TED英语演讲稿让我们来谈谈死亡.docx

1、TED英语演讲稿让我们来谈谈死亡TED英语演讲稿：让我们来谈谈死亡 简介：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peter saul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, i had second thoughts, really, about whether i could talk about this to such a vital and alive audience as you guys. then i remembered the quote from gloria steinem, which goes

2、, the truth will set you free, but first it will piss you off. (laughter) so - (laughter) so with that in mind, im going to set about trying to do those things here, and talk about dying in the 21st century. now the first thing that will piss you off, undoubtedly, is that all of us are, in fact, goi

3、ng to die in the 21st century. there will be no exceptions to that. there are, apparently, about one in eight of you who think youre immortal, on surveys, but - (laughter) unfortunately, that isnt going to happen. while i give this talk, in the next 10 minutes, a hundred million of my cells will die

4、, and over the course of today, 2,000 of my brain cells will die and never come back, so you could argue that the dying process starts pretty early in the piece. anyway, the second thing i want to say about dying in the 21st century, apart from its going to happen to everybody, is its shaping up to

5、be a bit of a train wreck for most of us, unless we do something to try and reclaim this process from the rather inexorable trajectory that its currently on. so there you go. thats the truth. no doubt that will piss you off, and now lets see whether we can set you free. i dont promise anything. now,

6、 as you heard in the intro, i work in intensive care, and i think ive kind of lived through the heyday of intensive care. its been a ride, man. this has been fantastic. we have machines that go ping. theres many of them up there. and we have some wizard technology which i think has worked really wel

7、l, and over the course of the time ive worked in intensive care, the death rate for males in australia has halved, and intensive care has had something to do with that. certainly, a lot of the technologies that we use have got something to do with that. so we have had tremendous success, and we kind

8、 of got caught up in our own success quite a bit, and we started using expressions like lifesaving. i really apologize to everybody for doing that, because obviously, we dont. what we do is prolong peoples lives, and delay death, and redirect death, but we cant, strictly speaking, save lives on any

9、sort of permanent basis. and whats really happened over the period of time that ive been working in intensive care is that the people whose lives we started saving back in the 70s, 80s, and 90s, are now coming to die in the 21st century of diseases that we no longer have the answers to in quite the

10、way we did then. so whats happening now is theres been a big shift in the way that people die, and most of what theyre dying of now isnt as amenable to what we can do as what it used to be like when i was doing this in the 80s and 90s. so we kind of got a bit caught up with this, and we havent reall

11、y squared with you guys about whats really happening now, and its about time we did. i kind of woke up to this bit in the late 90s when i met this guy. this guy is called jim, jim smith, and he looked like this. i was called down to the ward to see him. his is the little hand. i was called down to t

12、he ward to see him by a respiratory physician. he said, look, theres a guy down here. hes got pneumonia, and he looks like he needs intensive care. his daughters here and she wants everything possible to be done. which is a familiar phrase to us. so i go down to the ward and see jim, and his skin hi

13、s translucent like this. you can see his bones through the skin. hes very, very thin, and he is, indeed, very sick with pneumonia, and hes too sick to talk to me, so i talk to his daughter kathleen, and i say to her, did you and jim ever talk about what you would want done if he ended up in this kin

14、d of situation? and she looked at me and said, no, of course not! i thought, okay. take this steady. and i got talking to her, and after a while, she said to me, you know, we always thought thered be time. jim was 94. (laughter) and i realized that something wasnt happening here. there wasnt this di

15、alogue going on that i imagined was happening. so a group of us started doing survey work, and we looked at four and a half thousand nursing home residents in newcastle, in the newcastle area, and discovered that only one in a hundred of them had a plan about what to do when their hearts stopped bea

16、ting. one in a hundred. and only one in 500 of them had plan about what to do if they became seriously ill. and i realized, of course, this dialogue is definitely not occurring in the public at large. now, i work in acute care. this is john hunter hospital. and i thought, surely, we do better than t

17、hat. so a colleague of mine from nursing called lisa shaw and i went through hundreds and hundreds of sets of notes in the medical records department looking at whether there was any sign at all that anybody had had any conversation about what might happen to them if the treatment they were receivin

18、g was unsuccessful to the point that they would die. and we didnt find a single record of any preference about goals, treatments or outcomes from any of the sets of notes initiated by a doctor or by a patient. so we started to realize that we had a problem, and the problem is more serious because of

19、 this. what we know is that obviously we are all going to die, but how we die is actually really important, obviously not just to us, but also to how that features in the lives of all the people who live on afterwards. how we die lives on in the minds of everybody who survives us, and the stress cre

20、ated in families by dying is enormous, and in fact you get seven times as much stress by dying in intensive care as by dying just about anywhere else, so dying in intensive care is not your top option if youve got a choice. and, if that wasnt bad enough, of course, all of this is rapidly progressing

21、 towards the fact that many of you, in fact, about one in 10 of you at this point, will die in intensive care. in the u.s., its one in five. in miami, its three out of five people die in intensive care. so this is the sort of momentum that weve got at the moment. the reason why this is all happening

22、 is due to this, and i do have to take you through what this is about. these are the four ways to go. so one of these will happen to all of us. the ones you may know most about are the ones that are becoming increasingly of historical interest: sudden death. its quite likely in an audience this size

23、 this wont happen to anybody here. sudden death has become very rare. the death of little nell and cordelia and all that sort of stuff just doesnt happen anymore. the dying process of those with terminal illness that weve just seen occurs to younger people. by the time youve reached 80, this is unli

24、kely to happen to you. only one in 10 people who are over 80 will die of cancer. the big growth industry are these. what you die of is increasing organ failure, with your respiratory, cardiac, renal, whatever organs packing up. each of these would be an admission to an acute care hospital, at the en

25、d of which, or at some point during which, somebody says, enough is enough, and we stop. and this ones the biggest growth industry of all, and at least six out of 10 of the people in this room will die in this form, which is the dwindling of capacity with increasing frailty, and frailtys an inevitab

26、le part of aging, and increasing frailty is in fact the main thing that people die of now, and the last few years, or the last year of your life is spent with a great deal of disability, unfortunately. enjoying it so far? (laughs) (laughter) sorry, i just feel such a, i feel such a cassandra here. (

27、laughter) what can i say thats positive? whats positive is that this is happening at very great age, now. we are all, most of us, living to reach this point. you know, historically, we didnt do that. this is what happens to you when you live to be a great age, and unfortunately, increasing longevity

28、 does mean more old age, not more youth. im sorry to say that. (laughter) what we did, anyway, look, what we did, we didnt just take this lying down at john hunter hospital and elsewhere. weve started a whole series of projects to try and look about whether we could, in fact, involve people much mor

29、e in the way that things happen to them. but we realized, of course, that we are dealing with cultural issues, and this is, i love this klimt painting, because the more you look at it, the more you kind of get the whole issue thats going on here, which is clearly the separation of death from the liv

30、ing, and the fear like, if you actually look, theres one woman there who has her eyes open. shes the one hes looking at, and the one hes coming for. can you see that? she looks terrified. its an amazing picture. anyway, we had a major cultural issue. clearly, people didnt want us to talk about death

31、, or, we thought that. so with loads of funding from the federal government and the local health service, we introduced a thing at john hunter called respecting patient choices. we trained hundreds of people to go to the wards and talk to people about the fact that they would die, and what would the

32、y prefer under those circumstances. they loved it. the families and the patients, they loved it. ninety-eight percent of people really thought this just should have been normal practice, and that this is how things should work. and when they expressed wishes, all of those wishes came true, as it wer

33、e. we were able to make that happen for them. but then, when the funding ran out, we went back to look six months later, and everybody had stopped again, and nobody was having these conversations anymore. so that was really kind of heartbreaking for us, because we thought this was going to really take off. the cultural issue h