1. The process of globalization that dominates the beginning of the 21st century has created a context of global health interdependence in which many health threats transcend national boundaries, such as the spread of reemerging and new infectious diseases, increased microbial resistance to currently available drugs, and bioterrorism, and the challenges of financing the increasing demands of the public for better health.

21世紀(jì)初占主導(dǎo)地位的全球化進(jìn)程已造成了一個(gè)全球衛(wèi)生相互依賴的狀況，許多對(duì)健康的威脅是超越國(guó)界的。例如，老的傳染病重新興起，新的傳染病傳播，細(xì)菌對(duì)現(xiàn)有藥物的耐藥性不斷增加，生物恐怖主義，以及為滿足公眾日益增長(zhǎng)的對(duì)更好保健需求方面的財(cái)源受到挑戰(zhàn)。

2. Pressure to contain health care costs places physicians and other health care practitioners in difficult positions. If we pursue our patients’ best interests without regard to costs, we will accelerate health care inflation, a serious concern in an era in which governments throughout the industrialized world are struggling to offer care to their populations. 

But if we forsake patients' best interests in favor of society's pocketbook, we risk alienating our patients, who expect that we will be their untiring advocates.

控制衛(wèi)生保健成本的壓力使醫(yī)生和其他衛(wèi)生保健從業(yè)人員面臨著困難的處境。如果我們?yōu)榱瞬∪说淖畲罄嬷?，而不去考慮成本，我們會(huì)加速衛(wèi)生保健費(fèi)用膨脹?，F(xiàn)在，工業(yè)化國(guó)家的政府在為國(guó)民提供衛(wèi)生保健竭力掙扎著。在這樣一個(gè)時(shí)代里，衛(wèi)生保健費(fèi)用膨脹成了人們嚴(yán)重關(guān)切的問(wèn)題。

但是，如果我們?yōu)榱松鐣?huì)的財(cái)力問(wèn)題而舍棄病人的最大利益，我們就冒有同病人疏遠(yuǎn)的風(fēng)險(xiǎn)，因?yàn)椴∪似诖覀儠?huì)不屈不撓地支持他們。

3. Although disagreements persist among experts about what aspects of medical practice are captured by the term "medical professionalism," wide agreement has nevertheless emerged in recent years within academic medicine that it is essential to try to teach the concept of professionalism to medical students and residents. 

盡管專家對(duì)于醫(yī)學(xué)職業(yè)精神這個(gè)術(shù)語(yǔ)包含了行醫(yī)實(shí)踐的那些方面的分歧還會(huì)持續(xù)下去，但在近幾年里醫(yī)學(xué)界出現(xiàn)的廣泛認(rèn)同是，努力對(duì)醫(yī)學(xué)生和住院醫(yī)師教授職業(yè)精神概念是很重要的。

4. Despite a selection process that often passes over those who would make the best physicians, a training system that seems bent on wringing out the idealism and empathy with which most medical students start, and a medical establishment that far too often covers up for those who should not be practicing, the medical profession endures. 

Perhaps the profession owes its longevity to the pride and satisfaction its physicians realize from seeing the years of hard training and sacrifice make a crucial difference or even save a life.

盡管選拔過(guò)程常常忽視那些會(huì)成為最好醫(yī)生的人，盡管培養(yǎng)體制似乎決意要把醫(yī)學(xué)生一開(kāi)始的理想和同情心榨干，盡管醫(yī)療機(jī)構(gòu)常常掩蓋那些不該行醫(yī)的人，但醫(yī)學(xué)職業(yè)仍然在繼續(xù)著。

或許這一職業(yè)的長(zhǎng)久，要?dú)w功于醫(yī)生體會(huì)到的自豪和滿足。這樣的自豪和滿足源自醫(yī)生看到了多年的培訓(xùn)和犧牲起到關(guān)鍵甚至是救人一命的作用。

5. The moving stories I see every day of courage, love, and devotion, the memories I have of patients whose lives have touched mine and enriched me forever, keep me coming back to the endless fascination of the comedy and tragedy of the Shakespearean stage of life that is my ER—a drama in which among the leading players will always be the fallible human being who are physicians. 

我每天所見(jiàn)的動(dòng)人故事富有勇氣、充滿愛(ài)心和奉獻(xiàn)精神。病人的生活感動(dòng)了我，豐富了我的人生。這一切記憶使我不斷回到具有無(wú)窮魅力、莎士比亞式悲喜劇交加的人生舞臺(tái)—我的急診室。醫(yī)生總是劇中的主要演員，他們也是會(huì)犯錯(cuò)誤的人。

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