让我们来谈谈死亡英语演讲稿doc.docx

让我们来谈谈死亡英语演讲稿doc.docx

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让我们来谈谈死亡英语演讲稿doc

让我们来谈谈死亡英语演讲稿

　　look,ihadsecondthoughts,really,aboutwhethericouldtalkaboutthistosuchavitalandaliveaudienceasyouguys.thenirememberedthequotefromgloriasteinem,whichgoes,"thetruthwillsetyoufree,butfirstitwillpissyouoff."（laughter）so--（laughter）

　　sowiththatinmind,i'mgoingtosetabouttryingtodothosethingshere,andtalkaboutdyinginthe21stcentury.nowthefirstthingthatwillpissyouoff,undoubtedly,isthatallofusare,infact,goingtodieinthe21stcentury.therewillbenoexceptionstothat.thereare,apparently,aboutoneineightofyouwhothinkyou'reimmortal,onsurveys,but--（laughter）unfortunately,thatisn'tgoingtohappen.

　　whileigivethistalk,inthenext10minutes,ahundredmillionofmycellswilldie,andoverthecourseoftoday,2,000ofmybraincellswilldieandnevereback,soyoucouldarguethatthedyingprocessstartsprettyearlyinthepiece.

　　anyway,thesecondthingiwanttosayaboutdyinginthe21stcentury,apartfromit'sgoingtohappentoeverybody,isit'sshapinguptobeabitofatrainwreckformostofus,unlesswedosomethingtotryandreclaimthisprocessfromtheratherinexorabletrajectorythatit'scurrentlyon.

　　sothereyougo.that'sthetruth.nodoubtthatwillpissyouoff,andnowlet'sseewhetherwecansetyoufree.idon'tpromiseanything.now,asyouheardintheintro,iworkinintensivecare,andithinki'vekindoflivedthroughtheheydayofintensivecare.it'sbeenaride,man.thishasbeenfantastic.wehavemachinesthatgoping.there'smanyofthemupthere.andwehavesomewizardtechnologywhichithinkhasworkedreallywell,andoverthecourseofthetimei'veworkedinintensivecare,thedeathrateformalesinaustraliahashalved,andintensivecarehashadsomethingtodowiththat.certainly,alotofthetechnologiesthatweusehavegotsomethingtodowiththat.

　　sowehavehadtremendoussuess,andwekindofgotcaughtupinourownsuessquiteabit,andwestartedusingexpressionslike"lifesaving."ireallyapologizetoeverybodyfordoingthat,becauseobviously,wedon't.whatwedoisprolongpeople'slives,anddelaydeath,andredirectdeath,butwecan't,strictlyspeaking,savelivesonanysortofpermanentbasis.

　　andwhat'sreallyhappenedovertheperiodoftimethati'vebeenworkinginintensivecareisthatthepeoplewhoseliveswestartedsavingbackinthe'70s,'80s,and'90s,arenowingtodieinthe21stcenturyofdiseasesthatwenolongerhavetheanswerstoinquitethewaywedidthen.

　　sowhat'shappeningnowisthere'sbeenabigshiftinthewaythatpeopledie,andmostofwhatthey'redyingofnowisn'tasamenabletowhatwecandoaswhatitusedtobelikewheniwasdoingthisinthe'80sand'90s.

　　sowekindofgotabitcaughtupwiththis,andwehaven'treallysquaredwithyouguysaboutwhat'sreallyhappeningnow,andit'sabouttimewedid.ikindofwokeuptothisbitinthelate'90swhenimetthisguy.thisguyiscalledjim,jimsmith,andhelookedlikethis.iwascalleddowntothewardtoseehim.hisisthelittlehand.iwascalleddowntothewardtoseehimbyarespiratoryphysician.hesaid,"look,there'saguydownhere.he'sgotpneumonia,andhelookslikeheneedsintensivecare.hisdaughter'shereandshewantseverythingpossibletobedone."whichisafamiliarphrasetous.soigodowntothewardandseejim,andhisskinhistranslucentlikethis.youcanseehisbonesthroughtheskin.he'svery,verythin,andheis,indeed,verysickwithpneumonia,andhe'stoosicktotalktome,soitalktohisdaughterkathleen,andisaytoher,"didyouandjimevertalkaboutwhatyouwouldwantdoneifheendedupinthiskindofsituation?

"andshelookedatmeandsaid,

　　"no,ofcoursenot!

"ithought,"okay.takethissteady."andigottalkingtoher,andafterawhile,shesaidtome,"youknow,wealwaysthoughtthere'dbetime."

　　jimwas94.（laughter）andirealizedthatsomethingwasn'thappeninghere.therewasn'tthisdialoguegoingonthatiimaginedwashappening.soagroupofusstarteddoingsurveywork,andwelookedatfourandahalfthousandnursinghomeresidentsinnewcastle,inthenewcastlearea,anddiscoveredthatonlyoneinahundredofthemhadaplanaboutwhattodowhentheirheartsstoppedbeating.oneinahundred.andonlyonein500ofthemhadplanaboutwhattodoiftheybecameseriouslyill.andirealized,ofcourse,thisdialogueisdefinitelynotourringinthepublicatlarge.

　　now,iworkinacutecare.thisisjohnhunterhospital.andithought,surely,wedobetterthanthat.soacolleagueofminefromnursingcalledlisashawandiwentthroughhundredsandhundredsofsetsofnotesinthemedicalrecordsdepartmentlookingatwhethertherewasanysignatallthatanybodyhadhadanyconversationaboutwhatmighthappentothemifthetreatmenttheywerereceivingwasunsuessfultothepointthattheywoulddie.andwedidn'tfindasinglerecordofanypreferenceaboutgoals,treatmentsoroutesfromanyofthesetsofnotesinitiatedbyadoctororbyapatient.

　　sowestartedtorealizethatwehadaproblem,andtheproblemismoreseriousbecauseofthis.

　　whatweknowisthatobviouslyweareallgoingtodie,buthowwedieisactuallyreallyimportant,obviouslynotjusttous,butalsotohowthatfeaturesinthelivesofallthepeoplewholiveonafterwards.howwedielivesoninthemindsofeverybodywhosurvivesus,andthestresscreatedinfamiliesbydyingisenormous,andinfactyougetseventimesasmuchstressbydyinginintensivecareasbydyingjustaboutanywhereelse,sodyinginintensivecareisnotyourtopoptionifyou'vegotachoice.

　　and,ifthatwasn'tbadenough,ofcourse,allofthisisrapidlyprogressingtowardsthefactthatmanyofyou,infact,aboutonein10ofyouatthispoint,willdieinintensivecare.intheu.s.,it'soneinfive.inmiami,it'sthreeoutoffivepeopledieinintensivecare.sothisisthesortofmomentumthatwe'vegotatthemoment.

　　thereasonwhythisisallhappeningisduetothis,andidohavetotakeyouthroughwhatthisisabout.thesearethefourwaystogo.sooneofthesewillhappentoallofus.theonesyoumayknowmostaboutaretheonesthatarebeingincreasinglyofhistoricalinterest:

suddendeath.it'squitelikelyinanaudiencethissizethiswon'thappentoanybodyhere.suddendeathhasbeeveryrare.thedeathoflittlenellandcordeliaandallthatsortofstuffjustdoesn'thappenanymore.thedyingprocessofthosewithterminalillnessthatwe'vejustseenourstoyoungerpeople.bythetimeyou'vereached80,thisisunlikelytohappentoyou.onlyonein10peoplewhoareover80willdieofcancer.

　　thebiggrowthindustryarethese.whatyoudieofisincreasingorganfailure,withyourrespiratory,cardiac,renal,whateverorganspackingup.eachofthesewouldbeanadmissiontoanacutecarehospital,attheendofwhich,oratsomepointduringwhich,somebodysays,enoughisenough,andwestop.

　　andthisone'sthebiggestgrowthindustryofall,andatleastsixoutof10ofthepeopleinthisroomwilldieinthisform,whichisthedwindlingofcapacitywithincreasingfrailty,andfrailty'saninevitablepartofaging,andincreasingfrailtyisinfactthemainthingthatpeopledieofnow,andthelastfewyears,orthelastyearofyourlifeisspentwithagreatdealofdisability,unfortunately.

　　enjoyingitsofar?

（laughs）（laughter）sorry,ijustfeelsucha,ifeelsuchacassandrahere.（laughter）

　　whatcanisaythat'spositive?

what'spositiveisthatthisishappeningatverygreatage,now.weareall,mostofus,livingtoreachthispoint.youknow,historically,wedidn'tdothat.thisiswhathappenstoyouwhenyoulivetobeagreatage,andunfortunately,increasinglongevitydoesmeanmoreoldage,notmoreyouth.i'msorrytosaythat.（laughter）whatwedid,anyway,look,whatwedid,wedidn'tjusttakethislyingdownatjohnhunterhospitalandelsewhere.we'vestartedawholeseriesofprojectstotryandlookaboutwhetherwecould,infact,involvepeoplemuchmoreinthewaythatthingshappentothem.butwerealized,ofcourse,thatwearedealingwithculturalissues,andthisis,ilovethisklimtpainting,becausethemoreyoulookatit,themoreyoukindofgetthewholeissuethat'sgoingonhere,whichisclearlytheseparationofdeathfromtheliving,andthefear—like,ifyouactuallylook,there'sonewomantherewhohashereyesopen.she'stheonehe'slookingat,and[she's]theonehe'singfor.canyouseethat?

shelooksterrified.it'sanamazingpicture.

　　anyway,wehadamajorculturalissue.clearly,peopledidn'twantustotalkaboutdeath,or,wethoughtthat.sowithloadsoffundingfromthefederalgovernmentandthelocalhealthservice,weintroducedathingatjohnhuntercalledrespectingpatientchoices.wetrainedhundredsofpeopletogotothewardsandtalktopeopleaboutthefactthattheywoulddie,andwhatwouldtheypreferunderthosecircumstances.theylovedit.thefamiliesandthepatients,theylovedit.niy-eightpercentofpeoplereallythoughtthisjustshouldhavebeennormalpractice,andthatthisishowthingsshouldwork.andwhentheyexpressedwishes,allofthosewishescametrue,asitwere.wewereabletomakethathappenforthem.butthen,whenthefundingranout,wewentbacktolooksixmonthslater,andeverybodyhadstoppedagain,andnobodywashavingtheseconversationsanymore.sothatwasreallykindofheartbreakingforus,becausewethoughtthiswasgoingtoreallytakeoff.theculturalissuehadreasserted