TED Translation---Charity Tillemann-Dick: Singing after a double lung transplant

You'll never sing again, said her doctor. But in a story from the very edge of medical possibility, operatic soprano Charity Tillemann-Dick tells a double story of survival -- of her body, from a double lung transplant, and of her spirit, fueled by an unwavering will to sing. A powerful story from TEDMED 2010.

她的醫生告訴她：「妳再也無法唱歌了。」從醫學的可能性邊緣的一個故事裡，歌劇女高音伽綠地．提利曼．迪克訴說了一個存活下來的故事－她的身體在雙肺移植手術中後功存活下來，她的意志，充滿著堅持歌唱心願。這是TEDMED2010充滿力量的故事。

You may not know this, but you are celebrating an anniversary with me. I'm not married, but one year ago today, I woke up from a month-long coma, following a double lung transplant. Crazy, I know. Insane. Thank you.

你或許不知道， 不過你現在正和我慶祝一個週年紀念日。 我還沒結婚， 不過一年前的今天， 在雙肺移植手術後我從一個月長的 昏迷中清醒。 我知道，這很瘋狂，很危險。 謝謝。

Six years before that, I was starting my career as an opera singer in Europe, when I was diagnosed idiopathic pulmonary hypertension -- also known as PH It happens when there's a thickening in the pulmonary veins, making the right side of the heart work overtime, and causing what I call the reverse-Grinch effect. My heart was three and a half sizes too big. Physical activity becomes very difficult for people with this condition. And usually after two to five years, you die. I went to see this specialist, and she was top-of-the-field and told me I had to stop singing. She said, "Those high notes are going to kill you." While she didn't have any medical evidence to back up her claim that there was a relationship between operatic arias and pulmonary hypertension, she was absolutely emphatic I was singing my own obituary. I was very limited by my condition, physically. But I was not limited when I sang. And as air came up from my lungs, through my vocal cords and passed my lips as sound, it was the closest thing I had ever come to transcendence. And just because of someone's hunch, I wasn't going to give it up.

在手術的六年前， 我才剛開始我的事業， 在歐洲擔任一位歌劇歌手。 我被診斷出患有"原發性肺動脈高血壓"--- 就是所知的PH(肺高血壓)。 這種症狀發生在 當肺靜脈血管增厚時， 會讓右邊的心臟 超時工作，而造成我所說的 反向鬼靈精效應(故事裡的鬼靈精心臟縮小)。 我的心臟大上了 3.5倍， 擁有這種症狀的人 身體活動變的很吃力， 通常二到五年後 就會死去。 我去找這症狀的專家， 她是這領域的佼佼者， 而她告訴我該停止唱歌，她說：「那些高音符會害死你。」然而她沒有任何醫學上的證據 可以證實她說的 歌劇詠歎調 和PH 是有關連性的， 她非常的確定 我唱出的是自己的訃聞。 我完全受限於我身體的狀況，但我唱歌時就毫無限制了。當空氣從肺部升起 穿過我的聲帶 透過我的雙唇變成音樂，那是我做過 最棒的事了。我不因為別人的直覺而就這樣放棄歌唱。
Thankfully, I met Reda Girgis, who is dry as toast, but he and his team at Johns Hopkins didn't just want me to survive. They wanted me to live a meaningful life. This meant making trade-offs. I come from Colorado. It's a mile high, and I grew up there with my 10 brothers and sisters and two adoring parents. Well, the altitude exacerbated my symptoms. So I moved to Baltimore to be near my doctors and enrolled in conservatory nearby. I couldn't walk as much as I used to, so I opted for five-inch heels. And I gave up salt, I went vegan, and I started taking huge doses of -- sildenafil -- also known as Viagra.
幸好我遇到瑞達．葛蓋斯， 他挺無聊的， 但是，他和他在約翰霍普金斯醫院裡的團隊 希望我不只是只有存活下來， 他們希望我 過的是有意義的人生， 意思就是我該做個取捨了。 我從科羅拉多州來， 住在海拔一英里高的地方， 和我的十個兄弟姐妹 以及我很愛的爸媽一起成長。 然而，這樣的高海拔加重了我的病情， 所以我搬到離我的醫生比較近的巴爾的摩港市， 就讀在附近的音樂學院。 我沒辦法像以前一樣走的多， 所以我選擇五吋高的高跟鞋。 我不吃含鹽的食物， 開始吃全素， 也開始服用大量的 昔多芬--- 就是大家所知的威爾剛。

(Laughter)
 (笑聲)

My father and my grandfather were always looking for the newest thing in alternative or traditional therapies for PH, but after six months, I couldn't walk up a small hill, I couldn't climb a flight of stairs, I could barely stand up without feeling like I was going to faint. I had a heart catheterization, where they measure this internal arterial pulmonary pressure, which is supposed to be between 15 and 20. Mine was 146. I like to do things big. And it meant one thing: There is a big gun treatment for pulmonary hypertension called Flolan. And it's not just a drug, it's a way of life. doctors insert a catheter in your chest, which is attached to a pump that weighs about four and a half pounds. Every day, 24 hours, that pump is at your side, administering medicine directly to your heart. And it's not a particularly preferable medicine in many senses. This is a list of the side effects: If you eat too much salt, like a peanut butter and jelly sandwich, you'll probably end up in the ICU. If you go through a metal detector, you'll probably die. If you get a bubble in your medicine -- because you have to mix it every morning -- and it stays in there, you probably die. If you run out of medicine, you definitely die.
我的父親和祖父總是嘗試著在傳統及非傳統的 PH治療下 找尋新的事物， 但六個月後， 我無法走上小山丘，無法爬上一段樓梯． 我幾乎無法好好站著， 而不覺得自己快要昏倒了。 我有一個心導管， 醫生會在這心導管測出內部肺動脈壓力， 通常數據應該是15到20， 我的則是146。 我喜歡做大事， 而這代表一件事， 有一種肺高血壓的重要治療 叫作依前列醇， 這不只是種藥物， 也是種生活方式。 醫生在你的胸口放入導管 連接著幫浦， 大概4.5磅重， 每一天，24小時，幫浦都在你的身旁， 供給藥物， 直達你的心臟。 在很多方面來說， 這並不是一個 特別推薦的藥物， 這邊有一個副作用的清單， 如果吃太多鹽巴， 像是花生醬和果醬三明治， 你可能就要待在加護病房了。 如果你經過金屬探測器， 就可能會沒命。 如果你的藥有氣泡在裡頭--- 因為每天早上必須要混合藥物--- 然後氣泡留在藥裡， 你也許會沒命。 如果你的藥沒了，你一定會沒命。

No one wants to go on Flolan. But when I needed it, it was a godsend. Within a few days, I could walk again. Within a few weeks, I was performing. And in a few months, I debuted at the Kennedy Center. The pump was a little bit problematic when performing, so I'd attach it to my inner thigh with the help of the girdle and an ACE bandage. Literally hundreds of elevator rides were spent with me alone stuffing the pump into my Spanx, hoping the doors wouldn't open unexpectedly. And the tubing coming out of my chest was a nightmare for costume designers. I graduated from graduate school in 2006, and I got a fellowship to go back to Europe. A few days after arriving, I met this wonderful, old conductor who started casting me in all of these roles. And before long, I was commuting between Budapest, Milan and Florence. Though I was attached to this ugly, unwanted, high-maintenance, mechanical pet, my life was kind of like the happy part in an opera -- very complicated, but in a good way.
沒有人想要服用依前列醇， 但是，當我需要這種藥時， 這就像上天賜與的。 幾天內，我可以再度的走起路來， 幾個禮拜內，我開始上台表演， 幾個月內， 我在甘迺迪中心首次亮相。 在表演時，這個幫浦會有些麻煩， 所以我會把這個移到大腿內側， 用腰帶和繃帶固定者。 其實好多次 自己一個人搭著電梯時， 會把幫浦塞進我的緊身衣裡， 希望電梯門不要突然打開。 從我胸口突出的導管， 對服裝設計師來說真是個夢靨啊。 我在2006時從研究所畢業， 也我拿到了一筆獎學金讓我可以回到歐洲。 到歐洲的幾天後， 我遇見了這位年邁又很棒的樂團指揮， 他開始幫我選派角色。 不久前，我還在布達佩斯 米蘭和佛羅倫斯 三地往返， 雖然我和， 這個難看、不受歡迎 又很難搞的機器寵物連在一起， 我的生命就像歌劇裡的開心的部分--- 非常的複雜， 不過是在好的方面。

Then in February of 2008, my grandfather passed away. He was a big figure in all of our lives, and we loved him very much. It certainly didn't prepare me for what came next. Seven weeks later, I got a call from my family. My father had been in a catastrophic car accident, and he died. At 24, my death would have been entirely expected. But his -- well the only way I can articulate how it felt was that it precipitated my medical decline. Against my doctors' and family's wishes, I needed to go back for the funeral. I had to say goodbye in some way, shape or form. But soon I was showing signs of right-heart failure, and I had to return to sea level, doing so knowing that I probably would never see my home again.
在2008年 的二月， 我的祖父過世了， 他在我們的心目中是重要的人物， 我們也非常地愛他， 這件事當然讓我無法 為之後到來的事作準備。 七個禮拜後， 我接到一通家裡打來的電話， 我的父親遭遇一場非常嚴重的車禍， 結果他就這樣死了。 在我24歲時，死亡對我來說， 是無法預期到的， 但他的離去--- 唯一可以讓我訴說這個感受的狀況是 這件事造成 我的身體狀況下降。 不顧我的醫生和家人的期望， 我一定要趕到喪禮， 我必須要說聲再見， 不論是用什麼樣的方式或形式。 但是，很快的，我的右邊心臟出現的衰竭的訊號， 我必須要回到海平面上， 就是大家知道的 我可能再也無法看到我的家。

I canceled most of my engagements that summer, but I had one left in Tel Aviv, so I went. After one performance, I could barely drag myself from the stage to the taxicab. I sat down and felt the blood rush down from my face. And in the heat of the desert, I was freezing cold. My fingers started turning blue, and I was like, "What is going on here?" I heard my heart's valves snapping open and closed. The cab stopped, and I pulled my body from it feeling each ounce of weight as I walked to the elevator. I fell through my apartment door and crawled to the bathroom where I found my problem: I had forgotten to mix in the most important part of my medicine. I was dying. And if I didn't mix that stuff up fast, I would never leave that apartment alive. I started mixing, and I felt like everything was going to fall out through one hole or another, but I just kept on going. Finally, with the last bottle in and the last bubble out, I attached the pump to the tubing and lay there hoping it would kick in soon enough. If it didn't, I'd probably see my father sooner than I anticipated. Thankfully, in a few minutes, I saw the signature hive-like rash appear on my legs, which is a side effect of the medication, and I knew I'd be okay.
我取消掉我那年夏天大部分的約會， 不過我還有一個特拉維夫之約，所以我就去了。 在一場表演後， 我幾乎無法自己 從舞台上走到計程車上， 我坐了下來，感覺到血液 從臉上往下衝， 身處在這個熾熱的沙漠， 我卻感覺到寒冷， 我的指尖開始發紫， 我在想「現在到底發生什麼事了?」 我感覺我心臟的瓣膜 很用力地開開關關。 計程車停下後 我把我的身體從車內拖出來， 走到電梯的路上， 我感受到身體上的每一盎司的重量， 我倒在我的房門口， 爬進浴室裡， 然後我發現問題了， 我忘了混和 我藥裡面最重要的部分， 我瀕臨頻死， 而且要是我不趕快混和這些藥， 我就無法活著走出這個房間了。 我開始混和藥物， 我覺得好像每一樣東西都要這個洞口或別的洞口掉出來， 不過我就還是繼續調配藥物。 終於，最後一個罐子到進去，最後一個泡泡跑出來， 我把這個幫浦接上管子， 然後躺在那，希望這個藥可以 快點生效， 如果沒有的話，我想我有可能 比我預期的還要快看到我爸。 感謝上天，幾分鐘內 我看到蜂巢狀的疹出現 在我腿上， 這是這個藥物的副作用， 我知道，我沒事了。

We're not big on fear in my family, but I was scared. I went back to the States, anticipating I'd return to Europe, but the heart catheterization showed that I wasn't going anywhere farther that a flight-for-life from Johns Hopkins Hospital. I performed here and there, but as my condition deteriorated so did my voice. My doctor wanted me to get on the list for a lung transplant; I didn't. I had two friends who had recently died months after having very challenging surgeries. I knew another young man, though, who had PH who died while waiting for one. I wanted to live. I thought stem cells were a good option, but they hadn't developed to a point where I could take advantage of them yet. I officially took a break from singing, and I went to the Cleveland Clinic to be reevaluated for the third time in five years, for transplant. I was sitting there kind of unenthusiastically talking with the head transplant surgeon, and I asked him if I needed a transplant, what I could do to prepare. He said, "Be happy. A happy patient is a healthy patient." It was like in one verbal swoop he had channeled my thoughts on life and medicine and Confucius. I still didn't want a transplant, but in a month, I was back in the hospital with some severely [unclear] kankles -- very attractive. And it was right-heart failure.
我的家人們不輕易感到害怕， 但我很擔心。 我回到美國 期待我還可能會到歐洲， 但是我的心導管， 顯示出我不能到 比醫療直升機到約翰霍浦金斯大學醫院還要遠的地方。 我在各個地方表演， 但是，當我的身體狀況開始惡化後， 我的聲音也開始變糟了。 我的醫生希望將我排進肺移植手術的名單裡， 我不想要。 我有兩個朋友在經歷過非常挑戰性的手術後， 幾個月後的最近，他們也死去了 我還知道另一個年輕人，他得到肺高血壓， 在等待移植時也離開這個世界了。 我還想活下來， 我認為幹細胞或許是一個不錯的選擇， 不過這項技術還不到成熟的階段， 所以我也沒辦法從這上面得到幫助。 我終於開始休假不唱歌， 為了移植手術 出發到克里夫蘭診所， 這是五年內的第三次評估。 我坐著，和負責移植手術的外科醫生談話時 沒有任何的精力， 然後我問他：「要是我需要移植手術 我需要事前準備什麼呢?」 他說：「要開心。 當一個快樂的病人， 就是健康的病人。」 這個言語的衝擊 他改變了我對於 生命、藥物 和孔子的思想 。 我仍然不想要做移植手術 但是在一個月內 因為嚴重的腳踝腫脹 我回到醫院--- 看起來很美。 這是因為右心臟的衰竭。

I finally decided it was time to take my doctor's advice. It was time for me to go to Cleveland and to start the agonizing wait for a match. But the next morning, while I was still in the hospital, I got a telephone call. It was my doctor in Cleveland, Marie Budev. And they had lungs. It was a match. They were from Texas. And everybody was really happy for me, but me. Because, despite their problems, I had spent my whole life training my lungs, and I was not particularly enthusiastic about giving them up. I flew to Cleveland. And my family rushed there in hopes that they would meet me and say what we knew might be our final goodbye. But organs don't wait. And I went into surgery before I could say goodbye. The last thing I remember was lying on a white blanket, telling my surgeon that I needed to see my mother again, and to please try and save my voice. I fell into this apocalyptic dreamworld.
我終於決定 是時候該聽醫生的建議了， 是時候該去克里夫蘭診所 開始焦慮的等待 可配對的肺。 但是，隔日早晨 當我還在醫院時， 我接到一通電話， 是我在克里夫蘭診所的醫生 瑪麗．布戴夫， 他們有肺 可以配對了， 這對肺是從德州來。 大家為我感到非常開心， 但除了我以外 因為，除了肺的問題以外， 我花了我全部的人生去訓練我的肺， 所以我沒有很想要 放棄我的肺。 我飛到克里夫蘭， 我的家人們也都衝到那，， 他們希望可以見到我， 對我說 可能是最後一次的再見， 不過器官總是等不了， 在我可以說聲再見前， 我就進手術房了， 我所記得的最後一件事 是我躺在白色的毯子上 告訴我的醫生我需要再看一次我的母親 還有試著挽救我的聲音。 我陷入了世界末日般的幻境。

During the thirteen-and-a-half hour surgery, I flatlined twice, 40 quarts of blood were infused into my body. And in my surgeon's 20-year career, he said it was among the most difficult transplants that he's ever performed. They left my chest open for two weeks. You could see my over-sized heart beating inside of it. I was on a dozen machines that were keeping my alive. An infection ravaged my skin. I had hoped my voice would be saved, but my doctors knew that the breathing tubes going down my throat might have already destroyed it. If they stayed in, there was no way I would ever sing again. So my doctor got the ENT -- the top guy at the clinic -- to come down and give me surgery to move the tubes around my voice box. He said it would kill me. So my own surgeon performed the procedure in a last-ditch attempt to save my voice.
在這十三個半小時的手術裡， 我死過兩次， 40夸脫的血液 注入了我的身體， 在我醫生的20年職涯裡， 他說這次的手術是他有史以來 最難的一次了。 他們把我的胸膛打開兩個禮拜， 你們可以看見我過大的心臟 在胸腔裡跳動， 我身旁有一打的機器 幫助我活下去， 我的皮膚因感染而受到損害， 我只希望我的聲音還是完好的， 但我的醫生知道， 深入我喉嚨裡的呼吸管 可能已經毀掉我的聲音了， 如果管子持續放在我喉嚨裡，我就ㄧ定無法再唱歌。 所以我的醫生找來醫院裡 耳鼻喉科的頂尖醫生--- 來幫我做手術， 幫我把管子移到我喉嚨周圍， 他說這會導致我死亡， 所以我的醫生盡最大的力氣， 執行這項手術保住我的聲音。

Though my mom couldn't say goodbye to me before the surgery, she didn't leave my side in the months of recovery that followed. And if you want an example of perseverance, grit and strength in a beautiful, little package, it is her. One year ago to this very day, I woke up. I was 95 lbs. There were a dozen tubes coming in and out of my body. I couldn't walk, I couldn't talk, I couldn't eat, I couldn't move, I certainly couldn't sing, I couldn't even breathe, but when I looked up and I saw my mother, I couldn't help but smile.
雖然我的母親在手術前無法跟我 說聲再見， 但是在接下來幾個月手術後的恢復期， 她都陪在我身邊。 如果你想要一個例子 將毅力、 勇氣和力量 集中在一個美麗的小盒子裡， 那就是我母親了。 ㄧ年前 的這一天， 我醒來了。 我95磅重， 我的身體穿進穿出 數十支管子， 我無法走路，我無法說話， 我無法進食，我無法移動， 我也一定無法歌唱 甚至是無法呼吸。 但是當我抬頭往上看， 我看見我的媽媽， 我情不自禁地笑了。

Whether by a Mack truck or by heart failure or faulty lungs, death happens. But life isn't really just about avoiding death, is it? It's about living. Medical conditions don't negate the human condition. And when people are allowed to pursue their passions, doctors will find they have better, happier and healthier patients. My parents were totally stressed out about me going and auditioning and traveling and performing all over the place, but they knew that it was much better for me to do that than be preoccupied with my own mortality all of the time. And I'm so grateful they did.
無論是因為馬克卡車 或是心臟衰竭 亦或是有缺陷的肺， 死亡還是會發生， 不過生命並不是只有逃避死亡，不是嗎? 生命是關於活出自我， 疾病的狀況並不能否認人生的狀況， 當人們被允許 可以去追求理想時， 醫生就會發現病患變的更好， 更開心也更健康。 我爸媽對於我 走路、試演、旅行和 在各個地方表演感到很緊張， 但他們知道這對我來說比起 我被死亡的想法佔據著還要更好， 我也很感激他們是這樣想的。

This past summer when I was running and singing and dancing and playing with my nieces and my nephews and my brothers and my sisters and my mother and my grandmother in the Colorado Rockies, I couldn't help but think of that doctor who told me that I couldn't sing. And I wanted to tell her, and I want to tell you, we need to stop letting disease divorce us from our dreams. When we do, we will find that patients don't just survive, we thrive. And some of us might even sing.

去年夏天，當我在科羅拉多落磯山上， 和我的姪女、姪子、哥哥、姐姐們 還有我媽媽和祖母一起跑步、唱歌 跳舞和玩耍時， 我不禁想起那位醫生曾經告訴我 無法再度唱歌的話， 而我希望告訴她， 也希望能告訴你們， 我們應該要阻止疾病 讓我們和我們的夢想分離， 當我們這樣想， 我們會發現病人們 並不只是為了生存而活下來， 而是活得更好， 而有些人， 或許甚至可以唱歌。♫
(Applause) [Singing: French]
(掌聲) (♫唱歌：法文♫)

Thank you. (Applause) Thank you. And I'd like to thank my pianist, Monica Lee. (Applause) Thank you so much. Thank you.

謝謝 (掌聲) 謝謝 我要感謝我的鋼琴手，莫妮卡．李 (掌聲) 真的很感謝你們 謝謝