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

許爾文‧努蘭醫師談電擊療法

Filmed:
1,958,485 views

外科醫師暨作家許爾文‧努蘭,探討運用電擊療法醫治危及生命的重度憂鬱的發展,包括他自己罹患的憂鬱症。這是一篇有關解脫、就贖與重生的溫馨感人演講。
- 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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我想和第一次一樣
00:28
which哪一個 is to choose選擇 a light-hearted輕快 theme主題.
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挑個輕鬆的話題
00:31
Last time, I talked about death死亡 and dying垂死.
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上次我談論生與死
00:34
This time, I'm going to talk about mental心理 illness疾病.
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這次要談談精神疾病
00:39
But it has to be technological技術性,
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為著重技術面
00:40
so I'll talk about electroshock電擊 therapy治療. (Laughter笑聲)
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我選擇談電擊療法 (笑聲)
00:45
You know, ever since以來 man had any notion概念
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各位知道,自從人類最早發現
00:48
that some of his other people, his colleagues同事,
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身邊有些人,同僚等等
00:52
could be different不同, could be strange奇怪, could be severely嚴重 depressed鬱悶
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可能和自己不同、行徑怪異,或嚴重憂鬱
00:56
or what we now recognize認識 as schizophrenia精神分裂症,
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或是現在所謂的精神分裂症
01:00
he was certain某些 that this kind of illness疾病
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就斷定這種疾病
01:03
had to come from evil邪惡 spirits getting得到 into the body身體.
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一定是惡魔邪靈附身
01:06
So, the way of treating治療 these diseases疾病
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若要加以醫治
01:08
in early times was to, in some way or other,
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在早期,是使用各種方法
01:11
exorcise those evil邪惡 spirits, and this is still going on, as you know.
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驅邪除魔,至今仍是如此,誠如各位所知
01:16
But it wasn't enough足夠 to use the priests牧師.
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但是祭司的療癒力量有限
01:18
When medicine醫學 became成為 somewhat有些 scientific科學, in about 450 BC公元前,
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西元450年左右,醫學發展成為科學
01:23
with Hippocrates希波克拉底 and those boys男孩,
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醫學之父希波克拉底和他的學生
01:25
they tried試著 to look for herbs草藥, plants植物
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開始研究各種藥草、植物
01:29
that would literally按照字面 shake the bad spirits out.
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找出能有效將邪魔驅除於人體之外的藥方
01:32
So, they found發現 certain某些 plants植物 that could cause原因 convulsions抽搐.
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他們發現某些植物會導致人體抽搐
01:35
And the herbals草藥, the botanical植物 books圖書 of up to the late晚了 Middle中間 Ages時代,
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各種《草藥集》,涵蓋截至中世紀晚期
01:41
the Renaissance再生 are filled填充 with prescriptions處方
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即文藝復興時期的植物書籍
01:45
for causing造成 convulsions抽搐 to shake the evil邪惡 spirits out.
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記載許多誘發抽搐,來驅除邪靈的處方
01:50
Finally最後, in about the sixteenth第十六 century世紀,
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最後,到了大約16世紀
01:54
a physician醫師 whose誰的 name名稱 was Theophrastus泰奧弗拉斯 BombastusBombastus Aureolus奧拉斯 von Hohenheim霍恩海姆,
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一位名為霍因罕(Theophrastus Bombast von Hohenheim) 的醫生
02:00
called Paracelsus帕拉塞爾蘇斯, a name名稱 probably大概 familiar to some people here --
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又名帕拉切爾蘇斯(Paracelsus) ,在座可能有人知道
02:04
(Laughter笑聲) -- good, old Paracelsus帕拉塞爾蘇斯
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(笑聲) 老頑固帕拉切爾蘇斯
02:09
found發現 that he could predict預測 the degree of convulsion抽搐
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發現他能預測抽搐程度
02:13
by using運用 a measured測量 amount of camphor to produce生產 the convulsion抽搐.
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他利用定量的樟腦,誘發人體抽搐
02:17
Can you imagine想像 going to your closet壁櫥, pulling out a mothball封存, and
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你能想像,打開衣櫃,取出一顆樟腦丸
02:20
chewing咀嚼 on it if you're feeling感覺 depressed鬱悶?
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嚼食它,來緩解你的憂鬱嗎?
02:23
It's better than Prozac百憂解, but I wouldn't不會 recommend推薦 it.
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效果比百憂解好,不過我可不建議這麼做
02:26
So what we see in the seventeenth第十七, eighteenth第十八 century世紀
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發展到17、18世紀
02:29
is the continued繼續 search搜索 for medications藥物治療 other than camphor that'll那會 do the trick.
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人類繼續尋找樟腦以外的療方
02:34
Well, along沿 comes Benjamin本傑明 Franklin富蘭克林,
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這時出現了班傑明‧富蘭克林
02:36
and he comes close to convulsing抽搐 himself他自己
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他幾乎導致自己的身體抽搐
02:38
with a bolt螺栓 of electricity電力 off the end結束 of his kite風箏.
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當時是透過風箏傳導下來的雷電電流
02:42
And so people begin開始 thinking思維 in terms條款 of electricity電力 to produce生產 convulsions抽搐.
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所以人們開始思考如何用電流引發抽搐
02:47
And then, we fast-forward快進 to about 1932,
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到了1932年左右
02:51
when three Italian意大利 psychiatrists精神科醫生, who were largely大部分 treating治療 depression蕭條,
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有三位主治憂鬱症的義大利醫生
02:57
began開始 to notice注意 among其中 their patients耐心, who were also epileptics癲癇,
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觀察同時患有憂鬱症和癲癇症的病人
03:00
that if they had an epileptic癲癇 -- a series系列 of epileptic癲癇 fits適合,
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發現這些病人癲癇症發作之後
03:03
a lot of them in a row -- the depression蕭條 would very frequently經常 lift電梯.
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連續發作多次後,憂鬱症會相對減輕
03:07
Not only would it lift電梯, but it might威力 never return返回.
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不但減輕,有時甚至完全根治
03:11
So they got very interested有興趣 in producing生產 convulsions抽搐,
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所以他們很熱中研究如何誘發抽搐
03:16
measured測量 types類型 of convulsions抽搐.
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控制抽搐的程度
03:18
And they thought, "Well, we've我們已經 got electricity電力, we'll plug插頭 somebody into the wall.
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他們想:「我們有電源,何不把身體通電試試看?」
03:21
That always makes品牌 hair頭髮 stand up and people shake a lot."
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「身體觸電會毛髮直豎、渾身顫抖」
03:24
So, they tried試著 it on a few少數 pigs, and none沒有 of the pigs were killed殺害.
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他們用豬做電擊實驗,所有的豬都活了下來
03:28
So, they went to the police警察 and they said,
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他們就跑去跟警察說
03:30
"We know that at the Rome羅馬 railroad鐵路 station,
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「我們知道在羅馬火車站,」
03:33
there are all these lost丟失 souls靈魂 wandering飄零 around,
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「有許多徘徊的流浪漢,」
03:35
muttering咕噥 gibberish胡言亂語. Can you bring帶來 one of them to us?"
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「成天瘋言瘋語, 可不可以帶一個來參加我們的實驗?」
03:39
Someone有人 who is, as the Italians意大利 say, "cagootscagoots."
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就是義大利人所謂的腦袋秀逗
03:42
So they found發現 this "cagootscagoots" guy,
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於是他們找到一個腦袋秀逗的男子
03:44
a 39-year-old-歲 man who was really hopelessly絕望地 schizophrenic精神分裂症,
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一個嚴重精神分裂的39歲男子
03:47
who was known已知, had been known已知 for months個月,
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大家都知道他已經好幾個月
03:50
to be literally按照字面 defecating排糞 on himself他自己,
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經常在自己身上大小便
03:54
talking nothing that made製作 any sense,
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整天胡言亂語
03:56
and they brought him into the hospital醫院.
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於是他被帶到醫院
03:58
So these three psychiatrists精神科醫生, after about two or three weeks of observation意見,
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交給這三名醫生,經過兩三週的觀察
04:02
laid鋪設 him down on a table,
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醫師讓他平躺在病床上
04:04
connected連接的 his temples寺廟 to a very small source資源 of current當前.
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將兩邊太陽穴連接微量電流
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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他們想:「先試55伏特、1/5秒,」
04:13
That's not going to do anything terrible可怕 to him."
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「應該不會造成傷害。」
04:16
So they did that.
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於是他們就這麼做
04:17
Well, I have the following以下 from a firsthand第一手 observer觀察者,
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以下是第一線觀察員告訴我的
04:21
who told me this about 35 years年份 ago,
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他告訴我的時候大約是35年前
04:24
when I was thinking思維 about these things
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當時我正在思索這些電擊實驗
04:26
for some research研究 project項目 of mine.
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做為我研究計畫的參考
04:29
He said, "This fellow同伴" -- remember記得, he wasn't even put to sleep睡覺 --
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觀察員說:「這個流浪漢,」(記得嗎?他當時是清醒的)
04:33
"after this major重大的 grand盛大 mal發作 convulsion抽搐,
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「這次大發作抽筋完後,」
04:35
satSAT right up, looked看著 at these three fellas小伙子們 and said,
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「站起身來,瞪著三位醫生,大罵:
04:38
'What the fuck他媽的 are you assholes蛀蟲 trying to do?' "
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『你們這些混帳,在我身上亂搞什麼?』
04:42
(Laughter笑聲)
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(笑聲)
04:50
If I could only say that in Italian意大利.
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可惜我不會用義大利文講給各位聽
04:53
Well, they were happy快樂 as could be, because he
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醫生們非常開心,因為這個流浪漢
04:56
hadn't有沒有 said a rational合理的 word in the weeks of observation意見.
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在觀察期一句合邏輯的話也沒說過
05:00
So they plugged him in again,
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於是他們再度把他的身體通電
05:05
and this time they used 110 volts for half a second第二.
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這次通110伏特,持續半秒鐘
05:09
And to their amazement驚愕, after it was over,
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他們高興地發現,電擊以後
05:12
he began開始 speaking請講 like he was perfectly完美 well.
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流浪漢居然開始正常說話
05:15
He relapsed復發 a little bit, they gave him a series系列 of treatments治療,
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偶爾復發,醫生就給他一連串的治療
05:18
and he was essentially實質上 cured治愈.
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結果他被治好了
05:19
But of course課程, having schizophrenia精神分裂症,
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當然,因為他患的是精神分裂症
05:22
within a few少數 months個月, it returned.
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幾個月後,他又再度患病了
05:24
But they wrote a paper about this,
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但是醫生們做出一篇研究報告
05:26
and everybody每個人 in the Western西 world世界 began開始 using運用 electricity電力
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西方醫學界便開始利用電擊
05:31
to convulse抽搐 people who were either schizophrenic精神分裂症 or severely嚴重 depressed鬱悶.
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誘發精神分裂症或重度憂鬱症患者的身體抽搐
05:35
It didn't work very well on the schizophrenics精神分裂症患者,
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療效對精神分裂症患者並不理想
05:37
but it was pretty漂亮 clear明確 in the '30s and by the middle中間 of the '40s
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但30年代至40年代中,很明顯地
05:40
that electroconvulsiveelectroconvul​​sive therapy治療 was very, very effective有效
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電擊療法對憂鬱症的療效
05:46
in the treatment治療 of depression蕭條.
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非常顯著
05:48
And of course課程, in those days, there were no antidepressant抗抑鬱劑 drugs毒品,
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而且當時還沒有發明抗憂鬱藥
05:51
and it became成為 very, very popular流行.
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所以當時很流行
05:54
They would anesthetize麻醉 people,
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將病人麻醉
05:56
convulse抽搐 them, but the real真實 difficulty困難 was
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施予電擊,但是真正的困難是
05:59
that there was no way to paralyze癱瘓 muscles肌肉.
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因為當時無法抑制肌肉的抽搐
06:01
So people would have a real真實 grand盛大 mal發作 seizure發作.
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因此電擊會導致病人真的癲癇大發作
06:04
Bones骨頭 were broken破碎. Especially特別 in old, fragile脆弱 people,
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骨頭斷裂,尤其是老弱的病人
06:07
you couldn't不能 use it.
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並不適用電擊療法
06:09
And then in the 1950s, late晚了 1950s, the so-called所謂 muscle肌肉 relaxants
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1950年代末期,出現所謂的肌肉鬆弛劑
06:14
were developed發達 by pharmacologists藥理學家,
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由藥理學家發明的
06:16
and it got so that you could induce促使 a complete完成 convulsion抽搐,
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便可施予完整的電擊治療
06:20
an electroencephalographic腦電圖 convulsion抽搐 -- you could see it on the brain waves波浪 --
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即腦電圖(electroencephalographic)癲癇,會顯現在腦波中
06:23
without causing造成 any convulsion抽搐 in the body身體 except a little bit of twitching抽搐 of the toes腳趾.
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但是身體不會痙攣,只有腳趾會稍微抽動
06:28
So again, it was very, very popular流行 and very, very useful有用.
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所以電擊療法變得非常普遍、有效
06:34
Well, you know, in the middle中間 '60s,
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各位知道,到了60年代中期
06:36
the first antidepressants抗抑鬱藥 came來了 out. TofranilTofranil was the first.
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首度發明抗憂鬱劑,當時最早是妥富腦 (Tofranil)
06:40
In the late晚了 '70s, early '80s, there were others其他,
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70、80年代出現其他抗憂鬱藥物
06:44
and they were very effective有效.
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效果都很好
06:45
And patients'耐心' rights權利 groups seemed似乎 to get very upset煩亂
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加上當時病患權益團體非常不滿
06:48
about the kinds of things that they would witness見證.
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抗議他們所目睹的一些電擊治療情形
06:51
And so the whole整個 idea理念 of electroconvulsiveelectroconvul​​sive, electroshock電擊 therapy治療 disappeared消失,
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因此醫界停用電擊療法
06:57
but has had a renaissance再生 in the last 10 years年份.
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直到近10年才又恢復使用
07:01
And the reason原因 that it has had a renaissance再生
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原因是
07:04
is that probably大概 about 10 percent百分 of the people, severe嚴重 depressives抑鬱症,
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大約有1/10的病患,重度憂鬱患者
07:10
do not respond響應, regardless而不管 of what is doneDONE for them.
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對什麼治療都沒有反應
07:15
Now, why am I telling告訴 you this story故事 at this meeting會議?
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我為什麼要在此分享這個故事呢?
07:19
I'm telling告訴 you this story故事, because actually其實 ever since以來
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我告訴大家這個故事,其實是因為
07:22
Richard理查德 called me and asked me to talk about
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理查打電話給我,邀我來演講
07:24
-- as he asked all of his speakers音箱 --
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他對所有講者的一貫要求
07:26
to talk about something that would be new to this audience聽眾,
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是希望我能帶給聽眾新思維
07:29
that we had never talked about, never written書面 about,
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談論史無前例的議題
07:32
I've been planning規劃 this moment時刻.
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我一直期待準備這一刻
07:35
This reason原因 really is that I am a man who, almost幾乎 30 years年份 ago,
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因為30年前左右
07:40
had his life saved保存 by two long courses培訓班 of electroshock電擊 therapy治療.
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我的命是兩段電擊療程救回來的
07:48
And let me tell you this story故事.
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所以我想分享這個故事
07:52
I was, in the 1960s, in a marriage婚姻. To use the word bad
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在1960年代,我身陷糟糕的婚姻
07:58
would be perhaps也許 the understatement輕描淡寫 of the year.
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「糟糕」根本不足以形容
08:01
It was dreadful可怕.
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簡直是一場磨難
08:03
There are, I'm sure, enough足夠 divorced離婚 people in this room房間
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我相信在座也有些離婚人士
08:06
to know about the hostility敵意, the anger憤怒, who knows知道 what.
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知道那種敵意、憤怒,無盡的折磨
08:12
Being存在 someone有人 who had had a very difficult childhood童年,
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我有個不堪的童年
08:17
a very difficult adolescence青春期 --
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青少年時期也不好過
08:18
it had to do with not quite相當 poverty貧窮 but close.
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雖不貧賤,亦不遠矣
08:22
It had to do with being存在 brought up in a family家庭 where no one spoke English英語,
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我們全家沒有人會說英語
08:25
no one could read or write English英語.
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也不會讀寫英文
08:27
It had to do with death死亡 and disease疾病 and lots of other things.
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又遭逢親人病、死,和其他的苦難
08:31
I was a little prone易於 to depression蕭條.
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我經常憂鬱
08:33
So, as things got worse更差, as we really began開始 to hate討厭 each other,
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所以當情況越來越糟,我們開始彼此憎恨
08:37
I became成為 progressively逐步 depressed鬱悶 over a period of a couple一對 of years年份,
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有幾年我的憂鬱症變得日益嚴重
08:41
trying to save保存 this marriage婚姻,
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試圖挽救破裂的婚姻
08:43
which哪一個 was inevitably必將 not to be saved保存.
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但終究是回天乏術
08:47
Finally最後, I would schedule時間表 -- all my major重大的 surgical外科 cases,
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後來,我所有的病患手術,都得安排在
08:53
I was scheduling調度 them for 12, one o'clock in the afternoon下午,
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中午12點或下午1點才開始
08:57
because I couldn't不能 get out of bed before about 11 o'clock.
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因為我根本沒辦法在11點以前下床
09:01
And anybody任何人 who's誰是 been depressed鬱悶 here knows知道 what that's like.
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在座有得過憂鬱症的人才會了解那種情形
09:04
I couldn't不能 even pull the covers蓋子 off myself.
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我連掀開棉被的力氣都沒有
09:08
Well, you're in a university大學 medical center中央,
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當時我是在大學附設醫院
09:10
where everybody每個人 knows知道 everybody每個人, and it's perfectly完美 clear明確 to my colleagues同事,
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大家都很熟,同事們很清楚我的情況
09:13
so my referrals推介 began開始 to decrease減少.
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所以我的轉介病患越來越少
09:15
As my referrals推介 began開始 to decrease減少,
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當我的手術病患數量銳減
09:18
I clearly明確地 became成為 increasingly日益 depressed鬱悶
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更加劇了我的憂鬱症
09:22
until直到 I thought, my God, I can't work anymore.
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直到我發覺,天哪,我沒辦法工作了
09:24
And, in fact事實, it didn't make any difference區別
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事實上也沒什麼差別
09:26
because I didn't have any patients耐心 anymore.
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因為當時我已經沒有任何病患了
09:28
So, with the advice忠告 of my physician醫師,
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所以,我接受我的醫師建議
09:32
I had myself admitted承認 to the acute急性 care關心 psychiatric精神病 unit單元 of our university大學 hospital醫院.
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住進了我們大學醫院的精神科急性監護病房
09:37
And my colleagues同事, who had known已知 me since以來 medical school學校
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當時,從醫學院唸書就認識我的同事們
09:40
in that place地點, said, "Don't worry擔心, chap皴裂. Six weeks,
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給我打氣說:「放心,只要短短六週,」
09:42
you're back in the operating操作 room房間. Everything's一切都 going to be great."
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「你就可以回手術室操刀了,一切都會很順利」
09:46
Well, you know what bovine stercusstercus is?
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你知道英文的「bovine stercus (牛糞)」是什麼意思嗎?
09:50
That proved證實 to be a lot of bovine stercusstercus.
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那些安慰話根本是牛糞,一派胡言
09:56
I know some people who got tenure保有 in that place地點 with lies like that.
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那裡有些終身職教授都會扯這種謊言
10:01
(Laughter笑聲)
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(笑聲)
10:07
So I was one of their failures故障.
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我是他們謊言的活證
10:10
But it wasn't that simple簡單. Because by the time
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狀況根本沒那麼單純,因為後來
10:12
I got out of that unit單元, I was not functional實用 at all.
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我出院時,完全沒有行為能力
10:17
I could hardly幾乎不 see five feet in front面前 of myself.
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連眼前一公尺半以外都看不到
10:19
I shuffled洗牌 when I walked. I was bowed鞠躬 over.
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走路步履蹣跚,彎腰駝背
10:22
I rarely很少 bathed沐浴. I sometimes有時 didn't shave刮鬍子. It was dreadful可怕.
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很少洗澡,不刮鬍子,邋遢不堪
10:27
And it was clear明確 -- not to me,
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我的狀況很明顯--只是我自己不知道
10:30
because nothing was clear明確 to me at that time anymore --
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當時我什麼也不知道--
10:33
that I would need long-term長期 hospitalization住院治療
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我很顯然需要長期住院
10:37
in that awful可怕 place地點 called a mental心理 hospital醫院.
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住進精神療養院這個糟糕的地方
10:41
So I was admitted承認, in 1973, in the spring彈簧 of 1973,
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所以1973年春,我住進了精神療養院
10:47
to the Institute研究所 of Living活的, which哪一個 used to be called the Hartford哈特福德 Retreat撤退.
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住進安生機構(Institute of Living),本來是哈特福特安養院
10:50
It was founded成立 in the eighteenth第十八 century世紀,
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該院成立於18世紀
10:52
the largest最大 psychiatric精神病 hospital醫院 in the state of
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是康乃狄克州最大的精神病院
10:56
Connecticut康涅狄格, other than the huge巨大 public上市 hospitals醫院
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僅次於大型公立醫院
10:58
that existed存在 at that time.
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在當時來說
11:01
And they tried試著 everything they had.
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住進療養院以後,醫師們試過所有的療法
11:02
They tried試著 the usual通常 psychotherapy心理治療.
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他們試過一般的心理治療
11:04
They tried試著 every一切 medication藥物治療 available可得到 in those days.
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開過當時所有的憂鬱症藥物
11:07
And they did have TofranilTofranil and other things -- MellarilMellaril, who knows知道 what.
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包括妥富腦、美力廉(Mellaril) ,還有其他各式各樣的藥
11:11
Nothing happened發生 except that I got jaundiced黃疸 from one of these things.
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除了害我得黃疸病,病情一點也沒好轉
11:15
And finally最後, because I was well known已知 in Connecticut康涅狄格,
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最後,因為我在康州的名氣
11:21
they decided決定 they better have a meeting會議 of the senior前輩 staff員工.
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他們為我召開資深醫師會診
11:25
All the senior前輩 staff員工 got together一起, and I later後來 found發現 out what happened發生.
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召集所有資深醫護人員,我後來才知道內情
11:31
They put all their heads together一起 and they decided決定
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他們集思廣益的結論是
11:35
that there was nothing that could be doneDONE
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我已經無藥可醫
11:37
for this surgeon外科醫生 who had essentially實質上 separated分離 himself他自己 from the world世界,
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他們認為我已經完全自我封閉
11:41
who by that time had become成為 so overwhelmed不堪重負,
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被完全擊垮
11:45
not just with depression蕭條 and feelings情懷
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不只是憂鬱及感覺
11:48
of worthlessness無價值 and inadequacy不足之處,
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毫無自我價值和無能
11:50
but with obsessional強迫 thinking思維,
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還有強迫性思考
11:53
obsessional強迫 thinking思維 about coincidences巧合.
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滿腦子不停地想著各種巧合
11:55
And there were particular特定 numbers數字 that every一切 time I saw them,
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每次看到某些特定數字
11:58
just got me dreadfully可怕 upset煩亂 -- all kinds of ritualistic儀式 observances紀念活動,
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我都會非常苦惱。還有各種怪癖
12:04
just awful可怕, awful可怕 stuff東東.
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簡直糟糕透了
12:06
Remember記得 when you were a kid孩子, and you had to step on every一切 line?
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記得小時候走路,地上每條線你都想踩嗎?
12:09
Well, I was a grown長大的 man who had all of these rituals儀式,
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我當時已經是成人了,還是有很多怪癖
12:13
and it got so there was a throbbing悸動, there was a ferocious兇猛 fear恐懼 in my head.
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整個腦子被強烈的恐懼感攫獲
12:17
You've seen看到 this painting繪畫 by Edvard愛德華 Munch蒙克,
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大家看過孟克的畫作《吶喊》吧?
12:19
The Scream吶喊. Every一切 moment時刻 was a scream驚叫.
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這「吶喊」的意象無時不刻在我腦子裡轟轟作響
12:24
It was impossible不可能. So they decided決定 there was no therapy治療,
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我病入膏肓,醫師們束手無策
12:27
there was no treatment治療. But there was one treatment治療,
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百藥難醫,只剩一個辦法
12:30
which哪一個 actually其實 had been pioneered首創 at the Hartford哈特福德 hospital醫院 in the early 1940s,
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1940年代早期這家醫院率先採用這種療法
12:35
and you can imagine想像 what it was. It was pre-frontal前額葉 lobotomy切斷術.
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大家猜得到,就是腦前額葉切除術
12:43
So they decided決定 -- I didn't know this, again,
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所以他們決定
12:45
I found發現 this out later後來 --
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後來我才知道
12:46
that the only thing that could be doneDONE was
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唯一的希望
12:48
for this 43-year-old-歲 man to have a pre-frontal前額葉
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就是給這個43歲的老男人
12:52
lobotomy切斷術.
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做腦前額葉切除術
12:55
Well, as in all hospitals醫院, there was a resident居民
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就像所有醫院的做法
12:58
assigned分配 to my case案件. He was 27 years年份 old,
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他們指派一位住院醫師給我,年方27
13:01
and he would meet遇到 with me two or three times a week.
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我每週給他看診2、3次
13:03
And of course課程, I had been there, what, three or four months個月 at the time.
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當時我已經在那裡住院3、4個月了
13:07
And he asked to meet遇到 with the senior前輩 staff員工, and they agreed約定 to meet遇到 with him
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他也跟資深醫護人員會診
13:10
because he was very well thought of in that place地點.
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大家都公認他是個好醫生
13:12
They thought he had a really extraordinary非凡 future未來.
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認為他前途無量
13:16
And he dug in his heels腳跟 and said,
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他很堅持的說:
13:17
"No. I know this man better than any of you. I have met會見 with him over and over again.
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「不行。我比各位更清楚他的病情,我們經常相處。」
13:21
You've just seen看到 him from time to time. You've read reports報告 and so forth向前.
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「各位只是偶爾探視他,看醫療報告。」
13:25
I really honestly老老實實 believe that the basic基本 problem問題 here is pure depression蕭條,
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「我堅信他的問題是單純憂鬱症,」
13:30
and all of the obsessional強迫 thinking思維 comes out of it.
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「及伴隨的強迫性思考。」
13:33
And you know, of course課程, what'll什麼會 happen發生 if you do a pre-frontal前額葉 lobotomy切斷術.
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「各位也知道進行前額葉切除術的後果,」
13:36
Any of the results結果 along沿 the spectrum光譜,
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「什麼都有可能發生,」
13:40
from pretty漂亮 bad to terrible可怕, terrible可怕, terrible可怕
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「從不佳到不堪設想都有可能,」
13:42
is going to happen發生. If he does the best最好 he can,
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「如果手術很成功,康復狀況良好,」
13:46
he will have no further進一步 obsessions走火入魔,
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「他將不再有強迫性思考,」
13:48
probably大概 no depression蕭條, but his affect影響 will be dulled遲鈍,
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「憂鬱症也可能治好,但是他的情感會變遲鈍。」
13:51
he will never go back to surgery手術,
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「他可能再也無法當外科醫生,」
13:53
he will never be the loving愛心 father父親 that he was to his two children孩子,
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「或是兩個孩子的慈父。」
13:57
his life will be changed. If he has the usual通常 result結果,
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「他的人生將從此改變。如果是常見的手術結果,」
14:00
he will end結束 up like 'One'一 Flew弗盧 Over the Cuckoo's杜鵑的 Nest.'
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「他會像《飛越杜鵑窩》 一樣,」
14:03
And you know about that, just essentially實質上 in a stupor麻木 the rest休息 of his life."
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「終生癡呆恍惚。」
14:08
Well, he said, "Can't we try a course課程 of electroshock電擊 therapy治療?"
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「難道我們不能試一個電擊療程嗎?」
14:14
And you know why they agreed約定? They agreed約定 to humor幽默 him.
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他們不想和他爭執,所以才同意
14:17
They just thought, "Well, we'll give a course課程 of 10.
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他們想:「就試個10次吧。」
14:21
And so we'll lose失去 a little time. Big deal合同. It doesn't make any difference區別."
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「只是浪費一點時間,反正也沒差。」
14:25
So they gave the course課程 of 10,
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所以他們就給我10次電療
14:26
and the first -- the usual通常 course課程, incidentally順便, was six to eight
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第一個療程通常做6到8次
14:30
and still is six to eight.
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現在還是
14:32
Plugged堵塞 me into the wires電線, put me to sleep睡覺, gave me the muscle肌肉 relaxant.
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於是他們幫我貼導電片、麻醉、鬆弛肌肉
14:36
Six didn't work. Seven didn't work.
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6次不見效果,7次也沒有效
14:38
Eight didn't work. At nine, I noticed注意到 --
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8次還是無效。到了第9次,我感覺到
14:41
and it's wonderful精彩 that I could notice注意 anything
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(能自己感覺到真好)
14:44
-- I noticed注意到 a change更改. And at 10, I noticed注意到 a real真實 change更改.
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我開始感覺到變化。第10次,我才感到真正的不同
14:48
And he went back to them, and they agreed約定 to do another另一個 10.
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於是我的醫生又向他們要求再做一套10次療程
14:51
Again, not a single one of them
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這群醫生中還是沒有人相信
14:53
-- I think there are about seven or eight of them --
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他們大概有7、8位
14:55
thought this would do any good. They thought this was a temporary臨時 change更改.
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都不相信電療,認為只會暫時改善
14:57
But, lo and behold不料, by 16, by 17,
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結果跌破大家眼鏡,做完第16、17次
15:01
there were demonstrable論證 differences分歧 in the way I felt.
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我的感覺已經有明顯的差異
15:05
By 18 and 19, I was sleeping睡眠 through通過 the night.
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做完第18、19次,我已經可以安睡到天亮了
15:08
And by 20, I had the sense, I really had the sense
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第20次做完,我真的感覺
15:12
that I could overcome克服 this,
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自己可以戰勝憂鬱症
15:15
that I was now strong強大 enough足夠 that by an act法案 of will,
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我已經變得很堅強,可以靠意志力
15:18
I could blow打擊 the obsessional強迫 thinking思維 away.
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掃除強迫性思考
15:20
I could blow打擊 the depression蕭條 away.
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告別憂鬱
15:23
And I've never forgotten忘記了 -- I never will forget忘記
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我永遠也忘不了
15:26
-- standing常設 in the kitchen廚房 of the unit單元,
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站在療養院的廚房
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月的星期天早晨
15:33
standing常設 in the kitchen廚房 by myself and thinking思維, "I've got the strength強度 now to do this."
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獨自站在那裡,心想:「我現在有康復的力量了。」
15:39
It was as though雖然 those tightly緊緊 coiled盤繞 wires電線 in my head had been disconnected斷開的
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彷彿我腦中那些固著的電路被拆除了
15:44
and I could think clearly明確地.
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我可以清晰地思考
15:46
But I need a formula. I need some thing to say to myself
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但是我需要一個方法,一句提醒自己的話
15:51
when I begin開始 thinking思維 obsessionallyobsessionally, obsessively痴迷.
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以防我再陷入強迫性思考
15:55
Well, the Gilbert吉爾伯特 and Sullivan沙利文 fans球迷 in this room房間
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在座的蘇利文與吉柏特迷
16:00
will remember記得 "RuddigoreRuddigore," and they will remember記得 Mad Margaret瑪格麗特,
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會記得歌劇《Ruddigore》 和瘋狂瑪格麗特
16:03
and they will remember記得 that she was married已婚
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會記得她是嫁給
16:05
to a fellow同伴 named命名 Sir先生 DespardDespard MurgatroydMurgatroyd.
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德斯帕德爵士
16:09
And she used to go nuts堅果, every一切 five minutes分鐘 or so in the play,
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劇中瑪格麗特每5分鐘就會發狂
16:13
and he said to her, "We must必須 have a word to bring帶來 you back to reality現實,
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丈夫對她說:「我們得想個密語,把妳拉回現實。」
16:16
and the word, my dear, will be 'Basingstoke“貝辛斯托克.'"
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那個字就是「貝辛斯托克」
16:20
So every一切 time she got a little nuts堅果,
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所以每次她一開始發瘋
16:22
he would say, "Basingstoke貝辛斯托克!" And she would say,
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他就會喊:「貝辛斯托克!」
16:24
"Basingstoke貝辛斯托克, it is." And she would be fine for a little while.
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她就回答:「就貝辛斯托克吧!」然後恢復正常
16:28
Well, you know, I'm from the Bronx布朗克斯. I can't say "Basingstoke貝辛斯托克."
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我來自布隆克斯,不能說「貝辛斯托克」
16:32
But I had something better. And it was very simple簡單.
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所以想出更簡單的密語
16:36
It was, "Ah, fuck他媽的 it!"
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就是「哎,去他的!」
16:39
(Laughter笑聲) Much better than "Basingstoke貝辛斯托克,"
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(笑聲) 比「貝辛斯托克」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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至少對我來說,而且真的管用
16:48
Every一切 time I would begin開始 thinking思維 obsessionallyobsessionally --
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只要我又開始強迫性思考
16:50
again, once一旦 more, after 20 shock休克 treatments治療
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歷經20次電療之後
16:54
-- I would say, "Ah, fuck他媽的 it."
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我就會自己喊:「哎,去他的!」
16:58
And things got better and better,
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我的狀況越來越好
17:00
and within three or four months個月,
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3、4個月以後
17:03
I was discharged出院 from that hospital醫院, and I joined加盟 a group of surgeons外科醫生
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我出院,加入一個外科醫師團體
17:06
where I could work with other people in the community社區,
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我可以和他人共事
17:10
not in New Haven避風港, but fairly相當 close by.
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在康州紐哈芬市附近的一個社區
17:13
I stayed there for three years年份.
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我在那裡待了三年
17:15
At the end結束 of three years年份, I went back to New Haven避風港,
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之後,我回到紐哈芬市
17:19
had remarried再婚 by that time.
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當時我已經再婚
17:23
I brought my wife妻子 with me, actually其實, to make sure I could get through通過 this.
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所以帶太太一起去,幫助我繼續康復
17:29
My children孩子 came來了 back to live生活 with us.
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我的孩子也搬來同住
17:35
We had two more children孩子 after that.
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之後我們又生了兩個小孩
17:38
Resuscitated復甦 the career事業, even better than it had been before.
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我又回到工作崗位,表現比以前更好
17:43
Went right back into the university大學
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我馬上回到大學任教
17:47
and began開始 to write books圖書.
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並且開始寫書
17:50
Well, you know, it's been a wonderful精彩 life.
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到現在生活一直都過得很好
17:53
It's been, as I said, close to 30 years年份.
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如我先前說過,至今已經30年了
17:57
I stopped停止 doing surgery手術 about six years年份 ago
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我大約6年前停止為病患手術
18:00
and became成為 a full-time全職 writer作家, as many許多 people know.
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許多人知道,我從此開始全職寫作
18:04
But it's been very exciting扣人心弦. It's been very happy快樂.
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我覺得非常興奮快樂
18:07
Every一切 once一旦 in a while, I have to say, "Ah, fuck他媽的 it."
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偶爾,我還是得提醒自己:「哎,去他的!」
18:09
Every一切 once一旦 in a while, I get somewhat有些 depressed鬱悶 and a little obsessional強迫.
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偶爾,還是會憂鬱和強迫性思考
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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並沒有完全根治,但是電療確實有效
18:22
Why have I chosen選擇, after never, ever talking about this, to talk about it now?
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為什麼避談這個話題這麼多年以後,我現在選擇談論它?
18:30
Well, those of you who know some of these books圖書
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在座如果有我的讀者
18:33
know that one is about death死亡 and dying垂死,
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應該知道我寫過一本探討生死的書
18:36
one is about the human人的 body身體 and the human人的 spirit精神,
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一本探討人的身體和心靈
18:38
one is about the way mystical神秘 thoughts思念 are constantly經常 in our minds頭腦,
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一本則是探討我們腦中不斷浮現的神秘思緒
18:43
and they have always to do with my own擁有 personal個人 experiences經驗.
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都是由我個人的親身經歷而來的心得
18:48
One might威力 think reading these books圖書
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有些讀者可能會認為
18:51
-- and I've gotten得到 thousands數千 of letters about them
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從我成千上萬封讀者來信
18:54
by people who do think this --
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讀者認為
18:56
that based基於 on my life's人生 history歷史 as I've portrayed刻畫 in the books圖書,
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從我在書中分享的個人生命史看來
18:59
my early life's人生 history歷史, I am someone有人 who has overcome克服 adversity逆境.
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我是個從苦難中熬出頭的人
19:04
That I am someone有人 who has drunk, drank, drunk
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我曾歷經艱辛
19:09
of the bitter dregs of near-disaster近災難 in childhood童年
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童年嚐盡不幸的苦楚
19:16
and emerged出現 not just unscathed毫髮無損 but strengthened加強.
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逆境沒有打倒我,反倒使我更堅強
19:21
I really have it figured想通 out, so that I can advise勸告 people about
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我已真正開悟,可以跟大家分享
19:24
death死亡 and dying垂死, so that I can talk about mysticism神秘主義 and the human人的 spirit精神.
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如何面對生死,也可以談論神秘與心靈
19:29
And I've always felt guilty有罪 about that.
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以往我一直覺得心虛
19:31
I've always felt that somehow不知何故 I was an impostor騙子
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覺得自己像個騙子
19:34
because my readers讀者 don't know what I have just told you.
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因為讀者並不知道我今天說的故事
19:39
It's known已知 by some people in New Haven避風港, obviously明顯,
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當然,紐哈芬市有些人知道
19:42
but it is not generally通常 known已知.
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但是一般大眾並不知道
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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所以今天我分享這故事的原因之一
19:49
is to -- frankly坦率地說, selfishly自私 --
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其實是自私的
19:54
unburden表白 myself and let it be known已知
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想解除心理的負擔,讓大眾知道我的往事
19:57
that this is not an untroubled mind心神 that has written書面 all of these books圖書.
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知道這些書的作者,也有著困厄的心靈
20:03
But more importantly重要的, I think,
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最重要的是
20:06
is the fact事實 that a very significant重大 proportion比例
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在座有許多人
20:08
of people in this audience聽眾 are under 30,
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年紀還不滿30
20:12
and there are many許多, of course課程, who are well over 30.
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當然也有許多人早就超過30歲
20:18
For people under 30, and it looks容貌 to me like almost幾乎 all of you
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在我看來,現場的年輕人
20:21
-- I would say all of you --
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每一位年輕人
20:22
are either on the cusp風口浪尖 of a magnificent華麗的 and exciting扣人心弦 career事業
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正值令人興奮的美好生涯尖峰
20:27
or right into a magnificent華麗的 and exciting扣人心弦 career事業:
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或是即將邁入美好的生涯
20:31
anything can happen發生 to you. Things change更改.
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任何事都可能發生在你身上,世事無常
20:35
Accidents事故 happen發生. Something from childhood童年 comes back to haunt出沒 you.
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人有旦夕禍福,童年記憶可能回來糾纏你
20:39
You can be thrown拋出 off the track跟踪.
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使你困頓茫然
20:41
I hope希望 it happens發生 to none沒有 of you,
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我希望你們不會有這種經歷
20:42
but it will probably大概 happen發生 to a small percentage百分比 of you.
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但是少部分人還是會遇到
20:47
To those to whom it doesn't happen發生, there will be adversities逆境.
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即使不遇到這種經歷,也會有其他的人生逆境
20:52
If I, with the bleakness蒼涼 of spirit精神,
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假如連我這個希望渺茫
20:56
with no spirit精神, that I had in the 1970s
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1970年當時根本全然絕望的靈魂
21:01
and no possibility可能性 of recovery復甦,
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不可能康復
21:03
as far as that group of very experienced有經驗的 psychiatrists精神科醫生 thought,
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至少那群資深精神科醫師這麼認為
21:07
if I can find my way back from this,
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如果連我都能熬過黑暗
21:09
believe me, anybody任何人 can find their way back
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相信我,任何人都可以找回自我
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舊的, who have lived生活 through通過
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年長的聽眾
21:19
perhaps也許 not something as bad as this,
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也許你的故事並沒有這麼艱苦
21:22
but who have lived生活 through通過 difficult times,
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但也經歷過風風雨雨
21:25
perhaps也許 where they lost丟失 everything, as I did,
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或許曾經失去所有,就像我一樣
21:27
and started開始 out all over again, some of these things will seem似乎 very familiar.
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一切重頭來過,這個故事你可能很熟悉
21:34
There is recovery復甦.
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你絕對可以康復
21:39
There is redemption贖回. And there is resurrection復活.
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得到救贖、重獲新生
21:47
There are resurrection復活 themes主題 in every一切 society社會 that has ever been studied研究,
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每個社會都有重獲新生的故事
21:51
and it is because not just only do we fantasize夢想
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這是因為我們不僅是幻想
21:54
about the possibility可能性 of resurrection復活 and recovery復甦,
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重生與康復的可能性
21:57
but it actually其實 happens發生. And it happens發生 a lot.
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確實會發生,而且多有所聞
22:01
Perhaps也許 the most popular流行 resurrection復活 theme主題,
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或許最常聽到的重生故事
22:05
outside of specifically特別 religious宗教 ones那些,
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除了宗教事蹟以外
22:08
is the one about the phoenix鳳凰, the ancient story故事 of the phoenix鳳凰,
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就是有關鳳凰的古老神話
22:12
who, every一切 500 years年份, resurrects復活 itself本身 from its own擁有 ashes灰燼
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每500年,牠會從自己的灰燼中浴火重生
22:19
to go on to live生活 a life that is
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展開全新的生命
22:22
even more beautiful美麗 than it was before. Richard理查德,
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更加美好的新生命
22:25
thanks謝謝 very much.
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理查,非常謝謝你
Translated by Yesbydefault 倪文娟
Reviewed by Jenny Yang

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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