The most complex problems in our time can be solved with simple techniques, if we are able to dream.
在我們這個時代最複雜的問題 卻能用簡單的技術解決, 如果我們敢於逐夢的話。
As a child, I discovered that creativity is the key to cross from dreams to reality. I learned this from my grandmother, Dr. Ruth Tichauer, a Jewish refugee that settled in the heart of the Andes. That is how I grew up: encouraged to see beyond any limitation. So part of my education included helping her in remote, indigenous communities. I cherish those memories, because they helped me to understand life outside the city, a life with a lot of possibilities, without barriers, as language or culture.
小時候,我發現創造力是 跨越夢想與現實的關鍵。 我從我的祖母路得醫師學到這點, 她是位猶太難民, 定居在安第斯山脈中心地帶。 那正是我長大的方式, 被鼓勵去觀察超越任何限制的事物。 所以我受到的教育的一部分就是 在偏遠的原住民社區裡協助她。 我珍惜那些記憶, 因為它們幫助我了解 城市以外的生活, 一種具有多種可能性的生活, 沒有障礙,例如在語言或文化方面。
During those trips, my grandmother used to recite a Kipling poem: "Something hidden. Go and find it. Go and look behind the Mountains. Something lost behind the mountains. Lost and waiting for you. Go!"
在那些旅程中, 我的祖母常常朗誦吉卜林的詩: 「去找。找那些被藏起之物。 快,到山的後面找。 在山後,那些丟失之物, 在遺失中正等待著你。去吧!」
In the coming years, I became a medical student. One of every hundred children born worldwide has some kind of heart disease. There's a part of this problem I think I can solve -- the part of this problem I have spent my life working on.
在之後的數年,我成為一個醫學生。 全世界每一百個出生的小孩之中 就有一位有某種心臟病。 我想我能解決這問題的其中一部份── 這部分我已花費我的一生不斷鑽研。
The problem starts during pregnancy. The fetus needs to survive inside the mother. Survival depends on communication between the systemic and the pulmonary blood. At the moment of birth, this communication needs to stop. If it doesn't close, the baby has a hole in the heart. It is caused by prematurity and genetic conditions. But what we know today is that a lack of oxygen is also one of the causes. As you can see in the chart, the frequency of this kind of hole dramatically increases with altitude.
這問題是開始於懷孕期間, 胎兒需要在母體內生存, 存活則仰賴體循環 與肺循環間血液的交流。 而在出生時, 這種交流必須停止。 假如沒有關閉, 嬰兒的心臟就會有一個通孔。 這是因早產及基因異常造成的, 但現今我們知道的是 缺少氧氣也是原因之一。 在這圖表中你可看到, 這種心臟通孔的發生率 隨著海拔高度的增長而急劇增加。
Video: (Baby crying)
影片:(嬰兒哭聲)。
When you look at patients with this condition, they seem desperate to breathe. To close the hole, major surgery used to be the only solution.
當你看到這種狀況的病人, 他們似乎拼命地呼吸。 要關閉這通孔,
One night, my friend Malte, were camping in the Amazon region.
動大手術是過去唯一的治療方法。
The only thing that would not burn in the fire was a green avocado branch. Then came a moment of inspiration. So we used the branch as a mold for our first invention. The holes in children's hearts can be closed with it. A coil is a piece of wire wrapped onto itself. It maybe doesn't look so fancy to you now, but that was our first successful attempt to create a device for this major problem. In this video, we can see how a very tiny catheter takes the coil to the heart. The coil then closes the hole. After that moment of inspiration, there came a very long time of effort developing a prototype. In vitro and in vivo studies took thousands of hours of work in the lab. The coil, if it works, can save lives.
有天晚上,我的朋友馬爾它和我 在亞馬遜地區露營, 唯一無法在營火裡燃燒的 是一枝牛油果的嫩枝。 接著我們靈感泉湧, 所以我們用樹枝 作為我們首次發明的模型。 小孩心臟的通孔可以用它將之關閉。 線圈是由一條金屬絲自我盤繞而成。 現在你看它也許不怎麼起眼, 但那是我們第一次成功的嘗試, 為這重大問題製造出一個裝置。 在這影片中, 我們可看到一條極細的導管 如何將線圈帶到心臟, 然後線圈將通孔關閉。 在那靈感啟發後, 經過一段非常長時間的努力, 研發出這種裝置的雛形。 在實驗室裡,花費數千個小時 作生物體外與體內的研究; 如果成功,這線圈能挽救無數生命。
I returned from Germany to Bolivia, thinking that wherever we go, we have the opportunity to make a difference. With my wife and partner, Dr. Alexandra Heath, we started to see patients. After successfully treating patients with our coil, we felt really enthusiastic. But we live in a place that is 12,000 feet high. And, the patients there need a special device to solve their heart condition. The hole in altitude patients is different, because the orifice between the arteries is larger. Most patients cannot afford to be treated on time, and they die. The first coil could successfully treat only half of the patients in Bolivia. The search started again. We went back to the drawing board.
我從德國返回玻利維亞, 心想:無論到哪裡 我們都有機會有所作為。 我與我的妻子,也是同事 亞歷珊卓醫師 開始訪視病人。 使用我們的線圈成功治療病人之後, 我們真的感到滿腔熱忱。 但我們住在海拔 12,000 英尺的地方, 而且, 那裡的病人需要一種特殊的裝置 來解決他們心臟的狀況。 在高海拔病人的心臟通孔是不同的, 因為動脈間的開口比較大。 大部份病人付不起費用, 無法及時接受治療, 因而死亡了。 在玻利維亞,最初的線圈 只能成功地治療一半的病人。 研究再度展開, 我們重新返回設計階段,
After many trials, and with the help of my grandmother's indigenous friends in the mountains, we obtained a new device. For centuries, indigenous women told stories by weaving complex patterns on looms, and an unexpected skill helped us for the new device. We take this traditional method of weaving and make a design made by a smart material that records shape. It seems this time, the weaving allows us to create a seamless device that doesn't rust because it's made of only one piece. It can change by itself into very complex structures by a procedure that took decades to develop.
經過許多試驗, 在我祖母的山區原住民朋友協助下, 我們做了一種新的裝置。 數世紀以來,原住民婦女藉著 在織布機上編織複雜圖案述說故事, 而這種意料之外的技巧 幫助了我們的新裝置。 我們採用這種傳統編織法, 利用一種可記憶自身形狀的 智慧型材質完成了設計。 此次, 似乎編織法讓我們設計出 一種無瑕疵的裝置, 它不會生鏽, 因為它僅由一條金屬絲做成。 它能自己變形成為非常複雜的結構, 這過程花了數十年的研發,
As you can see, the device enters the body through the natural channels. Doctors have only to close the catheter through the hole. Our device expands, places itself and closes the hole. We have this beautiful delivery system that is so simple to use because it works by itself. No open surgery was necessary.
正如你們所看到的, 這裝置經由血液流動的 通道進入人體。 醫師只須將導管跨過通孔, 裝置會自行展開,自己擺好位置, 而後關閉心臟的通孔。 我們有這完美的置放系統, 使用非常簡單, 因為它自己就能發揮作用。 不再需要開心手術了!
(Applause)
(掌聲)
As doctors, we fight with diseases that take a long time and effort to heal -- if they do. This is the child from before, after the procedure. As you can see --
身為醫師,我們鍥而不捨地 與痼疾作戰── 假如它們可治癒的話。 這是先前的那個小孩, 經過治療以後的樣子。 正如你所看到的──
(Applause)
(掌聲)
As you can see, once the device is in place, the patient is 100 percent healed. From start to finish, the whole procedure takes only 30 minutes. That's very rewarding from the medical and human point of view. We are so proud that some of our former patients are part of our team -- a team, thanks to added close interaction with patients that work with us. Together, we have only one idea: the best solutions need to be simple. We lost the fear of creating something new.
正如你所看到,一旦裝置植入, 病人 100% 完全痊癒。 從開始至結束, 整個過程只花 30 分鐘。 從醫療以及常人的觀點來看, 那是非常值得的。 我們感到自豪的是 一些我們以前的病人 加入我們的團隊, 這個團隊歸功於 和我們一起工作的病人 所附加的緊密互動。 我們只有一個共同的信念: 最佳解決方案必須很簡潔。 我們不再畏懼創造新型式。
The path, it's not easy. Many obstacles arise all the time. But we receive strength from our patients. Their resilience and courage inspire our creativity. Our goal is to make sure that no child is left behind, not because of cost or access.
這路不容易走, 許多障礙一直出現; 但我們從病人得到力量, 他們的適應能力與勇氣 鼓舞我們的創造力。 我們的目標是要確保 沒有一個小孩會因為費用 或就醫機會的因素而被遺漏掉。
So we have to start a foundation with a one-to-one model. We will give one device for free to make sure that every child is treated. We are in many countries now, but we need to be everywhere. This whole thing began with one impossible idea as will continue it, really: No child is left behind.
所以我們必須建立一個基金會, 以一對一的模式, 我們免費提供一支裝置, 以確保每一個孩子都能接受治療。 我們現在已在許多國家中作業, 但我們必須擴大到各地。 整個事情始於一個異想天開的念頭, 事實上也會持續下去: 沒有一個小孩會被忽略遺漏。
Muchas gracias.
(西語)非常謝謝!
(Applause)
(掌聲)