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text,language
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will be used for extracurricular activities so this year Soélan will do,English
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back in pictures there was the phone the phone rang and then suddenly when he comes by he is having a crisis he is having a crisis because he,English
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remembers the ringing of the phone but it will quickly pass so a little look back in pictures and you will see what,English
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end the call and besides I'm reading but this fun newspaper about waking up so well I haven't put things away hello yes yes I am,English
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and okay I have a little bit,English
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pensions and he needs us to redo it simply in steel which is very practical for eating meals okay do you prefer general health,English
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or would you prefer to go deeper or does it require someone specific I have a lady he still had to be careful but,English
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he takes medication yes oh yes the blue pills okay in a box the lady the lady who is kind gave them to me you can hand in your prescriptions,English
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come on then open your mouth sir open your mouth a little wider sir open come on good yes so it won't be,English
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"very complicated, so you can rely on it, indeed the teeth are missing, if there was a device that had been",English
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"Lost, it's certain that it will take very late while we see each other several times today, I will do the paperwork for you. |
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because unfortunately it doesn't make them more responsible for teaching, so there is also a possibility if you want us to write the name or",English
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the initials on the short version so we will see each other several times next time we will start the,English
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"impressions, a new session of impressions, the fittings—it will take several appointments and",English
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"Me, the device is no longer available, so that's what I'm explaining to you, sir knows that several sessions of impressions will be needed.",English
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to slightly lift the shape of your mouth so that you are comfortable after we eat and so that the appliance fits well,English
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exactly on your teeth there beof it's a little bit long but at least we will have,English
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hello doctor errr hello madam you,English
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a year ago. and then you took some medicine I took a Doliprane this morning,English
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medical questionnaire to take a little look at your state of health who is your general practitioner his name is Doctor Unia and he is,English
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sit down for a few moments anyway you haven't sat down for a few moments anyway. are you okay?,English
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"Shall we go? Come on, I'll help you. So I'm going to explain a little more about these interdental brushes I was telling you about.",English
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"so it looks like this, it's a style like the ones we use, that you will have to go through between the |
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maybe very tight for me and will it fit? ah, we’ll do a test afterwards to see the space between the teeth to determine what size |
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Ah, an interdental brush, okay, that's for now, there you go, do you understand? We'll use it here. I will prescribe you a prescription pad with some |
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interdental brush sizes and you will be able to give it to your pharmacy, which will give us the references that I will write down for you, where there will be some |
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Hello, Mrs. Justin, I presume? Yes, that's right. So, we are going to enter your file, if you don't mind? So I will collect your |
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health insurance card. all right, very good. thank you very much. so we are going to check your phone number. |
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Very well, here you go, you have a room that can be found at the end of the hallway if you want to brush your teeth. The toilets are on the left. Well. I |
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Mrs. Joselin, the doctor, will be 15 minutes late; it is the first time she has an emergency patient, which has disrupted her schedule. |
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Do you prefer to reschedule the appointment or rather wait? Oh no, I prefer to wait. Very well, I will let him know, see you later. |
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Hello Mrs. Joselin, yes, I am Doctor Rantoranis, I will be taking care of you. Very well. If you like, we can proceed. |
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at the office, very well |
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Here you go, if you want to sit down for a moment. Thank you. If you want to tell me what I... |
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can I do for you? So I would need a scaling, possibly also a check-up of all my teeth, and whitening if possible. Very |
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All right. If you don't mind, we'll go over the questionnaire you filled out. Very good. Likewise. So I see that you don't smoke, that's very good. |
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you have no illness, I don't see any problem, neither cardiac, no blood pressure problem, no oral problem. no, I have some",English
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luck everything is going very well. you have never lost consciousness? neither. any allergies? neither. and you are not taking,English
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"Any medication? No medical treatment? Well, no. It's really just luck. That's good. Have you ever had any abnormal reactions, for example to any...",English
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"Local or general anesthesia? No, never, very good. No prolonged bleeding after a surgical procedure.",English
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"Extraction? No, neither. That's very good. Are we going to talk about your eating habits? Yes. |
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Do you snack between meals from time to time? Okay. We'll see, I'll explain a bit more to you later. |
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Question. Okay. Do you regularly drink sodas, Coca-Cola? Rarely, very rarely. Very well, regarding alcohol... |
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Do you drink more than ten glasses per week? Or not. No. That's very good, so I'm going to ask you to look and to |
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Please sign in the first column, and we will update it regularly as your follow-up progresses. Very well. Thank you. |
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If you want, maybe make yourself comfortable, take off your jacket, put your papers in the storage area in the treatment zone, and sit on the chair. |
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Lean your head back. Is it comfortable? Very good, perfect. I am going to put a towel on you. |
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will be used [...] there you go, you can settle in, can I start now? |
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So, lie down a little for me, I will start by examining your mucous membranes. Then we will examine your teeth. |
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Okay? So the examination of the mucous membranes—please stick out your tongue—does not reveal anything particular, everything is fine. |
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Good. Regarding the teeth, I can confirm that there are no cavities. |
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on the other hand, I notice a slight gingivitis with some bleeding of the gums, and this will disappear following the |
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they are healthy as here for example they are pale pink, there you go. so I suggest that next time we |
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At that time, we will do the scaling, I will teach you a new brushing technique, and afterwards, if you want, we can... |
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Hello Marius, hi my day, you know my name is |
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Nathalie, and I am the dentist, and I will take care of you today. Let's go if you want to come with me.",English
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"Marius, tell me, have you ever been to the dentist? Yes. Well, that's very good. Do you know your birthday then, tell me, you were born |
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when? October 5, 2011. that's good. and tell me, do you know why you are coming to see me today? okay. please, is there",English
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"Had health problems? No, for the individual, the attending physician? Mrs. Martin. His weight? He must weigh 23 kg. Very good.",English
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"Are there any allergies? No, not at all. Come on, Marius, do you want to come? Come. Look. I put a booster seat for you, you can get settled.",English
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"his armchair, go ahead. rest your head, there you go, look Marius. what we're going to use, a |
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little generator that acts like the wind in your hand, look. then we're going to use water, look. do you want me to show you? look. there. it gets wet. oh it's not |
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It's really nice out. And do you know the vacuum cleaner, look.",English
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"These ones say hello, it's funny? Yes, of course. Marius, tell me, we're going to look at your teeth, is that okay? Hm?",English
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"So you want to hold a silver pen, huh? Hold it tight and look in the mirror. You see? That will allow me to",English
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look at your teeth in your mouth go on lean in. open your mouth wide. oh those are some pretty teeth. now look,English
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"Marius, we’re going to clean your teeth with the little brush and a bit of paste. Look, do you see when it is? It’s nothing.",English
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"Not at all! Come on, we're going to do the same on your teeth. Okay. Yes, and great, open wide, open your mouth wide, that's perfect! Oh, it's going to make noise. |
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So. So I checked Marius's teeth carefully. He’s starting to get his permanent teeth coming in, so he’s going to...",English
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"You have to be careful, you’re going to keep them all your life. He brushes his teeth well so he needs to keep it up, that’s very good, Marius. I have",English
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checked a little bit. close your mouth. [...] the teeth for now are fine but it will be necessary,English
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"Still, monitor him once a year with a check-up to see if he continues to do well; at the same time, we fine-tune.",English
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"You were superb, so we're going to do something. Look. We're going to make an air balloon. Press the pedal.",English
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Go ahead. Yes. Does it hurt?,English
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"Oops, should we stop? Let's stop, he's going to explode.",English
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"Come on, look, look at the ball, everything is puffed up and there you go, and then you're going to decide for us with your eyes. |
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Every time they have been good, they can take a little toy home, so if you want, you can choose a little toy. As you wish. That's it, it's... |
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Finished. Come. You were superb today. I am very happy with you, you can be proud, it's very good. Alright, goodbye.",English
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"I am Dr. Sidonie Chhor, I am a general practitioner based in the city of Rennes, and I am also, at the same time, an associate lecturer in the department of",English
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general medicine of Rennes. So being a university general practitioner means practicing general medicine as an established general practitioner.,English
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"in outpatient clinics and more specifically when one is a teacher in general medicine, researchers",English
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"In primary care, we therefore work within the department of general medicine part-time for student training activities, training sessions",English
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"internship supervisors, and research activities on primary care. I am partly responsible for information on the third cycle",English
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for residents who have chosen the specialty of general medicine. But we are also in charge of teaching in the second cycle and the first cycle. We,English
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"everyone has more or less gotten used to saying this year is going to be special anyway. in any case, we have switched all our courses to a",English
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Digital format. So here I present to you a rather important concept to understand why the patients you are going to,English
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The patients you will meet during your general medicine internship as an extern are not the same as those you have encountered so far during your previous internships.,English
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"at the university hospital. when we don't know the patient, so the question is very broad at the beginning. so indeed you will learn how to do an examination and a |
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interrogation that are targeted by the reason for the patient's consultation, by their life history, and you will not be able to address things in such a",English
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"structured and systematized than your usual grid, the observation device by device with functional signs,",English
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"clinical signs, etc. It is also as part of this mission to welcome interns in our offices as internship supervisors from the University of Rennes 1, it is the",English
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faculty that organizes these internships by relying on its network of 380 internship supervisors affiliated with the University of Rennes 1.,English
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"Currently, I have a student who is an intern specifically in general medicine, and he needs to complete a pediatrics and gynecology internship, and",English
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"if within my practice he validates it. so you see, my name is Hugo, so I have been a general medicine intern for three months, it's a bit of a mess in the... |
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Office at Anatole France actually. My name is Bérengère Pierre, I am 24 years old and I am in my 6th year of medical school at the University of Rennes. And I |
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I am currently doing an internship in general medicine with two practitioners, including Dr. Chapron in Quebec. So, did you see how annoying it was, the people coming in for fever? |
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Is that it? Exactly. The consultation was quite hypersonic, I'll add a speaker quickly on the right.",English
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"I would like you to take a look as well, okay? Well, listen, we’ll go check the little one’s eardrums and then we’ll discuss it together afterwards.",English
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"It is the only internship in their program that is outside the university hospital, and so it is about discovering the diversity of patients and pathologies.",English
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"In this context, I give them back a familiar living environment and the uniqueness of the relationship between a primary care physician and a family doctor who supports people for",English
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all the reasons for consultation throughout their lives. what are we seeing each other for this morning? to do it. to do it? since last Friday,English
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"I had a very sore throat, just a sore throat. Okay. And I have an irritation cough at night on Tuesday and Wednesday. She is going to",English
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"discover what she has learned theoretically and apply it to patients who may be less severe, less emblematic than what she can read in her books or see",English
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in the hospital's inpatient beds with symptoms that are sometimes atypical or not yet sufficiently established to be easily identified,English
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diagnoses then right away that we show a little bit so if we look at the close monitoring not if we look at the monitoring,English
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breathe deeply through your mouth. the patients who are therefore in the offices of the faculty’s internship supervisors are,English
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very used to seeing their doctors consulted with someone next to them. Sometimes there are consultations where I let myself be questioned and let them do it,English
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Doctor? You’re playing a doctor. Here it’s fine for that. 37.7,English
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the posterior flow six musicians and there is no call time then now so we will find that yes. my project for now is really to,English
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stay as generalist as possible and then I have some ideas to maybe spend three or four days in a practice,English
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possibly a day elsewhere for example there for example I also started at the family planning center it's a place I really like there I,English
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went four times and I liked it a lot. I'm going to inject. and the prescription [...] 3,English
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Take a deep breath. We're going to do the injections. Do you know that it was your wife who made the appointment?,English
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"Do you want me to tell you the message she sent me, did she tell you? Good evening doctor, monthly visit for the little injection you had, just between us, I am very sad, he didn't... |
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Still not put. He hid the doctor from all of us, in the end he doesn't do anything.",English
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"Medicine, because there, typically, there was a message from his wife. There’s this aspect where you’re really at the heart of people’s lives as a doctor.",English
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"General practitioner and, above all, I should specify we're not in the city, we're more in a village, that's it, and so that's what it's about. Yes, that's it, we know the",English
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"people, we almost know them by heart because there are families that—for me, it's been 8 years now that I've been a doctor. There are families that I",English
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"have been following for 8 years and so I know, I know the husband, I know the wife, I know the son, I don't know the grandfather because he is with another doctor, but I know the |
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grandmother who talks to me about grandfather. So we learn a lot of things too and it also sometimes allows us to process things, but with a small difficulty, which is that here I no longer know the husband than the |
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woman, they talk to each other a lot, they talk about when they come here, they often come together, there’s no problem with that. but sometimes there are people who tell me, well, my husband did this, he does that, but he doesn’t want to |
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Let me tell you. Ah yes, okay, so I take the information and I have to ask the question that someone who would like to, for example, and... do you smoke? |
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Always? No, I don't smoke. You know who smokes but you can't say anything. But it's crazy because you really don't have the slightest... |
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same relationship as a general practitioner as what I was able to observe before, where indeed there was no follow-up for people, it was medicine, surgery, but in |
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pathologies, things like that. Specialists are a one-shot deal, they see people once, so the cardiologist, as we always say, he dares his waiting room, there are some people that we... |
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It's not heart problems here, I open my waiting room, these are people I know who sometimes come for different things or for the same thing as last time.",English
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and which we talk about again so it's totally different in terms of approach yes and the relationship is also different. well they know very well that in general I am at,English
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from the chest. on the other side this time? 138 108 not bad no nausea no constipation no,English
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We must be able to have the presence of mind to refer when we don't know. That's all. So we shouldn't act like ego monsters who are all in,English
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Never having anyone's help—we must be able to refer people to someone competent when something is beyond us. You need to,English
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There is possibly a risk that it has gone elsewhere. They saw that there were nodules in your lungs. The goal will be to have a treatment that will,English
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Off-putting. You see different things all the time and above all you get to know people. Providing care with someone who comes—why are you coming?,English
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week well it could wait two hours. we can make an appointment during the day you but that's it that's a,English
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Still? Yeah. Benign intradermal tumors corresponding to a dermatofibroma at,English
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who are close to me. no fever ok come I’m listening to you,English
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surgeons are in commentary and and a totally different practice as well and if I were offered here you can earn 3,English
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same place as the mayor or the teacher you see what I mean? yes that's it and it's something that I personally try to fight against a little bit because I try to put myself in,English
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Like that? There isn’t any Mor either? Strange. Eden absolutely must find out what this man ingested in order to save him. The patient is still between life and death.,English
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could ingest and a few seconds later the firefighters finally find several boxes of medication hidden at the top of a cupboard. ah well there we,English
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don't worry don't worry,English
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not. [...] the patient's mother is very worried. Jérôme takes care of reassuring her while the doctor looks after the patient. [...] less serious than expected,English
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"So it's okay for now. The mother is still very anxious. But you have to sit down quietly, relax, ma'am. Don't [...] like that, that’s it. |
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it's useless it's useless it's useless. he's not bad he's not bad. it's not dramatic, okay? so breathe, look |
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Okay, often behind the interventions of the SAMU teams there is real moral distress. The lady, she was not well, you know, the mother, she is desperate, she has had enough. |
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even a lot of family problems, they still have a lot of money problems, so they are in need, they need to be listened to, to be heard and for someone to listen a little [...] after a night under observation the patient returned home |
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him in good health. The Arras emergency medical service (SAMU) handles 6,800 callouts per year, more than 193,000 emergency calls, and almost 7,000 square kilometers to cover. The next morning, Jérôme |
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is called for a new emergency, a teenager has been injured in Thierry. It's impossible to go there by ambulance, the helicopter is needed. Here, the helicopter is already quite essential for",English
|
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"to locate and to access quickly because the access roads are difficult, the access routes are difficult, hardly passable by car. So we land near the child or the person in distress",English
|
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"it's there because of the helicopter. heading to the Thierry, a coal mountain like there are many in this former mining region. a mountain that has become the playground for the local teenagers |
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Corner. A 17-year-old has just had a bad fall on his bike. He reportedly lost consciousness. After several flyovers, the team locates the victim; the firefighters are already on site. |
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have access to this intensive care service, but to see their children they must follow very strict hygiene measures. The entire area is sterile; all risk of infection must be eliminated. The babies who are in these incubators are |
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isn't breathing anymore. For Virginie, it's anxiety because she knows she can't do anything. The nursery nurse tries to do",English
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restart the baby's breathing. Théo finally starts breathing again. it happens so it's always,English
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"stressful for the mother. It will pass. It will get better with time. It's not every time, but well, sometimes it does. |
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That. That goes fast. Just goes to show, well, life can change. In no time at all. Théo is still fragile. His parents are going to |
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having to live in anguish for long weeks. Because despite all the efforts of the team every year, about ten children die in this ward. In the room next door, a little girl, Louan, is considered as |
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a real miracle. Louan, let's say, is our oldest patient in the ward. She has been here for about a month and a half. She is a baby who wasn't gaining weight. |
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well, at first, who was too small, who was not within the limit of viability, and she was born at 29 weeks with a weight of 600 g. Louan was born at six and a half months, also with growth retardation. |
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important. At 600 g she was at the legal limit for resuscitation. Currently, the law states that a baby is viable from 22 weeks and 500 g, or 500 g. There are |
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30 years ago in France, they told you that children under 1000 g, well, it wasn't worth it, we wouldn't be able to resuscitate them. Louan has come a long way. Today she weighs 1 kg, but she still can't eat or breathe.",English
|
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"alone. A few kilometers away, on the main square of Arras, her parents Lidy and Vincent are trying as best they can to live with the absence of their daughter. Lidy is preparing for Louan's release, while Vincent |
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prefers to remain cautious. [...] the play mat, so that was bought by the great-grandmother, so she is far from putting it down, huh. Is that clear? The bed will be in the middle, the table extended in the |
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Resuscitation, right, so if it's only to live through a tragedy afterwards, it's actually pointless. Vincent is still worried. Over the weeks, the couple has come to accept their daughter's prematurity, but the beginning was difficult.",English
|
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"before bringing her home. if all goes well. Roubaix emergency service. here we treat more than 63,000",English
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"people every year. A colossal figure that makes it one of the most overwhelmed services in France. It is barely 10 a.m., the corridors are overflowing with patients, the waiting room is already full. Every day, a hundred people",English
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"present themselves at the emergency room and the wait can last several hours. already this morning she told me, I said oh dear oh dear oh dear, we're going to spend all of Saturday here. the first time it happened to me I had to wait more than 3 hours. I have |
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discussed in the hallway at the emergency room, a lady, and three and a half hours she’s there, she’s still waiting. we know when we come in but we don’t know when we leave. a very long wait except in cases of extreme emergency when the prognosis |
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Roubaix, he is the one handling the most serious cases today. Where is he found? In a public place. [...] No blood pressure. The pulse at first, I say to |
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Lately I don't know. He is cold, with cold extremities, so it's a patient who is bleeding a lot. Most likely of digestive origin in a patient who is taking... |
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long-term anticoagulants and who probably overdosed on her treatment. So her condition is quite complicated. Suicide attempt, accident, for |
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At the moment, it's impossible to know what really happened. One thing is certain: his condition is so serious that he absolutely must be transferred to the intensive care unit. I just came to see an admission brought in.",English
|
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"By the SAMU, a man in his fifties, so for us he has a blood pressure of 10, he had to be ventilated, it's dated, he has blood that continues to flow from the gastric area, we're almost at 1 L. We absolutely need a place with you. The man has",English
|
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"lost 1 liter of blood, the anesthetist has just taken over. for us, it's over, the anesthetist is here, we leave it to him. he knows how to do it better than we do. for this patient, the prognosis is |
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dark. After examination, the doctors will discover a tumor in his stomach. The resuscitation room will be vacated. And we will clean the room. |
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because we made some people leave here to install this gentleman, and there are people in the corridors whom we will bring back here. a crisis situation to which Dr. Pochet is accustomed. here the places |
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are expensive especially on weekends. it's Saturday, patients are going to start arriving. we have the capacity to accommodate on the three beds. there are six patients starting to gather in the hallways so this is a typical Saturday. so it's going to start. it's starting as it should.",English
|
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"What is a typical Saturday? It's people everywhere with nurses running all over the place, blood all over the sheets, that's a typical Saturday. Saving lives is for",English
|
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"That is why Dr. Pochet chose to be an emergency physician. But the emergency department also involves administrative problems. It is noon, and before seeing other patients, the doctor first has a small issue to deal with.",English
|
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"Settle. Now we just have to sign the discharge letters, handle the excessive ambulance requests. There's a young lady with whom I think I'm going to have some trouble. This woman, it had happened.",English
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"the day before for chest pain. She underwent a whole battery of tests, she is in perfect health but she refuses to leave the hospital on her own. I ask the doctor to call me an ambulance so that I can",English
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"go home quietly, and then the doctor refuses, tells me to manage on my own, that I have to go home in pajamas and slippers, that's it. she would really like me to get her an ambulance |
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lying down to take her home. and a lying-down ambulance is 200 €. there is no way the hospital will pay 200 €. I ask her to at least make the effort to call, or else we will call her a taxi, which will be quite expensive. |
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but we won't have good transportation. that's money we won't have for medicine or equipment at the hospital. but there's nothing to be done, the patient won't give up, she comes to harass the doctor right in front of his office. I...",English
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"Sir, if I came here to the emergency room, it's because I was sick. I know, and as for my job as a doctor, I did my job as a doctor: I examined you, I treated you, I did the assessment. I didn't come here to argue.",English
|
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"with you. ah, me neither. alright, I ask you to do your job to the end, sir. my job is done [...] you won't get any, ma'am, there's no point in... and why don't you want to do the [...]",English
|
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"yes, you think you’re going to force me to write a prescription. you’re a doctor. even a general practitioner. prescriptions for ambulances. there are people who are actually sick, they need me. but no, you’re not",English
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"sick anymore. But the patient doesn't stop there, she moves on to threats. I’ll take an ambulance at the hospital’s expense since sir does not |
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doesn't want to, and if downstairs they don't want to call the ambulance, well then I'll have the AST director called. you're going to give me your name so I can ask the director |
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from the hospital what happened. you were less of a nuisance yesterday when you arrived, you had chest pain and you were worried. well yes, I didn't know that this brief stay I spent here was going to turn out like this. so you're disappointed |
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You must not come back to this hospital anymore, madam. Oh no, I won't come back, but you won't be working here anymore. But will you hear about me, doctor? Yes, madam. Yes, you will hear about me. I think you have to be quite firm. |
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and then and then not give in to threats of complaints or dismissal because she knows people and so on. because we're used to seeing that since they all have pretty much the same speech. stop, we stop here, we stop here, that's enough. not |
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won’t pay the paramedics, they’ll send him a bill, without being sure of ever getting paid. careful, it’s starting. here we go. we’re going to |
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Where? A cardiac arrest. Come on, let's go. Back to the emergency medical service, 8 a.m., Doctor Eden and his team are heading out on a call. The firefighters have just",English
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"raise the alarm, a man he was transporting for a simple discomfort has just gone into cardiac arrest in their vehicle, they need to act quickly. the firefighters preferred to stop at the side of the",English
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"road. free yourself, go ahead Marchaud. the victim, a man in his fifties, is in respiratory and cardiac arrest. the firefighters are massaging the patient's heart to |
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keep alive. when you arrived, was the guy okay? yeah, he was okay. his blood pressure was normal, his heart rate was normal. |
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gradually the rhythm slowed down. it's not good, it's respiratory arrest. we've managed to revive him for now. you can start driving. head to the hospital emergency room, a",English
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"race against the clock begins. the victim is stabilized, but he must be taken to intensive care very quickly. was he blue when you arrived? he wasn't blue when we arrived, he was conscious. he was vomiting. he was vomiting up |
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Blood, is that all? Was he spitting or vomiting? Hi, this is [...] on an intervention on the Saint-Paul national road. It's a cardiorespiratory arrest. Pick him up, okay? Go ahead. [...] the heart of the",English
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The patient has just stopped for the second time. There is only one solution: electroshock. Are you ready? All right. Don't touch the stretcher.,English
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,English
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after a few seconds the beats resume.,English
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yes. we've recovered for now. we did well on the per there. look at that. it's not bad.,English
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,English
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,English
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,English
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,English
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almost an hour. I’ll fill out the papers for you. so difficult. very very difficult. difficult because after a,English
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,English
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,English
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,English
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,English
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,English
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,English
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,English
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,English
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,English
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,English
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,English
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,English
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,English
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A little girl is about to be born. Her father wants to be present at the birth; it's his first time witnessing a delivery.,English
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"ah yes, it's yeah, it's really new, I'm under some tension to see how it works, let's say. it feels strange, it feels strange. the dad is not at the",English
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end of her surprises because today Mathilde is going to give birth to her daughter in a somewhat unexpected way. you are going to give birth on your side. if you want? we no longer necessarily position them,English
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"Women in the gynecological position for giving birth. The ladies who are comfortable on their side, we keep them in that position and actually the baby is born here. There you go. Behind her. It's different from having both legs up. It's something else.",English
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"thing. I’ve never heard of that. I didn’t know you could give birth on your side. next time. and the couple will experience this new thing together—in a few minutes the baby will be here. go on, again, again, again",English
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"Again, again. Try to push a little bit longer. If you can, okay? Have confidence in yourself, it's important. |
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I don't know if we men would be able to handle that. We say we're strong, but I don't think so. Go on, go on, more than that. That's good. There's a little lock of baby hair coming. He's a little brunette like his dad. |
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Does daddy want to see the baby's head? Can you or not? As you wish. See her hair there, how she touches it nicely. Here comes the baby, very slowly. There you go, you’re doing well.",English
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"Sir, do you want to go back there? As you wish. No, I'll stay here. Does it bother you? No. Then you will see her come into the world. The father watches in awe as his daughter experiences her first moments of life. Do you feel that she's coming now?",English
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"Yes. Do you see your baby coming into the world? Gently, support the head well. Gently, push more ma’am, push more. Now we let the baby breathe, we let it come. Go ahead, breathe. Go ahead.",English
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"now. go ahead. gently, in a circular motion. we are going to cut the cord a little bit. the cord is wrapped around the baby's neck. there is a |
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risk of strangulation. the midwives don't panic. so that's the stylish one. 1, 2, and 3 loops of cord. come here. take her. there she is. as the cord puts its little head |
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In front. There you go. There you go. Great. That's it. Welcome, miss. We're going to |
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To think that I saw her from her very first little hair to her last foot, last toe. It's wonderful. It's true that it's beautiful, huh. I didn't think it was like that. An unforgettable moment for Mathilde. |
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and her husband. Véronique has been a midwife for 15 years, but with every birth she is moved by the parents' emotions. We share moments from the lives of women.",English
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"which are particularly precious. I would say the emotion of the parents—there is this mother who catches her baby, who puts it on her belly, and we think, but stop, this is, this is a moment of",English
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"thanks. no time to linger, an alarm goes off, it's the one in this future mother's room. so how are you? it's very |
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ah stop it, it hurts, it hurts. calm down, calm down. that's all, that's all, it's a little bit early for me to go to the delivery room, I'll check with the doctor if we can still get you set up with the epidural. because |
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you are still having fairly regular contractions. yes, I know. alright? brave. raise your hands. labor is very slow, it is still too early to give an epidural, but the midwife is worried about Magalie who |
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She has been suffering for more than 10 hours. She prefers to talk to the obstetrician about it. She is in a lot of pain, she is getting a bit tired, what do you think about putting her in the room with an epidural, is it too soon? I am examining her because. I don't know.",English
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hasn't moved for a little while now. hasn't moved for 2 hours. but it's a bit tight to put... you see it's a bit or I well... Magalie is exhausted from the pain.,English
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"The doctor decides to give her an epidural so that she can give birth in the best possible conditions. We don't like to bring patients into the delivery room too early, or to give an epidural too early, or |
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for nothing. In her case, we think that this allows us, first, to relieve her and, second, to pay more attention to fatigue and to prevent the patient from reaching the end of a long labor |
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hours, for twins, since we know it's going to be a bit more of a challenging delivery, so as not to be too tired. Yes, that's it, we choose that over fatigue. Magalie's troubles are not over yet. What she doesn't know yet, |
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6 a.m., it's a special day for the SAMU emergency doctors. Today they will be at an exceptional event: the Enduro du Touquet, a motorcycle race.",English
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"on the dunes. a competition that claims many victims every year. the emergency doctors turn the city airport into a field hospital. so here we will definitely need a helping hand, we’re going to unload the truck. the suture area will be right here. the team has",English
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"Just a few hours to set up an emergency service. 19 tons of medical equipment, 50 nurses and doctors soon ready to take care of the first injured. Here we are setting up what we call the ER, the emergency unit.",English
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"absolute. All the most serious patients who are stable are taken care of here. And next door, in the room next to it, will be the relative emergencies. So there it will be minor trauma, minor injuries, sutures. He is",English
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"Noon, the system is operational. The race starts in less than an hour, barely enough time to grab a sandwich. Momo's fry shop. So I go |
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Take a fr fricadel fr. For now, it's the calm before the storm. The team is getting ready for the rush. Usually, it's during the first |
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Most injuries happen in the first minute of the race. It's a very physical event in the long run, so the youngsters, the ""rookies"" as we call them, who go all out in the first lap, sometimes they...",English
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"do not always master well where there is still quite a lot of damage and breakage, so in the first laps of the race we picked up quite a few more or less minor injuries. The Enduro du Touquet is one of the",English
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"the most important motorcycle races in the world. a thousand riders at the start, among them professionals but mostly amateurs. and more than 450,000 visitors in an electrifying atmosphere,",English
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"Speed, alcohol, partying—a dangerous cocktail. So this year, a team of emergency doctors is going to the foot of the race to be as close as possible to any potential victims.",English
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"Normally we have to follow the procession at the end. Should we open there? Yeah yeah, that works, thanks. As soon as it's over, as soon as |
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It's done, I'm opening here so we can follow along. We're going to take a photo—well, we have to, we just have to, this is extraordinary. The race will start in a few moments. The engines are starting to heat up.",English
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"ah it's it's quite a sport, huh [...] they're crazy people, crazy. Jérôme and his team arrive on site, the start has just been given. The competitors have set off for 3 hours of |
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race of more than 100 km/h. in the airport emergency room, we follow the event on the screen. the race has been underway for 20 minutes. it's time for the first accidents—spectators, drivers, the",English
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"see. what? yes? louder. speak louder. the little boy reacts weakly, he is still in shock from the accident. he was with his father in the front row of",English
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the race when a motorcycle lost control.,English
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Was he hit on the side by the motorcycle? He was hit [...] but he took the helmet.,English
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"The child is suffering from a minor head injury, and the doctor suspects a broken nose.",English
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"The little boy is afraid, the nurses improvise to entertain him with what they have on hand. Find him something that amuses him a little.",English
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"he is there in front of everyone, wondering who is doing what, certainly very scared. do you like a little ball? guy, hold a funny one. are you coming with me? I",English
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"hold in the arms. The boy is taken to the nearest hospital for a check-up X-ray. His father is reassured, but the accident could have been much more serious.",English
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you got more flowers yeah yeah we saw the speed set given how we saw the barrier again afterwards we were lucky. honestly the barrier is cut,English
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"In two. So we were really lucky. What happened with the engine? It got back up, then it waved goodbye to us, and then...",English
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"It would be nice if they apologized, at least he checks in. There you go. The little boy was lucky, he got away with a broken nose. He",English
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"will return home the next day. In Arras, emergency in the neonatal unit. Theo has another episode.",English
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"Theo, Virginie's son, the little premature baby weighing one kilogram. His alarm went off, he is not breathing anymore. This time his mother is not there. |
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Come on, let's go. The two nurses are trying to revive the child by",English
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"Stimulant. After 2 minutes of apnea, Théo still isn't breathing. I exhale just for a moment into his mouth. |
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Little guy. You seem to be better than earlier. Oh yes, that always makes parents panic. The fainting spells, the bradycardias—that is, the heart slowing down. |
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Suddenly. So it's all premature babies who have them because premature babies are immature, their brains are also immature. The brain is what controls breathing, so from time to time they forget to",English
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"to breathe. But for Virginie and Guillaume, Theo's parents, these repeated fainting spells are unbearable. Every time she witnesses one, this mother can't get over it.",English
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"Not. There, I think that we think about everything, everything... even about things we shouldn't be thinking about, you know. |
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but... I saw him leaving, I saw that I could have, I could have lost the baby. when you see your child all blue, it's...",English
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"Me, this morning, it really scared me. Yesterday I was feeling very well and... how",English
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"today he did this to us. tomorrow he could very well do something else to us. so we have no idea what to expect, and we don't know how to move forward. tomorrow Virginie will leave the |
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she is absolutely glowing there, with her big eyes. it's the first time I've seen her like that. usually I always see those little eyes. we won't say worried but those",English
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"sleepy little eyes. ah I’m really impressed [...] and doesn’t daddy want to do skin-to-skin? what do you mean, skin-to-skin? on",English
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"you? not me, it's the fear of hurting her, I don't know how, how to hold her. I'm the one who wants to put her in after. not me, I'd rather not actually. really? yeah, I prefer not to",English
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"not. I'm not going to force you. don't want to try? no no. it's difficult for Vincent to establish a real connection with his daughter. and if this dad only comes once a week, it's his decision. it's a choice because it's",English
|
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"maybe at first the fear of getting attached. it's true that the worst can always happen, you can always get a phone call in the night telling us well, the little one, the little one isn't doing very well and she might",English
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might risk losing their life there. So it's a choice. But it's true that there are risks.,English
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"Always. At the Arras emergency medical service, Richard Loubert is an emergency physician. He is called to a birthday party. A 54-year-old man has fallen ill, apparently due to alcohol. Gentlemen",English
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"Ladies. Have you had a lot to drink tonight? Have you had a lot of alcohol tonight? Yeah, three faces. Three faces? What does three faces mean? Let's say, for once that he comes to my... |
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Birthday. Misfortune, he spoiled me, huh. He's 64 years old. Used to drinking, is that it? The alcohol was too strong, is that it? Okay, he didn't eat. Oh yes, he ate too. A slice of bread, well that's not enough. Yeah, but",English
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"You should have seen, he ate a filet mignon like that, smoked? Ah. Yeah, nothing serious. Since the beginning, the firefighters have been with him and the patient seems very grateful to them. He doesn't take any more meds. The firefighters are |
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|
Great. Well, sir, we're going to have to hospitalize you because, since you hit your head and lost consciousness, we're still going to have to monitor you tonight. But I want to say that... that |
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Those gentlemen there, they're fine. Oh yes, they're fine. I already repeated it but you've already said that three times. Do you want to repeat it? Head to the emergency room, we have to move the patient without anything.",English
|
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"break. we're going to go past, no, all my dishes are in there. we're not going to break them. my dishes. and once again, thank you.",English
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"Interventions related to alcohol, the SAMU emergency doctors are used to them. There are periods, it's the beginning of the month, people drink more than at the end of the month. At the end of the month they have less money. So we have, we call it, we have, we... |
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call it Saint-Rémi. well, Saint-Rémi. when they got their Saint-Rémi at the beginning of the month, usually there's a bit more consumption. here it's more like the party went wrong. the patient in any case only has one |
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only word on your lips, thank you. you have a lot of... ah the firefighters, they're good with firefighters, with firefighters, bravo, great firefighters. oh yeah, you haven't said it that much yet, sir, could you repeat it one more time? to be with |
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she's quietly in front of the TV or I don't know what, she's there holding your hand. it's beautiful, isn't it? it's beautiful. when you arrive at the hospital, the patient is not yet completely |
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Sobered up. Good sir, goodbye. Thank you and thank you once again. Wonderful, wonderful. Gently, I need my fingers, I need my fingers. Yeah, but you already said that. |
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Arras Maternity. Yes, good evening sir. We are going to take your wife to the delivery room, so if you would like to come closer to us? See you in a bit, sir. For Magalie, the mother of the twins, it's the",English
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"Big day. After more than 24 hours of contractions, the delivery is coming soon. Jérémy, the future father, has just arrived. Hello sir, madam. Go ahead, I'll get her settled for you. |
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The seat is for you, sir. You see, I've never made the trip this fast. Wait, I have something, I left at the...",English
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"Quickly. I really didn't think I'd have such a hard time like this. Honestly, I don't know how some women manage to make it simpler out of boredom. Perural, so I don't know. Magalie is",English
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"Relieved, in a few hours the babies will be here, the culmination of a beautiful love story. She comes from the south, he [...], she followed him. As they say, the first time I came.",English
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"I saw the time and I said oh my, and when I left, well, I cried like in the movie. So I followed all the way here. No regrets, on the contrary. We're good, right? |
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|
and we are fine. suddenly, in the hallway, cries of pain. a delivery is going very badly. come on, we |
|
|
Push. Come on, push. Come on, again. For half an hour the team has been trying to bring a child into the world. They have tried everything—forceps, suction—but |
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|
The child still isn't coming out. His heart rate is dropping. There's an emergency C-section, it's a race against time. He needs to go for a C-section—no, he can't, because the lady... |
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In a few minutes, the child and the mother are out of danger. It has to go very fast because the baby is in distress. The heartbeat slows down, so you have to do the cesarean very quickly, that's why less than 5 minutes.",English
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"he is, he was born. the father didn't even have time to realize what happened. it's true, for me it was hard to go through. they were lucky not to",English
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"ask me to follow them, because I think I cut and so I waited, I trusted them and there you go, it's perfect, the kid is in great shape, the mom too, and the dad is happy. |
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There you go. For Magalie, however, the wait is becoming more and more difficult. The pain is coming back. It's now been 36 hours since labor started. We're still going to try to |
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Turn onto your right side to try to relieve yourself. No, it's you, let's get back on your back. I thought it would be less. |
|
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long, even Magalie herself I think didn't expect it to be this long and maybe also this hard for her. Magalie is exhausted, and the medical team is starting to worry. It's been a little while that this lady |
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is on the way. it's taking a long time. and she is very lucky because she has little twins who are going to be born. but there is an anomaly in this case, it's the slowness with which the cervix is dilating |
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and the head is not coming down. After a day and a half of effort and pain, Magalie and Jérémy are about to receive bad news |
|
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news. 3 p.m. back to the Roubaix emergency room, a man arrives brought in by his wife. He is 34 years old, he suffers from schizophrenia. I left for work and as I was leaving for work I |
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I saw him walking in the street [...] who was falling everywhere, who was saying anything, who was really in a pitiful state. Okay, so today you're coming because you're doing better. |
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Are you losing it more and more? I can't talk about it at all because I don't remember anything that happened, so. The man drank alcohol and hasn't slept since.",English
|
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"several nights and doesn't remember anything. do you feel in danger for yourself or not? for myself, for others yes. okay, I'm afraid for him, because I'm afraid he'll do something, that he'll do something irreparable. |
|
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So, so, well it's true that in fact our current life, we're in the middle of a separation, but it's not because we're separating that I'm going to abandon her.",English
|
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"So there you go, I'm very scared, I'm scared for him because he's capable of going very far. The nurse's first instinct is to check his treatment for the",English
|
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|
schizophrenia. an impressive list of medications. it works. but if I didn't have all that I would hear a lot of people who don't exist. I would see,English
|
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"many people who don't exist. and I would almost be aggressive about it, because surviving in a world |
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Irrational, that's not my field. Take off your coat, you can put it on the chair. Doctor Babet is the head of the emergency department. She is going to examine the man because before making a diagnosis",English
|
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"psychiatric, she wants to make sure he is healthy, but she is going to have a surprise. have you taken any pills? so right now there are a lot of episodes of loss of consciousness like that? yes, right now yes, it seems to me",English
|
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"Weird. There are scars there, what was it? You uh... was it you? Yes. A knife wound? Yes. A gunshot?",English
|
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"Okay. How old were you? 17. 17 years old. Sit down, I will listen from the back. The fact that he had this significant trauma in his youth, for us, this patient, it shows that he may be capable of actions.",English
|
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"very violent, and if we hadn't undressed him, a psychiatrist seeing him in consultation would miss all that. Dr. Babet sees many cases like this. depression, |
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suicide attempt, schizophrenia, in Roubaix there is an average of a dozen psychiatric emergencies per day. That represents a huge number of patients. Well, it's true that in Roubaix there isn't a lot of work, that there are |
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many unemployed people, who are in delicate social situations, and the emergency services are to some extent a reflection of what is happening outside. after examination the doctor does not |
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detects no physical pathology. a blood test in my office, and an electrocardiogram. that's fine. so it's possible that it's the medication that's making you lose a bit |
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Did she leave the schizophrenic patient, only to be faced with another problem? Isn't it possible to get a coffee or something? Yes, and your money is here, we'll give it to the ambulance driver and you'll leave with it. And a coffee?",English
|
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"and a coffee. Well, I just ate, so a good coffee after eating is always nice. Are there any caregivers available to offer a coffee to Sir? Offer? With my money? Yes.",English
|
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|
"it's your money. I will put it in an envelope for you. and will you be able to buy me a coffee? yes. this man has been here since last night. homeless, he suffers from a dementia syndrome, but |
|
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he is not dangerous enough to be hospitalized. there are a lot of people who have social problems, many are chronic alcoholics who come in the evening with 4 g of alcohol, they |
|
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know that we are going to give them a shower, we are often going to change their clothes, we are going to give them a bed for a few hours, we can't leave them outside, especially at this time it has been extremely cold, we are obliged to",English
|
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|
"to accommodate them. The doctors have to find this patient a place to sleep tonight. [...] well, we do more than just a hotel, you know, because we have to try to find them a",English
|
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|
"accommodation solution, but we do more than just a hotel. in the meantime, the whole team must show a lot of patience. go ahead. a coffee, can I have a coffee? go ask her sir, she is in the back. can someone put sir in his",English
|
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"Room? And bring him a coffee? And my money, can you bring it here? Yes, sir. And my coffee? It will be brought to you. And my money too? Also. Meanwhile, the schizophrenic patient leaves from",English
|
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|
"his psychiatric consultation. He is allowed to go home, on the condition that he returns during the week to see a psychiatrist, and that he no longer drinks alcohol. If he takes medication and has a little drink, it has much more of an effect than if he",English
|
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|
"had to leave it there. but if he takes a car I don't know, do you drive? no no, not me, not now. normally. you block the way. I know. will it be okay? I don't know everything.",English
|
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|
"Going back, that's it, let's go. Goodbye. My return, the exit is that way. Yes. There you go. Avoid mixing. Yes. Thank you, sir. Good",English
|
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"Evening. Good luck, I'm counting on you for Thursday's consultation.",English
|
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"Arras maternity ward. The doctor has to tell Magalie and Jérémy, the future parents of twin girls, that not everything is going as planned. The first baby is not able to engage.",English
|
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"expected that things could move forward without too much trouble, but no, it's not progressing anymore. So I suggest we stop because you have tried everything, bravely, we have tried everything, and perform a cesarean section to deliver the babies in a safe condition in the end. |
|
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after 36 hours of pain and waiting, for Magalie it's a huge disappointment. all this pain all this",English
|
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"All this suffering to get here, I still would have wanted to, but oh well, it doesn't matter, that's what I want and now babies above all.",English
|
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"that's not the goal, which gets stuck. heading to the operating room. exceptionally, Jérémy can attend the cesarean section, for him it's a",English
|
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"Relief. It's a bit better. Anyway, I think she wouldn't have slept in good conditions because [...] she's tired. The main thing is good health for all the |
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Two, that's essential. More would be nice. After more than a day and a half of waiting, he will finally be able to discover his daughters. Look at these little hearts. Maya, the first of the twins, is born.",English
|
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"Jérémy is a father; for him, everything else is forgotten—this is happiness.",English
|
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"Happy, moved, happy. It's great. |
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|
A few minutes later, Mélissa, the second of the twins, arrives. The two look like their mother's mouth. The little nose, the mouth. A little later, the two healthy little girls are brought to their...",English
|
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"Mom, happy. It's the little family coming together. Quite simply. It's nothing but happiness. Oh oh la la, they are all",English
|
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"Cute, they are all well-behaved. Back to the Enduro du Touquet with the SAMU. Jérôme's team placed at the |
|
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Bottom of the race, has just been called for an intervention. A man who is having a serious malaise and is not doing very well according to witnesses. They sent the Red Cross, the firefighters, and then we are going to go as reinforcement for all that. The problem is that it's right in the middle of the crowd.",English
|
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"difficult for the team to find their way. Staircase 5, where is it? Staircase 5? Any idea? Is this staircase 5? The emergency exit is",English
|
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"Where? Let SAMU arrive. A little straight ahead [...] the city of Le Touquet turned into a giant stadium. We have to hurry. But the team is completely lost. Absolutely not in relation to what he has around him, we are in the crowd, we",English
|
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"can't see what's there, can't see the signs, can't see what we usually see. we never manage to come here, never, there are too many people in the city. damn. after 20 minutes the paramedics finally find the station of",English
|
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"help, but the patient regained consciousness. Has something like this ever happened to you, fainting like that? Do you have epilepsy or",English
|
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"Not? Yesterday, where did you sleep last night? I slept in a truck. In a truck? And this morning I was cold then. Did you eat? Yeah, I ate.",English
|
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"a kebab. oh that's very good, you're saved with that. a malaise mainly due to lack of sleep and alcohol. first intervention well then",English
|
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"There you go. Quite quick, nothing too serious. But well. In the airport emergency room, however, the teams are overwhelmed—race accident, a pilot is coming.",English
|
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"to arrive. how? this young motorcyclist has just had a motorcycle accident, he dislocated his shoulder. it's the worst. |
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Reduction. The shoulder is dislocated; now the humeral head needs to be put back into the socket. It's dislocated, it's very painful. That's why sometimes in the operating room we can do it under anesthesia.",English
|
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"Hey, hi everyone, I hope you're doing well. Today, a new video—we're going to talk about basic first aid gestures, really the basics, whether it's for the recovery position, cardiac arrest... |
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Cardiac arrest or total airway obstruction, whether in adults, children, or infants, goodbye to all that. Alright, let's go.",English
|
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"as you saw in the introduction, we are going to",English
|
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"Talking about first aid gestures, really, that's the basic thing to know because if you come across an accident, if it's someone in your family, that's all I... |
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I'm not going, he's unconscious, it's important to know what actions to take. These are simple actions but they can save a life. Must have",English
|
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"several situations that you may encounter in everyday life. so for example, first we will see someone who is choking goodbye",English
|
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"things to do. The second thing will be the recovery position, and then the third thing will be cardiac massage for a",English
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"adult or a baby. So, if you come across these situations, whoever is watching this video, which will last 10 minutes, is normally",English
|
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"you will be able to handle all these situations, and as I said, it's important, because you will be able to save lives, these are actions I |
|
|
I said simple, but effective. Of course, before the arrival of the firefighters, who will then take over. First, I invite you right away to |
|
|
Put your thumbs up under the video if you want a part 2. Come on, let's go, for total obstruction of the neighbors—that's what we call it now. |
|
|
Acute airway obstruction is when someone will no longer be able to breathe. It can be seen in an adult, for example when they are eating and |
|
|
He’s going to choke, I’ve already seen it during an intervention with a big piece of meat, the person hadn’t cut their food properly, hadn’t cut their food properly when |
|
|
she didn't necessarily swallow, she choked. so that can happen in a child or an infant who, well, they can come to my place with lego pieces, flow",English
|
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"things like that. Here we are dealing with acute airway obstruction, we agree that no air is passing through anymore, the person will often",English
|
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"now at the cost of trying to get some air, there is no noise, no sound coming through and it will start... so we were in agreement, you will",English
|
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"You have to act quickly, because if the person is modest, well, they will go into cardiac arrest, they will die. Come on, I'll show you the |
|
|
actions to take so I have Mika playing the victim. already the first thing to do is to look in the mouth to see if we can see the foreign object, and if we can |
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|
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Abdominal compression, so here we compress—the idea is to create a piston effect. So, there you go, we do from one to five. |
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times, then I look in the mouth to see if there is a foreign object, if I can remove it, and we continue like that. So, five back blows, we look in the |
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the side so you don't hit your head. then we always go back onto our knee. we fight, we press on my forearm",English
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Put pressure on the knee and then do 5 chest compressions. The idea is to create a piston effect to expel the foreign object. Done.,English
|
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That until they locate the foreign body or the person here goes into cardiorespiratory arrest. Now we will look at the obstruction.,English
|
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|
"partial airway obstruction, that is to say the person will eat something, but they can still breathe. So in this case, the procedure has always of course been called",English
|
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"the emergency services, but there you go, put her in the position where she feels best, encourage her to cough. Why? Because by coughing,",English
|
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she will be able to bring up the foreign object and maybe get it out. But of course it is also important to call for help because if,English
|
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"it never completely blocks the trachea, so you understand that it can be there. second action to know, we will",English
|
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"talk about the recovery position. in fact, there are many times during interventions every time I arrive on",English
|
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"The intervention, I always see them putting people in the recovery position, and even if they are conscious the whole time, I feel like it's... |
|
|
Yeah, there's a discomfort, ps. No, I'll explain to you why to do a recovery position. First, the recovery position is used for a person who |
|
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is unconscious but breathing. That is to say, for example, if we stimulate them and tell them mentally to open their eyes, I |
|
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give her little slaps, I don't know, I try to stimulate her, she doesn't react. so at that point, okay. we move on to the second step to see if she |
|
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breathe. the person is breathing, that's already a good thing. and now we see putting them in the recovery position, so on their side. why? to avoid two things: to",English
|
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|
"avoid is quite right that if she is lying down, if she vomits she will choke on her vomit because the vomit will not come out. and the second",English
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"thing, it's the same, she is unconscious so there are no more reflexes, the tongue can fall back and block the airways |
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airways so you can choke. so why are we going to put her on her side? precisely to avoid these two things. if she vomits, it will go to the side. |
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the neck, the airway clearance, and there I look for ten seconds to see who I see |
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might risk it. So now it's good, I see his name coming up. I can feel on my hand that he's breathing, so here we go, the goal is to put him on his side, we're going to do the recovery position.",English
|
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"lateral safety position. We will put their arm at 90° on the side they will be turned towards, then I take their palm with my palm, palm to palm, and I bring it onto",English
|
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"their cheek. Then I lift their leg and roll the person onto their side. Then I remove my hand, I open their mouth,",English
|
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"I continue to keep their leg at a 90-degree angle, I cover the victim while waiting for help, and I monitor their condition.",English
|
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"So I check if he is breathing. Here it's really about the technical actions, but what is important to know is to put her on her side after the knee. |
|
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the arm and not 90 honestly that's not the most important thing. if you do it, that's great for the person but the most |
|
|
The important thing is really to put her on her side. Third thing to do, we’re going to talk about cardiac massage. First, you need to know why to perform a massage. |
|
|
Well-being is not about giving a massage and then someone who is conscious, the poor thing, I think he will get into trouble—why perform a massage? |
|
|
Cardiac, we assess consciousness, it's really true love, the eyes, okay, no consciousness, we assess breathing out of ten, no breathing, unconscious.",English
|
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"no breathing so now we are going to perform a cardiac massage. the purpose of the massage is to press on the chest, and it is to",English
|
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create a piston effect. to compress the heart during a celebration the heart is simply a pump that sends blood and oxygen to the organs and the brain so by,English
|
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"By performing cardiac massage, we supply the organs, we supply the brain. That is why it is important to perform a massage.",English
|
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|
"Cardiac. We will of course use an AED, which is what you find in gyms and town halls—semi-automatic defibrillator.",English
|
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"Automatic external defibrillator, now that's exactly the same thing. We have the pads, and what are they actually for? |
|
|
as our person is in cardiac arrest, the heart is beating in a chaotic way, somewhat erratically. the USA note, our second one, will be useful to us |
|
|
In fact, what these wires will do is send electric shocks to the heart to reset it so that it will start beating again like it |
|
|
You have to. But if it's a flat line, meaning our heart is no longer beating, unfortunately the drawing will be useless, and we don't know that, so it's...",English
|
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|
"For that, it's important to immediately use this AED, this defibrillator. So, I arrive at a person, I don't know, they're not responding, so, Hello, ma'am.""",English
|
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"Shake my hands, open your eyes, I don't have an answer. Life, help, at ease. If I have my mobile phone, I can start calling 18, put it on. |
|
|
Speaker and here we go, so code ties, belts, at the ready, airway clearance, look at my hand, of course the forehead. |
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So here I have nothing, the person is in cardiac and respiratory arrest. So here we go. So here I still have either 18. |
|
|
the goal very quickly is to call for help, because I am going to start chest compressions. so |
|
|
Here we go, so for the cardiac massage, we look at the imaginary line of the nipples, fingers, elbows are locked, and here the goal is to do |
|
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I do too many compressions if it's someone I know, if it's someone from my family, I can do mouth-to-mouth, so in that case, I can do it, and I... |
|
|
breathe two more times, if the rib cage rises then it is not necessary. if it’s someone you find in the street, you are not |
|
|
obliged to do mouth-to-mouth, you perform nonstop cardiac massage. So then we’re going to use the small AED, defer the semi-automatic shock, so |
|
|
This is what you find in town halls, I told you, in gymnasiums, so first the victim has to be dry. If they are wet, you have to |
|
|
Dry. Then you will need to shave the victim so that the patches stick well. If there really is hair in many places, then it's simple to apply.",English
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patches you have the designs like this and also the designs for the child I put in place as on the,English
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drawing honestly there’s nothing complicated. tak tak the idea is actually to make a diagonal by going through the,English
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"heart because the electric current will take the easiest, most direct path, so here we see that I am pretty much here, our electric current will",English
|
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|
"move to the level of the heart. then after that, that's it, we read and we listen to what it tells us so of course we never do cardiac massage, not even |
|
|
If you put on the electrodes, one of you places the electrodes, Loti continues the cardiac massage. Oh, if it's a child, I told them there might be a little...",English
|
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|
"Pediatric pad that ensures the AED and puts it like that, the electric shock will be a little weaker. And if a shock is delivered, it will start, we know, because the goal",English
|
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|
"To work in pediatric emergency care, it's not enough to have your heart on your sleeve—you also need to have a strong stomach. |
|
|
we are at Trousseau, one of the largest children's hospitals in France, in the heart of the 12th arrondissement of Paris. here the emergency room is overwhelmed: bronchiolitis, gastroenteritis, enteritis, broken arms,",English
|
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|
"Minor injuries, epidemics, or serious illnesses, healthcare workers are on all fronts.",English
|
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|
"In the emergency room corridors, we followed Aminata, the nursing assistant who must identify priority cases as soon as they arrive. Pierre-Michel, the nurse who always has a gentle touch for his little patients,",English
|
|
|
"and Thibault the doctor who never stops, who are the ones saving our children, how do the young patients and their parents react, secrets from behind the scenes of the pediatric emergency room.",English
|
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|
"Trousseau Hospital in Paris, it is 7 a.m.",English
|
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|
"Aminata the nursing assistant is ready to go to the front line. She is the one who welcomes the little patients and their parents as soon as they arrive at the emergency room. Okay, you haven't given any medication? No, I haven't given anything. It's the first time she |
|
|
Is she coming to our place? She felt unwell, tired, dizzy. What's her name? Norma. So what's happening to this pretty girl? Actually, she is [...] everything is happening here at the reception, we have the |
|
|
First to arrive among the children, we see them first, the nurses who have questions, for example, should I see this child before the other? Seeing them arrive and run away. |
|
|
and the priority this morning has just come in. ah, I didn't really follow him. a burn, okay, a burn. in a few minutes, a seriously burned child will",English
|
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"arrive with the emergency medical services. Aminata goes to welcome her. Hello. and open the resuscitation room, the room where the most serious cases are examined.",English
|
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|
"What is her temperature? Handy, 18 months old, has just burned his arm with a second-degree burn by spilling a pot of hot water. The whole team",English
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|
Medical staff is mobilized. There is crossfire by the mother with water. [...] The nurses must quickly,English
|
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"assess his condition. All this while keeping calm. The child's case is worrying, but there's no question of passing the stress on to the child and the mother. The emergency services leave; the critical case has passed.",English
|
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|
"You didn't give anything at home before? Yes, Doliprane. Did you take Doliprane? I gave him the Doliprane. Was it you? And the codeine? It was me. Thank you. The intervention in the resuscitation room only lasted ten minutes; here, we leave as quickly as possible. For the rest of the evening... |
|
|
Handy is transferred to the hospital's burn unit. At Trousseau, there are real emergencies like this one and minor injuries.",English
|
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|
"Is it mom who's telling me or is it you? It's mom. First recipes to treat them quickly, knowing how to talk to children like little Julia here. Three years old. Oh, three years old. You",English
|
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|
"Are you going to school? Are you on vacation now? Now it's not school anymore, it's vacation. Oh, that's good. Okay. So did you fall? Dad stretched me out. Stretched what? Stretched out? Twisted? Did you twist your arm? |
|
|
Julien comes for those who are called in the service the cost of the coat, a great classic. But he took off the coat, we were in the subway, very crowded, she was hot so we weren't in",English
|
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"a comfortable position, he had to, he pulled the sleeve like that, the arm maybe she wasn't ready, I don't know, they're rushing, and so he screamed and then she stays. it's a displacement of the elbow fluids that goes",English
|
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be fixed in no time. where does it hurt? is it your neck or the front? it's there. is it here? you hurt yourself.,English
|
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,English
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|
,English
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and then you just have to put them back in place so that. we'll see in the waiting room [...]. does it still hurt? there you go. a quick consultation and it's a,English
|
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,English
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|
,English
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,English
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,English
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,English
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,English
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the urine. to be able to analyze it afterwards. to avoid being contaminated by a virus,English
|
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,English
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,English
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,English
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eight years old. The little boy is epileptic. Hello Luc. So I am a doctor [...] pediatrician. So I am coming back to the story but I would like to start again with the little one,English
|
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,English
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,English
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,English
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[...] and does it always end with the scream or not necessarily? oh no no no oh la la la la la the IV no it's fine it's fine now.,English
|
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|
Epilepsy is a neurological disorder whose causes are poorly understood and for which treatments are not always effective. Luc's mother is powerless in the face of her son's illness. Things need to change.,English
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,English
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|
,English
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,English
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,English
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,English
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the possibility of a urinary tract infection has been,English
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,English
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,English
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I had to stop often. At night it was rather... [...],English
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,English
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,English
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,English
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,English
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,English
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It was really an extra spot. Call me because it's true that it's a bit complicated. The lack of beds is a recurring problem at the hospital. Looking for spots has become part of Thibault's job.,English
|
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"Over there, it's not a problem except when there are issues with nurses who are absent due to sick leave, so then it's necessary to close some",English
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"beds in the hospital, but then the problem is that when patients need to be kept... Luc and his mother will have to be patient. That's it. We're here, and then when will we be...",English
|
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"Past, as for what has gone up. There you go. It's normal. It will take Thibault two hours and the arrival of a temporary nurse in neurology to obtain the Holy Grail: a bed for Luc tonight. |
|
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it's quite a comforter. Thomas, 8 years old, has just arrived at the emergency room for allergies. he must",English
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"Have a blood test. And he's probably the only child who goes with a smile on his face. Did you know about the mask or not yet? Yes, I know very well. Are you sure? |
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Thomas has already seen this mask during a previous visit. Because he remembers the association he made. It's nitrous oxide, which is called",English
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"Also laughing gas. It relieves pain. Thomas is not going to sleep, just get a noseful and have unexpected reactions.",English
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"Do you feel like you're on the moon yet or not? Yes, on the moon. The effects of the gas are already being felt. The nurse will be able to work. No? |
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I’ll hold the mask, I don’t mind. In 5 minutes the operation is over. Thomas comes out of his dream, he’s a bit groggy. |
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How are you? Are you feeling better? Isn't that your bag, ma'am? Oh yes. Apparently the effects are lasting. |
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Raphaël arrived at the emergency room last night with pneumonia. The doctor is monitoring the progression of the illness hour by hour. And to listen to Raphaël's breathing, Thibault has his technique. You are going to blow on the sheet and do",English
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Like this. Daddy will hold the paper and you will blow.,English
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"It's better, we'll see. It's not certain that he'll go out tonight. We'll see in the afternoon, but it's not certain because we'll see how he is. Okay? |
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The long day of an emergency room doctor is not limited to examining children. It is 1 p.m., and instead of going to eat, Thibault tackles administrative tasks. |
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Among these enjoyable activities is coding, which allows each medical procedure to be billed to social security. I write a number that corresponds to a pathology—for example, here he has pneumonia. |
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so I coded the pneumonia. In addition, he has a neurological problem so I code this neurological problem. He had a fever so I code the fever. The nephritis, I code the nephritis. There you go, if I had only coded the pneumonia |
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And in the emergency room, there are certain procedures that are more difficult to code than others. Aurélien, 22 months old, is panicked. |
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Even the famous laughing gas has no effect on him, and all because of a strange ailment, a strangling hair. A very fine hair is wrapped around |
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his toe and by tightening it prevented the blood from circulating. as a result, it will need to be properly disinfected. yeah, it happens and that without even staying properly in bed. it's often like that. I'm going to cut my hair. |
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no you just have to well it's difficult but look at the useful sheets when you get back check if there aren't things, because the hair actually stays. this somewhat ridiculous pathology is not very |
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Running to the emergency room actually has a name, but what is it? Aura, I just want to know what it's called when children have a little hair wrapped around their toes? I have",English
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"Forgot the name. Me too. You too? Lucy? Oh yes, a question. When children have hair on their toes, what is that called? That's a good question. You too. |
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We will find it again. The tourniquet syndrome, as it is called, is making headlines all the way to the operating room. |
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pause. Is that fresh, does it look like a fruit salad? Are you sending papers? Really nice like the drawing. Is that it? How is it possible because you’re going to explain the meanings to me up close, I didn’t understand everything about the hair. We’re going exactly. He |
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wraps around the toe and then at first it's like you have, how to say... two wounds. as if you had, so it's not too tight at first, you see, but then it starts to tighten and as a result it makes |
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two little lumps, and then the little lumps get infected and they... turn blue. turn blue and it makes [...] in the next room, at the doctors' office, the case of Niels, the baby with a fever, is being debated. two schools of thought. at",English
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"On the right, those who are in favor of a thorough examination, and on the left, those who would have already sent him home. Me, I wouldn't keep him. A month? I wouldn't keep him. You wouldn't even have monitored him? We're not even at twelve hours of fever.",English
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"if he is perfectly fine... or can we keep him until the end of the day? can we wait for the temperature? wait! 37.9? yes! I had the impression that... yes, that's why, |
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As a precaution, we’re running some tests. As a precaution, we’re going to monitor him a little longer. As a precaution, we’ll call him back in tomorrow. But, you see... |
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The doctors' investigation is stalling; they are unable to establish a diagnosis. So it is accompanied by a senior pediatrician that Diana, the intern, returns.",English
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"auscultate Niels. [...] but what I am told, nothing came to me to hold on to. hello.",English
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"Niels is doing better. The results are in. His chest X-rays as well as his blood test are normal. Even better, his temperature has gone down.",English
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"What we’re going to do is re-check the blood test at the end of the evening, at twelve hours, around 9:30 p.m. If by then he hasn’t had a fever,",English
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"No more than 38, and as long as the blood test is still very good, you will go home. Does that sound better, ma’am? Yes, already just not being alone. We have bad memories here, so...",English
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"Mode is used to hospital stays. Her eldest daughter has been hospitalized several times, but this afternoon the mother, Denise, is smiling again—her son has a good chance of being able to go home tonight.",English
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"In the emergency room to pass the time, the trick is Marie Paule and her colleague Françoise; the two grandmothers are volunteers for the association ""Hand in Hand."" Once a week, they organize board games in the",English
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I like the greens.,English
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"what is my role? well, you see, it's to give games to the children so that everything calms down, so we try to give some to everyone so that no one misses out and then |
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they will talk a little with the parents when it’s really too long, we talk a bit with the parents too because it’s true that they spend two, three, four hours here. it’s still quite long. Marie Paule has been a volunteer for ten years. this former sales assistant |
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chose the emergency room to fight the retirement blues. it's the activity. it's to stay in motion with the world because, well, when you are |
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In retirement, you don't see many people, you're no longer part of social life, and over there you see, ah, you see people, you see the medical staff, you see all that, so for me it's interesting.",English
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"and even at the hospital, these grandmotherly reflexes are never very far away. Over there? Be careful with the canes because you’ve already broken their legs.",English
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"So you must not do that, be careful. In the emergency room, nearly 80 doctors and nurses take turns caring for the patients.",English
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"It is then that Aminata finishes her day. Pierre-Michel, the night nurse, begins his.",English
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"welcome to the lair. autonomy. the fact that they have much less staff, we work much more years",English
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"As a team anyway, even during the day, but let's say that now the team is much more united. I can still enjoy giving to the children fully, I see them, I take care of them, and I don't have much pain, we have days of...",English
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"rest indeed even if we work 10-hour days, this week we will do 50 hours, next week it's a light week, we do 20, so that still gives us some |
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free time, they allow for activities with the family. Thibault, meanwhile, continues his frantic race. |
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Apparently the night is shaping up to be tough. Taking a minute to gather strength beforehand, he would have started. |
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Here since 8 a.m. this morning, we started the shift with four beds left in the hallway, no more room for hospitalization, and apparently I still have plenty, I still have children. |
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Hospitalized and I don't have a spot for now. We'll reassess in an hour, so there you go. Isn't it too stressful? A bit. It is stressful, yes, on call, but afterwards we like it, we...",English
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"likes it too. If it were a paralyzing stress, well, I would have stopped, I would be doing something else. And actually, Thibault is going to get his fill of stress. Coming? Ah, one of the two.",English
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"Santiago is 19 months old. He is from Chile and is on vacation in France with his family, but his first visit to Paris is to the Trousseau emergency room. Is he allergic to any medications? No. Allergy?",English
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Food? No allergy? Food? No. He doesn't take any medication chronically? And he's never had asthma? The little boy is actually suffering from a,English
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asthma attack. his state of health is worrying. but Thibault barely has time to examine him when another serious case arrives in the resuscitation room.,English
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"Hello ma'am, are you the mother? I am the doctor [...] on call. This little girl is only two weeks old, and she is already having her second bronchiolitis. She is here for... some discomfort. She has been |
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Hospitalized for bronchiolitis, is that right? Okay. And when will she be discharged? Did she have blue lips? Did she have blue lips, ma’am? I’m asking you a lot of questions, it’s because |
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[...] they all come at the same time. positioning? no, but now this is getting ridiculous. how. |
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Not counting the patients' parents. We go faster, we don't stop. There are three doctors for 150 visits, so there you go. We try to go as fast as possible. |
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The problem is that Niels's veins are very fragile. To obtain the necessary amount of blood, it has to be done several times and in different places on the body.",English
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Mode is a good mother. Are you going to inject him again?,English
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"After the fourth attempt, the blood draw was successful. Results in two hours.",English
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"Night has settled over Trousseau. In the corridors, the tension subsides.",English
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"Anything goes to kill time. Blowing bubbles, or telling a little story. Here we go, the puppet show is about to start.",English
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"Number. That's what they say. Damn but what a country where you have to pay me. But what country, what, oh dear, it's tomorrow, stakes all over the body, the body finally becomes",English
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to have a little now my pharmacy or there or there where. but the break was only short-lived. the children affected by the bronchiolitis epidemic are pouring in. Pierre Michel,English
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"to fit out emergencies. stop. his serious, sometimes life-threatening emergencies are Pierre's daily routine |
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David is going to have an on-call weekend that will put all his experience to the test. It saves the patient's leg. This guy doesn't know he could lose his leg, so it has to work. He will have to save the knee of a young man blown apart by a blow from a... |
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rifle. Emilie is in her seventh semester of obstetrics and gynecology. During a shift, she is going to handle a cesarean delivery that does not |
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Has to keep calm, not easy after so many hours of work. Where does it hurt? Hm? |
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of a hematoma. To rule out a fracture, the young woman is immediately sent to the radiology department, under close escort. Paul, these are not very easy patients, especially at this hour, to restrain. |
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But still, you have to keep calm. You have to be rigorous because it's at that moment, at that hour of the night, that you miss things. What do you mean? It's too easy to miss a small fracture, a little patient who's not doing well.",English
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"On the head scan, we should have done the standard ones like that. Pain in the ankle, external malleolus, pain in the knees.",English
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"Half an hour later, Paul can confirm his diagnosis. Just a simple sprain, and no fracture. She leaves.",English
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"Alright, bye everyone. Bye bye. Paul has already been taking care of patients for twelve hours straight without really taking a break.",English
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"oh fuck it's slippery. well, now I'll have to go home by scooter. how much is there, how much is piling up there. I think it's 6 or 7 cm. |
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How horrible. It's definitely a rather creepy candle, I don't know if I'll keep it for very long, you know. It's past midnight, Paul can finally go home, but will he make it? |
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Still a long time to keep up this hellish pace? On a Sunday morning in the parking lot of the Conception hospital, David comes |
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To be called by Pierre, his resident. You can't plan anything on the weekend when you're not on call. Which was full of his stuff, including the white coat. Several emergencies are waiting for him in the operating room. |
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Alright, it's fine. Hello, hello, how are you? I'm not too late, am I? Tell me a bit, Pierre. It's a wound from what did you say? From glass, while opening a bottle.",English
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"a minor wound for this first patient, Justin, needs to be stitched up, a very manageable task for Pierre. But a phone call from another department of",English
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"The hospital is going to disturb this moment's tranquility. Pierre, there were 4 other people who left from there. |
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I’m going to see him again, I’m going to see him. You’re going to continue on your own. Not a second to lose, David must very quickly assess the seriousness of this new emergency. |
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This is a patient who is not mine, who is hospitalized in a ward and is having a hemorrhage, who was seen this morning and was not |
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in a critical condition and then it worsens considerably so we have to intervene, to put him between two patients in the operating room. hello. hello. I came to see this |
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Sir. I am making a ticket. Yes, I will take it. Absolutely. It needs to be taken back, it needs to be taken back quickly. To take it back, that means that |
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of this service. Because of a poor assessment, this patient who is experiencing significant bleeding is now in danger. An emergency that will disrupt this day, which seemed quite calm until now. Pierre last night and it is not |
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Not like that, the patient? But last night, I wasn't there. Given the state of his back, his hemorrhage didn't start five minutes ago. No time for David to catch his breath. [...] he must very quickly |
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clock out, sir [...] come on, it's very urgent. let him pay at Clément agency. I know it's not you, I know it's not you. I'm sorry but you're the one who's here. |
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it's a mess right now, I'm sorry. the situation is getting complicated for David; his patient, who is suffering from a hematoma, might have |
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cannot take. Like everywhere, sometimes there are outbursts, but we must not forget that we have patients' lives in our hands, so of course there is attention—even if we seem relaxed and joke among ourselves, the pressure and attention are still there, and then",English
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It's mainly because we're concerned about the patients. David and Pierre now just have to wait for the anesthetist's green light to operate. But a new emergency is going to complicate this day once again.,English
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I'm even afraid to redo the coudres. The coudres TF1 masters so much ardor when I haven't done worse. Maybe a moment to please. But say buttons.,English
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,English
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,English
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hasn't moved for almost 24 hours. Emilie must quickly reassure her as well as her husband.,English
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"Emilie will take a few minutes to get the ultrasound machine working properly again. The baby is head down... and to announce the good news to her patient. Oh, she moves a lot.",English
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"it's completely turned. well, that reassures me. do you feel it moving well? that's why... usually she moves like that. whatever stimulates it, in any case, it's a fetus. everything is fine, Emilie is going |
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to be able to practice taking measurements. she doesn't let it happen easily. and estimate the baby's weight. she's always tough. I'm not the only one who has a sense. I was thinking, well, maybe I'm not very skilled but I can't see it. |
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can't imagine anymore. but I think she's measuring something... something is going on anyway. I haven't... the baby wasn't Lucien either for himself but well, there you go, I'm already trying to",English
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"To get my bearings again, to redo on the ultrasound machine buttons. Emilie will have the rest of the night to regain her reflexes and rebuild her confidence.",English
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"I feel out of it. It will come back. She will have to hurry, an emergency delivery will require her intervention.",English
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"medical school, a little before 9 o'clock. Hayatte has been waiting for this day for more than ten years. Hello, the room for the theses please. |
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the thesis room, yes. we don't have a booth for that. the thesis room. M 47. M47? you go up there. you follow them.",English
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"If Hayatte is so tense, it's because in a few seconds her entire career will be at stake in this room. For 15 minutes, and not a second longer, her work will be scrutinized and judged by |
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made the trip to encourage him. against social. thank you for your attention. there is work, the presentation was of good quality. the mission is accomplished. despite the stress is |
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Probity. I will respect all people, their autonomy and their will without any discrimination based on their condition or beliefs. Even under duress, I will not use ignorance. |
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Thank you very much, the day is here. There you go. Have a good day as well. Goodbye. Jean speaking. |
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triangular like that. There, when you touch it, you can really feel the bump at the front of the skull that protects his forehead. If it is not removed, Alexis's brain will not have the necessary space to develop normally in his",English
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"Theory, he won't be the one handling the practical part. A senior will take care of it, but not just any senior. He's the specialist for the entire Brittany region. A stroke of luck for Jean.",English
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"who is regularly by his side. he wants to make the most of his experience. so we need to give him two frontal bumps. and set his eyes further apart. obviously, it's not complicated. |
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We are going to do the infiltration. To reduce the risk of hemorrhage when opening the skull, the senior doctor will inject a rather special product, a mixture of adrenaline and xylocaine, a mixture that must |
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to continue learning a surgery that fascinates him. Today, this is very interesting because we have to anticipate how the skull will reform and so that the... |
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He once again has a Biarrot skull that is not completely deformed, it's interesting and also of interest in pediatrics because you have to anticipate a result that we'll only see in 10 or 20 years. Good to know how to do the same. |
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Laugh, but [...] the faster it is, the less it bleeds. I don't know if I spent fifteen minutes, we'll see during the rehearsal of the |
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interventions if I really save fifteen minutes. It should go well for him, I think. You shouldn't say it too much, but he's off to a good start. |
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The operation is a complete success. A few weeks later, Alexis will return home with a remodeled skull. A skull that will now allow his brain to develop. |
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role was, so by trying to examine him briefly, by looking a little bit, what interests me is at the level of the abdomen, at the level of the lungs, by looking a little at his legs, that's what interested me, to see that there is no",English
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"Major somatic problems. Apparently not, I need to go back and check his blood test, review the brain scan he had. The brain scan won't show anything particularly concerning. Paul |
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therefore ruled out a medical emergency. But given the very agitated behavior of his patient, he will ask the team to restrain and isolate him for his own safety. As always, in such cases |
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The man must now be evaluated by a psychiatrist once he has calmed down. The team will administer sedatives to this patient, but for long minutes it will be necessary to endure his screams. |
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throughout the department. The door of the cubicle must remain open; it is the most effective way to remotely monitor the evolution of the patient's state of consciousness, and it allows",English
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"The whole team can continue to handle the emergencies that keep coming in. An effective method, but one that can become a bit burdensome for the entire department in the long run, especially for Paul, who is already quite exhausted mentally.",English
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"Sunday, 5 p.m., return to the Hôpital de la Conception. David's patient, who is suffering from a severe hemorrhage, can now go to the operating room. He has finally digested his breakfast. Anesthetized. |
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So, in general, it is possible. Like that. Initially, this man came to the emergency room following a scooter accident involving his calf. A completely shredded calf that had to be |
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bleeding on the horizon on that side. but after four hours of waiting, the small initial hematoma has taken on worrying proportions on his back. now it is necessary to intervene urgently, the |
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never tired. it's forbidden to say you're tired anyway, they call us weak [...] if we say we're tired. well, go ahead. if this could be the last one of the day",English
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"would be good. in my opinion, no... five o'clock is still early you know, we're on call until tomorrow at 8:30 a.m. so... knowing that tomorrow at 8:30 a.m. it's a normal day, we go straight into it. |
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Here, the suction and the scalpel are connected. First step, David has to evacuate all the blood trapped under the scar. You can put even more. |
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In the light, please? So we can see where it's bleeding. The second priority is to find the source of the hemorrhage, and David's state of exhaustion won't help.",English
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"there is nothing obvious. I don't see anything bleeding here. I wouldn't want us to go back there afterwards. I don't want to have to operate on him again tonight. it's vessels that bleed very little, after being sealed in the morning it starts to stop [...]",English
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"afterwards he can't find it anymore. isn't there something that's bleeding though? it tires me out. deep down, there's something. david finally managed to find the responsible vessel. there! a little thing there. that's the end of the operation. |
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Marcel, can you hand me the two staples [...] all that's left is to close the wound with a few staples, a fairly simple procedure that David has performed thousands of times.",English
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"we don't care [...] in an exceptional move, David is not going to finish the operation. Exhausted by his hours chained to the operating room, he hands over to Pierre, his resident. |
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and what is Bandol monitoring by stepping on it? the hemorrhage? in the operating room, a patient has reached the end of her pregnancy. but her baby's heart rate has been showing for a few",English
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minutes of significant anomalies. Problem: her cervix is not sufficiently dilated to allow a child to be delivered immediately vaginally. It is Emilie who performs this emergency cesarean section under the supervision of,English
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"All the staff in the operating room can finally relax, starting with Emilie's boss. Everything spotless. Everything went well. We didn't make any mistakes today.",English
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So today I’m launching this new video series with a scientist whose name might ring a bell.,English
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"Mr. Yohann Gregor Mendel. Mendel was simply the first scientist in the 19th century to have understood the transmission of genes,",English
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"the beginning of genetics, all that by observing pea plants. not bad, right? first of all, to really understand",English
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"this video I refer you to a more classic video about the human cell I advise you to have at least already watched and understood it, it will",English
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"help to understand some concepts that I will cover here in the video. but you marry here, it was on the next one and we’ll meet again in a few minutes",English
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"Okay, you watched the video, we can go, let's get started right after the opening credits for the first history segment. |
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Yohann Mendel was born on July 20, 1822, in Heizendorf. At the time, this territory belonged to Austrian Silesia. |
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to give you an idea about the time, in 1822 we are thirty-three years after the French Revolution. It is the year when Champollion finally manages to decipher |
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hieroglyphs thanks to the famous Rosetta Stone. It is also the birth year of Pasteur, the great scientist known for having developed, among other things, the |
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rabies vaccine. In 1820, life expectancy did not even reach 50 years; indeed, there were many childhood diseases for which there was no |
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treatment, so there are many losses among young children. Yohann has three sisters; he is the only boy in the family. His father Anton manages the family farm like |
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It was very common at the time, and her mother Rosina is the daughter of a famous gardener who already used to take care of wealthy families back then. Among her three |
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sisters, only a Rosina who bears the same name as her mother will manage to reach a more or less decent life expectancy for the time and will die |
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at the age of 40. In 1822, we are more than a hundred years before the discovery of antibiotics; the slightest injury can cause death. |
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in excruciating pain. For a farmer like Mendel's father, a single misplaced pitchfork blow and a cut on the big toe can",English
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"cause death by sepsis very quickly. Yohann Mendel is sent to school, which he excels at, and he is encouraged by his teachers to",English
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"to continue his studies at the university. Unfortunately, his father falls seriously ill during his studies, and the farm being the main source of",English
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"Financial income at the time. The family no longer has enough income, so not enough money to send Johan to university.",English
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Mendel therefore enters the monastery to become a monk because he hopes that the monastery can finance his tuition fees.,English
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It was common practice at the time for monks to be sent to schools at the monastery's expense. Mendel therefore entered the monastery as a monk.,English
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courses in agriculture and viticulture. In 1851 Mendel was able to attend classes at the University of Vienna. There he studied,English
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Mendel returns to his monastery with a good education to become a science teacher. And alongside his teaching activity he,English
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after studying the points Mendel will even become interested in hybridization and reproduction in mice but he will quickly,English
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reprimanded because the breeding of mice he does in his own room causes cleanliness problems in the monastery. in 1865,English
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,English
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in which he has lived for a long time. his new responsibilities take him a little away from his studies and his research.,English
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where his discoveries are actually rediscoveries and wolves have defined the famous laws of Mendel. still in the present day,English
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We speak of Mendelian transmission for many genetic traits transmitted by chromosomes. I am placing here around me a few links.,English
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to videos already made on similar topics that might interest you before moving on to the next chapter.,English
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,English
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two families of plants. The first had exclusively mauve flowers and the other had exclusively white flowers.,English
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the plants used came from pure line families this simply means that all the parents of all the plants used had,English
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Exclusively flowers of the same color. We can therefore deduce from these that all the plants possess two genes.,English
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exactly the same for several generations. during the first crossbreeding experiment between the pure lines of mauve flowers and the pure lines of,English
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white flower among the girls. Mendel will therefore carry out a new experiment by taking the plants obtained from this second generation,English
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which are therefore all with mauve flowers. He will cross them with each other again and then obtains interesting results on the new plants obtained three,English
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one out of four have mauve flowers but one plant out of four or 25% of the plants again has white flowers even though both its parents had,English
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Take up the different plants and I will note next to them the genes they have inherited. The mauve-colored plant has two copies of its gene for,English
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a copy of dominant genes and a copy of the recessive gene. And so it is the dominant gene that is expressed. The plant obtained after the first,English
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the genes lowercase a uppercase A and 25% of the plants that have the genes lowercase a lowercase a. in the case of,English
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plants that have at least one copy of the capital A gene express the purple color because it is dominant. for the plants that have both genes,English
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recessive a lowercase a lowercase the white color is found even though the parents had mauve flowers. this therefore clearly proves that,English
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the recessive white gene therefore appears to be in the minority even though it is indeed transmitted from parent cells to daughter cells. this discovery was already,English
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,English
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third law the third law of Mendel. Hold on because this one is a little bit more difficult to follow. Mendel then studies two families of,English
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is dominant as well as the smooth side of the peas. The white color and the wrinkled side of the peas are recessive. By breeding two plants,English
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and smooth peas. the characteristics of the second plant seem here to be completely absent. then by reproducing again between the plants thus obtained,English
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of the plant but two recessive genes in the texture of the grain. The plant is therefore mauve and the grain wrinkled. Three plants out of 16 have two genes,English
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recessive in the color of the plant and at least 1 dominant gene in the texture of the grain. The plant therefore appears white and the grain smooth. And finally a,English
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1 plant out of 16 possesses only the recessive genes and thus the plant appears white with wrinkled seeds. It is also interesting to note that if we,English
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three laws which are still used today in modern genetics. The first law is the law of,English
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,English
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,English
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gets only purple-flowered plants but which has a capital A gene for the purple color and a lowercase a gene for the white color.,English
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dominant and 25% of plants that have a recessive appearance. These different laws were then published by Mendel to general indifference.,English
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Still nothing about genes and chromosomes. That kind of experience obviously makes you think. When I see that I’m not even capable,English
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to keep an orchid alive for a few weeks. And today? Mendelian transmission of genes,English
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,English
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genetic transmission which also has recessive and dominant traits. There are several genes that explain an individual's eye color but we,English
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"is generally, however, dealing with the transmission of a dominant brown color or a recessive blue color.",English
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"but to study the transmission of its characteristics, we are faced here with a technical and somewhat ethical difficulty",English
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We must not hide it from ourselves. How can one calculate in advance the purity of a parent's chromosomes? It is certain that a person who has both,English
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blue at minimum. but it's for the parent with brown eyes that it's going to get complicated. so let's look at all these children,English
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"if all the children have brown eyes, we know that the parent with brown eyes actually had two dominant brown genes, and therefore all these children are",English
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"heterozygotes with one dominant brown gene and one recessive blue gene, their eyes appear brown. If, on the other hand, their brown-eyed parents actually have",English
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a recessive blue gene 50% of his children will receive his dominant brown gene and will therefore have brown eyes. and 50% of his children will receive his,English
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"blue recessive gene and since they will have two blue recessive genes they will have blue eyes. of course, I am trying to explain this to you in a way",English
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"Very simple, but as always in life, in science and in medicine, nothing is ever completely black or white. What I mean is that if both your parents",English
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"have blue eyes and you have brown eyes, you shouldn't necessarily cry adultery on the part of one of your parents. In 10% of cases, two parents |
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dividing the genes by half. As far as hair color is concerned, the transmission is more or less equivalent. |
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after the life of Gregor Mendel, which I told you about in a previous history segment that I am bringing back without warning and without notice |
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directly here in the upper left corner of the screen, I encourage you to watch it, today we are going to look at the life and work of a |
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Frenchman named Mr. Louis Pasteur. Louis Pasteur is considered the father of vaccination, he is credited with Pasteurization which bears his |
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Name is a great institute, the Louis Pasteur Institute bears his name in France. But do you actually know exactly who Louis Pasteur was? What are his |
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this new video is a second history segment on the channel, right after this little intro that you love—see you in a moment |
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Louis Pasteur was born on December 27, 1822, in the Jura region of France, just a few months after Gregor Mendel. Louis is the |
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third child of the Pasteur family. His father, Joseph Pasteur, was first a Napoleonic soldier and then he retrained in the |
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tannery, the production of leather from animal hides. Louis's mother, Jeanne-Etiennette Rocqui, is a housewife but she will play a major role",English
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"in the moral and civic education of her son. Moreover, Louis Pasteur would pay tribute to them in a letter where he says this: Your enthusiasms, my valiant mother, you have",English
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"passed on to me. If I have always associated the greatness of science with the greatness of the homeland, it is because I was imbued with the feelings you had instilled in me.",English
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"Inspired. And yes, it is said that behind every great man there is a great woman, and once again this time it seems to be the case. Louis Pasteur follows a",English
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"Training in classic necklaces at the Arbois college, a small town in the French Jura. At that time, he became especially known for his abilities in",English
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"painting. After some hesitation, he obtained the baccalaureate in literature and then finally the baccalaureate in mathematics on his second attempt.",English
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"He then enters the Sorbonne and then the École Normale. At this school, he focuses on physics and chemistry; he mainly concentrates on these subjects.",English
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"on the study of crystals, which is called crystallography. This period of her life is particularly important because it will allow her to",English
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"make many discoveries about the shape of molecules. In fact, the three-dimensional structure of a molecule makes it possible to determine its shape",English
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"and by knowing the shape of a molecule, one can deduce its possible interactions with other molecules, and therefore bodies that are more and more",English
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"bigger. It is moreover thanks to this work that he received his first medal for his work on molecular chirality. Well, don't you |
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Don’t worry, we’ll talk about that in the next chapter. After his studies, Louis Pasteur became a professor in Dijon, then in Strasbourg, and finally he became the |
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Dean of the Faculty of Sciences of Lille. In 1861 and 1862, Pasteur enabled science to make a great leap forward. |
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by categorically refuting the theory of spontaneous generation. Spontaneous generation is a completely crazy theory nowadays, |
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but which dates back to the time of Aristotle and has survived for more than two thousand years. Stay with me in the next chapter, we will talk about it, you will see. |
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Sequela: a weakness of the left side of the body, thus a weakness in moving and using his left hand. In 1882, he was elected to the Académie Française. |
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In 1885 he discovered the vaccine against rabies, a true phenomenon that would finally earn him recognition and posterity. |
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All over the world. If today you talk about Louis Pasteur or if someone talks to you about him, they will probably mention the rabies vaccine. |
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it is his most remarkable and well-known work. But there are many others, of course. Of this work of colors at the Pasteur Institute, which is based on |
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1888. Louis Pasteur died on September 28, 1895. His body, first laid to rest at Notre Dame, was then transferred to |
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also enormously interested in fermentation and mainly in fermentation in the context of wine. and yes, Mr. Pasteur is French. we will |
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talk about all that and the microorganisms he discovered in the next chapter as well. finally, know that Louis Pasteur married Marie Laurent in 1849 and that he had five |
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children, the youngest of whom was also named Louis Pasteur, was also a member of the Académie Française. Louis Pasteur's wife played a",English
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"big role in his career, that has never been denied, but as was often the case at the time, she lived very much in his shadow. That's all for this |
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first approach to the life of Louis Pasteur, you can notice it is notable to see that Louis Pasteur did not succeed at everything on the first try, by |
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for example, his bachelor's degree in mathematics, showing that nothing is ever set in stone, nothing is ever simple. anyway, this was to talk about",English
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"The man, now on board, including a bit of his discoveries, and for that let's begin the next chapter. Louis Pasteur's discoveries were numerous and in order to",English
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"To avoid making a video that could last more than four hours, I will limit myself to explaining the four main ones to you, at least in my opinion. Molecular chirality",English
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"Louis Pasteur worked a lot in chemistry on crystals. In this way, he was able to",English
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"solve a riddle from that time which was related to tartaric acid. Well, I’m not going to go into the details of this experiment, that’s not the point of",English
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this video but I will rather talk to you about molecular chirality. Molecular chirality is something very important in chemistry and,English
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"mainly in pharmacology, so it concerns me directly as a general practitioner. The principle of chirality is to say that a molecule",English
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Complexes often have several versions of themselves. These two versions of themselves are called isomers. In,English
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"crystallography when light rays are sent through a mixture of a single decision-maker, this mixture will deflect the light ray in one direction or",English
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"in the other. This is quite peculiar because when we have a crystal composed of only one desire, the light is deviated in one direction.",English
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"when a crystal is composed of the other isomers, the light is deflected in another direction. and when a third crystal is composed of the two islets but",English
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"At the same time, the light is not deviated. However, if in this crystal or in this solution you manage to isolate the isomers, you can recreate two",English
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solutions or different crystals that will in turn deflect the light. these two isomers are actually exactly the same molecule but two mirror images,English
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"of this same molecule. Okay, let me explain this to you with a slightly quirky metaphor, just the way I like them. Here are two people who look very much alike.",English
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"have the same genetic code and, let's say, the same appearance, they are made up of the same molecules, but here is what happens if you try to shake their |
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Hand. If you extend your right hand as tradition dictates, you will notice that only one of these people matches you. For the other |
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it is impossible to shake his hand, it seems logical, so we all agree that this example is particularly stupid. for the person |
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to whom you don't know how to shake the right hand, it would be enough to shake the left hand. yes, except that in the human body, that's not how it works. and to explain this to you, I will |
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to see it in this representation. To explain the images a bit more for you, here an isomer is said to be dextrorotatory when it deflects light to the right, and it |
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is said to be levorotatory when it deflects light to the left. Well, this technique is not of great interest here. This property of forming isomers is in |
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reality due to carbon atoms. Carbon atoms have four bonding sites and are therefore said to be asymmetric. Well, I won't elaborate.",English
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"much more on the subject because that's not the topic of this video, which is a history video after all, but if you're interested, don't hesitate to |
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leave a comment in the video and we will make a video about isomers, about carbon asymmetry, it's relatively interesting especially in",English
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"chemistry. and then believe it or not, but in general, out of the 2 isomers only one has an actual property, the other is useless",English
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"strictly nothing. Let's take the case of omeprazole for these. When you take a 20 mg omeprazole tablet, you are actually taking 10 |
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mg of dextrogyre omeprazole and 10 mg of levogyre omeprazole. This may seem quite crazy to you, but on the |
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One of the two omeprazole molecules can bind to its receptor and carry out its action, while the other, which closely resembles it but is its mirror image, |
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mirror therefore cannot bind to the receptors and is thus inactive in the human body. To conclude with the example of omeprazole, know that this |
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Dextrogyre isomer, which has no activity—it simply does not work, and the levorotatory isomer is the active molecule of the product. In fact |
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For your information, there is currently another molecule called esomeprazole, which is actually only the levorotatory isomer. |
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It is less well known, but Pasteur was also one of the first to discover yeasts, those famous microorganisms that I will probably talk about. |
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one day on the channel. In Pasteur's time, many studies already existed and numerous theories prevailed to explain certain processes of",English
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fermentation mainly in wine. Pasteur then discovers that certain microorganisms can survive without the presence of oxygen and thus he defines the,English
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"Anaerobic term. It then demonstrates that certain microorganisms can, in the absence of oxygen, consume sugar.",English
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"to form in exchange for alcohol. In this way, he describes the process of alcoholic fermentation. On the other hand, if the yeast is in",English
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"in the presence of oxygen, alcohol production will be much lower; this is called the Pasteur effect. In the time of Louis Pasteur, France was already",English
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"major wine producer of course, and there was what was called the wine disease. In reality, many microorganisms proliferate and at",English
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"inside the wine and could cause the formation of vinegar, which of course altered the quality and taste of the famous wine. Pasteur had the idea",English
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which seems simple today to heat the 20 to 57 degrees in order to kill the microorganisms that were present to promote its preservation and the,English
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"storage. This process of heating wine was simply called Pasteurization and it was used for a very long time, but since then it has",English
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"to give up for wine since the 1930s more or less and it was transposed to milk. and yes, now milk is pasteurized. and his work on",English
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Microorganisms also enabled Pasteur to make numerous discoveries about the transmission of diseases by microorganisms.,English
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"At that time, Koch, the famous scientist whom I will probably talk about in a future history segment, had already discovered the bacillus that bore his name and the",English
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"Research on bacteria was progressing well. At that time, a surgeon named Joseph Lister had read Pasteur's work on |
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on the surgeon's hands, on the tools used, and finally on the patient's wounds. Spontaneous generation |
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This chapter is going to seem completely crazy to you, but we absolutely have to talk about it, and to talk about it, let's go back more than 2,000 years to that time.",English
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"from Aristotle, then before the year zero of our era. At that time, scientific knowledge was of course very limited. Aristotle therefore proposed a theory to",English
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"the explanation of life on Earth. Under particular conditions, molecules can magically combine to form life. Aristotle indeed",English
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"noticed through repeated observation that after a certain time mold appears as if by magic on bread, moths appear in wool.",English
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Mice appear in old clothes that have been left lying around in a barn. And if you leave a piece of fresh meat lying on a table,English
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"You will see that as if by magic, after a few days maggots will come out of this meat. How can we blame Aristotle at a time when the",English
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"science did not even exist, he had the merit of making many observations and of finding a theory that explained things according to him, but above all that",English
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"allowed people’s questions to be answered. Because it’s important to understand that at that time, we are before most religions, we are before the year 0 of our era. And of course",English
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"At that time, since religions still did not exist, there was no official answer given to the appearance of man and living beings on",English
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"the earth. a few hundred years later, with the emergence of religions, answers will be provided which, a few hundred years after that, will still be",English
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swept away by science. But where the story gets completely crazy is that this theory of spontaneous generation from Aristotle lasted for more than two,English
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"A thousand years until the middle of the 19th century. In reality, it was in the 17th century that Redi and Spallanzani had already tried to refute",English
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"this theory, but without being able to prove it. And when a theory has existed for more than 2000 years, I can assure you that you need solid arguments.",English
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"to manage to disprove it. Barely 150 years ago, Pasteur succeeded in demonstrating that spontaneous generation did not actually exist, and this thanks to a clever",English
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"experience. According to him, the appearance of mice, moths in wool, or mold on bread is actually due to the transport of microorganisms.",English
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invisible to the naked eye in the surrounding air. This caused a huge upheaval at the time because the theory of spontaneous generation was,English
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"supported by prominent figures such as Georges Clemenceau, and it had existed for more than 2000 years. Several experiments had therefore been",English
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carried out over the years or decades to show that spontaneous generation did not exist. One of the first experiments was to place a,English
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"Piece of meat in a jar on which a filter was placed. But unfortunately, it was discovered that maggots still developed in the meat.",English
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"an argument for spontaneous generation. So later, experiments actually showed that flies are able to land on the filter, and",English
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"to lay their eggs directly in the meat, which led to the development of maggots. Then Louis Pasteur had an absolutely brilliant idea that allowed him to",English
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"finally officially refute the theory of spontaneous generation. For this, he used a swan-neck flask as you can see in this",English
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"representation. In this experiment, Pasteur places inside the flask a swan neck, a culture medium, and he does not filter the air, he does not blow the",English
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"culture. This experiment therefore proves that spontaneous generation does not exist, because even if the environment is excellent for the growth of microorganisms, nothing",English
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"develop there. This very simple experiment is particularly interesting because it is highly reproducible, which is one of the key points of the",English
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"science. It was therefore reproduced many times at the time and in most cases, no microorganisms developed in the medium of",English
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"culture. In reality, it is actually one of the key points of science; of course, an experiment must be reproducible and reproduced under conditions",English
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different to be validated. An experiment that gives an astonishing result but is impossible to reproduce is generally not validated.,English
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"by the scientific community. And in this case, reproducing this experiment is relatively simple. Take a swan-neck flask, put a medium",English
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"culture inside and see what happens. In many cases, nothing will happen at all. Well, actually, with a scientific eye",English
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"Today, Pasteur's experiments are far from being irrefutable and they are burdened with numerous flaws. But after all, let's be honest, who",English
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"Today, no one could still claim that the theory of spontaneous generation is a reality. No, don't answer, I'd rather not.",English
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"to know. Rabies vaccine as early as 1876, thanks to his work on fermentation and microorganisms",English
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Pasteur deduced that most contagious diseases are actually also caused by microorganisms and are not due to spontaneous generation either.,English
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"spontaneous. He thus becomes an important supporter of the germ theory of infectious diseases. In 1880, he even discovers Staphylococcus. Pasteur",English
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"then turned his attention to the process of vaccination, a step that had already been well underway by his English counterpart Edward Jenner but which had the drawback",English
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"to inject live viruses into his patients, this was not without side effects of course. Pasteur's discovery would be to succeed in attenuating the |
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virus that is sent into the patient, that is to say, removing its pathogenic power and reducing the negative reactions of the human body. Pasteur |
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discovers then that when old cholera colonies are injected into hens, not only do they not die but they also seem to be protected |
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against later illnesses, no matter cholera. And that's where he will create a new type of vaccine: he will take an attenuated virus to inject it.",English
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"to hens and create a vaccination reaction. In 1880, Pasteur managed to immunize a flock of sheep from the",English
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"anthrax, thanks to a vaccine of his own composition. In 1880, he also began working on rabies. After four years of experimentation",English
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on various animals Pasteur comes to the conclusion that an attenuated rabies virus can be obtained by exposing the spinal cord of a rabbit infected with the,English
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"Rage in the open air. In fact, this is the subject of one of the most famous illustrations of Pasteur that I am placing here for you; you have probably already seen this painting. His first two",English
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Attempts at vaccination on human beings—a man in his sixties and an 11-year-old girl—were not successful.,English
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"the young girl unfortunately died the next day from rabies, which seemed relaxed even before the vaccination. later, a young man who came",English
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"to be bitten by a rabid dog was taken to Pasteur, who administered his vaccine to him, and the young man survived. But at the time, it was difficult to prove.",English
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"that the dog was actually rabid and finally that it had actually transmitted it to the child, since they did not yet have the symptoms. to prove",English
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"the effectiveness of his vaccine Pasteur then injected the real rabies virus into the child, who also survived. He therefore concluded that his vaccine must have",English
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"market. And yes, obviously medical ethics in Pasteur's time were not the same as those we might have today. And of course at |
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At that time, vaccination against rabies and its principle were strongly contested, and numerous complaints were even filed against Louis Pasteur. |
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Welcome to this special State of Health program dedicated to the family doctor, a species on the verge of extinction. This family doctor whom we used to consult throughout our lives |
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and whom we could sometimes disturb day and night, who knew the whole family precisely, well, he almost no longer exists. So why? We will obviously try to understand this with all our guests. And then, what model will replace |
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this precious family doctor whom we will soon see only in films and books? We are going to talk about it with you, Dr. Marine Crest. Thank you for being with us. You are a general practitioner in Marseille, you founded |
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the association Guérir en mer, you will tell us more in a moment. Guérir en mer, we understand the idea, which supports caregivers who are victims of burnout. You told me that you had one yourself, but during your studies, and now, you help |
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Doctors, whether young or less young, perhaps, to combine professional life with personal life. And you were commissioned by the Ministry of Health in March 2023 to write a report on the health of caregivers. |
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Frédéric Valletoux, [...] Horizons deputy for Seine-et-Marne, rapporteur of the bill on access to healthcare that has just been adopted in the first reading in the Senate. It came out somewhat amended, not to say quite heavily amended, actually. |
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But you will tell us what your proposals are, specifically, to transform this profession of doctor that you know perfectly well. |
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Hello Arnaud Bontemps, thank you for being with us. You were in charge of the territorial organization of healthcare at the CPAM, the Primary Health Insurance Fund of Seine-Saint-Denis, in the midst of the Covid crisis. So, you must have obviously seen what it is |
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that health care is under strain. And you co-founded the collective Nos services publics to put the issue of public service at the heart of the political debate. Thank you, Maria Roubtsova, for being with us. |
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Economist, health project manager at UFC-Que Choisir, you have contributed to writing reports on medical deserts. And finally, Dr. Hamon, Dr. Hamon, we know you well. Uh, you have 50 years of practice. |
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Happy anniversary! 50 years of general practice in your office in Clamart, in the Paris region. Also honorary president of the Federation of Doctors of France, |
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You have long been a spokesperson for the general practitioners' union. Are you still seeing patients, by the way? —I practice full time, full time in a group of five general practitioners that was created in '52, at a time when the Medical Council considered |
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that it wasn't good to gather together. It was a doctor... -We'll come back to that later, but the gathering is obviously interesting. My doctor, Dr. Crest, the family doctor, is gone. |
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because these are professions that are, in my opinion, very feminized. Ten years ago, I did a program titled Health Investigation: The End of the Family Doctor. So it was one of the first programs, it was ten years ago. |
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I am still a general practitioner and I consider myself a family doctor. So if the question is: Are there no more family doctors?, I think the answer is: there are. But they are not the ones who were there before and they won't be the ones who will be there tomorrow.",English
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"There are the patients too, and then there are the generations, the generations that evolve. Even I sometimes have trouble communicating, understanding colleagues who are a little bit younger or a little bit older, because everyone actually integrates their profession into their daily life.",English
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"in a different way, with necessities, needs that evolve along with those of society. That’s what makes it a profession that changes. —A family doctor, a family doctor was generally a man, and it’s a model that is disappearing. It has become much more feminized,",English
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"The number of general practitioners today who say no to new patients? -Well, today, nearly half of general practitioners refuse new patients.",English
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"So it's particularly complicated to find a primary care doctor, especially since there have been announcements made by the authorities this year saying that they would find primary care doctors for patients, especially for patients with long-term illnesses who don't have a primary care doctor.",English
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"And the first thing Social Security did was write to patients who didn't have a primary care doctor, as if it were up to the patients to sort it out, even though patients today are facing a systemic shortage problem. |
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and so it's not often... Often, it's not for lack of willingness on the patient's part that they can't find a primary care doctor, it's due to lack of accessibility, depending on where you live, depending on whether the doctors are close to retirement,",English
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"Do they already have a large patient base? You have already, uh, summarized or mentioned some causes, obviously, such as the medical demographics, uh, with a severe shortage, uh.",English
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Let's pause for a moment for a brief historical overview. Why are there fewer and fewer general practitioners? Explanation.,English
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I suggested to the municipality that my wife and I work two days a week as employees to try to help out a little while waiting to find a successor.,English
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that there is a system in place to ensure that the mistakes of the past regarding concentration and fair distribution are not repeated. -By what means? -That is up to the profession,English
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And it is the regions that decide how many doctors to train and where they will be placed. So we can clearly see here that some countries have adopted systems that are extremely different.,English
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to nurses who are trained for that. -Is that your bill? -It's in another... -Certificates for sick children can be replaced... -The Senate added it.,English
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"-...it was adopted based on sworn statements. Interesting. Do you agree? -Well, there are many things, there’s everything related to administrative tasks, certificates, etc., indeed that’s something we absolutely need to revisit, it’s an incredible waste of time,",English
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"On the other hand, if the medicine of tomorrow is teleconsultations and so on, I’ll quit the job I’m doing because I need to touch people, examine them, talk to them. —You’ll still see them, you’ll still have patients. —It won’t be the same at all.",English
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"And I think that's a big loss of meaning in the profession. On the other hand, there's something we haven't discussed: the patient has a key role to play in this, and we don't talk much about prevention. We're not very good at that in France. There are a lot of teleconsultations for young people, etc. |
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are due to anxiety responses, a lack of health education training in the population as a whole, meaning that people are extremely anxious, especially since Covid, they need to be |
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even more assisted, listened to, and supported. It inevitably falls to the general practitioner, but also to other healthcare professionals. In terms of prevention, there is a huge amount of work to be done. We could limit access... Of course, yes! Everything related to health prevention, healthy eating, health through sports, |
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It doesn't necessarily have an impact at time T, but at time T+1, on all chronic diseases, etc. -If I understand correctly, doctor, to sum up, but if I'm wrong please tell me, prevention is so important that you agree to delegate certain tasks, |
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for example, a medical certificate at the beginning of the school year for children... - or the medical certificate, it has no legal value. -And even vaccines? Vaccines? The renewal of vaccines? -The delegation of tasks must be done in a bilateral and coordinated manner. Obviously, there are tasks |
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which are which are to be delegated to other people as long as it allows for prevention, obviously—Every time we wanted to move forward in that direction, we ran into endless battles; just remember the battle for pharmacists to be able to vaccinate, it was indeed a battle against, sorry, but the doctors' unions,",English
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"who were against it. Advanced practice nurses are fighting against the doctors' unions who are against it. Every time we have had the will to say: and we are going to, we are going to, we are going to try to organize |
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teams of care around the doctor... One could say it's not about marginalizing the role and place of the doctor... -And yet, it allows for better quality. For example, in a health center where I volunteer in Seine-Saint-Denis,",English
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"in which there is an advanced practice nurse who works alongside doctors, she has 1-hour consultations with her diabetic patients. The quality is immeasurable. The follow-up of patients... - Diabetics, etc., it is extremely effective task delegation,",English
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"with the doctor in the office next door... -Thanks to what? -...with professions that work together. -Why does that exist? -That's because we're detached from fee-for-service payment, because we accept task delegation, and because we have multi-professional structures, with professionals who work together.",English
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"-I would like us to... I would like... -To generalize this across all of France, and imagine the cost of what you are presenting here! Imagine that I have an advanced practice nurse who spends an hour with a patient. That would be wonderful, but who pays for it, and how much do you pay her?",English
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"And what premises do you have, you know? -So Doctor, I would like to present another model to you, you’ll tell me what you think because it’s quite striking. We’re going back to the Creuse, sorry. Because once again, it’s one of the departments most affected by our topic, in Ajain.",English
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"Well, here, the doctors are not grouped together, the doctors take turns, and they do one-week missions, and it's under these conditions that we manage to have a doctor in front of the patients. |
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Report by Marianne Cazaux. – It may be hard to believe, but sometimes it is easier to find 50 doctors than just one. In the village of Ajain, |
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In the Creuse, every week, the general practitioners come and go, and they're all different. -It's a lady, the doctor, today. It's a lady. She's very kind. |
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Under the supervision of the coordinators, the practitioners take turns to ensure access to healthcare for the residents of this medical desert. 1,200 patients have chosen this health center as their primary care provider. |
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-Ajain Medical Center, hello? I’m putting you through with another patient, but since it’s an emergency... When a job offer was posted, |
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I wondered what it was. It was quite curious. And, and we get into this because we tell ourselves that we're in an adventure where we're here to help, to find solutions, above all. |
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to not just stay there saying to ourselves damn, we have nothing. - More than 200 general practitioners have also joined the project of the Médecins Solidaires collective. The replacement schedule is full until January 2024. |
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when you come in here you never know how your night is going to be. [...] I really like what I do, but it's exhausting. I've only been here for 2 years, and I can't take it anymore. it smells strong here. there is",English
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"insects there, Sir. We have to hold on, because otherwise the hospital will shut down, and so it's the poorest who suffer the |
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Sir, hello, you are at the hospital. Do you have pain anywhere? Does your head hurt or not? In the |
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Head, does it hurt? In the chest, does it hurt? Okay, move your legs. Move both legs, please. Move your legs. |
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You see, Alicia, if you have a patient who doesn't respond, well, you see that they can't really do anything, you have to do the tests yourself to find out. So I... |
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I don't feel like it's obvious. Right now I'm asking myself the question because I'm holding up a little less well. Hold the leg, hold the leg. |
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the assessment, the MRI, the whole thing. Yes, hello madam, Doctor Girard in the emergency room of |
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See you in a bit, goodbye. So he's a management teacher at 70 years old, honestly.",English
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"stylish, there really are some stylish people in this world, but then you really think, the guy. she is very good, five hours ago, and now",English
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Maybe he'll end up being disabled for life or something. OK,English
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more serious part of the emergencies than the SAS and for now we have a patient who is and so now I have a terrible choice. do I put a young person from,English
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and then I am in a lot of pain. are you all alone at home? and you,English
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Do you manage the pavilion all by yourself? Do you cook for yourself? Yes. Are you completely independent? Yes. [...],English
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that movement there is going to hurt you a lot. when I try to get up when I am,English
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The savings required of him have drastically increased since 2016.,English
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guys I'm in the middle of... ah wait... who is scan? who other stuff? ok great,English
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I spoke with your daughter on the phone; she told me she could come to your place tomorrow but not this evening.,English
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"and at night you go to sleep, sir. I didn't sleep last night. It's not that I don't want to keep you, |
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It's that I can't. Do you understand that? I know you're hurting, that's what |
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I'll put your bag next to you, okay?",English
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It breaks my heart to come back.,English
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"the Saint-Denis patient base, well yes, there are",English
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there is a precariousness that means there are certain social situations that lead us to have to make decisions at times that are not just medical,English
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"but social. are you taking your shower or not, sir? does it smell strong there?",English
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"There are insects there, sir. It's the direct consequence of people who can't find a general practitioner, don't know what to do, are in pain, and so they come for a consultation. |
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because people don't come to the emergency room for fun, they never come here for pleasure. what kind of social coverage do you have?",English
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Nothing? I can give you the contact information of a social worker. It's much more important and much more complicated today.,English
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reinforcement of the reinforcement. the reinforcement of the reinforcement? or to house it in flesh so that the,English
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when you come in here you never know how your night or your day is going to be. I started at 9 p.m. I didn't,English
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"I worked, I moved around a lot in all directions.",English
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The salary for me should be proportional to the workload.,English
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"and it's not proportional. how many hours do you work? that's really the minimum, on average for me it's 40 to 60 hours |
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we’re leaving everything protected, I have my security, the patients are very, very |
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aggressive because, well, obviously since there is a lot of waiting before seeing the staff, so people get impatient and so, well, that's how it goes",English
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"quickly turns into insult, into violence, that's it. I think they go too far. I think it leads to a decrease in empathy. |
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People are less empathetic than before. Empathy is decreasing too, yeah, it feels similar with patients, that's actually how it is, you can feel it. I just...",English
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"Assembly line work is even more so because we don't have time to properly take care of the patient. Still, we remain conscientious in |
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our work, we are going to do things but we do them so quickly and so mechanically. we no longer take the time to talk with the patient and to |
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see if we have more time to see if he is getting better, why he is in these conditions, why he is like that, because sometimes psychologically for the patient his |
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I am wasting my youth here, we really love what we do, me |
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I really like what I do but it's exhausting and I've only been here for 2 years, and I just can't take it anymore, honestly I can't take it anymore. defense the link between us we |
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We're changing careers, we're going to open a restaurant, open a restaurant. Almost all of Seine-Saint-Denis is |
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classified as an advanced medical desert. There is one doctor for 990 people, whereas the French average is one for 676 people. The doctors in |
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Seine-Saint-Denis therefore potentially has to take care of a third more patients. Shortage of doctors across France: 100,000. The reason: too few places in medical schools. |
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In the last 10 years, governments have increased the number of admissions up to removing the quota limit, the numerus clausus, in 2021; the only drawback is that the |
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The effects of these decisions will not be visible for about ten years. As for the healthcare staff at La Fontaine hospital, 20% of nursing and care assistant positions are vacant. |
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If we compare with other European countries, the salary of French nurses is lagging behind. Spanish nurses are paid 32% more and German nurses 42% more. |
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As for the Belgian, it's 98% more. Under these conditions, it's not surprising that 99% of establishments in France report having difficulties in |
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to recruit. To curb the crisis, the government announced a net salary increase of 183 euros during the Ségur de la santé. But this is considered |
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Insufficient according to many healthcare workers given the working conditions, and it remains below the European average. |
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yesterday. and here it’s 4 in the morning, well at 5 |
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Morning. You are? The son. And you are? The daughter. Okay, I just wanted to clarify because we saw your dad yesterday. |
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fall. What we would actually like is for him to be able to stop going back and forth, and since he is actually in a neurology department, we can |
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language but he's a management professor at 70 years old in a business school, he was in class just earlier. it's sad. |
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in fact, the bleeding will subside. During this acute phase of a few days, he will stay in a specialized center to make sure that things |
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potential for recovery, who is going to get what. So there you have it, but well, a man who was still active until today—I still think that there is |
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hard to believe. how do you deal with the impacts of possible illnesses or elements within yourself? how do we manage, well, it |
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You always have to have a lot of humility because, in fact, the main person concerned is the patient, not me. Then you take a step back, meaning that I... |
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I always tell myself I witness the proportion of things like that happening—of course, we see it in a very condensed way in our profession, but it's...",English
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"in fact, in quotation marks, just the statistical share of sick people, we see it very closely in our work, so we manage like that, with a bit of balance of",English
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"How can I help you? Hello, I was calling to make an appointment, please. Yes, very well. May I ask your name and your...",English
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First name please yes so it's Lucmila Vakili okay could you remind me of your name please so V A K I L I okay,English
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give me your phone number please of course so it's 06 84 30 73 83 okay and an address if,English
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"so you like 182 avenue de Guéroult, alright, if however you had a scheduling conflict, would you be so kind",English
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to call us back so that we can give your appointment to someone else yes no problem very well thank you so Thursday at 6 p.m. perfect thank you very much see you,English
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"Goodbye Mrs. Vakili, have a nice end of the day, goodbye.",English
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"Hello, dental office of Doctor Celle Sous here, who is speaking, how can I help you? Yes, hello, I am calling because I would like to come in as I have very, very...",English
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"Toothache, okay. Could you describe the pain to me a little, please? Yes, well, actually, it’s been throbbing since last night.",English
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"It hurts me a lot when I drink cold water, it really won't stop even if I take painkillers. |
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Alright, indeed you are quite uncomfortable, the doctor will see you as soon as possible, we have an opening at 1 p.m., is that... |
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Does that suit you? Yes, it's perfect, thank you, very well. So I will take your name, please. So, Lucmila.",English
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"Vakili, agreed, and a phone number 06 84 30 73 83, very well, see you later at 1 p.m., Mrs. Vakili.",English
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"See you later, thank you very much, have a nice rest of the day, thank you and goodbye.",English
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"Hello, dental office of Doctor Celle Sous Icila speaking, how can I help you? Hello, I'm calling because I would like to be seen as an emergency. |
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today please yes what is happening to you so I have a very, very bad toothache all right does this pain bother you |
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For a long time, yes, for a while, but I waited and then it passed, and has this pain ever woken you up at night? |
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No, otherwise I would have come right away. Alright, we will take care of it. I will take your name, please. So it's Vakili, alright, and...",English
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"Could you give me a phone number please? Of course, it's 06 84 13 73-83. Very well, then we can receive you. |
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The day after tomorrow at 6 p.m., does that work for you? Before that, it's difficult. Listen, we will proceed with one thing: if you see that the pain seems...",English
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"we will receive you as soon as you call us, otherwise the doctor is able to devote more time to you as agreed the day after tomorrow, what do you think, but",English
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"Alright, very well, so see you the day after tomorrow at 6 p.m. Have a good rest of the day, Mrs. Vakili. Thank you, you too. Goodbye. Goodbye.",English
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