I know it’s a little late in the day for it, but I want to start with breakfast. It was a Sunday in May 1990, final exam week of my first year in medical school. I was thoroughly tired of exams. Filling out another answer sheet with a number 2 pencil was the last thing I wanted to do. So I was thrilled to see the flyer on my desk for a breakfast seminar. Free breakfast and a lecture by Dr. Robert Mahley.

I went for the breakfast, but was nourished more by Dr. Mahley’s project, a population study of lipid metabolism in Turkey. Afterwards, I don’t know what possessed me, but I walked up to him and told him that in college I had studied lipid metabolism in elephant seals with Dr. Donald Puppione. Could I join his team and go to Turkey to take part in this research?

I remember the look on his face: who is this? But instead of laughing at my naiveté or doubting my ability, he took me on. That breakfast was the first step in my journey as a physician-scientist. Along the way, Dr. Mahley sent me to UT Southwestern, where I met Dr. Helen Hobbs. Since then, the two of them have supported every step of my career, including some challenging times, such as when I suddenly lost my husband, to discoveries that were exciting but very much counter to prevailing ideas. No matter how trivial or how difficult a problem, they were there to listen and advise. Through doubts, fears, and excitement, they were there. I am certain that without them, I would not be standing here today.

In those days, they knew, as I did not, that I was a future physician-scientist at risk. I might have become discouraged, or distracted, and quit research. But today, as a Council member, and this year, as President of the ASCI, I have spent considerable time thinking about the existential risks of physician-scientists.

Like many physicians working in academic centers, I was startled to learn how few of us there are: we make up less than 2% of US medical doctors (1). This number is based on a rather liberal definition of physicians doing research, in which research is not necessarily a major component of one’s effort. An increasing number of medical schools have abbreviated the basic science courses in their curricula. Perhaps more important, physician-scientists have virtually disappeared from the teaching arena of direct patient care. Today, practical nuances, such as documentation and charge capture, have displaced curiosity and understanding of patient presentations and disease pathophysiology. In response, many physician-scientists have retreated to the comfort zones of our laboratories; few of us have proactively stepped up to interact with students and residents in clinical settings.

With decreasing emphasis on basic science and having so few role models, how can we expect young people to want to become physician-scientists? Often, the brightest students most interested in science are those who are admitted to medical school. However, on the long path from medical school through residency, they often do not have any meaningful contact with role models, so even the most brilliant students cannot sustain that interest. In this climate, how can we expect physicians to play a key role in finding the root cause of disease? Who will bring the next infectious outbreak to the bench? Opportunities to develop treatments for nearly 5,000 diseases with known genetic causes will be deferred or lost. Even if we can provide accessible health care to everyone in our country, patients will still suffer from dementia, ALS, and many diseases of which we have little understanding. We cannot deemphasize research.

Of course, this is not a new problem. The term “endangered species” was used by Dr. James Wyngaarden to describe physician-scientists in the late 1970s (2). Since then, Drs. David Ginsburg, Robert Lefkowitz, Stuart Orkin, Leon Rosenberg, Andrew Schafer, and many others have discussed the declining number of physicians in research.

But what is new is our imagination fatigue. As I talk to colleagues, junior and senior, about physician-scientists, I have a growing sense that we are accepting the status quo rather than striving to promote the phenomenal science that we should bring to our patients. Often I hear that “the days of the triple threat are over” or that “today, one can no longer take care of patients and do research.” Many even say that it is not possible for an individual researcher to make major contributions, but rather that only teams can bring substantive advances.

I am not diminishing the importance of collaborations. Of course major discoveries are the culmination of many advances. But is it true that medicine and science have gotten so much harder?

I don’t think so. Instead, I suspect that we have simply accepted that it is much harder, only because we have been hearing that pessimistic refrain for so long. What we need to do is to imagine what is possible.

It is not that medicine or science has gotten harder, but rather the bureaucracy has gotten in the way, and the value system has changed. We accept the mounting administrative burden and rewards for medical procedures, rather than academic contributions. Others including Dr. Holly Smith have pointed out the unusual and complex arrangement in which medical education and research take place alongside the health care system. Research, education, and patient care have different goals. To evaluate their success with the same criteria can lead to the sense that individuals cannot participate in all three missions. Nevertheless, our Society has maintained an illustrious roster of physician-scientists for over 100 years; it is our responsibility to ensure its vitality. Let’s remember what we saw in our mentors who inspired us to become physician-scientists.We cannot sit and accept the stacks of reports on declining funding and the decreasing numbers of young physicians going into research. Instead, we have to fix them. The time is now. I think we all know what this “ideal situation” should look like. We do not need another study or report. We need to find practical and actionable solutions.

Today is the eve of the March for Science taking place in Washington, DC, and in cities around the world, including Chicago. We can take steps in our own march for science, starting right here. Let me share some steps, large and small, that I hope we can take together.

First, let me start with the boldest one: What if we have an independent fund to support young physician-scientists, especially at the transition from training to independence? Dr. Holly Smith referred to this period as “neonatal care.” He said, “In the biogenesis of a physician-scientist, one of the most neglected stages is that of the precarious transition into independence. This phase shift from training, which implies dependence, to independence as a scientist requires careful consideration and support” (3). So, let’s imagine a fund aimed to address this period of vulnerability. It will be coupled with mentoring, including strong commitment from advisors to help their trainees transition to independence. Sustained support should encourage our trainees to take on riskier and more challenging problems. The funding will be generous, but the bar will also be held high. This is a dream that several colleagues and I share; we are still discussing details. In the audience, if you are sitting on $1 billion, please talk to me. And for the rest, stay tuned and be a voice for funds for young investigators. We will need all of your support for this major step forward in our march.

Second, deans, department chairs, and division chiefs: fellows and young faculty have put their careers and therefore the future of biomedicine in your hands. The beginning of a career is the most difficult. Your encouragement of faculty can turn their worries into productive action. The intellectually stimulating culture and research support that you provide prompt a willingness to take on difficult clinical cases and challenging research questions. Research is accompanied by failures; your departments’ supportive environment can reassure our younger colleagues that each failed experiment is one step closer to a key finding. Most important, faculty pay close attention to how you judge them — whether it is by the amount of grant dollars, the number of clinical procedures, or the time spent to solve difficult cases and understand basic mechanisms. How you reward and/or compensate your faculty goes far beyond those individuals; it sets the value system for our community.

Even though we do not know exactly what fosters breakthroughs, we do know from academic pedigrees that excellence, curiosity, and creativity are contagious. Environments that demand critical thinking and true progress rather than incremental advances are important. Today, there is much uncertainty in funding for research and health care. In these times, an instinct may be to retreat to safer problems and use more conservative approaches, but these have long-term negative effects on science and medicine. Your leadership is critical at this juncture. Perhaps we can leverage this challenging time to encourage transformative changes on longstanding issues such as length of training, salary and compensation, as well as board and recertification requirements. Adversity does not have to hinder progress; we look to you for guidance and plans that invest in our futures.

Third, what can we do as the ASCI? We need to lead by examining the meaning of “honor” and “excellence” in selecting new members. It is easy for us to reward individuals by looking at discernible results, such as impact factors and grant dollars, rather than evaluating the process or the bravery in taking on difficult problems or spending time to understand a fundamental process that has no clear trajectory to disease treatments. We can either encourage a whole generation of physician-scientists who are good at scoring As or reward those who are committed to groundbreaking discoveries. The criteria we use in what Dr. Goldstein referred to as “mid-career checkups” (4) influence the composition of this room and the atmosphere of academic medicine. The Joint Meeting should be where everyone wants to come to hear the latest discoveries and meet the newest inductees — and not just a rite of passage. So let’s lead by carefully defining the meaning of “honor” in this honor society.

I just listed some big cultural changes that we have to make; there are also smaller steps that each of us can take, starting today.

Notice the students and fellows in this room, talk to them, show interest in their research and career plans, tell them to stay in touch, and check in with them from time to time. We like to say we offer a wonderful network. Demonstrate that by reaching out to our colleagues and young trainees.

Make sure our fellows and junior faculty have protected time and support for research. And if we notice they don’t, intervene for them, and don’t accept the less-than-ideal situation; help them to imagine and achieve the best.

Give to funds such as the Seldin~Smith Award or the Medical Fellows Fund that allow the ASCI to support young investigators. We need your financial support. We will be a good steward of your contributions. There is a table outside with information on ASCI programs that need your support; I hope you will stop by and make a contribution.

Come to the annual meeting regularly and encourage your colleagues to do the same — it’s a great time to catch up with friends, meet with mentors, and mentor the next generation. We cannot be a single voice for physician-scientists unless we act together. Consider the annual meeting a step in your march for science. A single march is not enough, nor is coming to the meeting only in the year of your induction.

Thank our hard-working staff and our Council members for their service. Every march needs good organizers. I, personally, have valued receiving their advice and expertise during my presidential year.

Fellows and students: your steps are the most difficult. Your responsibility is to work hard and excel. Like many others, I am going to tell you to follow your passion and remain curious. A question or a finding may be very cool at first sight, but for it to take root requires time and hard work. So start by finding an interesting topic, and then learn everything about it by reading, doing experiments, and talking to experts; in Dr. Michael Brown’s words, “be totally consumed by it” (5). Your strongest voice is showing excellence in what you do. Pick a reasonable set of things to do, and give it your all. Don’t be afraid to pursue hard problems, and don’t settle for anything less than excellence. This persistence will enable you to make discoveries that improve patients’ lives. You will find that these pursuits are intellectually gratifying and outright enjoyable.

I hope everyone in this room will refuse to accept the status quo, commit to doing something, and support each other’s efforts. We have to rekindle the same level of excitement that was present for those who started the ASCI in 1908. Fundamental research by ASCI members led to the development of drugs to treat heart diseases, stomach ulcers, and immune deficiencies. Later today, you will hear from three colleagues whose basic studies led to drugs for diabetes that benefited many millions of patients. It’s just the most recent evidence that our work is essential to America and the world.

Finally, let us be the generation that reverses the decline in the number of physician-scientists. We have to shed our imagination fatigue and take concerted actions together. I am confident that we can achieve this most important goal. Let’s march together; I count on each and every one of you to take bold steps to support physician-scientists.

Acknowledgments

I had the privilege of working with colleagues and friends who care deeply about physician-scientists. I wish to express my gratitude for their ideas, suggestions, and unwavering support. The enthusiasm and dedication of Mukesh Jain, Brian Kobilka, Robert Lefkowitz, Paul J. (PJ) Utz, and Tachi Yamada have motivated me to focus on building support for physician-scientists. I must also thank Victor Dzau, Kenneth (Kurt) Fischbeck, Frederick Ognibene, Marschall Runge, Holly Smith, and Andrew Schafer for their mentoring and advice. I thank Melanie Daub for many conversations and ideas on how we can improve support for trainees. Special thanks to members of my lab, in particular, Alan Bruzel, Colleen McGarry, and Isabel Wang, who sustain me by sharing their excitement and commitment to research. I dedicate this address to the memory of my husband, Richard S. Spielman, who taught me to “always be on the lookout for the presence of wonder” (6).

Footnotes

Reference information: J Clin Invest. 2017;127(10):3568–3570. https://doi.org/10.1172/JCI96939.

This article is adapted from a presentation at the 2017 AAP/ASCI/APSA Joint Meeting, April 22, 2017, in Chicago, Illinois, USA.

References

1. NIH. NIH Physician-Scientist Workforce Report, 2014. NIH Website. https://acd.od.nih.gov/documents/reports/PSW_Report_ACD_06042014.pdf Accessed August 17, 2017.
2. Wyngaarden JB. The clinical investigator as an endangered species. N Engl J Med. 1979;301(23):1254–1259.View this article via: PubMed CrossRef Google Scholar
3. Smith LH. Training of physician-scientists assessment of career outcomes. An address delivered at: Howard Hughes Medical Institute. 1995.
4. Goldstein JL. On the origin and prevention of PAIDS (Paralyzed Academic Investigator’s Disease Syndrome). J Clin Invest. 1986;78(3):848–854.View this article via: JCI PubMed CrossRef Google Scholar
5. Brown MS. November 7, 2014. How to win a Nobel Prize [Video file]. Retrieved from: https://www.youtube.com/watch?v=MdarocitY6k Accessed August 17, 2017.
6. Attributed to EB White.

我知道现在还有些晚，但是我想从早餐开始。那是1990年5月的星期日，这是我在医学院的第一年的期末考试周。我对考试完全厌倦了。我想做的最后一件事是用2号铅笔填写另一张答题纸。因此，我很高兴看到书桌上的传单参加早餐研讨会。免费早餐和罗伯特·马利（Robert Mahley）博士的演讲。

我去吃早餐，但是马赫利博士的项目对土耳其的脂质代谢进行了一项人口研究，为他提供了更多的营养。之后，我不知道我拥有什么，但我走到他面前，告诉他在大学里，我曾与唐纳德·普皮昂博士研究过海象中的脂质代谢。我可以加入他的团队并去土耳其参加这项研究吗？

我记得他的表情：这是谁？但是，他没有嘲笑我的天真或怀疑我的能力，反而接受了我。早餐是我作为医师科学家之旅的第一步。一路上，Mahley博士将我送往UT西南大学，在那里我遇到了Helen Hobbs博士。从那时起，他们两个人一直支持我职业生涯的每一个步骤，包括一些艰难的时期，例如我突然失去丈夫的那段时期，这些发现令人振奋，但却与当时的想法背道而驰。无论问题多么琐碎或多么困难，他们都会在那里倾听并提供建议。通过怀疑，恐惧和兴奋，他们在那里。我敢肯定，没有他们，我今天不会站在这里。

在那些日子里，他们像我以前所不知道的那样，知道我是一名未来的有风险的医师科学家。我可能会灰心或分心，然后退出研究。但是今天，作为理事会成员，以及今年，作为ASCI主席，我花了很多时间思考医师科学家的生存风险。

就像许多在学术中心工作的医生一样，我惊讶地发现我们中的人很少：我们只占不到美国医生的2％（1）。该数字基于对从事研究的医师的相当宽松的定义，其中研究不一定是一个人努力的主要组成部分。越来越多的医学院在其课程中缩写了基础科学课程。也许更重要的是，医师科学家实际上已经从直接患者护理的教学领域消失了。如今，实际的细微差别，例如文档和费用收取，已经取代了人们的好奇心以及对患者表现和疾病病理生理学的理解。作为回应，许多医师科学家已撤退到我们实验室的舒适区域。我们中很少有人主动加强与学生和居民在临床环境中的互动。

随着对基础科学的重视程度越来越低，而榜样却很少，我们如何期望年轻人成为医师医师？通常，对科学最感兴趣的最聪明的学生是那些被医学院录取的学生。但是，在从医学院到居住地的漫长道路上，他们通常与榜样没有任何有意义的联系，因此，即使是最杰出的学生也无法维持这种兴趣。在这种气候下，我们如何期望医生在寻找疾病的根本原因中发挥关键作用？谁将下一次传染病爆发带到替补席上？开发将近5,000种具有已知遗传原因的疾病的治疗方法的机会将被推迟或失去。即使我们可以为我们国家的每个人提供可用的医疗服务，患者仍然会遭受痴呆，ALS，还有许多我们还不了解的疾病。我们不能轻视研究。

当然，这不是一个新问题。James Wyngaarden博士使用术语“濒临灭绝的物种”来描述1970年代后期的医师-科学家（2）。从那以后，Dr。David Ginsburg，Robert Lefkowitz，Stuart Orkin，Leon Rosenberg，Andrew Schafer和其他许多人都讨论了研究中医师人数下降的问题。

但是新的是我们的想象力疲劳。当我与大三和大四的同事谈论医师科学家时，我越来越有一种感觉，我们正在接受现状，而不是努力促进我们应带给患者的非凡科学。我经常听到“三重威胁的时代已经过去”或“今天，人们再也无法照顾病人并进行研究了。” 许多人甚至说，单个研究人员不可能做出重大贡献，而是只有团队才能取得实质性进展。

我并没有降低合作的重要性。当然，重大发现是许多进步的结晶。但是，医学和科学变得如此困难难道真的吗？

我不这么认为。相反，我怀疑我们只是接受了这一点就困难得多了，只是因为我们已经听到这种悲观情绪已经存在了很长时间了。我们需要做的是想象可能的事情。

不是医学或科学变得越来越困难，而是官僚主义已经介入，价值体系已经改变。我们接受不断增加的行政负担和医疗程序的报酬，而不是学术贡献。包括霍莉·史密斯（Holly Smith）博士在内的其他人指出了医疗教育和研究与卫生保健系统同时进行的不寻常且复杂的安排。研究，教育和患者护理具有不同的目标。用相同的标准评估他们的成功可能会导致人们无法参加这三个任务。尽管如此，我们的学会保持着杰出的医师科学家名册已有100多年了。确保其活力是我们的责任。让我们回想一下在我们的导师中看到的启发我们成为医师科学家的东西。我们不能坐下来接受一堆堆积如山的关于资金减少和年轻医生参与研究的报告。相反，我们必须修复它们。就是现在。我认为我们都知道这种“理想情况”应该是什么样。我们不需要其他研究或报告。我们需要找到切实可行的解决方案。

今天是在华盛顿特区以及包括芝加哥在内的世界各城市举行的科学大游行的前夕。从这里开始，我们可以迈出自己的科学步伐。让我分享一些大大小小的步骤，希望我们能够共同努力。

首先，让我从最勇敢的开始：如果我们有一个独立的基金来支持年轻的医师科学家，特别是在从培训到独立的过渡中，该怎么办？霍莉·史密斯（Holly Smith）博士将这段时期称为“新生儿护理”。他说：“在医师-科学家的生物发生过程中，最容易被忽略的阶段之一就是the可危地过渡到独立。从暗示依赖的培训到作为科学家的独立这一阶段转变需要认真考虑和支持”（3）。因此，让我们想象一下一个旨在解决这一脆弱时期的基金。这将与指导相结合，包括顾问的坚定承诺，以帮助他们的受训者过渡到独立。持续的支持应鼓励我们的受训人员承担风险更大，更具挑战性的问题。资金将是慷慨的，但门槛也会很高。这是我和几个同事共同的梦想。我们仍在讨论细节。在听众中，如果您的资产为10亿美元，请与我交谈。接下来，请继续关注，并为年轻研究者争取资金。我们需要您的全力支持，才能在我们的前进中迈出重要的一步。

其次，院长，系主任和部门负责人：研究员和年轻教师已经将自己的职业生涯以及生物医学的未来掌握在您的手中。职业生涯的开始是最困难的。您对教师的鼓励可以将他们的烦恼变成富有成效的行动。您提供的具有智力刺激性的文化和研究支持会迅速地愿意处理棘手的临床案例和具有挑战性的研究问题。研究伴随着失败。您部门的支持环境可以使我们的年轻同事们放心，每个失败的实验离关键发现又近了一步。最重要的是，教师要密切注意如何判断它们-无论是拨款金额，临床程序数量还是解决疑难病例和了解基本机制所花费的时间。您如何奖励和/或补偿教职员工的能力远远超出了这些人。它为我们的社区设定了价值体系。

即使我们不确切知道是什么促进了突破，但我们确实从学术谱系中知道，卓越，好奇心和创造力具有感染力。重要的是需要批判性思维和真正进步而不是渐进进步的环境。如今，用于研究和医疗保健的资金存在很多不确定性。在这些时代，本能可能是退缩到更安全的问题上，并使用更为保守的方法，但是这些方法对科学和医学产生了长期的负面影响。在此关头，您的领导至关重要。也许我们可以利用这段具有挑战性的时间来鼓励在长期问题上进行变革，例如培训时间，薪资和薪酬以及董事会和重新认证的要求。逆境不必阻碍进步；逆境

第三，我们作为ASCI可以做什么？在选择新成员时，我们需要研究“荣誉”和“卓越”的含义。我们很容易通过查看可识别的结果（例如影响因素和拨款）来奖励个人，而不是评估过程或勇于面对棘手的问题或花费时间来了解没有明确疾病轨迹的基本过程，以此来奖励个人治疗。我们既可以鼓励全新一代擅长为As得分的医师科学家，也可以奖励那些致力于突破性发现的科学家。我们在Goldstein博士所说的“职业中期检查”中使用的标准（4）影响这个房间的组成和学术氛围。每个人都希望参加联席会议，以听取最新发现并会见最新入选者，而不仅仅是通过仪式。因此，让我们首先仔细定义这个荣誉社会中“荣誉”的含义。

我只列出了我们必须进行的一些重大文化变革；从今天开始，我们每个人都可以采取更小的步骤。

注意这个房间里的学生和同学，与他们交谈，对他们的研究和职业计划表现出兴趣，告诉他们保持联系，并不时与他们进行交流。我们想说我们提供了一个很棒的网络。通过与我们的同事和年轻学员接触来证明这一点。

确保我们的研究员和初级教师保护了时间和对研究的支持。而且，如果我们注意到他们不这样做，请为他们进行干预，也不要接受不理想的情况；帮助他们想象并取得最佳成绩。

捐赠诸如Seldin〜Smith奖或Medical Fellows基金之类的资金，这些资金可使ASCI支持年轻的研究人员。我们需要您的财务支持。我们将是您的贡献的好管家。外面有一张桌子，上面有需要您支持的有关ASCI计划的信息；希望您能为您做些贡献。

定期参加年会并鼓励您的同事也这样做-这是与朋友见面，与导师会面以及指导下一代的好时机。除非我们共同行动，否则我们不能成为医师科学家的唯一声音。考虑年度会议是您迈向科学的一步。仅仅进行一次游行是不够的，也不会仅在入职之年参加会议。

感谢我们的辛勤工作人员和安理会成员的服务。每次游行都需要良好的组织者。我个人很重视在总统任期内获得他们的建议和专业知识。

研究员和学生：您的步骤最困难。您的责任是努力工作并精益求精。像许多其他人一样，我将告诉您遵循自己的热情并保持好奇心。乍一看，问题或发现可能很酷，但要扎根，则需要时间和艰苦的工作。因此，首先要找到一个有趣的话题，然后通过阅读，进行实验以及与专家交谈来学习有关它的一切；用迈克尔·布朗博士的话说，“被它完全消耗掉了”（5）。您最有力的声音表明您的工作表现卓越。选择一组合理的事情，然后全力以赴。不要害怕追求棘手的问题，也不要为追求卓越而感到满足。这种持久性将使您能够发现改善患者生活的发现。您会发现这些追求在理智上令人愉悦，令人愉悦。

我希望这个会议室里的每个人都不会拒绝接受现状，致力于做点事情，并互相支持。对于1908年开始创建ASCI的人们，我们必须重新振作起来。ASCI成员的基础研究导致了开发用于治疗心脏病，胃溃疡和免疫缺陷的药物。今天晚些时候，您将从三位同事那里听到，他们的基础研究导致糖尿病药物受益，使数百万患者受益。这只是最近的证据，表明我们的工作对美国和世界至关重要。

最后，让我们成为扭转医师科学家人数下降趋势的一代。我们必须摆脱想象力的疲劳，并共同采取行动。我相信我们可以实现这一最重要的目标。让我们一起前进吧；我指望你们每一个人都采取大胆的步骤来支持医师科学家。

致谢

我有幸与深切关心医师科学家的同事和朋友一起工作。我感谢他们的想法，建议和坚定的支持。Mukesh Jain，Brian Kobilka，Robert Lefkowitz，Paul J.（PJ）Utz和Tachi Yamada的热情和奉献精神促使我专注于为医师科学家提供支持。我还必须感谢Victor Dzau，Kenneth（Kurt）Fischbeck，Frederick Ognibene，Marschall Runge，Holly Smith和Andrew Schafer的指导和建议。感谢Melanie Daub关于如何改善对学员的支持的许多对话和想法。特别感谢我实验室的成员，特别是Alan Bruzel，Colleen McGarry和Isabel Wang，他们通过分享他们对研究的热情和承诺来维持我的生命。我把这个地址献给我的丈夫，6）。

脚注

参考信息：J Clin Invest。2017; 127（10）：3568-3570。https://doi.org/10.1172/JCI96939。

本文改编自2017年4月22日在美国伊利诺伊州芝加哥举行的2017 AAP / ASCI / APSA联席会议上的演讲。

参考

1. NIH。NIH医生-科学家劳动力报告，2014年。NIH网站。https://acd.od.nih.gov/documents/reports/PSW_Report_ACD_06042014.pdf访问2017年8月17日。
2. 温加登（Wyngaarden）JB。临床研究者为濒危物种。新英格兰医学杂志。1979; 301（23）：1254–1259。查看此文章，网址为：PubMed CrossRef Google Scholar
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4. 戈德斯坦JL。关于PAIDS（麻痹性学术研究者疾病综合症）的起源和预防。J临床投资。1986; 78（3）：848–854。查看此文章，网址为：JCI PubMed CrossRef Google Scholar
5. 布朗女士。2014年11月7日。如何获得诺贝尔奖[视频文件]。取自：https : //www.youtube.com/watch?v= MdarocitY6k访问于2017年8月17日。
6. 归因于EB怀特。