His is the little hand.  他的小手可以说是骨瘦如柴。

　　I was called down to the ward to see him  一名呼吸内科医生

　　by a respiratory physician.  将我叫到他的诊室。

　　He said, "Look, there's a guy down here.  他对我说：“那有个病人”

　　He's got pneumonia,  他得的是肺炎，

　　and he looks like he needs intensive care.  看样子他需要入你们的ICU病房。

　　His daughter's here and she wants everything possible  他的女儿在这，

　　to be done."  她希望你们能尽一切办法……

　　Which is a familiar phrase to us.  这是我们常听到的一句话。

　　So I go down to the ward and see Jim,  所以，我去病房去看Jim Smith.

　　and his skin his translucent like this.  他的皮肤半透明成了这个样子。

　　You can see his bones through the skin.  透过他的皮肤，你们以看到他的骨头。

　　He's very, very thin,  他可是说是瘦骨嶙峋。

　　and he is, indeed, very sick with pneumonia,  他的肺炎已是相当严重了

　　and he's too sick to talk to me,  病得连和我们讲话的力气都没有了

　　so I talk to his daughter Kathleen, and I say to her,  所以，我问他的女儿Kathleen:

　　"Did you and Jim ever talk about  "你有没有和他谈过"

　　what you would want done  你会怎么处理这个事，

　　if he ended up in this kind of situation?"  如果他到了这种地步？

　　And she looked at me and said, "No, of course not!"  她看了看我，然后说：”没有，当然没有“

　　I thought, "Okay. Take this steady."  好吧，我当时想，慢慢做她的工作吧。

　　And I got talking to her, and after a while, she said to me,  我和她谈了很久，然后，她对我说：

　　"You know, we always thought there'd be time."  你知道的，我们也知道，迟早会有那一天的。

　　Jim was 94.  当时已经94岁了。

　　And I realized that something wasn't happening here.  这件事让我觉得，我们可以为这类病人做些事。

　　There wasn't this dialogue going on  要不是有这件事

　　that I imagined was happening.  我也想象不到我们会不会去做这件事。

　　So a group of us started doing survey work,  所以，我们有一个小组开始做一些调查工作，

　　and we looked at four and a half thousand nursing home  我们走访了

　　residents in Newcastle, in the Newcastle area,  Newcastle地区的4500个在养老院生活的老人，

　　and discovered that only one in a hundred of them  我们发现，他们当中只有1%的人

　　had a plan about what to do when their hearts stopped beating.  对他们生理死亡后的事有计划。

　　One in a hundred.  仅仅1%。

　　And only one in 500 of them had plan about what to do  只有500分之1的老人

　　if they became seriously ill.  会对他们病重时有应对计划。

　　And I realized, of course, this dialogue  这个对话使我意识到，

　　is definitely not occurring in the public at large.  我们生活中的很多人肯定也会对我们的身后事没有计划的。

　　Now, I work in acute care.  现在，我在ICU里工作。

　　This is John Hunter Hospital.  我的医院叫“John Hunter”医院。

　　And I thought, surely, we do better than that.  而过去我一直认为，我们做得比较好。

　　So a colleague of mine from nursing called Lisa Shaw and I  所以，我和我的同事Lisa Shaw，她来自养老院，

　　went through hundreds and hundreds of sets of notes  我们一起在医疗档案室

　　in the medical records department  翻看了成千上万本病历,

　　looking at whether there was any sign at all  我们想确认是否有

　　that anybody had had any conversation about  任何人曾经

　　what might happen to them if the treatment they were  就如果他们的治疗失败

　　receiving was unsuccessful to the point that they would die.  而导致他们死亡而作出任何安排的谈话。

　　And we didn't find a single record of any preference  可是，我们找不到关于他们的自我选择，

　　about goals, treatments or outcomes from any  目标、治疗或者最终结果这方面的东西

　　of the sets of notes initiated by a doctor or by a patient.  医生记录或病人自己写的都没有。

　　So we started to realize  我这才意识到

　　that we had a problem,  我们出了问题，

　　and the problem is more serious because of this.  而正因为这一点，这个问题变得更严重。

　　What we know is that obviously we are all going to die,  我们大家都知道的是很明显，我们都会死去，

　　but how we die is actually really important,  但我们以何种方式死去更重要，

　　obviously not just to us, but also to how that  很明显，这不仅对我们重要，

　　features in the lives of all the people who live on afterwards.  这对那些活着的人也很重要。

　　How we die lives on in the minds of everybody  其实我们会怎样死去，

　　who survives us, and  这在抢救我们的人的心中是心里有数的,

　　the stress created in families by dying is enormous,  而死亡给一个家庭带来的压力是巨大的，

　　and in fact you get seven times as much stress by dying  事实上，死在ICU所带来的压力

　　in intensive care as by dying just about anywhere else,  是死在其它地方所带来的压力的7倍，

　　so dying in intensive care is not your top option  所以，选择在ICU结束自己的生活并不是一个明智的决定

　　if you've got a choice. 如果你有得选择的话。