An ER doctor on triaging your "crazy busy" life | Darria Long

翻译人员: Wanting Zhong 校对人员: Yolanda Zhang

Raise your hand, and be honest,

如果你曾经用过“忙疯了”这个字眼

if you've used the phrase "crazy busy"

来形容你的一天、一周、一个月，

to describe your day, your week, your month.

请诚实地举起你的手。

I'm an emergency-room doctor,

我是一名急诊室医生，

and "crazy busy" is a phrase you will never hear me use.

你从来不会听到我说 “忙疯了”。

And after today,

今天之后，

I hope you'll stop using it, too.

我希望各位也不会再用这种说法。

Here's why you cannot afford to use "crazy"

为什么你不能用 “疯狂”

to describe your busy.

来形容你的忙碌？

Because when we are in what I refer to as Crazy Busy Mode,

因为当我们处于所谓的 “疯狂忙碌模式”中时，

we are simply less capable of handling the busy.

我们只不过是 更难以驾驭这种忙碌。

Here's what happens.

在这种情况下：

Your stress hormones rise and stay there,

你的应激激素会升高 并且居高不下，

your executive function in the prefrontal cortex declines.

你的前额叶皮质的 执行控制能力会下降。

That means your memory, your judgment, your impulse control deteriorate,

这意味着你的记忆、判断 和自制能力都会变差，

and the brain areas for anger and anxiety are activated.

而和愤怒、焦虑有关的 大脑区域则会被激活。

Do you feel that?

你们感受到了吗？

Here's the thing.

重点是，

You can be as busy as an emergency department

你能够像急诊室人员一样忙碌，

without feeling like you're crazy busy.

但却不会有忙疯了的感觉。

How?

怎么才能做到呢？

By using the same tactics that we use.

通过使用和我们一样的诀窍。

Our brains all process stress in similar fundamental ways.

我们的大脑都用相似的 基本方式处理压力。

But how we react to it

但是研究显示，

has been shown by research to be modifiable,

我们对压力的反应 是可以改变的，

whether it's emergencies or just daily, day-in, day-out stress.

不管是应对紧急情况， 还是日常的压力。

Now contrast Crazy Busy Mode

那么将 “疯狂忙碌状态”，

with how I think of us in the ER -- Ready Mode.

和我心目中急诊室的状态—— “准备就绪状态” 进行对比。

Ready Mode means whatever comes in through those doors,

准备就绪状态意味着 不管有什么从门外进来，

whether it's a multiple-car pileup,

无论是连环车祸的伤员，

or a patient having chest pain while stuck in an elevator,

困在电梯内的胸痛病人，

or another patient with an item stuck where it shouldn't be.

还是身体某个部位出现了 不该出现的东西的患者，

When you're know you're dying to ask.

我知道你们非常想问细节。

(Laughter)

（笑声）

Even on those days when you would swear you were being punked,

哪怕是那些你会发誓说 自己被整惨了的日子，

we're not afraid of it.

我们也不会害怕。

Because we know that whatever comes in through those ER double doors,

因为我们知道， 无论从急诊室门外进来什么，

that we can handle it.

我们都能够应付。

That we're ready.

我们准备好了。

That's Ready Mode.

这就是准备就绪模式。

We've trained for it,

我们是被训练出来的，

and you can, too.

而你也可以做到。

Here's how.

下面我要介绍一些方法。

Step one to go from Crazy Mode to Ready Mode

从疯狂模式到就绪模式的第一步，

is to relentlessly triage.

是不厌其烦地进行分类。

In Crazy Mode, you're always busy, always stressed,

在疯狂模式下， 你总是很忙，很有压力，

because you're reacting to every challenge with the same response.

是因为你对每一个挑战 都做出了相同的回应。

Contrast that with Ready Mode,

相比起来，在就绪模式中，

where we triage,

我们会进行分类，

which means we prioritize by degree of urgency.

也就是根据紧急程度 确定优先顺序。

This isn't just a nice way to get your to-do list done.

这不仅是一个能让你 完成待办事项的好方法。

Work by Dr. Robert Sapolsky

罗伯特 · 萨泊斯基博士 （Robert Sapolsky）的研究表明，

shows that individuals who cannot differentiate threat from non-threat

那些无法区分威胁和非威胁，

and react to everything with the same response

并对所有事情 都做出相同反应的人，

have double the level of stress hormones.

他们的应激激素水平 是常人的两倍。

Which is why this is the first skill to learn.

这就是为什么分类 是首先要学习的技能。

You can't take care of them all at once,

你无法同时处理好所有事情，

but you don't have to.

但你也没必要这样做。

Because we triage.

因为我们可以分类。

Red -- immediately life-threatening.

红色——立即有生命危险。

Yellow -- serious, but not immediately life-threatening.

黄色——严重， 但不会立即有生命危险。

Green -- minor.

绿色——轻度受伤。

And we focus our efforts first on the reds.

我们首先重点处理 被标成红色的病人。

Now hear this.

那么重点来了，

Part of the problem in Crazy Mode

疯狂模式的部分问题在于，

is that you are reacting to everything

你把所有事情当成了红色事项

as if it is red.

来应对。

So start by triaging correctly.

所以要从正确地分类开始，

Know your reds.

了解你的红色事项。

They're what is most important and where you can most move the needle.

这些是最重要， 也最能取得成效的部分。

Now it's easy to be confused by noise,

这很容易和干扰弄混，

but what it noisiest is not always what is most red.

但是吵得最大声的 并不一定是最紧急的。

In fact, my severe asthmatic patient is most at risk when he's quiet.

事实上，严重哮喘的病人在安静时， 生命反而最岌岌可危。

But my patient over here, demanding that I bring her flavored coffee creamer,

但在这边要求我 给她拿调味咖啡奶精的病人

she's noisy, but she's not red.

虽然很吵闹，却情况并不紧急。

I'll give you an example from my own life.

我给大家举一个我生活中的例子。

Last spring, my house flooded,

去年春天，我的房子被水淹了，

my one-year-old was in the ER,

当时，我一岁的孩子在急诊室，

I was supposed to do a fundraiser for my four-year-old's school

我还要为我四岁孩子的学校 筹办募捐活动，

and the final chapter of my book was beyond late.

并且我的书的最后一章 也已经逾期未交了。

Maybe not ironically, that was the chapter on stress.

讽刺的是，那一章是关于压力的。

(Laughter)

（笑声）

My red tasks were getting my one-year-old better

我的红色任务 是让我一岁的孩子好起来，

and finishing my book.

并且完成我的书。

That was it.

仅此而已。

Remember, relentlessly triage.

记住，不断地分类。

The house flood repair?

修复被水淹的房子？

Well, once we had stopped and stabilized the damage,

一旦我们止住漏水， 控制住损害，

it was no longer a red.

它就不再是红色事项了。

It felt red,

它让人感觉很紧急，

but it was in fact just noise.

但实际上只是干扰而已。

No, no really, it was quite noisy,

实话说，这种干扰真的非常吵，

this picture on the far right is me wearing earplugs

右边的这张照片 是我戴着耳塞，

to focus on my book,

专注于完成我的书，

while the floor is being mechanically dried around me.

同时在用机器烘干我的地板。

Know your reds,

了解你的红色事项，

and do not let your non-reds distract you from them.

并且不要让你的非红色事项 分散你的注意力。

By the way, it is liberating with a green task

顺便一提， 绿色任务能让你感到解脱，

to, every once in a while, be able to remind yourself,

偶尔能提醒一下自己，

"That's a green task. No one's going to die."

“那只是绿色任务， 没有人会死的。”

(Laughter)

（笑声）

It's OK if it's not perfect.

就算它不完美也没有关系。

Now there's one last triage level that we use in the worst scenarios.

还剩一个分类等级， 我们用它来表示最坏的情景。

And that is black.

黑色，

Those patients for whom there is nothing we can do.

是指那些我们无能为力的病人。

Where we must move on.

我们必须放弃他们。

And although it is gut-wrenching,

虽然这令人无比痛苦，

I mention it,

但我提到它，

because you each have your own equivalent black tasks in your life.

是因为你们生活中 也同样有黑色任务。

These are items that you must take off your list.

这些是你必须 从待办清单中移除的事项。

And I think many of you know what I'm talking about.

我觉得很多人都知道我在说什么。

For me, this was the fundraiser.

对我来说，这指的是募捐活动。

I had to step down.

我必须放弃。

Because as we in the ER know,

因为我们这样的 急诊室人员很清楚，

if you try to do everything,

如果你试图完成每件事，

you have no hope of saving your reds.

你就无望拯救你的红色病人。

Step two to go from Crazy Mode into Ready Mode

从疯狂模式到就绪模式的第二步，

is to expect and design for crazy.

是去预测疯狂，并为其做出规划。

Half of handling crazy is how you prepare for it.

想要处理疯狂忙碌的事情， 一半在于你怎么做准备。

So if step one we triage,

如果在第一步中， 我们将事情分类，

step two, we design to make those tasks easier to do.

第二步，我们把这些任务 规划得更容易完成。

Science shows us that the more options we have,

科学研究告诉我们， 当我们拥有的选择越多，

then the longer each decision takes.

我们做出每个决定的时间就越长。

And the more decisions we have to make, the more exhausted our brain gets

而当我们要做出的决定越多， 我们的大脑就越疲惫，

and the less it is capable of making good decisions.

并且更难做出正确的决定。

Which is why this step two

这就是为什么第二步

is about finding ways to reduce your daily decisions.

是要找到办法减少 你在生活中面临的选择。

Here are four easy examples you can use in your daily lifestyle.

这里有四个简单的例子， 你可以尝试运用到自己的日常生活中。

Plan.

计划。

Plan your entire week's meals on the weekend,

在周末计划你接下来一周的饮食，

so that when it's Wednesday at 6pm

这样等到周三晚上六点，

and everyone's hangry and requesting pizza,

大家都饿疯了， 嚷着要吃披萨的时候，

you have no decisions to make to get a healthy meal on the table.

你无需做出选择 就能吃上一顿健康的晚餐。

Automate.

自动化。

Never leave anything to remember that you could automate,

能够自动完成的东西 就没必要记住，

whether it's scheduling it as recurring or saved list, or recurrent purchases.

无论是日程表中的重复事项， 还是购物时的自动重复下单。

Colocate.

集中放置。

When it comes to exercise,

在健身的时候，

store all the equipment that you need for a certain activity together,

把所有要用的器材放在一起，

charged and ready,

充好电，准备好，

so you don't spend energy looking for it.

这样你就不用浪费精力四处寻找。

And decrease temptations,

还要抵制住诱惑，

for anyone driven by sugar cravings.

如果你嗜好甜食的话。

Anyone?

有人是这样吗？

Say aye, go ahead.

有吧。

That itself is its own form of Crazy Mode

甜食本身就是一种疯狂模式，

and self-medication for Crazy Mode,

也是疯狂模式的自制解药，

but stop working your willpower.

但不要再挑战你的意志力了。

Design differently.

而是做出不同的规划。

If a food is out of immediate reach,

如果某种食物不是触手可及，

such that you have to use a stool to reach it,

比如要踩着凳子才能够到，

even when it's chocolate,

哪怕是巧克力，

study participants ate 70 percent less without thinking about it.

研究中的被试者也少吃了 70%， 而且没有一直惦记这回事儿。

I know.

我知道，

Let that sit for a second.

你细细品一品。

(Laughter)

（笑声）

Design to make the choices you wish to make easier.

通过规划，让你更容易做出 你希望的选择。

Which bring us to the third step to go from Crazy Mode to Ready Mode,

这就让我们来到了从疯狂模式 转变为就绪模式的第三步：

and that is to get out of your head.

清除你脑海中的杂念。

Come with me.

我这里还有

Different story.

另外一个故事。

I'm working in a small, satellite ER,

我在一个小型的附属急诊室工作时，

when a woman comes in in labor.

进来了一位临产的女性。

I realize that the cord is wrapped not once

我意识到孩子的脖子被脐带缠了

but twice around the baby's neck.

不止一圈，而是两圈。

And I'm the only doctor.

我是唯一的当值医生。

I was scared.

我不由心生恐惧，

But I couldn't let it derail me.

但我不能让它干扰我。

Because, you see, we all get nervous.

因为我们都会紧张，

We all get scared,

我们都会害怕，

but it's what you do next that matters.

但关键的是你接下来的行动。

That first feeling isn't the problem.

第一感觉不是问题。

It can be an important sign.

它可以是重要的征兆。

The problem comes when we let it derail us.

当我们被这种感觉干扰， 才会出现问题。

When that internal monologue starts

当我们内心独白开始，

and we catastrophize and we start to get that tunnel vision.

我们开始想象最坏情况， 我们的眼界开始变得狭窄。

That's how you think when you're in Crazy Mode,

这就是你在疯狂模式下的思考模式，

and you cannot solve anything that way.

而它不能让你解决任何问题。

Now I promise to come back to the story,

我保证等会儿会继续讲故事，

but first, how do I get out of my own head?

但首先，我该怎样 从脑海中清除杂念？

There are many tactics that you may hear,

你可能听说过很多小技巧，

but for me, I find it best in the moment to actively put my focus on someone else.

但对我来说，我觉得最有用的 是主动将注意力集中在别人身上。

To deliberately make myself see the person in front of me,

故意让自己看见面前的人，

see myself in the arena with them --

想象自己和他们处于同一个立场——

what do they need, what do they fear

他们需要什么，他们害怕什么，

and how can I help?

我能怎么帮助他们？

This may sound like a whole lot of warm and fuzzy to you,

对你们来说， 这也许听起来很模糊，

but it's not.

但其实不是。

In fact, research shows that when you prime your brain

事实上，研究发现， 当你用同情心

with what is, essentially, compassion,

诱导你的大脑时，

we disrupt that tunnel vision and internal monologue.

就能瓦解内心独白和狭窄眼界。

You widen your perception,

你拓宽了你的感知，

so your brain can actually take in broader information,

从而让大脑能接受更广泛的信息，

so you see more possibilities and can make better decisions.

让你能看到更多可能性， 从而做出更好的决定。

Try it.

试试看。

Know that your internal monologue can derail you.

认识到你的内心独白会扰乱你，

And realize that when you get out of your own head,

还要意识到 当你消除这些杂念的时候，

you get out of your own way.

你就能扫除自身的障碍。

Now what happened to that baby?

那么那名婴儿后来怎么样了？

I focused not on my fear,

我没有关注我的恐惧，

but on the mother and the baby and what they needed me to do.

而是专注于这位妈妈和宝宝， 以及她们需要我做些什么。

And got the cord off of the baby's neck,

我把脐带从宝宝脖子上绕开，

and a healthy screaming, kicking baby arrived,

一个健康哭闹着的宝宝呱呱坠地，

just as the dad ran in from the parking lot,

这时他的爸爸 刚好从停车场冲进来，

"Hi, you have a son, I'm Dr. Darria.

“你好，是一个男孩。 我是达莉亚医生。

Congratulations, you want to cut the cord?"

恭喜你，你想要剪断脐带吗？”

(Laughter)

（笑声）

And for a moment,

那一刻，

the strong cries of a newborn

一个新生儿有力的哭声，

drowned out the beeps and the sirens that are the normal sounds of the ER.

盖过了急诊室司空见惯的 滴滴声和警报声。

But there was also something else.

但还不止这些。

Because when I walked back out of that mother's room,

当我走出那位母亲的房间时，

I saw several of my other patients hovering nearby.

我看见有其它几位病人在附近徘徊。

I suddenly realized that despite their own problems

我突然意识到， 虽然他们是因为各自的理由

that had brought them to the emergency room,

来到了急诊室，

they had all come together to root for this baby.

但他们都聚在了一起 为这个孩子加油。

And they now together shared in the joy.

而此时他们正在共同分享喜悦。

Because that is what happens when you go from Crazy Mode to Ready Mode.

因为这就是你从疯狂模式 进入就绪模式时发生的事。

Others notice.

别人也会注意到，

They want it too, they just don't know how,

他们也想要这种能力， 只是不知道该怎么做，

they just need one example.

他们只是需要一个例子。

Which could be you.

那可以是你。

Own the busy.

掌控自己的忙碌状态，

But stop calling it crazy.

但是不要再称它为疯狂。

You've always had that ability.

你一直都有这种能力，

But now ...

但是现在……

you're ready.

你准备好了。

Thank you.

谢谢。

(Applause)

（掌声）