在生命的盡頭你想要什么演講稿
Well, we all need a reason to wake up. For me, it just took 11,000 volts.
I know you're too polite to ask, so I will tell you.
One night, sophomore year of college, just back from Thanksgiving holiday, a few of my friends and I were horsing around, and we decided to climb atop a parked commuter train. It was just sitting there, with the wires that run overhead. Somehow, that seemed like a great idea at the time. We'd certainly done stupider things. I scurried up the ladder on the back, and when I stood up, the electrical current entered my arm, blew down and out my feet, and that was that. Would you believe that watch still works? Takes a licking!
My father wears it now in solidarity.
That night began my formal relationship with death -- my death -- and it also began my long run as a patient. It's a good word. It means one who suffers. So I guess we're all patients.
Now, the American health care system has more than its fair share of dysfunction -- to match its brilliance, to be sure. I'm a physician now, a hospice and palliative medicine doc, so I've seen care from both sides. And believe me: almost everyone who goes into healthcare really means well -- I mean, truly. But we who work in it are also unwitting agents for a system that too often does not serve.
Why? Well, there's actually a pretty easy answer to that question, and it explains a lot: because healthcare was designed with diseases, not people, at its center. Which is to say, of course, it was badly designed. And nowhere are the effects of bad design more heartbreaking or the opportunity for good design more compelling than at the end of life, where things are so distilled and concentrated. There are no do-overs.
My purpose today is to reach out across disciplines and invite design thinking into this big conversation. That is, to bring intention and creativity to the experience of dying. We have a monumental opportunity in front of us, before one of the few universal issues as individuals as well as a civil society: to rethink and redesign how it is we die.
So let's begin at the end. For most people, the scariest thing about death isn't being dead, it's dying, suffering. It's a key distinction. To get underneath this, it can be very helpful to tease out suffering which is necessary as it is, from suffering we can change. The former is a natural, essential part of life, part of the deal, and to this we are called to make space, adjust, grow. It can be really good to realize forces larger than ourselves. They bring proportionality, like a cosmic right-sizing. After my limbs were gone, that loss, for example, became fact, fixed -- necessarily part of my life, and I learned that I could no more reject this fact than reject myself. It took me a while, but I learned it eventually. Now, another great thing about necessary suffering is that it is the very thing that unites caregiver and care receiver -- human beings. This, we are finally realizing, is where healing happens. Yes, compassion -- literally, as we learned yesterday -- suffering together.
Now, on the systems side, on the other hand, so much of the suffering is unnecessary, invented. It serves no good purpose. But the good news is, since this brand of suffering is made up, well, we can change it. How we die is indeed something we can affect. Making the system sensitive to this fundamental distinction between necessary and unnecessary suffering gives us our first of three design cues for the day. After all, our role as caregivers, as people who care, is to relieve suffering -- not add to the pile.
True to the tenets of palliative care, I function as something of a reflective advocate, as much as prescribing physician. Quick aside: palliative care -- a very important field but poorly understood -- while it includes, it is not limited to end of life care. It is not limited to hospice. It's simply about comfort and living well at any stage. So please know that you don't have to be dying anytime soon to benefit from palliative care.
Now, let me introduce you to Frank. Sort of makes this point. I've been seeing Frank now for years. He's living with advancing prostate cancer on top of long-standing HIV. We work on his bone pain and his fatigue, but most of the time we spend thinking out loud together about his life -- really, about our lives. In this way, Frank grieves. In this way, he keeps up with his losses as they roll in, so that he's ready to take in the next moment. Loss is one thing, but regret, quite another. Frank has always been an adventurer -- he looks like something out of a Norman Rockwell painting -- and no fan of regret. So it wasn't surprising when he came into clinic one day, saying he wanted to raft down the Colorado River. Was this a good idea? With all the risks to his safety and his health, some would say no. Many did, but he went for it, while he still could. It was a glorious, marvelous trip: freezing water, blistering dry heat, scorpions, snakes, wildlife howling off the flaming walls of the Grand Canyon -- all the glorious side of the world beyond our control. Frank's decision, while maybe dramatic, is exactly the kind so many of us would make, if we only had the support to figure out what is best for ourselves over time.
So much of what we're talking about today is a shift in perspective. After my accident, when I went back to college, I changed my major to art history. Studying visual art, I figured I'd learn something about how to see -- a really potent lesson for a kid who couldn't change so much of what he was seeing. Perspective, that kind of alchemy we humans get to play with, turning anguish into a flower.
Flash forward: now I work at an amazing place in San Francisco called the Zen Hospice Project, where we have a little ritual that helps with this shift in perspective. When one of our residents dies, the mortuary men come, and as we're wheeling the body out through the garden, heading for the gate, we pause. Anyone who wants -- fellow residents, family, nurses, volunteers, the hearse drivers too, now -- shares a story or a song or silence, as we sprinkle the body with flower petals. It takes a few minutes; it's a sweet, simple parting image to usher in grief with warmth, rather than repugnance. Contrast that with the typical experience in the hospital setting, much like this -- floodlit room lined with tubes and beeping machines and blinking lights that don't stop even when the patient's life has. Cleaning crew swoops in, the body's whisked away, and it all feels as though that person had never really existed. Well-intended, of course, in the name of sterility, but hospitals tend to assault our senses, and the most we might hope for within those walls is numbness -- anesthetic, literally the opposite of aesthetic. I revere hospitals for what they can do; I am alive because of them. But we ask too much of our hospitals. They are places for acute trauma and treatable illness. They are no place to live and die; that's not what they were designed for.
Now mind you -- I am not giving up on the notion that our institutions can become more humane. Beauty can be found anywhere. I spent a few months in a burn unit at St. Barnabas Hospital in Livingston, New Jersey, where I got really great care at every turn, including good palliative care for my pain. And one night, it began to snow outside. I remember my nurses complaining about driving through it. And there was no window in my room, but it was great to just imagine it coming down all sticky. Next day, one of my nurses smuggled in a snowball for me. She brought it in to the unit. I cannot tell you the rapture I felt holding that in my hand, and the coldness dripping onto my burning skin; the miracle of it all, the fascination as I watched it melt and turn into water. In that moment, just being any part of this planet in this universe mattered more to me than whether I lived or died. That little snowball packed all the inspiration I needed to both try to live and be OK if I did not. In a hospital, that's a stolen moment.
In my work over the years, I've known many people who were ready to go, ready to die. Not because they had found some final peace or transcendence, but because they were so repulsed by what their lives had become -- in a word, cut off, or ugly. There are already record numbers of us living with chronic and terminal illness, and into ever older age. And we are nowhere near ready or prepared for this silver tsunami. We need an infrastructure dynamic enough to handle these seismic shifts in our population. Now is the time to create something new, something vital. I know we can because we have to. The alternative is just unacceptable. And the key ingredients are known: policy, education and training, systems, bricks and mortar. We have tons of input for designers of all stripes to work with.
We know, for example, from research what's most important to people who are closer to death: comfort; feeling unburdened and unburdening to those they love; existential peace; and a sense of wonderment and spirituality.
Over Zen Hospice's nearly 30 years, we've learned much more from our residents in subtle detail. Little things aren't so little. Take Janette. She finds it harder to breathe one day to the next due to ALS. Well, guess what? She wants to start smoking again -- and French cigarettes, if you please. Not out of some self-destructive bent, but to feel her lungs filled while she has them. Priorities change. Or Kate -- she just wants to know her dog Austin is lying at the foot of her bed, his cold muzzle against her dry skin, instead of more chemotherapy coursing through her veins -- she's done that. Sensuous, aesthetic gratification, where in a moment, in an instant, we are rewarded for just being. So much of it comes down to loving our time by way of the senses, by way of the body -- the very thing doing the living and the dying.
Probably the most poignant room in the Zen Hospice guest house is our kitchen, which is a little strange when you realize that so many of our residents can eat very little, if anything at all. But we realize we are providing sustenance on several levels: smell, a symbolic plane. Seriously, with all the heavy-duty stuff happening under our roof, one of the most tried and true interventions we know of, is to bake cookies. As long as we have our senses -- even just one -- we have at least the possibility of accessing what makes us feel human, connected. Imagine the ripples of this notion for the millions of people living and dying with dementia. Primal sensorial delights that say the things we don't have words for, impulses that make us stay present -- no need for a past or a future.
So, if teasing unnecessary suffering out of the system was our first design cue, then tending to dignity by way of the senses, by way of the body -- the aesthetic realm -- is design cue number two. Now this gets us quickly to the third and final bit for today; namely, we need to lift our sights, to set our sights on well-being, so that life and health and healthcare can become about making life more wonderful, rather than just less horrible. Beneficence.
Here, this gets right at the distinction between a disease-centered and a patient- or human-centered model of care, and here is where caring becomes a creative, generative, even playful act. "Play" may sound like a funny word here. But it is also one of our highest forms of adaptation. Consider every major compulsory effort it takes to be human. The need for food has birthed cuisine. The need for shelter has given rise to architecture. The need for cover, fashion. And for being subjected to the clock, well, we invented music. So, since dying is a necessary part of life, what might we create with this fact? By "play" I am in no way suggesting we take a light approach to dying or that we mandate any particular way of dying. There are mountains of sorrow that cannot move, and one way or another, we will all kneel there. Rather, I am asking that we make space -- physical, psychic room, to allow life to play itself all the way out -- so that rather than just getting out of the way, aging and dying can become a process of crescendo through to the end. We can't solve for death. I know some of you are working on this.
Meanwhile, we can --
We can design towards it. Parts of me died early on, and that's something we can all say one way or another. I got to redesign my life around this fact, and I tell you it has been a liberation to realize you can always find a shock of beauty or meaning in what life you have left, like that snowball lasting for a perfect moment, all the while melting away. If we love such moments ferociously, then maybe we can learn to live well -- not in spite of death, but because of it. Let death be what takes us, not lack of imagination.
Thank you.
中文演講稿
我們都需要一個(gè)醒來(lái)的理由。 對(duì)我來(lái)說(shuō)是11,000伏特。
我知道你們太禮貌了不會(huì)過(guò)問(wèn)， 那就讓我告訴你們。
在大學(xué)二年級(jí)， 感恩節(jié)假期后的一天晚上， 我和幾個(gè)朋友鬧著玩兒， 決定爬到一列停在一旁的通勤列車頂上。 它就停在那兒，纜線就在車頂上方。 不知為什么， 這似乎在那個(gè)時(shí)候是一個(gè)好主意。 我們的確干過(guò)比這個(gè)還傻的事。 我從后面的梯子竄了上去， 當(dāng)我站起來(lái)的時(shí)候， 一股電流進(jìn)入了我的手臂， 一直到我的腳下然后就這樣了。 你能相信那塊手表還沒(méi)壞嗎? 真是金剛不壞!
我的父親現(xiàn)在還一直戴著那塊手表。
那天晚上開(kāi)啟了我和死亡 正式的關(guān)系——我的死亡—— 也開(kāi)始了我作為病人的漫長(zhǎng)的旅程。 這是一個(gè)很合適的詞。 它的意思是一個(gè)受苦的人。 我想我們應(yīng)該都是病人吧。
美國(guó)的醫(yī)療保健系統(tǒng) 有不少的功能障礙—— 當(dāng)然，它也有杰出的方面。 我現(xiàn)在是一名醫(yī)生， 安寧病房和臨終關(guān)懷醫(yī)生， 所以我從兩個(gè)角度看醫(yī)療系統(tǒng)。 相信我：幾乎每一個(gè)從事醫(yī)療的人 都是十分好心的——是真的。 但是我們這些從事醫(yī)療的人也是 在一個(gè)有許多缺陷的系統(tǒng)中工作。
為什么呢? 其實(shí)有一個(gè)很簡(jiǎn)單的答案， 而且也能反映很多事情： 因?yàn)獒t(yī)療系統(tǒng)的設(shè)計(jì)是針對(duì)疾病的， 而病人不是焦點(diǎn)， 也就是說(shuō)這個(gè)設(shè)計(jì)是有問(wèn)題的。 而在生命的盡頭，不良的設(shè)計(jì)的影響 更加讓人心痛，完善的設(shè)計(jì)的機(jī)會(huì) 也顯得更有必要， 因?yàn)樵谏谋M頭， 所有的東西都是濃縮下來(lái)的精華。 沒(méi)有重新來(lái)過(guò)的機(jī)會(huì)。
我今天的目的就是號(hào)召各個(gè)領(lǐng)域的人們， 邀請(qǐng)大家把設(shè)計(jì)思維帶入這個(gè)大話題中。 也就是將好意和創(chuàng)意 帶入瀕死的經(jīng)歷。 這是一個(gè)十分難得的機(jī)會(huì)， 這是一個(gè)會(huì)影響到個(gè)人， 以及整個(gè)社會(huì)的 普遍問(wèn)題之一： 重新思考并設(shè)計(jì)我們?nèi)绾蚊鎸?duì)死亡。
我們從終點(diǎn)開(kāi)始談起。 對(duì)大多數(shù)人來(lái)說(shuō)， 變成死人并不是死亡最可怕的部分， 最可怕的是垂死，病痛。 這是一個(gè)關(guān)鍵的區(qū)別。 為了更好地領(lǐng)會(huì)這一切， 那就非常有必要 區(qū)分一下死亡無(wú)法避免的痛苦 和我們可以改變的痛苦。 前者是一個(gè)自然的， 生命中必不可少的一部分， 于是我們?yōu)樽约侯A(yù)留空間，調(diào)整，成長(zhǎng)。 能夠認(rèn)識(shí)到有比自己更強(qiáng)大的力量是件好事。 這能夠帶給我們均衡性， 一個(gè)全新的自我認(rèn)識(shí)。 在我失去肢體之后， 這個(gè)損失變成了一個(gè)事實(shí)，無(wú)法改變—— 這變成了我生活中的一部分， 我認(rèn)識(shí)到抵觸這個(gè)事實(shí)就是在抵觸自己。 過(guò)了一段時(shí)間，我才最終認(rèn)識(shí)到這一點(diǎn)。 這種不可避免的痛苦的另一個(gè)好處 是它最能夠 團(tuán)結(jié)照顧者和被看護(hù)者—— 增進(jìn)人與人之間的關(guān)系。 我們意識(shí)到這就是痊愈的開(kāi)始。 是的，同情——就像我們昨天所學(xué)的—— 一起承擔(dān)。
從另一方面，從醫(yī)療系統(tǒng)的角度來(lái)看， 有許多痛苦都是沒(méi)有必要的，制造出來(lái)的。 沒(méi)有任何意義。 但是好消息是：既然這種痛苦是人為造成的， 那我們就可以改變它。 如何死亡確實(shí)是我們可以改變的。 讓整個(gè)系統(tǒng)辨別不可避免的痛苦 和沒(méi)有必要的痛苦之間的最基本的區(qū)別 給予了我們?nèi)齻�(gè)中第一個(gè)的設(shè)計(jì)暗示。 畢竟我們作為照顧者的角色， 照顧病人是去減輕他的痛苦， 而不是雪上加霜。
這是緩和醫(yī)療的原則， 我的職責(zé)就是當(dāng)一個(gè)支持者， 就像一個(gè)處方醫(yī)生一樣。 順便提一下：緩和醫(yī)療——是一個(gè)非常重要的 工作領(lǐng)域，但是經(jīng)常被誤解—— 它涵蓋，但不僅限于病人臨終前。 不僅限于安寧病房。 而是在任何一個(gè)階段 都有舒適的生活品質(zhì)。 所以不一定是在病人臨終前 才能得到安寧緩和醫(yī)療。
現(xiàn)在，讓我給你們介紹一下弗蘭克。 他可以證明這一點(diǎn)。 我照顧弗蘭克好多年了。 他患有前列腺癌，外加艾滋病。 我們針對(duì)治療他的骨痛和疲倦問(wèn)題， 但是我們大多時(shí)間都在一起思考他的人生—— 其實(shí)，就是我們的人生。 弗蘭克用這種方法表達(dá)他的悲痛。 他用這種方法面對(duì)他所失去的一切， 這樣他才能去面對(duì)下一個(gè)難題。 失去是一回事兒，而后悔是另一回事兒。 弗蘭克一直是一個(gè)探險(xiǎn)家—— 他看上去像諾曼·洛克威爾的畫(huà)里的人物—— 他從不后悔。 所以我一點(diǎn)都不驚訝有一天他來(lái)到診所， 跟我說(shuō)他想泛竹筏從科羅拉多河順流而下。 這是一個(gè)好主意嗎? 考慮到他的人身安全和健康情況， 有些人會(huì)說(shuō)這不行。 很多人都這么說(shuō)，但是他依舊去了， 趁他還有能力去的時(shí)候。 那是一個(gè)美好，奇妙的旅程： 冰涼的水，干熱的酷暑，蝎子，蛇， 大峽谷似火的巖壁上各種野生動(dòng)物的嚎叫—— 都是我們無(wú)法控制的世界的壯麗的一面。 弗蘭克的決定，或許有些戲劇性， 但是如果我們有我們所需要的支持， 去尋找做最有利于自己的選擇， 那我們大多數(shù)人可能都會(huì)做出這樣的選擇。
今天聊到的許多都是從不同角度看問(wèn)題。 在我的事故發(fā)生之后，我回到了大學(xué)， 我把我的主修改成了藝術(shù)史。 在學(xué)習(xí)視覺(jué)藝術(shù)的過(guò)程中， 我發(fā)現(xiàn)我學(xué)會(huì)了如何去觀察—— 對(duì)于一個(gè)無(wú)法改變過(guò)去所見(jiàn)的孩子來(lái)說(shuō)， 那是強(qiáng)有力有的一課。 觀點(diǎn)是一種人們可以改變的煉金術(shù)， 可以把煎熬變成花朵。
往前快進(jìn)： 現(xiàn)在我在舊金山一個(gè)很棒的地方工作， 叫做禪宗安寧病房項(xiàng)目。 在那里我們會(huì)舉行一個(gè)小儀式 幫助我們換一個(gè)角度看問(wèn)題。 當(dāng)我們的一個(gè)病人去世后， 太平間的人會(huì)來(lái)， 當(dāng)我們推他的遺體車穿過(guò)花園時(shí)， 在大門(mén)前，我們會(huì)停留片刻。 任何人—— 其他的住客，家人，護(hù)士，志愿者， 還有靈車司機(jī)—— 如果他們?cè)敢猓麄儠?huì)分享一段故事， 一首歌，或者簡(jiǎn)單的沉默， 同時(shí)，我們?cè)谶z體上撒花瓣; 只有幾分鐘的時(shí)間; 這是個(gè)很美好，簡(jiǎn)單的告別場(chǎng)景， 用溫暖迎接悲痛， 而不是厭惡。 把這個(gè)和普通的醫(yī)院中的環(huán)境對(duì)比， 差不多跟這個(gè)一樣——燈光照明的房間中 排滿各種管子和嘟嘟叫的機(jī)器， 還有不停閃爍的燈光， 盡管病人的生命已經(jīng)停止了。 清理人員立即進(jìn)來(lái)，遺體被快速地接走， 然后就好像那個(gè)人從來(lái)沒(méi)有存在過(guò)似的。 從衛(wèi)生角度考慮，他們的做法當(dāng)然有道理， 但是醫(yī)院很容易侵犯我們的感官， 在那四面墻內(nèi)，我們最多也只能期盼麻木—— 麻木不仁，字面意思上和美感完全相反。 我敬仰醫(yī)院所做的一切， 因?yàn)橛兴鼈兾椰F(xiàn)在還活著。 但是我們對(duì)醫(yī)院的要求太高了。 它們是處理急性創(chuàng)傷和可治療疾病的地方。 它們不是應(yīng)對(duì)生死的地方; 它們不是為這個(gè)而設(shè)計(jì)的。
提醒一下——我并沒(méi)有放棄把 我們的醫(yī)療機(jī)構(gòu)變得更加人性化的想法。 任何地方都有美好的事物。 我在在新澤西州利文斯頓的圣巴納巴斯醫(yī)院 燒傷科呆了幾個(gè)月。 我在那里得到無(wú)微不至的照顧， 包括針對(duì)我的病痛的緩和治療。、 有一天晚上，外面開(kāi)始下雪。 我記得我的護(hù)士抱怨在雪天開(kāi)車。 我的房間沒(méi)有窗戶， 但是能想象迷漫的雪花也很好。 第二天，有一個(gè)護(hù)士為我偷偷地帶進(jìn)來(lái)一個(gè)雪球。 她把雪球帶到燒傷中心里面。 我無(wú)法描述我用手捧著雪球 那種欣喜若狂的感覺(jué)， 一股股寒意滴在我滾燙的皮膚上; 這一切有多么神奇， 我入迷地看著它融化成水。 在那一刻， 能夠?qū)儆谶@個(gè)星球上， 這個(gè)宇宙中任何一個(gè)部分對(duì)我來(lái)說(shuō) 比我的生與死還要重要。 那個(gè)小小的雪球包含了一切我所需要的鼓舞， 無(wú)論我試著活下去， 還是接受死亡都可以接受。 在醫(yī)院里，那是我珍藏的一段回憶。
在我多年的工作中，我結(jié)交了許多 愿意離開(kāi)，準(zhǔn)備好接受死亡的人。 并不是因?yàn)樗麄冋业搅?最終的安樂(lè)或者超越， 而是因?yàn)樗麄儽凰麄?生命中的轉(zhuǎn)折擊退了—— 有一個(gè)詞，也就是隔絕，丑陋。 生活在長(zhǎng)期病痛中和患有絕癥的人 已經(jīng)是歷史新高了， 年齡也不斷攀升。 而我們絲毫沒(méi)有準(zhǔn)備好迎接這個(gè)銀色海嘯。 我們需要一個(gè)有足夠動(dòng)力的 基礎(chǔ)設(shè)施去應(yīng)對(duì) 這些人口比例的重大變化。 現(xiàn)在正是時(shí)候去創(chuàng)造一個(gè) 全新的，重要的系統(tǒng)。 我知道我們可以成功， 因?yàn)槲覀儽仨氁@么做。 我們沒(méi)有選擇的余地。 而且，我們已經(jīng)把握住關(guān)鍵的因素了： 政策，教育和訓(xùn)練， 系統(tǒng)，磚塊和砂漿。 我們有無(wú)數(shù)的信息可以供設(shè)計(jì)師參考搭建。
比如說(shuō)，從調(diào)查研究中，我們可以得知 對(duì)于臨終的人而言，什么更加重要： 舒適;沒(méi)有任何負(fù)擔(dān)，也不牽累他們愛(ài)的人; 心境平靜;充滿感嘆和靈性的感覺(jué)。
在禪宗安寧病房將近30年的歷史中， 我們從我們的住客的 微妙的細(xì)節(jié)中學(xué)到了很多。 有些東西沒(méi)有它看上去那么小。 拿珍妮特舉例。 因?yàn)樗加袧u凍人癥， 每一天她的呼吸都會(huì)變得更加困難。 你們猜怎么樣? 她又開(kāi)始想抽煙了—— 還是法國(guó)香煙，如果可以的話。 并不是因?yàn)樽晕掖輾埖膬A向， 而是想在她還有肺的`時(shí)候， 去感受她的肺被充滿的感覺(jué)。 優(yōu)先順序不同了。 還有凱特——她只想感受著 她的狗狗奧斯丁躺在她的床腳， 他冷冷的鼻子貼著她干燥的皮膚， 而不是讓更多的化療流淌在她的血液中—— 她已經(jīng)經(jīng)歷過(guò)了。 在一剎那間，能夠感受到美感的滿足 立刻成為我們活著的獎(jiǎng)勵(lì)。 這種感覺(jué)在我們珍愛(ài)的時(shí)間中 通過(guò)感官和我們的身體—— 也就是正在經(jīng)歷生命和死亡的東西。
也許在禪宗安寧病房中 最凄涼的地方是我們的廚房， 你肯定覺(jué)得這有點(diǎn)奇怪， 因?yàn)橛性S多住在病房中的人 就算能進(jìn)食，也只能很少量。 但是我們意識(shí)到這樣可以在 許多層面上給他們提供支持： 比如嗅覺(jué)，一個(gè)象征性的平面。 真的，在我們的病房中所有的重大責(zé)任中， 其中我們所知的嘗試過(guò)多次， 也是最真切的治療方法， 是烘焙餅干。 只要我們還有感官—— 哪怕只有一個(gè)—— 我們至少還有可以接觸 人性的感覺(jué)，和世界連接。 對(duì)于全世界數(shù)百萬(wàn)的與癡呆癥 生死搏斗的人來(lái)說(shuō)， 我們可以想象一下這個(gè)觀點(diǎn)的效應(yīng)。 最原始的感官上的愉悅是我們無(wú)法用語(yǔ)言描述的， 是使我們珍惜當(dāng)下的沖動(dòng)—— 不需要回到過(guò)去或者展望未來(lái)。
如果把不必要的痛苦從系統(tǒng)中剔除 是我們的第一個(gè)設(shè)計(jì)提示的話， 那么給予人們感官上的， 身體上的尊嚴(yán)—— 美感的境界—— 則是我們的第二個(gè)設(shè)計(jì)提示。 這也把我們帶到今天 第三個(gè)和最后一個(gè)部分; 也就是，我們需要提高眼界， 把重點(diǎn)放在人們的福祉上， 為的是生命，健康和醫(yī)療 可以使生活變得更加美好， 而不只是少幾分可怕。 慈善。
區(qū)別就在這兒， 在一個(gè)以疾病為核心 和一個(gè)以人為核心的醫(yī)療模式之間， 在這兒，醫(yī)療變成了一種有創(chuàng)意、生產(chǎn)力， 甚至好玩的舉動(dòng)。 "玩"在這里是一個(gè)很有趣的詞。 但它也是我們適應(yīng)的最高境界之一。 想一想人類每一個(gè)不可缺少的需求。 我們對(duì)食物的需求帶來(lái)了烹飪。 我們對(duì)遮風(fēng)避雨的需求構(gòu)成了建筑。 我們對(duì)遮蔽身體的需求促成了時(shí)尚。 而因?yàn)槲覀円䦶挠跁r(shí)間， 我們發(fā)明了音樂(lè)。 那么，既然死亡也是生命中 必不可少的一部分， 我們又能創(chuàng)造出什么呢? 說(shuō)到"玩"，我決不是 在提議我們輕視死亡 或者指定某種特定的死亡方式。 有許多悲傷是我們無(wú)法消除的， 無(wú)論如何，我們都會(huì)屈服于它的。 我只是希望大家可以創(chuàng)造一點(diǎn)空間—— 生理和心理上的空間， 讓生命自己走完它的路—— 而不是把它趕走， 衰老和臨終可以變成 一個(gè)漸強(qiáng)的過(guò)程一直到結(jié)尾。 我們無(wú)法避免死亡。 我知道你們有些人在嘗試。
在此同時(shí)，我們可以——
我們可以針對(duì)死亡做設(shè)計(jì)。 我的一部分很早以前就已經(jīng)死了， 不管怎么說(shuō)，事實(shí)就是這樣。 但是我針對(duì)這個(gè)事實(shí)重新設(shè)計(jì)了我的人生， 當(dāng)你意識(shí)到你在生命中 永遠(yuǎn)可以找到 美好的事物和有意義的事情時(shí)， 我可以告訴你們這是一種解放。 就像那個(gè)停留在完美的一瞬間的雪球， 同時(shí)一直在融化。 如果我們能夠拼盡全力去愛(ài)那些片刻， 也許我們就能學(xué)會(huì)如何活得更加精彩—— 不是不顧死亡而活得精彩， 而是因?yàn)樗劳龆畹镁省?可以讓死亡奪走我們的生命， 但別讓它帶走我們的想象力。
謝謝
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