TED演讲：与极度不确定性共存的勇气！
字幕摘录
| 时间 | 英文 | 中文 |
|---|---|---|
| 0:05 | What's the worst that could happen? | 最糟糕的会发生什么? |
| 0:08 | Almost exactly 10 years ago, I was sitting in an exam room that was way too cold, waiting | 差不多10年前 我坐在一个太冷的考试室里 |
| 0:14 | to meet my new oncologist. | 来见我的新肿瘤学家 |
| 0:16 | I was terrified. | 我吓坏了。 |
| 0:18 | Even though my partner at the time was sitting right by my side, I felt completely alone. | 尽管我当时的搭档坐在我身边,我感到完全孤独. |
| 0:24 | I had just been diagnosed with breast cancer. | 我刚刚被诊断为乳腺癌 |
| 0:28 | And it seemed at the time that a single bright spot on a scan of my right lung meant that | 当时我右肺的扫描显示一个亮点 |
| 0:34 | the cancer had already spread. | 癌症已经蔓延了 |
| 0:37 | I had metastatic breast cancer. | 我患了发育性乳腺癌 |
| 0:40 | I had no medical training at this point, but I knew what it meant if it were true. | 此时我还没有接受过医学训练,但我知道如果是真的,那意味着什么. |
展开字幕全文（175 条）
| 序号 | 英文 | 中文 |
|---|---|---|
| 1 | What's the worst that could happen? | 最糟糕的会发生什么? |
| 2 | Almost exactly 10 years ago, I was sitting in an exam room that was way too cold, waiting | 差不多10年前 我坐在一个太冷的考试室里 |
| 3 | to meet my new oncologist. | 来见我的新肿瘤学家 |
| 4 | I was terrified. | 我吓坏了。 |
| 5 | Even though my partner at the time was sitting right by my side, I felt completely alone. | 尽管我当时的搭档坐在我身边,我感到完全孤独. |
| 6 | I had just been diagnosed with breast cancer. | 我刚刚被诊断为乳腺癌 |
| 7 | And it seemed at the time that a single bright spot on a scan of my right lung meant that | 当时我右肺的扫描显示一个亮点 |
| 8 | the cancer had already spread. | 癌症已经蔓延了 |
| 9 | I had metastatic breast cancer. | 我患了发育性乳腺癌 |
| 10 | I had no medical training at this point, but I knew what it meant if it were true. | 此时我还没有接受过医学训练,但我知道如果是真的,那意味着什么. |
| 11 | Incurable breast cancer. | 无法治愈的乳腺癌。 |
| 12 | Terminal breast cancer. | 终极乳腺癌。 |
| 13 | I was 27 years old, had just been accepted to medical school, and I wondered if I was | 我27岁,刚被医学院录取, 我想知道我是不是 |
| 14 | already at the end of my life. | 在我生命的尽头 |
| 15 | My new oncologist was not a warm person. | 我的新肿瘤学家 不是一个温暖的人。 |
| 16 | She dealt in simple facts, as many brilliant physicians do. | 她只处理简单的事实,就像许多杰出的医生一样。 |
| 17 | Our body is made up of cells, she started. | 我们的身体是由细胞组成的, 她开始。 |
| 18 | I stopped her. | 我拦住了她。 |
| 19 | I'm starting medical school soon. | 我马上就要上医学院了 |
| 20 | I know. | 我知道,我记得 |
| 21 | Instead of taking this as a signal to go backward, to start again, she went forward. | 而不是把它当作一个向后走的信号, 重新开始,她向前走。 |
| 22 | She said that I would need to start on chemotherapy to control the cancer. | 她说我需要开始化疗 控制癌症 |
| 23 | She launched into the details of the drug and the side effects and the schedule. | 她把药物的细节 副作用和日程安排 |
| 24 | I reminded her that we hadn't even yet biopsied the bright spot on my lung, and I asked if | 我提醒她,我们甚至还没有生化 在我的肺的亮点,我问 |
| 25 | she was sure that it was cancer. | 她肯定这是癌症 |
| 26 | I remember viscerally how she seemed almost frustrated with my question. | 我清楚地记得她对我的问题 似乎几乎感到沮丧 |
| 27 | Perhaps she thought I wasn't following along with her explanations, or worse still, I was | 也许她以为我没有听从她的解释 或者更糟糕的是,我是 |
| 28 | in denial. | 在否认。 |
| 29 | I simply wanted her to understand that as her patient, that biopsy was not just a mere | 我只是想让她明白 作为她的病人, 活检不只是一个简单的 |
| 30 | formality to prove an already foregone conclusion. | 证明一个已经放弃的结论的手续。 |
| 31 | It was a steel needle through skin, muscle, and bone that would deliver a deep piece of | 它是一个钢针 通过皮肤,肌肉,和骨骼 将传递一个深的一块 |
| 32 | me to the surface and answer a question I wish didn't have to be asked. | 回答一个问题 我希望不用问 |
| 33 | Before the biopsy, I could be a 27-year-old woman who might have metastatic breast cancer, | 在做活检之前,我可能是一个27岁 可能患有运动性乳腺癌的女人, |
| 34 | who probably had metastatic breast cancer. | 可能患了运动性乳腺癌 |
| 35 | This is a critical distinction, but it's not one that's emphasized in the most elite oncology | 这是一个关键的区别, 但这不是一个强调 在最精英的肿瘤学 |
| 36 | training. | 培训。 |
| 37 | Instead, I was dismissed with an appointment to start treatment in just a few weeks. | 相反,我被辞退了 预约在几周内开始治疗。 |
| 38 | So much has happened since that first visit. | 自从第一次访问以来,发生了许多事情。 |
| 39 | Ironically, the biopsy was not just a mere formality. | 具有讽刺意味的是,活体检查不仅仅是一种形式。 |
| 40 | My former oncologist was right. | 我之前的肿瘤医生是对的 |
| 41 | It did show cancer, but it was a totally separate lung cancer. | 它的确显示出癌症,但它是一个完全独立的肺癌。 |
| 42 | And as crazy as it sounds, this was great news. | 听起来很疯狂,这是个好消息。 |
| 43 | I did not have metastatic breast cancer. | 我没患过乳癌 |
| 44 | I had two different cancers, but both of them were localized. | 我患了两种不同的癌症, 但它们都是局部的。 |
| 45 | And so the lung cancer was localized enough that it could be removed. | 所以肺癌已经足够局部化,可以去除。 |
| 46 | And so the onslaught of treatments began with a lung surgery, continued with chemotherapy, | 治疗的冲击始于肺部手术 继续化疗 |
| 47 | and ended with a breast surgery just after my 28th birthday. | 最后在我28岁生日后做了乳房手术 |
| 48 | And then two weeks later, I started medical school. | 两周后,我开始了医学院。 |
| 49 | My new oncologist, who deals much more fluidly both with facts and their implications, very | 我的新肿瘤学家, 他更流畅地处理 事实及其影响,非常 |
| 50 | reasonably suggested that I should defer my acceptance to medical school for a year, | 合理建议我推迟一年接受医学院录取 |
| 51 | take some time to rest, to recover. | 需要一些时间休息, 恢复。 |
| 52 | And I trusted her advice. | 我信任她的建议 |
| 53 | I felt terrible during the intensive chemotherapy sessions. | 在强化化疗期间我感觉很糟 |
| 54 | And so I wrote to the dean. | 所以我写信给院长 |
| 55 | I explained my circumstances, and a deferral was speedily granted. | 我解释了我的情况, 并迅速批准了延期。 |
| 56 | But as the chemo fog lifted, I wondered what I was going to do with a year. | 但随着化疗雾的解除,我想知道我要用一年的时间做什么。 |
| 57 | Should I go to the beach? | 我应该去海滩吗? |
| 58 | I wasn't really a beach person. | 我不是一个真正的海滩人。 |
| 59 | And how many years did I have left anyway? | 我到底还剩多少年? |
| 60 | I really wanted to go to medical school. | 我真的很想上医学院 |
| 61 | It seemed like a missing piece of my puzzle. | 这似乎是我拼图中缺失的一块 |
| 62 | So instead of going around and around with indecision, I asked myself, | 因此,我不再犹豫不决,而是问自己: |
| 63 | what's the worst that could happen? | 会发生什么最糟糕的事? |
| 64 | Well, I could be too weak or too sick to do the work. | 好吧,我可能太虚弱或太病 做工作。 |
| 65 | It could be too hard for me emotionally. | 这对我来说可能太难了 |
| 66 | I could fail out of medical school. | 我可能从医学院退学了 |
| 67 | But then I remembered that wouldn't be the worst thing that happened to me even that year. | 但后来我记得,那不会是 最糟糕的事情 发生在我身上,即使当年。 |
| 68 | So why not get started? | 那为什么不开始呢? |
| 69 | Why not continue living the way that I wanted to live? | 为什么不继续像我想的那样生活? |
| 70 | 所以我就这么做了 And so I did. | |
| 71 | Bald and real thin, I put on my best earrings and my favorite dress. | 我穿上我最好的耳环和最喜欢的裙子 |
| 72 | And I started. | 我开始了。 |
| 73 | I pretended to belong. | 我假装属于我 |
| 74 | And I began to. | 我开始了。 |
| 75 | There is no way to describe how hard it was. | 无法描述这有多难。 |
| 76 | Some days it felt impossible. | 有时候感觉不可能 |
| 77 | It felt as if I was doing things that would never matter in the future. | 感觉好像我在做 未来永远不会重要的事情 |
| 78 | But every day I asked myself, are you still enjoying this? | 但我每天都问自己 你还喜欢这个吗? |
| 79 | Is this still what you want to be doing? | 这还是你想做的吗? |
| 80 | And every day the answer was yes, sometimes a very qualified yes, but a yes. | 每天都有答案是肯定的,有时是非常合格的是肯定的,但是是肯定的。 |
| 81 | And then just as I was getting comfortable and feeling like I might not necessarily fail out of medical school, | 然后当我感到舒服和感觉 可能不会失败出医学院, |
| 82 | I received even more devastating news. | 我收到了更毁灭性的消息。 |
| 83 | I learned that I had a mutation in a gene called TP53, or P53 for short. | 我得知我有一个基因突变 叫做TP53, 或P53的简称。 |
| 84 | Known as the guardian of the genome, a mutation, P53 is responsible for supervising the repair of our DNA. | 作为基因组的守护者,一个突变体,P53负责监督我们的DNA的修复. |
| 85 | A mutation in this gene means errors go uncorrected. | 这个基因的突变意味着错误得不到纠正. |
| 86 | It means that normal cells become cancerous at a much higher rate. | 这意味着正常细胞以更高的速度成为癌细胞. |
| 87 | All of a sudden, with this knowledge, my medical history made a terrible kind of sense. | 突然间,凭着这种知识,我的病史有了一种可怕的道理. |
| 88 | 我7岁时得了儿童癌症, rhabdomyosarcoma。 | |
| 89 | It recurred when I was a teenager. | 我十几岁的时候就再现了 |
| 90 | And this was all before P53 had been discovered in the lab. | 这都发生在P53在实验室被发现之前。 |
| 91 | Then I'd had young adult breast and lung cancers. | 然后,我患上了年轻的成人乳腺癌和肺癌。 |
| 92 | With the knowledge of this mutation, it seemed that there was likely no end to the number of cancers that I could expect in my future. | 由于对这个突变的了解,似乎我在未来可以预期的癌症数量可能没有结束. |
| 93 | And yet, I decided to become a radiation oncologist. | 然而,我决定成为一名放射肿瘤学家。 |
| 94 | I hope to graduate from residency in just a few months, | 我希望几个月后从居住区毕业 |
| 95 | move to a new city and start my first real job as a doctor and researcher. | 搬到一个新城市 开始我的第一个真正的工作 作为医生和研究员。 |
| 96 | 因为Grit。 | |
| 97 | Because of privilege. | 因为特权 |
| 98 | Because of therapy. | 因为治疗。 |
| 99 | Because of my medical teams and my family and my teachers. | 因为我的医疗队 我的家人和老师 |
| 100 | Because genetic diagnoses should give us the knowledge to move forward. | 因为基因诊断应该给我们 知识前进。 |
| 101 | And even in the year 2020, that generally doesn't mean miracle cures or medical breakthroughs. | 而即使在2020年,这一般并不意味着奇迹治愈或医学突破. |
| 102 | Having a devastating genetic diagnosis means learning to live with uncertainty. | 具有毁灭性的遗传诊断,意味着学会生活在不确定之中. |
| 103 | It means learning that you and your diagnosis are not the worst thing that could happen. | 这意味着学会你和你的诊断 并不是可能发生的最糟糕的事情 |
| 104 | Learning to live with uncertainty means walking forward into a life that is as full of beauty as it is of challenges. | 学会与不确定性共存意味着走向一个充满美丽和挑战的生活。 |
| 105 | It means learning for yourself that cancer is just part of your story. | 它意味着为自己学习 癌症只是你的故事的一部分。 |
| 106 | It may not be the worst thing that happens to you. | 这也许不是发生在你身上的最坏的事情 |
| 107 | If it is, that's OK. | 如果是这样,没关系。 |
| 108 | You can claim that and you can own that. | 你可以声称你拥有它。 |
| 109 | But let that be a narrative that you author and you authorize, not one that's prescribed to you by someone else. | 但这是你和作者授权的叙述 而不是别人给你规定的 |
| 110 | Have your deferral letter in hand, but use it on your terms. | 把你的延期信拿来 但用你的条件 |
| 111 | As I come to the end of my oncology training, I have deja vu again and again with the following scenario. | 当我的肿瘤学训练结束时,我一次又一次地经历了以下情景。 |
| 112 | A patient has cancer. | 一个病人得了癌症。 |
| 113 | There are several options, all of which offer a different balance between cure and quality of life. | 有几种选择,所有这些选择都为治疗和生活质量提供了不同的平衡。 |
| 114 | Between the possibility of alleviating suffering and the possibility of causing suffering. | 在减轻痛苦的可能性和造成痛苦的可能性之间。 |
| 115 | An oncologist lays out the options, but somewhere in the discussion, things get skewed. | 一个肿瘤学家提出了选择, 但是在讨论的某个地方,事情变得扭曲。 |
| 116 | The choice becomes something more like, well, you could choose to do something or you could choose to do nothing. | 选择会变得更像是, 你可以选择做一些事情 或者你可以选择什么都不做。 |
| 117 | We could be aggressive and treat your cancer or we could watch it. | 我们可以积极治疗你的癌症 或者看一看 |
| 118 | And 9.9 times out of 10, the patient says, I want to do everything I can do. | 病人说,我想尽我所能 |
| 119 | Of course. | 当然 |
| 120 | Who wouldn't want everything? | 谁不想要一切? |
| 121 | But what is everything? | 但什么是一切吗? |
| 122 | Is everything the ability to sit in your own home in front of your window, bathed in sunshine and surrounded by family? | 什么都能够坐在自己家的窗户前,在阳光下洗澡,被家人包围? |
| 123 | Is everything still being able to feel your fingers and your toes because they haven't gone numb from chemotherapy? | 你手指和脚趾都还没麻木吗? |
| 124 | As oncologists, our everything is cancer treatment. | 作为肿瘤学家 我们的一切都是癌症治疗 |
| 125 | It's radiation and surgery and chemotherapy and novel treatments. | 它的辐射和手术 化疗和新颖的治疗。 |
| 126 | And for us, the worst thing that could happen, and I have heard more than one oncologist say this, | 对我们来说,最糟糕的事情 会发生, 我已经听到不止一个肿瘤学家说, |
| 127 | the worst thing that could happen is that the patient will develop metastatic disease. | 可能发生的最糟糕的事情是病人会患上元病. |
| 128 | Or the worst thing that could happen is that five years from now, the cancer will grow and I'll have to give more radiation. | 或者最糟糕的事情是 5年后,癌症会增加 我不得不给更多的辐射。 |
| 129 | As a patient and as an oncologist, I would never argue that these are not devastating outcomes. | 作为一个病人和肿瘤学家,我绝不会说这些不是毁灭性的结果。 |
| 130 | But are they the worst? | 但他们是最坏的吗? |
| 131 | Should cancer control be at the center of our thinking always? | 癌症控制应该永远成为我们思想的中心吗? |
| 132 | Many unspeakably, unfathomably painful and brutal things have happened to me because of my cancers and my genetic mutation. | 由于我的癌症和基因突变,我发生了许多不可言喻的,不可言喻的痛苦和残酷的事情。 |
| 133 | And yet I consider myself very lucky indeed, because the worst thing that could happen never came to pass. | 但我认为自己确实很幸运 因为最糟糕的事情从未发生 |
| 134 | Because I have let devastation and uncertainty sit at the table, but somewhere off to the side. | 因为我让破坏和不确定因素坐到桌子上, 但某处是侧面。 |
| 135 | When I was diagnosed with metastatic breast cancer, I went to Boston for a second opinion, because what could I lose? | 当我被诊断为患有运动性乳腺癌时,我到波士顿做了第二次观察,因为我会失去什么? |
| 136 | When my oncologist gave me very good and very safe and very standard advice, | 当我的肿瘤学家给我非常好, 非常安全,非常标准的建议, |
| 137 | I started medical school anyway, even though I was undergoing active cancer treatment. | 我开始上医学院,尽管我正在接受积极的癌症治疗。 |
| 138 | Instead of shying away from patients with cancer, I became a radiation oncologist and I work with patients who are very much like me every single day. | 而不是躲开癌症患者, 我成为一名放射肿瘤学家, 我与病人一起工作 他们非常像我的每一天。 |
| 139 | Instead of imagining the suffering that I might cause to a future partner when I died of cancer, I married my wonderful husband. | 而不是想象我可能给未来的伴侣带来的痛苦 当我死于癌症时,我嫁给了我的好丈夫。 |
| 140 | Because the worst thing that can happen is always a series of negatives. | 因为最坏的事情是 总是一系列负面的。 |
| 141 | It's blank spaces that should be filled with life. | 空白的空间应该充满生命 |
| 142 | So what is the most that I have leaned into this kind of radical uncertainty? | 那么,什么是我最倾向于 这种激进的不确定性? |
| 143 | Well, this is William. | 这是威廉 |
| 144 | He is the most joyful person that I have ever met. | 他是我见过最快乐的人 |
| 145 | And in just over a year, he has already made the world a better place. | 在短短一年多的时间里,他已经使世界变得更美好。 |
| 146 | As oncologists, we talk to our patients as if the worst thing that could happen is that their cancer could come back or that it could spread or that they could die from it. | 作为肿瘤学家,我们和我们的病人交谈, 仿佛最糟糕的事情是 他们的癌症可能复发, 也可能扩散,或者他们会死于癌症。 |
| 147 | As a patient, I know that these are paramount, but I want to change the way that we think about this. | 作为一个病人,我知道这些是至高无上的,但我想改变我们对此的想法。 |
| 148 | And I want to change the way that we talk about this with our patients. | 我想改变我们和病人谈论这个问题的方式。 |
| 149 | As a patient, the worst thing that can happen is that cancer robs you of opportunity, of the ability to be and to do and to love. | 作为一个病人,最糟糕的事情是癌症会剥夺你的机会,剥夺你成为和做以及爱的能力. |
| 150 | And it will, at least temporarily it will. | 它会,至少暂时会。 |
| 151 | But to minimize this loss of life in the living, that is the harder and I would say truer job of the oncologist to take all the tools that we have | 但是为了把生命的损失降到最低,那就更难了,我要说,肿瘤学家更真正地 利用我们所有的工具 |
| 152 | and situate them in the context of a patient's whole entire life to be guides for how to sit with suffering, acknowledge it deeply, | 让他们在病人的一生中 成为如何忍受痛苦的导师 |
| 153 | but to not let fear of future suffering be the narrative for the journey forward. | 但不要让对未来痛苦的恐惧成为前进之路的叙述。 |
| 154 | One of my mentors always says the medicine part is easy and it never feels that way to a junior doctor, but its contours are finite. | 我的一位导师总是说,药物部分是容易的,对初级医生来说,从来没有这样的感觉,但是它的轮廓是有限的. |
| 155 | We have big studies to guide us and it's what we learn to do in residency. | 我们有大研究来指导我们 这就是我们在居住时学会的 |
| 156 | Much harder is learning how to help each patient navigate the multitudes contained in their illness. | 学习如何帮助每个病人 驾驭他们疾病中包含的人群,要困难得多。 |
| 157 | So I find it really funny that in retrospect, my life looks like a neat package. | 所以我觉得很有趣,回顾一下,我的生活 看起来像一个整洁的包裹。 |
| 158 | It looks as if I planned each successive step and that perhaps cancer has led to the good things in my life. | 似乎我计划了每一个连续的步骤, 可能癌症导致了我生命中的美好事物。 |
| 159 | Step one, apply to medical school. | 第一步,申请进入医学院. |
| 160 | Step two, get diagnosed with and treated for cancer. | 步骤二,确诊并治疗癌症. |
| 161 | And step three, have it all, a career and a family. | 第三步 拥有一切 事业和家庭 |
| 162 | But I will tell you that each phase was a leap of faith despite an almost paralyzing uncertainty. | 但我会告诉你,每个阶段都是一个信仰的飞跃,尽管一个几乎瘫痪的不确定性。 |
| 163 | And so it's that courage that I try to give to each of my patients. | 所以我试着给每个病人以勇气。 |
| 164 | I try to do this regardless of the technical medical details of cancers and treatment decisions and mutations. | 我试图做到这一点,不管 技术医疗细节 癌症和治疗决定 和突变。 |
| 165 | Regardless of the slippery fiction of prognosis. | 不管预后如何滑动 |
| 166 | I try to learn what they want and what they need, what they wish and what they worry, | 我试图学习他们想要什么,他们需要什么,他们希望什么,他们担心什么, |
| 167 | what they dream about, what animated them before and what will sustain them during | 他们的梦想是什么,他们之前的动画是什么,以及他们期间的维持 |
| 168 | the beastly process of cancer treatment. | 治疗癌症的猛烈过程 |
| 169 | It doesn't actually take that much time. | 其实不需要那么长时间 |
| 170 | It does take a few focused, quiet moments that require intentional cultivation. | 这确实需要一些集中、安静的时刻,需要有意种植。 |
| 171 | But this is partnership and it matters. | 但这是伙伴关系,很重要。 |
| 172 | Because the worst thing that can happen is to have an oncologist who does everything, | 因为最糟糕的事情是 让肿瘤医生做任何事 |
| 173 | everything to help cure your cancer. | 帮助治愈癌症的一切 |
| 174 | And who does nothing to help you live your life. | 而谁不做任何帮助 你生活。 |
| 175 | Thank you. | 谢谢 |
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