ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: I Couldn't Help but Notice | This American Life | Episode 894

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A quick warning, there are curse words that are unbeeped in today's episode of the show.

If you prefer a beeped version, you can find that at our website, thisamericanlife.org.

Back in June, Rick Cole was sitting in a meeting of the Pasadena Municipal Services Committee in City Hall there.

That's about as dull a sentence as you could start a podcast with.

But then things happen.

Rick's a council member.

And I get a text that I glance at from the police chief to the city council that says,

at 5.30 we're making a public announcement that there will be military exercises in northeast Pasadena.

They will take place at St. Luke Hospital, but do not reveal the location.

This is at 5.24, six minutes before the public is to be informed.

So you saw that and you thought what?

Well, I thought, that's really strange.

It's unprecedented there will be military exercises in a residential area.

That happens in America.

But still, it's strange when it's your area, with no notice at all.

The meeting ends.

Rick runs to another event.

Meanwhile, I had told my assistant to post on our Instagram account

that this military exercise was happening and to actually identify the location.

And she told me, you know, they told us very sternly not to say the location.

And I said, the people deserve to know where this is happening.

And did she post the name of the hospital?

She did.

Because you just figured, what are they going to do to me?

I'm just going to do this.

Exactly.

I mean, that's the way I've lived my life, Ira.

He's got stories.

If you ever run into Rick, get him to tell you the one about how he tried to stop Christopher Columbus's great,

great, great, great, great, great, great, great, great great-great-great-great-great-great-great-great-great-great-great-grandson from becoming Grand Marshal of Pasadena's Rose Parade. But I digress.

Anyway, that night in June, he heads over to this hospital, a creepy old building with broken windows and peeling paint.

It's been abandoned for years.

And sure enough, sometime around 8 p.m., these giant helicopters can be heard in the distance, getting closer and closer.

Then they disgorge paratroopers clambering down ropes onto the roof of the hospital.

Flashbang grenades are going off.

Simulated gunfire is rattling through the neighborhood.

I mean, it was jaw-dropping.

This is all supposed to end by 8.30, but in fact, it wasn't over until about 2 a.m.

To Rick, this was outrageous.

Why do this in a residential neighborhood with no warning so people had no chance to prepare?

Maybe go elsewhere for the night.

Maybe give their pets tranquilizers so they don't freak out.

Now people were hearing all the commotion, probably going onto their phones to figure out what was happening.

And he thought he needed to jump in and explain.

Councilmember Rick Hull here in front of the former St. Luke's Hospital.

As you can hear...

He's in the dark.

Explosions are flashing behind him, like he's some sort of suburban war correspondent.

Flashbangs and simulated gunfire are going on.

They're going to be going on for the next half an hour, we're told.

I was focused on the fact that I should tell people what's going on, because their dogs are going to bark, their kids are going to ask questions,

and they're going to wonder why are helicopters descending on Pasadena, why are they hearing gunfire in the neighborhood?

He'd done videos like this in the past, in the wake of the Eaten Fire last year, letting people know when it was safe to drink the water, read vegetables from their gardens, that kind of thing

and this is going to go on for a while

and good luck to the people that have got to get up

and go to work tomorrow morning it's funny the weird thing about this is

that it seems like you all were supposed to act like

this was not a weird thing to happen that's exactly did

it make you feel sort of crazy to be told like

oh no this is normal don't sweat it i wouldn't say crazy it it It infuriated me.

Yeah.

You know, we owe to the people we serve to treat them with respect

and to keep them informed about things that affect them.

And this was such an egregious breach of that trust.

I couldn't help but notice that nobody in the military seemed to care how everyday citizens were experiencing all this.

Then, as a 73-year-old council member, he felt a doo-doo to take what he saw as a more old-fashioned approach.

I reached, by the way, nearly 8 million people with his videos informing the public, succeeding more than he ever imagined.

Today on our program, we have stories of people who see a future arrive that feels uglier and meaner than the past.

And it's not like they can turn that around.

It's way too big.

But in every story today, there is somebody who takes a stand and tries to clean up the mess that's around them.

I'll call attention to that mess and say no. We have stories today of some very stubborn and idealistic people, from a small town in Maine to a school in Russia.

From WBEZ Chicago, Cis American Life, from Ira Glass.

Stay with us.

This is American Life Act 1, Closing Time.

Sometimes, as things change in a country because of big historic forces, doctors get put in some weird and difficult situations.

That's what happened in this first act, in Maine, way up north, in a rustic county.

That's so far north that the Canadian border is closer than the nearest U.S city.

The local hospital there is Holton Regional Hospital.

And last year, they announced they were going to close their labor and delivery unit with one month's notice.

Even the unit's nurse manager, Heather Quinn, had no idea this was actually coming.

It was delivered very abruptly and matter-of-factly, I guess.

This is what's happening.

Our birth rates are going down.

We can't recruit.

It's not basically a moneymaker.

so we're closing.

There was no, I'm sorry, you know, we hate to, you know, it was just very matter-of-factly.

It is a pretty matter-of-fact reality at this point in America, rural hospitals closing.

But labor and delivery departments, in particular, they've been vanishing in lots of rural areas.

And when a community loses its place to have babies, in the first weeks after that happens, that's when you really see what it means in people's lives.

and the story in May unfolded just after Holton Regional Hospital packed up its labor

and delivery department and closed the doors there.

As that was happening, a woman who lives in the area named Katie Gowell was pregnant with her fifth child.

This was a low-risk pregnancy.

She was planning to give birth at home just like she'd done with her fourth child.

Her family doctor, who was a midwife before she became a doctor, was going to deliver the baby.

So that was the plan.

29 days after Holton closed its labor and delivery department, Katie Gao went into labor at home.

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Reporter Elaine Appleton-Grant has the story of what happened next.

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Quick heads up before we start.

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Some of us here on staff found ourselves thinking about the

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TV show The Pit as we were making this story

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because there's no way to explain what happened without diving into some very vivid medical details during childbirth.

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Just want to say, if that's not for you, please know that is part of this story.

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Here's Elaine Appleton Grant.

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Sunday, June 1st, 2025.

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Just after midnight.

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Katie starts having contractions.

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She calls her mom and eventually her doctor.

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Lots of family members show up.

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They live nearby.

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She and her family run a business together, a big wilderness resort up the road.

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There's snacks.

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It's fun, but slow.

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Here's Katie.

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I'm like, well, mom, maybe I shouldn't have called them already, because it was sort of, I sort of kind of went like a standstill for a while.

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It's so slow that her doctor, Dr. Rose Fuchs, takes a nap on the couch, even with all the noise.

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But all of a sudden, it was like someone poked me awake, and I sat bolt upright, and I said, what did Katie say?

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And Katie was down the hallway in the bathroom at that point.

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So I went down there and I said, did you say something?

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And she said, yeah, I said my water broke.

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Katie's sitting on the toilet.

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Everything's fine.

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And then I just sat there for a few minutes in it.

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So then I'm like, well, I'm going to get up now.

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And then I went to wipe and I felt something.

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And she said, what's that?

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And I looked down in the toilet and there was probably eight inches of cord hanging out, not quite touching the toilet water, but close.

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So I was like immediately, this is very bad, right?

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This is a prolapsed cord, which rarely happens.

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I just said, it looks like the cord.

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We need to check you out.

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Let's get in the bed.

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A prolapsed cord is a dire medical emergency.

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It just happens sometimes.

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Katie didn't really have any risk factors.

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In a normal delivery, the baby's head comes out first.

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Its umbilical cord, which is the baby's blood and oxygen supply, follows.

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But not this time.

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The cord slipped out first.

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It's squiggly, like an old-fashioned telephone cord.

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You can see the red vein and purple arteries through the thin skin.

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If it's outside the body, it's a huge risk to the baby's life.

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Unless Katie can deliver now.

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And we got her on the bed, and I was checking to see, like, if she's completely dilated, you know, ready to push the baby out.

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I thought if I, you know, it's her fifth baby.

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I thought if we could give one push and finish this, I'll do that.

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But that wasn't the case.

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She was probably about six centimeters.

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Fully dilated is 10 centimeters.

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Katie's nowhere near giving birth.

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It could still be hours.

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Dr. Fuchs isn't saying any of this out loud.

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She spent years cultivating her doctory persona, calm, confident, and command.

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She is 60, elegant, and somehow old-fashioned.

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She wears a lot of ankle-length skirts, sometimes pulls her long silver hair up in a bun.

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She's been a primary care doctor for decades.

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She was a midwife before med school.

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In almost 40 years of practicing, she's attended about 1,000 births.

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She has never seen a prolapsed cord before.

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But she knows that the only way to save the baby is for Katie to have an emergency C-section now.

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If they were in a hospital, they'd be running down the hall to surgery.

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Speaking of hospitals, this is the first time Dr. Fuchs has attended a birth without a hospital labor

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and delivery unit nearby to back her up.

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I was terrified because I didn't want the baby to die.

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And so then what happened?

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I turned around and my nurse has beautiful big blue eyes and they always comfort me in the middle of anything.

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And I turned around and I looked in her eyes and I said, call 911.

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And her eyes went two sizes bigger because she's actually never heard me say that in working with her 12 years.

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Dr. Fuchs calmly advises Katie.

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I started to coach her that the life of the baby is at stake, and you're going to have to go through quite a bit if we're going to hope to save your child.

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Katie's shocked.

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So stunned, in fact, that the day becomes hazy.

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So she wants Dr. Fuchs to tell the story.

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Because me being in the moment, I don't remember every detail where she would remember every detail.

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And I trust her with telling my story.

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I trust her completely with everything.

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It's about 6.35 a.m.

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Here's what Dr. Fuchs knows.

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Best practice for a prolapsed cord is for Katie to be in surgery in 5 to 10 minutes.

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So the clock is ticking.

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She is 90 minutes away from any working obstetrics department.

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Just a month earlier, Katie's local birthing unit at Holton was still up and running.

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An entire institution designed to handle exactly this kind of emergency.

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But now, there's just Dr. Fuchs.

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So there in Katie's bedroom, Dr. Fuchs makes her first important decision.

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If the cord gets cold, if it dries out, the baby could die.

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Or possibly suffer brain damage.

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I chose what I thought was the best course of action, which I gently replaced it into the vagina.

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Is that okay to say, too?

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Okay.

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Gently replaced it inside.

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so that the warmth of her body would keep the cord warm because I knew we're in Maine, and although it was June, it wasn't that warm.

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But there's another problem.

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The baby's head is pressing down on the cord, which could also cut off the blood and oxygen supply.

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She has to protect the cord from the weight of the baby's head coming down the birth canal, right on top of it.

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So she gets into a position that obstetricians call riding the bed.

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I shifted myself and climbed onto the bed between her legs, crouching sort of on all fours, kneeling, crouching down.

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Then she starts pushing the baby's head back up the birth canal to make space for the cord.

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I, you know, was internally inside the patient, pushing upward toward her head as basically hard as I could,

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using two fingers to push up, the rest of my fingers to lightly be touching the cord to keep track of the heart tones at all times.

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Because if they slowed down, I knew something's pinching.

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If they slowed down, I also knew I needed to push up higher and get the head up higher.

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How much of your hand was inside Katie's body?

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Probably up to my wrist starting forearm.

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Meanwhile, Katie's own body wants to push the baby out, right?

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Contractions pushed down.

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So, you know, to have my hand, that's painful for her.

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And I knew it was painful.

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And I told her, I'm very sorry, but I can't care about your pain.

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It's a very weird pain.

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It's a deep pain.

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Anyone who's had a cervical biopsy, an endometrial biopsy, an IUD put in, I think it's a pain no one can describe.

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And then this is times a whole lot more because there's a baby in there too, and now someone's hand as well.

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It's 6.40.

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Sasha, Katie's husband, is on the phone with 911.

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The Penobscot County Dispatch Center, the busiest in the state.

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The dispatcher tells Sasha that an ambulance is on the way.

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Meantime, she's giving instructions.

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Have her roll up and get onto her knees and elbows, she tells Sasha, meaning tell Katie to get up onto her knees and elbows.

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Sasha, he's in another room

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because he has to move a dog gate to make a clear path for the ambulance crew when they arrive.

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So he yells these instructions to Dr. Fuchs.

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I said, no, we're not.

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And they said, well, that's what they're saying.

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I said, I don't care what they're saying.

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We are not doing that.

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You tell them a doctor's on site.

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The dispatcher also says, through Sasha, do not try to prevent the birth.

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Make sure that nothing is being pushed back into her vagina.

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But Dr. Fuchs knows that if she stops pushing the baby up, the baby will die.

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It's now been about seven minutes since the cord dropped.

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While Sasha's on the phone with the dispatcher, Dr. Fuchs's nurse calls Holton's emergency department, because at least the ER is still running,

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and the nurse says they plan to bring Katie to the ER.

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But the ER says no, they can't handle this, and Katie needs to be flown to a much farther hospital.

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So the 911 dispatcher switches gears and contacts Life Flight.

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That's Maine's Air Ambulance Service.

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And then warns the nurse that due to some bad weather, they're not sure a helicopter can fly.

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They're also not sure yet where Life Flight will pick Katie up, and where the local ambulance will have to take her to meet them.

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It is mayhem.

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A month ago, when Holton's OB was open, the medical sequence of events would have been clear.

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911 orders an ambulance, which takes Katie to Holton's Labor and Delivery Department.

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There, a trained obstetrician would perform an emergency C-section.

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There would have been no need to airlift Katie somewhere else.

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OBs in hospitals do C-sections all the time.

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Now Dr. Fuchs realizes, with dawning horror, that because of Holton's closure, no one seems to know or agree on who's actually in charge,

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where Katie can go, and even what should be done to save this baby.

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She's hunched over, counting the baby's heartbeats, and she attempts to take charge.

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Over her shoulder, she speaks to her nurse.

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And I said, you call Holton Regional.

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You know, you're telling them we're coming.

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And I mean we're coming.

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Houlton Regional, the hospital that closed its labor and delivery department but still has an emergency room.

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Dr. Fuchs thinks someone might be able to do a c-section there.

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It's about 6 48.

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13 minutes have passed.

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At the house, the ambulance crew has arrived.

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And they can't get in.

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It's an old main house.

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They can't get the gurney through the narrow hallway and around a sharp corner into the bedroom.

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The EMS crew, who don't seem to understand the situation, asked Katie to get up and walk to the gurney.

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I said, Sasha, then get a chainsaw and cut the wall down.

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What did he say?

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He was ready to go get a chainsaw and cut the wall down

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because they knew I wasn't moving and I wasn't allowing her to get up.

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I didn't care if it was EMS and their truck.

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I was not giving over my place of authority

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because I did not see that they had adequate knowledge or understanding of the situation.

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Finally, they managed to maneuver the gurney down the hall and into the bedroom.

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Now they have to lift both Katie and the doctor together onto the gurney,

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locked in their position, like lift the sheet they're both on and transfer them together.

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And while they do, Dr. Fuchs cannot move her hand at all.

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Meanwhile, she's waiting for the lead paramedic to get things going.

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We always count to three and then we all pull together like, you know, a bunch of he-men, right?

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So he's like, who's going to count?

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How are we going to do this?

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Are you going to count?

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Who's going to count?

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You know, they just kept on like that.

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And I looked at my nurse and I said, you count.

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So she took over.

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She heard me say that, and that was it.

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And I hate to get real loud on this mic, but she proceeded to just roar.

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We're going to count.

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One, two, three!

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And honestly, I think she almost single-handedly pulled me, Katie, over to the gurney with them helping some.

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It's about 6.58.

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Katie should have had a C-section 25 minutes ago.

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710. Katie and the doctor have been locked together for about 33 minutes.

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The EMTs load them into the ambulance.

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Dr. Fuchs is under the impression that a nurse has convinced Holton to accept them, and they are now heading to the Holton emergency room for the C-section.

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Katie's in terrible pain.

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Dr. Fuchs is on the gurney, balancing on both knees and one hand.

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Her other hand is inside Katie as the driver navigates the winding roads.

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It's a very bumpy road.

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These are the back roads of the county, right?

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So potholes, bumps, very curvy.

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At times I thought I was going to fall off the gurney.

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And the paramedic would grab the waistband on the back of my skirt and hold me.

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So I would hold steady.

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And I needed to hold steady.

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My hand had to hold steady.

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and her leg at one point slipped off the gurney and sort of fell down.

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And so I grabbed her leg and pulled it back up and I was holding her leg on the gurney with me.

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So it was a tight squeeze.

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I was beginning to feel exhausted.

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I myself don't have the best back and this was a very awkward position.

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And, you know, your legs are all curled up under you.

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So you're in an intense kneeling, you know, sitting on your legs squatting so my legs are falling asleep.

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My hand is starting to fall asleep from the angle that I'm at.

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That scares her.

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Without her hand, she can't count the baby's heartbeat and keep the baby alive.

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Her hand is the only instrument she has.

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But, you know, my hand would periodically feel like it was completely numb, and I would worry, like, am I going to be pinching this cord?

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And then it would sort of wake up again, you know, intermittently, but it was painful.

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Like when your hand falls asleep and it's very painful, it was becoming physically very painful to continue.

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Dr. Fuchs has scoliosis.

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This position is excruciating.

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She tells herself, hang on, it's not much longer, just until we get to Holton.

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But then they tell her the plan is still for Life Flight, Maine's Air Medical Service, to airlift them to Bangor.

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The helicopter is apparently going to pick them up at Holton.

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Life Flight's still headed to Holt and Regional?

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Correct.

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The Life Flight dispatcher and the hospital are mapping out these plans while Katie and Dr. Fuchs bounce around the ambulance.

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Yeah, they just started spooling up.

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I'm looking in my window at them.

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So, yeah, that's our plan.

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They are just now leaving the scene, headed to the hospital.

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I did not agree with that plan at all because I knew

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that I could not take another however many minutes it would take to get into Life Flight and then to fuel up.

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And then to stay like that until a C-section can be done at Eastern Main Hospital in Bangor.

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There's just no way.

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So bear with me for just a second.

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We're going to leave the ambulance and go over to another important place, Ivy's Motor Lodge, three minutes from Holton Hospital.

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That's where Dr. Monica Shearhart, an OBGYN, is sleeping.

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She's been on call here once a month for three years.

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And on this weekend, she's coming to the end of her time at Holton Hospital

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when the phone on her bedside table rings.

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I think they woke me up from sleep.

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So it was one of those like ring, ring phone call.

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What's going on?

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OK, I'll be there in five minutes.

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She throws on her leggings

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and goes to the hospital to meet the ambulance that's on its way with the patient who has a prolapsed cord.

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At the ER, they lay out the plan.

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They want her to stabilize Katie so she can take the life flight helicopter to Eastern Maine Medical Center for the C-section.

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That would take another hour.

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But I'm here.

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At that point, I'm like, no, we'll have the baby here.

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Let's go ahead and call in the OR team, and we should deliver her here.

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We still have that capability.

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And everyone at that point was like, oh, yeah, we can do that.

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So basically, they hadn't realized that they had the capability to do this.

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Yeah, they didn't even really think about the fact they still had that capability.

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But at that transition time, they did.

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I reached out to Holden to ask them why they wanted to transfer Katie in the first place.

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They said they couldn't comment on any specific patient.

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We asked Holden to comment on other decisions they made throughout this story.

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They responded, quote, We have no further comment regarding the closure of the OB department.

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Back to Dr. Shearhart waiting in the Holton ER.

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She's making the case to the team there that she wants to perform the C-section at Holton.

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And she prevails.

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But they can't do it without OB nurses.

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The birthing unit closed almost a month ago.

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So the ER has to call up the OB nurses who used to work in labor

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and delivery and ask them for help.

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A couple of them volunteer and rush in.

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Dr. Fuchs and Katie arrive at Holton at about 7.53 a.m.

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and there are people there to greet them.

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And so we pulled up at the ambulance entrance and the obstetrician came outside to meet us,

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which I was so glad for and started taking the history from me while we were unloading.

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And I was like, hi, I'm Dr. Sheerhart.

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I'm an OB-GYN.

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I'm the one on call today.

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Recommendation is, you know, emergency C-section if it's okay with you.

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And we're going to roll you right into the operating room and deliver the baby.

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Dr. Fuchs also was giving me kind of a sign out about what was happening with her, what her background was, and that she could still feel the cord pulse.

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They speed the gurney down the hall to the operating room.

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Katie is far from out of the woods.

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The baby has to survive through the surgery.

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And if she does, what about the possibility of brain damage or cerebral palsy?

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An anesthesiologist puts Katie under.

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At this point, Dr. Fuchs has been riding the bed for almost 90 minutes.

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Remember, no more than 10 minutes to C-section is best practice.

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She still can't leave her post, which means now they have another problem.

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The nurses can't fit the surgical tool table over Katie the way they normally would, because Dr. Fuchs is in the way, so her back will have to serve as the table.

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They throw a drape over her, basically a plastic bag.

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Dr. Fuchs will become part of the surgery.

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So we basically put the surgical drapes over the top of Dr. Fuchs through the, you know, betadine sterilizing fluid on Katie.

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They opened a bottle of iodine and dumped it over her belly, over my top of my arm, my forearm that was, you know, near her.

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So my cheek is laying on Katie's thigh.

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I have my head sideways, trying to breathe in a little air pocket in this drape.

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It's a very awkward position, to say the least, for her and me.

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We have surgery equipment and tubing and electrocautery and suction

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kind of sitting on top of Dr. Fuchs because she's right there between Katie's legs.

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They are, I can feel they are putting their tools on my back.

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But they're missing some usual tools, like a Doppler, to monitor the baby's heartbeat.

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And nurses sort of scurried about looking for a Doppler.

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They either couldn't find one or they didn't have one available, but they had no Doppler anyway.

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And so I told her, it's okay because I can feel the heartbeat.

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And so, you know, it had been 120s, but then at one point, while they were still prepping, it went down to like 90.

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And so I called that out to her.

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I said, so we're down to 90, you all better hurry.

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And what is optimum?

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A normal fetal heart rate is 120 to 160.

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And so we allow a little bit outside that range, but 90 is definitely getting in trouble.

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It's often the signal that there's an impending disaster.

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My fear was the next beat was going to be 60 and the next beat, you know, nothing.

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And then I did my usual, which I pushed a little harder on the head, tried a little harder to protect the cord, and I felt the heart rate go back up to like the 120s.

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So then I sort of called out again to reassure them, we're back up to the 120s, you're okay, we're doing all right.

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Dr. Shearhard starts the surgery.

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As soon as she went to sleep, I made the incision, got down to her uterus.

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I could feel them start to cut the skin and the muscle layers, you know, to enter the abdomen.

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And I thought, oh, dear, my fingers are awfully high up there.

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What if they cut my fingers?

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I'd better pull back a little bit at just the right moment, but not too soon to lose the heartbeat.

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So I withdrew a little bit, and then I could sort of feel them that they were in the uterus.

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And my hand reached down to pull the baby's head out, and our hands touched.

420

So my hand touched Dr. Fuchs' hand as I was lifting the baby's head out of the incision.

421

The C-section is done in two minutes, and the baby is breathing.

422

She's born at 7.58 a.m.

423

She's 7 pounds, 12 ounces.

424

Dr. Fuchs, gasping for air under the drape, slithers out and climbs off the table.

425

When she leaves the OR, she's shaky, starts to see black before her eyes.

426

She almost passes out from the sheer effort of the delivery.

427

Her nurse, the one with the big blue eyes and the loud voice, she runs and gets her a chair and a glass of water.

428

When Katie wakes up, her baby is alive.

429

But she's in an incubator that has lots of tubes.

430

Katie can't be with her.

431

And they can't stay here in the hospital.

432

With the department closed, the nurse is gone.

433

Holton has no way to admit a newborn, no one to take care of the baby, or of Katie, who should recover in a hospital for a couple of days.

434

The Life Flight medics are there, and they start getting the baby ready to fly to a bigger hospital.

435

Heidi doesn't understand what's happening.

436

I could see her off to my left when she was getting worked on.

437

And then when I was in the recovery room, she was still getting worked on because then that's when they put her in their incubator type thing.

438

I still didn't get to hold her.

439

Then they load the newborn into the life flight helicopter, and it takes off for Eastern Maine Medical.

440

I cried.

441

I cried.

442

I didn't know at that time.

443

I didn't know how she was.

444

I didn't get to see her.

445

I didn't get to know anything.

446

And then I just saw her and wheel her away.

447

It's just a, I don't know how to describe it.

448

It's a very hard thing, especially seeing her leave.

449

I don't know.

450

It's just hard.

451

It was hard.

452

Very hard.

453

Katie has to follow her new baby to the other hospital by ambulance, but she's just out of a major surgery.

454

She needs an OB nurse to accompany her, and Holton doesn't have anyone.

455

So the ER makes another call to Heather Quint.

456

Heather's the nurse you heard at the opening of this story, the one who used to run labor and delivery, and got the sudden matter-of-fact news that the OB department was closing.

457

They ask her to go with Katie in the ambulance.

458

Heather races to the hospital and walks into the recovery room.

459

I asked Heather why she showed up that day.

460

I wanted to be like, when they closed it down, I wanted to be like, okay, this is what you guys want, this is what you're going to get.

461

But the nurse in me, the person in me, that's my patient.

462

Hell yes, I'm going to be there.

463

I threw on my clothes and I was there

464

and I went to Bangor with her and I sat

465

and I held her hand and I talked to her the entire time.

466

So no, oh, when I got the call, I wanted to be like, figure it out.

467

But not when my patients were involved.

468

I'm like, yep, I'll be right down.

469

When I think about what it took to deliver this one baby, this is the thing I've been struck by the most.

470

So many people's instinct to save a life, no matter what.

471

Right now in America, the majority of rural hospitals no longer have labor and delivery departments.

472

And instead, here is a collection of people choosing to jump in, to fill in gaps.

473

This is a success story.

474

Katie's baby is fine, healthy, no brain damage, no cerebral palsy,

475

which is remarkable because this baby was much more likely to die than to survive.

476

This is what success can look like today.

477

In some places, we're creating a hero-based healthcare system.

478

And we can't rely on the Avengers in order to have a baby.

479

The whole Marvel Universe showing up to help a person give birth safely.

480

That's what hospitals are for.

481

Elaine Appleton-Ground.

482

That story was produced by Lily Sullivan and edited by Fia Bennett.

483

Elaine originally learned about this story from reporting by Emily Hedegaard and Stephanie McPheeters of the Maine Monitor.

484

Coming up, raise your hand if you know what Trud de la Cestia means.

485

That's in a minute, comrades, from Chicago Public Radio, when our program continues.

486

This is American Life from Ira Glass.

487

Today's program, I couldn't help but notice.

488

We have stories where people see a new future arrive, one that is not quite as pleasant as the past.

489

And they can't help themselves.

490

They take action in some way or another in their own little corner of the world.

491

We've arrived at Act II of our program, Act II, conversations about important things.

492

So the documentary that won this year's Academy Award is called Mr. Nobody Against Putin.

493

It was co-directed by a Russian guy and an American, Pasha Tonkin and David Borenstein.

494

And it's about the propaganda campaign that was rolled out in Russia after Russia invaded Ukraine in 2022.

495

And the shock of that propaganda push for one person in particular.

496

If you haven't seen the film, it is really worth seeing.

497

I am one of the people on staff here at This American Life.

498

Valerie Kipnis has watched it four times.

499

She'll tell you why.

500

Here's Val.

501

Here are some scenes from my family growing up.

502

Someone, let's say my mom, would say this to me.

503

Glory to labor, she'd say it in Russian.

504

Then she'd hand me a broom.

505

Or she'd say, Trud, делечести.

506

Labor is a matter of honor.

507

She used to say that on Sunday mornings when she woke me up for chores.

508

These are all propaganda slogans from her upbringing in the Soviet Union.

509

She and my dad both grew up there.

510

My dad would say things like this too.

511

So did my grandmothers.

512

They both live with us.

513

And these lines always got a laugh from each other.

514

Like my mom would say, Partie, nasz rollevoy.

515

The party is our helmsman.

516

And my grandmother Bella would laugh and say, Last time I saw that one was on the wall of an auditorium.

517

Unlike them, I grew up here, which meant I was always behind, always playing catch-up in a household full of inside jokes,

518

always trying to see into this world they had in their heads.

519

I was obsessed with it.

520

So I'd ask the same questions over and over again, and they would answer my questions patiently, kindly, on long car rides, on the subway to school,

521

on our walks near the BQE. But I kept going.

522

I wanted to understand what it actually felt like to live surrounded by banners and slogans.

523

My grandmother would shrug and say, It just was what it was.

524

It didn't feel special to us.

525

We didn't know another version of life.

526

And then she'd call me by my family nickname, Puchimuchka, which means roughly, kid who drives us crazy by asking why all the time.

527

Being a Puchimuchka and all, it's only natural that I watched this new documentary four times.

528

Three times before it won the Oscar.

529

And the thing I couldn't get enough of was

530

that here was a movie that answered some of the questions I'd been asking for so long.

531

The documentary starts less than a month after Russia invaded Ukraine, the beginning of the full-scale invasion.

532

And it focuses on one school and one town in Russia,

533

as the Ministry of Education rolls out a massive nationwide propaganda campaign — a new,

534

quote, patriotic curriculum — which Which would include new lesson plans for teachers, nationalistic poem recitations for students,

535

mandatory school-wide salutes to the flag, and mandatory lessons called Rozgavore o Vazlom

536

— conversations about important things — where teachers are asked to talk about stuff like the importance of war songs

537

or the heroism of Russian fighters.

538

Also, a single approved set of history textbooks written by two people closely affiliated with the Kremlin.

539

high schoolers would start paramilitary training in gym class.

540

And in the school that's in the documentary, one teacher captures how this all plays out.

541

Pasha Talonkin.

542

And I called him up.

543

Here was a person who made a whole film about what it felt like to see slogans in the auditorium.

544

Different slogans than the ones my parents and grandparents grew up with.

545

A very different time.

546

But with an undeniable similarity.

547

But then and now, the state had a tight grip on its own people.

548

And here was Pasha, who wasn't just seeing what was happening around him.

549

He wanted the whole world to see what he was seeing.

550

This is Pasha.

551

He's got a round, wide-eyed baby face, big glasses.

552

He's an impish kind of person, who talks through a smile like he's in on some joke you don't know about.

553

The school in the film is actually the same school he once attended.

554

And he loves the school, loves his students, loves his grumpy mom, she's the school librarian.

555

And when the film begins, he's the school's event coordinator and videographer.

556

He films the piano recitals, graduations, performances.

557

And under the brand new patriotic curriculum at Pasha's school, Pasha was told he now had a brand new role.

558

He would be filming teachers and students performing the new lessons be filming the new flag salutes and paramilitary trainings,

559

and he'd be sending all of that footage to the government as proof of compliance.

560

I wanted to know what he thought of his new role as he was doing it, how it actually felt.

561

He answered by telling me a story that never made it into the film.

562

What was I thinking about when I filmed this?

563

I mean, at first I was just, how do you say this in Russia, I started like sweating under my visor.

564

I just lost my mind about what was happening.

565

I just totally freaked out.

566

When I was going to film computer class, it didn't end up in the final cut, I asked myself a question.

567

Who is that idiot who is going to be watching all this shit?

568

I mean, who is he?

569

Who is that moron?

570

I mean, it should be some sort of paid job, sitting and watching all this shit.

571

I mean, they should pay you some money for that, at least a little bit.

572

Anyway, I did this one little bit of trickery, where I left in only the beginning of the class, where the teacher says, hello,

573

kids, and the end, where they say, okay, class is over.

574

But the shot itself went the whole time of the class, 45 minutes, so in the middle there was just a black screen, as if something had gone wrong with my camera.

575

And I sent the video in, and I sat there waiting as they looked over the footage, and I kept waiting for them to say, you know, we can't see it,

576

something went wrong, it's just a black screen.

577

And they didn't give me a single note, and I thought, I thought,

578

holy shit, I'm here not to actually record,

579

but to surveil the teachers, you know?

580

Watch out, we're watching you, we have a camera, here it is, recording you.

581

And in that moment, I thought, I'm being used.

582

I'm being used.

583

He figured, yeah, okay, they were using him.

584

But he was simultaneously and obsessively filming the changes at his school for his own purposes.

585

And the footage that Pasha captured was really eye-opening for me.

586

It answered so many of the questions I'd badgered my family with over the years.

587

Because the propaganda, as it rolls out, is sort of the opposite of what I'd always imagined it would be.

588

You know, the classic images of state control.

589

The seamless, crisp obedience.

590

Massive signs, arms being raised in unison, echoey speeches delivered to neat rows of thousands of people.

591

Pasha shows scenes that are so intimate and small and messy.

592

A teacher is stumbling over new words she's now required to say.

593

Denazification, demilitarization.

594

He films teenagers, bored out of their minds, staring blindly into space, as another teacher tells them.

595

If you were born in this country and you don't believe we're doing the right thing, then leap.

596

Go to the country that you think is better.

597

Pasha films young kids with these tiny red berets chanting new slogans in an assembly.

598

Patriot!

599

Nazi!

600

They're excited.

601

But looking at each other like, right?

602

We're saying the right thing?

603

The school days in the film look kind of normal, in so many ways, despite all the changes.

604

Kids still horse around and tease each other.

605

There are still piano recitals.

606

It's still just school.

607

But Paja was like the kid in the emperor's new clothes.

608

Every change stood out to him, and he couldn't stop talking about it.

609

His own mother was like, of course these things are happening.

610

They've always been this way.

611

Shut up.

612

And he argued with her.

613

He lived in a sort of continuous state of shock, about the war, about the propaganda.

614

And he told me that when the patriotic curriculum started, he kept sort of waiting for the people around him to

615

freak out as much as he was about what they were being asked to do.

616

But most people just went along with it, adapted, or chose to stay quiet.

617

I wondered why he didn't do that.

618

Then when I talked to him, I got it.

619

For starters, Pasha and I are almost the same age, in our 30s.

620

And part of why he's so stunned by what's happening is because of the era he grew up in.

621

It was right after the Soviet Union fell apart, but before Vladimir Putin really started consolidating power.

622

So Pasha was raised in this short window of time when students weren't flooded with slogans and propaganda in the schools.

623

when schools were left mostly untouched by the state apparatus, because the state apparatus had fallen apart.

624

And so what Pasha was seeing was something my parents and grandparents never got to see, the beginning of a propaganda push in the schools.

625

Which meant he understood what his school was losing when it adopted these changes.

626

And he knew what he was personally losing, as nationalism became more and more strictly enforced.

627

Over and over again in the film, he addresses people in his life in the camera directly.

628

Like, can you believe this?

629

Why is this happening?

630

Why?

631

He told me that off-camera he had many more exchanges like that, especially with the other teachers.

632

The teachers came to me.

633

They said, Pasha, we don't like all this.

634

And then they come into class and start to say what the Ministry of Education had sent over to them.

635

The teachers are hostages of this system too.

636

Pasha also saw himself as a hostage.

637

Before the war and the new curriculum, Pasha was the teacher with the Pussy Riot poster on his wall.

638

The cool guy.

639

The weirdo's office all the theater kids hung out in.

640

The teacher who had different politics than what was on TV every night.

641

And for a while, even after the war was underway, he was able to continue being that guy.

642

He wore blue and yellow paper clips on his clothing as symbols of support for Ukraine.

643

He hung an image of an anti-war flag in his office, flipped a Russian flag outside the school upside down.

644

One time, he even played Lady Gaga singing the Star-Spangled Banner during a flag assembly, instead of the Russian national anthem.

645

In the movie, he does things that I could not believe he was getting away with.

646

In a country that was introducing laws to criminalize things like even saying that the war was in fact a war.

647

How on earth could he just do these things and not get in trouble?

648

People sort of saw me as a jester, a holy fool, you know, there he goes, walking around, being foolish.

649

In Russia there is this historical tradition that the jester,

650

the holy fool could speak out even to the Tsar, you know, the lowest level of society, the most seemingly worthless people, they could say exactly what they thought,

651

tell anyone, right to their face.

652

But that didn't mean the Tsars would just ignore him forever.

653

When I talked to Pasha about how his constant provoking was playing out in real life, he told me that behind the scenes of making the film,

654

he could feel his status changing from holy fool to persona non grata.

655

This isn't in the film.

656

But at some point, at Pasha's school, compliance started being supervised in person via a new quote advisor on student affairs.

657

And this advisor took a special interest in Pasha.

658

This advisor was supposed to monitor student activity on social media, establish contact with them, basically sniff everything out.

659

And so one day this advisor came to me and said, I'm going to close your little bullshit factory, your office, in other words, right?

660

I'm going to close it.

661

And so I took my door off its hinges and put it in front of her door and said, how are you going to close this bullshit factory if it doesn't have any doors?

662

But, of course, this performance eventually ended, and I returned the door to its place.

663

But in the meantime, she got really committed to this work of telling the students not to come see me.

664

And fewer kids were showing up at his office.

665

The domain he'd carved out inside the school, not just the physical space of his office, but the permission he represented for kids who wanted to joke around,

666

talk freely, ask questions, and for him to be able to do that, that was being shrunk down to nothing.

667

When I asked Pasha what this period of his life felt like, he gave me an answer that I can't help but classify as literally the most Russian thing I've ever heard.

668

He said it was like this one painting he loves, Barge Haulers on the Volga, which is an oil on canvas painting by Ilya Ryepin.

669

It depicts 11 men hauling a barge along the banks of a river.

670

These men are at the point of collapse from exhaustion, oppressed by heavy, hot weather, leaning into these big leather straps attached to the boat they're pulling.

671

They're exhausted, covered in dirt.

672

But among them stands a younger man, whose face is in the path of the sun.

673

He looks in a different direction.

674

He looks up, and his body refuses to pull the boat.

675

He seems to be the only one questioning the work they're being asked to do.

676

Like, why are we doing all this?

677

And the rest of them just keep their head down, keep pulling this ship along the Volga, as if they don't hear what he's saying.

678

It's like you're speaking different languages.

679

You don't understand each other.

680

You don't have points of contact.

681

You don't have common views on basically any questions.

682

You can't discuss issues that demand discussion.

683

They require it not because you can change something, but because you need to not be alone.

684

You need to speak in order to feel support, to find at least one person that you can talk about this with.

685

But there's no one.

686

There's one last scene in the film that really got to me.

687

It's so inside, in a way that lets you really feel how much has changed in this one school, this one town.

688

Pasha gets invited to this party of a recent graduate.

689

Vanya, who is heading off to the army.

690

It's his going-away party.

691

All his friends toast to him and wish him luck in the future.

692

They post her pictures of Vanya.

693

Instead of cheese, they say army.

694

Then they take turns shaving his head with a shaver that breaks halfway through the process.

695

Pasha takes a turn at shaving Vanya's head.

696

As he does it, he asks, you decided to sign up on your own?

697

Vanya says, didn't have time.

698

They sent for me.

699

Pasha says, why didn't you call me?

700

Vanya sort of shrugs, as if Pasha's question is dumb and annoying.

701

But then quietly he mumbles.

702

It just all happened so fast, in a split second.

703

Besides that, it's all laughs and jokes and debauchery.

704

The shaving part is funny.

705

Everyone's kind of wasted.

706

But then, as it gets late, Vanya and his friends start embracing.

707

One guy cries and hugs him, tells him that he really loves him so much that he won't forget him.

708

He tells him, you're like a brother to me.

709

Not by blood, but by soul.

710

Vanya doesn't look so brave in the dark.

711

He looks small and scared.

712

His friends also do.

713

And that's when it hit me.

714

Before now, Vanya and the others seemed like they maybe believed in this war, like they wouldn't mind going to fight for Russia.

715

But in this moment, it feels like you can see everyone grasp the realness of the thing they've been saying, and then immediately understand that there was now no turning back.

716

Like a joke gone too far.

717

Because at this point, so many Russians have gone to fight this war.

718

And well over 100,000 Ukrainians have been killed in it.

719

— — Do people believe the propaganda?

720

I wondered this question over and over again as I was watching.

721

Does Vanya actually believe in the war he's going to fight?

722

Do the teachers believe that Russia is denazifying Ukraine?

723

Do the kids throwing fake grenades believe in the country they are being trained to defend?

724

It's a version of the question I've been asking my family my whole life.

725

But did you believe in the things you were being taught?

726

The things you were doing?

727

The slogans hung up in the gym?

728

Those are the questions they seem the most frustrated by.

729

It took me asking Pasha to figure out why.

730

When I asked him if the people around him believe in all this, he scoffed at me, the way my grandma does.

731

Like, that's a bad question, you dummy journalist.

732

Don't you understand?

733

He told me it doesn't matter if people believe in it or not.

734

What matters is that they say it, that they hang the slogans, teach the lessons, sing the anthems.

735

First, it's a routine that's like, you know, I believe, I don't believe, but I say it.

736

Then it becomes culture.

737

These lessons are already in the schedule.

738

Everyone's used to it.

739

You've got to say this, you've got to listen to that, you gotta raise the flag or whatever else.

740

And then it becomes a cage.

741

And you think, this is normal.

742

And I'd also add that the cage actually remains open.

743

And you can leave it at any moment.

744

But as soon as you do, you realize that everyone else is in the cage.

745

You walk out and you realize that you've become an outcast, a loner.

746

Like, your opinion, you, yourself, you don't matter to anyone.

747

And that's also the work of propaganda.

748

That's what it does.

749

Pasha became more and more isolated, retreated from his friends and family.

750

They stayed away from him too.

751

An unmarked vehicle showed up outside his home.

752

And he got scared and left the country without telling anyone where he was going or why.

753

and he can't go back.

754

I should probably fess up now and say, all those times I was asking my family about how they felt growing up, when I was posing those exact questions to Pasha,

755

in the back of my mind, I was always wondering, who would I be if I was put in that situation?

756

What kind of person?

757

Would I be able to see what was happening and push back?

758

When I saw the film and when I talked to Pasha, I found all these similarities between us.

759

We're both similar ages, similar tendency to ask questions.

760

And I did think, quietly, to myself, that had I been put in the situation, I probably would be like Pasha.

761

I told my dad this.

762

Big mistake.

763

He said, really?

764

You'd be like that?

765

What are you doing right now in this country?

766

There are things happening here that you don't like.

767

Then I said, I'm doing my best.

768

I think.

769

Then he said, well, isn't that great?

770

Your best.

771

What's that got to do with anything?

772

Valerie Kipnis is one of the producers of our show.

773

The actor who's reading Pasha's quotes in English was Elias Kleinbach.

774

How can it be that I miss much wrong?

775

Have I waited, waited way too long?

776

Have I played life like a game of bomb and then prayed into a song?

777

How can it be that it's all my fault?

778

Will I ever reach the tippy top?

779

Am I able to untie the knot that bound me all along?

780

Now that I've seen it, I can't unsee it.

781

World Program was produced today by Nadia Raymond and edited by Nancy Uptike.

782

The people who put together today's show include Khanna Jaffe, Walt, Adrian Lilly, Tobin Lowe, Molly Marcelo, Catherine Raimondo, Stone Nelson, Ruthie Petito, Ryan Rummery, Ruby Schwartz,

783

Francis Swanson, Christopher Sotala, Marisa Robertson-Texter, Julie Whittaker, and Diane Wu.

784

Our managing editor, Sara Abdurahman.

785

Senior editor, David Kestenbaum.

786

Our executive editor is Emmanuel Berry.

787

Special thanks today to Emmanuel Paré, David Borenstein, Katya Kitsia, Bella Shiavitz, Daniel Plyam, Catherine Emery, Ruth and Mark Fitzpatrick,

788

Henry Frank, Chris Lavoie, and Brett Morse.

789

Elaine Appleton Grant's story in Act One was supported by a grant from the National Institute for Healthcare Management.

790

This American Life is delivered to public radio stations by PRX, the public radio exchange.

791

Special thanks today to This American Life partners, Sean Collins and Stonewall and Traveler Peek.

792

Sean Collins, I know you.

793

We work together at NPR.

794

Nice to see you here in this ad.

795

How's Oklahoma?

796

They and all of our life partners have subscribed to help us keep making our program.

797

When you do that, you get to listen to ad-free, and you get other stuff, including bonus episodes.

798

Our most recent one that I did with one of my co-workers, Diane Wu, turned out so much more emotional and personal than I think either of us expected.

799

Anyway, if you want to hear that, you've got to join.

800

Go to thisamericanlife.org slash lifepartners.

801

That link is also in the show notes.

802

Thanks, as always, to our program's co-founder, Mr. Tori Malatia.

803

You know, his dream job was actually to be on Sesame Street.

804

When he auditioned, he was told his performance was not quite right for children.

805

We're going to count.

806

One, two, three.

807

I'm Ira Glass.

808

Back next week with more stories of this American life.

809

I can't talk to you.

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Middle School | This American Life | Episode 449

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155 ประโยค

สถานการณ์ที่เกิดขึ้น

ในการสนทนานี้ เราได้เห็นถึงเหตุการณ์ที่น่าสนใจในชุมชนของเมืองพาซาดีนา ซึ่งเป็นเรื่องที่ไม่คาดคิดเมื่อมีการฝึกซ้อมทางทหารในพื้นที่ที่อยู่อาศัย โดยไม่มีการแจ้งเตือนล่วงหน้า ซึ่งทำให้เกิดความวิตกกังวลในหมู่ประชาชน การตัดสินใจของสมาชิกสภาเมืองในการเปิดเผยข้อมูลเกี่ยวกับสถานที่ฝึกซ้อมนั้นแสดงให้เห็นถึงความรับผิดชอบและความต้องการที่จะให้ประชาชนได้รับข้อมูลที่ถูกต้อง แม้ว่าจะมีความเสี่ยงจากการกระทำนี้ก็ตาม

กลุ่มคำและการใช้คำที่มีประโยชน์

made a public announcement - ประกาศต่อสาธารณะ
military exercises - การฝึกซ้อมทางทหาร
residential area - เขตที่อยู่อาศัย
jump in and explain - เข้ามาอธิบาย
jaw-dropping - ทำให้อ้าปากค้าง

ความท้าทายในการชาโดว์อิ้ง

เพื่อฝึกทักษะการพูดภาษาอังกฤษให้ดีขึ้น คุณสามารถลองทำตามขั้นตอนง่ายๆ นี้ได้: เปิดวิดีโอที่คุณสนใจแล้วเลือกช่วงหนึ่งที่มีการสนทนา จากนั้นให้ลอง ชาโดว์อิ้งภาษาอังกฤษ โดยการเลียนแบบเสียงและการออกเสียงของผู้พูดในวิดีโอ คุณสามารถใช้เทคนิค shadowspeak เพื่อช่วยในการจับจังหวะและการเน้นเสียงที่ถูกต้อง ทำเช่นนี้เป็นประจำจะช่วยพัฒนาทักษะการพูดและการเข้าใจภาษาอังกฤษในบริบทจริงได้อย่างมีประสิทธิภาพ

ไวยากรณ์ในวิดีโอนี้

โครงสร้างที่ผู้พูดใช้บ่อยที่สุด พร้อมคำพูดจริงจากวิดีโอ:

โครงสร้าง	ในวิดีโอ
Present perfect continuous have/has been + -ing — การกระทำที่เริ่มก่อนหน้านี้และยังดำเนินอยู่	they've been vanishing · has been riding · they've been saying
ประโยคเงื่อนไข if + อนุประโยค, will/would + กริยา — เงื่อนไขและผลลัพธ์	If they were in a hospital, they'd be
“used to” used to + กริยา — นิสัยหรือสภาพในอดีตที่ตอนนี้ไม่เป็นแล้ว	used to work · used to run · used to say
Present perfect have/has + กริยาช่อง 3 — เหตุการณ์ในอดีตที่ยังเกี่ยวข้องกับปัจจุบัน	I've lived · It's been abandoned · She's been

เทคนิค Shadowing คืออะไร?

Shadowing เป็นเทคนิคการเรียนรู้ภาษาที่ได้รับการรับรองทางวิทยาศาสตร์ พัฒนาขึ้นสำหรับการฝึกนักแปลมืออาชีพ วิธีการนี้เรียบง่ายแต่ทรงพลัง: คุณฟังเสียงภาษาอังกฤษจากเจ้าของภาษาและพูดตามทันที — เหมือนเงาที่ตามผู้พูดด้วยช่วงเวลาห่าง 1-2 วินาที การวิจัยแสดงว่าเทคนิคนี้ปรับปรุงความแม่นยำในการออกเสียง ทำนองเสียง จังหวะ การเชื่อมเสียง การฟังเข้าใจ และความคล่องแคล่วในการพูดได้อย่างมีนัยสำคัญ

เทคนิค shadowing: อ่านคู่มือฉบับเต็มทีละขั้นตอน →

ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: I Couldn't Help but Notice | This American Life | Episode 894

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สถานการณ์ที่เกิดขึ้น

กลุ่มคำและการใช้คำที่มีประโยชน์

ความท้าทายในการชาโดว์อิ้ง

ไวยากรณ์ในวิดีโอนี้

เทคนิค Shadowing คืออะไร?