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

194,195 views ・ 2020-06-11

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翻译人员: Wanting Zhong 校对人员: Yolanda Zhang
00:13
Raise your hand, and be honest,
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如果你曾经用过“忙疯了”这个字眼
00:16
if you've used the phrase "crazy busy"
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来形容你的一天、一周、一个月,
00:20
to describe your day, your week, your month.
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请诚实地举起你的手。
00:26
I'm an emergency-room doctor,
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我是一名急诊室医生,
00:29
and "crazy busy" is a phrase you will never hear me use.
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你从来不会听到我说 “忙疯了”。
00:35
And after today,
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今天之后,
00:37
I hope you'll stop using it, too.
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我希望各位也不会再用这种说法。
00:41
Here's why you cannot afford to use "crazy"
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为什么你不能用 “疯狂”
00:45
to describe your busy.
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来形容你的忙碌?
00:47
Because when we are in what I refer to as Crazy Busy Mode,
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因为当我们处于所谓的 “疯狂忙碌模式”中时,
00:51
we are simply less capable of handling the busy.
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我们只不过是 更难以驾驭这种忙碌。
00:56
Here's what happens.
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在这种情况下:
00:58
Your stress hormones rise and stay there,
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你的应激激素会升高 并且居高不下,
01:00
your executive function in the prefrontal cortex declines.
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你的前额叶皮质的 执行控制能力会下降。
01:04
That means your memory, your judgment, your impulse control deteriorate,
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这意味着你的记忆、判断 和自制能力都会变差,
01:07
and the brain areas for anger and anxiety are activated.
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而和愤怒、焦虑有关的 大脑区域则会被激活。
01:12
Do you feel that?
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你们感受到了吗?
01:15
Here's the thing.
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重点是,
01:17
You can be as busy as an emergency department
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你能够像急诊室人员一样忙碌,
01:20
without feeling like you're crazy busy.
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但却不会有忙疯了的感觉。
01:25
How?
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怎么才能做到呢?
01:26
By using the same tactics that we use.
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通过使用和我们一样的诀窍。
01:28
Our brains all process stress in similar fundamental ways.
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我们的大脑都用相似的 基本方式处理压力。
01:32
But how we react to it
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但是研究显示,
01:34
has been shown by research to be modifiable,
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我们对压力的反应 是可以改变的,
01:37
whether it's emergencies or just daily, day-in, day-out stress.
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不管是应对紧急情况, 还是日常的压力。
01:42
Now contrast Crazy Busy Mode
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那么将 “疯狂忙碌状态”,
01:45
with how I think of us in the ER -- Ready Mode.
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和我心目中急诊室的状态—— “准备就绪状态” 进行对比。
01:49
Ready Mode means whatever comes in through those doors,
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准备就绪状态意味着 不管有什么从门外进来,
01:52
whether it's a multiple-car pileup,
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无论是连环车祸的伤员,
01:53
or a patient having chest pain while stuck in an elevator,
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困在电梯内的胸痛病人,
01:57
or another patient with an item stuck where it shouldn't be.
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还是身体某个部位出现了 不该出现的东西的患者,
02:02
When you're know you're dying to ask.
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我知道你们非常想问细节。
02:05
(Laughter)
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(笑声)
02:06
Even on those days when you would swear you were being punked,
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哪怕是那些你会发誓说 自己被整惨了的日子,
02:11
we're not afraid of it.
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我们也不会害怕。
02:14
Because we know that whatever comes in through those ER double doors,
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因为我们知道, 无论从急诊室门外进来什么,
02:18
that we can handle it.
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我们都能够应付。
02:20
That we're ready.
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我们准备好了。
02:21
That's Ready Mode.
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这就是准备就绪模式。
02:24
We've trained for it,
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我们是被训练出来的,
02:26
and you can, too.
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而你也可以做到。
02:29
Here's how.
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下面我要介绍一些方法。
02:30
Step one to go from Crazy Mode to Ready Mode
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从疯狂模式到就绪模式的第一步,
02:32
is to relentlessly triage.
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是不厌其烦地进行分类。
02:35
In Crazy Mode, you're always busy, always stressed,
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在疯狂模式下, 你总是很忙,很有压力,
02:37
because you're reacting to every challenge with the same response.
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是因为你对每一个挑战 都做出了相同的回应。
02:42
Contrast that with Ready Mode,
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相比起来,在就绪模式中,
02:44
where we triage,
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我们会进行分类,
02:46
which means we prioritize by degree of urgency.
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也就是根据紧急程度 确定优先顺序。
02:50
This isn't just a nice way to get your to-do list done.
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这不仅是一个能让你 完成待办事项的好方法。
02:53
Work by Dr. Robert Sapolsky
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罗伯特 · 萨泊斯基博士 (Robert Sapolsky)的研究表明,
02:55
shows that individuals who cannot differentiate threat from non-threat
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那些无法区分威胁和非威胁,
02:59
and react to everything with the same response
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并对所有事情 都做出相同反应的人,
03:02
have double the level of stress hormones.
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他们的应激激素水平 是常人的两倍。
03:05
Which is why this is the first skill to learn.
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这就是为什么分类 是首先要学习的技能。
03:08
You can't take care of them all at once,
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你无法同时处理好所有事情,
03:10
but you don't have to.
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但你也没必要这样做。
03:11
Because we triage.
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因为我们可以分类。
03:13
Red -- immediately life-threatening.
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红色——立即有生命危险。
03:15
Yellow -- serious, but not immediately life-threatening.
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黄色——严重, 但不会立即有生命危险。
03:19
Green -- minor.
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绿色——轻度受伤。
03:21
And we focus our efforts first on the reds.
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我们首先重点处理 被标成红色的病人。
03:25
Now hear this.
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那么重点来了,
03:27
Part of the problem in Crazy Mode
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疯狂模式的部分问题在于,
03:29
is that you are reacting to everything
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你把所有事情当成了红色事项
03:32
as if it is red.
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来应对。
03:36
So start by triaging correctly.
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所以要从正确地分类开始,
03:40
Know your reds.
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了解你的红色事项。
03:42
They're what is most important and where you can most move the needle.
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这些是最重要, 也最能取得成效的部分。
03:46
Now it's easy to be confused by noise,
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这很容易和干扰弄混,
03:49
but what it noisiest is not always what is most red.
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但是吵得最大声的 并不一定是最紧急的。
03:53
In fact, my severe asthmatic patient is most at risk when he's quiet.
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事实上,严重哮喘的病人在安静时, 生命反而最岌岌可危。
04:00
But my patient over here, demanding that I bring her flavored coffee creamer,
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但在这边要求我 给她拿调味咖啡奶精的病人
04:04
she's noisy, but she's not red.
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虽然很吵闹,却情况并不紧急。
04:08
I'll give you an example from my own life.
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我给大家举一个我生活中的例子。
04:10
Last spring, my house flooded,
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去年春天,我的房子被水淹了,
04:12
my one-year-old was in the ER,
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当时,我一岁的孩子在急诊室,
04:14
I was supposed to do a fundraiser for my four-year-old's school
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我还要为我四岁孩子的学校 筹办募捐活动,
04:17
and the final chapter of my book was beyond late.
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并且我的书的最后一章 也已经逾期未交了。
04:23
Maybe not ironically, that was the chapter on stress.
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讽刺的是,那一章是关于压力的。
04:26
(Laughter)
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(笑声)
04:29
My red tasks were getting my one-year-old better
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我的红色任务 是让我一岁的孩子好起来,
04:32
and finishing my book.
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并且完成我的书。
04:34
That was it.
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仅此而已。
04:35
Remember, relentlessly triage.
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记住,不断地分类。
04:38
The house flood repair?
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修复被水淹的房子?
04:40
Well, once we had stopped and stabilized the damage,
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一旦我们止住漏水, 控制住损害,
04:44
it was no longer a red.
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它就不再是红色事项了。
04:46
It felt red,
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它让人感觉很紧急,
04:47
but it was in fact just noise.
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但实际上只是干扰而已。
04:50
No, no really, it was quite noisy,
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实话说,这种干扰真的非常吵,
04:52
this picture on the far right is me wearing earplugs
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右边的这张照片 是我戴着耳塞,
04:55
to focus on my book,
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专注于完成我的书,
04:56
while the floor is being mechanically dried around me.
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同时在用机器烘干我的地板。
05:00
Know your reds,
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了解你的红色事项,
05:02
and do not let your non-reds distract you from them.
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并且不要让你的非红色事项 分散你的注意力。
05:06
By the way, it is liberating with a green task
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顺便一提, 绿色任务能让你感到解脱,
05:09
to, every once in a while, be able to remind yourself,
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偶尔能提醒一下自己,
05:12
"That's a green task. No one's going to die."
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“那只是绿色任务, 没有人会死的。”
05:15
(Laughter)
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(笑声)
05:16
It's OK if it's not perfect.
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就算它不完美也没有关系。
05:22
Now there's one last triage level that we use in the worst scenarios.
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还剩一个分类等级, 我们用它来表示最坏的情景。
05:26
And that is black.
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黑色,
05:28
Those patients for whom there is nothing we can do.
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是指那些我们无能为力的病人。
05:33
Where we must move on.
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我们必须放弃他们。
05:36
And although it is gut-wrenching,
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虽然这令人无比痛苦,
05:38
I mention it,
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但我提到它,
05:39
because you each have your own equivalent black tasks in your life.
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是因为你们生活中 也同样有黑色任务。
05:44
These are items that you must take off your list.
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这些是你必须 从待办清单中移除的事项。
05:48
And I think many of you know what I'm talking about.
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我觉得很多人都知道我在说什么。
05:51
For me, this was the fundraiser.
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对我来说,这指的是募捐活动。
05:54
I had to step down.
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我必须放弃。
05:56
Because as we in the ER know,
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因为我们这样的 急诊室人员很清楚,
05:58
if you try to do everything,
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如果你试图完成每件事,
06:00
you have no hope of saving your reds.
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你就无望拯救你的红色病人。
06:05
Step two to go from Crazy Mode into Ready Mode
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从疯狂模式到就绪模式的第二步,
06:09
is to expect and design for crazy.
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是去预测疯狂,并为其做出规划。
06:13
Half of handling crazy is how you prepare for it.
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想要处理疯狂忙碌的事情, 一半在于你怎么做准备。
06:17
So if step one we triage,
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如果在第一步中, 我们将事情分类,
06:19
step two, we design to make those tasks easier to do.
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第二步,我们把这些任务 规划得更容易完成。
06:23
Science shows us that the more options we have,
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科学研究告诉我们, 当我们拥有的选择越多,
06:26
then the longer each decision takes.
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我们做出每个决定的时间就越长。
06:28
And the more decisions we have to make, the more exhausted our brain gets
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而当我们要做出的决定越多, 我们的大脑就越疲惫,
06:32
and the less it is capable of making good decisions.
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并且更难做出正确的决定。
06:35
Which is why this step two
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这就是为什么第二步
06:37
is about finding ways to reduce your daily decisions.
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是要找到办法减少 你在生活中面临的选择。
06:41
Here are four easy examples you can use in your daily lifestyle.
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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。
06:45
Plan.
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计划。
06:47
Plan your entire week's meals on the weekend,
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在周末计划你接下来一周的饮食,
06:49
so that when it's Wednesday at 6pm
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这样等到周三晚上六点,
06:51
and everyone's hangry and requesting pizza,
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大家都饿疯了, 嚷着要吃披萨的时候,
06:54
you have no decisions to make to get a healthy meal on the table.
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你无需做出选择 就能吃上一顿健康的晚餐。
06:59
Automate.
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自动化。
07:00
Never leave anything to remember that you could automate,
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能够自动完成的东西 就没必要记住,
07:04
whether it's scheduling it as recurring or saved list, or recurrent purchases.
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无论是日程表中的重复事项, 还是购物时的自动重复下单。
07:09
Colocate.
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集中放置。
07:11
When it comes to exercise,
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在健身的时候,
07:12
store all the equipment that you need for a certain activity together,
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把所有要用的器材放在一起,
07:16
charged and ready,
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充好电,准备好,
07:17
so you don't spend energy looking for it.
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这样你就不用浪费精力四处寻找。
07:20
And decrease temptations,
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还要抵制住诱惑,
07:23
for anyone driven by sugar cravings.
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如果你嗜好甜食的话。
07:26
Anyone?
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有人是这样吗?
07:27
Say aye, go ahead.
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有吧。
07:29
That itself is its own form of Crazy Mode
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甜食本身就是一种疯狂模式,
07:31
and self-medication for Crazy Mode,
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也是疯狂模式的自制解药,
07:34
but stop working your willpower.
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但不要再挑战你的意志力了。
07:37
Design differently.
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而是做出不同的规划。
07:39
If a food is out of immediate reach,
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如果某种食物不是触手可及,
07:41
such that you have to use a stool to reach it,
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比如要踩着凳子才能够到,
07:44
even when it's chocolate,
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哪怕是巧克力,
07:47
study participants ate 70 percent less without thinking about it.
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研究中的被试者也少吃了 70%, 而且没有一直惦记这回事儿。
07:53
I know.
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我知道,
07:54
Let that sit for a second.
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你细细品一品。
07:55
(Laughter)
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(笑声)
07:57
Design to make the choices you wish to make easier.
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通过规划,让你更容易做出 你希望的选择。
08:02
Which bring us to the third step to go from Crazy Mode to Ready Mode,
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这就让我们来到了从疯狂模式 转变为就绪模式的第三步:
08:06
and that is to get out of your head.
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清除你脑海中的杂念。
08:10
Come with me.
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我这里还有
08:11
Different story.
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另外一个故事。
08:13
I'm working in a small, satellite ER,
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我在一个小型的附属急诊室工作时,
08:16
when a woman comes in in labor.
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进来了一位临产的女性。
08:18
I realize that the cord is wrapped not once
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我意识到孩子的脖子被脐带缠了
08:22
but twice around the baby's neck.
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不止一圈,而是两圈。
08:26
And I'm the only doctor.
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我是唯一的当值医生。
08:30
I was scared.
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我不由心生恐惧,
08:32
But I couldn't let it derail me.
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但我不能让它干扰我。
08:36
Because, you see, we all get nervous.
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因为我们都会紧张,
08:39
We all get scared,
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我们都会害怕,
08:41
but it's what you do next that matters.
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但关键的是你接下来的行动。
08:46
That first feeling isn't the problem.
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第一感觉不是问题。
08:48
It can be an important sign.
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它可以是重要的征兆。
08:50
The problem comes when we let it derail us.
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当我们被这种感觉干扰, 才会出现问题。
08:52
When that internal monologue starts
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当我们内心独白开始,
08:54
and we catastrophize and we start to get that tunnel vision.
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我们开始想象最坏情况, 我们的眼界开始变得狭窄。
08:57
That's how you think when you're in Crazy Mode,
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这就是你在疯狂模式下的思考模式,
08:59
and you cannot solve anything that way.
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而它不能让你解决任何问题。
09:04
Now I promise to come back to the story,
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我保证等会儿会继续讲故事,
09:06
but first, how do I get out of my own head?
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但首先,我该怎样 从脑海中清除杂念?
09:10
There are many tactics that you may hear,
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你可能听说过很多小技巧,
09:12
but for me, I find it best in the moment to actively put my focus on someone else.
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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。
09:18
To deliberately make myself see the person in front of me,
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故意让自己看见面前的人,
09:21
see myself in the arena with them --
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想象自己和他们处于同一个立场——
09:23
what do they need, what do they fear
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他们需要什么,他们害怕什么,
09:25
and how can I help?
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我能怎么帮助他们?
09:28
This may sound like a whole lot of warm and fuzzy to you,
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对你们来说, 这也许听起来很模糊,
09:32
but it's not.
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但其实不是。
09:33
In fact, research shows that when you prime your brain
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事实上,研究发现, 当你用同情心
09:36
with what is, essentially, compassion,
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诱导你的大脑时,
09:39
we disrupt that tunnel vision and internal monologue.
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就能瓦解内心独白和狭窄眼界。
09:42
You widen your perception,
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你拓宽了你的感知,
09:43
so your brain can actually take in broader information,
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从而让大脑能接受更广泛的信息,
09:47
so you see more possibilities and can make better decisions.
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让你能看到更多可能性, 从而做出更好的决定。
09:53
Try it.
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试试看。
09:55
Know that your internal monologue can derail you.
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认识到你的内心独白会扰乱你,
09:59
And realize that when you get out of your own head,
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还要意识到 当你消除这些杂念的时候,
10:04
you get out of your own way.
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你就能扫除自身的障碍。
10:09
Now what happened to that baby?
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那么那名婴儿后来怎么样了?
10:12
I focused not on my fear,
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我没有关注我的恐惧,
10:14
but on the mother and the baby and what they needed me to do.
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而是专注于这位妈妈和宝宝, 以及她们需要我做些什么。
10:18
And got the cord off of the baby's neck,
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我把脐带从宝宝脖子上绕开,
10:21
and a healthy screaming, kicking baby arrived,
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一个健康哭闹着的宝宝呱呱坠地,
10:24
just as the dad ran in from the parking lot,
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这时他的爸爸 刚好从停车场冲进来,
10:26
"Hi, you have a son, I'm Dr. Darria.
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“你好,是一个男孩。 我是达莉亚医生。
10:28
Congratulations, you want to cut the cord?"
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恭喜你,你想要剪断脐带吗?”
10:30
(Laughter)
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(笑声)
10:32
And for a moment,
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那一刻,
10:33
the strong cries of a newborn
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一个新生儿有力的哭声,
10:36
drowned out the beeps and the sirens that are the normal sounds of the ER.
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盖过了急诊室司空见惯的 滴滴声和警报声。
10:42
But there was also something else.
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但还不止这些。
10:45
Because when I walked back out of that mother's room,
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当我走出那位母亲的房间时,
10:49
I saw several of my other patients hovering nearby.
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我看见有其它几位病人在附近徘徊。
10:54
I suddenly realized that despite their own problems
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我突然意识到, 虽然他们是因为各自的理由
10:58
that had brought them to the emergency room,
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来到了急诊室,
11:00
they had all come together to root for this baby.
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但他们都聚在了一起 为这个孩子加油。
11:04
And they now together shared in the joy.
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而此时他们正在共同分享喜悦。
11:08
Because that is what happens when you go from Crazy Mode to Ready Mode.
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因为这就是你从疯狂模式 进入就绪模式时发生的事。
11:12
Others notice.
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别人也会注意到,
11:14
They want it too, they just don't know how,
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他们也想要这种能力, 只是不知道该怎么做,
11:16
they just need one example.
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他们只是需要一个例子。
11:18
Which could be you.
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那可以是你。
11:23
Own the busy.
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掌控自己的忙碌状态,
11:25
But stop calling it crazy.
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但是不要再称它为疯狂。
11:30
You've always had that ability.
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你一直都有这种能力,
11:34
But now ...
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但是现在……
11:35
you're ready.
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你准备好了。
11:37
Thank you.
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谢谢。
11:39
(Applause)
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(掌声)
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