When my brother called me in December of 1998, he said, "The news does not look good." This is him on the screen. He'd just been diagnosed with ALS, which is a disease that the average lifespan is three years. It paralyzes you. It starts by killing the motor neurons in your spinal cord. And you go from being a healthy, robust 29-year-old male to someone that cannot breathe, cannot move, cannot speak.
我弟在98年12月打電話給我 他說﹐我有一個壞消息 這就是他 他剛知道他得了肌肉萎縮性側索硬化症 病患預期壽命是三年 這疾病會讓你完全失去行為能力 從殺死中樞神經中的運動神經元開始 你逐漸地從一個健康 強壯的29歲男性 變成一個無法呼吸 無法移動﹐言語的人
This has actually been, to me, a gift, because we began a journey to learn a new way of thinking about life. And even though Steven passed away three years ago we had an amazing journey as a family. We did not even -- I think adversity is not even the right word. We looked at this and we said, "We're going to do something with this in an incredibly positive way." And I want to talk today about one of the things that we decided to do, which was to think about a new way of approaching healthcare. Because, as we all know here today, it doesn't work very well. I want to talk about it in the context of a story.
我把這次經驗看作一項禮物 我們開始學習 用新的方法思考人生 雖然 Steven 離開我們三年了 我們一起走過了一段神奇的旅途 我們甚至沒有 我甚至不覺得這是不幸的事件 我們接受它﹐然後把它當成一次機會 用樂觀的態度面對 我今天想對你們說的 便是我們決定要做的事情之一 用一種嶄新的方式去思考醫療產業 在座的我們都知道 現在的狀況並不是很理想 我希望用故事的方式和你們討論
This is the story of my brother. But it's just a story. And I want to go beyond the story, and go to something more. "Given my status, what is the best outcome I can hope to achieve, and how do I get there?" is what we are here to do in medicine, is what everyone should do. And those questions all have variables to them. All of our statuses are different. All of our hopes and dreams, what we want to accomplish, is different, and our paths will be different, they are all stories.
我弟弟的故事 我希望在他的故事以後 我們能發現我們能做的事還有很多 “就我的疾病來說﹐什麼是最樂觀的情況 我該怎麼做﹐才能達到那樣的情況﹖” 這便是醫療所該做的﹐每個人所該做的 每個人的問題和解答都不同 因為每個人的狀況不同 我們想達到的希望和夢想 都有所不同﹐我們的路徑也不同 這些都是故事
But it's a story until we convert it to data and so what we do, this concept we had, was to take Steven's status, "What is my status?" and go from this concept of walking, breathing, and then his hands, speak, and ultimately happiness and function. So, the first set of pathologies, they end up in the stick man on his icon, but the rest of them are really what's important here. Because Steven, despite the fact that he was paralyzed, as he was in that pool, he could not walk, he could not use his arms -- that's why he had the little floaty things on them, did you see those? -- he was happy. We were at the beach, he was raising his son, and he was productive.
但除非我們把這些故事變成數據 我們的概念是 把 Steve 的病情 “我的病情是什麼﹖” 把這個概念延伸到走路﹐呼吸 手的移動﹐說話 以及心理的情緒和各種反應 第一組病狀﹐他們會組成圖片上的 這個人形 但其他的資料才是重要的 因為就算 Steven 已經癱瘓 他在泳池裡﹐他不能走動 他不能移動手臂﹐所以才需要手臂上這些東西幫助他漂浮 看到了嗎﹖ 他很快樂﹐我們在沙灘上 他正舉起他的兒子﹐他還有反應
And we took this, and we converted it into data. But it's not a data point at that one moment in time. It is a data point of Steven in a context. Here he is in the pool. But here he is healthy, as a builder: taller, stronger, got all the women, amazing guy. Here he is walking down the aisle, but he can barely walk now, so it's impaired. And he could still hold his wife's hand, but he couldn't do buttons on his clothes, can't feed himself. And here he is, paralyzed completely, unable to breathe and move, over this time journey. These stories of his life, converted to data. He renovated my carriage house when he was completely paralyzed, and unable to speak, and unable to breathe, and he won an award for a historic restoration.
我們把這些資料都變成數據 這個數據不只是一個時間 而是過程裡的一個時間點 這時他在游泳池裡﹐但這裡他還很健康 一個又高又壯的建築工人 所有的女孩都喜歡他﹐了不起的男人 然後他結婚 但他不太能走﹐有些顛簸 他還可以牽著他太太的手﹐但他無法自己扣上釦子 不能自己吃飯 到最後﹐他完全癱瘓了 他不能呼吸﹐不能動 他人生旅程化為數據 他整修了我的馬廄 當他完全癱瘓﹐不能說話 不能呼吸時﹐他贏得了歷史文物整修獎
So, here's Steven alone, sharing this story in the world. And this is the insight, the thing that we are excited about, because we have gone away from the community that we are, the fact that we really do love each other and want to care for each other. We need to give to others to be successful. So, Steven is sharing this story, but he is not alone. There are so many other people sharing their stories. Not stories in words, but stories in data and words. And we convert that information into this structure, this understanding, this ability to convert those stories into something that is computable, to which we can begin to change the way medicine is done and delivered.
這是他一個人的故事 這就是這件事的意義﹐也是 我們興奮之處 我們從社區走出來 把我們對彼此的愛和關懷 把它分享給他人 Steven 分享了他的故事 但他並不孤單 有許多其他人正分享他們的故事 不只是語言﹐這些故事也由數據寫成 我們把這些資料放進這個程式 把這些理解從故事 化為可計算的數據 從這裡開始﹐我們可以改變 我們現有的健康醫療
We did this for ALS. We can do this for depression, Parkinson's disease, HIV. These are not simple, they are not internet scalable; they require thought and processes to find the meaningful information about the disease. So, this is what it looks like when you go to the website. And I'm going to show you what Patients Like Me, the company that myself, my youngest brother and a good friend from MIT started.
從肌肉萎縮性側索硬化症﹐憂鬱症 帕金斯症﹐愛滋病都可以用一樣的方法 這並不容易﹐不只是用戶的增加 還有更多考量和過程 才能把這些疾病資料變成有意義的資訊 這是你進入網站時的畫面 這個網站叫“病患如我” 是由我﹐我小弟 和一個麻省理工的朋友一起創立的
Here are the actual patients, there are 45,000 of them now, sharing their stories as data. Here is an M.S. patient. His name is Mike, and he is uniformly impaired on cognition, vision, walking, sensation. Those are things that are different for each M.S. patient. Each of them can have a different characteristic. You can see fibromyalgia, HIV, ALS, depression. Look at this HIV patient down here, Zinny. It's two years of this disease. All of the symptoms are not there. But he is working to keep his CD4 count high and his viral level low so he can make his life better.
現在有大約四萬五千個病患 和我們分享他們的故事和數據 這裡有個多發性硬化症病患 他叫麥克﹐他的認知﹐視覺 行走﹐感知都受損了 每個多發性硬化症病患都不太一樣 每個人的病徵都不同 你可以看到纖維肌症﹐愛滋﹐憂鬱症﹐和肌肉萎縮性側索硬化症 這裡有個叫金尼的愛滋病患 他已經得愛滋兩年了﹐還沒有出現任何病徵 他正努力保持高免疫細胞 和病毒數量低﹐讓他能夠過得更好
But you can aggregate this and you can discover things about treatments. Look at this, 2,000 people almost, on Copaxone. These are patients currently on drugs, sharing data. I love some of these, physical exercise, prayer. Anyone want to run a comparative effectiveness study on prayer against something? Let's look at prayer. What I love about this, just sort of interesting design problems. These are why people pray. Here is the schedule of how frequently they -- it's a dose. So, anyone want to see the 32 patients that pray for 60 minutes a day, and see if they're doing better, they probably are. Here they are. It's an open network, everybody is sharing. We can see it all.
綜合這些數據﹐就能發現不同治療所造成的差別 這裡有兩千多個正在使用格拉默的病患 這些正在用藥的病人一起 分享數據 有些很棒﹐運動﹐禱告 有人想要做禱告和其他治療法的比較研究嗎﹖ 讓我們看看禱告 我最喜歡的是這些有趣的設計問題 這是人們禱告的原因 這是他們禱告的頻率﹐像個劑量 如果你想知道32個每天禱告60分鐘的病患是不是比較健康 療癒程度是不是比較好﹐答案是“是的” 你可以看到﹐這些都是開放的 我們可以看到每個人分享的資訊
Or, I want to look at anxiety, because people are praying for anxiety. And here is data on 15,000 people's current anxiety, right now. How they treat it, the drugs, the components of it, their side effects, all of it in a rich environment, and you can drill down and see the individuals. This amazing data allows us to drill down and see what this drug is for -- 1,500 people on this drug, I think. Yes. I want to talk to the 58 patients down here who are taking four milligrams a day. And I want to talk to the ones of those that have been doing it for more than two years. So, you can see the duration. All open, all available. I'm going to log in.
如果我想看焦慮症﹐人們為了焦慮而禱告 這裡有一萬五千個焦慮患者的數據 他們如何治療 他們用的藥物﹐裡面的成份 副作用﹐這裡有豐富的資料 你可以繼續深入研究各個病患 這些驚人的數據讓我們深入了解 這些藥物的作用 一千五百個病患正在使用這個藥 讓我看看這58個病患 他們每天吃四毫克 我想和他們對話﹐看看他們用了兩年以後 現在的狀況如何 你可以看見他們的療程 一切資料都是開放的 我現在要登錄
And this is my brother's profile. And this is a new version of our platform we're launching right now. This is the second generation. It's going to be in Flash. And you can see here, as this animates over, Steven's actual data against the background of all other patients, against this information. The blue band is the 50th percentile. Steven is the 75th percentile, that he has non-genetic ALS. You scroll down in this profile and you can see all of his prescription drugs, but more than that, in the new version, I can look at this interactively. Wait, poor spinal capacity.
這是我弟弟的檔案 這是我們最近開放的新版平臺 第二代﹐用 Flash 播放器 你可以看到﹐當它移動的時候 Steven 的數據和其他病患的數據 相互比較 藍色帶是五十個百分點﹐Steven 是七十五 他患的是非遺傳性的肌肉萎縮性側索硬化症 這個檔案下面 有他所有處方藥的記錄 不只這樣﹐新版本裡可以互動 受損的脊椎功能
Doesn't this remind you of a great stock program? Wouldn't it be great if the technology we used to take care of ourselves was as good as the technology we use to make money? Detrol. In the side effects for his drug, integrated into that, the stem cell transplant that he had, the first in the world, shared openly for anyone who wants to see it.
這是否令你想起那些很好的股票軟體﹖ 如果我們能把這些拿來賺錢的科技拿來照顧健康 那不是很好嗎﹖ 托特羅定﹐這裡有藥物的副作用 結合幹細胞移植 全世界第一個公開的資料站
I love here -- the cyberkinetics implant, which was, again, the only patient's data that was online and available. You can adjust the time scale. You can adjust the symptoms. You can look at the interaction between how I treat my ALS. So, you click down on the ALS tab there. I'm taking three drugs to manage it. Some of them are experimental. I can look at my constipation, how to manage it. I can see magnesium citrate, and the side effects from that drug all integrated in the time in which they're meaningful.
我喜歡這個﹐植入性芯片 這也是網路上唯一公開的病患數據 你可以調整時間軸﹐症狀 我如何醫治我的肌肉萎縮性側索硬化症 點下面的肌肉萎縮性側索硬化症標籤 我吃三種藥﹐一些還在實驗階段 我該怎麼解決我的便秘問題 檸檬酸鎂和它的副作用 在它的有效期之內 它做了什麼
But I want more. I don't want to just look at this cool device, I want to take this data and make something even better. I want my brother's center of the universe and his symptoms and his drugs, and all of the things that interact among those, the side effects, to be in this beautiful data galaxy that we can look at in any way we want to understand it, so that we can take this information and go beyond just this simple model of what a record is.
我還想要更多 我不想只是看看這些功能 我希望能用這些數據改善現狀 我要我弟弟的狀況﹐病症 他的用藥 副作用﹐所有這些資訊 放進這個美麗的數據銀河 就可以用它來做很多研究 我們可以利用這些資料 超越過去的記錄模式 .
I don't even know what a medical record is. I want to solve a problem. I want an application. So, can I take this data -- rearrange yourself, put the symptoms in the left, the drugs across the top, tell me everything we know about Steven and everyone else, and what interacts. Years after he's had these drugs, I learned that everything he did to manage his excess saliva, including some positive side effects that came from other drugs, were making his constipation worse. And if anyone's ever had severe constipation, and you don't understand how much of an impact that has on your life -- yes, that was a pun.
我甚至不知道醫療記錄是什麼 我祇想解決問題﹐我想要一個應用程式 我把這些數據﹐你自己可以調整 把症狀放在左邊﹐藥物放上面 這可以告訴我們有關 Steven 和所有人的資料 哪些重複了 在他用這些藥的多年以後 我終於知道他為了控制唾液 和其他一些藥的副作用 惡化了他的便秘問題 如果有人曾經有過嚴重便秘 你不了解這對你生活的影響有多大 這是一個雙關語
You're trying to manage these, and this grid is available here, and we want to understand it. No one's ever had this kind of information. So, patients have this. We're for patients. This is all about patient health care, there was no doctors on our network. This is about the patients. So, how can we take this and bring them a tool that they can go back and they can engage the medical system? And we worked hard, and we thought about it and we said, "What's something we can use all the time, that we can use in the medical care system, that everyone will understand?"
你嘗試去理解這些 這個表格就在這裡 我們想要了解 在這之前從來沒有人擁有這些資料 這是為了病患做的 病患分享他們的醫療經驗﹐這裡沒有駐站醫生 全是病患自己 我們該如何使用這些資料 讓病患可以把這些資料帶回他們所使用的醫療系統﹖ 我們努力的思考﹐我們想 “什麼是我們現在的醫療系統中 所使用﹐而且每個人 都明白的﹖”
So, the patients print it out, because hospitals usually block us because they believe we are a social network. It's actually the most used feature on the website. Doctors actually love this sheet, and they're actually really engaged. So, we went from this story of Steven and his history to data, and then back to paper, where we went back and engaged the medical care system. And here's another paper. This is a journal, PNAS -- I think it's the Proceedings of the National Academy of Science of the United States of America. You've seen multiple of these today, when everyone's bragging about the amazing things they've done. This is a report about a drug called lithium. Lithium, that is a drug used to treat bipolar disorder, that a group in Italy found slowed ALS down in 16 patients, and published it.
於是病患把它印出來 因為醫院拒絕我們 他們覺得我們只是網路社群 這是網站上最多人使用的功能 醫生們喜歡這個資料﹐他們非常投入 於是我們從 Steven 的故事 把故事化為數據﹐然後回到紙上 然後回到我們的醫療系統 這是另外一種紙 這是《國家科学院院刊》 這是美國國家科學院裡的 一項刊物 你今天已經看到它幾次了﹐每個人都在吹噓 他們做的了不起的事情 這裡有個關於鋰這個藥物的報告 鋰本來是用來治療躁鬱症的 意大利的一個團體發現 它減緩了16個肌肉萎縮性側索硬化症的症狀﹐就發表了這篇文章
Now, we'll skip the critiques of the paper. But the short story is: If you're a patient, you want to be on the blue line. You don't want to be on the red line, you want to be on the blue line. Because the blue line is a better line. The red line is way downhill, the blue line is a good line. So, you know we said -- we looked at this, and what I love also is that people always accuse these Internet sites of promoting bad medicine and having people do things irresponsibly. So, this is what happened when PNAS published this. Ten percent of the people in our system took lithium. Ten percent of the patients started taking lithium based on 16 patients of data in a bad publication. And they call the Internet irresponsible. Here's the implication of what happens.
我們先不批評這個期刊 簡單的說﹐如果你是病患 你想在藍線上 你不想在紅線上﹐你想在藍線上 因為藍線比較好﹐紅線 在下面﹐藍線是好的 我們看著這個﹐我覺得那些 批評網路不負責任地廣告藥物 讓人們做出錯誤決定的人也很有趣 當《國家科学院院刊》發表這篇文章以後 我們系統裡有一成的人開始使用鋰 一成的病患因為16個病患的醫療結果開始使用鋰 因為這個錯誤的報告 他們卻說網路不負責任 這就是事情發生的經過
There's this one guy, named Humberto, from Brazil, who unfortunately passed away nine months ago, who said, "Hey, listen. Can you help us answer this question? Because I don't want to wait for the next trial, it's going to be years. I want to know now. Can you help us?" So, we launched some tools, we let them track their blood levels. We let them share the data and exchange it. You know, a data network. And they said, you know, "Jamie, PLM, can you guys tell us whether this works or not?" And we went around and we talked to people, and they said, "You can't run a clinical trial like this. You know? You don't have the blinding, you don't have data, it doesn't follow the scientific method. It's never going to work. You can't do it."
有個名叫 Humberto 的巴西人 他在九個月前過世了 他說“聽著﹐你可以幫我們回答這個問題嗎﹖ 因為我不想等下次實驗結束﹐那還得等上多年 我現在就要知道﹐你可以幫助我嗎﹖” 於是我們增加一些功能﹐讓他們追蹤血液質 互相分享交換數據 一個數據網 然後他們說“我們可以把產品生命週期管理的概念 運用在這裡嗎 ? ” 於是我們四處問人 他們說“你不能這樣做臨床測試 你們沒有雙盲測試﹐沒有數據 這沒有任何科學方法 這不行﹐你不能這樣做。”
So, I said, "Okay well we can't do that. Then we can do something harder." (Laughter) I can't say whether lithium works in all ALS patients, but I can say whether it works in Humberto. I bought a Mac about two years ago, I converted over, and I was so excited about this new feature of the time machine that came in Leopard. And we said -- because it's really cool, you can go back and you can look at the entire history of your computer, and find everything you've lost, and I loved it. And I said, "What if we built a time machine for patients, except instead of going backwards, we go forwards. Can we find out what's going to happen to you, so that you can maybe change it?"
於是我說“好吧我們不做這個﹐我們做一些更困難的。” (笑聲) 我不知道鋰在肌肉萎縮性側索硬化症患者身上是否都管用 但我知道它在 Humberto 身上是否管用 兩年前我把電腦換成蘋果 我對“時間機器”這個功能非常興奮 真的很酷 你可以回顧電腦裡的所有歷史 找到所有消失的資料﹐我非常喜歡 我說“我們可以為患者做一個時間機器嗎 但不是往回看﹐而是往未來前進 我們可以知道他們的病將會如何發展 或許可以改變這個結果﹖”
So, we did. We took all the patients like Humberto, That's the Apple background, we stole that because we didn't have time to build our own. This is a real app by the way. This is not just graphics. And you take those data, and we find the patients like him, and we bring their data together. And we bring their histories into it. And then we say, "Well how do we line them all up?" So, we line them all up so they go together around the meaningful points, integrated across everything we know about the patient. Full information, the entire course of their disease. And that's what is going to happen to Humberto, unless he does something. And he took lithium, and he went down the line. And it works almost every time.
於是我們聚集了所有病患資料 這個背景是蘋果的﹐因為我們沒有時間做自己的背景 這是一個真正的應用程式 不只是圖表 把所有病患,像他的病患 把他們的患病過程放進去 我們想“我們該怎麼排列它們? ” 於是我們把他們放在一起 在那些有意義的數據點上 綜合所有有關這個病患的訊息 他們完整的病史 這就是 Humberto 將要面對的病情 除非他做了別的措施 他吃了鋰﹐他的線往下掉 這幾乎百發百中
Now, the ones that it doesn't work are interesting. But almost all the time it works. It's actually scary. It's beautiful. So, we couldn't run a clinical trial, we couldn't figure it out. But we could see whether it was going to work for Humberto. And yeah, all the clinicians in the audience will talk about power and all the standard deviation. We'll do that later. But here is the answer of the mean of the patients that actually decided to take lithium. These are all the patients that started lithium. It's the Intent to Treat Curve. You can see here, the blue dots on the top, the light ones, those are the people in the study in PNAS that you wanted to be on. And the red ones are the ones, the pink ones on the bottom are the ones you didn't want to be. And the ones in the middle are all of our patients from the start of lithium at time zero, going forward, and then going backward.
那些於別人不同的曲線圖很有趣 但幾乎毫無例外 它準確地令我們害怕 我們不能做臨床實驗﹐我們不能完全理解 但我們可以知道它在 Humberto 身上是否管用 我們知道在場的醫生會談到統計效力 和標準差﹐我們晚點會提到 但答案在這裡 這是那些決定使用鋰的病人的 平均值 這些是全部使用鋰的病患 這是他們的治療曲線 你也可以看到﹐上面淡淡的藍點 是《國家科学院院刊》裡的病患 也是人們想要得到的結果 下面的粉色點則是你不想要的結果 中間的就是我們的病患 從開始服用鋰開始 繼續﹐然後繼續
So, you can see we matched them perfectly, perfectly. Terrifyingly accurate matching. And going forward, you actually don't want to be a lithium patient this time. You're actually doing slightly worse -- not significantly, but slightly worse. You don't want to be a lithium patient this time. But you know, a lot of people dropped out, the trial, there is too much drop out. Can we do the even harder thing? Can we go to the patients that actually decided to stay on lithium, because they were so convinced they were getting better?
你可以看見這些數據完美的一致 恐怖地相同 繼續下去﹐你就不希望自己是個服用鋰的病人了 病情開始稍微惡化﹐雖然不是很嚴重 但稍微惡化﹐你不想是服用鋰的病人了 但許多人放棄繼續 做完這個實驗 我們是否能找到那些 繼續服用鋰的病人 因為他們認為他們的病情已經開始好轉
We asked our control algorithm, are those 69 patients -- by the way, you'll notice that's four times the number of patients in the clinical trial -- can we look at those patients and say, "Can we match them with our time machine to the other patients that are just like them, and what happens?" Even the ones that believed they were getting better matched the controls exactly. Exactly. Those little lines? That's the power.
我們控制算法的結果是 這69個病人 也就是接受臨床實驗的四倍 我們看這些病患﹐然後說 “我們可以把他們放進我們的時間機器 和其他的病患比較一下 看看會有什麼結果” 結果是就算他們相信自己的病情好轉了 事實上卻和一樣。 這些線是什麼﹖這就是統計效力
So, we -- I can't tell you lithium doesn't work. I can't tell you that if you did it at a higher dose or if you run the study proper -- I can tell you that for those 69 people that took lithium, they didn't do any better than the people that were just like them, just like me, and that we had the power to detect that at about a quarter of the strengths reported in the initial study. We did that one year ahead of the time when the first clinical trial funded by the NIH for millions of dollars failed for futility last week, and announced it.
我不能告訴你鋰不管用 我不能說如果你用更高劑量 和你再做其他實驗﹐但我可以告訴你 那服用鋰的69人 他們的病情沒有改善 就像我一樣 我們有統計效力可以測試 原本的報告只有四分之一 我們比國家研究院贊助百萬的 臨床實驗還要早一年開始 上個禮拜他們公佈了他們的失敗 .
So, remember I told you about my brother's stem cell transplant. I never really knew whether it worked. And I put 100 million cells in his cisterna magna, in his lumbar cord, and filled out the IRBs and did all this work, and I never really knew. How did I not know? I mean, I didn't know what was going to happen to him. I actually asked Tim, who is the quant in our group -- we actually searched for about a year to find someone who could do the sort of math and statistics and modeling in healthcare, couldn't find anybody. So, we went to the finance industry. And there are these guys who used to model the future of interest rates, and all that kind of stuff. And some of them were available. So, we hired one. (Laughter)
記得我弟的幹細胞移植嗎 我不知道那管不管用 我在他的小腦延髓池和腰椎 植入了一億個細胞 填了一個同意臨床試驗證明書﹐做了這些 但我從來沒有真正知道 我怎麼可能不知道﹖ 我甚至不知道這樣會發生什麼 於是我問 Tim﹐我們這組人的數據分析師 我們找了一整年才找到 一個可以算這些統計﹐這些模型的人 在醫界我們一個也找不到﹐於是我們到金融界找 這些人擅於預測未來的利率 那些所有的東西 某些人突然有空了﹐於是我們請了一個 (笑聲)
We hired them, set them up, assisting at lab. I I.M. him things. That's the way I communicate with him, is like a little guy in a box. I I.M.ed Tim. I said, "Tim can you tell me whether my brother's stem cell transplant worked or not?" And he sent me this two days ago. It was that little outliers there. You see that guy that lived a long time? We have to go talk to him. Because I'd like to know what happened. Because something went different. But my brother didn't. My brother went straight down the line. It only works about 12 months.
我們請他們來﹐請他們幫助我們的實驗室 把東西在網上用即時通寄給他 像個盒子裡的小人﹐我在即時通上問他﹕ “Tim 你可以告訴我﹐我弟的幹細胞移植 到底有沒有用? ” 於是兩天前﹐他寄了這個給我 你看到這個異常值了嗎﹖有個男人活了很長時間﹖ 我們得去和他聊聊﹐因為我想知道他做了什麼 他一定做了一些不同的事 因為我弟弟沒有。我弟弟的線掉下去了 支撐了十二個月
It's the first version of the time machine. First time we ever tried it. We'll try to get it better later but 12 months so far. And, you know, I look at this, and I get really emotional. You look at the patients, you can drill in all the controls, you can look at them, you can ask them. And I found a woman that had -- we found her, she was odd because she had data after she died. And her husband had come in and entered her last functional scores, because he knew how much she cared. And I am thankful.
這是時間機器的第一個版本 我們第一次嘗試﹐我們會嘗試改進 十二個月了 當我看到這個 我心裡很激動 你看著這些病患﹐你可以比較所有的對照值 你看著他們﹐你問他們 我找到一個女人 因為她的數據很奇怪 在死後還有數據 他的丈夫在她死後登錄﹐輸入她最後的狀況 因為他知道她很在乎 我很感謝他
I can't believe that these people, years after my brother had died, helped me answer the question about whether an operation I did, and spent millions of dollars on years ago, worked or not. I wished it had been there when I'd done it the first time, and I'm really excited that it's here now, because the lab that I founded has some data on a drug that might work, and I'd like to show it. I'd like to show it in real time, now, and I want to do that for all of the diseases that we can do that for. I've got to thank the 45,000 people that are doing this social experiment with us. There is an amazing journey we are going on to become human again, to be part of community again, to share of ourselves, to be vulnerable, and it's very exciting. So, thank you. (Applause)
我不敢相信這些人 在我弟弟死後這麼多年 告訴我多年前我做的這個手術 這個花了幾百萬的手術 究竟有沒有用 我希望當時就有這個網站 在我當時開始做得時候 我真的很興奮現在我們有了這個功能 因為在這個實驗室裡 我們找到了一些數據﹐顯示某個藥可能有用 我希望展示給你們看 現在 我希望為所有的病都做到 我要謝謝這四萬五千個人 和我們一起進行這次社群實驗 我們一起在一個神奇的路途上 找回我們的人性 重新成為一個社群 分享我們自己的脆弱 這是很令人興奮的。謝謝大家。 (掌聲)