SEOUL, South Korea — It is the jewel of South Korea’s medical service: a 1,900-bed hospital of steel and glass owned by the famous Samsung conglomerate. It also is where a 35-year-old man whose symptoms were misdiagnosed as pneumonia languished for three days in an overcrowded emergency room and hallway, where he coughed up sputum teeming with the Middle East respiratory syndrome virus and exposed dozens.
韩国首尔——这是韩国医疗服务领域的一颗明珠：一座钢材和玻璃结构的医院，拥有1900张床位的，业主是著名的三星集团(Samsung)。也就是在这所医院里，一名35岁男子的症状被误诊为肺炎，在拥挤的急诊室和走廊里煎熬了三天。他咳出痰液中充满了中东呼吸综合征（简称MERS）的病毒，许多人因此暴露于病毒之中。
Doctors of the renowned hospital, the Samsung Medical Center in Seoul, were the first to confirm the disease, known as MERS, in another patient a week earlier but failed to detect the connection between the two cases. Investigators now say the misdiagnosed patient, awaiting a vacant bed in a general ward upstairs, wheezed and expectorated in common areas with no oversight, turning into a MERS “superspreader.”
这家著名的医院就是首尔的三星医疗中心(Samsung Medical Center)。早前一周，该院的医生最先在另一位MERS患者身上确诊了这种疾病，但他们未能发现两起病例之间的联系。调查人员现在说，这名被误诊的患者在普通病房楼上等待空床位时，没有人监护，他呼吸急促，而且咳痰，成为了MERS的“超级传播者”。The mistakes by the Samsung Medical Center are now the focus of much that has gone wrong to escalate South Korea’s MERS crisis, the worst outbreak beyond Saudi Arabia, where the disease first appeared in 2012. As of Tuesday, nearly half of all 162 confirmed MERS cases in South Korea have been traced to Samsung, historically regarded as the nation’s best hospital.
三星医疗中心犯的这个错误，现在成为了韩国MERS危机的焦点。这是除沙特阿拉伯之外，该疾病疫情爆发最严重的一次，它最早是2012年在沙特出现的。截至本周二，韩国162个确诊MERS病例中，有将近一半可以追溯到三星医疗中心。在大家眼中，它一贯都是全国最好的医院。
Several hundred of its patients are under quarantine in the hospital or elsewhere, either because their infections have been confirmed or they are under observation for symptoms. Nearly 300 of its 3,900 medical and other staff members are under similar quarantine. Other hospitals have refused to accept patients from Samsung for fear of infection. By Sunday, it stopped taking new patients as it struggled to prevent the virus from further spreading beyond its gleaming compound.
该院的数百名患者正在这家医院或其他地方接受隔离，要么是已经确诊感染，要么是正在观察症状。该院3900名医护及其他工作人员中，有将近300人也受到了类似的隔离。因为担心感染，其他医院拒绝接收来自三星医疗中心的患者。为了极力防止病毒进一步蔓延到这座光鲜的医院之外，这座医院到了周日已经不再接收新患者。“We offer our deep apologies to all MERS patients and those quarantined because of our employees,” said Song Jae-hoon, the president of the medical center, bowing before television cameras.
“我们向所有MERS患者，以及因为我院员工而受到隔离的人士，表达深深的歉意，”三星医疗中心院长宋在焄(Song Jae-hoon)说，并在电视镜头前鞠了一躬。Up until now, Samsung’s reputation for quality had gone unchallenged. South Koreans looked no further than its list of patients: Lee Kun-hee, the country’s richest man and the chairman of the Samsung conglomerate, has been hospitalized there, holed up in a 20th-floor V.I.P. room, since his heart attack last year.
在此之前，三星医院的口碑从未受到过挑战。韩国人一看到该医院的患者名单就信服了：韩国首富、三星企业集团会长李健熙(Lee Kun-hee)自去年心肌梗塞发作后，一直在该中心20楼的一个VIP病房里接受治疗。Nobody was surprised when Samsung diagnosed the country’s first case of MERS on May 20, attributing the discovery to its medical skills.
当三星在5月20日诊断出该国首例MERS病例时，没人觉得意外，还把病例的发现归功于该院的医疗技术。Calling Samsung a general hospital hardly explains its place in South Korea’s system.
说三星医疗中心是一家综合性医院，几乎无法解释它在韩国医疗系统中的位置。In South Korea, when a parent gets sick, it is widely considered a filial duty for the children to mobilize all connections to secure a bed in Samsung or at a few other mega-hospitals, including one run by another family-controlled conglomerate, Hyundai, that they believe provide the best care.
在韩国，人们普遍认为生病后，子女有义务动用一切关系在三星，或是其他几家大型医院弄到一张病床。韩国其他几家大医院中的一家，是由另一个家族企业集团现代(Hyundai)经营的。人们认为，这些医院提供的医护服务是最好的。When that strategy fails, patients are often taken into the hospitals’ emergency rooms, where they can wait for days for a bed in a general ward to be available.
这一策略失败后，患者常会被送到医院的急诊室。在那里，他们可能要等好几天，才能等到普通病房的一个床位。The Samsung hospital beds were usually filled, with 1,800 patients, with a long waiting list. Each day, 8,500 outpatients passed through.
三星医院的病床通常都是满员状态，住着1800名病人，还有很多人排队等着，每天还需要接诊8500名门诊患者。But it was not just the fame of Samsung that attracted patients. Medical service is so affordable under the country’s universal medical insurance system that “there is no threshold at hospitals,” said Kwon Jun-wook, a senior Heath Ministry official.
但吸引患者的，并不仅仅是三星的名气。韩国保健福祉部的高级官员权俊旭（Kwon Jun-wook，音）表示，在韩国的全民医疗保险制度下，医疗服务的成本完全可以承受，以至于“去医院根本没有门槛”。“Patients go to hospital as if they go shopping,” Mr. Kwon said, referring to the widespread practice of hospital hopping to get a second opinion or to get a referral to a mega-hospital, some of them with more than 2,000 beds.
“患者去医院就像去购物一样，”权俊旭说。他指的是人们为了得到重新诊断，或是转到大医院，而到不同医院就诊的普遍做法。部分大医院的病床超过2000张。Low medical fees also mean that hospitals must treat as many patients as possible to stay profitable. The big hospitals get more crowded as family members and private nurses they hired stay with patients, sleeping on cots between hospital beds. It is also important to social etiquette for South Koreans to visit hospitalized relatives, friends and colleagues, often with gifts like fruit boxes. Church members cluster around a patient’s bed, praying and singing.
医疗费用低也意味着，医院为了盈利，必须尽可能多地接诊患者。大医院更加拥挤，因为家属和他们雇来的私人护工会陪着患者，睡在病床之间的行军床上。对韩国人来说，看望住院的亲友和同事也是一项重要的社交礼仪。他们通常会带着水果礼盒等物品。教会的成员还会围在患者床边祈祷唱歌。The overall scene, as Koreans like to say, looks like a “flea market.”
就像韩国人喜欢说的那样，整个场面看着就像“跳蚤市场”一样。It is this overcrowded hospital condition that a World Health Organization mission said had made the otherwise modern South Korean hospitals particularly vulnerable to MERS. All those in the country who have the virus were infected in hospitals. Of them, 65 were relatives, friends or family-hired caretakers who contracted the disease while they were visiting or looking after hospitalized patients.
世界卫生组织(World Health Organization)的一个专家组表示，这种过于拥挤的就医环境，让其他角度都颇为现代的韩国医院，在面对MERS时特别脆弱。韩国所有的MERS病毒携带者都是在医院传染的。其中65人是病人的亲友，或是家人雇来的护工，在看望或照顾住院的病人时，感染了这种疾病。“The Samsung Medical Center is a national hospital in the sense that there are no regional boundaries in medical service in the country and everyone wants treatment there,” said Kim Woo-joo, head of the Korean Society of Infectious Diseases. “The MERS outbreak was a stress test of our medical system, revealing its problems.”
“韩国的医疗服务没有地域限制，从这一点来说，三星医疗中心是一家全国性的医院，所有人都想去那里治病，”大韩感染学会(Korean Society of Infectious Diseases)理事长金宇柱(Kim Woo-joo)说。“MERS的爆发是对我们医疗体系的一场压力测试，暴露出了它存在的问题。”At Samsung, the system began unraveling when the 35-year-old man, whom investigators called Patient No.14, arrived at its emergency room on May 27, a week after Samsung had discovered the first case.
在三星医疗中心，这套体系于5月27日，也就是三星诊断出首例病例的一周后开始崩溃。当时，被调查人员称作第14号患者的35岁男子，来到了三星的急诊室。Patient No.14 had been infected by the first patient when both were in the same hospital south of Seoul in mid-May. But neither he nor Samsung doctors had any clue he was infected. Unlike the first case, he had no record of having visited the Middle East.
5月中旬，因为与首例患者同处首尔南部的一家医院，第14号患者被对方传染。但这名患者和三星的医生，均未发现任何显示他已被传染的迹象。不同于首例病例，他没有去中东的经历。Samsung doctors diagnosed his case as pneumonia. But with no room in wards upstairs immediately available, he waited in the overcrowded emergency room for three days and sometimes loitered outside, investigators say.
三星的医生对他的诊断是肺炎。但调查人员表示，因为没能立即在楼上的住院部找到病房，他在过度拥挤的急诊室里等了三天，有时候还在急诊室外闲逛。It was not until May 29, when the Korean Centers for Disease Control and Prevention told them about the man’s possible link to the first case, that the emergency room doctors were alarmed, according to Samsung officials. By then, the man had become the biggest “superspreader” in the outbreak, infecting people in South Korea’s best hospital.
韩国官员称，直到5月29日，韩国疾病管理本部(Korean Centers for Disease Control and Prevention)告诉他们，这名男子可能与首例病例有关时，三星的医生才警觉起来。那时，该男子已经成了此轮疫情中最大的“超级传播者”，传染了韩国最好的医院里的人员。So far, a total of 162 MERS cases have been found in 13 hospitals, including 20 deaths. But before the disease was diagnosed, the patients also passed through 70 other hospitals, raising fears that they may have infected people there. In some train stations, the local authorities have used heat-detecting cameras to stop potential MERS carriers from entering their towns. More than 6,500 people are in quarantine or in self-isolation at home, many of them after visiting the Samsung hospital.
迄今为止，韩国总共在13家医院里发现了162例MERS病例，包括20例死亡病例。但在被诊断出该疾病前，这些患者还出入过其他70家医院。这让人们担心他们可能传染了那里的人。在一些火车站，当地政府为了防止MERS携带者进入各自的城镇而使用了温度检测摄像头。超过6500人处于隔离或在家自行隔离状态，他们中有很多人之前都去过三星医院。“What pains us the most is our failure to contain Patient No.14 at the Samsung hospital,” said Kwon Deok-cheol, a senior official at the government’s MERS response headquarters.
“最令我们痛苦的是，我们未能在三星医院隔离第14号患者，”一位名叫权德喆(Kwon Deok-cheol)的高级官员在政府的MERS应对总部说。Mr. Kwon said that the government planned to overhaul the country’s “hospital culture,” such as unrestrained visits. But critics also blamed a “Samsung-style management” for the crisis.
权德喆表示，政府打算改革韩国的“医院文化”，如无限制探望。但批评人士认为，“三星式的管理”也应为此次危机负责。