Lifelike simulations that make real-life surgery safer | Peter Weinstock

62,312 views ใƒป 2017-04-11

TED


์•„๋ž˜ ์˜๋ฌธ์ž๋ง‰์„ ๋”๋ธ”ํด๋ฆญํ•˜์‹œ๋ฉด ์˜์ƒ์ด ์žฌ์ƒ๋ฉ๋‹ˆ๋‹ค.

๋ฒˆ์—ญ: Mijin Kim ๊ฒ€ํ† : Jihyeon J. Kim
00:12
What if I told you there was a new technology
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์ œ๊ฐ€ ๋งŒ์•ฝ ์—ฌ๋Ÿฌ๋ถ„๋“ค๊ป˜ ์—ฌ๊ธฐ ์ƒˆ๋กœ์šด ๊ธฐ์ˆ ์ด ์žˆ๊ณ 
00:16
that, when placed in the hands of doctors and nurses,
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์ด ๊ธฐ์ˆ ์„ ์˜์‚ฌ์™€ ๊ฐ„ํ˜ธ์‚ฌ๊ฐ€ ์ด์šฉํ•˜๋ฉด
00:21
improved outcomes for children and adults, patients of all ages;
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์•„์ด๋“ค์ด๋‚˜ ์„ฑ์ธ, ๋ชจ๋“  ์—ฐ๋ น๋Œ€์˜ ํ™˜์ž๋“ค์˜ ๊ฒฐ๊ณผ๊ฐ€ ๊ฐœ์„ ๋˜๊ณ 
00:27
reduced pain and suffering,
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๊ณ ํ†ต๊ณผ ๊ดด๋กœ์›€์„ ์ค„์—ฌ์ฃผ๋ฉฐ
00:29
reduced time in the operating rooms,
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์ˆ˜์ˆ  ์‹œ๊ฐ„์„ ๋‹จ์ถ•์‹œ์ผœ์ฃผ๊ณ 
00:33
reduced anesthetic times,
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๋งˆ์ทจ ์‹œ๊ฐ„์„ ์ค„์—ฌ์ฃผ๊ณ 
00:35
had the ultimate dose-response curve
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์šฉ๋Ÿ‰ ๋ฐ˜์‘ ๊ณก์„ ์ด ์ตœ๊ณ ์น˜๋กœ ๋‚˜ํƒ€๋‚˜๋ฉฐ
00:37
that the more you did it,
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ํ•˜๋ฉด ํ• ์ˆ˜๋ก
00:39
the better it benefitted patients?
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ํ™˜์ž์—๊ฒŒ ๋” ์œ ์ตํ•˜๋‹ค๋ฉด ์–ด๋–ป๊ฒŒ ํ•˜์‹œ๊ฒ ์Šต๋‹ˆ๊นŒ?
00:43
Here's a kicker: it has no side effects,
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๋˜ ๋‹ค๋ฅธ ์žฅ์ ์ด ์žˆ์Šต๋‹ˆ๋‹ค: ๋ถ€์ž‘์šฉ์ด ์—†๋‹ค๋Š” ๊ฒƒ์ž…๋‹ˆ๋‹ค.
00:45
and it's available no matter where care is delivered.
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๋˜ํ•œ ์–ด๋””์„œ ์น˜๋ฃŒ๊ฐ€ ์ด๋ฃจ์–ด์ง€๋“  ์ƒ๊ด€์—†์ด ์ด์šฉ ํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
00:49
I can tell you as an ICU doctor at Boston Children's Hospital,
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์ €๋Š” ๋ณด์Šคํ„ด ์•„๋™๋ณ‘์›์˜ ์ค‘ํ™˜์ž์‹ค ์˜์‚ฌ๋กœ์„œ ๋ง์”€๋“œ๋ฆด ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
00:52
this would be a game changer for me.
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์ด๊ฒƒ์€ ์ €์—๊ฒŒ ์žˆ์–ด ํŒ๋„๋ฅผ ๋ฐ”๊ฟ€ ํš๊ธฐ์ ์ธ ๊ธฐ์ˆ ์ž…๋‹ˆ๋‹ค.
00:55
That technology is lifelike rehearsal.
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์ด ๊ธฐ์ˆ ์€ ๋ฐ”๋กœ ์‹ค๋ฌผ ๋ชจํ˜•์„ ์ด์šฉํ•œ ์‚ฌ์ „์—ฐ์Šต์ธ๋ฐ์š”.
01:00
This lifelike rehearsal is being delivered through medical simulation.
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์ด ์‹ค๋ฌผ ๋ชจํ˜•์„ ์ด์šฉํ•œ ์‚ฌ์ „์—ฐ์Šต์€ ์˜๋ฃŒ ์‹œ๋ฎฌ๋ ˆ์ด์…˜์„ ํ†ตํ•ด ์ด๋ฃจ์–ด์ง‘๋‹ˆ๋‹ค.
01:05
I thought I would start with a case,
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์•ž์— ๋†“์ธ ๊ด€๋ฌธ๋“ค์„ ์„ค๋ช…ํ•˜๊ธฐ ์œ„ํ•ด
01:09
just to really describe the challenge ahead,
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ํ•œ ์‚ฌ๋ก€๋กœ ์‹œ์ž‘ํ•ด๋ณผ๊นŒ ํ•ฉ๋‹ˆ๋‹ค.
01:12
and why this technology is not just going to improve health care
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๊ทธ๋ฆฌ๊ณ  ์ด ๊ธฐ์ˆ ์ด ์˜๋ฃŒ ์„œ๋น„์Šค๋ฅผ ๊ฐœ์„ ํ•  ์ˆ˜ ์žˆ๋Š” ๊ทผ๊ฑฐ๋ฟ๋งŒ์ด ์•„๋‹ˆ๋ผ
01:15
but why it's critical to health care.
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์˜๋ฃŒ์„œ๋น„์Šค์— ์žˆ์–ด ์™œ ์ค‘์š”ํ•œ์ง€๋ฅผ ๋ง์”€๋“œ๋ฆฌ๊ฒ ์Šต๋‹ˆ๋‹ค.
01:19
This is a child that's born, young girl.
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์ด ์•„์ด๋Š” ๊ฐ“ ํƒœ์–ด๋‚œ ์•„๊ธฐ์ž…๋‹ˆ๋‹ค. ์–ด๋ฆฐ ์—ฌ์ž์•„๊ธฐ์ฃ .
01:22
"Day of life zero," we call it,
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"ํƒœ์–ด๋‚œ ์ฒซ ๋‚ ", ์šฐ๋ฆฌ๋Š” ์ด๋ ‡๊ฒŒ ๋ถ€๋ฆ…๋‹ˆ๋‹ค.
01:24
the first day of life, just born into the world.
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ํƒœ์–ด๋‚˜์„œ ์ฒซ ๋ฒˆ์งธ ๋‚ , ์„ธ์ƒ์— ๋ง‰ ๋‚˜์˜จ๊ฑฐ์ฃ .
01:26
And just as she's being born,
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๊ทธ๋ฆฌ๊ณ  ์ด ์•„๊ธฐ๊ฐ€ ํƒœ์–ด๋‚˜์ž๋งˆ์ž
01:27
we notice very quickly that she is deteriorating.
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์ƒํƒœ๊ฐ€ ์•ˆ์ข‹์•„์ง„๋‹ค๋Š” ๊ฒƒ์„ ์šฐ๋ฆฌ๋Š” ๋น ๋ฅด๊ฒŒ ์•Œ์•„์ฐจ๋ฆด ์ˆ˜ ์žˆ์—ˆ์Šต๋‹ˆ๋‹ค.
01:30
Her heart rate is going up, her blood pressure is going down,
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์‹ฌ์žฅ๋ฐ•๋™์ด ๋นจ๋ผ์ง€๊ณ  ํ˜ˆ์••์€ ๋‚ฎ์•„์ง€๊ณ  ์žˆ์—ˆ์ฃ .
01:33
she's breathing very, very fast.
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์ˆจ์„ ๊ต‰์žฅํžˆ ๊ฐ€์˜๊ฒŒ ์‰ฌ๊ณ  ์žˆ์—ˆ์Šต๋‹ˆ๋‹ค.
01:36
And the reason for this is displayed in this chest X-ray.
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์ด ํ‰๋ถ€ ์—‘์Šค๋ ˆ์ด์—์„œ ๊ทผ๊ฑฐ๋ฅผ ์ฐพ์„ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
01:41
That's called a babygram,
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๋ฒ ์ด๋น„๊ทธ๋žจ์ด๋ผ๊ณ  ๋ถˆ๋ฆฌ๋Š” ๊ฑด๋ฐ์š”.
01:42
a full X-ray of a child's body, a little infant's body.
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์•„์ด์˜ ๋ชธ ์ „์ฒด๋ฅผ ์—‘์Šค๋ ˆ์ด ์ดฌ์˜ ํ•œ ๊ฒƒ์ž…๋‹ˆ๋‹ค. ์ž‘์€ ์•„๊ธฐ์˜ ๋ชธ์„์š”.
01:45
As you look on the top side of this,
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๋งจ ์œ„์ชฝ์„ ๋ณด์‹œ๋ฉด
01:47
that's where the heart and lungs are supposed to be.
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๊ทธ๊ณณ์ด ์‹ฌ์žฅ๊ณผ ํ๊ฐ€ ์žˆ์–ด์•ผ ํ•  ๋ถ€๋ถ„์ž…๋‹ˆ๋‹ค.
01:50
As you look at the bottom end, that's where the abdomen is,
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์•„๋ž˜์ชฝ์„ ๋ณด์‹œ๋ฉด ๋ณต๋ถ€๊ฐ€ ์žˆ๋Š” ๊ณณ์ด์ฃ .
01:52
and that's where the intestines are supposed to be.
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๊ทธ๋ฆฌ๊ณ  ์ด๊ณณ์€ ๋‚ด์žฅ๊ธฐ๊ด€์ด ์žˆ์–ด์•ผ ํ•˜๋Š” ๊ณณ์ด์ฃ .
01:55
And you can see how there's sort of that translucent area
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์ด ๋ฐ˜ํˆฌ๋ช…ํ•œ ๋ถ€๋ถ„์ด
01:58
that made its way up into the right side of this child's chest.
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์–ด๋–ป๊ฒŒ ์•„์ด์˜ ๊ฐ€์Šด์—์„œ ์˜ค๋ฅธ์ชฝ์œผ๋กœ ์˜ฎ๊ฒจ๊ฐ€๋Š”์ง€๋ฅผ ๋ณด์‹ค ์ˆ˜ ์žˆ์ฃ .
02:01
And those are the intestines -- in the wrong place.
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๊ทธ๋ฆฌ๊ณ  ์ด๊ณณ์ด ๋‚ด์žฅ๊ธฐ๊ด€์ž…๋‹ˆ๋‹ค. ์˜ณ์ง€ ์•Š์€ ์žฅ์†Œ์— ์žˆ์ฃ .
02:05
As a result, they're pushing on the lungs
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๊ทธ ๊ฒฐ๊ณผ ์ด ๊ธฐ๊ด€๋“ค์ด ํ๋ฅผ ๋ฐ€์–ด๋‚ด๊ณ 
02:07
and making it very difficult for this poor baby to breathe.
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์ด ๊ฐ€์—ฌ์šด ์•„๊ธฐ๊ฐ€ ์ˆจ์„ ์‰ฌ๊ธฐ ์–ด๋ ต๊ฒŒ ๋งŒ๋“ค๊ณ  ์žˆ์—ˆ์Šต๋‹ˆ๋‹ค.
02:11
The fix for this problem
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์ด ๋ฌธ์ œ๋ฅผ ํ•ด๊ฒฐํ•˜๊ธฐ ์œ„ํ•ด์„œ๋Š”
02:12
is to take this child immediately to the operating room,
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์•„๊ธฐ๋ฅผ ๊ณง๋ฐ”๋กœ ์ˆ˜์ˆ ์‹ค๋กœ ๋ฐ๋ ค๊ฐ€์„œ
02:15
bring those intestines back into the abdomen,
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๋‚ด์žฅ๊ธฐ๊ด€๋“ค์„ ๋ณต๋ถ€๋กœ ์ œ๋Œ€๋กœ ์˜ฎ๊ฒจ๋†“์•„
02:17
let the lungs expand
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ํ๋ฅผ ํ™•์žฅ์‹œ์ผœ
02:18
and allow this child to breathe again.
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์•„๊ธฐ๊ฐ€ ๋‹ค์‹œ ์ˆจ์„ ์‰ด ์ˆ˜ ์žˆ๊ฒŒ ํ•ด์•ผํ•ฉ๋‹ˆ๋‹ค.
02:21
But before she can go to the operating room,
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ํ•˜์ง€๋งŒ ๊ทธ๋…€๊ฐ€ ์ˆ˜์ˆ ์‹ค๋กœ ๊ฐ€๊ธฐ ์ „์—
02:23
she must get whisked away to the ICU, where I work.
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์ œ๊ฐ€ ์ผํ•˜๋Š” ์ค‘ํ™˜์ž์‹ค๋กœ ๋ฐ”๋กœ ๋ฐ๋ ค๊ฐ€์•ผ ํ•˜์ฃ .
02:26
I work with surgical teams.
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์ €๋Š” ์ˆ˜์ˆ ํŒ€๊ณผ ํ•จ๊ป˜ ์ผํ•˜๊ณ  ์žˆ์Šต๋‹ˆ๋‹ค.
02:28
We gather around her,
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์šฐ๋ฆฌ๋Š” ์•„๊ธฐ ์ฃผ๋ณ€์œผ๋กœ ํ•จ๊ป˜ ๋ชจ์˜€์Šต๋‹ˆ๋‹ค.
02:29
and we place this child on heart-lung bypass.
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๊ทธ๋ฆฌ๊ณ  ์‹ฌํ์šฐํšŒ์ˆ ์„ ์‹œ์ž‘ํ•˜์˜€์ฃ .
02:35
We put her to sleep,
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๊ทธ๋…€๋ฅผ ์ž ๋“ค๊ฒŒ ํ•œ ๋’ค
02:37
we make a tiny little incision in the neck,
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๋ชฉ์— ์ž‘์€ ์ ˆ๊ฐœ๋ฅผ ๋‚ด์–ด
02:39
we place catheters into the major vessels of the neck --
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์ฃผ์š” ํ˜ˆ๊ด€์— ์นดํ…Œํ„ฐ๋ฅผ ์‚ฝ์ž…ํ•˜์˜€์ฃ .
02:42
and I can tell you that these vessels are about the size of a pen,
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์ด ํ˜ˆ๊ด€์˜ ํฌ๊ธฐ๋Š” ํŽœ ์ •๋„๋ผ๊ณ  ๋ง์”€๋“œ๋ฆด ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
02:46
the tip of a pen --
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ํŽœ์˜ ๋๋ถ€๋ถ„์ด์ฃ .
02:48
and then we have blood drawn from the body,
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๊ทธ๋Ÿฐ ๋‹ค์Œ ๋ชธ์—์„œ ํ”ผ๋ฅผ ์ฑ„์ทจํ•˜์—ฌ
02:50
we bring it through a machine, it gets oxygenated,
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๊ธฐ๊ณ„์— ๋„ฃ์–ด ์‚ฐ์†Œ๋ฅผ ๊ณต๊ธ‰ํ•˜์˜€์Šต๋‹ˆ๋‹ค.
02:53
and it goes back into the body.
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๊ทธ๋ฆฌ๊ณ  ๋‹ค์‹œ ๋ชธ์— ์ฃผ์ž…ํ•˜์˜€์ฃ .
02:54
We save her life,
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์šฐ๋ฆฌ๋Š” ๊ทธ๋…€์˜ ๋ชฉ์ˆจ์„ ๊ตฌํ–ˆ์Šต๋‹ˆ๋‹ค.
02:56
and get her safely to the operating room.
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๊ทธ๋ฆฌ๊ณ  ์ˆ˜์ˆ ์‹ค๋กœ ์•ˆ์ „ํ•˜๊ฒŒ ์˜ฎ๊ฒผ์Šต๋‹ˆ๋‹ค.
03:00
Here's the problem:
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๋ฌธ์ œ๋Š” ์ด๊ฒ๋‹ˆ๋‹ค:
03:03
these disorders --
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์ด๋Ÿฐ ์งˆํ™˜
03:05
what is known is congenital diaphragmatic hernia --
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์„ ์ฒœ์„ฑํšก๊ฒฉ๋ง‰ํƒˆ์žฅ์ด๋ผ ๋ถˆ๋ฆฌ๋Š” ์ด ์งˆํ™˜์€
03:08
this hole in the diaphragm that has allowed these intestines to sneak up --
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ํšก๊ฒฝ๋ง‰์˜ ๊ตฌ๋ฉ์ด ๋‚ด์žฅ๊ธฐ๊ด€์„ ์›€์ง์ด๊ฒŒ ๋งŒ๋“œ๋Š”๋ฐ์š”.
03:12
these disorders are rare.
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์ด๋Ÿฐ ์งˆํ™˜์€ ํ”์น˜ ์•Š์Šต๋‹ˆ๋‹ค.
03:15
Even in the best hands in the world,
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์„ธ๊ณ„ ์ตœ๊ณ  ์ˆ˜์ค€์˜ ์˜์‚ฌ๋„
03:18
there is still a challenge to get the volume --
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์ด๋Ÿฐ ์งˆํ™˜์€ ๋งŽ์€ ์‚ฌ๋ก€๋ฅผ ํ™•๋ณดํ•˜๊ธฐ๊ฐ€ ์–ด๋ ต์Šต๋‹ˆ๋‹ค.
03:22
the natural volume of these patients --
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ํ™˜์ž๋ฅผ ๋งŒ๋‚˜๋Š”๋ฐ ์–ด๋ ค์›€์ด ์žˆ๊ธฐ ๋•Œ๋ฌธ์ด์ฃ .
03:24
in order to get our expertise curve at 100 percent.
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์ž์—ฐ์Šค๋ ˆ ๋ฐœ์ƒํ•˜๋Š” ํ™˜์ž๋“ค์„์š”.
03:26
They just don't present that often.
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์ด๋Ÿฐ ์งˆํ™˜์€ ๊ทธ๋ฆฌ ์ž์ฃผ ๋ฐœ์ƒํ•˜๋Š” ๊ฒƒ์ด ์•„๋‹™๋‹ˆ๋‹ค.
03:30
So how do you make the rare common?
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๊ทธ๋ ‡๋‹ค๋ฉด ์ด ํฌ์†Œ์„ฑ์„ ์–ด๋–ป๊ฒŒ ์ผ๋ฐ˜ํ™”์‹œํ‚ฌ ์ˆ˜ ์žˆ์„๊นŒ์š”?
03:35
Here's the other problem:
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๋˜ ๋‹ค๋ฅธ ๋ฌธ์ œ๊ฐ€ ์žˆ์Šต๋‹ˆ๋‹ค.
03:38
in the health care system that I trained for over 20 years,
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์ œ๊ฐ€ 20๋…„ ๋„˜๊ฒŒ ์ผํ•ด์™”๋˜ ์˜๋ฃŒ ์ฒด๊ณ„์—
03:42
what currently exists,
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ํ˜„์žฌ ์กด์žฌํ•˜๋Š” ๊ฒƒ์ธ๋ฐ์š”,
03:44
the model of training is called the apprenticeship model.
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์ด๋Ÿฐ ํ›ˆ๋ จ ๋ชจํ˜•์€ ๊ฒฌ์Šต ๋ชจํ˜•์ด๋ผ ๋ถˆ๋ฆฝ๋‹ˆ๋‹ค.
03:46
It's been around for centuries.
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๋ช‡ ์„ธ๊ธฐ ๋™์•ˆ ๊ณ„์†๋˜์–ด ์™”์ฃ .
03:48
It's based on this idea that you see a surgery maybe once,
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์—ฌ๋Ÿฌ๋ถ„์ด ์–ด๋–ค ์ˆ˜์ˆ ์„ ํ•œ ๋ฒˆ,
03:52
maybe several times,
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ํ˜น์€ ์—ฌ๋Ÿฌ ๋ฒˆ ๋ณธ ์ ์ด ์žˆ๋‹ค๋ฉด
03:54
you then go do that surgery,
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๊ฐ€์„œ ๊ทธ ์ˆ˜์ˆ ์„ ํ•  ์ˆ˜ ์žˆ๋‹ค๋Š” ๊ธฐ๋ณธ์ „์ œ์— ๊ทผ๊ฑฐํ•ฉ๋‹ˆ๋‹ค.
03:57
and then ultimately you teach that surgery to the next generation.
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๊ถ๊ทน์ ์œผ๋กœ๋Š” ๊ทธ ์ˆ˜์ˆ ์„ ๋‹ค์Œ ์„ธ๋Œ€์— ๊ฐ€๋ฅด์น˜๊ฒŒ ๋˜๋Š” ๊ฑฐ์ฃ .
04:02
And implicit in this model --
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์ด ๋ชจํ˜•์ด ์•”์‹œํ•˜๋Š” ์ ์„
04:05
I don't need to tell you this --
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์—ฌ๋Ÿฌ๋ถ„๊ป˜ ๋ง์”€๋“œ๋ฆด ํ•„์š”๋Š” ์—†์ง€๋งŒ
04:07
is that we practice on the very patients that we are delivering care to.
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์น˜๋ฃŒํ•ด์•ผ ํ•  ๋ฐ”๋กœ ๊ทธ ํ™˜์ž๋ฅผ ๊ฐ€์ง€๊ณ  ์šฐ๋ฆฌ๋Š” ์—ฐ์Šต์„ ํ•œ๋‹ค๋Š” ๊ฒ๋‹ˆ๋‹ค.
04:14
That's a problem.
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์ด๊ฒƒ์ด ๋ฌธ์ œ์ž…๋‹ˆ๋‹ค.
04:19
I think there's a better approach.
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์ €๋Š” ๋” ๋‚˜์€ ์ ‘๊ทผ๋ฒ•์ด ์žˆ์„ ๊ฑฐ๋ผ๊ณ  ์ƒ๊ฐํ•ฉ๋‹ˆ๋‹ค.
04:21
Medicine may very well be the last high-stakes industry
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์˜ํ•™์€ ๋ถ„๋ช… ์œ„ํ—˜ ๋ถ€๋‹ด์ด ํฐ ์‚ฐ์—… ์ค‘
04:25
that does not practice prior to game time.
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์‹ค์ „์— ์ž„ํ•˜๊ธฐ ์ „ ์—ฐ์Šต์„ ํ•˜์ง€ ์•Š๋Š” ์œ ์ผํ•œ ์‚ฐ์—…์ผ ๊ฒƒ์ž…๋‹ˆ๋‹ค.
04:30
I want to describe to you a better approach through medical simulation.
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์—ฌ๋Ÿฌ๋ถ„๊ป˜ ์˜๋ฃŒ ์‹œ๋ฎฌ๋ ˆ์ด์…˜์„ ํ†ตํ•œ ๋” ๋‚˜์€ ์ ‘๊ทผ๋ฒ•์„ ์†Œ๊ฐœํ•ด๋“œ๋ฆฌ๊ณ  ์‹ถ์Šต๋‹ˆ๋‹ค.
04:36
Well, the first thing we did is we went to other high-stakes industries
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์ฒซ ๋ฒˆ์งธ๋กœ ํ•œ ์ผ์€ ๋‹ค๋ฅธ ์œ„ํ—˜ํ•œ ์‚ฐ์—…์„ ๋ฐฉ๋ฌธํ•œ ๊ฒƒ์ž…๋‹ˆ๋‹ค.
04:39
that had been using this type of methodology for decades.
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๋ช‡ ์‹ญ๋…„ ๊ฐ„ ์ด๋Ÿฐ ๋ฐฉ๋ฒ•๋ก ์„ ์‚ฌ์šฉํ•ด ์™”๋˜ ์‚ฐ์—…์„์š”.
04:42
This is nuclear power.
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์ด๊ฒƒ์€ ์›์ž๋ ฅ์ž…๋‹ˆ๋‹ค.
04:44
Nuclear power runs scenarios on a regular basis
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์›์ž๋ ฅ์€ ์ •๊ธฐ์ ์œผ๋กœ ์‹œ๋‚˜๋ฆฌ์˜ค๋ฅผ ์‹คํ–‰ํ•ฉ๋‹ˆ๋‹ค.
04:48
in order to practice what they hope will never occur.
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์ ˆ๋Œ€ ์ผ์–ด๋‚˜์ง€ ์•Š๊ธฐ๋ฅผ ๋ฐ”๋ผ๋Š” ์ผ์„ ๋Œ€๋น„ํ•ด ์—ฐ์Šต์„ ํ•˜๋Š”๊ฑฐ์ฃ .
04:51
And as we're all very familiar, the airline industry --
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์šฐ๋ฆฌ ๋ชจ๋‘๊ฐ€ ์นœ์ˆ™ํ•œ ์ด๊ฒƒ์€ ํ•ญ๊ณต์‚ฐ์—…์ธ๋ฐ์š”
04:55
we all get on planes now, comforted by the idea
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์šฐ๋ฆฌ ๋ชจ๋‘๋Š” ๋น„ํ–‰๊ธฐ๋ฅผ ํƒˆ ๋•Œ ์กฐ์ข…์‚ฌ์™€ ์Šน๋ฌด์›๋“ค์ด
04:59
that pilots and crews have trained on simulators much like these,
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์ด๊ฐ™์€ ์‹œ๋ฎฌ๋ ˆ์ดํ„ฐ๋ฅผ ์ด์šฉํ•ด ์‹ค์Šต์„ ๋งˆ์ณค๋‹ค๋Š” ์ƒ๊ฐ์œผ๋กœ ํŽธํ•˜๊ฒŒ ํƒ‘์Šนํ•˜์ฃ .
05:04
training on scenarios that we hope will never occur,
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์ ˆ๋Œ€ ์ผ์–ด๋‚˜์ง€ ์•Š๊ธธ ๋ฐ”๋ผ๋Š” ์‹œ๋‚˜๋ฆฌ์˜ค๋ฅผ ๊ฐ€์ง€๊ณ  ์‹ค์Šต์„ ํ•˜๋Š”๊ฑฐ์ฃ .
05:07
but we know if they did,
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ํ•˜์ง€๋งŒ ๊ทธ๋“ค์ด ์‹ค์Šต์„ ํ–ˆ๋‹ค๋ฉด
05:09
they would be prepared for the worst.
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์ตœ์•…์˜ ์ƒํ™ฉ์— ๋Œ€๋น„ํ•œ ์ค€๋น„๊ฐ€ ๋˜์—ˆ์Œ์„ ์šฐ๋ฆฌ๋Š” ์•Œ๊ณ  ์žˆ์Šต๋‹ˆ๋‹ค.
05:12
In fact, the airline industry has gone as far as to create fuselages
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์‚ฌ์‹ค ํ•ญ๊ณต์‚ฐ์—…์€ ๋ชจ์˜ ํ™˜๊ฒฝ์„ ์œ„ํ•œ
05:17
of simulation environments,
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๊ธฐ์ฒด๋ฅผ ๋งŒ๋“ค์–ด ๋‚ผ ๋งŒํผ ๋งŽ์ด ๋ฐœ์ „ํ–ˆ์ฃ .
05:18
because of the importance of the team coming together.
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ํŒ€์ด ํ•จ๊ป˜ ์›€์ง์ด๋Š” ๊ฒƒ์ด ์ค‘์š”ํ•˜๊ธฐ ๋•Œ๋ฌธ์ž…๋‹ˆ๋‹ค.
05:22
This is an evacuation drill simulator.
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์ด๊ฒƒ์€ ํƒˆ์ถœ ํ›ˆ๋ จ ๋ชจ์˜์‹คํ—˜์žฅ์น˜์ž…๋‹ˆ๋‹ค.
05:25
So again, if that ever were to happen, these rare, rare events,
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๋”ฐ๋ผ์„œ ํ”์น˜ ์•Š์€ ์ด ์‚ฌ๊ณ ๊ฐ€ ํ˜น์‹œ๋ผ๋„ ๋ฐœ์ƒํ•˜๊ฒŒ ๋œ๋‹ค๋ฉด
05:29
they're ready to act on the drop of a dime.
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์ด๋“ค์€ ์ฆ‰์‹œ ์‹คํ–‰ ํ•  ์ค€๋น„๊ฐ€ ๋˜์–ด์žˆ์Šต๋‹ˆ๋‹ค.
05:34
I guess the most compelling for me in some ways is the sports industry --
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์–ด๋–ค์ ์—์„œ ์ œ๊ฐ€ ๊ฐ€์žฅ ๋ˆˆ์„ ๋—„ ์ˆ˜ ์—†์—ˆ๋˜ ๋ถ€๋ถ„์€ ์Šคํฌ์ธ  ์‚ฐ์—…์ธ ๊ฒƒ ๊ฐ™์€๋ฐ์š”.
05:40
arguably high stakes.
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๋…ผ์Ÿ์˜ ์—ฌ์ง€ ์—†์ด ์œ„ํ—˜ ๋ถ€๋‹ด์ด ํฐ ๋ถ„์•ผ์ฃ .
05:42
You think about a baseball team: baseball players practice.
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์•ผ๊ตฌ ํŒ€์„ ์ƒ๊ฐํ•ด๋ณด์„ธ์š”: ์•ผ๊ตฌ ์„ ์ˆ˜๋“ค์ด ์—ฐ์Šตํ•˜๋Š” ๋ชจ์Šต์„์š”.
05:45
I think it's a beautiful example of progressive training.
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์ ์ง„์  ํ›ˆ๋ จ์˜ ์•„๋ฆ„๋‹ค์šด ์˜ˆ๋ผ๊ณ  ์ƒ๊ฐํ•˜๋Š”๋ฐ์š”.
05:48
The first thing they do is go out to spring training.
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๊ทธ๋“ค์ด ๊ฐ€์žฅ ๋จผ์ € ํ•˜๋Š” ์ผ์€ ์Šคํ”„๋งํ›ˆ๋ จ์„ ๋– ๋‚˜๋Š” ๊ฒƒ์ž…๋‹ˆ๋‹ค.
05:51
They go to a spring training camp,
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์Šคํ”„๋ง ์บ ํ”„๋กœ ๋– ๋‚ฉ๋‹ˆ๋‹ค.
05:53
perhaps a simulator in baseball.
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์–ด์ฉŒ๋ฉด ์•ผ๊ตฌ์˜ ๋ชจ์˜์‹คํ—˜์žฅ์น˜ ๊ฐ™์€ ๊ฑฐ์ฃ .
05:56
They're not on the real field, but they're on a simulated field,
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๊ทธ๋“ค์€ ์ง„์งœ ๊ตฌ์žฅ์— ์žˆ๋Š” ๊ฒƒ์ด ์•„๋‹ˆ๋ผ ๋ชจ์˜ ๊ตฌ์žฅ์— ์žˆ์Šต๋‹ˆ๋‹ค.
05:59
and they're playing in the pregame season.
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๊ทธ๋ฆฌ๊ณ  ์ •๊ทœ ์‹œ์ฆŒ ์ „์— ๊ฒฝ๊ธฐ๋ฅผ ํ•˜๋Š”๊ฑฐ์ฃ .
06:01
Then they make their way to the field during the season games,
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๋ณธ ๊ฒŒ์ž„์ด ์‹œ์ž‘๋˜๋ฉด ๊ตฌ์žฅ์œผ๋กœ ๋‚˜๊ฐ‘๋‹ˆ๋‹ค.
06:05
and what's the first thing they do before they start the game?
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๊ฒฝ๊ธฐ๊ฐ€ ์‹œ์ž‘๋˜๊ธฐ ์ „ ์„ ์ˆ˜๋“ค์ด ๊ฐ€์žฅ ๋จผ์ € ํ•˜๋Š” ์ผ์€ ๋ฌด์—‡์ผ๊นŒ์š”?
06:08
They go into the batting cage and do batting practice for hours,
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ํƒ€๊ฒฉ ์—ฐ์Šต์žฅ์— ๋“ค์–ด๊ฐ€ ๋ช‡ ์‹œ๊ฐ„ ๋™์•ˆ ํƒ€๊ฒฉ ์—ฐ์Šต์„ ํ•ฉ๋‹ˆ๋‹ค.
06:12
having different types of pitches being thrown at them,
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์„ ์ˆ˜๋“ค์„ ํ–ฅํ•ด ๋˜์ ธ์ง€๋Š” ๊ฐ๊ธฐ ๋‹ค๋ฅธ ์ข…๋ฅ˜์˜ ํˆฌ๊ตฌ๋“ค์„ ๊ฒฝํ—˜ํ•˜๋Š” ๊ฑฐ์ฃ .
06:15
hitting ball after ball as they limber their muscles,
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๋Š์ž„์—†์ด ํƒ€๊ฒฉ์„ ํ•˜๋ฉฐ ๊ทผ์œก์„ ์ด์™„์‹œํ‚ค์ฃ .
06:20
getting ready for the game itself.
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๋ณธ ๊ฒฝ๊ธฐ๋ฅผ ์œ„ํ•ด ์ค€๋น„ํ•˜๋Š”๊ฒ๋‹ˆ๋‹ค.
06:22
And here's the most phenomenal part of this,
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๊ฐ€์žฅ ๊ฒฝ์ด๋กœ์šด ๋ถ€๋ถ„์€ ๋ฐ”๋กœ ์ด ์ ์ž…๋‹ˆ๋‹ค.
06:26
and for all of you who watch any sport event,
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์Šคํฌ์ธ  ๊ฒฝ๊ธฐ๋ฅผ ๋ณธ ์ ์ด ์žˆ๋Š” ๋ถ„์ด๋ผ๋ฉด
06:28
you will see this phenomenon happen.
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์ด ๋†€๋ผ์šด ์ผ์ด ์ผ์–ด๋‚˜๋Š” ์žฅ๋ฉด์„ ๋ณผ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
06:31
The batter gets into the batter's box,
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ํƒ€์ž๊ฐ€ ํƒ€์„์— ๋“ค์–ด์„œ๋ฉด
06:34
the pitcher gets ready to pitch.
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ํˆฌ์ˆ˜๋Š” ํˆฌ๊ตฌ๋ฅผ ํ•  ์ค€๋น„๋ฅผ ํ•˜์ฃ .
06:36
Right before the pitch is thrown,
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๊ณต์ด ๋˜์ ธ์ง€๊ธฐ ๋ฐ”๋กœ ์ง์ „์—
06:39
what does that batter do?
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ํƒ€์ž๋Š” ๋ฌด์—‡์„ ํ•˜์ฃ ?
06:40
The batter steps out of the box
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ํƒ€์„ ๋ฐ–์œผ๋กœ ์ž ์‹œ ๋‚˜์™€
06:44
and takes a practice swing.
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์—ฐ์Šต ์Šค์œ™์„ ํ•ฉ๋‹ˆ๋‹ค.
06:46
He wouldn't do it any other way.
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๋‹ค๋ฅธ ๊ฒƒ์„ ํ•˜์ง€ ์•Š์Šต๋‹ˆ๋‹ค.
06:49
I want to talk to you about how we're building practice swings like this
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์ €๋Š” ์˜ํ•™์—์„œ ์ด์™€ ๊ฐ™์€ ์—ฐ์Šต ์Šค์œ™์„
06:52
in medicine.
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์–ด๋–ป๊ฒŒ ๋งŒ๋“ค์–ด๋‚ด๋Š”์ง€๋ฅผ ๋ง์”€๋“œ๋ฆฌ๊ณ  ์‹ถ์Šต๋‹ˆ๋‹ค.
06:53
We are building batting cages for the patients that we care about
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์ €ํฌ๋Š” ์น˜๋ฃŒํ•ด์•ผ ํ•  ํ™˜์ž๋ฅผ ์œ„ํ•œ ํƒ€๊ฒฉ ์—ฐ์Šต์žฅ์„ ๋งŒ๋“ค๊ณ  ์žˆ๋Š” ๊ฒƒ์ž…๋‹ˆ๋‹ค.
06:58
at Boston Children's.
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๋ณด์Šคํ„ด ์•„๋™๋ณ‘์›์—์š”.
06:59
I want to use this case that we recently built.
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์ตœ๊ทผ์— ํ–ˆ๋˜ ์‚ฌ๋ก€๋ฅผ ๋“ค์–ด๋ณผ๊ฒŒ์š”.
07:02
It's the case of a four-year-old who had a progressively enlarging head,
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๋จธ๋ฆฌ๊ฐ€ ์„œ์„œํžˆ ์ปค์ง€๋Š” ๋„ค ์‚ด ์•„์ด์˜ ์‚ฌ๋ก€์ž…๋‹ˆ๋‹ค.
07:06
and as a result,
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๊ทธ ๊ฒฐ๊ณผ
07:07
had loss of developmental milestones, neurologic milestones,
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๋ฐœ๋‹ฌ์ด ์ œ๋Œ€๋กœ ์ด๋ฃจ์–ด์ง€์ง€ ์•Š์•˜์Šต๋‹ˆ๋‹ค. ์‹ ๊ฒฝํ•™์ ์ธ ๋ฐœ๋‹ฌ์ด์š”.
07:11
and the reason for this problem is here --
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๋ฌธ์ œ์˜ ์ด์œ ๋Š” ๋ฐ”๋กœ ์ด๊ฒƒ์ž…๋‹ˆ๋‹ค.
07:14
it's called hydrocephalus.
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๋‡Œ์ˆ˜์ข…์ด๋ผ๊ณ  ๋ถˆ๋ฆฌ๋Š”๋ฐ์š”.
07:16
So, a quick study in neurosurgery.
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๊ทธ๋Ÿผ ์‹ ๊ฒฝ์™ธ๊ณผ์ˆ˜์ˆ ์— ๋Œ€ํ•ด ์ž ์‹œ ์•Œ์•„๋ณผ๊ฒŒ์š”.
07:19
There's the brain,
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์—ฌ๊ธฐ ๋‡Œ๊ฐ€ ์žˆ์ฃ .
07:20
and you can see the cranium surrounding the brain.
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๋‡Œ๋ฅผ ๋‘˜๋Ÿฌ์‹ธ๊ณ ์žˆ๋Š” ๋‘๊ฐœ๊ณจ์ด ๋ณด์ด์‹ค ๊ฒ๋‹ˆ๋‹ค.
07:23
What surrounds the brain, between the brain and cranium,
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๋‡Œ์™€ ๋‘๊ฐœ๊ณจ ์‚ฌ์ด์— ์žˆ๋Š”, ๋‡Œ๋ฅผ ๋‘˜๋Ÿฌ์‹ธ๊ณ  ์žˆ๋Š” ๋ฌผ์งˆ์€
07:26
is something called cerebrospinal fluid or fluid,
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๋‡Œ์ฒ™์ˆ˜์•ก ํ˜น์€ ์œ ๋™์ฒด๋ผ ๋ถˆ๋ฆฌ๋Š” ๊ฒƒ์ž…๋‹ˆ๋‹ค.
07:30
which acts as a shock absorber.
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์ถฉ๊ฒฉ์„ ํก์ˆ˜ํ•ด์ฃผ๋Š” ์—ญํ• ์„ ํ•˜์ฃ .
07:32
In your heads right now,
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์ง€๊ธˆ ์ด ์ˆœ๊ฐ„ ์—ฌ๋Ÿฌ๋ถ„์˜ ๋จธ๋ฆฌ ์†์—์„œ๋Š”
07:33
there is cerebrospinal fluid just bathing your brains
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๋‡Œ์ฒ™์ˆ˜์•ก์ด ๋‡Œ ์ฃผ๋ณ€์„ ํ˜๋Ÿฌ๊ฐ€๋ฉฐ
07:37
and making its way around.
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๊ณ„์† ์›€์ง์—ฌ ๋‚˜๊ฐ€๊ณ  ์žˆ์ฃ .
07:38
It's produced in one area and flows through,
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๋‡Œ์ฒ™์ˆ˜์•ก์€ ํ•œ ๋ถ€๋ถ„์—์„œ ์ƒ์„ฑ๋˜์–ด ํ๋ฅธ ๋’ค
07:41
and then is re-exchanged.
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๋‹ค์‹œ ๋งž๋ฐ”๊พธ์–ด์ง‘๋‹ˆ๋‹ค.
07:42
And this beautiful flow pattern occurs for all of us.
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์ด ์•„๋ฆ„๋‹ค์šด ํ๋ฆ„์˜ ํŒจํ„ด์€ ์šฐ๋ฆฌ ๋ชจ๋‘์—๊ฒŒ์„œ ์ผ์–ด๋‚˜๋Š”๊ฑฐ์ฃ .
07:46
But unfortunately in some children,
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ํ•˜์ง€๋งŒ ๋ถˆํ–‰ํžˆ๋„ ์–ด๋–ค ์•„์ด๋“ค์—๊ฒŒ๋Š”
07:48
there's a blockage of this flow pattern,
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์ด ํ๋ฆ„์— ์žฅ์• ๊ฐ€ ์žˆ์Šต๋‹ˆ๋‹ค.
07:50
much like a traffic jam.
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๊ตํ†ต์ฒด์ฆ๊ณผ ๋‹ค๋ฅผ ๋ฐ” ์—†์ฃ .
07:52
As a result, the fluid accumulates,
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๊ทธ ๊ฒฐ๊ณผ ์ด ๋‡Œ์ฒ™์ˆ˜์•ก์ด ์ถ•์ ๋˜๋ฉด์„œ
07:55
and the brain is pushed aside.
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๋‡Œ๊ฐ€ ๋ฐ€๋ ค๋‚˜๊ฒŒ๋˜๋Š”๊ฒ๋‹ˆ๋‹ค.
07:58
It has difficulty growing.
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๋‡Œ๊ฐ€ ์ž๋ผ๋Š”๋ฐ ๋ฌธ์ œ๊ฐ€ ์ƒ๊ธฐ๋Š”๊ฑฐ์ฃ .
08:01
As a result, the child loses neurologic milestones.
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๊ทธ๋ž˜์„œ ๊ทธ ์•„์ด๋Š” ์‹ ๊ฒฝํ•™์  ๋ฐœ๋‹ฌ์„ ๋”ฐ๋ผ๊ฐ€์ง€ ๋ชปํ•˜๋Š” ๊ฑฐ์˜ˆ์š”.
08:04
This is a devastating disease in children.
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์•„์ด๋“ค์—๊ฒŒ๋Š” ์—„์ฒญ๋‚œ ์งˆ๋ณ‘์ด์ฃ .
08:08
The cure for this is surgery.
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์น˜๋ฃŒ๋ฒ•์€ ์ˆ˜์ˆ ์ž…๋‹ˆ๋‹ค.
08:11
The traditional surgery is to take a bit of the cranium off,
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์ „ํ†ต์ ์ธ ์ˆ˜์ˆ ์€ ๋‘๊ฐœ๊ณจ์„ ์กฐ๊ธˆ ์ ˆ๊ฐœํ•ด
08:14
a bit of the skull,
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์•„์ฃผ ์กฐ๊ธˆ๋งŒ์š”.
08:16
drain this fluid out, stick a drain in place,
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๋‡Œ์ฒ™์ˆ˜์•ก์„ ๋นผ๋‚ด๋Š”๊ฑฐ์ฃ . ๋ฐฐ์ˆ˜๊ด€์„ ๋šซ๋Š”๊ฑฐ์—์š”.
08:18
and then eventually bring this drain internal to the body.
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๊ฒฐ๊ตญ ์ด ๋ฐฐ์ˆ˜๊ด€์„ ๋ชธ์˜ ๋‹ค๋ฅธ ๋ถ€๋ถ„์œผ๋กœ ๊ฐ€์ ธ์˜ค๋Š” ๊ฑฐ์ฃ .
08:21
Big operation.
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๋Œ€์ˆ˜์ˆ ์ž…๋‹ˆ๋‹ค.
08:23
But some great news is that advances in neurosurgical care
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๊ทธ๋Ÿฌ๋‚˜ ์ข‹์€ ์†Œ์‹์€ ์‹ ๊ฒฝ์™ธ๊ณผ ์น˜๋ฃŒ์˜ ์ง„๋ณด๊ฐ€
08:28
have allowed us to develop minimally invasive approaches
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์ด ์ˆ˜์ˆ ์„ ํ•  ๋•Œ
08:31
to this surgery.
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์นผ์„ ์ตœ์†Œ๋กœ ๋Œˆ ์ˆ˜ ์žˆ๊ฒŒ ๋งŒ๋“ค์–ด ์ฃผ์—ˆ๋‹ค๋Š” ๊ฒ๋‹ˆ๋‹ค.
08:33
Through a small pinhole, a camera can be inserted,
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์•„์ฃผ ์ž‘์€ ๊ตฌ๋ฉ์„ ํ†ตํ•ด ์นด๋ฉ”๋ผ๊ฐ€ ๋“ค์–ด๊ฐ€๊ณ 
08:38
led into the deep brain structure,
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๊ทธ ์นด๋ฉ”๋ผ๊ฐ€ ๋” ๊นŠ์€ ๋‡Œ์˜ ๊ตฌ์กฐ๋กœ ์šฐ๋ฆฌ๋ฅผ ์ธ๋„ํ•˜๋ฉด
08:41
and cause a little hole in a membrane that allows all that fluid to drain,
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๋ชจ๋“  ๋‡Œ์ฒ™์ˆ˜์•ก์ด ๋น ์ ธ๋‚˜์˜ฌ ์ˆ˜ ์žˆ๋„๋ก ์„ธํฌ๋ง‰ ์•ˆ์— ๊ตฌ๋ฉ์„ ๋ƒ…๋‹ˆ๋‹ค.
08:45
much like it would in a sink.
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์‹ฑํฌ๋Œ€์™€ ๊ฐ™์€๊ฑฐ์ฃ .
08:47
All of a sudden, the brain is no longer under pressure,
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๊ทธ ์ˆœ๊ฐ„ ๋‡Œ๋Š” ๋” ์ด์ƒ ์••๋ ฅ์„ ๋ฐ›์ง€ ์•Š๊ณ 
08:50
can re-expand
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๋‹ค์‹œ ํ™•์žฅ ๋  ์ˆ˜ ์žˆ๋Š”๊ฑฐ์ฃ .
08:52
and we cure the child through a single-hole incision.
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๊ทธ๋Ÿฌ๋ฉด ์šฐ๋ฆฌ๋Š” ๋‹จ ํ•˜๋‚˜์˜ ๊ตฌ๋ฉ์„ ๋‚ด์–ด ์ด ์•„์ด๋ฅผ ์น˜๋ฃŒํ•˜๋Š”๊ฑฐ์ฃ .
08:56
But here's the problem:
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ํ•˜์ง€๋งŒ ๋ฌธ์ œ๊ฐ€ ์žˆ์Šต๋‹ˆ๋‹ค.
08:57
hydrocephalus is relatively rare.
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๋‡Œ์ˆ˜์ข…์€ ์ƒ๋Œ€์ ์œผ๋กœ ๋“œ๋ฌธ ์งˆํ™˜์ž…๋‹ˆ๋‹ค.
09:00
And there are no good training methods
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์ˆ˜์ˆ ์„ ์ œ๋Œ€๋กœ ํ•  ์ˆ˜ ์žˆ๋Š” ๊ธฐํšŒ๋ฅผ ๊ฐ–๊ฒŒ ๋ 
09:03
to get really good at getting this scope to the right place.
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์ข‹์€ ์‹ค์Šต ๋ฐฉ๋ฒ•์ด ์—†๋‹ค๋Š” ๊ฑฐ์ฃ .
09:06
But surgeons have been quite creative about this, even our own.
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ํ•˜์ง€๋งŒ ์™ธ๊ณผ์˜์‚ฌ๋“ค์€ ๊ฝค ์ฐฝ์˜์ ์ž…๋‹ˆ๋‹ค. ์šฐ๋ฆฌ๋„ ๋งˆ์ฐฌ๊ฐ€์ง€์ฃ .
09:11
And they've come up with training models.
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๊ทธ๋“ค์€ ์‹ค์Šต ๋ชจํ˜•์— ๋Œ€ํ•œ ๋‹ต์„ ์ฐพ์•„๋ƒˆ์ฃ .
09:13
Here's the current training model.
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์ด๊ฒƒ์ด ํ˜„์žฌ์˜ ์‹ค์Šต ๋ชจํ˜•์ž…๋‹ˆ๋‹ค.
09:14
(Laughter)
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(์›ƒ์Œ)
09:16
I kid you not.
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๋†๋‹ด์ด ์•„๋‹™๋‹ˆ๋‹ค.
09:18
This is a red pepper, not made in Hollywood;
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์ด๊ฒƒ์€ ํ”ผ๋ง์ž…๋‹ˆ๋‹ค. ํ—๋ฆฌ์šฐ๋“œ์—์„œ ๋งŒ๋“  ๊ฒƒ์ด ์•„๋‹ˆ์—์š”.
09:21
it's real red pepper.
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์ง„์งœ ํ”ผ๋ง์ž…๋‹ˆ๋‹ค.
09:22
And what surgeons do is they stick a scope into the pepper,
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์™ธ๊ณผ์˜์‚ฌ๋“ค์€ ํ”ผ๋ง ์•ˆ์— ์ž‘์€ ๊ด€์ฐฐ์šฉ ๊ธฐ๊ตฌ๋ฅผ ๊ฝ‚์Šต๋‹ˆ๋‹ค.
09:25
and they do what is called a "seedectomy."
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๊ทธ๋“ค์ด "์”จ์•—์ ˆ์ œ์ˆ "์ด๋ผ ๋ถ€๋ฅด๋Š” ์ผ์„ ํ•ฉ๋‹ˆ๋‹ค.
09:28
(Laughter)
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(์›ƒ์Œ)
09:30
They use this scope to remove seeds using a little tweezer.
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์ž‘์€ ํ•€์…‹์œผ๋กœ ์”จ์•—์„ ์ œ๊ฑฐํ•˜๊ธฐ ์œ„ํ•ด ์ด ๊ด€์ฐฐ์šฉ ๊ธฐ๊ตฌ๋ฅผ ์‚ฌ์šฉํ•ฉ๋‹ˆ๋‹ค.
09:37
And that is a way to get under their belts
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์ด๊ฒƒ์ด ๋ฐฐ์šฐ๊ธฐ ์œ„ํ•ด ๊ทธ๋“ค์ด ํ•˜๋Š” ๋ฐฉ๋ฒ•์ž…๋‹ˆ๋‹ค.
09:40
the rudimentary components of doing this surgery.
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์ด ์ˆ˜์ˆ ์„ ํ•˜๊ธฐ ์œ„ํ•œ ๊ฐ€์žฅ ๊ธฐ๋ณธ์ ์ธ ์š”์†Œ์ด์ฃ .
09:43
Then they head right into the apprenticeship model,
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๊ทธ๋ฆฌ๊ณ ๋‚˜์„œ ๋ฐ”๋กœ ๊ฒฌ์Šต ๋ชจํ˜•์œผ๋กœ ๋“ค์–ด๊ฐ€๊ฒŒ๋ฉ๋‹ˆ๋‹ค.
09:46
seeing many of them as they present themselves,
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์ˆ˜์ˆ ์„ ์ฐธ๊ด€ํ•˜๋ฉฐ ๋งŽ์€ ์‚ฌ๋ก€๋“ค์„ ๋ณด๋Š”๊ฑฐ์ฃ .
09:49
then doing it, and then teaching it --
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๊ทธ๋ฆฌ๊ณ  ์ˆ˜์ˆ ์„ ํ•˜๊ณ  ๊ฐ€๋ฅด์น˜๊ธฐ๋„ ํ•ฉ๋‹ˆ๋‹ค.
09:51
waiting for these patients to arrive.
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ํ™˜์ž๊ฐ€ ์˜ค๊ธฐ๋ฅผ ๊ธฐ๋‹ค๋ฆฌ๋ฉด์„œ์š”.
09:54
We can do a lot better.
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์šฐ๋ฆฌ๋Š” ํ›จ์”ฌ ๋” ๋‚˜์€ ๋ฐฉ๋ฒ•์œผ๋กœ ํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
09:55
We are manufacturing reproductions of children
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์•„์ด์˜ ๋ชจํ˜•์„ ์ œ์กฐํ•˜๊ณ  ์žˆ์Šต๋‹ˆ๋‹ค.
10:00
in order for surgeons and surgical teams to rehearse
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์™ธ๊ณผ์˜์‚ฌ์™€ ์ˆ˜์ˆ ํŒ€์ด
10:04
in the most relevant possible ways.
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์ตœ๋Œ€ํ•œ ๊ด€๋ จ์žˆ๋Š” ๋ฐฉ์‹์œผ๋กœ ์‚ฌ์ „์—ฐ์Šตํ• ์ˆ˜์žˆ๊ฒŒ ๋„์™€์ฃผ๋Š”๊ฑฐ์ฃ .
10:06
Let me show you this.
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์ด๊ฑธ ๋ณด์—ฌ๋“œ๋ฆด๊ฒŒ์š”.
10:08
Here's my team
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์ €ํฌ ํŒ€์ž…๋‹ˆ๋‹ค.
10:10
in what's called the SIM Engineering Division of the Simulator Program.
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์‹œ๋ฎฌ๋ ˆ์ด์…˜ ๊ณตํ•™์ด๋ผ ๋ถˆ๋ฆฝ๋‹ˆ๋‹ค. ์‹œ๋ฎฌ๋ ˆ์ดํ„ฐ ํ”„๋กœ๊ทธ๋žจ ๋ถ€์„œ์ฃ .
10:15
This is an amazing team of individuals.
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์—„์ฒญ๋‚œ ๊ฐœ๊ฐœ์ธ์ด ๋ชจ์—ฌ ๋งŒ๋“ค์–ด์ง„ ํŒ€์ž…๋‹ˆ๋‹ค.
10:18
They are mechanical engineers;
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๊ทธ๋“ค์€ ๊ธฐ๊ณ„๊ณตํ•™์ž์ž…๋‹ˆ๋‹ค.
10:20
you're seeing here, illustrators.
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์—ฌ๊ธฐ ์ผ๋Ÿฌ์ŠคํŠธ๋ ˆ์ดํ„ฐ๋ฅผ ๋ณด์‹ค ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
10:22
They take primary data from CT scans and MRIs,
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CT ์Šค์บ”๊ณผ MRI์—์„œ ๊ธฐ๋ณธ์ ์ธ ๋ฐ์ดํ„ฐ๋ฅผ ๋ฐ›์•„
10:27
translate it into digital information,
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๋””์ง€ํ„ธ ์ •๋ณด๋กœ ๋ณ€ํ™˜์‹œํ‚ต๋‹ˆ๋‹ค.
10:30
animate it,
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์—ฌ๊ธฐ์— ์ƒ๋ช…์„ ๋ถˆ์–ด ๋„ฃ์–ด
10:32
put it together into the components of the child itself,
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์ด ์•„์ด๋ฅผ ๊ตฌ์„ฑํ•˜๋Š” ์š”์†Œ๋กœ ๋‹ค์‹œ ๋งŒ๋“ญ๋‹ˆ๋‹ค.
10:36
surface-scan elements of the child that have been casted as needed,
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์ˆ˜์ˆ ์— ๋”ฐ๋ผ ํ•„์š”ํ•˜๋‹ค๋ฉด ์•„์ด์˜ ํ”ผ๋ถ€๋ฅผ ์Šค์บ”ํ•œ ์š”์†Œ๋„
10:40
depending on the surgery itself,
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๋งŒ๋“ค์–ด์งˆ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
10:43
and then take this digital data and be able to output it
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๊ทธ ๋’ค ์ด ๋””์ง€ํ„ธ ์ž๋ฃŒ๋ฅผ ๋ฐ›์•„ ์ถœ๋ ฅ ํ•  ์ˆ˜ ์žˆ๊ฒŒ ๋งŒ๋“ญ๋‹ˆ๋‹ค.
10:47
on state-of-the-art, three-dimensional printing devices
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์ตœ์ฒจ๋‹จ 3์ฐจ์› ํ”„๋ฆฐํ„ฐ๋ฅผ ์ด์šฉํ•ด
10:50
that allow us to print the components
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์ด ์š”์†Œ๋“ค์„ ์ถœ๋ ฅํ•˜๊ฒŒ ๋งŒ๋“ค์–ด์ค๋‹ˆ๋‹ค.
10:53
exactly to the micron detail of what the child's anatomy will look like.
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์ด ์•„์ด์˜ ๋ชธ์˜ ๊ตฌ์กฐ์™€ ๋ฐฑ๋งŒ๋ถ„์˜ ์ผ์˜ ์˜ค์ฐจ๋„ ์—†์ด ๋˜‘๊ฐ™์€ ๋ชจํ˜•์„์š”.
10:58
You can see here,
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์—ฌ๊ธฐ ๋ณด์‹ค ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
11:00
the skull of this child being printed
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์ด ์•„์ด์˜ ๋‘๊ฐœ๊ณจ์ด
11:02
in the hours before we performed this surgery.
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์ˆ˜์ˆ ์„ ํ•˜๊ธฐ ๋ช‡ ์‹œ๊ฐ„ ์ „์— ์ถœ๋ ฅ๋˜๊ณ  ์žˆ์Šต๋‹ˆ๋‹ค.
11:06
But we could not do this work
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ํ•˜์ง€๋งŒ ์บ˜๋ฆฌํฌ๋‹ˆ์•„ ํ—๋ฆฌ์šฐ๋“œ์˜ ์„œ๋ถ€ํ•ด์•ˆ์— ์žˆ๋Š” ์†Œ์ค‘ํ•œ ์นœ๊ตฌ ์—†์ด๋Š”
11:09
without our dear friends on the West Coast in Hollywood, California.
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์ด ์ผ์„ ํ•ด๋‚ผ ์ˆ˜ ์—†์—ˆ์„ ๊ฒ๋‹ˆ๋‹ค.
11:14
These are individuals that are incredibly talented
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์ด ์‚ฌ๋žŒ๋“ค์€ ์‹ค์ œ๋ฅผ ์žฌํ˜„ํ•˜๋Š”๋ฐ ์žˆ์–ด
11:17
at being able to recreate reality.
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ํƒ์›”ํ•œ ์žฌ๋Šฅ์„ ๊ฐ€์ง„ ์‚ฌ๋žŒ๋“ค์ž…๋‹ˆ๋‹ค.
11:20
It was not a long leap for us.
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์ด๊ฒƒ์€ ์ €ํฌ๋“ค์„ ์œ„ํ•œ ํฐ ๋„์•ฝ์ด ์•„๋‹™๋‹ˆ๋‹ค.
11:24
The more we got into this field,
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์ด ๋ถ„์•ผ๋กœ ์ ์  ๋“ค์–ด๊ฐˆ์ˆ˜๋ก
11:26
the more it became clear to us that we are doing cinematography.
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์šฐ๋ฆฌ๊ฐ€ ์˜ํ™”์ดฌ์˜์ˆ ์„ ํ•˜๊ณ  ์žˆ๋‹ค๋Š” ๊ฒƒ์ด ๋ช…ํ™•ํ•ด์ง‘๋‹ˆ๋‹ค.
11:30
We're doing filmmaking,
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์šฐ๋ฆฌ๋Š” ์˜ํ™”์ œ์ž‘์„ ํ•˜๊ณ  ์žˆ๋Š” ๊ฒ๋‹ˆ๋‹ค.
11:32
it's just that the actors are not actors.
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๋‹จ์ง€ ์ถœ์—ฐ์ž๋“ค์ด ๋ฐฐ์šฐ๊ฐ€ ์•„๋‹ ๋ฟ์ด์ฃ .
11:35
They're real doctors and nurses.
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์ถœ์—ฐ์ž๋“ค์€ ์ง„์งœ ์˜์‚ฌ์™€ ๊ฐ„ํ˜ธ์‚ฌ๋“ค์ž…๋‹ˆ๋‹ค.
11:39
So these are some photos of our dear friends at Fractured FX
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์ด๊ฒƒ์€ Fractured FX์—์„œ ์ผํ•˜๋Š” ์†Œ์ค‘ํ•œ ์นœ๊ตฌ๋“ค์˜ ์‚ฌ์ง„์ž…๋‹ˆ๋‹ค.
11:42
in Hollywood California,
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์บ˜๋ฆฌํฌ๋‹ˆ์•„ ํ—๋ฆฌ์šฐ๋“œ์— ์žˆ์ฃ .
11:43
an Emmy-Award-winning special effects firm.
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์—๋ฏธ์ƒ์„ ์ˆ˜์ƒํ•œ ํŠน์ˆ˜ํšจ๊ณผํŒ€์ž…๋‹ˆ๋‹ค.
11:47
This is Justin Raleigh and his group --
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์ด๊ฒƒ์€ ์ €์Šคํ‹ด ๋กค๋ฆฌ์™€ ๊ทธ์˜ ํŒ€์ด๊ณ 
11:50
this is not one of our patients --
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์ €ํฌ ํ™˜์ž๊ฐ€ ์•„๋‹™๋‹ˆ๋‹ค.
11:52
(Laughter)
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(์›ƒ์Œ)
11:53
but kind of the exquisite work that these individuals do.
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๊ทธ๋Ÿฌ๋‚˜ ์ด ์‚ฌ๋žŒ๋“ค์ด ํ•˜๋Š” ์ผ์€ ๋งค์šฐ ์ •๊ตํ•œ ์ž‘์—…์ด์ฃ .
11:56
We have now collaborated and fused our experience,
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์ด์ œ ์šฐ๋ฆฌ๋Š” ๊ณต๋™์œผ๋กœ ์ž‘์—…ํ•˜๊ณ  ์šฐ๋ฆฌ์˜ ๊ฒฝํ—˜์„ ๋…น์—ฌ๋ƒ…๋‹ˆ๋‹ค.
12:00
bringing their group to Boston Children's Hospital,
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์ด ํŒ€์„ ๋ณด์Šคํ„ด ์•„๋™๋ณ‘์›์— ๋ฐ๋ ค์˜ค๊ณ 
12:02
sending our group out to Hollywood, California
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์šฐ๋ฆฌ ํŒ€์„ ํ—๋ฆฌ์šฐ๋“œ๋กœ ๋ณด๋‚ด
12:05
and exchanging around this
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์„œ๋กœ ๊ตํ™˜ํ•˜์—ฌ
12:06
to be able to develop these type of simulators.
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์ด๋Ÿฐ ์ข…๋ฅ˜์˜ ์‹œ๋ฎฌ๋ ˆ์ดํ„ฐ๋ฅผ ๋ฐœ์ „์‹œํ‚ฌ ์ˆ˜ ์žˆ๊ฒŒ ๋งŒ๋“œ๋Š”๊ฒ๋‹ˆ๋‹ค.
12:10
What I'm about to show you is a reproduction of this child.
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์ œ๊ฐ€ ์ง€๊ธˆ ๋ณด์—ฌ๋“œ๋ฆด ๊ฒƒ์€ ์ด ์•„์ด์˜ ๋ชจํ˜•์ธ๋ฐ์š”.
12:18
You'll notice here that every hair on the child's head is reproduced.
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๋จธ๋ฆฌ์นด๋ฝ ํ•œ ์˜ฌ๊นŒ์ง€ ์žฌํ˜„๋˜์—ˆ๋‹ค๋Š” ๊ฒƒ์„ ๋ณด์‹ค ์ˆ˜ ์žˆ์„ ๊ฒ๋‹ˆ๋‹ค.
12:24
And in fact, this is also that reproduced child --
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๊ทธ๋ฆฌ๊ณ  ์‚ฌ์‹ค์€ ์ด๊ฒƒ ์—ญ์‹œ ์•„์ด์˜ ๋ชจํ˜•์ž…๋‹ˆ๋‹ค.
12:27
and I apologize for any queasy stomachs,
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๋ถˆํŽธํ•˜์…จ๋‹ค๋ฉด ์‚ฌ๊ณผ๋“œ๋ฆฝ๋‹ˆ๋‹ค.
12:31
but that is a reproduction and simulation
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๊ทธ๋Ÿฌ๋‚˜ ์ด๊ฒƒ์ด ๊ทธ๋“ค์ด ์ˆ˜์ˆ ํ•  ์•„์ด์˜
12:33
of the child they're about to operate on.
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๋ชจํ˜•์ด์ž ์‹œ๋ฎฌ๋ ˆ์ด์…˜์ž…๋‹ˆ๋‹ค.
12:38
Here's that membrane we had talked about,
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์ด๊ฒƒ์ด ์•„๊นŒ ๋ง์”€๋“œ๋ฆฐ ์„ธํฌ๋ง‰์ž…๋‹ˆ๋‹ค.
12:40
the inside of this child's brain.
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์ด ์•„์ด์˜ ๋‡Œ ์†์— ์žˆ๋Š”๊ฑฐ์ฃ .
12:43
What you're going to be seeing here is, on one side, the actual patient,
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์ง€๊ธˆ ๋ณด์‹œ๋Š” ๊ฒƒ์€ ํ•œ์ชฝ์€ ์‹ค์ œ ํ™˜์ž์ด๊ณ 
12:48
and on the other side, the simulator.
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๋‹ค๋ฅธ ์ชฝ์€ ์‹œ๋ฎฌ๋ ˆ์ดํ„ฐ์ž…๋‹ˆ๋‹ค.
12:50
As I mentioned, a scope, a little camera, needs to make its way down,
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๋ง์”€๋“œ๋ฆฐ๋Œ€๋กœ ๊ด€์ฐฐ์šฉ ๊ธฐ๊ตฌ์™€ ์ž‘์€ ์นด๋ฉ”๋ผ๊ฐ€ ๋“ค์–ด๊ฐ€์•ผํ•ฉ๋‹ˆ๋‹ค.
12:55
and you're seeing that here.
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์ง€๊ธˆ ๋ณด์ด์‹œ์ฃ .
12:56
It needs to make a small hole in this membrane
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์„ธํฌ๋ง‰ ์•ˆ์— ์ž‘์€ ๊ตฌ๋ฉ์„ ๋šซ์–ด์•ผํ•˜๊ณ 
12:58
and allow this fluid to seep out.
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๋‡Œ์ฒ™์ˆ˜์•ก์ด ํ˜๋Ÿฌ๋‚˜์˜ค๊ฒŒ ํ•ด์•ผํ•ฉ๋‹ˆ๋‹ค.
13:02
I won't do a quiz show to see who thinks which side is which,
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์–ด๋–ค ์ชฝ์ด ๋ฌด์—‡์ธ์ง€ ๋งž์ถ”๋Š” ๋ฌธ์ œ๋Š” ๋‚ด์ง€ ์•Š๊ฒ ์Šต๋‹ˆ๋‹ค.
13:08
but on the right is the simulator.
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์˜ค๋ฅธ์ชฝ์ด ์‹œ๋ฎฌ๋ ˆ์ดํ„ฐ์ž…๋‹ˆ๋‹ค.
13:12
So surgeons can now produce training opportunities,
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๋”ฐ๋ผ์„œ ์ด์ œ ์™ธ๊ณผ์˜์‚ฌ๋“ค์€ ์‹ค์Šต ๊ธฐํšŒ๋ฅผ ๋งŒ๋“ค์–ด ๋‚ผ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
13:16
do these surgeries as many times as they want,
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์–ธ์ œ๋“ ์ง€ ์›ํ•  ๋•Œ ์ˆ˜์ˆ ์„ ํ•  ์ˆ˜ ์žˆ๊ฒŒ ๋œ ๊ฑฐ์ฃ .
13:19
to their heart's content, until they feel comfortable.
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๋งˆ์Œ์ด ํŽธํ•ด์ง€๊ณ  ๋งŒ์กฑ๊ฐ์„ ๋Š๋‚„ ๋•Œ๊นŒ์ง€์š”.
13:22
And then, and only then, bring the child into the operating room.
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๊ทธ๋Ÿฌ๋ฉด ๊ทธ ๋•Œ ์•„์ด๋ฅผ ์ˆ˜์ˆ ์‹ค๋กœ ๋ฐ๋ ค์˜ค๋Š”๊ฒ๋‹ˆ๋‹ค.
13:25
But we don't stop here.
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ํ•˜์ง€๋งŒ ์—ฌ๊ธฐ์„œ ๋ฉˆ์ถ”์ง€ ์•Š์Šต๋‹ˆ๋‹ค.
13:27
We know that a key step to this is not just the skill itself,
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์—ฌ๊ธฐ์„œ ์ค‘์š”ํ•œ ๋ถ€๋ถ„์€ ์ˆ˜์ˆ  ๊ธฐ๋Ÿ‰ ์ž์ฒด๊ฐ€ ์•„๋‹˜์„ ์•Œ๊ณ  ์žˆ์Šต๋‹ˆ๋‹ค.
13:31
but combining that skill with a team who's going to deliver that care.
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์ˆ˜์ˆ  ๊ธฐ๋Ÿ‰์„ ํ•จ๊ป˜ ์น˜๋ฃŒํ•˜๊ฒŒ ๋  ํŒ€๊ณผ ๊ฒฐํ•ฉ์‹œํ‚ค๋Š”๊ฑฐ์ฃ .
13:35
Now we turn to Formula One.
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์ด์ œ ํฌ๋ฎฌ๋Ÿฌ ์› ์–˜๊ธฐ๋ฅผ ํ•ด๋ณด์ฃ .
13:38
And here is an example of a technician putting on a tire
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์ด๊ฒƒ์€ ๊ธฐ์ˆ ์ž๊ฐ€ ํƒ€์ด์–ด๋ฅผ ๋ผ์šฐ๋Š” ๋ชจ์Šต์ž…๋‹ˆ๋‹ค.
13:42
and doing that time and time again on this car.
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๊ฐ™์€ ์ฐจ์— ์—ฌ๋Ÿฌ ๋ฒˆ ๋ฐ˜๋ณตํ•ฉ๋‹ˆ๋‹ค.
13:45
But that is very quickly going to be incorporated
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์ด ์ผ์€ ๋งค์šฐ ๋น ๋ฅด๊ฒŒ
13:48
within team-training experiences,
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ํŒ€์ด ํ•จ๊ป˜ ์—ฐ์Šตํ•˜๋ฉฐ ์ด๋ฃจ์–ด์ ธ์•ผํ•ฉ๋‹ˆ๋‹ค.
13:50
now as a full team orchestrating the exchange of tires
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์ด์ œ ํŒ€ ๋™๋ฃŒ๋“ค์ด ํ•จ๊ป˜ ํƒ€์ด์–ด์˜ ๊ตํ™˜์„ ๋งˆ์น˜๋ฉด
13:54
and getting this car back on the speedway.
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์ฐจ๊ฐ€ ๋‹ค์‹œ ๊ฒฝ์ฃผ๋กœ๋กœ ๋‚˜๊ฐ€๊ฒŒ ํ•ฉ๋‹ˆ๋‹ค.
13:58
We've done that step in health care,
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์šฐ๋ฆฌ๋Š” ์ด ๋‹จ๊ณ„๋“ค์„ ์˜๋ฃŒ์„œ๋น„์Šค์—์„œ ํ•ด ์™”์Šต๋‹ˆ๋‹ค.
14:01
so now what you're about to see is a simulated operation.
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์ง€๊ธˆ ๋ณด์‹ค ๊ฒƒ์€ ๋ชจ์˜ ์ˆ˜์ˆ ์ž…๋‹ˆ๋‹ค.
14:06
We've taken the simulator I just described to you,
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์•„๊นŒ ์„ค๋ช… ๋“œ๋ฆฐ ์‹œ๋ฎฌ๋ ˆ์ดํ„ฐ๋ฅผ ๊ฐ€์ ธ์™”์Šต๋‹ˆ๋‹ค.
14:08
we've brought it into the operating room at Boston Children's Hospital,
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๋ณด์Šคํ„ด ์•„๋™๋ณ‘์›์˜ ์ˆ˜์ˆ ์‹ค๋กœ ๋“ค์—ฌ์˜จ๊ฑฐ์ฃ .
14:12
and these individuals -- these native teams, operative teams --
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๊ทธ๋ฆฌ๊ณ  ์ด ์‚ฌ๋žŒ๋“ค, ์ด ์ˆ˜์ˆ ํŒ€์€
14:16
are doing the surgery before the surgery.
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์ˆ˜์ˆ  ์ „์— ์ˆ˜์ˆ ์„ ํ•ฉ๋‹ˆ๋‹ค.
14:19
Operate twice;
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์ˆ˜์ˆ ์„ ๋‘ ๋ฒˆ ํ•˜๋Š” ๊ฑฐ์ฃ .
14:21
cut once.
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์ ˆ๊ฐœ๋Š” ํ•œ ๋ฒˆ์ด๊ณ ์š”.
14:22
Let me show that to you.
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๋ณด์—ฌ๋“œ๋ฆฌ๊ฒ ์Šต๋‹ˆ๋‹ค.
14:25
(Video) Surgical team member 1: You want the head down or head up?
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์ˆ˜์ˆ ํŒ€ ๋™๋ฃŒ1: ๋จธ๋ฆฌ๋ฅผ ๋‚ด๋ฆด๊นŒ์š”, ์˜ฌ๋ฆด๊นŒ์š”?
14:28
STM 2: Can you lower it down to 10?
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๋™๋ฃŒ2: 10๊นŒ์ง€ ๋‚ด๋ ค์ค„ ์ˆ˜ ์žˆ๋‚˜์š”?
14:30
STM 3: And then lower the whole table down a little bit?
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๋™๋ฃŒ3: ์ˆ˜์ˆ ๋Œ€ ์ž์ฒด๋ฅผ ์กฐ๊ธˆ๋งŒ ๋‚ด๋ ค์ค„๋ž˜์š”?
14:32
STM 4: Table coming down.
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๋™๋ฃŒ4: ์ˆ˜์ˆ ๋Œ€๊ฐ€ ๋‚ด๋ ค์˜ต๋‹ˆ๋‹ค.
14:36
STM 3: All right, this is behaving like a vessel.
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๋™๋ฃŒ3: ์ข‹์•„์š”, ์ด๊ฒŒ ํ˜ˆ๊ด€์ด๊ตฐ์š”.
14:39
Could we have the scissors back, please?
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๊ฐ€์œ„ ๋‹ค์‹œ ์ค„๋ž˜์š”?
14:41
STM 5: I'm taking my gloves, 8 to 8 1/2, all right? I'll be right in.
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๋™๋ฃŒ5: ์žฅ๊ฐ‘ ๋ฐ›์•˜์Šต๋‹ˆ๋‹ค. 8์—์„œ 8 1/2์‚ฌ์ด์ฆˆ๋กœ์š”. ๊ณง ๋“ค์–ด๊ฐ‘๋‹ˆ๋‹ค.
14:44
STM 6: Great! Thank you.
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๋™๋ฃŒ 6: ์ข‹์•„์š”! ๊ณ ๋งˆ์›Œ์š”.
14:48
Peter Weinstock: It's really amazing.
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์ •๋ง ์‹ ๊ธฐํ•˜์ฃ .
14:50
The second step to this, which is critical,
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์—ฌ๊ธฐ ๋‘ ๋ฒˆ์งธ ๋‹จ๊ณ„๊ฐ€ ์ค‘์š”ํ•œ๋ฐ์š”.
14:52
is we take these teams out immediately and debrief them.
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ํŒ€์„ ๊ณง๋ฐ”๋กœ ๋‚˜์˜ค๊ฒŒํ•ด์„œ ์–˜๊ธฐ๋ฅผ ๋“ฃ๋Š”๊ฑฐ์—์š”.
14:55
We use the same technologies
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์šฐ๋ฆฌ๋Š” ๊ตฐ๋Œ€์—์„œ ์‚ฌ์šฉ๋˜๋Š” ํ”„๋กœ์„ธ์Šค ๊ฐœ์„  ๋ฐฉ๋ฒ•๊ณผ
14:56
that are used in Lean and Six Sigma in the military,
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๋™์ผํ•œ ๊ธฐ์ˆ ์„ ์‚ฌ์šฉํ•ฉ๋‹ˆ๋‹ค.
15:01
and we bring them out and talk about what went right,
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๊ทธ๋“ค์„ ๋ฐ–์œผ๋กœ ๋‚˜์˜ค๊ฒŒํ•˜๊ณ  ์–ด๋–ค ์ ์ด ์ž˜ ๋˜์—ˆ๋Š”์ง€๋ฅผ ์–˜๊ธฐํ•ฉ๋‹ˆ๋‹ค.
15:04
but more importantly,
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ํ•˜์ง€๋งŒ ๋”์šฑ ์ค‘์š”ํ•œ ๊ฒƒ์€
15:06
we talk about what didn't go well,
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๋ฌด์—‡์ด ์ž˜๋ชป๋˜์—ˆ๋Š”์ง€๋ฅผ ์–˜๊ธฐํ•˜๋Š” ๊ฑฐ์ฃ .
15:08
and how we're going to fix it.
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๊ทธ๋ฆฌ๊ณ  ์–ด๋–ป๊ฒŒ ํ•ด๊ฒฐํ• ์ง€์— ๊ด€ํ•ด ๋งํ•˜๋Š” ๊ฑฐ์˜ˆ์š”.
15:10
Then we bring them right back in and do it again.
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๋ฐ”๋กœ ๋“ค์–ด๊ฐ€๊ฒŒ ํ•ด์„œ ๋‹ค์‹œ ํ•ด๋ด…๋‹ˆ๋‹ค.
15:13
Deliberative batting practice in the moments when it matters most.
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๊ฐ€์žฅ ์ค‘์š”ํ•œ ์ˆœ๊ฐ„์— ์‹ ์ค‘ํ•œ ํƒ€๊ฒฉ ์—ฐ์Šต์„ ํ•˜๋Š”๊ฑฐ์ฃ .
15:20
Let's go back to this case now.
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์ด์ œ ์ด ์‚ฌ๋ก€๋กœ ๋‹ค์‹œ ๋Œ์•„์™€ ๋ด…์‹œ๋‹ค.
15:22
Same child,
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๊ฐ™์€ ์•„์ด์ž…๋‹ˆ๋‹ค.
15:24
but now let me describe how we care for this child
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์ด์ œ ๋ณด์Šคํ„ด ์•„๋™๋ณ‘์›์—์„œ
15:26
at Boston Children's Hospital.
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์ด ์•„์ด๋ฅผ ์–ด๋–ป๊ฒŒ ์น˜๋ฃŒํ–ˆ๋Š”์ง€ ์„ค๋ช…ํ•ด๋“œ๋ฆด๊ฒŒ์š”.
15:28
This child was born at three o'clock in the morning.
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์ด ์•„์ด๋Š” ์ƒˆ๋ฒฝ 3์‹œ์— ํƒœ์–ด๋‚ฌ์Šต๋‹ˆ๋‹ค.
15:30
At two o'clock in the morning,
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๊ทธ๋ฆฌ๊ณ  ์ƒˆ๋ฒฝ 2์‹œ์—
15:32
we assembled the team,
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์šฐ๋ฆฌ๋Š” ํŒ€์„ ์†Œ์ง‘ํ–ˆ์ฃ .
15:34
and took the reproduced anatomy
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์Šค์บ”๊ณผ ์˜์ƒ์œผ๋กœ๋ถ€ํ„ฐ ์–ป์–ด๋‚ธ ์ž๋ฃŒ๋ฅผ ๊ฐ€์ง€๊ณ 
15:36
that we would gain out of scans and images,
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์•„์ด์™€ ๋˜‘๊ฐ™์€ ๋ชจํ˜•์„ ๋งŒ๋“ค์–ด๋ƒˆ์ฃ .
15:40
and brought that team to the virtual bedside,
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๊ฐ€์ƒ ์ˆ˜์ˆ ๋Œ€๋กœ ์ˆ˜์ˆ ํŒ€์„ ๋ถˆ๋ €์ฃ .
15:43
to a simulated bedside --
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๋ชจ์˜ ์ˆ˜์ˆ ๋Œ€๋กœ์š”.
15:44
the same team that's going to operate on this child in the hours ahead --
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๋ช‡ ์‹œ๊ฐ„ ๋’ค ์ด ์•„์ด๋ฅผ ์ˆ˜์ˆ ํ•  ํŒ€์ž…๋‹ˆ๋‹ค.
15:48
and we have them do the procedure.
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๊ทธ๋ฆฌ๊ณ  ์ ˆ์ฐจ๋ฅผ ๋”ฐ๋ฅด๊ฒŒ ํ–ˆ์ฃ .
15:51
Let me show you a moment of this.
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์ด ์ˆœ๊ฐ„์„ ๋ณด์—ฌ๋“œ๋ฆด๊ฒŒ์š”.
15:54
This is not a real incision.
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์‹ค์ œ ์ ˆ๊ฐœ๊ฐ€ ์•„๋‹™๋‹ˆ๋‹ค.
15:57
And the baby has not yet been born.
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์•„์ด๋Š” ์•„์ง ํƒœ์–ด๋‚˜์ง€ ์•Š์•˜์–ด์š”.
16:00
Imagine this.
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์ƒ์ƒํ•ด ๋ณด์„ธ์š”.
16:03
So now the conversations that I have with families
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๋ณด์Šคํ„ด ์•„๋™๋ณ‘์› ์ง‘์ค‘์น˜๋ฃŒ์‹ค์—์„œ
16:07
in the intensive care unit at Boston Children's Hospital
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์ œ๊ฐ€ ๊ฐ€์กฑ๋“ค๊ณผ ๋‚˜๋ˆ„๋Š” ๋Œ€ํ™”๋Š”
16:10
are totally different.
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์ด์ œ ์™„์ „ํžˆ ๋‹ฌ๋ผ์ง€๊ฒŒ ๋ฉ๋‹ˆ๋‹ค.
16:12
Imagine this conversation:
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์ด ๋Œ€ํ™”๋ฅผ ์ƒ์ƒํ•ด ๋ณด์‹œ์ฃ .
16:15
"Not only do we take care of this disorder frequently in our ICU,
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"์ด ์งˆํ™˜์€ ์ง‘์ค‘์น˜๋ฃŒ์‹ค์—์„œ ์—ฌ๋Ÿฌ ๋ฒˆ ์น˜๋ฃŒํ–ˆ์„ ๋ฟ ์•„๋‹ˆ๋ผ
16:20
and not only have we done surgeries
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๋‹น์‹ ์˜ ์•„์ด๊ฐ€ ํ•˜๊ฒŒ ๋  ์ˆ˜์ˆ ์„
16:22
like the surgery we're going to do on your child,
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์—ฌ๋Ÿฌ ๋ฒˆ ํ•ด ๋ณด์•˜์Šต๋‹ˆ๋‹ค.
16:25
but we have done your child's surgery.
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์‹ฌ์ง€์–ด ์ €ํฌ๋Š” ๋‹น์‹ ์˜ ์•„์ด์—๊ฒŒ ์ˆ˜์ˆ ์„ ํ–ˆ์–ด์š”.
16:29
And we did it two hours ago.
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๋‘ ์‹œ๊ฐ„ ์ „์—์š”.
16:32
And we did it 10 times.
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์—ด ๋ฒˆ์ด๋‚˜ ํ–ˆ์Šต๋‹ˆ๋‹ค.
16:35
And now we're prepared to take them back to the operating room."
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์ €ํฌ๋Š” ์ˆ˜์ˆ ์‹ค์— ๋“ค์–ด๊ฐˆ ์ค€๋น„๊ฐ€ ๋˜์—ˆ์Šต๋‹ˆ๋‹ค."
16:40
So a new technology in health care:
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๋”ฐ๋ผ์„œ ์˜๋ฃŒ์„œ๋น„์Šค์—์„œ์˜ ์ƒˆ๋กœ์šด ๊ธฐ์ˆ ์€
16:43
lifelike rehearsal.
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์‹ค๋ฌผ ๋ชจํ˜•์„ ์ด์šฉํ•œ ์‚ฌ์ „์—ฐ์Šต์ž…๋‹ˆ๋‹ค.
16:46
Practicing prior to game time.
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์‹ค์ „์— ์•ž์„œ ์—ฐ์Šต์„ ํ•˜๋Š” ๊ฑฐ์ฃ .
16:51
Thank you.
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๊ณ ๋ง™์Šต๋‹ˆ๋‹ค.
16:52
(Applause)
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(๋ฐ•์ˆ˜)
์ด ์›น์‚ฌ์ดํŠธ ์ •๋ณด

์ด ์‚ฌ์ดํŠธ๋Š” ์˜์–ด ํ•™์Šต์— ์œ ์šฉํ•œ YouTube ๋™์˜์ƒ์„ ์†Œ๊ฐœํ•ฉ๋‹ˆ๋‹ค. ์ „ ์„ธ๊ณ„ ์ตœ๊ณ ์˜ ์„ ์ƒ๋‹˜๋“ค์ด ๊ฐ€๋ฅด์น˜๋Š” ์˜์–ด ์ˆ˜์—…์„ ๋ณด๊ฒŒ ๋  ๊ฒƒ์ž…๋‹ˆ๋‹ค. ๊ฐ ๋™์˜์ƒ ํŽ˜์ด์ง€์— ํ‘œ์‹œ๋˜๋Š” ์˜์–ด ์ž๋ง‰์„ ๋”๋ธ” ํด๋ฆญํ•˜๋ฉด ๊ทธ๊ณณ์—์„œ ๋™์˜์ƒ์ด ์žฌ์ƒ๋ฉ๋‹ˆ๋‹ค. ๋น„๋””์˜ค ์žฌ์ƒ์— ๋งž์ถฐ ์ž๋ง‰์ด ์Šคํฌ๋กค๋ฉ๋‹ˆ๋‹ค. ์˜๊ฒฌ์ด๋‚˜ ์š”์ฒญ์ด ์žˆ๋Š” ๊ฒฝ์šฐ ์ด ๋ฌธ์˜ ์–‘์‹์„ ์‚ฌ์šฉํ•˜์—ฌ ๋ฌธ์˜ํ•˜์‹ญ์‹œ์˜ค.

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