世纪犯罪（2021）

是真的疼到要爆♥炸♥
that is really somebody experiencing unrelenting pain,
还是只是为了精神的满足
or they want the drug for the psychological effect?
你们应该知道
You know, I've been criticized because I said
我因为之前说在实际治疗的过程中
the treatment of--differen-- I mean, one treat--
当病人出现伪上瘾的时候
one option in trying to understand
我们是否应该继续给他们
if it's in pseudoaddiction,
足够的药量而被人批评
the treatment should be, give more drug.
伪上瘾的概念吧
The idea of pseudoaddiction,
在培训的时候也是说了好多回
that was talked about in training a fair amount.
你只需要告诉大夫
And the way you need to explain it to a physician
这都是假象
is--was false addiction.
他们确实看起来像是上瘾
They do look like they're becoming addicted
或者有觅药行为
or drug-seeking,
这个现象只是证明该提高药量了
and that's a sign you need to increase the dose.
在当时那种
It made sense when your--
满脑子都是解决
your eyes are glossed over
病人痛苦的情况下觉得是合理的
with a mission to treat untreated pain.
它填补了认知上的空白
It filled right in a gap of any of your knowledge,
而且还自动脑补出了完整的概念
and the story seemed to build on itself.
“哎对对对，伪上瘾”
And, "Yeah, that makes sense. Pseudoaddiction."
不过现在你转头想想
Well, looking back on it, you know,
简直就是脑子瓦特了啊
that's pretty hypocritical and crazy.
你认不认为当时
You don't think that there was
对高剂量的狂热追求蒙蔽了
a great enthusiasm for higher doses
可能存在副作用的理性认知？
without being concerned about the possible downside?
我觉得是
Oh, yes. Absolutely.
我觉得大家都很狂热
I think that there was a lot of enthusiasm.
我也是因为我觉得
I owned it because I thought--
只要我药量开够
I thought I could just give enough,
我的病人就会有正常的生活
and my patients would have a normal life.
我知道，所有的麻醉医生也知道
I know, and all anesthesiologists know,
只要药量拉满就不会再有疼痛
you can give enough opioid to take away the pain.
但是唯一的问题就是病人还会醒来么
The problem is, will they be awake,
还会活着么？
or alive?
我完成了我在教会的使命
I served a mission for my church,
是耶稣基♥督♥后期圣徒的教会
a Church of Jesus Christ of Latter-day Saints.
在完成使命之后
After returning from that mission,
我在老家的医院成为了
I was a pediatric psychiatrist
一名儿科精神病医生
at the local hospital,
Carol是韦伯州立大学
and Carol was graduating as a nurse
毕业的护士
from Weber State University,
也就是在那我们相遇了
and that's where we met.
生我们家老大的时候
With our first child,
当时已经过了预产期了
the due date had passed,
我媳妇儿说“咱得想个办法让这小兔崽子出来
and she said, "We've got to get this on the road.
去开老爸的船去
Go get Dad's boat.
我们就去了松景水库
We're going to Pineview Dam.
到了那儿以后
We get up there.
我媳妇儿就又是冲浪又是日光浴
She skis a lap, beaches on the sand,
然后告诉我“走咱卸货去”
and says, "Okay, I'm ready to have the baby."
她无所畏惧
She wasn't afraid of anything.
后面的一切本就不应该发生
This never should've happened.
有一天
One day,
我媳妇儿和老大
Carol and my oldest son
俩人出去玩儿
were going to Sam's Club,
有位84岁的老太太闯红灯
and an 84-year-old woman ran the stop sign,
我儿子的车直接就撞了上去
and my son's vehicle T-boned her car,
我媳妇儿被甩向了挡风玻璃
and she was thrown into the windshield.
神外用钢板和钢钉重建修复了
A neurosurgeon rebuilt her neck
她的颈椎
with a plate and screws.
当时也疼的不行
There was pain associated.
但是我媳妇儿的大夫
It was being managed very well
很负责照顾的很好
by our primary care physician,
但是有一天我们邻居来串门儿
but then a neighbor came to visit Carol one day,
这个邻居是一直后腰疼
who was suffering from lower back issues,
也就是那个时候他想我媳妇儿推荐了
and he recommended that Carol go see
生命树诊所
Lifetree Pain Clinic.
Lynn Webster医生是诊所的老板
Dr. Lynn Webster, he ran the clinic.
你为什么会给你的诊所起名叫“生命树”？
Why did you name your clinic "Lifetree"?
总得有个名字吧
Well, I had to name it something.
主要我希望大家能觉得
I wanted people to feel like
我的诊所是一个安心的地方
there was some stability to my clinic.
树都有树根儿嘛
That's the roots basically of a tree.
我希望这些能传递给
I was hoping it to be
我的病人一些支撑的力量
really a strength for my patients.
Webster会开奥施康定
Webster prescribed oxycodone.
我媳妇儿在服用芬太尼
She was on fentanyl.
在服用阿米替林
She was on amitriptyline.
还吃艾司唑仑助眠
She was on a hypnotic for sleep.
从她去生命树就诊的那一天开始
Her mannerisms, her behavior,
她整个人不管是言谈举止还是生活状态
everything changed after she started going to Lifetree
都变得非常差
in a negative way.
她会正常按点儿吃药
She would take the medication,
然后整个人就很飘的一个状态
and then she would get confused.
会晕晕乎乎的
She would get loopy.
然后过不了半个小时 45分钟
And then, you know, a half hour, 45 minutes later,
她就会说“哎呀该吃药了”
she would think, "Oh, I've got to take my medication."
然后又吃一次药
She'd take it again.
我都记不清有多少次我发现她
Numerous times, I found her unconscious
昏睡在家里不同的地方
in the strangest of places.
然后当她清醒过来之后
And then, when she'd come out of it,
根本就不记得自己都干过什么
she would have no knowledge of it.
在那之后只要我找到她
And so I started taking pictures
我就会先拍照片
of when I would find her.
我拍这些照片唯一的目的
And the only reason I took the pictures
就是为了向她证明
is so that I could show her
我并没有欺骗她
because she did not believe me.
最后有一天还是进了急诊
We'd end up in the emergency room.
我儿子John
And my son, John,
拿着生命树开的所有的药
got all of the pills that Lifetree had prescribed,
一起去的医院
and we took them out there.
我清楚地记得当时那个大夫
And I remember the physician
坐那说
saying,
“逗我呢？
"You got to be kidding me.
这TM谁开的药？有毒吧大象都不敢这么吃“
You got to be kidding me. You got to be kidding me."
然后这位大夫就帮我们
And he was able to convince her
把我媳妇儿送去了戒毒中心
to go in the program.
她最后也确实
She was able to get off
控制住了毒瘾
of all of the pills,
摆脱了这些药物
all of the patches.
她那会儿状态挺好的，开开心心
She was in great shape. She was happy.
每天都很积极，啥事儿都参与
She was smiling. She was involved.
突然有一天她开始吃泰诺
And she was on Tylenol.
再然后就是她回家
And the next thing that I know is that
告诉我说
she informed me that
Webster医生想见见我们两口子
Dr. Webster wanted to meet with she and I
好讨论一下我妻子的状况
to discuss her condition.
然后我们就去了，之后的事儿我这辈子都忘不了
So we went down, and I'll never forget.
他先是做了个我至今都想不明白的声明
He made a statement, and I'm still baffled by it.
他说“慢性病患者
He said, "A chronic pain sufferer
是不可能成为瘾君子的
cannot be an addict.
我才是你妻子的大夫
I am her physician.
我会给她开
I will prescribe the medications
我认为她需要的药
that I think she needs,
并且她不会转诊到其它人那去
and she will be under my care.
没有商量的余地“
And that will be the end of it." （这不就是毒贩+PUA，这孙子有点儿完犊子啊？）
我经常对我的患者说
I would often say to my patients,
特别是我给他们开高剂量阿片类药物的时候
when I was giving them higher doses of opioids,
我会告诉他们
I'd say,
严格按照我的医嘱吃
Take this medicine just as I say.