Uncle Reggie stories URS: That funny thyroid Reggie 叔叔的故事: 有趣的甲状腺 (Anya ZHANG 翻译)

The thyroid is a very funny organ, one of the few organs you can actually touch, right in your neck and right at your throat. I am especially interested in it partly because, right behind the thyroid, there are four little organs called the “parathyroid glands” which produce “my special hormones,” that I spent many decades studying. The best thyroid surgeon in Cincinnati was my great friend Dr. James Fidler. He was one of the kindest doctors I have ever met, and he loved to go on medical missions trips. In fact, he went with me 17 times to China! He loved to go up a hill behind the town that we were working in, to pray for the town. This he did early in the morning before surgery (surgeons are always up before dawn). Early one morning in India, he was doing the same thing, and halfway up the mountain, he collapsed from a heart attack.

One of the kindest thyroid surgeons in action. 最有爱心的甲状腺外科医生在进行手术

甲状腺是一个非常有趣的器官,它是几个你可以触摸到的器官之一:就在颈部喉咙的位置。我对甲状腺特别感兴趣,部分原因是: 甲状腺后方有四个被称为“甲状旁腺”的小器官,它们产生一种 “于我而言的特殊激素” :因我在过去几十年一直对它进行研究。 辛辛那提最好的甲状腺外科医生是我最好的朋友飞的力Jim Fidler博士。 他是我见过的最有爱心的医生之一。他喜欢去做医疗援助,我们结伴去了中国17次! 他喜欢在我们工作的城镇后的小山上为这个城镇祷告。 他通常会在开始一天手术前的清晨(外科医生一直在黎明前起床)进行祈祷。 在印度的一天早上,他正打算爬上山做同样的事,在半山腰的时候,他因心脏病发作而离开了这个世界。

The village people were so touched, that 1000 people showed up for his funeral. The funeral had to be done within 24 hours by local custom, so that his family did not even have time to fly from the USA to attend the funeral. But I will always remember him especially for the many times we worked together, and even sang together in China.

那个山村的村民很感动,聚集了1000人出席了葬礼。依据当地的习俗,葬礼必须在24小时内完成。 也是因此,他的家人无法从美国飞往参加葬礼。但我会永远记住他,特别是我们曾在一起工作,甚至在中国一起唱歌。

Often, he would give a talk on the thyroid and parathyroids, and I would be his translator in my primitive Mandarin. However, when he got to the subject of the parathyroids and calcium, it was “my territory.” So if he gave one sentence, my translation became four. He showed surprise about the discrepancy in length, but I reassured him that it was going to be a better talk. And it was! Anyway, a surgeon is supposed to operate, not to give talks.

他常常会以甲状腺和甲状旁腺为主题发表学术演讲,当然我会用我有限的华语用最通俗易懂的普通话进行翻译。然而,每当他讲到甲状旁腺和钙的问题时,就是“我的领域”:如果他讲了一句话,我就可以翻译出四句话。他常常会对翻译出的长度表示惊讶,但我向他保证,这将是一个更好的演讲。 这是!无论如何,一名外科医生应该擅长做手术,而不是发表演讲。

At the beginning of my research career in “calcium,” I was learning to measure different hormones that controlled calcium in the body, especially the parathyroid and later, vitamin D. But along came this new hormone called calcitonin, which was produced by the thyroid, so we were eager to measure it in babies, since there was next to no information about that. My research assistant had learned the technique of measuring calcitonin, and she used the blood of various people in the laboratory as “controls.” To our great surprise, her blood calcitonin level was sky-high. She was found to have thyroid cancer and measurements of blood calcitonin became a “marker” for early detection of thyroid cancer.

在最初开始以“钙”作为主要研究方向时,我同时在学习测量其它调控钙离子水平的激素:主要是甲状旁腺素,也包括维生素D。但是当时发现了一种被称为“降钙素”的新型激素,被认为是由甲状腺产生 。我们迫切地想测量它在婴儿中的含量,因为当时相关的研究还是空白。 我的研究助理已经学习了降钙素测定技术,她用实验室里工作人员的血液样本作“对照”,然后惊讶地发现她自己的血降钙素水平异常的高。 之后她被确诊患有甲状腺癌,因当时 “降钙素”水平是早期发现甲状腺癌的指标。

In the last decade, something surprising has been happening: one by one, I heard of many doctor friends developing thyroid tumors! My Korean former fellow, my China scholar friend, and a doctor member of our Asian church, developed thyroid tumors, and suddenly we were hearing unofficially that many doctors at the famous Peking Union Medical College had developed thyroid cancer also. Sure enough, in November of 2014 a report came out about an “epidemic” of thyroid cancer being reported in South Korea. But the point of the article was that there was a lot of overdiagnosis of thyroid cancer, because of early detection using modern-day ultrasonic (“echoes”) techniques.

在过去十年中,令人惊讶的事情一直在发生:我接二连三地听说很多医生朋友罹患了甲状腺肿瘤:我的韩裔前研究员、我的中国学者朋友、我们亚洲教会的医生,都发现了甲状腺肿瘤。另外,我们从非官方的渠道听说:北京协和医学院的许多医生也得了甲状腺癌。 果然,2014年11月,一份关于甲状腺癌在韩国的“流行病学”报告发表了。 不过文章的重点是甲状腺癌的诊断有矫枉过正的倾向,原因是使用现代超声波技术,可以早期发现甲状腺肿瘤。

I really have another love story with the thyroid. Even in medical school, during physiology classes, when we measured our own body functions, I noticed that my heart rate was always running above 90 per minute, much faster than the rest of the class. I wondered why my metabolism was running so fast, and why I was always so driven! Then one day in the newborn intensive care unit, while I was trying to start an intravenous medicine in a small premature baby, I noticed that my hands were shaking quite dramatically. I was in the middle of my internship, and my weight had dropped 20 pounds to a mere 95 pounds! I went to see my doctor, and the moment I walked in, he said, “you have thyrotoxicosis”, meaning I had an overactive thyroid. So he slammed me into the hospital, forced me to take two weeks off, and gave me five meals a day to fatten me up. It was one of the “best two weeks” of my life, when I could read many, many books, and relax in a hospital bed away from my very busy internship


“Epidemic” of thyroid cancer. N Engl J Med 2014;371:1765-1767
甲状腺癌的“流行趋势”。新英格兰杂志 2014;371:1765-1767

However, after that, the doctor gave me radioactive iodine, which killed my thyroid, and made me radioactive for a while. There is no question that my thyroid is now totally killed. In fact it is so killed that I have very little temperature control, so that when the weather gets cold, I have headaches, and I have to set the home temperature 4 degrees F higher than my wife’s comfort level. Then at the other extreme, I sweat profusely when the temperature goes up. The main system for temperature control, I guess cannot be replaced simply by my taking thyroid pills! The Designer of the natural temperature control system knew what He was doing, and we cannot match His brilliance with medicines!

后来,医生给我进行了放射性碘治疗,杀死了我的甲状腺。 毫无疑问,我的甲状腺现在完全没有功能了。 事实上,我的甲状腺真的功能丧失到几乎没有温度控制的能力。当天气变冷的时候,我会头痛,我必须将家里的温度设定在比我妻子舒适度高4华氏度。相反地,当温度升高时,我会大汗淋漓。 我猜测:温度控制的主要系统,不能靠服用甲状腺素片来取代!自然温度控制系统的设计师知道他在做什么,我们不能将他的精巧设计与药物相提并论!