字幕列表 影片播放 由 AI 自動生成 列印所有字幕 列印翻譯字幕 列印英文字幕 So you want to be a neurosurgeon. After all, it's super badass, second only to being 所以你想成為一名神經外科醫生。畢竟,它是超級壞蛋,僅次於成為... ... a rocket surgeon. Let's debunk the public perception myths of what it means to be a 一個火箭醫生。讓我們來揭穿公眾對做火箭醫生的認識誤區 neurosurgeon, and give it to you straight. This is the reality of neurosurgery. 神經外科醫生,直接給你說。這就是神經外科的現實。 Dr. Jubbal, MedSchoolInsiders.com. 朱波醫生,醫派內參網。 Welcome to our next installment in So You Want to Be. In this series, we highlight a 歡迎來到我們的下一期《所以你想成為》。在這個系列中,我們將重點介紹 specific specialty within medicine, such as neurosurgery, and help you decide if it's 醫學中的特定專業,如神經外科,並幫助您決定是否要選擇 a good fit for you. You can find the other specialties on our So You Want to Be playlist. 一個適合你的項目。你可以在我們的 "所以你想成為 "播放列表中找到其他專業。 A lot of you asked for neurosurgery in our poll, so that's what we're covering here. 很多人在我們的調查中問到了神經外科,所以這就是我們要報道的內容。 If you want to vote in upcoming polls to decide what future specialties we cover, make sure 如果您想在即將到來的民意調查中投票決定我們未來的專業內容,請確保 you're subscribed. 你已經訂閱了。 If you'd like to see what being a neurosurgeon looks like, check out my second channel, Kevin 如果你想知道作為一個神經外科醫生是什麼樣子的,請看我的第二個頻道,凱文。 Jubbal, M.D., where I do a second series in parallel called a Day in the Life. We'll Jubbal,醫學博士,在那裡我做第二個系列 在平行的叫一天的生活。我們將 be doing a Day in the Life of a Neurosurgeon soon and you don't want to miss it. show 將做一天的神經外科醫生的生活很快,你不希望錯過它。 footage from Daniel Choi day in the life of ortho spine surgeon where he is in the operating 崔永元在手術室的脊柱矯形外科醫生的生活片段。 room 房間 Neurological surgery, or neurosurgery for short, is much more than just brain surgery. 神經外科,簡稱神經外科,不僅僅是腦部手術。 The nervous system is comprised of two main components — the central nervous system, 神經系統主要由兩部分組成--中樞神經系統。 or CNS, and the peripheral nervous system, or PNS. Try saying that one 5 times as fast 或中樞神經系統,和周圍神經系統,或PNS。試著用5倍的速度說一個 as you can. The CNS includes the brain and spinal cord, whereas the PNS includes all 儘可能的。中樞神經系統包括大腦和脊髓,而初級神經系統包括所有的 other nerves within the body. Neurosurgery deals with surgical interventions of both. 體內的其他神經。神經外科學涉及到對這兩種神經的手術干預。 There are two overarching categories to neurosurgery: 1) Elective surgery, and 2) Emergent (i.e. 神經外科有兩個主要類別。1) 選擇性手術,2) 急診(即 non-elective) surgery. Elective surgeries take place on a non-emergent basis, and generally 非選擇性)手術。選擇性手術是在非緊急的基礎上進行的,一般是 involve treating conditions that are not immediately life threatening. They tend to fall into one 涉及治療不立即危及生命的疾病。它們往往屬於以下一種 of three categories: Cranial surgery, spine surgery, and peripheral nerve surgery. 的三類。顱骨手術,脊柱手術,和周圍神經手術。 Cranial surgery, as it sounds, involves operating on structures within the head (i.e. the brain). 顱骨手術,聽起來就涉及到對頭部結構(即大腦)的操作。 This category can be further subdivided into a few more subcategories: tumor surgery, vascular 這一類又可以再細分為幾個小類:腫瘤手術、血管 surgery, and functional neurosurgery. 手術,以及功能神經外科。 Tumors in the brain come in all shapes and sizes. They can be benign or malignant, slow 腦部的腫瘤有各種形狀和大小。它們可以是良性或惡性的,緩慢的。 or fast growing, life threatening or not. Some tumors can be observed without ever needing 或快速增長,是否有生命危險。有的腫瘤可以觀察到,而不需要進行 treatment, while others can be treated with radiation, but often, given the limited space 治療,而其他的則可以用放射線治療,但由於空間有限,通常 afforded by the human skull, and the sensitive nature of the brain's tissues, a neurosurgeon 人的頭蓋骨所提供的,以及大腦組織的敏感性質,神經外科醫生。 is called upon to surgically resect a tumor in the brain. 被要求通過手術切除腦部腫瘤。 Vascular neurosurgery involves treating abnormalities in blood vessels of the brain. Neurosurgeons 血管神經外科涉及治療腦血管的異常。神經外科醫生 might treat an aneurysm on a vessel, or bypass a blockage or narrowing of a vessel, much 可能會治療血管上的動脈瘤,或繞過血管的堵塞或狹窄,這一點非常重要。 the same way you would do coronary bypass in the heart. Though rather than opening the 就像你在心臟做冠狀動脈旁路手術一樣。雖然不是打開 chest, of course, neurosurgeons work through a small hole in the skull. 胸部,當然,神經外科醫生通過顱骨上的一個小孔工作。 Functional neurosurgery is the sexy stuff — the science fiction of the field. In functional 功能神經外科是性感的東西--該領域的科幻小說。在功能 neurosurgery, the brain is viewed as one large complicated electrical circuit, and neurosurgeons 神經外科,大腦被視為一個複雜的大電路,而神經外科醫生 try to modulate the circuit to bring about a desired outcome. This might involve placing 試圖調節電路,以達到預期的結果。這可能包括將 electrodes within the brain to stimulate certain structures, or creating lesions with radiation, 大腦內的電極來刺激某些結構,或用輻射製造病變。 ultrasonic energy or simple thermal ablation to effectively “turn off” structures that 超音波能量或簡單的熱燒蝕,以有效地 "關閉 "結構,以 might be causing a problem for a patient. Functional neurosurgery addresses pathologies 可能會給患者帶來問題。功能性神經外科解決的病理問題 such as Parkinson's disease, tremors, and obsessive compulsive disorder, among others. 如帕金森病、震顫和強迫症等。 Though what's most exciting about this subset of cranial surgery is what it hopes to treat 雖然這個顱骨手術的子集最讓人興奮的是它所希望治療的東西。 in the future - things like chronic pain, depression, PTSD, and substance addiction. 在未來--比如慢性疼痛、抑鬱症、創傷後應激障礙和藥物成癮。 Within spine surgery, there are a few subcategories as well: we'll call them “degenerative”, 在脊柱外科內部,也有一些小分類:我們稱之為 "退行性"。 “scoliosis”, and “tumors”. "脊柱側彎 "和 "腫瘤"。 The vast majority of spine surgery is done to treat good old fashioned wear and tear, 絕大多數的脊柱手術都是為了治療老式的磨損。 or degenerative disease, of the spine. As you might expect, degenerative disc disease 脊椎的退行性疾病。正如你所期望的,退行性椎間盤疾病 and osteoarthritis of the spine tend to occur in the cervical spine, or neck, and lumbar 和脊柱骨性關節炎往往發生在頸椎,或頸部,以及腰部。 spine, or lower back, which are the two most mobile parts of the spine. Your thoracic spine 脊柱或下背部,這是脊柱中最容易移動的兩個部位。你的胸椎 is less mobile because of your ribs (which create additional support and limit mobility). 因為你的肋骨(肋骨產生了額外的支撐,限制了移動性),所以移動性較差。 With these degenerative processes, the spinal cord itself or nerve roots exiting the spine 伴隨著這些退行性過程,脊髓本身或神經根從脊柱退出 can become compressed, leading to pain and weakness. Surgeons often are required to decompress 可能會被壓迫,導致疼痛和無力。外科醫生經常需要為患者減壓。 these structures by removing certain elements of the spine. When removing these bony arthritic 這些結構通過去除脊柱的某些元素。當去除這些骨性關節炎 spurs, or degenerated discs, the integrity of the spine can become compromised, which 脊椎骨刺或退化的椎間盤,其完整性可能會受到損害,而這 can require a spinal fusion to restore stability, although the fused segment has increased rigidity. 可以需要脊柱融合術來恢復穩定,雖然融合段的剛性增加。 Fusion is often achieved with rods and screws, and in some cases with disc replacement hardware. 融合通常是通過杆和螺釘來實現的,在某些情況下也可以通過椎間盤替換硬件來實現。 Spine surgery also includes repair of scoliosis, whereby curvature of the spine can become 脊柱手術還包括脊柱側彎的修復,即脊柱的彎曲可以變得更加明顯。 so severe as to cause pain, difficulty breathing, or other functional deficits. It's important 嚴重到導致疼痛、呼吸困難或其他功能障礙。重要的是 to note that spinal decompression surgeries and scoliosis repair can be performed by either 要注意的是,脊柱減壓手術和脊柱側彎修復術可以由以下兩種方式進行。 neurosurgeons or orthopedic surgeons. However, removal of tumors of the spinal cord is performed 神經外科醫生或骨科醫生。然而,脊髓腫瘤的切除是由以下醫生進行的。 exclusively by neurosurgeons. While a tumor in the liver or breast can be relatively quickly 專門由神經外科醫生進行。雖然肝臟或乳房的腫瘤可以相對快速地 resected, removing tumors around the spine can be quite involved, and take a long time 脊柱周圍的腫瘤切除術,涉及面廣,耗時長。 - even for small tumors - due to the care and precision required to leave the spinal - 即使是小的腫瘤--由於需要小心翼翼和精確地離開脊柱。 cord uninjured. 臍帶沒有受傷。 Peripheral neurosurgery, as the name suggests, involves operating on the peripheral nervous 周圍神經外科,顧名思義,就是對周圍神經進行手術。 system. This includes all nerves outside of the brain and spinal cord. These nerves can 系統。這包括大腦和脊髓以外的所有神經。這些神經可以 sprout tumors, or become injured in an accident. In such cases, a neurosurgeon may be called 長出腫瘤,或在事故中受傷。在這種情況下,神經外科醫生可能會被稱為 upon to remove that tumor, to reconnect severed nerves, or in some cases to connect part of 移除腫瘤,重新連接被切斷的神經,或在某些情況下連接部分神經。 a healthy, working, nerve to a damaged nerve in the hopes that a patient can regain function 將健康的、可以工作的神經移植到受損的神經上,希望病人能夠恢復功能。 of that nerve over time. 隨著時間的推移,該神經的。 If you're a trauma surgeon, you take shifts and handle traumas that come in on your shift. 如果你是一名創傷外科醫生,你要輪流值班,處理當班的創傷。 If you're a neurosurgeon, you have to operate on your scheduled cases but also take neurosurgery 如果你是一名神經外科醫生,你既要在預定的病例上做手術,又要接神經外科的手術。 trauma call on top. It's just part of the job. This includes traumatic injuries to both 外傷電話在上面。這只是工作的一部分。這包括外傷的兩個 the cranium and spine. Both are very urgent. 顱骨和脊柱。兩者都非常緊急。 Compared to other parts of the body, the skull is a fixed space, which results in its own 與身體的其他部位相比,頭骨是一個固定的空間,這就導致了它本身的 set of issues. If you bleed into your abdomen, you're concerned about exsanguination, meaning 一系列的問題。如果你的血流到了腹部,你就會擔心出血,也就是說。 you can bleed out and die, as your abdomen can distend to accommodate a large volume 你可能會失血過多而死亡,因為你的腹部可能會膨脹以容納大量的血。 of blood. In the cranium, however, a fixed space means that as you bleed, pressure increases, 的血液。然而,在顱內,固定的空間意味著當你出血時,壓力會增加。 resulting in compression of the brain. You won't ever exsanguinate as the skull is 導致腦部受壓。你永遠不會死亡,因為頭骨是 too small, but brain bleeds are deadly due to brain herniation, meaning compression and 太小,但腦出血是致命的,因為腦疝,意味著壓迫和。 pushing of critical structures through the foramen magnum outside the skull. Alleviating 通過顱骨外的大孔推送關鍵結構。緩解 pressure is key, and this is done with a decompressive hemicraniectomy, meaning removing part of 壓力是關鍵,這要通過減壓性的半顱切除術來完成,也就是說要切除一部分。 the skull to create space for the brain to swell after it has been injured. The excised 顱骨,為受傷後的大腦創造膨脹的空間。被切除的 segment is kept in the freezer and the neurosurgeons can put it back weeks or months later when 段保存在冰箱裡,神經外科醫生可以在幾周或幾個月後將其放回,當 the brain swelling has resolved. 腦部腫脹已經消除。 There are four main types of brain bleeds — epidural hematomas, subdural hematomas, 腦出血主要有四種類型--硬膜外血腫、硬膜下血腫。 subarachnoid hemorrhages, and intraparenchymal hemorrhages. Epi- means above and -dural refers 蛛網膜下腔出血和腦膜內出血。Epi-是指上面的意思,-dural是指...。 to the dura, the outermost layer of the meninges covering the brain. Epidural hematomas are 到硬膜,即覆蓋大腦的腦膜最外層。硬膜外血腫是 bleeds most commonly from the middle meningeal artery in the space below the skull but above 最常見的是腦膜中動脈出血,位於顱骨下方但高於顱骨的空間。 the dura. With an arterial source, these bleed quickly, and usually result from blunt trauma 動脈源,這些出血很快,通常是由於鈍性創傷造成的。如果有動脈來源,這些出血很快,通常是由鈍性創傷造成的。 to the head. Subdural hematomas are below the dura and are more common amongst elderly 到頭部。硬膜下血腫在硬膜下,在老年人中比較常見。 patients on blood thinners. These are venous bleeds and slower in nature, but can be equally 使用血液稀釋劑的患者。這些都是靜脈出血,性質較慢,但同樣可以是 urgent and life threatening Subarachnoid hemorrhages result from an aneurysm rupturing, and because 蛛網膜下腔出血是由於動脈瘤破裂造成的,具有緊迫性和生命危險性,而且由於蛛網膜下腔出血是由於動脈瘤破裂造成的。 it's below the arachnoid layer of the meninges, the blood fills the sulci of the brain, meaning 它在腦膜蛛網膜層以下,血液充滿了大腦的溝壑,也就是說... ... all the nooks and crannies, effectively coating the brain in blood, which can be toxic. Intraparenchymal 所有的犄角旮旯,有效地將血液塗抹在大腦中,而血液可能是有毒的。髓內 hemorrhages are bleeds within the actual tissue of the brain, and this can result from long 出血是指腦部實際組織內的出血,這可能是由於長期的 standing hypertension resulting in arteriosclerosis, or other reasons. 靜止性高血壓導致動脈硬化,或其他原因。 Ruptured aneurysms are usually handled by neurosurgeons, but sometimes by endovascular 動脈瘤破裂通常由神經外科醫生處理,但有時由血管內科醫生處理。 surgeons or interventional radiologists. Treatment is either coil placement or placing a clip 外科醫生或介入放射科醫生。治療方法是放置線圈或放置夾子 over the aneurysm. 在動脈瘤上。 Intraparenchymal hemorrhages can sometimes become large enough that they need to be evacuated. 脈管內出血有時會變得很大,需要進行排空。 In those cases, a neurosurgeon might make an opening in the skull and work their way 在這些情況下,神經外科醫生可能會在頭骨上開一個口子,然後用他們的方式來工作。 down to the hematoma to evacuate as much blood as safely possible without damaging surrounding 在不損害周圍環境的前提下,儘可能安全地排空血腫的血液。 structures. 結構。 If a patient fractures their spine, the spinal cord can become compressed, or even severed. 如果患者脊柱骨折,脊髓會受到壓迫,甚至斷裂。 In such cases, it is important to relieve pressure on the spinal cord quickly. Urgent 在這種情況下,迅速緩解脊髓的壓力是很重要的。緊急 decompression is often required, as is stabilization to reduce additional uncontrolled movement 通常需要減壓,也需要穩定,以減少額外的失控運動。 and further injury. This is why you see C-spine collars placed on trauma patients - for stability 和進一步的傷害。這就是為什麼你會看到C型脊柱項圈被放置在創傷病人身上的原因--為了穩定。 and to reduce the risk of additional spinal cord injuries. 並降低更多脊髓損傷的風險。 To become a neurosurgeon, you'll have to complete neurosurgery residency after medical 要想成為一名神經外科醫生,你必須在醫療後完成神經外科住院醫師的培訓 school. Neurosurgery has the longest residency start to finish, lasting 7 years in duration.. 學校。神經外科是住院醫師從開始到結束時間最長的,持續7年的時間。 Most residencies will include one year of dedicated research time, though not all. Show 大多數住院醫師將包括一年的專門研究時間,儘管不是全部。顯示 plastic surgery at 6 years, orthopedic surgery at 5 years, general surgery at 5 years, ENT 整形外科6年,骨科5年,普通外科5年,耳鼻喉科。 5 years 5年 In terms of competitiveness, neurosurgery is consistently in the top five, in most recent 在競爭力方面,神經外科一直處於前五名,在最新的 years being ranked third, only behind dermatology and plastic surgery. Show points ranking of 年被排在第三位,僅次於皮膚科和整形外科。顯示積分排名的 top five with columns representing the points, the height of which is proportional to their 前五名,其列代表點,其高度與它們的 ranking (like bar graphs). Refer to spreadsheet and use the total points in each category 排名(如柱狀圖)。參照電子表格,用每個類別的總分來計算。 Neurosurgery candidates are top students, with very high Step 1 and Step 2 scores, generally 神經外科的考生都是尖子生,Step1和Step2的分數都非常高,一般來說 only a few points below the average dermatology or plastic surgery matriculants. But what 只比一般的皮膚科或整形外科預科生低幾分。但是,什麼 truly sets neurosurgery applicants apart is their research. The average matriculant in 真正讓神經外科的申請人與眾不同的是他們的研究。一般預科生在 2018 pumped out over 18 publications, abstracts, or presentations by the time they applied 2018年抽出18篇以上的出版品、摘要或演講,到申請時。 to residency. In comparison, plastic surgery and dermatology were at 14 with orthopedic 到住院醫師。相比之下,整形外科和皮膚科在14與骨科。 surgery at 10. Most other specialties didn't even break 7. 手術在10。其他大部分專業甚至沒有突破7。 Why the focus on research in neurosurgery? Neurosurgery is a highly academic field, likely 為什麼要重視神經外科的研究?神經外科是一個高度學術化的領域,很可能是 due to the fact that there is so much room to improve outcomes in patients. Residencies 由於患者的治療效果有很大的改善空間。住院醫師 want to train surgeon scientists who will advance the field. While treatment modalities 希望培養能推動該領域發展的外科科學家。雖然治療方式 and outcomes have improved drastically in the past 20-30 years, there are several pathologies 和結果在過去的20-30年中得到了極大的改善,但有幾種病理現象 with bleak outcomes. For example, glioblastoma multiforme, or GBM for short, had an average 與黯淡的結果。例如,多發性膠質母細胞瘤,簡稱GBM,其平均壽命為 prognosis of about 5 months over a century ago. Despite all the technological advancement 一個多世紀前約5個月的預言。儘管科技進步 since, these days, even after aggressive surgery, radiation and chemotherapy, median survival 因為,如今,即使在接受了積極的手術、放療和化療之後,中位生存期 has improved to only 14-16 months 已改善到只有14-16個月 Medical students that end up applying to neurosurgery are a unique bunch and are a self-selecting 最終報考神經外科的醫學生是一個獨特的群體,是一個自我選擇的群體。 group. They take the meaning of workaholic to the next level. The award for most brutal 群體。他們將工作狂的含義提升到了一個新的高度。最殘酷的獎項 and rigorous residency, even amongst surgical residencies, is usually reserved for neurosurgery. 和嚴格的住院醫師資格,即使在外科住院醫師中,通常也是留給神經外科的。 Despite the 80 hour work week restrictions enacted by the ACGME, it's not uncommon 儘管ACGME頒佈了每週80小時的工作限制,但並不罕見。 to see neurosurgery residents exceeding these limits repeatedly. The good news is that as 看到神經外科住院醫師屢屢超過這些限制。好消息是,隨著 an attending, the days of working 90 hour weeks are now behind you, but that won't 作為一名主治醫師,每週工作90小時的日子已經過去了,但這並不會讓你的工作變得更輕鬆。 always be the case in residency. 始終是居住地的情況。 After completing residency, you can practice as a general neurosurgeon, or choose to sub-specialize 完成住院醫師培訓後,您可以作為普通神經外科醫生執業,也可以選擇分科。 further with fellowship. 進一步的與交情。 Skull-base is primarily concerned with tumors that grow along the base of the skull, which 顱底腫瘤主要是指沿顱底生長的腫瘤,即 is notoriously high end real estate. It's a shrinking field, mainly because less invasive 是出了名的高端房地產。這是一個正在萎縮的領域,主要是因為侵入性較低的。 options like radiosurgery and endovascular procedures are becoming more sophisticated 放射外科手術和血管內手術等選擇變得越來越複雜 and appealing for patients, but it's still an appealing subspecialty. Those with the 和對患者的吸引力,但它仍然是一個有吸引力的亞專業。那些有 best hands and stamina for 18 hour-plus surgeries go here. It's a young man's game. 最好的手和耐力 18小時以上的手術去這裡。這是一個年輕人的遊戲。 Neurovascular is highly technical, dealing with aneurysms, hemorrhagic strokes, and bypassing 神經血管的技術含量很高,要處理動脈瘤、出血性腦卒中、旁路等。 blockages in the brain. Call schedule is brutal, attracting those who are gluttons for punishment. 大腦中的堵塞。通話時間表是殘酷的,吸引著那些貪玩的人。 Outcomes can sometimes be particularly grim, which can take a toll over the course of one's 結果有時可能是特別嚴峻的,這可能對一個人的一生造成傷害。 career. You'll need a strong stomach. 事業。你需要一個強大的胃。 Functional and stereotactic surgery deals with modulating the electrical circuitry of 功能性手術和立體定向手術涉及到調控電子電路的問題。 the brain. These are the nerds of the nerds, usually with PhD's after their name or computer 的大腦。這些都是書呆子中的書呆子,通常名字後面都有博士學位,或者是計算機的 science backgrounds. 科學背景; Spine is for the jocks and ortho bros. There's a great deal of bony work, thus requiring 脊柱是為運動員和矯正師兄們準備的。有大量的骨性工作,是以需要... ... a higher degree of strength and on average less finesse than other aspects of neurosurgery. 與神經外科的其他方面相比,強度較高,平均精細度較低。 Pediatrics is for the neurosurgeons who are best at dealing with parents. A strong stomach 兒科是神經外科醫生的天下,他們最擅長和家長打交道。強健的胃 is prerequisite as children needing neurosurgical intervention generally don't have rosy outcomes. 是先決條件,因為需要神經外科干預的兒童一般不會有樂觀的結果。 Peripheral nerve is perhaps the smallest subspecialty within neurosurgery, partly because it's 周圍神經可能是神經外科中最小的亞專業,部分原因是它是一個很好的選擇。 not exclusive to neurosurgeons (you can get there through orthopedics or plastic surgery). 並不是神經外科醫生的專屬(你可以通過骨科或整形外科達到目的)。 It's for surgeons who enjoy operating all over the body, since the peripheral nervous 這是為那些喜歡在身體各處做手術的外科醫生準備的,因為周圍的神經 system exists everywhere outside of the brain and spinal cord. 系統存在於大腦和脊髓之外的所有地方。 Surgical neuro-oncology tends to attract surgeons with an interest in tumor biology. These surgeons 外科神經腫瘤學往往會吸引對腫瘤生物學感興趣的外科醫生。這些外科醫生 may spend up to half of their time in the research lab, studying additional methods 可能會有一半的時間在研究實驗室,研究其他方法 for tumor treatment beyond simple surgical resection. This is because a large subset 的腫瘤治療,而不是簡單的手術切除。這是因為有很大一部分 of brain tumors don't respond to just surgical resection (like GBM). 的腦腫瘤不響應只是手術切除(如GBM)。 Trauma/neurocritical care is for those surgeons who wish to focus on the multi-disciplinary 創傷/神經危重症護理是為那些希望專注於多學科的外科醫生準備的。 treatment of patients with traumatic neurological injuries. Beyond performing life saving surgeries, 外傷性神經損傷患者的治療。除了進行挽救生命的手術外。 these folks are interested in the longer-term post-operative recovery process for patients 這些人對病人術後的長期恢復過程感興趣。 suffering from TBI, spinal cord injury, aneurysm rupture or hemorrhagic stroke. 患有TBI、脊髓損傷、動脈瘤破裂或出血性中風; As a neurosurgeon, you'll be working on arguably the most fascinating and mysterious 作為一名神經外科醫生,你將從事的工作可以說是最迷人和最神祕的。 organ of the body — the brain. Psychiatrists and neurologists deal with the brain as well, 身體的器官--大腦。精神病學家和神經病學家也在處理大腦問題。 but in a non-surgical capacity. You'll get to touch, change, and augment the central 但在一個非手術的能力。你將會接觸、改變和增強中樞。 nervous system right in front of you, in real time. 神經系統就在你面前,實時的。 It's a highly innovative field, particularly the subspecialty of functional neurosurgery, 這是一個極具創新性的領域,尤其是功能神經外科這個亞專業。 where the line is blurred between what is you and what is hardware. It raises questions 什麼是你,什麼是硬件,這兩者之間的界限是模糊的。它提出了一些問題 about free will, consciousness, and other questions that are bound to keep you up late 關於自由意志,意識,以及其他一定會讓你熬夜的問題。 at night. 在晚上。 Only a few specialties truly save people's lives. Neurosurgery is one of them. At a moment's 只有少數幾個專科能真正拯救人們的生命。神經外科就是其中之一。瞬間 notice, you may be called in and rush to the hospital to save someone's life. While the 通知,你可能會被叫去趕往醫院救人。雖然 surgeries may become routine, the feeling of saving someone's life never will. Trauma 手術可能會成為例行公事,但救人的感覺永遠不會。創傷 and emergency medicine are some other specialties that share this aspect. 和急診醫學等其他一些專業都有這方面的特點。 Neurological surgery is a highly academic field, satisfying even the most intellectually 神經外科是一個學術性很強的領域,即使是最有智力的人也能滿足。 curious. You'll be surrounded by driven and truly impressive colleagues cut from the 充滿好奇心。你的周圍會有很多有幹勁的、真正令人印象深刻的同事,他們都是來自世界各地的優秀人才。 same cloth. To quote my neurosurgery friend, “not to say we're better than everyone, 同一塊布。引用我的神經外科朋友的話:"不是說我們比誰都強。 but we are.” He's joking of course, but only a little. 但我們是。"他當然是在開玩笑,但只是一點點。 As a doctor, you normally need to choose between honing surgical expertise and foregoing medical 作為一名醫生,你通常需要在磨練外科專業技術和放棄醫學之間做出選擇。 management, or vice versa. That's one thing I didn't enjoy about plastic surgery. I 管理,或者反之。這是我不喜歡整容的一個原因。I wasn't managing patients medically so much, just more so surgically. As a neurosurgeon, 並不是在醫學上管理病人那麼簡單,只是更多的是在手術上管理病人。作為一名神經外科醫生。 you'll be handling the medical side of things quite intensively — titrating sedatives 你要集中處理醫療方面的事情 -- 滴定鎮靜劑的劑量 to adjust for intracranial pressure abnormalities, adjusting ventilator settings, and reading 以調整顱內壓異常,調整呼吸機設置,讀取 EEG's to see if someone is seizing. You won't quite be a cardiothoracic surgeon, 做腦電圖檢查看是否有人抽搐你不會成為一個心胸外科醫生。 who are the most badass in terms of medical management while being surgeons, but you won't 哪些人在做外科醫生的同時,在醫療管理方面是最壞的,但你不會。 miss the medical side of medicine. 錯過了醫學方面。 In medical school, I rotated on orthopedic surgery, plastic surgery, and neurosurgery, 在醫學院,我輪轉了骨科、整形外科和神經外科。 the three specialties I was considering most seriously. One thing I loved about neurosurgery 我最認真考慮的三個專業。我很喜歡神經外科的一件事。 were the personalities. Some of the funniest and coolest surgeons I worked with were neurosurgeons. 是個性。我工作過的一些最有趣最酷的外科醫生都是神經外科醫生。 This isn't uncommon. The field is very humbling, and despite the stereotype, neurosurgeons 這並不稀奇。這個領域是非常謙卑的,儘管有刻板印象,神經外科醫生 are faced daily with the reality that they are not god. You can't take yourself too 每天都要面對自己不是神的現實。你不能把自己看得太重 seriously and you'll need to learn to laugh at yourself, otherwise you won't last. 說真的,你要學會自嘲,否則你不會長久。 There were two main factors that pushed me away from neurosurgery, despite my love for 有兩個主要因素把我從神經外科推開了,儘管我對神經外科充滿了熱愛 neuroscience and fascination with the brain. First, think about the types of patients that 神經科學和大腦的魅力。首先,思考一下患者的類型 need neurosurgical intervention. They're very sick and can often have poor outcomes. 需要神經外科介入治療。他們的病情很重,而且往往會有不良後果。 Many of your patients will succumb to immense suffering or death. That may not sound so 你的許多病人將屈服於巨大的痛苦或死亡。這聽起來可能不是那麼 bad right now, but day after day, year after year, that sort of heaviness will weigh on 現在不好,但日復一日,年復一年,那種沉重感會壓在 you. 你。 The other thing that pushed me away from neurosurgery was learning that it wasn't as precise and 另一件讓我遠離神經外科的事情是,我瞭解到神經外科沒有那麼精確,也沒有那麼好的治療效果。 meticulous as I would have expected brain surgery to be. Certain aspects are highly 細緻到我所預想的腦部手術的程度。某些方面是高度 precise, like skull-base, but much of neurosurgery is surprisingly crude and more similar to 精確,就像顱底,但神經外科的很多手術卻出奇的粗糙,更類似於 orthopedic surgery than something like plastic surgery. 骨科手術比整形手術之類的東西。 But wait, there's more. Neurosurgeons face one of the most challenging lifestyles of 但是,等等,還有更多。神經外科醫生面臨著最具挑戰性的生活方式之一。 any specialty, even beyond residency. That's because in addition to scheduled cases, you'll 任何專業,甚至超過了住院醫師。這是因為除了預定的病例外,您還將會有 need to take neurosurgery trauma call. In medicine, we say that neurosurgeons make the 需要接神經外科的外傷電話。在醫學上,我們說神經外科醫生使 most money, but don't have any time to enjoy it. The median salary is $680,000 per year, 錢最多,卻沒有時間享受。年薪中位數是68萬元。 and they're consistently number 1 or number 2 in terms of highest paid specialty, duking 他們一直是第一或第二號 在最高薪酬的專業,公爵。 it out with orthopedic spine surgeons. 它與骨科脊柱外科醫生。 The field is 92% men. While not as bad as orthopedic surgery, it's one of the most 這個領域92%是男性。雖然不如骨科,但也是一個最 male dominated specialties, although that is slowly changing. 男性占主導地位的專業,儘管這種情況正在慢慢改變。 The neurosurgeon stereotype comes with good and bad. For online dating apps, it's great, 神經外科醫生的刻板印象有好有壞。對於在線約會應用來說,它是偉大的。 but beyond that, the stereotype is difficult to deal with in the hospital. Others expect 但除此之外,陳舊的觀念在醫院裡很難處理。其他人期望 you to have a god complex, to be an asshole, egotistical, emotionless, or even sociopathic. 你有一個神情結,是一個混蛋, 自私,沒有感情,甚至反社會。 At this point, you'll know whether or not neurosurgery is right for you. It's a highly 此時,你就會知道神經外科手術是否適合你。這是一個高度 self-selecting group of people. Obviously, you need to enjoy the practice of surgery 自我選擇的群體。很明顯,你需要享受手術的實踐。 and have deep intellectual curiosity for the brain and mind. 並對大腦和心靈有深刻的知識好奇心。 But beyond that, you need to really want it more than anything else. You'll need incredible 但除此之外,你需要真正的想要它比什麼都重要。你需要難以置信的 stamina to endure a brutal 7 year residency and continue to work challenging and unpredictable 忍受了7年的艱苦工作,並繼續從事具有挑戰性和不可預測的工作。 hours as an attending. 擔任主治醫師的時間。 The stakes are high, and there's a consistently high sphincter tone and level of vigilance. 賭注很大,而且括約肌音調和警惕程度一直很高。 That's because, so often, patients with neurological injuries can be incredibly hard 這是因為,往往神經系統損傷的病人會非常難受。 to monitor. A patient in acute organ failure, mid-heart-attack, or exsanguinating during 來監測。急性器官衰竭、心梗中段、或出院期間的患者。 a trauma can be hard to ignore. But in neurosurgery, potentially devastating neurological complications 外傷是很難被忽視的。但在神經外科手術中,潛在的破壞性神經系統併發症,即 "神經系統併發症 "的發生,可能會影響到患者的生活品質。 - such as a stroke or a brain bleed - can occur with scary subtlety. Being on top of - 如中風或腦出血--會發生可怕的細微變化。身處在 the ball is a must. 球是必須的。 If you're all about that, you'll certainly get the excitement and rush from the unpredictability 如果你是全心全意的,你一定會從不可預知的情況下獲得刺激和快感 of trauma. You'll also get the highly technical aspect of something like plastic surgery. 的外傷。你還會得到整形外科這種技術含量很高的東西。 If you take deep pride in your work and have perfectionistic tendencies, neurosurgery may 如果你對自己的工作深感自豪,並且有完美主義的傾向,神經外科可能會 be a good fit. 是一個很好的契合點。 Big shout out to the neurosurgeons at Med School Insiders who helped me in the creation 大力讚揚Med School Insiders的神經外科醫生們,他們幫助我創建了。 of this video. If you're interested in becoming a neurosurgeon, you'll need to be a top 的這個視頻。如果你有興趣成為一名神經外科醫生,你需要成為一名頂尖的。 performing student. And who better to learn from and be mentored by than neurosurgeons 表演的學生。還有誰比神經外科醫生更適合學習和指導呢? themselves. If you need help acing your MCAT, USMLE, or other exams, our tutors can maximize 自己。如果你需要幫助你的MCAT,USMLE,或其他考試,我們的導師可以最大限度地提高你的成績。 your test day performance. If you're applying to medical school or neurosurgery residency, 你的考試日表現。如果你要申請醫學院或神經外科住院醫師。 our neurosurgeons can share the ins and outs of what it takes and how to navigate the highly 我們的神經外科醫生可以分享需要什麼以及如何駕馭高難度手術的來龍去脈。 competitive process most effectively. Learn more and see why our customers love us at 最有效的競爭過程。瞭解更多資訊,看看為什麼我們的客戶喜歡我們,在 MedSchoolInsiders.com. MedSchoolInsiders.com。 Thank you all so much for watching! This one was particularly fun to make. What specialty 非常感謝大家的觀看!這個做起來特別有意思。什麼特產 do you want me to cover next? Leave a comment down below, and make sure you're subscribed 你想讓我下一個報道嗎?請在下面留言,並確保你已經訂閱了。 to vote in the upcoming polls. If you enjoyed the video, hit that thumbs up button to keep 在即將到來的民意調查中投票。如果你喜歡的視頻,點擊大拇指按鈕,以保持 the YouTube gods happy. Much love to you all, and I will see you guys in that next one. YouTube的神高興。很愛你們,我們下一個節目中見。
B2 中高級 中文 外科 神經 手術 醫生 脊柱 腫瘤 So You Want to Be a NEUROSURGEON [Ep. 6] 117 3 Summer 發佈於 2020 年 08 月 22 日 更多分享 分享 收藏 回報 影片單字