第三十六章 值班
1.Almost everyone who goes to bed counts upon a full night’s rest: like a picket at the outposts, the doctor must be ever on call.
—— Karl Marx, 1796——1877
【译文】哪个上床睡觉的人不指望能美美睡上一夜，但医生必须像站岗的哨兵一样随时待命。
2.The surgeon's life is a very hard one.It is a life of endless strain.During most of the hours of every day his faculties are keyed up tense almost to the breaking point, and physical tire goes hand in hand with mental exhaustion.
—— J.Chalmers Da Costa, 1863——1933
【译文】外科医生的职业生涯很艰辛。生活充满无尽压力。每天大部分时间里，他的全部精力紧张到几乎要崩溃的地步，身体的劳累和精神疲惫如影随形。
3.Important decisions often have to be made at night when the physician,weary with the day’s work, and with perceptions and reasoning faculties somewhat jabbed, is both physically and mentally below his best.
—— Zachary Cope, 1881——1974
【译文】白天的工作已经让医生筋疲力尽，认知和推理能力都受到过一轮打击，无论是体力还是精神都不在最佳状态，然而夜幕降临，他们还是经常不得不做出重要决断。
【点评】为避免医生在这种不在状况的情况下犯错误，除医生本人主观上高度警惕外，管理者也应该对医生的劳逸状况给予关注。
4.Midnight calls are not made for the sake of hearing the surgeon's voice.
—— Mark M.Ravitch, 1910——1989
【译文】半夜三更的来电，不是就为了听听外科医生的声音。
【点评】所以从拿起电话那一刻开始就须打起十二分的精神。
5.If you stay up all day, you'll stay up all night.
【译文】你熬了一整天，可能还要熬一个通宵。
【点评】有时当值医生的运气就是那么差。
6.The progress of disease is not suspended between 5pm and morning rounds.
—— Mark M.Ravitch, 1910——1989(https://www.daowen.com)
【译文】晚上5点到早查房这段时间，不要指望疾病会停止进展。
7.Everything gets worse at night.
【译文】所有事情都是在晚上变坏的。
【点评】其实很多事情是白天没在意或没及时处理拖延至晚上的。
8.If you don't operate on your night on call you'll operate on your night off call.
【译文】要是当班的那晚没做手术，那么你就有可能在轮休的那晚被叫去做手术。
【点评】对有些病情的变化不要心存侥幸，该及时处理的不要企图可以躲过去。
9.Never walk through the ER unless you are called.
—— Moshe Schein
【译文】除非有人传唤你，否则不要路经急诊室。
【点评】想找活干的年轻医生倒是可多到急诊室转转。
10.If you arrive in the ER and don't know what to do, start putting in tubes until somebody arrives who knows.
—— Rip Pielfer
【译文】当你到达急诊室不知道该做什么时，就开始插各种管子，直到明白人到场。
【点评】初到急诊室的年轻医生，当你遇到一例危重急症患者不知从何下手时，请一定记住这个原则。
11.If he didn't want an operation why did he come to the ER at this time of night.
【译文】如果他不想做手术，为什么晚上这个时候还来急诊室呢？
【点评】那可不一定，晚上来急诊室就诊的外科患者未必都得马上做手术。