- [Dr. Mike] Wait, wait I wanna get a good shot. -[博士迈克]，等等，我想获得好成绩。
Okay, go, go. - [Yvette] You ready? 好，去，去-[Yvette]准备好了吗？
One, two, three. 一二三。
- All right, it's a bright and early day. -好吧，这是光明的一天。
It's time to be a doctor. 是时候当医生了。
(upbeat music) （欢快的音乐）
He has such an aggressive tongue. 他的舌头好斗。
All right, let's take this little guy for a walk. 好吧，让我们带这个小家伙去散步。
You ready? 你准备好了吗？
Let's go. 我们走吧。
(upbeat music) （欢快的音乐）
Look at that, peeing right on the grate. 看着那，在炉排上撒尿。
Did not make a mess. 没弄得一团糟。
I trained him well. 我训练他很好。
You can't see the Empire State Building. 您看不到帝国大厦。
It's right there. 就在那儿。
Touch it. 触摸它。
As any veteran dog owner will tell you, 正如任何资深狗主人都会告诉您的那样，
one of the biggest struggles of having a pup 幼仔最大的挣扎之一
is when you're walking them in the morning 当你早上走路时
and you wanna get to work 你想去上班
and your dog refuses to poop. 你的狗拒绝大便。
Bear, go poop. 熊，大便。
(upbeat music) （欢快的音乐）
My first patient today is actually at 8:00 a.m. 我今天的第一位病人实际上是上午8:00
but I wanna get in a little earlier 但我想早一点
to start working on my notes from the other day. 从第二天开始处理我的笔记。
Notes are the bane of the existence of a doctor 笔记是医生存在的祸根
because not only do we wanna see the patients, 因为我们不仅要看病人，
spend time with them, but then we become slaves 与他们共度时光，但后来我们成为奴隶
to the electronic medical record. 电子病历。
It's pretty brutal. 这很残酷。
What is that? 那是什么？
Bear, you wanna put that away? 熊，你想把它收起来吗？
All right, let's get to work. 好吧，让我们开始工作。
Today I'm gonna be working a long 12, 14 hour shift 今天我要工作12、14小时
as an outpatient family medicine doctor. 作为门诊家庭医学医生。
Now what does outpatient mean? 现在，门诊病人是什么意思？
It means that I'm gonna be seeing patients 这意味着我要去看病人
in an office setting where I don't have 在我没有的办公室里
to admit them, meaning that 承认他们，这意味着
they are not gonna stay overnight in the hospital. 他们不会在医院过夜。
So it's basically when you go in for your doctor's visit 所以基本上是您去看医生的时候
for a check-up, for a problem, 进行检查，发现问题
that's what I'm gonna be doing today. 那就是我今天要做的。
That's primarily actually what I do. 这实际上主要是我要做的。
So today we'll probably have around 30 patients 所以今天我们大概有30位患者
where maybe after each visit I'll come 每次拜访之后我可能会去哪里
and tell you what I did 告诉你我做了什么
and we can have a little learning opportunity. 我们可以有一点学习机会。
(tone dinging) (banging) （叮声）（砰砰声）
Oh my God. 哦，我的上帝。
Major fail. 重大失败。
When I see patients in my office, 当我在办公室看到病人时，
I see them for anything. 我什么都看不到。
Acute problems, meaning like they get sick today 急性问题，意味着他们今天生病了
or they have pain today 或者他们今天有痛苦
or something's going on where it's an urgent matter, 或紧急情况下发生的事情
but I also see them for primary care, 但是我也看到他们是初级保健
meaning that they're coming in 表示他们要进来
for chronic disease management and counseling. 用于慢性疾病的管理和咨询。
So I have diabetic patients that need 所以我有糖尿病患者需要
to check their numbers, 检查他们的号码，
make sure they're taking their medications optimally. 确保他们以最佳方式服用药物。
It's a really fun job 这是一项非常有趣的工作
'cause you really never know what's gonna happen. 因为你真的永远不知道会发生什么。
You don't know what kind of patient's gonna walk in. 你不知道什么样的病人会走进来。
(tone dinging) (banging) （叮声）（砰砰声）
God if you guys didn't know any better 上帝，如果你们不知道更好
you would have though I got into an accident. 尽管我出了车祸，你还是会的。
My commute isn't that bad. 我的通勤还不错。
It's around 45 minutes. 大约需要45分钟。
It's a reverse commute. 这是反向通勤。
Some people are like, wait, 有些人喜欢，等等，
you work in New Jersey but live in New York? 您在新泽西工作但住在纽约？
Yeah. 是的
That's actually a great strategy 这实际上是一个很好的策略
because I do a lot of TV stuff in New York 因为我在纽约做很多电视节目
so I have to be here, 所以我必须在这里
but then I love working in New Jersey 但后来我喜欢在新泽西工作
'cause that's where I did my residency training, 因为那是我进行居住培训的地方，
and I built up this patient panel of patients 我建立了这个病人小组
I actually love and have a connection with. 我实际上很爱并且与我有联系。
I'm growing old with them. 我和他们一起变老。
It's kinda funny to say. 这有点好笑。
I think we've got some great content. 我认为我们有一些很棒的内容。
(tone dinging) (banging) （叮声）（砰砰声）
God. 神。
I wonder what kind of clip I need to buy 我想知道我需要买哪种夹子
to keep this in my AC vent. 把它放在我的空调通风口
(tone dinging) (banging) （叮声）（砰砰声）
By the way, now that we're just hanging out here, 顺便说一下，现在我们只是在这里闲逛，
I'm having some water and I'm driving to work, 我喝水了，我开车去上班，
I need you to hit 我需要你打
that subscribe button 订阅按钮
and that notification bell 那通知铃
and set your alerts to all 并设置所有警报
just so that YouTube algorithm doesn't mess with us 只是为了让YouTube算法不会惹我们
any further. 再进一步。
I know only 15% of you have done that so far. 我知道到目前为止，只有15％的人这样做。
Step up your game. 加强您的游戏。
You can do better. 你可以做得更好。
Hit that notification bell. 打那个通知铃。
(engine revving) （发动机旋转）
I'm gonna get in trouble. 我会惹上麻烦。
Who's excited for work? - Michael, how are you? 谁为工作感到兴奋？ -迈克尔，你好吗？
Good morning. 早上好。
- Are you excited for work Jenny? -你为珍妮的工作感到兴奋吗？
- Oh I'm so excited to see your face. -哦，我很高兴看到你的脸。
- Isn't it a great day to save lives? -拯救生命不是美好的一天吗？
I'm gonna sit on this garbage can here. 我要坐在这里的垃圾桶上。
- Don't sit on the garbage can. -不要坐在垃圾桶上。
- No, I'm gonna sit -不，我要坐
on the garbage can. 在垃圾桶上。
Don't tell me what to do. - Oh Michael. 不要告诉我该怎么办。 -迈克尔。
- You're not my mom. -你不是我妈妈。
Maybe my work mom. 也许是我工作的妈妈。
What's the craziest thing you've ever seen? 您见过最疯狂的事情是什么？
- You're making me think back here. -你让我回想起这里。
- Yeah. -是的
- People that have passed -已通过的人
and there's a smile appears on their face within seconds 在几秒钟内他们的脸上露出笑容
of them totally passing away. 他们完全死了。
That's pretty amazing. 太神奇了
- Any good stories Jenny? -珍妮有什么好故事吗？
Let's cheer people up. 让我们振作起来。
- Michael, the good stories is there's lots -迈克尔，好故事很多
of men walking around with nice scrubs. 好的磨砂走动的男人。
- Ooh. - That's the best stories. 哦-那是最好的故事。
- Jenny's getting feisty today. -珍妮今天变得越来越时髦。
- (laughs) Get out of here. -（笑）离开这里。
- Let's talk about INR. -让我们谈谈INR。
- Okay, what about INR? -好的，INR呢？
Let's talk about it. 让我们来谈谈它。
- Not on the vlog. -不在视频博客上。
- Why not? - Okay. - 为什么不？ - 好的。
- INR is when a patient comes in -INR是患者进来时
for a test to see if they're taking their coumadin properly 进行测试以了解他们是否正确服用了香豆素
and appropriately, so let's check it out. 适当地，所以让我们检查一下。
So when you're looking at an INR, 因此，当您查看INR时，
what I'm looking at is to figure out, 我正在寻找的是找出
A, is the patient's dosage correct? A，病人的剂量是否正确？
B, are they coming in at the right intervals? B，他们按正确的时间间隔进来吗？
So if their levels are all over the place 所以如果他们的水平到处都是
and we can't get any stability, 我们无法获得任何稳定性，
we have to figure out why that's happening 我们必须弄清楚为什么会这样
and we have to check them more often. 而且我们必须更频繁地检查它们。
But if they're consistently having good numbers, 但是如果他们一直有不错的数字，
we can spread 'em out. 我们可以散布他们。
- Hey, hey hey hey hey. -嘿，嘿，嘿，嘿。
- Represent. -代表
- Represent, yes. -代表，是的。
- Jose, what's up baby. - (laughs) (mumbles) -乔斯，怎么了，宝贝。 -（笑）（喃喃自语）
Where'd you get this from? 你从哪里得到的？
- Today's a hospital vlog day, baby. -今天是医院的博客日，宝贝。
- Woooo. 喔
- You ready for it? -准备好了吗？
- I'm ready, I'm ready. - You gonna try -我准备好了，我准备好了。 -你会尝试
and get Liddy? 并得到Liddy？
- I'm ready, I'm ready to get Liddy. -我准备好了，我准备去找Liddy。
- Yo, you gotta DJ it up. -哟，你要DJ了。
- (laughs) Whatcha wanna hear? DJ-ing -（笑）想听到什么？ DJ音
for our patients. - Whatcha wanna hear? 为我们的病人。 -Whatcha想听吗？
Whatcha wanna hear? 想听什么？
- I wanna hear Reggaeton. -我想听听雷鬼。
- All right, I got you. -好吧，我知道了。
- (mumbles) Reggaeton. - Oh my god. -（喃喃自语）雷鬼。 - 哦，我的上帝。
What is going on in here? - [Jose] Them bones them bones 这是怎么回事？ -[Jose]他们骨头他们骨头
- Come on, come on it's a party. -来吧，来参加一个聚会。
(laughing) （笑）
All right Jose, how many patients you checking in right now? 好吧，何塞，您现在检查了几位患者？
You don't think you're working too hard. 您不认为您在努力工作。
- I just got in. -我刚进来。
- All right, go do your job. - All right. -好吧，去做你的工作。 - 好吧。
- 'Cause I need to see my patients. -因为我需要看病人。
So my typical day goes like this. 所以我平常的日子是这样的。
I come in. 我进来。
I try and catch up on the computer 我尝试赶上计算机
to call patients back, 叫病人回去
to look at results, 看结果
to write some notes that I missed the previous day, 写一些我前一天想念的笔记，
and then I go in 然后我进去
and every 15, 20 minutes I have a new patient. 我每15、20分钟就有一个新病人。
I'm in and out of the rooms. 我进出房间。
I'm in and out of the rooms, 我进进出出房间
like I just came out of a room 就像我刚从房间出来
with a patient who was complaining 和一个抱怨的病人
about really bad allergies. 真的很不好的过敏。
That's really interesting 真的很有趣
'cause typical pollen season is now over 因为典型的花粉季节已经过去
and now we're getting into that wintertime allergy season 现在我们进入了冬季过敏季节
and sometimes if you're using the same allergy medication 有时如果您使用相同的抗过敏药物
for too long you can actually build up a tolerance 时间太长，您实际上可以建立起宽容
to it and you need to rotate them. 到它，你需要旋转它们。
So what we're doing for this patient is 所以我们要为这个病人做的是
we're changing up the allergy medications. 我们正在更换过敏药物​​。
We're also giving medications directly 我们也直接提供药物
for where the symptoms are present, 对于出现症状的地方
so you think about the nose, the eyes, 所以你想到鼻子，眼睛，
and we're really trying to get them better 我们真的在努力使他们更好
by thinking big picture 'cause it's not enough 考虑大局面，因为这还不够
to just think about prevention. 只考虑预防。
We also need to think about treating the active symptoms. 我们还需要考虑治疗活动性症状。
Today's gonna be a busy day but I'm excited to get started. 今天将是忙碌的一天，但我很高兴开始。
So I just had to call a patient back 所以我只需要给病人打电话
for his ultrasound. 为他的超声波。
He came in with gynecomastia, 他进来了男性乳房发育症，
which is he had a breast mass, 他有乳房肿块，
basically breast tissue developing. 乳房组织基本发育。
And when we do that, we have to check hormonal levels. 当我们这样做时，我们必须检查激素水平。
If those hormonal levels are elevated, 如果这些荷尔蒙水平升高，
then we gotta do an ultrasound. 然后我们要做超声波检查。
If the ultrasound is negative then we gotta do a CAT scan. 如果超声波为阴性，则我们必须进行CAT扫描。
If that's negative then we need to know something. 如果那是负面的，那么我们需要知道一些事情。
So it's really interesting how we have 所以我们真的很有趣
to follow these sets of guidelines 遵循这些准则
so that we don't do extra testing 这样我们就不会做额外的测试
and we don't do undertesting. 而且我们不会做测试。
It's a very fine line that we have to follow here. 这是我们必须遵循的一条非常好的路线。
What's going on? 这是怎么回事？
- What's good? - 有什么好的？
- You wanna tell the peeps if you get any crazy calls -您想告诉偷窥者是否接到疯狂的电话
with people asking to come see me? 有人问我吗？
- Uh, yeah. -恩
Hi, can I speak to Dr. Mike? 嗨，我可以和迈克医生说话吗？
Uh, no. 嗯不
Can I help you? 我可以帮你吗？
Yeah, but can I just talk to him? 是的，但我可以和他谈谈吗？
Can I have his number? 能给我他的电话吗？
No, no no. 不不不。
We don't deal with that here, sorry. 抱歉，我们不在这里处理。
- So I'm with Dr. Stewart Green here. -我在这里和Stewart Green博士在一起。
- Hello, hi. - 你好。
- Who is an expert in everything when it comes -谁是一切方面的专家
to mental health. 对心理健康。
- (laughs) -（笑）
- Taught me everything I know. -告诉我我所知道的一切。
I talk a lot about anxiety and depression 我经常谈论焦虑和抑郁
on my channel, how rates are going up. 在我的频道上，费率如何上升。
Is that something you've noticed? 你注意到了吗？
- There is a lot more sort of tension, -还有更多的压力，
the large surrounding environment 广阔的环境
of the country these days, 这些天的国家，
and those things of course impact patients' lives 这些当然会影响患者的生活
and people who are susceptible 和易感人群
to developing significant anxiety and anxiety disorders, 发展为严重的焦虑症和焦虑症，
as we say. 正如我们所说。
So yes, there's more of it, 是的，还有更多，
and it's affecting youth as well. 而且也影响着年轻人。
- All right. - 好吧。
'Cause I got a really long day, 因为我度过了很长的一天，
I only get to eat once before I get home 我回家之前只能吃一次
which is gonna be around like 10:00 p.m., 大概是晚上10:00左右
so I picked up some Chipotle. 所以我买了一些Chipotle。
All right Tia. 好的，Tia。
What are you gonna tell me? 你要告诉我什么？
You gonna tell about a public patient 你会告诉一个公共病人
who is here for an employee physical? 谁在这里为员工服务？
We do that here, right? 我们在这里做，对不对？
- Yes we do actually. -是的，我们实际上做了。
- And what do we do generally for those patients? -我们通常为那些患者做什么？
- We just make sure they can breathe -我们只是确保他们可以呼吸
and they have a pulse. 他们有脉搏。
- What? - 什么？
What does a CMA do 'cause no one could answer this question. CMA会做什么，因为没人会回答这个问题。
- Oh, okay. - 哦好的。
Well generally it's a medical assistant 好吧，一般是医疗助手
so I'm still able to, like nurses back in the day, 所以我仍然可以像过去的护士一样
bring patients in, 带病人进来
do vital signs, draw blood, give injections, 做生命体征，抽血，打针，
and assist with procedures like skin biopsies, 并协助进行皮肤活检等程序
toenail removal. 脚趾甲去除。
- You gave the greatest answer so far. -到目前为止，您给出了最大的答案。
- No problem. - 没问题。
- You're a rock star. -你是摇滚明星。
- Yes. -是的
- So I just had a pretty interesting patient encounter. -所以我遇到了一个非常有趣的病人。
Patient's coming in for an earache. 病人来了要疼。
I looked through the patient's notes 我翻阅了病人的笔记
and she's been here a lot, 她来过很多次
and I see that she's been diagnosed with cancer, 我发现她被诊断出患有癌症，
was familiar to me so I looked back in my notes 我很熟悉，所以我回头看了一下笔记
and I found that I saw this patient 我发现我看到了这个病人
about a year ago. 大约一年前。
And it was actually me who caught the cancer. 实际上是我得了癌症。
I didn't know this. 我不知道
When I walked into the room the patient was basically 当我走进房间时，病人基本上是
in tears because she was happy to see me 泪流满面，因为她很高兴见到我
because I was the one that initially got the x-ray 因为我是最初得到X光片的人
to find her cancer 去发现她的癌症
because what happened was she had pneumonia. 因为发生的事情是她得了肺炎。
They did an x-ray, 他们拍了X光片，
but then when you get a pneumonia, 但是当你得了肺炎时
the way it shows up on an x-ray X射线显示的方式
it can actually cover the cancer, 它实际上可以掩盖癌症，
if there is a cancer or anything there. 如果有癌症或任何东西。
So that's why whenever a person gets better 所以这就是为什么一个人变得更好
we ask them to come back in for a follow-up x-ray 我们请他们回来进行X光检查
to make sure that there's nothing behind the pneumonia. 确保没有任何肺炎。
And what do you know, 你知道什么
she was still a little bit coughing. 她还是有点咳嗽。
Month went by. 一个月过去了。
I said let's get another x-ray. 我说让我们再拍X光片。
Boom, there was something else there. 繁荣，那里还有别的东西。
I ended up getting a CAT scan a few days later 几天后我最终得到了CAT扫描
and we found a cancer that was treated 我们发现了一种可以治疗的癌症
and now she's doing great. 现在她做得很好。
But now for her to come in for an earache 但是现在让她痛起来
and be doing well after being diagnosed, treated, 在被诊断，治疗后表现良好，
and her being really happy, 她真的很开心
she told me something really cute. 她告诉我一些非常可爱的事。
She says, "My kids, especially the little one, 她说：“我的孩子，尤其是小孩，
are such big fans of yours." 是你们的忠实粉丝。”
I said because of YouTube? 我说是因为YouTube？
They're like no, because you saved my life. 他们就像没有，因为您救了我的命。
And I said, oh how old is your little one? 我说，哦，你的小孩子多大了？
She's like 39. 她才39岁。
We have one of our staff members that's been here 我们有一位工作人员来过这里
for almost a decade and a half 持续了近十五年
so we're gonna go say good-bye to her, 所以我们要和她说再见，
but she's not ready. 但她还没准备好
It's a surprise. 这是个惊喜。
Hey! 嘿!
(clapping) （拍手）
We love you. 我们爱你。
Cut the cake. (cheering) 切蛋糕。 （欢呼）
Cut the cake. 切蛋糕。
Yvette we're trying to teach everybody how 伊薇特我们正在尝试教大家
to be healthy and happy and what are you doing? 健康快乐，您在做什么？
What are you doing here? 你在这里做什么？
- You really have the (mumbles) -你真的（含糊）
to call me out after I (mumbles) your cake-- 在我（喃喃自语）你的蛋糕后叫我出来-
- I didn't eat cake. -我没吃蛋糕。
I didn't eat no cake. - (laughs) 我没有不吃蛋糕。 -（笑）
- [Dr. Mike] Look at that, what is that? -[博士迈克]看那是什么？
- He had cake. -他有蛋糕。
I didn't have cake. 我没有蛋糕。
- Cut the cake. -切蛋糕。
Cut the cake. 切蛋糕。
Can you tell I'm a little tired. 你能告诉我有点累吗？
Yeah, it's past 8:00 p.m. 是的，已经过了8:00 pm
We started this day at six. 我们从六点开始这一天。
I'm almost there, the tail end. 我快到了，尾巴。
Just so you understand the struggle 只是为了让您了解斗争
that a doctor has to go through, 医生必须经历的
like I've worked non-stop pretty much all day 就像我整天不停地工作
for these 12, 13 hours, 在这12、13个小时里
whatever I worked, 不管我做什么
but my notes aren't all done. 但是我的笔记还没有全部完成。
So I either have to sit at my desk finishing these notes, 所以我要么必须坐在办公桌前整理这些笔记，
or I have to go home, 否则我必须回家
do them at home or tomorrow morning wake up extra early 在家还是明天早上起床
before I start doing my other stuff 在我开始做其他事情之前
and do the notes. 并做笔记。
So as you can see, 如您所见，
burnout can start happening very soon 倦怠很快就会开始发生
and very easily for physicians. 对医生来说非常容易
So the struggle is real but it's worthwhile struggle. 因此，斗争是真实的，但这是值得的。
Yvette, I'm scared. 伊薇特，我很害怕。
I don't wanna get the flu shot. 我不想打流感。
Gives you the flu. 给你感冒。
It does all this bad stuff. 它做所有这些坏事。
I don't want it. 我不要
- You better get it or you gonna wear a mask -最好得到它，否则就戴口罩
all flu season. 所有流感季节。
Would you like some cold spray first? 您先要一些冷喷雾吗？
- I don't, do I want cold spray? -我不想要冷喷吗？
No, I'm already cold as it is. 不，我已经很冷了。
- [Yvette] It will numb the area. -[Yvette]会使该区域麻木。
- Oh my God. - 哦，我的上帝。
I wish I wore an undershirt today for the video. 我希望今天能穿一件汗衫观看视频。
She said no heavy lifting but why? 她说没有沉重的负担，但是为什么呢？
I wanna heavy lift. 我想举重。
- No, no, no irritation -不，不，不刺激
just in case - Please. 以防万一-请。
- You have some type of discomfort, -你有某种不适感
elevated temperature. 高温。
You can take whatever you normally take. 您可以服用平时服用的任何东西。
Drink as much fluid - [Dr. Mike] It's happening. 多喝水-[博士。迈克]发生了。
- as possible. - [Dr. Mike] It's happening. -尽可能。 -[博士迈克]发生了。
- Take the pressure off a your arm. -减轻手臂的压力。
Let it hang free so if you could just sit up a little bit. 让它自由悬挂，以便您可以稍微坐一下。
No pressure on your arm. - [Dr. Mike] Oh my God. 手臂没有压力。 -[博士迈克]天哪。
It's happening. - Just let it hang. 正在发生。 -就挂吧。
- [Dr. Mike] There's so much -[博士迈克]有很多
nudity here. - [Yvette] Are you ready? 裸体在这里。 -[Yvette]准备好了吗？
- [Dr. Mike] Wait, wait I wanna get a good shot. -[博士迈克]，等等，我想获得好成绩。
Okay, go, go. - You ready? 好，去，去- 你准备好了吗？
One, two, three, 35. 一二三三十五
- Ooh, ooh, I'm just kidding. -哦，哦，我只是在开玩笑。
It doesn't hurt. 没伤
- It actually doesn't-- -实际上-
- It actually feels good. -感觉真好。
It feels like a relief 感觉很轻松
because I'm no longer gonna get the flu. 因为我不再感染流感。
Well at least 40 to 60% of the time. 至少有40％到60％的时间。
- (laughs) 40 to 60. -（笑）40至60。
- I went to walk out of the office without my tie. -我没有领带就走了出去。
Straight Magic Mike style. 直魔术迈克风格。
This is what happens when it's almost 10:00 p.m. 这是将近晚上10:00时发生的情况
Do you know where your children are Yvette. 你知道你的孩子在哪里Yvette。
- Yes. -是的
- Where? -在哪里？
- Home and in school. -家庭和学校。
- Margaret, do you know where your child is? -玛格丽特，你知道孩子在哪里吗？
- [Staff] I don't have any. - Not really. -[职员]我没有。 - 并不是的。
I know where one of them is, but there's three. 我知道其中之一，但是有三个。
- Well at least you got 33%. -至少你有33％。
Woo, long day in the office 哦，办公室里很忙
but we saved some lives. 但是我们救了一些命。
Took care of business. 做生意。
Now I'm gonna head home, 现在我要回家了
walk and feed the Bear. 走路并喂熊。
Maybe do some more work at home, 也许在家做更多的工作，
but that's what a day in the hospital's like boys and girls. 但这就是在医院里像男孩和女孩一样的一天。
Hope you enjoyed. 希望你喜欢。