Published July 2012
十大赌博平台排行榜问&A:米切尔·伯杰
Why did you decide to become a neurosurgeon?
There were probably two reasons. One was that in medical school, 对我来说最有意义的主题是神经系统. That clicked immediately with me. Number two, I always liked to build things. I built my mother a stool; I built my own dresser. I really liked to work with my hands. So I put those two things together and there it was – neurosurgery.
The diagnosis of a brain tumor used to be a death sentence. 这种情况正在改变吗??
重要的是要记住有许多不同类型的肿瘤有不同的预后. 但总的来说，这是一个更令人鼓舞的领域，有几个原因. 我们比以前更了解这些肿瘤的遗传学和生物学，也有更好的方法来预测病人的病情. 我们可以对肿瘤进行基于分子的分析来寻找各种分子特征. 如果我们看到某个染色体模式或某个基因功能不正常, we will know whether or not a patient will respond to therapy. Through those clues, 我们已经学会了如何用不同的方法来治疗这些肿瘤, much more successful than we've ever been.
Is that true for even for the most aggressive kinds of tumors?
很多肿瘤，比如非常严重的侵袭性肿瘤单靠手术是无法治愈的. But we can significantly prolong a person's life – good quality life. Over the last 20 years, 我们已经将最严重的神经胶质瘤患者的寿命延长了三倍, 胶质母细胞瘤.
How have you achieved that?
We do much more aggressive and 更安全的 surgery, and the radiation therapy we use is more targeted, 更有效的, 一次又一次, 更安全的. 然后我们有了更好的化疗药物替莫达和阿瓦斯汀. 阿瓦斯丁, 例如, blocks new blood vessel formation in a tumor, so it slows the tumor's growth – it's very impressive.
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What are other exciting developments in the field?
We could spend weeks talking about that. New 大脑映射 techniques, a lot of which we've pioneered here at UCSF, have really made a difference. We now can know where the language center in the brain is located, where the motor and sensory systems and the visual pathways are. 这让我们在手术中更具侵略性，但更重要的是，我们可以更安全. 这是巨大的. 在过去，许多病人因手术而受伤，这不仅缩短了他们的寿命, but also their quality of life. 脑部绘图在治疗低级别神经胶质瘤方面发挥了最大的作用, 生长较慢的肿瘤通常影响年轻人，手术一直是最有效的治疗方法. 我们做了一个低级别神经胶质瘤的研究，发现如果术后影像显示我们成功地完全切除了肿瘤, we can now achieve nearly a 100 percent ten-year survival. We never knew that before we did that study. This has changed the landscape of neurosurgery, 因为现在我们知道，当我们看到那些低级别的神经胶质瘤时我们必须尽我们所能切除它们.
What about new kinds of imaging systems?
成像技术彻底改变了这个领域，让我们看到了以前从未见过的东西. We have high resolution 核磁共振成像 扫描仪不仅能给我们肿瘤的解剖结构，还能告诉我们它的生理学——有多少细胞浸润了大脑的特定部位, how much blood flow is present in a given part of the brain, which is more indicative of a higher grade tumor.
这些进步是否使神经外科成为一个更快乐、更有希望的专业?
It's never been an unhappy profession – it's just challenging. 但我们改善患者预后的目标现在比以往任何时候都更容易实现. Knowing that you can help patients makes its very exciting.
脑肿瘤的发病率是否发生了变化——你似乎更经常听到有关脑肿瘤的消息?
No, it's been about the same. 儿童发病率约为每10万人中4至6人. And for adults, it's about 10 to 12 per 100,000 population. 但检出率更高，因为人们比以前做了更多的成像.
I read that you originally wanted to be a football player.
我在高中和大学都打橄榄球，并参加了芝加哥熊队的选拔，但没能在那里坚持下去, so I went to medical school. 足球是我生命中很重要的一部分，因为它教会了我如何在团队环境中工作.
Is that relevant to what you do now?
我想是的. Nobody administers care by themselves. You do it on a team.
你现在在一个委员会任职，就如何减少脑震荡和其他可能导致脑外伤的伤害向国家橄榄球联盟提供建议. That kind of takes you full circle, doesn't it?
我一直想回馈这项让我成为一名十大赌博平台排行榜的运动. 我学会了所有的纪律和团队管理，因为我是在足球场上. 这是我决定回馈的一种方式——帮助他们使这项运动更安全.
What does that entail?
游戏本质上是暴力的，除非我们改变规则，否则这一点不会改变. So we've changed the rules. We've outlawed helmet-to-helmet contact. 我们已经改变了开球的方式，所以开球的次数减少了，因为这是很多严重受伤发生的地方. 我们的目标是试图改变那些参加比赛的人的文化，以及那些像教练和队医一样管理比赛的人，让他们更加意识到这些伤病可能带来的后果.
What's the best part about working at UCSF?
It's a phenomenal environment. 我们在各个层面上都充满了人才——就像在全明星足球队里踢球一样.
你是个有名的十大赌博平台排行榜，对病人很平易近人.
I pride myself on that. 我一直有一个基本理念，我对待我的病人就像对待我的家人一样. 我一直都是这样，也将永远是这样. So why wouldn't I want to give a family member my phone number? Why wouldn't I want to give them access to me via email? I want them to feel comfortable with me. 我希望我们在一起完成这个过程时尽可能友好. I want them to rely on me and count on me. I want to do the worrying for them. I love my patients.
Do you stay in touch long term?
是的. I saw a patient today I hadn't seen in two years. I saw her getting some money out of the cash machine, tapped her on the shoulder, and gave her a hug and kiss. I like to hug my patients. I get a lot of warmth out of it. It makes me feel good.
That's not typical for neurosurgeons.
神经外科十大赌博平台排行榜s can be egocentric and standoffish. 我理解. Some people just can't get involved. 但我生活中的许多朋友都是我交往和约会的病人. 我认为，当你试图过双重生活——一种是十大赌博平台排行榜，一种是普通人——这是行不通的. I think it's all got to be one life.
