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你采访过1500个即将离世的人。
You've interviewed 1,500 people as they're about to die.
我们的研究显示，将近90%的人在接近死亡时开始经历非常强烈的梦境或幻觉，这和以往的任何体验都完全不同。
And what our research is showing is nearly 90% of people start to have very intense dreams or visions as they get closer to death, and it's unlike anything they've ever experienced.
有趣的是，这些现象并不像谵妄。
And what's fascinating is these events don't resemble delirium.
当我们让他们在0到10的范围内评价真实感时，他们总是给出10分。
When we ask them to scale it zero to 10 on the degree of realism, it's always a 10.
所以感觉就像真的发生过一样。
So it feels like this actually happened.
给我讲讲那些人吧。
Tell me about those people.
看个视频会不会有帮助？
Would it help to see a video?
做了30年这个工作，我逐渐明白，我们在面对死亡这件事上已经迷失了方向。
So after doing this for 30 years, what I've come to understand is that we've lost our way with dying.
信息太匮乏了，这种空白几乎全被恐惧和误解填满了，再加上医生们也不谈这些事，情况就更糟了。
There's such a lack of information, and that void is overwhelmingly filled with fear and mistruths, compounded by the fact that doctors don't have these discussions.
你能给我列出来吗？
Can you list them for me?
首先，我没见过有人在生命尽头提起遗憾。
First, I don't see people bringing up regret towards the end of their life.
他们不会想自己有没有什么遗憾吗？
They're not thinking about do they regret something?
不会，绝对不会。那些都过去了。
No. Hell no. No, it's gone.
死亡是一个极其真实的地方。
Death is this unbelievably truthful place.
你会被剥得只剩下最真实的自己，而如果你想想自己最好的样子，那从来不是取得了什么成就。
You're stripped to the bare bones of who you are, and if you think of the best version of yourself, it was never achieving something.
而是作为一个儿子，作为一个兄弟，作为一个朋友。
It was being a son, it was being a brother, it was being a friend.
然后最大的误区就是认为疼痛是不可避免的，但实际上并非如此。
And then the big myths are that pain is expected, and that's actually not true.
其实没有人们想象的那么痛苦。
It's less painful than people think.
哦，天哪，差远了。
Oh, gosh, by a mile.
但可悲的是，关于这个问题的讨论少得可怜。
But it's damning how little conversations there are to address that issue.
接下来这个，是我特别感兴趣的一个。
And then the next, this is one that fascinates me.
你马上就会明白为什么。
You're going to see why.
另外，我们这里有六张手写卡片，上面是你从照顾临终者中学到的经验。
And also, we have these six handwritten cards of lessons you've learned from caring for the dying.
我们会详细讨论这些，但根据你所有的经历，你觉得人死后还有生命吗？
We'll go into the full list, but from everything you've experienced, do you think there is life after death?
这可能是所有事情中最了不起的一点。
This is probably the most remarkable thing of all.
所以我觉得——
So I think-
各位，在节目开始之前，我想请大家帮个忙。
Guys, I've got a favor to ask before this episode begins.
算法是这样的，如果你关注一个节目，它就会把那个节目最好的几期非常显眼地推送到你的信息流里。
The algorithm, if you follow a show, will deliver you the best episodes from that show very prominently in your feed.
所以，当我们这个节目有最好的几期，分享最多、评分最高的几期时，我希望你能知道。
So when we have our best episodes on this show, the most shared episodes, the most rated episodes, I would love you to know.
而让你知道的最简单方法，就是点击那个关注按钮。
And the simple way for you to know that is to hit that follow button.
而且，这也是你能做的既简单又容易还免费的事情，能帮我们把节目做得更好。如果你能在你现在收听的这个应用上花一分钟，点一下关注按钮，我会非常感激。
But also, it's the simple, easy, free thing that you can do to help us make this show better, and I would be hugely grateful if you could take a minute on the app you're listening to this on right now and hit that follow button.
真的非常感谢。
Thank you so, so, so much.
克里斯托弗·克尔医生，您花了三十年的时间去经历我们大多数人可能一辈子都在试图回避的事情。
Dr. Christopher Kerr, you've spent three decades of your life experiencing something that most of us probably spend our lives trying to avoid.
这三十年您都做了些什么？
What is it you've done for the last three decades?
我之前也在回避这件事，但更像是偶然，我最终成为了一名临终关怀医生。
I was trying to avoid it, too, but more by accident, I ended up becoming a hospice doctor.
那是什么意思？
What does that mean?
临终关怀医生照顾那些被认为无法治愈的人。
A hospice doctor cares for that individual who is no longer deemed treatable.
所以您花了三十年照顾那些即将离世的人。
So you've spent 30 years caring for people that are going to die shortly.
是的。
Yes.
然后您开始采访他们。
And you started interviewing them.
到现在大概有一千五百个了。
Probably 1,500 at this point.
你为什么开始采访那些快要去世的人？
Why did you start interviewing people that were about to die?
因为他们的观点很重要。
Because their perspectives matter.
我刚到临终关怀机构时，完全没有准备好去照顾临终病人。
I arrived at hospice completely unprepared to be a doctor of the dying.
医学院教你的其实是如何战胜死亡，而不是如何照顾那些正在走向死亡的人。
Medical school prepares you really to defeat death, not to care for those who are dying.
但我的同事们，尤其是护士们，更关注病人真实的感受。
But my colleagues, particularly in nursing, were much more attuned to what the actual patient was experiencing.
我逐渐明白，病人的视角才是最重要的。当你开始把病人当作普通人来看待，你会发现他们有着丰富的情感和个人生活，而这些在生命的最后阶段才是真正重要的。
What I've come to understand is the patient perspective is the one that matters, and that when you start to see patients as people, you start to understand that they have these rich emotional and personal lives, and that's what matters at the end of life.
你做了多少研究？
How much research have you done?
因为我这里大概有15篇你发表的研究论文。
Because I've got, I think, 15 research papers here that you've published.
是的，我们做了很多。
Yeah, we've done a lot.
而且我们做的事情非常重要。
And we do very important things.
所以我们排除了意识混乱的状态。
So we rule out confusion states.
我们研究了创伤后成长，看看在临终的负面经历中是否真的有积极的收获。
We've done studies on post-traumatic growth to see whether within these negative experience of dying was there actually positive gain.
我们还研究了这对儿童的影响。
We've looked at the effect on children.
是孩子去世的时候吗？
When children die?
我们还研究了这些事情对丧亲之痛的影响。
And we've looked at the effect of these things on bereavement.
那些留下来的人，这对他们的哀伤过程有什么影响？
Those left behind, how did that influence their bereavement?
你还做了很多关于临终者所见幻象以及临终前几天所做之梦的研究。
And you've also done a lot of research on the visions people see as they're dying and the dreams they have in the days leading up to their dying.
是的，这正是我们研究的重点。
Yes, that's the focus.
绝大多数人，将近90%的人，开始做非常强烈的梦或看到幻象，其中最主要的主题是他们见到了自己深爱过却已失去的人。
The vast majority of people, nearly 90% of people, start to have very intense dreams or visions, and the overriding theme is that they're seeing people who they've loved and who they've lost.
而且非常具体的是，那些无条件、纯粹爱他们的人会出现，而那些没有这样爱他们的人则不会出现。
And very specifically, it's those that have loved them unconditionally, purely, and those that didn't, aren't there.
死亡是一个逐渐入睡的过程。
Dying is progressive sleep.
你的睡眠结构会改变，睡眠周期也会改变，而且你会越来越多地经历这种内在的体验。
Your sleep architecture changes, your sleep cycles changes, and evermore, you start to have these kind of inner experiences.
这很合理，对吧？
It makes sense, right?
也就是说，在临终的时候，你会变得反思，会变得内省。
That as you're dying, you're going to be reflective, you're going to be introspective.
而且这些现象通常在生命的最后一两周变得更加频繁。
And they usually become more prevalent towards the last week or two of life.
非常有趣的是，随着人们接近死亡，这些现象出现的频率会越来越高。
And what was very interesting, the frequency of these events increases as people approach death.
所以这一切都是为了真正让死亡过程更人性化。
So it's all been an attempt to really humanize the dying process.
所以，从医学模式出发，那种关注器官衰竭和疾病管理的模式，转而让我们看看患者在生命末期真正经历的是什么。
So take it from a medical model, which looks at organ failure and management of disease, and instead let's look instead what the patient's actually experiencing towards the end of their life.
而令人着迷的是，当你衡量哪些主题能给他们带来最大的安慰时，那就是见到已故的亲人。
And what's fascinating is when you measure what themes bring them the most comfort, it's seeing the deceased.
所以如果我快要离世了，最能给我安慰的就是见到我已故的亲人。
So if I'm passing away, the thing that brings me the most comfort is seeing my deceased relatives.
是的。
Yes.
我这里有一张图表，显示的是那些最让人感到安慰的关于逝者的梦境。
And I've got a graph here which shows the dreams of the dead that were most comforting.
我把它投到屏幕上。
I'll throw that up on the screen.
是的，我们用一个量表来测量什么最能给他们带来安慰，你可以看到，从活着的人到见到逝者，这个数值是上升的。
Yes, we measured on a scale what brought them the most comfort, and you can see it goes up between the living and seeing the dead.
看个视频会不会更有帮助？
Would it help to see a video?
我们之前给病人录了像，因为我们知道，我们的观众，尤其是医学界的观众，对临终病人会有一个刻板印象，觉得他们要么神志不清，要么思维迟钝。
What happened was we videoed patients early because we knew that our audience, particularly a medical audience, would have a view of what a dying patient was, that they were either compromised or feeble-minded.
所以把他们拍下来就变得非常重要。
And so it became very important to capture them on film.
这是保罗。
So this is Paul.
这其实是他去世前三周拍的，他基本上把各种情况都涵盖了。
This is actually three weeks before his death And he kind of covers all the bases.
这些梦非常生动。
So very vivid, these dreams.
做梦的人和梦中的人之间几乎不说话。
Very little is said between the dreamer and the person in the dream.
你会注意到所有这些视频中一个非常突出的特点，那就是完全没有恐惧。
What you'll notice in all these videos that's just striking is the absolute absence of fear.
这些梦从不否认他们即将离世的事实。
So these dreams never deny the fact that they're dying.
它们几乎超越了死亡，有时候他们真的很难找到语言来描述所见，但他们知道自己留下的感受，那就是他们被重新拼凑起来了。
They almost transcend it, and they really sometimes have trouble to find language for what they're seeing, but they know how they're left felt, which is they're kind of put back together.
我大概梦到她十五次了，也许吧。
I've probably had 15 dreams about her, maybe.
差不多这个数。
Somewhere in there.
我大多数时候做彩色的梦，她总是穿着一件漂亮的浅蓝色衣服。
I dream in color most times, and she always wears a beautiful light blue.
可能是西装，可能是礼服，也可能是连衣裙，但总是浅蓝色的。
It could be a suit, it could be a gown, it could be a dress, but it's always light blue.
有几次她给了我那种选美小姐的小挥手，还有几次她跟我打招呼，总是带着微笑。
And a couple of times, she's gave me the little beauty pageant wave, and a couple of times she sort of greet, always with a smile.
只有一两次我听到过她的声音。
Only one or twice I've ever heard her voice.
但她总是让我知道她很好。
But she always kind of lets me know she's fine.
所以在他去世前，他做了大概15个关于他已故妻子的梦？
So in the lead-up to his death, he's having, what, 15 dreams about his deceased wife?
是的。
Yes.
你怎么看这件事？
What do you make of that?
这意味着什么？
What does that mean?
说实话，我对这件事的看法正在改变。
Honestly, my view of this is changing.
在我刚开始做这个的时候，我会告诉你，这只是一段被重新唤醒的记忆。
I would have told you before when I started doing it, this was a rekindled memory.
所以那只是记忆吗？
So it was just a memory?
就像在看一张照片。
It was like looking at a picture.
然后回忆起那个画面。
And recalling the imagery.
有几个特点很突出，表明这远不止如此，几乎有一种持续的意识的延续，其中一个就是被重新唤醒的细节非常惊人。
There's a couple features that stand out that suggest there's a lot more than that, that there's almost this continued consciousness, and one is the detail that's rekindled is remarkable.
一个九十五岁的老人，他在五岁时失去了母亲，他谈到能闻到她的香水味，听到她的声音。
Ninety-five-year-old man, he lost his mother when he's five, and he talks about smelling her perfume and hearing her voice.
另一个是，这些互动中经常有交流，你会在其他视频中看到这一点。
The other is that often these interactions, and you're going to see this in other videos, there's communication.
所以它们不是静止的。
So they're not in still form.
再说一次，不是像看照片那样。
Again, not like looking at a picture.
你相信他的妻子真的还能被接触到，还是说通过他的梦境，他能够接触到关于她的记忆？
Do you believe his wife is still truly accessible, or are you saying that the memory of her is accessible through his dreams?
因为这两种说法差别很大。
Because they're very different propositions.
我不知道这意味着什么。
I don't know what this means.
我不敢大胆地说这证明了来世的存在。
I wouldn't be so bold as to say this speaks to an afterlife.
我更确信的是，那些爱过我们的人永远不会消失。
What I am more convinced of is that those who have loved us are never gone.
他们仍然可以与我们相通。
They're accessible to us.
让我着迷的是，在生命尽头，当人们神经受损、逐渐衰弱、无法动弹时，残留的功能依然是那种核心的联结感和被爱的感觉，而且这种感觉一直存在。
And what is fascinating to me is that at the end of life, when people are neurologically compromised, they're fading, they can't move, the remnant of function is still this core sense of being connected and loved, and that remains.
就像我们来到这个世界和离开这个世界时，有着惊人的对称性。
It's like we enter the world and leave the world with remarkable symmetry.
你来到这个世界，婴儿不懂语言，大脑尚未发育完全，但它知道母亲的爱。
You come into the world and the infant doesn't know language, undeveloped brain, but it knows its mother's love.
它知道自己感到联结和安全，而在生命的最末端，也差不多是同样的感觉。
It knows it feels connected and secured, and at the very end of life, it's kind of the same thing.
他们衰弱了，能力下降了，但他们所感受和感知到的，即使没有语言，也是同样的东西。
They're diminished, they're less capable, but what they're feeling and sensing, even without language, is the same thing.
有没有哪一段你拍到的、关于濒临死亡的病人的视频，最能让你相信意识会延续，或者我们爱的人其实从未真正离开，他们可以被召唤回这个世界？
Was there one particular video you got with a patient that was approaching their death that was most persuasive to you as it relates to believing that consciousness continues or that our loved ones aren't really ever gone, they are able to be summoned back into this world?
肯定是那些因为生活而受过伤、受过害，并且常常为此挣扎了几十年的人的视频。
Definitely the ones where people have injury or harm for having lived, and they've struggled with that, often for decades.
无论他们接受多少治疗、谈话疗法、药物，他们从未找到平静，但在这些经历中，他们最终找到了平静。
And no matter how much therapy, talk therapy, medication, they've never found peace, and they find it in the end in these experiences.
所以，一位老退伍军人在生命的最后几天里，饱受生存、死亡和创伤后应激障碍的折磨，他被带回到那些在海外阵亡的战友身边，得到了安慰。
So an old veteran who suffers with survival, death, and PTSD in the last days of life, he's brought back to those who died overseas, and he's comforted.
我觉得最了不起的，当然，是那些孩子们，他们处理这些的方式非常不同。
And I think some of the most remarkable ones, of course, are the children, who do this so differently.
但仅仅是我们内在有如此多的天生能力去治愈这些受伤和破碎的部分，而孩子们以绝对鼓舞人心的方式做到这一点，这一点本身就令人惊叹。
But just the fact that there's so much innate ability within us to heal these harmed and broken pieces, and for children who do this in ways that are absolutely inspiring.
他们通常并不戏剧化。
They're often not dramatic.
没有伟大的顿悟，没有伟大的揭示。
There's no great epiphany, no great reveal.
这些时刻只是关于活过和有意义。
These are moments of just having lived and mattered.
他们围坐在厨房的桌子旁。
They're sitting around a kitchen table.
如果你愿意，我们可以展示佛罗伦萨的例子，她就是一个例子。
If you want, we can show Florence, and she's an example.
她失去了丈夫，也失去了女儿，而这是她去世前的五天。
She's lost her husband and she's lost her daughter, and this is five days before her passing.
跟我们说说那些梦吧。
Tell us about the dreams.
但前几天晚上，我一下子就睡着了。
But the other night, I fell right into a sleep.
我们坐在厨房桌旁笑着。
We were sitting at the kitchen table laughing.
我能看到他们的脸。
I could see their faces.
我能感觉到那充满了敌人。
I could tell it was full of foes.
我们在笑。
We were laughing.
我们在聊天。
We were talking.
我们在吃饭。
We were eating.
这让我觉得那整整十二年好像从未发生过。
It made me feel like that whole 12 years had never existed.
因为太真实了，他就在眼前。
Because it was so real that he was there in the present.
而我女儿已经走了七年。
And seven years since my daughter was gone.
就像我们一直在一起，从未分开过。
It was like we were always together, never separated.
这让你对死亡有什么感觉？
How does it make you feel about the prospect of dying?
这改变了你的看法吗？
How does it change your view?
哦，我不害怕。
Oh, I'm not afraid.
当人们看到类似的情况时，可能会说，因为他们知道自己总有一天会离世，已经得到了诊断和预后。
When you see something like that, people might say, because they are aware that they're going to pass away at some point, they've been given that diagnosis, that prognosis.
对，大概在生命尽头，家人这些事会萦绕在他们心头，如果这些事一直在想，就会出现在梦里。
Presumably, yeah, the end of their life, their family, these are the things that would be on their mind, and if they're on their mind, they'd be in their dreams.
所以，是死亡的过程引发了这些梦或幻象，还是仅仅因为你梦到你所想的事情，而这些人显然在思考生命的终结？
So is it the process of death that's provoking these kind of dreams or visions, or is it just the case that you dream about what you think about, and obviously these people are thinking about the end of their lives?
对此唯一的反驳是，当你问他们这类问题时，最让他们不安的是你把这些称为梦，因为这些经历与他们以往的任何经历都截然不同。
The only rebuttal to that is when you ask them these sorts of questions The thing that gets the most distressed is when you refer to them as dreams, because these are unlike anything they've ever experienced.
所以它们不是梦，不是隐喻，不是奇幻，不需要解读。
So they're not dreams in the sense they're not metaphorical, they're not fantastical, they don't require interpretation.
我从未有病人问过：“嘿，你觉得这代表什么？”
I've never had a patient say, "Hey, what do you think this means?"
他们被赋予了一种知晓感，他们常说：“我平时不做梦”或“我不记得我的梦”或“不，这是真实的，这是真实发生的事。”
They're given this sense of knowing, and they'll often say, "I don't normally dream," or, "I don't recall my dream," or, "No, this was virtual, this was a happening."
所以他们毫不怀疑。
So they have no doubt.
当我们让他们给真实感打分，从零到十，他们总是打十分。
When we ask them to scale it zero to 10 on the degree of realism, it's always a 10.
所以感觉就像真的发生过一样。
So it feels like this actually happened.
那些在清醒状态下经历这些的人，你可以观察他们。
And those of them who are having these experiences in the wake state, you can watch them.
他们的目光直接穿过你。
They're looking right through you.
他们在看着房间。
They're looking at the room.
他们在抚摸一只并不存在的狗。
They're petting the dog that isn't there.
哦，所以有些人会有这些幻觉——
Oh, so some of them have these visions-
有50%的情况发生在他们清醒的时候。
50% occurring when they're awake.
即使离他们去世还有一段时间？
Even if it's quite some time before they pass away?
不，通常几周内就能测到，大概两周左右，而且越接近死亡越明显。
No, it's usually measurable within weeks, a couple of weeks, and it picks up as you get closer to death.
那越接近死亡，这些幻觉会怎么变化或发展？
And when it gets closer to death, how do these visions change or evolve?
会变得更沉浸。
Become more immersive.
所以再说一次，死亡是一个渐进的过程，就像睡眠一样，他们更多时间生活在另一个状态里，睡得越来越深。
So again, dying is progressive sleep, so they're living more in this other state where they're deeper and deeper sleep.
所以他们花更多时间在那里，而且有趣的是，他们醒来后常常希望回到那个状态。
So they spend more time there, and they'll often wake up, it's interesting, and wish they were going back into that other state.
很多时候，他们只是被所经历的重逢所温暖。
Oftentimes, they're just warmed by reunion of what they were experiencing.
时间和距离都消失了。
And time and distance go away.
所以他们的几十年被移动了，他们回忆起童年时失去的一只狗的非常生动的记忆，比如。
So their decades are moved, and they're recalling very vivid memories of a dog they lost in childhood, for example.
那你觉得这是他们大脑里的生物学、生理学现象，一堆化学物质在搅动，还是你觉得这是精神层面的？
So do you think this is a biological, physiological thing in their brain, a bunch of chemicals that are sloshing around, or do you think it is spiritual?
我也是神经生物学博士。
I'm also a PhD in neurobiology.
我花了五六年时间研究大脑，所以我对那个方向很感兴趣。
I spent five, six years studying the brain, so I'm drawn to that.
没人知道，我也接受这一点。
No one knows, and I'm good with that.
我觉得你可以指出大脑的某些区域，说爱存在于某些区域，某些神经递质与幸福相关。
I think you could point to parts of the brain here and say love lives in the certain areas, certain neurotransmitters are correlated with happiness.
你可以把所有的碎片都拿起来，但你无法拼凑出整体。
You can take all the pieces and you can't make the whole.
我无法向你展示爱在哪里。
I can't show you where love is.
我无法在培养皿里重现爱，也无法创造这种东西。
I can't recreate love in a dish, and I can't create this.
我觉得这确实超越了大脑功能，进入了另一个层面。
I think it really goes beyond brain function into something else.
那你觉得这是精神层面的了？
So you think it is spiritual then?
是的，我非常这么认为。
I do, very much.
你相信有灵魂吗？
Do you believe there is a soul?
相信。
Yes.
那么你会认为，生命超越了人体和大脑的生理机制吗？
And so you would posit, I guess, that lives beyond the physiology of the human body and brain?
是的。
Yes.
一半的美国人说，死去的亲人曾经来看过他们。
Half of Americans say a dead relative has visited them.
而这里获得53%选票的问题是：你是否曾经感觉到已故的家人以梦境或其他形式来看望过你？
And the answer here that has that 53% of votes is, have you ever felt a dead family member visit you in a dream or in any other form?
53%的人说他们有过这样的经历。
And 53% of people say they have.
34%的人说在过去一年里，他们感觉到已故家人的存在，28%的人说在过去一年里，他们曾向已故的家人讲述自己生活中的事情。
34% say in the past year they felt the presence of a dead family member, and 28% say in the past year they've told dead family members about events in their life.
我们依然保持着联系。
We remain connected.
15%的人说在过去一年里，已故的家人曾与他们交流过。
15% say in the past year they've had a dead family member communicate with them.
所有数据一直表明，至少在这个国家，人们的灵性取向比预期的要高，而且这一直如此。
All the data has always suggested that, at least in this country, there's a higher degree of spiritual orientation than you would expect, but that's always been the case.
当人们处于生命的最后阶段时，他们会变得更加虔诚和更有灵性吗？
When people are in their last days, do they become more religious and more spiritual?
是的。
Yes.
我们之所以知道，是因为他们关注的东西。
We know it because of what they focus on.
他们倾向于思考这些大事，而且往往都是关于人际关系的。
They tend to think about these big things, and again, they tend to be about relationships.
他们会问出更好的问题。
They ask these better questions.
我们研究过宗教这个问题，并没有发现宗教信仰会改变你对临终经历的感受。
We've looked at this question of religion, and we have not found that having a religious belief changes how you experience these end-of-life events.
这似乎真的不重要。
It just doesn't seem to matter.
而且大多数临终患者都会报告有临终梦境和幻象。
And most dying patients report end-of-life dreams and visions.
这里的统计数据显示，80%的医疗专业人员都亲眼见过或听说过这种情况。
The stats here show that 80% of healthcare professionals have witnessed or been told of one.
我没想到有这么多人会有临终梦境和幻觉。
I didn't realize it was so many people that are having these end-of-life dreams and visions.
我没想到是80%。
I didn't realize it was 80%.
而且，人们可能会认为这是因为谵妄，因为他们的疾病。
And again, people might think this is because of delirium, because of their illness.
不，这是个好问题，我们的研究聪明之处就在于，我们把谵妄的患者区分开了。
No, it's a good question, and that's what our studies did that was smart, is we sorted out the patients who are delirious.
所以我们每天在他们做问卷之前都会进行筛查。
So we screened them every day before they did a questionnaire.
再说，这些研究是大学批准的，所以必须有见证人，必须获得同意，而且认知功能必须完好。
Again, these are approved by a university, so it has to be witnessed, you have to have consent, you have to be cognitively intact.
所以在他们做问卷之前，每天都要接受谵妄筛查。
So before they did our questionnaire, every day they had to get a screen for delirium.
而这些事件并不像谵妄。
And these events don't resemble delirium.
谵妄是非常混乱的，最大的区别是大多数人在经历谵妄后会感到害怕或痛苦。
Delirium is very disorganized, and the biggest difference is most people are left frightened or distressed by delirium.
这些经历回忆起来非常清晰，它们基于真实发生的事情，而且给人留下的是一种安慰感，而不是痛苦或恐惧。
These events are recalled with acuity, they're based on real happenings, and they're left with a feeling of comfort, not distress or fear.
清晰。
Acuity.
清晰。
Acuity.
就是那种鲜明感。
Their sharpness.
除了这个，人们对于死亡还有哪些根本性的误解，是你职业生涯中一直试图去面对和纠正的？
What are the other sort of fundamental misunderstandings people have about death that you've spent your career trying to confront and reverse?
哦，那可太多了。
Oh, there are many.
死亡是一个过程。
Dying is a process.
死亡是一个瞬间。
Death is a moment.
它会随着时间变化。
It changes over time.
最大的误解是认为疼痛是预料之中或不可避免的，但实际上并非如此。
The big myths are that pain is expected or anticipated, and that's actually not true.
疼痛并不是必然的，而且即使有疼痛，也是可以缓解的。
Pain isn't, and the pain that is there can be resolved.
另一个误解是关于进食和饮水。
The other misconception's around eating and drinking.
人们会停止进食和饮水。
People stop eating and drinking.
这并不会带来痛苦。
It doesn't hurt.
他们停止进食和饮水是因为他们正在走向死亡。
They're not eating and drinking because they're dying.
大自然中有某种机制，我们不会想死，所以生命就慢慢消逝。
Something happens in nature that we don't die and want, so it just kind of dwindles.
而死亡真的就像光线逐渐变暗。
And dying is really like a dimming of the shades.
它是一个渐进的过程。
It's gradual.
你开始失去功能，活动减少。
You start to lose function, do less.
如果你得了流感，你会知道要卧床休息。
If you have the flu, you know to go to bed.
就是觉得不值得去做。
It just doesn't pay to do.
睡眠是首选，大多数人都是在睡眠中离世的。
Sleep is preferred, and most people die in sleep.
关键是要能安然离世，你得睡得好，但要睡得好，你得舒服。
The key is to die you have to be able to sleep well, but to sleep well you have to be comfortable.
人们往往认为，舒适就是身体上的舒适，但其实你还需要心理上的平静，以及存在意义上的安宁。
And what people tend to think is to be comfortable means you need to be physically comfortable, but you also need to be psychologically at peace, existentially at peace.
所以对我们来说，最重要的指标就是舒适的睡眠，因为如果你不舒服就睡不着，而如果你睡不着，就无法安详离世。
So the holy grail for us, the vital sign that matters for us, is comfortable sleep because you can't sleep if you're in discomfort, and you can't die if you can't sleep.
有一项著名的研究，是布罗尼·韦尔做的，我记得她好像是澳大利亚的一名临终关怀护士，她采访了那些临终的人，问他们有什么遗憾。
There's that famous study by Bronnie Ware, who I think was a palliative nurse in Australia, who interviewed people on their last days and asked them about their regrets.
你有没有做过类似的研究来了解这些？
Have you ever done any research like that to understand?
没有，而且我对那项研究其实挺有意见的。
No, and I really have trouble with the study.
真的吗？
Really?
首先，那项研究并不是基于实证的，对吧？
First of all, it wasn't empiric, right?
它只是基于一些对话，而且那并不是我的亲身经历。
It was based off of conversations, and that's not my experience.
我没见过有人在生命尽头提起遗憾。
I don't see people bringing up regret towards the end of their life.
如果你问他们有没有遗憾，他们肯定会给你一个答案。
Now, if you ask people if they had regrets, I'm sure they would give you an answer.
就像我问你：你最喜欢的颜色是什么？
It's like if I asked you, "What's your favorite color?"
你会有答案。
You have an answer.
但你不会整天想着：哦，这是我最喜欢的颜色。
But you don't go around thinking, "Oh, this is my favorite color."
对。
Sure.
所以遗憾，在我们的量化研究中显示，其实不会浮出水面。
So regrets, and this shows in our quantifiable study, don't come to the surface, actually.
很多遗憾都被放下了。
A lot of that gets let go of.
我可以诚实地说，我做这行快30年了，但我听到的并不是那样。
I can honestly say I've done this for nearly 30 years, and that's not what I hear.
那我们来看看这个，因为我觉得这挺重要的。
So let's take a look at this, because I think this is quite important.
说来也巧，我昨天还跟我未婚夫聊到这个，我们当时在讨论生活中什么才是真正重要的。
And I funnily enough, had this conversation with my fiancé yesterday when we were talking about what actually matters in life.
所以这里列出了11件医学院学生认为临终病人会在意的事情。
So here we have 11 things that medical students say they think will matter to a dying patient at the end of their life.
对，没错。
Yes, precisely.
然后你会告诉我，当你做了一项实证的、经过同行评审的研究，问那些只剩几天寿命的病人，什么才是真正重要的——
And then you're going to tell me what actually mattered when you did an empirical, peer-reviewed study and asking patients with days to live what actually-
好的
Sure
——对他们来说真正重要的东西。
... mattered to them.
嗯，临终关怀病人最在意的一件事就是不给别人添麻烦。
Well, the first one the hospice patient cares about is not being a burden.
他们变得无私。
They become selfless.
他们不想拖累家人。
They don't want to tax their family.
他们不想因为自己的病而影响家人的生活。
They don't want their illness to compromise their life.
他们想和家人在一起，但不想打扰家人的正常生活。
They want to spend time with them, but they don't want to interfere with their living.
你可能以为人到了生命尽头会越来越以自我为中心，但他们反而更关注别人。
You would think as people are close, nearing the end of their life, they would become more and more self-focused, and they become other focused.
有意思的是，这其实和幸福科学的研究结果很吻合，对吧？
And what's really interesting is actually this aligns well with that science of happiness work, right?
也就是说，更幸福的人是从为他人付出中获得意义，而不是只为自己。
Which says that the happier people derive meaning from doing for others rather than doing for self.
这些更好的特质在生命尽头反而会显现出来。
These better features kind of come to life at the end.
如果我有个亲戚快要离世，而他们最在意的是不成为负担——
If I've got a relative who's passing away, if this is the thing they care about most, not being a burden-
——作为亲人或家属，我能做些什么来减轻他们的这种担忧呢？
... is there something I can do as the loved one or the relative to ease this concern for them?
哦，我觉得是要把你的愿望和他们的期望对齐，也就是说你其实希望自己能在场陪伴。
Oh, I think it's aligning your wishes with their hope, which is your wish is you actually want to be a presence.
并且让他们知道，他们不是负担。
And letting them know that you're not a burden.
当然。
Absolutely.
他们不是负担。
They're not a burden.
好的。
Okay.
第二点。
Number two.
他们想要时间。
They want time.
好的，所以他们想和家人朋友在一起。
Okay, so they want to be around their friends and family.
这是他们最在乎的。
That's what they care about.
好的。
Okay.
再说一次，核心还是人际关系，对吧？
Again, fundamental here is its relationships, right?
就是这么回事。
That's what it's about.
那医学院的学生们以为会是什么呢？
And the medical students thought it would be?
觉得自己的生活有意义。
Feeling their life was meaningful.
再说，这个——
Again, this-
我觉得这很棒。
I think this is wonderful.
这个让我特别着迷。
This is one that fascinates me to boys.
所以你在二十多岁的时候，正处在成长的过程中，而且你已经有了某种影响。
So you're in your 20s, and you're on this journey of development and that you've had this impact of some sort.
那扇门关上了，他们不会活在回忆里，也不会怀疑自己是否有意义。
That door shut, and they're not living in the rear view mirror, and they're not wondering whether they had meaning or not.
这真的很相关，因为我和我的未婚妻前几天在车里，就是昨天，我们聊到这个，她转过头来问我：“你的动力是什么？”
This is very relevant because me and my fiancé were in the car the other day, it was yesterday, and we were talking about this, and she turned to me and said, "What's your why?"
而且几周前在这个播客里，有位嘉宾让我闭上眼睛，想象这是我生命的最后一天，那一刻唯一重要的就是谁在我床边——
And having sat here on this podcast with a guest a couple of weeks ago who asked me to close my eyes and imagined it was the last day of my life, the only thing that mattered in that moment was who was around my bed-
……以及他们怎么看我，他们是否安全、有保障。
... and what they thought of me, and were they safe and secure.
在那一刻，当我想象自己躺在临终的床上时，我并没有想到我的遗产、我产生的影响或我取得的成就。
And it didn't dawn on me in that moment where I visualized being on my deathbed, my legacy or the impact that I'd had or the achievements I'd accomplished.
这让我真正重新思考我的“为什么”是什么。
It's made me really reconsider what my why is.
因为实际上，如果在我生命的最后时刻，我关心的是谁站在那里，以及他们怎么看我。
Because really, if in the last moments of my life, what I'm concerned about is who stood there and what they think of me.
当我说他们怎么看我时，意思是，我的孩子们是否认为爸爸是个好人，他是否给我们留下了教训和原则——
And when I say what they think of me, it's like, do my kids think Dad was a good man, and did he leave us with lessons and principles-
……这样我们也能过上好日子。
... so we can live a good life, too.
那似乎是最重要的。
That seems to be most important.
所以这很有趣，因为我们在生活中浏览Instagram和LinkedIn，它们告诉我们：你的“为什么”是什么？
So it was just interesting because we go through life and we read Instagram and LinkedIn, and it tells us, what's your why?
你的遗产是什么？
What's your legacy?
你想对世界产生什么影响？
What impact do you want to have on the world?
你的目标是什么？
What's your purpose?
你的热情是什么？
What's your passion?
这些都是非常以自我为中心的事情。
And these are all things that are very self-focused.
但实际上，正如你所说，在那些时刻，真正重要的是他人。
But actually, it appears to me, as you've described, that actually in those moments, it's about others.
是的，这方面有很好的研究，对吧？
Yeah, and there's good work on this, right?
大脑预测什么能让我们快乐的能力，错得离谱。
Is the brain's ability to predict what makes us happy is horribly wrong.
我们预测能让我们快乐的东西，从来都不是可持续的，对吧？
What we predict makes us happy is never sustainable, right?
重要的是要放下那些我们以为重要的东西。
And what's important is to kind of dewant what matters.
放下那些重要的东西？
Dewant what matters?
对，因为——
Yeah, because-
那是什么意思？
What does that mean?
我们就像在跑步机上，追逐那些我们认为能让我们快乐的东西。
Well, we're on this treadmill of things that we think are going to make us happy.
升职。
Job promotion.
车子。
Car.
而且这些东西都不是可持续的，这一点已经被反复证明了无数次。
And they're not sustainable things, and that's proven over and over and over and over again.
归属感、连接、意义，这些才是真正重要的——我们从根本上就是注定要彼此归属的。
Belonging, connection, meaning, those are the things that-- We're fundamentally meant to belong to one another.
如果你想想自己最好的状态，那从来不是取得了什么成就。
If you think of the best version of yourself, it was never achieving something.
而是作为儿子、作为兄弟、作为朋友、作为未婚夫或男朋友，等等。
It was being a son, it was being a brother, it was being a friend, it was being a fiancé or boyfriend, whatever.
是这些让我们变得重要。
It's those things that make us important.
最终，从这项研究中你会发现，相互依赖有着巨大的价值。
And ultimately, what you find out of this research is the enormous value of interdependency.
这就是全部的关键，无论是在物质世界、自然界还是生态系统中。
And that's the whole deal, whether it's in the physical world, the natural world, the ecosystems.
但作为人类，我们注定要相互依赖，这在脆弱时刻表现得最为明显。
But as humans, we're meant to be interdependent, and that's most clear in moments of vulnerability.
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所以你给自己提了个问题，像是最后一天的那种问题。
So you posed yourself the question, kind of last day stuff.
你立刻就变得脆弱了。
You're immediately vulnerable.
而你做的事情是，你把所有对你有意义的人都拉进来了。
And what you did is you pulled in all these other people that matter to you.
因为我们只通过关系来定义自己。
Because we're defined only by our relationships.
那是唯一能留存下来的东西。
That's the only surviving thing.
不是那些看起来暂时重要的东西，而这一点正好证明了这一点。
Not by these other things that seem, in a transient sense, important, and that bears this out.
而美好的是，他们的关注点从自己身上转移了，希望也随之改变，对吧？
And what's beautiful is their concern shifts from self, and hope changes in that way, right?
先是希望治愈，然后只是希望别人好。
It's hope for cure, then just hope for others.
这真是一个关于我们是谁的精彩故事。
It's just this really wonderful story about who we are.
有趣的是，你说的这些，很多人理智上都能理解并相信，在生命的最后时刻，重要的是人际关系，但因此，这也意味着人际关系贯穿我们的一生。
It's interesting because the things you're saying, a lot of people will sort of intellectually understand and believe that it's about the relationships in these last moments, but therefore, it's about relationships through our life.
但当你看看我们每周、每月是如何分配时间的——
But then when you look at how we allocate our time on a weekly, monthly basis-
哦，对。
Oh, yeah.
这非常不成比例。
There's a disproportionate
这之间存在脱节。
There's a disconnect.
因为我们把时间花在成就、业绩、金钱、晋升、汽车等等上面。
Because we're allocating our time towards accomplishment or achievement or money or promotions or cars, whatever.
但到了最后时刻，一切都变成了别的东西。
But then in the final hour, it's all about something else.
而且如果我甚至——
And if I even-
……回顾一下我这周和今天的时间分配，我会说，'嗯。'
... reviewed the allocation of my time this week and day, I'd be like, "Well."
死亡是一个极其真实的地方。
Well, death is this unbelievably truthful place.
伪装会消失。
Pretense goes away.
所有肤浅的东西都会消失。
All the superficiality goes.
你会被剥去一切，只剩下最真实的自己。
You're stripped to the bare bones of who you are.
最终你会发现，我们之间的相似之处多于不同之处，作为人类有一种共通性，那就是彼此相连。
And what you end up finding is that we're more alike than unlike, and there's a universality to being human, and it involves being connected to one another.
我们的挣扎在于保持人性，而我们是共同经历这一切的，不是孤身一人。
Our struggle is to remain humane, and we go through this together, not alone.
而且，这又是一种对称，你在生命的开始能看到，在生命的结束也能看到。
And that's, again, there's a symmetry you see at the beginning of life, and you see it at the end of life.
政治就变得不重要了？
Politics falls away?
我当然希望如此。
I sure as hell hope so.
这很有意思，因为很多人一辈子都在为各种事情焦虑不安。
And it's interesting because so many people spend their lives getting agitated.
我这么说是因为你说过，我们之间的相似之处比我们以为的要多。
The reason I say that is because you said we're more alike than we believe.
哦，绝对是这样。
Oh, absolutely.
所以当你只剩下最本质的东西时，你不会真的去想左派、右派，或者那些政治议题。
And so when you're bare bones, you're not really thinking about the left, the right, this politics, this political issue.
当人们最脆弱的时候，你最终看到的是美、爱、温柔和脆弱。
What you end up seeing when people are most vulnerable, you see beauty, you see love, you see tenderness, you see vulnerability.
确实有一些人一辈子过得不好，但到了最后，当你看到他们更脆弱的一面时，我觉得你会看到他们更好的一面。
There are some awful humans that have lived a bad life, but in the end, when you see them in a more vulnerable state, I think you see their better nature.
你会看到温柔。
You see tenderness.
你会看到爱的表达。
You see expressions of love.
人们有很多伪装需要去处理，他们展现出来的形象，而疾病会把这些都剥掉。
There's a lot of pretense that people have to work through, personas that they present, and illness kind of strips you of that.
生病有一种巨大的平等效应，两周前对你重要的事情，现在对你来说已经不重要了。
It's this great leveling effect to be sick, that what matters to you two weeks earlier doesn't matter to you now.
好的，所以医学院的学生以为第三个会是疼痛症状管理。
Okay, so medical students thought the third would be pain symptom management.
对。
Yep.
而根据你的临终关怀病人的说法——
And according to your hospice patients-
对。
Yep
……他们同意。
... they agree.
他们答对了。
They got that one right.
对。
Yep.
那这意味着什么呢？
And what does that mean?
他们只是担心会疼。
That's just their concern is not being in pain.
不幸的是，关于会发生什么，大家聊得不多。
Unfortunately, there's not a lot of conversation about what to expect.
我们刚刚完成了一项关于这个的研究。
We just completed a study on this.
如果你被告知得了绝症，我敢打赌你最先涌上心头的念头之一就是痛苦。
If you were told you had a terminal disease, I guarantee one of your first overwhelming thoughts is suffering.
不幸的是，关于如何应对这个问题，比如会经历什么、什么时候发生、你会有什么感觉，以及如何安抚人心，这样的对话少得可怜，这真的很糟糕。
And unfortunately, it's damning how little conversations there are to address that issue in terms of what to expect, when to expect it, what you're going to feel, and reassure people.
而这些坦诚的对话其实并不会让人失去希望。
And these honest conversations actually don't take away hope.
它们反而让人重新找回掌控感。
They restore agency.
那误解是什么呢？
So what is the misunderstanding?
天哪，就是事情比人们想象的要严重得多。
Oh my gosh, that it's far worse than people think.
其实疼痛并不是问题，很少有我们控制不了的疼痛。
That there isn't a pain, rarely a pain we can't manage.
其实没有人们想的那么痛苦。
It's less painful than people think.
哦，天哪，差远了。
Oh, gosh, by a mile.
这可能是最大的误解。
That's probably the biggest myth.
关于死亡和临终。
About death and dying.
完全正确。
100%.
说实话，这又因为医生不进行这些讨论而变得更糟。
And honestly, it's compounded by the fact that doctors don't have these discussions.
好的。
Okay.
那么第四点，关于临终关怀病人说对他们最重要的事情。
So number four, in terms of what hospice patients say matters most to them.
与上帝和平相处。
Peace with God.
与上帝和平相处。
Being at peace with God.
大概只是信教的人吧，对吧？
And presumably just the religious ones, right?
不是。是与某种更大存在的信念和平相处。
No. It's peace with a belief of something larger.
我问过病人这个问题，他们会说，就像我会说的那样，“我不知道。”
I've asked patients this, and they'll say what I would say is that "I don't know."
这是一种存在感，不一定非要归因于某种信仰或神。
It's an existential feeling that doesn't necessarily have to be attributed to a belief or a god.
那他们是因为担心下地狱，还是因为不知道呢？
Now, is it because they're concerned they're going to go to hell or that they don't know?
不，我没听到过这种说法。
No, I don't hear that.
我相信曾经有审判的角色参与其中，但只是为了平静——
I'm sure there was a time when the role of judgment played in, but just to be at peace-
那是什么意思？
What does that mean?
……与宇宙的存在性达成和解。
... with the universe existentially.
有没有一种方式能让病人寻求内心的平静？
And is there a way to become at peace that patients will ask for?
我没听到过，但我想部分原因是请求宽恕。
I don't hear, but I imagine it's to ask for forgiveness in part.
你采访的医学生认为第四项是保持心智清醒。
And the medical students you interviewed thought number four would be being mentally aware.
是的，这确实会出现。
Yes, and that does come up.
所以我们现在就在这里。
So here we are.
那是第五项。
That's number five.
是的。
Yes.
在哪个临终关怀——好的。
In what hospice-- Okay.
然后下一个就是在家离世。
And then the next is dying at home.
这很令人痛心，因为80%的美国人希望在家离世，但实际只有大约30%能做到。
And this is tragic because 80% of Americans want to die at home and about 30% do.
为什么会这样？
Why is that?
这主要反映了我们对死亡的医疗化处理。
It's really reflective of mostly our medicalization of dying.
作为一个国家，我们在居家护理上的投入不足，导致人们最终不得不去医院，而他们最害怕的那种死亡方式，恰恰就是他们经历的。
As a country, we under-invest in care for at home so that people end up having to go into the hospital, and the death that they fear is the one they get.
医院越是三级或高级，治疗就越激进。
The more tertiary or advanced the hospital is, the more aggressive treatment there is.
这是医学那种抗拒死亡的做法的一部分。
It's part of the death-defying approach of medicine.
总有办法可以试一试。
There's always something you can do.
他们死在病房里，死在那种——讽刺的是，他们得到的治疗越多，其实并没有被证明能延长生命，但是——
They die in units, and they die in those sort of-- And the irony is the more they get, it actually hasn't been shown to enhance life, but-
他们得到更多什么？
The more what they get?
他们临终时得到更多的护理，更激进的治疗。
The more care, more aggressive care they get when they're dying.
所以你是说我们有时候会不必要地拖延这个过程。
So you're saying that we kind of drag it out a bit unnecessarily sometimes.
我觉得医学在尽力对抗死亡，但不幸的是，即使死亡已经很明显，治疗已经没有意义的时候，它常常还是不肯接受。
I think medicine does its best to defy death, and unfortunately, it often denies it even when it's obvious and when things have become futile.
如果医学在死亡客观存在的时候都不能接受它，那他们肯定不会去关注临终者的体验。
And if medicine can't appreciate death when it's objectively there, they're certainly not going to pay attention to the experience of the dying.
我觉得这很复杂，但我们在面对死亡这件事上已经迷失了方向。
And I think it's complicated, but we've lost our way with dying.
以前，人们是在家里、在社区中、在教堂的陪伴下离世的。
Dying used to be in the home and in the community, in connection to our church.
但在过去的一百年里，死亡变得机构化了。
And in the last 100 years, it's become institutionalized.
所以现在死亡就像个传闻一样。
So death is now like a rumor.
它发生在某个遥远的地方，可能是别人身上，但不再像过去那样离我们很近。
It's something that happens somewhere down the line, probably to somebody else, but it's not proximate to us like it used to be.
所以把这些因素放在一起看，我们把死亡机构化了，医学也变得只注重技术，不再有艺术性。
So you take all these factors together, the fact that we've institutionalized dying, the fact that medicine's become technically focused and no longer artful.
仅仅为了陪伴而存在，似乎是不被允许的。
It's not okay to be there for presence.
人们再也不能因为年老而自然离世了。
People can't die of old age anymore.
你得有大概五种诊断才行。
You got to have about five diagnoses.
所以它失去了优雅。
So it's lost its grace.
失去了人性。
It's lost its humanity.
那如果一个人知道自己要死了，你会建议他们通常不要去临终关怀机构，而是……
So if someone knows they're going to die, you would recommend they usually didn't come to a hospice and they-
不，要进临终关怀，这样你才能在家里去世。
No, get into a hospice so you can die at home.
所以……
So-
哦，原来是这样的，明白了。
Oh, versus it, okay
临终关怀更有可能让你的愿望和结果一致。临终关怀是从我们的社区中发展起来的，是对传统医院处理死亡方式的一种回应和反驳。
... hospice is more likely to align your wish to an outcome Hospice is developed out of our communities as an answer, as a rebuttal to the way dying were traditionally treated in a hospital.
那在医院去世，比在家里去世糟糕在哪里呢？
So what is it about dying in a hospital that is worse than dying at home?
我都不知道从哪儿说起。
I don't know where to begin.
对临终病人来说，重要的是熟悉的环境、有人陪伴、待在自己住的地方，还有那些让他们感到舒适的东西和他们爱的人。
What matters to the dying patient is familiarity, to be connected, to be where they live, the things that make them comfortable, the people they love.
他们不想半夜被叫醒。
They don't want to be woken in the night.
他们不想被扎针。
They don't want to be poked.
他们不想打点滴。
They don't want IVs.
他们不想再做检查。
They don't want another scan.
归根结底，重要的是什么能让你舒服，什么对你来说在最后时刻最重要，而和家人待在家里，就是人们最看重的。
It goes down to what will make you comfortable, what matters to you in the end, and being at home with your people is what matters to people.
有道理。
Makes sense.
那么第七点，就是让护理指示得到执行。
So number seven, having care directives followed.
这是什么意思？
What does that mean?
就是确保你想要发生的事情真的会发生。
And making sure that what you want to happen is going to happen.
好的。
Okay.
我觉得这一点很有意思，就是解决冲突。
And this is interesting, I think, resolving conflicts.
所以当医学生被问到，对临终者来说什么最重要时，他们把解决冲突排在了第七位。
So medical students who are asked about what matters most to those that are dying, they ranked the seventh thing that would matter as resolving conflicts.
有意思的是，这两点——生命是否有意义和解决冲突——是并列的。
And what's interesting is these two, right, is was life meaningful and resolving conflicts.
而临终病人其实已经看开了。
And the dying patient's kind of all good.
他们不是需要解决的问题。
They're not a problem to be solved.
你说得对。
You're right.
这是目前最有趣的发现——
That is the most interesting takeaway so far-
……
...
就是活着的人以为临终的人会很在意遗产、成就，还有——
is living people think the dying will be really concerned with legacy and what they accomplished and-
……是不是跟谁有过节，但临终病人——
... did they have any beef with anybody, but dying patients-
所以这就是为什么我对那些关于遗憾的研究有疑虑，明白吗？
And that's why I have trouble with that regret literature, okay?
因为那并不是他们所说的。
Because that's not what they're saying.
他们其实并不太关注生活中的负面经历，对吧？
They're not focused really on the negative aspects of having lived, right?
他们想要保持自己的本质，而他们的本质就是家庭、待在家里，以及与他们的上帝和平相处。
They're trying to preserve what makes them them, and what makes them them is their family and being in their home and being at peace with their God.
这在一定程度上说明了我们在日常生活中应该思考些什么。
That speaks to what we should be thinking about in our lives day to day to some degree.
嗯，而且这两者之间是有联系的。
Well, and again, there's a bridge between these two things.
认为人在临终时会改变这种想法其实并不完全正确。
The idea that this changes in death actually isn't all that true.
我觉得我们在临终时才会意识到这一点。
I think we're aware of it in dying.
耶鲁大学的桑托斯博士在幸福方面做了很棒的研究。
Dr. Santos at Yale does this wonderful work on happiness.
如果你往前追溯，做她那种关于幸福的研究，你会发现很多同样的道理。
If you go upstream and you do her sort of work on happiness, you reveal a lot of these same truths.
对，我们也生活在一个商业化的世界里，到处都充斥着营销，每天打开电视或手机，就有人告诉我们什么才是重要的。
Well, we also live in a commercialized world where we're exposed to marketing, and we're told what matters every day when we turn on the TV or open our phones.
有人告诉我们路易威登的包很重要，有人升职了我们就鼓掌。
And we're told that the Louis Vuitton bag matters, where we clap when someone gets the promotion.
所以确实有一种社会化的因素，把我们的价值观引向更物质化，甚至某种程度上更肤浅的方向。
So there is an element of sort of socialization that orientates our values towards being more materialistic and I guess shallow to some degree.
那些东西都是短暂的，无法持久。
Those things are transient and non-sustaining.
而这项幸福研究得出的一个关键点，就是要懂得品味，品味那些真正有价值的东西，比如我们的人际关系。
And one of the things that comes out of this happiness work is the importance of savoring and savoring things of worth, like our relationships.
有没有一些人，在离世前几天，因为自己过去的生活方式而真的感到不快乐？
Are there any people that were days from their own passing that were truly unhappy because of the way that they had lived their lives?
有，你怎么活，就怎么死，对吧？
Yeah, you die how you live, right?
你没法重新来过。
You can't reinvent it.
人生不是彩虹和鲜花。
It's not rainbows and flowers.
我确实见过这样的人，也写过他们，他们做过错事，害怕死亡。
I've certainly seen that, and I've written about them, and they're people who had done wrong, and they were fearful of dying.
害怕什么？
Fearful of what?
有几个案例中，他们从小是天主教徒，担心受到审判。
Well, in several cases, they had been raised Catholic, and they were worried about judgment.
有一个案例是警察，他因为从小接受忏悔教育，觉得自己必须把所有做过的坏事都告诉别人。
In the one case was actually a police officer, so he thought because he had been raised with confession, that he had to tell everybody all the horrible things he did wrong.
这挺有意思的。
And it was kind of interesting.
当时有个《纽约时报》的记者，她听了一大堆这样的故事。
We had a reporter from "The New York Times," and she got an earful.
他就是非得把心里话全倒出来不可。
He just had to be cathartic and say everything.
他想把罪过都抖搂出来，但这很少见。
He was trying to unleash his sins, but it's very rare.
这么说，你遇到的是一个警察在抖搂自己的罪过。
In that case, you've got a police officer unleashing their sins.
如果他们说了那些事，难道不会惹上法律麻烦吗？
Could that not result in legal consequences if they say things that-
是啊，你可能会这么想，因为他提到了殴打证人什么的。
Yeah, you'd think so because he talked about beating up witnesses and things like that.
我当时没想到这点，但确实是这样。
I never thought of that, but it's certainly true.
那没人追究吗？
And nothing was done about that?
没有。有意思的是，我们当时还有一个罪犯，他坐牢的时间比在外面待的时间还长，而且他也在镜头前，他确实有悔意，但最后这些悔意都得到了处理。
No. And what was interesting is we had a criminal, a guy who had spent more time in prison than out at the same time, and actually he's on film, and he had regrets, true, but they got addressed at the end.
什么意思？
What do you mean?
嗯，这是最美妙的事情之一。
Well, it's one of the most beautiful things.
大约有12%的病人会报告说他们做了令人痛苦或不舒服的梦。
So about 12% of our patients report dreams that are distressing or uncomfortable.
不是所有的梦都让人舒服。
They're not all comfortable.
而且，这也不奇怪。
And again, it's not surprising.
你会像你活着时那样死去。
You're going to die the way you lived.
我们之前搞错的是，这些梦有时是最具转变性的。
And what we got wrong was those are sometimes the most transformational.
正是在这些梦中，他们找到了治愈。
Those are the ones where they find healing.
他梦到自己做过的一些坏事。
He had a dream about some of the bad things he'd done.
哦，是的。
Oh, yeah.
然后那个——
And that-
引发了一个转变。
Caused a transformation.
德韦恩
Dwayne
他一生中犯过罪吗？
And he'd committed crimes in his life?
哦，是的。
Oh, yeah.
什么样的罪？
What kind of crimes?
两起谋杀未遂。
Two attempted murders.
两起谋杀，抱歉，但都是街头自卫。
Two murders, sorry, but both were self-defense on the street.
就是有人想抢劫他那种情况。
Somebody was trying to rob him sort of thing.
他大半辈子都流落街头。
He had lived on the streets most of his life.
但他从未正视过自己犯下的错，而这就是他的清算时刻。
But again, he never reckoned with the things he had done wrong, and this is his reckoning.
那这距离他去世有多少天？
And how many days was this before he passed away?
12天。
12.
12天。
12 days.
我的梦啊，还有我所有的噩梦，我都不喜欢。
My dreams, man, and all my nightmares, I don't like them.
我觉得是因为我的过去又找上我了——
I think it's because my past is coming back to me-
……
...
因为我以前做了错事。
from doing wrong.
我不是说我在外面的时候是个完美的人——
Because I'm not going to say I'm the perfect guy when I was out there-
……因为我在街上混，对别人做了坏事。
... because I was up and running the streets, doing wrong to individuals.
现在他们知道我的症状了。
And now they know my symptoms.
他们知道我病了。
They know I'm sick.
所以现在他们想伤害我。
So now they want to try to hurt me.
就像他们拿着刀，想割我的脖子——
It was like they were jigging a knife, trying to cut out my neck-
就是我得癌症的地方。
... where my cancer was at.
“别反抗了。
"Stop trying to fight.
对不起。”
I'm sorry."
我拼命想推开那个人，不让他伤害他。
Trying to fight this guy off from hurting him.
这让我很害怕。
It's scaring me.
我不是坏人，兄弟。
I'm not a bad individual, man.
唉，我确实得罪过很多人，包括我老婆。
Well, I done crossed a lot of people and my wife.
我需要帮助。
And I need help.
我真的需要帮助。
I need help.
我不想再这样过下去了——
I don't want to live my life-
天哪，走在外面还得提心吊胆，生怕有人从背后找我麻烦。
Man, out in society walking, have to look over my back, man.
我只希望大家能原谅我，并且明白我当时是生病了——
I just want people to forgive me, and please know that I was sick-
那时候我做的那些事，伤害了他们和他们的家人。
... at the time when I was doing certain things that was hurting them and their families.
我就想要这个。
That's all I want.
我不希望他们把我当成坏人，因为我不是。
I don't want them to look at me as a bad individual, because I'm not.
当然。
Definitely.
我需要帮助。
I need help.
结果就是，他睡不着觉。
What ends up happening, and he can't sleep.
再说回那个观点，如果睡不着，想死都难。
And again, going back to this idea that it's very hard to die if you can't sleep.
他最后醒了过来，要求见他的女儿。
He ends up waking up, and he asks to see his daughter.
她出现在镜头里，她描述说，这是她人生中第一次，他抱了她好几分钟，说有多爱她，还为自己做过的事道歉。
And she comes on the film, and what she describes is, for the first time in her life, he holds her for minutes and says how much he loves her and that he's sorry for what he had done.
所以，这种闭眼时的负面经历，带来了这种反省和请求原谅，而她当然原谅了他。
So this negative experience that was happening with his eyes closed brought this reckoning and this ask for forgiveness, which, of course, she gave.
那你觉得这是怎么回事？
And what do you make of that?
我又问你之前问过你的那个问题了。
Again, I'm asking you the same question I asked you earlier.
哦。
Oh.
你觉得那里发生了什么？
What do you think is happening there?
这是某种灵性体验吗？
Is that a spiritual thing?
还是说他只是接近生命尽头，感到悔恨，所以做了这些梦？
Is that just him approaching the end of his life and feeling remorseful, so he's having these dreams?
哦，不。他对这个没有意识控制。
Oh, no. He didn't have conscious control of this.
我一点都不相信那是他主动控制的。
I don't believe that for a second.
这些事发生的时候，他的眼睛是闭着的。
This was happening when his eyes were closed.
我觉得他在内心深处，知道自己做过的错事，有什么东西在逼着他去寻找平静，而且他确实找到了。
I think that he was carrying, at a very deep level, he knew the wrongs that he had done, and that something was forcing him to find peace, and it did.
某种东西。
Something.
某种东西。
Something.
我觉得是真相。
I think truth.
我觉得在他心里某个地方，他没法再嬉皮笑脸地糊弄过去了。
I think somewhere in him, he couldn't joke and jive around it.
死亡把这一切都浮到了表面，他需要找到平静。
Dying brought this to a surface, and he needed to find peace.
这对她来说，是件非常好的事。
And it was wonderful for her.
这让她彻底改变了。
It changed her completely.
最后的结果是，她每晚都陪着他，他安详地离世了。
And what ends up happening was she ends up spending every night with him, and he ends up passing comfortably.
我这里有一个数据，真的让我震惊了。
I have a stat here that genuinely shocked me.
数据显示，销售团队大约有50%的时间花在行政和手动更新CRM上，而不是销售上。
It says that sales teams spend about 50% of their time on admin and manual CRM updates rather than selling.
这对他们的利润来说非常致命，这也是为什么十年前在我之前的公司，我转而使用Pipedrive，也就是我们的赞助商。
That is deadly for their bottom line, and that is part of the reason why a decade ago at my previous company, I switched to using Pipedrive, who are our sponsor.
如果你从未用过Pipedrive，它是一个智能的AI驱动的销售CRM，他们刚刚推出了新的会议智能功能，比如内置在CRM中的AI笔记记录员。
If you've never used Pipedrive, it is an intelligent AI-powered sales CRM, and they just launched new meeting intelligence features like an AI note-taker built right into the CRM.
Pipedrive现在自动化了更多的行政工作，让你能专注于你最喜欢做的工作。
Pipedrive now automates more of the admin that stops you from doing the work that you love to do best.
在会议之前，它会将交易历史、邮件记录和之前的对话汇总成一份简报，让你做好准备。
Before your meeting, it pulls deal history, email records, and previous conversations into a single brief so you're prepared.
而且它会陪你一起开会。
And it joins your meetings with you.
它会在里面帮你记笔记，你就不用记了，而且它会把记下的笔记自动转成准确的CRM更新草稿。
It's in there to take notes so you don't need to, and it turns those notes that it takes into accurate auto-draft CRM updates.
已经有10万家公司用它来管理销售了。
100,000 companies are already running their sales on it.
你可以去Pipedrive.com/CEO注册，那里有专属的30天免费试用，比通常的14天更长。
You can sign up at Pipedrive.com/CEO where you'll get an exclusive 30-day free trial instead of the usual 14 days.
完全不需要信用卡。
Absolutely no credit card needed.
直接去Pipedrive.com/CEO就能开始。
Just head to Pipedrive.com/CEO to get started.
如果你做销售，或者你管理销售团队，我觉得你不会后悔的。
If you're in sales and you run a sales team, I don't think you'll regret it.
你可能觉得，Nespresso的前总裁应该很难被说服去换一家新的咖啡公司吧。
You'd think the former president of Nespresso would be a pretty hard person to convert to a new coffee company.
但只喝了一口Cometeer咖啡，他就决定投资了。
But just one sip of Cometeer Coffee made him invest.
但让我告诉你我成为投资者的原因。
But let me tell you the reason why I became an investor.
所以有一大箱这东西送到了我在伦敦办公室的桌上，然后大概一个半小时内，我们的Slack频道就开始炸了，大家都在问：“厨房里留下的那到底是什么东西？”
So I had a big box of this arrive on my desk in the London office, and then I'd say within about an hour and a half, the Slack channel that we have starts blowing up with people asking, "What the hell is that thing that's been left in the kitchen?"
简直难以置信。
It is unbelievable.
所以与其在家自己冲泡并平衡口味，他们在最佳时刻将其闪冻。
So instead of trying to make it yourself at home and balance the flavors, they flash freeze it at the perfect moment.
所以你只需要把它从包装里拿出来放进杯子，倒上热水，味道是你从未尝过的。
So all you have to do is pop it out of here into a cup, pour hot water on it, and it tastes like nothing you've tasted before.
你也可以做美味的冰咖啡饮品。
You can also make delicious iced coffee drinks as well.
直接倒进去就行。
Just pour it in.
不需要机器，也不用塑料冲泡那些乱七八糟的东西。
No machine, no brewing with plastic and all that nasty stuff.
而且现在去Cometeer.com/Steven下单，首单可以立减30美元。
And you can get $30 off your first order at Cometeer.com/Steven today.
网址是Cometeer.com/Steven。
That's Cometeer.com/Steven.
好，我们回到那张真正重要的清单上。
So back to our board of things that actually mattered.
现在是第七项。
We're on number seven.
好的。
Sure.
第八项。
Number eight.
感觉生活有意义。
Feeling that life was meaningful.
所以再整体回顾一下，他们是给了11个选项，还是给了很多选项？
So just to zoom out once again on this, were they given 11 options, or were they given lots of options?
很多选项。
Lots of options.
好的，这些是他们实际选出的11个。
Okay, and these are the 11 that they actually picked.
对。
Yep.
好的。
Okay.
所以第八点是他们在意生活是否有意义，但这个相对其他选项来说特别低——
So number eight is they cared that life was meaningful, but this is particularly low-
……相对于其他选项。
... relative to the others.
这个也是。
And so is this one.
尽可能活得久。
Living as long as possible.
你想知道为什么吗？
And you want to know what?
我从来没听过一个临终病人说“我想尽可能活得久”。
I've never had a dying patient say, "I want to live as long as possible."
他们想的是，在尽可能长的时间里，活得尽可能好。
What they want to do is live as well as they can, as long as they can.
但除非你生过病，否则你不会把这当作目标。
But unless you've been sick, that's not the goal.
这与医学界看待病人的方式完全相反。
Which is antithetical to the way the medical world looks at patients.
所以我们不惜一切代价继续治疗。
So we keep going at all costs.
我在这里读到一些统计数据，关于人们平均生病多少年。
There's some stats that I was reading here about how many years people spend sick on average.
我记得是在美国，如果我没记错数据的话。
I think it was in the United States, if I have the stats right.
对，数据显示我们一生中大约有11年是在健康状况不佳中度过的。
Yeah, it says up to sort of 11 years of our lives are lived in poor health.
所以，虽然我们在西太平洋地区的健康寿命是68岁，在欧洲是66岁，但我们大约有十年时间健康状况不佳。
So although our health span is, in the Western Pacific, 68 years, or in Europe, 66 years, we spend about a decade in poor health.
实际上，你刚才对我说的是，人们更关心的是他们的健康寿命，也就是他们拥有多少年的健康生活，而不是他们的寿命——
And actually, what you're saying to me is that people care more about their health span, how many years of good health they have, versus their lifespan-
……寿命只是他们活了多少年。
... which is just how many years they're alive.
是的，我认为这个观点在健康领域很难被理解，但生病确实很辛苦。
Yeah, and I think that's a perspective that's very hard to understand in health, but it's hard work being sick.
而且这对你爱的人也是一种负担。
And it's hard on those you love.
所以对我来说，这是有道理的。
So it makes sense to me.
那说到这个，现在一个热门话题就是长寿运动。
What about this, obviously a big subject at the moment is this longevity movement.
大家都想延长寿命，甚至想长生不老，诸如此类的。
People wanting to extend life and live forever and all these kinds of things.
你采访过成千上万临终的人，从你的角度来看，这是怎样的？
What is your perspective of interviewing thousands of people that are dying?
这对你对长寿的看法有什么影响？
How has it shaped your perspective on longevity?
我觉得这里面可能有些错觉。
I think that there's a risk of some illusion.
最近《科学》杂志上有篇文章说，寿命的55%由基因决定，但这并不能让你免受疾病等环境因素的影响。
There was an article in "Science" recently, 55% of lifespan is determined by genetics, and it doesn't leave you immune from circumstances of disease and whatnot.
我担心很多努力缺乏证据支持，我觉得重点真的应该放在好好生活上。
I worry a lot of the lack of evidence around some of the efforts, and I think the focus really needs to be on living well.
你看看那些蓝区的人，日本或意大利的老奶奶，她们可不会一大早跳进冷水里，还去测肌酐。
And if you look at the Blue Zone folks, that little old lady in Japan or Italy isn't waking up in a cold plunge and measuring her creatinine.
她只是生活得很好。
She's just living well.
她们活动，吃更多植物。
They move, they eat more plants.
她们非常社交。
They're highly social.
她们通过祈祷、冥想、音乐等方式来放松自己。
They take time to down-gear through prayer, meditation, music, whatever.
当你想到你遇到的那些离死亡只有几天的人，有没有一些人因为成就更多而更平静？
When you think about all the people you've met who were days from their death, are there some who were more at peace with it because they had accomplished more?
没有。
No.
那些最平静地离开这个世界的人有什么共同点？
What is the correlatory in terms of those that were most at peace with leaving this planet?
给予和接受的爱。
The love given and received.
这是唯一重要的事情。
That's the only thing that matters.
我见过一些人，他们过着极其简单的生活，但他们在爱中体验到的纯粹是无可比拟的。
I've seen people who have led remarkably simple lives, but they were pure in the love that they were able to experience.
所以他们离开时更平静。
And so they were happier to leave.
是的，没错。
Oh, yeah.
你要以一种能好好死去的方式生活，这意味着要好好去爱。
You want to live in a way that you can die well, and that means loving well.
你有没有遇到过相反的情况，就是有人身边没有一个人？
And have you experienced the opposite, where someone had nobody there?
哦，我经历过一些非常糟糕的情况。
Oh, I've had some very bad experiences.
其中一个我写过，她小时候被带到一个专门收留复杂情况孩子的家庭，从未见过或体验过爱，她感受到的那种空虚。
One of them I've written about, who was taken as a child into a home situation that was really for kids with a lot of complexity and had never seen or experienced love, and the emptiness she felt.
我永远不会忘记她对我说的话。
I never forget what she said to me.
她看到屏幕上有人在接吻，然后她说：“你知道吗，我看着这个，我从来都不理解。”
She was watching somebody kiss on a screen, and she goes, "You know, I look at that, I've never understood that."
她临终时感到空虚和遗憾。
And her dying was empty and regretful.
你是什么意思？
What do you mean?
给我讲讲那些非身体层面的东西。
Take me into the non-physical.
她被剥夺了爱。
She was denied love.
被父母剥夺了爱。
Denied love by parents.
她被男人利用过。
She was misused by men.
所以她所知道的爱情给她带来了伤害，而且她自己也清楚地意识到了这一点。
So what she knew of love hurt her, and she was aware enough to know that.
那她去世的时候，身边没有人吗？
And there was no one there when she passed away?
没有。不过有意思的是，
No. It's interesting, though.
她做过一个非常特别的梦。
She had one very interesting dream.
曾经有个男人想娶她，但她因为受过太多伤害而心存疑虑，所以当他向她求婚时，她立刻搬出了他们的公寓。
She had a man who had wanted to marry her, but she had been so taken advantage of that she was doubtful, and as soon as he asked her, she moved out of their apartment.
哦。
Huh.
这是她自我保护的方式。
As a way to self-protect.
在她生命的最后时刻，他来到她面前，告诉她他真的很爱她。
And at the end of her life, he came to her and told her that he really did love her.
所以她看到的是一种让她感到安慰的版本。
So she was shown some version of it that was soothing to her.
就是这样。
That was it.
很多人因为早期的创伤，对爱有些回避。
A lot of people, because of early traumas, are somewhat avoidant of love.
你提到她有人求婚时搬出了公寓。
You explained that she moved out of the apartment when someone tried to propose to her.
我多少能感同身受。
I could almost relate to some degree.
我记得我年轻的时候，大概十几岁，对承诺或者恋爱关系特别回避。
I remember in my early years, in my early teens, I was extremely avoidant of commitment or relationships or whatever.
我记得有个人，我追了四年，然后她转过身来告诉我，她现在想和我在一起。
And I remember this particular person turning around to me after I'd pursued them for four years, telling me that they would now want to be in a relationship with me.
我记得我追了四年之后，却立刻劝她打消这个念头。
And I remember immediately dissuading them after pursuing them for four years.
小心你求的东西，差不多是这个意思。
Careful what you ask for sort of thing.
但很多都根植于我们早期对爱、连接和关系的认知模式。
But a lot of it roots back to our early models of love and connection and relationships.
我们是否被以健康的方式示范过这些？
Were we modeled it in a healthy way?
这让我想到关于克服创伤和伤痛的话题。
And this kind of brings me to the point around overcoming trauma and wounds.
死亡的过程如何帮助我们面对最早的创伤，或者那些在生活中一直阻碍我们的创伤？
How does the process of dying help us confront our earliest traumas or the traumas that have held us back in our lives?
你见过这样的例子吗？
Have you seen evidence of that?
哦，太多了。
Oh, lots.
我在临终过程中见过很多，而且我觉得对我来说，这些是最有意义的，是我亲眼见证的最有意义的时刻。
I've seen it in this end-of-life process, and again, I think this is the most meaningful for me personally, the most meaningful ones that I witness.
所以我见过一个八岁时失去手臂的男人，他来自贫困家庭，从成长角度看，他的整个身份认同都围绕着如何独立、如何养家糊口等等。
So I've seen a man who had lost his arm at the age of eight, and he was from an impoverished family, and developmentally, his whole identity was how was he going to be independent and be able to be a provider, et cetera.
在他生命的尽头，他看见自己躺在床上，所有和他共事过的人都来看他，告诉他他是他们认识的最好的工人。
And at the end of his life, he sees himself lying in a bed, and everyone who he worked with came by him and told him he was the best worker they had known.
还有一位母亲，她的孩子因毒品犯罪入狱，她作为母亲的身份受到质疑，在她生命的尽头，她的父母来到她身边，告诉她她被爱着，她是个好母亲。
A mother whose child was in prison for drug offenses, and her identity as a mother is being questioned, and at the end of her life, her parents come to her and tell her she's loved and she was a good parent.
是在幻象中吗？
In a vision?
不是实际发生的？
Not physically?
不是。
No.
好的。
Okay.
不是。但话说回来，我们内心深处有些与生俱来的东西，能在生命最后时刻治愈这些破碎的部分，让我们变得完整。
No. But again, there's something in us that's innate that can heal these kind of broken pieces of us at the end that make us whole.
所以我又回到那个观点，最鼓舞人心的人是那些受过伤害的人，而且往往不是他们自己的错，但最终他们找到了内心的平静。
So again, I come back to it, the most inspiring people are the people who have been harmed, and often from nothing of their own doing, but that find peace in the end.
你觉得人死后还有生命吗？
Do you think there is life after death?
因为有一种想法是，我们的身体埋进土里，或者被火化，然后变成尘土，再变成树木、蜜蜂和鸟儿的一部分，就这样结束了。
Because one train of thought is that our bodies go into the ground, or we're cremated, and then we become dust, and then we become part of the trees and the bees and the birds, and that's it.
我不认为我们会以肉体的形式继续存在，但我又回到那个想法，似乎有一种共享的意识，我们早年经历的爱——很有意思，往往是那些无条件爱我们的人，而其他的爱就慢慢淡去了。
I don't think we go on in a physical form, but I go back to this idea that there seems to be this shared consciousness, that the love that we've experienced early in life-- And it's very interesting, it tends to be those who loved us unconditionally, and the other ones kind of go by the wayside.
他们和我们密不可分，当我们离开肉体时，他们反而变得更加清晰。
They're inseparable from us, and they become more present to us as we're leaving our physical form.
所以这确实暗示着某种集体意识在延续。
So it does suggest that there's some sort of collective consciousness that goes on.
回到你关于丧亲者的调查，那么多人觉得他们被逝者接触过，这很有意思。
And back to your survey on the bereaved, the fact that that many people feel that they're accessed by those who have passed is interesting.
你怎么看这个？
How do you see that?
我觉得意识这个东西真的很有意思。
I think that consciousness is a really fascinating thing.
我采访过很多人聊这个话题，以前我从来没把意识当成一个具体的东西来想，但现在我对意识可能是什么有了几个猜想。
I've interviewed lots of people on this subject, and I never really thought of consciousness as a thing before, but I've got a couple of hypotheses around what consciousness might be.
这些猜想我都不敢说我真的相信，但我记得有一个人，好像是个物理学家，跟我说他觉得意识可能就是宇宙理解自己的方式，他还跟我假设说，意识把自己分成很多很多小块，变成海底的鱼——
None of them I can say I necessarily believe, but I remember one particular, I think it was a physicist, telling me that he thinks maybe consciousness is the way that the universe understands itself, and he hypothesized to me that consciousness breaks itself into lots of little pieces, into fish at the bottom of the ocean-
……还有陆地上行走的人类，以及从天空俯瞰的鸟儿。
... and human beings that walk the land and birds that see from the sky.
这是意识用来学习和理解自己的方式。
And it's consciousness' way of learning about itself and understanding itself.
它把自己分解成这些活的生物。
It breaks itself into these living organisms.
所以它把一些送到海底，一些送到山顶，让它们各自去探索。
So you send some of them to the bottom of the oceans and some of them to the top of the mountains, and they all explore.
这也许能解释为什么人类，以及所有动物，都对新鲜事物这么着迷。
And it maybe explains why humans, but all animals, are so fascinated by novelty.
我们去度假的原因就是想体验新事物。
The reason we go on holidays is because we want to have new experiences.
我们会带着敬畏去看那些从未见过的东西，比如高山。
We go and look up in awe at things we've never seen before, like mountains.
有意思的是，我讲过一个故事，关于我在直布罗陀还是马耳他，记不清了，和那位物理学家聊完之后，我开车在街上，看到游客时完全换了一种眼光，因为他们会站在那里十分钟或一个小时，盯着从未见过的东西看。
It's interesting, I was telling the story about being in, I think Gibraltar or Malta or whatever it was, and driving down the street after I'd had this conversation with this physicist and looking at tourists in a completely new light because tourists are stood there for 10 minutes or an hour staring at something they've never seen before.
我觉得有趣的是，这种对未见之物的着迷，正是动物体验的一部分。
And it's interesting to me that that's part of the animal experience is this fascination with things we haven't seen.
所以，也许这个假设——意识是一个中心源头，分裂成无数碎片，进入存在中去理解自身——是合理的，不是完全站不住脚，而是有道理的。也许等我死后，我会回到意识的源头。
So maybe this hypothesis that consciousness is this central source that breaks into lots of pieces and goes off into existence to understand itself is a plausible, not completely indefensible, but plausible idea, and then maybe when I die, I return back to the source of consciousness.
我更喜欢我的版本。
I like my version better.
你知道吗，有趣的是，你应该看看那些对临终病人使用迷幻药的研究。
And you know what's interesting is that you should look at is the work that's done with psychedelics in dying patients.
跟我说说这个。
Tell me about that.
基本上，当他们服用迷幻药时——这些药原住民已经用了数千年——他们回来时，结构上已经改变了。
Basically, when they give psychedelic drugs, which indigenous people have been doing for thousands of years, they come back structurally altered.
首先，他们对死亡的恐惧消散了，他们倾向于把自己看作更宏大的存在，沉浸并连接到整个生命之中。
First of all, their fear of dying dissipates, and they tend to see themselves as something larger, immersed within and connected to life at large.
但他们以一种美好的方式感到平静。
But they're at peace in a beautiful way.
所以他们有了这种增强的意识，回来时变得不同，离开时也不同。
So they have this heightened awareness, and they come back differently, and they die differently.
就像通过这种工作，他们离开时变得不同。
And that's like with this work, they die differently.
那么回到我们的白板这里。
So back to our board here.
第十件事是什么？
What was the 10th thing?
在生命尽头，人们最看重的是什么？
What matters most to people at the end of their life?
把财务安排好。
Having finances in order.
嗯，有意思。
Hmm, interesting.
最后一个是解决冲突。
And the last one is resolving conflicts.
这就是我对遗憾这个概念有疑问的地方。
And that's where I have trouble with the idea of regret.
对，因为这对人们来说没那么重要。
Yeah, because it's not that important to people.
现在把这个反过来看。
So now invert this.
如果你去问人们：“你有冲突吗？”
So if you went to people and said, "Do you have conflicts?"
他们会说：“有啊，我有冲突。”
They'd go, "Yeah, I have conflicts."
或者，“你有遗憾吗？”
Or, "Do you have regrets?"
“有，我有遗憾。”
"Yeah, I have them."
但当你真正把它们按优先级排序时，它其实并不重要。
But when you actually rank order them as priorities, it's not relevant.
很有意思。
Very interesting.
非常非常有意思。
Very, very interesting.
这确实改变了我的想法，因为你说得对，我们经常谈论生命尽头的遗憾，而且通常我们误解了，以为遗憾是最重要的，你需要以一种没有遗憾的方式生活。
It's definitely changed my mind because you're right, because we talk about regrets at the end of your life and regret generally so often we end up misunderstanding that to mean that regrets are the most important thing and that you need to live your life in a way where you don't have regrets.
但实际上，你说的是，那些临终的人，他们生活中没有遗憾这件事，在他们的优先级和排名中似乎并不高。
But actually, you're saying that having spoken to those that are dying, living their life free from regret seems to be quite low in their priorities and their ranking.
嗯，我觉得这是我们时代的特征，我们变得内省和自我分析。
Well, I think it's a symptom of our times, which we become introspective and self-analytical.
所以如果你问这些问题，它们肯定会冒出来。
So if you ask these questions, they're going to come up.
但在实际的生活经历中，它们真的重要吗？
But in the lived experiences, are they actually relevant?
所以我们有这六张手写的卡片。
So we have these six handwritten cards.
这些是我在照顾临终病人时学到的教训，其中最突出的一点是，爱在身体消逝后依然存在。
So these are the lessons I've learned from actually caring for dying patients, and probably the one that stands out the most is that love endures after physical loss.
爱在身体消逝后依然存在。
Love endures after physical loss.
这个想法，也是我们研究真正证实的，就是那些已经离世的人，常常是几十年前离世的，在生命尽头会陪伴我们，而临终过程的一部分就是与他们的重逢，所以这种联系会延续下去。
So the idea that, and this is really what our research bears out, which is that people who have been lost, often decades earlier, are there for us at the end, and that part of that dying process is this reunion with and to them, so that survives.
说到这一点，现在正好可以谈谈悲伤这个话题。
And on that point, it's probably a good time to touch on the subject of grief.
以及临终过程如何影响那些留下来的人的悲伤体验。
And how the dying process impacts the grief that those left behind experience.
我们在这方面做了很多研究，简单来说，人怎么死确实会影响我们的哀伤过程。
And we've done a lot of work on this, and a long story short is that how people die absolutely affects our bereavement.
我们如何见证这个过程也会改变哀伤的方式，而且这是可以衡量的。
How we witness that changes our bereavement, and it's measurable.
所以那些有过这些经历的人，看着亲人重新连接，他们的哀伤方式非常不同，这在哀伤中是可以衡量的，包括他们如何记忆、如何回忆、如何克服障碍、如何愈合。
So people who have had these experiences, who have watched their loved one reconnect, grieve very differently, and it's measurable actually in grief, how they remember, how they recall, how they get through obstacles, how they heal.
所以如果我想以最健康的方式哀伤——
So if I want to grieve in the most healthy way-
……什么样的临终体验最有利于这一点？
... what dying experience is most conducive with that?
哦，看到所爱之人充满爱，而不是空虚或被身体形态所定义。
Oh, seeing that loved one as rich in love rather than empty and defined by their physical dimensions.
我不知道这会不会有帮助。
And I don't know if it would help.
你想看看詹妮弗的视频吗？
Do you want to show the video of Jennifer?
好的。
Sure.
但这个视频挺有意思的，原因有几个，因为这些临终经历并不是什么伟大的顿悟或启示。
But this is an interesting video for a couple of reasons, because these end-of-life events are not these great epiphanies or revelations.
它们只是非常真实的时刻，通常象征着一段关系。
They're just about very real moments that are symbolic, usually of a relationship.
她在描述她的伴侣帕特里克，他正处于生命尽头，他有这些经历，但她描述了这些经历对她意味着什么。
And she's describing her partner, Patrick, who's at the end of his life, and he has these experiences, but she describes what it means to her.
帕特里克是家里唯一知道怎么做那种酱汁的人，我认识他这么多年，他一直坚持说少了点什么。
Patrick was the only member of his family that knows how to make the sauce, and for all the years I knew him, he insisted something was missing.
在他奶奶去世之后？
After his grandmother had passed?
在她去世之后。
After she had passed.
那是在他去世前的那个星期天。
This would be the Sunday before he passed.
他早上醒来，我怎么劝他都不肯吃东西。
He woke up in the morning, and I couldn't get him to eat.
他不饿。
He wasn't hungry.
完全没有胃口。
Total loss of appetite.
我就说：“宝贝，我们得给你弄点早餐。
And I'm like, "Baby, we got to make you something for breakfast.
你想吃什么？”
What do you want?"
他说：“我饱了。”
He goes, "I'm full."
我说：“帕特，你昨天就吃了个布丁。
I said, "Pat, you had a Snack Pack pudding yesterday.
你怎么可能饱。”
You're not full."
他说：‘哦，不。我昨晚和娜娜·多洛雷斯一起吃的饭。’
And he's like, "Oh, no. I ate with Nana Dolores last night."
他坚信自己前一天晚上和奶奶一起做了酱汁，说能闻到味道，还能尝到，吃得很饱，而且奶奶这么多年后终于告诉他，他做错的那一步，就是在关火前最后一步要加一茶匙糖。
He believed he made sauce with his grandmother the night before, said he could smell it, he could still taste it, he was full from it, and she showed him, after all these years, what he had done wrong, which is the very last step before you take it off the burner was to add a teaspoon of sugar.
接下来的七个半小时，我们都在做他奶奶的酱汁，因为那需要那么长时间。
We spent the next seven and a half hours, because that's how long it takes, making his grandmother's sauce.
他加了糖。
He added the sugar.
那是帕特里克最后一次吃饭。
Last time Patrick ever ate.
每天早上他醒来都会问：‘今天是我要死的那天吗？’
Every morning he woke up saying, "Is today the day I'm going to die?"
我说：‘你准备好了就会走的。’
And I said, "You'll go when you're ready."
而他确实准备好了。
And he was ready.
那个梦帮你进一步接受现实了吗？
Did that dream help you accept that reality further?
当然。
Absolutely.
当然。
Absolutely.
而且不仅仅是接受他已经离开的事实，这让我想到，也许我们离开之后，真的有什么在等着我们。
And not only the reality that he is gone, it's made me think of maybe there is something out there after we go.
所以她记得他去世时的样子，就是他和所爱的人在一起，重新完整了。
So how she remembers him in death was that he was put back together by being with those he loved.
所以如果我知道我的某个亲人即将离世——
So if I know that one of my relatives is going to pass away-
……我应该做些什么来——因为在这种情况下，我的第一反应是保护家人免受悲伤，确保悲伤的过程尽可能健康。
... what should I be doing to-- Because my first instinct in that scenario is to protect my family from the grief of it, to make sure that the grief process is as healthy as it can possibly be.
我并不是想否认悲伤，因为我知道从我所读的一切来看，悲伤是不可避免的。
And I'm not trying to deny grief in any way, because I know that it's kind of unavoidable from everything I've read.
但作为一家人，我们有没有什么办法可以避免陷入非常痛苦的哀伤过程？
But is there things we can do as a family to insulate us from having a really negative grieving process?
我觉得一个办法就是彼此沟通，坦诚面对正在发生的事情。
I think one is obviously communicating and being open with each other and with what's happening.
我觉得最糟糕的结果之一，就是当死亡被否认的时候。
I think one of the worst outcomes we see in when death is denied.
所以如果你能看到它，如果它是可以预见的，而且很明显，你又离它很近，那伤害就会小一些，而不是一直否认、否认、否认，然后——
So if you see it, if it's forecastable, and it's obvious, and you're proximate to us, it's less of an injury than if it's denied, denied, denied, and then-
然后它就发生了。
And then it happens.
对。
Yes.
我们在医学中看到太多这样的情况了。
And we see so much of that in medicine.
所以这是生活的法则，就是接受。
So this is a rule for life, which is acceptance.
哦，天哪，是的。
Oh, gosh, yeah.
我们收治的临终关怀病人中，有三分之一在七天内就去世了。
A third of our patients that come into hospice are dead in seven days.
他们并不是在七天内才开始走向死亡，而是他们意识到了这一点。
They didn't just didn't start dying in seven days, they became aware of it.
所以我们把这种情况称为医疗伤害。
So what we do is, we refer to this as medical harm.
我们否认他们的现实，把他们隔离开，不让他们面对真相，结果他们只能突然、剧烈地面对这一切，这种伤害——你剥夺了他们的自主权，剥夺了他们按自己意愿安排时间的机会，剥夺了他们进行必要对话的机会，对丧亲者的影响也是巨大的。
We deny them and separate them and deny their reality, so they're left to figure it out suddenly and acutely, and that injury is-- You're robbing people of their agency, their time to spend the way they want, to have the conversations they need to have, and the impact to the bereaved is enormous.
所以，接受是第一位的。
So acceptance, number one.
还有别的吗？
Anything else?
陪伴。
Presence.
陪伴。
Presence.
以前不是这样的。
And it used to be this way.
以前，死亡是发生在家里，发生在社区里的。
It used to be death was in the home, and it was in the community.
那是大家共同经历的，这种共同的悲伤很好，因为我们天生就应该互相支持。
It was shared, and that shared grief is wonderful because we're meant to be mutually supportive.
相反的情况是，死亡被消毒处理了，比如在重症监护室里，穿着防护服。
The opposite is a sterilized death, so in an intensive care unit, in a gown.
任何让死亡过程失去人性的做法都是有害的。
Anything that dehumanizes the process of dying is injurious.
所以，接受，身体上的陪伴。
So acceptance, physical presence.
还有什么能帮助悲伤的过程吗？
Anything else that helps the grief process?
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