out of a post-apocalyptic horror film.

恐怖電影的劫後之事。

And it often is.

通常也是這樣。

It's been portrayed in movies and television for more than 50 years.

輻射病已經描述在電影和電視中超過五十年。

And those portrayals vary a lot.

而那些描述都大不相同。

I mean, the fate-worse-than-death described

我是說，這種極為難受的病描述在

in 1959's On the Beach is very different

在 1959 年的《海濱》與

than the 'based on a true story' version

2019 年「基於真實故事」的

depicted in the 2019 miniseries Chernobyl.

迷你劇《車諾比》的版本大相逕庭。

But if there's one thing pretty much all

但如果這些所有描述

these portrayals have in common, it's that

都有一個共同點，那就是

they get radiation sickness wrong—at least somewhat.

他們對輻射病有些誤解，至少有些錯誤。

Like, people don't just start oozing blood

像是，患者不只是從腿上

out of their legs, and you can't get the

冒出血來，而且你不會

illness from hugging a hospitalized loved one.

因為抱著住院的愛人而得到輻射病。

To start off, technically, radiation sickness

首先，嚴格來說，輻射病

is called Acute Radiation Syndrome or ARS.

叫急性輻射症候群，或是 ARS。

And it's not one thing, but rather, a bunch

這不是單一一件事，而是

of different syndromes that result from being

因為暴露在高劑量的游離輻射

exposed to large doses of ionizing radiation.

所產生一系列不同的症候群。

That's the kind of radiation that carries

這種輻射攜帶足夠的能量

enough energy to knock electrons off of atoms.

將原子中的電子偷走。

And it's a problem for your cells,

對細胞來說是個大問題，

because all that energy can break chemical bonds and

因為那些能量可以破壞化學鍵

therefore mess with essential molecules like DNA.

因而擾亂關鍵的分子，如 DNA。

Your cells have ways of fixing broken molecules,

你的細胞有辦法修復破損的分子，

of course, especially breaks to DNA.

當然，特別是 DNA 的破損。

But they aren't perfect, so ionizing radiation

但它們不是完美的，游離輻射

often leads to mutations.

經常導致突變

And let's be clear: cells don't become better from these mutations.

清楚來說：細胞不會因為這些突變而變好。

The more radiation-induced mutations

細胞有越多輻射誘發的突變

a cell has, the more likely it is that it will die or become cancerous.

死亡或癌變的可能性就越大。

So although radiation can change your DNA,

所以說，雖然輻射會改變你的 DNA，

it isn't going to turn you into a walking,

但也不會把你變成行屍走肉、

roaring, city destroyer a la Godzilla,

大聲咆哮的城市破壞者哥吉拉

or give you superpowers.

也不會給你超能力。

I'd hope that radiation myth was pretty

我希望那種輻射迷思很淺顯易懂，

obvious, but not all of them are so easy to spot.

但不是所有迷思都可以輕易點出。

For example, let's say a person walks into

例如，如果一個人走進

the exact wrong room and is exposed to a lot of radiation.

完全錯誤的房間，而且暴露在大量輻射中。

And by a lot, I mean enough that this person

大量的意思是，一個人

gets more than 0.7 grays of radiation exposure

待在房間五分鐘，

from spending five minutes in that room.

會得到 0.7 戈雷的輻射暴露。

A gray is a measure of how much energy is absorbed

戈雷是測量物體或人體

by an object or person per kilogram of weight.

體重每公斤能吸收多少能量

And though it might not sound like much,

雖然聽起來沒有很多，

0.7 grays is a lot.

但 0.7 戈雷很多

For comparison, when you get a chest x-ray,

比較一下，你在做胸部 X 光檢查時

you absorb about 0.0001 grays, and a full-on

會吸收到約 0.0001 戈雷，而全身

CT scan exposes you to just 0.01 grays.

電腦斷層掃描只有 0.01 戈雷。

So, yeah, 0.7 grays is a lot of radiation,

所以說，0.7 戈雷是很大量的輻射，

and this person has just been exposed to it.

而這個人才剛接觸到而已。

What happens next?

接下來會怎樣？

Based on Hollywood, you might think their

根據好萊塢的電影，可能認為他們的

skin will instantly blister or they'll start

皮膚會立刻起水泡，或是

bleeding from everywhere.

身體到處開始流血。

But that's not how radiation sickness works.

但那不是輻射病的症狀。

They might have no symptoms for a while.

他們可能短時間內不會有任何症狀。

Depending on the exposure, it could take minutes

根據暴露程度，可能需要數分鐘

to hours before they enter what's called

到數小時，才會進入

the prodromal stage of ARS.

ARS 的前驅期。

At this point, they might feel nauseous or vomit,

此時，他們可能會感到噁心或嘔吐，

or have a fever, headache, or diarrhea.

或者發燒、頭痛、腹瀉。

Symptoms like these can happen on and off for a few days.

像這些症狀會斷斷續續出現好幾天。

And we're not entirely sure why that happens.

而我們不太清楚為何會有那些症狀。

The best explanation we have is that radiation

最好的解釋是，輻射

somehow activates cells in the gastrointestinal

以某種方法刺激腸道的細胞，

tract to release the neurotransmitter serotonin,

來釋放出神經傳導物質——血清素，

and that triggers the brain's vomit center.

而這引發了大腦的嘔吐中樞。

A similar thing can happen when people get chemotherapy.

類似的事也發生在做化療時。

What's weird about ARS, though, is that

但 ARS 的奇特之處是，

after this period of queasiness, people often feel a lot better.

過完這段噁心的時期後，患者通常覺得好多了。

This is what's known as the latent stage.

這就是俗稱的潛伏期。

And as the name implies, during this phase,

正如其名，在這期間，

it might not seem like there's a lot going on.

似乎不會發生太多事。

A person who's been exposed can feel generally

暴露在輻射的人通常會感覺

healthy… but they're not.

很健康… 但其實不然。

Oddly enough, this is the stage where cells are actually dying.

奇怪的是，這是細胞實際在死亡的階段。

You see, the cells that die from radiation

要知道，細胞因輻射死亡

generally don't die right away.

通常不是馬上就會死。

DNA damage mostly becomes a problem when cells

當細胞分裂並意識到它們不能分裂時，

go to divide and realize they can'ｔ, because

DNA 的破損就成了一個問題，因為

the DNA has breaks in it or

DNA 已經斷裂，

the coding sequence is wrong.

或編碼序列是錯的。

So the length of the latent period

因此，潛伏期的長度

partially depends on where the

部分取決於

radiation damage occurred

輻射傷害在哪發生

and how often the affected cells divide.

以及受影響的細胞分裂頻率。

That's why, when symptoms start to show

這是為什麼症狀開始發生時，

up, they often appear in places like the intestines,

通常出現在腸道

bone marrow, or skin, because those tissues

骨髓、皮膚等地方，因為那些組織

contain cells that divide the most often.

包含的細胞分裂最頻繁。

Of course, how long the latent period lasts also depends

當然，潛伏期的長度也取決於

how strong the dose of radiation was.

輻射劑量的強度。

Higher doses over a shorter period of time

短時間內越高劑量的話

mean more damage, faster.

就代表傷害越多、越快。

Now, the latent period might sound similar

潛伏期聽起來可能類似於

to the incubation period of other illnesses

其他疾病的潛伏期，

where a person doesn't show symptoms,

即使一個人沒有出現症狀，

but they can transmit the disease to someone else.

但是可以將疾病傳播給其他人。

But, unlike TV shows would have you think,

但不像電視劇那樣讓你這麼認為，

people with ARS aren't dangerously radioactive.

患有 ARS 的人其實沒有危險的放射性。

Their radiation sickness isn't contagious.

他們的輻射病不具傳染性。

You could, say, sit by the bedside of your

可以說，在將死的夥伴旁，

dying partner for days or even weeks, and

坐上幾天甚至幾週，

you wouldn't develop ARS yourself.

你自己也不會得到 ARS。

Now, it is possible for a person to be emitting

一個人是有可能釋放出

dangerous amounts of radiation right after

造成危險的輻射量，

they've left the exposure site, because

在離開受到輻射暴露的地方後，因為

radioactive material can stick to their skin and clothes.

放射性物質可以附著在他們的皮膚和衣服上。

But once those clothes are removed and

不過一旦把那些衣服處理掉

their skin is thoroughly washed, the danger is gone—

以及將皮膚完全洗乾淨後，危險就解除了

even if there's still radioactive material inside them.

即是他們體內仍有放射性物質。

If they inhaled or swallowed bits of ash,

例如，如果他們吸入或吞入少量的灰，

for example, they might have stuff emitting

他們體內的物質

ionizing radiation inside their body.

可能會釋放出游離輻射。

But, even though any radioactive material

但是，即使放射性物質

inside them will continue to give off radiation

仍會在他們體內繼續釋放輻射，

until it fully decays, that radiation is lost so quickly to nearby cells that the person

直到輻射完全衰減，輻射才迅速失散到附近的細胞，而那個人

doesn't pose a danger to others.

就不會對他人造成危險。

Basically, it's just hurting them.

基本上，輻射只會傷害他們。

So, technically, you could go ahead and hug a loved one who's been hospitalized with ARS.

嚴格來說，你可以繼續擁抱已經接受在接受 ARS 治療的愛人。

But it might not be a good idea to do that—for their sake.

但為了他們好，最好不要那麼做。

You see, the radiation may have killed off a lot of the stem cells in bone marrow that make white blood cells.

因為輻射可能會殺死骨髓中大量產生白血球的幹細胞。

And those white blood cells are the immune system's army, so without them, the immune

而那些白血球是免疫系統的軍隊．因此要是沒有它們，

system is weakened and the person is vulnerable to infection.

免疫系統會很薄弱，人就容易受到感染。

Plus, damage done to other tissues — like connective tissue and blood vessels — can

此外，對結締組織和血管的損害

eventually cut off the bone marrow's blood supply.

最後可能會切斷骨髓的血液供應。

And without blood, the bone marrow keeps dying even after the radiation threat has passed.

沒了血液，即使輻射威脅已經消去，骨髓仍會繼續衰弱。

Eventually, the body can't compensate for the cell damage anymore.

最終，人體無法再補償細胞損傷。

And that that point, the person enters the manifest illness stage.

到了那時，患者就會進入到發病期。

This stage lasts anywhere from a few hours to several months, and looks different depending

這個階段會持續數小時到數個月不等，

on the kinds of tissues that were damaged.

視受損組織的種類而定。

Some forms of radiation syndrome show up in the skin, which can get dry, red, or itchy,

某些形式的輻射症候症會出現在皮膚上，可能會變得乾燥、發紅或發癢

or in severe cases can start to blister.

嚴重的話會開始長水泡。

Basically, it's the same idea as a sunburn—though, potentially, a lot worse.

基本上，這和曬傷是一樣的概念，但可能會更慘。

Other forms, triggered by smaller doses of radiation, mostly affect the bone marrow,

其他形式由較小劑量的輻射所引起，大多數會影響骨髓

resulting in internal bleeding, a drop in white blood cells, and anemia.

導致體內出血、白血球減少和貧血。

But if a person is exposed to more than 10 grays of radiation, advanced phases can also

但如果一個人暴露在超過 10 戈雷的輻射下，下一步階段也會對

have gastrointestinal effects, like severe diarrhea, vomiting, or becoming unable to

腸胃造成影響，像是嚴重的腹瀉、嘔吐、或是無法

absorb the nutrients in food.

吸收食物的營養。

And if the exposure was more than 50 grays, the patient could move really quickly through

如果暴露程度超過 50 戈雷，患者的早期階段

all the earlier stages to reach the manifest illness stage in a matter of hours.

會進行得非常快，大約幾小時就能到發病期。

And in cases like these, damage occurs to the central nervous and cardiovascular systems,

像這樣的情況，會對中樞神經和心血管系統造成傷害

resulting in convulsions or comas.

導致抽搐或昏迷。

And… there isn't really any chance of survival.

而且…這樣沒有機會救活。

But, the good news is, in most of those lower-dose scenarios, a person can recover—especially

但好消息是，大多數低劑量的情況，患者都可以康復，尤其是

if they receive prompt treatment.

如果他們有接受立即治療。

Though, there is no silver bullet.

但是沒有萬靈丹。

Hollywood seems to think all you have to do to survive a nearby nuclear disaster is pop some iodine tablets.

好萊塢似乎認為，要在附近的核災中生存，你必須要快速吃下碘片。

Don't get me wrong, iodine tablets are great.

別誤導我，碘片很有用。

And it's true these pills are recommended as soon radiation exposure is suspected.

確實，一旦懷疑有輻射暴露，就建議吃下這些藥。

But they're not a cure-all.

但碘片並不是解藥。

In fact, they don't so much treat ARS as prevent the person from absorbing too much

事實上，碘片對於 ARS 沒有太多治療效果，因為它會阻止人在甲狀腺中

radiation in their thyroid—that walnut-sized, H-shaped organ in your neck.

吸收過多的輻射，甲狀腺是脖子內核桃大小的 H 形器官。

See, the thyroid's job is to take iodine and use it to make thyroid hormones, which

記住，甲狀腺的工作就是攝取碘，並用它製造甲狀腺激素

help regulate your metabolism, among other things.

別的先不提，這有助於調節新陳代謝。

Most of the time, that's totally fine.

大多時候，這完全沒問題。

But if you've been in a fallout zone, you might have radioactive forms of iodine in

但是，如果你一直處在輻射區，你體內的碘可能具有放射性

your body—like iodine 131, which is one of the radioactive elements made in a nuclear reactor.

例如碘 131，它是核子反應爐製作的一種放射型元素。

And if a bunch of that gets into your thyroid, it can cause a lot of DNA damage and even

如果有不少碘 131 進入到甲狀腺中，就會導致大量 DNA 受損，甚至

lead to thyroid cancer.

造成甲狀腺癌。

Iodine pills contain potassium iodide, a stable form of iodine.

碘片中含有碘化鉀，其為碘的穩定形式。

The hope is that your thyroid absorbs it instead of the radioactive stuff.

希望你的甲狀腺是吸收它，而不是放射性物質。

And for that reason, they do help—but they only really protect the thyroid, because it's

基於這個原因，它們確實有幫助，但只能真正保護甲狀腺，因為

the body part that sucks up most of the iodine in your body.

它是人體的一部分，吸收體內大部分的碘。

And they don't help your body deal with any other radioactive elements.

它們不會幫助身體處理其他放射性元素。

Plus, they don't actually do anything to the radioactive material.

另外，它們其實對放射性物質沒有任何作用。

And if a person has radioactive stuff inside them—what doctors call internal contamination—getting

如果一個人體內有放射性物質，也就是醫生所稱的「體內汙染」，

rid of it will help minimize the total damage done, so that's an important part of treating ARS patients.

擺脫汙染有助於減低總傷害，因此這是治療 ARS 患者的重要部分。

Radioactive elements do eventually stop emitting radiation on their own, of course.

當然，放射性元素最後的確會自己停止釋放輻射。

Radioactive iodine, for example, has a half life of about eight days—so even if it's

例如，放射性碘的半衰期約為 8 天，因此，即使

still in a person's body, after 8 days, it's lost half of its radioactivity.

8 天後仍在人體內，也會失去其一半的輻射。

But it takes almost two months for it to lose 99% of its radioactivity, and other radioactive

但這幾乎要兩個月才能讓 99% 的輻射消失，而其他放射性元素

elements have much longer half-lives.

有更長的半衰期。

And remember, they're emitting cell-damaging radiation that whole time.

記住，它們會一直釋放傷害細胞的輻射。

So it's not ideal to just wait things out.

所以最好不要只是坐以待斃。

That's why, to speed things along, doctors might give a patient substances like radiogardase

這就是為什麼，為了加快速度，醫生會提供病患像是 radiogardase 或

or DTPA, which bind to radioactive metals to stop them from entering cells and block them from emitting radiation.

DTPA 等物質，它們會與放射性金屬結合，阻止它們進入細胞及發射輻射。

Once bound, they'll leave the body in urine or feces.

一旦被束縛，它們會透過尿液或糞便離開人體。

Even then, though, the whole process of totally removing radioactive material from a person's

即使如此，一個人完全清除體內放射性物質的整個過程

body can take several weeks or even years.

可能需要好幾週，甚至是好幾年。

And it doesn't treat the damage already done.

而且它不會處理已經造成的傷害。

Actual treatments for ARS might include transfusions

ARS 的實際治療方法可能包括輸血

to replace the blood cells that were damaged or destroyed by radiation, and cytokine therapy

來替換受到輻射傷害或摧毀的紅血球，以及細胞介質療法

to stimulate the bone marrow to make more white blood cells.

來刺激骨髓製造更多紅血球。

Many patients are also given antivirals and antifungals to prevent infections while their immune systems are weakened.

當患者的免疫系統衰弱時，許多患者還會接受抗病毒劑和抗真菌劑以防止感染。

And hopefully, with enough medical support, the person will reach the final stage: recovery,

希望說，有了足夠的醫療支援，患者能進入到最終階段：復原

where things pretty much go back to normal.

身體幾乎會回到正常狀態。

So yeah, radiation sickness can be really bad, but even without iodine tablets, people can recover.

沒錯，放射病確實很可怕，但即使沒有碘片，患者也可以復原。

That's different from a lot of what you see in movies or TV shows, where basically

這和你在電影或電視劇看到的差異很大，在電影或電視劇中，基本上

anyone exposed to radiation dies—even if they only left the bunker for a minute, or

任何人暴露在輻射下都會死亡，即使他們只離開地堡一分鐘，或者

were miles away on a bridge watching the fallout.

在好幾英哩外的橋上看著輻射。

In fact, actual cases of ARS are really rare.

事實上， ARS 的實際案例非常罕見。

And that's in part because the events that lead up to them, like nuclear bomb blasts

造成這種情況的部分原因是，它們發生的原因，如核彈爆炸

or reactor meltdowns, are thankfully rare.

或反應爐熔毀，所幸都非常罕見。

But it's also because you have to be pretty close to the action to get ARS.

但也是因為你必須非常靠近才會得到 ARS。

For example, as awful as the Chernobyl accident was, cases of ARS were limited to people who

例如，和車諾比核事故一樣可怕，ARS 的病例僅限於

worked in the plant or who went on-scene as emergency responders, and most of them actually didn't get ARS.

在反應爐工作或到場的急救人員，而大多數人其實沒有得到 ARS。

There were no confirmed cases in the residents of the closest town.

附近城鎮的居民中沒有確診病例。

Of course, the rareness of ARS is part of why we didn't really know a lot about radiation

當然，ARS 的稀有性一部分是因為我們對輻射病沒有很了解

sickness or how to treat it when some of the most inaccurate movies or shows were filmed.

或是在拍攝一些不準確的電影或影集時，不知道如何治療。

So they really may have thought that people with ARS were emitting tons of radiation,

例如，他們確實可能認為患有 ARS 的人會發出大量的輻射，

for example, though we now know better.

但我們現在知道的更多了。

And even today, myths from the past can persist because we don't really see ARS cases in our everyday lives.

甚至在現代，過去的迷思仍然存在，因為我們在日常生活中沒有實際見過 ARS 的病例。

Also, some things are just a whole lot less entertaining if they're portrayed accurately.

而且，如果如實描繪出一些東西，那麼娛樂性就會大大降低。

Like, we wouldn't have superhero movies if we let reality get in the way of a good origin story.

就像，如果我們讓現實妨礙好的原創故事，我們就不會有超級英雄的電影。

So maybe we can forgive our favorite filmmakers for not getting all the details 100 percent right.

因此，我們也許可以原諒最愛的電影人，沒有將所有細節原汁原味地正確呈現。

Maybe.

也許。

Of course, science fiction doesn't always get things wrong.

當然，科幻作品並不是永遠在誤導事情。

And if you liked learning about the scientific realities behind these TV tropes, you might

如果你想了解這些電視轉義背後的科學現實，你可能會

like our episode on 5 Sci-Fi Futures We Actually Should Worry About.