《钱在哪儿》翻译第128页-130页

萨顿原则

我个人对人类的有一个间接的永久性贡献，叫做萨顿原则。整个英语世界的医学生都学习过。萨顿原则实际上应该属于威廉.多克医生，他是一位非常杰出的纽约医生。回到1960年左右，多克医生当时是国王郡（Kings County）医院的医学教授，同时也是耶鲁大学医学院的客座教授。在与学生和实习生一起进行研究时，他遇到了一位来自波多黎各的年轻女孩，她的肝病让耶鲁医生感到困惑。

注意到病人来自何处后，多克医生不假思索的说：“你们为什么不应用萨顿原则？”考虑到这些学生花费了大量的时间读书，他解释说当威利萨顿被问到为什么要抢劫银行时 萨顿回答说：“因为钱就在那呀。”

多克医生所作出诊断的要点是：常规的做法是进行全套的检查和X射线检测，这样可以简单的确定病人肝脏的问题，或许更糟糕的问题，这样医生就会花费更多的时间区分有相同疾病的症状。与其如此，检查病人的显著特征不是一个坏主意，即便它只是一个预感，我们也可以快速做出一个检查和判断。医生指出，这个女孩来自波多黎各，而那里有一种非常普遍的寄生性肝病，称为血吸虫病。

组织切片被送到病理学家手中，结果是阴性。好了，没有发现问题，事情回到了开始时的状态。除了下面这件事：其中有个学生对多克医生所说的逻辑印象深刻。他花了几个小时用自己的显微镜仔细地检测组织切片，发现了病理学家遗漏的细小的血吸虫卵。这些会让萨顿原则更加强大。当你有足够的理由支持你的直觉，你就应该使用全部的精力去找到答案。

如果不是两位耶鲁医生当时在训练现场，这件事情到此就结束了。这两位医生Robert G. Petersdorf和Paul B. Beeson正在研究一种命名为FUO的现象，这种现象让整个医学界感到困惑。发烧的病人高烧至101华氏度并持续超过三周，然后开始减弱。这些症状在很长一段时间里不断的让医生伤透了脑筋。一年以后，这两位医生发表了他们的医学论文，“不明原因发烧”。这篇论文目前还是该领域的经典之作。正是这篇论文，他们让萨顿原则流行起来了。他们所做到事情是收集了一百个最终得到诊断的案例，他们发现虽然所有的这些病例都有不寻常的其他特点，但是在最终的分析结果中，80%都可以划分为三种常见疾病的类别。“萨顿原则，”他们说，并永久的将这个说法变成了医学词汇，根据这个原则，首先根据发生的频度检测那三个明显可能的情况。这样，他们不仅仅有更大的机会做出正确的诊断，还可以尽快的做出诊断并挽救病人的生命。

5年后，Beeson医生成为了牛津医学院的教授，当他开始为他的英国学生讲解萨顿原则的时候，很快发现他的学生们不仅仅听说过萨顿原则，并且已经使用了多年。

使用银行劫匪的格言作为医学教学的工具即讽刺又复杂，我必须承认，事实上，我从未说过这个话。是那些有进取心的记者们，他们觉得有必要使用这个词汇充实他们的稿件，所以荣誉归功记者们。我甚至不记得第一次是什么时候读到它，好像在某一天它出现了，然后就到处都可以看见。

如果有人问过我，或许我说过。这也是几乎每个人都说的东西。就像多克医生说的，这再明显不过了。

是这样吗？

为什么我要抢银行？因为我喜欢，因为我热爱。但我在银行里进行抢劫的时候，我比生命中其他任何时候都充满活力。我是如此喜欢关于抢劫每一个环节，以至于1到2周后，我就会寻找下一个机会。对于我来说，钱只是筹码，就这样，它是奖金。从所有的逻辑上分析，我不断的抢银行是愚蠢的。我可能获得的收益远远抵不上我付出的代价。

如果仅仅因为相比我在外面试图进监狱，我在监狱里面花费了更多的时间尝试逃出去，事实上，我花费了更多的时间计划如何越狱。如果任何胆大的记者曾经问过我，为什么我要越狱，我估计我会这样回答：“因为我在里面。”但是，你要知道，经过多年周密细致的计划，在每个人的注视下，在这么小的成功几率下逃脱出监狱，会给你带来激动和陶醉的感觉，这世上再也没有别的东西可以和这种感觉相比。

原文：
Sutton’s Law
Medical students throughout the English-speaking world are taught something called Sutton’s Law, my one permanent contribution, however indirect, to the good of mankind. Sutton’s Law really belongs to Dr.

William Dock, a very distinguished New York physician. Back around 1960, Dr. Dock, who was then a professor of medicine at Kings County Hospital, was a visiting professor at the Yale Medical School. In making the teaching rounds with the students and interns, he came across a young girl from Puerto Rico who had a liver disease that had left the Yale doctors baffled.

Taking note of where the patient came from, Dr. Dock said, just off the top of his head, “Why don’t you apply Sutton’s Law?” For the benefit of those students who had been wasting their youth reading books, he explained that when Willie Sutton had been asked why he robbed banks Sutton had answered, “Because that’s where the money is.” The diagnostic point Dr. Dock was making was that instead of starting at the top and going through the whole routine of tests and X-rays—most of which would simply confirm that something was wrong with her liver or, even worse, force them into wasting more time checking out diseases which had the same symptoms—it wasn’t a bad idea to look for the obvious, even if it was nothing more than a hunch, and take a shot at checking that out first.

The girl was from Puerto Rico, he pointed out, and there was a parasitic liver disease quite common in Puerto Rico called schistosomiasis.

A tissue sample was sent to the pathologist. It came back negative. Oh well, back to the drawing board. Except for one thing. One of the students had been so impressed by the logic of what Dr. Dock had said that he spent several hours examining the tissue under the microscope on his own and, at length, detected the tiny eggs of the schistosome that the pathologist had missed. Which made Sutton’s Law even stronger. When you have a strong personal stake in your hunch, you are going to be especially diligent in pursuing it to the very end.

That would have been the end of that except that there had been two Yale physicians on that training round, Drs. Robert G. Petersdorf and Paul B.

Beeson, who were working on a phenomenon called FUO, which had the whole medical profession baffled. Patients with fevers of at least 101 degrees which persisted for more than three weeks, and whose symptoms continued to puzzle their doctors for a period of time after the fever began to subside. A year later they published their medical paper, “Fevers of Unknown Origin,” which is still considered a classic in its field. And it was in this paper that they popularized Sutton’s Law. What they had done was collect one hundred of these cases which had eventually been diagnosed, and they discovered that although all of the cases had unusual side features, eighty percent of them could be broken down, in the final analysis, into three categories of common diseases. “Sutton’s Law,” they said, putting the phrase permanently into the medical vocabulary, dictated that by checking these three obvious possibilities first, in the order of their frequency, they would not only have a far better chance of making the correct diagnosis, they would be able to make the diagnosis quickly enough to save the patient’s life.

Five years later, Dr. Beeson became a professor of medicine at Oxford, and when he started to explain Sutton’s Law to his English students, he was very quickly informed that they had not only heard of it, they had been applying it for years.

The irony of using a bank robber’s maxim as an instrument for teaching medicine is compounded, I will now confess, by the fact that I never said it.

The credit belongs to some enterprising reporter who apparently felt a need to fill out his copy. I can’t even remember when I first read it. It just seemed to appear one day, and then it was everywhere.

If anybody had asked me, I’d have probably said it. That’s what almost anybody would say. Like Dr. Dock said, it couldn’t be more obvious.

Or could it? Why did I rob banks? Because I enjoyed it. I loved it. I was more alive when I was inside a bank, robbing it, than at any other time in my life. I enjoyed everything about it so much that one or two weeks later I’d be out looking for the next job. But to me the money was the chips, that’s all. The winnings. I kept robbing banks when, by all logic, it was foolish. When it could cost me far more than I could possibly gain.

Actually, I spent far more time planning how to break out of jails, if only because I spent so much more time inside, trying to get out, than outside, trying to get in. If any enterprising reporter had ever asked me why I broke out of jail, I suppose that’s what I would have said: “Because I was in.” But also, you know, because there’s a thrill that comes from breaking out of jail, after years of the most meticulous planning, with everybody watching you, against all the odds, that is like nothing else in the world.