TED2003
Sherwin Nuland: How electroshock therapy changed me
許爾文‧努蘭醫師談電擊療法
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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。
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. Full bio
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 much what I did the first time,
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我想和第一次一樣
00:28
which is to choose a light-hearted theme.
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挑個輕鬆的話題
00:31
Last time, I talked about death and dying.
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上次我談論生與死
00:34
This time, I'm going to talk about mental illness.
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這次要談談精神疾病
00:39
But it has to be technological,
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為著重技術面
00:40
so I'll talk about electroshock therapy. (Laughter)
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我選擇談電擊療法 (笑聲)
00:45
You know, ever since man had any notion
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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,
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身邊有些人，同僚等等
00:52
could be different, could be strange, could be severely depressed
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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 as schizophrenia,
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或是現在所謂的精神分裂症
01:00
he was certain that this kind of illness
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就斷定這種疾病
01:03
had to come from evil spirits getting into the body.
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一定是惡魔邪靈附身
01:06
So, the way of treating these diseases
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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 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 to use the priests.
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但是祭司的療癒力量有限
01:18
When medicine became somewhat scientific, in about 450 BC,
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西元450年左右，醫學發展成為科學
01:23
with Hippocrates and those boys,
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醫學之父希波克拉底和他的學生
01:25
they tried to look for herbs, plants
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開始研究各種藥草、植物
01:29
that would literally 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 certain plants that could cause convulsions.
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他們發現某些植物會導致人體抽搐
01:35
And the herbals, the botanical books of up to the late Middle Ages,
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各種《草藥集》，涵蓋截至中世紀晚期
01:41
the Renaissance are filled with prescriptions
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即文藝復興時期的植物書籍
01:45
for causing convulsions to shake the evil 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, in about the sixteenth century,
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最後，到了大約16世紀
01:54
a physician whose name was Theophrastus Bombastus Aureolus von Hohenheim,
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一位名為霍因罕(Theophrastus Bombast von Hohenheim) 的醫生
02:00
called Paracelsus, a name probably 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) -- good, old Paracelsus
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(笑聲) 老頑固帕拉切爾蘇斯
02:09
found that he could predict the degree of convulsion
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發現他能預測抽搐程度
02:13
by using a measured amount of camphor to produce the convulsion.
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他利用定量的樟腦，誘發人體抽搐
02:17
Can you imagine going to your closet, pulling out a mothball, and
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你能想像，打開衣櫃，取出一顆樟腦丸
02:20
chewing on it if you're feeling depressed?
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嚼食它，來緩解你的憂鬱嗎？
02:23
It's better than Prozac, but I wouldn't recommend 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, eighteenth century
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發展到17、18世紀
02:29
is the continued search for medications other than camphor that'll do the trick.
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人類繼續尋找樟腦以外的療方
02:34
Well, along comes Benjamin Franklin,
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這時出現了班傑明‧富蘭克林
02:36
and he comes close to convulsing himself
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他幾乎導致自己的身體抽搐
02:38
with a bolt of electricity off the end of his kite.
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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 thinking in terms of electricity to produce convulsions.
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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 to about 1932,
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到了1932年左右
02:51
when three Italian psychiatrists, who were largely treating depression,
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有三位主治憂鬱症的義大利醫生
02:57
began to notice among their patients, who were also epileptics,
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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 -- a series of epileptic fits,
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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 would very frequently lift.
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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, but it might never return.
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不但減輕，有時甚至完全根治
03:11
So they got very interested in producing convulsions,
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所以他們很熱中研究如何誘發抽搐
03:16
measured types of convulsions.
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控制抽搐的程度
03:18
And they thought, "Well, we've got electricity, we'll plug 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 hair 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 it on a few pigs, and none of the pigs were killed.
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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 and they said,
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他們就跑去跟警察說
03:30
"We know that at the Rome railroad station,
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「我們知道在羅馬火車站，」
03:33
there are all these lost souls wandering around,
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「有許多徘徊的流浪漢，」
03:35
muttering gibberish. Can you bring 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 who is, as the Italians say, "cagoots."
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就是義大利人所謂的腦袋秀逗
03:42
So they found this "cagoots" 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 man who was really hopelessly schizophrenic,
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一個嚴重精神分裂的39歲男子
03:47
who was known, had been known for months,
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大家都知道他已經好幾個月
03:50
to be literally defecating on himself,
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經常在自己身上大小便
03:54
talking nothing that made any sense,
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整天胡言亂語
03:56
and they brought him into the hospital.
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於是他被帶到醫院
03:58
So these three psychiatrists, after about two or three weeks of observation,
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交給這三名醫生，經過兩三週的觀察
04:02
laid him down on a table,
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醫師讓他平躺在病床上
04:04
connected his temples to a very small source of current.
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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 of a second.
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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 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 from a firsthand observer,
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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 ago,
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他告訴我的時候大約是35年前
04:24
when I was thinking 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 project of mine.
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做為我研究計畫的參考
04:29
He said, "This fellow" -- remember, he wasn't even put to sleep --
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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 grand mal convulsion,
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「這次大發作抽筋完後，」
04:35
sat right up, looked at these three fellas and said,
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「站起身來，瞪著三位醫生，大罵：
04:38
'What the fuck are you assholes trying to do?' "
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『你們這些混帳，在我身上亂搞什麼？』
04:42
(Laughter)
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(笑聲)
04:50
If I could only say that in Italian.
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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 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 said a rational word in the weeks of observation.
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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.
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這次通110伏特，持續半秒鐘
05:09
And to their amazement, after it was over,
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他們高興地發現，電擊以後
05:12
he began speaking like he was perfectly well.
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流浪漢居然開始正常說話
05:15
He relapsed a little bit, they gave him a series of treatments,
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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 cured.
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結果他被治好了
05:19
But of course, having schizophrenia,
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當然，因為他患的是精神分裂症
05:22
within a few months, 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 in the Western world began using electricity
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西方醫學界便開始利用電擊
05:31
to convulse people who were either schizophrenic or severely depressed.
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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,
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療效對精神分裂症患者並不理想
05:37
but it was pretty clear in the '30s and by the middle of the '40s
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但30年代至40年代中，很明顯地
05:40
that electroconvulsive therapy was very, very effective
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電擊療法對憂鬱症的療效
05:46
in the treatment of depression.
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非常顯著
05:48
And of course, in those days, there were no antidepressant drugs,
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而且當時還沒有發明抗憂鬱藥
05:51
and it became very, very popular.
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所以當時很流行
05:54
They would anesthetize people,
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將病人麻醉
05:56
convulse them, but the real difficulty 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 muscles.
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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 grand mal seizure.
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因此電擊會導致病人真的癲癇大發作
06:04
Bones were broken. Especially in old, fragile people,
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骨頭斷裂，尤其是老弱的病人
06:07
you couldn't use it.
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並不適用電擊療法
06:09
And then in the 1950s, late 1950s, the so-called muscle relaxants
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1950年代末期，出現所謂的肌肉鬆弛劑
06:14
were developed by pharmacologists,
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由藥理學家發明的
06:16
and it got so that you could induce a complete convulsion,
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便可施予完整的電擊治療
06:20
an electroencephalographic convulsion -- you could see it on the brain waves --
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即腦電圖(electroencephalographic)癲癇，會顯現在腦波中
06:23
without causing any convulsion in the body except a little bit of twitching of the toes.
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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 and very, very useful.
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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 '60s,
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各位知道，到了60年代中期
06:36
the first antidepressants came out. Tofranil 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 '70s, early '80s, there were others,
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70、80年代出現其他抗憂鬱藥物
06:44
and they were very effective.
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效果都很好
06:45
And patients' rights groups seemed to get very upset
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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.
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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 idea of electroconvulsive, electroshock therapy disappeared,
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因此醫界停用電擊療法
06:57
but has had a renaissance in the last 10 years.
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直到近10年才又恢復使用
07:01
And the reason that it has had a renaissance
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原因是
07:04
is that probably about 10 percent of the people, severe depressives,
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大約有1/10的病患，重度憂鬱患者
07:10
do not respond, regardless of what is done for them.
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對什麼治療都沒有反應
07:15
Now, why am I telling you this story at this meeting?
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我為什麼要在此分享這個故事呢？
07:19
I'm telling you this story, because actually ever since
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我告訴大家這個故事，其實是因為
07:22
Richard 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 --
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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,
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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 about,
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談論史無前例的議題
07:32
I've been planning this moment.
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我一直期待準備這一刻
07:35
This reason really is that I am a man who, almost 30 years ago,
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因為30年前左右
07:40
had his life saved by two long courses of electroshock therapy.
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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.
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所以我想分享這個故事
07:52
I was, in the 1960s, in a marriage. 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 the understatement of the year.
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「糟糕」根本不足以形容
08:01
It was dreadful.
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簡直是一場磨難
08:03
There are, I'm sure, enough divorced people in this room
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我相信在座也有些離婚人士
08:06
to know about the hostility, the anger, who knows what.
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知道那種敵意、憤怒，無盡的折磨
08:12
Being someone who had had a very difficult childhood,
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我有個不堪的童年
08:17
a very difficult adolescence --
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青少年時期也不好過
08:18
it had to do with not quite poverty but close.
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雖不貧賤，亦不遠矣
08:22
It had to do with being brought up in a family where no one spoke English,
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我們全家沒有人會說英語
08:25
no one could read or write English.
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也不會讀寫英文
08:27
It had to do with death and disease 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 to depression.
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我經常憂鬱
08:33
So, as things got worse, as we really began to hate 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 progressively depressed over a period of a couple of years,
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有幾年我的憂鬱症變得日益嚴重
08:41
trying to save this marriage,
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試圖挽救破裂的婚姻
08:43
which was inevitably not to be saved.
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但終究是回天乏術
08:47
Finally, I would schedule -- all my major surgical 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 them for 12, one o'clock in the afternoon,
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中午12點或下午1點才開始
08:57
because I couldn't 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 who's been depressed here knows 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 even pull the covers 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 medical center,
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當時我是在大學附設醫院
09:10
where everybody knows everybody, and it's perfectly clear to my colleagues,
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大家都很熟，同事們很清楚我的情況
09:13
so my referrals began to decrease.
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所以我的轉介病患越來越少
09:15
As my referrals began to decrease,
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當我的手術病患數量銳減
09:18
I clearly became increasingly depressed
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更加劇了我的憂鬱症
09:22
until 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, it didn't make any difference
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事實上也沒什麼差別
09:26
because I didn't have any patients 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 of my physician,
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所以，我接受我的醫師建議
09:32
I had myself admitted to the acute care psychiatric unit of our university hospital.
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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, who had known me since medical school
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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, said, "Don't worry, chap. 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 room. Everything's 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 stercus 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 to be a lot of bovine stercus.
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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 in that place 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)
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(笑聲)
10:07
So I was one of their failures.
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我是他們謊言的活證
10:10
But it wasn't that simple. 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, I was not functional at all.
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我出院時，完全沒有行為能力
10:17
I could hardly see five feet in front of myself.
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連眼前一公尺半以外都看不到
10:19
I shuffled when I walked. I was bowed over.
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走路步履蹣跚，彎腰駝背
10:22
I rarely bathed. I sometimes didn't shave. It was dreadful.
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很少洗澡，不刮鬍子，邋遢不堪
10:27
And it was clear -- 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 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 hospitalization
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我很顯然需要長期住院
10:37
in that awful place called a mental hospital.
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住進精神療養院這個糟糕的地方
10:41
So I was admitted, in 1973, in the spring 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 of Living, which used to be called the Hartford Retreat.
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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 in the eighteenth century,
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該院成立於18世紀
10:52
the largest psychiatric hospital in the state of
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是康乃狄克州最大的精神病院
10:56
Connecticut, other than the huge public hospitals
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僅次於大型公立醫院
10:58
that existed at that time.
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在當時來說
11:01
And they tried 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 the usual psychotherapy.
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他們試過一般的心理治療
11:04
They tried every medication available 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 Tofranil and other things -- Mellaril, who knows 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 except that I got jaundiced 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, because I was well known in Connecticut,
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最後，因為我在康州的名氣
11:21
they decided they better have a meeting of the senior staff.
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他們為我召開資深醫師會診
11:25
All the senior staff got together, and I later found out what happened.
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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 and they decided
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他們集思廣益的結論是
11:35
that there was nothing that could be done
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我已經無藥可醫
11:37
for this surgeon who had essentially separated himself from the world,
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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 so overwhelmed,
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被完全擊垮
11:45
not just with depression and feelings
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不只是憂鬱及感覺
11:48
of worthlessness and inadequacy,
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毫無自我價值和無能
11:50
but with obsessional thinking,
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還有強迫性思考
11:53
obsessional thinking about coincidences.
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滿腦子不停地想著各種巧合
11:55
And there were particular numbers that every time I saw them,
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每次看到某些特定數字
11:58
just got me dreadfully upset -- all kinds of ritualistic observances,
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我都會非常苦惱。還有各種怪癖
12:04
just awful, awful stuff.
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簡直糟糕透了
12:06
Remember when you were a kid, and you had to step on every 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 man who had all of these rituals,
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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, there was a ferocious fear 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 this painting by Edvard Munch,
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大家看過孟克的畫作《吶喊》吧？
12:19
The Scream. Every moment was a scream.
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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. So they decided there was no therapy,
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我病入膏肓，醫師們束手無策
12:27
there was no treatment. But there was one treatment,
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百藥難醫，只剩一個辦法
12:30
which actually had been pioneered at the Hartford hospital 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 what it was. It was pre-frontal lobotomy.
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大家猜得到，就是腦前額葉切除術
12:43
So they decided -- I didn't know this, again,
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所以他們決定
12:45
I found this out later --
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後來我才知道
12:46
that the only thing that could be done was
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唯一的希望
12:48
for this 43-year-old man to have a pre-frontal
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就是給這個43歲的老男人
12:52
lobotomy.
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做腦前額葉切除術
12:55
Well, as in all hospitals, there was a resident
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就像所有醫院的做法
12:58
assigned to my case. He was 27 years 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 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, I had been there, what, three or four months 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 with the senior staff, and they agreed to meet 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.
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大家都公認他是個好醫生
13:12
They thought he had a really extraordinary future.
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認為他前途無量
13:16
And he dug in his heels 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 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 him from time to time. You've read reports and so forth.
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「各位只是偶爾探視他，看醫療報告。」
13:25
I really honestly believe that the basic problem here is pure depression,
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「我堅信他的問題是單純憂鬱症，」
13:30
and all of the obsessional thinking comes out of it.
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「及伴隨的強迫性思考。」
13:33
And you know, of course, what'll happen if you do a pre-frontal lobotomy.
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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 along the spectrum,
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「什麼都有可能發生，」
13:40
from pretty bad to terrible, terrible, terrible
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「從不佳到不堪設想都有可能，」
13:42
is going to happen. If he does the best 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 obsessions,
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「他將不再有強迫性思考，」
13:48
probably no depression, but his affect will be dulled,
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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,
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「他可能再也無法當外科醫生，」
13:53
he will never be the loving father that he was to his two children,
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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 result,
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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 up like 'One Flew Over the Cuckoo's Nest.'
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「他會像《飛越杜鵑窩》 一樣，」
14:03
And you know about that, just essentially in a stupor the rest of his life."
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「終生癡呆恍惚。」
14:08
Well, he said, "Can't we try a course of electroshock therapy?"
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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? They agreed to humor 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 of 10.
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他們想：「就試個10次吧。」
14:21
And so we'll lose a little time. Big deal. It doesn't make any difference."
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「只是浪費一點時間，反正也沒差。」
14:25
So they gave the course of 10,
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所以他們就給我10次電療
14:26
and the first -- the usual course, incidentally, 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 me into the wires, put me to sleep, gave me the muscle 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 --
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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 that I could notice anything
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(能自己感覺到真好)
14:44
-- I noticed a change. And at 10, I noticed a real change.
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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 to do another 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 change.
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都不相信電療，認為只會暫時改善
14:57
But, lo and behold, 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 differences 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 through 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 this,
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自己可以戰勝憂鬱症
15:15
that I was now strong enough that by an act 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 the obsessional thinking away.
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掃除強迫性思考
15:20
I could blow the depression away.
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告別憂鬱
15:23
And I've never forgotten -- I never will forget
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我永遠也忘不了
15:26
-- standing in the kitchen of the unit,
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站在療養院的廚房
15:29
it was a Sunday morning in January of 1974,
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1974年1月的星期天早晨
15:33
standing in the kitchen by myself and thinking, "I've got the strength 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 those tightly coiled wires in my head had been disconnected
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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.
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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 thinking obsessionally, obsessively.
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以防我再陷入強迫性思考
15:55
Well, the Gilbert and Sullivan fans in this room
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在座的蘇利文與吉柏特迷
16:00
will remember "Ruddigore," and they will remember Mad Margaret,
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會記得歌劇《Ruddigore》 和瘋狂瑪格麗特
16:03
and they will remember that she was married
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會記得她是嫁給
16:05
to a fellow named Sir Despard Murgatroyd.
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德斯帕德爵士
16:09
And she used to go nuts, every five minutes 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 have a word to bring you back to reality,
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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.'"
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那個字就是「貝辛斯托克」
16:20
So every time she got a little nuts,
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所以每次她一開始發瘋
16:22
he would say, "Basingstoke!" And she would say,
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他就會喊：「貝辛斯托克！」
16:24
"Basingstoke, 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. I can't say "Basingstoke."
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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.
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所以想出更簡單的密語
16:36
It was, "Ah, fuck it!"
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就是「哎，去他的！」
16:39
(Laughter) Much better than "Basingstoke,"
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(笑聲) 比「貝辛斯托克」好多了
16:44
at least for me. And it worked -- my God, it worked.
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至少對我來說，而且真的管用
16:48
Every time I would begin thinking obsessionally --
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只要我又開始強迫性思考
16:50
again, once more, after 20 shock treatments
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歷經20次電療之後
16:54
-- I would say, "Ah, fuck 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,
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3、4個月以後
17:03
I was discharged from that hospital, and I joined a group of surgeons
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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,
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我可以和他人共事
17:10
not in New Haven, but fairly 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.
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我在那裡待了三年
17:15
At the end of three years, I went back to New Haven,
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之後，我回到紐哈芬市
17:19
had remarried by that time.
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當時我已經再婚
17:23
I brought my wife with me, actually, to make sure I could get through this.
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所以帶太太一起去，幫助我繼續康復
17:29
My children came back to live with us.
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我的孩子也搬來同住
17:35
We had two more children after that.
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之後我們又生了兩個小孩
17:38
Resuscitated the career, 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
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我馬上回到大學任教
17:47
and began to write books.
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並且開始寫書
17:50
Well, you know, it's been a wonderful 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.
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如我先前說過，至今已經30年了
17:57
I stopped doing surgery about six years ago
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我大約6年前停止為病患手術
18:00
and became a full-time writer, as many 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. It's been very happy.
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我覺得非常興奮快樂
18:07
Every once in a while, I have to say, "Ah, fuck it."
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偶爾，我還是得提醒自己：「哎，去他的！」
18:09
Every once in a while, I get somewhat depressed and a little obsessional.
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偶爾，還是會憂鬱和強迫性思考
18:12
So, I'm not free of all of this. But it's worked. It's always worked.
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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, 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
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在座如果有我的讀者
18:33
know that one is about death and dying,
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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 body and the human spirit,
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一本探討人的身體和心靈
18:38
one is about the way mystical thoughts are constantly in our minds,
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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 personal experiences.
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都是由我個人的親身經歷而來的心得
18:48
One might think reading these books
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有些讀者可能會認為
18:51
-- and I've gotten thousands 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 on my life's history as I've portrayed in the books,
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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 history, I am someone who has overcome adversity.
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我是個從苦難中熬出頭的人
19:04
That I am someone who has drunk, drank, drunk
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我曾歷經艱辛
19:09
of the bitter dregs of near-disaster in childhood
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童年嚐盡不幸的苦楚
19:16
and emerged not just unscathed but strengthened.
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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 out, so that I can advise people about
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我已真正開悟，可以跟大家分享
19:24
death and dying, so that I can talk about mysticism and the human spirit.
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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 about that.
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以往我一直覺得心虛
19:31
I've always felt that somehow I was an impostor
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覺得自己像個騙子
19:34
because my readers 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 by some people in New Haven, obviously,
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當然，紐哈芬市有些人知道
19:42
but it is not generally known.
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但是一般大眾並不知道
19:44
So one of the reasons that I have come here to talk about this today
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所以今天我分享這故事的原因之一
19:49
is to -- frankly, selfishly --
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其實是自私的
19:54
unburden myself and let it be known
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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 that has written all of these books.
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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, I think,
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最重要的是
20:06
is the fact that a very significant proportion
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在座有許多人
20:08
of people in this audience are under 30,
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年紀還不滿30
20:12
and there are many, of course, 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 to me like almost 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 of a magnificent and exciting career
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正值令人興奮的美好生涯尖峰
20:27
or right into a magnificent and exciting career:
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或是即將邁入美好的生涯
20:31
anything can happen to you. Things change.
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任何事都可能發生在你身上，世事無常
20:35
Accidents happen. Something from childhood comes back to haunt 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 off the track.
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使你困頓茫然
20:41
I hope it happens to none of you,
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我希望你們不會有這種經歷
20:42
but it will probably happen to a small percentage 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, there will be adversities.
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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 of spirit,
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假如連我這個希望渺茫
20:56
with no spirit, 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 of recovery,
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不可能康復
21:03
as far as that group of very experienced psychiatrists 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 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 that exists in their lives.
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克服生活中的任何逆境
21:18
And for those who are older, who have lived through
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年長的聽眾
21:19
perhaps 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 through difficult times,
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但也經歷過風風雨雨
21:25
perhaps where they lost 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 out all over again, some of these things will seem 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.
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你絕對可以康復
21:39
There is redemption. And there is resurrection.
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得到救贖、重獲新生
21:47
There are resurrection themes in every society that has ever been studied,
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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
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這是因為我們不僅是幻想
21:54
about the possibility of resurrection and recovery,
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重生與康復的可能性
21:57
but it actually happens. And it happens a lot.
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確實會發生，而且多有所聞
22:01
Perhaps the most popular resurrection theme,
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或許最常聽到的重生故事
22:05
outside of specifically religious ones,
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除了宗教事蹟以外
22:08
is the one about the phoenix, the ancient story of the phoenix,
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就是有關鳳凰的古老神話
22:12
who, every 500 years, resurrects itself from its own ashes
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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 a life that is
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展開全新的生命
22:22
even more beautiful than it was before. Richard,
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更加美好的新生命
22:25
thanks very much.
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理查，非常謝謝你
ABOUT THE SPEAKER
Sherwin Nuland - DoctorA 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.
Sherwin Nuland | Speaker | TED.com