ABOUT THE SPEAKER
Sherwin Nuland - Doctor
A practicing surgeon for three decades, Sherwin Nuland witnessed life and death in every variety. Then he turned to writing, exploring what there is to people beyond just anatomy.

Why you should listen

Sherwin Nuland was a practicing surgeon for 30 years and treated more than 10,000 patients -- then became an author and speaker on topics no smaller than life and death, our minds, our morality, aging and the human spirit.

His 1994 book How We Die: Reflections of Life's Final Chapter demythologizes the process of dying. Through stories of real patients and his own family, he examines the seven most common causes of death: old age, cancer, AIDS, Alzheimer's, accidents, heart disease and stroke, and their effects. The book, one of more than a dozen he wrote, won the National Book Award, was a finalist for the Pultizer Prize, and spent 34 weeks on the New York Times best-seller list. Other books include How We Live, The Art of Aging: A Doctor's Prescription for Well-Being; and The Soul of Medicine: Tales from the Bedside.

More profile about the speaker
Sherwin Nuland | Speaker | TED.com
TED2003

Sherwin Nuland: How electroshock therapy changed me

舍温纽兰讲解电击疗法

Filmed:
1,958,485 views

医生兼作家-舍温纽兰讨论电击疗法的发展,它可用于治疗危及生命的抑郁症,包括治愈了他自己的病症。这是一个关于治疗、救赎以及第二次生命的感人至深的演讲。
- Doctor
A practicing surgeon for three decades, Sherwin Nuland witnessed life and death in every variety. Then he turned to writing, exploring what there is to people beyond just anatomy. Full bio

Double-click the English transcript below to play the video.

00:26
I'd like to do pretty漂亮 much what I did the first time,
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我想能和第一次演讲一样,
00:28
which哪一个 is to choose选择 a light-hearted轻快 theme主题.
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选择一个轻松的主题。
00:31
Last time, I talked about death死亡 and dying垂死.
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上一次我谈论了关于生与死。
00:34
This time, I'm going to talk about mental心理 illness疾病.
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这次我要谈谈精神疾病。
00:39
But it has to be technological技术性,
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但它应该是技术性的,
00:40
so I'll talk about electroshock电击 therapy治疗. (Laughter笑声)
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所以我要谈谈电击疗法。(笑声)
00:45
You know, ever since以来 man had any notion概念
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大家知道,自从人们发现
00:48
that some of his other people, his colleagues同事,
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周边其他人,同僚等
00:52
could be different不同, could be strange奇怪, could be severely严重 depressed郁闷
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可能是和自己不同的,可能是行径奇怪,或者可能是严重抑郁的
00:56
or what we now recognize认识 as schizophrenia精神分裂症,
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或者是我们现在所指的精神分裂症
01:00
he was certain某些 that this kind of illness疾病
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就断定患了这种病
01:03
had to come from evil邪恶 spirits getting得到 into the body身体.
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一定是种魔鬼附体的病症。
01:06
So, the way of treating治疗 these diseases疾病
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为了治疗这种病症
01:08
in early times was to, in some way or other,
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在早期,应用了不同方法,
01:11
exorcise those evil邪恶 spirits, and this is still going on, as you know.
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众所周知,驱魔法一直沿用至今。
01:16
But it wasn't enough足够 to use the priests牧师.
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但是仅仅靠祭司是不够的。
01:18
When medicine医学 became成为 somewhat有些 scientific科学, in about 450 BC公元前,
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在约公元前450年,医药成为一门学科,
01:23
with Hippocrates希波克拉底 and those boys男孩,
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希波克拉底(希腊的名医,被尊为医学之父)和学生们
01:25
they tried试着 to look for herbs草药, plants植物
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尝试研究、寻找草药、植物,
01:29
that would literally按照字面 shake the bad spirits out.
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从中找出将恶魔驱除出人体的药方。
01:32
So, they found发现 certain某些 plants植物 that could cause原因 convulsions抽搐.
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他们发现某些植物可以引发人体抽搐。
01:35
And the herbals草药, the botanical植物 books图书 of up to the late晚了 Middle中间 Ages时代,
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到中世纪后期和文艺复兴时期的植物学书,即各种”本草集“,
01:41
the Renaissance再生 are filled填充 with prescriptions处方
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里面记录有很多药方
01:45
for causing造成 convulsions抽搐 to shake the evil邪恶 spirits out.
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都能靠诱发抽筋来驱除恶魔。
01:50
Finally最后, in about the sixteenth第十六 century世纪,
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最后,大约在16世纪,
01:54
a physician医师 whose谁的 name名称 was Theophrastus泰奥弗拉斯 BombastusBombastus Aureolus奥拉斯 von Hohenheim霍恩海姆,
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一个物理学家,名字叫做Theophrastus Bombastus Auricularis von Hohenheim
02:00
called Paracelsus帕拉塞尔苏斯, a name名称 probably大概 familiar to some people here --
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被称作帕拉塞尔苏斯,在座可能有人知道这个名字
02:04
(Laughter笑声) -- good, old Paracelsus帕拉塞尔苏斯
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-(笑声)-老顽固帕拉塞尔苏斯,
02:09
found发现 that he could predict预测 the degree of convulsion抽搐
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发现他可以预测抽搐的程度
02:13
by using运用 a measured测量 amount of camphor to produce生产 the convulsion抽搐.
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通过使用定量的樟脑诱发人体抽搐。
02:17
Can you imagine想像 going to your closet壁橱, pulling out a mothball封存, and
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你可以想象吗,走到你的衣橱,拿出一颗樟脑球然后
02:20
chewing咀嚼 on it if you're feeling感觉 depressed郁闷?
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嚼食它,想象这样缓解抑郁?
02:23
It's better than Prozac百忧解, but I wouldn't不会 recommend推荐 it.
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这个比百忧解(抗抑郁药)有效,但是我可不推荐这么做。
02:26
So what we see in the seventeenth第十七, eighteenth第十八 century世纪
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发展到17,18世纪
02:29
is the continued继续 search搜索 for medications药物治疗 other than camphor that'll那会 do the trick.
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人类继续寻找除了樟脑外的其他办法。
02:34
Well, along沿 comes Benjamin本杰明 Franklin富兰克林,
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这时出现了本杰明.富兰克林,
02:36
and he comes close to convulsing抽搐 himself他自己
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通过风筝电流,他几乎诱发自己抽搐
02:38
with a bolt螺栓 of electricity电力 off the end结束 of his kite风筝.
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这是通过风筝传导的雷电电流。
02:42
And so people begin开始 thinking思维 in terms条款 of electricity电力 to produce生产 convulsions抽搐.
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然后人们开始思考通过电流诱发抽搐。
02:47
And then, we fast-forward快进 to about 1932,
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到了大约1932年,
02:51
when three Italian意大利 psychiatrists精神科医生, who were largely大部分 treating治疗 depression萧条,
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3位主要治疗抑郁症的意大利精神病专家
02:57
began开始 to notice注意 among其中 their patients耐心, who were also epileptics癫痫,
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注意到他们的忧郁症病人中,那些同时患有癫痫症的患者,
03:00
that if they had an epileptic癫痫 -- a series系列 of epileptic癫痫 fits适合,
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如果他们癫痫症发作后,连续发作多次
03:03
a lot of them in a row -- the depression萧条 would very frequently经常 lift电梯.
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许多人抑郁症便减轻
03:07
Not only would it lift电梯, but it might威力 never return返回.
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不仅仅是减轻,还可能完全根治。
03:11
So they got very interested有兴趣 in producing生产 convulsions抽搐,
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所以他们对诱发抽搐很感兴趣,
03:16
measured测量 types类型 of convulsions抽搐.
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控制抽搐的程度。
03:18
And they thought, "Well, we've我们已经 got electricity电力, we'll plug插头 somebody into the wall.
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他们认为,“我们有电源,我们可以把身体通电试试看。
03:21
That always makes品牌 hair头发 stand up and people shake a lot."
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这样通电后体验者人头发竖起,身体颤动。”
03:24
So, they tried试着 it on a few少数 pigs, and none没有 of the pigs were killed杀害.
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于是,他们在猪身上做了几次试验,没有一头猪被电死。
03:28
So, they went to the police警察 and they said,
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然后他们去找警察说,
03:30
"We know that at the Rome罗马 railroad铁路 station,
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“我们知道在罗马火车站
03:33
there are all these lost丢失 souls灵魂 wandering飘零 around,
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很多无家可归之人四处流浪,
03:35
muttering咕哝 gibberish胡言乱语. Can you bring带来 one of them to us?"
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成天疯疯癫癫,你们能带来一个给我们做实验吗?”
03:39
Someone有人 who is, as the Italians意大利 say, "cagootscagoots."
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这就是意大利人常说的“脑袋秀逗“”短路了“
03:42
So they found发现 this "cagootscagoots" guy,
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于是他们找到了这样一个”脑袋秀逗“的人,
03:44
a 39-year-old-岁 man who was really hopelessly绝望地 schizophrenic精神分裂症,
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一个39岁的重度精神分裂男患者
03:47
who was known已知, had been known已知 for months个月,
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众人都知道他已经好几个月了,
03:50
to be literally按照字面 defecating排粪 on himself他自己,
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他在自己身上大小便,
03:54
talking nothing that made制作 any sense,
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整天胡言乱语,
03:56
and they brought him into the hospital醫院.
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他被送到医院。
03:58
So these three psychiatrists精神科医生, after about two or three weeks of observation意见,
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接下来这三个精神病专家经过2-3周的观察,
04:02
laid铺设 him down on a table,
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让他平躺到一个桌子上,
04:04
connected连接的 his temples寺庙 to a very small source资源 of current当前.
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把他的太阳穴用非常微弱的电流连接起来。
04:09
They thought, "Well, we'll try 55 volts, two-tenths十分之二 of a second第二.
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他们想“我们先试55伏特,2/10秒。
04:13
That's not going to do anything terrible可怕 to him."
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这不会对他造成伤害。”
04:16
So they did that.
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然后他们就尝试了。
04:17
Well, I have the following以下 from a firsthand第一手 observer观察者,
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下面是我从一个第一手观察者处获得的,
04:21
who told me this about 35 years年份 ago,
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他在35年前告诉我的,
04:24
when I was thinking思维 about these things
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当时我正在思考电疗这些事情
04:26
for some research研究 project项目 of mine.
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我有些研究项目,
04:29
He said, "This fellow同伴" -- remember记得, he wasn't even put to sleep睡觉 --
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他说,“这家伙”——记着,甚至没法让他入睡——
04:33
"after this major重大的 grand盛大 mal发作 convulsion抽搐,
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“在这次癫痫大发作以后,
04:35
satSAT right up, looked看着 at these three fellas小伙子们 and said,
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立刻坐起来,盯着三个专家说,
04:38
'What the fuck他妈的 are you assholes蛀虫 trying to do?' "
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”你们他妈的想对我做什么?“
04:42
(Laughter笑声)
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(笑声)
04:50
If I could only say that in Italian意大利.
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如果我能用意大利语说这个就好了。
04:53
Well, they were happy快乐 as could be, because he
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专家们很高兴,因为这个流浪汉
04:56
hadn't有没有 said a rational合理的 word in the weeks of observation意见.
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在过去几周观察期间,从未说过如此清醒符合逻辑的话。
05:00
So they plugged him in again,
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于是,他们又给他通电,
05:05
and this time they used 110 volts for half a second第二.
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这次,他们用110伏特,持续半秒。
05:09
And to their amazement惊愕, after it was over,
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让他们吃惊的是,经过这次尝试,
05:12
he began开始 speaking请讲 like he was perfectly完美 well.
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流浪汉开始说话,完全跟正常人一样了。
05:15
He relapsed复发 a little bit, they gave him a series系列 of treatments治疗,
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他偶尔复发,专家继续进行一系列的治疗,
05:18
and he was essentially实质上 cured治愈.
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他基本上被治愈了。
05:19
But of course课程, having schizophrenia精神分裂症,
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当然,他有精神分裂症,
05:22
within a few少数 months个月, it returned.
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几个月内又患病了。
05:24
But they wrote a paper about this,
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但是专家们针对这个试验完成了篇报告,
05:26
and everybody每个人 in the Western西 world世界 began开始 using运用 electricity电力
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然后西方医疗界开始使用电击疗法
05:31
to convulse抽搐 people who were either schizophrenic精神分裂症 or severely严重 depressed郁闷.
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诱发病人抽搐,以治疗精神分裂症或者严重抑郁症。
05:35
It didn't work very well on the schizophrenics精神分裂症患者,
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在治疗精神分裂症上,电击疗法效果不是很好,
05:37
but it was pretty漂亮 clear明确 in the '30s and by the middle中间 of the '40s
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但是在30年代和40年代中期,很明显
05:40
that electroconvulsiveelectroconvul​​sive therapy治疗 was very, very effective有效
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电击治疗对于治疗忧郁症
05:46
in the treatment治疗 of depression萧条.
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非常非常有效。
05:48
And of course课程, in those days, there were no antidepressant抗抑郁剂 drugs毒品,
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当然,在那个时候,没有抗抑郁的药,
05:51
and it became成为 very, very popular流行.
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电击疗法就非常普遍。
05:54
They would anesthetize麻醉 people,
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医生会麻醉患者,
05:56
convulse抽搐 them, but the real真实 difficulty困难 was
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电击使他们抽搐,但是真正的困难是,
05:59
that there was no way to paralyze瘫痪 muscles肌肉.
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没办法抑制肌肉抽搐
06:01
So people would have a real真实 grand盛大 mal发作 seizure发作.
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结果患者会有癫痫大发作。
06:04
Bones骨头 were broken破碎. Especially特别 in old, fragile脆弱 people,
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骨头断裂-特别是老年人,骨质脆弱的人,
06:07
you couldn't不能 use it.
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不能使用这个疗法。
06:09
And then in the 1950s, late晚了 1950s, the so-called所谓 muscle肌肉 relaxants
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后来,到了50年代后期,有了肌肉弛缓药,
06:14
were developed发达 by pharmacologists药理学家,
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药理学家发明的,
06:16
and it got so that you could induce促使 a complete完成 convulsion抽搐,
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这样就可以施予完整的电击诱发抽搐过程,
06:20
an electroencephalographic脑电图 convulsion抽搐 -- you could see it on the brain waves波浪 --
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脑电图癫痫—你可以从脑波看出来—
06:23
without causing造成 any convulsion抽搐 in the body身体 except a little bit of twitching抽搐 of the toes脚趾.
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不会引发身体的抽搐,除了一点点的脚趾抽动。
06:28
So again, it was very, very popular流行 and very, very useful有用.
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所以电击疗法变得非常非常普遍和有效。
06:34
Well, you know, in the middle中间 '60s,
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到了60年代中期,
06:36
the first antidepressants抗抑郁药 came来了 out. TofranilTofranil was the first.
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第一代抗抑郁药盐酸丙咪嗪产生了。
06:40
In the late晚了 '70s, early '80s, there were others其他,
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至70年代末,80年代初期,又有了其他一些药,
06:44
and they were very effective有效.
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这些药都很有效。
06:45
And patients'耐心' rights权利 groups seemed似乎 to get very upset烦乱
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当时电击治疗患者的权益团体非常不满
06:48
about the kinds of things that they would witness见证.
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抗议他们目睹的一些电击治疗方式。
06:51
And so the whole整个 idea理念 of electroconvulsiveelectroconvul​​sive, electroshock电击 therapy治疗 disappeared消失,
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所以电休克和电击疗法消失了
06:57
but has had a renaissance再生 in the last 10 years年份.
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-但是过去的10年里,又复苏了。
07:01
And the reason原因 that it has had a renaissance再生
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它复兴的原因是,
07:04
is that probably大概 about 10 percent百分 of the people, severe严重 depressives抑郁症,
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大约10%的人,重度抑郁症患者,
07:10
do not respond响应, regardless而不管 of what is doneDONE for them.
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对什么治疗都没有反应。
07:15
Now, why am I telling告诉 you this story故事 at this meeting会议?
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我为什么要给你们讲这些?
07:19
I'm telling告诉 you this story故事, because actually其实 ever since以来
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我讲这个故事,是因为
07:22
Richard理查德 called me and asked me to talk about
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理查给我打电话让我谈这个
07:24
-- as he asked all of his speakers音箱 --
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-就像他对其他演讲者一样-
07:26
to talk about something that would be new to this audience听众,
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谈一些对观众来说是很新鲜的话题,
07:29
that we had never talked about, never written书面 about,
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一个从未谈过和写过的话题。
07:32
I've been planning规划 this moment时刻.
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我一直在期待这个时刻。
07:35
This reason原因 really is that I am a man who, almost几乎 30 years年份 ago,
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真正的原因是大约30年前
07:40
had his life saved保存 by two long courses培训班 of electroshock电击 therapy治疗.
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2个长疗程的电击疗法挽救了我的生命。
07:48
And let me tell you this story故事.
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让我给你们讲讲这个故事。
07:52
I was, in the 1960s, in a marriage婚姻. To use the word bad
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60年代我结婚了,用“糟糕透了”这个词
07:58
would be perhaps也许 the understatement轻描淡写 of the year.
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都不足以形容
08:01
It was dreadful可怕.
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简直是糟糕极了。
08:03
There are, I'm sure, enough足够 divorced离婚 people in this room房间
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我相信在座的就有离婚的人
08:06
to know about the hostility敌意, the anger愤怒, who knows知道 what.
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知道那种敌意、愤怒,谁知道呢。
08:12
Being存在 someone有人 who had had a very difficult childhood童年,
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我有不堪的童年经历,
08:17
a very difficult adolescence青春期 --
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青春期也很痛苦,
08:18
it had to do with not quite相当 poverty贫穷 but close.
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虽然不是穷困潦倒,也差不多。
08:22
It had to do with being存在 brought up in a family家庭 where no one spoke English英语,
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生长在一个无人说英语的家庭里,
08:25
no one could read or write English英语.
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没人能读或写英语。
08:27
It had to do with death死亡 and disease疾病 and lots of other things.
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亲人经历了疾病和死亡,还有其他的不幸
08:31
I was a little prone易于 to depression萧条.
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我有点抑郁的倾向。
08:33
So, as things got worse更差, as we really began开始 to hate讨厌 each other,
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所以事情变得越来越糟,我们开始相互憎恨,
08:37
I became成为 progressively逐步 depressed郁闷 over a period of a couple一对 of years年份,
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我在那几年里逐渐变得抑郁,
08:41
trying to save保存 this marriage婚姻,
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虽努力挽救婚姻,
08:43
which哪一个 was inevitably必将 not to be saved保存.
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但却无法挽救。
08:47
Finally最后, I would schedule时间表 -- all my major重大的 surgical外科 cases,
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最后,我所有的大手术,
08:53
I was scheduling调度 them for 12, one o'clock in the afternoon下午,
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都安排在中午12点,下午1点
08:57
because I couldn't不能 get out of bed before about 11 o'clock.
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因为我无法在上午11点前起床。
09:01
And anybody任何人 who's谁是 been depressed郁闷 here knows知道 what that's like.
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在座有过抑郁症的人都能了解。
09:04
I couldn't不能 even pull the covers盖子 off myself.
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我甚至没力气把被子掀开。
09:08
Well, you're in a university大学 medical center中央,
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我是在大学附属医疗中心,
09:10
where everybody每个人 knows知道 everybody每个人, and it's perfectly完美 clear明确 to my colleagues同事,
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大家都很熟,我的同事们都知道我,
09:13
so my referrals推介 began开始 to decrease减少.
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所以我转接病人减少。
09:15
As my referrals推介 began开始 to decrease减少,
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当我的病人越来越少的时候,
09:18
I clearly明确地 became成为 increasingly日益 depressed郁闷
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我变得更加抑郁
09:22
until直到 I thought, my God, I can't work anymore.
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一直到我发现,天呢,我不能再工作了。
09:24
And, in fact事实, it didn't make any difference区别
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事实上这对我也没什不同,
09:26
because I didn't have any patients耐心 anymore.
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因为我也没有病人了。
09:28
So, with the advice忠告 of my physician医师,
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所以,接受我医师的建议,
09:32
I had myself admitted承认 to the acute急性 care关心 psychiatric精神病 unit单元 of our university大学 hospital醫院.
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我住进了我们大学医院的急性精神病治疗科。
09:37
And my colleagues同事, who had known已知 me since以来 medical school学校
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那些从医学院就认识我的同事们
09:40
in that place地点, said, "Don't worry担心, chap皴裂. Six weeks,
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告诉我“不要担心,伙计,6周,
09:42
you're back in the operating操作 room房间. Everything's一切都 going to be great."
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你就会回到手术室。一切都会好的。”
09:46
Well, you know what bovine stercusstercus is?
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你知道什么是扯淡吗?
09:50
That proved证实 to be a lot of bovine stercusstercus.
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这些话就是扯淡。
09:56
I know some people who got tenure保有 in that place地点 with lies like that.
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我知道有些人就靠这些谎言才有了终身教授的名头。
10:01
(Laughter笑声)
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(笑声)
10:07
So I was one of their failures故障.
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我是他们谎言的活证。
10:10
But it wasn't that simple简单. Because by the time
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事情不是那么简单。因为后来
10:12
I got out of that unit单元, I was not functional实用 at all.
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我出了院,根本就没有对我起作用。
10:17
I could hardly几乎不 see five feet in front面前 of myself.
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我几乎看不到我面前5英尺的东西。
10:19
I shuffled洗牌 when I walked. I was bowed鞠躬 over.
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我拖着脚走路,我弯着腰。
10:22
I rarely很少 bathed沐浴. I sometimes有时 didn't shave刮胡子. It was dreadful可怕.
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我几乎不洗澡,也不刮胡子。太糟糕了。
10:27
And it was clear明确 -- not to me,
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我的状况很明显—我自己不知道
10:30
because nothing was clear明确 to me at that time anymore --
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我当时什么都不知道—
10:33
that I would need long-term长期 hospitalization住院治疗
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明显我需要长期的入院治疗
10:37
in that awful可怕 place地点 called a mental心理 hospital醫院.
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住进在那个糟糕的叫做精神病院的地方。
10:41
So I was admitted承认, in 1973, in the spring弹簧 of 1973,
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所以1973年春天我住院了,
10:47
to the Institute研究所 of Living活的, which哪一个 used to be called the Hartford哈特福德 Retreat撤退.
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住在Living学院,以前被称作哈特福特疗养院。
10:50
It was founded成立 in the eighteenth第十八 century世纪,
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Living学院18世纪建成,
10:52
the largest最大 psychiatric精神病 hospital醫院 in the state of
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是康涅狄格州除了大型医院外
10:56
Connecticut康涅狄格, other than the huge巨大 public上市 hospitals医院
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最大的精神病院
10:58
that existed存在 at that time.
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在当时是这样的。
11:01
And they tried试着 everything they had.
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住院后,医生尽其所能。
11:02
They tried试着 the usual通常 psychotherapy心理治疗.
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他们试了常规的心理疗法,
11:04
They tried试着 every一切 medication药物治疗 available可得到 in those days.
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也尝试了那个时候所有可能的药物。
11:07
And they did have TofranilTofranil and other things -- MellarilMellaril, who knows知道 what.
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他们用了盐酸丙咪嗪和其他药-,硫醚嗪,谁知道。
11:11
Nothing happened发生 except that I got jaundiced黄疸 from one of these things.
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什么疗效都没有,除了害我得了黄疸病。
11:15
And finally最后, because I was well known已知 in Connecticut康涅狄格,
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最后,因为我在康涅狄格州很出名,
11:21
they decided决定 they better have a meeting会议 of the senior前辈 staff员工.
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他们决定组成专家组开个会。
11:25
All the senior前辈 staff员工 got together一起, and I later后来 found发现 out what happened发生.
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所有的高级专家聚在一起,后来我才知道。
11:31
They put all their heads together一起 and they decided决定
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他们集体讨论的结论是
11:35
that there was nothing that could be doneDONE
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他们无能为力了
11:37
for this surgeon外科医生 who had essentially实质上 separated分离 himself他自己 from the world世界,
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因为患者已经和世界脱节,
11:41
who by that time had become成为 so overwhelmed不堪重负,
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完全垮了。
11:45
not just with depression萧条 and feelings情怀
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不仅是郁闷感受
11:48
of worthlessness无价值 and inadequacy不足之处,
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无价值的和无能的感觉,
11:50
but with obsessional强迫 thinking思维,
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还有无法摆脱的强迫性思考,
11:53
obsessional强迫 thinking思维 about coincidences巧合.
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满脑子在想各种巧合
11:55
And there were particular特定 numbers数字 that every一切 time I saw them,
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有一些特别的数字,每次我看到
11:58
just got me dreadfully可怕 upset烦乱 -- all kinds of ritualistic仪式 observances纪念活动,
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都让我有种痛苦,还有各种怪癖
12:04
just awful可怕, awful可怕 stuff东东.
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糟糕透了。
12:06
Remember记得 when you were a kid孩子, and you had to step on every一切 line线?
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记得小时候走路,你要踩到地上每条线吗?
12:09
Well, I was a grown长大的 man who had all of these rituals仪式,
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我曾是个有这些怪癖的成年人,
12:13
and it got so there was a throbbing悸动, there was a ferocious凶猛 fear恐惧 in my head.
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脑中有种可怕的恐惧。
12:17
You've seen看到 this painting绘画 by Edvard爱德华 Munch蒙克,
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你们看过孟克的画
12:19
The Scream呐喊. Every一切 moment时刻 was a scream惊叫.
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“呐喊”。“呐喊”。每个时刻都在呐喊。
12:24
It was impossible不可能. So they decided决定 there was no therapy治疗,
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这是非常可怕的。所以医生认为我无药可救了,
12:27
there was no treatment治疗. But there was one treatment治疗,
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没有办法治疗。但是有一个方法,
12:30
which哪一个 actually其实 had been pioneered首创 at the Hartford哈特福德 hospital醫院 in the early 1940s,
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这个方法在19世纪40年代曾经在Hartford医院率先使用过,
12:35
and you can imagine想像 what it was. It was pre-frontal前额叶 lobotomy切断术.
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你可以想象这是什么方法。前脑叶白质切除术。
12:43
So they decided决定 -- I didn't know this, again,
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所以医生决定-不让我知道这一切。
12:45
I found发现 this out later后来 --
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我后来还是知道了-
12:46
that the only thing that could be doneDONE was
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唯一能做的就是
12:48
for this 43-year-old-岁 man to have a pre-frontal前额叶
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对于这个43岁的男人
12:52
lobotomy切断术.
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前脑叶白质切除术。
12:55
Well, as in all hospitals医院, there was a resident居民
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就像所有的医院一样,有一个住院医生
12:58
assigned分配 to my case案件. He was 27 years年份 old,
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被指派给我。他27岁,
13:01
and he would meet遇到 with me two or three times a week.
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他每周跟我见2-3次面。
13:03
And of course课程, I had been there, what, three or four months个月 at the time.
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我当时在医院住了3-4月。
13:07
And he asked to meet遇到 with the senior前辈 staff员工, and they agreed同意 to meet遇到 with him
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他跟其他资深的医生会诊, 资深医生同意跟他会诊
13:10
because he was very well thought of in that place地点.
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因为他是个深思熟虑的人。
13:12
They thought he had a really extraordinary非凡 future未来.
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他们认为他前途无量。
13:16
And he dug in his heels脚跟 and said,
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他坚持说,
13:17
"No. I know this man better than any of you. I have met会见 with him over and over again.
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“我比你们任何一个人都清楚这个病人,我们见过很多次面。
13:21
You've just seen看到 him from time to time. You've read reports报告 and so forth向前.
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你们只是偶尔探视他,看看他的病历。
13:25
I really honestly老老实实 believe that the basic基本 problem问题 here is pure depression萧条,
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我相信他的病就是单纯的忧郁症,
13:30
and all of the obsessional强迫 thinking思维 comes out of it.
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以及伴随的强迫性思考。
13:33
And you know, of course课程, what'll什么会 happen发生 if you do a pre-frontal前额叶 lobotomy切断术.
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你们当然知道进行前额叶切除的后果。
13:36
Any of the results结果 along沿 the spectrum光谱,
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任何情况都可能发生,
13:40
from pretty漂亮 bad to terrible可怕, terrible可怕, terrible可怕
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从不太理想到不堪设想,非常非常糟糕,
13:42
is going to happen发生. If he does the best最好 he can,
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都有可能发生。如果手术非常成功,
13:46
he will have no further进一步 obsessions走火入魔,
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他将不再会强迫性思考,
13:48
probably大概 no depression萧条, but his affect影响 will be dulled迟钝,
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也许不再忧郁,但是他的情感会迟钝,
13:51
he will never go back to surgery手术,
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他也许无法在做外科医生,
13:53
he will never be the loving爱心 father父亲 that he was to his two children孩子,
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也无法再成为他两个孩子的慈祥的父亲
13:57
his life will be changed. If he has the usual通常 result结果,
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他的人生从此改变。如果是一般的手术结果,
14:00
he will end结束 up like 'One'一 Flew弗卢 Over the Cuckoo's杜鹃的 Nest.'
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他会像“飞跃杜鹃窝”一样,
14:03
And you know about that, just essentially实质上 in a stupor麻木 the rest休息 of his life."
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终生痴呆恍惚。
14:08
Well, he said, "Can't we try a course课程 of electroshock电击 therapy治疗?"
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“难道我们不能尝试一下点击疗法吗?”
14:14
And you know why they agreed同意? They agreed同意 to humor幽默 him.
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你知道他们为什么同意了?他们不想和他争执。
14:17
They just thought, "Well, we'll give a course课程 of 10.
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他们想,就试10次电疗吧。
14:21
And so we'll lose失去 a little time. Big deal合同. It doesn't make any difference区别."
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我们只是浪费点时间。反正也没有什么区别。“
14:25
So they gave the course课程 of 10,
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所以他们给我进行了10个疗程的电击疗法,
14:26
and the first -- the usual通常 course课程, incidentally顺便, was six to eight
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第一个疗程通常是6-8次,
14:30
and still is six to eight.
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现在还是6-8次---
14:32
Plugged堵塞 me into the wires电线, put me to sleep睡觉, gave me the muscle肌肉 relaxant.
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于是他们给我帖导电片,麻醉,让我肌肉松弛。
14:36
Six didn't work. Seven didn't work.
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6次没有用,7次也没效果。
14:38
Eight didn't work. At nine, I noticed注意到 --
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8次还是没用,到了第9次,我感觉到---
14:41
and it's wonderful精彩 that I could notice注意 anything
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我自己能够感觉到真是太好了
14:44
-- I noticed注意到 a change更改. And at 10, I noticed注意到 a real真实 change更改.
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---我感觉到了变化。到了第10次,我感到了真的不同。
14:48
And he went back to them, and they agreed同意 to do another另一个 10.
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然后他找到其他医生们,他们同意再做10次。
14:51
Again, not a single one of them
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这些医生中没有一个相信
14:53
-- I think there are about seven or eight of them --
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-我想他们中大概7,8位都不信-
14:55
thought this would do any good. They thought this was a temporary临时 change更改.
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他们认为电击没有用。他们认为这只是暂时的改善。
14:57
But, lo and behold不料, by 16, by 17,
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结果让大家惊讶的是到了第16,17次,
15:01
there were demonstrable论证 differences分歧 in the way I felt.
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我已经明显感觉到了变化。
15:05
By 18 and 19, I was sleeping睡眠 through通过 the night.
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到了第18,19次,我已经可以安睡整晚了。
15:08
And by 20, I had the sense, I really had the sense
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第20次完成,我真的感觉
15:12
that I could overcome克服 this,
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我可以战胜忧郁症,
15:15
that I was now strong强大 enough足够 that by an act法案 of will,
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我已经很坚强,可以靠意志力
15:18
I could blow打击 the obsessional强迫 thinking思维 away.
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扫除强迫性思考,
15:20
I could blow打击 the depression萧条 away.
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告别忧郁症。
15:23
And I've never forgotten忘记了 -- I never will forget忘记
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我永远也不会忘记
15:26
-- standing常设 in the kitchen厨房 of the unit单元,
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站在疗养院的厨房,
15:29
it was a Sunday星期日 morning早上 in January一月 of 1974,
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1974年1月的星期天早上,
15:33
standing常设 in the kitchen厨房 by myself and thinking思维, "I've got the strength强度 now to do this."
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我独自站在厨房,心想”我现在有康复的力量了。“
15:39
It was as though虽然 those tightly紧紧 coiled盘绕 wires电线 in my head had been disconnected断开的
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好像在我头脑中紧紧纠结着的电路被拆除了
15:44
and I could think clearly明确地.
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我思路清晰。
15:46
But I need a formula. I need some thing to say to myself
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但我需要一个方法。需要提醒我自己
15:51
when I begin开始 thinking思维 obsessionallyobsessionally, obsessively痴迷.
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以防我陷入强迫性思考
15:55
Well, the Gilbert吉尔伯特 and Sullivan沙利文 fans球迷 in this room房间
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在座的吉尔伯特和沙利文的粉丝们
16:00
will remember记得 "RuddigoreRuddigore," and they will remember记得 Mad Margaret玛格丽特,
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会记得歌剧『Ruddy Gore』和疯狂玛格丽特
16:03
and they will remember记得 that she was married已婚
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会记得她嫁给
16:05
to a fellow同伴 named命名 Sir先生 DespardDespard MurgatroydMurgatroyd.
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一个名叫德斯帕特爵士
16:09
And she used to go nuts坚果, every一切 five minutes分钟 or so in the play,
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她在剧中差不多每5分钟都会发狂
16:13
and he said to her, "We must必须 have a word to bring带来 you back to reality现实,
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他对她说,“我们得有个密语把你拉回现实”
16:16
and the word, my dear, will be 'Basingstoke“贝辛斯托克.'"
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亲爱的,我们就定“贝辛斯托克”(地名)”吧
16:20
So every一切 time she got a little nuts坚果,
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所以每次她有点发狂时
16:22
he would say, "Basingstoke贝辛斯托克!" And she would say,
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他就说:“贝辛斯托克!” 她就回答说,
16:24
"Basingstoke贝辛斯托克, it is." And she would be fine for a little while.
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“是的,贝辛斯托克。” 她就能好一段时间。
16:28
Well, you know, I'm from the Bronx布朗克斯. I can't say "Basingstoke贝辛斯托克."
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好吧,你知道,我来自布朗克斯,我不能说"贝辛斯托克"
16:32
But I had something better. And it was very simple简单.
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我有更好的主意,非常简单
16:36
It was, "Ah, fuck他妈的 it!"
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就是:"诶呀,去他的!"
16:39
(Laughter笑声) Much better than "Basingstoke贝辛斯托克,"
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(笑声)比贝辛斯托克好多了
16:44
at least最小 for me. And it worked工作 -- my God, it worked工作.
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至少对于我来说,这真的管用,天呀.
16:48
Every一切 time I would begin开始 thinking思维 obsessionallyobsessionally --
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每次我开始强迫性思维时
16:50
again, once一旦 more, after 20 shock休克 treatments治疗
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在历经20次电疗之后
16:54
-- I would say, "Ah, fuck他妈的 it."
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我都说"哎呀,去他的!"
16:58
And things got better and better,
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状况变得越来越好,
17:00
and within three or four months个月,
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三四个月后,
17:03
I was discharged出院 from that hospital醫院, and I joined加盟 a group of surgeons外科医生
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我出院并加入外科医师团体
17:06
where I could work with other people in the community社区,
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我可以和其他人共事
17:10
not in New Haven避风港, but fairly相当 close by.
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并不在康州纽黑文市,但很近.
17:13
I stayed there for three years年份.
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在那里我待了3年
17:15
At the end结束 of three years年份, I went back to New Haven避风港,
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3年后,我回到了纽黑文市,
17:19
had remarried再婚 by that time.
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当时我已经再婚了.
17:23
I brought my wife妻子 with me, actually其实, to make sure I could get through通过 this.
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我带着我爱人, 帮助我一起康复.
17:29
My children孩子 came来了 back to live生活 with us.
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我的孩子也回来和我们一起住生活.
17:35
We had two more children孩子 after that.
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之后我们生了2个孩子
17:38
Resuscitated复苏 the career事业, even better than it had been before.
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我回到工作岗位,甚至比以前更好了.
17:43
Went right back into the university大学
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我回到大学
17:47
and began开始 to write books图书.
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开始写书.
17:50
Well, you know, it's been a wonderful精彩 life.
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现在的生活很好
17:53
It's been, as I said, close to 30 years年份.
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至今已经近30年了.
17:57
I stopped停止 doing surgery手术 about six years年份 ago
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大约6年前,我停止做手术了
18:00
and became成为 a full-time全职 writer作家, as many许多 people know.
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成为全职作家,这个很多人知道.
18:04
But it's been very exciting扣人心弦. It's been very happy快乐.
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这是令人幸福和快乐的.
18:07
Every一切 once一旦 in a while, I have to say, "Ah, fuck他妈的 it."
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偶尔,我还会说:"哎呀,去他的!"
18:09
Every一切 once一旦 in a while, I get somewhat有些 depressed郁闷 and a little obsessional强迫.
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偶尔,我还会郁闷并有点强迫性思维
18:12
So, I'm not free自由 of all of this. But it's worked工作. It's always worked工作.
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所以其实并没完全好,但电疗确实有效.
18:22
Why have I chosen选择, after never, ever talking about this, to talk about it now?
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为何我以前选择避而不谈这个,而现在却谈论它?
18:30
Well, those of you who know some of these books图书
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你们其中有些人知道我的这些书
18:33
know that one is about death死亡 and dying垂死,
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一本讨论生死的书,
18:36
one is about the human人的 body身体 and the human人的 spirit精神,
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关于人的身体和心灵的书,
18:38
one is about the way mystical神秘 thoughts思念 are constantly经常 in our minds头脑,
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一本神秘想法萦绕于心的书,
18:43
and they have always to do with my own拥有 personal个人 experiences经验.
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所有的都和我个人的经历有关系.
18:48
One might威力 think reading these books图书
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读者可能会想——
18:51
-- and I've gotten得到 thousands数千 of letters about them
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——我已经收到上千封信函
18:54
by people who do think this --
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读者确实这么认为——
18:56
that based基于 on my life's人生 history历史 as I've portrayed刻画 in the books图书,
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从我书中描绘的个人生命史来看
18:59
my early life's人生 history历史, I am someone有人 who has overcome克服 adversity逆境.
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从我早期的生活看,我是个已经克服磨难的人。
19:04
That I am someone有人 who has drunk, drank, drunk
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我遍尝苦难
19:09
of the bitter dregs of near-disaster近灾难 in childhood童年
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童年历经艰辛
19:16
and emerged出现 not just unscathed毫发无损 but strengthened加强.
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逆境没有挫败我,反而使我坚强
19:21
I really have it figured想通 out, so that I can advise劝告 people about
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我已经真正开悟,可以和大家分享
19:24
death死亡 and dying垂死, so that I can talk about mysticism神秘主义 and the human人的 spirit精神.
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生与死的思考, 也能谈谈神秘主意与人的心灵。
19:29
And I've always felt guilty有罪 about that.
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我一直感到心虚,
19:31
I've always felt that somehow不知何故 I was an impostor骗子
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一直觉得自己有点像冒充的
19:34
because my readers读者 don't know what I have just told you.
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因为读者不知道我今天说的。
19:39
It's known已知 by some people in New Haven避风港, obviously明显,
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很明显,纽黑文市有人知道,
19:42
but it is not generally通常 known已知.
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但一般来说,这不为人知。
19:44
So one of the reasons原因 that I have come here to talk about this today今天
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所以今天我来这里分享的原因之一是
19:49
is to -- frankly坦率地说, selfishly自私 --
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——坦白说,是自私地——
19:54
unburden表白 myself and let it be known已知
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解除我自己的心理负担,让大众知道
19:57
that this is not an untroubled mind心神 that has written书面 all of these books图书.
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写就这些书并非是无所忧虑的。
20:03
But more importantly重要的, I think,
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更重要的是,我认为,
20:06
is the fact事实 that a very significant重大 proportion比例
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在座的相当一拨人
20:08
of people in this audience听众 are under 30,
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年纪不满30岁,
20:12
and there are many许多, of course课程, who are well over 30.
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当然,也有很多超过30岁的。
20:18
For people under 30, and it looks容貌 to me like almost几乎 all of you
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对于30以下的人,在我看来,几乎你们所有人
20:21
-- I would say all of you --
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——你们所有人——
20:22
are either on the cusp风口浪尖 of a magnificent华丽的 and exciting扣人心弦 career事业
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要么在美好生涯尖峰
20:27
or right into a magnificent华丽的 and exciting扣人心弦 career事业:
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要么正要步入美好生涯,
20:31
anything can happen发生 to you. Things change更改.
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任何事情都可能发生在你身上。世事难料。
20:35
Accidents事故 happen发生. Something from childhood童年 comes back to haunt出没 you.
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祸福无常。童年记忆可能回来纠缠你,
20:39
You can be thrown抛出 off the track跟踪.
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你可能困顿茫然。
20:41
I hope希望 it happens发生 to none没有 of you,
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我希望不要发生在你们身上,
20:42
but it will probably大概 happen发生 to a small percentage百分比 of you.
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但少部分人可能会碰上。
20:47
To those to whom it doesn't happen发生, there will be adversities逆境.
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即使不碰到这样的经历,也有人生逆境。
20:52
If I, with the bleakness苍凉 of spirit精神,
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假如连我这个希望渺茫,
20:56
with no spirit精神, that I had in the 1970s
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1970年时根本全然绝望的灵魂
21:01
and no possibility可能性 of recovery复苏,
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不可能康复
21:03
as far as that group of very experienced有经验的 psychiatrists精神科医生 thought,
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至少那群资深精神科医师这么认为,
21:07
if I can find my way back from this,
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如果我能熬过去
21:09
believe me, anybody任何人 can find their way back
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相信我,任何人都能熬过来
21:13
from any adversity逆境 that exists存在 in their lives生活.
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克服生活中的任何逆境。
21:18
And for those who are older旧的, who have lived生活 through通过
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年长的人,已然有了生活
21:19
perhaps也许 not something as bad as this,
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可能没这么糟糕
21:22
but who have lived生活 through通过 difficult times,
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但也经历坎坷
21:25
perhaps也许 where they lost丢失 everything, as I did,
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可能如我样失去所有,
21:27
and started开始 out all over again, some of these things will seem似乎 very familiar.
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并从头再来, 一些事情似曾相熟。
21:34
There is recovery复苏.
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你可以康复。
21:39
There is redemption赎回. And there is resurrection复活.
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可以救赎,重获新生。
21:47
There are resurrection复活 themes主题 in every一切 society社会 that has ever been studied研究,
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每个社会都有重获新生的故事
21:51
and it is because not just only do we fantasize梦想
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这是因为我们不仅是幻想
21:54
about the possibility可能性 of resurrection复活 and recovery复苏,
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重生和康复的可能性
21:57
but it actually其实 happens发生. And it happens发生 a lot.
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而且它确实发生,而且它多有所闻。
22:01
Perhaps也许 the most popular流行 resurrection复活 theme主题,
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或许最经常听到的重生故事
22:05
outside of specifically特别 religious宗教 ones那些,
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除了宗教事务外
22:08
is the one about the phoenix凤凰, the ancient story故事 of the phoenix凤凰,
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就是有关凤凰的古老神话
22:12
who, every一切 500 years年份, resurrects复活 itself本身 from its own拥有 ashes灰烬
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每500年,它会从自己的灰烬中浴火重生
22:19
to go on to live生活 a life that is
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展开新的生命
22:22
even more beautiful美丽 than it was before. Richard理查德,
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更加美妙的新生命。理查,
22:25
thanks谢谢 very much.
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非常感谢。
Translated by Lawrence Wang
Reviewed by Zhu Jie

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ABOUT THE SPEAKER
Sherwin Nuland - Doctor
A practicing surgeon for three decades, Sherwin Nuland witnessed life and death in every variety. Then he turned to writing, exploring what there is to people beyond just anatomy.

Why you should listen

Sherwin Nuland was a practicing surgeon for 30 years and treated more than 10,000 patients -- then became an author and speaker on topics no smaller than life and death, our minds, our morality, aging and the human spirit.

His 1994 book How We Die: Reflections of Life's Final Chapter demythologizes the process of dying. Through stories of real patients and his own family, he examines the seven most common causes of death: old age, cancer, AIDS, Alzheimer's, accidents, heart disease and stroke, and their effects. The book, one of more than a dozen he wrote, won the National Book Award, was a finalist for the Pultizer Prize, and spent 34 weeks on the New York Times best-seller list. Other books include How We Live, The Art of Aging: A Doctor's Prescription for Well-Being; and The Soul of Medicine: Tales from the Bedside.

More profile about the speaker
Sherwin Nuland | Speaker | TED.com