TED英语演讲稿让我们来谈谈死亡Word格式文档下载.docx
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我们无法控制死亡的到来,但也许我们可以选择用何种态度来面对它。
特护专家petersaul博士希望通过演讲帮助人们弄清临终者真正的意愿,并选择适当的方式去面对。
look,ihadsecondthoughts,really,aboutwhethericouldtalkaboutthistosuchavitalandaliveaudienceasyouguys.thenirememberedthequotefromgloriasteinem,whichgoes,"
thetruthwillsetyoufree,butfirstitwillpissyouoff."
(laughter)so--(laughter)
sowiththatinmind,imgoingtosetabouttryingtodothosethingshere,andtalkaboutdyinginthe21stcentury.nowthefirstthingthatwillpissyouoff,undoubtedly,isthatallofusare,infact,goingtodieinthe21stcentury.therewillbenoexceptionstothat.thereare,apparently,aboutoneineightofyouwhothinkyoureimmortal,onsurveys,but--(laughter)unfortunately,thatisntgoingtohappen.
whileigivethistalk,inthenext10minutes,ahundredmillionofmycellswilldie,andoverthecourseoftoday,2,000ofmybraincellswilldieandnevercomeback,soyoucouldarguethatthedyingprocessstartsprettyearlyinthepiece.
anyway,thesecondthingiwanttosayaboutdyinginthe21stcentury,apartfromitsgoingtohappentoeverybody,isitsshapinguptobeabitofatrainwreckformostofus,unlesswedosomethingtotryandreclaimthisprocessfromtheratherinexorabletrajectorythatitscurrentlyon.
sothereyougo.thatsthetruth.nodoubtthatwillpissyouoff,andnowletsseewhetherwecansetyoufree.idontpromiseanything.now,asyouheardintheintro,iworkinintensivecare,andithinkivekindoflivedthroughtheheydayofintensivecare.itsbeenaride,man.thishasbeenfantastic.wehavemachinesthatgoping.theresmanyofthemupthere.andwehavesomewizardtechnologywhichithinkhasworkedreallywell,andoverthecourseofthetimeiveworkedinintensivecare,thedeathrateformalesinaustraliahashalved,andintensivecarehashadsomethingtodowiththat.certainly,alotofthetechnologiesthatweusehavegotsomethingtodowiththat.
sowehavehadtremendoussuccess,andwekindofgotcaughtupinourownsuccessquiteabit,andwestartedusingexpressionslike"
lifesaving."
ireallyapologizetoeverybodyfordoingthat,becauseobviously,wedont.whatwedoisprolongpeopleslives,anddelaydeath,andredirectdeath,butwecant,strictlyspeaking,savelivesonanysortofpermanentbasis.
andwhatsreallyhappenedovertheperiodoftimethativebeenworkinginintensivecareisthatthepeoplewhoseliveswestartedsavingbackinthe70s,80s,and90s,arenowcomingtodieinthe21stcenturyofdiseasesthatwenolongerhavetheanswerstoinquitethewaywedidthen.
sowhatshappeningnowistheresbeenabigshiftinthewaythatpeopledie,andmostofwhattheyredyingofnowisntasamenabletowhatwecandoaswhatitusedtobelikewheniwasdoingthisinthe80sand90s.
sowekindofgotabitcaughtupwiththis,andwehaventreallysquaredwithyouguysaboutwhatsreallyhappeningnow,anditsabouttimewedid.ikindofwokeuptothisbitinthelate90swhenimetthisguy.thisguyiscalledjim,jimsmith,andhelookedlikethis.iwascalleddowntothewardtoseehim.hisisthelittlehand.iwascalleddowntothewardtoseehimbyarespiratoryphysician.hesaid,"
look,theresaguydownhere.hesgotpneumonia,andhelookslikeheneedsintensivecare.hisdaughtershereandshewantseverythingpossibletobedone."
whichisafamiliarphrasetous.soigodowntothewardandseejim,andhisskinhistranslucentlikethis.youcanseehisbonesthroughtheskin.hesvery,verythin,andheis,indeed,verysickwithpneumonia,andhestoosicktotalktome,soitalktohisdaughterkathleen,andisaytoher,"
didyouandjimevertalkaboutwhatyouwouldwantdoneifheendedupinthiskindofsituation?
"
andshelookedatmeandsaid,
"
no,ofcoursenot!
ithought,"
okay.takethissteady."
andigottalkingtoher,andafterawhile,shesaidtome,"
youknow,wealwaysthoughttheredbetime."
jimwas94.(laughter)andirealizedthatsomethingwasnthappeninghere.therewasntthisdialoguegoingonthatiimaginedwashappening.soagroupofusstarteddoingsurveywork,andwelookedatfourandahalfthousandnursinghomeresidentsinnewcastle,inthenewcastlearea,anddiscoveredthatonlyoneinahundredofthemhadaplanaboutwhattodowhentheirheartsstoppedbeating.oneinahundred.andonlyonein500ofthemhadplanaboutwhattodoiftheybecameseriouslyill.andirealized,ofcourse,thisdialogueisdefinitelynotoccurringinthepublicatlarge.
now,iworkinacutecare.thisisjohnhunterhospital.andithought,surely,wedobetterthanthat.soacolleagueofminefromnursingcalledlisashawandiwentthroughhundredsandhundredsofsetsofnotesinthemedicalrecordsdepartmentlookingatwhethertherewasanysignatallthatanybodyhadhadanyconversationaboutwhatmighthappentothemifthetreatmenttheywerereceivingwasunsuccessfultothepointthattheywoulddie.andwedidntfindasinglerecordofanypreferenceaboutgoals,treatmentsoroutcomesfromanyofthesetsofnotesinitiatedbyadoctororbyapatient.
sowestartedtorealizethatwehadaproblem,andtheproblemismoreseriousbecauseofthis.
whatweknowisthatobviouslyweareallgoingtodie,buthowwedieisactuallyreallyimportant,obviouslynotjusttous,butalsotohowthatfeaturesinthelivesofallthepeoplewholiveonafterwards.howwedielivesoninthemindsofeverybodywhosurvivesus,andthestresscreatedinfamiliesbydyingisenormous,andinfactyougetseventimesasmuchstressbydyinginintensivecareasbydyingjustaboutanywhereelse,sodyinginintensivecareisnotyourtopoptionifyouvegotachoice.
and,ifthatwasntbadenough,ofcourse,allofthisisrapidlyprogressingtowardsthefactthatmanyofyou,infact,aboutonein10ofyouatthispoint,willdieinintensivecare.intheu.s.,itsoneinfive.inmiami,itsthreeoutoffivepeopledieinintensivecare.sothisisthesortofmomentumthatwevegotatthemoment.
thereasonwhythisisallhappeningisduetothis,andidohavetotakeyouthroughwhatthisisabout.thesearethefourwaystogo.sooneofthesewillhappentoallofus.theonesyoumayknowmostaboutaretheonesthatarebecomingincreasinglyofhistoricalinterest:
suddendeath.itsquitelikelyinanaudiencethissizethiswonthappentoanybodyhere.suddendeathhasbecomeveryrare.thedeathoflittlenellandcordeliaandallthatsortofstuffjustdoesnthappenanymore.thedyingprocessofthosewithterminalillnessthatwevejustseenoccurstoyoungerpeople.bythetimeyouvereached80,thisisunlikelytohappentoyou.onlyonein10peoplewhoareover80willdieofcancer.
thebiggrowthindustryarethese.whatyoudieofisincreasingorganfailure,withyourrespiratory,cardiac,renal,whateverorganspackingup.eachofthesewouldbeanadmissiontoanacutecarehospital,attheendofwhich,oratsomepointduringwhich,somebodysays,enoughisenough,andwestop.
andthisonesthebiggestgrowthindustryofall,andatleastsixoutof10ofthepeopleinthisroomwilldieinthisform,whichisthedwindlingofcapacitywithincreasingfrailty,andfrailtysaninevitablepartofaging,andincreasingfrailtyisinfactthemainthingthatpeopledieofnow,andthelastfewyears,orthelastyearofyourlifeisspentwithagreatdealofdisability,unfortunately.
enjoyingitsofar?
(laughs)(laughter)sorry,ijustfeelsucha,ifeelsuchacassandrahere.(laughter)
whatcanisaythatspositive?
whatspositiveisthatthisishappeningatverygreatage,now.weareall,mostofus,livingtoreachthispoint.youknow,historically,wedidntdothat.thisiswhathappenstoyouwhenyoulivetobeagreatage,andunfortunately,increasinglongevitydoesmeanmoreoldage,notmoreyouth.imsorrytosaythat.(laughter)whatwedid,anyway,look,whatwedid,wedidntjusttakethislyingdownatjohnhunterhospitalandelsewhere.wevestartedawholeseriesofprojectstotryandlookaboutwhetherwecould,infact,involvepeoplemuchmoreinthewaythatthingshappentothem.butwerealized,ofcourse,thatwearedealingwithculturalissues,andthisis,ilovethisklimtpainting,becausethemoreyoulookatit,themoreyoukindofgetthewholeissuethatsgoingonhere,whichisclearlytheseparationofdeathfromtheliving,andthefear—like,ifyouactuallylook,theresonewomantherewhohashereyesopen.shestheoneheslookingat,and[shes]theonehescomingfor.canyouseethat?
shelooksterrified.itsanamazingpicture.
anyway,wehadamajorculturalissue.clearly,peopledidntwantustotalkaboutdeath,or,wethoughtthat.sowithloadsoffundingfromthefederalgovernmentandthelocalhealthservice,weintroducedathingatjohnhuntercalledrespectingpatientchoices.wetrainedhundredsofpeopletogotothewardsandtalktopeopleaboutthefactthattheywoulddie,andwhatwouldtheypreferunderthosecircumstances.theylovedit.thefamiliesandthepatients,theylovedit.ninety-eightpercentofpeoplereallythoughtthisjustshouldhavebeennormalpractice,andthatthisishowthingsshouldwork.andwhentheyexpressedwishes,allofthosewishescametrue,asitwere.wewereabletomakethathappenforthem.butthen,whenthefundingranout,wewentbacktolooksixmonthslater,andeverybodyhadstoppedagain,andnobodywashavingtheseconversationsanymore.sothatwasreallykindofheartbreakingforus,becausewethoughtthiswasgoingtoreallytakeoff.theculturalissuehadreasserteditself.
soheresthepitch:
ithinkitsimportantthatwedontjustgetonthisfreewaytoicuwithoutthinkinghardaboutwhetherornotthatswhereweallwanttoendup,particularlyaswebecomeolderandincreasinglyfrailandicuhaslessandlessandlesstoofferus.therehastobealittlesideroadoffthereforpeoplewhodontwanttogoonthattrack.andihaveonesmallidea,andonebigideaaboutwhatcouldhappen.
andthisisthesmallidea.thesmallideais,letsallofusengagemorewiththisinthewaythatjasonhasillustrated.whycantwehavethesekindsofconversationswithourowneldersandpeoplewhomightbeapproachingthis?
thereareacoupleofthingsyoucando.oneofthemis,youcan,justaskthissimplequestion.thisquestionneverfails."
intheeventthatyoubecametoosicktospeakforyourself,whowouldyouliketospeakforyou?
thatsareallyimportantquestiontoaskpeople,becausegivingpeoplethecontroloverwhothatisproducesanamazingoutcome.thesecondthingyoucansayis,"
haveyouspokentothatpersonaboutthethingsthatareimportanttoyousothatwevegotabetterideaofwhatitiswecando?
sothatsthelittleidea.
thebigidea,ithink,ismorepolitical.ithinkwehavetogetontothis.isuggestedweshouldhaveoccupydeath.(laughter)mywifesaid,"
yeah,right,sit-insinthemortuary.yeah,yeah.sure."
(laughter)sothatonedidntreallyrun,butiwasverystruckbythis.now,imanaginghippie.idontknow,idontthinkilooklikethatanymore,butihad,twoofmykidswerebornathomeinthe80swhenhomebirthwasabigthing,andwebabyboomersareusedtotakingchargeofthesituation,soifyoujustreplaceallthesewordsofbirth,ilike"
peace,love,naturaldeath"
asanoption.idothinkwehavetogetpoliticalandstarttoreclaimthisprocessfromthemedicalizedmodelinwhichitsgoing.
now,listen,thatsoundslikeapitchforeuthanasia.iwanttomakeitabsolutelycrystalcleartoyouall,ihateeuthanasia.ithinkitsasideshow.idontthinkeuthanasiamatters.iactuallythinkthat,inplaceslikeoregon,whereyoucanhavephysician-assisted