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

譯者: Pui-Ching Siu 審譯者: Carol Wang

Raise your hand, and be honest,

請誠實地舉起你的手，

if you've used the phrase "crazy busy"

如果你用過「忙瘋了」這個詞

to describe your day, your week, your month.

來形容你的一天、一週或一個月。

I'm an emergency-room doctor,

我是急診室醫生，

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

你從來不會聽到 我用「忙瘋了」這個詞。

And after today,

今天過後，

I hope you'll stop using it, too.

我希望你們也停止使用它。

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

這是為什麼你不能用「瘋狂」

to describe your busy.

來形容你忙碌的程度：

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

當我們處於「瘋狂忙碌」模式時，

we are simply less capable of handling the busy.

處理忙碌的能力會變差。

Here's what happens.

以下是發生的變化：

Your stress hormones rise and stay there,

你的壓力荷爾蒙會升高， 並且持續那個狀態，

your executive function in the prefrontal cortex declines.

前額葉皮質的管控功能會下降。

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

這代表著，你的記憶力、 判斷力、自制力都會變差，

and the brain areas for anger and anxiety are activated.

大腦裡憤怒和焦慮的區域會被觸動。

Do you feel that?

你們有感受到嗎？

Here's the thing.

重點是，

You can be as busy as an emergency department

你可以像急診室人員一樣忙碌，

without feeling like you're crazy busy.

但不會感覺自己忙瘋了。

How?

怎麼做到？

By using the same tactics that we use.

透過使用和我們一樣的技巧。

Our brains all process stress in similar fundamental ways.

我們的大腦都使用 相似的基本方式處理壓力。

But how we react to it

但是，我們應對壓力的方法，

has been shown by research to be modifiable,

研究顯示是可以改變的，

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

不管是緊急狀況還是日常的壓力。

Now contrast Crazy Busy Mode

現在我們拿瘋狂忙碌模式

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

來對照我們急診室的「就緒模式」。

Ready Mode means whatever comes in through those doors,

就緒模式代表著， 不管是什麼從急診室的門進來——

whether it's a multiple-car pileup,

不管是連環車禍傷者，

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

困在電梯時胸口痛的病人，

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

還是東西卡在不該在的地方的病人，

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

在你很想知道到底在哪的時候也是。

(Laughter)

（笑聲）

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

即使某天你發誓自己被捉弄了，

we're not afraid of it.

我們也不會害怕。

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

因為無論什麼進入急診室雙開門，

我們知道自己都可以應付，

that we can handle it.

That we're ready.

我們已經準備好了。

That's Ready Mode.

這就是就緒模式。

We've trained for it,

是我們訓練出來的，

and you can, too.

你，也可以做到。

[瘋狂模式　就緒模式]

Here's how.

方法如下。

Step one to go from Crazy Mode to Ready Mode

從瘋狂模式轉換到就緒模式，

is to relentlessly triage.

第一步是不停地分類。

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

在瘋狂模式下， 你總是很忙，壓力很大，

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

這是因為你對全部挑戰 都作出一樣的回應。

Contrast that with Ready Mode,

相較之下，在就緒模式中，

where we triage,

我們會進行分類，

which means we prioritize by degree of urgency.

意思是根據緊急程度排出優先順序。

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

這不只是一個完成待辦清單的好方法。

Work by Dr. Robert Sapolsky

羅伯·薩普羅斯基博士的研究顯示，

shows that individuals who cannot differentiate threat from non-threat

那些無法區分威脅和非威脅，

and react to everything with the same response

並且對所有事情作出一樣反應的人，

have double the level of stress hormones.

他們的壓力荷爾蒙水平高出兩倍。

Which is why this is the first skill to learn.

這解釋了為什麼 分類是首要學習的技能。

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

你不能一次處理全部事情，

but you don't have to.

而且那是不必要的，

Because we triage.

因為我們可以分類。

Red -- immediately life-threatening.

紅色——當下有生命危險。

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

黃色——嚴重， 但當下沒有生命危險。

Green -- minor.

綠色——輕微。

And we focus our efforts first on the reds.

我們首先專注處理紅色事項。

Now hear this.

現在，聽我說。

Part of the problem in Crazy Mode

瘋狂模式其中一個問題是，

is that you are reacting to everything

你會把所有事情當成紅色事項看待，

as if it is red.

並作出反應。

So start by triaging correctly.

所以，首先要正確地分類。

Know your reds.

知道什麼事情屬於紅色，

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

那些是最重要並且改變最顯著的事情。

Now it's easy to be confused by noise,

然而，我們很容易被噪音混淆，

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

最吵鬧的不一定是最緊急的。

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

事實上，嚴重哮喘病人 在安靜時是最危險的。

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

另外一個病人要求我拿咖啡奶精給她，

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

她很吵，但是她並不緊急。

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

給你一個我生活中的例子。

Last spring, my house flooded,

去年春天，我的房子淹水了，

my one-year-old was in the ER,

我一歲的小孩進了急診室，

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

我還要為我四歲小孩的學校 籌辦募捐活動，

and the final chapter of my book was beyond late.

我寫的書最後一章已經遲交了。

Maybe not ironically, that was the chapter on stress.

諷刺的是，那一章是關於壓力的。

(Laughter)

（笑聲）

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

我的紅色任務 是讓我的一歲小孩好起來，

and finishing my book.

並且完成我的書。

That was it.

僅此而已。

Remember, relentlessly triage.

要記得不停地分類。

The house flood repair?

修復淹水的房子？

Well, once we had stopped and stabilized the damage,

一旦我們把損害停止並穩定下來時，

it was no longer a red.

它不再是紅色的事項。

It felt red,

它感覺很緊急，

but it was in fact just noise.

但事實上只是噪音。

No, no really, it was quite noisy,

真的非常吵。

this picture on the far right is me wearing earplugs

在右邊的照片裡是帶著耳塞的我，

to focus on my book,

正在專注於完成我的書。

while the floor is being mechanically dried around me.

同時，機器正在烘乾我周圍的地板。

Know your reds,

要知道你的紅色事項，

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

並且不要讓別的事項干擾你。

By the way, it is liberating with a green task

順帶一提，綠色事項 讓你感到自由自在，

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

偶爾可以提醒一下自己，

「這是綠色項目，沒有人會死的。」

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

(Laughter)

（笑聲）

It's OK if it's not perfect.

就算它不完美也沒有關係。

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

最後，剩下一個在最糟情況 會使用的分類等級。

And that is black.

那就是黑色。

Those patients for whom there is nothing we can do.

那是指我們無能為力的病人。

Where we must move on.

我們必須繼續向前走。

And although it is gut-wrenching,

雖然這令人感到痛苦，

I mention it,

我提到它是因為，

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

你們在生活中都有相似的黑色項目。

These are items that you must take off your list.

這些是你必須從待辦清單移除的。

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

我想你們知道我在說什麼。

For me, this was the fundraiser.

對我來說，這指的是募捐活動。

I had to step down.

我必須放棄。

Because as we in the ER know,

因為急診室的我們都知道，

if you try to do everything,

如果你嘗試完成每一件事，

you have no hope of saving your reds.

你就沒辦法拯救紅色等級的病人。

Step two to go from Crazy Mode into Ready Mode

從瘋狂模式轉到就緒模式的第二步是，

is to expect and design for crazy.

預料瘋狂並為它作出打算。

Half of handling crazy is how you prepare for it.

處理瘋狂，一半在於怎麼做好準備。

So if step one we triage,

在第一步，我們分類，

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

第二步，我們把這些項目 變得更容易完成。

Science shows us that the more options we have,

科學研究顯示，當我們有越多的選擇，

then the longer each decision takes.

作出決定的時間會越長。

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

當我們要作出越多決定的時候， 我們的大腦會更疲勞，

and the less it is capable of making good decisions.

就會更難作出正確的決定。

Which is why this step two

這就是為什麼在第二步，

is about finding ways to reduce your daily decisions.

目標是尋找辦法， 減少每天要做的決定。

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

這裡有四個簡單例子， 你可以用於日常生活中。

Plan.

計劃。

在週末時計劃好下一週的飲食。

Plan your entire week's meals on the weekend,

so that when it's Wednesday at 6pm

這樣的話，週三下午六點的時候，

and everyone's hangry and requesting pizza,

當大家又氣又餓地要求披薩的時候，

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

你不用為了健康的一頓而作出抉擇。

Automate.

自動化。

Never leave anything to remember that you could automate,

不需要記住能夠自動完成的事項。

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

把它安排為重複發生的事項、 列成清單，或是重複採購。

Colocate.

集中放置同類物品。

When it comes to exercise,

當運動的時候，

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

把你需要用到的器材放在一起，

charged and ready,

充滿電並準備好，

so you don't spend energy looking for it.

這樣的話，你就不用花費精力去找它們。

And decrease temptations,

還有，減少誘惑。

for anyone driven by sugar cravings.

特別是對於有吃糖嗜好的人們。

Anyone?

這裡有嗎？

Say aye, go ahead.

說一聲有，來吧。

That itself is its own form of Crazy Mode

它自身是瘋狂模式，

and self-medication for Crazy Mode,

它也是能夠改變瘋狂模式的關鍵。

but stop working your willpower.

但是，不要再使用意志力。

Design differently.

要作出不一樣的計劃。

If a food is out of immediate reach,

如果一個食物不是隨手可拿的，

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

例如，需要用到凳子才能搆得著，

even when it's chocolate,

即使那是巧克力，

study participants ate 70 percent less without thinking about it.

研究參加者少吃了 70%， 連想都沒想。

I know.

我知道，

Let that sit for a second.

仔細想想它。

(Laughter)

（笑聲）

Design to make the choices you wish to make easier.

計劃能夠把選擇變得更容易。

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

接下來是從瘋狂模式 轉成就緒模式的第三步，

and that is to get out of your head.

它就是：專注在頭腦以外的事。

Come with me.

跟我來，

Different story.

我有另一個故事。

I'm working in a small, satellite ER,

我在一個附屬的小急診室工作。

when a woman comes in in labor.

當一個女人臨產的時候，

I realize that the cord is wrapped not once

我發現臍帶在嬰兒的脖子 圍繞了不止一圈，

but twice around the baby's neck.

它圍繞了兩圈。

And I'm the only doctor.

當時我是唯一的醫生。

I was scared.

我很害怕。

But I couldn't let it derail me.

但我不能讓它阻擾我。

Because, you see, we all get nervous.

這是因為我們都會感到緊張，

We all get scared,

我們都會感到害怕，

but it's what you do next that matters.

但是，更重要的是你接下來所做的。

That first feeling isn't the problem.

第一個感覺並不是問題，

It can be an important sign.

而是重要的徵兆。

The problem comes when we let it derail us.

我們被它干擾的時候， 問題就會產生。

When that internal monologue starts

我們會開始產生內心的獨白，

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

我們把它災難化，眼光變得狹隘。

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

這就是在瘋狂模式下的思考，

and you cannot solve anything that way.

在這模式下，你無法解決任何事情。

Now I promise to come back to the story,

回到我的故事，

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

首先，我是怎麼消除那些想法的呢？

There are many tactics that you may hear,

你可能聽過許多技巧，

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

對我來說，積極專注在別人身上 是最有效的方法。

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

故意讓自己看見面前的人，

see myself in the arena with them --

看見自己和他們在同一戰場上——

what do they need, what do they fear

他們需要什麼，他們害怕什麼，

and how can I help?

我怎麼可以幫上忙？

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

對你來說，這感覺也許很模糊不清。

but it's not.

但其實不是的。

In fact, research shows that when you prime your brain

事實上，研究顯示當你在腦內 優先看待同情心的話，

with what is, essentially, compassion,

we disrupt that tunnel vision and internal monologue.

我們可以停止狹隘眼光和內心獨白。

You widen your perception,

你擴張自己的感知，

so your brain can actually take in broader information,

你的大腦可以接收更多資訊，

so you see more possibilities and can make better decisions.

你可以看見更多的可能性， 並且做出更好的抉擇。

Try it.

試試看吧。

Know that your internal monologue can derail you.

要知道內心獨白會干擾你。

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

要意識到當你專注在頭腦以外的事，

you get out of your own way.

你就可以改變自己。

Now what happened to that baby?

之後，那個嬰兒怎麼了？

I focused not on my fear,

我並沒有專注於恐懼，

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

反而專注於母親、嬰兒和他們所需的。

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

我把臍帶從嬰兒的脖子繞開，

and a healthy screaming, kicking baby arrived,

接著，一個健康哭鬧的嬰兒誕生了。

just as the dad ran in from the parking lot,

同時，他的父親剛從停車場趕來。

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

「你好，是一個男孩。 我是達里亞醫生。

Congratulations, you want to cut the cord?"

恭喜，你想剪臍帶嗎？」

(Laughter)

（笑聲）

And for a moment,

那一瞬間，

the strong cries of a newborn

新生嬰兒強烈的哭聲，

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

蓋過了嗶聲，警報聲等 急診室正常的聲音。

But there was also something else.

除此之外還有別的。

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

因為當我走出那位母親的病房時，

I saw several of my other patients hovering nearby.

我看見幾位我其他的病人在附近徘徊。

I suddenly realized that despite their own problems

我突然意識到，

不管是什麼原因把他們帶到急診室，

that had brought them to the emergency room,

they had all come together to root for this baby.

他們為了給這個嬰孩加油而團聚起來。

And they now together shared in the joy.

現在他們一起分享喜悅。

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

這就是當你從瘋狂模式 轉為就緒模式後所發生的事情。

Others notice.

其他人注意到了。

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

他們也想要這個能力， 但是不知道該怎麼做。

they just need one example.

他們只需要一個榜樣。

Which could be you.

那可以是你。

Own the busy.

掌管自己的忙碌，

But stop calling it crazy.

但是停止稱它為瘋狂。

You've always had that ability.

你一直都有這個能力。

But now ...

但是現在，

you're ready.

你準備好了。

Thank you.

謝謝。

(Applause)

（掌聲）