ABOUT THE SPEAKER
Daniel Levitin - Neuroscientist
Daniel Levitin incorporates findings from neuroscience into everyday life.

Why you should listen

Dr. Daniel Levitin is a neuroscientist at McGill University in Montreal, dean at Minerva Schools in San Francisco and a musician. His research focuses on pattern processing in the brain.

His three books This Is Your Brain on MusicThe World in Six Songs, and the recent The Organized Mind are all bestsellers. A polymath at heart, he has performed with top musicians and holds a few gold and platinum records.

Levitin earned his B.A. in Cognitive Psychology and Cognitive Science at Stanford University, and went on to earn his Ph.D. in Psychology from the University of Oregon, researching complex auditory patterns and pattern processing in expert and non-expert populations. He completed post-doctoral training at Stanford University Medical School (in Neuroimaging) and at UC Berkeley (in Cognitive Psychology). He has consulted on audio sound source separation for the U.S. Navy, and on audio quality for several rock bands and record labels (including the Grateful Dead and Steely Dan), and served as one of the “Golden Ears” expert listeners in the original Dolby AC3 compression tests. He worked for two years at the Silicon Valley think tank Interval Research Corporation.

He taught at Stanford University in the Department of Computer Science, the Program in Human-Computer Interaction, and the Departments of Psychology, Anthropology, Computer Music, and History of Science. 

More profile about the speaker
Daniel Levitin | Speaker | TED.com
TEDGlobal>London

Daniel Levitin: How to stay calm when you know you'll be stressed

丹尼爾.列維廷: 知道自己處於壓力中時,如何保持冷靜?

Filmed:
15,873,808 views

你的最佳狀態絕對不是在壓力之下。事實上,數千年來,人腦在高壓情況下都會釋放出皮質醇,抑制理性邏輯的思考,卻能幫助你在危急時保住性命,例如遭受獅子攻擊時。神經科學家丹尼爾.列維廷認為,當你處在壓力中、頭腦渾沌時,有個方法能幫助你避免錯誤決策 - 「事前剖析」。「我們無論如何都會出錯。」他說:「但我們可以事先想想會出什麼錯。」
- Neuroscientist
Daniel Levitin incorporates findings from neuroscience into everyday life. Full bio

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

00:13
A few少數 years年份 ago,
I broke打破 into my own擁有 house.
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幾年前,我闖進自己家裡。
當時我剛開車回到家,
00:16
I had just driven驅動 home,
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00:18
it was around midnight午夜
in the dead of Montreal蒙特利爾 winter冬季,
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就在蒙特婁寒冬中的午夜時分,
我剛拜訪完住在
鎮上另一邊的朋友傑夫。
00:20
I had been visiting訪問 my friend朋友,
Jeff傑夫, across橫過 town,
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00:23
and the thermometer溫度計 on the front面前 porch門廊
read minus減去 40 degrees --
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門廊前的溫度計顯示零下40度 -
00:27
and don't bother asking
if that's Celsius攝氏 or Fahrenheit飛輪海,
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就別問我是攝氏還是華氏了,
00:30
minus減去 40 is where the two scales meet遇到 --
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零下40度剛好是
攝氏等於華氏的溫度 -
00:33
it was very cold.
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非常地寒冷。
00:34
And as I stood站在 on the front面前 porch門廊
fumbling摸索 in my pockets口袋,
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當我站在門廊前翻著口袋時,
00:37
I found發現 I didn't have my keys按鍵.
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發現鑰匙不在自己身上。
00:40
In fact事實, I could see them
through通過 the window窗口,
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事實上,我還能從窗外看到那串鑰匙,
00:42
lying說謊 on the dining用餐 room房間 table
where I had left them.
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它就被我擱在餐桌上靜靜地躺著。
00:45
So I quickly很快 ran around
and tried試著 all the other doors and windows視窗,
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所以我快速繞了一圈,
試了試所有的門和窗戶,
00:48
and they were locked鎖定 tight.
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發現每一扇都鎖得緊緊的。
00:50
I thought about calling調用 a locksmith鎖匠 --
at least最小 I had my cellphone手機,
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我想著要不要找鎖匠來 -
至少手機還在身上,
00:53
but at midnight午夜, it could take a while
for a locksmith鎖匠 to show顯示 up,
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但在這種午夜時分,
要找鎖匠來可有得等了,
00:56
and it was cold.
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天氣又這麼冷。
我也不能再回去傑夫那借住一晚,
01:00
I couldn't不能 go back to my friend朋友
Jeff's傑夫的 house for the night
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01:03
because I had an early flight飛行
to Europe歐洲 the next下一個 morning早上,
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因為隔天一早我就得飛到歐洲,
01:05
and I needed需要 to get
my passport護照 and my suitcase手提箱.
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我得拿到我的護照和行李。
01:08
So, desperate殊死 and freezing冷凍 cold,
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所以,在這個令人絕望
又冷得要命的時刻,
01:10
I found發現 a large rock and I broke打破
through通過 the basement地下室 window窗口,
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我找到一塊大石後,
砸破地下室的玻璃,
01:14
cleared清除 out the shards碎片 of glass玻璃,
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清了清玻璃碎片後
01:16
I crawled through通過,
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就爬了進去,
01:17
I found發現 a piece of cardboard紙板
and taped錄音 it up over the opening開盤,
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然後找了一片厚紙板
貼在窗戶破掉的地方,
01:21
figuring盤算 that in the morning早上,
on the way to the airport飛機場,
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心裡估算著明天早上往機場的路上
01:24
I could call my contractor承包商
and ask him to fix固定 it.
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可以打電話給我的承包商,
請他幫我修好玻璃。
01:26
This was going to be expensive昂貴,
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維修費一定很貴,
01:28
but probably大概 no more expensive昂貴
than a middle-of-the-night半夜 locksmith鎖匠,
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但應該不會比午夜時分
請鎖匠來開鎖還貴,
01:31
so I figured想通, under the circumstances情況,
I was coming未來 out even.
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所以我想,在當時的情況下,
這個決定也沒讓我虧到。
因為我是個受過訓練的神經學家,
01:36
Now, I'm a neuroscientist神經學家 by training訓練
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01:39
and I know a little bit
about how the brain performs施行 under stress強調.
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對於大腦在壓力之下的運作略有了解,
01:43
It releases發布 cortisol皮質醇
that raises加薪 your heart rate,
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我知道它會釋出皮質醇,
增加你的心跳、
01:46
it modulates調製 adrenaline腎上腺素 levels水平
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調解腎上腺素、
01:49
and it clouds your thinking思維.
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並讓你思緒渾沌不清。
01:51
So the next下一個 morning早上,
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所以第二天早上,
01:53
when I woke醒來 up on too little sleep睡覺,
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當我從嚴重不足的睡眠中醒來後,
01:55
worrying令人擔憂 about the hole in the window窗口,
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就開始擔心玻璃上的那個破洞,
01:58
and a mental心理 note注意
that I had to call my contractor承包商,
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心裡一直惦記著要打電話給承包商,
02:01
and the freezing冷凍 temperatures溫度,
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天氣又冷得要命,
02:02
and the meetings會議 I had upcoming即將到來 in Europe歐洲,
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還有即將要在歐洲開的那些會議,
02:05
and, you know, with all
the cortisol皮質醇 in my brain,
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而你知道的,因為有許多皮質醇在大腦裡,
02:08
my thinking思維 was cloudy多雲的,
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我的思緒一片渾沌,
02:10
but I didn't know it was cloudy多雲的
because my thinking思維 was cloudy多雲的.
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而正因它一片渾沌,
我根本沒發現它一片渾沌
02:13
(Laughter笑聲)
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(笑聲)
02:15
And it wasn't until直到 I got
to the airport飛機場 check-in報到 counter計數器,
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而當我到達機場的報到櫃台時,
02:18
that I realized實現 I didn't have my passport護照.
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我才發現自己竟然沒帶護照。
02:20
(Laughter笑聲)
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(笑聲)
02:22
So I raced賽跑 home in the snow
and ice, 40 minutes分鐘,
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所以我在冰雪中疾馳回家,
花了40分鐘,
02:26
got my passport護照,
raced賽跑 back to the airport飛機場,
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拿到護照後再火速回到機場,
02:28
I made製作 it just in time,
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在最後關頭總算趕上,
02:30
but they had given特定 away
my seat座位 to someone有人 else其他,
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但他們已經把我的座位
先讓給別人了,
02:32
so I got stuck卡住 in the back of the plane平面,
next下一個 to the bathrooms浴室,
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於是我只能被擠到
飛機的最後方、廁所旁的位子,
02:35
in a seat座位 that wouldn't不會 recline橫臥,
on an eight-hour八小時 flight飛行.
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座椅還無法向後倾斜,
而且得撐8小時。
好吧,至少在這8小時中
我有很多時間思考,反正也別想睡了。
02:39
Well, I had a lot of time to think
during those eight hours小時 and no sleep睡覺.
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(笑聲)
02:43
(Laughter笑聲)
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然後我開始想,我能不能先做些什麼,
02:44
And I started開始 wondering想知道,
are there things that I can do,
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或是設置好什麼機制,
02:47
systems系統 that I can put into place地點,
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02:49
that will prevent避免 bad things
from happening事件?
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來幫助我避免壞事發生?
02:51
Or at least最小 if bad things happen發生,
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或至少發生了壞事之後,
02:53
will minimize最小化 the likelihood可能性
of it being存在 a total catastrophe災難.
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能把造成重大損害的可能性降到最低,
所以我開始思考這些事,
02:59
So I started開始 thinking思維 about that,
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但我的思緒直到一個月後才漸漸清晰。
03:00
but my thoughts思念 didn't crystallize結晶
until直到 about a month later後來.
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那時我正和我的同事,諾貝爾經濟學獎
得主丹尼爾‧卡尼曼一起吃晚餐,
03:03
I was having dinner晚餐 with my colleague同事,
Danny丹尼 Kahneman卡尼曼, the Nobel諾貝爾 Prize winner優勝者,
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我有點不好意思地
提到破窗進入自己家裡、
03:07
and I somewhat有些 embarrassedly不好意思 told him
about having broken破碎 my window窗口,
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03:10
and, you know, forgotten忘記了 my passport護照,
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還有忘記帶護照等等的事,
03:13
and Danny丹尼 shared共享 with me
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於是丹尼爾和我分享
03:14
that he'd他會 been practicing
something called prospective預期 hindsight事後.
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他正在實行一種叫做
「前瞻性後見之明」的東西。
03:19
(Laughter笑聲)
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(笑聲)
03:20
It's something that he had gotten得到
from the psychologist心理學家 Gary加里 Klein克萊恩,
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這東西是他從心理學家
蓋瑞.克萊恩那裡得來的,
03:24
who had written書面 about it
a few少數 years年份 before,
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幾年前他曾寫過相關著作,
03:26
also called the pre-mortem預驗.
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又將其稱為「事前剖析」。
03:28
Now, you all know what the postmortem事後 is.
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各位一定都知道事後剖析是什麼。
03:30
Whenever每當 there's a disaster災害,
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每當有災難降臨,
03:31
a team球隊 of experts專家 come in and they try
to figure數字 out what went wrong錯誤, right?
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一組專家就會來到事發現場,
設法釐清出了什麼問題,對吧?
03:36
Well, in the pre-mortem預驗, Danny丹尼 explained解釋,
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那麼,事前剖析,根據丹尼爾的解釋,
03:38
you look ahead and you try to figure數字 out
all the things that could go wrong錯誤,
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就是你先往前看,
設法找出所有可能出錯的事,
03:42
and then you try to figure數字 out
what you can do
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接著再嘗試找出對應的解決方式
03:45
to prevent避免 those things from happening事件,
or to minimize最小化 the damage損傷.
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來防止這些事發生或將傷害降到最低。
03:48
So what I want to talk to you about today今天
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所以今天要和各位聊的,
03:51
are some of the things we can do
in the form形成 of a pre-mortem預驗.
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是我們能用「事前剖析」來做些什麼。
03:55
Some of them are obvious明顯,
some of them are not so obvious明顯.
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有些顯而易見,有些不那麼明顯。
03:58
I'll start開始 with the obvious明顯 ones那些.
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我先從顯而易見的開始。
03:59
Around the home, designate指定 a place地點
for things that are easily容易 lost丟失.
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在房子四處,給每個容易
遺失的東西一個專屬位置。
這聽起來像是常識,也確實是,
04:05
Now, this sounds聲音
like common共同 sense, and it is,
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04:09
but there's a lot of science科學
to back this up,
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但它有許多理論基礎可為其佐證,
04:12
based基於 on the way our spatial空間的 memory記憶 works作品.
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像是我們空間記憶的運作方式。
04:15
There's a structure結構體 in the brain
called the hippocampus海馬,
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大腦裡有個結構叫做海馬體,
04:18
that evolved進化 over tens
of thousands數千 of years年份,
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它經過成千上萬年的演化而來,
04:21
to keep track跟踪 of the locations地點
of important重要 things --
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負責追蹤每個重要物品的位置 -
04:25
where the well is,
where fish can be found發現,
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例如井的位置、哪裡可以捕到魚、
04:27
that stand of fruit水果 trees樹木,
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果樹的位置、
04:30
where the friendly友善 and enemy敵人 tribes部落 live生活.
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或是同盟及敵對的部落在哪裡等等。
04:32
The hippocampus海馬 is the part部分 of the brain
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海馬體是大腦裡的一部分,
04:34
that in London倫敦 taxicab出租車 drivers司機
becomes enlarged放大.
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倫敦的計程車司機
這個部分比常人還大。
04:38
It's the part部分 of the brain
that allows允許 squirrels松鼠 to find their nuts堅果.
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松鼠可以順利找到松果
也是靠大腦的這個部分。
04:41
And if you're wondering想知道,
somebody actually其實 did the experiment實驗
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如果你有興趣,
有人的確做過這個實驗,
04:44
where they cut off
the olfactory嗅覺 sense of the squirrels松鼠,
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在他們切斷松鼠的嗅覺之後,
04:47
and they could still find their nuts堅果.
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發現牠們仍能找到松果。
牠們用的不是嗅覺,而是海馬體,
04:49
They weren't using運用 smell,
they were using運用 the hippocampus海馬,
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04:52
this exquisitely玲瓏 evolved進化 mechanism機制
in the brain for finding發現 things.
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大腦裡一個為了找到東西
而高度演化而成的機制。
04:57
But it's really good for things
that don't move移動 around much,
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但它對靜止不動的物體比較有用,
05:01
not so good for things that move移動 around.
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對會移動的東西就沒那麼有效。
05:03
So this is why we lose失去 car汽車 keys按鍵
and reading glasses眼鏡 and passports護照.
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這就是為什麼我們很容易
遺失鑰匙、老花眼鏡和護照。
05:07
So in the home,
designate指定 a spot for your keys按鍵 --
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所以在家時,幫你的鑰匙
找個固定位置 -
05:10
a hook by the door,
maybe a decorative裝飾 bowl.
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例如掛在門上、或放在裝飾性的碗裡。
05:13
For your passport護照, a particular特定 drawer抽屜.
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至於護照,擺在某個特定的抽屜裡。
05:15
For your reading glasses眼鏡,
a particular特定 table.
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老花眼鏡則可以固定放在某個桌子上。
05:18
If you designate指定 a spot
and you're scrupulous一絲不苟 about it,
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如果東西都放到定位而且你夠留意,
05:21
your things will always be there
when you look for them.
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當需要時,永遠能在定位找到東西。
05:24
What about travel旅行?
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那旅行時該怎麼辦?
05:25
Take a cell細胞 phone電話 picture圖片
of your credit信用 cards,
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用手機幫你的信用卡拍幾張照,
05:28
your driver's司機 license執照, your passport護照,
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還有駕照、護照也拍幾張,
05:30
mail郵件 it to yourself你自己 so it's in the cloud.
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然後寄給自己,照片就會在雲端留存。
05:32
If these things are lost丟失 or stolen被盜,
you can facilitate促進 replacement替代.
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如果這些東西掉了或被偷,
至少有東西先擋著用。
05:37
Now these are some rather obvious明顯 things.
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這些都是相對明顯的事。
05:39
Remember記得, when you're under stress強調,
the brain releases發布 cortisol皮質醇.
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記住,當你處在壓力中,
你的大腦會釋放皮質醇。
05:43
Cortisol皮質醇 is toxic有毒的,
and it causes原因 cloudy多雲的 thinking思維.
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皮質醇是有害的,他會阻礙你的思考。
05:46
So part部分 of the practice實踐 of the pre-mortem預驗
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所以「事前剖析」部分的實踐方式,
05:49
is to recognize認識 that under stress強調
you're not going to be at your best最好,
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是要意識到壓力會讓你
無法處在最佳狀態,
05:53
and you should put systems系統 in place地點.
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所以你得將事情安排得井然有序。
05:55
And there's perhaps也許
no more stressful壓力 a situation情況
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而可能沒有任何狀況
05:58
than when you're confronted面對
with a medical decision決定 to make.
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比當你面臨醫療決策時
更令人感到壓力了。
06:02
And at some point, all of us
are going to be in that position位置,
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在人生的某個時刻,
我們都面臨這樣的狀況,
06:05
where we have to make
a very important重要 decision決定
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迫使我們必須做出重大決策,
06:07
about the future未來 of our medical care關心
or that of a loved喜愛 one,
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而這個決策可能事關
我們所愛的人未來的醫療照護,
06:11
to help them with a decision決定.
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必須幫他們做個選擇。
06:12
And so I want to talk about that.
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所以我想談談這個情境。
06:14
And I'm going to talk about
a very particular特定 medical condition條件.
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我特別想談論的是
這個特殊的醫療情境。
06:17
But this stands站立 as a proxy代理 for all kinds
of medical decision-making做決定,
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但這個情境可以代表所有的醫療決策,
06:21
and indeed確實 for financial金融 decision-making做決定,
and social社會 decision-making做決定 --
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事實上,還可以代表財務決策、社交決策 -
06:25
any kind of decision決定 you have to make
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任何一種你必須
06:27
that would benefit效益 from a rational合理的
assessment評定 of the facts事實.
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針對事實進行理性評估的決策。
06:31
So suppose假設 you go to your doctor醫生
and the doctor醫生 says,
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所以假如你去看醫生,醫生告訴你:
06:34
"I just got your lab實驗室 work back,
your cholesterol's膽固醇的 a little high."
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「我剛拿到你的檢驗報告,
你的膽固醇偏高。」
在座各位都知道高膽固醇
06:39
Now, you all know that high cholesterol膽固醇
135
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06:42
is associated相關 with an increased增加 risk風險
of cardiovascular心血管 disease疾病,
136
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可能會增加心血管疾病、
06:46
heart attack攻擊, stroke行程.
137
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心臟病及中風的風險。
06:47
And so you're thinking思維
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所以你開始想
06:49
having high cholesterol膽固醇
isn't the best最好 thing,
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高膽固醇可不是什麼好事,
06:51
and so the doctor醫生 says,
"You know, I'd like to give you a drug藥物
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3016
然後醫生接著說:「我想幫你開一種藥
06:54
that will help you
lower降低 your cholesterol膽固醇, a statin他汀類藥物."
141
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來幫助你降低膽固醇,
叫斯達汀(statin)。」
06:57
And you've probably大概 heard聽說 of statins他汀類藥物,
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你可能聽過斯達汀類藥物,
知道它們是當今世上
最廣泛地被開立的藥物,
06:59
you know that they're among其中
the most widely廣泛 prescribed規定 drugs毒品
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你甚至可能認識正在服用的人。
07:01
in the world世界 today今天,
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07:03
you probably大概 even know
people who take them.
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所以你想著:
「好啊!給我來點斯達汀。」
07:05
And so you're thinking思維,
"Yeah! Give me the statin他汀類藥物."
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但這時候,你應該要問一個問題,
07:07
But there's a question
you should ask at this point,
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07:10
a statistic統計 you should ask for
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這個問題是大部分醫生
07:11
that most doctors醫生
don't like talking about,
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都不願談論到的統計數據,
07:14
and pharmaceutical製藥 companies公司
like talking about even less.
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製藥公司甚至提到更少。
這個數據就是NNT--
「需要治療的人數」。
07:18
It's for the number needed需要 to treat對待.
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07:21
Now, what is this, the NNTNNT?
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1976
那麼,這個「NNT」是什麼呢?
( 用來衡量藥物治療有效性的一種指標 )
07:23
It's the number of people
that need to take a drug藥物
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它是指--某藥物或手術或療程
07:26
or undergo經歷 a surgery手術
or any medical procedure程序
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平均每多少人裡,
才有一人從中獲得助益。
07:29
before one person is helped幫助.
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你可能會想,這是哪門子統計數字?
07:31
And you're thinking思維,
what kind of crazy statistic統計 is that?
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07:34
The number should be one.
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這個數據應該就是" 1 " 啊。
07:35
My doctor醫生 wouldn't不會 prescribe規定
something to me
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我的醫生理當不會開立
07:37
if it's not going to help.
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對我沒有幫助的藥物。
07:39
But actually其實, medical practice實踐
doesn't work that way.
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但事實上,醫療的實務
不是這樣運作的。
07:41
And it's not the doctor's醫生 fault故障,
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而這不是醫生的錯,
07:43
if it's anybody's任何人的 fault故障,
it's the fault故障 of scientists科學家們 like me.
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如果一定要說是誰的錯,
那就是像我這樣的科學家。
07:46
We haven't沒有 figured想通 out
the underlying底層 mechanisms機制 well enough足夠.
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我們還不夠了解這些藥品
基礎的運作機制。
07:48
But GlaxoSmithKline葛蘭素史克公司 estimates估計
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然而葛蘭素史克公司
(全球第三大製藥商)預測,
07:51
that 90 percent百分 of the drugs毒品 work
in only 30 to 50 percent百分 of the people.
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高達90%的藥品
都只對30%至50%的人有效。
07:56
So the number needed需要 to treat對待
for the most widely廣泛 prescribed規定 statin他汀類藥物,
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那麼對最廣泛應用的
斯達汀來說,所需治療人數
08:00
what do you suppose假設 it is?
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你猜猜看是多少?
08:02
How many許多 people have to take it
before one person is helped幫助?
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每多少人裡才有一人從中獲得助益?
08:05
300.
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473240
1200
300....
這個數據來自一個研究,
08:07
This is according根據 to research研究
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1381
08:08
by research研究 practitioners從業者
Jerome杰羅姆 GroopmanGroopman and Pamela帕梅拉 HartzbandHartzband,
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由醫療研究者傑若‧古柏曼
和潘蜜拉‧哈茨班德進行,
08:12
independently獨立地 confirmed確認 by Bloomberg彭博.comCOM.
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同時被Bloomberg.com網站
獨立證實的研究。
08:14
I ran through通過 the numbers數字 myself.
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我自己想了一下這個數字。
300個人必須服用這種藥物一年,
08:17
300 people have to
take the drug藥物 for a year
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08:20
before one heart attack攻擊, stroke行程
or other adverse不利的 event事件 is prevented防止.
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才能阻止一次心臟病、
中風或其他病變。
08:24
Now you're probably大概 thinking思維,
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現在你可能在想,「好吧,至少
有 1/300的機率能降低我的膽固醇。
08:25
"Well, OK, one in 300 chance機會
of lowering降低 my cholesterol膽固醇.
177
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2811
08:28
Why not, docDOC? Give me
the prescription處方 anyway無論如何."
178
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2216
為何不要呢,醫生?還是開給我吧。」
08:30
But you should ask at this point
for another另一個 statistic統計,
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2856
但這時你得問到另一個統計數據,
08:33
and that is, "Tell me
about the side effects效果." Right?
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也就是,「副作用是什麼?」對吧?
08:36
So for this particular特定 drug藥物,
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1656
以這種藥而言,
08:37
the side effects效果 occur發生
in five percent百分 of the patients耐心.
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3656
它會對5%的病患產生副作用。
08:41
And they include包括 terrible可怕 things --
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它們包含很可怕的症狀 -
08:43
debilitating衰弱 muscle肌肉 and joint聯合 pain疼痛,
gastrointestinal胃腸道 distress苦難 --
184
511331
4444
例如四肢無力、關節疼痛、
腸胃不適 -
08:47
but now you're thinking思維, "Five percent百分,
185
515799
1859
但現在你可能又想,「就5%嘛,
不會這麼剛好發生在我身上,
08:49
not very likely容易
it's going to happen發生 to me,
186
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2014
我還是吃這個藥吧。」
08:51
I'll still take the drug藥物."
187
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1238
但等一等。
08:52
But wait a minute分鐘.
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1194
記得在壓力下你並沒有思考得很透徹。
08:54
Remember記得 under stress強調
you're not thinking思維 clearly明確地.
189
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2336
所以事先想想你該怎麼處理這個狀況,
08:56
So think about how you're going
to work through通過 this ahead of time,
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3165
你就不用事到臨頭再
進行一連串的推理了。
08:59
so you don't have to manufacture製造
the chain of reasoning推理 on the spot.
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每300個人,對吧?才有一個有用,
09:02
300 people take the drug藥物, right?
One person's人的 helped幫助,
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2492
這300人裡有5%會產生副作用,
09:05
five percent百分 of those 300
have side effects效果,
193
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2407
09:07
that's 15 people.
194
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1480
也就是15人。
09:09
You're 15 times more likely容易
to be harmed傷害 by the drug藥物
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3896
這個藥對你造成傷害的可能性,
09:13
than you are to be helped幫助 by the drug藥物.
196
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高達對你有所幫助的15倍之多。
09:16
Now, I'm not saying whether是否 you
should take the statin他汀類藥物 or not.
197
544560
2905
現在我要說的,
不是你應該服用斯達汀與否。
09:19
I'm just saying you should have
this conversation會話 with your doctor醫生.
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3143
而是你得和你的醫生談談。
在醫學道德上這是需要的,
09:22
Medical ethics倫理 requires要求 it,
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1320
09:24
it's part部分 of the principle原理
of informed通知 consent同意.
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2296
這是知情同意原則的一部份。
09:26
You have the right to have access訪問
to this kind of information信息
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3216
你有權得知這樣的資訊,
09:29
to begin開始 the conversation會話 about whether是否
you want to take the risks風險 or not.
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來和醫生討論
你是否願意承擔這些風險。
09:33
Now you might威力 be thinking思維
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現在你可能在想,
09:34
I've pulled this number
out of the air空氣 for shock休克 value,
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我只是為了嚇嚇大家才丟出這個數字,
09:37
but in fact事實 it's rather typical典型,
this number needed需要 to treat對待.
205
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3256
但實際上,這個治療所需人數
是相對具有代表性的。
09:40
For the most widely廣泛 performed執行 surgery手術
on men男人 over the age年齡 of 50,
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4616
對於50歲以上男性最常進行的手術,
09:45
removal切除 of the prostate前列腺 for cancer癌症,
207
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2216
做的最多的手術是為治療
前列腺癌而切除前列腺,
09:47
the number needed需要 to treat對待 is 49.
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2576
治療所需人數是49。
09:50
That's right, 49 surgeries手術 are doneDONE
for every一切 one person who's誰是 helped幫助.
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4176
沒錯,每49個手術
才有一人真正受益。
09:54
And the side effects效果 in that case案件
occur發生 in 50 percent百分 of the patients耐心.
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4656
而所有的病患中,
有50%可能產生副作用,
09:59
They include包括 impotence性無能,
erectile勃起 dysfunction功能障礙,
211
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2856
包含陽痿、勃起功能障礙,
10:01
urinary尿 incontinence失禁, rectal直腸的 tearing撕裂,
212
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2776
尿失禁、直腸撕裂、
10:04
fecal糞便 incontinence失禁.
213
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1456
和排糞失禁。
10:06
And if you're lucky幸運, and you're one
of the 50 percent百分 who has these,
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如果你夠幸運,
而你是這50%之一的話,
10:09
they'll他們會 only last for a year or two.
215
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2040
這些副作用只會維持一到兩年。
10:12
So the idea理念 of the pre-mortem預驗
is to think ahead of time
216
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3616
所以「事前剖析」這個方法是事先想好
10:16
to the questions問題
that you might威力 be able能夠 to ask
217
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2536
所有你能問的問題,
10:19
that will push the conversation會話 forward前鋒.
218
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2376
讓討論能進行得更順利。
10:21
You don't want to have to manufacture製造
all of this on the spot.
219
609480
3096
你不會希望事到臨頭才處理這些問題。
10:24
And you also want to think
about things like quality質量 of life.
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你也會希望能想想生活品質之類的事。
10:27
Because you have a choice選擇 oftentimes通常情況下,
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因為很多時候你其實有選擇機會,
10:29
do you I want a shorter life
that's pain-free無痛,
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2296
「我想要短暫一點、
但沒有痛苦的人生,
10:31
or a longer life that might威力 have
a great deal合同 of pain疼痛 towards the end結束?
223
619640
3776
還是長一點,但可能得
一路忍受痛苦的人生?」
10:35
These are things to talk about
and think about now,
224
623440
2416
這些都是值得思考的事,所以趕快
和家人及你所愛的人好好想想。
10:37
with your family家庭 and your loved喜愛 ones那些.
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1816
你還是可能一時激動改變心意,
10:39
You might威力 change更改 your mind心神
in the heat of the moment時刻,
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2496
但至少你已練習過這樣的思考。
10:42
but at least最小 you're practiced
with this kind of thinking思維.
227
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3056
10:45
Remember記得, our brain under stress強調
releases發布 cortisol皮質醇,
228
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4616
請記住,我們的大腦
會在壓力下釋放皮質醇,
10:49
and one of the things
that happens發生 at that moment時刻
229
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2336
在此情況下會發生的事
10:52
is a whole整個 bunch on systems系統 shut關閉 down.
230
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1936
就是整個系統一起停工。
10:54
There's an evolutionary發展的 reason原因 for this.
231
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1905
在生物演化上這是有道理的。
10:56
Face-to-face面對面 with a predator捕食者,
you don't need your digestive消化 system系統,
232
644209
3407
當獵食者就在你面前時,
你不需要你的消化系統、
10:59
or your libido性慾, or your immune免疫的 system系統,
233
647640
2456
也不需要性慾、或是免疫系統,
11:02
because if you're body身體 is expending花費
metabolism代謝 on those things
234
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3656
因為如果你的身體將代謝反應
擴展到這些事情上,
11:05
and you don't react應對 quickly很快,
235
653800
1656
你無法快速反應,
11:07
you might威力 become成為 the lion's獅子 lunch午餐,
and then none沒有 of those things matter.
236
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3976
可能讓你變成獅子的午餐,
然後這些事情就再也不重要了。
11:11
Unfortunately不幸,
237
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1416
很不幸地,
11:12
one of the things that goes out the window窗口
during those times of stress強調
238
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3616
能讓我們在這種高壓時刻
脫離險境的東西之一,
11:16
is rational合理的, logical合乎邏輯 thinking思維,
239
664560
1976
就是理性、邏輯思考,
11:18
as Danny丹尼 Kahneman卡尼曼
and his colleagues同事 have shown顯示.
240
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3416
正如丹尼爾.卡尼曼
和他的同事證明的。
11:22
So we need to train培養 ourselves我們自己
to think ahead
241
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3176
所以我們得訓練自己
在遇到這種狀況前預先思考。
11:25
to these kinds of situations情況.
242
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2256
11:27
I think the important重要 point here
is recognizing認識 that all of us are flawed有缺陷.
243
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6176
我想此處的重點是
要認清我們自己並不是完美的。
11:33
We all are going to fail失敗 now and then.
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2856
我們無論如何都會出錯。
11:36
The idea理念 is to think ahead
to what those failures故障 might威力 be,
245
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3616
但我們可以預先思考可能會出什麼錯,
11:40
to put systems系統 in place地點
that will help minimize最小化 the damage損傷,
246
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然後事先把事情安排妥當,
將傷害降到最低,
11:44
or to prevent避免 the bad things
from happening事件 in the first place地點.
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或是在一開始就避免壞事發生。
回到蒙特婁那個大雪紛飛的夜晚,
11:48
Getting入門 back to that
snowy似雪 night in Montreal蒙特利爾,
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11:50
when I got back from my trip,
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當我從歐洲回來後,
11:52
I had my contractor承包商 install安裝
a combination組合 lock next下一個 to the door,
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我請承包商在門的旁邊
裝了一個密碼鎖,
11:56
with a key to the front面前 door in it,
an easy簡單 to remember記得 combination組合.
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裡面裝著前門的鑰匙,
並設定了一個好記的密碼。
12:00
And I have to admit承認,
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而我必須承認,
12:01
I still have piles of mail郵件
that haven't沒有 been sorted分類,
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我還有許多郵件沒有整理,
12:04
and piles of emails電子郵件
that I haven't沒有 gone走了 through通過.
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也有許多電子郵件還沒看完。
12:07
So I'm not completely全然 organized有組織的,
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所以我並不是個井然有序的人,
12:09
but I see organization組織
as a gradual process處理,
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但我將井然有序視為一個漸進的過程,
12:12
and I'm getting得到 there.
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而我會越來越井然有序。
12:13
Thank you very much.
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非常感謝各位。
12:14
(Applause掌聲)
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(掌聲)
Translated by Allen Kuo
Reviewed by Yi-Fan Yu

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ABOUT THE SPEAKER
Daniel Levitin - Neuroscientist
Daniel Levitin incorporates findings from neuroscience into everyday life.

Why you should listen

Dr. Daniel Levitin is a neuroscientist at McGill University in Montreal, dean at Minerva Schools in San Francisco and a musician. His research focuses on pattern processing in the brain.

His three books This Is Your Brain on MusicThe World in Six Songs, and the recent The Organized Mind are all bestsellers. A polymath at heart, he has performed with top musicians and holds a few gold and platinum records.

Levitin earned his B.A. in Cognitive Psychology and Cognitive Science at Stanford University, and went on to earn his Ph.D. in Psychology from the University of Oregon, researching complex auditory patterns and pattern processing in expert and non-expert populations. He completed post-doctoral training at Stanford University Medical School (in Neuroimaging) and at UC Berkeley (in Cognitive Psychology). He has consulted on audio sound source separation for the U.S. Navy, and on audio quality for several rock bands and record labels (including the Grateful Dead and Steely Dan), and served as one of the “Golden Ears” expert listeners in the original Dolby AC3 compression tests. He worked for two years at the Silicon Valley think tank Interval Research Corporation.

He taught at Stanford University in the Department of Computer Science, the Program in Human-Computer Interaction, and the Departments of Psychology, Anthropology, Computer Music, and History of Science. 

More profile about the speaker
Daniel Levitin | Speaker | TED.com