作人员，他们就会试图把你安置在那里。
Her co-workers have decorated it for her.
她的同事为她装饰了它。
She changes into a gown, climbs into bed.
她换上长袍，爬上床。
Clay sets a Bluetooth Speaker on the windowsill, opens his phone, starts the playlist.
克莱在窗台上放了一个蓝牙扬声器，打开手机，启动播放列表。
"Push It," it's on everyone's playlist.
“Push It”出现在每个人的播放列表中。
The Beach Boys' "Don't Worry Baby."
海滩男孩的“宝贝别担心”。
And so far, Clara's not worried.
到目前为止，克拉拉并不担心。
Even when she receives the drugs to start her labor, everything feels surprisingly OK.
即使当她收到药物开始分娩时，一切都出奇地好。
By around lunchtime the next day, she's in some pain from her contractions and is debating whether it's time to go for an epidural.
第二天午餐时间左右，她因宫缩感到有些疼痛，正在考虑是否需要进行硬膜外麻醉。
And I felt really, really neurotic about it.
我对此感到非常非常神经质。
Not wanting to get it too soon because I wanted to be able to stay upright and keep moving.
不想太早得到它，因为我希望能够保持直立并继续前进。
But you don't want to wait too long because then you're dying in pain.
但你不想等太久，因为那样你就会在痛苦中死去。
Yeah.
是的。
Clara Hochhauser One of my coworkers, a midwife, came in and talked with me and was just like, all right, Clara, it's fine.
克拉拉·霍克豪瑟 (Clara Hochhauser) 我的一位同事，一名助产士，进来和我交谈，说，好吧，克拉拉，没关系。
Just get it.
就拿它吧。
If you're ready, you can get it.
如果你准备好了，你就可以得到它。
It's nothing to get perfect here.
这里没有什么可以做到完美的。
If you want it and you know you want it, just do it.
如果你想要它并且你知道你想要它，那就去做吧。
So Heather did my epidural.
所以希瑟做了我的硬膜外麻醉。
Heather Nixon, the head of obstetric anesthesia at UIC, charismatic, assertive, boss lady, but not bossy.
希瑟·尼克松 (Heather Nixon)，伊利诺伊大学芝加哥分校 (UIC) 产科麻醉科主任，有魅力、自信，是一位女老板，但并不专横。
Let's actually meet Heather on the way into the room.
让我们在进入房间的路上真正见到希瑟吧。
Let's watch her leaving her office downstairs on the anesthesia floor.
让我们看着她在楼下的麻醉地板上离开办公室。
Heather's office-- mini fridge, on top of it a framed photo of four women dressed up for girls' night, a black leather couch with a hot pink pillow where lots of times Heather spends the night.
希瑟的办公室——迷你冰箱，上面挂着一张镶框照片，上面是四位为女孩之夜打扮的女性，一张黑色皮沙发，上面有一个粉红色的枕头，希瑟很多次都在里面过夜。
Heather is 51, with two daughters in college.
希瑟今年 51 岁，有两个正在上大学的女儿。
But she's the one with the energy of a college kid-- can sleep anywhere, pop up bright-eyed at weird hours.
但她却拥有大学生般的活力——可以在任何地方睡觉，在奇怪的时间出现时眼睛明亮。
My residents actually did a skit once with me.
我的居民曾经和我一起演过一个小品。
They do the end of the year roast of the attendings.
他们每年都会对主治人员进行烤肉。
And it was a skit where it was like 3:00 in the morning and they kept answering the phone.
这是一个小品，凌晨 3:00 左右他们一直在接电话。
And I was like, hey, it's Nixon from anesthesia.
我当时想，嘿，这是麻醉后的尼克松。
And they're like, we have no idea how you're always awake.
他们说，我们不知道你怎么总是醒着的。
You're always like, let's talk about stuff at like 3:00 in the morning.
你总是喜欢，我们在凌晨 3:00 左右讨论一些事情吧。
I'm like, I don't know.
我想，我不知道。
Heather has lived in Chicago for 30 years, came to the city straight after finishing college.
Heather 在芝加哥生活了 30 年，大学毕业后直接来到这座城市。
She knew she wanted to be a doctor, but she had to pay off student loans first.
她知道自己想成为一名医生，但她必须先还清学生贷款。
So she worked as a shot girl in a bar off Rush Street, T-shirt tied up, abdomen showing.
于是，她在拉什街附近的一家酒吧里当了一名枪手，T恤扎起来，露出腹部。
Anesthesia itself came as a surprise to Heather.
麻醉本身就让希瑟感到惊讶。
It wasn't a specialty she'd ever thought she'd want to do.
这不是她曾经想过自己想做的专业。
But she had a mentor who made her fall in love with it.
但她有一位导师，让她爱上了它。
This is the case for a lot of anesthesiologists.
这是很多麻醉科医生的情况。
There's a common misconception that this is the doctor who just puts you to sleep.
人们普遍误解，认为医生只是让你入睡。
But there's a lot more to it than that.
但还有更多的事情要做。
The surgeon has their head down in the surgical field.
外科医生低着头在手术区域。
The anesthesiologist is watching over all of you.
麻醉师正在注视着你们所有人。
When Heather discovered the subspecialty of obstetric anesthesia, she had a feeling like, OB, this is my tribe.
当希瑟发现产科麻醉这一专业时，她有一种感觉，OB，这就是我的部落。
These are my people.
这些是我的人。
I think you'll find two types of anesthesiologists-- the ones who are the introverts who like to hide behind the drapes with asleep patients and then there's the type that really like to engage with their patients.
我想你会发现两种类型的麻醉师——一种是内向的人，喜欢躲在窗帘后面和熟睡的病人在一起，另一种是真正喜欢与病人互动的人。
And those are maybe the tribe of OB anesthesiologists, the ones who want to be there talking to their patients.
这些人可能是产科麻醉师群体，他们希望在那里与患者交谈。
Many OB anesthesiologists proudly identify the same way.
许多产科麻醉师自豪地以同样的方式进行识别。
They like awake patients, not sleeping patients.
他们喜欢清醒的病人，而不是熟睡的病人。
Now we catch back up to the action.
现在我们回到行动。
And we see Heather enter Clara's room and begin arranging her equipment on a tray.
我们看到希瑟进入克拉拉的房间，开始把她的设备放在托盘上。
Clara sits erect on the bed, waiting, bed pumped up high, her feet dangling.
克拉拉笔直地坐在床上，等待着，床被打得很高，她的脚晃来晃去。
She'd asked for Heather to do her epidural like, hey, Nixon you gonna be around?
她要求希瑟给她做硬膜外麻醉，就像，嘿，尼克松，你会在吗？
Heather was happy to do it.
希瑟很乐意这样做。
She does this for all her providers delivering if she can.
如果可以的话，她会为所有提供服务的提供者这样做。
Not that a resident couldn't do it, but you want to take ownership if, god forbid, something goes wrong.
并不是说居民不能做到这一点，但如果上帝保佑，如果出现问题，你想拥有所有权。
Close on Heather's gloved fingers touching Clara's spine.
希瑟戴手套的手指靠近克拉拉的脊椎。
Now we're going to watch Heather actually do this procedure.
现在我们将观看希瑟实际执行此过程。
We're going to be talking a lot about procedures on this show, and viewers need to be grounded in them.
我们将在这个节目中讨论很多关于程序的内容，观众需要扎根于这些程序。
And does anyone really know what an epidural is, besides the thing you can get for pain when you're having a baby?
除了生孩子时可以用来止痛的东西之外，还有人真正知道硬膜外麻醉是什么吗？
Now we see Clara take an anxious peek over her shoulder and Heather telling her, no, no, I'll talk you through it.
现在我们看到克拉拉焦急地回头看了一眼，希瑟告诉她，不，不，我会告诉你这件事。
You'd think nurses and OBs, they'd be the most relaxed about the epidural, but they're just as nervous as anyone.
您可能认为护士和产科医生对硬膜外麻醉最放松，但他们和其他人一样紧张。
From her tray, Heather picks up something that looks like a swizzle stick, like what you use to stir a cocktail.
希瑟从托盘中拿起一个看起来像搅拌棒的东西，就像你用来搅拌鸡尾酒的东西一样。
This is actually a large, hollow needle, and its placement in Clara's back, this might cause someone to turn from the screen for just a second.
这实际上是一根大的空心针，将其放置在克拉拉的背部，这可能会导致某人从屏幕上转过身来一秒钟。
So I'll tell you what Heather's doing.
所以我会告诉你希瑟在做什么。
She's inching that needle into Clara's back a little deeper, a little more, until the tip enters what's called the epidural space.
她将针慢慢地插入克拉拉的背部，更深一点，再深一点，直到针尖进入所谓的硬膜外腔。
Heather finds that space by feel.
希瑟凭感觉找到了那个空间。
There's a ligament she's looking for.
她正在寻找一根韧带。
And not everyone's ligament feels the same.
并不是每个人的韧带感觉都一样。
Some of them feel really rubbery.
其中一些感觉非常有弹性。
Some of them feel kind of like crackly or poppily, you know, popping.
其中一些感觉有点像爆裂声或罂粟味，你知道，爆裂声。
Some of them feel kind of really, like, gentle, like almost when you pass through, you're like, oh, something's different, but I'm just going to stop there.
他们中的一些人感觉真的很温柔，就像当你经过时，你会觉得，哦，有些东西不一样了，但我就到此为止。
Now, Heather threads a thin plastic tube, a catheter, you know this word, through the large, hollow needle until the plastic tube is inside the epidural space as well.
现在，希瑟将一根细塑料管，一根导管，你知道这个词，穿过大的空心针，直到塑料管也进入硬膜外腔内。
We could go one level deeper with the science, explain that the epidural space is not really a space at all, just potential space.
我们可以更深入地研究科学，解释硬膜外腔根本不是真正的空间，只是潜在的空间。
But I won't get into this.
但我不会介入这个。
Just nod to it so that doctors watching can be like, on this show, they know what they're talking about.
只需点头，这样观看的医生就可以像在这个节目中一样知道自己在说什么。
Now, Heather slides the needle off the plastic tube, which stays in Clara's back.
现在，希瑟将针从留在克拉拉背部的塑料管上滑下来。
Anesthetic drugs will be delivered through the tube, bathing the nerves near her spinal cord.
麻醉药物将通过管子输送，麻醉脊髓附近的神经。
Clara is relieved when the procedure is over.
手术结束后，克拉拉松了口气。
Even though it wasn't like a painful needle or something like that, it was such a strange, unnerving feeling, that pressure in your spine or whatever.
尽管它不像一根痛苦的针或类似的东西，但它是一种奇怪的、令人不安的感觉，脊椎上的压力或其他什么。
But I got it and it was fine.
但我得到了它并且很好。
But then around dinner time, I think, was the first time that trouble started with my epidural, where I didn't really even understand what was happening because it was just in my vagina that I felt pain.
但我想，晚餐时间左右，我的硬膜外麻醉第一次出现了问题，我什至不明白发生了什么，因为我只是在阴道里感到疼痛。
So I wasn't really-- I wasn't aware of contractions.
所以我并没有真正意识到宫缩。
It was just all of a sudden, it felt like my vagina was just being shredded.
突然间，我感觉我的阴道被撕碎了。
I don't know.
我不知道。
It literally felt like somebody had a steel toe boot and was just kicking around in there.
从字面上看，感觉就像有人穿着钢头靴子，只是在里面踢来踢去。
Oh, geez.
哦，天啊。
Clara's epidural is topped up with more drugs.
克拉拉的硬膜外麻醉中加入了更多药物。
And that does the trick.
这就成功了。
She's more comfortable right away.
她立刻就舒服多了。
A couple hours later, at 11 o'clock, Heather signs out to the anesthesiologist on the overnight shift and fills him in on Clara.
几个小时后，即 11 点，Heather 向值夜班的麻醉师汇报情况，并向他汇报了 Clara 的情况。
When I was signing out, I was like, hey, this is the deal.
当我退出时，我想，嘿，这就是交易。
It's working, blah, blah, blah.
它正在工作，等等，等等。
And so I didn't anticipate any problems when I left.
所以我离开时并没有预料到会出现任何问题。
Otherwise, I would have probably stayed.
否则，我可能会留下来。
In hindsight, now, one of the things I'm always like, for my providers that I'm taking care of, I kind of just stay in the hospital.
事后看来，现在，对于我所照顾的提供者来说，我一直喜欢的一件事是，我只是呆在医院里。
Because I just want to be the one who's there if anything happens.
因为我只想成为发生任何事情时在场的人。
We see Heather get in her car, drive away from the hospital.
我们看到希瑟钻进车里，驶离医院。
Clara had been comfortable when Heather left.
希瑟离开时，克拉拉感到很舒服。
But several hours later, she's having the same pain again.
但几个小时后，她再次感到同样的疼痛。
And other things are going wrong, too.
其他事情也出了问题。
Her labor is stalling.
她的生产陷入停滞。
Her blood sugar is climbing.
她的血糖正在上升。
So are the babies' heart rates.
婴儿的心率也是如此。
Clara knows she's headed for a C-section, but she requests one last half hour laboring on her hands and knees just to see if that will help.
克拉拉知道她将要进行剖腹产，但她请求最后半个小时用手和膝盖进行分娩，看看是否会有帮助。
Now we see the room, dark, except for the lights of the monitors, Clara on all fours in the hospital bed.
现在我们看到房间里一片漆黑，除了监视器的灯光，克拉拉趴在病床上。
Close of her forearms, we briefly glimpsed the tattoos.
在她的前臂附近，我们短暂地瞥见了纹身。
We remember for a moment that Clara has stripped a layer off for us.
我们记得克拉拉为我们脱下了一层衣服。
There's a lot of vulnerability in what she's allowing us to see.
她让我们看到的东西中有很多脆弱性。
The only other person in the room is Clay.
房间里唯一的另一个人是克莱。
That was another thing Clara had requested, just please, everyone clear out and give me one more try.
这是克拉拉要求的另一件事，请大家都离开，再给我一次尝试。
But the try doesn't work, and there's no more time to waste.
但这种尝试并没有奏效，而且没有更多的时间可以浪费了。
The nurses unplug Clara from her monitors and push her cumbersome bed down the hall to the OR.
护士们拔掉了克拉拉的监护仪电源，然后将她笨重的病床推到了手术室。
But I was like, OK, it's gonna be fine.
但我想，好吧，一切都会好起来的。
It's gonna be fine.
会没事的。
My babies are gonna be born.
我的宝宝们就要出生了
And yeah, she called me around 3:00 or 4:00 in the morning that they had decided to do a C-section.
是的，她在凌晨 3:00 或 4:00 左右打电话给我，说他们决定进行剖腹产。
Mindy was at home, asleep, but she got right out of bed and grabbed her camera bag.
明迪在家睡着了，但她立即从床上起来，抓起相机包。
We see her, strap over her shoulder, hurrying down the bungalow's front steps and into her minivan.
我们看到她肩上背着安全带，匆匆走下平房前面的台阶，走进她的小货车。
So I raced over there.
于是我就跑到了那里。
And it was a little bit of an urgent case, meaning it's not what we call a crash, like where we literally just rip cords out of the wall and run.
这是一个有点紧急的情况，这意味着这不是我们所说的崩溃，就像我们实际上只是把电线从墙上扯下来然后逃跑一样。
It was like, all right, we're doing this now.
就好像，好吧，我们现在就这样做。
Let's move.
我们走吧。
So I'm only 10 minutes away from the hospital when there's no traffic.
所以在不堵车的时候我距离医院只有10分钟的路程。
So I raced over there.
于是我就跑到了那里。
And I parked on the street because I'm like, it's an urgent case.
我把车停在街上，因为我想，这是一个紧急情况。
I need to go because they might start before I get there.
我得走了，因为他们可能在我到达之前就开始了。
I even got a parking ticket that day.
那天我什至收到了一张停车罚单。
Because at night, you don't pay for the meters, but I was there so long that in the morning, they gave me a ticket.
因为晚上不用付电表费，但我在那里待了太久，早上他们给了我一张票。
But, anyways.
但是，无论如何。
Up on the fourth floor, Mindy takes a plastic-wrapped surgical suit from a closet and pulls the coverall on over her clothes.
在四楼，明迪从壁橱里拿出一套塑料包裹的手术服，然后把连体服套在衣服外面。
Then she turns toward Clara's OR.
然后她转向克拉拉的手术室。
And I walked in when she was on the operating room table.
当她躺在手术台上时我走进去。
And I actually have a beautiful photo of her.
我实际上有一张她的漂亮照片。
She has not seen these photos-- or I gave them to her, but I don't think she's ever been able to look at them.
她没有看过这些照片——或者说我把它们给了她，但我认为她从来没有看过它们。
But it's the door of the operating room halfway open.
但手术室的门半开着。
And she's laying there with her arms out, and she's looking at me smiling.
她躺在那里，张开双臂，微笑着看着我。
So then, when I got there and I took that picture, just her joy and I almost sensed relief.
所以，当我到达那里并拍下那张照片时，只有她的喜悦和我几乎感到如释重负。
She knew I was there.
她知道我在那儿。
And we are all either night shift nurses or day shift nurses.
我们都是夜班护士或白班护士。
And even though we're all one team, there's more of a friendship and bond.
尽管我们都是一个团队，但更多的是友谊和纽带。
Day shift nurses, we all know how we work.
白班护士，我们都知道我们是如何工作的。
And night shift, we don't work with them ever.
还有夜班，我们从来不和他们一起工作。
So we don't know how they roll.
所以我们不知道它们是如何滚动的。
So I think that smile was like, I'm having my babies.
所以我认为那个微笑就像是，我正在生孩子。
You made it to take my pictures.
你竟然来给我拍照了
You're here.
你在这里。
You're one of me, one of our team.
你是我的一员，我们团队的一员。
So yeah, and I, too, was like, yes, I'm here for you.
所以是的，我也想，是的，我在这里等你。
And [SIGHS], this is why this case is so hard because I feel like I failed her 100%.
[叹气]，这就是为什么这个案子如此困难，因为我觉得我 100% 辜负了她。
Coming up, the failures in Clara's surgery and where those lead.
接下来是克拉拉手术的失败以及这些失败的后果。
That's in a minute from Chicago Public Radio, when our program continues.
芝加哥公共广播电台一分钟后我们的节目仍在继续。
It's This American Life.
这就是美国生活。
I'm Ira Glass.
我是艾拉·格拉斯。
Today's show-- "Chicago Hope." We're hearing a story from the new season of The Retrievals podcast.
今天的节目——《芝加哥希望》。我们正在听新一季“检索”播客的故事。
Susan Burton takes up where she left off.
苏珊·伯顿继续她上次停下来的地方。
When Mindy arrives, Clara is still being prepped for surgery.
当明迪到达时，克拉拉仍在准备手术。
She's flat on her back in the OR, which is obviously not where she wanted to be.
她在手术室里平躺着，这显然不是她想要的地方。
The L&D operating rooms at UIC are relatively small, out of another era.
UIC的L&D手术室相对较小，属于另一个时代。
Mint green tiles on the walls, like you're stepping into the showers at a YWCA.
墙壁上铺着薄荷绿色的瓷砖，就像您走进 YWCA 的淋浴间一样。
Harsh light.
刺眼的光线。
But Clara is calm.
但克拉拉很平静。
We see her now through Mindy's viewfinder, her eyes closed, the expression on her face.
现在我们通过明迪的取景器看到她，她闭着眼睛，脸上的表情。
My god, it's the embodiment of a word whose use is rarely earned-- beatific.
天哪，它体现了一个很少有人使用的词——幸福。
And I took pictures of everything.
我把所有的东西都拍了照片。
I took pictures of Clay and her holding hands.
我拍了克莱和她牵手的照片。
I took pictures of the teams waiting, two different teams for two different babies, pictures of anesthesia working.
我拍了等待的团队的照片，两个不同的团队负责两个不同的婴儿，还有麻醉工作的照片。
I like to take pictures of people there because we never get to do that because of privacy laws.
我喜欢给那里的人拍照，因为根据隐私法，我们永远不能这样做。
So for them to know that I'm on their team, it's almost like, here's a picture of you actually in a case.
因此，为了让他们知道我是他们团队的一员，这几乎就像是，这是一张你实际上在案件中的照片。
Surgery's getting closer now.
现在离手术越来越近了。
There are poles on either side of Clara's bed, and soon a giant piece of medical paper will be stretched between the poles, blocking Clara's view of her abdomen.
克拉拉的床两边都有柱子，很快柱子之间就会拉出一张巨大的医用纸，挡住克拉拉看自己腹部的视线。
This paper is called the drape, and it both protects the surgical field from contamination and protects the patient from the sight of her open body.
这种纸被称为手术单，它既可以保护手术区域免受污染，又可以保护患者不被看到她开放的身体。
The anesthesiologist has added more drugs to Clara's epidural, making it strong enough to get her through the surgery.
麻醉师在克拉拉的硬膜外麻醉中添加了更多药物，使其强度足以让她完成手术。
Now the doctors need to test to see if the anesthesia is working.
现在医生需要测试麻醉是否有效。
Tight on the skin test, it's so weirdly basic-- the anesthesiologist poking Clara with a broken tongue depressor.
皮肤测试非常严格，这是非常奇怪的基础——麻醉师用破损的压舌板戳克拉拉。
Another doctor does something more severe-- clamping Clara's belly hard with a surgical instrument.
另一位医生做了更严厉的事情——用手术器械用力夹住克拉拉的腹部。
Clara feels none of it.
克拉拉对此毫无感觉。
And that means they're ready to go.
这意味着他们已经准备好出发了。
There's a decision to make about the C-section, how much of this procedure to show.
关于剖腹产需要做出决定，要展示多少过程。
Like Mindy said, how graphic are we doing?
就像明迪说的，我们做得怎么样？
We're not going for gore on this series, for showing open bodies for the kick of it.
我们不会在这个系列中追求血腥，而是为了展示开放的身体以获得刺激。
But we do want visceral, all the meanings of that word.
但我们确实想要这个词的本能的、所有的含义。
Viscera, literally, that's what's inside a patient's abdomen.
内脏，顾名思义，就是病人腹部里面的东西。
But also how that word is applied to art.
还有这个词如何应用于艺术。
Art that's visceral-- it's of the body, it attends to the body.
艺术是发自内心的——它是关于身体的，它关注身体。
Hopefully, it makes you feel something in your body.
希望它能让你感觉到身体里有什么东西。
A visceral aesthetic, muscular, close to the bone.
有一种发自内心的美感，肌肉发达，接近骨骼。
Raw but not sensational, not shying away.
原始但不煽情，不回避。
OK, enough self-regard, enough theory.
好吧，足够的自尊，足够的理论。
What does this mean in practice?
这在实践中意味着什么？
Now the surgeon calls out, incision, and then cuts into Clara's abdomen, just above the pubic bone.
现在外科医生喊道，切开，然后切入克拉拉的腹部，就在耻骨上方。
We're not seeing the scalpel in her flesh, OK, but just know that this kind of cut is called a bikini incision.
我们没有看到她的肉里有手术刀，好吧，但只知道这种切口称为比基尼切口。
Bikini sounds tiny, but this cut is big.
比基尼听起来很小，但这个切口很大。
Once Clara's abdomen is open, the surgeon needs to reach the uterus.
一旦克拉拉的腹部打开，外科医生就需要到达子宫。
The uterus is behind a pair of muscles.
子宫位于一对肌肉的后面。
Now we see, actually see, the surgeon and the OB resident position themselves on either side of Clara and pull.
现在我们看到，实际上看到，外科医生和产科住院医师将自己定位在 Clara 的两侧并拉动。
These two women in scrubs pull so hard to separate this muscle that their bodies lean back, like in tug of war.
这两个穿着手术服的女人用力拉扯这块肌肉，以至于她们的身体向后倾斜，就像拔河一样。
This is a very physical surgery.
这是一个非常体力的手术。
When Clara is a nurse in a C-section, she either covers her eyes or looks away for this part.
当克拉拉是一名进行剖腹产手术的护士时，她要么遮住眼睛，要么把视线移开。
But of course, today Clara is the patient.
当然，今天的病人是克拉拉。
We go behind the drape now, tight on her face, but something's different, radically different.
现在我们走到窗帘后面，紧紧地捂着她的脸，但有些东西不同了，完全不同了。
It was just moments ago that she was beatific, but now her mouth is tight.
刚才还还很幸福，现在却嘴巴紧闭了。
I just remember, all of a sudden just being like, oh my god, I don't feel good, you know?
我只记得，突然之间，天哪，我感觉不太好，你知道吗？
Yeah.
是的。
Clara Hochhauser And I don't know, I assumed I was just panicking.
Clara Hochhauser：我不知道，我以为我只是惊慌失措。
I assumed that I just needed to relax a little bit.
我以为我只需要放松一下。
A few years earlier, Clara had had a panic attack during another surgery at UIC, an eye surgery, cataracts, weird to have them at such a young age.
几年前，克拉拉在伊利诺伊大学芝加哥分校的另一次眼科手术中惊恐发作，得了白内障，这么年轻就得了白内障，这很奇怪。
In the surgery, a different kind of paper drape had been unfolded over Clara's whole body, like a death shroud, so that she was entirely covered in blue paper except for a hole over one eye.
在手术中，克拉拉的全身铺上了另一种纸巾，就像裹尸布一样，除了一只眼睛上有一个洞外，她全身都被蓝色的纸覆盖着。
And then she'd heard the doctor say, you need to give her something else, she's hyperventilating.
然后她听到医生说，你需要给她点别的东西，她呼吸过度。
All through her pregnancy, she'd been worried that if she needed a C-section, she would have a panic attack again.
在整个怀孕期间，她一直担心如果需要剖腹产，她会再次陷入恐慌。
And so I had spoken with Dr. Nixon about strategies for how to deal with that if I panic.
因此，我与尼克松博士讨论了如果我感到恐慌时如何应对的策略。
Yeah.
是的。
Clara Hochhauser And we talked about the different medicines they can give, and that sometimes in that case, nitrous oxide is a really nice, you know, just breath the gas for a little bit.
Clara Hochhauser 我们讨论了他们可以提供的不同药物，有时在这种情况下，一氧化二氮非常好，你知道，只需呼吸一点气体即可。
'Cause they don't last that long.
因为它们不会持续那么久。
So maybe you can just breathe the gas for a minute or so.
所以也许你可以呼吸气体一分钟左右。
And it'll pass, and then you'll be fine, you know?
一切都会过去，然后你就会没事的，知道吗？
Yeah.
是的。
Clara Hochhauser So I asked, can I just have some gas or something?
Clara Hochhauser 所以我问，我可以喝点汽油什么的吗？
And he put the mask on.
然后他戴上了面具。
And it just was getting worse.
而且情况还在变得更糟。
And I remember feeling very nauseous and just saying that I wasn't OK.
我记得我感到非常恶心，只是说我不太舒服。
And then everything was really fuzzy and hazy.
然后一切都变得非常模糊和朦胧。
And I am not, I guess, thankfully, able to necessarily recall it in as much detail as I could at first.
我想，谢天谢地，我不一定能像一开始那样详细地回忆起它。
But it was an unfathomable amount of pain.
但这是一种无法估量的痛苦。
And I remember begging them to stop.
我记得我恳求他们停止。
And it wasn't until she just kept begging like, please, please, please.
直到她不断地恳求，求求你，求你，求你。
And one of the attendings, she looked at me and told me to tell her that it was OK.
其中一位主治医生看着我，让我告诉她没关系。
She told me to tell her partner, please tell him it's OK.
她让我告诉她的伴侣，请告诉他没关系。
So at that moment, I was no longer a friend or an advocate.
所以在那一刻，我不再是朋友或倡导者。
I was more like a staff member being told by the doctor, it's fine.
我更像是医生告诉我的工作人员，没关系。
So I remember telling Clay, like, Clay this is normal.
所以我记得告诉克莱，克莱，这很正常。
This sometimes happens.
有时会发生这种情况。
And Clay, I remember his body language was very like, yeah, OK, I hear you, but don't talk to me.
克莱，我记得他的肢体语言很像，是的，好吧，我听到了，但别跟我说话。
And I remember being like, oh my gosh.
我记得当时的感觉是，天哪。
Because he was so stressed out.
因为他压力太大了。
That's one thing I regret the most, that that provider looked at me and said, tell them it's OK, and that I did what she told me to, knowing that it wasn't OK.
这是我最后悔的一件事，那个提供者看着我说，告诉他们没关系，我就按照她告诉我的去做，知道那不好。
I think that's one of my biggest things that I replay over and over again, that I didn't say, it's not OK.
我认为这是我最重要的事情之一，我一遍又一遍地重播，但我没有说，这不好。
Can we stop?
我们可以停下来吗？
Clara's anesthesia is not working.
克拉拉的麻醉不起作用。
She is now in the middle of major abdominal surgery, and she can feel that surgery.
她现在正在进行腹部大手术，她能感觉到手术的过程。
Clara knew this could happen.
克拉拉知道这可能会发生。
She had seen this happen.
她亲眼目睹了这种情况的发生。
Intraoperative pain during cesarean-- healthcare providers know about it.
剖腹产术中的术中疼痛——医疗保健提供者都知道这一点。
Patients don't.
病人则不然。
When Clara herself first started working on L&D, and patients in labor would tell her, for my last baby, I had a C-section, and I felt everything, Clara would think to herself, that can't be true, there's no way.
当克拉拉本人第一次开始从事 L&D 工作时，临产患者会告诉她，我的最后一个孩子是剖腹产的，我感觉到了一切，克拉拉会想，这不可能是真的，没有办法。
Who would do that?
谁会这么做？
And then she saw it happen.
然后她就看到了这一切的发生。
And now it is happening to her.
而现在，这一切正发生在她身上。
Visceral, that key word, what Clara is feeling is visceral pain, meaning pain that originates inside her abdomen.
内脏，这个关键词，克拉拉感受到的是内脏疼痛，意思是来自腹部内部的疼痛。
When the doctors did the skin test, Clara didn't feel it, right?
当医生做皮试时，克拉拉没有感觉到，对吗？
She was numb.
她已经麻木了。
But sometimes a cesarean patient is numb when you test her skin.
但有时，当你测试剖腹产患者的皮肤时，她会感到麻木。
And when you open her up, you find she's not.
当你打开她的心扉时，你会发现她不是。
There are a lot of reasons for this, but in the moment, the reason for the pain doesn't totally matter.
造成这种情况的原因有很多，但目前，疼痛的原因并不完全重要。
What matters is that you treat it.
重要的是你对待它。
The babies, we missed the delivery, but we see them now at the edge of the room in newborn warmers.
婴儿们，我们错过了分娩，但我们现在看到他们在新生儿保暖箱里躺在房间的边缘。
And we understand they are healthy, that they are OK.
我们知道他们很健康，一切都很好。
But Clara is not.
但克拉拉不是。
We see Clara punching the drape, as if trying to hit the OBs.
我们看到克拉拉猛击幕布，好像试图攻击 OB。
What are the OBs doing on the other side of the drape?
幕布另一边的 OB 正在做什么？
What are they understanding?
他们明白什么？
What are they feeling?
他们有什么感受？
Why are they ordering Mindy to tell Clara's husband everything is all right?
为什么他们命令明迪告诉克拉拉的丈夫一切都好？
We don't know the answers to these questions yet.
我们还不知道这些问题的答案。
We're on the side of the drape with Clara and the anesthesiologist, who's giving her supplemental drugs-- fentanyl, ketamine.
我们站在克拉拉和麻醉师一边，麻醉师正在给她补充药物——芬太尼、氯胺酮。
Is he doing the right thing, giving her those drugs?
他给她服用这些药物是正确的做法吗？
We don't know this yet, either.
我们还不知道这一点。
But the feeling we convey now is that something is wrong, very wrong.
但我们现在传达的感觉是有些事情不对劲，非常不对劲。
What's going on inside for Clara is that all these drugs have her hallucinating.
克拉拉内心的想法是，所有这些药物都让她产生了幻觉。
Is this the kind of show where we do a magical realism thing of inhabiting her consciousness?
这是我们在她的意识中做魔幻现实主义的表演吗？
I mean, it could be, yes, why not use it this way?
我的意思是，可能是的，为什么不这样使用呢？
Why not use it to show what Clara is seeing?
为什么不用它来展示克拉拉所看到的东西呢？
A story I heard-- I'll say this fast-- a mother is given ketamine during her C-section.
我听到的一个故事——我会很快说——一位母亲在剖腹产期间服用了氯胺酮。
Her baby is born and the nurse brings her the baby.
她的孩子出生了，护士给她带来了孩子。
And the patient says, this is a lovely baby, but this is not my baby.
病人说，这是一个可爱的宝宝，但这不是我的宝宝。
My baby does not have two heads.
我的宝宝没有两个头。
I heard this story from a doctor.
我从一位医生那里听到了这个故事。
It happened while she was still a resident.
这件事发生在她还是居民的时候。
And she told me that after that woman, she never used ketamine for a cesarean patient again.
她告诉我，在那之后，她再也没有为剖腹产患者使用过氯胺酮。
What Clara is seeing, we see now, colors and shapes.
克拉拉所看到的，我们现在看到的，颜色和形状。
If you're a certain kind of person, you might be fine looking at an open abdomen but freaked out looking at hallucinations.
如果你是某种人，你可能会觉得看到开放的腹部还好，但看到幻觉就会感到害怕。
Clara feels unable to communicate.
克拉拉感觉无法沟通。
She was just so slurry, like please, please stop.
她真是太糊涂了，就像求求你，求你停下来。
No, no, no. She sounded like she was out of her body at that point.
不，不，不。那一刻她听起来就像是脱离了身体。
And I almost started thinking like, I know she's had issues with post-traumatic stress type issues.
我几乎开始想，我知道她有创伤后压力类型的问题。
So I'm like, maybe this is not pain thing.
所以我想，也许这不是痛苦的事情。
Maybe it's a psychological thing.
也许这是一个心理问题。
And this happens a lot where patients complain of pain and we brush it off as, she's anxious.
这种情况经常发生，病人抱怨疼痛，而我们却忽略了，因为她很焦虑。
It's just pressure.
这只是压力。
But it wasn't.
但事实并非如此。
Because she would feel anytime they touched or did the cautery.
因为只要他们触碰或烧灼，她就会有感觉。
Like, she would say the burning, she could feel the burning.
就像，她会说燃烧，她能感觉到燃烧。
The cautery instrument is called the Bovie.
烧灼器械称为 Bovie。
It stanches bleeding.
它可以止血。
And the red hot pain of it is something Clara remembers precisely.
克拉拉清楚地记得那种灼热的疼痛。
Something that years later, would wake her up in the middle of the night.
多年后的某件事，会在半夜把她吵醒。
The sear of that instrument, Clara, exclaiming, ow, and a doctor saying, we'll move to the other side.
那个仪器的灼烧感，克拉拉，惊呼，噢，然后一位医生说，我们要搬到另一边。
What?
什么？
There's still a lot of surgery left after the delivery.
产后还有很多手术要做。
And now we're going to see a part I know some people might not want to see.
现在我们将看到一些我知道有些人可能不想看到的部分。
Brace for it.
做好准备。
I'm giving you the warning.
我给你警告。
The doctor is lifting Clara's uterus out of her body and resting it on her abdomen.
医生正在将克拉拉的子宫从她的身体中取出并放在她的腹部。
It's like a giant, shiny Easter egg.
它就像一个巨大的、闪亮的复活节彩蛋。
The uterus has been exteriorized.
子宫已被取出。
That's what this is called.
这就是所谓的。
And the reason we're seeing this is-- please remember that Clara can feel this, can feel her organ being lifted out of her body.
我们看到这个的原因是——请记住，克拉拉可以感觉到这一点，可以感觉到她的器官被从她的身体中提起。
Oh, and at some point during all of this, Clara starts throwing up.
哦，在这一切过程中的某个时刻，克拉拉开始呕吐。
Now, the surgeon sticks a good portion of her forearm into Clara's body.
现在，外科医生将她前臂的很大一部分刺入克拉拉的体内。
What we see in the shot is just the arm disappearing into the abdomen.
我们在镜头中看到的只是手臂消失在腹部。
She's using a pad of gauze to check for internal bleeding.
她正在用一块纱布检查是否有内出血。
Again, the point is, Clara is feeling this.
重点是，克拉拉也感受到了这一点。
Now we hear her scream, "Why are you doing this?
现在我们听到她尖叫：“你为什么要这样做？
Make it stop." And now we do, as if on her command, we leave the surgery.
让它停下来。”现在我们就离开了手术室，就像是按照她的命令一样。
We need to get out of this OR where bad things are happening and we don't understand why.
我们需要摆脱这种情况，或者是那些正在发生坏事但我们不明白原因的地方。
Outside of the operating room, an obstetric anesthesiologist named Cory is arriving for his 7:00 AM shift.
手术室外面，一位名叫科里 (Cory) 的产科麻醉师将于早上 7:00 轮班。
Cory, we're not going to meet Cory as a main character.
科里，我们不会以主角身份见到科里。
Maybe he's someone who will be developed later in another episode.
也许他是稍后会在另一集中发展的人。
He's trim and boyishly handsome.
他身材修长，英俊如男孩。
We watch as several nurses urge him toward the OR.
我们看到几名护士催促他前往手术室。
Cory, you need to get in there now.
科里，你现在需要进去。
Cory pushes open the door and enters the room just as the surgeons are putting the final stitches in Clara's skin.
科里推开门进入房间，此时外科医生正在对克拉拉的皮肤进行最后缝线。
And then all of a sudden, at some point, it was over.
然后突然之间，在某个时刻，一切都结束了。
And I just, the first thing I remember is just looking around.
我记得的第一件事就是环顾四周。
And then Cory was there.
然后科里就在那里。
He's one of the anesthesiologists.
他是麻醉师之一。
Yeah.
是的。
Clara Hochhauser And I remember seeing Cory, and he came right by down my face.
克拉拉·霍赫豪瑟（Clara Hochhauser） 我记得见过科里，他从我脸上走过来。
'Cause I was still on the table, but all the drapes, everything was gone and done.
因为我还在桌子上，但所有的窗帘、一切都已经消失了。
And Cory was right there.
科里就在那里。
And I remember, I was just like, oh, Cory, you'll help me.
我记得，我当时就想，哦，科里，你会帮助我的。
I was just like, oh, you'll help me.
我当时就想，哦，你会帮助我的。
Cory, Clara knows him, trusts him, unlike the other anesthesiologist.
科里，克拉拉认识他，信任他，不像其他麻醉师。
She had no idea who that guy was.
她不知道那个人是谁。
We see some relief in Clara's face and we see Cory holding back tears.
我们看到克拉拉脸上露出了一些轻松的表情，我们看到科里强忍着泪水。
And even though there's no resolution or total explanation, at least we know that Clara is being cared for.
尽管没有解决方案或完整的解释，但至少我们知道克拉拉正在得到照顾。
Cory wheels Clara to the recovery room, the PACU, and as soon as she's settled, Cory goes down the hall and calls his boss-- Heather.
科里推着克拉拉去康复室，PACU，她一安顿下来，科里就走到大厅，给他的老板希瑟打电话。
He calls me and he's like, Heather, something happened.
他打电话给我，他说，希瑟，出事了。
And I was like, OK.
我当时想，好吧。
What's going on?
这是怎么回事？
Heather was at home.
希瑟在家。
She'd been at the hospital so long the night before that she got the day off.
前一天晚上她在医院待了很长时间，所以今天请了假。
Cory told her about Clara.
科里向她讲述了克拉拉的事。
Oh my god, no, no, no, no, no, no, no, no, no. That just can't be.
天哪，不，不，不，不，不，不，不，不，不。那是不可能的。
And I was like, Cory, what happened?
我当时想，科里，发生了什么事？
He's like, I don't even know.
他就像，我什至不知道。
And I just felt-- I felt horrible.
我只是觉得——我感觉很糟糕。
I felt like I shouldn't have left the hospital, that I should have just stayed until she was safely taken care, that she had delivered, that I had let her down in that.
我觉得我不应该离开医院，我应该留下来直到她得到安全照顾，她已经分娩了，我让她失望了。
And then I got mad.
然后我就生气了。
And then I got really mad.
然后我真的很生气。
Heather is mad because she's in charge here.
希瑟很生气，因为她是这里的负责人。
And she's an anesthesiologist.
她是一名麻醉师。
The thing the anesthesiologist is in the room to do is manage pain.
麻醉师在房间里要做的就是控制疼痛。
Cutting someone's body open and then operating when they can feel it, that is not supposed to happen.
切开某人的身体，然后在他们能感觉到的时候进行手术，这是不应该发生的。
That's something from history or from war.
这是历史或战争中的事情。
But in the United States, it happens 100,000 times a year.
但在美国，这种情况每年会发生10万次。
That's the best estimate of how many patients have significant pain during cesarean.
这是对有多少患者在剖腹产期间出现明显疼痛的最佳估计。
Not all of these patients feel the exact same intensity of pain, or at the same parts of the surgery, or for the same length of time, but the pain they feel is significant.
并非所有这些患者都感受到完全相同的疼痛强度，或者在手术的相同部位，或者持续相同的时间，但他们感受到的疼痛是显着的。
Most people don't know about this.
大多数人不知道这一点。
Until recently, I didn't.
直到最近，我还没有。
I learned of it from listeners to season one of this podcast.
我从该播客第一季的听众那里了解到这一点。
It doesn't matter if you haven't heard season one.
如果你没听过第一季也没关系。
The details are less important than the common experience it described-- pain a doctor didn't listen to, pain a doctor didn't adequately treat.
细节并不重要，重要的是它所描述的常见经历——医生没有倾听的疼痛，医生没有充分治疗的疼痛。
That experience resonated with many listeners, and hundreds of them, mostly women, began writing to me with their own stories.
这段经历引起了许多听众的共鸣，其中数百人（其中大部分是女性）开始写信给我讲述自己的故事。
One afternoon, I opened a note that was unlike any I'd received so far.
一天下午，我打开了一张纸条，它与我迄今为止收到的任何纸条都不一样。
"I had a C-section," the email began, "where anesthesia was not properly administered.
“我进行了剖腹产，”电子邮件开头，“麻醉没有得到适当管理。
I remember telling them I could feel the cutting, the moving of my organs, the burning, shocking, brutal pain, and being told that wasn't possible and that I would just have to tough it out."
我记得告诉他们我能感觉到切割、器官的移动、灼烧感、震惊的、残酷的疼痛，但他们告诉我这是不可能的，我只能坚持下去。”
To me, this listener's experience seemed so out of range that it might be singular.
对我来说，这位听众的经历似乎超出了范围，以至于可能是奇异的。
Then I opened two more of these notes.
然后我又打开了两本笔记。
Soon I understood this was a subject that would come up again and again.
很快我就明白这是一个会一次又一次出现的话题。
C-sections are the most frequently performed surgery in the world.
剖腹产是世界上最常进行的手术。
In the US, there are 1.2 million of them a year.
在美国，每年有 120 万这样的人。
So 100,000 patients a year feeling pain during cesarean, that's 8%.
每年有 10 万名患者在剖腹产期间感到疼痛，即 8%。
Some people say the rate is even higher.
有人说这个比率还更高。
There's no other surgery where this happens, no other major surgery where it would be acceptable for 8% of patients to feel that surgery.
没有其他手术会发生这种情况，也没有其他大型手术可以让 8% 的患者感受到手术的感觉。
8% is a brand new number from a recently completed study.
8% 是最近完成的一项研究中的全新数字。
It didn't replace an old number.
它没有取代旧号码。
It's the first number of its kind.
这是同类中的第一个数字。
Until now, nobody had ever done a study like this, asking thousands of patients in the US and Canada whether they felt pain during their C-sections.
到目前为止，还没有人做过这样的研究，询问美国和加拿大的数千名患者在剖腹产时是否感到疼痛。
But now the study has been done by doctors who recognize that this is a problem and that putting a number to it is a step toward solving it.
但现在这项研究是由医生们完成的，他们认识到这是一个问题，并且给出一个数字是解决这个问题的一步。
And this is what this story is about.
这就是这个故事的主题。
Not just that there's a problem with severe pain, but that people are trying to solve it.
不仅存在剧烈疼痛的问题，而且人们正在努力解决它。
As soon as I finished season one of The Retrievals, people began asking me, what are the solutions to fixing this problem in medicine of dismissing women's pain?
当我完成《检索》第一季时，人们开始问我，解决女性痛苦的医学问题有什么解决方案？
I was surprised the first time I got this question about solutions.
当我第一次收到这个有关解决方案的问题时，我感到很惊讶。
Obviously, I should not have been surprised.
显然，我不应该感到惊讶。
But I didn't have a bullet point list.
但我没有要点列表。
How to shift an entire culture, how to listen to women patients-- these are really complicated issues.
如何改变整个文化，如何倾听女性患者的心声——这些都是非常复杂的问题。
And solutions had not been the focus of my reporting.
解决方案并不是我报告的重点。
I looked at what went wrong.
我看看出了什么问题。
Exploring what went wrong doesn't automatically translate to solutions on how to make it right.
探索问题所在并不会自动转化为纠正问题的解决方案。
But this question made me curious.
但这个问题让我很好奇。
Well, what are the solutions?
那么，有哪些解决方案呢？
It turned out that a bunch of people interested in pain during cesarean were thinking about the same thing.
事实证明，一群对剖腹产疼痛感兴趣的人都在思考同样的事情。
So here we go, a case study in solving one of medicine's most persistent problems, listening to women patients and adequately treating their pain, told through the experiences of four women-- Clara, Heather, Mindy, and Susanna, who run up against this problem and take it on, with efforts that touch both individual patients and entire countries.
因此，我们开始了一个案例研究，旨在解决医学上最持久的问题之一，倾听女性患者的心声并充分治疗她们的疼痛，通过四位女性——克拉拉、希瑟、明迪和苏珊娜的经历来讲述，她们遇到了这个问题并解决了这个问题，她们的努力影响到个体患者和整个国家。
How do they do this?
他们是如何做到这一点的？
What can they change?
他们能改变什么？
And what does it cost them?
他们为此付出了什么代价？
Back at the hospital, Clara has been moved from the PACU to a bed.
回到医院后，克拉拉已从 PACU 转移到病床上。
It isn't long before she hears from Heather.
不久她就收到了希瑟的消息。
It was that day.
就是那天。
She was really upset too.
她也确实很难过。
She was really sorry that it happened.
发生这样的事她真的很遗憾。
Yeah.
是的。
Clara Hochhauser Because Cory, obviously, yeah, Cory told her.
克拉拉·霍赫豪瑟 因为科里，显然，是的，科里告诉她。
Anyway, and she was really sorry.
无论如何，她真的很抱歉。
The first time I saw her, she looked at me and she goes, Heather, what the fuck?
我第一次见到她时，她看着我，然后说，希瑟，他妈的怎么了？
What the fuck, Heather?
搞什么鬼，希瑟？
And I just went, I'm so sorry.
我刚刚去了，非常抱歉。
And she was really-- it was hard.
她真的——这很难。
She was really, really raw.
她真的非常非常原始。
She was not OK.
她不太好。
And I said to her, I said, listen, when you're ready, I'd love to just get some information from you.
我对她说，听着，当你准备好时，我很乐意从你那里得到一些信息。
Because I'm going to take this beyond where we are right now.
因为我要让这件事超越我们现在的处境。
I said, I'm going to make sure that institutionally, this doesn't happen again.
我说，我会从制度上确保这种情况不会再发生。
And I'm going to make sure that people hear about this and that this can be used for good.
我将确保人们听到这一点，并确保它可以用于公益事业。
She wasn't going to let it go and she was gonna take action.
她不会就此罢休，她要采取行动。
She was gonna do something to prevent this from happening again.
她要做点什么来避免这种事再次发生。
And now we see Clara in her bed, and we follow her gaze out of the window, out of the hospital, down to the street, where we pause for a second over Mindy's minivan, an orange parking ticket on the windshield.
现在我们看到克拉拉躺在床上，我们顺着她的目光望向窗外，走出医院，来到街上，我们在明迪的小型货车上停了下来，挡风玻璃上贴着一张橙色的停车罚单。
And then we continue across the city, arcing back over the same elevated tracks and wide highways we traversed earlier, only now it's dusk instead of dawn.
然后我们继续穿过城市，沿着我们之前走过的高架轨道和宽阔的高速公路蜿蜒返回，只是现在是黄昏而不是黎明。
And when we get to the lake, we turn around so that we can see the sunset over those magnificent buildings, their windows fiery with the day's last light.
当我们到达湖边时，我们转过身去，这样我们就可以看到那些宏伟建筑上的日落，它们的窗户被当天最后的阳光照亮。
And we hold that shot as the music swells and the credits roll.
随着音乐的响起和片尾字幕的滚动，我们保持着这个镜头。
Susan Burton.
苏珊·伯顿。
OK, so that was the opening episode of season two of her podcast, The Retrievals.
好的，这就是她的播客《检索》第二季的开场一集。
And I kind of said this at the top of the show.
我在节目开头说过这句话。
As the story unfolds in later episodes of the podcast, it does this thing that I think almost never happens in a big investigative story.
随着故事在播客的后续剧集中展开，它做了我认为在大型调查故事中几乎不会发生的事情。
It becomes surprisingly hopeful.
它变得令人惊讶地充满希望。
Doctors take a look at the problem that Susan is documenting, and then they act the way that you would hope that doctors would act.
医生会查看 Susan 记录的问题，然后按照您希望医生采取的方式行事。
They take it seriously.
他们认真对待它。
People step forward to try to change things.
人们挺身而出，试图改变现状。
One of them is the head of obstetric anesthesia from this first episode, Heather Nixon.
其中之一是第一集中的产科麻醉负责人希瑟·尼克松。
I'm going to play you a clip from the second episode so you can hear what I'm talking about.
我将向您播放第二集的剪辑，以便您可以听到我在说什么。
It's interesting.
这很有趣。
By sheer coincidence, Heather Nixon had been scheduled to give a speech on pain during cesareans at a major medical conference before she saw how the anesthesia in Clara's C-section went wrong.
纯属巧合的是，希瑟·尼克松原本计划在一次重要的医学会议上发表关于剖腹产疼痛的演讲，然后才看到克拉拉剖腹产时的麻醉出了问题。
And so she had been planning on doing a speech focusing on technical tips.
因此，她一直计划做一场专注于技术技巧的演讲。
But now she rethought this.
但现在她重新思考了这一点。
She decided to do something much more participatory than a typical medical conference speech.
她决定做一些比典型的医学会议演讲更具参与性的事情。
And when the day of the speech came, she began her talk by telling the assembled doctors the story of Clara's cesarean, how Clara felt, what was happening during her surgery, and really what that did to Clara in the aftermath.
当演讲那天到来时，她首先向聚集在一起的医生讲述了克拉拉剖腹产的故事、克拉拉的感受、手术过程中发生的事情以及手术后对克拉拉的影响。
And then, the action turns, the story turns to one of a number of very insidery, almost behind-the-scenes moments where doctors are trying to be honest with each other and with themselves about their own failures and how to fix them.
然后，动作发生转变，故事转向许多非常内部的、几乎是幕后的时刻之一，医生们试图对彼此和自己诚实，了解自己的失败以及如何解决这些问题。
OK, here's a bit of that.
好的，这是一些内容。
Usually at a medical conference, people are typing on their laptops or holding their phones up to the screen to take pictures of the slides.
通常在医学会议上，人们会在笔记本电脑上打字或将手机举到屏幕上拍摄幻灯片的照片。
This room is still
这个房间还是
So this is a harrowing story.
所以这是一个令人痛心的故事。
It made me mad.
这让我很生气。
It made me sad.
这让我很难过。
It made me frustrated.
这让我很沮丧。
And it made me really take a deep dive into what is going on in our country.
这让我真正深入了解了我们国家正在发生的事情。
If you go to Google and you search intraoperative pain for cesarean delivery, you will see horror stories across this country.
如果你去谷歌搜索剖腹产的术中疼痛，你会看到这个国家各地的恐怖故事。
And this is really staggering because nowhere else in anesthesia do we allow this to happen.
这确实令人震惊，因为在麻醉领域，我们不允许这种情况发生。
Nowhere, right?
无处可去，对吧？
If you have a block that doesn't work for an ortho case, your patient goes to sleep.
如果您的模块不适用于矫形病例，您的患者就会进入睡眠状态。
We don't suffer through it.
我们不会因此而受苦。
We don't bite the bullet.
我们不会硬着头皮。
We don't ask our patient to just take it.
我们不会要求我们的病人服用它。
So I'm going to ask just this room at this moment, how many people in the last month have had a patient who's had severe intraoperative pain?
所以我现在想问一下在座的各位，上个月有多少人遇到过术中剧烈疼痛的病人？
There are hundreds of people in the room.
房间里有数百人。
We watch as half of them raise their hands-- half.
我们看到他们中有一半人举起了手——一半。
Heather had asked how many people in the last month had a patient who had severe pain during their C-section, and half of the doctors raised their hands.
希瑟询问上个月有多少人在剖腹产时感到剧烈疼痛，一半的医生举起了手。
OK.
好的。
So this is not rare.
所以这种情况并不罕见。
We have a group of experts in the room who clearly are experiencing this on a daily basis, and we're just beginning to talk about it.
我们房间里有一群专家，他们显然每天都在经历这一点，而我们才刚刚开始讨论它。
And it's crazy that we're just beginning to talk about it because it's a known problem, Heather says.
希瑟说，我们才开始谈论这个问题，因为这是一个已知的问题，这太疯狂了。
She ticks through all the different kinds of knowing.
她勾选了所有不同类型的知识。
There's medical literature.
有医学文献。
There's litigation.
有诉讼。
There's doctors' own experiences in the operating room.
有医生在手术室里的亲身经历。
So what that means is that there's an active kind of not knowing, and that act of not knowing is as much of a problem as the pain itself.
所以这意味着存在一种主动的不知道，而这种不知道的行为与痛苦本身一样都是一个问题。
So how do we fix this?
那么我们该如何解决这个问题呢？
How do we think about this?
我们如何看待这个问题？
And how do we change what's happening?
我们如何改变正在发生的事情？
So why is this happening?
那么为什么会发生这种情况呢？
All right, I'm going to assume that everyone in this room is passionate about what they do.
好吧，我假设这个房间里的每个人都对他们所做的事情充满热情。
They love obstetric patients.
他们热爱产科病人。
They're here to learn.
他们来这里是为了学习。
They want to do the best.
他们想做到最好。
And I'm going to assume that no one gets into medicine to hurt people, OK?
我假设没有人进入医学界是为了伤害别人，好吗？
We want to help people.
我们想帮助人们。
So what is the disconnect?
那么什么是脱节呢？
Heather's put the questions to the group plainly.
希瑟向大家明确提出了问题。
How willing they'll be to wrestle with them is anyone's guess.
任何人都猜测他们会多么愿意与他们摔跤。
She opens the discussion to the room.
她开始在房间里进行讨论。
The first person to speak is a doctor from New York City named Dan.
第一个发言的是来自纽约市的一位名叫丹的医生。
When we think about why this happens, I think there is this specter in the back of our heads that says, oh crap, the spinal is not working.
当我们思考为什么会发生这种情况时，我认为我们的后脑勺里有一个幽灵在说，哦，糟糕，脊柱不工作了。
If I have to induce general anesthesia, there's a chance, because we all have PTSD, that the pregnant airway is horrific, that I'm going to lose the airway and the mom will die.
如果我必须进行全身麻醉，那么有可能，因为我们都有创伤后应激障碍，怀孕的气道是可怕的，我会失去气道，妈妈会死。
And I think that is what is-- I'm gonna say it, that is a fear of mine, that I will lose the airway.
我认为这就是——我要说的是，这是我的恐惧，我会失去呼吸道。
And then they'll be like, well, yeah, she was uncomfortable, but maybe you could have muscled through and at least she'd be alive.
然后他们会说，好吧，是的，她很不舒服，但也许你可以强行挺过去，至少她还活着。
And so that is the balance that I find when I'm dealing with this in the operating room.
这就是我在手术室处理这个问题时找到的平衡。
And I don't know if other people have had that same discussion in their head.
我不知道其他人是否也有过同样的讨论。
No warm up.
没有热身。
No superficial comments before the room really gets going.
在房间真正开始之前没有肤浅的评论。
Dan goes deep straight away.
丹立即深入。
Sometimes I'm scared, he's saying.
有时我很害怕，他说。
I'm scared of the biggest thing of all.
我害怕最重要的事情。
And in that situation, it seems like the better choice is pain.
在这种情况下，似乎更好的选择就是痛苦。
Heather meets Dan's vulnerability with some of her own.
希瑟用自己的一些弱点来应对丹的脆弱。
So I think that that's a wonderful point.
所以我认为这是一个很棒的观点。
We were taught, since fellowship, since I was a baby, I was taught, don't take on the airway.
从团契开始，我们就被教导，从我还是个婴儿的时候起，我就被教导，不要上呼吸道。
Pregnant is the big bad wolf.
怀孕了就是大灰狼。
Stay away from it.
远离它。
This is how moms die.
妈妈们就是这样死去的。
You'll never recover.
你永远不会康复。
The family will never recover.
家人永远无法康复。
And so, especially towards the end of a case, you might be like, eh, do I really need to?
因此，尤其是在案件即将结束时，您可能会想，呃，我真的需要这样做吗？
This is the gray area that's ugly and it doesn't feel good.
这是丑陋的灰色区域，而且感觉不好。
And at the end of the day, I don't feel satisfied with my job because maybe I did the right thing, maybe I didn't.
归根结底，我对自己的工作并不满意，因为也许我做对了，也许没有。
And I'm honest enough to admit it.
我很诚实地承认这一点。
I've been in that situation several times where I've looked at this and been like, do I really want to do this?
我曾经多次遇到过这种情况，我看着这个并想，我真的想这样做吗？
Even when the patient maybe had some discomfort.
即使患者可能有一些不适。
From the stage, Heather sees one of the women she trained with in fellowship, giving her a look like, same.
从舞台上，希瑟看到了一位与她一起训练的女性，她看起来和她一样。
People start lining up behind the mics.
人们开始在麦克风后面排队。
There's a doctor who practices in New Jersey.
有一位在新泽西行医的医生。
So that for me, it's not just about, oh, the patient's comfortable or she's just exaggerating.
所以对我来说，这不仅仅是，哦，病人感到舒服或者她只是在夸大其词。
It's sometimes that fear that if I do get into a general anesthesia, no one knows how to help me.
有时我会担心，如果我真的进行全身麻醉，没有人知道如何帮助我。
And there's Zevy.
还有泽维。
Zevy I'm Zevy.
泽维 我是泽维。
I'm also from New York City.
我也来自纽约市。
I actually really appreciate your point about saying the quiet part out loud, where we're here--
我真的很欣赏你大声说出安静部分的观点，我们在这里——
The part that spinals and epidurals can fail.
脊髓和硬膜外麻醉可能失败的部分。
When do you tell the patient this thing that you know to be true, but that may sound so alarming to them?
你什么时候告诉病人这件事你知道是真的，但对他们来说可能听起来如此令人震惊？
These things fail.
这些事情都失败了。
Wait, what?
等等，什么？
You're telling me this now?
你现在告诉我这个？
I was wondering how many people actually say that in the pre-op, discuss that spinals and epidurals actually fail.
我想知道有多少人实际上在术前说过，讨论脊柱和硬膜外麻醉实际上失败了。
And if they do fail, we test for it.
如果他们确实失败了，我们会进行测试。
And we have options to fix it beforehand, even during your consent process.
即使在您同意的过程中，我们也可以选择提前修复它。
I'm Andi.
我是安迪。
I'm from Stanford.
我来自斯坦福大学。
I just wanted to share one of my techniques.
我只是想分享我的一项技术。
Sometimes I either have a patient where maybe there's a language barrier, they're exhausted, they're really scared, and I think my block is working because my block is going to work, but to take my ego out of it--
有时我的病人可能存在语言障碍，他们精疲力尽，他们真的很害怕，我认为我的障碍正在发挥作用，因为我的障碍将会发挥作用，但要消除我的自我意识 -
We are tight on Andi's face so that you can see she's being self-deprecating, not cocky, gently reminding the group to be alert to their own hubris.
我们紧紧盯着安迪的脸，这样你就可以看到她是在自嘲，而不是自大，温和地提醒大家要警惕自己的傲慢。
Doctors continue to come forward, asking questions, offering tips, letting out frustrations.
医生们继续挺身而出，提出问题，提供建议，发泄不满。
Intraoperatively, I think that the pain versus pressure question is a trope that I really hate in our specialty.
在术中，我认为疼痛与压力的问题是我在我们的专业中非常讨厌的一个比喻。
But to sort of give the patient the feeling of, don't worry your pretty little head about this, it's fine, [LAUGHS] that is horrible.
但为了给病人这样的感觉，别担心你的小脑袋，这很好，[笑]这太可怕了。
It is horrible to not feel listened to.
感觉不被倾听是很可怕的。
And so I think we all have to--
所以我认为我们都必须——
Heather had been worried that there would come a moment like, OK, it's great we're talking about this, but what do we do?
希瑟一直担心会有这样的时刻，好吧，我们正在谈论这个真是太好了，但是我们该怎么办呢？
Where's the algorithm we follow if a patient is in severe pain?
如果患者剧烈疼痛，我们遵循的算法在哪里？
She wasn't sending anyone off with an algorithm to follow because that algorithm didn't exist.
她并没有派任何人去遵循算法，因为该算法不存在。
So just a quick thought-- Susan Burton And it's clear that the audience is eager to come up with solutions.
所以只是一个快速的想法 - 苏珊·伯顿 很明显，观众渴望找到解决方案。
Um, I do have a way-- Susan Burton There's a lot of crowdsourcing, Heather and others talking about everything from specific doses of medicine to styles of communication.
嗯，我确实有办法——苏珊·伯顿（Susan Burton）有很多众包，希瑟和其他人谈论从特定剂量的药物到沟通方式的所有内容。
Heather has scoured the medical literature for relevant research on this.
希瑟在医学文献中搜寻了这方面的相关研究。
But for today, the goal is not to settle on a fix.
但今天的目标不是解决问题。
This is steps to solve a problem.
这是解决问题的步骤。
Step one-- talk about the problem.
第一步——讨论问题。
That was what Heather wanted, and apparently it was what the room had wanted too.
这就是希瑟想要的，显然这也是整个房间想要的。
Susan Burton.
苏珊·伯顿。
From there, through the later episodes of this podcast, we hear doctors try to put in place procedures to fix this problem and to change the culture in their operating rooms.
从那时起，通过本播客的后面几集，我们听到医生试图制定程序来解决这个问题并改变手术室的文化。
It's really something.
真的是很了不起。
And one of the key people who makes this happen is somebody who's not even a doctor.
实现这一目标的关键人物之一甚至不是医生。
That's a whole story in itself.
这本身就是一个完整的故事。
So The Retrievals Season Two.
所以《检索》第二季。
There are four episodes in all from Serial and The New York Times.
《连续剧》和《纽约时报》共有四集。
You can get it wherever you get your podcasts.
无论您在哪里获取播客，都可以获取它。
So what you heard today on our show, The Retrievals Season Two, was hosted, written, and reported by Susan Burton, produced by Julie Snyder and Ben Phelan.
今天您在我们的节目《检索》第二季中听到的内容是由苏珊·伯顿 (Susan Burton) 主持、编剧和报道，朱莉·斯奈德 (Julie Snyder) 和本·费兰 (Ben Phelan) 制作的。
It was edited by Julie Snyder, with additional editing by Laura Starcheski and Jessica Weisberg and engineered by Phoebe Wang, with original music by Dan Powell, Fritz Myers, and Nick Thornburn.
它由 Julie Snyder 编辑，Laura Starcheski 和 Jessica Weisberg 额外编辑，Phoebe Wang 设计，Dan Powell、Fritz Myers 和 Nick Thornburn 原创音乐。
Special thanks to Elizabeth Livingston, Blair Arthur, Vanessa Lehner, Rachel Roberts, Lynn Holland, Carolina Mendoza, Clara Hochhauser, and Jaime Daly.
特别感谢伊丽莎白·利文斯顿、布莱尔·亚瑟、凡妮莎·莱纳、雷切尔·罗伯茨、林恩·霍兰德、卡罗莱纳·门多萨、克拉拉·霍克豪瑟和杰米·戴利。
Our This American Life episode was put together by Miki Meek, Stowe Nelson, and Angela Gervasi.
我们的《美国生活》这一集由 Miki Meek、Stowe Nelson 和 Angela Gervasi 共同制作。
Our website, thisamericanlife.org.
我们的网站 thisamericanlife.org。
If you would like to get lots of bonus content and help us keep our show going, you can become a life partner.
如果您想获得大量奖励内容并帮助我们继续我们的节目，您可以成为终身伴侣。
Subscribe to our program by going to thisamericanlife.org/lifepartners.
请访问 thisamericanlife.org/lifepartners 订阅我们的计划。
This American Life is delivered to public radio stations by PRX, the Public Radio Exchange.
《美国生活》由公共广播电台 PRX 向公共广播电台播出。
Thanks, as always, to our program's co-founder, Mr. Torey Malatia.
一如既往地感谢我们项目的联合创始人 Torey Malatia 先生。
He remembers his first monthly paycheck working at a public radio station.
他记得他在一家公共广播电台工作时的第一份月薪。
I guess it was a long time ago.
我想那是很久以前的事了。
$200.
200 美元。
And I was like, [GASPS], that's a lot of money.
我当时想，[喘气]，那是很多钱。
I'm Ira Glass.
我是艾拉·格拉斯。
Back next week with more stories of This American Life.
下周我们将带来更多《美国生活》的故事。
This American Life is produced in collaboration with WBEZ Chicago and delivered to stations by PRX The Public Radio Exchange.
《This American Life》与 WBEZ Chicago 合作制作，并由 PRX 公共广播电台传送到各电台。