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.
你也许不知道, 其实你在和我一起进行周年庆祝。 我没有结婚, 但是一年前的今天, 我从长达一个月的昏迷中 苏醒过来, 那是在做完双肺移植手术之后。 这很疯狂,我知道。像疯了一样。 谢谢。
Six years before that, I was starting my career as an opera singer in Europe, when I was diagnosed with 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.
在那之前的六年, 我刚开始我的事业 在欧洲作为一个歌剧演唱者。 当时我被诊断出 患有特发性肺高压-- 也被称作为PH 这个疾病的诱因是 肺静脉增厚, 这使得右边的心脏 超负荷工作, 而且也引发了我称之为 反向-格林奇效应。 我的心脏当时是正常心脏的三倍半大 过大了。 有这种病症的人们 身体运动变的十分困难。 而且通常过了两到五年, 你就会死。 我去见了一个专家, 她是这个领域的佼佼者 她告诉我说我必须停止歌唱。 她说,“那些高音会害死你的。” 但是她没有任何医学上的证据 来支持她的 有关这两者之间有联系的论断 这两者是歌剧咏叹调和 特发性肺高压, 她十分肯定 我在唱响我自己的葬歌。 因为这个病,我在体能上受到了限制。 但是当我唱歌时,我是自由的。 随着空气进入我的肺部, 穿过我的声带 滑过我的嘴唇成为声音, 这是我能做的 最卓越的事情了。 就仅仅为了他人的判断直觉, 我是不会放弃。
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 a 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.
谢天谢地,我遇到了睿达·乔治, 他是一个拘谨的人, 但是他和他在约翰霍普金斯的团队 不仅仅只是希望我能活下来。 他们希望我 过上有意义的生活。 这就意味着要权衡取舍。 我来自科罗拉多州。 海拔一英里, 我和我的十个兄弟姐妹一起长大 还有敬爱的父母亲。 可是高海拔恶化了我的症状。 所以我搬去了巴尔的摩以便靠近我的医生 我也进入了附近的一所音乐学院。 我不能再像以往那样走很多的路, 所以我选择了五英尺高的鞋。 我不再食用盐, 我成为了纯素主义者, 而且我开始服用大量的-- 西地那非-- 也就是万艾可(伟哥)。
(Laughter)
(笑声)
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 into 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.
我父亲和我祖父一直在寻找最新的 无论是非常规的还是常规的 对PH的治疗方法, 但是六个月以后, 我无法走上小斜坡,我无法爬楼梯, 我连站起来都 伴随着晕眩的感觉。 我做了心脏插管术, 这样就能测量我的肺动脉内压, 内压大致范围应该是15到20. 我的是146. 我喜欢把事情做的彻底。 这就意味着: 要做风险很大的治疗 对于特发性肺高压,这种治疗称作依前列醇钠。 它不仅仅是一种药物, 它是一种生活方式。 医生在我的胸腔内嵌入了导管, 它与一个唧筒连接着 唧筒重达约4.5磅。 每一天,24小时,那个唧筒与你连接着, 向你的心脏 传送药物。 这不是 一种令人喜欢的药物 在某种程度上。 这有一系列副反应: 如果吃太多的盐, 比如花生油或者果酱三明治, 你可能会在重点加护病房死去。 如果你穿过一个金属探测器, 你可能死去。 如果在药物中有气泡-- 因为每天早上你都得混合它-- 如果气泡残留在那里, 你有可能死去。 如果药物用完了,你一定会死去。
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.
没有人喜欢服用依前列醇钠。 但是当我需要它的时候, 它是上帝的礼物。 几天之后,我能再次走路了。 几周之后,我可以演出了。 几个月之后, 我在肯尼迪中心登台演出。 在我演出时有这个唧筒会不方便, 所以我将它绑在大腿内侧 使用肢带和ACE绷带将它缠绕。 事实上,上百次我乘坐电梯 独自一个人 将唧筒绑在我的塑身裤上, 并且祈祷门不会意外地打开。 我胸部露出来的管子 是服装设计师的噩梦。 我于2006年从学校毕业, 获得奖学金返回欧洲。 到达的几天后, 我遇到了这个极好的指挥 他赋予我各种角色。 不久后,我开始奔波在 布达佩斯,米兰 和佛罗伦萨之间。 尽管我带着这个 难看的,不是我想要的, 极度需要维护的机械宠物, 我的生活就像歌剧中的那欢快部分-- 虽然十分复杂, 但是正面积极的。
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.
到了 2008年2月份, 我的祖父过世了。 他是我们生活的主心轴, 我们十分爱他。 显然我对于接下来要发生的事情 毫无准备。 7周以后, 我接到一通从家里打来的电话。 我父亲遭遇了一场灾难性的车祸, 他死了。 24岁那年,我的死亡是 完全可以预期的。 但是他的死亡-- 我唯一能表达的感觉是 它猛地 使我的病情恶化。 不顾医生和家庭的期望, 我需要返回参加葬礼。 无论如何病重与否,我需要去道别 。 但是很快我的右心脏出现了衰竭信号, 我不得不返回到海平面低的地方, 这样就意味着 我很有可能再也见不到我的家了。
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.
我取消了夏天的大多数预约, 但是我还有一个预约在以色列的特拉维夫,所以我去了。 一场演出之后, 我甚至都不能把自己 从舞台拖向出租车。 我坐上车后,感觉到血液 从我的头部冲下来。 在这个沙漠的中心地带, 我感觉到十分冷。 我的手指变为紫色, 我就像是,“到底发生什么了?” 我听到了我的心脏阀门 啪地打开然后关上。 出租车停下来, 我把我的身体拖下车 步履维艰 当我走向电梯时。 我跌进公寓的门 爬向浴室 然后我发现了问题所在: 我忘记了混合 药物中最重要的那一部分。 我就快死了。 如果我没有及时混合那一部分, 我就不能活着离开公寓了。 我开始混合, 我感觉周遭事物都在离我而去, 我只是继续操作。 最后,随着最后一瓶药物混合好,最后一个气泡消失, 我把唧筒和管子连接 躺在那里,期望药物能够 及时注入。 如果不及时,我就会去见我父亲了 这比我预期的要早。 谢天谢地,几分钟以后, 我看到了蜂窝状的疹子 出现在我的腿上, 它是这个治疗的副反应, 我就知道我不会死了。
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 further 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 edemic kankles -- very attractive. And it was right-heart failure.
我们家族不易恐惧, 但是这次我吓坏了。 我返回美国, 期待我能返回欧洲, 但是心脏插管术显示 我不能离开 超过约翰·霍普金医院关乎生死的一个机程的距离。 我四处演出, 但是随着我病情的恶化 我的音色也下降了。 我的医生希望我做肺移植手术; 但是我不想做。 我有两个朋友最近刚刚去世 就在她们做完很有挑战性的手术的几个月后。 我还知道另外一个年轻人,他也患有PH 在等待肺的时候死去了。 我想要活下去。 我觉得干细胞是一个很好的选择, 但是他们还没有发展到那个 我可以利用它们的水平。 我停止了歌唱, 我去了克利夫兰医院 再次进行肺移植的评估 这是五年中的第三次。 我坐在那里漫不经心地 和首席移植手术医生交谈, 我问他如果我要做移植手术, 我应该准备些什么。 他说,“要乐观。 一个乐观的病人 就是一个健康的病人。” 这就像一道闪电 他让我想通了 关于生活和治疗 以及孔子。 我仍然不想做移植手术, 但是一个月后, 我返回医院 因为足部肿大-- 十分明显。 这是因为右心脏衰竭。
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 dream world.
最终我决定 是时候听从医生的建议了。 是时候我要返回克利夫兰 然后开始那令人苦恼的等待 等待匹配的肺。 但是第二天早晨, 我还在医院的时候, 接到了一通电话。 是我在克利夫兰的医生 玛丽·布德夫。 他们得到了肺。 它们和我是匹配的。 这肺来自德克萨斯。 所有人都真心的为我感到高兴, 除了我以外。 因为,尽管我的肺部有很多问题, 但是我这一生都在训练它们, 所以我不是那么急切的 想要放弃它们。 我飞抵克利夫兰。 我的家人急忙赶去 希望能够见我一面 然后对我道别 也许这是最后一面。 但是器官不等人。 所以我开始了手术 在我和家人道别之前。 我最后记得的事情就是 躺在白色的单子上, 告诉我的医生,我需要再见我妈妈一面, 请努力帮我保住我的声音。 我进入了天堂般的梦境。
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 me 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.
在这十三个半小时的手术中, 我心脏跳停昏厥两次, 40夸脱血 输入到我的体内。 医生说,在他20年的手术生涯中, 这次基本是他做过的最困难的 移植手术了。 他们把我的胸腔打开了两周。 你都可以看到我那过大的心脏 在那里跳动。 我身边有许多仪器 它们维系着我的生命。 我的皮肤受到了感染。 我是希望我的声音能够得以保留, 但是我的医生知道 那些通过我喉咙呼吸管 可能会毁掉我的声音。 如果它们通过喉咙,我将不能再歌唱。 所以医生找到了眼耳鼻喉科-- 这医院最顶尖的人才--过来 给我做手术 让这些管子绕过我的喉咙。 他说这样做对我是致命的。 所以我的主治医生亲自做了这个手术 为保住我的声音做最后一搏。
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.
虽然在手术前我母亲没能 见我一面, 但是她在随后几个月的观察期中 与我寸步不离。 如果你需要一个 坚韧, 慈爱和坚强 集于一体的美好化身, 这就是我母亲。 一年前 的这一天, 我醒来。 我只有95磅。 有一打管子 穿进我体内。 我不能走路,不能说话。 不能吃,不能动, 当然,我也不能唱歌。 我甚至不能呼吸, 但是当我抬头看 到我的母亲时, 我情不自禁地微笑。
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.
无论是麦克牌卡车(暗示车祸) 还是心脏衰竭 还是肺移植失败, 死亡总会发生。 但是生活不仅仅是避免死亡,对吧? 它关乎活下去。 疾病并不能完全否定人们求生的意志。 所以人们一旦可以 追随他们的热情所在, 医生发现他们拥有了更棒 更幸福更健康的病人。 我的父母很担忧我 出去试镜 旅行和四处表演, 但是他们知道我这样做我自己会感觉好很多 这样总比整日担心我自己的死亡要好很多。 我感谢他们这样理解我。
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.
这是去年夏天我跑啊唱啊 跳啊玩啊,和我的侄子与侄女 我的兄弟和姐妹,我的母亲和祖母 在科罗拉多洛矶, 我不由地想起了那个医生 她说我不能再歌唱了。 但是我想告诉她, 我想告诉大家, 我们必须停止让疾病 剥夺我们的梦想。 当我们做到了, 我们将发现病人 不仅仅是活下来了, 我们会活力四射。 有些病人 甚至可以歌唱。
(Applause) [Singing: French]
(鼓掌) [歌唱:法语]
Thank you. (Applause) Thank you. And I'd like to thank my pianist, Monica Lee. (Applause) Thank you so much. Thank you.
谢谢。 (鼓掌) 谢谢。 谢谢我的钢琴师,莫妮卡·李。 (鼓掌) 十分感谢。 谢谢。