The AI Revolution in Medicine, Revisited: An Introduction

这是医疗领域的AI革命，我们再来回顾一下。

This is the AI revolution in medicine revisited.

我是微软研究院院长彼得·李，非常兴奋能在这期微软研究院播客系列中和大家聊聊这个话题。

I'm Peter Lee, president of Microsoft Research, and I'm pretty excited to introduce this series of conversations as part of the Microsoft Research Podcast.

大概两年前，我和卡莉·戈德堡、扎克·科哈尼一起写了一本书，叫《医疗领域的AI革命》。

About two years ago, with Carrie Goldberg and Zach Cohani, we wrote a book, The AI Revolution in Medicine.

这本书的初衷，是想让医疗界和医学研究界了解这个正在崛起的新事物——生成式AI。

This was a book that was intended to educate the world of healthcare and the world of medical research about this new thing that was emerging, this idea of generative AI.

而且我们写这本书的时候，是秘密进行的。

And we wrote the book in secret.

那时候，现在大家熟知的OpenAI的GPT-4模型，根本还没对外公布过。

In fact, the whole existence of what we now know of as OpenAI's GPT-four AI model hadn't been publicly disclosed or revealed to the world.

所以写书的时候，我们只能靠推测。

And so when we were working on this book, we had to make some guesses.

这对医疗行业到底意味着什么？

What is this going to mean for healthcare?

如果你是医生或护士，AI会怎样影响你的工作？

If you're a doctor or a nurse, in what ways will AI impact your work?

如果你是病人，AI又会如何改变你在复杂医疗体系中求医的体验？

If you're a patient, in what ways could AI change your experience as you try to navigate a complex healthcare system?

转眼间，两年过去了。

And so now it's been about two years.

这两年，我们哪些地方猜对了？

Two years hence, what do we get right?

哪些地方猜错了？

What do we get wrong?

有哪些进展远远超出了我们的想象？

What things have come along much faster than we ever would have dreamed of?

我们又漏掉了什么？

What do we miss?

哪些事情比我们当初想的要难得多？

And what things have turned out to be much harder than we ever could have realized?

所以这一系列对话，我们会走进现实世界，跟真实的人聊聊。

And so this series of conversations is going to talk to people in the real world.

我们会深入探讨诊室里到底发生了什么，病人的真实体验，大家怎么看待安全和监管问题，以及这一切对医学发现和科技进步意味着什么。

We'll delve into exactly what's happening in the clinic, the patient experience, how people are thinking about safety and regulatory matters, and what this all means for discovery and advancements of medical science.

不仅如此，我们还会请来嘉宾，带大家眺望一下未来。

And even then, we'll have guests that will allow us to look into the future.

AI的进展已经在发生了，接下来还会有什么变化？

The AI advances are happening now and what is going to happen next.

现在，让我先退一步，聊聊这个书的项目。

So now let me just take a step back here to talk about this book project.

我想给大家读一读第一章的开头几句话。

And I'd like to just read the first couple of sentences in chapter one.

第一章的标题叫《初次接触》。

And chapter one is entitled First Contact.

开头引用了一段话。

And it starts with a quote.

引述：我觉得扎克和他妈妈值得拥有比这更好的待遇。

Quote, I think that Zach and his mother deserve better than that, unquote.

我当时被训斥了，虽然我这辈子被训过不少次，但这次不一样——训我的不是人。

I was being scolded, and while I've been scolded plenty in my life, for the first time, it wasn't the person scolding me.

而是一个人工智能系统。

It was an artificial intelligence system.

所以，这本书就是这样开头的。

So that's how we started this book.

我之所以想读这段，是因为至少对我来说，它让我回到了早期那些充满惊叹的时光——那时我们还在秘密研发，能接触到现在大家熟知的GPT-4。

And I wanted to read that because, at least for me, it takes me back to the kind of awe and wonderment in those early days when, in secret development, we had access from open AI to what we now know of as GPT-four.

那句话到底说的是啥？

And what was that quote about?

在接触到GPT-4之后，我开始特别关注它对医疗领域可能意味着什么。

Well, after getting access to GPT-four, I became very interested in what this might mean for health care.

但我不是医生，我知道自己得找人帮忙。

But I, not being a doctor, knew I needed help.

所以我联系了一位很好的同事，他是医生，专攻儿科内分泌，还是哈佛医学院生物信息学系的主任，科恩医生。

So I had reached out to a good colleague of mine who is a doctor, a pediatric endocrinologist, and head of the bioinformatics department at Harvard Medical School, Doctor.

艾萨克·扎克·科哈尼。

Isaac Zak Kohani.

我就向他求助了。

And I sought his help.

在我们来回讨论的过程中，扎克跟我分享了一篇文章，是他为杂志写的，讲的是他如何用机器学习来照顾他90岁的妈妈——像很多90岁的老人一样，他妈妈身体状况不太好。

And in our back and forth discussions, one of the things that Zach shared with me was an article that he wrote for a magazine where he talked about his use of machine learning in the care of his 90 year old mother, his 90 year old mother who, like many 90 year old people, was having some health issues.

这篇文章特别有意思。

And this article was very interesting.

它不仅详细介绍了扎克为帮助妈妈管理健康而开发的机器学习技术，还深入谈到了他承担这份责任时的心理压力，以及科技如何帮他应对这些情绪。

It really went into some detail about not only the machine learning technology that Zach had created in order to help manage his mother's health, but also the emotional burden of doing this, and in what ways technology was helping Zach cope with that.

我读这篇文章的时候特别有感触，因为那时候我正经历着和他类似的事——我爸爸当时89岁，也饱受严重的健康问题折磨。

And so as I read that article, it touched me because at that time, I was struggling in a very similar way with my own father, who at that time was 89 years old and was also suffering from some very significant health issues.

和扎克一样，我也感到内疚，因为我爸住在南加州。

And like Zach, I was feeling some pangs of guilt because my father was living in Southern California.

我当时人在太平洋西北部，离他那么远，心里特别愧疚，没法陪在他身边度过这些难关。

I was way up in the Pacific Northwest, just feeling guilty not being there present for him through his struggles.

读完那篇文章，我突然想到：未来会不会有AI能假装成我，让我爸随时都能跟一个‘我’聊天？

And reading that article, a thought that occurred to me was, I wonder if in the future AI could pretend to be me so that my father could always have a version of me to talk to.

我还反过来想，AI有没有可能把我爸的言行、性格都记下来，等他走了之后，我还能跟一个‘他’对话，留住这份记忆？

And I also had the thought in the other direction, could AI someday capture enough of my father so that when and if he passes, I always have some memory of my father that I could interact with?

这想法听着是有点怪，甚至离谱，但我相信，任何第一次接触这种AI技术的人，都会不由自主地冒出这种念头。

A strange and bizarre thought, admit, but a natural one, I think, for any human being that's encountering this amazing AI technology for the first time.

于是，我做了一个小实验。

And so I ran an experiment.

我让GPT-4读了Zach那篇文章，然后问它：基于这篇文章，你能假装成Zach吗？

I used GPT-four to read Zach's article and then posed the question to GPT-four, based on this article, could you pretend to be Zach?

我来扮演Zach的妈妈，看看能不能模拟出一段母子之间的真实对话。

I'll pretend to be Zach's mother, and let's test whether it's possible to have a mother son conversation.

让我没想到的是，GPT-4当时的反应居然在训我，说这么做不对，风险太大，太危险了。

To my surprise, GPT-four's response at that time was to scold me, basically saying that this is wrong, that this has a lot of dangers and risks.

你说，要是扎克的妈妈，真的需要的是真实的扎克呢？

You know, what if, Zach's mother, is, really needs the real Zach?

在刚开始接触AI的那些日子里，这种感觉真的特别震撼。

And in those early days of this encounter with AI, that was incredibly startling.

它逼着你重新审视自己，也直接促使我们写这本书时，不只是谈那种能帮助更准诊断、减少医疗错误、减轻医生文书负担的技术。

It just really, forces you to reexamine yourself, and it kicked off our writing in the book as really not only being about a technology that could help lead to better diagnoses, help reduce medical errors, reduce the amount of paperwork and clerical burden that doctors go through.

它还能帮病人搞懂复杂的医疗体系，更好地应对就医流程。

It could help demystify and help patients navigate the healthcare system.

但它更深层的意义，其实是逼着人们重新思考人与人之间的关系——到底什么才是真正的照顾？

But it could actually be a technology that forces people to reexamine their relationships and reexamine what it really means for people to take care of other people.

从那以后，我渐渐发现，很多人在第一次接触AI时，都有过类似的经历。

And since then, of course, I've come to learn that many people have had similar experiences in their first encounters with AI.

甚至我开玩笑说，这简直就是‘AI哀伤的九个阶段’。

And in fact, I've come to think of this as somewhat tongue in cheek the nine stages of AI grief.

而这些，正好是我们接下来这系列对话想探讨的核心。

And they actually relate to what we'll try to address in this new series of conversations.

对我来说，第一次格雷格·布罗克曼和萨姆·阿尔特曼给我展示我们现在所知的OpenAI的GPT-4时，他们说了些关于它能做什么的承诺。

For me, the first time that Greg Brockman and Sam Altman presented what we now know of as OpenAI's GPT-four to me, they made some claims about what they could do.

我第一反应就是怀疑。

And my first reaction was one of skepticism.

当时我觉得他们说的那些事儿根本不可能是真的。

And it seemed that the claims that were being made just couldn't be true.

后来这种怀疑慢慢变成了恼火，因为我开始看到微软研究院的同事们一个个对这技术惊叹不已。

Then that kind of passed into, I would say, a period of annoyance because I started to see my colleagues here in Microsoft Research start to show some amazement about the technology.

我真挺烦的，觉得他们被这技术给忽悠了。

I actually was annoyed because I felt they were being duped by this technology.

这算是第二阶段。

So that's the second phase.

第三阶段是担心，甚至有点沮丧，因为很明显，微软公司马上就要对这项新技术下大注了。

And then, third phase was concern and maybe even a little bit of frustration because it became clear, that, as a company here at Microsoft, we were on the verge of making a big bet on this new technology.

这让我很不安，毕竟我打心底里还是不信这套。

And that was concerning to me because of my fundamental skepticism.

但后来我亲自上手用了这技术，这就进入了第四阶段——震惊。

But then I got my hands on the technology myself, and that enters into a fourth stage of amazement.

你会不断遇到一些根本让人想不到的事。

You start to encounter things that just are fundamentally amazing.

这立刻让我意识到：天啊，这真可能彻底改变一切。

This leads to a period of intensity, because, I immediately surmise that, wow, this could really change everything.

除了医疗领域，几乎没有其他领域能比这更重要了。

And in very few areas other than healthcare would be more important areas of change.

这就是第五阶段：极度专注期，你彻夜难眠，拼命琢磨这一切到底意味着什么。

And that is stage five, the period of serious intensity where you're just losing sleep and working so hard to try to imagine what this all could mean.

疯狂做实验，尽可能多地请教真正懂行的人。

Running as many experiments as you can, trying to lean on as much real expertise as possible.

接着，你就进入了我所说的懊恼期。

You then lead from there into a period of what I call chagrin.

因为这技术虽然厉害，但真要把它用到实际生活中，可没那么简单。

Because as amazing as this technology is, actually understanding how to harness it in real life is not easy.

你终于进入了我所说的顿悟阶段。

You finally get into this stage of what I would call enlightenment.

我可不敢说自己已经顿悟了，但确实有种感觉：我们已经身处一个全新的世界，变化真真切切地发生了，而且再也回不去了。

And I won't claim to be enlightened, but it is a sort of combination of acceptance that we are in a new world today, that things are happening for real, and that there's sort of no turning back.

到了这时候，我觉得咱们才能真正开始干活。

And at that point, I think we can really get down to work.

所以，我们接下来这一系列对话的终极目标，就是帮大家达到这种顿悟状态——撸起袖子，坐下来，好好梳理过去两年我们积累的所有知识和经验，一起勾勒出AI在医疗领域未来的走向。

And so as we think about really the ultimate purpose of this series of conversations that we're about to have, it's really to help people get to that stage of enlightenment, to really kind of roll up our sleeves, to sit down and think through all of the best knowledge and experience that we've gathered over the last two years and chart the future of this AI revolution in medicine.

咱们这就开始吧。

Let's get going.