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譯者: Joan Liu
審譯者: Yakun Li
00:15
Our face is hugely important
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我們的臉部非常重要
00:18
because it's the external, visual part
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因為我們的臉部裸露在外
00:20
that everybody else sees.
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大家都會看到
00:22
Let's not forget it's a functional entity.
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但我們不要忘記,臉部也是有實際功用的。
00:24
We have strong skull bones
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我們有強壯的頭顱骨,
00:26
that protect the most important organ in our body: the brain.
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用來保護我們身上最重要的器官:腦。
00:29
It's where our senses are located, our special senses --
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這是我們感官的所在,我們特別的感官 ——
00:32
our vision, our speech,
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視覺、說話能力、
00:34
our hearing, our smell, our taste.
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聽覺、嗅覺、味覺。
00:36
And this bone
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這塊骨頭上
00:38
is peppered, as you can see, with the light shining through the skull
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分散着一些別的東西,你可以透過光看到,上面有
00:41
with cavities, the sinuses,
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一些孔洞,這是鼻竇
00:43
which warm and moisten the air we breathe.
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可以將我們吸入的空氣加溫加溼。
00:46
But also imagine if they were filled with solid bone --
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但想想看,如果這是塊實心的骨頭,
00:49
our head would be dead weight,
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我們的頭會非常重,
00:51
we wouldn't be able to hold it erect,
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重到我們無法將之豎直。
00:53
we wouldn't be able to look at the world around us.
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我們也就沒有辦法看我們周遭的世界。
01:02
This woman is slowly dying
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這位女性正在步入死亡,
01:04
because the benign tumors in her facial bones
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因為他她臉部骨頭上的良性腫瘤
01:07
have completely obliterated her mouth and her nose
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已經封住了她的口鼻,
01:10
so she can't breathe and eat.
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導致她無法呼吸和進食。
01:12
Attached to the facial bones
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臉骨上連著
01:14
that define our face's structure
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的肌肉構成了臉部的結構
01:18
are the muscles that deliver our facial expression,
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這些肌肉也讓我們可以有臉部表情,
01:21
our universal language of expression,
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一個人類中共通的語言
01:24
our social-signaling system.
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一個人與人交往的信號系統
01:26
And overlying this is the skin drape,
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在這外面是皮質層,
01:29
which is a hugely complex
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是一個很複雜、
01:31
three-dimensional structure --
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立體的結構:
01:33
taking right-angled bends here and there,
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在恰當的地方凹折
01:35
having thin areas like the eyelids,
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有像眼皮這樣很薄的部份、
01:38
thick areas like the cheek, different colors.
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也有像臉頰般厚、不同顏色的部份。
01:41
And then we have the sensual factor of the face.
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然後臉部還有負責感官的部份。
01:44
Where do we like to kiss people?
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我們最喜歡親吻的哪裡?
01:46
On the lips. Nibble the ears maybe.
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嘴唇,或是輕咬耳朵。
01:49
It's the face where we're attracted to with that.
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我們被臉部所吸引,想要親吻
01:52
But let's not forget the hair.
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但我們也別忘記了毛髮
01:54
You're looking at the image on your left-hand side --
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你們現在看看左邊的這張照片。
01:56
that's my son with his eyebrows present.
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那是我兒子有眉毛的樣子
01:58
Look how odd he looks with the eyebrows missing.
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看看他沒有眉毛時有多奇怪。
02:01
There's a definite difference.
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這裡有一個很明顯的差別。
02:03
And imagine if he had hair sprouting from the middle of his nose,
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想像一下他鼻子中間冒出毛髮
02:05
he'd look even odder still.
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他鐵定看起來會更怪。
02:07
Dysmorphophobia
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醜狀恐懼症
02:09
is an extreme version
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是一種極端的例子,
02:11
of the fact that we don't see ourselves
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是一種我們看到的自己
02:13
as others see us.
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與他人看到的我們很不相同的症狀。
02:15
It's a shocking truth
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很驚人的事實是
02:17
that we only see mirror images of ourselves,
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我們只能從鏡子中看到我們自己,
02:20
and we only see ourselves
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或是從
02:22
in freeze-frame photographic images
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不動的照片等圖像中看到自己,
02:24
that capture a mere fraction of the time that we live.
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但這些只是我們生命中的一小部份。
02:27
Dysmorphophobia
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醜狀恐懼症
02:29
is a perversion of this
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是這個現象的一種變態的症狀,
02:31
where people who may be very good looking
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表現是長得還不錯的人
02:33
regard themselves as hideously ugly
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認為自己極度醜陋
02:35
and are constantly seeking surgery
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且不斷地尋求整形手術
02:37
to correct their facial appearance.
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來改正他們的臉部外貌。
02:40
They don't need this. They need psychiatric help.
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他們不需要整形手術,他們需要的是心理幫助
02:43
Max has kindly donated his photograph to me.
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Max很好心的捐了這張照片給我。
02:45
He doesn't have dysmorphophobia, but I'm using his photograph
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他沒有醜狀恐懼症,但我用他的照片
02:48
to illustrate the fact that he looks exactly like a dysmorphophobic.
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來顯示他長得就跟一個醜狀恐懼症病患一樣。
02:50
In other words, he looks entirely normal.
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換句話說,他長得非常正常。
02:53
Age is another thing
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年齡是另一個
02:56
when our attitude toward our appearance changes.
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改變我們對自己的外表的態度的因素。
02:58
So children judge themselves, learn to judge themselves,
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孩童們經由周圍的大人們的行為來
03:01
by the behavior of adults around them.
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評斷、學著評斷他們自己。
03:04
Here's a classic example: Rebecca has a benign blood vessel tumor
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這是個經典的例子:Rebecca有一個良性的血管腫瘤
03:07
that's growing out through her skull, has obliterated her nose,
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從她的頭顱內長出來,已經埋沒了她的鼻子,
03:10
and she's having difficulty seeing.
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並且影響到了她的視力
03:12
As you can see, it's blocking her vision.
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你們可以看到,腫瘤已經擋到她的視線了。
03:14
She's also in danger, when she damages this,
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如果她弄傷這個腫瘤,她也有
03:16
of bleeding profusely.
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大量失血的危險。
03:18
Our research has shown
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我們的研究顯示
03:20
that the parents and close loved ones of these children
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這樣孩子的父母親及關愛他們的人
03:23
adore them.
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非常喜歡他們。
03:25
They've grown used to their face; they think they're special.
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他們已經習慣了他們的臉蛋,他們覺得這很特別。
03:28
Actually, sometimes the parents argue
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事實上,有時候他們的父母親
03:30
about whether these children should have the lesion removed.
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會為了是否要將這些缺陷移除而起爭執。
03:33
And occasionally they suffer intense grief reactions
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偶而他們會感到強烈的悲傷
03:35
because the child they've grown to love
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因為他們已經漸漸愛上的孩子
03:37
has changed so dramatically and they don't recognize them.
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有了非常大的轉變,使他們無法認出孩子。
03:40
But other adults
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但有些其他成年人
03:42
say incredibly painful things.
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會說一些非常傷人的話。
03:44
They say, "How dare you take this child out of the house
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他們說:「你怎麼可以帶這樣的孩子出去
03:46
and terrify other people.
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會嚇到其他人!
03:48
Shouldn't you be doing something about this? Why haven't you had it removed?"
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你不是應該做些甚麼嗎?你不是該把那個東西拿掉嗎?」
03:51
And other children in curiosity come up and poke the lesion,
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然後其他小孩好奇地圍過來戳病變的地方,
03:54
because -- a natural curiosity.
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純粹是因為好奇。
03:56
And that obviously alerts the child
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這樣很顯然地會讓這孩子
03:58
to their unusual nature.
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警覺他自己與別人不同的特質。
04:00
After surgery, everything normalizes.
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手術過後,一切都回歸正常。
04:03
The adults behave more naturally,
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成年人表現得更正常,
04:05
and the children play more readily with other children.
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孩子更容易和其他孩子玩耍。
04:08
As teenagers --
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在青少年時期,
04:11
just think back to your teenage years --
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就想想你們的青少年時期,
04:13
we're going through a dramatic
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那時我們都會經歷一些巨大的變化,
04:15
and often disproportionate change
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尤其是我們的臉部
04:17
in our facial appearance.
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會有一些相比而言更加顯著的變化
04:19
We're trying to struggle to find our identity.
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那時的我們為了找到自己的定位而努力
04:21
We crave the approval of our peers.
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我們渴望得到同齡人的肯定。
04:23
So our facial appearance is vital to us
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當我們試圖向世界展示自己的時候
04:26
as we're trying to project ourselves to the world.
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我們的臉部的樣子對我們就至關重要
04:28
Just remember that single acne spot
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想想那個臉上冒出來的一個青春痘
04:30
that crippled you for several days.
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就讓你不開心了好幾天。
04:34
How long did you spend looking in the mirror every day,
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你一天花多少時間站在鏡子前面
04:37
practicing your sardonic look, practicing your serious look,
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練習你的嘲諷表情,練習你的嚴肅表情
04:40
trying to look like Sean Connery, as I did,
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或像我一樣試著看起來像sean connery(蘇格蘭演員)那樣
04:42
trying to raise one eyebrow?
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只揚起一邊的眉毛。
04:44
It's a crippling time.
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那是一段令人不正常的時間
04:46
I've chosen to show this profile view of Sue
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我選了這張Sue的側面照
04:50
because what it shows is her lower jaw jutting forward
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因為可以看出她的下巴突出
04:53
and her lower lip jutting forward.
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且她的下唇也往前突出。
04:55
I'd like you all in the audience now to push your lower jaw forward.
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請在座各位把你們的下巴往前推,
04:58
Turn to the person next to you,
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然後看看你旁邊的人,
05:00
push your lower jaws forward. Turn to the person next to you
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把下巴凸出,轉向你旁邊的人,
05:02
and look at them -- they look miserable.
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看看他們--他們看起來很慘兮兮的
05:04
That's exactly what people used to say to Sue.
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那就是人們一直跟Sue說的。
05:07
She wasn't miserable at all.
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但她一點都不感到悲慘
05:09
But people used to say to her, "Why are you so miserable?"
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但人們一直跟她說:「為什麼你那麼慘兮兮的?」
05:13
People were making misjudgments all the time
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人們總是誤解她的
05:16
on her mood.
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心情。
05:18
Teachers and peers were underestimating her; she was teased at school.
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老師和同儕總是低估她,她在學校被人嘲笑。
05:21
So she chose to have facial surgery.
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所以她選擇了臉部整形。
05:23
After the facial surgery,
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整形過後,
05:25
she said, "My face now reflects my personality.
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她說:「我的臉蛋現在可以反映出我的個性了。
05:28
People know now that I'm enthusiastic,
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人們知道我很熱心,
05:31
that I'm a happy person."
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我是個快樂的人。」
05:33
And that's the change that can be achieved for teenagers.
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而且這是個在青少年身上可以做到的改變。
05:37
Is this change, though, a real change,
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這樣的改變是一個真的改變嗎?
05:39
or is it a figment of the imagination
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還是只是病患自己
05:42
of the patient themselves?
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腦海中的想像?
05:44
Well we studied teenagers' attitudes
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我們研究了青少年
05:46
to photographs of patients having this corrective facial surgery.
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對有過這樣的改正性臉部手術照片的態度。
05:48
And what we found was --
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下面就是我們的研究結果
05:51
we jumbled up the photographs
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我們把照片弄亂
05:53
so they couldn't recognize the before and after --
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讓他們認不出哪些是術前照片哪些是術後照片。
05:55
what we found was that the patients were regarded
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我們發現,術後的病患
05:57
as being more attractive after the surgery.
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看起來更具吸引力。
05:59
Well that's not surprising, but we also asked them to judge them
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當然這不令人驚訝,但我們也要被試青少年們判斷這些照片人物的
06:02
on honesty, intelligence,
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誠實度、智商、
06:04
friendliness, violence.
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友善度、暴力程度。
06:07
They were all perceived as being
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在術前他們給人的感覺是
06:09
less than normal in all those characteristics --
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在這些特質上不正常的
06:11
more violent, etc. -- before the surgery.
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手術前的形象被認為更暴力
06:14
After the surgery,
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術後
06:16
they were perceived as being more intelligent,
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他們給人的感覺是更聰明、
06:18
more friendly, more honest, less violent --
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更友善、更誠實、較不暴力。
06:21
and yet we hadn't operated on their intellect
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但我們並沒有改變他們的
06:23
or their character.
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智商或者個性
06:25
When people get older,
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隨著年紀增長,
06:27
they don't necessarily choose to follow this kind of surgery.
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他們不一定會選擇這樣的手術。
06:30
Their presence in the consultation suite
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他們在諮商室的原因是
06:32
is a result of the slings and arrows of outrageous fortune.
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一連串厄運的結果。
06:35
What happens to them
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他們是經歷了癌症
06:37
is that they may have suffered cancer or trauma.
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或創傷的病患。
06:39
So this is a photograph of Henry,
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這是一張亨利的照片。
06:41
two weeks after he had a malignant cancer removed
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這是他移除左臉上的惡性腫瘤後
06:44
from the left side of his face -- his cheekbone,
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兩個禮拜的照片,包括左臉臉頰、
06:47
his upper jaw, his eye-socket.
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上顎、眼圈。
06:49
He looks pretty good at this stage.
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他在這個階段看起來很不錯。
06:51
But over the course of the next 15 years he had 14 more operations,
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但在接下來的十五年內他又接受了十四次整形手術,
06:54
as the disease ravaged his face
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因為疾病摧殘著他的臉
06:56
and destroyed my reconstruction regularly.
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且定期地破壞我的整形結果。
06:58
I learned a huge amount from Henry.
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我從亨利身上學到很多。
07:00
Henry taught me
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亨利讓我瞭解
07:02
that you can carry on working.
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一個這樣的病患可以繼續工作。
07:04
He worked as an advocate. He continued to play cricket.
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他的工作是辯護者。他繼續打板球。
07:07
He enjoyed life to the full,
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他很享受著他的生活。
07:09
and this was probably because he had a successful, fulfilling job
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且這很有可能是因為他有一個成功的、有滿足感的工作
07:11
and a caring family
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和一個關懷他的家人
07:13
and was able to participate socially.
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並且他仍然可以進行正常的社交活動。
07:15
He maintained a calm insouciance.
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他一種冷靜而漫不經心的生活態度
07:18
I don't say he overcame this; he didn't overcome it.
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我不是說他克服了自己的問題,他並沒有。
07:21
This was something more than that. He ignored it.
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他做到了比克服更難的:他忽視了它。
07:24
He ignored the disfigurement that was happening in his life
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他忽視他生命中這些扭曲的部份
07:27
and carried on oblivious to it.
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然後繼續過他的生活,無視這些扭曲。
07:30
And that's what these people can do.
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這就是這些人可以做的。
07:32
Henriapi illustrates this phenomenon as well.
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Henriapi也同樣做到了這點。
07:34
This is a man in his 20s
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這是一個二十多歲的男人。
07:36
whose first visit out of Nigeria was with this malignant cancer
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他第一次離開尼日利亞就是為了來英國
07:39
that he came to the United Kingdom to have operated on.
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來移除臉上的這個惡性腫瘤。
07:41
It was my longest operation.
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這是我做過最長的手術。
07:43
It took 23 hours. I did it with my neurosurgeon.
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手術花了23小時。我和一個神經外科醫生一起完成的。
07:46
We removed all the bones at the right side of his face --
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我們把他右半邊的臉的骨頭全部拿出來,
07:48
his eye, his nose,
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包括他的眼睛、他的鼻子、
07:50
the skull bones, the facial skin --
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他的頭顱骨、他的臉部皮膚,
07:52
and reconstructed him with tissue from the back.
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然後利用他背部的組織來復建。
07:55
He continued to work as a psychiatric nurse.
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他繼續當一個心理護士。
07:57
He got married. He had a son called Jeremiah.
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他後來結婚且生了一個名為Jeremiah的兒子。
08:00
And again, he said,
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再次的他說:「
08:02
"This painting of me with my son Jeremiah
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這幅我和我兒子Jeremiah的圖畫
08:05
shows me as the successful man that I feel that I am."
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顯示出了我是一個成功男人,就像我自己認為的這樣。」
08:08
His facial disfigurement
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他臉部的變形
08:10
did not affect him
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並沒有影響他,
08:12
because he had the support of a family;
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因為他有家人的支持
08:14
he had a successful, fulfilling job.
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和成功、有滿足感的工作。
08:16
So we've seen that we can change people's faces.
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所以我們已經看到我們可以改變人們的臉部。
08:19
But when we change people's faces,
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但當我們改變人們的臉的時候,
08:21
are we changing their identity --
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我們有改變他們的對自己定位嗎?
08:23
for better or for worse?
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不管是變好還是變壞。
08:26
For instance,
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舉例來說,
08:28
there are two different types of facial surgery.
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主要有兩種臉部手術。
08:30
We can categorize it like that.
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我們可以將它分類。
08:32
We can say there are patients who choose to have facial surgery --
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我們可以說有些病患選擇要做臉部手術--
08:34
like Sue.
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像是Sue。
08:36
When they have facial surgery,
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當他們做了臉部手術後
08:38
they feel their lives have changed
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他們感覺他們的人生改變了。
08:40
because other people perceive them
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因為其他人對他們的看法變了
08:43
as better people.
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認為他們是更好的人
08:45
They don't feel different.
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他們不會感覺不同。
08:47
They feel that they've actually gained
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他們感覺他們真的得到了
08:49
what they never had,
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他們之前沒有的東西,
08:51
that their face now reflects their personality.
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那就是他們的臉終於可以反映出他們的個性。
08:53
And actually that's probably the difference between cosmetic surgery
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事實上這就是是美容手術和這樣的手術
08:56
and this kind of surgery.
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的區別
08:58
Because you might say, "Well, this type of surgery
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因為你可能會說:「嗯,這樣的手術
09:01
might be regarded as cosmetic."
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可以被看成是美容整形手術。」
09:03
If you do cosmetic surgery, patients are often less happy.
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如果你做整形手術,病患一般來說比較不開心。
09:06
They're trying to achieve difference in their lives.
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他們想要改變人生。
09:12
Sue wasn't trying to achieve difference in her life.
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Sue不是要改變人生,
09:14
She was just trying to achieve the face
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她只是想要她的臉
09:16
that matched her personality.
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和她的個性相符。
09:18
But then we have other people
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但也有一些其他人
09:20
who don't choose to have facial surgery.
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不會選擇臉部手術。
09:22
They're people who have their face shot off.
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他們是那些臉被槍打毀的人
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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讓我為在座那些較膽小的人把這圖片拿掉,換成一張空白的投影片
09:27
They have it forced upon them.
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他們的臉部是被強加在他們身上的。
09:29
And again, as I told you,
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再次的,讓我提醒你們,
09:31
if they have a caring family
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如果他們有個關懷他們的家庭
09:33
and good work life,
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和好工作,
09:36
then they can lead normal and fulfilled lives.
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那們他們可以有一個正常且滿足的生活。
09:39
Their identity doesn't change.
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他們的身分並沒有被感變。
09:41
Is this business
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這樣在乎外表
09:43
about appearance and preoccupation with it
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的情況
09:45
a Western phenomenon?
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只存在於西方文化嗎?
09:47
Muzetta's family give the lie to this.
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Muzetta的家庭告訴我們不是的。
09:50
This is a little Bangladeshi girl from the east end of London
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這是倫敦東部的一個孟加拉女孩,
09:53
who's got a huge malignant tumor on the right side of her face,
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她右臉上有一個很大的惡性腫瘤。
09:56
which has already made her blind
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這已經讓她變瞎了
09:58
and which is rapidly growing and is going to kill her shortly.
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並且如果這個腫瘤繼續成長的話,很快就會取了她的生命。
10:00
After she had surgery to remove the tumor,
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腫瘤移除手術後,
10:03
her parents dressed her in this beautiful green velvet dress,
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她父母親為她穿上漂亮的綠絲絨洋裝
10:06
a pink ribbon in her hair,
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在她頭髮上系上一個粉紅色的絲帶
10:08
and they wanted the painting to be shown around the world,
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他們希望這幅畫可以在全世界展示,
10:10
despite the fact that they were orthodox Muslims
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雖然他們是保守伊斯蘭教徒
10:13
and the mother wore a full burqa.
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且他母親是穿全身的罩袍的。
10:15
So it's not simply a Western phenomenon.
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所以這不是只是西方的問題。
10:20
We make judgments on people's faces
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我們幾乎隨時都在
10:22
all the time.
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對別人的臉作出評判
10:24
It's been going on since we can think of Lombroso
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這可以追朔到朗柏朔的犯罪學說時代,
10:27
and the way he would define criminal faces.
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包括他如何定義“罪犯臉“
10:29
He said you could see criminal faces,
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他說你可以可以看出哪些是”罪犯臉“
10:31
judging them just on the photographs that were showed.
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僅從照片就可以
10:34
Good-looking people
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長得好看的人
10:36
are always judged as being more friendly.
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會被認為是比較有親和力的。
10:38
We look at O.J. --
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看看O.J.
10:40
he's a good-looking guy.
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他是個長得還不錯的人。
10:42
We'd like to spend time with him. He looks friendly.
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我們會想要跟他在一起。他看起來很好相處。
10:45
Now we know that he's a convicted wife-batterer,
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但現在我們知道他是個家庭暴力者,
10:48
and actually he's not the good guy.
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並且事實上他不是個好人。
10:50
And beauty doesn't equate to goodness,
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而且美貌跟好心是不能劃上等號的,
10:54
and certainly doesn't equate to contentment.
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而且也絕對不能跟滿足感劃上等號。
10:57
So we've talked about the static face
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所以我們已經談了靜態的臉,
10:59
and judging the static face,
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也評斷靜態的臉。
11:01
but actually, we're more comfortable
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但事實上,我們更會評斷
11:03
with judging the moving face.
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動態的臉。
11:05
We think we can judge people on their expressions.
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我們認為我們可以透過人們的表情評斷他們。
11:08
U.K. jurors in the U.K. justice system
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英國法律體制下的陪審團
11:11
like to see a live witness
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喜歡在在現場觀察證人
11:13
to see whether they can pick up the telltale signs of mendacity --
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看是否能看出一些謊言的蛛絲馬跡:
11:16
the blink, the hesitation.
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眨眼、猶豫。
11:19
And so they want to see live witnesses.
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所以他們喜歡到現場的證人
11:22
Todorov tells us that, in a tenth of a second,
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Todorov 告訴我們,在十分之一秒中,
11:25
we can make a judgment on somebody's face.
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我們可以對一個人的臉做出一個評判
11:28
Are we uncomfortable with this image? Yes, we are.
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我們會覺得這張圖片讓人不舒服嗎?是的。
11:31
Would we be happy if our doctor's face, our lawyer's face,
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如果我們的醫生、我們的律師、
11:34
our financial adviser's face was covered?
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我們的理財顧問把臉遮起來,我們會開心嗎?
11:36
We'd be pretty uncomfortable.
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我們會很不舒服。
11:38
But are we good at making the judgments
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但我們真的能夠由臉部外貌和動作
11:40
on facial appearance and movement?
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做出正確的評斷嗎?
11:43
The truth is that there's a five-minute rule,
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事實上有個五分鐘規則,
11:45
not the tenth-of-a-second rule like Todorov, but a five-minute rule.
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不是像Todorov說的十分之一秒,而是五分鐘。
11:48
If you spend five minutes with somebody,
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如果你跟一個人在一起超過五分鐘,
11:50
you start looking beyond their facial appearance,
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你就會開始注意臉部外貌以外的情況
11:52
and the people who you're initially attracted to
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一些一開始吸引你的人
11:54
may seem boring and you lose interest in them,
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可能會讓你覺得無聊然後你對他們就沒有興趣了
11:56
and the people who you didn't immediately seek out,
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然後那些你因為他們沒有長得特別好看
11:58
because you didn't find them particularly attractive,
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而馬上註意到的人
12:00
become attractive people
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可能會用他們的個性
12:02
because of their personality.
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吸引上你
12:05
So we've talked a lot about facial appearance.
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所以我們已經談了很多關於臉部外貌的東西。
12:08
I now want to share
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我現在想要分享一些
12:10
a little bit of the surgery that we do --
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關於我們做的手術:
12:12
where we're at and where we're going.
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現狀和未來的走向
12:14
This is an image of Ann
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這是一張Ann的圖片。
12:16
who's had her right jaw removed and the base of her skull removed.
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她的右顎和頭顱骨基底被移除了。
12:18
And you can see in the images afterward,
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在後面的圖像中
12:20
we've managed to reconstruct her successfully.
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你可以看到我們成功地重建了她的臉
12:22
But that's not good enough.
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但那還不夠好。
12:24
This is what Ann wants. She wants to be out kayaking,
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那不是Ann要的。她想要能夠出去划船,
12:26
she wants to be out climbing mountains.
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她要能夠出去爬山。
12:28
And that's what she achieved, and that's what we have to get to.
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且那是她做到的,也是我們必須讓她能夠做到的。
12:30
This is a horrific image,
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這是個恐怖的圖像,
12:32
so I'm putting my hand up now.
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所以我也把我的手舉起來了。
12:34
This is a photograph of Adi,
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這是一張Adi的照片。
12:36
a Nigerian bank manager who had his face shot off
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他是一個尼日利亞的銀行主管
12:38
in an armed robbery.
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他的臉在一個武裝搶劫中被打毀
12:40
And he lost his lower jaw, his lip, his chin
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他失去了下顎、嘴唇、下巴、
12:42
and his upper jaw and teeth.
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上顎和牙齒
12:44
This is the bar that he set for us.
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這是他給我們的標準。
12:46
"I want to look like this. This is how I looked before."
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「我想要看起來像這樣。這是我之前的長相。」
12:49
So with modern technology,
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以現在的科技,
12:51
we used computers to make models.
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我們利用電腦來作模型。
12:54
We made a model of the jaw without bone in it.
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我們做了一個沒有骨頭的顎模型。
12:56
We then bent a plate up to it.
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然後我們做了一個金屬板。
12:58
We put it in place
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我們把它放在該在的位置,
13:00
so we knew it was an accurate position.
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讓我們知道正確的位置。
13:02
We then put bone and tissue from the back.
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然後我們從背部提取骨頭和組織。
13:05
Here you can see the plate holding it,
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這裡我們可以看到金屬板固定,
13:07
and you can see the implants being put in --
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你也可以看到移植組織置入--
13:10
so that in one operation
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所以一個手術後
13:12
we achieve this
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我們做到
13:15
and this.
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這樣。
13:17
So the patient's life is restored.
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這樣病患的生活就重歸正軌了
13:19
That's the good news.
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那是好消息。
13:21
However, his chin skin
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但是他的下巴皮膚
13:23
doesn't look the same as it did before.
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跟以前看起來不大一樣。
13:25
It's skin from his back.
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因為是背部的皮膚。
13:27
It's thicker, it's darker, it's coarser, it doesn't have the contours.
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是更厚、更深、跟粗糙且沒有輪廓。
13:30
And that's where we're failing,
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這就是我們做不到的。
13:32
and that's where we need the face transplant.
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也是為什麼我們需要臉部移殖。
13:34
The face transplant has a role
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臉部移殖在
13:36
probably in burns patients to replace the skin.
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被火燒傷的病患的植皮過程中有很重要的角色。
13:39
We can replace the underlying skeletal structure,
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我們可以重建底層的骨骼結構,
13:41
but we're still not good at replacing the facial skin.
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但我們仍然不大會重建臉部皮膚。
13:44
So it's very valuable
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所以如果可以在我們的醫療設備中
13:46
to have that tool in our armamentarium.
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有這樣一個工具,那會是很有價值的
13:48
But the patients are going to have to take drugs
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但這些病患會接下來的一輩子都需要吃一些藥
13:50
that suppress their immune system for the rest of their lives.
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來壓制他們的免疫系統。
13:52
What does that mean?
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這是什麼意思?
13:54
They have an increased risk of infection, an increased risk of malignancy.
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他們有更高的風險會被感染、也更有可能會有惡性腫瘤。
13:57
This is not a life-saving transplant --
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這不是保住生命的移殖,
13:59
like a heart, or liver, or lung transplant --
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不是像移殖心臟或是肝臟或是肺臟,
14:02
it is a quality-of-life transplant,
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而是一個改善生命質量的移殖。
14:05
and as a result,
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最後,
14:07
are the patients going to say, if they get a malignant cancer 10 or 15 years on,
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如果病患在十或十五年後得了惡性腫瘤,他會不會說:
14:10
"I wish I'd had conventional reconstructive techniques rather than this
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「我希望我做了常規的重建手術而不是這個手術,
14:13
because I'm now dying of a malignant cancer"? We don't know yet.
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因為我現在垂死於惡性腫瘤?」我們還不知道。
14:16
We also don't know what they feel
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我們也不知道他們對於
14:19
about recognition and identity.
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識別和身分的感受。
14:21
Bernard Devauchelle and Sylvie Testelin, who did the first operation,
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Bernard Devauchelle和Sylvie Testelin,第一次做了這樣的手術
14:24
are studying that.
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他們正在研究這個
14:26
Donors are going to be short on the ground,
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捐贈者也非常少,
14:29
because how many people want to have their loved one's face
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因為有多少人願意他們深愛的人
14:32
removed at the point of death?
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在死亡的時候將臉部移去。
14:35
So there are going to be problems
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所以在臉部移殖上
14:37
with face transplantation.
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會有一些問題的。
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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未來已經快到了——
14:43
and the future is tissue engineering.
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這個未來就是生物組織建造
14:45
Just imagine,
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想想看,
14:47
I can make a biologically-degradable template.
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我可以做一個可以生物化降解的模板。
14:50
I can put it in place where it's meant to be.
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我可以將這個模板放在該放的地方。
14:52
I can sprinkle a few cells,
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我可以撒上一些細胞,
14:54
stem cells from the patient's own hip,
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一些從病患自己胯上取得的幹細胞,
14:56
a little bit of genetically engineered protein,
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加上一些基因工程製造出的蛋白質,
14:58
and lo and behold, leave it for four months and the face is grown.
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然後靜候四個月,臉部就可以長出來。
15:02
This is a bit like a Julia Child recipe.
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這有點像是童話故事中的食譜。
15:06
But we've still got problems.
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但我們仍然有一些問題。
15:08
We've got mouth cancer to solve.
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我們仍然有口腔癌要解決。
15:10
We're still not curing enough patients -- it's the most disfiguring cancer.
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我們仍然沒有辦法救足夠病患--但它是最容易毀容的癌症。
15:13
We're still not reconstructing them well enough.
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我們仍然沒有辦法足夠好的重建這部分
15:16
In the U.K. we have an epidemic
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在英國,年輕的族群臉部受傷
15:18
of facial injuries among young people.
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有擴大的趨勢。
15:20
We still can't get rid of scars.
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我們仍然沒有辦法不留下疤痕。
15:22
We need to do research.
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我們仍然需要作研究。
15:24
And the best news of all
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但最好的消息是
15:26
is that surgeons know
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外科醫生們知道
15:28
that we need to do research.
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我們需要進一步研究。
15:30
And we've set up charities
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所以我們已經建立起慈善基金
15:32
that will help us fund
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幫助我們
15:34
the clinical research
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作臨床研究
15:36
to determine the best treatment practice now
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來決定目前最好的手術方式
15:38
and better treatment into the future,
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以及未來更好的處理方法。
15:40
so we don't just sit on our laurels and say, "Okay, we're doing okay.
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所以我們不是坐在那說:「好,我們已經做地夠好了。
15:42
Let's leave it as it is."
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就這樣吧。」
15:44
Thank you very much indeed.
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非常謝謝你們。
15:46
(Applause)
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(掌聲)
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