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  • Raise your hand, and be honest,

    譯者: Pui-Ching Siu 審譯者: Carol Wang

  • if you've used the phrase "crazy busy"

    請誠實地舉起你的手,

  • to describe your day, your week, your month.

    如果你用過「忙瘋了」這個詞

  • I'm an emergency-room doctor,

    來形容你的一天、一週或一個月。

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

    我是急診室醫生,

  • And after today,

    你從來不會聽到 我用「忙瘋了」這個詞。

  • I hope you'll stop using it, too.

    今天過後,

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

    我希望你們也停止使用它。

  • to describe your busy.

    這是為什麼你不能用「瘋狂」

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

    來形容你忙碌的程度:

  • we are simply less capable of handling the busy.

    當我們處於「瘋狂忙碌」模式時,

  • Here's what happens.

    處理忙碌的能力會變差。

  • Your stress hormones rise and stay there,

    以下是發生的變化:

  • your executive function in the prefrontal cortex declines.

    你的壓力荷爾蒙會升高, 並且持續那個狀態,

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

    前額葉皮質的管控功能會下降。

  • and the brain areas for anger and anxiety are activated.

    這代表著,你的記憶力、 判斷力、自制力都會變差,

  • Do you feel that?

    大腦裡憤怒和焦慮的區域會被觸動。

  • Here's the thing.

    你們有感受到嗎?

  • You can be as busy as an emergency department

    重點是,

  • without feeling like you're crazy busy.

    你可以像急診室人員一樣忙碌,

  • How?

    但不會感覺自己忙瘋了。

  • By using the same tactics that we use.

    怎麼做到?

  • Our brains all process stress in similar fundamental ways.

    透過使用和我們一樣的技巧。

  • But how we react to it

    我們的大腦都使用 相似的基本方式處理壓力。

  • has been shown by research to be modifiable,

    但是,我們應對壓力的方法,

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

    研究顯示是可以改變的,

  • Now contrast Crazy Busy Mode

    不管是緊急狀況還是日常的壓力。

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

    現在我們拿瘋狂忙碌模式

  • Ready Mode means whatever comes in through those doors,

    來對照我們急診室的「就緒模式」。

  • whether it's a multiple-car pileup,

    就緒模式代表著, 不管是什麼從急診室的門進來——

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

    不管是連環車禍傷者,

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

    困在電梯時胸口痛的病人,

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

    還是東西卡在不該在的地方的病人,

  • (Laughter)

    在你很想知道到底在哪的時候也是。

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

    (笑聲)

  • we're not afraid of it.

    即使某天你發誓自己被捉弄了,

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

    我們也不會害怕。

  • that we can handle it.

    因為無論什麼進入急診室雙開門,

  • That we're ready.

    我們知道自己都可以應付,

  • That's Ready Mode.

    我們已經準備好了。

  • We've trained for it,

    這就是就緒模式。

  • and you can, too.

    是我們訓練出來的,

  • Here's how.

    你,也可以做到。

  • Step one to go from Crazy Mode to Ready Mode

    [瘋狂模式 就緒模式]

  • is to relentlessly triage.

    方法如下。

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

    從瘋狂模式轉換到就緒模式,

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

    第一步是不停地分類。

  • Contrast that with Ready Mode,

    在瘋狂模式下, 你總是很忙,壓力很大,

  • where we triage,

    這是因為你對全部挑戰 都作出一樣的回應。

  • which means we prioritize by degree of urgency.

    相較之下,在就緒模式中,

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

    我們會進行分類,

  • Work by Dr. Robert Sapolsky

    意思是根據緊急程度排出優先順序。

  • shows that individuals who cannot differentiate threat from non-threat

    這不只是一個完成待辦清單的好方法。

  • and react to everything with the same response

    羅伯·薩普羅斯基博士的研究顯示,

  • have double the level of stress hormones.

    那些無法區分威脅和非威脅,

  • Which is why this is the first skill to learn.

    並且對所有事情作出一樣反應的人,

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

    他們的壓力荷爾蒙水平高出兩倍。

  • but you don't have to.

    這解釋了為什麼 分類是首要學習的技能。

  • Because we triage.

    你不能一次處理全部事情,

  • Red -- immediately life-threatening.

    而且那是不必要的,

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

    因為我們可以分類。

  • Green -- minor.

    紅色——當下有生命危險。

  • And we focus our efforts first on the reds.

    黃色——嚴重, 但當下沒有生命危險。

  • Now hear this.

    綠色——輕微。

  • Part of the problem in Crazy Mode

    我們首先專注處理紅色事項。

  • is that you are reacting to everything

    現在,聽我說。

  • as if it is red.

    瘋狂模式其中一個問題是,

  • So start by triaging correctly.

    你會把所有事情當成紅色事項看待,

  • Know your reds.

    並作出反應。

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

    所以,首先要正確地分類。

  • Now it's easy to be confused by noise,

    知道什麼事情屬於紅色,

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

    那些是最重要並且改變最顯著的事情。

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

    然而,我們很容易被噪音混淆,

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

    最吵鬧的不一定是最緊急的。

  • she's noisy, but she's not red.

    事實上,嚴重哮喘病人 在安靜時是最危險的。

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

    另外一個病人要求我拿咖啡奶精給她,

  • Last spring, my house flooded,

    她很吵,但是她並不緊急。

  • my one-year-old was in the ER,

    給你一個我生活中的例子。

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

    去年春天,我的房子淹水了,

  • and the final chapter of my book was beyond late.

    我一歲的小孩進了急診室,

  • Maybe not ironically, that was the chapter on stress.

    我還要為我四歲小孩的學校 籌辦募捐活動,

  • (Laughter)

    我寫的書最後一章已經遲交了。

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

    諷刺的是,那一章是關於壓力的。

  • and finishing my book.

    (笑聲)

  • That was it.

    我的紅色任務 是讓我的一歲小孩好起來,

  • Remember, relentlessly triage.

    並且完成我的書。

  • The house flood repair?

    僅此而已。

  • Well, once we had stopped and stabilized the damage,

    要記得不停地分類。

  • it was no longer a red.

    修復淹水的房子?

  • It felt red,

    一旦我們把損害停止並穩定下來時,

  • but it was in fact just noise.

    它不再是紅色的事項。

  • No, no really, it was quite noisy,

    它感覺很緊急,

  • this picture on the far right is me wearing earplugs

    但事實上只是噪音。

  • to focus on my book,

    真的非常吵。

  • while the floor is being mechanically dried around me.

    在右邊的照片裡是帶著耳塞的我,

  • Know your reds,

    正在專注於完成我的書。

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

    同時,機器正在烘乾我周圍的地板。

  • By the way, it is liberating with a green task

    要知道你的紅色事項,

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

    並且不要讓別的事項干擾你。

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

    順帶一提,綠色事項 讓你感到自由自在,

  • (Laughter)

    偶爾可以提醒一下自己,

  • It's OK if it's not perfect.

    「這是綠色項目,沒有人會死的。」

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

    (笑聲)

  • And that is black.

    就算它不完美也沒有關係。

  • Those patients for whom there is nothing we can do.

    最後,剩下一個在最糟情況 會使用的分類等級。

  • Where we must move on.

    那就是黑色。

  • And although it is gut-wrenching,

    那是指我們無能為力的病人。

  • I mention it,

    我們必須繼續向前走。

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

    雖然這令人感到痛苦,

  • These are items that you must take off your list.

    我提到它是因為,

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

    你們在生活中都有相似的黑色項目。

  • For me, this was the fundraiser.

    這些是你必須從待辦清單移除的。

  • I had to step down.

    我想你們知道我在說什麼。

  • Because as we in the ER know,

    對我來說,這指的是募捐活動。

  • if you try to do everything,

    我必須放棄。

  • you have no hope of saving your reds.

    因為急診室的我們都知道,

  • Step two to go from Crazy Mode into Ready Mode

    如果你嘗試完成每一件事,

  • is to expect and design for crazy.

    你就沒辦法拯救紅色等級的病人。

  • Half of handling crazy is how you prepare for it.

    從瘋狂模式轉到就緒模式的第二步是,

  • So if step one we triage,

    預料瘋狂並為它作出打算。

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

    處理瘋狂,一半在於怎麼做好準備。

  • Science shows us that the more options we have,

    在第一步,我們分類,

  • then the longer each decision takes.

    第二步,我們把這些項目 變得更容易完成。

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

    科學研究顯示,當我們有越多的選擇,

  • and the less it is capable of making good decisions.

    作出決定的時間會越長。

  • Which is why this step two

    當我們要作出越多決定的時候, 我們的大腦會更疲勞,

  • is about finding ways to reduce your daily decisions.

    就會更難作出正確的決定。

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

    這就是為什麼在第二步,

  • Plan.

    目標是尋找辦法, 減少每天要做的決定。

  • Plan your entire week's meals on the weekend,

    這裡有四個簡單例子, 你可以用於日常生活中。

  • so that when it's Wednesday at 6pm

    計劃。

  • and everyone's hangry and requesting pizza,

    在週末時計劃好下一週的飲食。

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

    這樣的話,週三下午六點的時候,

  • Automate.

    當大家又氣又餓地要求披薩的時候,

  • Never leave anything to remember that you could automate,

    你不用為了健康的一頓而作出抉擇。

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

    自動化。

  • Colocate.

    不需要記住能夠自動完成的事項。

  • When it comes to exercise,

    把它安排為重複發生的事項、 列成清單,或是重複採購。

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

    集中放置同類物品。

  • charged and ready,

    當運動的時候,

  • so you don't spend energy looking for it.

    把你需要用到的器材放在一起,

  • And decrease temptations,

    充滿電並準備好,

  • for anyone driven by sugar cravings.

    這樣的話,你就不用花費精力去找它們。

  • Anyone?

    還有,減少誘惑。

  • Say aye, go ahead.

    特別是對於有吃糖嗜好的人們。

  • That itself is its own form of Crazy Mode

    這裡有嗎?

  • and self-medication for Crazy Mode,

    說一聲有,來吧。

  • but stop working your willpower.

    它自身是瘋狂模式,

  • Design differently.

    它也是能夠改變瘋狂模式的關鍵。

  • If a food is out of immediate reach,

    但是,不要再使用意志力。

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

    要作出不一樣的計劃。

  • even when it's chocolate,

    如果一個食物不是隨手可拿的,

  • study participants ate 70 percent less without thinking about it.

    例如,需要用到凳子才能搆得著,

  • I know.

    即使那是巧克力,

  • Let that sit for a second.

    研究參加者少吃了 70%, 連想都沒想。

  • (Laughter)

    我知道,

  • Design to make the choices you wish to make easier.

    仔細想想它。

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

    (笑聲)

  • and that is to get out of your head.

    計劃能夠把選擇變得更容易。

  • Come with me.

    接下來是從瘋狂模式 轉成就緒模式的第三步,

  • Different story.

    它就是:專注在頭腦以外的事。

  • I'm working in a small, satellite ER,

    跟我來,

  • when a woman comes in in labor.

    我有另一個故事。

  • I realize that the cord is wrapped not once

    我在一個附屬的小急診室工作。

  • but twice around the baby's neck.

    當一個女人臨產的時候,

  • And I'm the only doctor.

    我發現臍帶在嬰兒的脖子 圍繞了不止一圈,

  • I was scared.

    它圍繞了兩圈。

  • But I couldn't let it derail me.

    當時我是唯一的醫生。

  • Because, you see, we all get nervous.

    我很害怕。

  • We all get scared,

    但我不能讓它阻擾我。

  • but it's what you do next that matters.

    這是因為我們都會感到緊張,

  • That first feeling isn't the problem.

    我們都會感到害怕,

  • It can be an important sign.

    但是,更重要的是你接下來所做的。

  • The problem comes when we let it derail us.

    第一個感覺並不是問題,

  • When that internal monologue starts

    而是重要的徵兆。

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

    我們被它干擾的時候, 問題就會產生。

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

    我們會開始產生內心的獨白,

  • and you cannot solve anything that way.

    我們把它災難化,眼光變得狹隘。

  • Now I promise to come back to the story,

    這就是在瘋狂模式下的思考,

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

    在這模式下,你無法解決任何事情。

  • There are many tactics that you may hear,

    回到我的故事,

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

    首先,我是怎麼消除那些想法的呢?

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

    你可能聽過許多技巧,

  • see myself in the arena with them --

    對我來說,積極專注在別人身上 是最有效的方法。

  • what do they need, what do they fear

    故意讓自己看見面前的人,

  • and how can I help?

    看見自己和他們在同一戰場上——

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

    他們需要什麼,他們害怕什麼,

  • but it's not.

    我怎麼可以幫上忙?

  • In fact, research shows that when you prime your brain

    對你來說,這感覺也許很模糊不清。

  • with what is, essentially, compassion,

    但其實不是的。

  • we disrupt that tunnel vision and internal monologue.

    事實上,研究顯示當你在腦內 優先看待同情心的話,

  • You widen your perception,

    我們可以停止狹隘眼光和內心獨白。

  • so your brain can actually take in broader information,

    你擴張自己的感知,

  • so you see more possibilities and can make better decisions.

    你的大腦可以接收更多資訊,

  • Try it.

    你可以看見更多的可能性, 並且做出更好的抉擇。

  • Know that your internal monologue can derail you.

    試試看吧。

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

    要知道內心獨白會干擾你。

  • you get out of your own way.

    要意識到當你專注在頭腦以外的事,

  • Now what happened to that baby?

    你就可以改變自己。

  • I focused not on my fear,

    之後,那個嬰兒怎麼了?

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

    我並沒有專注於恐懼,

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

    反而專注於母親、嬰兒和他們所需的。

  • and a healthy screaming, kicking baby arrived,

    我把臍帶從嬰兒的脖子繞開,

  • just as the dad ran in from the parking lot,

    接著,一個健康哭鬧的嬰兒誕生了。

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

    同時,他的父親剛從停車場趕來。

  • Congratulations, you want to cut the cord?"

    「你好,是一個男孩。 我是達里亞醫生。

  • (Laughter)

    恭喜,你想剪臍帶嗎?」

  • And for a moment,

    (笑聲)

  • the strong cries of a newborn

    那一瞬間,

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

    新生嬰兒強烈的哭聲,

  • But there was also something else.

    蓋過了嗶聲,警報聲等 急診室正常的聲音。

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

    除此之外還有別的。

  • I saw several of my other patients hovering nearby.

    因為當我走出那位母親的病房時,

  • I suddenly realized that despite their own problems

    我看見幾位我其他的病人在附近徘徊。

  • that had brought them to the emergency room,

    我突然意識到,

  • they had all come together to root for this baby.

    不管是什麼原因把他們帶到急診室,

  • And they now together shared in the joy.

    他們為了給這個嬰孩加油而團聚起來。

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

    現在他們一起分享喜悅。

  • Others notice.

    這就是當你從瘋狂模式 轉為就緒模式後所發生的事情。

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

    其他人注意到了。

  • they just need one example.

    他們也想要這個能力, 但是不知道該怎麼做。

  • Which could be you.

    他們只需要一個榜樣。

  • Own the busy.

    那可以是你。

  • But stop calling it crazy.

    掌管自己的忙碌,

  • You've always had that ability.

    但是停止稱它為瘋狂。

  • But now ...

    你一直都有這個能力。

  • you're ready.

    但是現在,

  • Thank you.

    你準備好了。

  • (Applause)

    謝謝。

Raise your hand, and be honest,

譯者: Pui-Ching Siu 審譯者: Carol Wang

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A2 初級 中文 模式 急診室 作出 瘋狂 分類 紅色

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

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    林宜悉 發佈於 2020 年 11 月 03 日
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