Complications: A Surgeon's Notes on an Imperfect Science 医生的修炼

Part I - Fallibility (孰能无过)

Chapter: Education of a Knife (一把刀的修炼)

central line: [Central venous catheter](<https://en.wikipedia.org/wiki/Central_venous_catheter>) [中心靜脈導管](<https://zh.wikipedia.org/wiki/%E4%B8%AD%E5%BF%83%E9%9D%9C%E8%84%88%E5%B0%8E%E7%AE%A1>)

tetanus 破伤风。由「破伤风梭菌」引起的一种细菌感染性疾病，体表伤口如果被破伤风梭菌污染，在缺氧条件下，细菌的芽孢会萌发，产生破伤风痉挛毒素。这是一种毒性很强的神经毒素，微量作用于神经系统，即可导致严重肌痉挛症状，进而可能造成死亡。

被动免疫
* TAT（TAT，Tetanus Antitoxin 破伤风抗毒素。便宜（需皮试防止过敏）
* TIG （TIG ，Human Tetanus Immunoglobulin）人破伤风免疫球蛋白。注射后即刻产生免疫效果，但持续时间较短，免疫时间为2周，一般不超过3周。贵。

免疫制剂分为主动免疫制剂 & 被动免疫制剂。
* 主动免疫：注射“细菌标记物”，人体免疫系统识别后，自己产生抗体（需要一定时间，但持续时间长）
* 被动免疫：从外界输入抗体（见效快，但持续时间短），拿来就用。

Chapter: The Computer and the Hernia Factory (像机器一样精准)

hernia: 疝气；脱肠

Chapter: When Doctors Make Mistakes (切烂的喉咙)

EMT: emergency medical technician

Vital signs
* responsiveness to pain
* **Pulse** rate
* **Blood pressure** (BP)
* **Respiration** rate (rate of breathing)
* Body **temperature**
* oxygen saturation (O2 sat) (动脉)血氧饱和度。正常人> 95%
  * oximeter 夹在手指上的[非侵入式血氧饱和度测量仪器](<https://zh.wikipedia.org/wiki/%E8%84%89%E6%90%8F%E6%B0%A7%E9%A5%B1%E5%92%8C%E5%BA%A6%E6%B3%95>) (血氧儀)

Chapter: Nine Thousand Surgeons (9000个医生的嘉年华)

Chapter: When Good Doctors Go Bad (好医生是怎么变坏的)

Morbidity and mortality conferences (MMCs) are a long-held legacy institution in academic medicine that enable medical providers and hospital administrators to learn from systemic and individual errors, thereby leading to improved medical care. Originally, this forum had 1 major role—education.

Part II Mystery (难解之谜)

Chapter: Full Moon Friday the Thriteenth (13号、星期五、月圆夜)

[Friday the 13th](<https://en.wikipedia.org/wiki/Friday_the_13th>) 西方文化认为[13號星期五](<https://zh.wikipedia.org/wiki/13%E8%99%9F%E6%98%9F%E6%9C%9F%E4%BA%94>)不吉利。圣殿骑士团在1307年10月13日周五遭到法国國王腓力四世屠殺。《聖經》故事里，耶稣遭其門徒之一的加略人猶大出賣而遭逮捕當天即是星期五，猶大是當天最後的晚餐中的第13位客人。
[Texas-sharpshooter fallacy](<https://en.wikipedia.org/wiki/Texas_sharpshooter_fallacy>) [德州神槍手謬誤](<https://zh.wikipedia.org/wiki/%E5%BE%B7%E5%B7%9E%E7%A5%9E%E6%A7%8D%E6%89%8B%E8%AC%AC%E8%AA%A4>)，中文固有的的說法又稱為先射箭再畫靶，是一種因果謬誤，原用以形容流行病學上的集群錯覺，後衍伸泛指將統計上隨機產生的群集獨立出來，宣稱有統計顯著性的謬誤。通俗地讲，就是在大量的数据/证据中刻意地挑选出对自己的观点有利的数据/证据，而将其余对自己不利的数据/证据弃之不用。
This propensity to see nonexistent patterns has been called the Texas-sharpshooter fallacy

Full moon day: less suicide.

Chapter: The Plain Perplex (疼痛的迷雾)

In one study of five hundred patients undergoing dental proce- dures, those who were given a placebo injection and reassured that it would relieve their pain had the least discomfort—not only less than the patients who got a placebo and were told nothing but also less than the patients who got a real anesthetic without any reassuring comment that it would work. Today, it is abundantly evident that the brain is actively involved in the experience of pain, and is no mere bell on a string. Today, every medical textbook teaches the **Gate-Control Theory** as fact. There’s a problem with it, though. It doesn’t explain people like Roland Scott Quinlan.

// Gate control theory suggests that the spinal cord contains a neurological 'gate' that either blocks pain signals or allows them to continue on to the brain. This theory is often used to explain both phantom and chronic pain issues.

thalamus 视床

[Brain in a vat](<https://en.wikipedia.org/wiki/Brain_in_a_vat>) （or Brain in a jar)

Chapter: A Queasy Feeling: nausea / vomiting (孕吐30周)

Chapter: Crimson Tide (blushing) (一说话就脸红的女主播)

手术切断部分交感神经：阻断脸红，同时脸部和手部不再出汗。

Chapter: The Man Who Couldn’t Stop Eating (吃个不停的人)