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BJMiller_2015-_人生尽头有何求_
Well, we all need a reason to wake up. 我们都需要一个醒来的理由。
For me, it just took 11,000 volts . 对我来说是11,000伏特。
volts:n.伏特(volt的复数形式);电压;
I know you're too polite to ask, so I will tell you. 我知道你们太礼貌了不会过问, 那就让我告诉你们。
One night, sophomore year of college, just back from Thanksgiving holiday, a few of my friends and I were horsing around, and we decided to climb atop a parked commuter train. 在大学二年级, 感恩节假期后的一天晚上, 我和几个朋友闹着玩儿, 决定爬到一列停在一旁的通勤列车顶上。
sophomore:n.(大学)二年级学生:(高中)二年级学生: horsing:v.为…备马;猛推或用力向上举;(horse的现在分词) atop:prep.在…的顶上;adv.在顶上; commuter:n.通勤者,经常乘公共车辆往返者;[交]月季票乘客;
It was just sitting there, with the wires that run overhead . 它就停在那儿,缆线就在车顶上方。
overhead:n.开销;经常费用;经常开支;adj.头上方的;地面以上的;adv.在头上方;在空中
Somehow , that seemed like a great idea at the time. 不知为什么,这似乎在那个时候是一个好主意。
Somehow:adv.以某种方法;莫名其妙地;
We'd certainly done stupider things. 我们的确干过比这个还傻的事。
I scurried up the ladder on the back, and when I stood up, the electrical current entered my arm, blew down and out my feet, and that was that. 我从后面的梯子窜了上去, 当我站起来的时候, 一股电流进入了我的手臂, 一直到我的脚下然后就这样了。
scurried:n.急跑;短距离赛跑(或赛马);vi.急赶;急跑;vt.急赶; ladder:n.阶梯;途径;梯状物;v.成名;发迹;在…上装设梯子; electrical:adj.有关电的;电气科学的; down and out:贫困潦倒的;被击倒不能再战的;
Would you believe that watch still works? 你能相信那块手表还没坏吗？
Takes a licking ! 真是金刚不坏！
licking:n.惨败,一败涂地;v.舔;舔吃;掠过;舔食;(lick的现在分词)
(Laughter) （笑声）
My father wears it now in solidarity . 我的父亲现在还一直戴着那块手表。
solidarity:n.团结,团结一致;
That night began my formal relationship with death -- my death -- and it also began my long run as a patient . 那天晚上开启了我和死亡正式的关系——我的死亡—— 也开始了我作为病人的漫长的旅程。
formal:adj.适合正式场合的; n.(美)须穿礼服的社交集会; (口)夜礼服; patient:adj.有耐心的,能容忍的;n.病人;患者;
It's a good word. 这是一个很合适的词。
It means one who suffers. 它的意思是一个受苦的人。
So I guess we're all patients . 我想我们应该都是病人吧。
patients:n.接受治疗者,病人;(patient的复数)
Now, the American health care system has more than its fair share of dysfunction -- to match its brilliance , to be sure . 美国的医疗保健系统 有不少的功能障碍—— 当然,它也有杰出的方面。
health care:n.卫生保健; dysfunction:n.功能紊乱;机能障碍;官能不良;vi.功能失调;出现机能障碍;垮掉; brilliance:n.光辉;才华;宏伟; to be sure:诚然;的确;哎呀(表惊奇);
I'm a physician now, a hospice and palliative medicine doc, so I've seen care from both sides. 我现在是一名医生,安宁病房和临终关怀医生, 所以我从两个角度看医疗系统。
physician:n.[医]医师;内科医师; hospice:n.收容所;旅客招待所;救济院; palliative:n.辩解;缓和剂;暂时姑息的手段;adj.缓和的;掩饰的;可斟酌的;
And believe me: almost everyone who goes into healthcare really means well -- I mean, truly. 相信我:几乎每一个从事医疗的人 都是十分好心的——是真的。
healthcare:n.医疗保健;健康护理,健康服务;卫生保健;
But we who work in it are also unwitting agents for a system that too often does not serve. 但是我们这些从事医疗的人也是 在一个有许多缺陷的系统中工作。
unwitting:adj.不知情的;不知不觉的;v.使精神错乱;使丧失智能;(unwit的现在分词) agents:n.代理人,经纪人;原动力;(agent的复数)
Why? 为什么呢？
Well, there's actually a pretty easy answer to that question, and it explains a lot: because healthcare was designed with diseases , not people, at its center. 其实有一个很简单的答案, 而且也能反映很多事情: 因为医疗系统的设计是针对疾病的,而病人不是焦点,
diseases:n.[医]病(disease的复数);[医]疾病;[植保]病害;疾病种类;
Which is to say, of course, it was badly designed. 也就是说这个设计是有问题的。
And nowhere are the effects of bad design more heartbreaking or the opportunity for good design more compelling than at the end of life, where things are so distilled and concentrated . 而在生命的尽头,不良的设计的影响 更加让人心痛,完善的设计的机会 也显得更有必要, 因为在生命的尽头,所有的东西都是浓缩下来的精华。
nowhere:v.无处; n.无处; adj.不存在的; heartbreaking:adj.令人心碎的;使人悲痛的; compelling:adj.引人入胜的; v.强迫; (compel的现在分词) distilled:adj.由蒸馏得来的;净化的;v.蒸馏(distill的过去式); concentrated:adj.决心要做的; v.集中(注意力); (concentrate的过去式和过去分词)
There are no do-overs . 没有重新来过的机会。
do-overs:回头路;反悔的机会;重做;
My purpose today is to reach out across disciplines and invite design thinking into this big conversation. 我今天的目的就是号召各个领域的人们, 邀请大家把设计思维带入这个大话题中。
disciplines:n.[管理]纪律(discipline的复数); v.训导;
That is, to bring intention and creativity to the experience of dying. 也就是将好意和创意 带入濒死的经历。
intention:n.意图;目的;意向;愈合;
We have a monumental opportunity in front of us, before one of the few universal issues as individuals as well as a civil society: to rethink and redesign how it is we die. 这是一个十分难得的机会, 这是一个会影响到个人,以及整个社会的 普遍问题之一: 重新思考并设计我们如何面对死亡。
monumental:adj.不朽的;纪念碑的;非常的; universal:adj.普遍的;全体的;全世界的;共同的; issues:n.重要议题;争论的问题;v.宣布;公布;发出;(issue的第三人称单数和复数) individuals:n.[经]个人;[生物]个体(individual的复数); as well as:也;和…一样;不但…而且; civil:adj.公民的;民间的;文职的;有礼貌的;根据民法的; rethink:v.重新考虑;再想;n.重新考虑;反思;新想法; redesign:vt.重新设计;n.重新设计;新设计;
So let's begin at the end. 我们从终点开始谈起。
For most people, the scariest thing about death isn't being dead, it's dying, suffering. 对大多数人来说,变成死人并不是死亡最可怕的部分, 最可怕的是垂死,病痛。
It's a key distinction . 这是一个关键的区别。
distinction:n.区别;区分;差别;卓越;
To get underneath this, it can be very helpful to tease out suffering which is necessary as it is, from suffering we can change. 为了更好地领会这一切,那就非常有必要 区分一下死亡无法避免的痛苦 和我们可以改变的痛苦。
underneath:prep.在…的下面;在…的支配下;n.下面;底部;adj.下面的;底层的; tease:v.取笑; n.戏弄;
The former is a natural, essential part of life, part of the deal, and to this we are called to make space, adjust , grow. 前者是一个自然的,生命中必不可少的一部分, 于是我们为自己预留空间,调整,成长。
essential:n.要点;要素;实质;必需品;adj.完全必要的;必不可少的;极其重要的;本质的; adjust:v.调整;调节;适应;习惯;
It can be really good to realize forces larger than ourselves. 能够认识到有比自己更强大的力量是件好事。
They bring proportionality , like a cosmic right-sizing . 这能够带给我们均衡性, 一个全新的自我认识。
proportionality:n.相称;均衡;比例性; cosmic:adj.宇宙的; right-sizing:n.裁员,合理精简;
After my limbs were gone, that loss, for example, became fact, fixed -- necessarily part of my life, and I learned that I could no more reject this fact than reject myself. 在我失去肢体之后, 这个损失变成了一个事实,无法改变—— 这变成了我生活中的一部分, 我认识到抵触这个事实就是在抵触自己。
limbs:n.[解剖]四肢(limb的复数); necessarily:adv.必要地;必定地,必然地; reject:v.排斥;拒收;拒绝接受;不予考虑;n.废品;次品;不合格者;被剔除者;
It took me a while, but I learned it eventually . 过了一段时间,我才最终认识到这一点。
eventually:adv.最后,终于;
Now, another great thing about necessary suffering is that it is the very thing that unites caregiver and care receiver -- human beings. 这种不可避免的痛苦的另一个好处 是它最能够 团结照顾者和被看护者—— 增进人与人之间的关系。
unites:联合;合并; caregiver:n.照料者,护理者;
This, we are finally realizing, is where healing happens. 我们意识到这就是痊愈的开始。
finally:adv.终于;最终;(用于列举)最后;彻底地; healing:n.康复; adj.痊愈中的; v.(使)康复,复原; (heal的现在分词)
Yes, compassion -- literally , as we learned yesterday -- suffering together. 是的,同情——就像我们昨天所学的—— 一起承担。
compassion:n.同情;怜悯; literally:adv.按字面:字面上:确实地:
Now, on the systems side, on the other hand , so much of the suffering is unnecessary, invented. 从另一方面,从医疗系统的角度来看, 有许多痛苦都是没有必要的,制造出来的。
on the other hand:另一方面;
It serves no good purpose. 没有任何意义。
But the good news is, since this brand of suffering is made up, well, we can change it. 但是好消息是:既然这种痛苦是人为造成的, 那我们就可以改变它。
brand:v.铭刻于,铭记;打烙印于;印…商标于;n.商标,牌子;烙印;
How we die is indeed something we can affect. 如何死亡确实是我们可以改变的。
Making the system sensitive to this fundamental distinction between necessary and unnecessary suffering gives us our first of three design cues for the day. 让整个系统辨别不可避免的痛苦 和没有必要的痛苦之间的最基本的区别 给予了我们三个中第一个的设计暗示。
sensitive:adj.敏感的;感觉的;易受影响的;n.敏感的人;有灵异能力的人; fundamental:n.基础; adj.十分重大的; cues:n.开端,线索;提示,关键;球杆;诱因(cue的复数形式);
After all, our role as caregivers , as people who care, is to relieve suffering -- not add to the pile . 毕竟我们作为照顾者的角色, 照顾病人是去减轻他的痛苦,而不是雪上加霜。
caregivers:n.照顾者;看护人(caregiver的复数); relieve:v.减轻;缓解;缓和;接替; pile:n.桩;堆;摞;桩柱;v.堆放;摞起;叠放;放置;
True to the tenets of palliative care, 这是缓和医疗的原则,
tenets:n.原理,原则(tenet的复数);信条;
I function as something of a reflective advocate , as much as prescribing physician. 我的职责就是当一个支持者, 就像一个处方医生一样。
reflective:adj.反射的;反映的;沉思的; advocate:v.拥护;支持;提倡;n.支持者;提倡者;辩护律师;出庭辩护人; prescribing:v.给…开(药);让…采用(疗法);开(处方);命令;(prescribe的现在分词)
Quick aside: palliative care -- a very important field but poorly understood -- while it includes, it is not limited to end of life care. 顺便提一下:缓和医疗——是一个非常重要的工作领域,但是经常被误解—— 它涵盖,但不仅限于病人临终前。
limited:adj.有限的; n.高级快车; v.限制; (limit的过去分词和过去式)
It is not limited to hospice. 不仅限于安宁病房。
It's simply about comfort and living well at any stage. 而是在任何一个阶段都有舒适的生活品质。
So please know that you don't have to be dying anytime soon to benefit from palliative care. 所以不一定是在病人临终前 才能得到安宁缓和医疗。
Now, let me introduce you to Frank . 现在,让我给你们介绍一下弗兰克。
Frank:adj.坦白的,直率的;老实的;n.免费邮寄特权;v.免费邮寄;
Sort of makes this point. 他可以证明这一点。
I've been seeing Frank now for years. 我照顾弗兰克好多年了。
He's living with advancing prostate cancer on top of long-standing HIV . 他患有前列腺癌,外加艾滋病。
prostate:adj.前列腺的;n.[解剖]前列腺; cancer:n.癌症;恶性肿瘤; long-standing:adj.长期存在的;存在已久的; HIV:n.艾滋病病毒;
We work on his bone pain and his fatigue , but most of the time we spend thinking out loud together about his life -- really, about our lives. 我们针对治疗他的骨痛和疲倦问题, 但是我们大多时间都在一起思考他的人生—— 其实,就是我们的人生。
fatigue:n.疲劳;劳累;厌倦;(金属或木材的)疲劳;v.疲劳;使疲乏;(士兵)担任杂役;
In this way, Frank grieves . 弗兰克用这种方法表达他的悲痛。
grieves:v.使悲伤;悲叹;
In this way, he keeps up with his losses as they roll in, so that he's ready to take in the next moment. 他用这种方法面对他所失去的一切, 这样他才能去面对下一个难题。
Loss is one thing, but regret, quite another. 失去是一回事儿,而后悔是另一回事儿。
Frank has always been an adventurer -- he looks like something out of a Norman Rockwell painting -- and no fan of regret. 弗兰克一直是一个探险家—— 他看上去像诺曼·洛克威尔的画里的人物—— 他从不后悔。
adventurer:n.冒险家;投机商人;
So it wasn't surprising when he came into clinic one day, saying he wanted to raft down the Colorado River. 所以我一点都不惊讶有一天他来到诊所, 跟我说他想泛竹筏从科罗拉多河顺流而下。
clinic:n.诊所;临床实习;(医院的)门诊部;门诊时间; raft:n.筏;救生艇;(美)大量;vt.筏运;制成筏;vi.乘筏; Colorado:n.科罗拉多;[城]科罗拉多州;科罗拉多河;
Was this a good idea? 这是一个好主意吗？
With all the risks to his safety and his health, some would say no. 考虑到他的人身安全和健康情况,有些人会说这不行。
Many did, but he went for it, while he still could. 很多人都这么说,但是他依旧去了,趁他还有能力去的时候。
It was a glorious , marvelous trip: freezing water, blistering dry heat, scorpions , snakes, wildlife howling off the flaming walls of the Grand Canyon -- all the glorious side of the world beyond our control. 那是一个美好,奇妙的旅程: 冰凉的水,干热的酷暑,蝎子,蛇, 大峡谷似火的岩壁上各种野生动物的嚎叫—— 都是我们无法控制的世界的壮丽的一面。
glorious:adj.光荣的;辉煌的;极好的; marvelous:adj.了不起的;非凡的;令人惊异的;不平常的; blistering:adj.猛烈的; n.[涂料]起泡; v.起水疱; scorpions:n.蝎子;蝎形弩(scorpion的复数形式); Canyon:n.(周围有悬崖峭壁的)峡谷;(
Frank's decision, while maybe dramatic , is exactly the kind so many of us would make, if we only had the support to figure out what is best for ourselves over time. 弗兰克的决定,或许有些戏剧性, 但是如果我们有我们所需要的支持,去寻找做最有利于自己的选择, 那我们大多数人可能都会做出这样的选择。
dramatic:adj.突然的;巨大的;令人吃惊的;激动人心的;
So much of what we're talking about today is a shift in perspective . 今天聊到的许多都是从不同角度看问题。
shift:n.移动;变化;手段;轮班;v.移动;转变;转换; perspective:n.观点;远景;透视图;adj.透视的;
After my accident, when I went back to college, 在我的事故发生之后,我回到了大学,
I changed my major to art history . 我把我的主修改成了艺术史。
art history:n.艺术史;
Studying visual art, I figured I'd learn something about how to see -- a really potent lesson for a kid who couldn't change so much of what he was seeing. 在学习视觉艺术的过程中,我发现我学会了如何去观察—— 对于一个无法改变过去所见的孩子来说, 那是强有力有的一课。
visual:adj.视觉的,视力的;栩栩如生的; potent:adj.有效的;强有力的,有权势的;有说服力的;
Perspective, that kind of alchemy we humans get to play with, turning anguish into a flower. 观点是一种人们可以改变的炼金术, 可以把煎熬变成花朵。
alchemy:n.点金术;魔力; anguish:n.痛苦;苦恼;v.使极度痛苦;感到极度的痛苦;
Flash forward : now I work at an amazing place in San Francisco called the Zen Hospice Project, where we have a little ritual that helps with this shift in perspective. 往前快进:现在我在旧金山一个很棒的地方工作, 叫做禅宗安宁病房项目。 在那里我们会举行一个小仪式帮助我们换一个角度看问题。
Flash forward:n.提前叙述未来事件(小说,电影等中的); ritual:n.仪式;惯例;礼制;adj.仪式的;例行的;礼节性的;
When one of our residents dies, the mortuary men come, and as we're wheeling the body out through the garden, heading for the gate, we pause. 当我们的一个病人去世后, 太平间的人会来,当我们推他的遗体车穿过花园时, 在大门前,我们会停留片刻。
residents:n.居民;住院医生;房客;(resident的复数) mortuary:n.太平间;停尸间;adj.死的;悲哀的;
Anyone who wants -- fellow residents, family, nurses, volunteers , the hearse drivers too, now -- shares a story or a song or silence, as we sprinkle the body with flower petals . 任何人—— 其他的住客,家人,护士,志愿者, 还有灵车司机—— 如果他们愿意,他们会分享一段故事,一首歌,或者简单的沉默, 同时,我们在遗体上撒花瓣;
volunteers:n.志愿者; v.自愿做; (volunteer的第三人称单数和复数) hearse:n.灵车;棺材; sprinkle:v.撒;洒;把…撒(或洒)在…上;用…点缀;下小雨;n.小雨; petals:n.[植]花瓣;翼瓣(petal的复数形式);v.绽出花瓣(petal的第三人称单数形式);
It takes a few minutes; it's a sweet, simple parting image to usher in grief with warmth, rather than repugnance . 只有几分钟的时间; 这是个很美好,简单的告别场景,用温暖迎接悲痛, 而不是厌恶。
usher:v.引入;引领;引导;把…引往;n.引座员;(法院的)传达员,门卫;男傧相; grief:n.悲痛;忧伤;不幸; repugnance:n.反感;厌恶;不一致,抵触;
Contrast that with the typical experience in the hospital setting, much like this -- floodlit room lined with tubes and beeping machines and blinking lights that don't stop even when the patient's life has. 把这个和普通的医院中的环境对比, 差不多跟这个一样——灯光照明的房间中排满各种管子和嘟嘟叫的机器, 还有不停闪烁的灯光,尽管病人的生命已经停止了。
Contrast:n.对比;对照;反差;明显的差异;v.对比;对照;形成对比; typical:adj.典型的;特有的;象征性的; floodlit:adj.照明的,泛光灯照明的; beeping:v.发出哔哔声;(使汽车喇叭等)发出嘟嘟声;(beep的现在分词) blinking:adv.讨厌,可恶;v.眨眼睛;闪烁;(blink的现在分词)
Cleaning crew swoops in, the body's whisked away, and it all feels as though that person had never really existed. 清理人员立即进来,遗体被快速地接走, 然后就好像那个人从来没有存在过似的。
swoops:vi.猛扑;突然袭击;突然下降;飞扑;n.猛扑;俯冲;突然袭击;vt.攫取;抓去; whisked:v.搅打,搅动;匆匆带走;迅速送走(whisk的过去分词和过去式)
Well-intended, of course, in the name of sterility , but hospitals tend to assault our senses, and the most we might hope for within those walls is numbness -- anesthetic , literally the opposite of aesthetic . 从卫生角度考虑,他们的做法当然有道理, 但是医院很容易侵犯我们的感官, 在那四面墙内,我们最多也只能期盼麻木—— 麻木不仁,字面意思上和美感完全相反。
in the name of:以…的名义; sterility:n.[泌尿]不育;[妇产]不孕;无菌;不毛;内容贫乏; assault:v.袭击;殴打;威胁;非议;(assault的现在分词) numbness:n.麻木;麻痹; anesthetic:adj.麻醉的;感觉缺失的;n.麻醉剂,麻药; aesthetic:adj.美的;美学的;审美的,具有审美趣味的;
I revere hospitals for what they can do; I am alive because of them. 我敬仰医院所做的一切,因为有它们我现在还活着。
revere:vt.敬畏;尊敬;崇敬;
But we ask too much of our hospitals. 但是我们对医院的要求太高了。
They are places for acute trauma and treatable illness. 它们是处理急性创伤和可治疗疾病的地方。
acute:adj.严重的,[医]急性的;敏锐的;激烈的;尖声的; trauma:n.[外科]创伤(由心理创伤造成精神上的异常);外伤; treatable:adj.能治疗的;好对付的;能处理的;
They are no place to live and die; that's not what they were designed for. 它们不是应对生死的地方;它们不是为这个而设计的。
Now mind you -- I am not giving up on the notion that our institutions can become more humane . 提醒一下——我并没有放弃把 我们的医疗机构变得更加人性化的想法。
notion:n.观念;信念;理解; institutions:n.机构;慈善机构;风俗习惯,制度;(institution的复数) humane:adj.仁慈的,人道的;高尚的;
Beauty can be found anywhere. 任何地方都有美好的事物。
I spent a few months in a burn unit at St. Barnabas Hospital in Livingston, New Jersey, where I got really great care at every turn, including good palliative care for my pain. 我在在新泽西州利文斯顿的圣巴纳巴斯医院 烧伤科呆了几个月。 我在那里得到无微不至的照顾, 包括针对我的病痛的缓和治疗。、
And one night, it began to snow outside. 有一天晚上,外面开始下雪。
I remember my nurses complaining about driving through it. 我记得我的护士抱怨在雪天开车。
complaining:adj.抱怨的;v.抱怨;控诉;(complain的现在分词)
And there was no window in my room, but it was great to just imagine it coming down all sticky . 我的房间没有窗户, 但是能想象迷漫的雪花也很好。
sticky:adj.粘的;粘性的;
Next day, one of my nurses smuggled in a snowball for me. 第二天,有一个护士为我偷偷地带进来一个雪球。
smuggled:v.走私;私运;偷运(smuggle的过去分词和过去式)
She brought it in to the unit. 她把雪球带到烧伤中心里面。
I cannot tell you the rapture I felt holding that in my hand, and the coldness dripping onto my burning skin; the miracle of it all, the fascination as I watched it melt and turn into water. 我无法描述我用手捧着雪球那种欣喜若狂的感觉, 一股股寒意滴在我滚烫的皮肤上; 这一切有多么神奇, 我入迷地看着它融化成水。
rapture:n.兴高采烈;vt.使…狂喜; coldness:n.寒冷;冷淡; dripping:adj.湿淋淋的; n.(烤肉时渗出的)油; v.滴下; (drip的现在分词) miracle:n.奇迹,奇迹般的人或物;惊人的事例; fascination:n.魅力;魔力;入迷; melt:v.融化;(使)软化;
In that moment, just being any part of this planet in this universe mattered more to me than whether I lived or died. 在那一刻, 能够属于这个星球上,这个宇宙中任何一个部分对我来说 比我的生与死还要重要。
That little snowball packed all the inspiration I needed to both try to live and be OK if I did not. 那个小小的雪球包含了一切我所需要的鼓舞, 无论我试着活下去,还是接受死亡都可以接受。
In a hospital, that's a stolen moment. 在医院里,那是我珍藏的一段回忆。
In my work over the years, I've known many people who were ready to go, ready to die. 在我多年的工作中,我结交了许多 愿意离开,准备好接受死亡的人。
work over:研究;检查;重做;殴打;
Not because they had found some final peace or transcendence , but because they were so repulsed by what their lives had become -- in a word, cut off, or ugly . 并不是因为他们找到了最终的安乐或者超越, 而是因为他们被他们生命中的转折击退了—— 有一个词,也就是隔绝,丑陋。
transcendence:n.超越;卓越;超然存在; repulsed:v.使厌恶;使反感;击退;打垮(repulse的过去分词和过去式) ugly:adj.丑陋的;邪恶的;令人厌恶的;
There are already record numbers of us living with chronic and terminal illness, and into ever older age. 生活在长期病痛中和患有绝症的人已经是历史新高了, 年龄也不断攀升。
chronic:adj.慢性的;长期的;习惯性的; terminal:n.终端;航站楼;终端机;航空终点站;adj.晚期的;不治的;致命的;患绝症的;
And we are nowhere near ready or prepared for this silver tsunami . 而我们丝毫没有准备好迎接这个银色海啸。
silver:n.银; v.给…镀(或包)银; adj.银色的; tsunami:n.海啸;
We need an infrastructure dynamic enough to handle these seismic shifts in our population. 我们需要一个有足够动力的基础设施去应对 这些人口比例的重大变化。
infrastructure:n.基础设施;公共建设;下部构造; dynamic:n.动力; adj.充满活力的; handle:n.[建]把手;柄;手感;口实;v.处理;操作;运用;买卖;触摸; seismic:adj.地震的;因地震而引起的; shifts:n.转移; v.转移; (shift的第三人称单数)
Now is the time to create something new, something vital . 现在正是时候去创造一个全新的,重要的系统。
vital:adj.至关重要的;生死攸关的;有活力的;
I know we can because we have to. 我知道我们可以成功,因为我们必须要这么做。
The alternative is just unacceptable . 我们没有选择的余地。
alternative:adj.供选择的;选择性的;交替的;n.二中择一;供替代的选择; unacceptable:adj.不能接受(或允许、同意)的;
And the key ingredients are known: policy , education and training, systems, bricks and mortar . 而且,我们已经把握住关键的因素了: 政策,教育和训练, 系统,砖块和砂浆。
ingredients:n.成分;(尤指烹饪)原料;(成功的)要素;(ingredient的复数) policy:n.政策,方针;保险单; mortar:n.迫击炮;臼,研钵;灰浆;vt.用灰泥涂抹,用灰泥结合;
We have tons of input for designers of all stripes to work with. 我们有无数的信息可以供设计师参考搭建。
input:n.投入; v.把(数据等)输入计算机; stripes:n.条子布;条纹布(stripe复数形式);v.给…加条纹(stripe的三单形式);
We know, for example, from research what's most important to people who are closer to death: comfort; feeling unburdened and unburdening to those they love; existential peace; and a sense of wonderment and spirituality . 比如说,从调查研究中,我们可以得知 对于临终的人而言,什么更加重要: 舒适;没有任何负担,也不牵累他们爱的人; 心境平静;充满感叹和灵性的感觉。
unburdened:v.倾诉;诉说;诉苦;给…解除(负担);分忧;(unburden的过去式和过去分词) unburdening:v.倾诉;诉说;诉苦;分忧(unburden的现在分词) existential:adj.存在主义的;有关存在的;存在判断的; wonderment:n.惊奇;惊叹; spirituality:n.灵性;精神性;
Over Zen Hospice's nearly 30 years, we've learned much more from our residents in subtle detail. 在禅宗安宁病房将近30年的历史中, 我们从我们的住客的微妙的细节中学到了很多。
subtle:adj.微妙的;精细的;敏感的;狡猾的;稀薄的;
Little things aren't so little. 有些东西没有它看上去那么小。
Take Janette. 拿珍妮特举例。
She finds it harder to breathe one day to the next due to ALS. 因为她患有渐冻人症,每一天她的呼吸都会变得更加困难。
Well, guess what? 你们猜怎么样？
She wants to start smoking again -- and French cigarettes, if you please. 她又开始想抽烟了—— 还是法国香烟,如果可以的话。
Not out of some self-destructive bent, but to feel her lungs filled while she has them. 并不是因为自我摧残的倾向, 而是想在她还有肺的时候,去感受她的肺被充满的感觉。
self-destructive:adj.自毁的;表现自杀欲望的;
Priorities change. 优先顺序不同了。
Priorities:n.优先事项;优先权;重点;(priority的复数)
Or Kate -- she just wants to know her dog Austin is lying at the foot of her bed, his cold muzzle against her dry skin, instead of more chemotherapy coursing through her veins -- she's done that. 还有凯特——她只想感受着 她的狗狗奥斯丁躺在她的床脚, 他冷冷的鼻子贴着她干燥的皮肤, 而不是让更多的化疗流淌在她的血液中—— 她已经经历过了。
at the foot of:在…(山)脚下;在…的下部; muzzle:n.枪口,炮口;口套,口络;动物的鼻口;vt.使…缄默;给…戴口套;封锁…的言论; chemotherapy:n.[临床]化学疗法; veins:n.[解剖]静脉(vein的复数); v.使有脉络;
Sensuous , aesthetic gratification , where in a moment , in an instant , we are rewarded for just being. 在一刹那间,能够感受到美感的满足 立刻成为我们活着的奖励。
Sensuous:adj.感觉上的,依感观的;诉诸美感的; gratification:n.满意;喜悦;使人满意之事; in a moment:立刻; in an instant:瞬间;马上; rewarded:v.奖励;奖赏;给以报酬;(reward的过去分词和过去式)
So much of it comes down to loving our time by way of the senses, by way of the body -- the very thing doing the living and the dying. 这种感觉在我们珍爱的时间中通过感官和我们的身体—— 也就是正在经历生命和死亡的东西。
by way of:经由;当作;
Probably the most poignant room in the Zen Hospice guest house is our kitchen, which is a little strange when you realize that so many of our residents can eat very little, if anything at all. 也许在禅宗安宁病房中 最凄凉的地方是我们的厨房, 你肯定觉得这有点奇怪, 因为有许多住在病房中的人就算能进食,也只能很少量。
poignant:adj.尖锐的;辛酸的;深刻的;切中要害的; guest house:n.小旅馆;(大房子旁供客人居住的)客房;
But we realize we are providing sustenance on several levels: smell, a symbolic plane. 但是我们意识到这样可以在许多层面上给他们提供支持: 比如嗅觉,一个象征性的平面。
sustenance:n.食物;生计;支持; symbolic:adj.象征的;符号的;使用符号的;
Seriously, with all the heavy-duty stuff happening under our roof, one of the most tried and true interventions we know of, is to bake cookies. 真的,在我们的病房中所有的重大责任中, 其中我们所知的尝试过多次,也是最真切的治疗方法, 是烘焙饼干。
heavy-duty:adj.耐用的;重型的,重负荷的; stuff:n.东西:物品:基本特征:v.填满:装满:标本: interventions:n.[法]干预,干涉;处置(intervention的复数); bake:n.烤; v.焙; (变得)灼热;
As long as we have our senses -- even just one -- we have at least the possibility of accessing what makes us feel human, connected. 只要我们还有感官—— 哪怕只有一个—— 我们至少还有可以接触 人性的感觉,和世界连接。
As long as:conj.只要;长达;如果;既然;
Imagine the ripples of this notion for the millions of people living and dying with dementia . 对于全世界数百万的与痴呆症 生死搏斗的人来说,我们可以想象一下这个观点的效应。
ripples:n.涟漪;波纹(ripple的复数);v.呈波状(ripple的单三形式); dementia:n.[内科]痴呆;
Primal sensorial delights that say the things we don't have words for, impulses that make us stay present -- no need for a past or a future. 最原始的感官上的愉悦是我们无法用语言描述的, 是使我们珍惜当下的冲动—— 不需要回到过去或者展望未来。
Primal:adj.原始的; n.被压抑童年情绪的释放; vt.释放(被压抑的童年情绪); sensorial:adj.知觉的;感觉的; delights:n.高兴; v.使高兴; (delight的第三人称单数和复数) have words:争吵; impulses:n.[心理]冲动; v.推动(impulse的第三人称单数);
So, if teasing unnecessary suffering out of the system was our first design cue, then tending to dignity by way of the senses, by way of the body -- the aesthetic realm -- is design cue number two. 如果把不必要的痛苦从系统中剔除是我们的第一个设计提示的话, 那么给予人们感官上的, 身体上的尊严——美感的境界—— 则是我们的第二个设计提示。
teasing:adj.开玩笑的;n.取笑;挑逗;v.取笑;戏弄;招惹;(tease的现在分词) dignity:n.尊严;高贵; realm:n.领域,范围;王国;
Now this gets us quickly to the third and final bit for today; namely , we need to lift our sights, to set our sights on well-being , so that life and health and healthcare can become about making life more wonderful, rather than just less horrible . 这也把我们带到今天第三个和最后一个部分; 也就是,我们需要提高眼界,把重点放在人们的福祉上, 为的是生命,健康和医疗 可以使生活变得更加美好, 而不只是少几分可怕。
namely:adv.也就是;即是;换句话说; well-being:n.幸福;康乐; horrible:可怕的,极讨厌的,
Beneficence . 慈善。
Beneficence:n.慈善;善行;捐款;
Here, this gets right at the distinction between a disease-centered and a patient- or human-centered model of care, and here is where caring becomes a creative , generative , even playful act. 区别就在这儿, 在一个以疾病为核心和一个以人为核心的医疗模式之间, 在这儿,医疗变成了一种有创意、生产力, 甚至好玩的举动。
creative:adj.创造性的; generative:adj.生殖的;生产的;有生殖力的;有生产力的; playful:adj.开玩笑的;幽默的;爱嬉戏的;
'"Play" may sound like a funny word here. “玩”在这里是一个很有趣的词。
But it is also one of our highest forms of adaptation . 但它也是我们适应的最高境界之一。
adaptation:n.适应;改编;改编本,改写本;
Consider every major compulsory effort it takes to be human. 想一想人类每一个不可缺少的需求。
compulsory:adj.义务的;必修的;被强制的;n.(花样滑冰、竞技体操等的)规定动作;
The need for food has birthed cuisine . 我们对食物的需求带来了烹饪。
cuisine:n.烹饪,烹调法;
The need for shelter has given rise to architecture . 我们对遮风避雨的需求构成了建筑。
architecture:n.建筑学;建筑风格;建筑式样;架构;
The need for cover, fashion. 我们对遮蔽身体的需求促成了时尚。
And for being subjected to the clock, well, we invented music. 而因为我们要服从于时间, 我们发明了音乐。
So, since dying is a necessary part of life, what might we create with this fact? 那么,既然死亡也是生命中必不可少的一部分, 我们又能创造出什么呢？
By "play" I am in no way suggesting we take a light approach to dying or that we mandate any particular way of dying. 说到“玩”,我决不是在提议我们轻视死亡 或者指定某种特定的死亡方式。
in no way:决不; approach:n.方法;路径;v.接近;建议;着手处理; mandate:n.授权;命令,指令;委托管理;受命进行的工作;vt.授权;托管;
There are mountains of sorrow that cannot move, and one way or another, we will all kneel there. 有许多悲伤是我们无法消除的, 无论如何,我们都会屈服于它的。
kneel:v.跪;跪着;跪下;
Rather, I am asking that we make space -- physical , psychic room, to allow life to play itself all the way out -- so that rather than just getting out of the way, aging and dying can become a process of crescendo through to the end. 我只是希望大家可以创造一点空间—— 生理和心理上的空间,让生命自己走完它的路—— 而不是把它赶走, 衰老和临终可以变成一个渐强的过程一直到结尾。
physical:adj.[物]物理的;身体的;物质的;符合自然法则的;n.体格检查; psychic:adj.精神的;心灵的;灵魂的;超自然的;n.灵媒;巫师; process:v.处理;加工;列队行进;n.过程,进行;方法,adj.经过特殊加工(或处理)的; crescendo:n.声音渐增;adv.渐次加强地;adj.渐强的;vi.音量逐渐增强;
We can't solve for death. 我们无法避免死亡。
I know some of you are working on this. 我知道你们有些人在尝试。
(Laughter) （笑声）
Meanwhile , we can -- 在此同时,我们可以——
Meanwhile:adv.同时,其间;n.其间,其时;
(Laughter) （笑声）
We can design towards it. 我们可以针对死亡做设计。
Parts of me died early on, and that's something we can all say one way or another. 我的一部分很早以前就已经死了, 不管怎么说,事实就是这样。
I got to redesign my life around this fact, and I tell you it has been a liberation to realize you can always find a shock of beauty or meaning in what life you have left, like that snowball lasting for a perfect moment, all the while melting away. 但是我针对这个事实重新设计了我的人生, 当你意识到你在生命中 永远可以找到美好的事物和有意义的事情时, 我可以告诉你们这是一种解放。 就像那个停留在完美的一瞬间的雪球, 同时一直在融化。
liberation:n.释放,解放; melting:adj.感人的;v.(使)熔化,融化;(melt的现在分词)
If we love such moments ferociously , then maybe we can learn to live well -- not in spite of death, but because of it. 如果我们能够拼尽全力去爱那些片刻, 也许我们就能学会如何活得更加精彩—— 不是不顾死亡而活得精彩, 而是因为死亡而活得精彩。
ferociously:adv.残忍地;野蛮地;凶猛地; in spite of:尽管;不管,不顾;
Let death be what takes us, not lack of imagination . 可以让死亡夺走我们的生命, 但别让它带走我们的想象力。
imagination:n.想象;想象力;创造力;想象的事物;
Thank you. 谢谢
(Applause) （掌声）