TED2009
Oliver Sacks: What hallucination reveals about our minds
奧利佛•薩克斯：從幻覺認識我們的心智
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神經科學家兼作家奧利佛•薩克斯帶領我們認識邦奈特症候群 (Charles Bonnett Syndrome)，也就是視力受損的人所出現的鮮明幻視。他以溫馨口吻詳細描述病患的體驗，也說明了這個鮮為報導的現象背後的生理機制。
Oliver Sacks - Neurological anthropologist
Since "Awakenings" stormed the bestseller lists (and the silver screen), Oliver Sacks has become an unlikely household name, single-handedly inventing the genre of neurological anthropology. Full bio
Since "Awakenings" stormed the bestseller lists (and the silver screen), Oliver Sacks has become an unlikely household name, single-handedly inventing the genre of neurological anthropology. Full bio
Double-click the English transcript below to play the video.
00:12
We see with the eyes,
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我們用眼睛看東西，
00:15
but we see with the brain as well.
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但也用腦看東西。
00:18
And seeing with the brain is often called imagination.
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用腦看就是所謂的想像。
00:22
And we are familiar with the landscapes of our own imagination,
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我們很熟悉自己的想像世界是什麼樣貌。
00:27
our inscapes. We've lived with them all our lives.
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那是我們的本質，一輩子跟著我們。
00:31
But there are also hallucinations as well,
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但此外還有一種東西是幻覺。
00:35
and hallucinations are completely different.
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幻覺就截然不同了。
00:38
They don't seem to be of our creation.
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幻覺不像是我們創造出來的，
00:40
They don't seem to be under our control.
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似乎不受我們控制，
00:42
They seem to come from the outside,
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好像是從外面來的，
00:44
and to mimic perception.
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然後偽裝成知覺。
00:47
So I am going to be talking about hallucinations,
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我今天要講的就是幻覺。
00:51
and a particular sort of visual hallucination
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而且是我在病患身上看到的
00:55
which I see among my patients.
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一種特殊的視覺幻覺。
01:00
A few months ago, I got a phone call
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幾個月前，我接到一通電話。
01:04
from a nursing home where I work.
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是我服務的安養院打來的。
01:06
They told me that one of their residents, an old lady in her 90s,
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他們說院裡有一位90幾歲的老太太
01:11
was seeing things,
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出現了幻視。
01:13
and they wondered if she'd gone bonkers
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他們不知道她是瘋了呢？
01:16
or, because she was an old lady,
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還是說，因為她是老太太，
01:18
whether she'd had a stroke, or whether she had Alzheimer's.
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也許她中風了，或者得了阿茲海默氏症。
01:21
And so they asked me if I would come and see Rosalie,
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所以他們問我能不能來看一下羅莎莉，
01:26
the old lady.
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也就是這位老太太。
01:28
I went in to see her.
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我去探視她，
01:30
It was evident straight away
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馬上就看得出來
01:32
that she was perfectly sane
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她的心智很正常，
01:35
and lucid and of good intelligence,
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神智清楚，也很聰明。
01:38
but she'd been very startled and very bewildered,
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但是她很驚慌、很困惑，
01:42
because she'd been seeing things.
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因為她出現了幻視。
01:45
And she told me --
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她跟我說，
01:48
the nurses hadn't mentioned this --
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這一點護士沒提到，
01:50
that she was blind,
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她是盲人。
01:52
that she had been completely blind from macular degeneration for five years.
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她因為黃斑病變，已經完全失明5年了。
01:57
But now, for the last few days, she'd been seeing things.
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可是，這幾天卻開始看到東西。
02:00
So I said, "What sort of things?"
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我就說：「什麼樣的東西？」
02:03
And she said, "People in Eastern dress,
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她說：穿東方服飾、穿袍子的人
02:06
in drapes, walking up and down stairs.
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走樓梯上上下下。
02:10
A man who turns towards me and smiles.
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一個男的轉身對我微笑，
02:13
But he has huge teeth on one side of his mouth.
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但他臉上有一邊的牙齒非常巨大。
02:17
Animals too.
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也會看到動物。
02:19
I see a white building. It's snowing, a soft snow.
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我看到一棟白色建築。下著一點雪。
02:22
I see this horse with a harness, dragging the snow away.
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我看到一匹上了馬鞍的馬，把雪拖走。
02:27
Then, one night, the scene changes.
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後來有天晚上，場景變了。
02:31
I see cats and dogs walking towards me.
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我看到很多貓跟狗走向我，
02:33
They come to a certain point and then stop.
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走到一個地方就停住，
02:36
Then it changes again.
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然後場景又變了。
02:38
I see a lot of children. They are walking up and down stairs.
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我看到很多小孩，上上下下地走樓梯。
02:41
They wear bright colors, rose and blue,
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他們穿著鮮豔的玫瑰色跟藍色，
02:44
like Eastern dress."
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像是東方服飾。
02:47
Sometimes, she said, before the people come on,
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她說，有時候在這些人物出現之前，
02:50
she may hallucinate pink and blue squares on the floor,
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她會出現幻視，看到地板上有粉紅色跟藍色方塊，
02:54
which seem to go up to the ceiling.
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一路連到天花板上。
02:57
I said, "Is this like a dream?"
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我說，這像是做夢嗎？
03:01
And she said, "No, it's not like a dream. It's like a movie."
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她說，不像做夢，像電影。
03:04
She said, "It's got color. It's got motion.
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有顏色，有動作，
03:07
But it's completely silent, like a silent movie."
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但是完全沒有聲音，像是默劇。
03:11
And she said that it's a rather boring movie.
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她說，而且是挺無聊的電影。
03:13
She said, "All these people with Eastern dress,
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一堆穿著東方服飾的人
03:16
walking up and down, very repetitive, very limited."
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走上走下，一直重複，沒什麼變化。
03:21
(Laughter)
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（笑聲）
03:23
And she has a sense of humor.
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她很幽默，
03:25
She knew it was a hallucination.
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她知道那是幻視，
03:27
But she was frightened. She'd lived 95 years
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但是她很害怕。她活到95歲了，
03:29
and she'd never had a hallucination before.
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以前從沒出現過幻覺。
03:32
She said that the hallucinations were unrelated
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她說這些幻覺
03:35
to anything she was thinking or feeling or doing,
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跟她的思考感覺或動作完全不相關。
03:39
that they seemed to come on by themselves, or disappear.
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幻視好像憑空出現，或憑空消失，
03:43
She had no control over them.
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她沒辦法控制。
03:45
She said she didn't recognize
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幻視中
03:47
any of the people or places
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出現的人或地點
03:49
in the hallucinations.
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她都不認得。
03:51
And none of the people or the animals,
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而這些人或動物，
03:53
well, they all seemed oblivious of her.
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似乎也都無視於她的存在。
03:57
And she didn't know what was going on.
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她不知道這是怎麼一回事，
03:59
She wondered if she was going mad
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不知道自己是發瘋了，
04:01
or losing her mind.
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還是神智不清了。
04:03
Well, I examined her carefully.
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我仔細地幫她檢查。
04:05
She was a bright old lady,
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她是一位聰明的老太太。
04:07
perfectly sane. She had no medical problems.
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心智完全正常，沒有什麼病症，
04:11
She wasn't on any medications which could produce hallucinations.
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沒有服用可能導致幻覺的藥物。
04:15
But she was blind.
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但是她失明了。
04:17
And I then said to her,
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於是我就跟她說：
04:19
"I think I know what you have."
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「我想我知道你得了什麼病。」
04:21
I said, "There is a special form of visual hallucination
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我說，這是一種特殊的幻視，
04:25
which may go with deteriorating vision or blindness.
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常伴隨視力惡化或失明出現。
04:29
This was originally described," I said,
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這種症狀最早的紀錄，
04:32
"right back in the 18th century,
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是在18世紀，
04:34
by a man called Charles Bonnet.
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由一位查爾士•邦奈特最先發現的。
04:37
And you have Charles Bonnet syndrome.
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你有邦奈特症候群，
04:40
There is nothing wrong with your brain. There is nothing wrong with your mind.
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你的大腦沒問題，心智沒問題，
04:42
You have Charles Bonnet syndrome."
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你得的是邦奈特症候群。
04:45
And she was very relieved at this,
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她聽了就放心了，
04:48
that there was nothing seriously the matter,
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還好不是什麼嚴重的病。
04:52
and also rather curious.
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同時她也很好奇。
04:55
She said, "Who is this Charles Bonnet?"
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她說：「查爾士•邦奈特是誰？」
04:57
She said, "Did he have them himself?"
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他自己有這個症狀群嗎？
05:00
And she said, "Tell all the nurses
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然後她說，去跟所有的護士說，
05:03
that I have Charles Bonnet syndrome."
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我有邦奈特症候群。
05:06
(Laughter)
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（笑聲）
05:08
"I'm not crazy. I'm not demented. I have Charles Bonnet syndrome."
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我沒發瘋，不是精神失常，我有邦奈特症候群。
05:12
Well, so I did tell the nurses.
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我也的確跟所有的護士說了。
05:14
Now this, for me, is a common situation.
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這對我來說是常見的情況。
05:17
I work in old-age homes, largely.
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我主要在老人院服務，
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I see a lot of elderly people
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我有很多老人病患
05:21
who are hearing impaired or visually impaired.
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他們聽力或視力受損。
05:25
About 10 percent of the hearing impaired people
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聽力受損的人當中約有10%
05:27
get musical hallucinations.
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出現音樂的幻聽。
05:30
And about 10 percent of the visually impaired people
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視力受損的人當中約有10%
05:33
get visual hallucinations.
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出現幻視。
05:35
You don't have to be completely blind,
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不一定要全盲，
05:37
only sufficiently impaired.
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視力受損到一定程度就有可能。
05:39
Now with the original description in the 18th century,
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說到18世紀對這症候群的描述，
05:43
Charles Bonnet did not have them.
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查爾士•邦奈特本人沒有這個症候群，
05:45
His grandfather had these hallucinations.
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是他的外祖父有。
05:48
His grandfather was a magistrate, an elderly man.
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他的外祖父是一位地方官員，年紀很大了。
05:51
He'd had cataract surgery.
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他動過白內障手術，
05:54
His vision was pretty poor.
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視力非常差。
05:56
And in 1759, he described to his grandson
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1759年，他把他所看到的幻視
06:01
various things he was seeing.
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描述給外孫聽。
06:03
The first thing he said was he saw
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首先他說他看到
06:05
a handkerchief in midair.
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一條手帕浮在半空中。
06:07
It was a large blue handkerchief
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一條藍色的大手帕，
06:09
with four orange circles.
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上面有四個橘色圓圈。
06:11
And he knew it was a hallucination.
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他知道那是幻視，
06:14
You don't have handkerchiefs in midair.
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手帕不會浮在半空中。
06:16
And then he saw a big wheel in midair.
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然後他看到一個大輪子浮在半空中。
06:20
But sometimes he wasn't sure whether he was hallucinating or not,
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但有時他不太確定到底是不是幻覺，
06:25
because the hallucinations would fit
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因為幻覺
06:27
in the context of the visions.
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會符合他的視覺情境。
06:29
So on one occasion, when his granddaughters were visiting them,
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有一次，外孫女來看他，
06:32
he said, "And who are these handsome young men with you?"
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他說，跟妳一起來的這些英俊小夥子是誰呀？
06:37
And they said, "Alas, Grandpapa, there are no handsome young men."
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家人說，外公，沒有什麼英俊小夥子呀。
06:41
And then the handsome young men disappeared.
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然後英俊小夥子就消失了。
06:45
It's typical of these hallucinations
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這類幻視的一個特色是
06:48
that they may come in a flash and disappear in a flash.
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會憑空出現，憑空消失。
06:51
They don't usually fade in and out.
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通常不是淡入淡出，
06:53
They are rather sudden, and they change suddenly.
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而是很突然的，而且會一下子改變。
06:56
Charles Lullin, the grandfather,
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查爾士•盧蘭，這位外祖父
06:59
saw hundreds of different figures,
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看到幾百個不同的人物，
07:02
different landscapes of all sorts.
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各式各樣的景色。
07:04
On one occasion, he saw a man in a bathrobe smoking a pipe,
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有一次他看到一個男的穿著浴袍抽煙斗，
07:08
and realized it was himself.
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結果發現那是他自己。
07:11
That was the only figure he recognized.
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那是他唯一認得的人物。
07:14
On one occasion when he was walking in the streets of Paris,
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有一次他走在巴黎街頭，
07:18
he saw -- this was real -- a scaffolding.
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他看到真的鷹架，
07:21
But when he got back home, he saw a miniature of the scaffolding
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但回到家以後，他看到鷹架的縮小版，
07:24
six inches high, on his study table.
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6吋高的鷹架出現在他書桌上。
07:28
This repetition of perception
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這種重複出現的知覺，
07:31
is sometimes called palinopsia.
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有時候叫做視覺重複。
07:33
With him and with Rosalie,
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他跟羅莎莉
07:38
what seems to be going on --
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經驗到的...
07:40
and Rosalie said, "What's going on?" --
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羅莎莉也問，這是怎麼回事？
07:42
and I said that as you lose vision,
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我說，當視覺惡化，
07:45
as the visual parts of the brain are no longer getting any input,
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腦中負責視覺的部分再也收不到刺激，
07:48
they become hyperactive and excitable,
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就變得特別活躍，特別容易被激發，
07:51
and they start to fire spontaneously.
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開始自發性的活躍起來，
07:53
And you start to see things.
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幻視就出現了。
07:56
The things you see can be very complicated indeed.
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幻視的內容可能非常複雜。
07:59
With another patient of mine,
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我有另一位病患，
08:03
who, also had some vision,
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她還保有一些視力。
08:05
the vision she had could be disturbing.
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她看到的東西就有點恐怖。
08:09
On one occasion, she said she saw
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有一次她說她看到
08:12
a man in a striped shirt in a restaurant.
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餐廳裡有一個穿著條紋襯衫的男子，
08:15
And he turned around. And then
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男子轉過身來，
08:17
he divided into six figures in striped shirts,
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分裂成六個穿著條紋襯衫的人，
08:20
who started walking towards her.
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開始朝她走來。
08:23
And then the six figures came together again, like a concertina.
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然後六個人物又合併成一個，像六角手風琴摺起來一樣。
08:26
Once, when she was driving,
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有一次她開車，
08:28
or rather, her husband was driving,
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應該說，是她先生在開車，
08:30
the road divided into four
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道路分裂成四條，
08:32
and she felt herself going simultaneously up four roads.
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她覺得自己同時走在四條路上。
08:36
She had very mobile hallucinations as well.
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她的幻視也有很動作鮮明的，
08:41
A lot of them had to do with a car.
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很多都跟汽車有關。
08:44
Sometimes she would see a teenage boy
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有時候她會看到一個青少年
08:46
sitting on the hood of the car.
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坐在汽車引擎蓋上，
08:49
He was very tenacious and he moved rather gracefully
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車子轉彎，他很頑強地坐在那兒，
08:51
when the car turned.
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動作卻很優雅。
08:53
And then when they came to a stop,
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當車子停下來時，
08:56
the boy would do a sudden vertical takeoff, 100 foot in the air,
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男孩會突然直線向上衝，離地100呎，
08:59
and then disappear.
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然後消失。
09:02
Another patient of mine had a different sort of hallucination.
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我還有一位病患，她有另一種幻視。
09:07
This was a woman who didn't have trouble with her eyes,
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這位女士不是眼睛有問題，
09:10
but the visual parts of her brain,
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而是大腦處理視覺的部份，
09:12
a little tumor in the occipital cortex.
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枕葉皮質長了一個小腫瘤。
09:15
And, above all, she would see cartoons.
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她最常出現的幻視是卡通。
09:20
These cartoons would be transparent
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這些卡通是透明的，
09:25
and would cover half the visual field, like a screen.
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像一層螢幕一樣，遮蓋半個視野。
09:28
And especially she saw cartoons of Kermit the Frog.
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特別的是她會看到科米蛙的卡通。
09:34
(Laughter)
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（笑聲）
09:35
Now, I don't watch Sesame Street,
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我不看芝麻街的。
09:38
but she made a point of saying,
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但她特別提出來說：
09:41
"Why Kermit?" She said, "Kermit the Frog means nothing to me.
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「為什麼是科米蛙？它對我來說沒有任何意義。」
09:45
You know, I was wondering about Freudian determinants.
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我本來在猜想佛洛依德決定因素。
09:48
Why Kermit?
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為什麼是科米蛙？
09:50
Kermit the Frog means nothing to me."
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科米蛙對我來說沒有任何意義。
09:52
She didn't mind the cartoons too much.
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這些卡通她是不太介意，
09:54
But what did disturb her was she got very persistent
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讓她很不安的是
09:58
images or hallucinations of faces
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臉的幻視不斷出現。
10:01
and as with Rosalie, the faces were often deformed,
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跟羅莎莉一樣，這些臉經常是扭曲的，
10:04
with very large teeth or very large eyes.
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牙齒很大，或是眼睛很大，
10:08
And these frightened her.
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這讓她很害怕。
10:11
Well, what is going on with these people?
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這些人究竟是怎麼了呢？
10:15
As a physician, I have to try and define what's going on,
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身為醫生，我必須試著解釋，
10:18
and to reassure people,
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並且讓病患放心。
10:20
especially to reassure them that they're not going insane.
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特別是要讓他們放心，他們並不是發瘋了。
10:24
Something like 10 percent, as I said,
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我剛剛說，約有10%
10:27
of visually impaired people get these.
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視覺受損的人會出現這些幻視，
10:30
But no more than one percent of the people acknowledge them,
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但只有不到1%的人會說出來。
10:34
because they are afraid they will be seen as insane or something.
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因為他們擔心被認為是瘋子之類的。
10:37
And if they do mention them to their own doctors
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就算他們跟醫生說，
10:39
they may be misdiagnosed.
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也有可能被誤診。
10:42
In particular, the notion is that if you see
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一般的看法是，如果你有
10:44
things or hear things, you're going mad,
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幻視或幻聽，你就是發瘋了。
10:47
but the psychotic hallucinations are quite different.
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然而，精神病患的幻覺是很不一樣的。
10:50
Psychotic hallucinations, whether they are visual or vocal,
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精神疾病產生的幻覺，不管是幻視或幻聽，
10:53
they address you. They accuse you.
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會跟你對話，指責你，
10:55
They seduce you. They humiliate you.
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誘惑你，羞辱你，
10:57
They jeer at you.
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嘲笑你，
11:00
You interact with them.
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你跟幻覺有互動。
11:02
There is none of this quality of being addressed
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但邦奈特症候群的幻視
11:05
with these Charles Bonnet hallucinations.
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沒有這種互動的特性。
11:08
There is a film. You're seeing a film which has nothing to do with you,
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是電影，你在看一場跟你不相關的電影，
11:12
or that's how people think about it.
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這是病患的感覺。
11:15
There is also a rare thing called temporal lobe epilepsy,
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有一種罕見的症狀叫顳葉癲癇。
11:19
and sometimes, if one has this,
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有時候，顳葉癲癇的患者
11:22
one may feel oneself transported back
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可能會覺得自己回到過去，
11:24
to a time and place in the past.
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特定的時間地點。
11:27
You're at a particular road junction.
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你人在一個特定的路口，
11:29
You smell chestnuts roasting.
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聞到烤栗子的香味，
11:31
You hear the traffic. All the senses are involved.
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聽到車聲，所有的感官刺激都有，
11:34
And you're waiting for your girl.
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你在等你的女朋友。
11:36
And it's that Tuesday evening back in 1982.
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時間回到1982年那個星期二晚上。
11:40
And the temporal lobe hallucinations
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顳葉癲癇的幻覺
11:42
are all-sense hallucinations,
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是多感官幻覺，
11:44
full of feeling, full of familiarity,
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充滿感受，充滿熟悉感，
11:47
located in space and time,
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發生在特定的時間地點，
11:49
coherent, dramatic.
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情節一致而戲劇化。
11:51
The Charles Bonnet ones are quite different.
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邦奈特症候群的幻覺很不一樣。
11:54
So in the Charles Bonnet hallucinations,
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邦奈特症候群的幻覺
11:58
you have all sorts of levels,
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有各種不同的層次。
12:00
from the geometrical hallucinations --
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從幾何圖形的幻覺，
12:02
the pink and blue squares the woman had --
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老太太看到的粉紅色和藍色方塊，
12:05
up to quite elaborate hallucinations
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到很繁複的幻覺，
12:09
with figures and especially faces.
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像是人物，特別是臉孔。
12:12
Faces, and sometimes deformed faces,
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臉孔，有時候是扭曲的臉孔，
12:15
are the single commonest thing
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是這類幻覺中
12:18
in these hallucinations.
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最常見的。
12:20
And one of the second commonest is cartoons.
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第二常見的是卡通。
12:23
So, what is going on?
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究竟是怎麼回事呢？
12:26
Fascinatingly, in the last few years,
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有趣的是，過去幾年
12:28
it's been possible to do functional brain imagery,
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我們開始可以做功能性大腦造影，
12:32
to do fMRI on people as they are hallucinating.
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在人出現幻覺時做 fMRI（功能性磁振造影）。
12:36
And in fact, to find that different parts
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實際上也發現
12:40
of the visual brain are activated
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當人出現幻視時
12:43
as they are hallucinating.
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大腦處理視覺的不同部位活躍起來。
12:45
When people have these simple geometrical hallucinations,
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如果是簡單的幾何幻視，
12:48
the primary visual cortex is activated.
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主要視覺皮質會活動，
12:52
This is the part of the brain which perceives edges and patterns.
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這是大腦負責感受邊界、圖案的部位。
12:55
You don't form images with your primary visual cortex.
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主要視覺皮質無法形成影像，
12:59
When images are formed,
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要形成影像，
13:02
a higher part of the visual cortex
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要牽涉到位於顳葉，
13:04
is involved in the temporal lobe.
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更高等的視覺皮質。
13:06
And in particular, one area of the temporal lobe
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特別是顳葉有一個區域
13:11
is called the fusiform gyrus.
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叫做梭狀回 (fusiform gyrus)。
13:13
And it's known that if people have damage in the fusiform gyrus,
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我們已經知道，梭狀回如果受損，
13:17
they maybe lose the ability to recognize faces.
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人就可能無法辨識臉孔。
13:21
But if there is an abnormal activity in the fusiform gyrus,
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但是如果梭狀回活動異常，
13:25
they may hallucinate faces,
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就可能出現臉孔的幻視。
13:27
and this is exactly what you find in some of these people.
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這也正是我們在這些人身上看到的。
13:30
There is an area in the anterior part of this gyrus
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梭狀回前端有一個區域
13:34
where teeth and eyes are represented,
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負責處理牙齒和眼睛。
13:39
and that part of the gyrus is activated
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當患者出現變形臉孔的幻視，
13:42
when people get the deformed hallucinations.
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梭狀回的這個部分是活躍的。
13:46
There is another part of the brain
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大腦還有另一個部分，
13:48
which is especially activated
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在看到卡通時
13:50
when one sees cartoons.
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會活躍起來。
13:52
It's activated when one recognizes cartoons,
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當我們辨識卡通，畫卡通，
13:55
when one draws cartoons, and when one hallucinates them.
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出現卡通幻視時，這部份會活躍起來。
13:59
It's very interesting that that should be specific.
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很有趣地腦中竟然有這樣專門的部位。
14:02
There are other parts of the brain which are specifically involved
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大腦還有其他部位經過特化，
14:05
with the recognition and hallucination
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處理建築物、景色的
14:07
of buildings and landscapes.
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辨識及幻覺。
14:10
Around 1970, it was found that there were not only parts of the brain,
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1970年左右，研究人員發現大腦不只有特化的部位，
14:13
but particular cells.
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還有特化的細胞。
14:15
"Face cells" were discovered around 1970.
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「臉部細胞」是在1970年左右發現的。
14:20
And now we know that there are hundreds of other
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現在我們知道有上百種
14:22
sorts of cells,
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不同的細胞，
14:24
which can be very, very specific.
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負責非常特定的功能。
14:26
So you may not only have
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可能不只有
14:28
"car" cells,
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「汽車」細胞，
14:30
you may have "Aston Martin" cells.
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可能還有「奧斯頓馬汀車」細胞。
14:33
(Laughter)
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（笑聲）
14:35
I saw an Aston Martin this morning.
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我今天早上看到一台奧斯頓馬汀車，
14:37
I had to bring it in.
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非提一下不可。
14:39
And now it's in there somewhere.
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現在那在我腦子裡了。
14:42
(Laughter)
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（笑聲）
14:45
Now, at this level, in what's called the inferotemporal cortex,
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在這個層級，在顳下皮質的地方
14:49
there are only visual images,
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只有視覺影像，
14:52
or figments or fragments.
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或者說片段。
14:55
It's only at higher levels
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要到更高的層級，
14:58
that the other senses join in
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才有其他感官融入進來，
15:00
and there are connections with memory and emotion.
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跟記憶、情緒連結起來。
15:02
And in the Charles Bonnet syndrome,
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邦奈特症候群
15:05
you don't go to those higher levels.
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則不會牽涉到較高層級，
15:07
You're in these levels of inferior visual cortex
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是在顳下視覺皮質的層級。
15:10
where you have thousands and tens of thousands
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這裡有成千上萬，
15:12
and millions of images,
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甚至好幾百萬的影像，
15:15
or figments, or fragmentary figments,
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或者說片段的虛構影像，
15:17
all neurally encoded
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以神經編碼的方式
15:19
in particular cells or small clusters of cells.
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儲存在特定的細胞或細胞群中。
15:23
Normally these are all part of
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正常情況下，
15:26
the integrated stream of perception, or imagination,
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這會跟知覺、想像整合在一起，
15:30
and one is not conscious of them.
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我們不會意識到這些影像。
15:33
It is only if one is visually impaired or blind
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只有當我們視力受損，或失明時，
15:37
that the process is interrupted.
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這個程序才被打斷。
15:39
And instead of getting normal perception,
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出現的就不是正常的感知，
15:42
you're getting an anarchic,
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而是下顳葉的
15:44
convulsive stimulation, or release,
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這些視覺細胞
15:47
of all of these visual cells
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雜亂無章、痙攣似的
15:49
in the inferotemporal cortex.
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被刺激、釋放。
15:51
So, suddenly you see a face. Suddenly you see a car.
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所以你突然看到一張臉，突然看到一台車。
15:54
Suddenly this, and suddenly that.
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一下子這個，一下子那個。
15:57
The mind does its best to organize
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大腦會盡可能地組織，
15:59
and to give some sort of coherence to this,
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讓它有一點連貫性，
16:02
but not terribly successfully.
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但也不是太成功。
16:04
When these were first described,
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這種症狀當初被發現時，
16:06
it was thought that they could be interpreted like dreams.
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心理學家以為這些影像可以當做夢一樣來解析。
16:10
But in fact people say,
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但實際上患者會說：
16:12
"I don't recognize the people. I can't form any associations."
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「我不認得這些人，想不出什麼關連。」
16:15
"Kermit means nothing to me."
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「科米蛙對我來說沒有任何意義」
16:18
You don't get anywhere thinking of them as dreams.
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把這些幻視當成夢來處理是沒有用的。
16:23
Well, I've more or less said what I wanted.
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好，我想說的差不多說完了。
16:28
I think I just want to recapitulate
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我只想再次說明，
16:31
and say this is common.
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邦奈特症候群是常見的。
16:33
Think of the number of blind people.
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想想看世界上有多少盲人，
16:35
There must be hundreds of thousands of blind people
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當中一定有幾十萬盲人
16:37
who have these hallucinations,
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有這些幻視，
16:39
but are too scared to mention them.
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但是因為害怕，所以不敢說出來。
16:41
So this sort of thing needs to be brought into
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所以這樣的事情必須要讓大家了解，
16:44
notice, for patients, for doctors, for the public.
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要讓病患、醫師、大眾知道。
16:50
Finally, I think they are
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最後，我認為
16:52
infinitely interesting and valuable,
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這類幻視非常有意思，也很有價值，
16:55
for giving one some insight as to how the brain works.
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能讓我們一窺大腦的運作。
16:59
Charles Bonnet said, 250 years ago --
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250年前，查爾士說，
17:02
he wondered how, thinking these hallucinations,
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關於這些幻視，
17:06
how, as he put it, the theater of the mind
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照他的說法是，在心靈的舞台上，
17:09
could be generated by the machinery of the brain.
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不知道大腦的機器是如何創造出這些幻視的。
17:12
Now, 250 years later,
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現在，250年之後，
17:15
I think we're beginning to glimpse how this is done.
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我想我們開始慢慢看到背後的機制。
17:18
Thanks very much.
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謝謝大家。
17:20
(Applause)
350
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（掌聲）
17:23
Chris Anderson: That was superb. Thank you so much.
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真是太棒了，非常感謝。
17:26
You speak about these things with so much insight
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您的演講充滿了洞見，
17:28
and empathy for your patients.
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以及對病人的同理心。
17:31
Have you yourself experienced any of the syndromes you write about?
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您書中所寫的症候群，您本人有任何經驗嗎？
17:36
Oliver Sacks: I was afraid you'd ask that.
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我就擔心你問這個。
17:38
(Laughter)
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（笑聲）
17:39
Well, yeah, a lot of them.
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有的，很多。
17:42
And actually I'm a little visually impaired myself.
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其實我自己的視力也有點受損，
17:45
I'm blind in one eye, and not terribly good in the other.
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一隻眼睛失明，另一隻也好不到哪兒去。
17:48
And I see the geometrical hallucinations.
360
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我會看到幾何圖形的幻視。
17:52
But they stop there.
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但僅此而已。
17:54
CA: And they don't disturb you?
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幻視不會讓你煩惱嗎？
17:56
Because you understand what's doing it, it doesn't make you worried?
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因為你知道是怎麼回事，所以不會擔心嗎？
17:58
OS: Well they don't disturb me any more than my tinnitus,
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幻視讓我煩惱的程度不會超過耳鳴，
18:02
which I ignore.
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耳鳴我是不管的。
18:05
They occasionally interest me,
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有時候幻視會引起我的興趣，
18:07
and I have many pictures of them in my notebooks.
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我的筆記本裡有很多幻視的影像。
18:10
I've gone and had an fMRI myself,
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我自己也做過 fMRI,
18:13
to see how my visual cortex is taking over.
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看到我的視覺皮質如何主導。
18:16
And when I see all these hexagons
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還有當我在偏頭痛時
18:20
and complex things, which I also have,
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看到六邊形
18:22
in visual migraine,
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跟複雜的圖形，
18:24
I wonder whether everyone sees things like this,
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我會想是不是人人都會看到這種東西，
18:26
and whether things like cave art or ornamental art
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還有洞穴藝術、裝飾藝術
18:29
may have been derived from them a bit.
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是不是跟這有一點關係。
18:32
CA: That was an utterly, utterly fascinating talk.
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真是非常引人入勝的演講。
18:34
Thank you so much for sharing.
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非常謝謝您的分享。
18:36
OS: Thank you. Thank you.
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謝謝，謝謝。
18:38
(Applause)
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（掌聲）
ABOUT THE SPEAKER
Oliver Sacks - Neurological anthropologistSince "Awakenings" stormed the bestseller lists (and the silver screen), Oliver Sacks has become an unlikely household name, single-handedly inventing the genre of neurological anthropology.
Why you should listen
Oliver Sacks was a ground-breaking neurologist -- and a gifted storyteller who enriched our knowledge of the infinite variations of human psychology. After his pioneering work with “sleepy sickness” patients (who were in fact survivors of an early-20th-century pandemic), Sacks went on to study the connections between music and the brain, as well as disorders such as Tourette's syndrome, Parkinson's disease, and many other little-understood disorders that often count Sacks as one of their first chroniclers.
Sacks was well known as a writer of such best-selling case histories as Hallucinations, The Man Who Mistook His Wife for a Hat, An Anthropologist on Mars, and his memoir of his early work, Awakenings, all of which have breathed new life into the dusty 19th-century tradition of the clinical anecdote. Sacks' writing, compassion and wide-ranging knowledge catapults the genre into the 21st century and brings the far frontiers of neurological experience into the view of millions of readers worldwide. Sacks died at age 82 in August 2015.
Read TED's long, wonderful Q&A with Oliver Sacks >>
Oliver Sacks | Speaker | TED.com