TEDxKrakow
Tal Golesworthy: How I repaired my own heart
Tal Golesworthy: 我是如何修復了我自己的心臟
Filmed:
Readability: 4.6
1,418,296 views
Tal Golesworthy 是一個鍋爐工程師 - 他擅長管道和水管設施。當他需要透過手術來解決關乎到他生命的大動脈的問題時，他結合了他的工程師技術和他的醫生的醫療知識，並設計了一個更好的修復方式。
Tal Golesworthy - Engineer and artist
Tal Golesworthy is an engineer and entrepreneur, working in research and development of combustion and air pollution control -- until he decided to innovate in his own health. Full bio
Tal Golesworthy is an engineer and entrepreneur, working in research and development of combustion and air pollution control -- until he decided to innovate in his own health. Full bio
Double-click the English transcript below to play the video.
00:15
I'm a process engineer.
0
0
2000
我是一個製程工程師。
00:17
I know all about boilers and incinerators
1
2000
3000
我知道關於鍋爐和焚化爐的一切，
00:20
and fabric filters and cyclones and things like that,
2
5000
3000
包括像織物過濾器和旋風分離器一樣的東西。
00:23
but I also have Marfan syndrome.
3
8000
2000
但我也患有馬凡氏症候群。
00:25
This is an inherited disorder.
4
10000
3000
它是一個遺傳性疾病。
00:28
And in 1992
5
13000
2000
在1992年，
00:30
I participated in a genetic study
6
15000
2000
我參加了一項基因研究，
00:32
and found to my horror, as you can see from the slide,
7
17000
3000
我驚恐的發現，如同你從投影片上所看到的，
00:35
that my ascending aorta was not in the normal range,
8
20000
3000
我的升主動脈不在底下那條綠線標示出的
00:38
the green line at the bottom.
9
23000
2000
正常範圍之內。
00:40
Everyone in here will be between 3.2 and 3.6 cm.
10
25000
3000
在座的每位的升主動脈都會在 3.2 到 3.6 公分之內，
00:43
I was already up at 4.4.
11
28000
3000
而我的是 4.4.
00:46
And as you can see,
12
31000
2000
如你所見，
00:48
my aorta dilated progressively,
13
33000
2000
我的主動脈不斷的擴大，
00:50
and I got closer and closer
14
35000
2000
而我也離需要手術的階段
00:52
to the point where surgery was going to be necessary.
15
37000
3000
越來越近。
00:55
The surgery on offer was pretty gruesome --
16
40000
3000
這項手術有些可怕 -
00:58
anesthetize you, open your chest,
17
43000
3000
麻醉你後將你的胸腔打開，
01:01
put you on an artificial heart and lung machine,
18
46000
3000
將你接上人工心肺儀器，
01:04
drop your body temperature to about 18 centigrade,
19
49000
3000
將你的身體溫度降到大約攝氏18度左右，
01:07
stop your heart, cut the aorta out,
20
52000
3000
停止你的心臟跳動，切除大動脈，
01:10
replace it with a plastic valve and a plastic aorta,
21
55000
3000
替換上人工瓣膜和人工大動脈，
01:13
and, most importantly,
22
58000
2000
最後，最重要的，
01:15
commit you to a lifetime of anticoagulation therapy,
23
60000
3000
你將一輩子需要使用華法令阻凝劑的
01:18
normally warfarin.
24
63000
2000
抗凝療法。
01:20
The thought of the surgery was not attractive.
25
65000
3000
手術這件事情聽起來不是很吸引人，
01:23
The thought of the warfarin
26
68000
2000
而需要使用華法令阻凝劑的這個想法
01:25
was really quite frightening.
27
70000
2000
讓我感到非常害怕。
01:27
So I said to myself, I'm an engineer, I'm in R and D,
28
72000
3000
所以我告訴自己，我是一名搞研究開發的工程師，
01:30
this is just a plumbing problem.
29
75000
2000
這只是一個像水管的問題，
01:32
I can do this. I can change this.
30
77000
2000
我可以自己搞定，我可以改變它。
01:34
So I set out
31
79000
2000
於是我開始嘗試
01:36
to change the entire treatment
32
81000
2000
改變對於動脈擴張的
01:38
for aortic dilation.
33
83000
3000
全部療程。
01:41
The project aim is really quite simple.
34
86000
4000
我的目標非常簡單。
01:45
The only real problem with the ascending aorta
35
90000
3000
有著馬凡氏癥候群的人的升大動脈的
01:48
in people with Marfan syndrome
36
93000
2000
唯一真正地問題
01:50
is it lacks some tensile strength.
37
95000
2000
就是它缺乏張力。
01:52
So the possibility exists
38
97000
2000
所以有一個可能便是
01:54
to simply externally wrap the pipe.
39
99000
4000
將血管從外面包住，
01:58
And it would remain stable and operate quite happily.
40
103000
3000
它便可以保持穩定並正常的運作。
02:01
If your high-pressure hose pipe,
41
106000
2000
如果你的高壓水管，
02:03
or your high-pressure hydraulic line, bulges a little,
42
108000
3000
或你的高壓液壓管路有一點點的膨脹，
02:06
you just wrap some tape around the outside of it.
43
111000
2000
你只需要用一些膠帶纏繞住它的外面。
02:08
It really is that simple in concept,
44
113000
3000
這個原理非常簡單，
02:11
though not in execution.
45
116000
3000
但在執行上卻恰恰相反。
02:14
The great advantage of an external support for me
46
119000
3000
這種外部的支撐對我有一個很大的好處，
02:17
was that I could retain all of my own bits,
47
122000
3000
那就是我可以保持我自己身體的部份，
02:20
all of my own endothelium and valves,
48
125000
2000
我自己所有的內皮和瓣膜，
02:22
and not need any anticoagulation therapy.
49
127000
3000
以及不需要任何的抗凝療法。
02:25
So where do we start?
50
130000
2000
那我們從哪裡開始呢？
02:27
Well this is a sagittal slice through me.
51
132000
3000
這是我的一個矢狀切片，
02:30
You could see in the middle
52
135000
2000
你可以看到在中間
02:32
that device, that little structure, squeezing out.
53
137000
3000
有個很小的結構在往外擠壓。
02:35
Now that's a left ventricle
54
140000
2000
那是左心室
02:37
pushing blood up through the aortic valve --
55
142000
2000
在通過主動脈辦 -
02:39
you can see two of the leaflets of the aortic valve working there --
56
144000
4000
你可以看到主動脈瓣的兩個瓣膜在工作 -
02:43
up into the ascending aorta.
57
148000
2000
往升大動脈中壓血。
02:45
And it's that part, the ascending aorta,
58
150000
2000
而升大動脈的
02:47
which dilates and ultimately bursts,
59
152000
4000
擴大和最終的破裂
02:51
which, of course, is fatal.
60
156000
3000
終將致命。
02:54
We started by organizing image acquisition
61
159000
3000
我們從排列核磁共振
02:57
from magnetic resonance imaging machines
62
162000
3000
和電腦斷層掃描
03:00
and CT imaging machines
63
165000
2000
得到的照片開始，
03:02
from which to make a model
64
167000
3000
來為患者的大動脈
03:05
of the patient's aorta.
65
170000
3000
建造一個模型。
03:08
This is a model of my aorta.
66
173000
3000
這是我的大動脈的模型。
03:11
I've got a real one in my pocket,
67
176000
2000
我的口袋裏面有一個真的模型，
03:13
if anyone would like to look at it and play with it.
68
178000
3000
如果有人想看並把玩一下。
03:16
You can see, it's quite a complex structure.
69
181000
2000
你可以看到，它的構造有些複雜。
03:18
It has a funny trilobal shape at the bottom,
70
183000
3000
它下方一個奇怪的三葉形的形狀
03:21
which contains the aortic valve.
71
186000
2000
包括了主動脈瓣。
03:23
It then comes back into a round form
72
188000
2000
接著它慢慢變成了圓形，
03:25
and then tapers and curves off.
73
190000
2000
並逐漸變細。
03:27
So it's quite a difficult structure
74
192000
2000
所以的確是個滿難建造的
03:29
to produce.
75
194000
3000
一個架構
03:32
This, like I say, is a CAD model of me,
76
197000
2000
這個，就像我說的，是我的電腦輔助設計出來的模型，
03:34
and this is one of the later CAD models.
77
199000
2000
而這個是最新的模型之一。
03:36
We went through an iterative process
78
201000
2000
爲了建造更好的模型，
03:38
of producing better and better models.
79
203000
2000
我們經歷了很多反複的步驟。
03:40
When we produced that model
80
205000
3000
當我們建造這個模型的時候，
03:43
we turn it into a solid plastic model,
81
208000
3000
正如你所見，
03:46
as you can see,
82
211000
2000
我們利用快速成型技術，
03:48
using a rapid prototyping technique,
83
213000
2000
一種工程技術，
03:50
another engineering technique.
84
215000
2000
把它變成了一個實體塑料模型。
03:52
We then use that former
85
217000
2000
我們接著用先前的模型
03:54
to manufacture a perfectly bespoke
86
219000
2000
來生產一個完全預製的
03:56
porous textile mesh,
87
221000
2000
以之前的模型為形狀
03:58
which takes the shape of the former
88
223000
2000
完全適合大動脈的
04:00
and perfectly fits the aorta.
89
225000
2000
多孔紡織網。
04:02
So this is absolutely personalized medicine
90
227000
2000
所以這是完完全全的
04:04
at its best really.
91
229000
2000
最好的個體化醫療。
04:06
Every patient we do
92
231000
2000
我們的每一個病患
04:08
has an absolutely bespoke implant.
93
233000
4000
都有一個完全為他們訂製的植入物。
04:12
Once you've made it, the installation's quite easy.
94
237000
3000
當你建造了它后，裝上它還算簡單。
04:15
John Pepper, bless his heart,
95
240000
3000
John Pepper，上帝保佑他，
04:18
professor of cardiothoracic surgery --
96
243000
2000
他是一位心胸外科的教授 -
04:20
never done it before in his life --
97
245000
2000
在他的生涯中，之前從未做過這個手術。
04:22
he put the first one in, didn't like it, took it out, put the second one in.
98
247000
2000
他將第一個放進去后，覺得不怎麼好，拿了出來，又放了第二個進去。
04:24
Happy, away I went.
99
249000
2000
然後我開心的離開了。
04:26
Four and a half hours on the table and everything was done.
100
251000
3000
躺在手術臺上四個半小時，然後一切都搞定了。
04:29
So the surgical implantation actually was the easiest part.
101
254000
4000
所以手術植入其實是最簡單的部份。
04:33
If you compare our new treatment to the existing alternative,
102
258000
3000
如果你將我們的新療法和現有的
04:36
the so-called composite aortic root graft,
103
261000
3000
所謂的複合主動脈根部移植物來做比較，
04:39
there are one of two startling comparisons,
104
264000
2000
有兩個讓人吃驚的發現。
04:41
which I'm sure will be clear to all of you.
105
266000
3000
我待會會很清楚的展現在各位面前。
04:44
Two hours to install one of our devices
106
269000
2000
裝我們的裝置需要花兩個小時，
04:46
compared to six hours
107
271000
2000
而現有的治療卻需要
04:48
for the existing treatment.
108
273000
2000
六個小時。
04:50
The existing treatment requires, as I've said,
109
275000
2000
現有的治療，就像我所提到的，
04:52
the heart and lung bypass machine
110
277000
2000
需要人工心肺儀器，
04:54
and it requires a total body cooling.
111
279000
2000
並需要完全的冷卻人體。
04:56
We don't need any of that; we work on a beating heart.
112
281000
3000
我們都不需要上面說的那些； 我們是在一個跳動的心臟上做手術。
04:59
He opens you up, he accesses the aorta while your heart is beating,
113
284000
3000
醫生將你的胸腔打開，在對的溫度下，和你的心臟持續跳動之時
05:02
all at the right temperature.
114
287000
2000
揀出大動脈。
05:04
No breaking into your circulatory system.
115
289000
2000
你的血液循環系統也不需要被打斷。
05:06
So it really is great.
116
291000
2000
所以它真的很好。
05:08
But for me, absolutely the best point
117
293000
3000
但對我來說，最好的一點
05:11
is there is no anticoagulation therapy required.
118
296000
3000
是不需要任何的抗凝療法。
05:14
I don't take any drugs at all
119
299000
2000
除了我選擇吃的養生藥物之外，
05:16
other than recreational ones that I would choose to take.
120
301000
2000
我不需要吃任何的藥。
05:18
(Laughter)
121
303000
2000
（笑聲）
05:20
And in fact, if you speak to people who are on long-term warfarin,
122
305000
3000
事實上，如果你和長期使用華法令抗凝療法的人交談，
05:23
it is a serious compromise to your quality of life.
123
308000
3000
你會發現華法令對生活的品質有著嚴重的損害。
05:26
And even worse,
124
311000
2000
更糟的是，
05:28
it inevitably foreshortens your life.
125
313000
2000
它不可避免的會縮短你的生命。
05:30
Likewise, if you have the artificial valve option,
126
315000
3000
同樣的，如果你選擇了人造瓣膜，
05:33
you're committed to antibiotic therapy
127
318000
2000
當你有任何的侵犯性的治療時，
05:35
whenever you have any intrusive medical treatment at all.
128
320000
3000
你都需要使用抗生素療程。
05:38
Even trips to the dentist require that you take antibiotics,
129
323000
3000
連去牙醫那你都需要吃抗生素
05:41
in case you get an internal infection on the valve.
130
326000
3000
來預防任何瓣膜的內部感染。
05:44
Again, I don't have any of that, so I'm entirely free.
131
329000
3000
而我，完全不需要這些，所以我是完全自由的。
05:47
My aorta is fixed, I haven't got to worry about it,
132
332000
3000
我的大動脈被治好了，我不需要擔心它，
05:50
which is a rebirth for me.
133
335000
3000
這對我來說是一個重生。
05:54
Back to the theme of the presentation:
134
339000
2000
重新回到我演講的主題：
05:56
In multidisciplinary research,
135
341000
2000
在跨越多個領域的研究中，
05:58
how on earth does a process engineer used to working with boilers
136
343000
3000
一個習慣和鍋爐工作的製程工程師
06:01
end up producing a medical device
137
346000
2000
是如何建造一個完全改變他自己生命的
06:03
which transforms his own life?
138
348000
2000
醫療儀器？
06:05
Well the answer to that is a multidisciplinary team.
139
350000
3000
一個跨領域的團隊是這個問題的答案。
06:08
This is a list of the core team.
140
353000
3000
這是中心團隊的人員列表。
06:11
And as you can see,
141
356000
2000
就像你所看到的，
06:13
there are not only two principal technical disciplines there,
142
358000
3000
它不僅僅包括了兩個大的領域，
06:16
medicine and engineering,
143
361000
2000
醫學和工程學，
06:18
but also there are various specialists
144
363000
2000
也包括了這兩種領域中的
06:20
from within those two disciplines.
145
365000
2000
各種專業人員。
06:22
John Pepper there
146
367000
2000
John Pepper 是
06:24
was the cardiac surgeon who did the actual work on me,
147
369000
3000
為我動手術的那位心臟外科醫生。
06:27
but everyone else there had to contribute one way or another.
148
372000
3000
但名單中的每一位都做出了一定的貢獻。
06:30
Raad Mohiaddin, medical radiologist:
149
375000
2000
Raad Mohiaddin 是醫療放射專家：
06:32
We had to get good quality images
150
377000
2000
我們需要高質量的圖像
06:34
from which to make the CAD model.
151
379000
2000
來建造電腦輔助冠狀動脈模型。
06:36
Warren Thornton, who still does all our CAD models for us,
152
381000
3000
Warren Thornton 仍然在為我們建造所有的模型。
06:39
had to write a bespoke piece of CAD code
153
384000
3000
他需要為每一個預訂的模型
06:42
to produce this model
154
387000
2000
從一個相當困難的數據輸入資料中
06:44
from this really rather difficult input data set.
155
389000
3000
寫一個特殊的電腦輔助模型編碼。
06:49
There are some barriers to this though. There are some problems with it.
156
394000
3000
但這仍然有些障礙以及問題。
06:52
Jargon is a big one.
157
397000
2000
行業術語是很大的一個。
06:54
I would think no one in this room understands
158
399000
2000
我認為在座的每一位應該都不知道
06:56
those four first jargon points there.
159
401000
3000
前面這四個行業術語。
06:59
The engineers amongst you
160
404000
2000
在座的工程師們
07:01
will recognize rapid prototyping and CAD.
161
406000
2000
可以認出快速成型和電腦輔助設計。
07:03
The medics amongst you, if there are any, will recognize the first two.
162
408000
3000
在座的醫療行業的，如果有的話，可以認出前兩個。
07:06
But there will be nobody else in this room
163
411000
2000
但在座的沒有人
07:08
that understands all of those four words.
164
413000
2000
可以明白全部的四個詞。
07:10
Taking the jargon out was very important
165
415000
2000
將行業術語剔除
07:12
to ensure that everyone in the team
166
417000
2000
對確保團隊中的每個人
07:14
understood exactly what was meant
167
419000
2000
在一個詞被使用時
07:16
when a particular phrase was used.
168
421000
2000
能夠明白它的意思，非常的重要。
07:18
Our disciplinary conventions were funny as well.
169
423000
3000
各個行業習慣的不同也非常有趣。
07:21
We took a lot of horizontal slice images through me,
170
426000
3000
透過我，我們得到了很多橫切圖像，
07:24
produced those slices and then used those to build a CAD model.
171
429000
4000
製造這些切片圖像並用他們來建造電腦輔助設計模型。
07:28
And the very first CAD model we made,
172
433000
2000
我們建造的第一個模型，
07:30
the surgeons were playing with the plastic model,
173
435000
3000
外科醫生在把玩了這個塑料模型後
07:33
couldn't quite figure it out.
174
438000
2000
不太能夠完全理解。
07:35
And then we realized that it was actually a mirror image
175
440000
2000
然後我們意識到它是真的大動脈的
07:37
of the real aorta.
176
442000
2000
翻版。
07:39
And it was a mirror image
177
444000
2000
它是一個鏡像圖像
07:41
because in the real world we always look down on plans,
178
446000
3000
因為在現實中我們總是從上面的角度往下看，
07:44
plans of houses or streets or maps.
179
449000
3000
房子或者是街道的規劃圖或地圖。
07:47
In the medical world they look up at plans.
180
452000
3000
在醫學的世界中，他們是由下往上看規劃圖，
07:50
So the horizontal images were all an inversion.
181
455000
3000
所以橫切圖像是完全相反的。
07:53
So one needs to be careful with disciplinary conventions.
182
458000
3000
所以我們也要注意行業的習慣。
07:56
Everyone needs to understand
183
461000
2000
每個人都需要明白
07:58
what is assumed and what is not assumed.
184
463000
3000
什麽是假設的，什麽是沒有被假設的。
08:01
Institutional barriers
185
466000
2000
制度性障礙
08:03
were another serious headache in the project.
186
468000
3000
是項目中另一個讓人頭痛的問題。
08:06
The Brompton Hospital was taken over
187
471000
2000
布朗普頓醫院在被
08:08
by Imperial College's School of Medicine,
188
473000
2000
帝國學院的醫學院接管後，
08:10
and there are some seriously bad relationship problems
189
475000
3000
兩個機構之間存在著
08:13
between the two organizations.
190
478000
2000
非常嚴重的問題。
08:15
I was working with Imperial and the Brompton,
191
480000
2000
我在和帝國和布朗普頓合作的時候，
08:17
and this generated some serious problems with the project,
192
482000
3000
因為兩者之間的問題使得我們的計畫產生了一些嚴重的問題，
08:20
really problems that shouldn't exist.
193
485000
3000
一些其實根本就不應該存在的問題。
08:23
Research and ethics committee: If you want to do anything new in surgery,
194
488000
3000
研究和倫理委員會： 如果你想在手術中做些新的嘗試，
08:26
you have to get a license from your local research and ethics.
195
491000
3000
你必須先從當地的研究和倫理委員會處獲得許可證。
08:29
I'm sure it's the same in Poland.
196
494000
2000
我確定波蘭也是這樣的。
08:31
There will be some form of equivalent,
197
496000
3000
那將會有一些類似的程序
08:34
which licenses new types of surgery.
198
499000
3000
來許可新的類型的手術。
08:37
We didn't only have the bureaucratic problems associated with that,
199
502000
3000
我們不僅僅有著和這有關的官僚問題，
08:40
was also had professional jealousies.
200
505000
2000
我們還遭到了一些同行的嫉妒。
08:42
There were people on the research and ethics committee
201
507000
2000
有些在研究和倫理委員會的人
08:44
who really didn't want to see John Pepper succeed again,
202
509000
3000
並不希望 John Pepper 再次成功，
08:47
because he's so successful.
203
512000
2000
因為他已經是如此的有成就。
08:49
And they made extra problems for us.
204
514000
3000
所以他們對我們造成了很多多餘的問題，
08:53
Bureaucratic problems:
205
518000
2000
官僚問題：
08:55
Ultimately when you have a new treatment
206
520000
3000
當你有一個新的療程的時候，
08:58
you have to have a guidance note going out
207
523000
2000
最終你必須給國內的每個醫院寄出一個
09:00
for all of the hospitals in the country.
208
525000
2000
指導說明。
09:02
In the U.K. we have the National Institute for Clinical Excellence, NICE.
209
527000
2000
在英國，我們有國家衛生醫療質量標準署，簡稱NICE。
09:04
You'll have an equivalent in Poland, no doubt.
210
529000
3000
你們在波蘭毫無疑問的也有類似的機構。
09:07
We had to get past the NICE problem.
211
532000
3000
我們必須通過NICE這一關。
09:10
We now have a great clinical guidance out on the Net.
212
535000
3000
我們現在在網路上有一個很好的臨床指導書。
09:13
So any of the hospitals interested
213
538000
2000
所以每個有興趣的醫院
09:15
can come along, read the NICE report
214
540000
3000
都可以上網讀這份報告，
09:18
get in touch with us and then get doing it themselves.
215
543000
3000
和我們聯繫，然後自己可以開始進行這項手術。
09:23
Funding barriers:
216
548000
2000
資金障礙：
09:25
Another big area to be concerned with.
217
550000
3000
資金來源是另一個需要考量的大問題。
09:29
A big problem with understanding one of those perspectives:
218
554000
3000
另一個個跟理解這個願景的情況的大問題是
09:32
When we first approached
219
557000
2000
當我們第一次跟英國提供這種資金援助的
09:34
one of the big U.K. charitable organizations that funds this kind of stuff,
220
559000
4000
大的慈善機構之一接洽的時候，
09:38
what they were looking at was essentially an engineering proposal.
221
563000
3000
從他們的角度看，根本是一個工程提案。
09:41
They didn't understand it; they were doctors, they were next to God.
222
566000
2000
他們看不懂； 因為他們是醫生，他們僅次於上帝。
09:43
It must be rubbish. They binned it.
223
568000
2000
所以它肯定是垃圾。 於是他們將它扔了。
09:45
So in the end I went to private investors
224
570000
2000
所以最後，我放棄了。
09:47
and I just gave up on it.
225
572000
2000
我轉而去找私人投資者。
09:49
But most R and D is going to be institutionally funded,
226
574000
3000
但大多數的研究開發資金來源都是來自於
09:52
by the Polish Academy of Sciences
227
577000
2000
波蘭科學學院，
09:54
or the Engineering and Physical Sciences Research Council or whatever,
228
579000
4000
或者是工程物理研究院類似的機構，
09:58
and you need to get past those people.
229
583000
2000
然後你必須通過這些人的審核。
10:00
Jargon is a huge problem when you're trying to work across disciplines,
230
585000
3000
當你嘗試跨領域工作時，行業術語是 一個大問題。
10:03
because in an engineering world,
231
588000
2000
因為在工程師的世界裡，
10:05
we all understand CAD and R.P. --
232
590000
2000
我們都懂什麼是CAD和R.P. --
10:07
not in the medical world.
233
592000
2000
但醫療世界工作者卻不會懂。
10:09
I suppose ultimately the funding bureaucrats have really got to get their act together.
234
594000
3000
我覺得最終，贊助的機構一定要開始有所作為，
10:12
They've really got to start talking to each other,
235
597000
2000
要開始和其他機構溝通，
10:14
and they've got to exercise a bit of imagination,
236
599000
3000
並且開始運用一些想像力。
10:17
if that's not too much to ask --
237
602000
3000
如果不是個太過份的要求的話，
10:20
which it probably is.
238
605000
3000
但事實上可能是。
10:23
I've coined a phrase "obstructive conservatism."
239
608000
3000
我創造了一個叫做”妨礙性保守主義“ 的詞。
10:26
So many people in the medical world don't want to change,
240
611000
3000
很多醫療世界中的人不想要改變，
10:29
particularly not when some jumped-up engineer has come along with the answer.
241
614000
3000
特別是當一個工程師突然莫名其妙的跳出來並帶來了答案。
10:32
They don't want to change.
242
617000
2000
他們不想改變。
10:34
They simply want to do whatever they've done before.
243
619000
2000
他們只想做以前一直都在做的。
10:36
And in fact, there are many surgeons in the U.K.
244
621000
2000
事實上，很多英國的外科醫生
10:38
still waiting for one of our patients
245
623000
3000
仍然在等著我們病患中的某個人
10:41
to have some sort of episode,
246
626000
2000
發生一些問題，
10:43
so that they can say, "Ah, I told you that was no good."
247
628000
3000
好讓他們可以說： 『你看！我跟你說那個是不好的。』
10:46
We've actually got 30 patients.
248
631000
2000
我們目前有30個病患。
10:48
I'm at seven and a half years.
249
633000
2000
我的手術到現在已經7年半。
10:50
We've got 90 post-op patient years between us,
250
635000
2000
所有的病患手術後加起來的時間有90年，
10:52
and we haven't had a single problem.
251
637000
2000
但我們到目前都沒有任何問題。
10:54
And still, there are people in the U.K. saying,
252
639000
2000
但還是有英國人在說，
10:56
"Yeah, that external aortic root, yeah, it'll never work, you know."
253
641000
3000
『喔，那個外部大動脈支撐喔，它不會有效的。』
10:59
It really is a problem. It really is a problem.
254
644000
2000
這真的是個問題，真的是個問題。
11:01
I'm sure everyone in this room has come across arrogance
255
646000
3000
我確定在座的每位都在
11:04
amongst medics, doctors, surgeons at some point.
256
649000
4000
醫療界，醫生，外科醫生那裡經歷過傲慢的態度。
11:08
The middle point is simply
257
653000
2000
這僅僅是
11:10
the way that the doctors protect themselves.
258
655000
3000
醫生們保護他們自己的折衷方法。
11:13
"Yeah, well of course, I'm looking after my patient."
259
658000
3000
『我當然要照顧我的病患。』
11:16
I think it's not good, but there you are, that's my view.
260
661000
3000
我覺得這種想法是不好的，但你看。這是我的想法。
11:19
Egos, of course, again, a huge problem
261
664000
2000
自傲，當然，也是 一個很大的問題。
11:21
If you're working in a multidisciplinary team,
262
666000
2000
當你在一個跨領域的團隊裏面工作，
11:23
you've got to give your guys the benefit of the doubt.
263
668000
3000
你必須相信你的隊友，
11:26
You've got to express support for them.
264
671000
2000
必須表達對他們的支持。
11:28
Tom Treasure, professor of cardiothoracic surgery:
265
673000
3000
Tom Treasure，一位心胸外科教授，
11:31
incredible guy.
266
676000
2000
令人難以置信的一個人。
11:33
Dead easy to give him respect.
267
678000
2000
尊重他是件很容易的事情。
11:35
Him giving me respect? Slightly different.
268
680000
3000
他給我尊重？這就有點不同了。
11:38
That's all the bad news.
269
683000
2000
這些都是不好的消息。
11:40
The good news is the benefits are stonkingly huge.
270
685000
4000
好消息是它的益處非常的大。
11:44
Translate that one. I bet they can't.
271
689000
2000
翻譯這個。我賭他們不能。
11:46
(Laughter)
272
691000
2000
（笑聲）
11:48
When you have a group of people
273
693000
2000
當你有一群
11:50
who have had a different professional training, a different professional experience,
274
695000
3000
有不同的專業訓練和經驗的人，
11:53
they not only have a different knowledge base,
275
698000
2000
他們不僅僅有著不同的知識基礎，
11:55
but they have a different perspective on everything.
276
700000
2000
他們也對每個事物有不同的觀點。
11:57
And if you can bring those guys together
277
702000
2000
如果你能將這些人都聚在一起
11:59
and you can get them talking and understanding each other,
278
704000
3000
讓他們開始交流並且互相理解對方，
12:02
the results can be spectacular.
279
707000
3000
結果將會是非常的好。
12:05
You can find novel solutions, really novel solutions,
280
710000
3000
你可以找到新的解決方案，非常新的方案，
12:08
that have never been looked at before
281
713000
2000
甚至是從來沒有被看過的，
12:10
very, very quickly and easily.
282
715000
2000
非常，非常的快和容易。
12:12
You can shortcut huge amounts of work
283
717000
3000
使用這些延長的知識庫，
12:15
simply by using the extended knowledge base you have.
284
720000
3000
你便可以減少很多的工作量。
12:18
And as a result,
285
723000
2000
結果便是
12:20
it's an entirely different use of the technology
286
725000
3000
一個使用科技和你周遭的知識
12:23
and the knowledge around you.
287
728000
3000
的一個完全不同的方式。
12:26
The result of all this
288
731000
2000
這一切的結果便是
12:28
is that you can get incredibly quick progress
289
733000
3000
在很小的資金下
12:31
on incredibly small budgets.
290
736000
2000
可以獲得很快的進展。
12:33
I'm so embarrassed at how cheap it was
291
738000
2000
我對從我的想法到接受手術植入變為現實
12:35
to get from my idea to me being implanted
292
740000
3000
花了多麼少的錢而感到羞愧，
12:38
that I'm not prepared to tell you what it cost.
293
743000
2000
所以我並不打算告訴你們花了多少錢。
12:40
Because I suspect there are
294
745000
2000
因為我認為
12:42
absolutely standard surgical treatments
295
747000
2000
完全的標準手術療程是存在的，
12:44
probably in the USA
296
749000
2000
可能在美國是有的。
12:46
which cost more
297
751000
2000
這樣的情況下
12:48
for a one-off patient
298
753000
3000
在一個病患上的花費
12:51
than the cost of us getting from my dream
299
756000
3000
都比從將我的夢想到變為真實
12:54
to my reality.
300
759000
2000
的花費來得更多。
12:56
That's all I want to say, and I've got three minutes left.
301
761000
3000
以上是我所想說的，而我還有三分鐘的時間。
12:59
So Heather's going to like me.
302
764000
2000
所以Heather將會很開心。
13:01
If you have any questions, please come up and talk to me later on.
303
766000
3000
如果你有任何問題，請待會上來跟我聯繫。
13:04
It would be a pleasure to speak with you. Many thanks.
304
769000
3000
這將是我的榮幸。感謝大家。
ABOUT THE SPEAKER
Tal Golesworthy - Engineer and artistTal Golesworthy is an engineer and entrepreneur, working in research and development of combustion and air pollution control -- until he decided to innovate in his own health.
Why you should listen
Tal Golesworthy is an experienced engineer and entrepreneur who branched out into bio-engineering in response to his own dilated aorta. His company now funds the research and development of devices that will help people with aortic dilation avoid major surgery and lifelong drug therapy.
He also has considerable expertise over a wide range of combustion and process plant including conventional and novel combustion systems, and his background has also included several years as an information scientist, and hot gas cleaning.
Tal Golesworthy | Speaker | TED.com