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“让死亡带走我们,而不是因为缺乏想象力”| 年度最该看的一场

字幕摘录

时间英文中文
0:14Well, we all need a reason to wake up.我们都需要一个醒过来的理由
0:19For me, it just took 11,000 volts.对我来说,它只需要11,000伏特。
0:23I know you're too polite to ask, so I will tell you.我知道你太客气了 问,所以我会告诉你。
0:27One night, sophomore year of college,一天晚上,大二的时候,
0:29just back from Thanksgiving holiday,感恩节刚回来
0:33a few of my friends and I were horsing around,我和几个朋友到处乱跑
0:36and we decided to climb atop a parked commuter train.我们决定爬上停靠的通勤列车
0:39And we were on our way to the airport,我们正要去机场
0:40just sitting there with the wires that run overhead.只是坐在那里 电线运行的顶端。
0:43Somehow, that seemed like a great idea at the time.不知怎的,这似乎是 一个伟大的想法在当时。
展开字幕全文(314 条)
序号英文中文
1Well, we all need a reason to wake up.我们都需要一个醒过来的理由
2For me, it just took 11,000 volts.对我来说,它只需要11,000伏特。
3I know you're too polite to ask, so I will tell you.我知道你太客气了 问,所以我会告诉你。
4One night, sophomore year of college,一天晚上,大二的时候,
5just back from Thanksgiving holiday,感恩节刚回来
6a few of my friends and I were horsing around,我和几个朋友到处乱跑
7and we decided to climb atop a parked commuter train.我们决定爬上停靠的通勤列车
8And we were on our way to the airport,我们正要去机场
9just sitting there with the wires that run overhead.只是坐在那里 电线运行的顶端。
10Somehow, that seemed like a great idea at the time.不知怎的,这似乎是 一个伟大的想法在当时。
11We'd certainly done stupider things.我们当然会做更蠢的事
12I scurried up the ladder on the back,我冲到后面的梯子上
13and when I stood up,当我站起来的时候,
14the electrical current entered my arm,电流进入我的手臂,
15blew down and out my feet, and that was that.炸掉我的脚,就是这样。
16Would you believe that watch still works?你相信那只表还能用吗?
17Takes a licking.需要一个舔。
18My father wears it now in solidarity.我的父亲现在穿着它团结。
19That night began my formal relationship with death.那晚我和死亡开始了正式的关系
20и
21And it also began my long run as a patient,也开始了我作为一个病人的长期运行,
22which is a good word.这是一个好词。
23It means one who suffers.谓受苦者.
24So I guess we're all patients.我想我们都是病人
25Now, the American health care system现在,美国医疗保健系统
26has more than its fair share of dysfunction,在功能失调方面,
27to match its brilliance, to be sure.与它的辉煌相匹配,肯定。
28I'm a physician now, a hospice and palliative medicine doc,我现在是医生 临终疗养院和治病医生
29so I've seen care from both sides.所以我从两边都看到了关心
30And believe me, most everyone who goes into health care并且相信我,大多数的人 谁去保健
31really means well.真的意味着很好。
32I mean, truly.我是说,真的
33But we who work in it但我们在其中工作
34are also unwitting agents for a system that too often does not serve.也是一种不知情的代理,而这种系统往往不起作用。
35Why?为什么?
36Well, there's actually a pretty easy answer to that question.其实这个问题的答案很简单
37And it explains a lot.这解释了很多
38Because health care was designed with diseases,因为保健是用疾病设计的,
39not people, at its center.不是人,在它的中心。
40Which is to say, of course, it was badly designed.这就是说,当然,它是设计不好的。
41And nowhere are the effects of bad design无处不在设计不良的效果
42more heartbreaking,更让人心碎,
43or the opportunity for good design more compelling或更好的设计机会
44than at the end of life,比临终时,
45where things are so distilled and concentrated.在那里,事物如此蒸馏和集中。
46There are no do-overs.无有复行.
47My purpose today is to reach out across disciplines今天我的目的就是要跨学科
48and invite design thinking into this big conversation.并且邀请设计思考 在这次大对话。
49That is, to bring intention and creativity也就是带来意向和创造力
50to the experience of dying.经历死亡
51We have a monumental opportunity in front of us我们面前有一个巨大的机会
52before a universal, one of the few universal issues成为少数普遍问题之一
53as individuals as well as a civil society个人以及民间社会
54to rethink and redesign how it is we die.重新思考和重新设计我们是如何死去的
55So let's begin at the end.所以从头开始吧
56For most people, the scariest thing about death isn't being dead.对大多数人来说 死亡最恐怖的不是死
57It's dying, suffering.临终,受苦.
58It's a key distinction.关键区别.
59And to get underneath this,为了躲到这下面
60it can be very helpful to tease out suffering,取笑痛苦会很有帮助
61which is necessary, as it is,这是必要的,因为它是,
62from suffering we can change.从痛苦中我们可以改变。
63The former is a natural, essential part of life,前者是生命中一个自然而必不可少的部分,
64part of the deal.交易的一部分。
65And to this, we are called to make space,为此,我们被要求创造空间,
66adjust, grow.调整,增长。
67It can be really good to realize forces larger than ourselves.实现比我们更大的力量是非常好的。
68They bring proportionality,他们带来了相称性,
69like a cosmic right-sizing.就像一个宇宙的右旋尺寸。
70After my limbs were gone,我的四肢不见了之后
71that loss, for example, became fact, fixed,例如,损失变成了事实,固定,
72necessarily part of my life.一定是我生命的一部分。
73And I learned I could no more reject this fact than reject myself.我发现我拒绝这个事实 只能拒绝自己
74Took me a while, but I'd learned it eventually.花了我一段时间,但我终于学会了。
75Now, another great thing about necessary suffering现在,另一个伟大的事情 关于必要的痛苦
76is that it is the very thing是,这是 事情
77that unites caregiver and care receiver,团结照顾者和接受照顾者,
78human beings.人类
79This, we are finally realizing, is where healing happens.我们终于意识到,这是治愈的地方。
80Yes, compassion.对,同情心
81Literally, as we learned yesterday,从字面上说,我们昨天学到,
82suffering together.一起受苦受难
83Now, on the systems side, on the other hand,在系统方面, 另一方面,
84so much of the suffering is unnecessary, invented.所以很多痛苦是不必要的,发明。
85It serves no good purpose.没用的
86But the good news is,但好消息是,我们...
87since this brand of suffering is made up,因为这个品牌的痛苦是编造的,
88well, we can change it.我们可以改变它。
89How we die is indeed something we can affect.我们的死亡确实会影响我们。
90Now, making the system sensitive to this fundamental distinction现在,使这个系统敏感于这个根本区别
91between necessary and unnecessary suffering在必要和不必要的痛苦之间
92gives us our first of three design cues for the day.给我们三个设计提示中的第一个
93After all, our role as caregivers,毕竟,我们作为照顾者的作用,
94as people who care,作为关心的人,
95is to relieve suffering,以解除苦难,
96not add to the pile.不增加堆积。
97True to the tenets of palliative care,忠于缓和治疗的原则,
98I function as something of a reflective advocate我是一个反省律师
99as much as a prescribing physician.就像开处方的医生一样
100Quick aside, palliative care,快让开 缓解治疗
101very important field but poorly understood.非常重要的领域,但理解不足。
102While it includes, it is not limited to end-of-life care.虽然它包括,但不限于报废护理。
103It is not limited to hospice.它不仅限于收容所。
104It's simply about comfort and living well at any stage.这仅仅是在任何阶段的舒适和美好生活.
105OK, so please know that you don't have to be dying anytime soonOK,所以请记住,你不必死 任何时间快
106to benefit from palliative care.享受缓和治疗。
107Now, let me introduce you to Frank.现在,让我给你介绍弗兰克。
108He sort of makes this point.他说到这一点。
109I've been seeing Frank now for years.我和弗兰克交往多年了
110He's living with advancing prostate cancer他活在先进的前列腺癌中
111on top of longstanding HIV.在长期的艾滋病毒之上。
112We work on his bone pain and his fatigue,我们研究他的骨痛和疲劳
113but most of the time we spend thinking out loud together about his life,但大部分时间,我们花 大声思考他的生活,
114really about our lives.关于我们的生活
115In this way, Frank grieves.这样,弗兰克会感到悲伤.
116In this way, he keeps up with his losses as they roll in,这样一来,他一直承受着损失
117so that he's ready to take in the next moment.以便他准备好 在下一个时刻。
118Loss is one thing, but regret quite another.损失是一回事,但遗憾是另一回事。
119So Frank has always been an adventurer.所以弗兰克一直是一个冒险家。
120Looks like something out of a Norman Rockwell painting,看起来像诺曼·洛克威尔画里的东西
121and no fan of regret.也无悔恨之心
122So it wasn't surprising when he came into clinic one day,所以当他有一天来诊所时 并不奇怪
123saying he wanted to raft down the Colorado River.说他想在科罗拉多河下游
124Was this a good idea?好主意吗?
125With all the risks to his safety and his health,他的安全和健康都受到威胁
126some would say no, many did, but he went for it,有些人会说不,许多人会, 但他去这样做,
127while he still could.但他还是可以的
128And it was a glorious, marvelous trip.它是一个辉煌,美妙的旅程。
129Freezing water,冻水,
130blistering dry heat,燃烧干热,
131scorpion snakes,蝎子蛇,
132wildlife howling off the flaming walls of the Grand Canyon.野生动物在大峡谷的火墙上嚎叫
133All the glorious side of the world beyond our control.我们无法控制世界的光荣一面
134Frank's decision, while maybe dramatic,弗兰克的决定,虽然也许很戏剧化,
135is exactly the kind so many of us would make我们很多人都会这样
136if we only had the support to figure out what is best for ourselves,如果我们只得到支持 找出什么是对我们最好,
137over time.随着时间的推移。
138So much of what we're talking about today is a shift in perspective.我们今天谈论的很多是视角的转变.
139After my accident, when I went back to college,我出事后 当我回到大学时
140I changed my major to art history.我改学艺术史
141Studying visual art, I figured I'd learn something about how to see.研究视觉艺术,我想我会学到一些如何看的东西。
142A really potent lesson for a kid who couldn't change对于一个无法改变的小孩来说 是一个非常有力的教训
143so much of what he was seeing.这么多他看到的。
144Perspective, that kind of alchemy we humans get to play with,透视,这种炼金术 我们人类可以玩,
145turning anguish into a flower.把痛苦变成花朵
146Flash forward, now I work at an amazing place in San Francisco闪亮的前进,现在我在旧金山一个惊人的地方工作
147called the Zen Hospice Project,叫做"禅螺计划",
148where we have a little ritual that helps with this shift in perspective.在那里,我们有一个小小的仪式 帮助这个转变的视角。
149When one of our residents dies,当我们的一个居民死了,
150the mortuary men come,死尸们来了,
151and as we're wheeling the body out through the garden,当我们把尸体从花园里推出来时
152heading for the gate, we pause.向大门前进,我们暂停。
153Anyone who wants, fellow residents, family, nurses, volunteers,任何想要的人,同胞,家人,护士,志愿者,
154the hearse drivers, too, now,火车司机也是,现在
155share a story or a song or silence分享一个故事或一首歌或沉默
156as we sprinkle the body with flower petals.我们用花瓣撒满身体
157It takes a few minutes,需要几分钟
158a sweet, simple parting image一个甜蜜,简单的分离图像
159to usher in grief with warmth,以温暖带来悲伤,
160rather than repugnance.而不是厌恶。
161Contrast that with the typical experience in the hospital setting,与医院环境的典型经验相对应
162much like this floodlit room很像这个淹水室
163lined with tubes and beeping machines and blinking lights用管子、哔声机和闪烁灯线
164that don't stop even when the patient's life has.即使病人有生命 也不会停止
165Cleaning crews swoops in, the body's whisked away,清理人员冲进来 尸体被刮掉了
166and it all feels as though that person had never really existed.感觉就像那个人从未真正存在过
167Well-intended, of course, in the name of sterility,当然,以不孕症为名,
168but hospitals tend to assault our senses.但医院会攻击我们的感官
169And the most we might hope for within those walls is numbness,我们最希望的就是麻木
170anesthetic,麻醉剂,
171literally the opposite of aesthetic.和美学相反
172I revere hospitals for what they can do.我敬重医院的能耐
173I am alive because of them.我活着是因为他们。
174But we ask too much of our hospitals.但我们要求的医院太多。
175They are places for acute trauma and treatable illness.它们是急性创伤和可治疗疾病的场所。
176They're no place to live and die.二者不生不灭.
177That's not what they were designed for.这不是他们设计的目的
178Now, mind you, I'm not giving up on the notion记住,我不会放弃这个想法
179that our institutions can become more humane.我们的机构可以变得更加人道。
180Beauty can be found anywhere.美貌随处可见.
181I spent a few months in a burn unit at St. Barnabas Hospital我在圣巴纳巴斯医院烧伤室待了几个月
182in Livingston, New Jersey,在新泽西州利文斯顿
183where I got really great care at every turn,在那里,我得到了非常的关心 在每一个转弯,
184including good palliative care for my pain.包括治疗我疼痛的缓解疗法
185And one night, it began to snow outside.有一天晚上 外面开始下雪
186I remember my nurses complaining about driving through it.我记得我的护士抱怨开车经过那里
187And there was no window in my room,我房间没有窗户
188but it was great to just imagine it coming down all sticky.但它是伟大的,只是想象 它下来了所有的粘。
189The next day, one of my nurses smuggled in a snowball for me.第二天 我的一位护士为我走私了雪球
190She brought it into the unit.她把它带进了部队
191I cannot tell you the rapture I felt holding it in my hand,我不能告诉你,我感到的快乐 握在我手中,
192the coldness dripping onto my burning skin,寒冷滴在我的燃烧的皮肤上,
193the miracle of it all,这是其中的奇迹,
194the fascination as I watched it melt and turn into water.我看着它融化变成水的迷恋
195In that moment,在那一刻
196just being any part of this planet in this universe成为宇宙中这个星球的任何一部分
197mattered more to me than whether I lived or died.对我而言,比起我死还是活更重要
198That little snowball packed all the inspiration I needed那个小雪球 收拾了我需要的灵感
199to both try to live and be OK if I did not.试着活下来 并保持平静 如果我没有。
200In a hospital, that's a stolen moment.在医院里,那是被偷走的时刻。
201In my work, over the years,多年来,在我的工作里,
202I've known many people who were ready to go, ready to die.我认识很多人,他们准备去,准备去死。
203And not because they had found some final peace or transcendence,并不是因为他们找到了 最终的和平或超越,
204but because they were so repulsed by what their lives had become.因为他们被自己的人生所厌恶
205In a word, cut off.一句话,切断。
206Ugly.丑恶.
207There are already record numbers of us living with chronic and terminal illness已经有创纪录的数字 我们生活在慢性和绝症
208and into ever-older age.进入更老的年代
209And we are nowhere near ready or prepared for this silver tsunami.我们还没准备好迎接银色海啸
210We need an infrastructure dynamic enough我们需要足够多的基础设施
211to handle these seismic shifts in our population.处理这些地震变化 我们的人口。
212Now is a time to create something new, something vital.现在是创造新事物的时候, 重要的东西。
213I know we can because we have to.我知道我们可以,因为我们必须这样做。
214The alternative is just unacceptable.另一种选择是不可接受的。
215And the key ingredients are known.而关键成分已知.
216Policy, education and training,政策、教育和培训,
217systems, bricks and mortar.系统、砖和迫击炮。
218We have tons of input for designers of all stripes to work with.我们有吨量的输入 用于所有条纹的设计者工作。
219We know, for example, from research,我们从研究中知道
220what's most important to people who are closer to death.对离死亡更近的人来说最重要的
221Comfort, feeling unburdened舒舒服服,无拘无束
222and unburdening to those they love.并减轻他们所爱者的重负。
223Existential peace存在的和平
224and a sense of wonderment and spirituality.和一种奇异和精神的感觉。
225Over Zen Hospice's nearly 30 years,超过三十年来,禅何斯比斯,
226we've learned much more from our residents in subtle detail.我们从居民那里学到了更多的细节
227Little things aren't so little.小东西不是那么少。
228Take Jeanette.带上珍妮特
229She finds it harder to breathe one day to the next due to ALS.由于ALS,她觉得一天呼吸到第二天更困难.
230Well, guess what?你猜怎么着?
231She wants to start smoking again.她想重新开始抽烟。
232And French cigarettes, if you please.还有法国香烟,如果你愿意的话。
233Not out of some self-destructive bent,不是从自毁的弯曲,
234but to feel her lungs filled while she has them.但是在她有肺的时候感受她的肺部充沛
235Priorities change.优先事项发生变化。
236Or Kate.或者凯特
237She just wants to know her dog Austin is lying at the foot of her bed,她只是想知道她的狗奥斯汀躺在床脚下
238his cold muzzle against her dry skin.他对着她干燥的皮肤的冷口
239Instead of more chemotherapy coursing through her veins,而不是更多的化疗 通过她的血管凝结,
240she's done that.她这样做了。
241Sensuous aesthetic gratification敏锐的审美满足
242where in a moment, in an instant,在那一刻,在瞬间,
243we are rewarded for just being.我们因为只是存在而得到回报。
244So much of it comes down to loving our time by way of the senses,如此之多的事物 来到了爱我们的时间 通过感官,
245by way of the body,通过身体,
246the very thing doing the living and the dying.做活的和死的一样
247Probably the most poignant room in a Zen Hospice guesthouse is our kitchen,可能是我们家的厨房 是Zen Hospice招待所里最漂亮的房间
248which is a little strange when you realize这有点奇怪 当你意识到
249that so many of our residents can eat very little, if anything at all.我们的很多居民 吃得很少,甚至任何东西。
250But we realize we are providing sustenance on several levels.但是我们意识到,我们正在提供若干层面的生计。
251Smell, a symbolic plane.闻起来,一个象征性的飞机。
252Seriously, with all the heavy-duty stuff happening under our roof,说真的 在我们屋檐下 发生了许多重活
253one of the most tried-and-true interventions we know of我们所知道的 最尝试和最真实的发言之一
254is to bake cookies.是烤饼干。
255As long as we have our senses, even just one,只要我们有感官,哪怕只有一个
256we have at least the possibility of accessing我们至少可以访问
257what makes us feel human, connected.是什么让我们觉得人,联系。
258Imagine the ripples of this notion想象一下这个概念的波折
259for the millions of people living and dying with dementia.数百万人因痴呆而死
260Primal, sensorial delights初步的感官快乐
261that say the things we don't have words for.说我们没有话要说
262Impulses that make us stay present.冲动让我们留在原地
263No need for a past or a future.不需要过去或未来
264So if teasing unnecessary suffering out of the system所以,如果调侃不必要的痛苦 走出系统
265was our first design cue,这是我们第一个设计提示,
266then tending to dignity by way of the senses,然后通过感官保持尊严,
267by way of the body,通过身体,
268the aesthetic realm, is design cue number two.美学领域,是设计二号提示。
269Now, this gets us quickly to the third and final bit for today.现在,这让我们很快 到了今天的第三,也是最后一点。
270Namely, we need to lift our sights, to set our sights on well-being也就是说,我们需要抬起我们的视线 把视线定在幸福上
271so that life can become, and health, and health care can become使生活、健康和保健
272about making life more wonderful,关于让生活更加美好,
273rather than just less horrible.而不是仅仅减少恐怖。
274Beneficence.益众生.
275Here, this gets right at the distinction between a disease-centered这里,这是正确的区别 以疾病为中心
276and a patient- or human-centered model of care.和以病人或人为中心的护理模式。
277And here is where caring becomes a creative, generative, even playful act.在这里,关爱变成了一种创造性的, 遗传性的,甚至游戏性的行为。
278Play may sound like a funny word here.演奏听起来可能像一个有趣的词。
279But it's also one of our highest forms of adaptation.但它也是我们最高的适应形式之一.
280Consider every major compulsory effort it takes to be human.考虑做为人类的每一项重大强制努力。
281The need for food is birth cuisine.食物的需求是生菜.
282The need for shelters, given rise to architecture.住房需要,导致建筑。
283The need for cover, fashion.需要掩护,时尚
284And for being subjected to the clock?受时钟支配?
285Well, we invented music.我们发明了音乐
286So, since dying is a necessary part of life,既然死亡是生命的必要部分
287what might we create with this fact?我们能用这个事实创造什么?
288By play, I am in no way suggesting that we take a light approach to dying我绝对不建议我们用轻轻的死法
289or that we mandate any particular way of dying.或者我们授权任何特定的死亡方式
290There are mountains of sorrow that cannot move,有悲伤的山 无法移动,
291and one way or another, we will all kneel there.不管怎么样 我们都跪在那里
292Rather, I am asking we make space,相反,我要求我们创造空间,
293physical, psychic room,物理的,灵媒的房间,
294to allow life to play itself all the way out,为了让生活 发挥自己的方式,
295so that rather than just getting out of the way,这样,而不是仅仅让开,
296aging and dying can become a process of crescendo through to the end.衰老和死亡会变成一个 持续到最后的重现过程
297We can't solve for death.我们无法解决死亡
298I know some of you are working on this.我知道你们中有些人正在研究这个
299Meanwhile, we can design towards it.与此同时,我们可以设计它。
300Now, parts of me died early on,现在,我的一部分早死了,
301and that's something we can all say one way or another.这也是我们可以说的一种方式。
302I got to redesign my life around this fact,我得重新规划我的生活
303and I tell you it has been a liberation我告诉你这是一次解放
304{\fn黑体\fs22\bord1\shad0\3aHBE\4aH00\fscx67\fscy66\2cHFFFFFF\3cH808080}意识到你总能找到美的震撼
305in what life you have left,在你们所剩的生活中,
306like that snowball lasting for a perfect moment,像那个雪球 持续一个完美的时刻,
307all the while melting away.在融化的时候
308If we love such moments ferociously,如果我们热衷于这种时刻
309then maybe we can learn to live well,也许我们可以学会过好日子
310not in spite of death,尽管死亡,
311but because of it.但因为它。
312Let death be what takes us,让死亡成为夺去我们的生命
313not lack of imagination.而不是缺乏想象力。
314Thank you.谢谢
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