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Look, I had second thoughts, really, about whether I could talk about this to such a vital and alive audience as you guys. Then I remembered the quote from Gloria Steinem, which goes,"The truth will set you free, but first it will piss you off."
说实话，我犹豫过到底应不应该对你们一群如此有活力的观众讲这个题目。但我又想起了Gloria Steinem的一句话，她是这样说的“真相会给你自由，但它会先令你难受”所以呢...
About trying to do those things here, and talk about dying in the 21st century. Now the first thing that will piss you off, undoubtedly, is that all of us are, in fact, going to die in the 21st century. There will be no exceptions to that. There are, apparently, about one in eight of you who think you're immortal, on surveys, but -- Unfortunately, that isn't going to happen.
所以谨记着这一点，我要开始试图来谈谈这些事聊一聊21世纪的死亡。首先，第一件会令你们十分不爽的，毫无疑问的，就是我们所有人，事实上，都将在21世纪死去。这不会有例外吧！可是根据调查，我们当中每8个人就会有1个人觉得自己可以长生不老，但是......不幸的是，长生不老是不可能的。
While I give this talk, in the next 10 minutes, a hundred million of my cells will die, and over the course of today, 2,000 of my brain cells will die and never come back, so you could argue that the dying process starts pretty early in the piece.
在接下来的这10分钟内，就在我做这个演讲的同时，我身体里的一亿个细胞将死去，今天，我的2000个脑细胞会死去，而且永远不会回来。所以可以说，死亡的过程，其实在这类的日常小事中就开始了。
So there you go. That's the truth. No doubt that will piss you off, and now let's see whether we can set you free. I don't promise anything. Now, as you heard in the intro, I work in intensive care, and I think I've kind of lived through the heyday of intensive care. It's been a ride, man. This has been fantastic. We have machines that go ping. There's many of them up there. And we have some wizard technology which I think has worked really well, and over the crouse of the time I've worked in intensice care, the death rate for males in Australia has halved, and intensive care has had something to do with that. Certainly, a lot of the technologies that we use have got something to do with that.
这就是我要告诉你的真相。毫无疑问，这会让你非常不爽，但现在我们来看看，可不可以让你获得自由并重生。但我不能向你保证什么。正如你们在介绍中听到的一样，我在ICU工作，而且我想我经历过ICU的黄金时期。那就像坐过山车一样，那真的一直都很棒。我们又很先进的设备。这照片上就有很多啊。我们又一些魔术般的技术，我觉得一直以来都很好用。在我在ICU工作的时间里，澳大利亚的男性死亡率减少了一半，这根ICU特护是有关系的。当然，这跟我们采用的许多技术也有很大的关系。
So we have had tremendous success, and we kind of got caught up in our own success quite a bit, and we started using expressions like "lifesaving." I really apologize to everybody for doing that, because obviously, we don't. What we do is prolong people's lives, and delay death, and redirect death, but we can't, strictly speaking, save lives on any sort of permanent basis.
所以我们取得过巨大的成功，而我们有点被自己的成功冲昏了头脑，所以，我们开始用一些像是“挽救生命”之类的词语形容自己，为此我真的要对所有人表示歉意，因为，很明显，我们并不能救命。我们能做的是延长人们的生命，让死亡迟一点到来，让死亡的过程改变一点点，但是严格来说，从任何永久性的角度看，我们并不能拯救病人的生命。
And what's really happened over the period of time that I've been working in intensive care is that the people whose lives we started saving back in the '70s, '80s, and '90s, are now coming to die in the 21st century of diseases that we no longer have the answers to in quite the way we did then. So what's happening now is there's been a big shift in the way that people die, and most of what they're dying of now isn't as amenable to what we can do as what it used to be like when I was doing this in the '80s and '90s.
而从我在ICU这些年的工作经验来看，事实的真相是，我们在70年代，80年代，90年代所救过来的人，现在慢慢开始在21世纪逝去——死于我们当时没法治愈现在也一样没法治愈的疾病。而最大的不同点是，人们死亡的方式发生了巨大的转变。而大部分让人们致死的疾病，已经和我们当年在80年代、90年代处理的方法有了很大的不同了。
Now, I work in acute care. This is John Hunter Hospital. And I though, surely, we do better than that. So a colleague of mine from nursing called Lisa Shaw and I went through hundreds and hundreds of sets of notes in the medical records department looking at whether there was any sign at all that anybody had had any conversation about what might happen to them if the treatment they were receiving was unsuccessful to the point that they would die. And we didn't find a single record of any preference about goals, treatments or outcomes from any of the sets of notes initiated by a doctor or by a patient.
现在，我在ICU里工作。我的医院叫“John Hunter”医院。而过去我一直认为，我们做得比较好。所以，我和我的同事Lisa Shaw，她来自养老院，我们一起在医疗档案室，翻看了成千上万本病历，我们想确认是否有任何人曾经就如果他们的治疗失败而导致他们死亡而做出的任何安排的谈话。可是，我们找不到关于他们的自我选择，目标、治疗或者最重结果这方面的东西，医生记录或病人自己写的都没有。
So we started to ralize that we had a problem, and the problem is more serious because of this.
我这才意识到，我们出了问题，而正是因为这一点，这个问题变得很严重。