地平线系列：我的神奇大脑（2018）

我大概是晚上十一点一刻
I got home at about quarter past 11,
或者十一点半到家
half past 11 at night,
发现他像胎儿一样蜷缩着抱着头
and I found him clutching his head in the foetal position,
说着"停下这该死的痛苦吧"
saying, "Stop this effing pain."
我意识到事态十分严重
And I knew that there was something very, very wrong.
所以我叫了救护车
So I called an ambulance,
他们把我们送到了本地的医院急救室
and they took us to our local hospital A&E.
我看着他慢慢地陷入昏迷
And slowly I saw him slip into a coma.
早上七点
And at seven o'clock in the morning,
医生对我说
the doctor said to me,
"你给他在新西兰的孩子们打电♥话♥吧"
"You should call his children in New Zealand."
我明白他可能凶多吉少了
Which I knew meant that he was probably going to die.
救护车入口
我们到了国王学院医院
And we got to King's and
他们那里的设施非常先进
they have an amazing set up there.
一切都有条不紊地进行
Everything just kind of kicked into place,
外科医生来征询我们是否进行手术
and the surgeon came to ask for our consent to operate,
他说"我们不确定理查德能否活到
and said, "We don't know if Richard will survive long enough to
接受手术的时候"
Have the operation."
如果能 他可能会在手术台上再次出血
"And if he does, he may bleed again on the table.
这样的话预后就不太乐观
"And if he does that, the prognosis is not good.
他也许会成为植物人"
"He'll probably be a vegetable."
我能做的只有等待和期望
There was nothing I could do but wait and hope.
期望他能活下来
Hope that he survived.
期望外科医生有能力能救活他
Hope that the surgeon had the skill to save his life.
但同样期望 如果他活下来了
But also hope, if he did survive,
理查德 我的理查德
that Richard, my Richard,
还是原来的那个他
would still be there.
我叫菲奥娜·劳埃德-戴维斯
My name is Fiona Lloyd-Davies.
电影制♥作♥人兼记者
I'm a film-maker and a journalist,
过去的四年里
and for the past four years,
我一直在记录我丈夫在一场灾难性的脑溢血后
I've been documenting my husband's battle back to life
为重获新生而进行的奋斗
after suffering a catastrophic brain haemorrhage.
地平线
我的神奇大脑 理查德的战争
我第一次了解理查德
So, the first time that I heard about Richard
是因为值班的神经外科
was that the on-call neurosurgical
住院医师给我打电♥话♥
registrar phoned me up
向我描述了病情
and described to me the condition,
说一位正在接受血液稀释的病人
which was a patient who was known to be on thinners to thin the blood,
可能跌倒了
who'd had a possible fall,
且发现他的意识水平
and was found with a diminished and decreasing level
正在持续减弱
of consciousness.
头部扫描与电脑断层扫描
And then a head scan and a CT scan
表明在大脑左侧
which showed a large area of fresh bleeding
表面存在
over the surface of the brain,
大面♥积♥的新鲜出血
on the left-hand side of the brain.
换句话说 就是大脑中控制语言
In other words, the part of the brain that controls speech,
兰贾维· 班古
神经外科会诊医师
涉及到记忆
is involved in memory,
而且赋予我们独有的特征
and gives us a lot of the unique features
塑造了我们每个人的人格的那部分
that make us the individuals we are.
所以他显然很可能
So it was clear that he could well
会在记忆 语言 性格方面
be left with significant deficits in memory,
出现严重缺陷
in speech, in personality,
而且他以后的生活质量
and he may well have a quality of life that
很可能无法被他接受
he may not have valued,
或者他的家人可能会代他认为
or that his family may have felt on his behalf
他无法接受
that he didn't value.
但此刻你必须作出决定
But you have to make a decision at that point as to, OK,
我们要怎么办 没什么思考的时间
what are we going to do? You haven't got long to decide.
我们最后决定放手一搏
And we decided that we should try.
速度就是关键
Then it's speed is of the essence.
所谓"时间就是大脑" 确实如此
So we say, "Time is brain," And it really was.
我们直接把他送进了手术室
We took him straight into the operating theatre.
然后施行了创伤开颅术
We then raised what's called a trauma craniotomy
也叫问号♥型骨瓣开颅术
or a question-mark flap,
也就是切开颅骨的一侧
which is a cut that covers one side of the skull.
用气动钻把颅骨钻开
Drill with an air drill through the skull
抬起颅骨左边的
to lift up a large flap of the skull
一片大骨瓣
on that left-hand side.
暴露出大脑外层
That exposes the outer lining of the brain,
也就是硬脑膜
what's called the dura.
骨瓣之下可以看到硬脑膜处于拉紧状态
And underneath that you could see that the dura was tense,
凸起
it was bulging,
发蓝
it was blue,
且脑中不存在
and there was no pulsation of the brain
与心跳同步的脉搏
in time with the heartbeat,
而这与正常人不同
which is what you see with a normal person.
这就表明
And that showed
大脑表面之下有一个很大的凝块
that there was a large clot sitting over the surface of the brain,
压♥迫♥着大脑
compressing the brain,
阻碍了氧气与血液向大脑的输送
and actually preventing oxygen and blood getting to the brain,
所以大脑受到了来自血凝块的主动损伤
and so the brain was actively being damaged by the blood clot.
大脑就像一块果冻
The brain is like a jelly.
就像非常脆弱的果冻
It's like a very delicate jelly.
和这个蜡制大脑不同
It's not like this wax brain here,
我们可以拿在手中看得很清楚
which I can hold very clearly in my hands.
真正的大脑极其易碎 极其柔软
A real brain is incredibly delicate, incredibly soft.
问题在于如果打开大脑外层 硬脑膜
Problem is if you open the lining of the brain, the dura,
取出凝块 如果动作太快
to let the clot out, and you do that too quickly,
大脑就会开始通过
the brain can actually start to squeeze out
脑膜的开口向外挤出
through the opening in the lining that you've made,
就像从管中挤出牙膏一样
rather like toothpaste through a tube.
显然这样挤出来的大脑
Obviously that brain that squeezes out like that,
将会受到不可逆的损伤
it's going to be irreparably damaged.
你无法再恢复脑部
You're not going to get that brain back.
所以要非常小心地一点一点扩展切口
So, very carefully, bit by bit, you extend the cut as you go,
去除一点凝块就扩大一点切口
removing a bit of clot, making the opening a bit bigger,
去除一点凝块就扩大一点切口
removing a bit of clot, making the opening a bit bigger,
希望在结束的时候
so that hopefully by the time you've finished,
暴露出了整个大脑
you've uncovered the whole surface of the brain
左侧的表面
on that left-hand side.
去除了血凝块
You remove the blood clot,
而大脑还没有开始通过
and the brain has not started to swell out
硬脑膜上的开口肿胀挤出
through the opening in the dura that you've made.
去除大脑表面的凝块后
So, having removed the clot from the surface of the brain,
我需要判断
the decision for me was
"我有没有释放掉足够的压力
"Have I relieved enough pressure
使理查德能够挺过这场手术"
"so that Richard's going to survive this operation?"
因此在理查德的手术中我们没有把骨头复位
So what we did in Richard's case was we didn't put the bone back.
我们使脑膜保持开放
We left the lining of the brain open,
给大脑一点膨胀的空间
which allowed the brain to swell a little bit.
但我们没有把头骨放回去
And we didn't put that skull back.
也就是说
So, in other words,
他大脑的这片区域上方只有皮肤和肌肉
there was just skin and muscle over this area of the brain.
这就营造了一小片空间
So it allows that little bit of wiggle room,
可以这么想
if you want to think about it that way,
让大脑可以
for the swelling to occur
在手术后的几天发生肿胀
in the first few days after the operation.
中风后三周 达伦特谷医院
当肿胀消下去之后
Once the swelling had gone down,
中风带来的灾难性后果就一目了然了
the catastrophic effect of the stroke was plain to see,
他看起来就像是缺了一半的大脑一样
and it looked as if he'd lost half his brain.
作为一种适应机制 我拿出了我的相机
As a way of coping, I reached out for my camera
开始记录发生的事情
and started to record what happened.
我也用文字记录了下来
And I also kept a written diary.
"日记内容 九月六日 周五
"Diary entry, Friday 6th of September.
"他通过了吞咽测试 不再需要饲管喂食了
"He's passed the swallow test and no longer needs a feeding tube.
"他可以喝浓汤了 这是个重大进展"
"He's eating puree - giant leap forward."
吞咽指南
液体 照常
食物 吞咽困难患者用叉子捣碎
宝贝 今天感觉怎么样