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

譯者: Mingxu Chen 審譯者: Anny Chung

A few years ago,

幾年前

my mom developed rheumatoid arthritis.

我母親患了類風濕關節炎

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

她的手腕，膝蓋根腳趾都腫起來 導致難以忍受的慢性疼痛

She had to file for disability.

她甚至需要登記殘障手冊

She stopped attending our local mosque.

無法再去清真寺

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

有些時候連早上刷牙都痛得辦不到

I wanted to help.

我想要幫她

But I didn't know how.

但我不知道該怎麼做

I'm not a doctor.

我不是醫生

So, what I am is a historian of medicine.

我只是一個醫藥歷史學家

So I started to research the history of chronic pain.

所以我開始研究慢性疼痛的歷史

Turns out, UCLA has an entire history of pain collection

結果 在UCLA有完整的

in their archives.

疼痛歷史檔案

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

我找到一個很棒的故事

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

有一個人拯救了無數個 像我母親這樣身患病痛的人

people like my mom.

讓他們免於疼痛

Yet, I had never heard of him.

但我從沒聽說過他

There were no biographies of him, no Hollywood movies.

沒有他的自傳，也沒有拍成電影

His name was John J. Bonica.

他叫做約翰 J.博尼卡

But when our story begins,

但在這個故事的起頭

he was better known as Johnny "Bull" Walker.

大家都稱他做強尼 “鬥牛” 沃克

It was a summer day in 1941.

那是1941年夏季的一天

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

馬戲團剛剛抵達一個叫 布魯克菲爾德的紐約小鎮

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

大家蜂擁而來去看鋼絲行走者，小丑們

if they were lucky, the human cannonball.

幸運一點還能看得到人體大炮

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

他們也來看壯漢 “鬥牛” 沃克

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

只要一美元，他可包準把觀眾壓倒在地

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

在那天，從馬戲團擴音器裡

over the circus P.A. system.

傳出廣播

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

他們急需一個醫生到動物區幫忙

Something had gone wrong with the lion tamer.

訓獸師出事了

The climax of his act had gone wrong,

他在表演的高潮時出了差錯

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

腦袋卡在了獅子的嘴裡

He was running out of air;

幾乎無法呼吸

the crowd watched in horror

觀眾陷入恐懼

as he struggled and then passed out.

馴獸師奮力掙扎接著昏了過去

When the lion finally did relax its jaws,

當獅子最終鬆開了下顎

the lion tamer just slumped to the ground, motionless.

馴獸師躺在地上 一動也不動

When he came to a few minutes later,

當他在幾分鐘後甦醒過來

he saw a familiar figure hunched over him.

發現在他面前蹲著的是一個熟悉的身影

It was Bull Walker.

那就是鬥牛沃克

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

這個壯漢做了人工呼吸 挽救了他的生命

Now, the strongman hadn't told anyone,

沃克沒有告訴任何人

but he was actually a third-year medical student.

自己實際上是一個三年級的醫學生

He toured with the circus during summers to pay tuition,

他參加馬戲表演是為了攢點學費

but kept it a secret to protect his persona.

但是他把這件事當做一個秘密 來保存他的身份

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

他在馬戲團應扮演一個大塊頭的莽夫

not a nerdy do-gooder.

而不是一個有學者風範的好人

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

他的同學也不知道他的秘密

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

在同儕間大家認為 運動員都是蠢笨不可救藥的那種

So he didn't tell them about the circus,

因此他沒有告訴同學馬戲團的事

or about how he wrestled professionally on evenings and weekends.

也沒告訴他們自己在晚上和週末 參加職業摔跤比賽

He used a pseudonym like Bull Walker,

他使用像Bull Walker 或者是

or later, the Masked Marvel.

Masked Marvel 的藝名

He even kept it a secret that same year,

甚至當他贏得了輕量組的

when he was crowned the Light Heavyweight Champion

世界冠軍時

他依然沒有將秘密透漏出去

of the world.

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

那些年來 博尼卡同時過著兩條不同的生活

He was a wrestler;

一名摔跤手

he was a doctor.

一位醫生

He was a heel;

一名混蛋

he was a hero.

一位英雄

He inflicted pain,

他造就痛苦

and he treated it.

他施予治療

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

在那時他並不知道 但在接下來的50年

he'd draw on these dueling identities

他將會利用這兩個相對決的生命經驗

to forge a whole new way to think about pain.

去探索關於疼痛的新思路

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

這將改造現代醫學，以至於幾十年後

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

時代周刊將稱他為疼痛研究之父

But that all happened later.

當然 那都是之後發生的事情了

In 1942, Bonica graduated medical school and married Emma,

1942年，博尼卡畢業並和他的甜心

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

在一次比賽中結識的艾瑪 結了婚

He still wrestled in secret -- he had to.

他依然不得不繼續秘密地摔跤

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

因為在紐約聖文森特醫院實習並無薪水

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

靠著他的冠軍腰帶

like Madison Square Garden,

他在麥迪遜花園廣場等的大場地

against big-time opponents,

與著名對手較勁

like Everett "The Blonde Bear" Marshall,

例如 “金色大熊” 馬歇爾

or three-time world champion, Angelo Savoldi.

或者是三屆世錦賽冠軍 賽沃爾迪

The matches took a toll on his body;

這些比賽損傷了他的身體

he tore hip joints, fractured ribs.

磨損了他的肌腱 並導致了數根肋骨骨折

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

一晚 “恐怖突厥”的腳趾在沃克的臉上劃了一道 像艾爾卡朋臉上的傷疤

down the side of his face.

（卡朋 芝加哥黑幫老大 左頰上有三條傷疤)

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

隔天早晨上班時，他只好戴口罩掩飾傷口

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

有兩次，博尼卡上手術房跟刀時

眼睛瘀傷嚴重至他根本看不清

he couldn't see out of it.

But worst of all were his mangled cauliflower ears.

不過最糟糕的是那雙被打開花的耳朵

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

感覺就像在大腦兩邊掛了個棒球

Pain just kept accumulating in his life.

疼痛不斷在他的生活中積累

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

他看著他的妻子於他工作的醫院生產

She heaved and pushed, clearly in anguish.

她努力推，很明顯十分痛苦

Her obstetrician called out to the intern on duty

產科醫生叫當值的實習生

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

去給她用些乙醚以減輕痛苦

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

但是實習生尚年輕，工作僅三星期

he was jittery, and in applying the ether,

他非常緊張 用乙醚的時候

irritated Emma's throat.

刺激了艾瑪的喉嚨

She vomited and choked, and started to turn blue.

她的嘔吐物阻擋呼吸道 臉色發紫

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

博尼卡看到了這一切 趕走了實習醫師

cleared her airway,

清空艾瑪的呼吸道

and saved his wife and his unborn daughter.

挽救了他的妻子和還未出世的女兒

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

就在那一刻 他決定將於生投身於麻醉醫學

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

後來 他甚至發明用於產婦的無痛分娩技術

But before he could focus on obstetrics,

但是在他聚焦於婦產科之前

Bonica had to report for basic training.

博尼卡得到部隊報到

Right around D-Day,

大概在諾曼底登陸的時候

Bonica showed up to Madigan Army Medical Center,

博尼卡加入了接近 Tacoma

的馬迪根陸軍醫學中心

near Tacoma.

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

座擁 7700 床位 它是全美最大的陸軍醫院

Bonica was in charge of all pain control there.

博尼卡在那裡負責所有疼痛治療

He was only 27.

他當時僅 27 歲

Treating so many patients, Bonica started noticing cases

在治療了很多病人之後 博尼卡開始注意到

that contradicted everything he had learned.

一些案例和他學到的知識完全不符

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

疼痛被視為身體的警報

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

是身體對於受傷 -- 如骨折 -- 的反應

But in some cases,

但是在某些情況下

like after a patient had a leg amputated,

比如照料一名腿部截肢的病人

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

病人可能抱怨 在那條不存在的腿上仍感到疼痛

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

但是如果說傷口被治療了 為什麼警報會持續個不停?

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

還有一些其他的病例 患者沒有任何創傷

and yet, still the patient hurt.

卻依然感受到疼痛

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

博尼卡和醫院裡的所有專家

neurologists, psychiatrists, others.

外科醫生 神經科醫師 精神病學者等等交流

And he tried to get their opinions on his patients.

聽聽他們對病人的看法

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

這很費時，因此他是開始在午餐期間 組織小組會議

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

以一個專家團隊去同病患的疼痛作抗爭

No one had ever focused on pain this way before.

從來沒有人如此專注於疼痛

After that, he hit the books.

接下來，他沉迷書中

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

他讀遍了所有能找到的醫學書

carefully noting every mention of the word "pain."

小心翼翼地標記任何關於疼痛的出處

Out of the 14,000 pages he read,

在他讀遍的14000頁中

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

“疼痛”這個詞僅出現於17頁半

Seventeen and a half.

只有17頁半啊

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

疼痛對病人們來說可是 最基礎、普遍、又無可奈何的事情

Bonica was shocked -- I'm quoting him,

博尼卡被深深地震撼了，他說:

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

"見鬼 從這裡可得出什麼结論?

The most important thing from the patient's perspective,

病人角度來看最重要的事情

they don't talk about."

他們卻避而不談。"

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

所以在接下來的八年 博尼卡不斷的提起它

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

他不斷的記錄 他將會填補那些缺失的頁數

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

他寫了一部被後世稱為疼痛學的聖經

In it he proposed new strategies,

在此書中提出了一個新的方法

new treatments using nerve-block injections.

神經阻滯注射法

He proposed a new institution, the Pain Clinic,

基於那些午間討論

他提出了一個全新的部門 疼痛診療部

based on those lunchtime meetings.

But the most important thing about his book

但這本書最重要的貢獻是

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

它是對醫療界的一個當頭棒喝

A desperate plea to doctors to take pain seriously

讓醫生在病患的生活中

沒有絲毫藉口不去認真對待疼痛

in patients' lives.

He recast the very purpose of medicine.

他完完全改變了醫學的目標

The goal wasn't to make patients better;

目標並不是讓病患“更好”

it was to make patients feel better.

而是讓病患感覺更好

He pushed his pain agenda for decades,

他不遺餘力的推行他的疼痛病學

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

直到最終在七O 年代被人所接受

Hundreds of pain clinics sprung up all over the world.

疼痛科如雨後春筍般在全世界發展

But as they did -- a tragic twist.

然而在這其中 悲劇發生了

Bonica's years of wrestling caught up to him.

博尼卡這麼多年的摔跤歷史傷了身體

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

儘管他已經遠離比賽二十多年了

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

但是1500多場比賽 在他的身體中總會留下印記

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

在他50多歲時 已患有嚴重的關節炎

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

接下去的二十年 他總共做了二十二次手術

including four spine operations,

這其中包括四次脊柱手術

and hip replacement after hip replacement.

和一次接一次的髋關節置换手術

He could barely raise his arm, turn his neck.

他幾乎無法舉起胳膊 轉動脖子

He needed aluminum crutches to walk.

走路也要靠拐杖

His friends and former students became his doctors.

朋友和從前的學生變成了他的醫生

One recalled that he probably had more nerve-block injections

據說他接受的神經阻滯麻醉次數

than anyone else on the planet.

超過世界上任何一個人

Already a workaholic, he worked even more --

他每天工作15到18個小時

遠超一個工作狂的定義

15- to 18-hour days.

Healing others became more than just his job,

治療他人不僅僅是他的工作

it was his own most effective form of relief.

而是他一生的信仰

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

“如果我不這麼工作下去” 他告訴記者

"I would be a completely disabled guy."

“我將會是一個廢人”

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

在1980年代早期 一次去佛羅里達的出差中

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

博尼卡讓一個從前的學生 載著自己去Tampa的海德公園

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

他們穿過一排排棕櫚樹

停在了裡面有銀色巨大的加農炮的車庫前

with giant silver howitzer cannons hidden in the garage.

The house belonged to the Zacchini family,

這間房子屬於査西尼一家

who were something like American circus royalty.

査西尼一家差不多是美國馬戲團的貴族

Decades earlier, Bonica had watched them,

幾十年前 博尼卡曾經看過他們的表演

clad in silver jumpsuits and goggles,

身穿銀色緊身衣頭戴護目鏡

doing the act they pioneered -- the Human Cannonball.

來表演人體大炮

But now they were like him: retired.

不過現在他們和他一樣 業已退休

That generation is all dead now, including Bonica,

那一代人都已經消逝（包括博尼卡）

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

所以沒有人知道他們談論了什麼

But still, I love imagining it.

不過我很喜歡想像那一天發生的事情

The strongman and the human cannonballs reunited,

壯漢和人體大炮表演者重逢

showing off old scars, and new ones.

互相炫耀自己的傷疤

Maybe Bonica gave them medical advice.

或許博尼卡告訴他們如何療傷

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

或許他會告訴他們

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

在馬戲團和摔跤的經歷塑造了他的生活

Bonica saw pain close up.

博尼卡將病痛視為生命的一部分

He felt it. He lived it.

他感受它 和它為伴

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

這讓他無法忽視其他人的痛苦

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

出於同情 他意外開創了一個新領域

played a major role in getting medicine to acknowledge pain

並於促使醫學慎重對待疼痛上

in and of itself.

扮演了重要角色

In that same oral history,

在一個採訪中

Bonica claimed that pain

博尼卡曾聲稱疼痛

is the most complex human experience.

是人類最複雜的體驗

That it involves your past life, your current life,

它涉及了你從前的生活 你現在的生活

your interactions, your family.

你的家庭 你的人際關係

That was definitely true for Bonica.

對博尼卡來說確實如此

But it was also true for my mom.

對於我的母親 依然成立

It's easy for doctors to see my mom

醫生很容易把我的母親視為

as a kind of professional patient,

一個 "職業病人"

a woman who just spends her days in waiting rooms.

一個常年待在候診室的人

Sometimes I get stuck seeing her that same way.

有時我也是這麼想的

But as I saw Bonica's pain --

但是當我審視博尼卡先生的病痛

a testament to his fully lived life --

疼痛是他精彩一生的證明

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

我逐漸回想起 我母親的疼痛所包含的種種

Before they got swollen and arthritic,

在手指還沒因關節炎變而浮腫之前

my mom's fingers clacked away

我母親的雙手於電腦鍵盤上

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

於醫院的人事部工作

They folded samosas for our entire mosque.

為大家包 samosas （咖喱角）

When I was a kid, they cut my hair,

當我還是個孩子的時候 那雙手為我理髮

wiped my nose,

擦乾淨我的鼻子

tied my shoes.

為我繫鞋帶

Thank you.

謝謝大家

(Applause)

（掌聲）