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Transcriber: Ilze Garda Reviewer: Denise RQ In this talk, I'm going to give you the single most important lesson my colleagues and I have learned from looking at 83,000 brain scans.
轉錄員：Ilze Garda 審校：Denise RQ 在這個演講中，我將給你們我和同事從查看 83,000 個腦部掃描中學到的最重要的一課。
But first, let me put the lesson into context.
但首先，讓我將這堂課放在背景中。
I am in the middle of seven children.
我是七個孩子中的中間那個。
Growing up, my father called me a maverick which to him was not a good thing.
成長過程中，我父親稱我為特立獨行的人，對他來說這不是好事。
In 1972, the army called my number, and I was trained as an infantry medic where my love of medicine was born.
1972 年，軍隊徵召了我，我被訓練成步兵醫護兵，在那裡我對醫學的熱愛誕生了。
But since I truly hated the idea of being shot at or sleeping in the mud, I got myself retrained as an X-ray technician and developed a passion for medical imaging.
但由於我真的很討厭被射擊或在泥濘中睡覺的想法，我重新訓練成為 X 光技術員，並對醫學影像產生了熱情。
As our professors used to say: "How do you know, unless you look?" In 1979, when I was a second-year medical student, someone in my family became seriously suicidal,
正如我們教授常說的：「你怎麼知道，除非你看？」1979 年，當我還是二年級醫學生時，我家人中有人變得嚴重自殺傾向，
and I took her to see a wonderful psychiatrist.
我帶她去見了一位很棒的精神科醫生。
Over time, I realized if he helped her, which he did, it would not only save her life, but it would also help her children and even her future grandchildren,
隨著時間推移，我意識到如果他幫助她，他確實做到了，這不僅會拯救她的生命，還會幫助她的孩子，甚至她未來的孫子，
as they would be shaped by someone who is happier and more stable.
因為他們會被一個更快樂、更穩定的人塑造。
I fell in love with psychiatry because I realized it had the potential to change generations of people.
我愛上了精神醫學，因為我意識到它有改變幾代人的潛力。
In 1991, I went to my first lecture on brain SPECT imaging.
1991 年，我參加了第一次關於腦部 SPECT 影像的講座。
SPECT is a nuclear medicine study that looks at the blood flow and activity, it looks at how your brain works.
SPECT 是一種核醫學研究，它觀察血流和活動，它觀察你的大腦如何運作。
SPECT was presented as a tool to help psychiatrists get more information to help their patients.
SPECT 被呈現為一種工具，幫助精神科醫生獲得更多資訊來幫助他們的病人。
In that one lecture, my two professional loves, medical imaging and psychiatry, came together, and quite honestly, revolutionized my life.
在那一次講座中，我的兩個專業熱愛，醫學影像和精神醫學，結合在一起，坦率地說，徹底改變了我的生活。
Over the next 22 years, my colleagues and I would build the world's largest database of brain scans related to behavior on patients from 93 countries.
在接下來的 22 年裡，我和同事將建立世界上最大的與行為相關的腦部掃描數據庫，來自 93 個國家的病人。
SPECT basically tells us three things about the brain: good activity, too little, or too much.
SPECT 基本上告訴我們關於大腦的三件事：活動良好、太少或太多。
Here's a set of healthy SPECT scans.
這是一組健康的 SPECT 掃描。
The image on the left shows the outside surface of the brain, and a healthy scan shows full, even, symmetrical activity.
左邊的圖像顯示大腦的外表面，健康的掃描顯示完整、均勻、對稱的活動。
The color is not important, it's the shape that matters.
顏色不重要，重要的是形狀。
In the image on the right, red equals the areas of high activity, and in a healthy brain, they're typically in the back part of the brain.
在右邊的圖像中，紅色等於高活動區域，在健康的大腦中，它們通常在大腦的後部。
Here's a healthy scan compared to someone who had two strokes.
這是與一個有兩次中風的人的掃描比較。
You can see the holes of activity.
你可以看到活動的洞。
Here's what Alzheimer's looks like, where the back half of the brain is deteriorating.
這是阿茲海默症的樣子，大腦的後半部分正在惡化。
Did you know that Alzheimer's disease actually starts in the brain 30 to 50 years before you have any symptoms?
你知道阿茲海默症實際上在你出現任何症狀之前 30 到 50 年就開始在大腦中發展了嗎？
Here's a scan of a traumatic brain injury.
這是創傷性腦損傷的掃描。
Your brain is soft, and your skull is really hard.
你的大腦是柔軟的，你的頭骨真的很硬。
The real reason not to use drugs - they damage your brain.
不使用毒品的真正原因——它們會損害你的大腦。
Obsessive–compulsive disorder where the front part of the brain typically works too hard, so that people cannot turn off their thoughts.
強迫症，大腦前部通常工作過度，以至於人們無法關閉他們的想法。
An epilepsy where we frequently see areas of increased activity.
癲癇，我們經常看到活動增加的區域。
In 1992, I went to an all-day conference on brain SPECT imaging, it was amazing and mirrored our own early experience using SPECT in psychiatry.
1992 年，我參加了一個關於腦部 SPECT 影像的全天會議，這很驚人，並反映了我們自己在精神醫學中使用 SPECT 的早期經驗。
But at that same meeting, researchers started to complain loudly that clinical psychiatrists like me should not be doing scans, that they were only for their research.
但在同一次會議上，研究人員開始大聲抱怨像我這樣的臨床精神科醫生不應該做掃描，它們只應該用於他們的研究。
Being the maverick and having clinical experience, I thought that was a really dumb idea.
作為特立獨行的人並有臨床經驗，我認為這是一個非常愚蠢的想法。
Without imaging, psychiatrists then and even now make diagnosis like they did in 1840, when Abraham Lincoln was depressed, by talking to people and looking for symptom clusters.
沒有影像，精神科醫生那時甚至現在都像 1840 年那樣做診斷，當亞伯拉罕·林肯憂鬱時，通過與人們交談並尋找症狀群。
Imaging was showing us there was a better way.
影像向我們展示了一種更好的方法。
Did you know that psychiatrists are the only medical specialists that virtually never look at the organ they treat?
你知道精神科醫生是唯一幾乎從不看他們治療的器官的醫學專科醫生嗎？
Cardiologists look, neurologists look, orthopedic doctors look, virtually every other medical specialties look - psychiatrists guess.
心臟科醫生看，神經科醫生看，骨科醫生看，幾乎所有其他醫學專科都看——精神科醫生猜測。
Before imaging, I always felt like I was throwing darts in the dark at my patients and had hurt some of them which horrified me.
在影像之前，我總是覺得我在黑暗中向我的病人投擲飛鏢，並傷害了其中一些人，這讓我感到恐懼。
There is a reason that most psychiatric medications have black box warnings.
大多數精神科藥物都有黑框警告是有原因的。
Give them to the wrong person, and you can precipitate a disaster.
把它們給錯人，你可能會引發災難。
Early on, our imaging work taught us many important lessons, such as illnesses, like ADHD, anxiety, depression, and addictions, are not simple or single disorders in the brain,
早期，我們的影像工作教會了我們許多重要的教訓，比如像 ADHD、焦慮、憂鬱和成癮等疾病，並不是大腦中簡單或單一的疾病，
they all have multiple types.
它們都有多種類型。
For example, here are two patients who have been diagnosed with major depression, that had virtually the same symptoms, yet radically different brains.
例如，這裡有兩個被診斷為重度憂鬱症的病人，他們有幾乎相同的症狀，但大腦卻截然不同。
One had really low activity in the brain, the other one had really high activity.
一個大腦活動非常低，另一個活動非常高。
How would you ever know what to do for them, unless you actually looked?
除非你真的看了，否則你怎麼知道該為他們做什麼？
Treatment needs to be tailored to individual brains, not clusters of symptoms.
治療需要針對個別大腦量身定制，而不是症狀群。
Our imaging work also taught us that mild traumatic brain injury was a major cause of psychiatric illness that ruin people's lives, and virtually no one knew about it because they would see psychiatrists
我們的影像工作也教會了我們，輕度創傷性腦損傷是毀掉人們生活的精神疾病的主要原因，幾乎沒有人知道這一點，因為他們會去看精神科醫生
for things like temper problems, anxiety, depression, and insomnia, and they would never look, so they would never know.
因為脾氣問題、焦慮、憂鬱和失眠等問題，他們永遠不會看，所以他們永遠不會知道。
Here's a scan of a 15-year-old boy who felt down a flight of stairs at the age of three.
這是一個 15 歲男孩的掃描，他在三歲時從樓梯上摔下來。
Even though he was unconscious for only a few minutes, there was nothing mild about the enduring effect that injury had on this boy's life.
儘管他只失去意識幾分鐘，但那次傷害對這個男孩生活的持久影響一點也不輕微。
When I met him at the age of 15, he had just been kicked out of his third residential treatment program for violence.
當我在他 15 歲時見到他時，他剛剛因為暴力而被第三個住院治療計畫開除。
He needed a brain rehabilitation program, not just more medication thrown at him in the dark, or behavioral therapy which, if you think about it, is really cruel.
他需要一個大腦復健計畫，而不僅僅是在黑暗中向他投擲更多藥物，或行為治療，如果你仔細想想，這真的很殘酷。
To put him on a behavioral therapy program when behavior is really an expression of the problem, it's not the problem.
當行為真的是問題的表達時，讓他接受行為治療計畫，這不是問題。
Researchers have found that undiagnosed brain injuries are a major cause of homelessness, drug and alcohol abuse, depression, panic attacks, ADHD, and suicide.
研究人員發現，未診斷的腦損傷是無家可歸、藥物和酒精濫用、憂鬱、恐慌發作、ADHD 和自殺的主要原因。
We are in for a pending disaster with the hundreds and thousands of soldiers coming back from Iraq and Afganistan, and virtually no one is looking at the function of their brain.
我們正面臨一場即將發生的災難，數以百計和數以千計的士兵從伊拉克和阿富汗回來，幾乎沒有人在看他們大腦的功能。
As we continued our work with SPECT, the criticism grew louder, but so did the lessons.
隨著我們繼續使用 SPECT 的工作，批評聲越來越大，但教訓也越來越多。
Judges and defense attorneys sought our help to understand criminal behavior.
法官和辯護律師尋求我們的幫助來理解犯罪行為。
Today, we have scanned over 500 convicted felons including 90 murderers.
今天，我們已經掃描了超過 500 名被判有罪的重罪犯，包括 90 名殺人犯。
Our work taught us that people who do bad things often have troubled brains.
我們的工作教會了我們，做壞事的人往往有問題的大腦。
That was not a surprise.
這並不令人驚訝。
But what did surprise us was that many of these brains could be rehabilitated.
但真正讓我們驚訝的是，這些大腦中的許多都可以復健。
So here's a radical idea.
所以這裡有一個激進的想法。
What if we evaluated and treated troubled brains rather than simply warehousing them in toxic, stressful environments?
如果我們評估和治療有問題的大腦，而不是簡單地將它們存放在有毒、有壓力的環境中呢？
In my experience, we could save tremendous amounts of money by making these people more functional, so when they left prison, they could work, support their families and pay taxes.
根據我的經驗，我們可以通過讓這些人更有功能來節省大量金錢，所以當他們離開監獄時，他們可以工作、養家糊口並納稅。
Dostoyevsky once said: "A society should be judged not by how well it treats its outstanding citizens, but by how it treats its criminals." Instead of just crime and punishment,
杜斯妥也夫斯基曾經說過：「一個社會應該不是根據它如何對待傑出公民來評判，而是根據它如何對待罪犯來評判。」而不是僅僅是犯罪和懲罰，
we should be thinking about crime evaluation and treatment.
我們應該思考犯罪評估和治療。
So after 22 years and 83,000 scans, the single most important lesson my colleagues and I have learned is that you can literally change people's brains.
所以在 22 年和 83,000 次掃描之後，我和同事學到的最重要的一課是，你實際上可以改變人們的大腦。
And when you do, you change their life.
當你這樣做時，你改變了他們的生活。
You are not stuck with the brain you have, you can make it better, and we can prove it.
你不必被困在你現有的大腦中，你可以讓它變得更好，我們可以證明這一點。
My colleagues and I performed the first and largest study on active and retired NFL players, showing high levels of damage in these players at the time
我和同事對現役和退役的 NFL 球員進行了第一次也是最大規模的研究，顯示這些球員在當時有高水平的損傷
when the NFL said they didn't know if playing football caused long-term brain damage.
當時 NFL 說他們不知道打美式足球是否會導致長期腦損傷。
The fact was they didn't want to know.
事實是他們不想知道。
That was not a surprise.
這並不令人驚訝。
you know, 28 out of 30 nine-year-olds would go: "Probably a bad idea for your life." But what really got us excited was the second part of the study
你知道，30 個九歲孩子中有 28 個會說：「對你的生活來說可能是個壞主意。」但真正讓我們興奮的是研究的第二部分
where we put players on a brain-smart program and demonstrated that 80% of them could improve in the areas of blood flow, memory, and mood, that you are not stuck with the brain you have,
我們讓球員接受大腦智能計畫，並證明其中 80% 的人可以在血流、記憶和情緒方面改善，你不必被困在你現有的大腦中，
you can make it better on a brain-smart program.
你可以通過大腦智能計畫讓它變得更好。
How exciting is that?
這有多令人興奮？
I am so excited.
我非常興奮。
Reversing brain damage is a very exciting new frontier, but the implications are really much wider.
逆轉腦損傷是一個非常令人興奮的新領域，但影響確實更廣泛。
Here is this scan of a teenage girl who has ADHD, who was cutting herself, failing in school, and fighting with her parents.
這是一個患有 ADHD 的十幾歲女孩的掃描，她自殘、在學校失敗，並與父母爭吵。
When we improved her brain, she went from D's and F's to A's and B's, and was much more emotionally stable.
當我們改善她的大腦時，她從 D 和 F 變成 A 和 B，並且情緒穩定得多。
Here is the scan of Nancy.
這是 Nancy 的掃描。
Nancy had been diagnosed with dementia, and her doctor told her husband that he should find a home for her because within a year, she would not know his name.
Nancy 被診斷為失智症，她的醫生告訴她丈夫，他應該為她找一個家，因為在一年內，她不會知道他的名字。
But on an intensive, brain-rehabilitation program, Nancy's brain was better, as was her memory, and four years later, Nancy still knows her husband's name.
但在一個密集的大腦復健計畫中，Nancy 的大腦變好了，她的記憶也變好了，四年後，Nancy 仍然知道她丈夫的名字。
Or my favorite story to illustrate this point: Andrew, a 9-year-old boy who attacked a little girl on the baseball field for no particular reason, and at the time, was drawing pictures of himself
或者我最喜歡的故事來說明這一點：Andrew，一個 9 歲的男孩，在棒球場上無緣無故地攻擊一個小女孩，當時正在畫自己的畫
hanging from a tree and shooting other children.
掛在樹上並射擊其他孩子。
Andrew was Columbine, Aurora, and Sandy Hook waiting to happen.
Andrew 是等待發生的科倫拜、奧羅拉和桑迪鬍克。
Most psychiatrists would have medicated Andrew, as they did Eric Harris and the other mass shooters before they committed their awful crimes, but SPECT imaging taught me that I had to look at his brain
大多數精神科醫生會給 Andrew 用藥，就像他們在 Eric Harris 和其他大規模槍手犯下可怕罪行之前對他們做的那樣，但 SPECT 影像教會了我必須看他的大腦
and not throw darts in the dark at him to understand what he needed.
而不是在黑暗中向他投擲飛鏢來理解他需要什麼。
His SPECT scan showed a cyst, the size of a golf ball, occupying the space of his left temple lobe.
他的 SPECT 掃描顯示一個囊腫，高爾夫球大小，佔據了他左顳葉的空間。
No amount of medication or therapy would have helped Andrew.
任何數量的藥物或治療都不會幫助 Andrew。
When the cyst was removed, his behavior completely went back to normal, and he became the sweet, loving boy he always wanted to be.
當囊腫被移除時，他的行為完全恢復正常，他成為了他一直想成為的甜美、有愛心的男孩。
Now 18 years later, Andrew, who is my nephew, owns his own home, is employed and pays taxes.
現在 18 年後，Andrew，我的侄子，擁有自己的房子，有工作並納稅。
Because someone bothered to look at his brain, he has been a better son, and will be a better husband, father, and grandfather.
因為有人費心看他的大腦，他成為了一個更好的兒子，並且將成為一個更好的丈夫、父親和祖父。
When you have the privilege of changing someone's brain, you not only change his or her life but you have the opportunity to change generations to come.
當你有改變某人大腦的特權時，你不僅改變了他或她的生活，而且你有機會改變未來的幾代人。
I'm Dr. Daniel Amen. Thank you.
我是 Daniel Amen 醫生。謝謝。
點擊句子跳轉到對應位置
Transcriber: Ilze Garda Reviewer: Denise RQ In this talk, I'm going to give you the single most important lesson my colleagues and I have learned from looking at 83,000 brain scans.
轉錄員：Ilze Garda 審校：Denise RQ 在這個演講中，我將給你們我和同事從查看 83,000 個腦部掃描中學到的最重要的一課。
But first, let me put the lesson into context.
但首先，讓我將這堂課放在背景中。
I am in the middle of seven children.
我是七個孩子中的中間那個。
Growing up, my father called me a maverick which to him was not a good thing.
成長過程中，我父親稱我為特立獨行的人，對他來說這不是好事。
In 1972, the army called my number, and I was trained as an infantry medic where my love of medicine was born.
1972 年，軍隊徵召了我，我被訓練成步兵醫護兵，在那裡我對醫學的熱愛誕生了。
But since I truly hated the idea of being shot at or sleeping in the mud, I got myself retrained as an X-ray technician and developed a passion for medical imaging.
但由於我真的很討厭被射擊或在泥濘中睡覺的想法，我重新訓練成為 X 光技術員，並對醫學影像產生了熱情。
As our professors used to say: "How do you know, unless you look?" In 1979, when I was a second-year medical student, someone in my family became seriously suicidal,
正如我們教授常說的：「你怎麼知道，除非你看？」1979 年，當我還是二年級醫學生時，我家人中有人變得嚴重自殺傾向，
and I took her to see a wonderful psychiatrist.
我帶她去見了一位很棒的精神科醫生。
Over time, I realized if he helped her, which he did, it would not only save her life, but it would also help her children and even her future grandchildren,
隨著時間推移，我意識到如果他幫助她，他確實做到了，這不僅會拯救她的生命，還會幫助她的孩子，甚至她未來的孫子，
as they would be shaped by someone who is happier and more stable.
因為他們會被一個更快樂、更穩定的人塑造。
I fell in love with psychiatry because I realized it had the potential to change generations of people.
我愛上了精神醫學，因為我意識到它有改變幾代人的潛力。
In 1991, I went to my first lecture on brain SPECT imaging.
1991 年，我參加了第一次關於腦部 SPECT 影像的講座。
SPECT is a nuclear medicine study that looks at the blood flow and activity, it looks at how your brain works.
SPECT 是一種核醫學研究，它觀察血流和活動，它觀察你的大腦如何運作。
SPECT was presented as a tool to help psychiatrists get more information to help their patients.
SPECT 被呈現為一種工具，幫助精神科醫生獲得更多資訊來幫助他們的病人。
In that one lecture, my two professional loves, medical imaging and psychiatry, came together, and quite honestly, revolutionized my life.
在那一次講座中，我的兩個專業熱愛，醫學影像和精神醫學，結合在一起，坦率地說，徹底改變了我的生活。
Over the next 22 years, my colleagues and I would build the world's largest database of brain scans related to behavior on patients from 93 countries.
在接下來的 22 年裡，我和同事將建立世界上最大的與行為相關的腦部掃描數據庫，來自 93 個國家的病人。
SPECT basically tells us three things about the brain: good activity, too little, or too much.
SPECT 基本上告訴我們關於大腦的三件事：活動良好、太少或太多。
Here's a set of healthy SPECT scans.
這是一組健康的 SPECT 掃描。
The image on the left shows the outside surface of the brain, and a healthy scan shows full, even, symmetrical activity.
左邊的圖像顯示大腦的外表面，健康的掃描顯示完整、均勻、對稱的活動。
The color is not important, it's the shape that matters.
顏色不重要，重要的是形狀。
In the image on the right, red equals the areas of high activity, and in a healthy brain, they're typically in the back part of the brain.
在右邊的圖像中，紅色等於高活動區域，在健康的大腦中，它們通常在大腦的後部。
Here's a healthy scan compared to someone who had two strokes.
這是與一個有兩次中風的人的掃描比較。
You can see the holes of activity.
你可以看到活動的洞。
Here's what Alzheimer's looks like, where the back half of the brain is deteriorating.
這是阿茲海默症的樣子，大腦的後半部分正在惡化。
Did you know that Alzheimer's disease actually starts in the brain 30 to 50 years before you have any symptoms?
你知道阿茲海默症實際上在你出現任何症狀之前 30 到 50 年就開始在大腦中發展了嗎？
Here's a scan of a traumatic brain injury.
這是創傷性腦損傷的掃描。
Your brain is soft, and your skull is really hard.
你的大腦是柔軟的，你的頭骨真的很硬。
The real reason not to use drugs - they damage your brain.
不使用毒品的真正原因——它們會損害你的大腦。
Obsessive–compulsive disorder where the front part of the brain typically works too hard, so that people cannot turn off their thoughts.
強迫症，大腦前部通常工作過度，以至於人們無法關閉他們的想法。
An epilepsy where we frequently see areas of increased activity.
癲癇，我們經常看到活動增加的區域。
In 1992, I went to an all-day conference on brain SPECT imaging, it was amazing and mirrored our own early experience using SPECT in psychiatry.
1992 年，我參加了一個關於腦部 SPECT 影像的全天會議，這很驚人，並反映了我們自己在精神醫學中使用 SPECT 的早期經驗。
But at that same meeting, researchers started to complain loudly that clinical psychiatrists like me should not be doing scans, that they were only for their research.
但在同一次會議上，研究人員開始大聲抱怨像我這樣的臨床精神科醫生不應該做掃描，它們只應該用於他們的研究。
Being the maverick and having clinical experience, I thought that was a really dumb idea.
作為特立獨行的人並有臨床經驗，我認為這是一個非常愚蠢的想法。
Without imaging, psychiatrists then and even now make diagnosis like they did in 1840, when Abraham Lincoln was depressed, by talking to people and looking for symptom clusters.
沒有影像，精神科醫生那時甚至現在都像 1840 年那樣做診斷，當亞伯拉罕·林肯憂鬱時，通過與人們交談並尋找症狀群。
Imaging was showing us there was a better way.
影像向我們展示了一種更好的方法。
Did you know that psychiatrists are the only medical specialists that virtually never look at the organ they treat?
你知道精神科醫生是唯一幾乎從不看他們治療的器官的醫學專科醫生嗎？
Cardiologists look, neurologists look, orthopedic doctors look, virtually every other medical specialties look - psychiatrists guess.
心臟科醫生看，神經科醫生看，骨科醫生看，幾乎所有其他醫學專科都看——精神科醫生猜測。
Before imaging, I always felt like I was throwing darts in the dark at my patients and had hurt some of them which horrified me.
在影像之前，我總是覺得我在黑暗中向我的病人投擲飛鏢，並傷害了其中一些人，這讓我感到恐懼。
There is a reason that most psychiatric medications have black box warnings.
大多數精神科藥物都有黑框警告是有原因的。
Give them to the wrong person, and you can precipitate a disaster.
把它們給錯人，你可能會引發災難。
Early on, our imaging work taught us many important lessons, such as illnesses, like ADHD, anxiety, depression, and addictions, are not simple or single disorders in the brain,
早期，我們的影像工作教會了我們許多重要的教訓，比如像 ADHD、焦慮、憂鬱和成癮等疾病，並不是大腦中簡單或單一的疾病，
they all have multiple types.
它們都有多種類型。
For example, here are two patients who have been diagnosed with major depression, that had virtually the same symptoms, yet radically different brains.
例如，這裡有兩個被診斷為重度憂鬱症的病人，他們有幾乎相同的症狀，但大腦卻截然不同。
One had really low activity in the brain, the other one had really high activity.
一個大腦活動非常低，另一個活動非常高。
How would you ever know what to do for them, unless you actually looked?
除非你真的看了，否則你怎麼知道該為他們做什麼？
Treatment needs to be tailored to individual brains, not clusters of symptoms.
治療需要針對個別大腦量身定制，而不是症狀群。
Our imaging work also taught us that mild traumatic brain injury was a major cause of psychiatric illness that ruin people's lives, and virtually no one knew about it because they would see psychiatrists
我們的影像工作也教會了我們，輕度創傷性腦損傷是毀掉人們生活的精神疾病的主要原因，幾乎沒有人知道這一點，因為他們會去看精神科醫生
for things like temper problems, anxiety, depression, and insomnia, and they would never look, so they would never know.
因為脾氣問題、焦慮、憂鬱和失眠等問題，他們永遠不會看，所以他們永遠不會知道。
Here's a scan of a 15-year-old boy who felt down a flight of stairs at the age of three.
這是一個 15 歲男孩的掃描，他在三歲時從樓梯上摔下來。
Even though he was unconscious for only a few minutes, there was nothing mild about the enduring effect that injury had on this boy's life.
儘管他只失去意識幾分鐘，但那次傷害對這個男孩生活的持久影響一點也不輕微。
When I met him at the age of 15, he had just been kicked out of his third residential treatment program for violence.
當我在他 15 歲時見到他時，他剛剛因為暴力而被第三個住院治療計畫開除。
He needed a brain rehabilitation program, not just more medication thrown at him in the dark, or behavioral therapy which, if you think about it, is really cruel.
他需要一個大腦復健計畫，而不僅僅是在黑暗中向他投擲更多藥物，或行為治療，如果你仔細想想，這真的很殘酷。
To put him on a behavioral therapy program when behavior is really an expression of the problem, it's not the problem.
當行為真的是問題的表達時，讓他接受行為治療計畫，這不是問題。
Researchers have found that undiagnosed brain injuries are a major cause of homelessness, drug and alcohol abuse, depression, panic attacks, ADHD, and suicide.
研究人員發現，未診斷的腦損傷是無家可歸、藥物和酒精濫用、憂鬱、恐慌發作、ADHD 和自殺的主要原因。
We are in for a pending disaster with the hundreds and thousands of soldiers coming back from Iraq and Afganistan, and virtually no one is looking at the function of their brain.
我們正面臨一場即將發生的災難，數以百計和數以千計的士兵從伊拉克和阿富汗回來，幾乎沒有人在看他們大腦的功能。
As we continued our work with SPECT, the criticism grew louder, but so did the lessons.
隨著我們繼續使用 SPECT 的工作，批評聲越來越大，但教訓也越來越多。
Judges and defense attorneys sought our help to understand criminal behavior.
法官和辯護律師尋求我們的幫助來理解犯罪行為。
Today, we have scanned over 500 convicted felons including 90 murderers.
今天，我們已經掃描了超過 500 名被判有罪的重罪犯，包括 90 名殺人犯。
Our work taught us that people who do bad things often have troubled brains.
我們的工作教會了我們，做壞事的人往往有問題的大腦。
That was not a surprise.
這並不令人驚訝。
But what did surprise us was that many of these brains could be rehabilitated.
但真正讓我們驚訝的是，這些大腦中的許多都可以復健。
So here's a radical idea.
所以這裡有一個激進的想法。
What if we evaluated and treated troubled brains rather than simply warehousing them in toxic, stressful environments?
如果我們評估和治療有問題的大腦，而不是簡單地將它們存放在有毒、有壓力的環境中呢？
In my experience, we could save tremendous amounts of money by making these people more functional, so when they left prison, they could work, support their families and pay taxes.
根據我的經驗，我們可以通過讓這些人更有功能來節省大量金錢，所以當他們離開監獄時，他們可以工作、養家糊口並納稅。
Dostoyevsky once said: "A society should be judged not by how well it treats its outstanding citizens, but by how it treats its criminals." Instead of just crime and punishment,
杜斯妥也夫斯基曾經說過：「一個社會應該不是根據它如何對待傑出公民來評判，而是根據它如何對待罪犯來評判。」而不是僅僅是犯罪和懲罰，
we should be thinking about crime evaluation and treatment.
我們應該思考犯罪評估和治療。
So after 22 years and 83,000 scans, the single most important lesson my colleagues and I have learned is that you can literally change people's brains.
所以在 22 年和 83,000 次掃描之後，我和同事學到的最重要的一課是，你實際上可以改變人們的大腦。
And when you do, you change their life.
當你這樣做時，你改變了他們的生活。
You are not stuck with the brain you have, you can make it better, and we can prove it.
你不必被困在你現有的大腦中，你可以讓它變得更好，我們可以證明這一點。
My colleagues and I performed the first and largest study on active and retired NFL players, showing high levels of damage in these players at the time
我和同事對現役和退役的 NFL 球員進行了第一次也是最大規模的研究，顯示這些球員在當時有高水平的損傷
when the NFL said they didn't know if playing football caused long-term brain damage.
當時 NFL 說他們不知道打美式足球是否會導致長期腦損傷。
The fact was they didn't want to know.
事實是他們不想知道。
That was not a surprise.
這並不令人驚訝。
you know, 28 out of 30 nine-year-olds would go: "Probably a bad idea for your life." But what really got us excited was the second part of the study
你知道，30 個九歲孩子中有 28 個會說：「對你的生活來說可能是個壞主意。」但真正讓我們興奮的是研究的第二部分
where we put players on a brain-smart program and demonstrated that 80% of them could improve in the areas of blood flow, memory, and mood, that you are not stuck with the brain you have,
我們讓球員接受大腦智能計畫，並證明其中 80% 的人可以在血流、記憶和情緒方面改善，你不必被困在你現有的大腦中，
you can make it better on a brain-smart program.
你可以通過大腦智能計畫讓它變得更好。
How exciting is that?
這有多令人興奮？
I am so excited.
我非常興奮。
Reversing brain damage is a very exciting new frontier, but the implications are really much wider.
逆轉腦損傷是一個非常令人興奮的新領域，但影響確實更廣泛。
Here is this scan of a teenage girl who has ADHD, who was cutting herself, failing in school, and fighting with her parents.
這是一個患有 ADHD 的十幾歲女孩的掃描，她自殘、在學校失敗，並與父母爭吵。
When we improved her brain, she went from D's and F's to A's and B's, and was much more emotionally stable.
當我們改善她的大腦時，她從 D 和 F 變成 A 和 B，並且情緒穩定得多。
Here is the scan of Nancy.
這是 Nancy 的掃描。
Nancy had been diagnosed with dementia, and her doctor told her husband that he should find a home for her because within a year, she would not know his name.
Nancy 被診斷為失智症，她的醫生告訴她丈夫，他應該為她找一個家，因為在一年內，她不會知道他的名字。
But on an intensive, brain-rehabilitation program, Nancy's brain was better, as was her memory, and four years later, Nancy still knows her husband's name.
但在一個密集的大腦復健計畫中，Nancy 的大腦變好了，她的記憶也變好了，四年後，Nancy 仍然知道她丈夫的名字。
Or my favorite story to illustrate this point: Andrew, a 9-year-old boy who attacked a little girl on the baseball field for no particular reason, and at the time, was drawing pictures of himself
或者我最喜歡的故事來說明這一點：Andrew，一個 9 歲的男孩，在棒球場上無緣無故地攻擊一個小女孩，當時正在畫自己的畫
hanging from a tree and shooting other children.
掛在樹上並射擊其他孩子。
Andrew was Columbine, Aurora, and Sandy Hook waiting to happen.
Andrew 是等待發生的科倫拜、奧羅拉和桑迪鬍克。
Most psychiatrists would have medicated Andrew, as they did Eric Harris and the other mass shooters before they committed their awful crimes, but SPECT imaging taught me that I had to look at his brain
大多數精神科醫生會給 Andrew 用藥，就像他們在 Eric Harris 和其他大規模槍手犯下可怕罪行之前對他們做的那樣，但 SPECT 影像教會了我必須看他的大腦
and not throw darts in the dark at him to understand what he needed.
而不是在黑暗中向他投擲飛鏢來理解他需要什麼。
His SPECT scan showed a cyst, the size of a golf ball, occupying the space of his left temple lobe.
他的 SPECT 掃描顯示一個囊腫，高爾夫球大小，佔據了他左顳葉的空間。
No amount of medication or therapy would have helped Andrew.
任何數量的藥物或治療都不會幫助 Andrew。
When the cyst was removed, his behavior completely went back to normal, and he became the sweet, loving boy he always wanted to be.
當囊腫被移除時，他的行為完全恢復正常，他成為了他一直想成為的甜美、有愛心的男孩。
Now 18 years later, Andrew, who is my nephew, owns his own home, is employed and pays taxes.
現在 18 年後，Andrew，我的侄子，擁有自己的房子，有工作並納稅。
Because someone bothered to look at his brain, he has been a better son, and will be a better husband, father, and grandfather.
因為有人費心看他的大腦，他成為了一個更好的兒子，並且將成為一個更好的丈夫、父親和祖父。
When you have the privilege of changing someone's brain, you not only change his or her life but you have the opportunity to change generations to come.
當你有改變某人大腦的特權時，你不僅改變了他或她的生活，而且你有機會改變未來的幾代人。
I'm Dr. Daniel Amen. Thank you.
我是 Daniel Amen 醫生。謝謝。