急诊室的医生如何在混乱中保持冷静和专注？根据多年的经验，急诊科医生达里亚龙（Darria Long）分享了一个直截了当的框架，可以帮助你在生活开始变得“疯狂忙碌”时恢复控制，减少不知所措的感觉
演讲者：Darria Long
演讲题目：An ER doctor on triaging your "crazy busy" lifeRaise your hand, and be honest, if you've used the phrase "crazy busy" to describe your day, your week, your month. I'm an emergency-room doctor, and "crazy busy" is a phrase you will never hear me use. And after today, I hope you'll stop using it, too.
如果可以用“疯狂的忙碌”来形容你的一天、一周、一个月，那就举手，说实话。我是急诊室的医生，但你永远不会听到我用“疯狂的忙碌”这个词。今天之后，我希望你也停止使用它。
Here's why you cannot afford to use "crazy" to describe your busy. Because when we are in what I refer to as Crazy Busy Mode, we are simply less capable of handling the busy. Here's what happens. Your stress hormones rise and stay there, your executive function in the prefrontal cortex declines. That means your memory, your judgment, your impulse control deteriorate, and the brain areas for anger and anxiety are activated. Do you feel that?这就是为什么你不能用“疯狂”来形容你很忙碌的原因。因为当我们处于我所说的“疯狂忙碌”模式时，我们根本就没有能力处理繁忙的事情。那其中发生了什么呢？你的压力荷尔蒙上升并停留在那里，你前额叶皮层的执行功能下降。这意味着你的记忆力、你的判断力、你的冲动控制能力都在下降，大脑中愤怒和焦虑的区域被激活。你感觉到了吗？Here's the thing. You can be as busy as an emergency department without feeling like you're crazy busy. How? By using the same tactics that we use. Our brains all process stress in similar fundamental ways. But how we react to it has been shown by research to be modifiable, whether it's emergencies or just daily, day-in, day-out stress.事情是这样的。你可以像在急诊室一样忙，但却不会觉得自己忙得不可开交。怎么可以做到？你可以试试用和我们一样的策略。我们的大脑都以类似的基本方式处理压力。但研究表明，无论是紧急情况，还是每天日复一日的压力，我们对它的反应都是可以改变的。Now contrast Crazy Busy Mode with how I think of us in the ER -- Ready Mode. Ready Mode means whatever comes in through those doors, whether it's a multiple-car pileup, or a patient having chest pain while stuck in an elevator, or another patient with an item stuck where it shouldn't be. When you're know you're dying to ask.现在把疯狂忙碌模式和我在急诊室的状态对比一下。准备模式是指通过这些门进入的任何东西，无论是多辆车相撞，或是患者在电梯中卡住时胸痛，或是另一名患者将物品卡在不应该的地方。这时你一定很想知道这样状况背后的原因。Even on those days when you would swear you were being punked, we're not afraid of it. Because we know that whatever comes in through those ER double doors, that we can handle it. That we're ready. That's Ready Mode. We've trained for it, and you can, too. Here's how.甚至你发誓当时如果真的那样做是肯定会被打的，我们也不怕。因为我们知道无论什么状况从急诊室的双门进来，我们都能处理。我们准备好了。那是就绪模式。我们已经训练过了，你也可以。这是怎么做到的呢？Step one to go from Crazy Mode to Ready Mode is to relentlessly triage. In Crazy Mode, you're always busy, always stressed, because you're reacting to every challenge with the same response. Contrast that with Ready Mode, where we triage, which means we prioritize by degree of urgency. This isn't just a nice way to get your to-do list done.从疯狂模式到准备模式的第一步是无情地分类。在疯狂模式下，你总是很忙，总是很紧张，因为你对每一个挑战的反应都是一样的。与就绪模式相比，我们在就绪模式中进行分类，这意味着我们应该按紧急程度进行优先级排序。这不仅仅是完成你的待办事项的好方法。Work by Dr. Robert Sapolsky shows that individuals who cannot differentiate threat from non-threat and react to everything with the same response have double the level of stress hormones. Which is why this is the first skill to learn. You can't take care of them all at once, but you don't have to. Because we triage.罗伯特·萨波尔斯基博士的研究表明，不能区分威胁和非威胁并对所有事物做出相同反应的人，其应激激素水平是正常人的两倍。这就是为什么这是第一个要学习的技能。你不可能一下子把他们都照顾好，但你也不必担心。因为我们要分类。Red -- immediately life-threatening. Yellow -- serious, but not immediately life-threatening. Green -- minor. And we focus our efforts first on the reds. Now hear this. Part of the problem in Crazy Mode is that you are reacting to everything as if it is red. So start by triaging correctly. Know your reds. They're what is most important and where you can most move the needle.红色——立即危及生命。黄色——严重，但不会立即危及生命。绿色——次要。我们的努力首先集中在红色事项上面。现在听听这个。疯狂模式下一些突出的问题是，你对一切的反应就像是红色的一样。所以从正确的分类开始。了解你的红色事项。它们是最重要的，也是你最应该移动针头的地方。Now it's easy to be confused by noise, but what it noisiest is not always what is most red. In fact, my severe asthmatic patient is most at risk when he's quiet. But my patient over here, demanding that I bring her flavored coffee creamer, she's noisy, but she's not red.现在很容易被噪音弄糊涂，但最吵的并不总是最红的。事实上，我的严重哮喘患者在安静的时候是最危险的。但我的病人在这里，要求我给她带调味咖啡奶精，她很吵，不过那不是红色事项。I'll give you an example from my own life. Last spring, my house flooded, my one-year-old was in the ER, I was supposed to do a fundraiser for my four-year-old's school and the final chapter of my book was beyond late. Maybe not ironically, that was the chapter on stress.我给你举一个我自己生活中的例子。去年春天，我的房子被淹了，我一岁的孩子在急诊室，我本该为我四岁的孩子的学校筹款，并且我的书还有最后一章还没读完，时间已经过得太久了。那可不是讽刺，因为最后一章是关于压力的。My red tasks were getting my one-year-old better and finishing my book. That was it. Remember, relentlessly triage. The house flood repair? Well, once we had stopped and stabilized the damage, it was no longer a red. It felt red, but it was in fact just noise. 我的红色任务是让我一岁的孩子好起来，接着再读完我的书。就这样。记住，无情地分类。房子被洪水淹没了？好吧，一旦我们截止并稳定了损失，它就不再是红色了。有时你也会遇到一些感觉是红色的，但实际上只是噪音的情况。No, no really, it was quite noisy, this picture on the far right is me wearing earplugs to focus on my book, while the floor is being mechanically dried around me. Know your reds, and do not let your non-reds distract you from them.不，不，真的，太吵了，最右边的这张照片是我戴着耳塞专心看书，而我周围的地板正在被机械干燥。认真了解你的红色事项，不要让你的非红色事项分散你的注意力。By the way, it is liberating with a green task to, every once in a while, be able to remind yourself, "That's a green task. No one's going to die." It's OK if it's not perfect.顺便说一句，它正在释放绿色事项，每隔一段时间就能提醒自己：“这是绿色事项。没有人会死。”所以如果不完美的话也可以。Now there's one last triage level that we use in the worst scenarios. And that is black. Those patients for whom there is nothing we can do. Where we must move on. And although it is gut-wrenching, I mention it, because you each have your own equivalent black tasks in your life. 现在我们在最坏的情况下使用最后一个分类级别。那是黑色事项。那些我们无能为力的病人。我们必须继续努力。尽管这让人很难受，但我还是提到了，因为你们每个人在生活中都有自己的黑色事项。These are items that you must take off your list. And I think many of you know what I'm talking about. For me, this was the fundraiser. I had to step down. Because as we in the ER know, if you try to do everything, you have no hope of saving your reds.这些是你必须从单子上去掉的项目。我想你们很多人都知道我在说什么。对我来说，这就是筹款活动。我不得不放下架子。因为正如前面我们对急诊室的了解，如果你尝试做所有事情，你就不可能做好那些红色事项。Step two to go from Crazy Mode into Ready Mode is to expect and design for crazy. Half of handling crazy is how you prepare for it. So if step one we triage, step two, we design to make those tasks easier to do. Science shows us that the more options we have, then the longer each decision takes. 从疯狂模式到准备模式的第二步是为疯狂准备和设计。绝大多数疯狂的程度都是取决于你是如何准备的。所以，如果第一步我们分类，第二步，我们就要设计，使这些任务更容易完成。科学告诉我们，我们有越多的选择，那么每个决定需要的时间就越长。And the more decisions we have to make, the more exhausted our brain gets and the less it is capable of making good decisions. Which is why this step two is about finding ways to reduce your daily decisions.我们要做的决定越多，我们的大脑就越疲惫不堪，做正确决定的能力就越差。这就是为什么第二步是寻找减少日常决策的方法。Here are four easy examples you can use in your daily lifestyle. Plan. Plan your entire week's meals on the weekend, so that when it's Wednesday at 6pm and everyone's hangry and requesting pizza, you have no decisions to make to get a healthy meal on the table. 这里有四个简单的例子，你可以在你的日常生活中使用。计划。在周末计划你一周的饮食，这样当周三下午6点，每个人都在酒廊和点披萨的时候，你不用再三考量就能在餐桌上吃一顿健康的饭了。Automate. Never leave anything to remember that you could automate, whether it's scheduling it as recurring or saved list, or recurrent purchases. Colocate. When it comes to exercise, store all the equipment that you need for a certain activity together, charged and ready, so you don't spend energy looking for it.自动化。永远不要忘记任何可以自动化的事情，无论是将其计划为重复列表还是已保存列表，还是定期购买的物品。搭配。比如在运动前，将完成某项活动所需的所有设备一起存放，充电并准备就绪，这样你就无需花费精力去寻找它。And decrease temptations, for anyone driven by sugar cravings. Anyone? Say aye, go ahead. That itself is its own form of Crazy Mode and self-medication for Crazy Mode, but stop working your willpower. Design differently. If a food is out of immediate reach, such that you have to use a stool to reach it, even when it's chocolate, study participants ate 70 percent less without thinking about it. I know. Let that sit for a second.减少诱惑，对任何受糖竟欲望驱使的人来说都是至关重要的。有这样的人吗？好的，继续。这本身就是它自己的疯狂模式和疯狂模式的自我疗愈，但停止调动你的意志力。设计也是有区别的。如果某样食物你无法即时得到，比如说你也必须使用凳子才能拿到，即使是巧克力，不用想都知道研究参与者的进食量减少了70％。我知道最好的解决办法。想吃之前先拖延一下。Design to make the choices you wish to make easier.Which bring us to the third step to go from Crazy Mode to Ready Mode, and that is to get out of your head. Come with me. Different story. I'm working in a small, satellite ER, when a woman comes in in labor. I realize that the cord is wrapped not once but twice around the baby's neck. And I'm the only doctor. I was scared. But I couldn't let it derail me.这将我们带到第三步，从疯狂模式到准备模式，那就是摆脱复杂情绪的困扰。跟我来。这是一个不同的故事。我在一个小型卫星急诊室工作，当时一个女人来分娩。我意识到脐带绕着婴儿的脖子不是一圈而是两圈。我是唯一的医生。我很害怕。但我不能因为它而脱离轨道。Because, you see, we all get nervous. We all get scared, but it's what you do next that matters. That first feeling isn't the problem. It can be an important sign. The problem comes when we let it derail us. When that internal monologue starts and we catastrophize and we start to get that tunnel vision. That's how you think when you're in Crazy Mode, and you cannot solve anything that way.因为，你看，我们都很紧张。我们都害怕，但重要的是你接下来要做什么。第一感觉不是问题。这可能是一个重要的信号。当我们因它而脱离轨道时，问题就来了。当内心的独白开始时，我们就遇到了史诗级灾难，我们的视野就像进入隧道般黑暗狭窄。当你处于疯狂状态时，你就是这样想的，你不能用这种方式解决任何问题。Now I promise to come back to the story, but first, how do I get out of my own head? There are many tactics that you may hear, but for me, I find it best in the moment to actively put my focus on someone else. To deliberately make myself see the person in front of me, see myself in the arena with them -- what do they need, what do they fear and how can I help?现在我保证后面会提到如何解决这件事的，但首先，我该如何摆脱自己大脑的困扰？你可能听过很多策略，但对我来说，我发现在这个时候最好是积极地把注意力放在别人身上。故意让自己看到眼前的人，看到自己和他们在同一个光圈下——他们需要什么，他们害怕什么，我能帮什么忙？This may sound like a whole lot of warm and fuzzy to you, but it's not. In fact, research shows that when you prime your brain with what is, essentially, compassion, we disrupt that tunnel vision and internal monologue. You widen your perception, so your brain can actually take in broader information, so you see more possibilities and can make better decisions. 对你来说，这听起来很温馨很模糊，但事实并非如此。事实上，研究表明，当你的大脑充满同情时，我们会破坏你的视觉和内心独白。你拓宽了你的感知，所以你的大脑实际上可以接受更广泛的信息，所以你看到了更多的可能性，可以做出更好的决定。Try it. Know that your internal monologue can derail you. And realize that when you get out of your own head, you get out of your own way.试试看。了解你内心的独白会让你脱离原先的轨道。意识到当你从你自己的困扰中走出来时，你就从你自己固化的模式中走出来了。Now what happened to that baby? I focused not on my fear, but on the mother and the baby and what they needed me to do. And got the cord off of the baby's neck, and a healthy screaming, kicking baby arrived, just as the dad ran in from the parking lot, "Hi, you have a son, I'm Dr. Darria. Congratulations, you want to cut the cord?"那孩子怎么了？我关注的不是我的恐惧，而是母亲和孩子以及他们需要我做什么。把孩子脖子上的脐带取下来，接着你会听到一个健康的尖叫，孩子顺利出生了，就在这时爸爸从停车场跑进来，我对他说，“嗨，你得了个儿子，我是达瑞亚医生。恭喜，你想剪断脐带吗？”And for a moment, the strong cries of a newborn drowned out the beeps and the sirens that are the normal sounds of the ER. But there was also something else. Because when I walked back out of that mother's room, I saw several of my other patients hovering nearby. 一时间，新生儿的强烈哭声淹没了呼噜声和警报器，这是急诊室的正常声音。但有时也有别的事情。因为当我走出那个母亲的房间时，我看到其他几个病人在附近徘徊。I suddenly realized that despite their own problems that had brought them to the emergency room, they had all come together to root for this baby. And they now together shared in the joy.我突然意识到，尽管他们自己的病痛把他们带到了急诊室，但他们却聚集在一起为这个孩子祈祷。现在他们也一起分享了这份喜悦。Because that is what happens when you go from Crazy Mode to Ready Mode. Others notice. They want it too, they just don't know how, they just need one example. Which could be you. Own the busy. But stop calling it crazy. You've always had that ability. But now ... you're ready. Thank you.因为当你从疯狂模式变成准备模式的时候就会发生这种情况。其他人应该都注意到了。他们也想要，只是不知道怎么做，他们只需要一个例子。可能你也想。即使你很忙碌。但别再为它疯狂了。你一直都有应对它的能力。现在......你应该已经准备好了。谢谢大家。
TED演讲80篇