disease called encephalitis lethargica. Sometimes, patients would experience headaches, fever,

被稱為 "昏睡腦炎 "的疾病。有時，病人會出現頭痛、發燒。

vertigo, or trouble sleeping but then make a full recovery. Others became comatose and

眩暈，或睡眠困難，但後來完全康復。其他人則變得昏迷不醒，並

died. And still others afflicted with the disease slipped into a sleepy, almost comatose

死亡。還有一些受這種疾病折磨的人陷入了昏睡，幾乎昏迷不醒。

state that they never recovered from. They presented with paralysis of the eye muscles,

他們從未恢復過的狀態。他們表現為眼部肌肉癱瘓。

double vision, and sometimes lost control of their facial muscles, rendering them expressionless.

複視，有時還失去對面部肌肉的控制，使他們沒有表情。

But no two cases were the same, and doctors never figured out what caused the disease

但沒有兩個病例是相同的，醫生們從來沒有弄清楚是什麼導致了這種疾病。

or any good treatment options. The epidemic hit its peak in the 1920s and left up to half

或任何良好的治療方案。該流行病在20世紀20年代達到頂峰，並留下了多達一半的

a million people dead. But a number of patients survived in the sleepy state for decades.

一百萬人死亡。但是有一些病人在沉睡狀態下存活了幾十年。

Then thirty years later in the 1950s, researchers made a breakthrough into the body's production

然後在30年後的20世紀50年代，研究人員在身體的生產方面取得了突破性進展。

of the chemical dopamine—sometimes known as the happiness chemical. Dopamine treatment

的化學物質多巴胺--有時被稱為幸福的化學物質。多巴胺治療

was thought to be a miracle cure for Parkinson's disease, and an unconventional and empathetic

被認為是治療帕金森病的奇蹟，以及一個非傳統的、具有同情心的

neurologist named Oliver Sacks wondered if it could also help the forgotten encephalitis

名為奧利弗-薩克斯的神經學家想知道它是否也能幫助被遺忘的腦炎患者。

lethargica patients, bringing them back into the world after decades in their sleepy state.

昏睡症患者，使他們在幾十年的昏睡狀態後重新回到世界中。

You may have heard of Oliver Sacks before, but let me tell you, this dude was cool. He

你可能以前聽說過奧利弗-薩克斯，但讓我告訴你，這傢伙很冷靜。他

rode motorcycles with the Hells Angels and was a competitive weightlifter who at one

他曾與地獄天使組織一起騎摩托車，並且是一名有競爭力的舉重運動員，曾一度

point squatted 600 pounds! But more than anything, he was a misfit in the medical community – and

穴位深蹲600磅!但更重要的是，他在醫學界是個不合群的人--而且

it was his approach as a clinician that set him apart. See, by the 1950s science had matured

正是他作為一個臨床醫生的方法使他與眾不同。請看，到20世紀50年代，科學已經成熟了

to a place that was very modern, analytic -- and distant. In contrast, Oliver was extremely

到一個非常現代、分析性的地方，而且很遙遠。與此相反，奧利弗是非常

empathetic and tried to see the world through his patients' eyes. Instead of treating

他具有同情心，並試圖通過病人的眼睛看世界。與其說是治療

the disease -- the approach popular in medicine at this time, Oliver treated the person. In

這時醫學界流行的方法是，奧利弗對人進行治療。在

the words of one observer, his primary diagnostic question was “How are you?”. In 1966,

用一位觀察家的話說，他的主要診斷問題是 "你怎麼樣？"。在1966年。

he moved to New York and started working at Beth Abraham, a chronic disease hospital.

他搬到了紐約，開始在貝斯亞伯拉罕（Beth Abraham）一家慢性病醫院工作。

That's where he met a group of 80 patients who had been institutionalized with encephalitis

在那裡，他遇到了一群80名因腦炎而被送入機構的病人。

lethargica and they showed little awareness of their surroundings. Their ability to move

昏睡，他們對周圍的環境表現出很少的意識。他們的移動能力

was severely compromised. They were unable to walk or even speak. Some had been admitted

被嚴重損害。他們無法行走，甚至無法說話。有些人已經被送進醫院

in the 1920s at the peak of the epidemic and had been in their sleepy states for up to

在20世紀20年代流行病的高峰期，他們處於沉睡狀態的時間長達一年。

40 years. Now, around that time, researchers were using dopamine in experimental treatments

40年了。現在，大約在那個時候，研究人員正在使用多巴胺進行實驗性治療

for Parkinson's Disease which presented with many of the same symptoms. So Sacks

帕金森病的症狀有許多是相同的。是以，薩克斯

wondered if their strategies might help with his patients, even though his patients were

想知道他們的策略是否對他的病人有幫助，儘管他的病人是

more severely affected. While we associate dopamine these days as a “happiness chemical”,

受到更嚴重的影響。雖然我們現在把多巴胺聯想為 "幸福的化學物質"。

it has a ton of jobs inside our bodies. In the 1950s, a scientist figured out that dopamine

它在我們的身體裡有大量的工作。在20世紀50年代，一位科學家發現，多巴胺

is what's called a neurotransmitter, a chemical that lets nerve cells communicate with each

是所謂的神經遞質，一種讓神經細胞相互交流的化學物質。

other. That same scientist then experimented with a chemical called DOPA, a chemical precursor

其他。同一位科學家隨後用一種叫做DOPA的化學物質進行了實驗，這是一種化學前體。

to dopamine, and found it alleviated Parkinson's symptoms in animals. A different researcher

到多巴胺，並發現它能緩解動物的帕金森病症狀。一位不同的研究人員

took a look at the brains of deceased Parkinson's patients and found that they were deficient

對已故帕金森病患者的大腦進行了研究，發現他們缺乏

in dopamine. Making the connection, this researcher proposed giving living Parkinson's patients

在多巴胺中。有了這種聯繫，這位研究人員建議給活著的帕金森病人

DOPA as a way to relieve symptoms. From there, scientists found that giving intravenous DOPA

DOPA作為一種緩解症狀的方法。從那裡，科學家們發現，給予靜脈注射DOPA

improved symptoms of Parkinsons. And a form of the drug called L-DOPA proved especially

改善帕金森症的症狀。而一種名為L-DOPA的藥物被證明是特別的

effective. It was later found that L-DOPA (in the presence of certain enzymes) could

有效。後來發現，L-DOPA（在某些酶的存在下）可以

cross the blood brain barrier while DOPA could not, making L-DOPA the best medication to

L-DOPA可以穿過血腦屏障，而DOPA則不能，這使得L-DOPA成為最佳的藥物。

treat Parkinsons at the time. By the late 1960s, there was a lot of excitement around

當時治療帕金森症。到20世紀60年代末，圍繞著這一問題出現了很多興奮點。

L-DOPA in the neurological community. Some of Dr. Sacks's patients actually requested

L-DOPA在神經病學界的應用。薩克斯醫生的一些病人實際上要求

the drug after hearing about it. But Sacks hesitated to use the drug on his patients

在聽說了這種藥物之後。但是薩克斯對在他的病人身上使用這種藥物猶豫不決。

for 2 full years. Part of that was its prohibitively high cost. The other was the unknown: he was

整整兩年的時間。部分原因是其費用太高，令人望而卻步。另一個原因是未知因素：他是

concerned about how his patients would react to the new treatment. Yes, L-DOPA had a good

他擔心他的病人對這種新的治療方法會有什麼反應。是的，L-DOPA有一個很好的

track record in Parkinson's patients, but encephalitis lethargica was a different disease

在帕金森病患者中的記錄，但昏睡症腦炎是一種不同的疾病。

that still wasn't well understood. But following the death of some of his patients in the summer

這一點仍然沒有得到很好的理解。但在他的一些病人在夏天死亡之後

of 1968, Oliver felt compelled to experiment with L-DOPA. So in March of 1969, he began

1968年，奧利弗感到必須對L-DOPA進行實驗。於是在1969年3月，他開始

an experiment on a small group of patients. He studied 6 patients total, 3 were put on

在一小群病人身上做了一個實驗。他總共研究了6個病人，其中3個被放在了

L-DOPA, 3 were given a placebo for a 90 day long observational study. At first, the treatment

L-DOPA，3人被給予安慰劑，進行為期90天的觀察性研究。起初，治療

was a success. The L-DOPA patients were “awakened” from their decades-long sleep. Very quickly

是一種成功。L-DOPA患者從長達幾十年的睡眠中被 "喚醒"。非常迅速地

after receiving the medication, some were able to speak and even walk for the first

在接受藥物治療後，一些人能夠說話，甚至第一次能夠走路。

time in decades. After seeing success in the trial, Sacks started treating his other encephalitis

幾十年來的一次。在看到試驗的成功後，薩克斯開始治療他的其他腦炎

lethargica patients with L-DOPA. They improved dramatically at first, but quickly developed

使用L-DOPA的昏睡症患者。他們起初有顯著的改善，但很快就發展成

tolerance to the medication and needed increased dosage to keep their symptoms at bay. To this

對藥物的耐受性，需要增加劑量來保持他們的症狀。對此

day, we still don't know why. One idea is that some of the patients who had the disease

日，我們仍然不知道原因。一個想法是，一些患病的病人

had symptoms that were exacerbated by some of the metabolic byproducts of dopamine. So

有一些症狀因多巴胺的一些代謝副產品而加劇。所以

as patients took L-DOPA, their bodies metabolized it which created this byproduct that caused

當病人服用L-DOPA時，他們的身體會進行代謝，產生這種副產品，導致

other symptoms. Nobody has researched this hypothesis specifically on encephalitis lethargica

其他症狀。沒有人專門研究過這一假說，對腦炎昏睡症的研究。

patients, but research from other brain disorders points in that direction. Regardless, Oliver

患者，但來自其他腦部疾病的研究指向了這個方向。不管怎麼說，奧利弗

had a drug that he knew would help people, so he was compelled to share his results,

有一種藥物，他知道會幫助人們，所以他不得不分享他的成果。

but his study was more observational than traditionally quantitative, so his work was

但他的研究更多的是觀察性的，而不是傳統意義上的定量，所以他的工作是

rejected by professional journals. Unable to publish in the medical literature, he described

被專業雜誌拒絕。由於無法在醫學文獻中發表，他描述了

his findings in a book, Awakenings, which was released in 1973. And not only did he

他將自己的發現寫進了《覺醒》一書，該書於1973年發行。而且他不僅

document how dopamine was involved in encephalitis lethargica, he gave detailed case histories

他記錄了多巴胺是如何參與昏睡性腦炎的，並提供了詳細的病例記錄。

for each patient. In Awakenings, each patient is described by name, not relegated to a number.

為每個病人提供的服務。在《覺醒》中，每個病人都有名字描述，而不是被歸為一個數字。

And therein lies his legacy. Sacks wasn't the only person experimenting with L-DOPA

他的遺產就在這裡。薩克斯並不是唯一用L-DOPA進行實驗的人

at the time, but his observations were meticulous and described his patients' Parkinson's-like

當時，他的觀察是細緻的，並描述了他的病人的帕金森症狀。

symptoms better than anyone else. He aimed a spotlight on the value of minute observation

症狀比任何人都好。他將聚光燈對準了細微觀察的價值

and description. His lasting impact on medicine is his empathetic and personal approach to

和描述。他對醫學的持久影響是他的同情心和個人方法，以

treatment and his insistence on the individuality of every patient. His work finally caught

他的治療方法和他對每個病人的個性的堅持。他的工作終於吸引了

a more popular audience when Awakenings was adapted into a Hollywood movie starring Robert

當《覺醒》被改編成好萊塢電影，由羅伯特.羅傑斯主演時，更受觀眾歡迎。

de Niro and Robin Williams in 1990. Having read Awakenings, I was struck at how Oliver

德尼羅和羅賓-威廉斯在1990年。在閱讀了《覺醒》之後，我對奧利弗-德尼羅的作品感到震驚。

wrote his patients' case histories in such a vivid and empathetic way. As a reader, I

他以如此生動和富有同情心的方式來寫他的病人的病歷。作為一個讀者，我

couldn't help but to put myself in the patients' shoes. Oliver Sacks turned observations into

我忍不住要把自己放在病人的位置上。奧利弗-薩克斯把觀察結果變成了

humanized stories, giving a face and voice to patients with chronic mental and neurological

人性化的故事，為慢性精神和神經系統疾病患者提供了一個面孔和聲音。

conditions. This approach of treating the person, not the disease would ultimately make

條件。這種治療人而不是治療疾病的方法最終會使

him a key figure in modern neurology , and his work has now inspired generations of younger

他是現代神經病學的關鍵人物，他的工作現在已經啟發了幾代年輕的神經病學專家。

doctors. If you're interested in the story of Dr. Oliver Sacks and the rest of his work,

醫生。如果你對奧利弗-薩克斯醫生的故事和他的其他工作感興趣。

check out Oliver Sacks: His Own Life, now streaming on PBS and available on major platforms!

請看《奧利弗-薩克斯。他自己的生活，現在在PBS上播放，並可在主要平臺上獲得!

And as always, we appreciate when you like the video, and subscribe. Thanks for watching.

和往常一樣，我們感謝你喜歡這個視頻，並訂閱。謝謝你的觀看。