ABOUT THE SPEAKER
Iain Hutchison - Facial surgeon
Iain Hutchison is a pioneering oral and facial surgeon; his foundation, Saving Faces, explores the nature of our expressions.

Why you should listen

Iain Hutchison thinks deeply about our faces. In his practice at St. Bartholomew’s, Royal London and University College London Hospitals, he has seen faces that lack the basic ability to function, to communicate emotion, to serve as a window to the world. His work involves repairing individual faces that have been impaired through cancer, birth defect or accidents—and asking all of us to look beyond first impressions.

One way he’s seeding the conversation is through the Facial Surgery Research Foundation/Saving Faces, which supports facial surgery research and education as well as a groundbreaking artistic residency by painter Mark Gilbert. Right in Hutchison’s office, patients sat for Gilbert before and after facial surgery, resulting in searching, honest portraits that show the humanity even of someone whose face we might be unwilling to look at. The “Saving Faces” exhibit has been seen by more than two million gallery visitors. Hutchison is also an active advocate of running clinical trials for facial surgery, and he funds and co-supervises two psychology PhD students to study ways to improve emotional and functional outcomes.

As he says: "Facial surgery is challenging not only because of its intricacy but because it has a profound effect on the patient’s psyche."

More profile about the speaker
Iain Hutchison | Speaker | TED.com
TEDGlobal 2010

Iain Hutchison: Saving faces: A facial surgeon's craft

Iain Hutchison 談拯救臉部

Filmed:
660,758 views

臉部手術師Iain Hutchison的工作幫助對象是臉部極度變形的病患。他改進了臉部手術的技術,進而來改善這些病患的生活。他藉由使用他們的肖像來慶祝他們作為人類的存在。註:此演講包含極度變形及嚴重受傷的恐怖臉部圖像--為何極度變形的臉蛋可以讓我們如此恐懼?Hutchison提供了對此問題的發人深省的解釋。感覺想吐?在12:10-13:19中間停止觀看螢幕但繼續聽演講。
- Facial surgeon
Iain Hutchison is a pioneering oral and facial surgeon; his foundation, Saving Faces, explores the nature of our expressions. Full bio

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

00:15
Our face面對 is hugely巨大 important重要
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我們的臉部非常重要
00:18
because it's the external外部, visual視覺 part部分
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因為我們的臉部裸露在外
00:20
that everybody每個人 else其他 sees看到.
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大家都會看到
00:22
Let's not forget忘記 it's a functional實用 entity實體.
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但我們不要忘記,臉部也是有實際功用的。
00:24
We have strong強大 skull頭骨 bones骨頭
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我們有強壯的頭顱骨,
00:26
that protect保護 the most important重要 organ器官 in our body身體: the brain.
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用來保護我們身上最重要的器官:腦。
00:29
It's where our senses感官 are located位於, our special特別 senses感官 --
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這是我們感官的所在,我們特別的感官 ——
00:32
our vision視力, our speech言語,
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視覺、說話能力、
00:34
our hearing聽力, our smell, our taste味道.
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聽覺、嗅覺、味覺。
00:36
And this bone
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這塊骨頭上
00:38
is peppered接二連三, as you can see, with the light shining閃亮的 through通過 the skull頭骨
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分散着一些別的東西,你可以透過光看到,上面有
00:41
with cavities, the sinuses鼻竇,
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一些孔洞,這是鼻竇
00:43
which哪一個 warm and moisten the air空氣 we breathe呼吸.
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可以將我們吸入的空氣加溫加溼。
00:46
But also imagine想像 if they were filled填充 with solid固體 bone --
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但想想看,如果這是塊實心的骨頭,
00:49
our head would be dead weight重量,
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我們的頭會非常重,
00:51
we wouldn't不會 be able能夠 to hold保持 it erect直立,
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重到我們無法將之豎直。
00:53
we wouldn't不會 be able能夠 to look at the world世界 around us.
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我們也就沒有辦法看我們周遭的世界。
01:02
This woman女人 is slowly慢慢地 dying垂死
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這位女性正在步入死亡,
01:04
because the benign良性 tumors腫瘤 in her facial面部 bones骨頭
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因為他她臉部骨頭上的良性腫瘤
01:07
have completely全然 obliterated湮沒 her mouth and her nose鼻子
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已經封住了她的口鼻,
01:10
so she can't breathe呼吸 and eat.
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導致她無法呼吸和進食。
01:12
Attached to the facial面部 bones骨頭
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臉骨上連著
01:14
that define確定 our face's臉的 structure結構體
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的肌肉構成了臉部的結構
01:18
are the muscles肌肉 that deliver交付 our facial面部 expression表達,
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這些肌肉也讓我們可以有臉部表情,
01:21
our universal普遍 language語言 of expression表達,
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一個人類中共通的語言
01:24
our social-signaling社會信號 system系統.
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一個人與人交往的信號系統
01:26
And overlying this is the skin皮膚 drape懸垂,
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在這外面是皮質層,
01:29
which哪一個 is a hugely巨大 complex複雜
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是一個很複雜、
01:31
three-dimensional三維 structure結構體 --
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立體的結構:
01:33
taking服用 right-angled直角 bends彎曲 here and there,
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在恰當的地方凹折
01:35
having thin areas like the eyelids眼皮,
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有像眼皮這樣很薄的部份、
01:38
thick areas like the cheek臉頰, different不同 colors顏色.
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也有像臉頰般厚、不同顏色的部份。
01:41
And then we have the sensual聲色 factor因子 of the face面對.
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然後臉部還有負責感官的部份。
01:44
Where do we like to kiss people?
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我們最喜歡親吻的哪裡?
01:46
On the lips嘴唇. Nibble蠶食 the ears耳朵 maybe.
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嘴唇,或是輕咬耳朵。
01:49
It's the face面對 where we're attracted吸引 to with that.
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我們被臉部所吸引,想要親吻
01:52
But let's not forget忘記 the hair頭髮.
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但我們也別忘記了毛髮
01:54
You're looking at the image圖片 on your left-hand左手 side --
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你們現在看看左邊的這張照片。
01:56
that's my son兒子 with his eyebrows眉毛 present當下.
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那是我兒子有眉毛的樣子
01:58
Look how odd he looks容貌 with the eyebrows眉毛 missing失踪.
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看看他沒有眉毛時有多奇怪。
02:01
There's a definite difference區別.
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這裡有一個很明顯的差別。
02:03
And imagine想像 if he had hair頭髮 sprouting發芽 from the middle中間 of his nose鼻子,
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想像一下他鼻子中間冒出毛髮
02:05
he'd他會 look even odder更古怪的 still.
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他鐵定看起來會更怪。
02:07
DysmorphophobiaDysmorphophobia
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醜狀恐懼症
02:09
is an extreme極端 version
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是一種極端的例子,
02:11
of the fact事實 that we don't see ourselves我們自己
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是一種我們看到的自己
02:13
as others其他 see us.
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與他人看到的我們很不相同的症狀。
02:15
It's a shocking觸目驚心 truth真相
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很驚人的事實是
02:17
that we only see mirror鏡子 images圖片 of ourselves我們自己,
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我們只能從鏡子中看到我們自己,
02:20
and we only see ourselves我們自己
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或是從
02:22
in freeze-frame凍結幀 photographic攝影 images圖片
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不動的照片等圖像中看到自己,
02:24
that capture捕獲 a mere fraction分數 of the time that we live生活.
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但這些只是我們生命中的一小部份。
02:27
DysmorphophobiaDysmorphophobia
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醜狀恐懼症
02:29
is a perversion變態 of this
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是這個現象的一種變態的症狀,
02:31
where people who may可能 be very good looking
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表現是長得還不錯的人
02:33
regard看待 themselves他們自己 as hideously令人髮指 ugly醜陋
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認為自己極度醜陋
02:35
and are constantly經常 seeking surgery手術
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且不斷地尋求整形手術
02:37
to correct正確 their facial面部 appearance出現.
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來改正他們的臉部外貌。
02:40
They don't need this. They need psychiatric精神病 help.
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他們不需要整形手術,他們需要的是心理幫助
02:43
Max馬克斯 has kindly和藹 donated捐贈 his photograph照片 to me.
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Max很好心的捐了這張照片給我。
02:45
He doesn't have dysmorphophobiadysmorphophobia, but I'm using運用 his photograph照片
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他沒有醜狀恐懼症,但我用他的照片
02:48
to illustrate說明 the fact事實 that he looks容貌 exactly究竟 like a dysmorphophobicdysmorphophobic.
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來顯示他長得就跟一個醜狀恐懼症病患一樣。
02:50
In other words, he looks容貌 entirely完全 normal正常.
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換句話說,他長得非常正常。
02:53
Age年齡 is another另一個 thing
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年齡是另一個
02:56
when our attitude態度 toward our appearance出現 changes變化.
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改變我們對自己的外表的態度的因素。
02:58
So children孩子 judge法官 themselves他們自己, learn學習 to judge法官 themselves他們自己,
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孩童們經由周圍的大人們的行為來
03:01
by the behavior行為 of adults成年人 around them.
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評斷、學著評斷他們自己。
03:04
Here's這裡的 a classic經典 example: Rebecca麗貝卡 has a benign良性 blood血液 vessel船隻 tumor
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這是個經典的例子:Rebecca有一個良性的血管腫瘤
03:07
that's growing生長 out through通過 her skull頭骨, has obliterated湮沒 her nose鼻子,
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從她的頭顱內長出來,已經埋沒了她的鼻子,
03:10
and she's having difficulty困難 seeing眼看.
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並且影響到了她的視力
03:12
As you can see, it's blocking閉塞 her vision視力.
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你們可以看到,腫瘤已經擋到她的視線了。
03:14
She's also in danger危險, when she damages賠償 this,
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如果她弄傷這個腫瘤,她也有
03:16
of bleeding流血的 profusely豐富地.
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大量失血的危險。
03:18
Our research研究 has shown顯示
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我們的研究顯示
03:20
that the parents父母 and close loved喜愛 ones那些 of these children孩子
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這樣孩子的父母親及關愛他們的人
03:23
adore崇拜 them.
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非常喜歡他們。
03:25
They've他們已經 grown長大的 used to their face面對; they think they're special特別.
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他們已經習慣了他們的臉蛋,他們覺得這很特別。
03:28
Actually其實, sometimes有時 the parents父母 argue爭論
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事實上,有時候他們的父母親
03:30
about whether是否 these children孩子 should have the lesion病變 removed去除.
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會為了是否要將這些缺陷移除而起爭執。
03:33
And occasionally偶爾 they suffer遭受 intense激烈 grief哀思 reactions反應
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偶而他們會感到強烈的悲傷
03:35
because the child兒童 they've他們已經 grown長大的 to love
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因為他們已經漸漸愛上的孩子
03:37
has changed so dramatically顯著 and they don't recognize認識 them.
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有了非常大的轉變,使他們無法認出孩子。
03:40
But other adults成年人
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但有些其他成年人
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say incredibly令人難以置信 painful痛苦 things.
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會說一些非常傷人的話。
03:44
They say, "How dare you take this child兒童 out of the house
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他們說:「你怎麼可以帶這樣的孩子出去
03:46
and terrify驚嚇 other people.
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會嚇到其他人!
03:48
Shouldn't不能 you be doing something about this? Why haven't沒有 you had it removed去除?"
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你不是應該做些甚麼嗎?你不是該把那個東西拿掉嗎?」
03:51
And other children孩子 in curiosity好奇心 come up and poke the lesion病變,
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然後其他小孩好奇地圍過來戳病變的地方,
03:54
because -- a natural自然 curiosity好奇心.
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純粹是因為好奇。
03:56
And that obviously明顯 alerts警報 the child兒童
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這樣很顯然地會讓這孩子
03:58
to their unusual異常 nature性質.
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警覺他自己與別人不同的特質。
04:00
After surgery手術, everything normalizes規格化.
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手術過後,一切都回歸正常。
04:03
The adults成年人 behave表現 more naturally自然,
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成年人表現得更正常,
04:05
and the children孩子 play more readily容易 with other children孩子.
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孩子更容易和其他孩子玩耍。
04:08
As teenagers青少年 --
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在青少年時期,
04:11
just think back to your teenage青少年 years年份 --
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就想想你們的青少年時期,
04:13
we're going through通過 a dramatic戲劇性
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那時我們都會經歷一些巨大的變化,
04:15
and often經常 disproportionate不成比例 change更改
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尤其是我們的臉部
04:17
in our facial面部 appearance出現.
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會有一些相比而言更加顯著的變化
04:19
We're trying to struggle鬥爭 to find our identity身分.
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那時的我們為了找到自己的定位而努力
04:21
We crave渴望 the approval贊同 of our peers同行.
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我們渴望得到同齡人的肯定。
04:23
So our facial面部 appearance出現 is vital重要 to us
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當我們試圖向世界展示自己的時候
04:26
as we're trying to project項目 ourselves我們自己 to the world世界.
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我們的臉部的樣子對我們就至關重要
04:28
Just remember記得 that single acne粉刺 spot
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想想那個臉上冒出來的一個青春痘
04:30
that crippled you for several一些 days.
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就讓你不開心了好幾天。
04:34
How long did you spend looking in the mirror鏡子 every一切 day,
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你一天花多少時間站在鏡子前面
04:37
practicing your sardonic諷刺 look, practicing your serious嚴重 look,
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練習你的嘲諷表情,練習你的嚴肅表情
04:40
trying to look like Sean肖恩 Connery康納利, as I did,
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或像我一樣試著看起來像sean connery(蘇格蘭演員)那樣
04:42
trying to raise提高 one eyebrow?
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只揚起一邊的眉毛。
04:44
It's a crippling癱瘓 time.
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那是一段令人不正常的時間
04:46
I've chosen選擇 to show顯示 this profile輪廓 view視圖 of Sue起訴
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我選了這張Sue的側面照
04:50
because what it shows節目 is her lower降低 jaw jutting凸出的 forward前鋒
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因為可以看出她的下巴突出
04:53
and her lower降低 lip jutting凸出的 forward前鋒.
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且她的下唇也往前突出。
04:55
I'd like you all in the audience聽眾 now to push your lower降低 jaw forward前鋒.
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請在座各位把你們的下巴往前推,
04:58
Turn to the person next下一個 to you,
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然後看看你旁邊的人,
05:00
push your lower降低 jaws forward前鋒. Turn to the person next下一個 to you
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把下巴凸出,轉向你旁邊的人,
05:02
and look at them -- they look miserable.
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看看他們--他們看起來很慘兮兮的
05:04
That's exactly究竟 what people used to say to Sue起訴.
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那就是人們一直跟Sue說的。
05:07
She wasn't miserable at all.
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但她一點都不感到悲慘
05:09
But people used to say to her, "Why are you so miserable?"
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但人們一直跟她說:「為什麼你那麼慘兮兮的?」
05:13
People were making製造 misjudgments誤判 all the time
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人們總是誤解她的
05:16
on her mood心情.
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心情。
05:18
Teachers教師 and peers同行 were underestimating低估 her; she was teased戲弄 at school學校.
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老師和同儕總是低估她,她在學校被人嘲笑。
05:21
So she chose選擇 to have facial面部 surgery手術.
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所以她選擇了臉部整形。
05:23
After the facial面部 surgery手術,
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整形過後,
05:25
she said, "My face面對 now reflects反映 my personality個性.
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她說:「我的臉蛋現在可以反映出我的個性了。
05:28
People know now that I'm enthusiastic熱情,
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人們知道我很熱心,
05:31
that I'm a happy快樂 person."
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我是個快樂的人。」
05:33
And that's the change更改 that can be achieved實現 for teenagers青少年.
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而且這是個在青少年身上可以做到的改變。
05:37
Is this change更改, though雖然, a real真實 change更改,
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這樣的改變是一個真的改變嗎?
05:39
or is it a figment虛構 of the imagination想像力
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還是只是病患自己
05:42
of the patient患者 themselves他們自己?
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腦海中的想像?
05:44
Well we studied研究 teenagers'青少年' attitudes態度
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我們研究了青少年
05:46
to photographs照片 of patients耐心 having this corrective糾正的 facial面部 surgery手術.
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對有過這樣的改正性臉部手術照片的態度。
05:48
And what we found發現 was --
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下面就是我們的研究結果
05:51
we jumbled錯雜 up the photographs照片
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我們把照片弄亂
05:53
so they couldn't不能 recognize認識 the before and after --
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讓他們認不出哪些是術前照片哪些是術後照片。
05:55
what we found發現 was that the patients耐心 were regarded認為
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我們發現,術後的病患
05:57
as being存在 more attractive有吸引力 after the surgery手術.
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看起來更具吸引力。
05:59
Well that's not surprising奇怪, but we also asked them to judge法官 them
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當然這不令人驚訝,但我們也要被試青少年們判斷這些照片人物的
06:02
on honesty誠實, intelligence情報,
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誠實度、智商、
06:04
friendliness友好, violence暴力.
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友善度、暴力程度。
06:07
They were all perceived感知 as being存在
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在術前他們給人的感覺是
06:09
less than normal正常 in all those characteristics特點 --
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在這些特質上不正常的
06:11
more violent暴力, etc等等. -- before the surgery手術.
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手術前的形象被認為更暴力
06:14
After the surgery手術,
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術後
06:16
they were perceived感知 as being存在 more intelligent智能,
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他們給人的感覺是更聰明、
06:18
more friendly友善, more honest誠實, less violent暴力 --
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更友善、更誠實、較不暴力。
06:21
and yet然而 we hadn't有沒有 operated操作 on their intellect智力
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但我們並沒有改變他們的
06:23
or their character字符.
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智商或者個性
06:25
When people get older舊的,
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隨著年紀增長,
06:27
they don't necessarily一定 choose選擇 to follow跟隨 this kind of surgery手術.
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他們不一定會選擇這樣的手術。
06:30
Their presence存在 in the consultation會診 suite套房
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他們在諮商室的原因是
06:32
is a result結果 of the slings吊索 and arrows箭頭 of outrageous蠻橫的 fortune幸運.
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一連串厄運的結果。
06:35
What happens發生 to them
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他們是經歷了癌症
06:37
is that they may可能 have suffered遭遇 cancer癌症 or trauma外傷.
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或創傷的病患。
06:39
So this is a photograph照片 of Henry亨利,
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這是一張亨利的照片。
06:41
two weeks after he had a malignant惡性 cancer癌症 removed去除
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這是他移除左臉上的惡性腫瘤後
06:44
from the left side of his face面對 -- his cheekbone,
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兩個禮拜的照片,包括左臉臉頰、
06:47
his upper jaw, his eye-socket眼窩.
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上顎、眼圈。
06:49
He looks容貌 pretty漂亮 good at this stage階段.
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他在這個階段看起來很不錯。
06:51
But over the course課程 of the next下一個 15 years年份 he had 14 more operations操作,
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但在接下來的十五年內他又接受了十四次整形手術,
06:54
as the disease疾病 ravaged蹂躪 his face面對
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因為疾病摧殘著他的臉
06:56
and destroyed銷毀 my reconstruction重建 regularly經常.
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且定期地破壞我的整形結果。
06:58
I learned學到了 a huge巨大 amount from Henry亨利.
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我從亨利身上學到很多。
07:00
Henry亨利 taught me
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亨利讓我瞭解
07:02
that you can carry攜帶 on working加工.
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一個這樣的病患可以繼續工作。
07:04
He worked工作 as an advocate主張. He continued繼續 to play cricket蟋蟀.
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他的工作是辯護者。他繼續打板球。
07:07
He enjoyed享受 life to the full充分,
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他很享受著他的生活。
07:09
and this was probably大概 because he had a successful成功, fulfilling履行 job工作
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且這很有可能是因為他有一個成功的、有滿足感的工作
07:11
and a caring愛心 family家庭
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和一個關懷他的家人
07:13
and was able能夠 to participate參加 socially社交上.
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並且他仍然可以進行正常的社交活動。
07:15
He maintained保持 a calm冷靜 insouciance漫不經心.
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他一種冷靜而漫不經心的生活態度
07:18
I don't say he overcame克服了 this; he didn't overcome克服 it.
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我不是說他克服了自己的問題,他並沒有。
07:21
This was something more than that. He ignored忽視 it.
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他做到了比克服更難的:他忽視了它。
07:24
He ignored忽視 the disfigurement毀容 that was happening事件 in his life
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他忽視他生命中這些扭曲的部份
07:27
and carried攜帶的 on oblivious渾然不覺 to it.
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然後繼續過他的生活,無視這些扭曲。
07:30
And that's what these people can do.
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這就是這些人可以做的。
07:32
HenriapiHenriapi illustrates說明 this phenomenon現象 as well.
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Henriapi也同樣做到了這點。
07:34
This is a man in his 20s
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這是一個二十多歲的男人。
07:36
whose誰的 first visit訪問 out of Nigeria尼日利亞 was with this malignant惡性 cancer癌症
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他第一次離開尼日利亞就是為了來英國
07:39
that he came來了 to the United聯合的 Kingdom王國 to have operated操作 on.
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來移除臉上的這個惡性腫瘤。
07:41
It was my longest最長 operation手術.
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這是我做過最長的手術。
07:43
It took 23 hours小時. I did it with my neurosurgeon神經外科醫生.
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手術花了23小時。我和一個神經外科醫生一起完成的。
07:46
We removed去除 all the bones骨頭 at the right side of his face面對 --
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我們把他右半邊的臉的骨頭全部拿出來,
07:48
his eye, his nose鼻子,
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包括他的眼睛、他的鼻子、
07:50
the skull頭骨 bones骨頭, the facial面部 skin皮膚 --
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他的頭顱骨、他的臉部皮膚,
07:52
and reconstructed重建 him with tissue組織 from the back.
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然後利用他背部的組織來復建。
07:55
He continued繼續 to work as a psychiatric精神病 nurse護士.
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他繼續當一個心理護士。
07:57
He got married已婚. He had a son兒子 called Jeremiah耶利米.
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他後來結婚且生了一個名為Jeremiah的兒子。
08:00
And again, he said,
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再次的他說:「
08:02
"This painting繪畫 of me with my son兒子 Jeremiah耶利米
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這幅我和我兒子Jeremiah的圖畫
08:05
shows節目 me as the successful成功 man that I feel that I am."
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顯示出了我是一個成功男人,就像我自己認為的這樣。」
08:08
His facial面部 disfigurement毀容
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他臉部的變形
08:10
did not affect影響 him
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並沒有影響他,
08:12
because he had the support支持 of a family家庭;
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因為他有家人的支持
08:14
he had a successful成功, fulfilling履行 job工作.
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和成功、有滿足感的工作。
08:16
So we've我們已經 seen看到 that we can change更改 people's人們 faces面孔.
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所以我們已經看到我們可以改變人們的臉部。
08:19
But when we change更改 people's人們 faces面孔,
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但當我們改變人們的臉的時候,
08:21
are we changing改變 their identity身分 --
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我們有改變他們的對自己定位嗎?
08:23
for better or for worse更差?
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不管是變好還是變壞。
08:26
For instance,
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舉例來說,
08:28
there are two different不同 types類型 of facial面部 surgery手術.
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主要有兩種臉部手術。
08:30
We can categorize分類 it like that.
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我們可以將它分類。
08:32
We can say there are patients耐心 who choose選擇 to have facial面部 surgery手術 --
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我們可以說有些病患選擇要做臉部手術--
08:34
like Sue起訴.
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像是Sue。
08:36
When they have facial面部 surgery手術,
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當他們做了臉部手術後
08:38
they feel their lives生活 have changed
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他們感覺他們的人生改變了。
08:40
because other people perceive感知 them
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因為其他人對他們的看法變了
08:43
as better people.
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認為他們是更好的人
08:45
They don't feel different不同.
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他們不會感覺不同。
08:47
They feel that they've他們已經 actually其實 gained獲得
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他們感覺他們真的得到了
08:49
what they never had,
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他們之前沒有的東西,
08:51
that their face面對 now reflects反映 their personality個性.
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那就是他們的臉終於可以反映出他們的個性。
08:53
And actually其實 that's probably大概 the difference區別 between之間 cosmetic化妝品 surgery手術
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事實上這就是是美容手術和這樣的手術
08:56
and this kind of surgery手術.
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的區別
08:58
Because you might威力 say, "Well, this type類型 of surgery手術
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因為你可能會說:「嗯,這樣的手術
09:01
might威力 be regarded認為 as cosmetic化妝品."
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可以被看成是美容整形手術。」
09:03
If you do cosmetic化妝品 surgery手術, patients耐心 are often經常 less happy快樂.
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如果你做整形手術,病患一般來說比較不開心。
09:06
They're trying to achieve實現 difference區別 in their lives生活.
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他們想要改變人生。
09:12
Sue起訴 wasn't trying to achieve實現 difference區別 in her life.
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Sue不是要改變人生,
09:14
She was just trying to achieve實現 the face面對
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她只是想要她的臉
09:16
that matched匹配 her personality個性.
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和她的個性相符。
09:18
But then we have other people
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但也有一些其他人
09:20
who don't choose選擇 to have facial面部 surgery手術.
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不會選擇臉部手術。
09:22
They're people who have their face面對 shot射擊 off.
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他們是那些臉被槍打毀的人
09:24
I'll move移動 it off, and we'll have a blank空白 slide滑動 for those who are squeamish過於拘謹的 amongst其中包括 you.
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讓我為在座那些較膽小的人把這圖片拿掉,換成一張空白的投影片
09:27
They have it forced被迫 upon them.
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他們的臉部是被強加在他們身上的。
09:29
And again, as I told you,
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再次的,讓我提醒你們,
09:31
if they have a caring愛心 family家庭
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如果他們有個關懷他們的家庭
09:33
and good work life,
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和好工作,
09:36
then they can lead normal正常 and fulfilled完成 lives生活.
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那們他們可以有一個正常且滿足的生活。
09:39
Their identity身分 doesn't change更改.
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他們的身分並沒有被感變。
09:41
Is this business商業
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這樣在乎外表
09:43
about appearance出現 and preoccupation當務之急 with it
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的情況
09:45
a Western西 phenomenon現象?
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只存在於西方文化嗎?
09:47
Muzetta'sMuzetta的 family家庭 give the lie謊言 to this.
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Muzetta的家庭告訴我們不是的。
09:50
This is a little Bangladeshi孟加拉國 girl女孩 from the east end結束 of London倫敦
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這是倫敦東部的一個孟加拉女孩,
09:53
who's誰是 got a huge巨大 malignant惡性 tumor on the right side of her face面對,
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她右臉上有一個很大的惡性腫瘤。
09:56
which哪一個 has already已經 made製作 her blind
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這已經讓她變瞎了
09:58
and which哪一個 is rapidly急速 growing生長 and is going to kill her shortly不久.
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並且如果這個腫瘤繼續成長的話,很快就會取了她的生命。
10:00
After she had surgery手術 to remove去掉 the tumor,
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腫瘤移除手術後,
10:03
her parents父母 dressed連衣裙的 her in this beautiful美麗 green綠色 velvet絲絨 dress連衣裙,
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她父母親為她穿上漂亮的綠絲絨洋裝
10:06
a pink ribbon色帶 in her hair頭髮,
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在她頭髮上系上一個粉紅色的絲帶
10:08
and they wanted the painting繪畫 to be shown顯示 around the world世界,
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他們希望這幅畫可以在全世界展示,
10:10
despite儘管 the fact事實 that they were orthodox正統 Muslims穆斯林
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雖然他們是保守伊斯蘭教徒
10:13
and the mother母親 wore穿著 a full充分 burqa布卡.
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且他母親是穿全身的罩袍的。
10:15
So it's not simply只是 a Western西 phenomenon現象.
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所以這不是只是西方的問題。
10:20
We make judgments判斷 on people's人們 faces面孔
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我們幾乎隨時都在
10:22
all the time.
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對別人的臉作出評判
10:24
It's been going on since以來 we can think of Lombroso龍勃羅梭
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這可以追朔到朗柏朔的犯罪學說時代,
10:27
and the way he would define確定 criminal刑事 faces面孔.
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包括他如何定義“罪犯臉“
10:29
He said you could see criminal刑事 faces面孔,
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他說你可以可以看出哪些是”罪犯臉“
10:31
judging判斷 them just on the photographs照片 that were showed顯示.
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僅從照片就可以
10:34
Good-looking好看 people
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長得好看的人
10:36
are always judged判斷 as being存在 more friendly友善.
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會被認為是比較有親和力的。
10:38
We look at O.J. --
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看看O.J.
10:40
he's a good-looking好看 guy.
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他是個長得還不錯的人。
10:42
We'd星期三 like to spend time with him. He looks容貌 friendly友善.
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我們會想要跟他在一起。他看起來很好相處。
10:45
Now we know that he's a convicted被定罪 wife-batterer妻子打人,
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但現在我們知道他是個家庭暴力者,
10:48
and actually其實 he's not the good guy.
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並且事實上他不是個好人。
10:50
And beauty美女 doesn't equate等同 to goodness善良,
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而且美貌跟好心是不能劃上等號的,
10:54
and certainly當然 doesn't equate等同 to contentment滿意.
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而且也絕對不能跟滿足感劃上等號。
10:57
So we've我們已經 talked about the static靜態的 face面對
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所以我們已經談了靜態的臉,
10:59
and judging判斷 the static靜態的 face面對,
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也評斷靜態的臉。
11:01
but actually其實, we're more comfortable自在
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但事實上,我們更會評斷
11:03
with judging判斷 the moving移動 face面對.
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動態的臉。
11:05
We think we can judge法官 people on their expressions表達式.
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我們認為我們可以透過人們的表情評斷他們。
11:08
U.K. jurors陪審員 in the U.K. justice正義 system系統
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英國法律體制下的陪審團
11:11
like to see a live生活 witness見證
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喜歡在在現場觀察證人
11:13
to see whether是否 they can pick up the telltale揭秘 signs跡象 of mendacity謊言 --
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看是否能看出一些謊言的蛛絲馬跡:
11:16
the blink, the hesitation猶豫.
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眨眼、猶豫。
11:19
And so they want to see live生活 witnesses目擊者.
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所以他們喜歡到現場的證人
11:22
Todorov托多羅夫 tells告訴 us that, in a tenth第十 of a second第二,
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Todorov 告訴我們,在十分之一秒中,
11:25
we can make a judgment判斷 on somebody's某人的 face面對.
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我們可以對一個人的臉做出一個評判
11:28
Are we uncomfortable不舒服 with this image圖片? Yes, we are.
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我們會覺得這張圖片讓人不舒服嗎?是的。
11:31
Would we be happy快樂 if our doctor's醫生 face面對, our lawyer's律師 face面對,
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如果我們的醫生、我們的律師、
11:34
our financial金融 adviser's顧問的 face面對 was covered覆蓋?
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我們的理財顧問把臉遮起來,我們會開心嗎?
11:36
We'd星期三 be pretty漂亮 uncomfortable不舒服.
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我們會很不舒服。
11:38
But are we good at making製造 the judgments判斷
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但我們真的能夠由臉部外貌和動作
11:40
on facial面部 appearance出現 and movement運動?
280
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做出正確的評斷嗎?
11:43
The truth真相 is that there's a five-minute五分鐘 rule規則,
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事實上有個五分鐘規則,
11:45
not the tenth-of-a-second第十對的一第二 rule規則 like Todorov托多羅夫, but a five-minute五分鐘 rule規則.
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不是像Todorov說的十分之一秒,而是五分鐘。
11:48
If you spend five minutes分鐘 with somebody,
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如果你跟一個人在一起超過五分鐘,
11:50
you start開始 looking beyond their facial面部 appearance出現,
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你就會開始注意臉部外貌以外的情況
11:52
and the people who you're initially原來 attracted吸引 to
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一些一開始吸引你的人
11:54
may可能 seem似乎 boring無聊 and you lose失去 interest利益 in them,
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可能會讓你覺得無聊然後你對他們就沒有興趣了
11:56
and the people who you didn't immediately立即 seek尋求 out,
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然後那些你因為他們沒有長得特別好看
11:58
because you didn't find them particularly尤其 attractive有吸引力,
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而馬上註意到的人
12:00
become成為 attractive有吸引力 people
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可能會用他們的個性
12:02
because of their personality個性.
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吸引上你
12:05
So we've我們已經 talked a lot about facial面部 appearance出現.
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所以我們已經談了很多關於臉部外貌的東西。
12:08
I now want to share分享
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我現在想要分享一些
12:10
a little bit of the surgery手術 that we do --
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關於我們做的手術:
12:12
where we're at and where we're going.
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現狀和未來的走向
12:14
This is an image圖片 of Ann
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這是一張Ann的圖片。
12:16
who's誰是 had her right jaw removed去除 and the base基礎 of her skull頭骨 removed去除.
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她的右顎和頭顱骨基底被移除了。
12:18
And you can see in the images圖片 afterward之後,
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在後面的圖像中
12:20
we've我們已經 managed管理 to reconstruct重建 her successfully順利.
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你可以看到我們成功地重建了她的臉
12:22
But that's not good enough足夠.
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但那還不夠好。
12:24
This is what Ann wants. She wants to be out kayaking皮划艇,
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那不是Ann要的。她想要能夠出去划船,
12:26
she wants to be out climbing攀登 mountains.
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她要能夠出去爬山。
12:28
And that's what she achieved實現, and that's what we have to get to.
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且那是她做到的,也是我們必須讓她能夠做到的。
12:30
This is a horrific可怕的 image圖片,
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這是個恐怖的圖像,
12:32
so I'm putting my hand up now.
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所以我也把我的手舉起來了。
12:34
This is a photograph照片 of Adi阿迪,
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這是一張Adi的照片。
12:36
a Nigerian尼日利亞 bank銀行 manager經理 who had his face面對 shot射擊 off
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他是一個尼日利亞的銀行主管
12:38
in an armed武裝 robbery搶劫.
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他的臉在一個武裝搶劫中被打毀
12:40
And he lost丟失 his lower降低 jaw, his lip, his chin下巴
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他失去了下顎、嘴唇、下巴、
12:42
and his upper jaw and teeth.
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上顎和牙齒
12:44
This is the bar酒吧 that he set for us.
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這是他給我們的標準。
12:46
"I want to look like this. This is how I looked看著 before."
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「我想要看起來像這樣。這是我之前的長相。」
12:49
So with modern現代 technology技術,
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以現在的科技,
12:51
we used computers電腦 to make models楷模.
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我們利用電腦來作模型。
12:54
We made製作 a model模型 of the jaw without bone in it.
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我們做了一個沒有骨頭的顎模型。
12:56
We then bent彎曲 a plate盤子 up to it.
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然後我們做了一個金屬板。
12:58
We put it in place地點
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我們把它放在該在的位置,
13:00
so we knew知道 it was an accurate準確 position位置.
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讓我們知道正確的位置。
13:02
We then put bone and tissue組織 from the back.
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然後我們從背部提取骨頭和組織。
13:05
Here you can see the plate盤子 holding保持 it,
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這裡我們可以看到金屬板固定,
13:07
and you can see the implants植入物 being存在 put in --
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你也可以看到移植組織置入--
13:10
so that in one operation手術
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所以一個手術後
13:12
we achieve實現 this
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我們做到
13:15
and this.
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這樣。
13:17
So the patient's耐心 life is restored恢復.
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這樣病患的生活就重歸正軌了
13:19
That's the good news新聞.
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那是好消息。
13:21
However然而, his chin下巴 skin皮膚
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但是他的下巴皮膚
13:23
doesn't look the same相同 as it did before.
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跟以前看起來不大一樣。
13:25
It's skin皮膚 from his back.
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因為是背部的皮膚。
13:27
It's thicker更厚的, it's darker, it's coarser粗糙, it doesn't have the contours輪廓.
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是更厚、更深、跟粗糙且沒有輪廓。
13:30
And that's where we're failing失敗,
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這就是我們做不到的。
13:32
and that's where we need the face面對 transplant移植.
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也是為什麼我們需要臉部移殖。
13:34
The face面對 transplant移植 has a role角色
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臉部移殖在
13:36
probably大概 in burns燒傷 patients耐心 to replace更換 the skin皮膚.
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被火燒傷的病患的植皮過程中有很重要的角色。
13:39
We can replace更換 the underlying底層 skeletal骨骼 structure結構體,
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我們可以重建底層的骨骼結構,
13:41
but we're still not good at replacing更換 the facial面部 skin皮膚.
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但我們仍然不大會重建臉部皮膚。
13:44
So it's very valuable有價值
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所以如果可以在我們的醫療設備中
13:46
to have that tool工具 in our armamentarium醫療設備.
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有這樣一個工具,那會是很有價值的
13:48
But the patients耐心 are going to have to take drugs毒品
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但這些病患會接下來的一輩子都需要吃一些藥
13:50
that suppress壓制 their immune免疫的 system系統 for the rest休息 of their lives生活.
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來壓制他們的免疫系統。
13:52
What does that mean?
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這是什麼意思?
13:54
They have an increased增加 risk風險 of infection感染, an increased增加 risk風險 of malignancy惡性腫瘤.
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他們有更高的風險會被感染、也更有可能會有惡性腫瘤。
13:57
This is not a life-saving救生 transplant移植 --
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這不是保住生命的移殖,
13:59
like a heart, or liver, or lung transplant移植 --
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不是像移殖心臟或是肝臟或是肺臟,
14:02
it is a quality-of-life生活質量 transplant移植,
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而是一個改善生命質量的移殖。
14:05
and as a result結果,
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最後,
14:07
are the patients耐心 going to say, if they get a malignant惡性 cancer癌症 10 or 15 years年份 on,
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如果病患在十或十五年後得了惡性腫瘤,他會不會說:
14:10
"I wish希望 I'd had conventional常規 reconstructive重建 techniques技術 rather than this
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「我希望我做了常規的重建手術而不是這個手術,
14:13
because I'm now dying垂死 of a malignant惡性 cancer癌症"? We don't know yet然而.
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因為我現在垂死於惡性腫瘤?」我們還不知道。
14:16
We also don't know what they feel
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我們也不知道他們對於
14:19
about recognition承認 and identity身分.
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識別和身分的感受。
14:21
Bernard伯納德 DevauchelleDevauchelle and Sylvie西爾維 TestelinTestelin, who did the first operation手術,
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Bernard Devauchelle和Sylvie Testelin,第一次做了這樣的手術
14:24
are studying研究 that.
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他們正在研究這個
14:26
Donors捐助者 are going to be short on the ground地面,
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捐贈者也非常少,
14:29
because how many許多 people want to have their loved喜愛 one's那些 face面對
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因為有多少人願意他們深愛的人
14:32
removed去除 at the point of death死亡?
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在死亡的時候將臉部移去。
14:35
So there are going to be problems問題
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所以在臉部移殖上
14:37
with face面對 transplantation移植.
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會有一些問題的。
14:39
So the better news新聞 is
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所以更好的消息是
14:41
the future's期貨 almost幾乎 here --
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未來已經快到了——
14:43
and the future未來 is tissue組織 engineering工程.
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這個未來就是生物組織建造
14:45
Just imagine想像,
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想想看,
14:47
I can make a biologically-degradable生物降解 template模板.
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我可以做一個可以生物化降解的模板。
14:50
I can put it in place地點 where it's meant意味著 to be.
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我可以將這個模板放在該放的地方。
14:52
I can sprinkle a few少數 cells細胞,
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我可以撒上一些細胞,
14:54
stem cells細胞 from the patient's耐心 own擁有 hip臀部,
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一些從病患自己胯上取得的幹細胞,
14:56
a little bit of genetically基因 engineered工程 protein蛋白,
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加上一些基因工程製造出的蛋白質,
14:58
and lo and behold不料, leave離開 it for four months個月 and the face面對 is grown長大的.
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然後靜候四個月,臉部就可以長出來。
15:02
This is a bit like a Julia朱莉婭 Child兒童 recipe食譜.
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這有點像是童話故事中的食譜。
15:06
But we've我們已經 still got problems問題.
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但我們仍然有一些問題。
15:08
We've我們已經 got mouth cancer癌症 to solve解決.
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我們仍然有口腔癌要解決。
15:10
We're still not curing養護 enough足夠 patients耐心 -- it's the most disfiguring毀容 cancer癌症.
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我們仍然沒有辦法救足夠病患--但它是最容易毀容的癌症。
15:13
We're still not reconstructing重建 them well enough足夠.
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我們仍然沒有辦法足夠好的重建這部分
15:16
In the U.K. we have an epidemic疫情
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在英國,年輕的族群臉部受傷
15:18
of facial面部 injuries受傷 among其中 young年輕 people.
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有擴大的趨勢。
15:20
We still can't get rid擺脫 of scars傷疤.
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我們仍然沒有辦法不留下疤痕。
15:22
We need to do research研究.
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我們仍然需要作研究。
15:24
And the best最好 news新聞 of all
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但最好的消息是
15:26
is that surgeons外科醫生 know
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外科醫生們知道
15:28
that we need to do research研究.
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我們需要進一步研究。
15:30
And we've我們已經 set up charities慈善機構
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所以我們已經建立起慈善基金
15:32
that will help us fund基金
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幫助我們
15:34
the clinical臨床 research研究
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作臨床研究
15:36
to determine確定 the best最好 treatment治療 practice實踐 now
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來決定目前最好的手術方式
15:38
and better treatment治療 into the future未來,
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以及未來更好的處理方法。
15:40
so we don't just sit on our laurels桂冠 and say, "Okay, we're doing okay.
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所以我們不是坐在那說:「好,我們已經做地夠好了。
15:42
Let's leave離開 it as it is."
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就這樣吧。」
15:44
Thank you very much indeed確實.
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非常謝謝你們。
15:46
(Applause掌聲)
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(掌聲)
Translated by Joan Liu
Reviewed by Yakun Li

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ABOUT THE SPEAKER
Iain Hutchison - Facial surgeon
Iain Hutchison is a pioneering oral and facial surgeon; his foundation, Saving Faces, explores the nature of our expressions.

Why you should listen

Iain Hutchison thinks deeply about our faces. In his practice at St. Bartholomew’s, Royal London and University College London Hospitals, he has seen faces that lack the basic ability to function, to communicate emotion, to serve as a window to the world. His work involves repairing individual faces that have been impaired through cancer, birth defect or accidents—and asking all of us to look beyond first impressions.

One way he’s seeding the conversation is through the Facial Surgery Research Foundation/Saving Faces, which supports facial surgery research and education as well as a groundbreaking artistic residency by painter Mark Gilbert. Right in Hutchison’s office, patients sat for Gilbert before and after facial surgery, resulting in searching, honest portraits that show the humanity even of someone whose face we might be unwilling to look at. The “Saving Faces” exhibit has been seen by more than two million gallery visitors. Hutchison is also an active advocate of running clinical trials for facial surgery, and he funds and co-supervises two psychology PhD students to study ways to improve emotional and functional outcomes.

As he says: "Facial surgery is challenging not only because of its intricacy but because it has a profound effect on the patient’s psyche."

More profile about the speaker
Iain Hutchison | Speaker | TED.com