Robert Gupta: Between music and medicine

Translator: Joseph Geni Reviewer: Morton Bast

譯者: Anny Chung 審譯者: Yuguo Zhang

(Music)

(音樂)

(Applause)

(掌聲)

Thank you very much. (Applause)

十分感謝

Thank you. It's a distinct privilege to be here.

謝謝，十分榮幸能夠來到這裡

A few weeks ago, I saw a video on YouTube

幾個禮拜前，我在Youtube上看了一段影片

of Congresswoman Gabrielle Giffords

關於眾議員Gabrielle Giffords

at the early stages of her recovery

在那次恐怖槍擊後

from one of those awful bullets.

的早期復健階段

This one entered her left hemisphere, and

子彈跑進她的左額葉

knocked out her Broca's area, the speech center of her brain.

帶走了她腦袋的布羅卡區，掌控語言的中心

And in this session, Gabby's working with a speech therapist,

在這個療程中，Gabby和她的語言治療師一同努力

and she's struggling to produce

而她十分努力想要擠出

some of the most basic words, and you can see her

一些最基本的單字，你能看見她

growing more and more devastated, until she ultimately

開始變得心力憔悴，直到她崩出眼淚

breaks down into sobbing tears, and she starts sobbing

然後開始啜泣

wordlessly into the arms of her therapist.

無言地倒在治療師懷裡

And after a few moments, her therapist tries a new tack,

過了一會兒，她的治療師採取了一個新方法

and they start singing together,

他們開始一同唱歌

and Gabby starts to sing through her tears,

Gabby在淚眼下開始歌唱

and you can hear her clearly able to enunciate

然後你能聽到她明顯地能夠表現

the words to a song that describe the way she feels,

歌中表達她情緒的單字

and she sings, in one descending scale, she sings,

然後她唱著，在一段下降的旋律中，她唱道

"Let it shine, let it shine, let it shine."

「讓它閃耀，讓它閃耀，讓它閃耀」

And it's a very powerful and poignant reminder of how

這是十分震撼且發人省思的，並提醒我們

the beauty of music has the ability to speak

音樂的美妙能述說文字無法道盡的故事

where words fail, in this case literally speak.

甚至在這個例子中，真正的讓人開口說話

Seeing this video of Gabby Giffords reminded me

看著Gabby Giffords的影片讓我想起

of the work of Dr. Gottfried Schlaug,

Gottfried Schlaug博士的研究

one of the preeminent neuroscientists studying music and the brain at Harvard,

他是哈佛研究音樂與大腦的神經學權威

and Schlaug is a proponent of a therapy called

同時Schlaug也是一項叫做「旋律語調療法」的支持者

Melodic Intonation Therapy, which has become very popular in music therapy now.

這項療法現在在音樂療法之中十分受歡迎

Schlaug found that his stroke victims who were aphasic,

Schlaug 發現他一些因為中風而失語的患者

could not form sentences of three- or four-word sentences,

原本無法組織超過三四個單字的句子

but they could still sing the lyrics to a song,

但卻仍然能唱出歌中的整段歌詞

whether it was "Happy Birthday To You"

不管是「生日快樂歌」

or their favorite song by the Eagles or the Rolling Stones.

或是這些患者的最愛、像是老鷹合唱團、滾石的歌

And after 70 hours of intensive singing lessons,

而在七十個小時密集的歌唱療程後

he found that the music was able to literally rewire

他發現音樂有辦法實質地重新搭接上

the brains of his patients and create a homologous

病人腦中的連結，並在他們的左額葉

speech center in their right hemisphere

創造出對應的語言中心

to compensate for the left hemisphere's damage.

以彌補左額葉的損害

When I was 17, I visited Dr. Schlaug's lab, and in one afternoon

當我十七歲的時候，我在某個下午拜訪了Schlaug博士的實驗室

he walked me through some of the leading research

他帶著我看過了一些大腦和音樂的尖端研究

on music and the brain -- how musicians had

裏頭說著音樂家和一般人相較起來

fundamentally different brain structure than non-musicians,

是如何有著顯著不同的大腦

how music, and listening to music,

音樂和聽音樂是如何

could just light up the entire brain, from

激發整個大腦

our prefrontal cortex all the way back to our cerebellum,

從前額葉皮層一路到我們的小腦

how music was becoming a neuropsychiatric modality

音樂是如何變成一個神經精神的療法

to help children with autism, to help people struggling

去幫助有自閉症的小孩

with stress and anxiety and depression,

或是去幫助與焦慮和憂鬱症抗爭的病人

how deeply Parkinsonian patients would find that their tremor

帕金森重度患者的顫抖以及行動不穩

and their gait would steady when they listened to music,

在聽音樂時為何能夠穩定緩和

and how late-stage Alzheimer's patients, whose dementia

還有晚期阿茲海默症患者，他們的記憶

was so far progressed that they could no longer recognize

已退化至無法認出至親

their family, could still pick out a tune by Chopin

卻仍能夠回憶起小時候學的

at the piano that they had learned when they were children.

蕭邦鋼琴名曲。

But I had an ulterior motive of visiting Gottfried Schlaug,

但是我拜訪Schlaug博士其實有個自私的動機

and it was this: that I was at a crossroads in my life,

也就是，當時我徘迴於人生的十字路口

trying to choose between music and medicine.

試著於醫學與音樂之間做一個抉擇

I had just completed my undergraduate, and I was working

我那時大學剛畢業，並在Dennis Selkoe

as a research assistant at the lab of Dennis Selkoe,

的實驗室做研究助理

studying Parkinson's disease at Harvard, and I had fallen

於哈佛大學研究帕金森氏症

in love with neuroscience. I wanted to become a surgeon.

而我愛上了神經科學，我想要成為外科醫師

I wanted to become a doctor like Paul Farmer or Rick Hodes,

我想要成為像Paul Farmer 或是 Rick Hodes 一般的醫師

these kind of fearless men who go into places like Haiti or Ethiopia

像他們一樣能夠無所畏懼地前往海地或衣索比亞

and work with AIDS patients with multidrug-resistant

並進行愛滋、多重抗藥肺結核、

tuberculosis, or with children with disfiguring cancers.

或是兒童顏面損傷癌症的治療工作

I wanted to become that kind of Red Cross doctor,

我想要成為那種紅十字會的醫師

that doctor without borders.

那穿越國界的醫師

On the other hand, I had played the violin my entire life.

然而，我自幼學習小提琴

Music for me was more than a passion. It was obsession.

我對音樂有得不只是熱情，而是狂熱

It was oxygen. I was lucky enough to have studied

它就像氧氣一樣。我很幸運地能夠於曼哈頓的

at the Juilliard School in Manhattan, and to have played

茱利亞音樂學院習琴，並且於特拉維夫

my debut with Zubin Mehta and the Israeli philharmonic orchestra in Tel Aviv,

與以色列愛樂管弦樂團及祖賓梅塔首次登台演出

and it turned out that Gottfried Schlaug

而湊巧的昰，原來Schlaug博士

had studied as an organist at the Vienna Conservatory,

曾經於維也納音樂學院主修管風琴

but had given up his love for music to pursue a career

但最後放棄音樂以追求醫學志業

in medicine. And that afternoon, I had to ask him,

而那天下午，我非得問他

"How was it for you making that decision?"

"你做了這個決定之後有何感想?"

And he said that there were still times when he wished

他說，有時他仍然希望

he could go back and play the organ the way he used to,

他能夠回到像從前彈奏管風琴的時光

and that for me, medical school could wait,

而對於我來說，醫學院能夠以後再說

but that the violin simply would not.

但是小提琴卻沒有辦法

And after two more years of studying music, I decided

於是，我繼續進修小提琴演奏兩年過後，我決定

to shoot for the impossible before taking the MCAT

在回頭考MCAT申請醫學院

and applying to medical school like a good Indian son

當個有出息的印度兒子

to become the next Dr. Gupta. (Laughter)

成為下一個Gupta醫師之前 (笑聲)

And I decided to shoot for the impossible and I took

我決定給自己一個近乎不可能的機會

an audition for the esteemed Los Angeles Philharmonic.

並參加聲名遠播的洛杉磯愛樂的甄試

It was my first audition, and after three days of playing

那是我第一個正式甄試，而經過了

behind a screen in a trial week, I was offered the position.

連續三天於屏風後演奏，我被錄取了

And it was a dream. It was a wild dream to perform

那有如美夢成真。我最瘋狂的夢想就是能夠

in an orchestra, to perform in the iconic Walt Disney Concert Hall

在樂團中演奏，於經典的迪士尼交響廳表演

in an orchestra conducted now by the famous Gustavo Dudamel,

並於樂團中由現今名聲響亮的Gustavo Dudamel指揮

but much more importantly to me to be surrounded

但對我而言更加重要的是

by musicians and mentors that became my new family,

樂團的音樂家和老師，他們成為我的家人

my new musical home.

我的音樂家庭

But a year later, I met another musician who had also

一年後，我認識了另一位音樂家

studied at Juilliard, one who profoundly helped me

他同樣從茱莉亞畢業，並且深切地幫助我

find my voice and shaped my identity as a musician.

發掘以及塑造我身為音樂家的風格及身分

Nathaniel Ayers was a double bassist at Juilliard, but

Nathaniel Ayers 在茱莉亞時修習低音大提琴

he suffered a series of psychotic episodes in his early 20s,

然而他二十幾歲時不幸精神病發

was treated with thorazine at Bellevue,

並在Bellevue醫院接受氯丙嗨(精神分裂藥名)治療

and ended up living homeless on the streets of Skid Row

三十年後，他落的無家可歸

in downtown Los Angeles 30 years later.

流連於洛杉磯市中心的貧民窟(Skid Row)

Nathaniel's story has become a beacon for homelessness

Nathaniel的故事已經成為美國各地

and mental health advocacy throughout the United States,

心理健康宣導以及街友輔導的代表故事

as told through the book and the movie "The Soloist,"

並被寫成書和拍成電影《心靈獨奏》

but I became his friend, and I became his violin teacher,

但是我成為他的朋友，他的小提琴老師

and I told him that wherever he had his violin,

我告訴他，無論在哪裡，只要他帶著他的小提琴

and wherever I had mine, I would play a lesson with him.

我也帶著我的琴，我就會陪他演奏上課

And on the many times I saw Nathaniel on Skid Row,

在我多次於Skid Row陪Nathaniel演奏時

I witnessed how music was able to bring him back

我親眼目睹音樂如何能夠將他從黑暗之中舉起

from his very darkest moments, from what seemed to me

我親眼目睹音樂如何能夠將他從黑暗之中舉起

in my untrained eye to be

如何幫助他從，在我這外行人眼中看來是 精神分裂的邊緣，得到緩和

the beginnings of a schizophrenic episode.

如何幫助他從，在我這外行人眼中看來是 精神分裂的邊緣，得到緩和

Playing for Nathaniel, the music took on a deeper meaning,

當我為Nathaniel演奏時，音樂有了更深刻的意義

because now it was about communication,

因為音樂成為我們溝通的方式

a communication where words failed, a communication

當言語表達無法傳達時

of a message that went deeper than words, that registered

音樂的主旨有辦法比言語更深刻的

at a fundamentally primal level in Nathaniel's psyche,

於Nathaniel的精神最原始之處激起回應

yet came as a true musical offering from me.

並來自我忠實的音樂奉獻

I found myself growing outraged that someone

我開始為Nathaniel的遭遇感到憤慨

like Nathaniel could have ever been homeless on Skid Row

一個像他如此有才華的人，只因為他的精神病況

because of his mental illness, yet how many tens of thousands

而淪落街頭，然而僅在Skid Row

of others there were out there on Skid Row alone

就有上萬的人，擁有同樣悲慘的故事

who had stories as tragic as his, but were never going to have a book or a movie

但卻沒有人幫他們寫成書、拍成電影

made about them that got them off the streets?

讓他們能夠脫離無家可歸的困境?

And at the very core of this crisis of mine, I felt somehow

而在我心靈交戰的核心

the life of music had chosen me, where somehow,

我感到是音樂這條路選擇了我

perhaps possibly in a very naive sense, I felt what Skid Row

而我有點幼稚地以為

really needed was somebody like Paul Farmer

Skid Row這種地方需要的是像Paul Farmer醫師的人

and not another classical musician playing on Bunker Hill.

而不是又一個在Bunker Hill演奏的古典音樂家 (Bunker Hill是迪士尼音樂廳所在地)

But in the end, it was Nathaniel who showed me

但最後，還是Nathaniel使我了解

that if I was truly passionate about change,

如果我真正有熱情改變現況

if I wanted to make a difference, I already had the perfect instrument to do it,

如果我想要有所影響，我其實早就擁有最適合的工具

that music was the bridge that connected my world and his.

音樂就是連接我們倆的世界的橋梁

There's a beautiful quote

德國浪漫樂派作曲家羅伯‧舒曼

by the Romantic German composer Robert Schumann,

有一句美麗的名言

who said, "To send light into the darkness of men's hearts,

他說:「將光明送入人內心暗處

such is the duty of the artist."

這就是藝術家的職責」

And this is a particularly poignant quote

他這句話特別發人省思

because Schumann himself suffered from schizophrenia

因為舒曼本身受精神分裂症所擾

and died in asylum.

並於精神病院過世

And inspired by what I learned from Nathaniel,

我由Nathaniel身上所學到的種種受到啟發

I started an organization on Skid Row of musicians

並於Skid Row組織了一個音樂家團體

called Street Symphony, bringing the light of music

叫做街頭交響樂(Street Symphony)，致力於

into the very darkest places, performing

將音樂之光芒帶進最黑暗的地方

for the homeless and mentally ill at shelters and clinics

為Skid Row的庇護所和醫療站服務的街友

on Skid Row, performing for combat veterans

以及精神病患演奏，為受創傷後壓力症候群所苦的榮民

with post-traumatic stress disorder, and for the incarcerated

受監禁的罪犯、以及被稱為喪心病症的人們演奏。

and those labeled as criminally insane.

受監禁的罪犯、以及被稱為喪心病症的人們演奏。

After one of our events at the Patton State Hospital

有一次，我們於San Bernadino的Patton State醫院

in San Bernardino, a woman walked up to us

演奏結束，有一位女士走上前來

and she had tears streaming down her face,

她淚流滿面

and she had a palsy, she was shaking,

並些許的顫抖著

and she had this gorgeous smile, and she said

並有個美麗的微笑，她說

that she had never heard classical music before,

她從來沒有聽過古典音樂

she didn't think she was going to like it, she had never

她本來覺得她不會喜歡，她沒聽過小提琴

heard a violin before, but that hearing this music was like hearing the sunshine,

但是她聽到這音樂就像是聽到陽光一般

and that nobody ever came to visit them, and that for the first time in six years,

而以前根本就不會有人探訪他們，她說

when she heard us play, she stopped shaking without medication.

在這六年來第一次，她在聽我們演奏時， 不需藥物，就停止顫抖

Suddenly, what we're finding with these concerts,

忽然間，我們發現這些表演

away from the stage, away from the footlights, out

離開了舞台，遠離聚光燈

of the tuxedo tails, the musicians become the conduit

褪去了燕尾服，音樂家成為

for delivering the tremendous therapeutic benefits

傳達身心療癒的媒介

of music on the brain to an audience that would never

透過音樂進入大腦，慰藉一群

have access to this room,

永遠無法進入表演廳的觀眾

would never have access to the kind of music that we make.

永遠無法接近我們所創作的這種音樂

Just as medicine serves to heal more

就如同醫藥的目標不只是治療

than the building blocks of the body alone,

建構軀體的一塊塊積木

the power and beauty of music transcends the "E"

音樂的力與美遠超越我們所愛的TED縮寫中的"E" (entertainment 娛樂)

in the middle of our beloved acronym.

音樂的力與美遠超越我們所愛的TED縮寫中的"E" (entertainment 娛樂)

Music transcends the aesthetic beauty alone.

音樂超越純粹的美學價值

The synchrony of emotions that we experience when we

那種種參差的情感，可啟發於

hear an opera by Wagner, or a symphony by Brahms,

韋格納的歌劇，或是布拉姆斯的交響樂

or chamber music by Beethoven, compels us to remember

或是貝多芬的室內樂，那情感促使我們憶起

our shared, common humanity, the deeply communal

我們共同的人性，那於最深處聯繫的意識

connected consciousness, the empathic consciousness

也就是同理心意識

that neuropsychiatrist Iain McGilchrist says is hard-wired

神經心理學家Iain McGilchrist曾說這意識

into our brain's right hemisphere.

於大腦右葉有具體的通路

And for those living in the most dehumanizing conditions

而對於那些生活在最抹滅人性的狀態中

of mental illness within homelessness

受精神疾病所苦、流落街頭

and incarceration, the music and the beauty of music

或是遭受監禁，音樂的美及力量

offers a chance for them to transcend the world around them,

足以讓他們有機會超脫四周的世界

to remember that they still have the capacity to experience

並認清他們仍有能力去體驗美麗的事物

something beautiful and that humanity has not forgotten them.

而世界的人們並沒有忘記他們的存在

And the spark of that beauty, the spark of that humanity

那美感觸發的火花，那閃耀的人性

transforms into hope,

將蛻變成希望

and we know, whether we choose the path of music

而我們都知道，無論我們選擇的是音樂

or of medicine, that's the very first thing we must instill

或是醫學之路，希望永遠是最需要灌輸的

within our communities, within our audiences,

無論是在我們的社區之中，或是觀眾之間

if we want to inspire healing from within.

希望是由內心療癒的第一步

I'd like to end with a quote by John Keats,

我想要以英國浪漫派詩人，

the Romantic English poet,

濟慈，曾說的一句話做作結

a very famous quote that I'm sure all of you know.

這句名言你們多數人大概聽過

Keats himself had also given up a career in medicine

濟慈本人也曾放棄醫學職業

to pursue poetry, but he died when he was a year older than me.

以專心作詩。他過世時只比我大一歲

And Keats said, "Beauty is truth, and truth beauty.

濟慈寫道: 「美及是真，真理及是美。那就是

That is all ye know on Earth, and all ye need to know."

所有你在這世上所知，和你所須知的一切。」

(Music)

(音樂)

(Applause)

(掌聲)