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阿图·葛文德已为《纽约客》撰写了四本书和无数篇文章。
Atul Gawande has written four books and countless articles for The New Yorker.
当你想到文笔好的医生时，他将是第一个浮现在脑海中的人。
When you think about doctors who write well, he's gonna be the first person who comes to mind.
他的独特之处在于，这并非他与生俱来的天赋。
What's unique about him is that this isn't something that came naturally to him.
研究、写作、编辑、雕琢句子、讲述故事的工作。
The work of research, writing, editing, shaping sentences, telling stories.
这些都是他自学掌握的技能。
Those are all things that he taught himself.
他是一名外科医生，工作强度大、要求高，却仍能完成如此大量的写作。
He's a surgeon, so intense, so demanding, and he's still been able to write as much as he has.
他是如何做到的？
How has he done it?
对他而言，写作的纪律性意味着什么？
What is the discipline of writing for him been?
这就是本期节目的主题。
That's what this episode is all about.
好的。
Okay.
让我向你们展示我最近使用的写作工具Sublime，他们是本期节目的赞助商。
Let me show you this new tool that I've been using to write called Sublime, and they're the sponsor of this episode.
接下来我将演示如何用Sublime撰写这篇在x平台获得近百万曝光的帖子。
And what I'm gonna do is I'm gonna show you how I use Sublime to write this post on x, which got almost a million impressions.
它最初只是些基础的笔记功能。
So it started off with the basic note taking stuff.
我起初只是随手记笔记，但之后的功能才真正独特。
I was just throwing notes in, but it's the stuff that came after that was really unique.
这就是Sublime的特别之处。
That's what makes Sublime special.
你们看这个思维导图，它让我发现了本不存在的关联，这让我大为震撼。
You'll see here that I had this mind map, and that allowed me to begin to see connections that weren't even there, and I was blown away by this.
而且这还远未结束。
And then it didn't just end there.
Sublime有个'保存一条，发现百条'的功能，输入一条信息后，它就会自动推荐相关内容。
Sublime has this save one, discover a 100 feature where you can just put in a piece of information, and all of a sudden it just starts recommending things.
就像拥有一位品味出众的研究助手。
It's like having a research assistant that actually has good taste.
这些内容都是由真实用户添加的。
And these are put in there by actual human beings.
现在有了思维导图和所有相关想法，我开始认真构思文章结构。
And so now I had the mind map, I had all the related ideas, and I really started to think about how am I actually gonna structure this piece.
Sublime帮我发现了自己都没意识到的结构关联，看清了观点间的实际联系。
And Sublime helped me see parts of my structure that I didn't even realize were there to see how ideas were actually connected.
要知道，Sublime是由一群追求创意与美感的人打造的，而不仅仅是生产力和效率。
See, Sublime is built by people who care about creativity and beauty and not just productivity and efficiency.
在使用过程中你就能感受到这点。
And you can feel that as you use the app.
如果你想在自己的写作中使用Sublime，可以访问sublime.app并使用优惠码Perrell，他们会给你打8折。
So if you wanna use Sublime in your own writing, well, you can go to sublime.app and use the promo code Perrell, and they'll give you 20% off.
好的。
Alright.
让我们进入正题吧。
Let's get to the episode.
你得告诉我。
You gotta tell me.
那么该如何描述你的——用泰勒·考恩的话说——阿图尔·加万德式生产函数呢？
So how describe your sort of, as Tyler Cowen would call it, the Atul Gawande production function.
比如，你已经完成了这么多事情。
Like, you have just done so many things.
在准备过程中最让我惊讶的可能是，你涉猎了如此多不同领域，同时还能持续在写作和职业发展上稳步前进？
It might have been the thing that surprised me the most in the prep, is all the different sorts of things that you've done and how have you persistently marched forward as a writer but then also in building your career?
这就是数十年如一日自律与专注的体现。
There's just a sense of discipline and dedication over many decades.
我的一位朋友说过他常给的建议，我意识到这正是我一生的写照：40岁前对一切说好，40岁后对一切说不。
Well a friend of mine said that the advice he often gives is, and I realize this is what I've done all my whole life, say yes to everything before you're 40 and say no to everything after you're 40.
他的意思是，40岁前你还不清楚自己擅长什么、什么能让你充满干劲，而且世界在不断变化。
So by that he meant, before you're 40, you don't know what you're good at, you don't know what you're energized by, and the world is changing.
就像我大学毕业时，互联网还不成气候，没人想到后来能靠它创造财富。
Like when I graduated from college, there wasn't, you know, internet the wasn't a thing, like it would become, fortunes made over it.
如今很多人从事的职业当时根本不存在。
And jobs that many people have today simply didn't exist.
你又不是专门为此受过训练。
It's not like you trained for them.
因此，尝试大量你好奇或可能感兴趣的事物，能让你发现自己真正关注什么——哪些部分让我充满干劲，哪些部分让我精疲力竭。
So trying lots of things that you're curious about or potentially interested in allows you to figure out if you pay attention, oh here's what the parts of it I'm energized by, here are the parts of it that exhaust me.
然后只需最大化你的能量来源。
And then just maximize for your energy.
这就是我当时在做的事。
And that's what I was doing.
我在国会山工作过，组过乐队，在实验室待过，还开始为朋友创办的网络杂志撰稿。
So I worked on the hill, I had a band, I worked in some labs, I started writing for my friend, you know, his internet magazine.
当我走进手术室时，被彻底震撼了。
I went into an Operating Room and was blown away.
我把这些经历拼凑起来，发现最终做的三件事看似毫无关联。
And I pieced it together and I found there were three things I ended up doing that did not make any sense.
我学习外科手术技术，长期关注政策与公共事务，最终聚焦于推动全民健康、公共卫生和医疗体系发展。
I was learning how to do surgery, I had this long standing interest in policy and public affairs that ended up focusing on advancing health for the overall population, public health and health systems.
我还发现了写作的乐趣。
And I found writing.
这些主题逐渐浮现——人到四十应该认清这些方向。
And the theme that emerged, so by the time you're 40 you should know those things.
对你而言这些方向是什么？
What are those things for you?
此后对其他事情都要说不，因为现在你可以确信：我能长期专注这些领域，并且深知自己热爱它们。
And after that you say no to everything else because now the bet you can make is I can work at these things for a long time and know that I care about them.
如今我已60岁，三十年来我一直对人类健康充满迷恋，甚至可以说是痴迷——从科学、艺术、实践、专业的角度，以及作为这个世界一员的生活体验。我们虽然发现了如何使人类寿命翻倍，却尚未学会如何让这项成果普及所有人，如何可靠地实施，如何让社会负担得起，如何帮助人们获取所需资源，并应对其复杂性和影响。
And so now that I'm 60, I've had three decades of a fascination and I'd say an obsession with seeing humanity through the eye of health, the science, the art, the practice, the expertise, the experience of being a person in the world where we've discovered how to double human lifespan, but we haven't learned how to make it available to everybody, how to deliver it reliably, how to make it affordable to societies, how to help people navigate their way through getting the pieces of it you need, and dealing with its complications and its impact.
因此，我从事的工作或许各不相同，但它们都至少为我揭示了新事物——无论是我的外科实践，还是在政府与公共卫生领域的工作。
And so, you know, it might be different things I've been doing, but they're all illuminating something new, at least for me, whether it was my surgery practice, the work I did in government and public health.
二十五年前，我就开始研究如何在外科手术中提升群体层面的治疗效果。
I started twenty five years ago researching how can we improve outcomes at population scale in surgery.
我通过清单系统和体系改革取代了主要依赖惩罚和培训的旧模式，转而构建能让人们更容易做正确之事、更难犯错的体系。
I got this work with checklists and systems to replace systems that were mainly about improving through punishment and training to now how do we build for systems that can make it easier for people to do the right thing and harder for people to do the wrong thing.
最终结果就是，我的工作轨迹看起来可能显得非常分散。
So the net result has been it can look like I've been all over the place.
我不得不问，为什么一位外科医生要写作？
I've to ask, why would a surgeon write?
这看似是完全不相关的领域，可能也不是最明智的时间投资方式，但背后显然有更深层的原因。
You know, it seems so separate and it probably doesn't seem like the most financially prudent way to spend your time, but there's definitely something deeper.
你对这门技艺极为认真。
You take this craft very seriously.
其实我进入医学领域是非常自然的事。
Well, I came to medicine very naturally.
但写作对我而言绝非自然而然。
I did not come to writing very naturally.
我绝非天生就是作家。
I wasn't born a writer by any means.
直到我从事外科工作后，有位朋友创办了网络杂志——那时还是《石板杂志》的时代。
So it was after I was in surgery, a friend of mine started an internet magazine, it was Slate Magazine at that time.
石板？
Slate?
好的。
Okay.
那是在1996年，网景导航者的时代。
So it was 1996, Netscape Navigator days.
而且他没有，你知道的，花钱请专业记者来为一个前途未卜的项目撰稿。
And he was not getting, you know, paid journalists to come and write for something that was a shot in the dark.
所以他就会问朋友，你能写吗？
And so he'd ask his friends, could you write?
于是我开始为他写些小文章。
And so I started writing small pieces for him.
这些就像是日记，对吧？
These were like diaries, right?
是的，我写的第一篇就是日记。
Yeah, the very first thing I did was just a diary.
比如让贝克写了一篇，他写得非常棒，然后他问我是否愿意写一篇关于外科住院医师第二年值班的经历。
Know, like, gotten Beck to do one and so that, and he did an amazing one and then he asked me if I'd do one from just being on surgery duty as a second year resident in surgical training.
那几乎就是意识流写作，每天结束时记下笔记，直接发出去。
And so that was almost stream of consciousness, just taking notes at the end of the day, firing it off.
当时我们还没有合适的词来形容，本质上就是博客。
We didn't have a word for what it was then, was essentially a blog.
后来他又让我多写几篇，这就成了我的一个宣泄出口。
And then he asked me to do some more pieces and that became an outlet for me.
我注意到的是，每天结束住院医师工作回到家后，我都会抽出一个半小时到几个小时来研究某个主题或写作。
What I noticed about it was that I was getting home from you know, my day in residency and making time, making an hour and a half, a couple hours to be researching a piece or to be writing.
这对我来说是个信号，表明我在做这件事时获得的是精力而非疲惫。
And that was just a signal to me that it was that I was finding energy instead of exhaustion from doing it.
你知道，我最初写的那些文章并不怎么样。
You know, my first pieces were not that good.
里面有很多令人尴尬的地方。
There's lots embarrassing about them.
比喻手法过于做作，相互冲突，诸如此类的问题。
The metaphors were overwrought and clashed and all of those kinds of things.
但我在这个过程中每一步都在学习。
But I was but I learned every step of the way.
就像我的朋友杰克·韦斯伯格会告诉我：这部分你做得好，那部分还需要改进。
Like, you know, my friend, his name is Jake Weisberg, would tell me, alright, this is what you're doing well, this is what you're not doing well.
他算是某种编辑角色？
He was like an editor of sorts?
他当时就是在担任编辑。
He was being an editor.
不错。
Cool.
是啊。
Yeah.
然后他会说：这部分多写点，那部分少写点。把稿子还给我时，我总会问：这些修改是什么意思？
And so and and then would say, you know, do more of the first, do less of the second, and then he'd hand it back to me and I'd say, what's this for?
他会说，你知道的，要重写。
He'd say, you know, to rewrite.
我在大学里从没重写过任何东西。
I'd never rewritten a thing in college.
就像，我从来没听说过这种事。
Like, I'd never heard of it.
比如，谁会重写东西啊？
Like, who rewrites anything?
而那个，你知道的，成为了契机——几年后当我得到为《纽约客》撰稿的机会时，那篇文章经历了22次重写。
And that's, you know, was the opening into, you know, when I got a couple years later a chance to write for The New Yorker, that was 22 rewrites.
而且，你知道的，我不得不...我逐渐适应了这个过程。
And, you know, I I had to I built up some tolerance for the process.
22次重写是你为《纽约客》写的第一篇文章？
22 rewrites was the first New Yorker post that you wrote.
是吗？
Yeah?
第一篇《纽约客》的文章大约4000字，经历了22次来回修改，5次彻底重写。
For the first New Yorker piece, about 4,000 words was had 22 back and forths, five complete rewrites.
我原以为两个月就能完成，结果花了九个月。
I thought it would be a couple month thing, it ended up being nine months.
但你知道的，文章确实越改越好。
But I you know, it just kept getting better.
当时你想扇编辑耳光还是觉得这种严谨值得尊重？
Did you want to slap the editor in the face or were you like I respect this?
每次这都让我充满焦虑，因为我心想，好了，我完成了，我还有外科培训要做，这样挺好的。
So every time filled me with anxiety because I was like, okay, I'm done, I've got my surgical training to do, and so this is great.
然后他又会回来说，嗯，这里还需要再完善一点，那里还需要再调整一些。
And then he'd come back and say, well, there's a little more of this or a little more that.
要不加上这个？你知道的，我想看看，我必须确认一下。
How about adding, you know, I want to see, I've got to see.
但每次我都能学到新东西，让作品变得更好。
But every time I was learning something new that was making it significantly better.
所以我实在没法反对。
So I couldn't really object.
说实话我快抓狂了，但更多是因为他总能发现可以改进的地方。
You know, I wanted to tear my hair out, but it was more that he kept finding stuff that could make it better.
这很疯狂，这也将是我们谈话的主题之一——当你和那些经营公司的人、医生等群体交谈时，最常见的借口可能就是‘我没时间写作’。
You know it's crazy and this is going to be one of themes of the conversation is when you talk to people who run companies, who are doctors, whatever it is, the most common excuse might be I don't have time to write.
你彻底粉碎了这个该死的借口。
You have blown that excuse out of the freaking water.
四本书，天知道还有多少篇《纽约客》文章。
Like four books, who knows how many New Yorker articles.
你是怎么做到的？
How are you able to do that?
你可不是朝九晚五的普通工作，你的职业不仅耗时，还需要高度的认知专注和强度——但你依然能完成写作。
Like you don't just have a nine to five, you have a serious job that doesn't just take a lot of time but demands a kind of cognitive awareness and intensity and you're still able to do it.
我回顾住院医师时期，总在想当时怎么...
I look back on my residency and I wonder how
我做到了。
I did it.
我真的认为这就像我遵循的基本原则一样简单：如果某件事能给我能量，我就多做；如果让我精疲力尽，我就少做。写作给了我能量，手术也是，还有我做的一些研究工作。
And I really think it was just as simple as the basic principle I followed is if it gives me energy, I want to do more of it, and if it exhausts me, I do less of it, and the writing gave me energy, and surgery does, and some of the research stuff I did.
所以我只是一路把每个球都往前推进一点点。
And so I just kept moving each ball a little bit forward along the way.
你知道的，我并没有试图写大量的内容。
I had, you know, I wasn't trying to write insane amounts.
我设定了每月三十小时的目标。
I set a goal of thirty hours a month.
我大部分写作时间都达到了每月三十小时，平均每天一小时左右。
And most of what I was writing was putting in thirty hours a month, like an average of an hour a day.
这感觉是可行的。
That felt doable.
当你说
When you say
平均每天一小时，是指中位数一小时，还是存在很大波动？
average of an hour a day, was it like the median an hour, or was there high variance?
波动很大对吧？
High variance, right?
所以把初稿写下来就是利用我能抽出的任何时间做些基础研究。
So getting an initial draft down on paper would be just whatever time I could grab to do some basic research.
那时候手术室里有大量周转时间，有时候你可能要等上一个小时甚至一个半小时才能进行下一台手术。
Those days there was a lot of turn turnover time in the operating room, like you could wait an hour, hour and a half between cases sometimes.
这样我就能集中精力阅读材料，利用周末时间花几个小时把它搞定。
And so I could get a slug of just reading stuff, know, get some weekend time and put a few hours into just getting it down.
你知道，最初那几天是在为Slate写一篇800字的文章。
And, you know, those initial days was writing an 800 word piece for Slate.
我为《纽约客》写的第一篇文章，头几年每年大概写一两篇，那时我即将结束外科培训。
My first piece for The New Yorker, I was doing like one or two a year for the first couple years, and as I was getting to the end of my surgical training.
后来我对时间有了更多掌控，开始执业后我就专门留出时间写作。
And then I had more control over my time, and as I entered into practice I started reserving time for it.
知道吗，我就能划出更大的时间块来完成这件事。
Know, I'd be able to chunk out bigger blocks and try to make that happen.
但我的第一本书是2002年出版的，那时距离我完成培训还有一年左右，那是本散文集。
But, you know, my first book was 2002, so it about a year before I finished the training, and that was a collection of essays.
其中三分之二的文章曾在《纽约客》上发表过。
Two thirds of them had appeared in The New Yorker.
我还得再完成大约三分之一的量。
I had to finish out one, you know, one third more.
签合同时，我记得我躺在客厅地毯上，大口喘着气想：我到底干了什么？
And when I signed the contract, I remember I I laid down on my living room carpet and just I had to just breathing heavy saying like, what the hell did I just do?
因为我不确定能否在规定时间内写完那些额外的文章。
Because I don't know that I can get that chunk of those extra essays written in that time.
但我们做到了。
But we made it.
我的经纪人把我从崩溃边缘拉回来，让我坚持完成了。
My agent talked me off the ledge and just pushed through.
那么，为《纽约客》写作时，如何与《纽约客》的独特文风相协调呢？
And then with writing for The New Yorker, how does it work with The New Yorker voice?
因为说到《纽约客》的文风，我想不出还有哪本杂志能拥有更鲜明的风格了，但你的工具又该如何适配呢？
Because The New Yorker voice, I can't think of a magazine that has a more distinct voice and style, but then your tool, right?
那么你如何看待这两者之间的相似性、差异性以及如何调和它们？
So how do you think about the similarities, the differences, the reconciliation of those two things?
其实，我一直觉得我只是在用自己本真的声音写作，并不觉得需要刻意模仿——可能是我读《纽约客》太多，早已潜移默化。
Well, you know, I always felt like I was simply using my voice, and I didn't feel like I was needing to I think I either just had read so much New Yorker that I had imbibed.
浸染
Washed
了你。
over you.
但我会力求表达精准、清晰，避免冗长句式，尽可能呈现画面感，同时始终围绕核心论点展开。
But, you know, trying to be very crisp, very clear, not really long sentences, be as vivid visual as I can, but also it's all about the argument.
比如，我是否构建了有力的论证框架？讲述的故事是否能阐明这个论点？
Like, I'm do I have a sound case I'm making and a story I'm telling that illuminates that case?
当然，编辑的作用至关重要。我在那里的编辑亨利·芬德非常出色，可以说他在写作上培养和指导了我。
So, you know, the editor is definitely, and my editor there Henry Fender who's amazing, you know, has definitely sort of raised me and coached me in my writing.
所以我肯定吸收了他们许多写作方式。
So I'm sure I imbibed a lot of the way that they write.
你认为《纽约客》区别于其他刊物的独特风格是什么？
What would you describe as the New Yorker style that is different from what you see elsewhere?
我总觉得会有意想不到的闪光点。
I always think there's going to be a flare.
我不知道为什么用这个词，但纽约风格或《纽约客》风格确实有一种张扬、一种活力、一种独特的自信。
I don't know why that's the word, but there's a flare, there's a pizzazz, there's kind of a swagger to the New York style or the New Yorker style.
你说的是那些简洁不冗长的句子，但很多时候会让人觉得枯燥，而我并不认为《纽约客》的风格是枯燥的。
You're talking about clear sentences aren't too long and a lot of times you get a kind of dryness from that and I do not think of the New Yorker as being dry.
我几乎能想象那种步态——就像西村女孩昂首阔步穿过纽约城的样子，那种蕴含其中的能量，同时还带着明确的方向感。
I almost think of the kind of walk that like a West Village girl kind of like struts through New York City and the kind of energy that's sort of embodied within that while also having a sense of direction.
不知怎的，《纽约客》就带着这种感觉，还夹杂着一点卡通式的纽约幽默，这种风格可以追溯到最早的《纽约客》封面。
Somehow the New Yorker has that with like a little touch of like the cartoonish New Yorker humor that goes back to the very early New Yorker covers.
你想说的是，我被允许以一种在《纽约时报》或其他地方写作时不可能的方式表达自己的声音——比如在文章中穿插笑话。
Well, what you're getting at is I was allowed to have a voice in a way that I wouldn't have if I was writing for the New York Times or So writing I could tell jokes in the middle of it.
你知道，我总是有个小目标，特别是当我在讲述一个手术案例时。比如我写过一篇叫《瘙痒》的文章，讲一个女人的额头痒得如此剧烈，以至于她抓穿了自己的头骨，伤到了大脑。
You know, like I always had a little goal, especially if it's one I'm telling about a surgical case or a, you know, something, you know, I wrote a piece about the, called The Itch, about a woman who had an itch so severe on her forehead that she scratched through her skull and injured her own brain.
什么？
What?
是的。
Yes.
整个目标就是讲述这个骇人的故事，让它揭示大脑运作的某些原理，关于感觉的哲学意义，同时还要让你读着读着觉得痒。
And the whole goal was tell this macabre story, have it illuminate something about the brain and how it works, sensation and what philosophically that meant, and make you itchy.
这就是我的目标之一——我想让你感到瘙痒。
Like that was one of my goals, I wanted to make you itchy.
在其他地方我可能就没有这种创作机会了，对吧？
And like I wouldn't have had that opportunity somewhere else, right?
我尝试在新闻报道中运用通常属于小说创作的技巧，用讲故事的笔法来呈现事实。
I'm trying to use techniques that are typically associated with fiction writers in a reporting piece that is telling a story.
你知道，这可能是一种纽约客的风格，对吧？
And you know, that may be a kind of New Yorker style, right?
我试图讲述一个精心编写的故事，试图吸引你，通常围绕那些真正耸人听闻的主题。
That I'm trying to tell a well written story, I'm trying to grab you, often around subjects that are that one's really sensational.
对吧？
Right?
我本可以写关于洗手的事情。
I I could be writing about washing hands.
比如，我最早的一篇文章就是关于医院里因有人不洗手而导致两百万人感染的事。
Like, of my one of my earliest pieces was about, you know, two million people who get infected in hospitals because someone doesn't wash their hands.
而且
And
仅仅是洗手这个平凡故事及其问题...那些坐着的
just the the prosaic story of hand washing and the problems Those sitting
这些都是有趣的例子，因为我想探讨切入点这个概念。
are interesting examples because I wanna get into the idea of entry points.
对吧？
Right?
就像第一个例子会让你眉毛一扬觉得'哇'，而第二个例子则因为其非常重要且超级简单让我想读下去。
Like, that first one is something that makes your eyebrows go up like woah and then the second one makes me want to read it because it's very important, it's super simple.
然后我在思考的问题是：为什么我有时不洗手，尽管这显然已被证明能改善我自己和他人的健康状况？
And then the question that I was thinking about is why don't I wash my hands sometimes even though it's obviously so proven to improve my own health outcomes in other people's too?
是的，然后你就触及到行为层面了。
Yeah, and then you get to the behavior.
这很重要，你懂吗？
It's like important, you know?
比如在机场洗手间，如果有人站在旁边，你洗手的概率会翻倍不止。
Well and if you're in a bathroom you know, at the airport, if someone is standing there, you are more than double more likely to actually wash your hands as opposed to if someone
这对我来说确实如此。
That's is standing true for me.
还有，我发现自己会看着别人想：你居然没洗手。
Also, you know what's true for me is I'll look at other people and I'll be like, you didn't wash your hands.
你到底有什么毛病？
What the heck is wrong with you?
然后我自己上完厕所45秒后也真的不洗手。
And I will literally not wash my hands after going to the bathroom like forty five seconds later.
可能说太多了，
Probably TMI,
你懂吧？
you know?
没错。
Exactly.
离我远点。
Don't come anywhere close to me.
我经常想这个问题，因为不知道为什么有时会嫌洗手麻烦，但看到相关数据又会想：老兄你在干嘛？
But I think about this a lot because I don't know why I sometimes get annoyed with washing my hands, but then I'll read the numbers on it and it's like what are you doing, dude?
这明明是举手之劳。
It's such low hanging fruit.
是啊，是啊。
Yeah, yeah.
嗯，这就是为了未来看不见的延迟收益而采取当前行动的问题，虽然可能性低但意义重大。
Well, it's the problem of an action now for the sake of an invisible delayed gain later that is low likelihood but significant.
所以当你在机场旅行或今天我们握手后，你感冒或流感的可能性并非微不足道。
So your likelihood you will get a cold or a flu when you're traveling through the airport or when we finish from shaking hands with each other today is not insignificant.
微不足道。
Insignificant.
所以每天洗几次手。
So washing your hands a few times a day.
我25分钟前刚洗过手。
I washed my hands twenty five minutes ago.
哦，那里
Oh there
你看。
you go.
因为还有别人在看着呢，你知道的。
Because someone else was watching you know.
告诉我关于切入点的事。
Tell me about the entry points.
告诉我你思考切入点的方式——你有核心论点，那可以说是文章的主旨，然后你还有文章的整体框架，是这样
Tell me about the entry points of how you think about okay you have the core argument and that's the thrust of the piece I could say, and then you have the almost the framing of the piece, is that how
你认为的吗？
you think about it?
嗯，我是说我保存了一个潜在文章创意的清单。
Well, I mean I keep a list of potential ideas for articles.
这是同一个清单，可能涉及研究，也可能是《纽约客》的故事点子，甚至可能是书籍构思。
It's the same list that is about could be about research but also is about story ideas for the New Yorker or it might even be book ideas.
这个持续更新的清单我已经保存多年，现在已超过400条了。
And I've kept that running list for years, it's past 400.
是像苹果备忘录那样的吗？
Is that like an Apple note?
对，就是苹果备忘录。
Yeah, an Apple note.
其中很多点子就躺在那里没有进展，因为它们要么是缺少宏观意义框架的精彩故事，你知道，就像你看到很多戏剧性事件那样。
And many of them sit there and don't have any legs because it has the, it's either a cool story with no larger frame of meaning, You know, like you see lots of dramatic things.
比如有人去世了，有人写了篇非常有趣的文章签署了什么。
Someone died, someone had, you know, a really interesting article that signed something.
你知道那个患瘙痒症的女人吗？我读到那个病例报告时就记在笔记本里，觉得这是个好故事。
You know, the woman who had the itch, I read that as a case report and that went down in my notebook as that is a, that's a cool story.
但我当时没有深入思考：为什么这很有趣？它的价值在哪里？
But I didn't have anything like, okay, why is that interesting, what makes that work?
当我后来想到或读到与之相关的内容时，就会把新想法加进去，这样就完整了，明白吗？
And when I then either think of or read something that connects up with that, now that goes into it and now I have it, right?
我需要两者兼备。
I need both.
我需要有意义的故事主线、情节、内涵、哲学思考、抽象概念、心智模型或理念，还需要能承载这些内容的叙事载体。
I need the meaningful narrative, the story, the meaning, the philosophy, the abstract concept, the mental model or idea, and the vehicle that's the story that can make that move.
然后它可以是一个以这个概念开头的引子，你知道，我写那篇文章时每年有200万人在医院感染。
And then it can be an opening that starts with the idea, you know, 2,000,000 people picking up infections in hospitals per year back when I was writing that article.
我认为数字下降了，但感染人数仍然很多。
I think it's down, but it's still a lot of people.
接着我的采访对象是医院里负责感染控制的那位女性主管。
And then I had the vehicle was following along with the woman in my hospital who leads infection control.
她的全部工作就是督促人们洗手，而她说'我不想当洗手警察'。
And her whole job is trying to keep people washing their hands And she's like, I don't want to be the handwashing police.
就像'我上医学院不是为了当洗手警察'。
Like, I didn't go to medical school to be the handwashing police.
而且你知道，跟随她工作时，Purell洗手液刚问世，就是那种酒精免洗洗手液。
And, and you know, following her in her job, Purell was just coming out, you know, alcohol based hand rubs.
所以这简直改变了她的生活。
So it was like changing her life.
现在这个故事有几个转折让它非常引人入胜，开头可以用她的故事，也可以用一个冲突场景。
And so there are several turns to the story now that made it really compelling, and the opening could be her, it could be a confrontation.
人们总是忍不住想从最戏剧性的案例开始写。
The temptation is always to start with a very dramatic case.
然后它就变得非常模式化了
And then it becomes a very predictable it's
很有趣，对吧？
funny, right?
因为这就是作家的职责之一。
Because this is one role of the writers.
可以说人类对无聊事物存在偏见，这影响着我们的行为倾向和思考偏好。
You could say that humans have an against boring bias in terms of what we're inclined to do and not to do, what we're inclined to think about and not think about.
世界上有太多事情，尤其在健康领域，谈论或思考起来都显得乏味。
And there are so many things in the world, probably in health more than anywhere, that are kind of boring to talk about, boring to think about.
但如果真能促使人们改变行为去讨论这些，社会将获得巨大进步。
But if you actually get people to change their behavior to talk about it, huge improvements to society.
是的。
Yes.
问题在于我们不仅对无聊事物有偏见，对可预测性事物也同样如此。
The thing is we also have a bias not only for not boring, but also for not predictable.
就像我书里写的，每章开头都是'他躺在急诊室里'。
And if you read, you know, in a book I write, every chapter opening with a he was in the emergency room.
你很快就会发现这种固定模式。
You're just going to, you're going to notice the mechanics at work.
所以有时要以惊人观点开篇，有时要先营造场景，这些都是我后来才学会的。
And so sometimes you start with a surprising idea, sometimes you start with setting a scene and I had to learn that.
要知道，这花了我很长时间。
You know, it took a lot of time.
我的编辑会直接指出，比如这个开头是O型结构，意味着首尾相接。
My editor would talk about like, he'd literally talk about, you know, this one is an O, meaning we're starting Is where it ends.
故事将在结局处开篇。
It's going to start where it ends.
而这个更像是W型结构。
And this one's more like a W.
我们有三个高峰，我们将逐一攻克，从左至右推进。
We've got three peaks and we're going to work our way through and we're going to advance from left to right.
就像手术室里一样，你每次都在尽可能重复相同的操作。
One of the things, like in surgery in an Operating Room you're trying to do as much as possible the same thing every time.
你不是在追求创意，而是像站在罚球线上，力求每个动作都精准无误，做到百发百中。
You're not trying to be creative, you're trying to be like you're at the free throw line and you're trying to make every move so you're sinking 99 out of 100, 100 out of 100.
你知道，我并不想改变游戏规则。
You know, I'm not making I don't want to change the game.
而在写作中，它的魅力部分在于那是我不断尝试创新的领域。
And in writing, part of what's attractive about it is that's the space where I'm constantly trying to do something new every time.
某种程度上，随着时间推移会越来越难，因为你用尽了技巧，必须想办法让这次与众不同。
And it gets harder and harder as time goes on in some ways because you use up your tricks and you've got to figure out how am I going to make this time different.
你是否考虑过成为全职作家而放弃医学？还是说你的考量始终是：'不，留在医学领域才能写出更有影响力的故事'——用比喻来说，就是保持手术刀在手？
Do you ever think about being a full time writer and leaving medicine or was your calculus always, No, I can write better stories and have more impact if I stay in medicine, if I keep the blade in my hands so to speak?
这反映了我缺乏自信——我害怕放弃其他一切，仅依赖已有经验。
I think it's a reflection of my lack of confidence that I'm afraid of giving up anything else and just relying on the experiences I've had.
我是说，了不起的作家几乎不需要写作之外的额外经历，但我总觉得灵感之泉会枯竭。
I mean amazing writers are drawing on almost no added experience outside of their writing, but I sort of feel like the well will dry up.
如果我不继续从事外科手术、公共卫生和研究这些迫使我走出舒适区、挑战自我、学习新事物的领域，我还能有什么可写的？
What will I have to say if I'm not out there trying to do something in surgery and public health and research and something that gets me out of my comfort zone trying to challenge, learn, do new things?
作家对自己最大的谎言就是：'啊，这个我稍后会记得写下来。'
The biggest lie that writers will tell themselves is, Ah, I'll remember that later.
不。
No.
我是说，有太多时候我在听播客时想保存些内容，结果却总没保存成，因为用手机打字实在太麻烦了，你懂吧？
I mean, there's so many times when I'm listening to a podcast, I wanna save something and I just never end up saving it because typing it into the phone is just too much work, you know?
不过，我找到了一个绝佳的解决方案。
Well, I found a great solution to that problem.
它叫Podcast Magic，还是本期节目的赞助商呢。
It's called Podcast Magic and they're the sponsor of this episode.
操作起来超级简单。
So what you do, super easy.
假设你正在用Apple或Spotify收听，如果听到这段对话中特别喜欢的部分，只需截个图，然后发邮件到PodcastMagic@Sublime.app。
Say you're listening on Apple or on Spotify, if you find a bit in this conversation that you really like, just take a screenshot of it, and then email it to PodcastMagic@Sublime.app.
只要在一分钟内发送邮件，你就能收到回复，里面包含文字稿、上下文等所有你需要的信息。
If you email it like a minute later, you'll get an email back with the transcript, the context, all the information that you need.
这样一来，你就不需要记下所有信息了。
And then that way, you don't need to write down all the information.
所以如果你在对话中发现特别喜欢的内容，不妨试试播客的魔力。
So if you find something in the conversation that you really like, well, check out podcast magic.
好了，我们开始采访吧。
Alright, let's get to the interview.
那么当你为《纽约客》撰稿时，如何兼顾文章的时效性（这是2022年6月刊）与永恒性呢？
And then when you're writing for The New Yorker, how do you think about integrating the timeliness of a piece, this is in the June 2022 edition, with the timelessness of a piece.
说实话，我经常重读文章，应该说《纽约客》上我读过的文章平均都有十年历史了。
You know, I go back and I I I would actually say the median New Yorker piece I read is like ten years old.
你懂我意思吧？
You know?
它可能是所有杂志出版物中最古老的。
There's probably the oldest of any magazine publication.
《纽约客》给人的感觉是，它的文章会经得起时间考验，但也必须有一个‘为何是现在’的理由，对吧？
And there's a sense with the New Yorker that the pieces will age well, but also there's got to be a reason for why now, right?
是的。
Yeah.
我认为《纽约客》其实有两类截然不同的文章，既有西摩·赫什报道阿布格莱布事件那样的深度调查，也随时在发布突发新闻。
I mean I think there's really two different kinds of pieces in The New Yorker because they have the Sy Hirsch, Abu Ghraib story and they have the they are breaking news all the time.
而后者并非我的职责范畴，对吧？
And that is not one of my roles, right?
这种情况很少发生。
It's rarely the case.
奥巴马医改时期我写过大量相关文章，如今我也在持续撰写关于国内外公共卫生体系瓦解及其危害的报道。
I was doing a lot of writing around when Obamacare was happening, I'm doing a lot of writing now around the dismantling of public health at home and abroad, and the damage that's doing.
这让我比以往更注重时效性和截稿压力。
And so that's meant much more timeliness and deadline driven than I'm used to.
无论是为《纽约客》撰稿、写书还是其他媒体，我大部分时间都在思考：我写的东西五年十年后还会有人愿意读吗？
For the most part I'm thinking about in my writing for whether it's The New Yorker or for a book or other outlets, can I write something that people will still want to read five or ten years from now?
这就是我的终极追求——经得起五年甚至十年的考验。
That's my holy grail is five or ten years from now.
当然，现在年纪渐长，我开始思考：这个期限能不能更长些？
Course, now I'm older, and then I think, okay, can it be even longer than that?
但你知道，我写的那些非时效性文章，编辑部有时会压稿两三四个月，因为截稿紧迫的内容总是优先排期。
But you know, the pieces I'm writing, they'll land and then they'll sit on them sometimes for two, three, four months because many of the deadline driven ones are getting first priority for space.
如果我写的是长篇大论，八千到一万字，那这就是他们所谓的封面故事。
If I'm writing really long pieces, eight, ten thousand words, then that's their quote unquote cover story.
所以杂志通常只会刊登一篇重磅文章。
And so they'll only do one really big piece generally in a magazine.
因此可能要等上一阵子。
And so that might wait a while.
最妙的地方在于选择那些常青的话题，就像我们刚才讨论的痛点问题。
And the beauty of it is picking topics that feel evergreen, like the itch that we were just talking about.
这个话题随时都可以发表。
That could go at any time.
不过这些书差别很大对吧？
Yeah, the books are very different though, right?
我是说像《最好的告别》这样的书，其实没有时效性限制。
The books I mean, being mortal, that doesn't really have an expiration date.
如果写得好，确实不会过时。
If I'm doing it right, it doesn't.
希望如此。
I hope it doesn't.
《最好的告别》已经出版12年了，反响一直很好。
Being mortal is 12 years old now and it's been amazing.
就像把孩子送到世界上，看着他长大，并不断听到关于他的好消息。
It's like putting a child out in the world and seeing it grow up and hearing back good things about how he's doing.
《最好的告别》源于我经常写书的动机——那些让我感到困惑、痛苦或不安的事物。
Being Mortal was written out of Often my books come from things I don't understand and I'm either distressed or uncomfortable about.
那时在我的执业生涯中，作为一名外科医生，我正处于职业生涯中期，主要从事癌症手术。
And so by that point in my practice, I was middle of my practice as a surgeon, I was primarily doing cancer surgery.
我已经过了那个阶段，你知道的，并发症阶段。我的第一本书讲述的是面对不完美时的困扰，那时我还在学习曲线上，进行着最初的手术，你知道的，以及如何获得许可去做那些事，会犯错。
I'd reached past the stage, you know, Complications, my first book was about discomfort from being imperfect, and still being on a learning curve, doing my first operations, you know, and how do I get permission to do that, making mistakes.
到我写《身为凡人》时，我已经能坦然面对自己犯的错误。
By the time I'm writing being mortal, I'm comfortable with the errors I make.
我对自己的能力有信心，能够解决问题，即使事情出错时，我也在尽力做到最好。
I'm confident in my ability to fix things and also that even when things go wrong that I'm doing the best I can.
相比之下，在癌症诊疗中，你也会遇到那些你无法治愈的人。
By contrast, in a cancer practice you're also seeing people who you can't fix.
而我对自己能否胜任照顾那些我无法解决问题的病人感到不安。
And I was not comfortable that I was being competent at being able to take care of people whose problems I could not fix.
我不知道如何才算是在自己所做的事情上表现出色。
I didn't know what it meant to be great at what I was doing.
我曾遇到过一些病例，很明显我让情况变得更糟，损害了他们的生活质量，却未能延长他们的生命。
I'd had cases where we clearly were I was making people worse off and harming their quality of life without helping with their quantity of life.
这促使我开始利用写作的机会来探讨这一困境。
And that prompted me to start using the chance to be a writer to say let me write about this dilemma.
最初是《纽约客》上的一篇文章，讲述一位35岁左右的女性，怀有第一个孩子时被诊断出四期肺癌，后来又出现了第二种癌症，我被叫去治疗。
And first it started this New Yorker piece about a woman in her mid-30s who was pregnant with her first child and diagnosed with stage four lung cancer and then had a second cancer that I was called in to treat.
在探索治疗路径时，我意识到自己没能给予她我认为应该懂得如何提供的支持。
And navigating a pathway where I just was not offering her the support I felt I should know how to give.
于是我采访了许多患者，了解他们的经历，其中很多相当严峻和令人不安，关于他们在医疗体系中的感受。
And so I interviewed lots of patients about their experiences, many of them pretty grim and disturbing about how they felt in the medical machine.
然后我采访了姑息治疗医生、护士、养老院工作人员、老年病专家等人，经过200次访谈后，最终得出一个显而易见的结论。
And then interviewed people who were palliative care doctors and nurses, nursing home, workers, geriatric specialists, and learned, you know, by the end, after 200 interviews, a kind of duh.
人们的生活目标不仅仅是延长寿命。
People have goals in their life besides just living longer.
对他们真正重要的优先事项。
Priorities that really matter to them.
这些优先事项因人而异。
Those priorities are different from person to person.
它们会随着时间而改变。
They will change over time.
而了解人们优先事项最有效的方式就是直接询问他们。
And the most effective way to know what people's priorities are is to ask them.
但我们很少询问，主动询问的概率不到四分之一。
And we don't ask, we ask less than a quarter of the time.
由此导致的结果就是你们的医疗护理。
And the result of that is your care.
如果不主动询问，你们的护理方案往往与患者的真实需求脱节，最终导致痛苦。
If you don't ask, your care is often out of alignment with their priorities, and the result of that is suffering.
因此我通过写作来记录这个过程——改变与患者交谈的方式、调整提问内容、改进诊疗实践，后来当我父亲罹患绝症时，这些改变也发挥了巨大作用。
And so it was walking through getting to write about, now walking through the experience of changing the way I talked to people, the questions I asked, how I practiced, and then finding that it that when my dad had a terminal illness, it made a huge difference there too.
让我们先快速回顾一下你说的'我需要把这件事写下来'这个部分。
Let's just walk back real quick to the part of this that says I need to write about that.
你刚才用了'困惑'这个词来形容那种挣扎感，请详细说说当你决定'好吧，我真的要开始写这本书了'时的切身感受。
There was, you sort of used the word confusion, grappling with, Tell me more about the felt sense that you have when it's like, alright, I'm really going to commit to a book here.
嗯，
Well,
我列出的许多写作主题，都是那些让我突然驻足思考的事情。
lot of the things that I write down in my list of things to write about are things that calm bring me up short.
而且我觉得
And I feel like
让你驻足思考？
Bring me up short?
意思是这要么是一个让我惊讶的想法，要么是一个我找不到好答案的问题。
Meaning that it's either an idea that surprises me or a problem that I don't have a good answer to.
然后
And
我在不同时期写过关于人们走向生命终点的故事。
I'd at various points written about people coming to the end of life.
在我的第一本书《并发症》中，我写过一个案例《我再次归来且更强大》。
I wrote about a case in my first book Complications, I Came Back Again and Better.
每次我的结论都非常不尽如人意。
And each time my conclusion was very unsatisfactory.
我不知道该如何提供帮助，不清楚自己该扮演什么角色，不知道该为患者提供什么、做什么或说什么。
I didn't have a way to offer, I didn't know what my role was, you know, with people and what I should be offering, doing or saying to them.
而理解这些，正是我通过写作来厘清困惑的方式。
And understanding, so reaching the point that I could writing is my way of grappling with the problems that confuse me.
这些往往正是医学的科学性、艺术性和人文性相互碰撞的领域，而通过文字梳理这些矛盾正是我的专长。
They are often where the science and the art and the humanity of medicine collide and sorting it out is what I can do on the page.
我经常在日记或其他地方这样做，当我感觉看到出路时，就能通过书写找到解决方法。
I'm often doing that in a journal or other things and then that can start to become something when I feel like I'm seeing a way through and I can write my way through it.
是的。
Yeah.
跟我讲讲这个，这是你写的东西。
Tell me about this, this is something you wrote.
当然。
Sure.
我们最终的目标毕竟不是善终，而是活出精彩人生直到最后一刻。
Our ultimate goal after all is not a good death, but a good life to the very end.
真正领悟到这一点源于
Really embracing that that's from
《身为凡人》这本书，真正理解其含义改变了我的行医方式。
being mortal really understanding what that meant changed my practice.
以前我会说医学的目标是拯救生命，帮助人们尽可能独立自主地生活。
So I would have said that the goal of medicine was to save people's lives and help them live as independently and ably as possible.
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但当你无法做到这一点时，目标又是什么？
But when you can't do that, then what is the goal?
后来我意识到，关键在于理解人们除了延长生命外的人生优先事项。
And what I came to realize is it's understanding what people's priorities are besides just living longer for their life.
举个例子，有两件事。
And so as an example, two things.
第一件是遇到一位临终关怀医生，他指导我如何与重症患者沟通。
Number one was meeting a palliative care clinician who could walk me through, here's what I do when I'm talking to people about their very serious illness.
我，你知道，他们会问一些关键问题。
I, you know, they ask some key questions.
你对自己病情现状的理解是什么？
What's your understanding of where you are with your illness?
如果病情恶化，你愿意接受什么？你的希望和恐惧分别是什么？
What are you willing to, what are your hopes and what are your fears if this gets worse?
为了延长生命，你愿意牺牲什么，不愿意牺牲什么？为什么？
What are you willing to sacrifice, what are you not willing to sacrifice for the sake of more time, and why?
你能接受的最低生活质量标准是什么？
What's the minimum quality of life you'd find acceptable?
这样你就能得到人们给出的答案——如果只是问'除了延长寿命外你的首要考虑是什么'，人们往往无法回答。
And that gives you the answers people give you people can't if you just say, what are your priorities besides living longer?
人们通常无法给你一个明确的答案。
People often can't give you a clear answer.
但他们能回答我刚才问的那些问题，而这些答案能说明问题。
But they can answer those questions that I just asked you, and that can tell you.
比如，我书中写到的一位受访者说，最低生活质量标准是：
So for example, one person I write about said, minimal quality of life.
只要能看电视上的足球比赛和吃巧克力冰淇淋，对我来说就足够了。
Well, if I can watch football on television and eat chocolate ice cream, that'd be good enough for me.
这简直是最完美的生前预嘱。
Like, that's the best living will ever.
这就是你需要的指示。
That's the instructions you need.
对吗？
Right?
如果你能理解的话，这次手术、这种药物还能让我继续吃巧克力冰淇淋和看电视上的足球比赛吗？
If you can you know, will this operation, will this medicine help me still eat chocolate ice cream and watch football on television?
是吗？
Yes?
把它给我。
Give it to me.
让我继续下去。
Keep me going.
不行吗？
No?
让我走。
Let me go.
然后我对患有脑瘤且病情恶化的父亲说，那个医生说可以吃巧克力冰淇淋和看电视上的足球比赛。
And then I said to my father, who had a brain tumor, that was advancing, and said, so, you know, this guy said chocolate ice cream and football on television.
他说，这对我来说远远不够。
He said, no way is that good enough for me.
于是我们就开始行动了。
And we were off to the races.
那好吧，什么才是？
So okay, what is?
这指引着我们不断调整方向。
And then that guided us to the things and to change over time.
要知道，最初他是一名外科医生，他的回答、他的故事就是‘我是一名外科医生’。
You know, in the beginning he was a surgeon and it was, you know, his answer, his story was, I am a surgeon.
我的首要任务是继续做外科手术。
My priority is to keep on doing surgery.
因此这就是我们优先考虑的事情。
And so that's what we prioritized.
后来当他无法再做手术时，他感到迷茫，不知道还能做什么。
And then when he couldn't do it anymore, he was lost and didn't know what there was to do.
然后他意识到，他热爱外科手术的原因在于与人建立联系，并能为他们做些有益的事。
And then he realized what he loved about surgery was connecting with people and being able to do something good for them.
即使带着这个肿瘤，他还是竞选了俄亥俄州东南部扶轮社的地区总监，一年内走访了66个俱乐部，帮助他们规划慈善工作和社区建设。
And even with this tumor, he ran for district governor of the Rotary Club in Southeastern Ohio and visited 66 clubs in the course of a year, visiting them, helping them figure out how they're going to, what charitable work they're going to do and building community.
而且，你知道，关键问题是——什么才是最重要的？
And, you know, it was one thing you know, what was most important?
什么能让他度过美好的一天？
What would give him a good day?
让生命有价值的事物在不断演变。嗯。
What made life worth living evolved Mhmm.
随着他的身体机能衰退，但在每个阶段——甚至当他逐渐四肢瘫痪时——他都能找到新的人生意义。
As his capacities declined, but he found something at each step even when he was becoming quadriplegic.
哇。
Wow.
知道吗，我特别喜欢和外科医生聊天，因为你们个个都充满激情。
You know, I love talking to surgeons, because y'all are intense.
就是那种特别强烈的感觉，你懂吗？
Like, real intense, you know?
这是你们节目里的常规内容吗？
This is a regular thing on your show?
什么，外科医生？
What, surgeons?
对，就是外科医生如何写作。
Yeah, how surgeons write.
嗯，外科医生是怎么写作的。
Well, how surgeons write.
其实我想问你，为什么世界上没有更多像阿图尔·葛文德这样的人？
There's well, I was gonna ask you, why aren't there more Atul Gawandes in the world?
然后我就想，可能这份工作强度太大，让人很难有精力写作。
And then I was just like, I think the job, it might just be too intense to make it easy for people to write.
实际上有很多医生作家。
There's lots of doctor writers, actually.
真的吗？
Really?
是啊。
Yeah.
其实，我有个好朋友叫悉达多·穆克吉，他是外科医生，肿瘤学家，但不是外科肿瘤学家。
In fact, there's, you know, one of my good friends is Sid Mukherjee, who is a surgeon, who's an oncologist, not a surgical oncologist.
他写过关于癌症的书，叫《众病之王》，还得了普利策奖。
And wrote about cancer, wrote a book called Emperor of All Maladies, won the Pulitzer.
我心目中的英雄包括Sherwin Newland，一位在1980年写了《How We Die》的外科医生。
My heroes included Sherwin Newland, a surgeon who wrote How We Die in 1980.
当然还有Oliver Sacks。
Oliver Sacks, of course.
我提到外科医生这一点是想说，在我看来，外科医生就像是医学界的职业运动员，就...
What I was getting at with the surgery point is that surgeons seem to me like the professional athletes of the world of medicine in terms
就强度和追求进步的决心而言。
of the intensity, the commitment to improvement.
我相信你到处都能看到这一点，但我遇到的每个外科医生都有这种特质。
I'm sure you see it all over the place, but every surgeon I've met has that about them.
我们都有一定程度的自负。
We have a certain amount of ego.
没错。
Yep.
嗯哼。
Uh-huh.
我们相信自己，你知道，我们是山丘之王。
We believe we are, you know, we are the the kings of the of the hill.
但这部分也是表演，部分是我感兴趣探究的，因为外科医生的性格是吸引我选择这个专业的部分原因。
But but that's also partly show and partly what I'm interested in probing because the character of surgeons was part of what drew me to the specialty.
我原本是公共卫生和政策方向的人，初级护理是...
I was a public health and policy person, primary care was
是啊，90年代临床医学的一群逻辑性很强的人，
Yeah, a logical bunch of way clinical in the '90s,
我在90年代为克林顿工作过。
I worked for Clinton in the '90s.
我认识并见过的最优秀的外科医生，都是兼具自信与谦逊的人。
And the best surgeons I knew and got to see were people who had confidence and humility.
自信与谦逊。
Confidence and humility.
同时具备。
At the same time.
理解这一点很重要——你绝不会想要一个毫无畏惧的外科医生，也不会想要一个畏手畏脚的外科医生。
And understanding what that was, you you never want a surgeon who is not a little bit afraid and you don't want a surgeon who's paralyzed.
这让我觉得他们格外有趣。
And that made them incredibly interesting to me.
我以前是个总给自己留退路的人，就像我最爱的《纽约客》漫画里那个墓碑上写着'他始终保留选择权'的家伙，那就是我的写照。
I was a guy you know, my favorite New Yorker cartoon was the gravestone that said he kept his options open, and that was me.
我进入这个领域，很大程度上是为了锻炼自己的决策能力和塑造性格，和其他目的一样重要。
And I did it as much I I went into the field as much to shape my own ability to make decisions and and character as anything else.
哇哦。
Oh wow.
是啊。
Yeah.
你是在说那个惯例吗？就是你在房子里审读书稿草稿，还负责请大家吃晚饭？
Is this thing that you do around reading drafts of books in a house where you buy dinner?
当你进行到某个阶段——对我来说大概是完成四分之三，或者刚写完初稿时，这时内容已大体成型但还没完全定型。
When you're at a point that you're, you know, for me it's about three quarters of the way through, or maybe even getting the first draft, when you've got enough of it down but you're not totally committed to it.
你愿意把它撕碎。
You're willing to tear it up.
所以有时候你可能会走得太远，以至于你其实不想听到任何反馈。
So sometimes you can get so far you don't actually want to hear any feedback.
对，这里的黏土还有点湿。
Right, the clay is still a little wet here.
与其把它发给所有人说'给我反馈'，然后没人回应，不如改成'我请你吃中餐，我们喝点酒，聊聊这本书'。
And instead of sending it out to everybody like, give me feedback, and then you'll hear from nobody, it's I'm gonna buy you Chinese dinner, we're gonna have some wine and we're gonna talk about the book.
这给了他们一个截止日期。
It gives them a deadline.
时间限制。
Time boxes it.
时间限制。
Time boxes it.
然后召集五六个朋友，都是作家，问问他们对这本书的看法。
And then get five, six friends who would come together, writers, and ask them what they think about the book.
比如《最好的告别》就是个例子。
So like Being Mortal is an example.
我组织过那个草稿读书会，里面有很多我发现的关于养老院历史的资料，我觉得特别有意思，这部分内容不少。
I had that rough draft book club and I had all this history of nursing homes that I found completely fascinating, and there's a fair amount in there.
还有半章内容提到我父亲的肿瘤，以及接近尾声时的那个过程。
And half of a chapter I had mentioning my dad's tumor and that process sort of towards the end.
大家一致的反馈是：把养老院历史砍掉一半，多写写你父亲。
And universal feedback came back that cut the nursing home history by half, give us a lot more of your dad.
我曾觉得讲述自己的家庭故事太过自我放纵，好像人们并不想听这些，但让我告诉你，这恰恰相反。
And I felt like it was too indulgent telling my family story and like people don't want to hear that, let me tell you, let me teach you something about of course it's the opposite.
这要求我比以往在文字中更坦率地面对家庭这类话题。
It required me being a little more vulnerable than I've normally been in print about family and stuff like that.
所以这体验棒极了。
So it was fantastic.
这正是我需要的。
It was exactly what I needed.
而且你知道，并不需要逐行逐句地处理。
And, you know, it didn't need to be line by line.
它帮助我理解了一本书的情感核心在哪里，什么能打动读者，什么不能。
It's, you know, helped me understand where the emotional heart of a book is, where the what's what's grabbing people, what's not grabbing people.
让我们看看这个问题是否合适。
Let's see if this question works.
你如何看待作品的不同核心要素？
How do you think about sort of the different hearts of a piece?
比如你提到的情感核心。
Like, you're talking about the emotional heart.
我们讨论过思想核心，或许还有故事核心。
We've talked about the idea heart, maybe the story heart.
一部作品究竟有哪些不同的核心要素？
Like, what are the the different hearts of a of a piece?
如果非要列个清单（暂时找不到更合适的词），你认为必须包含哪些要素？
Almost if you had to think of a checklist, for lack of better word, of things to get, what would those things be?
我现在正在写下一本书，已经完成了大约三分之二，正卡在这个问题上。
Well, I'm in the middle of my next book now and I'm about just got to the point I'm about two thirds of way through and I'm grappling with exactly this.
等等，这是在披萨之夜之前还是之后？
Wait, is this before pizza night or after pizza
这还是在披萨之夜之前。
This is still before pizza night.
好的。
Okay.
这本书讲的是思维如何改变，这是暂定书名，不会作为最终标题。
So the book is about how minds change, that's the working title, it won't be the title.
它探讨了医学和公共卫生领域中个体行为改变的经验。
And it's about experiences in medicine and public health with individual behavior change.
我清楚自己要讲述的专业故事，最终我们让手术核查表在约十年内被全球75%的手术室采用。
And so I know the technical story I'm telling, and by the end I've learned we got the surgical checklist adopted in seventy five percent of the operating rooms in the world within about a decade.
以及我们实现这一目标的策略等等。
And what our strategy was for making that happen, etc.
所以这个故事有个智力核心。
So there's an intellectual heart to the story.
我需要一个能让人全程保持阅读欲望的叙事方式。
I needed the narrative that would make it compelling to go all the way through that.
因此我需要构建一个有效的情节走向。
And so I needed the story arc that would work.
而我现在才开始摸索的最后部分，是情感核心的定位。
And then the final part that I'm only just starting to feel my way towards now is where is the emotional heart?
为什么这能吸引任何人？
Why will this grip anybody?
而我发现的问题核心在于：我们为何总想改变他人？
And that I'm finding is somewhere around why do we even want other people to change?
没错。
Right.
我们为何要在乎？
Why do we care?
对。
Right.
那我们是不是太专横了？
And what what is are we just bossy?
我们只是贪图权力快感吗？
Do we just want the power trip?
确实。
Right.
这到底是怎么回事？
Like, what the hell is going on with that?
当然，在当下特朗普执政时期，某种程度的变革正通过强制手段推行——如今事态的严重性已远超四年前我刚着手写这本书时的局面。
And and, of course, in this moment in time with Trump and the administration and and a certain amount of change being being forced, you know, happening by coercion, there's also the conflict of, you know, the stakes are much higher than when I first started the book four years ago.
因此，正是将这些碎片拼凑起来的过程，让作品逐渐鲜活生动，最终抵达目标。
So the, it's fitting those pieces together that makes it more, that starts to make it live and breathe more and get there.
那么你现在处理这些问题时，具体采取了哪些解决措施？
So as you're now working through that, you're working through those problems, what are you doing to work through them?
你是不是有点，我需要按钮座位。
Are you just kind of, I need button seat.
我只需要不停地敲键盘。
I just need to hammer away at the keyboard.
离我远点。
Get away from me.
我每个月需要三十个小时。
I need the thirty hours a month.
这就是我要做的。
That's how I'm going to do it.
你在谈话中吗？
Are you in conversation?
你已经和编辑合作了吗？
Are you already working with an editor?
你有这个问题。
You have this problem.
你打算怎么解决它，让自己更清楚些？
What are you doing to solve it and give yourself some clarity there?
是的，我尽量避免过多讨论这件事。
Yeah, I'm avoiding getting in too much conversation about it.
主要是和我自己以及我妻子交谈，她每天都得忍受我的沮丧。
The conversation is mainly with myself and my wife who has to deal with my frustration on a daily basis.
而且我每个月写的远超过三十小时，因为要在2026年初完成，我之前在政府工作了三年，那时没法写。
And I'm writing a lot more than thirty hours a month to get it done because it's due in early twenty twenty six, and I'd taken three years in government, so I couldn't write then.
但这是个数学问题
But it's a math problem to
对我来说。
me.
大概会在
It's going to be somewhere around
这是个数学问题。
It's a math problem.
是的，比如9万到10万字，我分解了一下，意味着我每周平均要写2000字，所以我得有足够时间做研究然后写作。
Yeah, like it's 90 to 100,000 words, I broke it down, it means I've to average about 2,000 words a week, so I have to get enough time to do the research and then write.
我只是尽量从头到尾推进，先完成2000字。
And I'm just trying to go start to finish as much as possible, and get 2,000 words down.
我甚至把它拆分成30分钟的小段。
And I chunk it out even into thirty minute increments.
这让我妻子抓狂。
It drives my wife crazy.
但我就是按30分钟分段来，希望在9点前完成两个30分钟的工作量。
But I'm doing thirty minute increments, and just by 09:00 I want to have gotten two thirty minute increments in.
一旦能做到这点，我就能顺利推进了。
And then once I can get that, I can get it going.
我尽量保证每天至少有8个这样的30分钟工作段。
I try to have eight of those thirty minute increments at a minimum in a day.
有时候有其他事情要处理，就不得不中断。
Some days there's other stuff going on, so I have to miss it.
这不过是数学问题。
And it's just math.
继续前进就好。
Just keep on going.
有些事情现在行不通，你可以稍后再解决。
Some things aren't working and you'll work it out later.
然后我遇到了问题，不可避免地要回头做些修改。
And then I see problems and inevitably I go back and I do some revising.
但我正努力保持前进的势头，先把想法落实到纸上。
But I'm trying to keep the forward momentum going so that I'm just getting it down on paper.
研究、写作、编辑，这是三个主要阶段。
Research, writing, editing, those are the three phases.
跟我聊聊这些阶段吧。
Talk to me about those.
是的，而且它们并不那么界限分明。
Yeah, and they're not quite as neat.
并不是简单地先研究、再写作、最后编辑。
Like it isn't just start with research, then write, then edit.
听起来更像是融合在一起的，对吧？
It sounds like it's more fused, yeah?
没错，前期需要大量研究来启动，过程中又会发现‘哦，我真想更深入了解这个’。
Yeah, there is a lot of upfront research that gets it going, and then as I'm going I find, oh, I'd really love to know more about this.
你看，我在那边做了大量研究，养老院那些内容，虽然比预期有趣得多，但实在太多了。
I have you know, this is I did lots of research over there, and that nursing home stuff, okay, that was interesting, more interesting than I expected, but way too much.
对。
Right.
你知道，我需要对这个故事进行更多开发，或者采访更多人，或者当我遇到瓶颈时，需要更深入地剖析问题。
You know, I need to do more development of this story or more interviewing with people or I've hit a wall where I have to unpack things more.
但总的来说，没错。
But in general, that's right.
大量研究，完成初稿，然后不断修改、修改、再修改。
A lot of research, getting a first draft down, and then revising, revising, revising.
我过去讨厌修改，但现在这是我期待的部分。
And I hated revising, but now it's the part I look forward to.
等不及要完成它了。
Can't wait to get this done.
初稿总是痛苦的，但我知道修改会让它变得更好。
The first draft is always painful, and but the revisions, I know that will make it better.
你最喜欢它的哪一点？
What is it that you love so much about it?
这样风险更小。
It is less dicey.
我的意思是到那时，我更有信心认为这段时间花得值。
I mean by that point I have more confidence that it's good time spent.
对。
Right.
就像我能...这个东西实际上正在
Like I can This thing's actually going
置身于这个世界中。
to be out in the world.
是的，或者说我确实有些内容，通过调整、修改和重写，我能让它变得更好，到那时我就会确信这个故事值得讲述
Yeah, or that I actually have something and with tweaking and revising and rewriting, it will be I can make it better, it'll be by that point, I've become convinced it's worth telling the story
并写下来。
and writing it.
是的。
Yeah.
我想让你读一下《我们现在衰老的方式》这篇文章中的一段话，这是《纽约客》上的一篇报道。
Well I want you to read this quote from The Way We Age Now, an article in The New Yorker.
这段话有点长，所以请大家耐心听，但我觉得它能引出我想讨论的重点——关于写作风格，以及如何既务实传达信息，又能做到优雅且富有活力。
And it's a little bit long so I'm just gonna ask people to stick with us, but I think that it gets to where I want to go which is style and how you think about the pragmatic conveying of information to doing it in a way that has some elegance and some spunk.
好的。
Alright.
人体中最坚硬的物质是牙齿的白色珐琅质。
The hardest substance in the human body is the white enamel of the teeth.
随着年龄增长，它仍会逐渐磨损，暴露出下面更柔软、颜色更深的牙本质层。
With age, it wears away nonetheless, allowing the softer darker layers underneath to show through.
与此同时，牙髓和牙根部位的血液供应会萎缩，唾液分泌也会减少。
Meanwhile, the blood supply to the pulp and the roots of the teeth atrophies and the flow of saliva diminishes.
牙龈往往会发炎并开始萎缩，暴露出牙根，使牙齿松动，看起来变长——尤其是下排牙齿。
The gums tend to become inflamed and pull away from the teeth, exposing the base, making them unstable and elongating their appearance, especially the lower ones.
专家表示，通过检查一颗牙齿就能判断一个人的年龄，误差不超过五岁——前提是这个人还有牙齿可供检查？
Experts say they can gauge a person's age to within five years from the examination of a single tooth if the person has any teeth left to examine?
我是说，这里有几件事让我印象深刻。
I mean, there's a few things that stand out to me here.
在医学领域我经常看到的一点，也是我喜欢医学写作的原因，就是它对我来说像一门新语言，因为我对医学一窍不通，但我能学到很多新词汇，比如牙齿的白色珐琅质，这让我获得平时接触不到的形象。
One thing that I see in medicine all the time is what I love about medical writing is it's like a new language for me because I don't know the first thing about medicine, but I learn all these new words like even white enamel, the teeth, it gives me new images that I don't usually get.
但需要在医学术语和大众都能理解的语言之间取得平衡。
But it's a balance between the medical language and also using language that everybody would know.
这是我在听你读那段时想到的一点。
That's one thing that I was thinking about as you were reading that.
是的，我通常会用我们日常使用的语言，非常讨厌那种居高临下、不给我专业术语的感觉。
Yeah, I generally use the language we use rather than I really dislike it when when it someone, feels like I'm reading someone who's talking down to me and not giving me the terms that they use.
你可以为我解释这些术语，让我理解它们。
And you you can define them for me, you can make me understand it.
所以我尽量不使用幼稚的词汇，而是用实际的专业术语。
And so I try as much as possible to not use the kiddie words, but to use the actual words.
但要以一种我能信任你能理解的方式使用它们。
And but then use them in such a way that I don't have to that I can trust you to be able to understand it.
那么当我读你的某个句子或段落时，我该如何理解你做了哪些编辑和修改？你想达到什么效果？
So as I read one of your sentences, one of your paragraphs, how should I think about what kind of editing has been done, what kind of revision do you do, what it is that you're going for?
是的，比如在描述复杂内容时，我会尽量缩短句子，让每个观点都清晰明了，避免把复杂概念混在一起。
Yeah, like with this the when I'm talking about something complex, I'm trying to make the sentences shorter, so each idea is crisp and I'm not running complex ideas together.
这个主题很棒，因为我可以让它非常具象化，而且
Now this is great because I can this is a subject I can make very visual, and that
这样会更容易理解。
can make it easier.
牙齿的白色珐琅质。
The white enamel of the teeth.
是啊。
Yeah.
还有，你知道的，牙髓和牙根的血液供应，那些会萎缩。
And the, you know, the blood supply to the pulp and the roots of the teeth, those atrophy.
唾液分泌会减少。
The flow of saliva diminishes.
这些都是你可以想象会发生的事情，尤其在我这个年纪——这周我就60岁了，我能明显感觉到这些变化，对吧？
Those are those are all things that you can picture happening, and certainly at my age now, I'm 60 this week, I feel it happening, right?
现在我终于明白'年迈齿长'的真正含义了，牙龈萎缩后这些俗语就变得形象起来。
I know what long in the tooth actually means now as the gums pull away and those kinds of sayings come to be.
所以，首先需要考虑的是，我能把它可视化吗？
And, and so the, you know, constructing it is number one, can I make it visual?
我是否在每句话中都传递了新的信息？
Am I conveying a new piece of information with each sentence?
另外，每句话是否都是必要的？
And then also does it, is it nest is each sentence necessary?
这些内容是否能累积成一幅完整的画面？
Does it add up to an accumulating picture?
你知道吗，我敢打赌我刚开始写这个的时候，篇幅是现在的两倍长。
Can you know, a lot of I'll bet you I started this, and it was twice as long.
哦，真的吗？
Oh, really?
是的。
Yeah.
而且原本有很多冗长的句子，后来我缩短了它们，强化了意象描写，尽量确保使用动作动词。
And it had more run on sentences, and then I shortened it, and then sharpened the imagery, tried to make sure I'm using action verbs.
所有这些都是在尽可能地压缩、精简、提炼。
All all of that's going into into compressing, condensing, distilling as much as possible.
在这些方面，你觉得在早期阶段你最不理解的是什么？那时候你可能会想'这这这可不是我最好的作品'？
And of those things, what do you think you least understood in those slate days when you were like, this this this is not my best writing?
所有这些。
All of that.
所有这些。
All of that.
所有这些。
All of that.
我那时完全不懂，比如我会在一句话里用个比喻，但下一句再用就毫无意义了。
I didn't understand, like, I would use a metaphor in one sentence that made no sense to use in the next sentence.
牙齿本身就能讲述这个故事。
The the teeth could say the story by themselves.
我不需要说'就像嘴里有一排栅栏似的牙齿'这种话。
I didn't need to say, you know, it was like a picket fence of teeth in the mouth.
对吧？
Right?
人们会给掉牙想出各种比喻，比如像墓碑倒下，连带着墓前的石碑也倒了。
I could people have all these metaphors for a tooth falling out, you know, it's like gravestones with a with with a grave with a headstone popped over.
比如那些常用的东西，我毫无疑问地把其中一些加了进去，然后又需要把它们配对分开，因为你能看出来。
Like, of those are in are commonly used and I undoubtedly threw some of those in there and then needed to pair them away, because you could see it.
你觉得这些年来你的叙事方式有哪些演变？
How do you feel like your storytelling has evolved over the years?
当我刚开始写作时，特别是为《纽约客》和我的编辑亨利·芬德工作时，我记得我们不得不修改的一点是他说：想象你正在给我稳定摄像机，你知道的，就像有人戴着GoPro，你需要用固定在头上的GoPro来讲述故事，展示正在发生的事情。
When I first started writing, especially for The New Yorker and Henry Fender, my editor, I remember one of the things that we had to revise was he said, imagine you're giving me the Steadicam, you know, the person has a GoPro, you're telling the story with a GoPro attached to your head and you need to show what's happening.
所以你知道，那第一篇文章是关于医学自动化的。
And so I you know, that first piece was about, automation in medicine.
一个是能通过心电图诊断心脏病的计算机程序，另一个是加拿大一家做疝气手术的工厂。
One, a computer program that could diagnose heart attacks from an EKG, and the other a factory in Canada that did hernia operations.
所以一个是人如机器，一个是心电图。
And so one was a person as a machine, one was the EKG.
心电图研究有令人信服的数据，但我没有展示心电图是什么样子的？
And the EKG study had compelling data, but I wasn't showing you what's an EKG look like?
你怎样才能开始看到它？
How can you begin to see it?
然后你看到的和医生看到的有什么区别，心脏病专家可能从那些小尖峰中看到什么？
And then what's the difference between what you see and what a doctor is seeing, a cardiologist might be seeing in the little spikes that are there?
然后机器看到的可能与心脏病专家看到的有何不同？
And then what's a machine seeing that might be different from what the cardiologist is seeing?
所以你知道，我必须在第一篇文章中学习，这很棒。
And so, you know, I had to learn in that first piece, and it was great.
我有一位老师，就像写作课的老师一样，引导我说，好吧，你需要在这方面多做些。
I had a teacher who was it was like a writing writing class, walking me through, like, okay, you gotta do more of this.
现在能做到这一点，你知道，这花了很多功夫。
Can now make this you know, that it took a ton.
而我，好消息是，我确实在学习并且能够，你知道，开始应用这些。
And I and the good news is I I do learn and and can, you know, begin to apply that.
所以现在，你知道，我典型的《纽约客》文章需要三到四次修改，但在完成前不会改22遍。
So now, you know, my my typical New Yorker piece is going to need three or four revisions, but not 22 before we're done.
你在写作时有多考虑你的受众？比如解释过度或不足、措辞选择、你想触及和说服的人群类型，书籍与《纽约客》的区别，你对这些事情的意识有多强？
How much do you think about your audience when you're writing in terms of over explaining, under explaining, word choice, the kind of people who you're trying to reach and persuade, books versus The New Yorker, how conscious are you about those things?
我非常清楚，因为我写的每篇文章都在思考它的受众是谁。
I'm very conscious because everything I'm writing I'm thinking about who is the audience for it.
可能是科学期刊，可能是《纽约客》，也可能是书籍。
It could be a scientific journal, it could for the New Yorker, it could be for the book.
你知道，大多数情况下我试图触及读者，这是美国受众中愿意花时间阅读的一部分人
You know, for the most part I'm trying to get to readers, and that is a subset of the American audience who is going to be willing to sit with something
对美国受众中日益减少的那部分人来说。
for A decreasing subset of the American audience.
而且愿意
And are going
花时间阅读一万字的文章。
to be willing to sit with it for 10,000 words.
要知道，坐下来读一万字需要很长时间，大概要二、三十分钟。
Know, that 10,000 words is a long time to sit and read that's probably twenty, thirty minutes.
也许更久，现在想想可能要一两个小时。
Maybe longer, that's an hour or two now that I think about it.
然后一本书会有8万字或更多，所以人们真的必须是——这些人就像我的朋友，你知道的，我在想那些人会觉得什么内容引人入胜。
And then a book is going be 80,000 words or more, and so people really have to be, those people are people like my friends, people you know, I'm thinking about the people who what they will find compelling.
不过大多数时候，我信任的是我自己是否会被吸引。
For the most part I'm trusting, however, whether I would find it compelling.
我更多是在想象读者是像我这样的人。
I'm sort of imagining it's people like me more than anything.
所以让我惊讶的是这些书表现不错，假设读者都像我——这点我原本完全没预料到。
And so the surprise to me is that the books have done well, assuming people are like me, which I don't think I would have guessed.
你是否觉得自己必须克服某种导致装腔作势的自我意识？
Do you feel like you had to get over a certain kind of ego that leads to posturing?
因为这确实像是，比如医学期刊或经济学期刊，天哪，那些写作简直...
Because it does seem like, you know, if I think of a medical journal or an economics journal, oh my goodness, the writing is so
完全浮夸做作。
It's totally turgid.
浮夸，谢谢，说得好。
Turgid, thank you, good work.
即使在为科学期刊撰稿时，我也不断强迫我的合著者：我们不要用被动语态，比如'进行了统计分析'这种。
Even when writing for a journal, a scientific journal, I'm constantly forcing my co authors, we're not going to use the passive voice like, you know, a statistical analysis was done.
要让文章值得一读。
Make this worth reading.
要让人们真正明确重点，比如：核心结论是什么？
And getting people to be really clear, like, what's the headline here?
别给我——我们有这10个不同的结果——这种表述。
What, you know, don't give me, we have all these 10 different results.
这背后的含义是什么？
What's the meaning behind it?
我们该如何应用它们？
How do we apply them?
你知道的，是的，我们必须把它讲清楚。
You know, yes, we've got to lay it out.
其他人可能会得出不同的理解，但我们必须给出我们认为的含义。
Other people may come to a different meaning behind it, but we have to give what we think the meaning are.
无论我们花了多少个月或几年来试图理解它，理解一个试验或研究，我们一直与之共存。
We've lived with this for however many months or years we might have been trying to make sense of it, of a trial or a study.
因此每个行业都有其术语，而这些术语往往成为无法清晰表达你在做什么的原因。
And so every profession gets its terminology and often that terminology becomes a way of not being able to articulate what you're doing.
可能是人们自己并不真正理解他们使用的词语，从而模糊了背后的概念。
And it can be the people themselves are not really understanding the words they're using and are obscuring whatever concept is behind that.
是的，术语的最佳状态是能开辟新的认知视角。
Yeah, terminology at its best opens up these new vectors of sight.
你开始看到、想到那些原本无法触及的事物，世界因此变得更加精确。
You begin to see things, think things that you wouldn't be able to see and think otherwise and the world becomes more precise.
我们这样说是有原因的，是的
There's reasons why we Yes, say these
如果这就是该术语的定义方式，但在
if that's the way the term But at the
最糟的情况下它恰恰会起到反作用。
worst it does exactly the opposite.
这几乎变成了一个私人俱乐部，人们基本上在说：'我们要用这些术语来设门槛，这样当我们谈论商业时，他们就不会明白ROIC是什么意思。'
It almost becomes a private club of people basically saying, We're gonna gatekeep people by using these words, and then they won't understand what if we're talking about business, what ROIC means.
我不知道医学领域的对应术语是什么。
I don't know what the equivalent is in medicine.
确实，这件事有好有坏。
And yeah, there's good things and bad things about this.
是的。
Yes.
显然，人工智能一直是医疗健康行业的热门话题。
Obviously, AI has been a big topic of conversation in the healthcare industry.
既然你已经了解了这些，你会如何从写作世界的角度、从进步速度的角度重新思考人工智能？
Now that you've looked at that, how might you think about AI differently in terms of the world of writing, in terms of the rate of improvement?
我们该使用它吗？
Should we use it?
我们不该使用它吗？
Should we not use it?
就像戴上你的医学思维帽，观察写作领域时，你会想到什么？
Like putting on your medicine hat, looking at the world of writing, where does your mind go?
是啊，我是说在AI和健康领域，人们浪费太多时间在幻想'手机会取代医生'这种事上。
Yeah, I mean AI and health, people waste too much time on like, know, your phone is going to replace your doctor.
'我们不再需要你了，谁还需要你呢？'
We won't need you anymore, who needs you?
这只是因为人们根本不了解医学是什么。
That's just people don't understand what medicine is.
这不仅仅是得到诊断和治疗。
It's not just get a diagnosis and get a treatment.
要知道，在肿瘤学和心脏病学领域，诊断是起点。
Know, oncology and cardiology, you're starting with the diagnosis.
所有棘手的问题都由此开始，需要权衡各种利弊、人们的不同目标、治疗结果的起伏，还要应对医疗体系和个人痛苦等问题。
All the hard stuff comes from there, and it's navigating different trade offs, different goals people have, the ups and downs of outcomes, navigating the system and your own suffering and things like that.
但人工智能是这一过程中的宝贵工具。
But AI is a valuable tool along the way.
在写作方面，我只是把它当作另一种工具。
And in writing, I'm just using it as another tool.
你知道，我的书需要大量研究，我发现它能缩短研究所需的时间。
You know, there's a lot of research that goes into my books, and I'm finding it's shortening the amount of time it takes to do research.
比如我当前这本书中有整整一个章节，讲述19世纪中期在没有互联网的世界里，麻醉技术如何在两个月内传播开来。我部署了两三个不同模型，让它们检索19世纪外科医生的第一手记录，告诉我他们的发现。
Like there's a whole section in my current book about, you know, how did anesthesia spread within two months in the mid-nineteenth century, in a world where there was no internet, getting I deployed two or three different models, you know, me to nineteenth century firsthand accounts of surgeons and tell me, you know, what they're finding.
这就像是打了兴奋剂的谷歌。
And that's like Google on steroids.
它就是打了兴奋剂的谷歌。
It's Google on steroids.
当然它也会出错。
And of course it's wrong.
比如它找到了很棒的资料，但编造了引文。
Like, it found great stuff but made up the quotes.
哦，哇。
Oh, wow.
引语总是编造的。
Quotes are always made up.
永远不要完全相信AI。
Never trust AI Exactly.
但在研究助理的帮助下，你知道吗，我们从三个月的图书馆研究缩短到两周就找到了——你看，最终发现了19世纪的十份手术记录，这些可都是宝藏啊。
But with my research assistant, you know, we went from three months of library research to two weeks to find, you know, getting down to, oh, here are 10 surgical accounts from the nineteenth century that are actually gold.
而且，你知道，虽然不像他们给我的引语那样整洁干净，但却让我们能够以此为起点继续工作。
And, you know, not quite as neat and clean as the quotes that they gave me, but allowed me allowed us to work from there.
第二件事是文字编辑。
A second thing is copy editing.
我觉得这非常有价值，帮助我，你知道，找出哪些是冗余内容。
I find it incredibly valuable, helping me, you know, find where is the fat.
还有一次是我要做一个演讲，初稿有4000字，实在太长了。
And another one was I was giving a giving a talk, and my first draft was 4,000 words, which was way too long.
演讲时间应该在15到20分钟左右，相当于2000字。
It needed to be about a fifteen, twenty minute talk, which is like 2,000 words.
我就说，把它删减到2000字吧。
And I'd say, cut this to 2,000 words.
然后我又用了三个不同的平台，想看看它们会如何不同地删减内容。
And I'd again, I used three different platforms and just to see how they differently cut it.
当然，ChatGPT最后给了我一个500字的版本。
And then, of course, ChatGPT gives me a 500 word version.
就像在说：不不不，这也太短了。
Like, no, no, no.
给我一个2000字的版本。
Give me a 2,000 word version.
对。
Right.
比如，抱歉。
Like, sorry.
然后它说，抱歉，抱歉，抱歉，给了我一个1000字的版本。
And it says, sorry, sorry, sorry, gives me a thousand word version.
这根本不是我想要的。
Like that is not what I wanted.
我想要200字、2000字，但它从没给过我2000字的版本，结果我得到了六个不同的版本。
I wanted 200 words, 2,000 words, and it never gave me a 2,000 word, but I ended up with like six different versions.
所有人都否定了我的开场趣闻。
Everyone killed my opening anecdote.
而且，你知道，我不得不承认，我不得不让步，好吧，那是个可爱的故事，但对文章来说并不真正有效或必要。
And, you know, and I was like and I had to confess, I had to concede, alright, it's a it was a cute story, but it wasn't really working or necessary for it.
所以我认为这是个很好的指导。
And so I thought that was that was good guidance.
但到目前为止，我发现让它起草内容要么没用，要么没成果。
But getting it to draft stuff or not useful or fruitful, I've I've found at this point.
最后一个问题。
Last question.
有没有哪本书让你觉得内心渴望去写，觉得命中注定要写，或许你认为将来终究会去写，因为你需要更多人生阅历或需要提升写作技巧才能完成它？
Is there a book that you feel like you want to write, that you feel called to write, that maybe you think you're going to end up writing later because you need more life experience or you need more skill as a writer in order to write that?
在这一点上，我不能断言情况就是如此。
I can't say that that's the case at this point.
比如，我有想写的主题，但还没找到让它们生动呈现的方式。有些我认为非常重要的事，写成书可能不够有趣，对我而言是重要政策，但可能不适合出版。
Like, I have topics I want to write about, I haven't figured out how to bring them alive yet, like there are things that I think are really important, but may not be interesting as a book, just feel like important policy to me, but may not be there.
我确实对小说或回忆录体裁很动心。
I do think I'm tempted by fiction or memoir.
而小说创作完全让我望而生畏。
And fiction is totally intimidating.
而且我也不确定自己是否有创作小说的必要。
And also, I'm not clear I haven't felt the need for fiction.
在任何时候，我想讲述的故事更像是——你知道的——如何从现实事件和真实故事的黏土中雕琢成型？
Like, at any given moment, the stories that I want to tell, it's been more like, you know, how do I chisel from the clay of what what the actual facts and story are?
但我非常喜爱阅读小说，也时常思考：什么样的虚构作品才能真正反映我们所处的时代？
But I love reading a lot of fiction, and I'm you know, I puzzle over what's the what's the fiction that would really matter for the time that we are.
只是我不确定自己能否写出那样的作品。
I just don't know that I would be able to write that.
嗯。
Yeah.
那么，乌关德尔，非常感谢你。
So, Uguandre, thank you very much.
谢谢。
Thank you.
很高兴认识你。
It's good to meet you.
荣幸
Pleasure
很高兴见到你。
to meet you.
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