Jeg vil gerne gøre stort set det samme som første gang, og tale om et opløftende emne. Sidste gang talte jeg om døden og at dø. Denne gang vil jeg tale om mental sygdom.
I'd like to do pretty much what I did the first time, which is to choose a lighthearted theme. Last time, I talked about death and dying. (Laughter)
This time, I'm going to talk about mental illness.
Men det skal jo være noget teknologisk, så jeg vil tale om elektrochok. (Latter)
(Laughter) But it has to be technological, so I'll talk about electroshock therapy.
Siden mennesket har været opmærksom på at nogle af hans artsfæller, hans kollegaer, kunne være anderledes - sære - svært deprimeret eller det, vi i dag kender som skizofrene, var man sikker på, at den slags sygdom måtte komme fra onde ånder, som fandt adgang til ens krop. Så måden man behandlede disse sygdomme i gamle dage var, på en eller anden måde, at uddrive disse onde ånder. Og det forgår stadigt i dag, som bekendt.
(Laughter) You know, ever since man had any notion that some of his other people, his colleagues, could be different, could be strange, could be severely depressed or what we now recognize as schizophrenia, he was certain that this kind of illness had to come from evil spirits getting into the body. So the way of treating these diseases in early times was to, in some way or other, exorcise those evil spirits. And this is still going on, as you know.
Men det var ikke nok at bruge præster. Da medicinen blev delvist videnskabeligt ca. 450 f.kr., med Hippocrates og de drenge. De prøvede at finde urter, planter, som bogstaveligt talt ville ryste de onde ånder ud. Så de fandt særlige planter, der ville forårsage ryste-kramper. Og "Urter," de botaniske bøger langt op i middelalderen og Renæssancen, er fyldt med opskrifter på frembringelse af ryste-kramper, som skulle ryste de onde ånder ud.
But it wasn't enough to use the priests. When medicine became somewhat scientific, in about 450 BC, with Hippocrates and those boys, they tried to look for herbs, plants that would literally shake the bad spirits out. So they found certain plants that could cause convulsions. And the herbals, the botanical books of up to the late Middle Ages, the Renaissance, are filled with prescriptions for causing convulsions to shake the evil spirits out.
Endeligt, omkring det 16 århundrede, fik en læge hvis navn var Theophrastus Bombastus Auricularis von Hohenheim, kaldet Paracelsus, et navn der sikkert er bekendt for nogle af jer, -- (latter) -- gode gamle Paracelsus, fandt, at han kunne forudsige mængden af kramper ved at bruge en afmålt mængde af kampfer til at frembringe kramper. Kunne du forstille dig at gå hen til dit skab, tage en mølkugle ud og tygge på den, hvis du følte dig deprimeret? Det er sikkert bedre end Prozac, men jeg vil nu ikke anbefale det.
Finally, in about the 16th century, a physician whose name was Theophrastus Bombastus Aureolus von Hohenheim -- called Paracelsus, a name probably familiar to some people here -- (Laughter) good old Paracelsus -- found that he could predict the degree of convulsion by using a measured amount of camphor to produce the convulsion. Can you imagine going to your closet, pulling out a mothball and chewing on it if you're feeling depressed? It's better than Prozac, but I wouldn't recommend it.
Så hvad vi så i det 17 og 18 århundrede var den forsatte søgen efter andre medikamenter end kampfer. Så kom Benjamin Franklin, og han var nær ved at få ryste-kramper selv af et elektriske stød fra hans drage. Så folk begyndte at tænke på elektricitet, når de ville skabe kramper.
(Laughter) So, what we see in the 17th, 18th century is the continued search for medications other than camphor that'll do the trick. Well, along comes Benjamin Franklin, and he comes close to convulsing himself with a bolt of electricity off the end of his kite. And so people begin thinking in terms of electricity to produce convulsions.
Og nu spoler vi tiden frem til omkring 1932, hvor tre Italienske læger, som for det meste behandlede depression, begyndte at ligge mærke til, at blandt dem der også var epileptikere at hvis de havde et epileptisk -- en hel serie af epileptiske anfald, i række efter hinanden -- depressionen ville da ofte formindskes. Ikke bare formindskes, men nogen fik det aldrig igen. Så de blev meget interesseret i at frembringe kramper, kontrollerede slags kramper.
And then we fast-forward to about 1932, when three Italian psychiatrists who were largely treating depression began to notice among their patients, who were also epileptics, that if they had a series of epileptic fits, a lot of them in a row -- the depression would very frequently lift. Not only would it lift, but it might never return. So they got very interested in producing convulsions, measured types of convulsions.
Og de tænkte, "Nå ja, vi har jo det der elektricitet, vi prøver at sætte strøm til nogen. Det får jo altid deres hår til at rejse sig og folk ryster en masse." Så, de testede det på et par svin, og ingen af svinene døde. Så de gik til politiet og sagde, "Vi ved at på Rom´s banegård vandrer alle de der fortabte sjæle rundt, og mumler volapyk. Kunne i bringe én af dem til os?" Én, der er det Italienerne kalder "cagutis." Så de fandt en "cagutis" gut, en 39-år-gammel mand, der var håbløst skizofren, som var kendt for i måneder, at have smurt sig i lort - bogstaveligt talt, som ikke sagde noget, der gav mening, og ham bragte de så hen på hospitalet. Så disse tre psykiatere - efter cirka to til tre ugers observation - lagde ham på et bord, og forbandt hans tindinger til en meget svag strøm. De tænkte, "Vi prøver 55 volt, to tiende dele af et sekund. Det kan da umuligt gøre ham noget slemt." Så det gjorde de.
And they thought, "Well, we've got electricity, we'll plug somebody into the wall. That always makes hair stand up and people shake a lot." So they tried it on a few pigs, and none of the pigs were killed. So they went to the police and they said, "We know that at the Rome railroad station, there are all these lost souls wandering around, muttering gibberish. Can you bring one of them to us?" Someone who is, as the Italians say, "gagootz." So they found this "gagootz" guy, a 39-year-old man who was really hopelessly schizophrenic, who was known, had been known for months, to be literally defecating on himself, talking nothing that made any sense, and they brought him into the hospital. So these three psychiatrists, after about two or three weeks of observation, laid him down on a table, connected his temples to a very small source of current. They thought, "Well, we'll try 55 volts, two-tenths of a second. That's not going to do anything terrible to him." So they did that.
Jeg har det følgende fra et øjenvidne, der fortalte mig det for ca 35 år siden, da jeg overvejede dette emne til et forsknings projekt. Han sagde, "Denne fyr -- husk på, han var ikke engang bedøvet -- efter denne drabelige omgang kramper, satte sig op, kiggede på de tre gutter og sagde, "Hvad helvede har i røvhuller gang i?" (Latter)
Well, I have the following from a firsthand observer, who told me this about 35 years ago, when I was thinking about these things for some research project of mine. He said, "This fellow" -- remember, he wasn't even put to sleep -- "after this major grand mal convulsion, sat right up, looked at these three fellas and said, 'What the fuck are you assholes trying to do?'"
Kunne jeg dog bare sige det på Italiensk.
(Laughter) If I could only say that in Italian.
Nå ja, de blev så glade, for han
(Laughter)
havde ikke ydret én fornuftig sætning i de uger, han blev observeret. Så de satte ham i stikket igen,
Well, they were happy as could be, because he hadn't said a rational word in the weeks of observation. (Laughter)
og denne gang brugte de 110 volt i ca et halvt sekund. Og til deres forbløffelse, efter det var slut, begyndte han at tale, som var han sig selv igen. Han fik lidt tilbage fald, men de gav ham en serie behandlinger, og han blev praktisk taget kureret. Men naturligvis, med skizofreni kom det jo tilbage i løbet af et par måneder.
So they plugged him in again, and this time, they used 110 volts for half a second. And to their amazement, after it was over, he began speaking like he was perfectly well. He relapsed a little bit, they gave him a series of treatments, and he was essentially cured. But of course, having schizophrenia, within a few months, it returned.
Men de skrev en afhandling om dette, og alle i den vestlige verden begyndte at bruge elektricitet til at frembringe kramper på folk, der var enten skizofrene eller deprimerede Det fungerede ikke særligt godt på de skizofrene, men det stod rimeligt klart i 30rne og i midten af 40rne, at elektrisk krampe-terapi var meget, meget effektivt til behandling af depression.
But they wrote a paper about this, and everybody in the western world began using electricity to convulse people who were either schizophrenic or severely depressed. It didn't work very well on the schizophrenics, but it was pretty clear in the '30s and by the middle of the '40s that electroconvulsive therapy was very, very effective in the treatment of depression.
Og naturligvis, var der dengang, ikke noget der hed antidepressiva, og det blev meget, meget populært. De bedøvede folk, gav dem kramper, men det store problem var, at der ikke var nogen metode til at lamme muskler. Så folk ville få nogen virkeligt drabelige krampeanfald. Ben brækkede -- specielt på gamle, skrøbelige mennesker, kunne man ikke bruge det. Men så i 1950, de sene 1950ere, blev muskel-afslapningmidler udviklet af farmaceuter, og det gjorde muligt at frembringe en komplet krampe, en elektroencefalografisk krampetrækning -- man kunne se det på hjernebølgerne -- uden at frembringe nogen kramper i kroppen, på nær lidt rysten i tæerne. Så det var igen meget, meget populært og meget, meget nyttigt.
And of course, in those days, there were no antidepressant drugs, and it became very, very popular. They would anesthetize people, convulse them ... But the real difficulty was that there was no way to paralyze muscles. So people would have a real grand mal seizure. Bones were broken; especially in old, fragile people, you couldn't use it. And then in the late 1950s, the so-called "muscle relaxants" were developed by pharmacologists, and it got so that you could induce a complete convulsion, an electroencephalographic convulsion -- you could see it on the brain waves -- without causing any convulsion in the body except a little bit of twitching of the toes. So again, it was very, very popular and very, very useful.
Nåh, men så i midten af 60erne, kom de første antidepressiva frem. Tofranil var det første. Og i de sene 70ere og tidlige 80ere kom der flere, som var meget effektive. Og patientrettigheds-grupperne blev åbenbart meget oprørt over de ting, de kom til at være vidne til. Så hele ideen med eletro-krampe, elektrochok-terapi forsvandt -- men det har haft en renæssance i de seneste 10 år. Og årsagen til at det har fået en renæssance er sikkert, at ca. 10 procent af de stærkt depressive patienter, ikke får nogen bedring, uanset hvad der gøres.
Well, you know, in the middle '60s, the first antidepressants came out. Tofranil was the first. In the late '70s, early '80s, there were others, and they were very effective. And patients' rights groups seemed to get very upset about the kinds of things that they would witness, so the whole idea of electroconvulsive, electroshock therapy disappeared, but has had a renaissance in the last 10 years. And the reason that it has had a renaissance is that probably about 10 percent of the people, severe depressives, do not respond, regardless of what is done for them.
Hvorfor fortæller jeg denne historie ved dette møde? Jeg fortæller denne historie, fordi faktisk lige siden Richard ringede til mig og og bad mig tale om -- som han beder af alle sine talere -- at tale om noget, som ville være nyt for jer, som vi aldrig har holdt tale om og aldrig skrevet om. Jeg har længe planlagt dette øjeblik. Årsagen er i virkeligheden, at jeg er en mand, som for næsten 30 år siden fik sit liv reddet ved to lange forløb med elektrochok terapi. Og lad mig fortælle denne historie.
Now why am I telling you this story at this meeting? I'm telling you this story because, actually, ever since Richard called me and asked me to talk about -- as he asked all of his speakers -- to talk about something that would be new to this audience that we had never talked about, never written about. I've been planning this moment. This reason really is that I am a man who, almost 30 years ago, had his life saved by two long courses of electroshock therapy. And let me tell you this story.
Jeg var, i 1960erne, i et ægteskab ... at bruge ordet "dårligt" ville måske være dette års underdrivelse. Det var rædselsfuldt. Der er sikkert mange fraskilte i denne sal der kender til den fjendtlighed, den vrede, og hvad ved jeg. Som én, der har haft en meget besværlig barndom, og en meget besværlig ungdom, -- det havde noget at gøre med -- ikke just fattigdom, men tæt på. Det havde noget at gøre med at vokse op i en familie, hvor ingen talte Engelsk Ingen kunne læse eller skrive Engelsk. Det havde noget at gøre med død og sygdom om mange andre ting. -- Jeg havde også en tendens til depression.
I was, in the 1960s, in a marriage. To use the word "bad" would be perhaps the understatement of the year. It was dreadful. There are, I'm sure, enough divorced people in this room to know about the hostility, the anger, who knows what. Being someone who had had a very difficult childhood, a very difficult adolescence -- it had to do with not quite poverty, but close. It had to do with being brought up in a family where no one spoke English, no one could read or write English. It had to do with death and disease and lots of other things. I was a little prone to depression.
Så, da tingene blev værre, da vi virkeligt begyndte at hade hinanden, begyndte jeg gradvis, at blive deprimeret løbet af nogen år, mens jeg kæmpede for dette ægteskab, som tydeligvis ikke stod til at redde. Til sidst, ville jeg planlægge -- alle mine store operationer, Jeg placerede dem til klokken tolv - et stykker om eftermiddagen, fordi jeg ikke kunne komme ud af sengen før kl. 11. Og alle som har prøvet at være deprimeret her, ved hvordan det er. Jeg kunne ikke engang løfte min dyne.
So, as things got worse, as we really began to hate each other, I became progressively depressed over a period of a couple of years trying to save this marriage, which was inevitably not to be saved. Finally, I would schedule -- all my major surgical cases, I was scheduling them for 12, one o'clock in the afternoon, because I couldn't get out of bed before about 11 o'clock. Anybody who's been depressed here knows what that's like. I couldn't even pull the covers off myself.
Man er i universitetets operationscenter, hvor alle kender alle, og mine kollegaer så det tydeligt, så henvisningerne til mig, begyndte at dale. Som henvisningerne begynde at dale, blev jeg tydeligt mere og mere deprimeret, du godeste, jeg kan ikke arbejde længere. Og det gjorde egentlig ingen forskel, for jeg havde ingen patienter længere.
Well, you're in a university medical center, where everybody knows everybody. And it's perfectly clear to my colleagues, so my referrals began to decrease. As my referrals began to decrease, I clearly became increasingly depressed, until I thought, "My God, I can't work anymore." And, in fact, it didn't make any difference, because I didn't have any patients anymore.
Så, efter råd fra min læge, fik jeg mig selv indlagt hos Akut Psykiatrisk afdeling på vores universitets hospital. Og mine kollegaer, som kendte mig siden lægestudiet på stedet, sagde, "Ikke noget problem, makker. Seks uger, og du er tilbage i operationsrummet igen. Alt bliver godt." Ja, i ved vel hvad bovine stercus står for ikke? Det viste sig at være det rene bovine stercus.
So, with the advice of my physician, I had myself admitted to the acute care psychiatric unit of our university hospital. And my colleagues, who had known me since medical school, in that place, said, "Don't worry, Shep. Six weeks, you're back in the operating room. Everything's going to be great." Well, you know what bovine stercus is? That proved to be a lot of bovine stercus.
Jeg kender flere, der er blevet fastansatte ved at fyre den slags løgne af. (Latter)
(Laughter) I know some people who got tenure in that place with lies like that. (Laughter)
Så jeg var en af deres nederlag.
(Laughter and applause) So I was one of their failures.
Men det var ikke bare så simpelt. For på den tid forlod jeg afdelingen, Jeg fungerede overhovedet ikke længere. Jeg kunne knapt nok se fem fod frem for mig. Jeg slæbte fødderne når jeg gik. Jeg var sammenbøjet. Jeg gik sjældent i bad. Jeg barberede mig til tider ikke. Det var forfærdeligt. Og det stod helt klart -- bare ikke for mig, for ingenting stod længere klart for mig -- at jeg have brug for en lang-tids indlæggelse på det frygtelige sted, man kalder et psykiatrisk hospital. Så jeg blev indlagt, i 1973, foråret 1973, på "De Levendes Institut", hvilket før blev kaldt Hartford Rekreat. Det blev grundlagt i det 18 århundrede, det største psykiatriske hospital i staten Connecticut, udover de store offentlige hospitaler der fandtes dengang.
But it wasn't that simple, because by the time I got out of that unit, I was not functional at all. I could hardly see five feet in front of myself. I shuffled when I walked. I was bowed over. I rarely bathed. I sometimes didn't shave. It was dreadful. And it was clear -- not to me, because nothing was clear to me at that time anymore -- that I would need long-term hospitalization in that awful place called a "mental hospital." So I was admitted, in the spring of 1973, to the Institute of Living, which used to be called the Hartford Retreat. It was founded in the 18th century, the largest psychiatric hospital in the state of Connecticut, other than the huge public hospitals that existed at that time. And they tried everything they had.
De forsøgte med alt hvad de havde. De prøvede med almindelig psykoterapi. De forsøgte med alt tilgængelig medicin fra dengang. De havde Trofranil og andre ting -- Mellaril, hvem ved hvad. Intet skete, udover at jeg blev endnu mere dyster. Og endeligt, fordi jeg var velkendt i Connecticut, besluttede de, at de nok hellere måtte have et møde med de overordnede. Alle de overordnede holdt møde, og jeg har siden fundet ud af hvad der skete.
They tried the usual psychotherapy. They tried every medication available in those days. And they did have Tofranil and other things -- Mellaril, who knows what. Nothing happened except that I got jaundiced from one of these things. And finally, because I was well-known in Connecticut, they decided they better have a meeting of the senior staff. All the senior staff got together, and I later found out what happened.
De stak deres hoveder sammen, og de besluttede, at der ikke var mere, der kunne gøres for denne kirurg, der mere eller mindre havde separeret sig selv fra omverden, der på det tidspunkt var blevet så overmandet -- ikke bare med depression og følelser af uværdighed og utilstrækkelighed, men med tvangstanker, tvangstanker omkring tilfældige sammenfald. Og det var i særdeleshed tal, som gjorde mig frygtelig oprørt, hver gang jeg så dem. Alle mulige ritualer -- bare frygteligt, frygteligt. Husker du fra din barndom, hvor du gik på linjerne på fortovet? Jeg var en voksen mand, der havde den slags ritualer, og det blev så slemt, at hvis jeg hørte noget banke -- så skete der frygtelige ting oppe i mit hovede. I har alle set Edvard Munch´s maleri, "Skriget." "Skriget." Min hverdag var et stort skrig. Det var helt umuligt. Så de besluttede, at der ikke fandtes nogen behandling, der fandtes ingen behandling. Men der var dog én behandling, som faktisk blev udforsket på Hartford hospital i de tidlige 1940erne, og i kan nok nok forstille jer hvad det var. Det var det hvide snit.
They put all their heads together, and they decided that there was nothing that could be done for this surgeon who had essentially separated himself from the world, who by that time had become so overwhelmed, not just with depression and feelings of worthlessness and inadequacy, but with obsessional thinking, obsessional thinking about coincidences. And there were particular numbers that every time I saw them, just got me dreadfully upset, all kinds of ritualistic observances ... just awful, awful stuff. Remember when you were a kid, and you had to step on every line? Well, I was a grown man who had all of these rituals, and it got so there was a throbbing, there was a ferocious fear in my head. You've seen this painting by Edvard Munch, "The Scream." Every moment was a scream; it was impossible. So they decided there was no therapy, there was no treatment. But there was one treatment, which actually had been pioneered at the Hartford Hospital in the early 1940s, and you can imagine what it was: it was prefrontal lobotomy.
Så de besluttede -- Jeg vidste intet om dette, som sagt, Det var noget jeg fandt ud af senere -- at det eneste der kunne gøres for denne 43-år-gamle mand var at give ham det ... hvide snit
(Imitates a popping sound) So they decided -- I didn't know this, again, I found this out later -- that the only thing that could be done was for this 43-year-old man to have a prefrontal lobotomy. Well, as in all hospitals,
Nå ja, som ved alle hospitaler, var der en reservelæge tilknyttet min sag. Han var 27 år gammel, og han havde møder med mig to tre gange om ugen. Og naturligvis, jeg havde været der -- tre eller fire måneder på det tidspunkt. Og han bad om et møde med den øverste ledelse, og det gik de med til, for de havde høje tanker om ham på stedet. De mente han havde en meget lysende fremtid for sig.
there was a resident assigned to my case. He was 27 years old, and he would meet with me two or three times a week. And of course, I had been there, what, three or four months at the time. He asked to meet with the senior staff, and they agreed to meet with him, because he was very well thought of in that place. They thought he had a really extraordinary future.
Og han satte hælene i og sagde, "Nej. Jeg kender denne mand bedre end nogen af jer. Jeg har mødt ham gang på gang. I har bare set ham ind i mellem. I har læst hans journaler og så videre. Jeg tror, helt ærligt at hovedproblemet her er rendyrket depression, og at alle tvangstankerne kommer heraf. Og i ved naturligvis, hvad der sker hvis man får det hvide snit. Resultatet bliver alt fra slemt, til forfærdeligt, frygteligt, slemt. Hvis han gøre det bedste han kan, vil han ikke længere have tvangstanker, sandsynligvis ingen depression, men hans væsen vil være sløvet, han vil aldrig vende tilbage til kirurgi, han vil aldrig blive den kærlige far som han var for sine to børn, han liv vil være forandret. Hvis han får det sædvanlige resultat, vil han ende som Jack Nicholson i "Gøgereden" Og det er i udmærket klar over, han vil praktisk talt gå i en døs resten af sit liv.
And he dug in his heels and said, "No. I know this man better than any of you. I have met with him over and over again. You've just seen him from time to time. You've read reports and so forth. I really honestly believe that the basic problem here is pure depression, and all of the obsessional thinking comes out of it. And you know, of course, what'll happen if you do a prefrontal lobotomy. Any of the results along the spectrum, from pretty bad to terrible, terrible, terrible, is going to happen. If he does the best he can, he will have no further obsessions, probably no depression, but his affect will be dulled, he will never go back to surgery, he will never be the loving father that he was to his two children, his life will be changed. If he has the usual result, he'll end up like 'One Flew Over the Cuckoo's Nest.' And you know about that, just essentially in a stupor the rest of his life."
Ja, han sagde, "kan vi ikke prøve et række elektrochok-behandlinger?" Og ved i hvad? - De gik med til det. De gik med for at behage ham. De tænkte, "Nå ja, vi giver ham 10 behandlinger. Og vi spilder måske lidt tid. Og hvad så.? Det gør alligevel ingen forskel." Så de godkendte 10 behandlinger, og i starten -- det sædvanlige var, forresten, seks til otte behandlinger og det er stadig seks til otte -- de tilsluttede mig til ledningerne, bedøvede mig, gav mig et muskel afslappende middel. Seks virkede ikke. Syv virkede ikke. Otte virkede ikke. ved ni, bemærkede jeg -- og det var skønt jeg overhovede bemærkede noget som helst -- Jeg bemærkede en forandring. Og ved 10, bemærkede jeg en virkelig forandring.
"Well," he said, "can't we try a course of electroshock therapy?" And you know why they agreed? They agreed to humor him. They just thought, "Well, we'll give a course of 10. So we'll lose a little time. Big deal. It doesn't make any difference." So they gave the course of 10, and the first -- the usual course, incidentally, was six to eight, and still is six to eight -- plugged me into the wires, put me to sleep, gave me the muscle relaxant. Six didn't work. Seven didn't work. Eight didn't work. At nine, I noticed -- it's wonderful that I could notice anything -- I noticed a change.
Og han gik tilbage til dem, og de gik med til at prøve 10 mere.
And at 10, I noticed a real change.
Igen - ikke en eneste en af dem -- Jeg mener, der var omkring syv eller otte af dem -- troede det ville være til nogen nytte. De troede det var en midlertidig ændring. Men, sørme, ved 16, og ved 17, var der en mærkbar forskel i måden jeg havde det på. Ved 18 og 19, sov jeg igennem om natten. Og ved 20, begynde jeg at fornemme, jeg havde virkeligt den fornemmelse at jeg kunne overvinde dette, at jeg nu var stærk nok til at jeg, ved ren viljestyrke, kunne feje tvangstankerne af mig. Jeg kunne feje depressionen bort.
And he went back to them, and they agreed to do another 10. Again, not a single one of them -- I think there are about seven or eight of them -- thought this would do any good. They thought this was a temporary change. But, lo and behold, by 16, by 17, there were demonstrable differences in the way I felt. By 18 and 19, I was sleeping through the night. And by 20, I had the sense, I really had the sense, that I could overcome this, that I was now strong enough that by an act of will, I could blow the obsessional thinking away. I could blow the depression away.
Og jeg har aldrig glemt - Jeg vil aldrig glemme -- da jeg stod i køkkenet på afdelingen, det var en Søndag morgen i Januar 1973 --4-- mens jeg stod alene i køkkenet og tænkte, "Jeg har styrken til at klare dette nu." Det var, som om de stramt sammenkrøllede ledninger inde i mit hovede var blevet løsnet og jeg kunne tænke klart. Men jeg behøver en opskrift. Jeg behøver noget at sige til mig selv når mine tvangstanker, besætter mig. Gilbert og Sullivan fan´s her til stede husker "Ruddy Gore," og de husker gale Margaret, og de husker, at hun var gift med en fyr, der hed Sir Despard Murgatroyd. Og i stykket gik hun indimellem amok, hvert femte minut eller deromkring, og han sagde til hende, "Vi må lave et ord der bringer dig tilbage til virkeligheden, og det ord, min kære, vil være 'Basingstoke." Så hver gang hun gik lidt amok, han ville udbryde "Basingstoke!" Og hun ville svare, "Basingstoke, minsandten" Og så ville hun have det fint for en stund.
And I've never forgotten -- I never will forget -- standing in the kitchen of the unit -- it was a Sunday morning in January of 1974 -- standing in the kitchen by myself and thinking, "I've got the strength now to do this." It was as though those tightly coiled wires in my head had been disconnected, and I could think clearly. But I need a formula. I need some thing to say to myself when I begin thinking obsessionally, obsessively. Well, the Gilbert and Sullivan fans in this room will remember "Ruddigore," and they will remember Mad Margaret, and they will remember that she was married to a fella named Sir Despard Murgatroyd. And she used to go nuts every five minutes or so in the play. And he said to her, "We must have a word to bring you back to reality, and the word, my dear, will be 'Basingstoke.'" So every time she got a little nuts, he would say, "Basingstoke!" And she would say, "Basingstoke, it is!" And she'd be fine for a little while. (Laughter)
Nu jeg jo fra the Bronx. Jeg kan ikke gå og sige "Basingstoke." Men jeg fandt noget der var bedre. Og det var meget simpelt.
Well, you know, I'm from the Bronx. I can't say "Basingstoke." (Laughter)
Det var, "Årrrh, op i røven!" (Latter) Meget bedre end Basingstoke,
But I had something better. And it was very simple. It was, "Ah, fuck it!" (Laughter)
i det mindste for mig. Og det fungerede, min Gud, det fungerede. Hver gang jeg begyndte at få tvangstanker -- igen, efter 20 chok behandlinger -- ville jeg sige, "Årrrh, op i røven." Og så fik jeg det bedre, og i løbet af tre til fire måneder, blev jeg udskrevet fra hospitalet og jeg meldte mig til en gruppe kirurger, hvor jeg kunne arbejde med andre i lokalsamfundet, ikke på New Haven, men rimeligt tæt ved. Der blev jeg i tre år. Efter de tre år, vendte jeg tilbage til New Haven, havde giftet mig igen på det tidspunkt. Jeg tog min kone med mig, for at være sikker på at jeg kunne komme igennem det. Mine børn kom tilbage for at bo hos os. Vi fik to børn mere bagefter. Genoplivede karrieren, den blev faktisk bedre end den var før. Fik straks min gamle stilling tilbage på universitet. og begyndte at skrive bøger. Ja, det har været et skønt liv. Som sagt er der gået tæt på 30 år. Jeg stoppede med kirurgi for ca seks år siden, og blev fuldtids forfatter, som mange er klar over. Men det har været meget spændende. Det har været meget lykkeligt.
Much better than "Basingstoke," at least for me. And it worked! My God, it worked. Every time I would begin thinking obsessionally -- again, once more, after 20 shock treatments -- I would say, "Ah, fuck it." And things got better and better, and within three or four months, I was discharged from that hospital. I joined a group of surgeons, where I could work with other people, in a community, not in New Haven, but fairly close by. I stayed there for three years. At the end of three years, I went back to New Haven, had remarried by that time. I brought my wife with me, actually, to make sure I could get through this. My children came back to live with us. We had two more children after that. Resuscitated the career, even better than it had been before. Went right back into the university and began to write books. Well, you know, it's been a wonderful life. It's been, as I said, close to 30 years. I stopped doing surgery about six years ago and became a full-time writer, as many people know. But it's been very exciting. It's been very happy.
Ind i mellem, er jeg stadig nødt til at sige, "Årrrh, op i røven." Ind i mellem, bliver jeg stadig lettere deprimeret og får lidt tvangstanker. Så jeg er ikke fri fra alt det der. Men det fungerede. Det har altid fungeret. Hvorfor har jeg besluttet, efter aldrig nogensinde at have talt om dette, at tale om det nu? Jo, de af jer som kender nogle af disse bøger, ved at én er om død og at dø. Én er om menneskets krop og sjæl, Én er om den måde underlige tanker er i vores sind hele tiden, og de har altid noget at gøre med vores egne personlige erfaringer. Man kunne tænke, efter at have læst disse bøger, -- jeg har fået tusinder af breve om dem af folk, der mener dette -- Det er baseret på min livs historie, som jeg har beskrevet i bogen, min tidlige livs historie. Jeg er én der har overvundet hårde trængsler. At jeg er en der har drukket --- drak, drukket -- af de bitre frugter af nær-katastrofer i min barndom, og komme ud af det uden skræmmer, men styrket. Jeg har virkeligt regnet det ud, så nu er jeg i stand til at give folk råd om død og at dø, så jeg kan tale om mysticisme og den menneskelige ånd.
Every once in a while, I have to say, "Ah, fuck it." Every once in a while, I get somewhat depressed and a little obsessional. So, I'm not free of all of this. But it's worked. It's always worked. Why have I chosen, after never, ever talking about this, to talk about it now? Well, those of you who know some of these books know that one is about death and dying, one is about the human body and the human spirit, one is about the way mystical thoughts are constantly in our minds. And they have always to do with my own personal experiences. One might think reading these books -- and I've gotten thousands of letters about them by people who do think this -- that, based on my life's history as I portray it in the books, my early life's history, I am someone who has overcome adversity, that I am someone who has drunk -- drank? -- drunk of the bitter dregs of near-disaster in childhood and emerged not just unscathed but strengthened. I really have it figured out so that I can advise people about death and dying, so that I can talk about mysticism and the human spirit.
Og det har jeg altid haft skyldfølelse over. Jeg har altid følt, at jeg har været en hykler, for mine læsere kender ikke til det jeg lige har fortalt jer. Det er kendt for nogle på New Haven, naturligvis, men det er ikke almindeligt kendt. Så en af årsagerne til, at jeg er kommet her i dag for at tale om dette er -- helt ærligt, egoistiske grunde -- slippe min byrde og lade det blive kendt, at det ikke har været et ubekymret sind, som har skrevet alle disse bøger. Men mere vigtigt, syntes jeg, er det faktum, at en meget stor gruppe i dette publikum er under 30, og der er mange, naturligvis, som er et godt stykke over 30. For folk under 30, hvilket vil for mig forekommer at være næsten jer alle sammen, -- jeg tror næsten jer alle --- enten er på kanten af en storslået og spændende karriere eller i fuld gang med en storslået og spændende karriere, Alt kan ske for jer. Ting forandres. Ulykker sker. Noget fra jeres barndom kan komme tilbage og forfølge jer. I kan blive smidt af i svinget. Jeg håber ikke det sker for nogen af jer, men det vil sandsynligvis hænde for en lille procentdel af jer.
And I've always felt guilty about that. I've always felt that somehow I was an impostor, because my readers don't know what I have just told you. It's known by some people in New Haven, obviously, but it is not generally known. So one of the reasons that I have come here to talk about this today is to -- frankly, selfishly -- unburden myself and let it be known that this is not an untroubled mind that has written all of these books. But more importantly, I think, is the fact that a very significant proportion of people in this audience are under 30, and there are many, of course, who are well over 30. For people under 30, and it looks to me like almost all of you, I would say all of you, are either on the cusp of a magnificent and exciting career or right into a magnificent and exciting career: anything can happen to you. Things change. Accidents happen. Something from childhood comes back to haunt you. You can be thrown off the track. I hope it happens to none of you, but it will probably happen to a small percentage of you.
For de af jer, som det ikke hænder for, vil der være modstand. Hvis jeg, med den sidste rest af ånden, uden den ånd, som jeg havde i 1970erne, og ingen mulighed for helbredelse, ifølge den gruppe af meget erfarne psykiatere´s mening, hvis jeg kan finde en vej tilbage fra af dette, tro mig, så kan alle finde en vej tilbage fra hvilken som helst modstand i deres liv.
To those to whom it doesn't happen, there will be adversities. If I, with the bleakness of spirit -- with no spirit -- that I had in the 1970s, and no possibility of recovery as far as that group of very experienced psychiatrists thought, if I can find my way back from this, believe me, anybody can find their way back from any adversity that exists in their lives.
Og for dem som er ældre, som har levet igennem noget, der muligvis ikke er så slemt som dette, men som har gået gennem besværlige tider, muligvis mistet alt, lige som mig, og har startet helt forfra - vil noget af dette virke meget familiært. Der er mulighed forbedring. Der er tilgivelse. Og der er fornyelse. Der er fornyelses temaer i hvert et samfund, der nogen sinde er blevet studeret, og det er på grund af, at vi ikke bare fantaserer om muligheden for fornyelse og genopstandelse, men det sker faktisk. Og det sker mange gange.
And for those who are older, who have lived through perhaps not something as bad as this, but who have lived through difficult times, perhaps where they lost everything, as I did, and started out all over again: some of these things will seem very familiar. There is recovery. There is redemption. And there is resurrection. There are resurrection themes in every society that has ever been studied, and it is because not just only do we fantasize about the possibility of resurrection and recovery, but it actually happens. And it happens a lot.
Muligvis er det mest populære genopstandelses-tema, udover de specifikt religiøse, den om fuglen føniks, den gamle historie om fuglen føniks, der, for hvert 500 år, genopstår fra sin egen aske, for at forsætte et liv, der er endnu smukkere end det var før. Tak
Perhaps the most popular resurrection theme, outside of specifically religious ones, is the one about the phoenix, the ancient story of the phoenix, who, every 500 years, resurrects itself from its own ashes to go on to live a life that is even more beautiful than it was before. Richard, thanks very much.