请双击下面的英文字幕来播放视频。
翻译人员: Yuanjing Jin
校对人员: Angelia King
00:15
Our face is hugely important
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我们的面部十分重要
00:18
because it's the external, visual part
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因为它是身体外部可视的部分
00:20
that everybody else sees.
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所有人都可以看见。
00:22
Let's not forget it's a functional entity.
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我们别忘了它也是一个功能实体。
00:24
We have strong skull bones
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我们有坚固的头盖骨
00:26
that protect the most important organ in our body: the brain.
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用来保护我们身体中最重要的器官:大脑。
00:29
It's where our senses are located, our special senses --
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我们感官也位于面部,我们的一些特殊感官 --
00:32
our vision, our speech,
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我们的视觉,我们的言语,
00:34
our hearing, our smell, our taste.
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我们的听力,我们的嗅觉,我们的味觉。
00:36
And this bone
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这块骨头
00:38
is peppered, as you can see, with the light shining through the skull
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布满了 正如你看到的 穿透过头盖骨的光线
00:41
with cavities, the sinuses,
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还有空腔, 鼻窦,
00:43
which warm and moisten the air we breathe.
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使我们吸入的空气变的温暖和湿润。
00:46
But also imagine if they were filled with solid bone --
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但想象一下,如果这全是实心的骨头,
00:49
our head would be dead weight,
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我们的头会变得非常重,
00:51
we wouldn't be able to hold it erect,
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我们将不能抬起头,
00:53
we wouldn't be able to look at the world around us.
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我们也不能看到我们四周的世界。
01:02
This woman is slowly dying
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这个女人正在慢慢的死去
01:04
because the benign tumors in her facial bones
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因为她面颅骨里的良性肿瘤
01:07
have completely obliterated her mouth and her nose
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已经彻底毁坏了她的嘴巴和鼻子,
01:10
so she can't breathe and eat.
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所以她不能呼吸也不能吃东西。
01:12
Attached to the facial bones
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依附于面颅骨
01:14
that define our face's structure
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用来勾画我们面部结构的
01:18
are the muscles that deliver our facial expression,
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是传递我们面部表情的肌肉,
01:21
our universal language of expression,
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我们通用的表情语言
01:24
our social-signaling system.
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我们的社会信号体系。
01:26
And overlying this is the skin drape,
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覆盖其上的是皮肤褶皱,
01:29
which is a hugely complex
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它是个极其复杂的
01:31
three-dimensional structure --
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三维结构 --
01:33
taking right-angled bends here and there,
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在这里那里会有各种角度的弯折
01:35
having thin areas like the eyelids,
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有薄如眼睑的区域,
01:38
thick areas like the cheek, different colors.
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有厚如脸颊的区域和不同的颜色组成。
01:41
And then we have the sensual factor of the face.
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我们的脸上也有官能要素。
01:44
Where do we like to kiss people?
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我们喜欢亲吻别人什么地方?
01:46
On the lips. Nibble the ears maybe.
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嘴唇上。也许在耳边轻咬。
01:49
It's the face where we're attracted to with that.
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这正是因为我们被面部所吸引。
01:52
But let's not forget the hair.
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不过我们也不要忘记头发。
01:54
You're looking at the image on your left-hand side --
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你现在看一下你左手边的图片 --
01:56
that's my son with his eyebrows present.
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这是我儿子有眉毛的照片,
01:58
Look how odd he looks with the eyebrows missing.
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而他没有眉毛的照片看起来是不是很奇怪。
02:01
There's a definite difference.
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这有着决定性的差异。
02:03
And imagine if he had hair sprouting from the middle of his nose,
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想象一下他如果从鼻子中间有毛发
02:05
he'd look even odder still.
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他会看起来更加奇怪。
02:07
Dysmorphophobia
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曲影症
02:09
is an extreme version
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是一个事实的极端特例
02:11
of the fact that we don't see ourselves
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我们看我们自己
02:13
as others see us.
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和别人看我们是不同的。
02:15
It's a shocking truth
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这是个让人震惊的事实
02:17
that we only see mirror images of ourselves,
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我们只能看到我们的镜像,
02:20
and we only see ourselves
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我们只能看到我们自己
02:22
in freeze-frame photographic images
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在定格的照片中
02:24
that capture a mere fraction of the time that we live.
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这些照片只能捕获我们生活中的短暂瞬间。
02:27
Dysmorphophobia
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曲影症
02:29
is a perversion of this
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是这一事实的反常行为
02:31
where people who may be very good looking
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有些相貌很好看的人
02:33
regard themselves as hideously ugly
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认为自己面目狰狞
02:35
and are constantly seeking surgery
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并且不断寻求通过手术
02:37
to correct their facial appearance.
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来矫正他们的容貌。
02:40
They don't need this. They need psychiatric help.
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他们并不需要手术, 他们需要心理辅导。
02:43
Max has kindly donated his photograph to me.
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马克斯好心的把他的照片捐赠给我。
02:45
He doesn't have dysmorphophobia, but I'm using his photograph
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他没有曲影症,但我用他的照片
02:48
to illustrate the fact that he looks exactly like a dysmorphophobic.
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来说明他看起来跟一个曲影症患者一样。
02:50
In other words, he looks entirely normal.
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换句话说,他看起来完全正常。
02:53
Age is another thing
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年龄是另外一个因素
02:56
when our attitude toward our appearance changes.
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在我们对待自己容貌态度的改变之中。
02:58
So children judge themselves, learn to judge themselves,
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所以孩子们自我衡量,学习自我衡量
03:01
by the behavior of adults around them.
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是通过他们身边成年人的行为。
03:04
Here's a classic example: Rebecca has a benign blood vessel tumor
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这是个经典案例:丽贝卡的良性血管瘤
03:07
that's growing out through her skull, has obliterated her nose,
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从她的头骨中长出来,并且毁坏了她的鼻子,
03:10
and she's having difficulty seeing.
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她看东西已经成问题。
03:12
As you can see, it's blocking her vision.
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你可以看到,肿瘤阻挡了她的视线。
03:14
She's also in danger, when she damages this,
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如果她弄破了肿瘤她的生命也会
03:16
of bleeding profusely.
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因为大出血而有危险。
03:18
Our research has shown
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我们的研究表明
03:20
that the parents and close loved ones of these children
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这些孩子们的父母和亲近的人们
03:23
adore them.
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极其喜欢他们。
03:25
They've grown used to their face; they think they're special.
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他们已经习惯了这些孩子们的脸;他们觉得这些孩子很特殊。
03:28
Actually, sometimes the parents argue
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其实,有的时候父母们会讨论
03:30
about whether these children should have the lesion removed.
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是不是要把这些孩子的病变除去。
03:33
And occasionally they suffer intense grief reactions
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偶尔的,他们会难过
03:35
because the child they've grown to love
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因为他们心爱的孩子
03:37
has changed so dramatically and they don't recognize them.
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会有如此大的变化以至于都不能认出他们来了。
03:40
But other adults
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但另外的成年人
03:42
say incredibly painful things.
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会说一些让人难以置信的心痛的话。
03:44
They say, "How dare you take this child out of the house
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他们会说,“你们怎么敢把这个孩子带出家门
03:46
and terrify other people.
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这会吓到其他人的。
03:48
Shouldn't you be doing something about this? Why haven't you had it removed?"
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你们难道不应该做些什么么? 为什么不把这些病变除去?”
03:51
And other children in curiosity come up and poke the lesion,
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其他的孩子们会好奇的上来戳一戳,
03:54
because -- a natural curiosity.
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因为一种自然的好奇心。
03:56
And that obviously alerts the child
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这当然会让这个孩子意识到
03:58
to their unusual nature.
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他不寻常的特质。
04:00
After surgery, everything normalizes.
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手术之后,一切归于正常。
04:03
The adults behave more naturally,
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大人们的举动更自然,
04:05
and the children play more readily with other children.
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这些孩子和其他孩子也更玩的来。
04:08
As teenagers --
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作为青少年--
04:11
just think back to your teenage years --
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回想一下你们的青少年时期--
04:13
we're going through a dramatic
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我们经历着戏剧性的
04:15
and often disproportionate change
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时常是不成比例的
04:17
in our facial appearance.
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面部变化。
04:19
We're trying to struggle to find our identity.
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我们努力的寻找自己的身份
04:21
We crave the approval of our peers.
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我们渴望得到同龄人的认可。
04:23
So our facial appearance is vital to us
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所以我们的面容对我们来说极其重要
04:26
as we're trying to project ourselves to the world.
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当我们努力的向世界展现自己。
04:28
Just remember that single acne spot
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还记得吗?一个青春痘
04:30
that crippled you for several days.
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就可以让你好几天都精神萎靡。
04:34
How long did you spend looking in the mirror every day,
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你每天花多长时间盯着镜子,
04:37
practicing your sardonic look, practicing your serious look,
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练习讽刺的表情,严肃的表情,
04:40
trying to look like Sean Connery, as I did,
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尝试看起来更像肖恩·康纳利,像我小时候一样。
04:42
trying to raise one eyebrow?
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尝试着扬起一只眉毛。
04:44
It's a crippling time.
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那是个让人束手无策的时期。
04:46
I've chosen to show this profile view of Sue
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我选择给你们看苏的侧面像,
04:50
because what it shows is her lower jaw jutting forward
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因为这样可以看出来她的下颚向前凸出
04:53
and her lower lip jutting forward.
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她的下唇也向前凸出。
04:55
I'd like you all in the audience now to push your lower jaw forward.
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我想让你们在座的每一位现在把你们的下颚推向前,
04:58
Turn to the person next to you,
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然后转向旁边的人,
05:00
push your lower jaws forward. Turn to the person next to you
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把你们的下颚推向前,然后转向你旁边的人
05:02
and look at them -- they look miserable.
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看着他们 -- 他们看起来很忧愁。
05:04
That's exactly what people used to say to Sue.
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正如所有人告诉苏的一样。
05:07
She wasn't miserable at all.
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她一点也不忧愁。
05:09
But people used to say to her, "Why are you so miserable?"
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但是大家以前都会问她:“为什么你那么难过?”
05:13
People were making misjudgments all the time
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人们总是错误的判断
05:16
on her mood.
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她的情绪。
05:18
Teachers and peers were underestimating her; she was teased at school.
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她被老师和同学低估,在学校被取笑。
05:21
So she chose to have facial surgery.
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所以她选择了面部手术。
05:23
After the facial surgery,
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手术之后,
05:25
she said, "My face now reflects my personality.
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她说:“现在我的脸是我的个性的写照。
05:28
People know now that I'm enthusiastic,
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人们现在知道我很积极,
05:31
that I'm a happy person."
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我是个很幸福的人。”
05:33
And that's the change that can be achieved for teenagers.
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青少年们可以实现这样的改变。
05:37
Is this change, though, a real change,
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这样的改变到底是真实的改变,
05:39
or is it a figment of the imagination
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还是只是虚构的
05:42
of the patient themselves?
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病人自己的想象?
05:44
Well we studied teenagers' attitudes
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我们考察青少年们
05:46
to photographs of patients having this corrective facial surgery.
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对矫正面部手术患者照片的态度。
05:48
And what we found was --
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我们发现 --
05:51
we jumbled up the photographs
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我们把这些照片混杂在一起
05:53
so they couldn't recognize the before and after --
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所以他们不能识别哪些是手术前那些是手术之后 --
05:55
what we found was that the patients were regarded
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我们发现这些病人们
05:57
as being more attractive after the surgery.
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在手术之后被认为更加有吸引力。
05:59
Well that's not surprising, but we also asked them to judge them
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这并不让人惊讶, 但我们继续让这些青少年们对
06:02
on honesty, intelligence,
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诚信度,聪明程度,
06:04
friendliness, violence.
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友善度,暴力程度进行评判。
06:07
They were all perceived as being
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在手术之前的病人们都被认为
06:09
less than normal in all those characteristics --
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在这些品质上不够正常
06:11
more violent, etc. -- before the surgery.
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比如更暴力,等等。
06:14
After the surgery,
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手术之后,
06:16
they were perceived as being more intelligent,
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病人们被认为更聪明,
06:18
more friendly, more honest, less violent --
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更友好,更诚实,更平和 --
06:21
and yet we hadn't operated on their intellect
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可是我们并没有对他们的智力
06:23
or their character.
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或者性格动手术。
06:25
When people get older,
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当人们的年龄增长,
06:27
they don't necessarily choose to follow this kind of surgery.
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他们不一定选择这类手术。
06:30
Their presence in the consultation suite
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他们对咨询室的光顾
06:32
is a result of the slings and arrows of outrageous fortune.
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是被厄运打击的结果。
06:35
What happens to them
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他们正在经历的
06:37
is that they may have suffered cancer or trauma.
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可能是癌症或者创伤的折磨。
06:39
So this is a photograph of Henry,
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这是亨利的一张照片
06:41
two weeks after he had a malignant cancer removed
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在他把恶性肿瘤
06:44
from the left side of his face -- his cheekbone,
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从他左侧的脸上 - 他的颧骨,
06:47
his upper jaw, his eye-socket.
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他的上颚和眼窝上切除几周之后照得。
06:49
He looks pretty good at this stage.
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他这个时期看起来还不错。
06:51
But over the course of the next 15 years he had 14 more operations,
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但是接下来的15年,他接受了14次手术,
06:54
as the disease ravaged his face
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因为疾病毁了他的脸
06:56
and destroyed my reconstruction regularly.
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也毁了我定期对他面部的整容。
06:58
I learned a huge amount from Henry.
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我从亨利那里学到了很多东西。
07:00
Henry taught me
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亨利告诉了我
07:02
that you can carry on working.
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我还可以继续工作。
07:04
He worked as an advocate. He continued to play cricket.
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他是个辩护律师。他还在继续打板球。
07:07
He enjoyed life to the full,
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他全心全意地享受生命。
07:09
and this was probably because he had a successful, fulfilling job
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这可能因为他有一份成功的令他满意的工作
07:11
and a caring family
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一个充满关爱的家庭
07:13
and was able to participate socially.
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他也可以参与社会活动。
07:15
He maintained a calm insouciance.
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他依旧镇定自若。
07:18
I don't say he overcame this; he didn't overcome it.
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我并不是说他战胜了肿瘤;他没有。
07:21
This was something more than that. He ignored it.
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但重要的是:他忽略了它。
07:24
He ignored the disfigurement that was happening in his life
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他忽略发生在他脸上的毁容
07:27
and carried on oblivious to it.
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他忘却疾病, 继续生活。
07:30
And that's what these people can do.
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这是这些人可以做到的。
07:32
Henriapi illustrates this phenomenon as well.
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亨利阿皮也阐述了这个现象。
07:34
This is a man in his 20s
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这是个二十多岁的年轻尼日利亚男子
07:36
whose first visit out of Nigeria was with this malignant cancer
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他第一次出国是因为他的恶性肿瘤
07:39
that he came to the United Kingdom to have operated on.
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他需要到英国做手术。
07:41
It was my longest operation.
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这是我最长的一次手术。
07:43
It took 23 hours. I did it with my neurosurgeon.
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历时23个小时。我跟我的神经外科医生一起。
07:46
We removed all the bones at the right side of his face --
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我们把他右脸的所有骨头都除去 --
07:48
his eye, his nose,
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他的眼睛,鼻子,
07:50
the skull bones, the facial skin --
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头骨,面部皮肤 --
07:52
and reconstructed him with tissue from the back.
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用他背部的组织给他整容。
07:55
He continued to work as a psychiatric nurse.
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亨利阿皮继续着他精神科护士的工作。
07:57
He got married. He had a son called Jeremiah.
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他结了婚,他的儿子叫耶利米。
08:00
And again, he said,
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他说,
08:02
"This painting of me with my son Jeremiah
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“这幅我跟我儿子耶利米的画像
08:05
shows me as the successful man that I feel that I am."
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告诉我我觉得到我是个成功的人。”
08:08
His facial disfigurement
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他的面部畸形
08:10
did not affect him
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没有影响到他
08:12
because he had the support of a family;
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因为他有他家人的支持,
08:14
he had a successful, fulfilling job.
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他有一份成功的令他满足的工作。
08:16
So we've seen that we can change people's faces.
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所以我们看到我们可以改变这些人的面部。
08:19
But when we change people's faces,
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但当我们改变人们的面部时,
08:21
are we changing their identity --
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我们同时也改变了他们的身份,
08:23
for better or for worse?
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这到底是好还是不好?
08:26
For instance,
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比如说,
08:28
there are two different types of facial surgery.
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有两种不同的面部手术。
08:30
We can categorize it like that.
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我们可以这样归类。
08:32
We can say there are patients who choose to have facial surgery --
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我们可以说一种是病人选择进行面部手术 --
08:34
like Sue.
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正如苏.
08:36
When they have facial surgery,
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他们进行面部手术之后,
08:38
they feel their lives have changed
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感觉到他们的生活改变了,
08:40
because other people perceive them
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因为其他人认为他们
08:43
as better people.
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是更好的人。
08:45
They don't feel different.
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他们本身并没感觉有什么不一样。
08:47
They feel that they've actually gained
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但他们觉得他们获得了一些
08:49
what they never had,
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他们曾经没有的东西,
08:51
that their face now reflects their personality.
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他们的面部现在反映了他们的个性。
08:53
And actually that's probably the difference between cosmetic surgery
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这可能是整容手术
08:56
and this kind of surgery.
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和这些手术的不同之处。
08:58
Because you might say, "Well, this type of surgery
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因为你可能会说,“这种手术
09:01
might be regarded as cosmetic."
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也可以被认为是整容性质的。”
09:03
If you do cosmetic surgery, patients are often less happy.
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如果你进行整容手术,病人们通常不会那么满意。
09:06
They're trying to achieve difference in their lives.
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整容手术病人想要改变生活。
09:12
Sue wasn't trying to achieve difference in her life.
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苏并没有想改变生活,
09:14
She was just trying to achieve the face
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她只是想让她的面部
09:16
that matched her personality.
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和她的个性相匹配。
09:18
But then we have other people
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也有其他一些人
09:20
who don't choose to have facial surgery.
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他们没有选择面部手术。
09:22
They're people who have their face shot off.
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这些人的面部被严重毁坏。
09:24
I'll move it off, and we'll have a blank slide for those who are squeamish amongst you.
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我还是赶紧把图片移开,为了你们中感觉不舒服的人我们还是看着这张空白的幻灯片吧。
09:27
They have it forced upon them.
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但是他们被迫要做面部手术。
09:29
And again, as I told you,
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正如我告诉你的,
09:31
if they have a caring family
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如果他们有个关心他们的家庭
09:33
and good work life,
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好的工作和生活,
09:36
then they can lead normal and fulfilled lives.
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他们可以过正常和满意的生活。
09:39
Their identity doesn't change.
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他们的身份并没有变化。
09:41
Is this business
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这样的
09:43
about appearance and preoccupation with it
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关于外表和对其专注的行业
09:45
a Western phenomenon?
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是一种西方的现象么?
09:47
Muzetta's family give the lie to this.
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Muzetta一家的经历说明并不是这样的。
09:50
This is a little Bangladeshi girl from the east end of London
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这个住在伦敦东部的孟加拉国小女孩
09:53
who's got a huge malignant tumor on the right side of her face,
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她右脸上巨大的恶性肿瘤,
09:56
which has already made her blind
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已经使她看不见东西,
09:58
and which is rapidly growing and is going to kill her shortly.
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并且还在急速生长,在不久的将来会杀死她。
10:00
After she had surgery to remove the tumor,
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在她手术移除肿瘤之后,
10:03
her parents dressed her in this beautiful green velvet dress,
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她的父母给她穿上漂亮的绿色天鹅绒连衣裙,
10:06
a pink ribbon in her hair,
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用粉色丝带装饰她的头发,
10:08
and they wanted the painting to be shown around the world,
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他们希望全世界都可以看到这个画像,
10:10
despite the fact that they were orthodox Muslims
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虽然他们是正统的穆斯林教徒
10:13
and the mother wore a full burqa.
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她的母亲一直穿罩袍。
10:15
So it's not simply a Western phenomenon.
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所以这并不只是一个西方现象。
10:20
We make judgments on people's faces
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我们根据人的面部做判断
10:22
all the time.
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每时每刻。
10:24
It's been going on since we can think of Lombroso
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从Lombrosso
10:27
and the way he would define criminal faces.
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和他定义罪犯脸部方法开始。
10:29
He said you could see criminal faces,
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他说你可以
10:31
judging them just on the photographs that were showed.
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只从照片就看出来哪些是罪犯的面孔。
10:34
Good-looking people
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好看的人们
10:36
are always judged as being more friendly.
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总是会被认为更加友好。
10:38
We look at O.J. --
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当我们看到O.J (O·J·辛普森) --
10:40
he's a good-looking guy.
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他长的不错。
10:42
We'd like to spend time with him. He looks friendly.
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我们愿意花时间和他相处。他看起来挺友善。
10:45
Now we know that he's a convicted wife-batterer,
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我们现在知道他因为殴打他的妻子而判有罪,
10:48
and actually he's not the good guy.
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他其实并不是个好人。
10:50
And beauty doesn't equate to goodness,
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美貌并不等同于善良,
10:54
and certainly doesn't equate to contentment.
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更不等同于满足。
10:57
So we've talked about the static face
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我们谈了静态的面部
10:59
and judging the static face,
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和对静态面部的判断,
11:01
but actually, we're more comfortable
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事实上,我们更习惯于
11:03
with judging the moving face.
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从动态的面部来判断。
11:05
We think we can judge people on their expressions.
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我们觉得我们可以从人们的表情进行判断。
11:08
U.K. jurors in the U.K. justice system
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英国法律体系下的陪审员
11:11
like to see a live witness
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喜欢见到现场目击者
11:13
to see whether they can pick up the telltale signs of mendacity --
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这样他们可以看出来是否有泄露真相的迹象 --
11:16
the blink, the hesitation.
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眨眼,犹豫。
11:19
And so they want to see live witnesses.
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所以他们想见到现场目击人。
11:22
Todorov tells us that, in a tenth of a second,
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托多罗夫告诉我们,只用十分之一秒,
11:25
we can make a judgment on somebody's face.
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我们就可以根据他人的面部来做判断。
11:28
Are we uncomfortable with this image? Yes, we are.
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我们对这个画面感觉的不舒服么?确实是这样。
11:31
Would we be happy if our doctor's face, our lawyer's face,
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如果我们的医生,律师,
11:34
our financial adviser's face was covered?
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金融顾问的脸被遮起来,我们会开心么?
11:36
We'd be pretty uncomfortable.
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我们会挺不舒服的。
11:38
But are we good at making the judgments
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但是我们能够很好的
11:40
on facial appearance and movement?
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根据面部外观和活动做判断么?
11:43
The truth is that there's a five-minute rule,
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真实情况是有一个五分钟准则 --
11:45
not the tenth-of-a-second rule like Todorov, but a five-minute rule.
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并不是托多罗夫所说的十分之一秒,但是是一个五分钟准则。
11:48
If you spend five minutes with somebody,
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如果你和某个人相处五分钟,
11:50
you start looking beyond their facial appearance,
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你会开始注意到他们面部外观之外的地方,
11:52
and the people who you're initially attracted to
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这些一开始吸引你的人
11:54
may seem boring and you lose interest in them,
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可能会让你觉得很无聊,你对他们不再有兴趣,
11:56
and the people who you didn't immediately seek out,
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然后有些并没有立刻就引起你注意的人,
11:58
because you didn't find them particularly attractive,
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因为你一开始并没觉得他们特别有吸引力,
12:00
become attractive people
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变得更加引人瞩目
12:02
because of their personality.
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是因为他们的个性。
12:05
So we've talked a lot about facial appearance.
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我们谈了一些面部外观。
12:08
I now want to share
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现在我想和你们分享
12:10
a little bit of the surgery that we do --
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一些我们做的手术 --
12:12
where we're at and where we're going.
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我们现在和未来在做的手术。
12:14
This is an image of Ann
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这是一幅安的图片
12:16
who's had her right jaw removed and the base of her skull removed.
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她的右下颚和头骨底部被移除了。
12:18
And you can see in the images afterward,
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你可以看到手术后的图片,
12:20
we've managed to reconstruct her successfully.
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我们对她整形的很成功。
12:22
But that's not good enough.
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但依旧不够好。
12:24
This is what Ann wants. She wants to be out kayaking,
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安想要到外面去划皮划艇,
12:26
she wants to be out climbing mountains.
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她想去爬山。
12:28
And that's what she achieved, and that's what we have to get to.
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这些她曾经都做过,而这是我们现在需要努力的方向。
12:30
This is a horrific image,
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这是一张恐怖的图片,
12:32
so I'm putting my hand up now.
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所以我把我的手盖在上面。
12:34
This is a photograph of Adi,
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这是阿迪的一张照片,
12:36
a Nigerian bank manager who had his face shot off
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一位尼日利亚的银行经理,他的面部
12:38
in an armed robbery.
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在一起持枪抢劫中被严重毁容。
12:40
And he lost his lower jaw, his lip, his chin
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他失去了下颚,嘴唇,下巴
12:42
and his upper jaw and teeth.
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还有上颚和牙齿。
12:44
This is the bar that he set for us.
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这是他对我们的期望。
12:46
"I want to look like this. This is how I looked before."
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“我想看起来像这样。这是我以前的样子。”
12:49
So with modern technology,
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使用现代技术,
12:51
we used computers to make models.
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我们用电脑做出模型。
12:54
We made a model of the jaw without bone in it.
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我们做了个无骨的的颚部模型。
12:56
We then bent a plate up to it.
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然后我们折弯一块薄板。
12:58
We put it in place
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放入适当的地方
13:00
so we knew it was an accurate position.
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这样我们可以知道一个精确的位置。
13:02
We then put bone and tissue from the back.
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之后我们把骨头和组织放在其后。
13:05
Here you can see the plate holding it,
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你可以看到薄板支撑着它,
13:07
and you can see the implants being put in --
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植入体正在被放进去--
13:10
so that in one operation
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在一次手术之中
13:12
we achieve this
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我们做到了这个
13:15
and this.
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还有这个。
13:17
So the patient's life is restored.
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这位病人恢复了正常生活。
13:19
That's the good news.
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这是好消息。
13:21
However, his chin skin
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虽然如此,他下颚的皮肤
13:23
doesn't look the same as it did before.
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看起来跟以前不一样。
13:25
It's skin from his back.
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这是他背部的皮肤。
13:27
It's thicker, it's darker, it's coarser, it doesn't have the contours.
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所以更厚,颜色更深,更粗糙一些,也没有应有的轮廓。
13:30
And that's where we're failing,
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这些是我们不足的地方。
13:32
and that's where we need the face transplant.
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这时候我们需要面部移植。
13:34
The face transplant has a role
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面部移植手术
13:36
probably in burns patients to replace the skin.
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可能在更换烧伤病人的皮肤中扮演了一个重要角色。
13:39
We can replace the underlying skeletal structure,
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我们可以替换底层的骨骼结构,
13:41
but we're still not good at replacing the facial skin.
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但是我们对面部皮肤的替换还很不足。
13:44
So it's very valuable
336
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所以
13:46
to have that tool in our armamentarium.
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在我们医疗设备中有这样的工具是十分重要的。
13:48
But the patients are going to have to take drugs
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可是病人们会终身需要服药
13:50
that suppress their immune system for the rest of their lives.
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用来抑制他们的免疫系统。
13:52
What does that mean?
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这说明什么呢?
13:54
They have an increased risk of infection, an increased risk of malignancy.
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他们会更可能被感染,有更大风险使病情恶化。
13:57
This is not a life-saving transplant --
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这并不是一个挽救生命的移植 --
13:59
like a heart, or liver, or lung transplant --
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比如心脏,肝脏,肺部移植 --
14:02
it is a quality-of-life transplant,
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这是一种生命质量的移植,
14:05
and as a result,
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移植的结果
14:07
are the patients going to say, if they get a malignant cancer 10 or 15 years on,
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是这些病人们是不是会说,如果他们十年或者十五年后会罹患恶性肿瘤,
14:10
"I wish I'd had conventional reconstructive techniques rather than this
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“我还不如当时用常规的整容方法而不是用这个,
14:13
because I'm now dying of a malignant cancer"? We don't know yet.
348
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因为我现在正在死于恶性肿瘤?”我们还不清楚。
14:16
We also don't know what they feel
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我们也不知道他们
14:19
about recognition and identity.
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对此的认可度和认同有什么感受。
14:21
Bernard Devauchelle and Sylvie Testelin, who did the first operation,
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首先尝试此类手术的伯纳德·德沃谢勒和塞尔维·泰斯特兰
14:24
are studying that.
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对他们进行了研究。
14:26
Donors are going to be short on the ground,
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接受手术的人不会很多,
14:29
because how many people want to have their loved one's face
354
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有多少人愿意自己关爱的人的脸部
14:32
removed at the point of death?
355
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在他/她过世的时候被移除。
14:35
So there are going to be problems
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所以会有很多的问题
14:37
with face transplantation.
357
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对于面部移植。
14:39
So the better news is
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所以更好的消息是
14:41
the future's almost here --
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未来即将到来--
14:43
and the future is tissue engineering.
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这个未来就是组织工程。
14:45
Just imagine,
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想象一下,
14:47
I can make a biologically-degradable template.
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我可以做一个生物上可降解的模板。
14:50
I can put it in place where it's meant to be.
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我可以将它放在它应该在的地方。
14:52
I can sprinkle a few cells,
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我可以随机分配一些细胞,
14:54
stem cells from the patient's own hip,
365
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从病人髋关节抽取一些干细胞,
14:56
a little bit of genetically engineered protein,
366
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一些转基因的蛋白质,
14:58
and lo and behold, leave it for four months and the face is grown.
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然后瞧,四个月后面部就长好了。
15:02
This is a bit like a Julia Child recipe.
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这有些像一份朱莉娅的儿童菜谱。
15:06
But we've still got problems.
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但我们还有很多问题。
15:08
We've got mouth cancer to solve.
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我们需要解决口腔癌。
15:10
We're still not curing enough patients -- it's the most disfiguring cancer.
371
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3000
我们仍然没有治愈足够多的病人--这是最严重的癌症毁容。
15:13
We're still not reconstructing them well enough.
372
913260
3000
我们的整容术还是不够好。
15:16
In the U.K. we have an epidemic
373
916260
2000
在英国
15:18
of facial injuries among young people.
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面部创伤在年轻人中很普遍。
15:20
We still can't get rid of scars.
375
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2000
我们还是不能消除疤痕。
15:22
We need to do research.
376
922260
2000
我们需要研究。
15:24
And the best news of all
377
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最好的消息
15:26
is that surgeons know
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是医生们知道
15:28
that we need to do research.
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我们需要做研究。
15:30
And we've set up charities
380
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我们已经建立慈善组织
15:32
that will help us fund
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给予我们
15:34
the clinical research
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临床试验资金方面的帮助
15:36
to determine the best treatment practice now
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用来测定目前最好的理疗实践
15:38
and better treatment into the future,
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938260
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和将来更好的治疗方法,
15:40
so we don't just sit on our laurels and say, "Okay, we're doing okay.
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所以我们不能安于现状说,“我们做的还不错。
15:42
Let's leave it as it is."
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我们就这样算了吧。”
15:44
Thank you very much indeed.
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十分感谢。
15:46
(Applause)
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(掌声)
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