KevinJones_2015X[凯文琼斯][为什么好奇心是科学与医药的钥匙].pdf

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1、www.XiYuS锡育软件Science.科学。00:12The very word for many of you conjures unhappy memoriesof boredom in high school biology or physics class.这个词对于你们中的很多人来说,召唤了对于高中生物 或是物理课堂的苦闷记忆。00:14But let me assure that what you did there had very little todo with science.但是我向你们保证,你们在那时经历的 与科学是大相径庭的。00:21That was reall

2、y the what of science.那只是科学“是什么”。00:26It was the history of what other people had discovered.那是前人发现的历史记载。00:28What Im most interested in as a scientist is the how ofscience.我对于成为一名科学家最感兴趣的地方 是科学的“为什么”。00:32Because science is knowledge in process.因为科学的知识是正在探寻中的。00:37We make an observation,guess an ex

3、planation for thatobservation,and then make a prediction that we can testwith an experiment or other observation.我们进行观察,对观察提出一种设想原因,做一种可以通过实验或是 其他观察论证的假设。00:41A couple of examples.举些例子。00:49First of all,people noticed that the Earth was below,the skyabove,and both the Sun and the Moon seemed to go a

4、roundthem.首先,人们注意到了大地在脚下,天空在头顶,太阳和月亮都看似围绕着它们在移动00:50Their guessed explanation was that the Earth must be thecenter of the universe.他们提出的设想是 地球一定是宇宙的中心。00:58conjures:vt.念咒召唤;用魔法驱赶;提出,想象;恳求/vi.施魔法;变魔术 boredom:n.厌倦;令人厌烦的事物 prediction:n.预报;预言 or other:或者说 First of all:adv.首先The prediction:everything sho

5、uld circle around the Earth.预测即为:一切都是围绕着地球运动的。01:04This was first really tested when Galileo got his hands on oneof the first telescopes,and as he gazed into the night sky,what he found there was a planet,Jupiter,with four moonscircling around it.当伽里略着手于第一台望远镜,望向天空的时候,这件事第一次 被真正测试了,他发现的是一颗行星,木星,周围还有

6、四颗卫星环绕着它。01:08He then used those moons to follow the path of Jupiter andfound that Jupiter also was not going around the Earth butaround the Sun.之后,他又利用这些卫星去跟踪木星的轨道 发现木星也不是围绕地球运动的 而是围绕太阳运动的。01:23So the prediction test failed.所以说这个假说测试就失败了。01:35And this led to the discarding of the theory that the Ea

7、rthwas the center of the universe.这就导致了地球是宇宙的中心 这个理论被推翻。01:38Another example:Sir Isaac Newton noticed that things fall tothe Earth.另一个例子:艾萨克牛顿爵士注意到了东西都是向地面坠落的。01:42The guessed explanation was gravity,the prediction thateverything should fall to the Earth.设想原因是引力,预测是万物都会落向地面。01:46But of course,not ev

8、erything does fall to the Earth.但是当然,并不是所有东西都落向地面的。01:53So did we discard gravity?但是我们就抛弃引力吗？01:58No.We revised the theory and said,gravity pulls things tothe Earth unless there is an equal and opposite force in theother direction.不。我们重新改写理论,说引力将万物拉向地面,除非事物还受到大小相同方向相反的力的作用。02:00gazed:vi.凝视;注视/n.凝视;注

9、视 Jupiter:n.天木星;朱庇特(罗马神话中的宙斯神)circling:n.环骑/vt.盘旋,绕轨道运行(circle现在分词形式)discarding:v.丢弃;打出(discard的ing形式)Newton:n.牛顿(英国科学家);牛顿(力的单位)revised:adj.改进的/v.修改;校订;复习(revise的过去分词形式)This led us to learn something new.这引领我们学到了新的东西。02:10We began to pay more attention to the bird and the birdswings,and just think

10、of all the discoveries that have flownfrom that line of thinking.我们开始更多的关注鸟儿和它们的翅膀,想一想从那条思路 引出的一系列发现。02:12So the test failures,the exceptions,the outliers teach us whatwe dont know and lead us to something new.所以那些测试的失败,意外,异常值 给我们传授了未知,引领我们去发现新的东西。02:21TED演讲者：Kevin B.Jones|凯文?琼斯演讲标题：Why curiosity is

11、 the key to science and medicine|为什么好奇心是科学与医药的钥匙？内容概要：Science is a learning process that involves experimentation,failure and revision and the science of medicine is no exception.Cancer researcher Kevin B.Jones faces the deepunknowns about surgery and medical care with a simple answer:honesty.In a t

12、houghtful talkabout the nature of knowledge,Jones shows how science is at its best when scientists humblyadmit what they do not yet understand.科学是一个包括实验，失败与改写的学习过程关于医药的科学就更不例外。癌症研究员凯文?琼斯以一种简单的答案面对关于手术和医疗领域最深奥的未知：诚实。在这个围绕知识本质的令人深思的演讲中，琼斯展示了，当科学家们谦逊的承认他们所不明白的东西时，科学是如何做到更好的。This is how science moves fo

13、rward.This is how science learns.科学就是这样不断前行。科学就是这样不断学习。02:32Sometimes in the media,and even more rarely,butsometimes even scientists will say that something or otherhas been scientifically proven.有的时候在媒体当中,甚至更罕见的,有时甚至科学家们会说 这个或是那个已经被科学证明了。02:35But I hope that you understand that science never proves

14、anything definitively forever.但是,我希望你们能够明白,科学从不能证明任何东西,永远都不可能。02:43Hopefully science remains curious enough to look for andhumble enough to recognize when we have found the nextoutlier,the next exception,which,like Jupiters moons,teaches us what we dont actually know.希望科学始终保持那种好奇感 让我们去探寻,和那种谦逊感,当我们发

15、现下一个异常值,下一个特例,就像木星的卫星那样的东西的时候,教会我们那些我们并不了解的东西。02:51Were going to change gears here for a second.我们要在这里变换一小会儿主题了。03:09flown:v.fly的过去分词 outliers:n.分化异常值;离群值;离开本体的东西;局外人(outlier的复数)scientifically:adv.系统地;合乎科学地;学问上 definitively:adv.决定性地;最后地 gears:n.机齿轮,机传动装置(gear的复数形式)/v.以齿轮连起,安排(gear的三单形式)The caduceus,

16、or the symbol of medicine,means a lot ofdifferent things to different people,but most of our publicdiscourse on medicine really turns it into an engineeringproblem.墨丘利的节杖,或者说是医药的象征,对于不同的人,有着不同的意义,但是我们的普遍公共医学论述却将它转变为了一个工程问题。03:11We have the hallways of Congress,and the boardrooms ofinsurance companie

17、s that try to figure out how to pay for it.我们的国会长廊,还有保险公司的董事会都试图找到支付它们的途径03:21The ethicists and epidemiologists try to figure out how bestto distribute medicine,and the hospitals and physicians areabsolutely obsessed with their protocols and checklists,trying to figure out how best to safely apply m

18、edicine.伦理学家和流行病学家 试图找到如何更好分配药物的方法,医院和医生们却完全沉迷于 他们的协议和清单,试图找到更安全应用药物的方法。03:27These are all good things.这些都是好事。03:40However,they also all assume at some level that the textbookof medicine is closed.但是,他们也都在 一定程度上假定了 医学教科书是封闭的。03:42We start to measure the quality of our health care by howquickly we ca

19、n access it.我们就开始以我们能多快速的得到医疗服务 来衡量我们的医疗质量。03:51caduceus:n.墨丘利的节杖(医学的标志);使者杖 discourse:n.论述;谈话;演讲/vi.演说;谈论;讲述/vt.说出;演奏出 hallways:n.(美)走廊;门厅(hallway的复数)boardrooms:n.会议室；交换场所 ethicists:n.伦理学家 epidemiologists:n.流行病学家(epidemiologist的复数)physicians:n.内科内科医生(physician的复数)protocols:n.协议;礼仪礼节;条款(protocol的复数)

20、/v.拟定议定书;拟定草案(protocol的三单形式)checklists:n.清单(checklist的复数)It doesnt surprise me that in this climate,many of ourinstitutions for the provision of health care start to look aheck of a lot like Jiffy Lube.在这种风气下,许多机构 为寻求医疗服务,开始大批搜寻润滑油的行为,03:56(Laughter)The only problem is that when I graduated frommedi

21、cal school,I didnt get one of those little doohickeysthat your mechanic has to plug into your car and find outexactly whats wrong with it,because the textbook ofmedicine is not closed.（笑声）唯一的问题是,当我从医学院毕业的时候,我并没有得到那个像是你的机械师 一插进你的汽车里就能知道 车子哪里出问题的小窍门,因为医学课本 并非是封闭的。04:03Medicine is science.医药是科学。04:21Me

22、dicine is knowledge in process.医药是正在进程中的知识。04:23We make an observation,we guess an explanation of thatobservation,and then we make a prediction that we can test.我们先观察现象,然后猜测现象背后的解释,之后我们作出一个能够被测试的假设04:27Now,the testing ground of most predictions in medicine ispopulations.当下,我们在医药领域大多数的测试场地就是 群体。04:33

23、And you may remember from those boring days in biologyclass that populations tend to distribute around a mean as aGaussian or a normal curve.然后也许你还记得在那些无聊的生物课上 关于群体倾向于呈现 围绕平均值的 高斯或是正态分布曲线。04:38Therefore,in medicine,after we make a prediction from aguessed explanation,we test it in a population.因此,在医

24、药领域,在我们用一种可能的原因作出预测之后,我们就在群体中测试它。04:47provision:n.规定;条款;准备;经供应品/vt.供给食物及必需品 Jiffy:n.一会儿,瞬间 Lube:n.润滑油(等于lubrication)doohickeys:n.窍门;小玩意;装置 predictions:n.预测,预言(prediction复数形式)That means that what we know in medicine,our knowledgeand our know-how,comes from populations but extendsonly as far as the ne

25、xt outlier,the next exception,which,likeJupiters moons,will teach us what we dont actually know.这就意味着,我们关于医药学习的知识,我们的所有知识,都来自于群体,而只有当达到下一个异常值的时候,下一个特例,我们的知识才会扩张,它们教会了我们并不了解的东西。04:55Now,I am a surgeon who looks after patients with sarcoma.现在,我是一名外科医生,正在寻找肉瘤病人。05:14Sarcoma is a very rare form of cance

26、r.肉瘤是一种极其罕见的癌症。05:17Its the cancer of flesh and bones.是骨与肌肉的癌变。05:20And I would tell you that every one of my patients is anoutlier,is an exception.然后我会告诉你,我的每一位病人都是异常值,都是特例。05:23There is no surgery I have ever performed for a sarcomapatient that has ever been guided by a randomizedcontrolled clinic

27、al trial,what we consider the best kind ofpopulation-based evidence in medicine.我为这些肉瘤患者做的手术,没有任何一个是对照着,临床实验案例,就是那些我们认识中最适合医药的 以群体为基础的实验证据,没有任何一个是被其指导着完成的。05:30People talk about thinking outside the box,but we donteven have a box in sarcoma.人们总说要跳出定式思维,但是在肉瘤病症上,我们没有定式。05:42www.XiYuS锡育软件What we do ha

28、ve as we take a bath in the uncertainty andunknowns and exceptions and outliers that surround us insarcoma is easy access to what I think are those two mostimportant values for any science:humility and curiosity.当我们沐浴在关于肉瘤的,环绕我们的,那些未知,不确定,特例,异常值中的时候,我们所拥有的,是我眼中对于任何一种科学,最重要的两种价值观:谦逊和好奇心。05:47know-how

29、:n.诀窍;实际知识;专门技能 sarcoma:n.肿瘤肉瘤,恶性毒瘤 randomized:adj.数随机化的,随机的/v.使随机化;做任意排列(randomize的过去分词)clinical:adj.临床的；诊所的 population-based:基于人群的 uncertainty:n.不确定,不可靠 unknowns:n.未知事件(unknown的复数)humility:n.谦卑,谦逊Because if I am humble and curious,when a patient asks me aquestion,and I dont know the answer,Ill ask

30、 a colleaguewho may have a similar albeit distinct patient with sarcoma.因为如果我是谦逊的,好奇心强的,当病人询问我问题的时候,如果我不知道问题的答案,我就会去询问有着相似的,尽管是不同的肉瘤病人的同事。06:04Well even establish international collaborations.我们甚至会建立国际间的合作。06:15Those patients will start to talk to each other through chatrooms and support groups.那些病人

31、也会开始在聊天室和支持团体中 互相交流。06:17Its through this kind of humbly curious communication thatwe begin to try and learn new things.是通过这种谦逊的,好奇的交流过程,我们开始去尝试并学习新的知识。06:22As an example,this is a patient of mine who had a cancernear his knee.作为例子,这是我的一位病人 他在膝盖附近长了一个肿瘤。06:31Because of humbly curious communication i

32、n internationalcollaborations,we have learned that we can repurpose theankle to serve as the knee when we have to remove the kneewith the cancer.正因为那种在国际合作中谦逊的 好奇心驱使的沟通,我们学习到了如果必须在移除肿瘤的同时移除膝盖,那么我们可以用踝关节代替膝关节的位置。06:35He can then wear a prosthetic and run and jump and play.这样他就可以带着假肢跑,跳,玩耍了。06:46This

33、opportunity was available to him because ofinternational collaborations.是国际间合作 给了他这样的机会。06:50albeit:conj.虽然;即使 collaborations:n.协作(collaboration的复数)humbly:adv.谦逊地;卑贱地;低声下气地 repurpose:vt.改换意图;重新目的化 serve as:担任,充当;起的作用 prosthetic:adj.假体的;非朊基的It was desirable to him because he had contacted otherpatien

34、ts who had experienced it.这也是他所希望的,因为他与经历过这些的其他病人联系过了。06:56And so exceptions and outliers in medicine teach us what wedont know,but also lead us to new thinking.所以在医药领域的特例与异常值 教会了我们那些不了解的东西,同时也引发了我们作出新的思考。07:01Now,very importantly,all the new thinking that outliers andexceptions lead us to in medici

35、ne does not only apply to theoutliers and exceptions.现在,非常重要的是,所有这些在医药领域关于异常值和特例的新的思考 并非只能运用于那些特例的情况中。07:11It is not that we only learn from sarcoma patients ways tomanage sarcoma patients.我们从肉瘤病人身上学习到的,并非仅仅是治疗肉瘤病人的方法。07:20Sometimes,the outliers and the exceptions teach us thingsthat matter quite a

36、lot to the general population.有的时候,这些异常情况,这些特例,也教会了我们一些,对大众同样十分重要的事情。07:26Like a tree standing outside a forest,the outliers and theexceptions draw our attention and lead us into a muchgreater sense of perhaps what a tree is.就像是身处树林之外的一棵树,这些外围的,特例般的存在,吸引了我们的注意力,并能够引领我们得到一个,像是“树是什么”,这种更为宏观的认识。07:35We

37、 often talk about losing the forests for the trees,but onealso loses a tree within a forest.我们经常说,树木们失去了森林,但是,我们也会 失去森林里的树木。07:45But the tree that stands out by itself makes thoserelationships that define a tree,the relationships betweentrunk and roots and branches,much more apparent.那些独自站立的树,它们同样,甚

38、至以一种更加明确的方式 定义了树木的概念,树干,树根与树枝间的联系。07:53contacted:交往,接触(contact的过去式和过去分词)Even if that tree is crooked or even if that tree has veryunusual relationships between trunk and roots and branches,it nonetheless draws our attention and allows us to makeobservations that we can then test in the generalpopula

39、tion.即使那颗树是弯曲的,或者甚至它的树干,树根与树枝 之间的联系是非同寻常的,它吸引了我们的注意力,让我们作出了观察,然后能够在普试群体中进行测试。08:03I told you that sarcomas are rare.我告诉过你们了,肉瘤是罕见的。08:18They make up about one percent of all cancers.它们只在所有癌症中占有1%08:20You also probably know that cancer is considered a geneticdisease.你也许还知道癌症是一种基因疾病。08:23By genetic di

40、sease we mean that cancer is caused byoncogenes that are turned on in cancer and tumorsuppressor genes that are turned off to cause cancer.基因疾病是指癌症是由于 原癌基因的触发和 抑癌基因的失效所诱发的。08:27You might think that we learned about oncogenes and tumorsuppressor genes from common cancers like breast cancerand prostat

41、e cancer and lung cancer,but youd be wrong.你也许会认为我们是从那先常见癌症,像是乳腺癌,前列腺癌,肺癌中,发现原癌基因与抑癌基因的,但是,那样想你就错了。08:36We learned about oncogenes and tumor suppressor genesfor the first time in that itty-bitty little one percent of cancerscalled sarcoma.我们是从那些极少数的,1%的肉瘤中 第一次的,学习到了原癌基因和抑癌基因的。08:46crooked:adj.弯曲的;歪的

42、;不正当的 nonetheless:adv.尽管如此，但是 observations:n.观察,观察值;观察结果;(观察后发表的)言论(observation的复数形式)in the general:通常,一般 oncogenes:n.遗肿瘤致癌基因(oncogene的复数)suppressor:n.抑制器;消除器 prostate:adj.前列腺的/n.解剖前列腺 itty-bitty:adj.极小的(等于itsy-bitsy)In 1966,Peyton Rous got the Nobel Prize for realizing thatchickens had a transmissi

43、ble form of sarcoma.1966年,佩顿劳斯获得了诺贝尔奖 他发现了鸡群中一种 传染性的肉瘤。08:54Thirty years later,Harold Varmus and Mike Bishopdiscovered what that transmissible element was.三十年之后,哈罗德瓦尔姆斯与麦克毕晓普发现了那种传染性的因子究竟是什么。09:03It was a virus carrying a gene,the src oncogene.那是一种病毒 它携带一种基因,那就是肉瘤原癌基因。09:08Now,I will not tell you th

44、at src is the most importantoncogene.现在,我不会说肉瘤原癌基因是最重要的原癌基因。09:13I will not tell you that src is the most frequently turned ononcogene in all of cancer.我也不会告诉你 肉瘤原癌基因是最常见的原癌基因。09:17But it was the first oncogene.但是,它是第一个被发现的原癌基因。09:22The exception,the outlier drew our attention and led us tosomething

45、 that taught us very important things about therest of biology.那个特例,那个异常值,它吸引了我们的注意力,并引领了我们,教会了我们关于整个生物领域重要的东西。09:25Now,TP53 is the most important tumor suppressor gene.当下,肿瘤抑制蛋白p53是最重要的抑癌因子。09:36It is the most frequently turned off tumor suppressor gene inalmost every kind of cancer.它是最常见的失效而引发各种肿瘤

46、的 抑癌基因。09:41But we didnt learn about it from common cancers.但是我们并不是从一般的癌症当中发现它的。09:46We learned about it when doctors Li and Fraumeni werelooking at families,and they realized that these families hadway too many sarcomas.是当李医生和弗劳梅尼医生 在关注家庭史过程中,发现有些家庭患肉瘤病人概率远高于其他家庭时09:48transmissible:adj.能传送的;能透射的;可传

47、达的 Bishop:n.主教/象 frequently:adv.频繁地,经常地;时常,屡次I told you that sarcoma is rare.我告诉过你们了,肉瘤很罕见。09:57Remember that a one in a million diagnosis,if it happenstwice in one family,is way too common in that family.记住,百万分之一的诊断率,如果在同一个家庭中出现两例,那就已经远高于其他家庭了。09:59The very fact that these are rare draws our attent

48、ion andleads us to new kinds of thinking.就是因为它们十分罕见的特性,吸引了我们的注意力,并引发了我们作出新的思考。10:08Now,many of you may say,and may rightly say,that yeah,Kevin,thats great,but youre not talking about a birds wing.你们中的很多人可能会说,或者现在正在说,嗯,凯文,这听起来不错,但是你所说的并非是鸟的翅膀,10:17Youre not talking about moons floating around some pl

49、anetJupiter.或者是卫星围绕着木星漂行。10:24This is a person.这是一个人。10:28This outlier,this exception,may lead to the advancement ofscience,but this is a person.这种特例,这种异常值,也许会引领我们科学的进步,但是,这是一个人。10:30And all I can say is that I know that all too well.而我能说的只是,我太了解了。10:36I have conversations with these patients with r

50、are and deadlydiseases.我与这些患有罕见的,致命的疾病的患者交流过。10:41I write about these conversations.我记录下了我们的对话。10:45These conversations are terribly fraught.这些谈话都是极度令人担忧的。10:47diagnosis:n.诊断 rightly:adv.正确地;恰当地;公正地;合适地 lead to:导致;通向 advancement:n.前进,进步;提升fraught:adj.担心的,忧虑的;充满的Theyre fraught with horrible phrases l