超级人类
数千年来，我们想驯服大自然 For thousands of years we've tried to tame nature
试图控制驱策生命的力量 to control the forces that drive life itself
我们建造了强力的机器 we've built machines of great power
和保护我们免受伤害的屏障 and created barriers to protect us from the elements
我们因而改变了世界 and in doing so we've transformed the world
我们今日几乎能去 任何想去的地方 Today we can go almost anywhere we want,
我们以惊人的速度发现新事物 and we're making new discoveries at a breathtaking rate
我们在工程与建设上的成就 Already our accomplishments in engineering and construction
已早凌驾祖父母辈所能想像 have gone way beyond what our grandparents could ever have imagined
有时候 我们似乎能创造任何事情 Sometimes it seems we can create anything
但是地球上最惊人的工程 But the most stunning piece of engineering on the planet
是遗传而来，而非经由制造 is something we've inherited, not something that we've made
相对于所有的改变 And in contrast to all the changes that have occurred,
几千年来 it's one thing that in the last few thousand years,
它完全没有变化 hasn't really changed at all
它就是我们的身体 It's our very own human body
本系列节目将带我们 重新发现身体 In this series, we'll rediscover the body
它未经诉说的治疗再生力 - its untold powers to heal and renew
我们将认识潘妮 we'll meet Penny
这家庭录影带 保有她最后一次走路 whose last steps were captured on this home Video
她的降落伞失灵 她以时速120英里重跌地面 when her parachute failed, she hit the ground at 120 mph
她跌断脊椎 Her spine was severed
但在4年后的今天 她开始恢复部分感觉 but now after four years, she's started to regain some feeling
医学上无法解释 Medically, there is no explanation
为何意外发生后5年 才出现这情形 why this should start happening five years after my accident
我们将介绍 研究组织再生的医师 we'll show you how doctors studying tissue regeneration
如何观察蝾螈的再生能力 follow nature's example in the salamander, whose severed limb will re-grow
但若不可能重新生长 新的移植技术帮得上忙 But when re-growth isn't possible, new transplanting techniques can help
霍蓝 是全世界第一个手臂移植者 Clint Hallam had the world's first arm transplant
我第一次看到我的手 觉得这太神奇了 My first thoughts when l- when I saw my hand was that it was a miracle
我们跟随他 与陌生手臂的挣扎过程 we join him as he struggles with his new, unfamiliar limb
不行 No, no, no
以及与接受首创手术的人 做亲密访谈 we take intimate journeys with people having pioneering operations
听听身体里有别人器官的感觉 Hear how it feels to have another person's body part in your own
我后半生都会为那个人祈祷 I'll probably pray for that person for the rest of my life
我觉得好像必须杀别人 自己才能活 I feel like I'm putting a gun- and I'm gonna shoot somebody just so I can live
我们将发现 面对风险时的非凡勇气 we'll discover the extraordinary courage involved in facing risks
如果这样继续下去 If it goes in, and it does happen,
他会能听得见但不能微笑 he's gonna be able to hear but he's not gonna be able to smile
我们将看到感染扩散过程 we'll watch infection as it spreads
以及身体发展出来的防御机制 and discover the defences the body has evolved to fight back
我们将认识 接受新癌症疗法的病患 we'll meet people trying new cancer treatments,
包括帮助身体 自行对付癌病毒的疗法 including one designed to help the body fight its own battle
我看了磁振造影扫瞄 结果让人兴奋 I've just seen the MRI scan and I have to say it's very exciting
最后我将介绍我的领域 And finally I want to show you what's happening in my own area:
生殖医学的最新动态 许多研究令人兴奋 Reproductive medicine, where some of the most exciting research is going on,
但也同时进入 人类从未曾碰触的地方 but where we are also taking nature into strange uncharted territories
我们在学习人体天生的力量 Here, too, we are learning how to tap into the innate powers that our bodies possess
多亏了这些对我们自己的认识 Thanks to all that we're learning about ourselves,
因而发生了值得注意的事情 something remarkable is happening
人类史上第一次 For the first time in history,
我们不再只能 对身体自愈力感到惊奇 we're able to do more than just wonder at the body's ability to heal itself
我们还能改变 增进自然的力量 - we can actually change that ability and improve on nature itself,
于此同时，我们也开始了解到 and in doing so we're beginning to understand
人体的超人之处 just how superhuman the body really is
第01集 创伤医疗
最能显现出人体的超人之处 Nowhere is the superhuman nature of the body
莫过于外伤医疗： 对受伤的治疗 more starkly revealed than in trauma medicine: The treatment of injury
那一晚的事我全不记得 I don't remember anything that night
我发现我的左手脱落 I realised my arm- my left arm had almost fallen off
只剩皮与身体相连 and was hanging there by the skin
他们必须止血 我内出血 They had to stop the bleeding - I was bleeding internally
因为脾脏裂开，所以必须切除 - they had to remove my spleen 'cause it had ruptured in the accident
有人问我撑得了吗 不可能 Somebody asked - would I make it? And it was - no way
全球最大的大众健康议题是 受伤，外伤 The number one public health issue in the world is injury, is trauma
出事地点是 西园旁的西南高路，收到 on the scene on the South west Freeway at west Park, acknowledge
全世界每一天 Every day, all over the world,
都有数千人因外伤送急诊 thousands of people will be rushed to hospital as a result of trauma
外伤颇有趣 Trauma is kind of interesting:
全世界每个人都怕得癌症 Everybody in the world is scared to death of having a cancer,
随意看看周围 看很多人吃的东西 and I would make a point of the fact that if you look around the room
就知道这些人该担心 a lot of folks ought to be scared of having a heart attack or a stroke,
会得心脏病或中风 you can tell what they're eating
大家更害怕会得爱滋病 People are hysterical about getting AIDS,
但却没有人害怕受伤 but nobody thinks they're gonna get hurt
外伤远胜于 心脏病，中风，癌症三者相加 Trauma outstrips heart disease, stroke and cancer combined
这小男孩出了车祸 This little boy has been in a traffic accident
这是4岁的狄米区 OK, this is four-year-old Dmitry
他在西哥伦比亚骑脚踏车 He was down there in west Columbia riding his bicycle,
被时速25英里的汽车撞倒 when he was struck by a motor vehicle travelling around 25 miles per hour
他们会照顾你 狄米区，你的狮子在这里 They're gonna look after you, Dmitry, there's your lion, buddy
狄米区，我们要对你做很多事 Dmitry, we're gonna be doing a lot of things to you
帮你拍照 we're gonna be taking some pictures
你要躺着不能动 - it's real important that you lie still while we do it,
好吗？ 我们要把你移下来 OK? Then we'll get you off this board...
急诊室里的外伤小组 面临无数的问题 In an emergency room, trauma teams are faced with endless questions
狄米区，还不会开始 Dmitry, Dmitry, that's not gonna happen yet, Buddy
可能有骨折或内出血 Bones may be broken, there may be internal bleeding
这里呢 what about right here?
他抱怨前面痛 He was complaining about pain in the? Area
他的感觉功能颇正常 His sensation's pretty much intact
在X光和超音波等科技协助下 with the help of technology like X-ray and ultrasound
将可发现并处理每个潜在问题 最好还能将之去除 each potential problem can be discovered, addressed or, hopefully, ruled out
我要找妈妈 I want my mum
她一到，我们就会带她来找你 As soon as she gets here, we're gonna get here right at your side, OK?
我要她来接我 Yeah, I want?
你要她来接你？ You want?
狄米区很幸运 意外没带来严重后果 Fortunately for Dmitry, he survived his trauma without serious consequences
但是外伤是个严重问题 而且不会突然消失 But trauma is a massive problem, and it won't just go away
我们这个国家 在否认一项失控的流行病 we are a nation in denial of an epidemic that's running wild
但是否认不会有任何帮助， And denial ain't a river in Egypt!
外伤的最大杀手是汽车 And the biggest killer In this epidemic of trauma is the car
造成44岁以下的 最大死因是撞车 The Number One cause of death for people under the age of 44 is car crashes
我们很难想像 车祸中强大的减速力 It's hard to imagine the massive deceleration forces of a car crash
那么这个呢？ So how about this?
这么强的撞击力 很难想像人能逃过车祸一劫 With collisions like these, it's amazing any of us survive car crashes at all
在撞击时那一刹那 In the fraction of a second during impact
地心引力的作用 the huge G-forces involved
能使 人体重量增加到60倍之多 can mean that the human body weight can multiply up to 60 times
这辆车的驾驶迎头撞上巴士 And these same huge deceleration forces are
便感受到相同的减速力量 what the driver of this car experienced when he crashed headlong into a bus
全世界 每年有数百万人因车祸受伤 Every year, millions of people around the world are injured in car crashes
夏普在探望姐姐后 Michael Sharp had been driving home from seeing his sister
回家路上与巴士相撞 when his car collided with a bus
我不记得那晚任何事情 I don't remember anything that night
我不知道他怎么走出车外 I don't know how he walked out of that car...
但我很高兴他那样做 I don't know But I'm glad he did
他说他没有背痛 He says he's got no back pain No back pain
当夏普被移出撞烂的车时 他的情况很糟 when Michael was removed from his wrecked car, he was in a bad way
他随即出现外伤休克典型症状 He soon began to show classic symptoms of traumatic shock
他意识模糊，带攻击性 He's confused and aggressive
不，别动.别那样 No, stay stay stay stay, No, don't do it, don't do it, Stay there, stay there
他瞳孔扩张，开始出汗 His pupils dilate, and he starts to sweat
他血压升高，心跳加速 His blood pressure rises and his heart beats faster
他的血管接着会开始收缩 Soon his veins start to constrict
将血液从皮肤转流到重要器官 and redirect the flow of blood away from his skin to his vital organs
他的呼吸变得快速急促 His breathing becomes fast and short as his lungs
因为他的肺部需要大量氧气 work to capture as much oxygen as possible
大批白血球动员到受伤的区域 Armies of white blood cells are mobilised to the site of injury
这是人体处理伤害的标准过程 This is the body's standard way of coping with its injuries
外伤小组 也在执行他们的标准程序 The trauma team are also going through their standard response
三项称为ABC的急救程序 - they're following three life-saving principles known as the ABCs
A代表气道，他们检查 夏普的气道，确定畅通 Firstly, 'A', they check Michael's airways making sure
不然他就无法呼吸，也就是B they're clear without which 'B' for breathing wouldn't be possible
如果不能呼吸 And if you can't breathe
就不能让生命赖以维持的氧气 进入体内 you can't get life-sustaining oxygen into the body,
那么C，也就是循环 and without that there would be no oxygen for the circulation,
就不能带氧气到全身 'C', to carry around the body
大脑特别敏感 短暂时间没有氧气都不行 The brain in particular is very sensitive to even a short while without oxygen
只要3分钟 就可能造成永久性大脑伤害 within as little as three minutes, you could suffer permanent brain damage
夏普到医院后开始发作 when they got Michael into hospital he started to fit
这令人苦恼 但是头部遭重击经常有此情形 It's distressing but quite common after a severe blow to the head
帮我稳定他的脖子 OK, somebody stabilise his neck for me please
他说胸腔和颈部不会疼痛 He says he's got no pain in his chest or neck
我不知道自己是否该觉得幸运 I don't know if I'm supposed to feel lucky or anything, I just- y'know,
因为它发生得很快 我一点也不记得 because it happened so quickly and I don't remember anything about it,
所以我没有发生过事情的感觉 it doesn't feel like anything really happened
我现在对生命的看法完全不同 I look at life totally different now
给我看你的左脚 Show me your left foot
以前我认为理所当然的 Things that I used to take for granted before,
现在会付出关心 I mean I actually concentrate on it now
我一直都爱科林，我大儿子 No, I mean always loved Corin: Corin's my big boy,
但我现在给他更多注意力 but I am more focussed on Corin now
左脚 Left foot, see that left foot...
我很幸运还在 I'm lucky to be here
治疗严重受伤患者 不只是与时间赛跑 Treating a seriously injured patient is not just a race against the clock
有血，但看不到明显伤口 There's blood there, can't see an obvious laceration...
叫麻醉科 Call Anaesthesia
他有大血肿 He's got a big haemotoma,
很难摸出下面是否有骨头 it's hard to feel if there's a bony thing under there or not...
每一个面临外伤病患的医生 都需做出明确决定 Every doctor, faced with a trauma victim, has to make precise decisions,
而且每个决定都可能带来后果 and each one of them can have consequences
那是第二个，这是第一个 ...that was the second, this is the first...
叫麻醉科，他的呼吸很怪 Yeah, let's get anaesthesia, this is awfully weird breathing...
所以医师们 必须随时准备改变计划 So doctors have to be ready to vary their game-plan
荷西，麻醉先等一下 Jose. Hold on anaesthesia for a second
拿staple remover来，把他翻身 Get a staple remover - roll him back and get a staple remover
不知道是什么，翻回去 It's like a? Don't know what that is - roll him back
外面没东西 ...there's nothing on the outside...
外伤医疗正经历革命性的改变 And trauma medicine is going through some quite revolutionary changes:
这是因为我们对人体在受伤后 Changes driven by our increased understanding of the ways
保护自己的能力 the human body tries to preserve itself after injury
有了进一步的了解 身体最想保存的就是血液 And the thing the body tries to preserve above almost everything else is blood
一滴血包含约5百万个红血球 One drop of blood contains about five million red blood cells
红血球约占全部血液的一半 Red blood cells make up just under half the total volume of blood,
主要功能是将氧气 从肺部带到身体其他地方 and their main function is to carry oxygen from the lungs to the rest of the body
我们每天制造 2兆个新的红血球 we produce two hundred billion new red cells every day,
而每24个小时，体内的血液 and in twenty four hours the blood in our bodies travels
便走了1万9千公里 等于绕行美国四次 a total of 19,000 kilometres: That's four times across the USA
我们将这珍贵的液体 视为理所当然 we tend to take this precious liquid for granted
人体能应付大量失血 Our bodies cope pretty well with large blood losses,
但我们没有无限制的血液供给 but we don't have an unlimited supply
惊人的是在没有外出血下 what's surprising is how much can be lost in an accident
一场意外也能失去大量的血 without there being any external bleeding
譬如你脚断了 If you broke your leg for example,
你可能失去 1/3到大腿的血液供给 you could lose a third of your blood supply into your thigh
这种内出血 可导致血压大幅下降 These sorts of internal injuries can lead to a massive fall in blood pressure,
而标准医疗反应一直以 and the standard medical response has always been to try
迅速更换体液来尝试补救 and correct it by replacing the blood fluid as fast as possible
但标准医疗反应有可能是错的 But standard medical responses can be wrong
战争给了我们最好的教训 And nowhere has this lesson been better learned than in war
(1969年 越南)
好，100米 OK. One zero zero metres...
好，把他带回来，别忘了止血 OK, bring him back, bring him back here Remember to stop the bleeding
越战场上的伤极为恐怖 Injuries in the Vietnam war were horrendous,
但特别的是 医疗救护抵达的速度 but what was unique was the speed at which medical help arrived:
直升机能在数分钟内找到伤者 Helicopters were able to reach the injured within minutes
当时标准的治疗 是替换失血 At that time, the standard treatment was to replace lost blood
及尽速提高血压 and to raise the blood pressure as quickly as possible
伤兵还没离开地面前 就已被灌入血液或其他流体 Blood or other fluids were poured in before soldiers even got off the ground
许多伤者后来死亡 Many of the injured went on to die
医生们开始怀疑这种治疗 可能造成的伤害比帮助多 Doctors have begun to wonder if sometimes this treatment did more harm than good
我确定这世纪中 I am sure that a number of these people this century
很多人是因为治疗而死 have actually probably been killed by their treatment
有人提出 特别是有 Someone's come up - particularly in wars like Vietnam
就近医疗的越战 插管， where they had medical support in close - put lines up,
提高血压，穿刺不止 raised their blood pressure, didn't stop the tap,
我相信那反而让伤者再流血 and I'm sure they've made them re-bleed
身体应付流血是形成血凝块 The way the body responds to bleeding is by forming a clot
血小板冲向伤口 Platelets in the blood rush to the injury site
由纤维蛋白凝聚在一起 and are cemented together by fibrin
刚开始的血凝块很脆弱 Initially, the clot is quite delicate and easily blown
血压一变就容易被打碎 apart by a change in blood pressure
血凝块是个水坝，堵住血流 A blood clot is a dam: It plugs the flow of blood
血压低 血凝块承受的力量就低 If the blood pressure is low, there's less for the clot to hold back
但若提高血压 水坝就会决堤 But increase the pressure, and the dam could burst,
造成危险 and that could be disastrous
这就是越战 很多军人遇到的情形 And that's exactly what happened to many of the soldiers in Vietnam
他们突然被送上直升机 Suddenly, They're pulled into a helicopter
被插管血压提高 造成再度流血 lines are put in, blood pressure's driven up - they bleed
大自然建了 这个要照顾我们的机制 I think Mother Nature's built in a mechanism to take care of us
没有几千年之久 也有几世纪之久 - it's centuries-old, if not millenia-old
我们该小心，不要设计出 破坏这机制的疗法 - we've got to be damn careful that any treatment we devise does not upset that
吉姆莱恩曾是 福克兰战役的外科医生 Jim Ryan was a surgeon in the Falklands,
该役的医疗情况很不同 where medical circumstances were very different
(1982年 福克兰群岛)
与越战不同 夜间作战及恶劣天气 Unlike Vietnam, night battles and bad weather meant
使得直升机救护任务 变得不可能 quick helicopter recovery was impossible
伤兵常需独处数个钟头 Injured soldiers were often left alone for hours,
给了大自然有机会工作 and Mother Nature was given a chance to work
1982年 葛大卫隶属伞兵第二营队 In 1982, David Gray was in the 2nd Battalion of the Parachute Regiment
当时他才18岁 He was just eighteen years old
他在古斯葛蓝 遭受可怕的迫击炮轰炸 when he suffered appalling injuries in a mortar attackat Goose Green
我们打过了山脊 we broke the brow of the hill,
所以后面有部队 so of course you had your rear echelon at the back,
前线弟兄进入古斯葛蓝 your front-line blokes going into Goose Green
所以受伤的人下山坡 and then everybody that was injured on that slope going down,
没有掩护 were exposed
还被狙击攻击 - and under sniper fire as well
我回头找中枪的汤尼 I went back for Tony Tye who'd been shot
他右臂被枪打中 - he had a gunshot wound in his right arm,
然后我被迫击炮打中 And then I got hit by a mortar round
砰地一声 Thud
我不知道怎么形容 I can't describe what it was like
我心想，好险，转个身 I thought: That was very close
低头看才发现我右脚不见了 I rolled over and when I looked down I realised that me right foot had gone
我大概躺了3到4小时 I was probably laying there for three to four hours
才有注射 before I actually was administered with any fluids
整段时间我都在流血 And I was losing blood all the time I was doing it
有人问我 when somebody asked:
撑得过吗 不可能 Would I make it? It was: No way
没人认为 和大卫一样重伤的军人会存活 Soldiers with injuries as bad as David's were not expected to survive,
但许多人活了下来 yet many of them did
我们很震惊，又高兴又震惊 we were shocked - pleased and shocked to see
看到他们被严重截肢 多重伤害 people still alive having waited six, eight,
在等了6，8，10小时后还活着 ten hours with dramatic amputations, multiple injuries -
很多人应该死，但有些人没死 many of them should have died, but some of them didn't
吉姆莱恩相信 在治疗前长久的等待 Jim Ryan believes that the long wait before fluids
可能就是这些人得救的原因 were administered may actually have saved these men's lives
他们可能倒下，安静躺卧 虽然大量流血 They probably fell down, lay very quiet, they will have bled out significantly,
但还不致丧命 but not to the point of death
他们形成很好的血凝块 They'd clot- they'd form a good clot,
没有人注射提高血压 no one gives them fluids to raise their blood pressure
他们坚持着 and they- they just hang in there
重伤但是能撑住 血压低，脉搏快 really quite ill but hanging in there, low blood pressure, high pulse
呼吸快，觉得冷 但安静躺着休息 breathing rapidly, getting cold, but lying quietly and resting
由于这样的观察 As a result of observations like this,
给予伤患流体的方式受到质疑 the routine giving of fluids to all trauma victims is being questioned
现在急救人员 在提高血压前会观察，等待 Paramedics now watch and wait before trying to raise blood pressure
福克兰战役还有另一项特点： 天寒 But there was another vital factor at work in the Falklands: The cold
我最记得的是冷 手指和脸都僵硬 The cold I can remember probably more than anything: Numbness, fingers, face...
极度寒冷 Profoundly cold.
我们以前没有低温温度计 Y'know, un- we didn't have really low-reading thermometers,
那儿的温度在温度计之下 but these were off the values of the thermometers that we had
绝对低于华氏30度 - certainly below 30
看起来和尸体一样 Almost looking like corpses
寒冷非但没造成严重伤害 But rather than doing any serious harm,
吉姆莱恩认为 寒冷可能有助生存 Jim Ryan feels the cold may actually have helped survival
我认为在这个情况 I think in this situation -
相信很多人同意我的说法 and many people would agree with me
低体温，程度轻微的体温过低 - hypothermia, a mild degree of hypothermia,
具正面保护作用 is positively protective
低温让整个系统变慢 I think it just slows the whole thing down
战争显示出 what war has revealed
有时候寒冷可以救人命 about the human body is that sometimes cold can be a life-saver
这个知识 现在被用来拯救意外伤患 And this knowledge is now being used to save accident victims
一个寒冷的11月天 On a freezing November day,
凯特自马上摔落 Kate Close was thrown from her horse
急救人员2个小时后才抵达 Paramedics didn't reach her for nearly two hours,
当时的她已非常冰冷 by which time she was extremely cold
最主要的考量 是她严重的头部外伤 The main concern was her massive head injury,
她被紧急送到皇家伦敦医院 and she was rushed to the Royal London Hospital
主治医生威尔森 也十分担心她的头伤 Her doctor, Alastair wilson, was also extremely worried about her head injury
他吩咐做紧急电脑断层扫瞄 而结果十分骇人 He ordered an urgent CT scan and the results were horrific
嗳呀，老天， Oh, crikey, O'Reilly!
看看那些空气 Look at that, look at all that air as well
因为她的伤势非常严重 In view of the fairly gross nature of her injuries,
当时我觉得她的存活率 只有5% I felt that probably her survival chances where in the region of perhaps 5%,
我没抱太大希望 so I wasn't being very hopeful at that stage
接着威尔森做了个特殊决定 Alastair wilson then made an extraordinary decision:
他决定不要为她取暖 He decided not to warm her up
她的体温很低 Her temperature was very low
刚开始在34度以下 - it was just- initially I think just under 34 degrees,
我们认为就一方面来说是好事 and then we felt well, this is probably a good thing on the one hand
因为低温 会降低大脑的氧需求量 because it's going to reduce the oxygen requirements of the brain,
比较不容易变成缺氧状态 which means that it's less likely to become hypoxic:
大脑会对自己造成伤害 To get into a state where it's doing damage to itself
当凯特落马，大脑受伤时 when Kate fell off her horse and injured her brain,
开启了一个危险的连锁反应 it set off a dangerous chain reaction
脑细胞受伤可能引起 有害化学物质的释放 Any injury to brain cells can trigger the release of destructive chemicals
如果不被阻止，这些化学物质 将引起未受伤的细胞死亡 If they're not stopped, these chemicals cause other uninjured brain cells to die
虽然我们不确知原因为何 Although we don't know precisely why,
但我们知道将大脑降温几度 we do know that cooling the brain
就能停止伤害扩散 by just a few degrees can stop further widespread damage happening
还是冰冷的凯特被送进手术房 Still cold, Kate was rushed to surgery,
移除她脑中的血块 where the blood clot that had formed on her brain was removed
惊人的是，她的大脑没有受伤 Amazingly, she suffered no brain damage
我一直很讨厌冷 I've always, always hated the cold
但现在我知道了 But now I've been told that as a result of hypothermia,
体温低帮助我活命 that's one of the things that helped to save me
我还是不喜欢感觉冷 I still don't like feeling cold, I must admit
我不喜欢冷 但这个情况 I don't like the cold, but on this occasion,
老天，冷帮了我很多忙 my goodness me! It did me a lot of favour, it really, really did
体温低的好处 Research into the benefits of being cold
是现在外伤医疗的研究尖端 is now at the cutting edge of trauma medicine
外伤不只是战争和车祸 Trauma isn't just war and car crashes
它也可能是来到这世界的 第一刻：被出生 - it can be part of our first moments in this world: Being born
对许多人来说 出生是一生中最危险的经历 For many of us, being born is the most dangerous event we'll ever experience
滑下产道距离虽然不长 但可能非常惊险 The journey down the birth canal may be short but it can be very hazardous
罗司沃克在出生时极度缺氧 During his delivery, Ross walker was starved of oxygen
存活且没有大脑伤害的可能性 非常之小 The chance of surviving without severe brain damage was extremely low
我第一个注意到的是他很安静 The first thing that struck me was the fact that he was quiet,
他没有什么动作 and there was no particular movement from him
心跳应该是每分钟140-145下 The heart-rate should have been around 140-145 beats per minute,
但他只有80下 and he'd gone down to about 80 beats per minute
他第二次痉挛时 Once he had fitted for the second time,
医院才发现问题更严重 they realised that there was something worse than what they first thought
他们告诉我们 They told us
他严重大脑伤害的机率是94% that it was 94% chance that he could have severe brain damage
缺氧已经开始 他脑中的化学反应 Lack of oxygen had begun the chemical chain reaction in his brain,
现在他的脑细胞已经开始死亡 and now some of his brain cells were starting to die off
罗司被送进 伦敦的汉默斯密医院 Ross was rushed to the Hammersmith Hospital in London
尝试非常不同的疗法 where they were trying a radically different treatment
要避免大脑伤害 像罗司这样的婴儿被降温 To prevent brain damage, babies like Ross were cooled down
他在一个没有底也没有盖子的 圆形装置物 He was in a like a paddling pool without the bottom or the top,
他在中间，有冷气吹向他 and he was in the centre and the cold air was blowing across him
让他的体温降2度 So that was cooling him down by two degrees below the body temperature
他摸起来很冷也干 And he was cold to touch, and dry as well,
那是很奇怪的事情 and, yeah, it seemed an odd thing to do
因为自然反应是抱他让他暖 And your natural reaction is to cuddle them and keep them warm-
把他包起来 对，包住他 wrap him up- That's right, wrap him up,
医院解释过 so once they'd explained
为何那样做的原因后 why the reasons why they thought that would help,
我们知道那可能是最好的方法 well obviously we knew it was probably for the best
所以只好压住那些感觉 and y'know had to cope with those sort of feelings
先等待，之后再好好抱他 until we could give him a proper cuddle later on
我觉得无助 I felt helpless,
因为什么都不能做 'cause I couldn't do anything,
不能抱他，什么都帮不了 I couldn't hold him, I couldn't do anything to help him
当罗司刚到医院时 when he first arrived at the Hammersmith,
他的脑波等于是零 Ross's brain-wave output was virtually zero
随着他变得越来越冷 As he became cooler and cooler,
他的父母只能等待 his parents simply had to wait to see what might happen
我们坐在床边 we just sat by the bedside,
等着脑波机器 didn't we, just watching and willing this machine
显示动作 to show us some brain waves that were showing signs of activity
分秒时日的过去 As the hours- minutes, hours and days
我们看到脑波开始有动作 went by we could see the brain waves picking up,
我们看到有光芒，有了目标 we could see that there was a light coming on and we had something to aim for
接下来的2年内 持续的脑部扫瞄显示 Over the following two years, successive brain scans revealed that
罗司发育成正常健康的幼儿 Ross was developing into a normal, healthy toddler
他是很开心的小孩 He's a very happy boy,
很活泼，跳来跳去，喜欢玩 he's very lively, he's jumping around and he enjoys playing
他很好玩 He's good fun
没有那治疗 我不知道罗司会变成怎样 I don't know what kind of boy Ross would have been without this treatment
他就像个正常的2岁小孩 He's right where he should be for a normal two year old
这最好吃，对不对？ It's the best bit, isn't it?
也许他是自己好起来的 We could say that he may have got better on his own- of his own accord,
但是在心里面我觉得 but at the end of the day I feel that in our heart of hearts
要是没有那治疗 that we can say that without the treatment
他可能就会是大脑严重受伤 that he would have been severely brain-damaged
虽然这听来很怪 但冷的确能对你有好处 Although it does seem rather odd, being cold can actually be good for you
医生们现在尝试各种情境 Doctors are now trying it in a variety of circumstances,
从心脏病到头部外伤 from heart attacks to head injuries
身体在经历外伤后会自然变冷 After trauma, the body can become cold naturally
事实上，冷却是我们 称为休克的最后阶段 In fact, cooling is often the end-point of the process we call shock
人在休克时的怪反应 And the often strange ways people behave when they're in shock
可追溯到我们的演化起源 can be traced back to our evolutionary origins
就我们的身体来说 As far as our bodies are concerned,
我们还只是挣扎存活的动物而已 we're still just animals fighting for survival,
试图逃脱 寻找安全藏匿的处所 struggling to escape and find a safe place to hide
这叫做抗争不了就脱逃 It's called 'Fight or Flight'
身体充满了肾上腺素 The body is flooded with adrenaline
肾上腺素使心跳加快 Adrenaline makes the heart beat faster;
肺部更用力工作 The lungs work harder;
身体在呐喊：逃，逃， The body is shouting: Escape! Escape!
这也就是为何 患者通常会抗拒救护者的原因 It's why victims often struggle with people trying to save them
别这样，凯特，不要打了 You can't, Kate, don't fight now Don't fight now...
同时间，大脑释放出 At the same time, the brain releases a surge
止痛贺尔蒙：脑内啡 of pain-killing hormones: Endorphines
脑内啡的作用之强 These are so powerful
让你的肢体被炸断了 你还没感觉 that you can have a limb blown off and feel nothing
我从腰部以下完全没感觉 I'd literally gone numb from the waist downwards
已经过了疼痛的极限 You'd just gone through your pain barrier
但是不久之后，这些贺尔蒙的 作用力开始消失 After a while, however, the effects of these hormones start to wear off
心跳渐缓，血压降低 The heart slows down, blood pressure drops
血块开始形成 Clots form
血液抽离，只存留在重要器官 Blood drains away from all but the most essential organs
身体冷却 开始自我修复的漫长过程 The body cools and starts the long process of self-repair
与身体和谐运作的概念 一点都不新 The idea of trying to work in harmony with the body is hardly a new one
这里是希腊的科斯岛 This is the Greek island of Kos
这里曾经是医学之父 希波克拉底的故乡 It was once home to the ancient world's most famous doctor, Hippocrates
希波克拉底教导他的学生 Hippocrates taught his followers that it was vital to observe
观察倾听身体想说什么 至关重要 and listen to what the body was trying to say
这听来或许没什么 但现代医学即是从此开始 It may not look much, but this is where modern medicine really began
2千5百年前 Two and a half thousand years ago,
这些废墟即是早期的医院 these ruins form one of the earliest kind of hospital
不是那种我们熟悉的医院 It wasn't the sort that you and I might recognise perhaps:
这儿没有麻醉药，没有抗生素 There were no anaesthetics, no antibiotics,
也没有任何 受过高度专业训练的医生 nor any doctors with highly specialised training, It was more a temple for healing
这儿比较像是一座心灵庙堂 A place where pilgrims could simply come to rest
朝觐者来此安宁孤绝之处修养 in these peaceful and isolated surroundings
在洛杉矶 让身体自行痊愈的观念 In Los Angeles, this idea of leaving the body to heal itself
发展到连 希波克拉底也无法想像的极端 has been taken to an extreme even Hippocrates could never have imagined
1999年7月6号上午11点 11 am, July 6th 1999.
洛杉矶市区一家工厂爆炸 A factory in downtown L.A. Exploded
在此担架上的男子 吉摩严重受伤 The man on this stretcher Kiomo Vasques suffered horrendous injuries
他被送到洛城郡医院 and was rushed to L.A. County Hospital
当他抵达急诊室时 when he arrived in the emergency room,
医生认为他的存活率很低 doctors had little hope that he would survive:
吉摩脖子折断，头壳裂伤 腹部大量出血 Kiomo had a broken neck, a fractured skull and a huge bleed into his abdomen
这么多的严重伤口 with so many terrible injuries, his surgeon,
使得主治医师狄梅崔 必须做非常勇敢的决定 Dr. Demetriades, had to make a very brave decision
因为病患伤势的严重性 Because of the severity of the patient,
我们在几分钟内决定 we decided within a matter of minutes
采用一种非传统的作法 that we should follow a different approach, an unconventional approach,
所谓的伤害控制程序 the so-called 'Damage Control Procedure' Damage Control Procedure
多重伤害下的身体 处于非常脆弱的状况 After multiple injury, the body is in an incredibly fragile state
伤害控制法明白 病患随时可能丧命 Damage control recognises that in this state it takes very little to kill the patient
人体有其特定的生理储备 The human body has certain physiological reserves
如果生理储备耗竭了 If the physiological reserves become exhausted
超过它极限时 就是病患生命的结束 and it tips over the cliff, this is the end of patient's life
于是他们做了最少的动作 来让病患存活 So they did the bare minimum necessary to keep their patient alive
先不顾其它的伤口 Ignoring his other injuries,
医生将他的肝脏缝合缠上纱布 they glued his liver together and packed it with gauze
接着，并不是将他的肚子缝合 And then, instead of sewing him back together,
医生以塑胶布盖住他的内脏 they covered his guts with plastic and left him,
希望他能自行痊愈 in the hope that he would heal himself
吉摩被留在加护病房 稳定3天 Kiomo was left to stabilise for three days in intensive care
然后狄梅崔医师 才开始进一步的手术 Only then did Dr. Demetriades attempt to perform further surgery
医生移除外层塑胶套 They removed the outer plastic cover
结果令人安心 他的肝脏在复原 To their relief, his liver was now healing
而且内出血也停止 and his internal bleeding had stopped
肠子看来很健康，好消息 The bowel looks nice... and healthy: It's good news.
检查完肠子是否有受伤后 After checking his bowel for further injuries,
医师以猪肠做的特殊薄膜 they reconstructed his abdominal wall with a special membrane
重建他的腹壁 made out of pig's intestines
最后再将他缝合 And then, at last, they sewed him up
他的存活率 His chances of survival-
你问世界上任何医生 you can ask any surgeon anywhere in the world
都会说几乎是零 will tell you they are near zero
我确定 如果没有这个伤害控制程序 I am certain that without this Damage Control Procedure
他在第一次手术时 就会死在手术台上 he would have died on the table in the operating room during the first operation
我们有了越来越多经验后发现 The more and more experience we get, you realise that
有时候你做的少 反而会对病人比较好 the less you do the better will be for the patient, sometimes
吉摩在经历这些后 But after everything that has happened to Kiomo,
会使他致命的很可能是 接下来在加护病房的这几周 it is the next few weeks in intensive care that could well kill him
这里是加护病房区 This is the Intensive Care Unit,
1百个护士只照顾13个病人 where it takes around a hundred nurses to look after just thirteen people
这是因为每一个病人 都给予生命维持机器 That's because every patient is given life-support:
帮助病患呼吸，喂食及排泄 Machines breathe for them, feed them and remove waste products
每个重要器官 都能全天候仔细监控 Every vital organ can be carefully monitored around the clock
每个人都在等康复迹象 what everyone is hoping for is any sign of recovery
而医师们明白 他们需要注意其他迹象 But the staff know that they need to look out for something else
20%死于外伤的病患 20% of patients who die from injuries
是受伤后2到3周 die in the intensive care unit
死在加护病房里 approximately two to three weeks after their injury
就在你认为病人好转时 Just when you think they're getting better,
肝脏和肾脏开始衰竭 organs like the liver and kidneys start to fail
病人死亡是因为 身体有时候对外伤过度反应 They die because sometimes the body over-reacts to trauma
这叫做多重器官衰竭 It's called Multiple Organ Failure
彼得和珍妮佛原本应该会如此 And it's what should have happened to Peter Blaud and Jennifer Vaughn,
他们两人都有严重的多重伤害 both of whom suffered horrific multiple injuries
我的车是驾驶座门被撞 My car was hit on the driver's side door...
然后冲向马路对面的栅栏 which was then pushed... into a fence on the opposite side of the road
我脊椎下半部大量出血 I was bleeding to death from the lower base of my spine
医生切除我的脾脏 因为车祸时撞裂 They had to remove my spleen, 'cause it had ruptured in the accident,
我的肝脏也有裂伤 my liver also had a tear in it,
我的骨盆有6处裂伤 and my pelvic bone was broken in six places
她因车祸受到大范围重伤 She had severe extensive injuries from a motor vehicle crash
评估时发现 and at the time of evaluation,
她的脾脏和肝脏都受伤流血 she had intra-abdominal injuries to her spleen and liver that were both bleeding,
她的骨盆严重裂伤 she had a severe injury to her pelvis with fractures
她的双肺也因胸腔重击而出血 and she had bleeding into both of her lungs from hitting her chest during the crash
彼得也因机车撞车而伤势严重 Peter Blaud also suffered massive injuries during a motor-bike crash
我骑摩托车转弯 I was riding my street-bike going round a corner,
抬头一看 看到一辆车停在路中间 and as I looked up I saw a vehicle sitting right in the middle of the road
我一只手腕断了几个地方 I had a broken wrist in a couple of spots,
锁骨断裂，前后都是 broken collar-bone, both front and back,
断了10根肋骨 ten broken ribs...
几根肋骨刺到我的肺部 Couple of those ribs actually punctured my lung...
底端肋骨刺破我的肺部 The bottom rib severed my lung...
脾脏在撞击时裂开，撞伤肾脏 I ruptured my spleen upon impact, I bruised my kidneys...
我发现左手臂 I realised my arm- my left arm
只剩皮肤和身体相连 had almost fallen off and was hanging there by the skin
他的伤势严重到 His injuries were so extensive that his probability of
存活率可说在10%以下 surviving was probably less than 10%
珍妮佛和彼得这样的多重伤口 在车祸中很常见 Multiple injuries like Jennifer's and Peter's are common in car accidents,
因为车祸时 because in a car accident, several different
有数种撞击同时发生 collisions happen at the same time
金属撞击金属 Metal crashes into metal
器官撞上骨骼或被移位 Organs crash into skeletons, or get ripped from their moorings
皮肉绽开 Flesh is pierced and punctured
人体就是还没演化到 能应付如此剧烈的伤害 The human body just hasn't evolved to cope with injuries as dreadful as these
野生动物受伤到 无法自我修复的只有一死 In the wild, animals who are injured beyond the point of self-repair simply die
没有医疗设施让它们活命 There are no medical systems to keep them alive
死亡只是自然循环的一部份 Death is part of the natural order of things
但是我们当然就不同了 But we, of course, are different
基本上就是原本活不了的 These patients basically are surviving injuries that
伤患逃过一劫 evolution did not plan on them surviving
科技进步表示我们能让人活着 Technology means we now keep people alive,
即使伤势早已超过 even when their injuries are well beyond the normal limits
身体能痊愈的正常限度 of the body's ability to heal itself
由机器维持生命 身体当然会混淆不清 Kept alive by machines, the body is understandably in a state of confusion,
于是以过度补偿回应 and it responds by over-compensating
重伤引起身体 Severe injuries trigger the release of huge numbers of white cells,
释出大量中性白血球 called Nutrofils into the blood
它们的工作是消灭细菌 但也可能令人致命 Their job is to kill bacteria, but they can end up killing you
就像颠峰期的车辆 为了回应受伤 It's like cars in the rush hour: In response to injury,
数百万个中性白血球 全都同时要赶去上工 millions of Nutrofils all trying to get to work at the same time
它们同时前往受伤部位 They're all heading in the same direction towards the injury site
要消灭入侵的细菌 where they're trying to kill any invading bacteria
但是这庞大数量可能导致悲剧 But sheer weight of numbers can lead to disaster
麻烦的是严重外伤时 The trouble is when there's been really serious trauma,
会出现太多白血球 you get too many of them,
然后它们全都黏在一起 这是它们的本性 and then they all stick together, which is what they're designed to do,
然后就会出现塞车 最后就全面拥塞停滞 and then a jam starts and in the end you get gridlock
白血球拥塞会阻碍正常血流 A gridlock of nutrofils will eventually block normal blood flow
没有了血 氧气就不能传输到重要器官 without blood, the oxygen supply to vital organs is cut off
于是器官便--关闭死亡 One by one they shut down and die
应该是救命的血球 到后来造成致命 And the very cells which should be saving life actually end it
有点像每下愈况 It's kind of an insidious process
情况会随时间越来越恶化 that tends to get worse and worse over time, can affect
身体任何器官系统都会受影响 any organ system of the body,
每种器官系统--受到影响 and in general kind of goes from one organ system to the other, you know,
身体像个精密协调的机制 the body works as a very fine-tuned mechanism
当这很复杂的机制 and when part of that over-
有部分系统失衡时 that very complex mechanism gets out of balance
就会导致其他系统的失衡 it leads to imbalance in the other systems
当彼得和珍妮佛抵达医院时 when Peter Blaud and Jennifer Vaughn arrrived at hospital,
梅尔医师预测 这二人将在加护病房久住 Dr. Maier anticipated both would have a long stay in the ICU
并可能发展出多重器官衰竭 and develop multiple organ failure
虽然我们一开始能让她稳定 Even though we were able to stabilise her initially,
她出现多重器官衰竭 her risk of developing multiple organ failure and
或因此而死的机率非常地高 even having a high risk of dying from multiple organ failure was significant
为避免这种情况的发生 To try to prevent this happening,
珍妮佛与彼得服用一种 Jennifer and Peter were rapidly
叫路可瑞思的实验药物 given an experimental drug called Lucarest
有点像魔鬼沾 一面是小钩 Kind of like Velcro: There's little hooks on one side
另一面是毛绒状 and the fuzzy stuff on the other side,
白血球会因此黏合 and the white blood cell will - will stick as a result of this
再加上抗生素 And a number of antibodies
亦即路可瑞思 - which is what Lucarest is
会黏住白血球 - have been developed that bind to these adhesion molecules,
有点像是进一步包住魔鬼沾 让它不会再黏下去 it's kind of like coating the Velcro so that it doesn't stick any more
使用抗生素能避免白血球黏合 By using these anti-bodies, we can prevent the white blood cell from sticking,
白血球不黏合 and as a result of preventing it from sticking
就不会造成伤害 can prevent it from causing injury
白血球不黏合 血液就能自由流动 If they don't stick, free-flow of blood is possible,
氧气就能抵达重要器官 so oxygen can reach vital organs,
理论上就能避免多重器官衰竭 and in theory multiple organ failure can be avoided
不管是不是这药物的作用 whether or not it was thanks to the drug,
彼得与珍妮佛都有惊人的复原 both Peter and Jennifer made extraordinary rapid recoveries
虽然我们无法证明是药的功劳 Although we cannot prove definitely that the drug is what did it,
但复原情况良好 it was a remarkable recovery
其他也服用这个药的病患 也有相同成效 and we've seen this in other patients that have received the drug also
意外后才2个月 珍妮佛已返回工作岗位 Just two months after her accident, Jennifer was back at work
我对人生的看法 有了很大的改变 It changed my outlook on life a lot,
我对人生，对人，朋友 都有了不同看法 You know, it taught me a lot about life, and about people and about friends
该好好把握人生 因为生命无常 and just to enjoy it while you're here, 'cause so quickly you can lose it
生命中的机会 The opportunity and chances
有时候很快就会消失 that we get sometimes are taken away from us really quickly,
所以该好好掌握人生 努力过活 and so you need to take advantage of life and live it to your fullest
伤害控制手术后3个月 Three months after his damage control surgery,
吉摩离开加护病房 不再有危险 Kiomo was out of intensive care and out of danger
早安，吉摩，你好 Good morning, Kiomo, how are you?
你还好吗？ 还好 Are you all right? Si
告诉他他会恢复健康 Tell him that he'll recover- well, he'll be stronger than before
Gracias
谢谢 I also want him
我还要他 Once a year, at Christmas, during Christmas-time,
每年写圣诞卡 给我报告近况 to send me a card and tell me how he is doing
古代希腊人 首先强调 The ancient Greeks were the first to really emphasise
聆听身体的重要性 有趣的是 the importance of listening to the body, and in a funny sort of way,
人类在 几世纪取得科技的大进步后 after centuries of making huge technological strides,
我们又回到最早的起点 we've managed to come full circle
现代医学正经历一场革命 Modern medicine is undergoing a revolution
这场革命回归到 But it's a revolution that harks back to the ideas
这座庙建立人的理念 of the people that built this temple
我们在学习，探索我们的力量 we're now learning that as well as exploiting our strengths,
我们将能与我们的身体合作 克服身体的弱点 we can work with our body to overcome its weaknesses