利用温度优化表现、大脑与身体健康 | 克雷格·海勒博士

也许我们可以详细解释一下，为什么这些通道会分布在它们所在的位置。

And maybe walk us through a theory as to why we would have these portals located where they are.

然后我们可以讨论如何利用它们来提升表现。

And then we can talk about how one might leverage them for performance.

好的，这些通道位于无毛皮肤上，这是一个专业术语，明白吗？

Okay, where the portals are, are in the glabrous skin, big word, okay?

无毛的意思就是没有毛发。

Glabrous just means no hair.

所以这是没有毛发的皮肤。

So it's the hairless skin.

你可能会说，我身体的大部分地方都没有毛发。

You say, well, of my body is without hair.

不，你身体的大部分区域其实都有毛囊。

No, most of your body has hair follicles.

我们是哺乳动物。

We are mammals.

哺乳动物有毛发。

Mammals have fur.

我们虽然失去了毛发，但身体大部分区域仍保留着有毛皮肤的特征，除了那些我们的哺乳动物近亲原本就没有毛发的皮肤区域。

We've lost the fur, but we still have those, that hairy skin phenotype all over our body, except, except for those skin surfaces where our mammal relatives didn't have fur.

比如脚掌的肉垫。

So the pads of the feet.

对于灵长类动物，则是面部的上半部分。

And for the primates, upper part of the face.

对于兔子，则是耳朵的内表面。

For rabbits, no portions of the ears, the inner surface

关于这个，我不太清楚该说什么。

of the I don't know talk about that.

对于熊来说，舌头没有毛发。

For bears, no tongue.

熊的舌头很大，非常大。

Bears have big tongues, huge tongues.

我也不知道这一点。

I didn't know that either.

我还没那么近距离接触过熊。

I haven't been that close to a bear yet.

我还没和熊比过谁舔得厉害。

I haven't had a licking match with a bear.

还没呢，没有。

Not yet, no.

所以，我们的哺乳类亲戚无法通过全身表面散热。

So anyway, our mammalian relatives can't lose heat over their overall body surface.

因此，在哺乳动物进化的早期，它们就在那些没有毛发的有限区域演化出了特殊的血管。

So probably very early on in mammalian evolution, they evolved these special blood vessels in the limited surface areas that don't have fur.

正如我所说，这些血管是动脉和静脉之间的旁路。

And as I said, what these blood vessels are, are shunts between the arteries and the veins.

动脉和静脉都是低阻力血管。

Arteries and veins are both low resistance vessels.

所以你可以实现高流速。

So you can have high flow rate.

毛细血管通常位于动脉和静脉之间，阻力很高，因为它们非常

Capillaries, which normally are between arteries and veins are high resistance because they're very

细小，对吧？

tiny, okay?

我学到的知识是血液从动脉流向毛细血管，再到静脉，然后返回心脏，这样说对吗？

Is it fair to say that what I was taught is that blood flows from arteries, then to capillaries and then to veins and then back to the heart?

这有点像从心脏通过动脉，然后经过这些微小的毛细血管，它们就像小河口和溪流，再通过静脉回到心脏。

It's sort of like from the heart through arteries, then through these little capillaries, which are like little estuaries and streams, and then to the veins back to the heart.

这通常是正确的吗？

Is generally true?

完全正确。

Absolutely.

所以我在基础生理学中学到的知识仍然有效，我在你的课上应该不会不及格。

So what I learned in basic physiology is still, I wouldn't get an F in your class.

不。

No.

也许能得个D或C，但还不够。

Maybe a D or a C, but not enough.

那太好了。

So that's excellent.

好的。

Okay.

所以你的意思是，在无毛皮肤或无毛皮肤下方。

And so you're saying that in this glabrous or beneath the glabrous skin.

存在这些动静脉吻合支。

There are these shunts.

它们直接从动脉通向静脉。

And those go directly from arteries to veins.

你跳过了毛细血管。

You skip the capillaries.

毛细血管，是的。

Capillaries, yep.

我明白了。

I see.

实际上，既然我提到皮肤，当我用手掌触摸时，这些血管距离表面有多深？

And actually, as long as I say that in the skin, when I feel the pads in my hands, how deep to the surface do these vessels reside?

嗯，显然，当你身体温暖时，看看你的手掌，它们会相当红润。

Well, below the, obviously the So if you are warm and you look at your palms of your hands, they are fairly red.

但手背就不会。

The backs of your hands aren't.

你的手背上没有这些血管。

You don't have these vessels in the backs of your hands.

现在，如果你拿一个玻璃杯，比如一个水杯，对吧？

Now, if you take a glass, like a water tumbler, right?

然后你握住它，稍微用力一捏，手就会变白。

And you grab it, You can see if you squeeze a little bit, the hand goes white.

这是因为你阻断了血流。

That's because you've shut off that blood flow.

哦，有意思。

Oh, interesting.

我要做一下这个小家庭实验。

I'm going to do that little home experiment.

所以如果你在炎热的天气里骑自行车，不要一直紧握把手，要时不时地放松。

So if you're bicycling on a hot day, you don't want to be grabbing your handlebars all the time, you want to periodically.

这很重要。

Well, is important.

我知道你了解一些我们即将讨论的惊人成果，但最近我在斯坦福举办的一场关于人类表现的讲座上听到你提到过，那场讲座我们俩都参与了。

I know you're privy to some really amazing results that we're going to talk about, but I actually heard you say this during this lecture recently that Stanford held about human performance that we're both part of.

你提到过，如果你在骑车且高强度运动时，想要完成更多工作，我们现在知道为什么保持凉爽对持续工作至关重要。

And you mentioned this, that if you're cycling and you're working hard and you want to be able to do more work, we now know why you want to remain cool in order to continue to do work.

如果你太热，情况就不好了，因为握把太紧实际上会限制你的表现。

And if you get too warm, that's bad, that gripping the handlebars too tightly will actually limit your performance.

是的。

Right.

而且在佩洛顿健身车或其他任何设备上，或者滑雪时，可能也是如此，对吧？

And that's probably also true on the Peloton or any other kind of device, or the skier or anything Right, like

对。

right.

所以要放松握力，或者如果安全的话，你实际上应该

So loosen the grip, or if you safely can, you want to actually

让双手暴露在外界环境中。

expose your hands to the world.

那戴手套的人呢？

Now what about for people wearing gloves?

根据你所说的，我觉得戴手套简直太疯狂了。

To me, that just seems crazy based on everything you're telling me.

手套确实会阻碍手部散热，就像袜子会阻碍脚部散热一样，明白吗？

Well, gloves definitely impede heat loss from the hands, just as socks impede heat loss from the feet, okay?

所以，如果你想最大化散热，手上戴的保护层应该越薄越好。

So if you want to maximize your heat loss, you want to have as thinner protectors as possible on your hands.

当然，脚部的情况更复杂，因为你需要用脚来完成某些动作。

And of course the feet are more problematical because you have to be using them in certain ways.

有些人光脚跑步。

Some people run barefoot.

是的，没错。

Well, yeah.

是的，这已经变得有点流行了。

Yeah, that's become somewhat popular.

看起来它似乎兴起又消失了。

It seems like it kind of came and went.

他们曾经有过那种五指鞋，但看起来太滑稽了，我想大多数人还是愿意接受普通鞋子带来的性能损失。

They had those toe shoes things, but they looked so ridiculous that I think most people just were willing to take the performance hindrance of regular shoes.

实际上，斯坦福大学有一位田径教练，曾经因为提倡不穿跑鞋训练而闻名。

Actually, had a track coach here at Stanford who for a while was famous for introducing training without shoes, running shoes.

很有趣。

Interesting.

他认为这是因为改变了跑步者的姿势

And he thought it was because it changed the posture of

跑步者的姿势。

the runner.

我认为这是因为提高了跑步者散热的能力。

And I think it was just due to the fact that it was increasing the capacity of his runners to lose heat.

很有趣。

Interesting.

是的，手部发热显然会妨碍表现。

Yeah, so heating up at the level of the hands obviously is going to hinder performance.

那么，如果可以的话，跑步时呢？

So if I can, how about with running?

我注意到我在高中时曾短暂地横穿过全国，虽然跑得并不好，但当时我们被要求跑步时像手里握着饼干一样轻轻握拳，保持双手放松。

I noticed I ran across the country briefly in high school and not particularly well at that, but that we were told to run as if we were holding crackers in our fingers or something like very lightly and to keep hands kind of loose.

所以这样跑步实际上会比——更有益于表现——

So running like this would actually be more beneficial performance than-

哦，那么，

Oh, then,

或者像握着手机那样，这可能是现在大多数人正在做的，对吧？

then- Or gripping a phone, which is probably what most people are doing nowadays, right?

有意思。

Interesting.

我跟你说说我曾经的一次经历。

I'll tell you an experience I had once.

我冬天在阿拉斯加时出去跑步，不小心忘了戴手套。

I was in Alaska in the winter and I went out running and I absent mindedly forgot gloves.

跑了一小会儿后我才意识到，因为手背被冻得疼，而手掌却在出汗、发烫。

And I realized this after a short period running, because the backs of my hands were aching from the cold, the palms of my hands were sweating and were hot.

哦，太神奇了，太神奇了。

Oh, amazing, amazing.

这些区域确实是真实存在的。

So these compartments are a real thing.

你提到了脸部的上半部分。

And you mentioned the upper half of the face.

上半部分，

The upper part,

那里是我们灵长类祖先没有毛发的地方。

that's where our primate ancestors don't have fur.

还有我们脚底。

And the bottoms of our feet.

让我们花点时间谈谈一些与这些无毛皮肤表面正确降温相关的惊人成果。

So let's just take a moment and talk about some of the more amazing results that have

与这些无毛皮肤表面的适当冷却相关的研究结果。

been associated with proper cooling of these glabrous skin surfaces.

让我再介绍一件事。

Let me introduce one more thing.

当然。

Sure.

因为你之前问过关于往头上泼水的事，对吧？

Because you asked earlier about the pouring of water on the head, okay?

有一个不太被充分认识的事实是：流经胡须线以上面部特殊血管的血液——也就是无毛皮肤区域——这些血液会通过静脉回流到心脏，但它的回流方式非常特别。

One of the things which is not appreciated fully is that the blood which is perfusing these special blood vessels in the face above the beard line, that's the non hairy skin, that blood then returns in the venous supply to the heart, but it actually does it in a very strange way.

我一时想不起那个名字了。

It actually goes through what are called, I'm blocking on the name now.

慢慢来。

Take your time.

这些血管会穿过颅骨，这就是为什么头皮被割伤时会大量出血的原因。

These are blood vessels that go through the skull, And that's why the scalp bleeds a lot if you cut the scalp.

这些血管被称为，我想说是‘emergent’，但其实不是这个词，有一个词意思是‘离开’。

And these blood vessels, which are called, I want to say emergent, but it's not emergent, it's a word that means leaving.

这些血管最初被认为是血液离开大脑的通道。

And these blood vessels were primarily thought to be ways that blood is leaving the brain.

但当你过热时，这些血管中的血流方向会逆转。

But when you're overheated, the direction of flow in those blood vessels reverses.

因此，从面部区域流来的冷却血液会进入这一循环，实际上成为大脑的冷却源。

So the cooled blood that's coming from your facial region goes into that circulation and actually is a cooling source for the brain.

所以你可以冷却大脑。

So you can cool the brain.

你可以通过这种方式对大脑产生冷却效果。

You can have a cooling effect on the

通过往头上浇水来冷却大脑。

brain by pouring water on your head.

有趣的是，这种做法，至少对我来说，我最常联想到的是格斗运动。

Interesting, so that practice, which we, at least for me, I most commonly associate with combat sports.

是的。

Yeah.

在比赛中，选手会回到自己的角落，通常会坐在凳子上，除非他们想在角落里进行心理战，那样的话甚至不会坐下。

Where someone, the fighter goes to their corner, they usually sit down on a stool, unless they're trying to do some mental warfare from the corner, in which case they don't even take a seat.

他们的团队会拧干一块浸满冷水的海绵，敷在他们身上。

And their corner crew will squeeze a glove, excuse me, a sponge full of cold water over them.

你所说的这种做法，在冷却大脑方面确实有一定效果。

That you're saying is somewhat effective in cooling the brain.

是的，这是大脑自然降温的机制之一。

Yeah, it's one of the natural mechanisms for cooling the brain.

我想稍后也回到这个话题，但冷却大脑在减轻身体损伤、缓解脑震荡的负面影响方面，有没有已知的好处？

I want to return to this at some point as well, but is there any known benefit to cooling the brain in terms of offsetting physical damage, offsetting the negative effects of concussion?

因为拳手常常在后颈或头部放置冷敷物，不仅是为了降温，还因为有一种理论认为，这可能减轻神经元的损伤。

Because one of the reasons why fighters will often get a cold the back, cold item on the back of the neck or on the head, is not just to cool them down, but the theory is that it might offset some of the damage of neurons.

我对此无法发表评论。

I just can't comment on that.

我知道这些观点，但它们存在争议。

I'm aware of those ideas, but they're controversial.

对于脑部损伤，你希望做的一件事是减轻肿胀。

One of the things that you want to do for injury to the brain is to decrease swelling.

减少身体许多部位肿胀的一种方法就是降温。

And one of the ways that you decrease swelling in many parts of the body is to cool.

它能减少炎症，降低血流。

It decreases inflammation, it decreases the blood flow.

所以我认为这是一个非常有趣的话题，值得深入研究。

So I think it's a really interesting topic and it's something that should be investigated.

但要研究这个话题有点困难。

It's kind of hard to investigate.

是的，很有趣。

Yeah, interesting.

好吧，我听过这些故事，也看过相关数据，所以我相信这些说法。

Okay, so I hear these stories and I've seen the data, so I believe the stories.

也许你可以讲讲你们团队在无氧运动和对这些无毛皮肤区域进行适当降温方面的观察案例。

Maybe tell us a story about an observation that your group has made with respect to anaerobic exercise and proper cooling of these glabrous surfaces.

对。

Yeah.

我们可以谈谈这项技术。

And we can talk about the technology.

对的。

Yep.

也许先给我们讲讲 dips 的例子。

Maybe give us the dips example first.

好的。

Okay.

当然，我认为大多数人对 dips 都很熟悉。

So of course, I think most people are familiar with dips.

你应当往下蹲。

You're supposed to, I guess, get down.

抬起

Raise

并放下你的

and lower your

体重。

body mass.

是的，抬起并放下你的体重。

Yeah, raise and lower your body mass.

通常双腿悬垂，有时力量足够的人会在那里附加重量，这本质上是一个复合上身锻炼动作。

Usually with your legs dangling down, sometimes people strong enough to attach a weight there and they'll do, it's essentially a compound upper body exercise.

对。

Right.

对大多数人来说，做一个俯卧撑并不特别令人印象深刻，做100个会非常惊人，做20个对一些人来说也很了不起，等等。

One dip would not be particularly impressive for most people, 100 would be very impressive, 20 would be impressive for some, etcetera.

当一位有经验的运动员进来进行多组俯卧撑时，会发生什么？

What happens when a skilled athlete comes in and does dips for multiple sets?

当他们通过无汗皮肤进行适当冷却时，又会发生什么？

And then what happens when they cool properly using the glabrous skin This

这发生在我们早期研究期间，当时我们首次发现冷却有助于提升你的运动量和完成更多重复次数的能力，明白吗？

was a story that occurred early on in our investigations when we first made the discoveries that cooling has a benefit to increase your work volume, your capacity to do more reps, okay?

所以这个消息传到了49人队的营地，他们的球员之一格雷格·克拉克——当时是一名近端锋，曾在斯坦福大学打过这个位置——决定过来看看，我不知道是他自己主动来的，还是被邀请的。

So the word got over, I think, to the 49ers camp and one of their players, Greg Clark, who was a tight end at the time, he had been tight end at Stanford, he decided, or I don't know if he was asked or what, to come over and check it out.

于是格雷格来了，我们问他：格雷格，你擅长什么？

So Greg came over and we said, Greg, what are you good at?

你喜欢做什么运动？

What activity do you like to do?

他说：俯卧撑。

He said, Dips.

我能做很多俯卧撑。

I can do a lot of dips.

我第一组能做40个，大概能做五组。

I can do 40 dips in a first set and I can probably do five sets.

这对我来说是常规训练。

That's a usual workout for me.

我们说：好的。

And we said, okay.

于是有一天他来到健身房，就真的这么做了。

So he came over to the gym one day and that's exactly what he did.

他第一组做了40个双杠臂屈伸，然后大概是25个、15个这样递减。

He did 40 dips the first set and then maybe twenty five and fifteen and down.

你还记得他每组之间大概休息多久吗？

Do you recall roughly what kind of rest periods he was taking between Yeah,

我们把休息时间标准化为三分钟，因为这是我们设定的冷却间隔。

standardized the rest period to three minutes because that's what we had set on for cooling as the interval.

那休息时间还挺长的。

That's a good long rest period.

是的，没错。

Yeah, is.

还是很多

Still a lot

个双杠臂屈伸。

of dips.

我明白了。

I got it.

是的，这个休息时间实际上比许多人在锻炼时愿意休息的时间要长。

Yeah, it's actually a longer rest period than many people would prefer during workouts.

他们想尽可能多做——

They want to make the most-

我不是，我更喜欢多休息。

Not me, I prefer to take as much rest Yeah.

尽可能多休息。

As I possibly

几天后他回来了，第一组做了42个，比之前好了一点，现在周围的人都围过来看。

several days later he came back and his first set he did, I think maybe 42, a little bit better, but now people were standing around watching.

所以当时有点想表现一下的压力。

So there was a little impetus there to show off.

他的第二组，我记不清具体数字了，但比控制日的第二组高了很多。

So then his second set was, I don't remember the numbers, but very much above the second set on the control day.

这发生在我们降温之后。

This was after we cooled

他的，好的。

his Okay.

他确实，手掌在什么时候

He does, palm when is

他是在什么时候进行降温的？

he doing the cooling?

他坐着，把手放在我们设计的设备里，这些设备可以冷却他的手掌。

He's sitting down and putting his hands in the devices that we had built, which were cooling the palms of his hands.

这种降温需要多长时间？

For how long does that cooling take?

他能在三分钟的休息期内完成吗？

Can he do it inside of a three minute rest period?

是的，我们就是这么做的。

Yeah, that's what we were doing.

我们将休息或冷却的时间标准化为三分钟。

We standardized the interval for resting or cooling to three minutes.

好的，但重点是他做到了第五组，而且所有组的完成量都超过了前一天的表现。

Okay, but the point is he got to his fifth set and all of the sets were above what he had done on the previous day.

他说：‘你知道吗，我一点都不累，我可以再做一组。’

And he said, You know, I'm not tired, I can do another set.

然后我可以再做一组。

And then I can do another set.

我可以再做一组。

I can do another set.

我可以再做一组。

I can do another set.

因此，通过冷却，从一天到两三天后，他的总训练量翻了一倍。

So from one day to two or three days later with cooling, he doubled the total work volume.

他完成的俯卧撑总数翻了一倍。

He doubled the total number of dips.

通过增加每组的组数和重复次数，

By adding more sets and more repetitions to each Right,

对。

right.

于是他连续四周，每周回来两次。

So then he kept coming back for four more weeks, twice a week.

到那个月结束时，他完成了300次俯卧撑。

And by the end of that month, he was doing 300 dips.

哇，那提升了多少百分比？

Wow, so what percentage?

他增加了三倍。

So he tripled.

增加了三倍。

Tripled.

他增加了三倍。

He tripled.

所以这里有一位处于巅峰体能状态的职业运动员，他的表现提升了三倍，太惊人了，他能做到

So here's a professional athlete at peak physical conditioning and he triples Amazing, what he can

太惊人了。

amazing.

关于他的恢复能力，有进行过探讨或讨论吗？

And in terms of his ability to recover, was that explored or discussed at all?

因为我的理解是，如果我们对肌肉在无氧训练中施加足够的压力，就能刺激肌肉代偿性再生等过程。

Because my understanding is that if we cause enough stress to a muscle during anaerobic training, we provide the stimulus for compensatory regrowth, etcetera.

对，对。

Right, right.

但如果我们增加训练量，实际上就增加了所需的恢复量或恢复时间。

But if we do more work, we essentially scale up the amount of recovery that's needed or the recovery time.

我非常好奇他在这些超常表现的训练之间是否需要更长的恢复时间。

I'm very curious about whether or not he needed longer to recover between these super performing workouts.

这非常有趣。

That's very interesting.

那是一个重大的发现，当时我们并没有意识到自己正在做出这样的发现。

That was a major discovery, which we didn't realize we were making at the time.

你提到的这种现象叫做延迟性肌肉酸痛，也就是DOMS。

There is this phenomenon you're referring to as delayed onset muscle soreness, DOMS.

这是因为当我们增加锻炼的强度和量时，肌肉会出现那些微小的撕裂等等，对吧？

And this is due to those little micro tears and so forth that are happening as we extend our workout capacity, volume, okay?

我们多次经历过这种情况：运动员或任何人来到实验室后，都会超越他们之前的目标和预期。

So we've had this experience so many times that an athlete or anyone will come in to the lab and they will exceed what their previous goals were, their previous expectations.

我总能预见到他们接下来会说什么。

And I can always see the words coming out of their mouth.

我明天肯定会浑身酸痛。

I'm going to be so sore tomorrow.

但他们从来不会。

They never are.

很有趣。

Interesting.

我们实际上已经用一组新手验证了这一点。

And we've actually demonstrated that with a naive group.

我们开设了一门体能训练课，课程初期让其中一半学员测试他们的真正体能极限，看看他们能完成多少。

We had a class, a physical conditioning class, and we had half of them, the first days of the class, had to establish their true capacity, what they could do.

对这些新学员来说，这些训练量相当大。

So these were pretty heavy workouts for these new recruits.

我们让其中一半人接受冷疗，另一半则不接受。

And we gave half of them the benefit of cooling and the other half not.

然后我们让他们记录自己主观感受到的延迟性肌肉酸痛程度。

And then we had them record their subjective levels of delayed onset muscle soreness.

接受冷疗的那组人没有出现明显的肌肉酸痛。

And those that were cooled didn't have significant muscle soreness.

太惊人了。

Amazing.

我知道还有一些已发表的研究结果，我们会为那些看到类似效果的人提供相关论文链接——我应该说，是类似提升表现的效果，比如卧推、俯卧撑等。你能否举一个耐力训练或有氧运动方面的例子，比如跑步、骑车之类的？

And I know there are also published results, and we will provide links to some of these papers for people seeing similar effects, I should say similar performance enhancing effects using bench presses, bench press or pushups or other Maybe sorts of you could give us an example from the realm of endurance work or aerobic work, running, cycling, things of that sort.

对我们来说，其中一个问题是，现在的设备并不真正便携。

Well, one of the problems for us is that our equipment now is not really portable.

我的意思是，它在

I mean, it's portable in the

你可以把它带到

sense you can carry it to

健身房或足球场方面是便携的。

the gym or to the football field.

但你不可能带着它跑步。

But you're not going to run with it.

但你是可以带着它跑步的，

But you're going run with it,

或者把它装在自行车上。

Or equip a bicycle with it.

不过，什么时候会有自行车上的冷却手柄呢？

Although when are the cooling handles on bicycles coming?

是的，那会很好。

Yeah, that would be good.

但有一项流动性的活动是打高尔夫，人们已经把它装在了高尔夫球车上。

But one itinerant activity is golfing and people have put it on their golf carts they're out.

打高尔夫的人真的会热到那种程度吗？

Do people really heat up that much in golf?

他们会的。

They do.

并不是想贬低高尔夫球手，但在我看来，高尔夫就是挥杆、然后走路，接着坐球车，最后吃饭。

Not to be disparaging of the golfers, but the way I conceptualize golf, it's like a swing and then a walk, and then a cart ride, and then a meal.

我可能刚刚冒犯了所有在打高尔夫的人。

I probably just offended all the golfers out there.

当时我们为国防部做项目，他们想评估一下我们所做的事情是否真的有价值。

Well, time we had, we were doing work for the Department of Defense and they wanted to check it out, whether or not what we were doing was really worthwhile.

于是他们派了一支特种部队士兵来当我们的受试者，测试这项设备。

So they sent out a team of special ops soldiers to be our subjects subjects and and test it out.

他们在那儿待了一周。

They were here for a week.

所以那是一段有趣的时光。

So that was a fun week.

是的，我和那些家伙合作过一些项目。

Yeah, I do some work with those guys.

他们都是拼命工作的人。

They're hard driving guys.

他们也很懂得享受乐趣。

They also know how to have fun.

但确实，如果他们有关闭或放弃的开关，那也深藏在他们的神经系统里。

But yeah, they definitely special have, If they have an off or a quit ops switch, it's buried deep within their nervous system.

他们不喜欢按下那个放弃的开关。

They don't like to hit that quit switch.

所以，撰写最终报告的那个人在报告后附加了一段说明，他说：‘我告诉你，我回家后，他们把这项技术带走了。'

So the guy who wrote the final report, he gave an addendum to the report and he said, Well, I'll tell you this, after I've gotten home, they took the technology with them.

他们想回家。

They wanted to get home.

哦，是的，听起来很合理。

Oh yeah, sounds about right.

使用它后，我的每一件球杆都多打了20码，这可不是开玩笑的。

And using it, it has added 20 yards to every club in my bag, and that's no effing small

哇，所以它能让人们击球更远。

Wow, so it's allowing people to hit further, hit the golf ball further.

对。

Right.

有意思。

Interesting.

好吧，所以对于那些高尔夫球手来说，这就是克雷格回馈给你们的奖励，以弥补我之前对高尔夫的那些吐槽。

All right, so for golf players out there, then that's a reward you get back from Craig for all my little knocks on golf.

其实，我对高尔夫没有任何吐槽。

I actually, I don't have any knock on golf.

我只是不认为热身是这项运动的限制因素。

I just don't think about it as a sport where heating up is a limiting factor.

既然他们能从开球中获得更多收益，你觉得这是怎么回事？

So since they're getting more out of their drive, what do you think is going on there?

嗯，他们可能是在热身。

Well, they can be heating up.

他们穿着衣服对吧？

They're wearing right?

他们在大热天里戴着手套，不过让我再给你讲一个关于高尔夫球手的严肃故事。

They're wearing gloves on a hot day and so But let me just tell you one more serious story about golfers.

那就是患有多发性硬化症的人对温度极其敏感。

And that is individuals with multiple sclerosis are exceedingly temperature sensitive.

我之前不知道这一点。

I didn't know that.

所以他们可能还能活动，但必须待在凉爽的地方，并且不能大幅增加运动量。

So they may still be mobile, but they have to stay in cool locations and not increase their exercise to any great extent.

但我们确实有患多发性硬化症的受试者，他们只是把设备安装在高尔夫球车上，夏天照样出来打高尔夫。

But we've had subjects that have, with multiple sclerosis, who have just essentially put the device on their golf cart and they're back out playing golf in the middle of the summer.

这太棒了。

Oh, that's great.

是的。

Yeah.

这太棒了。

That's great.

是的。

Yeah.

任何能让人们保持正常生活和娱乐方式的东西都很棒。

Anything that allows people to have normal levels of livelihood and recreation is great.

我们总是想着在巅峰和精英水平上提升表现、更加努力，但确实，任何能让人们保持行动能力和功能性的方法都很棒。

We always think about performance at these kind of like peak and elite levels and pushing harder, but yeah, anything that allows people to be mobile and functional is great.

那你最喜欢的耐力运动例子是什么？

So what's your favorite example of endurance?

请告诉我们极端的例子，然后我们再讨论平均值，以确保我们全面比较平均值与例外情况。

And feel free to give us the extreme one, and then we'll talk about averages to make sure we're thorough about averages versus exceptions.

没错，我们在实地方面的研究还不多。

Right, we haven't done a lot in the field.

我的意思是，在户外，我们大部分的耐力测试都是在高温房间内使用跑步机进行的。

I mean, outdoors, most of our endurance has been in hot room with treadmill work and so forth.

所以我们最早的一个实验，大概有18名来自街头的受试者。

So the very first experiment we had, I think maybe 18 subjects just off the street.

我的意思是，我们只是在走廊里招募路人，邀请他们进来参与实验。

I mean, we just recruited people in the hallways, Come on in and do this.

我们发现，对于这一组人，在一次使用冷却装置和一次不使用冷却装置的试验中，他们在高温环境下（约40摄氏度）在跑步机上坡行走的耐力可以翻倍。

And what we found is we could, for this group, with one trial with and without cooling, we could double their endurance walking on the treadmill, walking uphill on the treadmill in the heat, like maybe 40 degrees ambient temperature, 40 degrees centigrade.

那么这个实验具体是怎么进行的？

So what does that experiment look like?

你们让受试者在倾斜的跑步机上行走，而且环境非常热。

You're having people walk on an incline, it's really warm.

有些人会直接按下退出按钮，说我已经受够了，然后从跑步机上下来。

Some people are just going to hit the quit button and say, I've had enough and get off the treadmill.

是的。

Right.

在适当降温的情况下，他们是什么时候进行降温的？

With proper cooling, when are they doing the cooling?

他们是持续进行降温的。

They're doing it continuously.

我明白了。

I see.

因为在实验室里，我们可以把设备悬挂在天花板上，例如。

Because in the laboratory, we can suspend devices from the ceiling, for example.

当然。

Sure.

现在我们确实有可穿戴设备的原型了。

Now we do have prototype wearable devices.

几年前，我们是回应来自塞拉利昂埃博拉工作人员的邮件才开展这些工作的。

We did them in response to emails from Ebola workers a number of years ago in Sierra Leone.

他们说：我们读过你们关于运动员的研究。

They said, We've read about your work with athletes.

你们能为我们做点什么吗？

Can't you do something for us?

我的意思是，我们穿着个人防护装备，无法在高温区域停留超过十五到二十分钟。

I mean, we're in the personal protective gear and we can't be in the hot zone for more than fifteen or twenty minutes.

这促使我们开始挑战开发可穿戴系统，使其能穿在防护服里面。

So that started us on the challenge of developing wearable systems that could go under the PPE.

我们现在已经发表了这项研究成果。

We've published that work now.

这太棒了。

That's great.

我猜在沙漠和其他地区执行任务的军事特种部队可能也对此很关注。

I'm guessing the military special operators that are out in the desert and other locations are probably Well, about this

一旦他们得到了。

once they get it.

一旦他们得到了。

Once they get it.

快来了，快来了。

It's coming, it's coming.

是的，我想有些人可能会疑惑，既然有这么多研究，而且多年来取得了如此惊人的成果，为什么我们很少听到关于它的消息呢？

Yeah, I think some people might wonder, if there are all these studies and there are these incredible results over the years, why haven't we heard more about it?

我也会听听你的看法，但我会稍微发表一下个人意见：最好的实验室研究成果及其实际应用，通常需要大量的研究。

And I will ask your opinion on that as well, but I'll just editorialize a little bit, is that the best laboratory work and its practical applications oftentimes requires many studies.

而且，通常缺乏一个渠道，可以把这些信息传递到技术领域。

And oftentimes there isn't a portal, so to speak, to get that information out into the technology sector.

所以有一家公司正在开发这项技术，供人们使用——对。

So there is a company that's developing this technology for people to use- Right.

购买和使用。

To purchase and use.

对。

Right.

你不如现在就告诉我们，那家公司叫什么名字？

You might as well just tell us now, what is the name of that company?

他们有网站吗？

And do they have a website?

人们一定会想知道在哪里能买到这种神奇的技术。

People are going to want to know where can they get this magical technology.

对。

Right.

有没有一种更便宜的替代版本？

And is there a poor man's version of it as well?

这家公司叫Arteria，拼写是A-R-T-E-R-I-A，网站是www.coolmit.com。

Well, the company is Arteria, A R T E R I A, and the website is www.coolmit.com.

所以CoolMit就是coolmit.com。

So CoolMit is just coolmitt, coolmit.com.

这个网站很棒。

It's a great website.

当我访问时，上面说这项技术目前仅提供给专业运动队和军队使用。

When I went there, it says that right now the technology is only available to professional sports teams and military.

这是真的吗？

Is that true?

目前的情况是，这项技术的新版本正处于测试阶段。

Well, where we stand now is the new version of the technology is sort of in beta test versions.

我们已经把它交给了之前使用过这项技术的人手中。

We got it into the hands of people who had used the technology before.

现在有NFL球队在使用，还有大学球队、奥运会团队、海豹突击队、美国职业棒球大联盟、NBA、国家网球协会，他们都在某些地点试用这项技术并反馈使用效果。

So there's NFL teams that are using, there's college teams, there's Olympics, there's the Navy Seals, Major League Baseball, the NBA, the National Tennis Association, they have locations where now they are trying this out and reporting back, how's it working?

你打算如何改进它？

How could you change it?

你打算如何提升它？

How could you improve it?

太好了。

Great.

以此类推。

And so forth.

所以我们现在就处于这个阶段。

So that's where we are.

但在网站上，你实际上可以注册，成为将来能够获得该设备的人之一。

But on the website, you can actually sign up for being one who will be able to get one when they are finally manufactured.

目前它们只是小批量生产，因为你想在发现如何改进后及时调整。

They're now being made in fairly small lots because you want to change things as you realize how it can be improved.

是的，毕竟这里是斯坦福。

Yeah, this is Stanford after all.

你希望把技术做到完美。

You want to get the technology right.

我常开玩笑说，我喜欢斯坦福的一个原因不仅是我的同事们非常出色、思想超前，而且他们都是完美主义者。

I like to joke that one of the reasons I like being at Stanford so much is that not only are my colleagues amazing and they're so forward thinking, but they're all perfectionists.

因此，完美主义的心态是，必须做到完美才能上线，这么说吧。

And so the perfectionist mindset is it has to be perfect before it can go live, so to speak.

我认为会有很多人感兴趣。

Well, I think there will be a lot of interest.

让我们稍微详细谈谈这项技术，然后讨论一下是否存在更原始形式的该技术，无论是出于安全还是性能的考虑。

Let's talk about the technology in a little more detail for a moment, and then let's talk about whether or not cruder forms of that technology exist, either for sake of safety and or performance.

所以，据我理解，这个‘酷爽手套’是一种手套，也就是戴在手上的装置。

So what is, the cool mitt, as I understand, is it's a mitt, it's a glove.

是的。

Yeah.

你把手放进去，握住一个表面，这个表面会冷却你的手，再通过这个特殊通道，降低你的核心体温和全身肌肉的温度。

You put your hand into, you hold onto a surface and that surface cools your hand and thereby through this specialized portal, cools your core body temperature and all the muscles of the body.

如果我现在就使用它，主观上会觉得它冰凉刺骨，还是只是凉爽？

Subjectively, if I were to do this right now, would I think that it was ice cold or would I think it was just cool?

只是凉爽。

Just cool.

冰

Ice

太冷了。

cold is too cold.

所以人们总是问，为什么不能直接把手伸进冰水桶里呢？

So people always ask, well, why can't you just stick your hand in a bucket of ice water?

那样太冷了。

It's too cold.

这样做的结果是导致你试图最大化散热的那些门户血管发生反射性收缩。

What that does is that causes reflex vasoconstriction of the very portals that you're trying to maximize the heat loss from.

所以当你把手伸进冷水里，拿出来时手是冷的。

So you stick your hand in cold water, when it comes out, it's cold.

你只是

You just

把所有的热量都封闭起来了 是的，你的

sealed up all the heat Yeah, your

对。

right.

所以，我曾经建议过一个人，他说：‘我跑步的时候，能不能带一罐冷冻的果汁？’？

So what I sort of recommended to someone at one point, they said, Well, when I'm running, can I just carry a frozen juice can?

它会慢慢融化。

And it will gradually melt.

我说：‘不行，因为那样会减少那只手的散热’。

And I said, Well, no, because that's going to decrease the heat loss from that hand.

但如果你每隔几分钟换一只手，或许可行。

But if every couple minutes you switched hands, it might work.

我觉得现在一定有人已经在这么做了，同时也尝试这种方法。

Well, I have a feeling that there are people now doing that as well as trying this.

那么，在适当温度的冷却液中，人们把手放进手套里多长时间呢？

So how long, in the coolant at the proper temperature, long are people putting their hands into the mitt?

我们再次统一采用三分钟。

We once again had just standardized on three minutes.

其中一部分原因是，热量流失的速率呈指数下降曲线，明白吗？

And part of the reason for that is that the law, the rate of heat loss is an exponentially declining curve, okay?

三分钟大致能覆盖曲线中最有效的部分。

And three minutes sort of gets the best part of the curve.

你可以延长浸泡时间以获得更多的益处，但性价比最高的阶段是在前两到三分钟内。

So you can go longer and get more benefit, but the biggest bang for the buck is in the first two, three minutes.

你提到了一些令人印象深刻的应用机构、运动队和军队都在使用这项技术。

Okay, you mentioned a number of impressive organizations, sports teams, and military that are using this.

这种技术我通常在比赛场边是看不到的。

This is not something that I typically see on the sidelines of games.

不过说实话，我也没仔细留意过。

Although to be honest, I haven't looked very carefully.

我猜他们可能在一定程度上对这项技术保密。

I'm guessing that they are probably keeping the technology somewhat under wraps.

他们是在哪里、如何使用这项技术的？

Where and how are they doing this?

他们是回到更衣室吗？

Are they running back to the locker room?

我的意思是，特种军事人员在做他们的事，但就运动员而言，有没有可能，假设性地说，运动员们在悄悄地使用这项技术？

I mean, military special operators are doing their thing, but in terms of the athletes, is it possible, hypothetically, that athletes are doing this somewhat incognito?

有可能，但我真的不知道。

It's possible, but I really don't know.

有人在这里的斯坦福提到，他们没看到橄榄球队在使用它。

People have mentioned here at Stanford, they don't see the football team using it.

嗯，斯坦福这里的橄榄球队主要在寒冷或凉爽的天气里比赛。

Well, the football team here at Stanford is mostly playing in cold weather, cool weather.

夜场比赛天气比较凉爽。

Night games are cool.

即使在白天比赛，这里也通常不会很热。

Even date games are not very hot frequently here.

但当他们去像亚利桑那或犹他这样炎热的地方时，至少我们的教练肖说，他们会带上它，那时他们才能感受到它的益处，才会使用它。

But when they go to a hot place like Arizona or Utah, at least our coach Shaw says that they take it with them and that's when they find the benefit, that's when they use it.

有意思。

Interesting.

那么，有没有一种穷人版的这种方法，也就是穷人或穷女人用的版本？

So is there a poor person's, poor man or woman's version of this?

你提到过果汁罐来回传递，还提到过冷却双手。

You mentioned the juice can passing back and forth, you mentioned cooling the hands.

不少人跟我说过

A number of people said to

在我稍微了解了这项科学和技术之后，他们表示自己体验到了冷却带来的显著正面效果，我承认我也这么做过——拿一包冷冻蓝莓，来回在手里传递。现在和你聊了之后，我才意识到我可能没坚持足够长的时间。

me after learning a little bit about this science and technology, that they've experienced some big effects, positive effects of cooling by, and I confess I've done this, taking a package of frozen blueberries and just kind of passing it back and forth Now between my talking to you, I realize I probably didn't do it long enough.

我当时只是大概传递了三十秒，然后就回去继续下一组训练。

I was only doing maybe thirty seconds passing it back and forth between my hands and then going back into sets.

我确实感受到了提升表现的效果，绝对有。

I did see a performance enhancing effect, absolutely.

但我意识到我可能没有优化这个方法。

But I realized I probably wasn't optimizing the protocol.

如果你要为健身房制定一个粗略的方案，比如说，因为跑步有点复杂，但如果人们想以某种方式尝试一下，这个方案会是什么样子？

If you were going to give a crude protocol for, let's just say for the gym, because with running, it's a little bit tricky, but what would that look like if people wanted to just play with this in some sort of fashion?

这会是种实验性的做法。

Well, would be experimental.

当然。

Sure.

是的，这些都没有什么严格的控制。

Yeah, none of that is very controlled.

你提到用冷冻豌豆是个好主意。

Your idea of frozen peas is a good idea.

而且我认为，由于还没有人对此进行过实际研究，你得自己摸索出最适合你的方法。

And I think since there's been no actual study of that, you would have to be you working out what is the best for you.

但其中一种判断方法是：当你用一只手握着冷冻豌豆，然后换到另一只手时，如果有人过来摸你的手，是暖的还是冷的？

But one way to figure it out is that if after you hold the cold peas in one hand and you switch it to the other hand, if someone then comes and feels your hand, is it warm or cold?

如果手是冷的，那就说明你的血管收缩了。

If it's cold, it means you vasoconstricted.

如果感觉是温的，说明温热的血液仍然流经那里。

If it's warm, it means the hot blood is still going there.

好的，我们在实验室里就是这样做的。

Okay, so we do that in the lab.

关键是不要让血管收缩，对吗？

And the key is for it to not vasoconstrict?

对。

Right.

好的。

Okay.

所以这里有一个测试方法，大家注意。

So there's a test out there, folks.

如果你打算以一种比较粗略的方式尝试这种方法，至少在冷却手套更广泛普及之前。

If you're going to try this in kind of crude fashion, at least until the cool mitt is available more broadly to the general public.

你需要评估一下，当别人触摸你的手掌时，是否真的感觉凉爽。

You want to assess whether or not your palms actually feel cool to the touch by somebody else.

如果真是这样，那就意味着你基本上关闭了血流通道，导致更多热量被封闭在里面，这是不利的。

And if it does, that means you've essentially shut down the porta, you're sealing in more heat, which is bad.

那把这种冷敷包放在脸上或者脚上呢？

What about putting this cold pack of some sort on the face or- Or the feet.

更多地放在脚上。

More of the feet.

我在家锻炼，通常不赤脚锻炼，但我可以像70年代那些人一样，光着脚走路，光脚蹲下，我可以把脚放在上面吗？

I work out at home, I don't often work out barefooted, but I suppose I could like they did in the 70s, when those guys were walking around without shoes and squatting without any shoes or socks on, could I put my feet

放在上面？

on them?

可以的。

You could.

如果你只是用一个水循环垫，让凉水在其中循环，就可以把脚放在上面，明白吗？

If you simply had a water perfused pad and you were circulating cool water through it, you could just put your feet on it, okay?

问题的一部分在于，你不想只是简单地用一个冷敷包。

Part of the problem is that you don't want Let's say you have just a cold pack of something.

问题又回到了边界层上。

The problem is back to boundary layers again.

如果你没有冷却介质的对流流动，散热器的效果就会降低，因为在散热器材料和你的皮肤之间会形成一层边界层。

If you don't have a convective stream of the cooling medium, the heat sink is not as effective because there'll be a boundary layer developed between the heat sink material and your skin.

这会降低它的效果。

So that decreases its efficacy.

我明白了。

I see.

也许我们暂时谈一谈辐射和对流，把这一点说清楚。

Maybe we should just for a moment talk about radiation and convection, and just make that clear.

比如，如果是在一个寒冷的夜晚，我坐在篝火旁，把双手伸向火堆。

Like if I put my hands, let's say it's a cold night and I'm at a campfire, I and take my hands and I put them out to the fire.

你感受到的是辐射。

You're getting radiation.

你感受到的是辐射。

You're getting radiation.

对。

Right.

好的。

Okay.

对。

Right.

然后如果是一个有风的温暖夜晚，不，我不知道这是否是最好的例子。

And then if it's a windy, warm night, no, I don't know if that's the best example.

给我们一个对流的好例子。

Give us a good example of convection.

对流确实体现在凉爽的微风中。

Convection sure, is in a cool breeze.

是的。

Yeah.

有风寒效应时，那就是对流造成的。

With a wind chill factor, that's due to convection.

好吗？

Okay?

但从两个物体之间的热量传递角度来看，如果介质发生对流，比如内部是血液、外部是水，当两侧都存在对流时，热交换会增强。

But in terms of heat transfer between two objects, if you have convection of the medium, whether it's blood on the inside and water on the outside, you increase the heat exchange if you have convection on both sides.

对，这就是为什么我把脚直接放在两包冷冻豌豆上时，根本无法形成循环，因此热传递效果很差。

Right, so this is why just planting my feet on two packages of fro My bare feet on two packages of frozen peas, there's really no opportunity for circulation and therefore heat transfer.

所以这其实并不理想，我——

So it's not really optimal, which is, I-

但同样，要获得任何效果，都取决于接触面积。

But once again, it depends on the surface area to get any benefit at all.

我们发表过一项研究，调查了现场治疗高热的标准方法。

We have a study that we published, which was investigating the standard treatment for hyperthermia in the field.

医学组织推荐的标准治疗方法是使用冷敷包，放在腋下和腹股沟。

And the standard treatment that's recommended by medical organizations is you take cold packs and you put them in the axilla, the groin.

腋下是指腋窝吗？

The axilla or the armpits?

腋窝，是的，腹股沟，也就是

The armpits, yeah, the groin, which is

皮肤薄，血管丰富。

Thin skin, lots of vasculature.

对，还有颈部。

Right, and the neck.

所以我们进行了研究，让受试者体温升高，然后测量在推荐位置（腋窝、腹股沟）放置冷却袋与在无毛皮肤（手掌、脚底和面部）上放置时的降温速率。

So what we did is we did studies in which we made people hyperthermic, and then we measured the rate at which we could cool them by putting those positions in those heat exchange bags in the recommended location versus on the glabrous skin, versus palms, soles, and face.

降温速率翻了一倍。

The cooling rate was double.

哇哦。

Wow.

所以我们把同样的冰袋、冷敷包放在热交换门户上，而不是腋窝、腹股沟和

So we put the same ice packs, the same cold packs on the heat portals rather than the axilla, the groin and

面部。

the face.

哇。

Wow.

或者脖子。

Or the neck.

哇。

Wow.

所以，脸部、双手和脚底冷却你的速度是将冷敷包放在腋下、腹股沟或后颈的两倍。

So face, hands, and bottoms of feet will cool you twice as fast as putting cold packs into your armpits, your groin, or back of neck.

所以我喜欢打个比方，如果你的汽车过热了， okay，你有一根水管，你应该把水喷在冷却系统的哪个部位？

So I like to give the analogy of if your car is overheating, okay, and you have a hose, a garden hose, where should you spray your cooling system?

你应该喷在散热器上，还是应该喷在进出散热器的管道上？

Should you spray the radiator or should you spray the tubes going in and out of the radiator?

把冷敷包放在腋下、腹股沟和脖子背后的理由是，你靠近了主要动脉。

Well, the rationale with putting these cold packs in the axilla, the groin in the neck is that you're getting close to the major arteries.

没错，那样确实有效，但如果你真正增加了散热表面——也就是散热器——的散热能力，效果会好得多。

Sure, that's going to be effective, but it's much more effective if you actually increase the heat loss capacity of the radiating surface, the radiators.

所以你要冷却那些流向核心的高温血液。

So you cool the hot stuff heading toward the core.

这基本上就是标准操作程序，就是针对动脉进行降温。

That's essentially what the standard operating procedure is, that you hit the arteries.

太神奇了。

Amazing.

还有静脉，动脉和静脉。

And the veins, arteries and veins.

我来讲一个小故事，说明几乎所有人都搞错了这一点，然后我会借此机会问问你关于刻意加热与刻意降温的看法。

I'm going to just tell a brief story that illustrates how almost everybody gets this stuff wrong, and then I'm going use that as an opportunity to ask you about heating, deliberate heating as opposed to deliberate cooling.

大约四个月前，我的一个朋友——顺便说一下，他曾在海豹突击队服役九年，是个非常擅长冷水游泳的人。

So about four months ago, a friend of mine, incidentally, a guy who did nine years in the SEAL team is really skilled cold water swimmer.

我们一大早就去游泳了。

We went out for a swim in the morning.

我的表现根本无法和他相提并论。

I'm not nearly even close to being in the same universe of his output potential.

我们经常进行这种游泳，我对这些很熟悉。

We do these swims, I'm familiar with them.

我身上有足够的脂肪，能在寒冷的太平洋里保持温暖，不用穿潜水服。

I got enough blubber on me that I stay warm enough in the cold Pacific, no wetsuits.

我们每天早上游大约一英里的冷水泳。

We do the morning cold swim for about a mile or so.

我们带了一个我非常熟悉的年轻孩子，他有时会和我们一起活动、训练，但他体脂非常低。

And we brought with us a young kid that I know real well that hangs out with us sometimes and trains with us, who's got very little body fat.

他虽然吃得多，但身材异常瘦削，对吧？

He's just exceptionally lean despite eating everything inside, right?

是个青少年，优秀的运动员，很棒的孩子，游泳也很出色。

Teenager, great athlete, great kid, great swimmer.

我们在那里游泳时，和他交谈，发现他明显已经失温了。

So we're out there swimming, and at some point we're talking to him and it's clear that he's gone hypothermic.

他说话含糊不清，状态不太好。

He's slurring his words, he's not doing well.

所以我们把他带到海滩上，他的牙齿开始发黄，浑身发抖， saliva 变得稀薄透明，明显是失温了。

So we get him onto the beach, his teeth are turning yellow, he's quaking, he's not, he's got, you know, his saliva is taking on that consistency that's clear, like he's hypothermic.

我们去了救生员站，救生员说：好的，我们来测他的生命体征，做所有必要的检查。

We go to the lifeguard station, lifeguard says, Okay, let's get his vitals, let's do all this.

同时，我们试着站在他旁边，通过温暖他的躯干来帮他升温。

Meanwhile, try and stand next to him, you know, and heat him up by heating up his torso.

于是我们就贴着他，我们的朋友，努力给他取暖。

So there we are, like pressing against this guy, our friend, trying to heat him up.

他们给他盖上了毯子。

They get a blanket on him.

我这才意识到，他光着脚。

He's, I'm realizing he was barefoot.

他的脸是裸露的，虽然我们用毯子盖住了他的头。

His face was exposed, although we did cover his head with the blanket.

后来他慢慢恢复了，我们给他喝了些温热的液体，他就没事了，状态很好。

And he eventually came back, we got some warm liquids into him and he was okay, he was fine.

我不知道他妈妈以后还会不会让他跟我们一起游泳。

I don't know that his mother is ever going to let him swim with us again.

我以前失踪过，都是因为那次事件。

I ever disappear and go missing, it's because of that incident.

不管怎样，他表现得很好，已经康复了，又回到水里，状态不错。

Anyway, he did great, he recovered, he's back in the water and doing well.

但我意识到，从我们回到海滩到他恢复正常，整个过程我们几乎全做错了。

But I realized that pretty much everything from the point where we got back on the beach until he was back to normal, we did incorrectly.

我们给他暖了躯干，却让他的四肢暴露在外，还以为自己做的是对的。

We heated his torso, we left his extremities exposed, and we assumed we were doing the right thing.

那个救生员是一位在大型公共海滩工作的专业救生员。

And the lifeguard is a skilled lifeguard at a major public beach.

所以我想问个简单的问题：我们是不是全搞错了？

So I guess the simple question is, did we get everything wrong?

我们有没有做对过什么？

Did we get anything right?

在那种情况或类似情况下，更好的做法是什么来给低体温患者取暖？

And what would have been the better option to heat up a hypothermic person in that or a similar situation?

你问得很有意思，因为这正是我们开始研究这个领域的契机。

Well, it's interesting you asked that because that is the way we got into this area of investigation.

我研究的是下丘脑如何调节体温，属于神经生理学领域。

I worked on how the hypothalamus regulates body temperature, neurophysiology.

有一天，我们和麻醉科的一位同事进行了讨论。

And one day we were having a discussion with a colleague in the department of anesthesia.

他开玩笑地对我的同事说：是啊，你们觉得自己对体温了解得很多。

And he jokingly said to my colleague, he said, Yeah, you guys think you know so much about temperature.

我打赌你们解决不了我们复苏室遇到的问题。

I bet you couldn't solve a problem we have in the recovery room.

什么问题？

What's that?

病人做完手术出来时体温很低，我们要花好几个小时才能让他们停止颤抖。

Well, the patients come out of surgery, they're hypothermic, and it takes us hours to get them to stop shivering.

恢复室里他们是怎么做的？

What do they do in the recovery room?

正是你建议的那样。

Exactly what you suggested.

他们用暖毯子，开加热灯，要花一到两个小时才能让这些病人停止颤抖，把体温升上来。

They put in warm blankets, they put in heat lamps, and it takes them an hour or two hours to get these patients to stop shivering, to bring them back up.

所以我们说，啊，这真是个简单的问题。

So we say, Ah, it's a trivial problem.

不，这是个难题。

No, it's a hard problem.

这是个难题，因为你在麻醉状态下血管会扩张。

It's a hard problem because when you're under anesthesia, you're vasodilated.

当你从麻醉中醒来时，你会体温过低并出现血管收缩。

When you come out of anesthesia, you're hypothermic and you vasoconstrict.

这使得热量很难进入体内。

That makes it very difficult to get heat into the body.