シャドーイング練習: Anesthesiology: Basics – Anesthesiology | Lecturio - 動画で英語スピーキングを学ぶ

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Hello ladies and gentlemen.

Here are a series of questions and answers to start you thinking about anesthesiology.

I'll follow that with a short history of the specialty and a discussion on how anesthesiology has changed the world.

A common question I'm asked and it's a reasonable question.

I've been told that I will be asleep during my surgery.

I don't think surgery could be performed on me if I were just asleep.

Is general anesthesia the same as sleep?

General anesthesia is not just deeper sleep.

It's much better compared to a state of reversible coma.

It's a type of coma that we can induce and we can reverse, and yes, we can reverse it,

and you will wake up from your anesthetic.

The second common question I'm asked is, I've been told that I will be paralyzed during my surgery.

Isn't this dangerous?

How will I breathe?

This statement is often accompanied by my students with statements like, that's really gross and how would you do that to people?

The answer is you may be paralyzed during your surgery

if the surgeon requires muscle relaxation to complete the surgery successfully

and safely or if the anesthesiologist must place a breathing tube in your trachea.

The anesthesiologist is responsible for managing your breathing and will make sure that you have no memory for this whole experience.

Third question that's commonly asked is, will I remember being operated upon?

You will remember entering the operating room and being introduced to the team members

that are going to be involved in your surgery.

You will then be given an anesthetic, which will eliminate all memory of the surgical experience itself.

And you will not be awakened, and you will not reform your memory until the surgery is completed.

After the anesthetic is gone, won't I have a lot of pain?

When anesthesia is properly delivered, the provider assures that pain prevention is an important aspect of the care.

Before the end of surgery, the anesthesiologist will provide you with painkillers that will produce good pain relief when you wake up.

In addition, the nurses in the recovery room will give you additional pain relief if you require it.

So here's a definition from the Oxford Dictionary.

It's not sleep.

Surgery cannot be performed under conditions of normal sleep.

Period.

And the Oxford Dictionary says, An anesthetic that affects the whole body and it usually causes a loss of consciousness,

i .e., he had an operation under general anesthesia.

Anesthesia.

The critical word here is a reversible drug -induced state of unconsciousness, which is characterized by a coma -like state under the control of the anesthetist,

a term that is also known as anesthesiologist, depending on what part of the world you're in.

It's often associated with muscle paralysis.

It's always associated with profound amnesia for the surgical event.

So how did anesthesia develop?

Well, it's all thanks to the dentists.

Doctors can't take any credit for it.

Prior to 1846, there was no known way to provide anesthesia to those undergoing surgery.

The whole process of surgery was extraordinarily painful, bloody and dirty.

Surgeons were praised for the speed, not skill, in their sexful completions of operations.

Surgical procedures were either very superficial, drainage of abscesses or removal of small skin lesions, or major amputations of limbs,

caesarean section, all without any anesthesia.

The Massachusetts General Hospital, at the time that this whole event occurs, was the busiest surgical site in North America.

It provided surgical procedures to an average of five patients a week.

After 1846, longer, more complex surgical procedures developed,

and the field of surgery exploded.

Now over 100 procedures are done at Massachusetts General Hospital a day,

and new surgical procedures are being developed at a very rapid pace.

So the first dentist we're going to talk about is Dr. Horace Wells.

He's the real father of anesthesiology, although the term's been used on many individuals.

Yes, he was a dentist.

In 1844, he went to a party.

It was a nitrous oxide party where people gathered and enjoyed themselves and breathed nitrous oxide,

usually out of a big paper bag.

And one of the things he noticed was a woman smashed her leg very hard against a bench

and ended up with a large laceration on her leg, which should have been extremely painful.

She had no sense of pain whatsoever from it.

And from this observation, he then went about using nitrous oxide in his dental practice.

He had his own tooth extracted under nitrous oxide anesthesia and had very little discomfort.

And in 1845, he demonstrated nitrous oxide for surgical anesthesia at the Massachusetts General Hospital.

Unfortunately, as you're going to learn in this course, nitrous oxide is not a strong anesthetic.

And it was a dismal failure.

And he was shamed before all the physicians in Massachusetts and the dentists.

Nitrous oxide provides good analgesia, good pain control, but cannot provide full anesthesia.

So the patient cried out during the surgery, Wells was humiliated, and he ultimately committed suicide.

This was a typical advertisement in those days for a laughing gas party, nitrous oxide party.

So you can see, laugh, sing, dance, speak, or fight, all those wonderful things you could do with nitrous oxide on board.

So the next dentist to come along was Dr. William Morton, also in Massachusetts.

He had actually been predated by Dr. Crawford Long in Great Britain, who did do surgery under ether anesthesia, but didn't bother publishing his results.

So the first described and known event in general anesthesia occurred on October 16, 1845.

Dr. Morton provided anesthesia to a young man having a tumor removed from his neck under ether anesthesia.

And the chief surgeon turned to the crowd in the room and said, in the very pompous way of that

Victorian era, gentlemen, this is no humbug.

And Morton's name was made.

Morton was a bit of a scamp,

unfortunately, and he tried to make more out of this than he was able to by coloring ether orange

and then trying to patent it as orange ether,

claiming it was superior to regular ether that had actually been around as a solvent and cleaning agent for centuries.

So this is a painting of that first event and this is from 1845 at the Massachusetts General.

This operating room is still in existence and you can visit it if you wish,

but you can see how very different the world was then than it is now.

All these people gathered around the operating room table wearing street clothes.

They may, in fact, be people right off the street because like public executions,

surgery was a popular spectator sport in the mid part of the 19th century.

You can see Morton holding his bottle of ether and the surgeon working on the young man's neck.

So that started general anesthesia for general surgery.

But it was important to move beyond that to other areas of need.

And the area that was likely to be missed in all of this was obstetrical anesthesia.

Partly this was due to the biases of the era that said,

you know, pain during labor was a required part of woman's recompense for original sin.

Well, there was a very powerful lady in existence in that era in Great Britain.

That was Queen Victoria.

And she wasn't willing to be punished for something that might have happened in the Garden of Eaton.

And with her eighth child, she had 11, I believe, she asked Dr. John Snow,

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who was the first practicing anesthesiologist in Great Britain, to provide her with anesthesia.

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Snow's an interesting man.

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And for those of you who are aware of the London pump cholera story,

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it's the same John Snow who discovered that pump and was able to prevent cholera from spreading in London.

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And so in a way, he's the father of epidemiology, and he's also one of the fathers of anesthesiology.

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Very amazing man.

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Anyway, after she delivered her baby, Queen Victoria said, Dr. Snow gave the blessed chloroform, and the effect was soothing,

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quieting, and delightful beyond measure.

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And from that moment forward, obstetrical anesthesia had a solid place in medicine.

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So this is what it looked like to start with.

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This is a bottle of ether and a Schimmelbush mask.

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And the mask is basically just a wire mask that you laid some gauze over,

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and you poured ether directly on the gauze and put the mask

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and gauze over the patient's face and they breathe the vapor.

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This is a modern anesthetic machine, a little bit fancier than the Schimmel -Busch mask,

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much more sophisticated, full of very complex warning systems and monitoring systems, which we'll discuss in more detail in a later lecture.

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Other forms of anesthesia that have developed include regional anesthesia, which developed as local anesthetics were created,

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and one of the first people involved in this story was Sigmund Freud, who thought that cocaine would be both a useful medication

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and felt that it would be particularly useful in the treatment of depression.

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And unfortunately, Sigmund Freud had to withdraw this belief in a later period because one of his best friends,

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who was a very famous American surgeon, became addicted to cocaine and died from its use.

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In any case, the use of cocaine and other simple local anesthetics led to the development of spinal and epidural anesthesia.

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And we can now provide complete loss of sensation to many parts of the body, and particularly the limbs, for surgery.

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Spinal anesthesia is the commonest form of anesthesia for cesarean sections,

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for instance, whereas epidural anesthesia is useful for pain relief during labor or after certain types of surgery.

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Spinal anesthesia is often used for surgery of the legs.

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With modern ultrasound equipment, it is now possible to pass a needle directly to a nerve without perforating the nerve

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or hitting blood vessels under direct vision using ultrasound.

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And this has revolutionized the use of regional anesthesia over the last 5 to 10 years.

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Anesthesia is an extremely safe medical specialty.

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It's one of the safest interventions in modern medicine.

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My practice started in 1980.

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At that time, people used to die on the operating room table.

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In 2014, it's extraordinarily rare for this to happen.

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In developed countries, the mortality rate from general anesthesia is usually stated to be around 1 in 10 ,000

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or maybe as high as 1 in 20 ,000.

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The rate is much lower, however, in young, healthy individuals.

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Also in developed countries, the rate of permanent neurologic damage from spinal or epidural anesthesia is less than 1 in 100 ,000.

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So in a career, most anesthesiologists will never see this happen.

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So our lecture series is going to be laid out like this.

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An introductory lecture, which you're hearing now, a lecture on physiologic aspects of anesthesia, drugs used in anesthesia, and anesthetic systems.

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We'll then move into the more clinical aspects of the specialty and talk about general anesthesia, regional anesthesia, emergencies in the operating room,

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intensive care of patients, pain management, and anesthesia for special populations such such as the pregnant patient,

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children, thoracic anesthesia, neuroanesthesia.

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And then at the very end, we'll summarize everything and we'll have a short discussion about anesthesia and its use in other medical disciplines,

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and the future of anesthesia, and some of the opportunities for young anesthesiologists opening into the future.

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So in this lecture, we've summarized the history of anesthesiology

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and given you a bit of an overview of what general anesthesia and regional anesthesia look like.

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We're going to go into a great more detail in the subsequent lectures, and I hope you join us for those.

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このレッスンの語彙とスピーキングのポイント

このスピーキングレッスンは、動画「Anesthesiology: Basics – Anesthesiology」を教材にしています。繰り返し出てくる語は次のとおりです：anesthesia, surgery, anesthetic, nitrous, oxide。この動画には、シャドーイング用の文が148文、単語が1942語あります。音声の長さは13:33です。話す速さは1分あたり約143語で安定しており、シャドーイングしやすいペースです。英語の頻出3,000語に含まれる単語は79%だけなので、語彙は難しめです。

この動画の重要語彙

動画に出てくる覚えておきたい単語15語を、発音と意味つきで紹介します。

単語	発音	意味
oxide 名詞	/ˈɑksaɪd/	酸化物
lecture 名詞	/ˈlɛk.t͡ʃə/	講義
procedure 名詞	/pɹəˈsiː.d͡ʒə/	手段, やり方
mask 名詞	/mæsk/	仮面, 覆面
breathe 動詞	/bɹiːð/	呼吸する, 息をする
surgeon 名詞	/ˈsɝd͡ʒən/	外科医, 執刀医
dentist 名詞	/ˈdɛntɪst/	歯医者, 歯科医
aspect 名詞	/ˈæspɛkt/	様相
cocaine 名詞	/koʊˈkeɪn/	コカイン
specialty 名詞	/ˈspɛʃ.əl.ti/	専門
coma 名詞	/ˈkoʊmə/	昏睡
muscle 名詞	/ˈmʌs.əl/	筋肉, 筋
asleep 形容詞	/əˈsliːp/	寝ている, 眠っている
painful 形容詞	/ˈpeɪn.fl̩/	痛い, 痛みの伴う
pump 名詞	/pʌmp/	ポンプ, 喞筒

動画に出てくる句動詞

単語	発音	意味
wake up 動詞	/ˌweɪk ˈʌp/	目覚める, 目を覚ます

繰り返し練習したい文

動画に出てくる短く完結した文です。日常会話でそのまま使えます。

How will I breathe?
Third question that's commonly asked is, will I remember being operated upon?
After the anesthetic is gone, won't I have a lot of pain?

この動画の文法

話し手がよく使っている文型を、動画の実際の表現とともに紹介します。

文型	動画での表現
受動態 be + 過去分詞 — 誰がするかより、何が起きるかに焦点を当てる	I've been told · could be performed · is often accompanied
現在完了形 have/has + 過去分詞 — 過去の出来事が今も関係している	has changed · I've been told · term's been
関係詞節 who / which + 節 — 人や物について情報を加える	anesthetic, which will · unconsciousness, which is

注意したい発音

話し手はwe'll, you're, I'mなど、短縮形や弱形を21回使っています。聞こえたとおりの短い形で発音しましょう。

「th」の音: breathe /bɹiːð/, gather /ˈɡæðɚ/, bother /ˈbɑðɚ/, eighth /eɪtθ/, tooth /tuθ/
「sh」と「zh」の音: specialty /ˈspɛʃ.əl.ti/, execution /ˌɛk.sɪˈkjuː.ʃən/, prevention /pɹɪˈvɛnʃən/, intervention /ɪntɚˈvɛnʃən/, completion /kəmˈpliː.ʃən/
長い単語（アクセントの位置に注意）: superior /sʊˈpɪɹ.i.ɚ/, successfully /səkˈsɛs.fə.li/, execution /ˌɛk.sɪˈkjuː.ʃən/, intervention /ɪntɚˈvɛnʃən/, eliminate /ɪˈlɪm.ɪ.neɪt/

日本語話者が苦手な音：

/r/ と /l/ の区別 — /l/ は舌先を歯茎につけ、/r/ はどこにもつけない: ultrasound /ʌl.tɹə.saʊnd/, removal /ɹɪˈmuː.vəl/, partly /ˈpɑɹtli/, mortality /mɔɹˈtælɪti/, relaxation /rᵻˌlækˈseɪ.ʃən/
/v/ — /b/ にならないように、上の歯を下唇に当てる: reverse /ɹɪˈvɝs/, nerve /nɝv/, removal /ɹɪˈmuː.vəl/, prevention /pɹɪˈvɛnʃən/, vessel /ˈvɛsəl/
/f/ — 「フ」ではなく、上の歯と下唇で出す: painful /ˈpeɪn.fl̩/, belief /bɪˈliːf/, successfully /səkˈsɛs.fə.li/, fancy /ˈfæn.si/, safely /ˈseɪfli/

この動画での練習方法

まず声を出さずに動画を最後まで聞き、知らない単語をメモします。
通常の速度で一文ずつシャドーイングし、話し手のリズムに合うまで繰り返します。
自分の声を録音して元の音声と比べます。oxide, lecture, procedureなどの単語に特に注意しましょう。

シャドーイングとは？英語上達に効果的な理由

シャドーイング（Shadowing）は、もともとプロの通訳者養成プログラムで開発された言語学習法で、多言語習得者として知られるDr. Alexander Arguelles によって広く普及されました。方法はシンプルですが非常に効果的：ネイティブスピーカーの英語を聞きながら、1〜2秒の遅延で声に出してすぐに繰り返す——まるで「影（shadow）」のように話者を追いかけます。文法ドリルや受動的なリスニングと異なり、シャドーイングは脳と口の筋肉が同時にリアルタイムで英語を処理・再現することを強制します。研究により、発音精度、抑揚、リズム、連音、リスニング力、そして会話の流暢さが大幅に向上することが確認されています。IELTSスピーキング対策や自然な英語コミュニケーションを目指す方に特におすすめです。

シャドーイングのやり方: ステップ別の完全ガイドを読む →

シャドーイング練習: Anesthesiology: Basics – Anesthesiology | Lecturio - 動画で英語スピーキングを学ぶ

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