Latif Nasser: The amazing story of the man who gave us modern pain relief

翻译人员: lin quan 校对人员: Hayley Kang

A few years ago,

几年前，

my mom developed rheumatoid arthritis.

我母亲得了类风湿性关节炎。

Her wrists, knees and toes swelled up, causing crippling, chronic pain.

她肿起的手腕，膝盖，和脚趾 让她长久以来痛苦不堪。

She had to file for disability.

她不得不去申请残障证。

She stopped attending our local mosque.

她不再去我们当地的清真寺参加活动。

Some mornings it was too painful for her to brush her teeth.

有些早晨她甚至疼得无法刷牙。

I wanted to help.

我想帮助她，

But I didn't know how.

但却感到束手无策。

I'm not a doctor.

我并不是医生。

So, what I am is a historian of medicine.

我只是一个医药历史学者。

So I started to research the history of chronic pain.

于是我开始研究慢性疼痛的历史。

Turns out, UCLA has an entire history of pain collection

我发现加州大学洛杉矶分校的档案里 收藏了关于疼痛的

完整历史记录。

in their archives.

And I found a story -- a fantastic story --

从中我找到了一则奇妙的故事——

of a man who saved -- rescued -- millions of people from pain;

关于一个男人如何将数百万人 从疼痛中拯救出来的故事；

people like my mom.

那些和我母亲一样的人。

Yet, I had never heard of him.

然而，我从来没有听说过他。

There were no biographies of him, no Hollywood movies.

没有关于他的传记， 或好莱坞电影。

His name was John J. Bonica.

他名叫约翰 J. 博尼卡，

But when our story begins,

不过在这个故事刚开始的时候，

he was better known as Johnny "Bull" Walker.

他常常被人称作约翰尼 “斗牛士” 沃克。

It was a summer day in 1941.

那是1941年的一个夏日。

The circus had just arrived in the tiny town of Brookfield, New York.

一个马戏团刚刚来到 纽约的布鲁克菲尔德镇上。

Spectators flocked to see the wire-walkers, the tramp clowns --

观众蜂拥而至来看走钢丝表演和小丑——

if they were lucky, the human cannonball.

如果运气够好，还能看到人体炮弹。

They also came to see the strongman, Johnny "Bull" Walker,

他们还想见见大力士 约翰尼 “斗牛士” 沃克，

a brawny bully who'd pin you for a dollar.

只花1块钱，就可以跟他一较高下。

You know, on that particular day, a voice rang out

可在那一天，马戏团的广播中

over the circus P.A. system.

传来了一个声音。

They needed a doctor urgently, in the live animal tent.

他们在动物蓬急需一名医生。

Something had gone wrong with the lion tamer.

驯兽师出事了。

The climax of his act had gone wrong,

他在表演进行到最精彩的时候 发生了意外，

and his head was stuck inside the lion's mouth.

他的头卡在了狮子嘴里。

He was running out of air;

他快要窒息了；

the crowd watched in horror

观众惊恐地看着他。

as he struggled and then passed out.

他挣扎了一阵，昏了过去。

When the lion finally did relax its jaws,

当狮子终于张开嘴巴的时候，

the lion tamer just slumped to the ground, motionless.

驯兽师瘫倒在地上，一动不动。

When he came to a few minutes later,

几分钟后，当他醒来，

he saw a familiar figure hunched over him.

他看到了一张熟悉的面孔。

It was Bull Walker.

那是“斗牛士“沃克。

The strongman had given the lion tamer mouth-to-mouth, and saved his life.

这位大力士通过人工呼吸 挽救了驯兽师的生命。

Now, the strongman hadn't told anyone,

大力士从没有跟任何人提起过，

but he was actually a third-year medical student.

他其实是医学院的三年级学生。

He toured with the circus during summers to pay tuition,

他通过暑假跟着马戏团巡游来 赚钱付学费，

but kept it a secret to protect his persona.

却为了维护角色形象而绝口不提此事。

He was supposed to be a brute, a villain --

他想让大家认为自己是 一位土霸，恶棍——

not a nerdy do-gooder.

而不是勤奋好学的书呆子。

His medical colleagues didn't know his secret, either.

他在医学院的同事也不知道他的秘密。

As he put it, "If you were an athlete, you were a dumb dodo."

正如他所说，“如果你是个运动员， 理所应当就是个笨蛋。”

So he didn't tell them about the circus,

因此他没有透露任何关于马戏团，

or about how he wrestled professionally on evenings and weekends.

以及在傍晚和周末参加职业摔跤的事情。

He used a pseudonym like Bull Walker,

他用艺名“斗牛士”沃克，

or later, the Masked Marvel.

后来还用过“蒙面奇侠”。

He even kept it a secret that same year,

即便在他得到

when he was crowned the Light Heavyweight Champion

世界摔跤轻重量级冠军的那一年，

of the world.

他仍然保守着这个秘密。

Over the years, John J. Bonica lived these parallel lives.

约翰 J 博尼卡过了数年这样的双面生活。

He was a wrestler;

他是摔跤手；

he was a doctor.

也是医生。

He was a heel;

他是混蛋，

he was a hero.

也是英雄。

He inflicted pain,

他给别人带来痛苦，

and he treated it.

也能治疗疼痛。

And he didn’t know it at the time, but over the next five decades,

他当时还不知道， 在未来的五十年里，

he'd draw on these dueling identities

他会利用这两个不同的角色

to forge a whole new way to think about pain.

来创造一个对待疼痛的全新观念。

It'd change modern medicine so much so, that decades later,

这种观念将为现代医学带来巨大的改变,

Time magazine would call him pain relief's founding father.

多年后，时代杂志会称其为“止痛之父”。

But that all happened later.

但那都是后话了。

In 1942, Bonica graduated medical school and married Emma,

1942年，博尼卡从医学院毕业， 迎娶了艾玛,

his sweetheart, whom he had met at one of his matches years before.

他们几年前在他的一场比赛中相识。

He still wrestled in secret -- he had to.

他仍然偷偷地从事职业摔跤—— 他别无选择。

His internship at New York's St. Vincent's Hospital paid nothing.

因为他在纽约圣文森特医院 实习期间没有任何收入。

With his championship belt, he wrestled in big-ticket venues,

带着他的冠军金腰带， 他不断参加大型的摔跤比赛，

like Madison Square Garden,

像在麦迪逊广场花园，

against big-time opponents,

面对的都是大牌对手，

like Everett "The Blonde Bear" Marshall,

比如埃弗里特 “金发熊” 马歇尔，

or three-time world champion, Angelo Savoldi.

或是荣获三次世界冠军的 安杰洛 萨沃尔迪。

The matches took a toll on his body;

摔跤比赛严重地影响了他的身体状况；

he tore hip joints, fractured ribs.

他损伤过腰关节，断过肋骨。

One night, The Terrible Turk's big toe scratched a scar like Capone's

一天晚上，“凶悍土耳其人” 的大脚指 在他脸上划出了一道

down the side of his face.

像卡彭（美国著名罪犯，绰号“疤面”） 一样的伤疤。

The next morning at work, he had to wear a surgical mask to hide it.

第二天早晨去上班时， 他只能带着医用口罩来遮掩伤势。

Twice Bonica showed up to the O.R. with one eye so bruised,

有两次，博尼卡出现在护士室的时候， 一只眼睛是青肿的，

he couldn't see out of it.

完全看不见东西。

But worst of all were his mangled cauliflower ears.

然而最糟糕的还是他那破损的菜花耳。

He said they felt like two baseballs on the sides of his head.

他说感觉就像头旁边挂了两个棒球。

Pain just kept accumulating in his life.

生活中的疼痛始终有增无减。

Next, he watched his wife go into labor at his hospital.

接着，他看着老婆在自己的医院分娩。

She heaved and pushed, clearly in anguish.

她挣扎着，明显承受着巨大的痛苦。

Her obstetrician called out to the intern on duty

产科医生叫来了值班的实习生，

to give her a few drops of ether to ease her pain.

要给她几滴醚来缓解疼痛。

But the intern was a young guy, just three weeks on the job --

但那位实习生很年轻， 才实习了三个星期——

he was jittery, and in applying the ether,

他战战兢兢地进行麻醉时，

irritated Emma's throat.

不小心刺激到了艾玛的喉咙。

She vomited and choked, and started to turn blue.

她开始呕吐，呼吸困难， 面色开始发青。

Bonica, who was watching all this, pushed the intern out of the way,

在一旁看着的博尼卡把实习生推开，

cleared her airway,

清理了她的呼吸道，

and saved his wife and his unborn daughter.

拯救了自己的妻子和未出生女儿的命。

At that moment, he decided to devote his life to anesthesiology.

从那一刻起，他决定致力于麻醉科。

Later, he'd even go on to help develop the epidural, for delivering mothers.

后来，他甚至为帮助分娩的母亲 而发明了硬膜外麻醉术。

But before he could focus on obstetrics,

但在他可以完全转行妇产科之前，

博尼卡必须完成他的基本培训。

Bonica had to report for basic training.

Right around D-Day,

在诺曼底登陆日前后，

Bonica showed up to Madigan Army Medical Center,

博尼卡出现在了塔科马附近的

near Tacoma.

马迪根陆军医疗中心。

At 7,700 beds, it was one of the largest army hospitals in America.

那是美国最大的军事医院之一， 有7700张病床。

Bonica was in charge of all pain control there.

那里所有的止痛工作都由博尼卡负责。

He was only 27.

他当时只有二十七岁。

Treating so many patients, Bonica started noticing cases

接触过大量病人以后， 博尼卡开始注意到，

that contradicted everything he had learned.

一些案例完全有悖于之前所学的知识。

Pain was supposed to be a kind of alarm bell -- in a good way --

疼痛本应该是一种有益的警钟，

a body's way of signaling an injury, like a broken arm.

是身体在受伤的情况下发出信号的 一种方式，例如骨折的时候。

But in some cases,

但在某些案例里，

like after a patient had a leg amputated,

比如一个病人刚做了腿部截肢后，

that patient might still complain of pain in that nonexistent leg.

可能还会感觉到 本不该存在的腿部疼痛。

But if the injury had been treated, why would the alarm bell keep ringing?

如果伤口已经被处理过了， 怎么还会警钟长鸣呢？

There were other cases in which there was no evidence of an injury whatsoever,

有些案例里没有任何受伤的迹象，

但是，这些病人仍然很痛苦。

and yet, still the patient hurt.

Bonica tracked down all the specialists at his hospital -- surgeons,

博尼卡跟踪观察了医院里的所有医生 ——外科医生，

neurologists, psychiatrists, others.

神经科医生，精神病医生，等等。

And he tried to get their opinions on his patients.

他想问一下这些医生对他的病人的看法。

It took too long, so he started organizing group meetings over lunch.

为了节省时间， 他开始在午餐时间组织会议。

It would be like a tag team of specialists going up against the patient's pain.

其间很多专业人士会一起讨论 病人的疼痛症状。

No one had ever focused on pain this way before.

之前从来没有人如此重视过疼痛。

After that, he hit the books.

在这之后，他开始查阅资料。

He read every medical textbook he could get his hands on,

他读了所有能拿到的医学资料，

carefully noting every mention of the word "pain."

仔细标记了所有提到“疼痛”二字的地方。

Out of the 14,000 pages he read,

在他读过的14000页内容中，

the word "pain" was on 17 and a half of them.

“疼痛”只在十七页半中出现。

Seventeen and a half.

十七页半。

For the most basic, most common, most frustrating part of being a patient.

这是作为一个病人最基本，最常见， 却也最令人无奈的地方。

Bonica was shocked -- I'm quoting him,

博尼卡被震惊了—— 他的原话是这么说的，

他说，“就这点信息， 你能得出什么结论呢？

he said, "What the hell kind of conclusion can you come to there?

The most important thing from the patient's perspective,

在病人眼中最重要的事情，

they don't talk about."

他们（医生）从来不在乎。“

So over the next eight years, Bonica would talk about it.

在接下来的八年里， 博尼卡对此重视起来。

He'd write about it; he'd write those missing pages.

他写了关于疼痛的书； 他要补全那些缺失的内容。

He wrote what would later be known as the Bible of Pain.

他写了后来被人誉为“疼痛圣经”的书。

In it he proposed new strategies,

在书中他提出的了新的方法，

用神经抑制注射来缓解疼痛。

new treatments using nerve-block injections.

He proposed a new institution, the Pain Clinic,

他提倡建立一个新的机构， “疼痛诊所”，

based on those lunchtime meetings.

这个想法来源于之前的午餐会议。

But the most important thing about his book

但是关于这本书最重要的事情是，

was that it was kind of an emotional alarm bell for medicine.

它是一个医学警钟。

A desperate plea to doctors to take pain seriously

一个希望医生能够更加关注 病人疼痛症状的

in patients' lives.

迫切意愿。

He recast the very purpose of medicine.

他重新定义了医学的宗旨。

The goal wasn't to make patients better;

目标并不仅仅是让病人康复，

it was to make patients feel better.

而是减少病人在这个过程中遭受的痛苦。

He pushed his pain agenda for decades,

他几十年来一直在 推行自己的疼痛计划，

before it finally took hold in the mid-'70s.

直到70年代中期。

Hundreds of pain clinics sprung up all over the world.

那时候，已有几百家疼痛诊所 在世界各地开放。

But as they did -- a tragic twist.

但是，一个悲伤的转折出现了，

Bonica's years of wrestling caught up to him.

博尼卡数年摔跤生涯的 后果显露出来了。

He had been out of the ring for over 20 years,

他已经20多年不摔跤了，

but those 1,500 professional bouts had left a mark on his body.

但1500名职业摔交手还是在他身上 留下了难以磨灭印记。

Still in his mid-50s, he suffered severe osteoarthritis.

50多岁的时候， 他就备受骨关节炎的折磨。

Over the next 20 years he'd have 22 surgeries,

在接下来的20多年里， 他经历了22个手术，

including four spine operations,

包括4个脊椎手术，

and hip replacement after hip replacement.

一次又一次的髋骨替换。

He could barely raise his arm, turn his neck.

他几乎不能抬起手臂或者转头。

He needed aluminum crutches to walk.

他需要铝支架来帮助他行走。

His friends and former students became his doctors.

他的朋友和校友成了他的医生。

One recalled that he probably had more nerve-block injections

一个医生说，他也许经历过 比这个星球上任何其他人

than anyone else on the planet.

都要多的神经抑制注射。

Already a workaholic, he worked even more --

他已经是一个工作狂了， 却还要变本加厉——

15- to 18-hour days.

每天工作15-18个小时。

Healing others became more than just his job,

治愈别人对他来说不仅仅是工作，

it was his own most effective form of relief.

对他自己来说也是一种解脱。

"If I wasn't as busy as I am," he told a reporter at the time,

他曾跟一位记者这么说， “如果我没有这么忙，

"I would be a completely disabled guy."

我可能早就是个残废了。”

On a business trip to Florida in the early 1980s,

1980年初，在去弗罗里达出差的路上，

Bonica got a former student to drive him to the Hyde Park area in Tampa.

博尼卡让一位校友把他 送到坦帕的海德公园。

They drove past palm trees and pulled up to an old mansion,

他们穿过许多棕榈树， 在一所老别墅前停下，

with giant silver howitzer cannons hidden in the garage.

车库里藏着巨大的银色榴弹加农炮。

The house belonged to the Zacchini family,

这房子属于萨奇尼家族，

who were something like American circus royalty.

一个类似美国皇家马戏团的家族。

Decades earlier, Bonica had watched them,

几十年前，博尼卡曾见过他们

clad in silver jumpsuits and goggles,

穿着银色的表演服和护目镜，

doing the act they pioneered -- the Human Cannonball.

进行着他们的拿手表演：人肉炮弹。

But now they were like him: retired.

但是他们现在跟他一样：退休了。

That generation is all dead now, including Bonica,

那一代人已经逝去了，包括博尼卡，

so there's no way to know exactly what they said that day.

所以没有人知道当时他们说了些什么。

But still, I love imagining it.

但是我依然忍不住要去想象。

The strongman and the human cannonballs reunited,

“大力士”和“人肉炮弹”重聚了，

showing off old scars, and new ones.

展示彼此的旧伤新疤。

Maybe Bonica gave them medical advice.

也许博尼卡会给他们医疗建议。

Maybe he told them what he later said in an oral history,

也许他会把之后在口述历史中的 内容告诉他们，

which is that his time in the circus and wrestling deeply molded his life.

那段在马戏团摔跤的时光 造就了他现在的人生。

Bonica saw pain close up.

博尼卡近距离接触过疼痛。

He felt it. He lived it.

感受着伴随着他一生的疼痛。

And it made it impossible for him to ignore in others.

而这使他无法无视别人的痛苦。

Out of that empathy, he spun a whole new field,

出于那种同情， 他推动了一个新的领域，

played a major role in getting medicine to acknowledge pain

为研制针对缓解疼痛的药物

in and of itself.

做出了巨大贡献。

In that same oral history,

在同一段口述历史中，

Bonica claimed that pain

博尼卡认为，疼痛

is the most complex human experience.

是人类最复杂的经历。

That it involves your past life, your current life,

它包含了你过去的生活， 你现在的生活，

your interactions, your family.

你的社会关系，你的家人。

That was definitely true for Bonica.

这一点对博尼卡而言毋庸置疑。

But it was also true for my mom.

但同样也适用于我的母亲。

It's easy for doctors to see my mom

医生们可以轻而易举地把我妈妈当成

as a kind of professional patient,

老病号来看待，

a woman who just spends her days in waiting rooms.

她整天整天地呆在诊所的等候室。

Sometimes I get stuck seeing her that same way.

有时候我也不禁会这样想。

But as I saw Bonica's pain --

但当我看到博尼卡的痛苦——

a testament to his fully lived life --

作为他传奇一生的见证——

I started to remember all the things that my mom's pain holds.

我想起了我母亲所遭受的一切痛苦。

Before they got swollen and arthritic,

在她的手指患上关节炎，

my mom's fingers clacked away

肿到无法工作之前，

in the hospital H.R. department where she worked.

她一直在医院的人力资源部忙碌着。

They folded samosas for our entire mosque.

她用一双手为整个清真寺 折过印度咖喱角。

When I was a kid, they cut my hair,

当我还是孩子的时候， 这双手为我剪过头发，

wiped my nose,

为我擦过鼻子，

tied my shoes.

还帮我系过鞋带。

Thank you.

谢谢大家。

(Applause)

（掌声）