TEDSummit 2019
Sandeep Jauhar: How your emotions change the shape of your heart
桑迪普·乔哈尔: 你的情感如何改变心脏的形状
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“我们情感生活的记录写在我们的心脏上，”心脏病学家兼作家桑迪普·乔哈尔如是说。在这个令人惊奇的演讲中，他探讨了我们的情绪是如何神秘地影响我们的心脏，使它们改变形状，以应对悲伤或恐惧，对破碎的心作出情感反应。他呼吁人们转变照顾我们最重要的器官的模式。
Sandeep Jauhar - Physician, writer
Sandeep Jauhar is a practicing cardiologist passionate about communicating medicine in all its glorious, quirky, inescapable humanity. Full bio
Sandeep Jauhar is a practicing cardiologist passionate about communicating medicine in all its glorious, quirky, inescapable humanity. Full bio
Double-click the English transcript below to play the video.
00:13
No other organ,
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没有其他器官，
00:14
perhaps no other object in human life,
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可能在整个人生中
也没有其他的东西，
也没有其他的东西，
00:18
is as imbued with metaphor
and meaning as the human heart.
and meaning as the human heart.
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像人类的心脏一样充满隐喻和意义。
00:23
Over the course of history,
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在历史的长河中，
00:24
the heart has been a symbol
of our emotional lives.
of our emotional lives.
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心是我们情感生活的象征。
00:28
It was considered by many
to be the seat of the soul,
to be the seat of the soul,
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它曾被很多人视为灵魂的座驾，
00:32
the repository of the emotions.
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情感的仓库。
00:35
The very word "emotion" stems in part
from the French verb "émouvoir,"
from the French verb "émouvoir,"
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“emotion（情感）”这个词部分
源自法语动词“emouvoir”，
源自法语动词“emouvoir”，
00:42
meaning "to stir up."
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意思是“搅动”。
00:44
And perhaps it's only logical
that emotions would be linked to an organ
that emotions would be linked to an organ
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也许将情感和以跳动为特征的器官
00:48
characterized by its agitated movement.
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联系在一起是唯一的正确逻辑。
00:51
But what is this link?
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但这个联系是什么？
00:53
Is it real or purely metaphorical?
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它是真实的还是纯粹隐喻？
00:57
As a heart specialist,
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作为心脏专家，
00:59
I am here today to tell you
that this link is very real.
that this link is very real.
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我今天在这里要告诉你们，
这个联系是真实的。
这个联系是真实的。
01:05
Emotions, you will learn,
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你将了解到，情感
01:07
can and do have a direct
physical effect on the human heart.
physical effect on the human heart.
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能够，也实会对人类心脏
产生直接的物理影响。
产生直接的物理影响。
01:14
But before we get into this,
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但在我们深入之前，
01:15
let's talk a bit about
the metaphorical heart.
the metaphorical heart.
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让我们来谈谈隐喻意义上的心。
01:18
The symbolism of the emotional heart
endures even today.
endures even today.
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即便在今天，情感之心
的象征意义仍然存在。
的象征意义仍然存在。
01:23
If we ask people which image
they most associate with love,
they most associate with love,
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如果问人们哪一个图片可以让人
联想到爱，
联想到爱，
01:28
there's no question that the Valentine
heart would the top the list.
heart would the top the list.
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毫无疑义，恋人之心会高居榜首。
01:33
The heart shape, called a cardioid,
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心脏的形状，称为心形，
01:36
is common in nature.
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在自然中很常见。
01:38
It's found in the leaves,
flowers and seeds of many plants,
flowers and seeds of many plants,
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它存在于树叶，鲜花和
很多植物的种子中，
很多植物的种子中，
01:43
including silphium,
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包括串叶松香草，
01:45
which was used for birth control
in the Middle Ages
in the Middle Ages
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曾经在中世纪被用于生育控制，
01:48
and perhaps is the reason why
the heart became associated
the heart became associated
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这也许就是为什么心会与
01:52
with sex and romantic love.
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性爱与浪漫联系在一起。
01:55
Whatever the reason,
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出于某种原因，
01:57
hearts began to appear in paintings
of lovers in the 13th century.
of lovers in the 13th century.
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13世纪，情人的画像中
开始出现心形图案。
开始出现心形图案。
02:02
Over time, the pictures
came to be colored red,
came to be colored red,
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随着时间的推移，
这些画被涂成红色，
这些画被涂成红色，
02:06
the color of blood,
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鲜血的颜色，
02:08
a symbol of passion.
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激情的象征。
02:09
In the Roman Catholic Church,
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在罗马天主教会，
02:11
the heart shape became known
as the Sacred Heart of Jesus.
as the Sacred Heart of Jesus.
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心的形状被称为耶稣的圣心。
02:16
Adorned with thorns
and emitting ethereal light,
and emitting ethereal light,
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装饰着荆棘，散发着缥缈的光芒，
02:20
it became an insignia of monastic love.
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它成了修道院之爱的象征。
02:24
This association between the heart
and love has withstood modernity.
and love has withstood modernity.
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这种心与爱之间的联系
经受住了现代的考验。
经受住了现代的考验。
02:28
When Barney Clark, a retired dentist
with end-stage heart failure,
with end-stage heart failure,
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1982年，患有末期心力衰竭
的退休牙医巴尼·克拉克
的退休牙医巴尼·克拉克
02:34
received the first permanent
artificial heart in Utah in 1982,
artificial heart in Utah in 1982,
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在犹他州接受了首例永久性
人工心脏移植手术，
人工心脏移植手术，
02:39
his wife of 39 years
reportedly asked the doctors,
reportedly asked the doctors,
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他39岁的妻子曾向医生咨询，
02:45
"Will he still be able to love me?"
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“他还会爱我吗？”
02:48
Today, we know that the heart
is not the source of love
is not the source of love
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今天，我们知道心脏不是爱
02:52
or the other emotions, per se;
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或其他情感的源头，
02:54
the ancients were mistaken.
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古人弄错了。
02:55
And yet, more and more,
we have come to understand
we have come to understand
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然而，我们开始越来越多地了解到
02:58
that the connection between the heart
and the emotions is a highly intimate one.
and the emotions is a highly intimate one.
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心脏和情感的联系是
极为亲密的整体。
极为亲密的整体。
03:03
The heart may not originate our feelings,
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心脏可能不是我们感觉的起源，
03:06
but it is highly responsive to them.
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但它对感觉非常敏感。
03:08
In a sense, a record of our emotional life
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在某种意义上，我们情感生活的记录
03:11
is written on our hearts.
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就写在我们的心脏上。
03:13
Fear and grief, for example,
can cause profound cardiac injury.
can cause profound cardiac injury.
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例如，恐惧和悲伤会导致
严重的心脏损伤。
严重的心脏损伤。
03:18
The nerves that control unconscious
processes such as the heartbeat
processes such as the heartbeat
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控制无意识过程，如心跳的神经
03:23
can sense distress
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可以感觉到痛苦，
03:25
and trigger a maladaptive
fight-or-flight response
fight-or-flight response
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并引发适应不良的“战斗或逃跑”反应，
03:30
that triggers blood vessels to constrict,
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导致血管收缩，
03:33
the heart to gallop
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心跳加速
03:35
and blood pressure to rise,
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和血压上升，
03:37
resulting in damage.
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导致损伤。
03:39
In other words,
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换句话说，
03:41
it is increasingly clear
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越来越清晰的是，
03:44
that our hearts are extraordinarily
sensitive to our emotional system,
sensitive to our emotional system,
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我们的心脏对我们的
情感系统，对隐喻的心，
情感系统，对隐喻的心，
03:49
to the metaphorical heart, if you will.
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极度敏感。
03:52
There is a heart disorder
first recognized about two decades ago
first recognized about two decades ago
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大约20年前，
人们首次发现了一种名为
人们首次发现了一种名为
03:56
called "takotsubo cardiomyopathy,"
or "the broken heart syndrome,"
or "the broken heart syndrome,"
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“应激性心肌病”的心脏病，
即“心碎综合症”，
即“心碎综合症”，
04:01
in which the heart acutely weakens
in response to intense stress or grief,
in response to intense stress or grief,
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在这种情况下，心脏在面对巨大
的压力或悲伤时急剧衰弱，
的压力或悲伤时急剧衰弱，
04:08
such as after a romantic breakup
or the death of a loved one.
or the death of a loved one.
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比如跟爱人分手或爱人去世后。
04:11
As these pictures show,
the grieving heart in the middle
the grieving heart in the middle
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就像这些照片显示的，中间悲伤的心
04:15
looks very different
than the normal heart on the left.
than the normal heart on the left.
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跟左边正常的心看来很不同。
04:18
It appears stunned
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它看起来像是被打晕了，
04:20
and frequently balloons into
the distinctive shape of a takotsubo,
the distinctive shape of a takotsubo,
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往往会膨胀成章鱼壶的独特形状，
04:24
shown on the right,
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如右图所示，
04:25
a Japanese pot with a wide base
and a narrow neck.
and a narrow neck.
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一种有宽的底座和窄的日本锅。
04:29
We don't know exactly why this happens,
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我们还不知道这个发生的确实原因，
04:32
and the syndrome usually resolves
within a few weeks.
within a few weeks.
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这种症状通常会在几周内消失。
04:35
However, in the acute period,
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然而，在急性期，
04:37
it can cause heart failure,
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它可能会导致心脏衰竭，
04:40
life-threatening arrhythmias,
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危及生命的心律失常，
04:42
even death.
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甚至死亡。
04:43
For example, the husband
of an elderly patient of mine
of an elderly patient of mine
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比如，我的一个老年病人的丈夫
04:49
had died recently.
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最近去世了。
04:51
She was sad, of course, but accepting.
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她很悲伤，当然，
但接受这个现实了。
但接受这个现实了。
04:55
Maybe even a bit relieved.
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也许松一口气。
04:57
It had been a very long illness;
he'd had dementia.
he'd had dementia.
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这是一场持续了多年的疾病，
他患有老年痴呆。
他患有老年痴呆。
05:00
But a week after the funeral,
she looked at his picture
she looked at his picture
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但在葬礼结束的一周后，
她看着他的照片，
她看着他的照片，
05:04
and became tearful.
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变得泪眼模糊。
05:06
And then she developed chest pain,
and with it, came shortness of breath,
and with it, came shortness of breath,
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然后她出现了胸痛，
随之而来的是呼吸急促，
随之而来的是呼吸急促，
05:11
distended neck veins, a sweaty brow,
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脖子上青筋膨胀，额头出汗，
05:14
a noticeable panting
as she was sitting up in a chair --
as she was sitting up in a chair --
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当她坐在椅子上时，
明显地感到气喘吁吁——
明显地感到气喘吁吁——
05:18
all signs of heart failure.
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这些都是心脏衰竭的迹象。
05:23
She was admitted to the hospital,
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她被送进了医院，
05:25
where an ultrasound confirmed
what we already suspected:
what we already suspected:
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医院超声波验证了我们的怀疑：
05:29
her heart had weakened
to less than half its normal capacity
to less than half its normal capacity
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她的心脏已经衰弱到只有
不到一半的正常功能，
不到一半的正常功能，
05:36
and had ballooned into
the distinctive shape of a takotsubo.
the distinctive shape of a takotsubo.
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并且膨胀成明显的章鱼壶形状。
05:40
But no other tests were amiss,
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但检查不出其他问题，
05:43
no sign of clogged arteries anywhere.
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没有动脉阻塞的现象。
05:46
Two weeks later, her emotional state
had returned to normal
had returned to normal
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2周后，她的情感状态恢复正常，
05:50
and so, an ultrasound confirmed,
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并且，超声波检测确认，
05:55
had her heart.
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心脏也恢复了健康。
05:56
Takotsubo cardiomyopathy has been linked
to many stressful situations,
to many stressful situations,
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应激性心肌病跟很多压力环境有关，
06:02
including public speaking --
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包括公共演讲——
06:05
(Laughter)
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（笑声）
06:10
(Applause)
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（掌声）
06:16
domestic disputes, gambling losses,
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家庭争分，赌博损失，
06:20
even a surprise birthday party.
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甚至一个惊喜的
生日派对都包括在内。
生日派对都包括在内。
06:22
(Laughter)
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（笑声）
06:23
It's even been associated
with widespread social upheaval,
with widespread social upheaval,
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它甚至与广泛的社会动乱有关，
06:28
such as after a natural disaster.
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比如一场自然灾害后。
06:30
For example, in 2004,
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例如，2004年，
06:32
a massive earthquake devastated a district
on the largest island in Japan.
on the largest island in Japan.
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一场大地震摧毁了日本
最大岛屿上的一个地区，
最大岛屿上的一个地区，
06:39
More than 60 people were killed,
and thousands were injured.
and thousands were injured.
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超过60个人死亡，几千人受伤。
06:43
On the heels of this catastrophe,
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在这场灾难之后，
06:45
researchers found that the incidents
of takotsubo cardiomyopathy
of takotsubo cardiomyopathy
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研究者发现跟一年前同期相比，
06:50
increased twenty-four-fold in the district
one month after the earthquake,
one month after the earthquake,
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该地区在大地震后
一个月的应激性心肌病
一个月的应激性心肌病
06:56
compared to a similar
period the year before.
period the year before.
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发病率增加了24倍，
07:00
The residences of these cases
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这些病例发生的位置
07:02
closely correlated with
the intensity of the tremor.
the intensity of the tremor.
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与地震的强度密切相关。
07:05
In almost every case,
patients lived near the epicenter.
patients lived near the epicenter.
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在几乎每个病例中，
病人都是住在震中附近。
病人都是住在震中附近。
07:10
Interestingly, takotsubo cardiomyopathy
has been seen after a happy event, too,
has been seen after a happy event, too,
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有趣的是，应激性心肌病也曾在
一些愉快的事件后被发现，
一些愉快的事件后被发现，
07:17
but the heart appears
to react differently,
to react differently,
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但心脏反应似乎不一样，
07:19
ballooning in the midportion,
for example, and not at the apex.
for example, and not at the apex.
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在中部膨胀，而不是在顶部。
07:24
Why different emotional precipitants
would result in different cardiac changes
would result in different cardiac changes
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为什么不同的情绪会
导致心脏的不同变化
导致心脏的不同变化
07:29
remains a mystery.
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仍然是个迷。
07:31
But today, perhaps as an ode
to our ancient philosophers,
to our ancient philosophers,
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但今天，也许是作为对
我们古代哲学家的赞歌，
我们古代哲学家的赞歌，
07:36
we can say that even if emotions
are not contained inside our hearts,
are not contained inside our hearts,
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我们可以说即便情感
不存在于我们的心脏中，
不存在于我们的心脏中，
07:42
the emotional heart overlaps
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情感的心跟它的
07:48
its biological counterpart,
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生物体依然是以一种
07:50
in surprising and mysterious ways.
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惊人和神秘的方式相对应的。
07:54
Heart syndromes, including sudden death,
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心脏综合症，包括猝死，
07:58
have long been reported in individuals
experiencing intense emotional disturbance
experiencing intense emotional disturbance
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长期以来，在个人隐喻之心经受了
强烈的情感干扰或混乱后的猝死
强烈的情感干扰或混乱后的猝死
08:03
or turmoil in their metaphorical hearts.
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广泛见诸报端。
08:07
In 1942,
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1942年，
08:09
the Harvard physiologist Walter Cannon
published a paper called "'Voodoo' Death,"
published a paper called "'Voodoo' Death,"
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哈佛生理学家沃尔特·坎农发表了一篇
名为《巫毒教的死亡》的论文，
名为《巫毒教的死亡》的论文，
08:14
in which he described
cases of death from fright
cases of death from fright
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在文中，他描述了一些
相信自己被诅咒的人
相信自己被诅咒的人
08:18
in people who believed
they had been cursed,
they had been cursed,
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因为恐惧而死亡的案例，
08:20
such as by a witch doctor
or as a consequence of eating taboo fruit.
or as a consequence of eating taboo fruit.
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比如被巫医或食用禁果后。
08:25
In many cases, the victim, all hope lost,
dropped dead on the spot.
dropped dead on the spot.
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在很多案例中，牺牲者
绝望至极，当场猝死。
绝望至极，当场猝死。
08:31
What these cases had in common
was the victim's absolute belief
was the victim's absolute belief
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这些案例的共同之处在于
牺牲者们绝对相信
牺牲者们绝对相信
08:36
that there was an external force
that could cause their demise,
that could cause their demise,
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有一种外部的力量
会导致他们的死亡，
会导致他们的死亡，
08:39
and against which
they were powerless to fight.
they were powerless to fight.
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并且他们无力反抗。
08:41
This perceived lack of control,
Cannon postulated,
Cannon postulated,
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坎农假定，这些明显的失控
08:45
resulted in an unmitigated
physiological response,
physiological response,
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引发了全面的生理反应，
08:48
in which blood vessels
constricted to such a degree
constricted to such a degree
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血管收缩到使血容量
08:53
that blood volume acutely dropped,
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急剧下降的程度，
08:56
blood pressure plummeted,
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血压下降，
08:58
the heart acutely weakened,
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心脏急剧衰弱，
09:00
and massive organ damage resulted
from a lack of transported oxygen.
from a lack of transported oxygen.
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并且因为缺少氧气的输送
而导致大规模的器官损坏。
而导致大规模的器官损坏。
09:05
Cannon believed that voodoo deaths
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坎农认为巫毒教的死亡
09:09
were limited to indigenous
or "primitive" people.
or "primitive" people.
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仅限于土著或“原始”人。
09:13
But over the years, these types of deaths
have been shown to occur
have been shown to occur
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但许多年来，
这些类型的死亡也出现在
这些类型的死亡也出现在
09:18
in all manner of modern people, too.
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各种各样的现代人身上。
09:21
Today, death by grief has been seen
in spouses and in siblings.
in spouses and in siblings.
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今天，因悲伤而导致的死亡
出现在配偶和兄弟姐妹上。
出现在配偶和兄弟姐妹上。
09:28
Broken hearts are literally
and figuratively deadly.
and figuratively deadly.
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破碎的心在生理上和
隐喻上都是致命的。
隐喻上都是致命的。
09:32
These associations hold true
even for animals.
even for animals.
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这种联系甚至在动物身上也成立。
09:36
In a fascinating study in 1980
published in the journal "Science,"
published in the journal "Science,"
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在1980年发表在《科学》期刊上
的一个有趣研究中，
的一个有趣研究中，
09:42
researchers fed caged rabbits
a high-cholesterol diet
a high-cholesterol diet
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研究人员给笼养的兔子
喂食高胆固醇食物，
喂食高胆固醇食物，
09:46
to study its effect
on cardiovascular disease.
on cardiovascular disease.
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以研究其对心血管疾病的影响。
09:50
Surprisingly, they found that some rabbits
developed a lot more disease than others,
developed a lot more disease than others,
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出乎意料的是，他们发现一些
兔子患的病就是比其他兔子多，
兔子患的病就是比其他兔子多，
09:56
but they couldn't explain why.
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但他们无法解释为什么。
09:57
The rabbits had very similar diet,
environment and genetic makeup.
environment and genetic makeup.
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这些兔子的饮食结构，
环境和基因构成都是类似的。
环境和基因构成都是类似的。
10:03
They thought it might have
something to do with
something to do with
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他们认为可能和
10:06
how frequently the technician
interacted with the rabbits.
interacted with the rabbits.
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技术员跟兔子互动频率有关。
10:10
So they repeated the study,
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所以他们重复了这个研究，
10:12
dividing the rabbits into two groups.
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把这些兔子分成两组。
10:14
Both groups were fed
a high-cholesterol diet.
a high-cholesterol diet.
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两组都吃高胆固醇的食物。
10:17
But in one group, the rabbits
were removed from their cages,
were removed from their cages,
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但其中一组，兔子被带出笼子，
10:22
held, petted, talked to, played with,
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被人们抱着，爱抚着，
和它说话，和它玩耍，
和它说话，和它玩耍，
10:26
and in the other group,
the rabbits remained in their cages
the rabbits remained in their cages
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另一组的兔子则被留在笼子里
10:29
and were left alone.
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不闻不管。
10:31
At one year, on autopsy,
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一年之后，在对兔子进行解剖时，
10:34
the researchers found
that the rabbits in the first group,
that the rabbits in the first group,
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研究者发现第一组的兔子，
10:40
that received human interaction,
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那组有人类互动的兔子，
10:42
had 60 percent less aortic disease
than rabbits in the other group,
than rabbits in the other group,
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主动脉疾病比另一组少60%，
10:48
despite having similar cholesterol levels,
blood pressure and heart rate.
blood pressure and heart rate.
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尽管有相似的胆固醇水平，
血压和心率。
血压和心率。
10:53
Today, the care of the heart has become
less the province of philosophers,
less the province of philosophers,
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今天，对心灵的关怀已不再是
哲学家们的专利，
哲学家们的专利，
10:59
who dwell upon the heart's
metaphorical meanings,
metaphorical meanings,
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他们专注于心灵的隐喻意义，
11:04
and more the domain of doctors like me,
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并且越来越多的进入
像我这样的医生领域，
像我这样的医生领域，
11:08
wielding technologies
that even a century ago,
that even a century ago,
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运用着甚至1个世纪前的技术，
11:11
because of the heart's exalted
status in human culture,
status in human culture,
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因为心脏在人类文化中的崇高地位，
11:14
were considered taboo.
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被认为是禁忌。
11:16
In the process, the heart
has been transformed
has been transformed
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在这个过程中，心脏
11:20
from an almost supernatural object
imbued with metaphor and meaning
imbued with metaphor and meaning
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从充满隐喻和意义的超自然的物体
11:25
into a machine that can be
manipulated and controlled.
manipulated and controlled.
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转变成了可以操纵和控制的机器。
11:31
But this is the key point:
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但这里有个关键点：
11:33
these manipulations, we now understand,
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我们现在明白，这些操纵
11:36
must be complemented
by attention to the emotional life
by attention to the emotional life
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必须辅以对情感生活的关注，
11:41
that the heart, for thousands of years,
was believed to contain.
was believed to contain.
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毕竟数千年来，人们认为
情感生活包含在心脏之中。
情感生活包含在心脏之中。
11:45
Consider, for example,
the Lifestyle Heart Trial,
the Lifestyle Heart Trial,
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比如，《生活方式心脏试验》，
11:49
published in the British journal
"The Lancet" in 1990.
"The Lancet" in 1990.
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1990年发表于英国《柳叶刀》杂志。
11:53
Forty-eight patients with moderate
or severe coronary disease
or severe coronary disease
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48名患有中度或重度
冠状动脉疾病的患者
冠状动脉疾病的患者
11:57
were randomly assigned to usual care
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被随机分配到常规护理
12:00
or an intensive lifestyle
that included a low-fat vegetarian diet,
that included a low-fat vegetarian diet,
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或一组包括低脂素食，
适度有氧运动，
适度有氧运动，
12:06
moderate aerobic exercise,
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群体社会心理支持
12:08
group psychosocial support
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以及压力管理建议的
12:09
and stress management advice.
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密集生活方式小组。
12:11
The researchers found
that the lifestyle patients
that the lifestyle patients
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研究者发现密集生活组病人
12:16
had a nearly five percent reduction
in coronary plaque.
in coronary plaque.
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冠状动脉斑块减少了近5%。
12:21
Control patients, on the other hand,
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控制组，反之，
12:23
had five percent more
coronary plaque at one year
coronary plaque at one year
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一年后冠状动脉斑块增加了5%，
12:28
and 28 percent more at five years.
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并且5年后增加了28%。
12:30
They also had nearly double
the rate of cardiac events,
the rate of cardiac events,
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他们患心脏病的几率翻倍，
12:34
like heart attacks,
coronary bypass surgery
coronary bypass surgery
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比如心脏病发作，冠状动脉搭桥手术
12:38
and cardiac-related deaths.
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和心脏病相关的死亡。
12:40
Now, here's an interesting fact:
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有一个有趣的事实：
12:42
some patients in the control group
adopted diet and exercise plans
adopted diet and exercise plans
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5294
对照组的一些患者采用
的饮食和锻炼计划
的饮食和锻炼计划
12:48
that were nearly as intense
as those in the intensive lifestyle group.
as those in the intensive lifestyle group.
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几乎与生活方式密集组
的患者一样多。
的患者一样多。
12:53
Their heart disease still progressed.
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他们的心脏疾病仍然在持续。
12:56
Diet and exercise alone were not enough
to facilitate coronary disease regression.
to facilitate coronary disease regression.
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单靠饮食和运动不足以促进
冠状动脉疾病的消退。
冠状动脉疾病的消退。
13:02
At both one- and five-year follow-ups,
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在1年和5年的随访中，
13:06
stress management
was more strongly correlated
was more strongly correlated
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人们发现相比锻炼，压力管理
13:09
with reversal of coronary disease
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与冠状动脉疾病的逆转
13:11
than exercise was.
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1528
更加紧密相关。
13:14
No doubt, this and similar
studies are small,
studies are small,
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毫无疑问，这项研究和
类似的研究规模都很小，
类似的研究规模都很小，
13:17
and, of course, correlation
does not prove causation.
does not prove causation.
214
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当然，相关性并不能证明因果关系。
13:20
It's certainly possible that stress
leads to unhealthy habits,
leads to unhealthy habits,
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当然可能压力导致不健康习惯，
13:25
and that's the real reason
for the increased cardiovascular risk.
for the increased cardiovascular risk.
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是心血管风险增加的真正原因。
13:28
But as with the association
of smoking and lung cancer,
of smoking and lung cancer,
217
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3601
但就像吸烟和肺癌的关系一样，
13:32
when so many studies show the same thing,
218
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当如此多的研究都显示了同样的事情，
13:35
and when there are mechanisms
to explain a causal relationship,
to explain a causal relationship,
219
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当存在解释因果关系的机制时，
13:38
it seems capricious to deny
that one probably exists.
that one probably exists.
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否定一个可能存在
的说法是不负责任的。
的说法是不负责任的。
13:43
What many doctors have concluded
is what I, too, have learned
is what I, too, have learned
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许多医生得出的结论，也是我近20年
13:47
in my nearly two decades
as a heart specialist:
as a heart specialist:
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作为心脏专家了解到的：
13:51
the emotional heart intersects
with its biological counterpart
with its biological counterpart
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情感之心与它的生理对应物以一种
13:55
in surprising and mysterious ways.
224
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惊奇和神秘的方式相交叉。
13:58
And yet, medicine today continues
to conceptualize the heart as a machine.
to conceptualize the heart as a machine.
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然而，今天的医学继续将
心脏概念化为一台机器。
心脏概念化为一台机器。
14:03
This conceptualization
has had great benefits.
has had great benefits.
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这种概念化有很大的好处。
14:07
Cardiology, my field,
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心脏病学，我的领域，
14:09
is undoubtedly one of the greatest
scientific success stories
scientific success stories
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毫无疑问是过去100年最具成就的
14:14
of the past 100 years.
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科学领域之一。
14:17
Stents, pacemakers, defibrillators,
coronary bypass surgery,
coronary bypass surgery,
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支架，起搏器，除颤器，
冠状动脉搭桥手术，
冠状动脉搭桥手术，
14:22
heart transplants --
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心脏移植——
14:24
all these things were developed
or invented after World War II.
or invented after World War II.
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所有这些都是在二战后
发展或发明的。
发展或发明的。
14:28
However, it's possible
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然而，我们可能
14:30
that we are approaching the limits
of what scientific medicine can do
of what scientific medicine can do
234
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已经接近了科学药物在对抗
14:35
to combat heart disease.
235
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心脏疾病上的极限。
14:37
Indeed, the rate of decline
of cardiovascular mortality
of cardiovascular mortality
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3365
事实上，在过去的十年中，
心血管疾病死亡率
心血管疾病死亡率
14:40
has slowed significantly
in the past decade.
in the past decade.
237
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的下降速度已经明显放缓。
14:45
We will need to shift to a new paradigm
238
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我们需要转向新的模式
14:48
to continue to make the kind of progress
to which we have become accustomed.
to which we have become accustomed.
239
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3995
去继续取得我们已经习惯的进步。
14:52
In this paradigm, psychosocial factors
will need to be front and center
will need to be front and center
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在这种模式下，心理社会因素
将需要成为我们思考
将需要成为我们思考
心脏问题的前提和中心。
14:57
in how we think about heart problems.
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2124
15:00
This is going to be an uphill battle,
242
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这将是一场艰苦的战斗，
15:02
and it remains a domain
that is largely unexplored.
that is largely unexplored.
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3943
在很大程度上它仍然
是一个尚未被探索的领域。
是一个尚未被探索的领域。
15:07
The American Heart Association
still does not list emotional stress
still does not list emotional stress
244
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5165
美国心脏学会仍然没有把情感压力
15:13
as a key modifiable risk factor
for heart disease,
for heart disease,
245
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3791
作为心理疾病的一个可改变危险因素，
15:16
perhaps in part because blood cholesterol
is so much easier to lower
is so much easier to lower
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部分原因可能是因为血压中的
胆固醇相比情感和社会混乱
胆固醇相比情感和社会混乱
15:21
than emotional and social disruption.
247
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2675
更容易降低。
15:25
There is a better way, perhaps,
248
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2392
也许，有更好的方式。
15:27
if we recognize that when
we say "a broken heart,"
we say "a broken heart,"
249
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4877
如果我们知道当人们说
“破碎的心”时，
“破碎的心”时，
15:32
we are indeed sometimes talking
about a real broken heart.
about a real broken heart.
250
920899
4614
他们说的确实是一颗
真的破碎的心脏。
真的破碎的心脏。
15:37
We must, must pay more attention to
the power and importance of the emotions
the power and importance of the emotions
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在照看我们的心脏时，
我们就必须更加关注
我们就必须更加关注
情感的力量和重要性。
15:44
in taking care of our hearts.
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1751
15:46
Emotional stress, I have learned,
253
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2339
我认识到，情感压力
15:48
is often a matter of life and death.
254
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往往是生死攸关的问题。
15:53
Thank you.
255
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谢谢。
15:54
(Applause)
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（掌声）
Translated by psjmz mz
ABOUT THE SPEAKER
Sandeep Jauhar - Physician, writerSandeep Jauhar is a practicing cardiologist passionate about communicating medicine in all its glorious, quirky, inescapable humanity.
Why you should listen
In addition to his medical practice, Dr. Sandeep Jauhar writes about medicine and its impacts on culture for a wide-ranging audience. He is a contributing opinion writer for the New York Times and has written three best-selling books.
His most recent book, Heart: A History (a finalist for the 2019 Wellcome Book prize), tells the little-known story of the doctors who risked their careers -- and the patients who risked their lives -- to understand our most vital organ. Weaving his own experiences with the defining discoveries of the past, Jauhar braids tales of breakthrough, hubris and sorrow to create a lucid chronicle of our life's most intimate chamber. The book also confronts the limits of medical technology, arguing that future progress will be determined more by how we choose to live rather than by any device we invent. Indeed, as the book explains, our emotional lives are absolutely key to our heart health. Jauhar is the Director of the Heart Failure Program at Northwell Health's Long Island Jewish Medical Center.
Sandeep Jauhar | Speaker | TED.com