Leana Wen: What your doctor won’t disclose

翻译人员: Chenyang Lin 校对人员: Yulan Zhang

They told me that I'm a traitor to my own profession,

他们告诉我, 我背叛了自己的职业,

that I should be fired,

我应该被解雇,

have my medical license taken away,

我的医生执照应该被吊销,

that I should go back to my own country.

我应该回到自己的国家。

我的邮箱被入侵了。

My email got hacked.

In a discussion forum for other doctors,

在一个其他医生开设的论坛上

someone took credit for "Twitter-bombing" my account.

有人轰炸我的推特账户, 而且还得到了其他人的赞赏。

Now, I didn't know if this was a good or bad thing,

当时, 我不知道是一件好事还是坏事,

but then came the response:

但是接着有人回复了:

"Too bad it wasn't a real bomb."

"可惜不是真的炸弹。“

I never thought that I would do something

我从来没有想到过我做的事情

that would provoke this level of anger among other doctors.

能激起其他医生们这种程度的愤怒。

Becoming a doctor was my dream.

成为一个医生曾是我的梦想。

I grew up in China,

我在中国长大,

and my earliest memories are of being rushed to the hospital

我最早的记忆是被匆忙送到医院

because I had such bad asthma that I was there nearly every week.

因为我有很严重的哮喘, 以至于当时几乎每周都在那里。

I had this one doctor, Dr. Sam, who always took care of me.

我有一个总是照顾我的医生, 山姆医生。

She was about the same age as my mother.

她当时和我的妈妈一个年纪。

She had this wild, curly hair,

她有一头狂乱的卷发,

and she always wore these bright yellow flowery dresses.

而且她总是穿着一条明黄色的花裙子。

She was one of those doctors who,

她是那些医生中的一个,

if you fell and you broke your arm,

如果你跌倒并摔伤了胳膊,

she would ask you why you weren't laughing

她会问你是为什么不笑

because it's your humerus. Get it?

因为那是你的肱骨（与搞笑同音）, 明白吗?

See, you'd groan,

你会痛得哇哇叫,

but she'd always make you feel better after having seen her.

但是在见到她之后她总是会让你感觉很好。

Well, we all have that childhood hero

我们所有人都有

that we want to grow up to be just like, right?

我们想长大后成为的儿时英雄, 对吗?

Well, I wanted to be just like Dr. Sam.

我想成为像山姆的医生。

When I was eight, my parents and I moved to the U.S.,

当我八岁的时候, 我的父母和我搬到了美国,

and ours became the typical immigrant narrative.

我们成为了典型的移民家庭。

My parents cleaned hotel rooms and washed dishes and pumped gas

我的父母去清理酒店房间、 洗盘子和给瓦斯充气

so that I could pursue my dream.

来让我追逐我的梦想。

Well, eventually I learned enough English,

最后, 我学了足够的英语,

and my parents were so happy

我的父母很开心

the day that I got into medical school and took my oath of healing and service.

对于我进入医学院学习, 并为治疗服务宣下了誓言。

But then one day, everything changed.

但是有一天, 所有的事情都变了。

My mother called me to tell me that she wasn't feeling well,

我的妈妈打电话和我说 她感觉不是很好,

she had a cough that wouldn't go away, she was short of breath and tired.

她得的咳嗽一直没有好 她喘不过气而且一直很疲累。

Well, I knew that my mother was someone who never complained about anything.

我知道我的妈妈是那种 从来不向他人抱怨的人。

For her to tell me that something was the matter,

所以当她告诉我她觉得不对劲的时候,

I knew something had to be really wrong.

我就知道事情不妙了。

And it was:

结果：

We found out that she had stage IV breast cancer,

我们发现她已经到了乳腺癌四期,

cancer that by then had spread to her lungs, her bones, and her brain.

癌细胞当时已经扩散到她的肺,骨头和大脑里。

My mother was brave, though, and she had hope.

我的妈妈是勇敢的, 她一直抱有希望。

She went through surgery and radiation,

她经历了手术和放射治疗,

and was on her third round of chemotherapy

在她在进行第三轮的化疗的时候

when she lost her address book.

她弄丢了她的通讯薄。

She tried to look up her oncologist's phone number on the Internet

她想从网上找到她的肿瘤科医生的电话

and she found it, but she found something else too.

她找到了, 并且也找到了一些其他的东西。

On several websites,

在一些网站上,

he was listed as a highly paid speaker to a drug company,

他是一家药物公司高薪聘请的代言人，

and in fact often spoke on behalf

而且, 事实上经常为他给我妈定的化疗方案

of the same chemo regimen that he had prescribed her.

作代表宣传。

She called me in a panic,

她很慌张的给我打电话,

and I didn't know what to believe.

我不知道该相信什么。

Maybe this was the right chemo regimen for her,

可能为她做的化疗方案是对的,

but maybe it wasn't.

但是也可能不是,

It made her scared and it made her doubt.

这使她非常害怕并产生怀疑。

When it comes to medicine,

当我们遇到药物问题时,

having that trust is a must,

这种信任非常重要,

and when that trust is gone, then all that's left is fear.

当信任失去了, 那么剩下的就只有害怕了。

There's another side to this fear.

这份恐惧也有着另外一面。

As a medical student, I was taking care of this 19-year-old

作为一个医学院的学生, 我一直照顾一个19岁的

who was biking back to his dorm

骑自行车回他的宿舍的路上

when he got struck and hit,

被撞倒, 卡在

run over by an SUV.

一辆越野车里的人。

He had seven broken ribs,

他有七根断掉的肋骨，

shattered hip bones,

破裂的臀部骨头，

and he was bleeding inside his belly and inside his brain.

他的腹部和脑袋一直在流血。

Now, imagine being his parents

现在，想象一下他的父母

who flew in from Seattle, 2,000 miles away,

要从2000英里外的西雅图飞过来,

to find their son in a coma.

为了去见正在昏迷的儿子。

I mean, you'd want to find out what's going on with him, right?

我意思是， 他们真的想找出 到底发生了什么在他的身上？

They asked to attend our bedside rounds

他们要求去参加我们的查房,

where we discussed his condition and his plan,

听取我们的诊疗经过。

which I thought was a reasonable request,

我认为是个合理的请求。

and also would give us a chance to show them

同时也给我们一个机会去向他们展示

how much we were trying and how much we cared.

我们有多努力和关心,

The head doctor, though, said no.

尽管主治医生说不行。

He gave all kinds of reasons.

他给了很多方面的原因。

Maybe they'll get in the nurse's way.

可能他们会妨碍护士的工作.

Maybe they'll stop students from asking questions.

可能他们会阻止学生问问题。

He even said,

他甚至说，

"What if they see mistakes and sue us?"

“如果他们看到错误并起诉我们怎么办？”

What I saw behind every excuse was deep fear,

我看到的是每个借口后面深深的恐惧,

and what I learned was that to become a doctor,

我学到的是去成为一个医生,

we have to put on our white coats,

我们不得不穿上白大褂,

put up a wall, and hide behind it.

筑起一道墙, 并藏在后面。

There's a hidden epidemic in medicine.

这其实是一种在医学领域里隐藏的风气。

Of course, patients are scared when they come to the doctor.

当然, 患者会害怕当他们去看医生的时候。

Imagine you wake up with this terrible bellyache,

想象你因肚子痛而醒来,

you go to the hospital,

你去医院,

you're lying in this strange place, you're on this hospital gurney,

你躺在一个一个陌生的地方, 你在医院的轮床上,

you're wearing this flimsy gown,

你穿着单薄的病人服，

strangers are coming to poke and prod at you.

陌生人过来对你一通摆弄,

You don't know what's going to happen.

你不知道将发生什么。

You don't even know if you're going to get the blanket you asked for 30 minutes ago.

你甚至不知道你会不会 拿到你30分钟前要的毛毯。

But it's not just patients who are scared;

但是这不仅仅是患者害怕;

doctors are scared too.

医生也一样害怕,

We're scared of patients finding out who we are

我们害怕患者找出我们是谁

and what medicine is all about.

和医学是关于什么的,

And so what do we do?

所以我们做什么呢?

We put on our white coats and we hide behind them.

我们穿上我们的白大褂并藏在后面,

Of course, the more we hide,

当然, 我们越是想隐藏,

the more people want to know what it is that we're hiding.

人们就越想知道我们隐藏的是什么.

The more fear then spirals into mistrust and poor medical care.

越多的害怕就会造成医患之间不信任, 以及贫乏的医疗救助。

We don't just have a fear of sickness,

我们不仅仅有着对疾病的害怕,

we have a sickness of fear.

我们也患上了恐惧病。

Can we bridge this disconnect

我们能在患者需求和医生之间

between what patients need and what doctors do?

的这种隔阂搭建桥梁吗?

Can we overcome the sickness of fear?

我们能克服这种恐惧吗?

Let me ask you differently:

让我换种方式问你:

If hiding isn't the answer, what if we did the opposite?

如果隐藏并不是解决问题的答案, 假使我们反方向而行之了呢?

What if doctors were to become totally transparent with their patients?

如果医生和患者之间变得完全透明呢?

Last fall, I conducted a research study to find out

去年秋天, 我做了一个研究学习去找出

what it is that people want to know about their healthcare.

人们想知道关于他们医疗保健的哪些事情。

I didn't just want to study patients in a hospital,

我不仅是想了解医院病人们的想法,

but everyday people.

而是所有人。

So my two medical students, Suhavi Tucker and Laura Johns,

所以我的两个实习生, 苏诃毗·塔克和劳拉·约翰,

literally took their research to the streets.

到街上做了这个研究。

They went to banks, coffee shops, senior centers,

他们去了医院, 咖啡店, 老人中心,

Chinese restaurants and train stations.

中餐厅和火车站。

What did they find?

他们发现了什么呢?

Well, when we asked people,

当我们问他们,

"What do you want to know about your healthcare?"

你们想知道关于你们的医疗保健的什么?

people responded with what they want to know about their doctors,

人们回应他们想知道 关于他们的医生的信息,

because people understand health care

因为人们知道医疗保健

to be the individual interaction between them and their doctors.

是他们和他们医生之间的个人互动。

When we asked, "What do you want to know about your doctors?"

当我们问, "你们想知道关于医生的什么?"

people gave three different answers.

人们给了三个不同的回答。

Some want to know that their doctor is competent

一些人想知道他们的医生是有能力

and certified to practice medicine.

和资格去行医。

Some want to be sure that their doctor is unbiased

一些人想确定他们的医生公正的

and is making decisions based on evidence and science,

做决定是基于科学依据,

not on who pays them.

而不是谁给他们付钱。

Surprisingly to us,

令我们惊讶的是,

many people want to know something else about their doctors.

许多人想知道关于医生的其他事情。

Jonathan, a 28-year-old law student,

乔纳森, 一个28岁的法律学生,

says he wants to find someone who is comfortable with LGBTQ patients

说他想找一些愿意为同性 双性恋及跨性别患者治疗,

and specializes in LGBT health.

而且是这一类别相关疾病的专家。

Serena, a 32-year-old accountant,

塞丽娜, 一个32岁的会计,

says that it's important to her for her doctor to share her values

说她的医生分享她的价值观

when it comes to reproductive choice and women's rights.

在生育选择上和女性权力上 对她说是重要的。

Frank, a 59-year-old hardware store owner,

弗兰克, 一个59岁的五金店老板,

doesn't even like going to the doctor

甚至不喜欢去看医生

and wants to find someone who believes in prevention first,

只是想找以预防为先，

but who is comfortable with alternative treatments.

而且愿意进行替代疗法的医生。

One after another, our respondents told us

一个接一个的, 我们的回应者告诉我们

that that doctor-patient relationship is a deeply intimate one —

医生和患者之间的关系是紧密到可以

that to show their doctors their bodies

让他们的医生去看他们的身体

and tell them their deepest secrets,

并可以告诉他们最深秘密的。

they want to first understand their doctor's values.

他们想先了解他们的医生的价值观。

Just because doctors have to see every patient

仅仅是因为医生可以去看每一个患者

doesn't mean that patients have to see every doctor.

并不代表每个患者就不得不去看每个医生。

People want to know about their doctors first

人们想先了解他们的医生

so that they can make an informed choice.

所以他们可以在知情情况下做出选择,

As a result of this, I formed a campaign,

通过这个结果, 我组织一个活动,

Who's My Doctor?

我的医生是谁?

that calls for total transparency in medicine.

来呼吁医疗界的透明化。

Participating doctors voluntarily disclose

自愿参与的医生公开信息

on a public website

在一个公共网站上,

not just information about where we went to medical school

不仅仅我们上了哪家医学院

and what specialty we're in,

我们的专业是什么,

but also our conflicts of interest.

而且还有我们的经济利益冲突。

We go beyond the Government in the Sunshine Act

我们已经超出了政府关于

about drug company affiliations,

制药从属公司的阳光行动,

and we talk about how we're paid.

我们讨论了我们是如何得到报酬的。

Incentives matter.

诱因很重要。

If you go to your doctor because of back pain,

如果你去看医生因为背痛,

you might want to know he's getting paid 5,000 dollars to perform spine surgery

你可能想知道, 他做一个 脊柱手术就能拿到5000美金,

versus 25 dollars to refer you to see a physical therapist,

而引荐你去看物理治疗只能拿到25美金。

or if he's getting paid the same thing no matter what he recommends.

或者说不管他推荐你什么, 他得到的支付都是一样的。

Then, we go one step further.

然后, 我们更进一步。

We add our values when it comes to women's health,

我们带来了更多的好处：比如女性健康,

LGBT health, alternative medicine,

同性双性恋及跨性者的健康问题, 替代疗法,

preventive health, and end-of-life decisions.

卫生预防, 以及临终决定。

We pledge to our patients that we are here to serve you,

我们向我们的患者 保证我们在这里是为你服务。

so you have a right to know who we are.

所以你有权利知道我们是谁,

We believe that transparency can be the cure for fear.

我们相信这种透明可以治疗恐惧。

I thought some doctors would sign on and others wouldn't,

我当时认为一些医生 会签下这份协议, 一些不会,

but I had no idea of the huge backlash that would ensue.

但是我不知道接下来 会产生这么大的反对意见。

Within one week of starting Who's My Doctor?

在这项活动开始的一周内

Medscape's public forum

知名医学网站医景的公共论坛

and several online doctors' communities

和一些网上医生社区

had thousands of posts about this topic.

有了上千个关于这个话题的帖子。

Here are a few.

这里有一些

From a gastroenterologist in Portland:

来自于波特兰的一个胃肠病专家:

"I devoted 12 years of my life to being a slave.

"我奉献了我生命中的12年去成为一个奴隶,

I have loans and mortgages.

我有贷款和抵押贷款,

I depend on lunches from drug companies to serve patients."

我依靠制药公司给的饭碗去给患者服务。“

Well, times may be hard for everyone,

这个时代对于每一个人都是困难的,

but try telling your patient

但是尝试去告诉你的患者

making 35,000 dollars a year to serve a family of four

一年赚35,000美金去养活一家四口

that you need the free lunch.

使你需要这个免费午餐。

From an orthopedic surgeon in Charlotte:

这个是来自夏洛特的一名矫形外科医生:

"I find it an invasion of my privacy to disclose where my income comes from.

“我认为公开我的收入来源 是一种对我隐私的侵犯,

My patients don't disclose their incomes to me."

我的病人也不向我公开他们的收入情况。“

But your patients' sources of income don't affect your health.

但是你病人的收入来源不影响你的健康。

From a psychiatrist in New York City:

这个是来自一名纽约的精神科的医生:

"Pretty soon we will have to disclose whether we prefer cats to dogs,

"不久之后我们将不得不公开 我们是否喜欢喜欢猫比狗多一点,

what model of car we drive,

我们开什么类型的车,

and what toilet paper we use."

我们用什么厕纸。“

Well, how you feel about Toyotas or Cottonelle

你的丰田汽车和斯科特纸的看法

won't affect your patients' health,

不会影响你的病人的健康,

but your views on a woman's right to choose

但是你对女性权利的选择,

and preventive medicine and end-of-life decisions just might.

预防医学和临终决定的看法是可能的。

And my favorite, from a Kansas City cardiologist:

还有我最喜欢的一条, 来自于堪萨斯城的心脏科医生:

"More government-mandated stuff?

“更多国家指定的医生?

Dr. Wen needs to move back to her own country."

文医生需要搬回自己的国家。“

Well, two pieces of good news.

这有两条好消息,

First of all, this is meant to be voluntary and not mandatory,

第一, 这应该是自愿的而不是强制的,

and second of all, I'm American and I'm already here.

第二, 我是美国人, 而且我已经在这了。

(Laughter) (Applause)

(掌声)

Within a month, my employers were getting calls

一个月之内, 我的雇主接到过几通电话

asking for me to be fired.

要求解雇我。

I received mail at my undisclosed home address

在我的一个私人的居所里, 收到了一封邮件

with threats to contact the medical board to sanction me.

威胁说要去联系医委会制裁我,

My friends and family urged me to quit this campaign.

我的朋友和家庭强烈要求我 从这个活动里退出,

After the bomb threat, I was done.

在收到炸弹威胁后, 我受够了。

But then I heard from patients.

但是然后我从患者那里听说,

Over social media, a TweetChat,

基于大众评价, Tweetchat,

which I'd learned what that was by then,

是我在当时用的社交工具,

generated 4.3 million impressions,

已经产生了430万的留言,

and thousands of people wrote to encourage me to continue.

上千人留言鼓励我继续。

They wrote with things like,

他们写下一些如,

"If doctors are doing something they're that ashamed of,

“如果医生做了一些让他们感到羞愧的事情,

they shouldn't be doing it."

他们就不应该那样做。“

"Elected officials have to disclose campaign contributions.

“当选官员在公开他们的竞选资金来源，

Lawyers have to disclose conflicts of interests.

律师在公开他们的经济利益冲突的情况下，

Why shouldn't doctors?"

医生怎么就不能公开了?“

And finally, many people wrote and said,

最后, 许多人留言说,

"Let us patients decide

“让我们患者决定

what's important when we're choosing a doctor."

当我们选一个医生的时候，什么才是重要的。”

In our initial trial,

在我们初期的实验里,

over 300 doctors have taken the total transparency pledge.

超过300个医生参与了这个透明承诺。

What a crazy new idea, right?

多么疯狂的想法, 对吗?

But actually, this is not that new of a concept at all.

但是事实上, 这一点都不算是新的概念。

Remember Dr. Sam, my doctor in China,

记得山姆医生,

with the goofy jokes and the wild hair?

那个会讲傻傻的笑话和 狂野的头发的中国医生吗?

Well, she was my doctor,

她曾是我的医生,

but she was also our neighbor

但是她同时也是

who lived in the building across the street.

住在街对面的邻居。

I went to the same school as her daughter.

我和她的女儿去的同一所学校,

My parents and I trusted her

我的父母和我相信她

because we knew who she was and what she stood for,

因为我们知道她是怎样的一个人 和她的信仰是什么,

and she had no need to hide from us.

她不需要向我们隐藏什么。

Just one generation ago, this was the norm in the U.S. as well.

仅仅这一代之前, 这在美国也是常态。

You knew that your family doctor was the father of two teenage boys,

你知道你的家庭医生 是两个十几岁男孩的父亲,

that he quit smoking a few years ago,

他几年前把烟戒掉了,

that he says he's a regular churchgoer,

经常去做礼拜,

but you see him twice a year: once at Easter

但是你见他一年两次: 要么是在复活节

and once when his mother-in-law comes to town.

要么就是他的岳母到访的时候。

You knew what he was about,

你知道关于他的事情,

and he had no need to hide from you.

他不需要向你隐藏什么。

But the sickness of fear has taken over,

但是现在已经恐惧占据了,

and patients suffer the consequences.

患者为其承担后果。

I know this firsthand.

我亲身经历过的。

My mother fought her cancer for eight years.

我的妈妈和癌症做了八年的斗争,

She was a planner,

她是一个有计划的人,

and she thought a lot about how she wanted to live

她想了很多关于她想如何活

and how she wanted to die.

和她想如何死去。

Not only did she sign advance directives,

她不仅签了预留医疗指示协议,

she wrote a 12-page document about how she had suffered enough,

而且她写下了12页, 关于她遭受的是怎样的痛苦,

how it was time for her to go.

是时候让她走了。

One day, when I was a resident physician,

一天, 当我是一名住院医师的时候,

I got a call to say that she was in the intensive care unit.

我接到电话说她在特护病房。

By the time I got there, she was about to be intubated

我到那儿时, 她正要被插管

and put on a breathing machine.

装上呼吸机。

"But this is not what she wants," I said, "and we have documents."

“但是这不是她想要的,“ 我说, “我们有协议的。“

The ICU doctor looked at me in the eye,

重症加护病房的医生看着我的眼睛,

pointed at my then 16-year-old sister, and said,

指着我16岁的妹妹说,

"Do you remember when you were that age?

“你记得当你是这个年纪的时候吗?

How would you have liked to grow up without your mother?"

你会想要没有妈妈陪在你身边吗?“

Her oncologist was there too, and said,

她的肿瘤医生也在那里对我说,

"This is your mother.

“这是你的妈妈。

Can you really face yourself for the rest of your life

在你接下去的日子里, 你真的能面对你自己

if you don't do everything for her?"

如果你没有为她尽全力?“

I knew my mother so well.

我非常了解我的妈妈。

I understood what her directives meant so well,

我明白她签的协议是什么,

but I was a physician.

但是我也是一名医生。

That was the single hardest decision I ever made,

这曾是我人生当中做的一个最难的决定：

to let her die in peace,

让她在平静地死去,

and I carry those words of those doctors with me

我每一天都在想

every single day.

这些医生的话

We can bridge the disconnect

我们能在患者需求和医生之间

between what doctors do and what patients need.

的这种隔阂搭建桥梁。

We can get there, because we've been there before,

我们可以做到, 因为之前我们做到过,

and we know that transparency gets us to that trust.

我们知道这种透明让我们得到信任。

Research has shown us that openness also helps doctors,

研究已经表明公开也可以帮助医生,

that having open medical records,

有一个公开的的病历,

being willing to talk about medical errors,

就会愿意去讨论医疗差错,

will increase patient trust,

这将增加患者的信任

improve health outcomes,

改善健康结果,

and reduce malpractice.

减少治疗不当。

That openness, that trust,

公开, 信任,

is only going to be more important

只会变得更加重要，

as we move from the infectious to the behavioral model of disease.

因为我们关注的是疾病的行为模式， 而不是它的传染模式。

Bacteria may not care so much about trust and intimacy,

细菌可能不关心信任和亲密

but for people to tackle the hard lifestyle choices,

但是为了帮助患者彻底改变他们不良生活嗜好，

to address issues like smoking cessation,

为了让患者戒烟，

blood-pressure management and diabetes control,

为了让患者控制血压，控制血糖，

well, that requires us to establish trust.

这些都要求我们去建立医患信任感。

Here's what other transparent doctors have said.

以下是其他参与透明活动的医生说的。

Brandon Combs, an internist in Denver:

布兰登∙库姆斯, 在丹佛的内科医生:

"This has brought me closer to my patients.

“这让我和我的患者亲近。

The type of relationship I've developed —

这种我一直以来建立起来的 医患关系恰恰就是

that's why I entered medicine."

为什么当初我行医的原因。“

Aaron Stupple, an internist in Denver:

亚伦, 丹佛的一名内科医生

"I tell my patients that I am totally open with them.

我告诉我的患者们，我对他们完全公开。

I don't hide anything from them.

我不向他们隐藏任何什么。

This is me. Now tell me about you.

这就是我, 你呢。

We're in this together."

我们同心协力。“

May Nguyen, a family physician in Houston:

五月阮, 休斯顿的一名家庭医生:

"My colleagues are astounded by what I'm doing.

"我的同事对于我在做什么都很震惊。

They ask me how I could be so brave.

他们问我, 我怎么这么勇敢。

I said, I'm not being brave,

我说, 这不是勇敢,

it's my job."

这是我的工作。"

I leave you today with a final thought.

今天我留给你们最后一个思考。

Being totally transparent is scary.

成为完全透明是令人害怕的,

You feel naked, exposed and vulnerable,

你感觉很不安, 脆弱,

but that vulnerability, that humility,

但是那些脆弱, 谦卑,

it can be an extraordinary benefit to the practice of medicine.

对于我们行医来说, 会带来非同凡响的益处。

When doctors are willing to step off our pedestals,

当医生愿意放下架子,

take off our white coats,

脱下白大褂,

and show our patients who we are and what medicine is all about,

向我们的患者展示我们是谁 和医学是关于什么的,

that's when we begin to overcome the sickness of fear.

那就是我们开始去克服恐惧的时候,

That's when we establish trust.

那就是我们建立信任的时候,

That's when we change the paradigm of medicine

那就是我们改变医学模式

from one of secrecy and hiding

从秘密和隐藏

to one that is fully open and engaged

到完全开放

for our patients.

并参与我们的患者中去。

Thank you.

谢谢。

(Applause)

(掌声)