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2018年03月24日 08:07:56来源:飞度技术好医院在线

THE PRESIDENT: Hello everybody, and happy holidays. THE FIRST LADY: We know how busy this time of year is for everyone, so we’re not going to take much of your time. But we did want to take a moment to wish you all a Merry Christmas, from our family to yours. THE PRESIDENT: This is a season for millions of Americans to be together with family, to continue long-held holiday traditions, and to show our gratitude to those we love. And along the way, some of us might even watch a little basketball or eat some Christmas cookies, too. THE FIRST LADY: Here at the White House, over the past few weeks, we’ve had about 70,000 people from all across the country come visit us and look at our holiday decorations. This year’s theme was “Gather Around: Stories of the Season.” And in every room of the house, we tried to tell a story about who we are as Americans and how we celebrate the holidays together. And we made certain to highlight some of the most powerful stories we know—the stories of our outstanding troops, veterans, and military families and their service and sacrifice for our country. THE PRESIDENT: Our extraordinary men and women in uniform are serving so that the rest of us can enjoy the blessings we cherish during the holidays. But that means many of our troops are far from home and far from family. They’re spending some extra time on the phone with their loved ones back home. Or they’re setting up chats so they can watch as the presents are opened. So today, we want all of our troops to know that you’re in our thoughts and prayers this holiday season. And here’s the good news: For many of our troops and newest veterans, this might be the first time in years that they’ve been with their families on Christmas. In fact, with the Iraq war over and the transition in Afghanistan, fewer of our men and women in uniform are deployed in harm’s way than at any time in the last decade. THE FIRST LADY: And that’s something we all can be thankful for. And with more and more of our troops back here at home, now it’s our turn to serve—it’s our turn to step up and show our gratitude for the military families who have given us so much. And that’s why Jill Biden and I started our Joining Forces initiative—to rally all Americans to support our military families in ways large and small. And again and again, we have been overwhelmed by the response we’ve gotten as folks from across the country have found new ways to give back to these families through their schools, businesses, and houses of worship. THE PRESIDENT: That’s the same spirit of giving that connects all of us during the holidays. So many people all across the country are helping out at soup kitchens, buying gifts for children in need, or organizing food or clothing drives for their neighbors. For families like ours, that service is a chance to celebrate the birth of Christ and live out what He taught us – to love our neighbors as we would ourselves; to feed the hungry and look after the sick; to be our brother’s keeper and our sister’s keeper. And for all of us as Americans, regardless of our faith, those are values that can drive us to be better parents and friends, better neighbors and better citizens. THE FIRST LADY: So as we look to the New Year, let’s pledge ourselves to living out those values by reaching out and lifting up those in our communities who could use a hand up. THE PRESIDENT: So Merry Christmas, everyone. And from the two of us, as well as Malia, Sasha, Grandma, Bo… THE FIRST LADY: And Sunny, the newest Obama. THE PRESIDENT: We wish you all a blessed and safe holiday season. THE FIRST LADY: Happy holidays everybody, and God bless.201501/352223。

  • I want you to imagine two couples我希望大家设想一下,两对夫妇in the middle of 1979在1979年的年中on the exact same day, at the exact same moment,在相同的一天,相同的时刻each conceiving a baby -- okay?每对怀上了一个孩子 -- 好So two couples each conceiving one baby.那么两对夫妇各自都都怀上了一个孩子Now I dont want you to spend too much time imagining the conception,现在,我不希望大家花太多的时间去想象怀because if you spend all that time imagining that conception,因为如果你花太多时间去想它youre not going to listen to me.你就不会听我说了So just imagine that for a moment.所以稍微想一下就好了And in this scenario,那么在这种情况下I want to imagine that, in one case,我来设想一下,一个个例是the sperm is carrying a Y chromosome,携带着Y染色体的精子meeting that X chromosome of the egg.遇到携带着X染色体的卵子And in the other case,另一个是the sperm is carrying an X chromosome,携带着X染色体的精子meeting the X chromosome of the egg.遇到携带着X染色体的卵子Both are viable; both take off.两个都存活下来了,两个都开始发育Well come back to these people later.我们之后再来看这两对夫妇So I wear two hats我担任两个角色in most of what I do.在我所从事的领域As the one hat,一个角色是I do history of anatomy.我做解剖学历史研究Im a historian by training,我是个史学工作者and what I study in that case我所研究的是is the way that people have dealt with anatomy --人类是怎么对待解剖学的——meaning human bodies, animal bodies --对无论是人类躯体,或是动物躯体——how they dealt with bodily fluids, concepts of bodies;他们如何处理体液,抽象的躯体how have they thought about bodies.他们是如何看待躯体的The other hat that Ive worn in my work另一个角色是is as an activist,一名社会活动家as a patient advocate --作为一个为病人辩护人的角色——or, as I sometimes say, as an impatient advocate --或者说,像我有时候说的,作为医生们的病人的辩护人——for people who are patients of doctors.我是很激进的In that case, what Ive worked with那样的话,在我工作中is people who have body types所接触到的是一些that challenge social norms.挑战着社会规范的人So some of what Ive worked on, for example,比如,我接触到的一些人is people who are conjoined twins --是连体婴儿two people within one body.两个人共用一个身体Some of what Ive worked on is people who have dwarfism --还有一些是侏儒症患者so people who are much shorter than typical.他们比一般人要矮小的多And a lot of what Ive worked on另外,许多我接触的人is people who have atypical sex --他们的性别与众不同 --so people who dont have the standard male即他们没有很标准的男性特征or the standard female body types.或者女性特有的身体特征And as a general term, we can use the term intersex for this.总的来说,这个症状可以被叫做双性人Intersex comes in a lot of different forms.双性可以有多种的形式Ill just give you a few examples我来举几个例子of the types of ways you can have sex来说明你可以具有that isnt standard for male or female.既不是标准的男性特征也不是标准的女性特征的类型So in one instance,例子之一you can have somebody who has an XY chromosomal basis,一个人可以拥有XY染色体and that SRY gene on the Y chromosome并且,在Y染色体上的SRY基因(雄性性别决定基因)tells the proto-gonads, which we all have in the fetal life,刺激我们在胎儿时期都有的原始性腺to become testes.使其变成睾丸And so in the fetal life the testes are pumping out testosterone.因此在胎儿时期,睾丸分泌睾丸激素But because this individual lacks receptors但是这个个体缺少受体to hear that testosterone,来接收睾丸激素the body doesnt react to the testosterone.身体不能对睾丸激素做出反应And this is a syndrome called androgen insensitivity syndrome.这是一种叫做睾丸不敏感(睾丸女性化)综合征So lots of levels of testosterone, but no reaction to it.所以,睾丸激素的量很大,但是不能引起反应As a consequence, the body develops因此,身体就会朝着more along the female typical path.女性化的趋势发展When the child is born, she looks like a girl.当婴儿诞生时,她看起来像个女孩儿She is a girl. She is raised as a girl.她就是女孩儿,并且被当作小姑娘来抚养And its often not until she hits puberty大多数情况,直到青春期and shes growing and developing breasts,她的胸部开始发育的时候but shes not getting her period,她却没有女性周期that somebody figures out somethings up here.这时我们才会开始怀疑有什么差错And they do some tests and figure out于是他们检查发现that, instead of having ovaries inside and a uterus,她并没有卵巢和子宫she actually has testes inside, and she has a Y chromosome.实际上,在她身体内有睾丸,并且她携带着Y染色体Now whats important to understand现在,有一个重要问题需要说明的是is you may think of this person as really being male,大家一定认为这个人实际上是个男孩儿but theyre really not.其实并非如此Females, like males,女性,和男性一样have in our bodies something called the adrenal glands.体内有一个器官叫做肾上腺Theyre in the back of our body.它在我们身体的后端And the adrenal glands make androgens,并且肾上腺负责分泌雄性激素which are a masculinizing hormone.即一种雄性荷尔蒙Most females like me -- I believe myself to be a typical female --像我一样的大多数女性--我相信我自己是个典型的女性--I dont actually know my chromosomal make-up我其实不太清楚我的染色体的组成but I think Im probably typical --但是我想我应该是有典型的女性——most females like me are actually androgen-sensitive.大多数像我一样的女性实际上是雄激素敏感的Were making androgen, and were responding to androgens.我们分泌雄性激素,并且对它有反应The consequence is that somebody like me结果是,有的像我一样女性,has actually had a brain exposed to more androgens大脑暴露在过多的雄性激素下than the woman born with testes比那个出生时有睾丸的女孩who has androgen insensitivity syndrome.那个雄性激素不敏感综合征的女孩有的雄性激素还多So sex is really complicated; its not just that intersex people所以说性别是个非常复杂的东西;并不是说那些双性的人are in the middle of all the sex spectrum --就处在男性和女性之间——in some ways, they can be all over the place.在某些方面,他们可以覆盖整个性特征的范围201508/393909。
  • And that brings me to what I see is a paradox.这在我看来是一个巨大的悖论The modern world is an incredible source of innovation现代世界是一个无可比拟的创新之源and Stanford stands at the center of that,斯坦福则位于这一切的中心creating new companies,创立起新公司new schools of thought,和新的思想学派prize-winning professors,充满获奖教授inspired art and literature,启迪知识与智慧miracle drugs,研发出神奇药物and amazing graduates.培养出了不起的毕业生Whether you are a scientist with a new discovery,无论你是得到新发现的科学家or working in the trenches to understand the needs of the most marginalized,还是奋战于满足边缘人群需求最前线的人you are advancing amazing breakthroughs in what human beings can do for each other.你都是在推动人类相互帮助上的伟大突破At the same time, if you ask people across the ed States同时在美国范围内 如果你问人们is the future going to be better than the past,未来会比过去更好吗most say no.大多数人会说 不会My kids will be worse off than I am.我的子孙会比我过得糟糕They think innovation wont make the world better for them or their children.他们认为创新不会让他们及子孙的世界变得更好So who is right?到底谁对呢The people who say innovation will create new possibilities and make the world better?是那些声称创新能够创造新机遇并让世界变得更好的人201412/346821。
  • Clearly, people didnt want us to talk about death,显而易见,人们并不希望我们和他们谈论死亡,or, we thought that.或者,我们自己如此认为。So with loads of funding from the Federal Government所以,在联邦政府和地方卫生部门资金的持下and the local Health Service, we introduced a thing我们在John Hunter医院引入了at John Hunter called Respecting Patient Choices.一个名为“尊重病人的选择”的项目We trained hundreds of people to go to the wards我们培训了成百上千的工作人员,and talk to people about the fact that they would die,派他到病房去告诉别人他们大限将至and what would they prefer under those circumstances.然后问他们有什么打算。They loved it. The families and the patients, they loved it.此举受到病人和家属的欢迎。Ninety-eight percent of people really thought98%的人真的认为this just should have been normal practice,这应该成为一种常态化的做法,and that this is how things should work.同时,这也是顺应自然的做法。And when they expressed wishes,而当这些病人表达他们的意愿的时候,all of those wishes came true, as it were.所有这些意愿都可以实现。We were able to make that happen for them.我们可以帮他们实行他们的意愿。But then, when the funding ran out,然而,当这笔资金用完之后中,we went back to look six months later,六个月后我们再来评估这一项目,and everybody had stopped again,这一做法又被停止了。and nobody was having these conversations anymore.也没有人去进行这方面的谈话了。So that was really kind of heartbreaking for us,这是一种很令我们心酸的结局,because we thought this was going to really take off.因为我们一直以为,这会成为一种常态化的东西。The cultural issue had reasserted itself.文化问题又一次得到了体现。So heres the pitch:这就是问题所在。I think its important that we dont just get on this freeway我认为,在我们决定走上去ICU这条路时,to ICU without thinking hard about whether or not我们真的要想thats where we all want to end up,我们是否真的想死在ICU里,particularly as we become older and increasingly frail这点在我们老态龙钟和变得脆弱不堪时尤其重要,and ICU has less and less and less to offer us.这时,ICU能为我们做的事情是少之又少的。There has to be a little side road如果不去ICU,肯定还有其它的选择的off there for people who dont want to go on that track.前提是——你不想死在ICU里。And I have one small idea,而对于可能发生的事,我有一个“小”主意and one big idea about what could happen.我一个“大”主意And this is the small idea.我的小主意是:The small idea is, lets all of us让我们所有人engage more with this in the way that Jason has illustrated.更多地象Jason所描述的那样。Why cant we have these kinds of conversations我们为什么就不能和Jason一样with our own elders和我们的长辈and people who might be approaching this?或者那些正在慢慢变老的人和Jason一样谈一下这个问题呢?There are a couple of things you can do.你可以为此做一些事情。One of them is, you can,其中一个是,just ask this simple question. This question never fails.你只需问一个简单的问题。这是一个很有用的问题。;In the event that you became too sick to speak for yourself,“万一你病得不能讲话了,who would you like to speak for you?;你想让谁代你表达你的心声呢?”Thats a really important question to ask people,这真是一个非常重要的问题,because giving people the control over who that is这是因为,给予谁这个权利produces an amazing outcome.会给你带来不同的结局。The second thing you can say is,你可以说的第二个事情是,;Have you spoken to that person“你和哪个人谈过了about the things that are important to you你认为对你来说是很重要的事吗so that weve got a better idea of what it is we can do?;那样我们就比较清楚我们能为你做些什么。So thats the little idea.这就是我的“小”主意。The big idea, I think, is more political.我的大主意,我认为更实用。I think we have to get onto this.我认为,我们必须做好一件事。I suggested we should have Occupy Death.我建议搞一个“占领死亡”运动(Occupy Death)My wife said, ;Yeah, right, sit-ins in the mortuary.我妻子对我说,“对,对,到太平间去静坐”Yeah, yeah. Sure.;对,应该的。So that one didnt really run,所以,这个行不通,but I was very struck by this.但我还是受到一些打击的。Now, Im an aging hippie.现在,我是一个老嬉皮士。I dont know, I dont think I look like that anymore, but我不知道,我并不认为我还象一个嬉皮士,但是I had, two of my kids were born at home in the 80s在90年代,我的两个小孩都是在家里生产的when home birth was a big thing, and we baby boomers那时,在家生小孩是件大事,而我们这帮婴儿潮年代出生的人are used to taking charge of the situation,已经习惯了处理这些事,so if you just replace all these words of birth,所以,如果你要替换掉这些关于生产的字,I like ;Peace, Love, Natural Death; as an option.我会选择“和平、爱和自然死亡”I do think we have to get political我真的认为,我们必须得面对现实and start to reclaim this process from并且重申这一进程the medicalized model in which its going.从我们现行的医疗化模型中解放出来Now, listen, that sounds like a pitch for euthanasia.听走来,好像我又在鼓吹安乐死。I want to make it absolutely crystal clear to you all,我想向各位澄清一下I hate euthanasia. I think its a sideshow.我讨厌安乐死。我认为那是一个次要的问题。I dont think euthanasia matters.我不认为安乐死会有什么好处I actually think that,事实上,我认为,in places like Oregon,在象Oregon这类地方,where you can have physician-assisted suicide,你可以寻求到一些在医生的辅助下的自杀方式,you take a poisonous dose of stuff,你可以吃点毒药之类的东西,only half a percent of people ever do that.可只有0.5%的人做过这样的蠢事。Im more interested in what happens to the 99.5 percent其实,我对其它的99.5%的of people who dont want to do that.不想通过毒而死去的人感兴趣。I think most people dont want to be dead,我想,大多数人都不想死,but I do think most people want to have some control但我认为,大多数人都想能够控制over how their dying process proceeds.自己死亡的过程。So Im an opponent of euthanasia,所以,我反对安乐死,but I do think we have to give people back some control.但我又认为,我们应该给病重的人一些自己控制权。It deprives euthanasia of its oxygen supply.这能够让安乐死失去理由。I think we should be looking at stopping我认为,我们应该去尝试了解病人the want for euthanasia,想要安乐死背后的原因,not for making it illegal or legal or worrying about it at all.而不只是让它合法代或非法,或者毫不关心。This is a e from Dame Cicely Saunders,这是Dame Cicely Saunders的一句话,whom I met when I was a medical student.我还是一个医学院学生的时候遇过她She founded the hospice movement.她创立了护理所运动。And she said, ;You matter because you are,她说,“你就是你,你是重要的,and you matter to the last moment of your life.;直到你生命的最后一刻。“And I firmly believe that我坚定地相信thats the message that we have to carry forward.这是我们应该继续前行的旨意Thank you.谢谢201507/388609。
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