Steven Schwaitzberg: A universal translator for surgeons

Translator: Timothy Covell Reviewer: Morton Bast

譯者: Clement Fu 審譯者: Eric Xia

So I want to talk to you about two things tonight.

今晚，我想跟大家談兩件事。

Number one:

首先，

Teaching surgery and doing surgery

教授外科手術、進行外科手術

is really hard.

真的很困難。

And second,

其次，

that language is one of the most profound things

語言是其中一樣最根深柢固的東西

that separate us all over the world.

將世界上不同的人分隔。

And in my little corner of the world,

而對於在世界上細小一角的我，

these two things are actually related,

上述兩件事其實息息相關，

and I want to tell you how tonight.

而今晚，我想跟大家道出理由。

Now, nobody wants an operation.

好了，沒有人是想做手術的。

Who here has had surgery?

在座各位，誰又曾經動過手術？

Did you want it?

是你想的嗎？

Keep your hands up if you wanted an operation.

想做手術的，把手舉定。

Nobody wants an operation.

無人想做手術。

In particular, nobody wants an operation

尤其是，無人想自己做的手術

with tools like these through large incisions

會用上這樣的工具，手術時開個大切口，

that cause a lot of pain,

會帶來極大痛楚，

that cause a lot of time out of work or out of school,

要請假缺課缺勤好一段時間，

that leave a big scar.

或是會留下大疤痕。

But if you have to have an operation,

但如果你必須要做手術的話，

what you really want is a minimally invasive operation.

你真正想要的是個微創手術。

That's what I want to talk to you about tonight --

這就是今晚我想跟你說的話題 --

how doing and teaching this type of surgery

如何進行並教授這一類型的手術，

led us on a search

怎樣引領我們

for a better universal translator.

搜尋更好的通用翻譯器。

Now, this type of surgery is hard,

好了，這類型的手術很艱難，

and it starts by putting people to sleep,

開始時先把病人麻醉入睡，

putting carbon dioxide in their abdomen,

將二氧化碳打進病人的腹部，

blowing them up like a balloon,

將他們像氣球一樣吹漲，

sticking one of these sharp pointy things into their abdomen --

將這些尖銳的東西，用其中一樣貼住腹部 --

it's dangerous stuff --

那是危險物品 --

and taking instruments and watching it on a TV screen.

接駁手術儀器並在電視螢幕上監察。

So let's see what it looks like.

那不如一齊看看，看起來會是怎樣。

So this is gallbladder surgery.

這是個膽囊手術。

We perform a million of these a year

單是在美國，我們每年

in the United States alone.

會做成上百萬次。

This is the real thing. There's no blood.

這是實際手術時的情況。見不到血的。

And you can see how focused the surgeons are,

而你可以見到外科醫生多麼的專注，

how much concentration it takes.

需要多大的集中力。

You can see it in their faces.

從他們的面部表情，可見一斑。

It's hard to teach, and it's not all that easy to learn.

要好好教授很難，而且也不都是那麼容易學習的事。

We do about five million of these in the United States

在美國，我們做了其中約五百萬宗手術，

and maybe 20 million of these worldwide.

全球就大概有二千萬宗。

All right, you've all heard the term:

好了，你們幾乎全都聽過這句說話：

"He's a born surgeon."

「他是天生華佗。」

Let me tell you, surgeons are not born.

讓我告訴你，外科醫生並非天生的。

Surgeons are not made either.

外科醫生也不是製造出來的。

There are no little tanks where we're making surgeons.

我們沒有小孵化槽可以將外科醫生製造出來。

Surgeons are trained one step at a time.

外科醫生是一步一步訓練出來的。

It starts with a foundation, basic skills.

是由一個基礎開始，即是基本技巧。

We build on that and we take people, hopefully, to the operating room

我們建基其上，並帶領學生，充滿期待地走進手術室，

where they learn to be an assistant.

在這兒他們學習如何成為手術助理。

Then we teach them to be a surgeon in training.

之後我們會指導他們成為實習外科醫生。

And when they do all of that for about five years,

而當大約五年之後他們把所有這些做完，

they get the coveted board certification.

他們會得到夢寐以求的資格認證。

If you need surgery, you want to be operated on

若你需要做手術，你會想由一位

by a board-certified surgeon.

已獲取資格認證的外科醫生操刀。

You get your board certificate,

你拿到資格認證後，

and you can go out into practice.

就能出外執業。

And eventually, if you're lucky, you achieve mastery.

而到最後，若你夠幸運的話，你就能成為精湛的名醫師。

Now that foundation is so important

基礎是何其重要，

that a number of us

使得我們一部分來自美國最大的普通外科醫生協會 --

from the largest general surgery society in the United States, SAGES,

美國胃腸道與內視鏡手術協會(SAGES) 的成員，

started in the late 1990s a training program

在 90 年代末，開始了一個培訓計劃，

that would assure that every surgeon who practices minimally invasive surgery

確保每位外科醫生，在進行微創手術之前，

would have a strong foundation of knowledge and skills

都會有穩固的知識和技術基礎，

necessary to go on and do procedures.

以便能夠遵從並執行手術程序。

Now the science behind this is so potent

背後的科學理念顯而易見，

that it became required by the American Board of Surgery

因此現在美國外科醫學委員會 (ABS) 要求

in order for a young surgeon to become board certified.

年輕的外科醫生都要參與培訓計劃才能得到資格認證。

It's not a lecture, it's not a course,

這不是個講課，不是個課程，

it's all of that plus a high-stakes assessment.

而是上述兩者，加上嚴謹的評核。

It's hard.

換言之，難。

Now just this past year,

在剛過去的一年，

one of our partners, the American College of Surgeons,

我們其中一個夥伴機構，美國外科醫師學院 (ACS)，

teamed up with us to make an announcement

與我們攜手，一起宣布：

that all surgeons should be FLS (Fundamentals of Laparoscopic Surgery)-certified

所有外科醫生都要先得到 FLS (腹腔鏡手術基礎) 證書

before they do minimally invasive surgery.

才能進行微創手術。

And are we talking about just people here in the U.S. and Canada?

我們是否只是說在美國這裏和加拿大的人？

No, we just said all surgeons.

不，我們是說「所有外科醫生」。

So to lift this education and training worldwide

所以，要將這項教育和培訓推至全球，

is a very large task,

工程浩大，

something I'm very personally excited about as we travel around the world.

雖然個人而言，我對我們能環遊世界各地感到很興奮。

SAGES does surgery all over the world, teaching and educating surgeons.

SAGES 在世界各地進行外科手術，教導並培訓外科醫生。

So we have a problem, and one of the problems is distance.

所以我們有個問題，而問題之一就是距離。

We can't travel everywhere.

我們總不能遊遍世界每一個角落。

We need to make the world a smaller place.

我們需要讓世界變得更小。

And I think that we can develop some tools to do so.

而我想，我們可以開發一些工具達到這個目的。

And one of the tools I like personally is using video.

而我個人喜歡的工具之一，就是運用影片。

So I was inspired by a friend.

我受到一位朋友啟發。

This is Allan Okrainec from Toronto.

他是來自多倫多的 Allan Okrainec 。

And he proved

而他就證明了

that you could actually teach people to do surgery

透過視像會議，你其實可以教授別人

using video conferencing.

怎樣進行外科手術。

So here's Allan teaching an English-speaking surgeon in Africa

這就是 Allan 教授一位身處非洲、會說英語的外科醫生，

these basic fundamental skills

傳授這些基本的基礎技巧

necessary to do minimally invasive surgery.

以進行微創手術。

Very inspiring.

很有啟發性。

But for this examination, which is really hard,

但對於考試，這個真的很難的考試，

we have a problem.

我們有個問題。

Even people who say they speak English,

即使別人說他們會說英語，

only 14 percent pass.

僅百分之 14 及格。

Because for them it's not a surgery test,

因為對他們而言，那不是個外科測試，

it's an English test.

而是英語測試。

Let me bring it to you locally.

讓我帶你看看本地實況。

I work at the Cambridge Hospital.

我在劍橋醫院 (Cambridge Hospital) 工作。

It's the primary Harvard Medical School teaching facility.

那是哈佛醫學院 (Harvard Medical School) 的主要教學大樓。

We have more than 100 translators covering 63 languages,

我們有超過 100 位翻譯員，涵蓋 63 種語言，

and we spend millions of dollars just in our little hospital.

而光是我們一所小醫院，就花上數以百萬元。

It's a big labor-intensive effort.

翻譯真是個龐大又費人力的功夫。

If you think about the worldwide burden

若你想想要推至全球，

of trying to talk to your patients --

與病人溝通 --

not just teaching surgeons, just trying to talk to your patients --

不單是教授外科醫生，而是嘗試與病人溝通 --

there aren't enough translators in the world.

世界上根本就沒有足夠翻譯員。

We need to employ technology to assist us in this quest.

這項艱鉅的任務，需要引進科技作援手。

At our hospital we see everybody from Harvard professors

在我們的醫院裏，見到的人，由哈佛教授

to people who just got here last week.

到上星期才剛抵埗的留學生都有。

And you have no idea how hard it is

而你無法想像，和一個語言不通的人交流

to talk to somebody or take care of somebody you can't talk to.

或是照顧一個語言不通的人，有多麼困難。

And there isn't always a translator available.

而且翻譯員不是隨傳隨到的。

So we need tools.

所以我們需要工具。

We need a universal translator.

我們需要一部通用翻譯器。

One of the things that I want to leave you with as you think about this talk

當你細味今次演講時，我想贈你一言：

is that this talk is not just about us preaching to the world.

今次演講，不是說，我們要怎樣向世界傳道授業。

It's really about setting up a dialogue.

我們真正希望的，是能夠創立對話。

We have a lot to learn.

我們仍有許多需要學習的地方。

Here in the United States we spend more money per person

我們在美國，投放的個人醫療費用比其他國家多，

for outcomes that are not better than many countries in the world.

得出來的醫療成效，卻不比世界上其他國家理想。

Maybe we have something to learn as well.

也許，我們也有需要學習的地方。

So I'm passionate about teaching these FLS skills all over the world.

因此，我對在全球教授這些 FLS 技巧，充滿期待。

This past year I've been in Latin America, I've been in China,

過去的一年，我走訪過拉丁美洲，走訪過中國，

talking about the fundamentals of laparoscopic surgery.

講解腹腔鏡手術的基礎。

And everywhere I go the barrier is:

而所到各處，我見到當地人都遇上一道障礙：

"We want this, but we need it in our language."

「我們想向外取經，但我們更需要能聽得懂。」

So here's what we think we want to do:

而這就是我們希望能夠做到的事：

Imagine giving a lecture

想像一下，在一堂講課中，

and being able to talk to people in their own native language simultaneously.

能夠以當地人的母語與他們即時溝通。

I want to talk to the people in Asia, Latin America, Africa, Europe

比方說，我想跟身處亞洲、拉丁美洲、非洲、歐洲的人

seamlessly, accurately

都能準確無誤地傳情達意，

and in a cost-effective fashion using technology.

並且透過科技，節省高昂的成本。

And it has to be bi-directional.

而且溝通必須要雙向的。

They have to be able to teach us something as well.

他們要同時能夠向我們賜教。

It's a big task.

這項任務，殊不簡單。

So we looked for a universal translator; I thought there would be one out there.

於是我們開始尋找一部通用翻譯器；我想坊間應該有售。

Your webpage has translation, your cellphone has translation,

你可以找到在線翻譯，你的手機也有翻譯功能，

but nothing that's good enough to teach surgery.

但這些都不夠好，都不足以教授外科手術。

Because we need a lexicon. What is a lexicon?

因為我們需要詞庫。甚麼是詞庫？

A lexicon is a body of words that describes a domain.

詞庫就是一個特定領域中，用作描述的一體系字詞。

I need to have a health care lexicon.

我需要一個醫療衛生的詞庫。

And in that I need a surgery lexicon.

當中，需要一個外術手術的詞庫。

That's a tall order. We have to work at it.

這個要求甚高。我們需要動手實幹。

So let me show you what we're doing.

讓我為大家展示一下我們迄今初步得出的成果。

This is research -- can't buy it.

這是自家研究 -- 坊間買不到的。

We're working with the folks at IBM Research from the Accessibility Center

我們與 IBM 可及性中心 (Accessibility Center) 的研究人員合作，

to string together technologies to work towards the universal translator.

將一系列的科技串連起來，建構一部通用翻譯器。

It starts with a framework system

這部翻譯器由一個框架系統開始，

where when the surgeon delivers the lecture

當外科醫生講解授課時，

using a framework of captioning technology,

使用一個帶有顯示字幕技術的框架，

we then add another technology to do video conferencing.

然後我們讓這個框架同時具備視像會議系統的科技。

But we don't have the words yet, so we add a third technology.

但是字幕未有文字，於是我們加入第三種科技。

And now we've got the words,

現在字幕已打出文字，

and we can apply the special sauce: the translation.

接著就壓軸出場：文字翻譯。

We get the words up in a window and then apply the magic.

我們將字幕放到獨立的視窗，並施展這個法術。

We work with a fourth technology.

我們套用第四種科技。

And we currently have access to eleven language pairs.

目前，我們有十一對語言組可供使用。

More to come as we think about trying to make the world a smaller place.

應該陸續有來，好讓世界變得更小。

And I'd like to show you our prototype

現在，我想為大家展示一下成品的雛型，

of stringing all of these technologies that don't necessarily always talk to each other

將這些本來未必太相配的科技串連起來，

to become something useful.

變成一樣有用的產品。

Narrator: Fundamentals of Laparoscopic Surgery.

旁白：腹腔鏡手術基礎 (FLS)。

Module five: manual skills practice.

單元五：實作技巧實習。

Students may display captions in their native language.

學生可以選擇顯示自己母語的字幕。

Steven Schwaitzberg: If you're in Latin America,

Steven Schwaitzberg: 若你身處拉丁美洲，

you click the "I want it in Spanish" button

當你按一下「西班牙語字幕」的按鈕，

and out it comes in real time in Spanish.

就會即時顯示西班牙語的翻譯。

But if you happen to be sitting in Beijing at the same time,

但若果你這時身處北京

by using technology in a constructive fashion,

活用科技，

you could get it in Mandarin or you could get it in Russian --

你可以選用國語，又或選用俄語 --

on and on and on, simultaneously without the use of human translators.

如此類推，持續不斷，不經人手即時翻譯。

But that's the lectures.

但那只是講課。

If you remember what I told you about FLS at the beginning,

如果你還記得一開始我說過的 FLS，

it's knowledge and skills.

那是知識和技巧的結合。

The difference in an operation

一個手術

between doing something successfully and not

成功與否，

may be moving your hand this much.

可能差別只在於你的手是否移動了分毫距離。

So we're going to take it one step further;

所以我們更上一層樓；

we've brought my friend Allan back.

我把我的朋友 Allan 又叫回來了。

Allan Okrainec: Today we're going to practice suturing.

Allan Okrainec: 今日，我們將會練習一下縫合傷口。

This is how you hold the needle.

首先，將針這樣用手握着。

Grab the needle at the tip.

手握針的尖端。

It's important to be accurate.

最重要是準確。

Aim for the black dots.

瞄準黑點。

Orient your loop this way.

將線這樣繞一個圈。

Now go ahead and cut.

現在將線剪斷。

Very good Oscar. I'll see you next week.

做得很好，Oscar。下星期再見。

SS: So that's what we're working on

SS: 這就是我們現在

in our quest for the universal translator.

努力邁向一部通用翻譯器的現況。

We want it to be bi-directional.

我們希望是雙向的。

We have a need to learn as well as to teach.

我們教授的同時，也需要學習。

I can think of a million uses for a tool like this.

這樣的一件工具，我能想到百萬多個用途。

As we think about intersecting technologies --

當我們想到將不同科技互相融合 --

everybody has a cell phone with a camera --

現在每人都有一部配備相機的手機 --

we could use this everywhere,

我們能夠將這項技術到處應用，

whether it be health care, patient care,

不論是醫療衛生、病人護理、

engineering, law, conferencing, translating videos.

工程、法律、會議、影片翻譯。

This is a ubiquitous tool.

這是個無處不在的工具。

In order to break down our barriers,

為了消除障礙，

we have to learn to talk to people,

我們要學習與人們溝通，

to demand that people work on translation.

為此，也要求人們為翻譯而努力。

We need it for our everyday life,

這項技術，會在我們的日常生活發揮作用，

in order to make the world a smaller place.

好讓世界的距離變得更小。

Thank you very much.

多謝各位。

(Applause)

(掌聲)