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

TED英语演讲稿：让我们来谈谈死亡

WhileIgivethistalk,inthenext10minutes,ahundredmillionofmycellswilldie,andoverthecourseoftoday,2,000ofmybraincellswilldieandnevereback,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,andwestartedusingexpressionslikelifesaving.Ireallyapologizetoeverybodyfordoingthat,becauseobviously,wedont.Whatwedoisprolongpeopleslives,anddelaydeath,andredirectdeath,butwecant,strictlyspeaking,savelivesonanysortofpermanentbasis.

AndwhatsreallyhappenedovertheperiodoftimethatIvebeenworkinginintensivecareisthatthepeoplewhoseliveswestartedsavingbackinthe70s,80s,and90s,arenowingtodieinthe21stcenturyofdiseasesthatwenolongerhavetheanswerstoinquitethewaywedidthen.

TED英语演讲稿：让我们来谈谈死亡

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,treatmentsoroutesfromanyofthesetsofnotesinitiatedbyadoctororbyapatient.

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.Theonesyoumayknowmostaboutaretheonesthatarebeingincreasinglyofhistoricalinterest:suddendeath.Itsquitelikelyinanaudiencethissizethiswonthappentoanybodyhere.Suddendeathhasbeeveryrare.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,andthefearLike,ifyouactuallylook,theresonewomantherewhohashereyesopen.Shestheoneheslookingat,and[shes]theonehesingfor.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,particularlyaswebeeolderandincreasinglyfrailandICUhaslessandlessandlesstoofferus.Therehastobealittlesideroadoffthereforpeoplewhodontwanttogoonthattrack.AndIhaveonesmallidea,andonebigideaaboutwhatcouldhappen.

Andthisisthesmallidea.Thesmallideais,letsallofusengagemorewiththisinthewaythatJasonhasillustrated.Whycantwehavethesekindsofconversationswithourowneldersandpeoplewhomightbeapproachingthis?Thereareacoupleofthingsyoucando.Oneofthemis,youcan,justaskthissimplequestion.Thisquestionneverfails.Intheeventthatyoubecametoosicktospeakforyourself,whowouldyouliketospeakforyou?Thatsareallyimportantquestiontoaskpeople,becausegivingpeoplethecontroloverwhothatisproducesanamazingoute.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,IlikePeace,Love,NaturalDeathasanoption.Idothinkwehavetogetpoliticalan