RELEARNING HOW TO DRIVE

重新學習如何駕駛

You can teach yourself to shift into parasympathetic mode by managing stress, eliminating stress, or changing your lens on stress. But once you’ve shifted into it, the parasympathetic needs fuel in order to run. If the tank is empty, you could drop back out of healing mode soon after standing up from your relaxation response exercise. And what fuels the parasympathetic is basically this: love and connection.

您可以通過管理壓力、消除壓力或改變對壓力的看法來教自己進入副交感神經模式。但是一旦你適應了它，副交感神經就需要燃料才能運行。如果水箱是空的，您可以在放鬆反應練習中站起來后很快退出治療模式。而推動副交感神經的基本上是這樣的：愛和聯繫。

Does that sound crazy? I thought so, at first. It seemed too simple. And in some ways, it is simple. For years, research has been accumulating showing that love—both for others and for yourself—and connecting with other people keeps you healthier, while an absence of those relationships and connections can spell trouble for your immune system. And I’m not talking exclusively about deep connections; you don’t have to run around falling in love with everyone you meet. Even moments of “micro-connection” can deliver hits of the potent love cocktail, spool up the parasympathetic, and keep it fueled up and running.

這聽起來是不是很瘋狂？起初我是這麼認為的。這似乎太簡單了。在某些方面，這很簡單。多年來，研究不斷積累表明，愛——無論是對他人還是對自己——以及與他人的聯繫會讓你更健康，而缺乏這些關係和聯繫會給你的免疫系統帶來麻煩。我不只談論深層聯繫;你不必四處奔波，愛上你遇到的每一個人。即使是 「微連接 」的時刻，也可以帶來強效的愛情雞尾酒，激發副交感神經，並使其保持活力。

A few months after my first visit to Brazil, a young American man arrived there with a backpack of clothes, an angry scar from a failed radiosurgery that was healing under a prickle of shaved hair on his head, very little money, and three months to live. In 2003, Matt Ireland was in his early twenties and had recently graduated from college. He’d landed his dream job in Telluride, Colorado, at an adventure sports company perched in the Rocky Mountains. In the winter, he led ski tours; in the summer, it was mountain biking. When there were no guests, he worked long days clearing trails miles and miles up on the mountain. It was a beautiful place, and he was happy—at least at first. But at a certain point, his mood shifted and darkened. He started to feel really alone, even though he was surrounded by coworkers whom he liked. He sank into a strange and surprising depression.

在我第一次訪問巴西幾個月後，一位年輕的美國男子帶著一包衣服來到那裡，一個放射外科手術失敗留下的憤怒疤痕，在他頭上的剃光頭髮下正在癒合，錢很少，只剩三個月的壽命。2003 年，Matt Ireland 20 歲出頭，剛剛大學畢業。他在科羅拉多州特柳賴德的一家位於落基山脈的冒險運動公司找到了他夢寐以求的工作。冬天，他帶領滑雪團;夏天，是山地自行車。當沒有客人時，他會長時間工作，在山上清理數英里的小徑。那是個美麗的地方，他很開心——至少一開始是這樣。但在某個時刻，他的情緒發生了變化，變得陰暗了。他開始感到非常孤獨，即使他周圍都是他喜歡的同事。他陷入了一種奇怪而令人驚訝的抑鬱中。

“I’d never felt that way before,” he says now. “People usually give me shit because I’m so happy.”

“我以前從來沒有這種感覺，”他現在說。“人們通常會因為我太高興而給我拉。”

In retrospect, his mood changes were the first in a cascade of symptoms indicating a serious problem in the brain. He started getting headaches. They always came at the same time: ten o’clock in the morning, just as he and his colleagues were getting ready to head up to the trail for a day’s work slicing through downed trees with chain saws. The first few days, he tried to ignore it. It wasn’t a bad headache, but it was an odd headache. It didn’t throb through his skull like a normal headache or go away when he washed down an ibuprofen with a tall glass of water. It seemed deep inside his head in a place where he’d never before felt any kind of sensation. It lodged there like a bullet, radiating more and more pain as the days went by. Soon, he couldn’t go up on the mountain to work anymore. He was dizzy, nauseated, and weak. The headaches came every twenty-four hours, and they got worse every time. He vomited; he was incapacitated by the pain. His coworkers urged him to go to the doctor, and finally, scared, he went.

回想起來，他的情緒變化是一連串癥狀中的第一個，表明大腦存在嚴重問題。他開始頭痛。他們總是在同一時間來：早上十點，正當他和他的同事們準備前往小徑進行一天的工作，用鏈鋸劈開倒下的樹木時。最初的幾天，他試圖忽視它。這不是一個嚴重的頭痛，但這是一個奇怪的頭痛。它並沒有像正常的頭痛那樣在他的頭骨裡跳動，也沒有在他用一大杯水衝掉布洛芬時消失。它似乎在他的腦海深處，在一個他以前從未有過任何感覺的地方。它像子彈一樣卡在那裡，隨著時間的流逝，散發出越來越多的痛苦。很快，他就不能再上山工作了。他頭暈、噁心、虛弱。頭痛每 24 小時發作一次，而且每次都變得更糟。他嘔吐了;他被痛苦壓得失去了行動能力。他的同事催促他去看醫生，最後，他害怕地去了。

It didn’t take long for them to make a diagnosis. The MRI showed, unmistakably, a large tumor pressing on his optic nerve. They didn’t know what it was, but they told him they had to get it out immediately or it was going to kill him.

他們很快就做出了診斷。MRI 明確無誤地顯示一個大腫瘤壓迫著他的視神經。他們不知道那是什麼，但他們告訴他必須立即把它拿出來，否則它會殺死他。

They shaved his head, prepped him for surgery. He was whisked into the OR. Count backward from one hundred, said the muffled voice of the anesthesiologist, hovering over him with her blue face mask. The last thing he remembers thinking is, I am going to die.

他們給他剃了光頭，為他做手術做準備。他被送進了手術室。從一百開始倒數，麻醉師低沉的聲音說，戴著藍色面罩在他身上盤旋。他記得最後的想法是，我要死了。

When he woke up, surprised to find himself still alive, there was a shunt in his skull, draining cranial fluid. He was in a nauseous fog of anesthesia, his head aching with pressure. The surgeon told him it had all gone well—they’d removed a large amount of the tumor, which they had sent off for biopsy. In the meantime, the headaches should stop. The surgeon seemed optimistic. His initial diagnosis was brain cancer, but not the worst kind; he estimated that Matt had stage I or II and that it would be treatable.

當他醒來時，驚訝地發現自己還活著，他的顱骨有一個分流器，排出了顱液。他處於令人作嘔的麻醉迷霧中，他的頭因壓力而疼痛。外科醫生告訴他一切都很順利——他們已經切除了大量的腫瘤，他們已經送去進行活檢。與此同時，頭痛應該停止。外科醫生似乎很樂觀。他最初被診斷為腦癌，但不是最糟糕的那種;他估計馬特患有 I 期或 II 期，並且是可以治療的。

Within days, though, Matt took a turn for the worse. Even while he was recuperating from surgery, the tumor had started to grow again. They did another biopsy, took samples of cranial fluid. Within two weeks, they had revised their initial diagnosis. This time there was no optimism, no cheerful “we can fix it” attitude. The new diagnosis was a death sentence: glioblastoma multiforme, stage IV.

然而，幾天后，馬特的情況就變得更糟了。即使在他從手術中恢復期間，腫瘤也開始再次生長。他們又做了一次活檢，採集了顱液樣本。在兩周內，他們修改了最初的診斷。這一次沒有樂觀，沒有歡快的“我們能解決”的態度。新的診斷是死刑判決：多形性膠質母細胞瘤，IV 期。

There was no treatment that would work against this type of cancer—not one that would actually cure it. The long tentacles of cancer reach deep into the brain tissue, making complete removal impossible. The average survival time is twelve to eighteen months; only 2 to 5 percent of those diagnosed are still alive five years later. It is an illness that is taught as ultimately having no survivors. Matt’s doctor recommended a course of chemo, but only to slow down the progression of the disease. Laser therapy as a palliative measure was also suggested, to perhaps buy him some time. Time. It had seemed to stretch into infinity when he was standing at the tree line in the thin air of the Rockies, looking out to the horizon miles away. Now, he had very little of it.

沒有治療方法可以對抗這種類型的癌症——沒有一種可以真正治癒它的治療方法。癌症的長觸角深入腦組織，無法完全切除。平均存留時間為 12 到 18 個月;只有 2% 到 5% 的確診患者在五年後還活著。這是一種被教導為最終沒有倖存者的疾病。馬特的醫生建議進行一個療程的化療，但只是為了減緩疾病的進展。還建議將鐳射療法作為一種姑息治療措施，也許可以為他爭取一些時間。時間。當他站在落基山脈稀薄空氣中的樹林線上，眺望著幾英里外的地平線時，它似乎延伸到了無限遠。現在，他擁有的已經很少了。

As a seasonal worker, he didn’t have health insurance. The surgery had wiped out his tiny savings and then some. His friends had fund-raised some cash for him, but once he paid off the staggering medical bills, he only had a little bit left over. He moved home, back to Vermont, to live with his mother. He knew that any form of treatment he undertook would only give him a few extra weeks or months and could come with debilitating side effects, but he wanted to buy all the time that was for sale. Matt launched into both radiotherapy and chemo, and when a new, experimental gamma ray radiosurgery option was offered at a world-class clinic at Dartmouth, he took it.

作為一名季節性工人，他沒有健康保險。手術花光了他微薄的積蓄，然後又花光了一些。他的朋友們為他籌集了一些現金，但當他付清了高昂的醫療費用后，他只剩下一點點了。他搬回家，回到佛蒙特州，與母親住在一起。他知道他接受的任何形式的治療都只會給他帶來幾周或幾個月的額外時間，並且可能會帶來使人虛弱的副作用，但他想買下所有待售的時間。Matt 開始涉足放療和化療，當達特茅斯的一家世界級診所提供一種新的實驗性伽馬射線放射外科手術方案時，他接受了它。

But the chemo felt like poison in his body, and he began to think of it that way. It made him sick, numbed his senses. He rapidly lost weight. No matter what he ate, it tasted the same kind of awful. “A spoonful of sugar and a spoonful of salt tasted exactly the same,” he says. “Like ash.”

但化療感覺就像他體內的毒藥，他開始這樣想。這讓他感到噁心，麻木了他的感官。他的體重很快就減輕了。無論他吃什麼，味道都是一樣的糟糕。“一勺糖和一勺鹽的味道完全一樣，”他說。“就像灰燼一樣。”

Matt first turned to diet, as Pablo Kelly had. He read Beating Cancer with Nutrition and learned that one in five cancer patients who die don’t actually die from the cancer—they die from malnutrition. Cachexia, a severe wasting of the muscles, seriously limits the body’s ability to fight cancer and heal, and the National Cancer Institute estimates that it kills 20 percent of cancer patients. It’s possible that these patients might have eventually succumbed to their disease anyway, but when malnutrition is wiping so many out before that point, there’s no way to know. Like so many other recoverers, Matt decided that he needed to focus on eating the most nutrient-dense foods he could if he was going to give himself the best shot at recovery, or even just lengthening his very short time on earth.

馬特首先轉向節食，就像巴勃羅·凱利 （Pablo Kelly） 一樣。他閱讀了《用營養戰勝癌症》，瞭解到五分之一的死亡癌症患者實際上並不是死於癌症——他們死於營養不良。惡病質是一種嚴重的肌肉消耗，嚴重限制了身體抵抗癌症和癒合的能力，美國國家癌症研究所估計它導致 20% 的癌症患者死亡。無論如何，這些患者最終都可能死於他們的疾病，但當營養不良在那之前消滅了這麼多人時，就無法知道了。像許多其他康復者一樣，馬特決定，如果他要給自己最好的康復機會，甚至只是延長他在地球上的短暫時間，他需要專注於吃最營養豐富的食物。

After two weeks, Matt decided the chemo wasn’t going to work for him. “It was ruining what was left of my life,” he said. He flushed the pills down the toilet.

兩周后，Matt 決定化療對他不起作用。“它毀了我生命中剩下的一切，”他說。他把藥片衝進馬桶。

He had higher hopes for the radiosurgery, which the doctors at Dartmouth thought might represent a new, exciting way to treat glioblastomas. But the experimental new surgery, which used a special kind of laser to more precisely target the rapidly growing tumor, was not much more helpful than other standard interventions like radiation therapy.

他對放射外科手術寄予厚望，達特茅斯學院的醫生認為這可能代表一種新的、令人興奮的膠質母細胞瘤治療方法。但是，這種實驗性的新手術使用一種特殊的鐳射來更精確地針對快速生長的腫瘤，並不比放射治療等其他標準干預措施有用多少。

One day, out of the blue, a neighbor called him at his mother’s house. She’d heard about his struggle from some friends in town and wanted to help. She’d had cancer, too, she said, but got better—after she’d traveled to a healing center in Brazil. She described the community there, the people who arrived, the feeling of being loved and accepted, the transformative experience of truly believing you could get better. The neighbor invited him over, poured him some tea. She showed him the scars from her surgeries. She’d had a terminal diagnosis, just like he had.

有一天，一個鄰居突然在媽家給他打了電話。她從鎮上的一些朋友那裡聽說了他的掙扎，想幫忙。她說，她也得了癌症，但在她去了巴西的一家康復中心后，病情好轉了。她描述了那裡的社區、到達的人、被愛和接受的感覺，以及真正相信自己可以變得更好的變革性經歷。鄰居邀請他過來，給他倒了一些茶。她向他展示了她手術留下的疤痕。她被診斷出患有絕症，就像他一樣。

Matt was intrigued but told her traveling to Brazil was out of the question. He couldn’t afford it.

馬特很感興趣，但告訴她去巴西旅行是不可能的。他負擔不起。

“Stop,” she said. “Clear your mind. If your heart tells you that you need to go, I’ll buy you a ticket.”

“停下來，”她說。清理你的頭腦。如果你的心告訴你需要去，我就給你買張票。

A clock ticked quietly over the sink as he considered her words; he felt a swelling sense of possibility. So many people had told him what to do, what special treatments or tactics to try. But without a cushion of money or health insurance, everything had seemed so out of reach.

當他思考她的話時，水槽上的聲音安靜地滴答作響;他感到一種膨脹的可能性。很多人告訴他該怎麼做，嘗試什麼特殊的治療方法或策略。但是，如果沒有錢或健康保險，一切都顯得遙不可及。

“Okay,” he said. “Yes, I want to go. I need to go.”

“好吧，”他說。“是的，我想走。我得走了。

He ended the experimental radiosurgery at Dartmouth. They did an MRI to check the tumor’s progression and found that the growth rate had slowed slightly. They told him they’d bought him a couple of extra months—a victory, in the landscape of glioblastoma multiforme—and to wait for his scar to heal before he traveled.

他結束了達特茅斯的實驗性放射外科手術。他們做了 MRI 檢查腫瘤的進展，發現生長速度略有減慢。他們告訴他，他們為他多買了幾個月的時間——在多形性膠質母細胞瘤領域，這是一場勝利——並等待他的疤痕癒合后再旅行。

Did he have doubts about going to Brazil, on what could have been a wild-goose chase? Of course, he told me.

他是否對去巴西有疑慮，這可能是一場瘋狂的追逐？當然，他告訴我。

“But I had to do something,” he says now. “I couldn’t just sit at home and die.”

“但我必須做點什麼，”他現在說。“我不能就這樣坐在家裡死去。”

In Brazil, he rented a cheap pousada at the edge of town, listened to the birds screech through the wooden shutters. The first night there, he had a strange and vivid dream, which he still remembers in perfect detail. He remembers it well because he thought he was awake—everything was so clear and real. Or maybe it wasn’t a dream but a vision. He isn’t sure. He woke up in the middle of the night—or dreamed he did. He sat up in bed and noticed that the bathroom light was on. Oh, shoot, he thought, I have to turn that off. But before he could move, the light shifted and flickered as if someone was walking around in there. And then a figure emerged, a woman, so shrouded in light that he could barely make her out. She approached him and placed her hands on his head. In that moment, he felt the most powerful physical sensation that melted from the crown of his head, over his shoulders and down his body, all the way to his toes.

在巴西，他在城邊租了一間便宜的 pousada，聽著鳥兒透過木製百葉窗發出的尖叫聲。在那裡的第一個晚上，他做了一個奇怪而生動的夢，他仍然清楚地記得這個夢。他記得很清楚，因為他覺得自己醒了——一切都是那麼清晰和真實。或者，也許這不是一個夢想，而是一個願景。他不確定。他在半夜醒來——或者做夢。他在床上坐起來，注意到浴室的燈亮著。哦，開槍，他想，我得關掉它。但在他能夠移動之前，光線發生了變化，閃爍著，彷彿有人在裡面走來走去。然後一個身影出現，一個女人，被光線籠罩著，他幾乎看不清她。她走近他，把手放在他的頭上。在那一刻，他感受到了最強烈的身體感覺，從他的頭頂融化了，越過他的肩膀，沿著他的身體，一直到他的腳趾。

“It was a feeling of pure love, perfection, light, God, whatever you want to call it,” he says. “It was like when you get the chills, only multiplied by fifty thousand.”

“這是一種純粹的愛、完美、光明、上帝的感覺，無論你想怎麼稱呼它，”他說。“就像你感到寒意時，只乘以五萬。”

The figure lifted her hand, stepped away, and vanished. He woke up sitting on the edge of his bed in the dark.

那個人抬起她的手，走開，然後消失了。他在黑暗中坐在床沿上醒來。

“I don’t know what it was. I’ve never had a vision like that in my life, either before or since,” he reports. “Or maybe it was just a dream—you decide.”

“我不知道那是什麼。我這輩子從來沒有見過這樣的景象，無論是以前還是之後，“他報告道。“或者，也許這隻是一場夢——你自己決定。”

Matt felt echoes of that same sensation throughout his time in Brazil. He felt those reverberations—of light, love, and acceptance—everywhere in the community.

Matt 在巴西的整個時間里都感受到了同樣的感覺。他在社區中無處不在地感受到了那些迴響——光明、愛和接納。

Once back in Vermont, he did not restart any kind of treatment. He went into the clinic in Dartmouth for checkups, but he didn’t want to get a brain scan. If the tumor was still growing, as it almost surely was, he didn’t want to know. He didn’t want the fear, the constant panicked thoughts of illness and death intruding when he was trying so hard to stay peaceful and calm. They pressed for an MRI, but he declined. So, instead, they checked his healing scar, took his vitals. He seemed healthy enough—besides the fact that he was dying, which they all knew.

回到佛蒙特州后，他沒有重新開始任何形式的治療。他去達特茅斯的診所做檢查，但他不想做腦部掃描。如果腫瘤還在生長，幾乎可以肯定，他不想知道。他不想要恐懼，不想要疾病和死亡的持續恐慌想法，當他如此努力地保持平靜和平靜時。他們敦促進行 MRI 檢查，但他拒絕了。所以，他們反而檢查了他正在癒合的疤痕，測量了他的生命體征。他看起來足夠健康——除了他快要死了的事實，他們都知道這一點。

Months ticked by, and he passed the “expiration date” given to him at his diagnosis. He didn’t feel the disease progressing. He felt good—better than he probably deserved to feel, given his prognosis. But he also felt wobbly, on edge, like he was perched on a thin ledge, about to topple to one side or the other. But would it be into life or into death?

幾個月過去了，他度過了診斷時給他的“到期日”。他沒有感覺到病情進展。他感覺很好——考慮到他的預後，他可能應該有的感覺要好。但他也感到搖搖晃晃，緊張不安，就像他棲息在一個薄薄的壁架上，即將向一側或另一側傾倒。但它是進入生還是死？

He tried to spend as much time with friends and family as possible—just connecting. He felt instinctively that it helped. Friends helped out where they could, paying for acupuncture sessions and craniosacral work. It was hard at times to keep the negative voices at bay. He felt negative energy from some of the people around him—it wasn’t an immersive, hopeful community as there had been in Brazil. One of his mother’s friends kept telling her to force him to go back on chemo, to go to the hospital. He was too tired to explain to her that he had tried all kinds of treatments and that they hadn’t really gotten him anywhere. There’s nothing more we can do for you, the doctors had said at the end of his radiosurgery.

他試圖盡可能多地花時間與朋友和家人在一起——只是聯繫。他本能地覺得這有説明。朋友們盡其所能提供説明，支付針灸課程和顱骶手術的費用。有時很難阻止負面聲音。他從周圍的一些人那裡感受到了負能量——那不是像巴西那樣身臨其境、充滿希望的社區。他母親的一個朋友一直告訴她，強迫他重新接受化療，去醫院。他太累了，無法向她解釋他已經嘗試了各種治療方法，但都沒有真正讓他有任何進展。我們不能再為你做任何事情了，醫生在他的放射外科手術結束時說。

Finally, he felt he had to know. He asked his mother to take him to Dartmouth to get an MRI.

最後，他覺得他必須知道。他讓媽媽帶他去達特茅斯做核磁共振檢查。

His doctors were shocked—the tumor had shrunk. It was not an outcome that was considered possible with glioblastoma multiforme. They tried not to give him too much hope. Perhaps it was only a fluke, a temporary remission. They didn’t want him to start thinking he would be cured; there was no cure for GM.

他的醫生很震驚——腫瘤已經縮小了。多形性膠質母細胞瘤不被認為是可能的結局。他們盡量不給他太多希望。也許這隻是一個僥倖，暫時的緩解。他們不想讓他開始認為他會痊癒;轉基因沒有治癒方法。

Then one day, another friend of his mother’s made a comment that changed his course. Having heard his long story, she didn’t respond negatively. “Seems like it’s working,” she said. “He should go back to Brazil.”

然後有一天，他母親的另一個朋友發表了一條評論，改變了他的想法。聽了他的長篇大論，她並沒有消極地回答。“看起來它奏效了，”她說。“他應該回巴西去。”

Reinvigorated, he scraped the money together and booked his flight.

重新振作起來，他湊齊了錢，預訂了機票。

Returning to Brazil and the close, loving community felt like slipping into a warm bath. He relaxed into the arms of the community as soon as he arrived, rejoining the rhythms of the little town. And then one night, walking into the internet café to write an email to his mother, he met a young woman whose presence, energy, and direct gaze stopped him short. They exchanged names. She was there because she was depressed, she told him. Her life had lost meaning. She’d just lost her brother to Lou Gehrig’s disease and her father to cancer—the very same cancer that Matt had. They snapped together like magnets, each realizing—in one of those rare encounters—that they were made for each other.

回到巴西和這個親密、充滿愛的社區，感覺就像溜進了個熱水澡。他一到這裡就放鬆地投入了社區的懷抱，重新融入了小鎮的節奏。然後有一天晚上，他走進網吧給他的母親寫一封電子郵件，遇到了一位年輕女子，她的存在、活力和直接的目光讓他停了下來。他們交換了名字。她告訴他，她在那裡是因為她很沮喪。她的生活已經失去了意義。她剛剛失去了她的哥哥，死於盧·賈里克病，她的父親死於癌症——和馬特一樣患有同樣的癌症。他們像磁鐵一樣緊緊地合在一起，每個人都意識到——在一次難得的相遇中——他們是為彼此而生的。

They were together from the night they first met. Matt didn’t go back to Vermont. He stayed, worked odd jobs. They got married. They rented a house in town, and his wife went to work at the local pharmacy. As before, Matt initially avoided diagnostic imaging. But finally, two years after his initial diagnosis, he agreed to an MRI. It was a very different image from the one the doctors had hung on the light board in the hospital in Denver, which had shown a huge white mass where there should have been clean, gray brain matter. In this one, there was barely anything visible—just a tiny little knot of white, like a pinkie fingerprint on the film. They weren’t sure what it was—a last remnant of the shrunken tumor or perhaps just scar tissue. Either way, the impossible had happened—his cancer had turned around; the tumor had melted away.

他們從第一次見面的那天晚上就在一起了。馬特沒有回到佛蒙特州。他留下來，打零工。他們結婚了。他們在鎮上租了一所房子，他的妻子去當地的藥店工作。和以前一樣，Matt 最初避免進行診斷成像。但最終，在他初步診斷兩年後，他同意進行 MRI 檢查。這與醫生掛在丹佛醫院燈板上的圖像截然不同，後者顯示一個巨大的白色腫塊，而本應有乾淨的灰色腦物質。在這張照片中，幾乎看不到任何東西——只有一個小小的白色結，就像膠片上的小指指紋一樣。他們不確定那是什麼——縮小的腫瘤的最後殘餘，或者可能只是疤痕組織。無論哪種方式，不可能的事情都發生了——他的癌症已經好轉;腫瘤已經融化了。

Matt still lives in Brazil with his wife, the love of his life. After undergoing radiation therapy, he wasn’t supposed to be able to have children. The doctors had warned him before he accepted treatment. He’d always wanted kids, but he went through with the treatment anyway. He had so badly wanted to live. He had some sperm frozen at the time, but after years of paying for storage, it became too expensive. He had to let the dream of biological children go.

Matt 仍然和他的妻子住在巴西，他是他一生的摯愛。接受放射治療后，他不應該能夠生育。醫生在他接受治療之前就警告過他。他一直想要孩子，但他還是接受了治療。他非常想活下去。當時他冷凍了一些精子，但經過多年的儲存費用，它變得太貴了。他不得不放棄親生孩子的夢想。

His sons are now three and five. As it turned out, he was able to have children—to watch his wife carry a new life, bring a baby into the world that was part him and part her, twice. Talking to him on the phone, a fuzzy international line, I could hear the high joyous shrieks of little kids off in the distance. “It’s pretty busy around here,” Matt said, laughing.

他的兒子現在分別是3歲和5歲。事實證明，他能夠生孩子——看著他的妻子重獲新生，將一個嬰兒帶到這個世界，這個世界既是他的一部分，也是她的部分，兩次。我和他通電話，一條模糊的國際線路，我能聽到遠處小孩子高亢歡快的尖叫聲。“這附近很忙，”馬特笑著說。

It’s been fifteen years now since Matt was diagnosed with glioblastoma multiforme, the most aggressive form of brain cancer, and given four months to live without treatment. Something turned his disease around in a unique way, a way that medicine today considers impossible to replicate. What was it? There are, of course, many swirling factors that could be at play here, including many of those that we’ve already discussed in previous chapters: major diet changes, massive reduction in stress, a changed outlook on life and the challenges ahead. But Matt has his own theory about what changed things for him.

自從Matt被診斷出患有多形性膠質母細胞瘤（最具侵襲性的腦癌）以來，已經過去了15年，並被要求在沒有治療的情況下生活四個月。某種東西以一種獨特的方式扭轉了他的疾病，這種方式是當今醫學認為無法複製的。那是什麼？當然，這裡可能有許多漩渦因素在起作用，包括我們在前幾章中已經討論過的許多因素：飲食的重大改變、壓力的大幅減輕、人生觀的改變和未來的挑戰。但Matt對是什麼改變了他有自己的理論。

“It was love that healed me,” he says with conviction. “To me, that’s what God is, that’s what life is. That’s what getting better is, it’s love.”

“是愛治癒了我，”他堅定地說。“對我來說，這就是上帝，這就是生活。這就是變得更好，這就是愛。

LOVE MEDICINE

愛醫學

When we experience feelings of love and connection, our brains release a cocktail of hormones and chemicals. How exactly that cocktail is mixed (i.e., which hormones specifically are dumped into your bloodstream) depends on what type of experience you’re having. Attraction, romantic love, platonic love, and social connection all have their own specific mixture, but most involve some combination of dopamine, testosterone, estrogen, vasopressin, and most importantly, oxytocin. Oxytocin, first isolated in new mothers nursing their babies, is often called “the love drug” because it’s both activated by, and helps to create, connection, attraction, love, and bonding. And beyond helping to make and deepen relationships, it has health benefits. Oxytocin is known to be a kind of anti-stress tonic, counteracting the effects of fight or flight and stress hormones. It is also both anti-inflammatory and parasympathetic in its effects.

當我們體驗到愛和聯繫的感覺時，我們的大腦會釋放出荷爾蒙和化學物質的混合物。這種雞尾酒究竟是如何混合的（即，哪些激素專門傾倒到你的血液中）取決於你所擁有的體驗類型。吸引力、浪漫的愛情、柏拉圖式的愛情和社會關係都有其特定的混合物，但大多數涉及多巴胺、睾丸激素、雌激素、加壓素，最重要的是催產素的某種組合。催產素首先在哺乳嬰兒的新媽媽中分離出來，通常被稱為「愛情藥物」，因為它既被聯繫、吸引、愛和紐帶啟動，又有助於創造聯繫、吸引、愛和紐帶。除了説明建立和加深關係外，它還對健康有益。眾所周知，催產素是一種抗壓力補品，可以抵消戰鬥或逃跑以及壓力荷爾蒙的影響。它的作用也是抗炎和副交感神經。

So what controls the release of this “love medicine” into your body? The vagus nerve. Vagus is Latin for wandering, and in line with its poetic name, the vagus wanders everywhere through your body. It exits the brain stem at the base of your skull, deep in your neck. It actually runs quite close to the carotid artery. Press your fingers to the pulse point on your neck and you are as close as you can get to your vagus nerve. From that spot under your fingers, it shoots down to your heart and beyond, where it regulates heartbeat and dozens of other vital functions. If you have any doubts about how deep and rapid the connection is between the mind and the body, the vagus is that literal link between the two—a thick, humming power line that runs from your brain to your gut.

那麼，是什麼控制了這種 「愛情藥 」釋放到你體內呢？迷走神經。迷走神經在拉丁語中是徘徊的意思，正如它的詩意名稱一樣，迷走神經在你的身體里到處遊蕩。它從顱底的腦幹流出，深入到脖子深處。它實際上非常靠近頸動脈。將手指按壓到脖子上的脈搏點，您就可以盡可能靠近迷走神經。它從你手指下的那個點射到你的心臟甚至更遠的地方，在那裡它調節心跳和數十種其他重要功能。如果您對心靈和身體之間的聯繫有多深和多快有任何疑問，迷走神經就是兩者之間的字面聯繫——一條從你的大腦到你的腸道的粗而嗡嗡作響的電力線。

The vagus nerve, in the way that it passes information both upstream and down, works a lot like the nutrition system in a tree. Picture your body as the tree, and the vagus nerve as the xylem and phloem, the transport tissues deep inside the tree’s structure that pull water up to the leaves and then pass nutrients back down through the trunk. Your vagus nerve functions the same way, but with information. Remember those old pneumatic tube systems that banks used to have—you’d put your deposit envelope in the little canister, and it would whoosh away? Imagine that happening in the vagus nerve, up and down, passing messages between mind and body millions of times over the course of a day.

迷走神經在上游和向下傳遞資訊的方式，其工作方式很像樹上的營養系統。將您的身體想像成樹木，迷走神經作為木質部和韌皮部，這是樹木結構深處的運輸組織，將水拉到葉子上，然後通過樹幹將營養物質送回去。您的迷走神經以相同的方式運作，但需要資訊。還記得銀行過去那些舊的氣動管系統嗎——你把存款信封放在小罐子裡，它就會嗖地走開嗎？想像一下，這發生在迷走神經中，上下移動，在一天內在身心之間傳遞資訊數百萬次。

Eighty percent of the vagus pulls information up into the brain. The other 20 percent sends information down into the body. This means that a great deal of sensory information is being collected for your brain and that decisions are then made in the brain and sent out all over the body. It’s a rapid, constantly flowing system that allows your heartbeat, breathing, digestion, endocrine system (the network of glands that releases hormones through your body), and immune system to constantly adjust and respond to all the collected information.

80% 的迷走神經將資訊拉入大腦。另外 20% 將資訊向下發送到體內。這意味著您的大腦正在收集大量感官信息，然後在大腦中做出決定併發送到全身。它是一個快速、持續流動的系統，可讓您的心跳、呼吸、消化、內分泌系統（通過身體釋放激素的腺體網路）和免疫系統不斷調整和回應所有收集到的資訊。

Think of how often you’ve used the phrases gut feeling or broken heart or told someone you had butterflies in your stomach. You feel different emotions in different parts of your body for a good reason: these areas are hotbeds of neuroreceptors. Recent research is showing that we actually have three “brains”—the head brain, heart brain, and gut brain—and our health and development depend on keeping them in balance and alignment. With the vagus as the connecting cord, emotions flood through our systems in the form of neural messages and hormones. Some signals begin in the gut, or the heart, and flow upstream to the head brain, while others cascade from above. In this way, our thoughts and emotions have both instant and long-lasting effects on all our biological systems: nervous, endocrine, immune.

想想你有多少次使用直覺或心碎這些短語，或者告訴別人你的胃裡有蝴蝶。您在身體的不同部位感受到不同的情緒是有充分理由的：這些區域是神經受體的溫床。最近的研究表明，我們實際上有三個“大腦”——頭腦、心腦和腸腦——我們的健康和發育取決於保持它們的平衡和對齊。以迷走神經作為連接線，情緒以神經資訊和激素的形式湧入我們的系統。一些信號從腸道或心臟開始，向上游流向頭腦，而另一些信號則從上方級聯。通過這種方式，我們的思想和情緒對我們所有的生物系統都有即時和持久的影響：神經、內分泌、免疫。

In the previous chapter, we talked about the relaxation response and why it works. What we didn’t talk about was the role of the vagus in that physiological response. When you do the deep, abdominal breathing that Benson recommends, you stimulate your vagus nerve. Even a deep sigh can activate it briefly—think of brushing your fingers over guitar strings, eliciting a rich, vibrating chord that reverberates for a couple of seconds. When you experience feelings of love and connection, it’s like playing a whole song for your vagus nerve. The level of cortisol in your system begins to drop, and your telomerase is allowed to build back up to a healthy, balanced level. If you can keep on strumming those strings and keep your parasympathetic activated, a host of amazing health benefits will follow.

在上一章中，我們討論了鬆弛反應及其工作原理。我們沒有討論的是迷走神經在這種生理反應中的作用。當您進行 Benson 建議的深腹式呼吸時，您會刺激您的迷走神經。即使是深深的歎息也可以短暫地啟動它——想想你的手指在吉他弦上擦過，引發一個豐富、振動的和弦，回蕩幾秒鐘。當你體驗到愛和聯繫的感覺時，就像為你的迷走神經播放一整首歌。您系統中的皮質醇水平開始下降，您的端粒酶被允許恢復到健康、平衡的水準。如果你能繼續彈奏這些琴弦並保持你的副交感神經激活，那麼許多驚人的健康益處就會隨之而來。

We know that inflammation is the common pathway underlying many diverse illnesses. But renowned neurosurgeon, immunologist, and inventor Kevin Tracey made an important discovery after the death by sepsis of a young woman under his care: the vagus nerve appears to be an “inflammatory reflex” that works in the opposite direction of chronic inflammation, to offset or reverse its deleterious effects.¹ When activated, the vagus senses inflammation in the body and relays this information to the brain and central nervous system, which then reflexively powers up the immune system, inhibiting inflammation and preventing organ damage. Studies are under way to explore the extent to which stimulation of the vagus can prevent or reverse many inflammatory diseases, including arthritis, colitis, epilepsy, congestive heart failure, sepsis, Crohn’s disease, headaches, tinnitus, depression, diabetes, and possibly other autoimmune diseases. But the question then becomes: How do you activate or stimulate your vagus nerve?

我們知道炎症是許多不同疾病的常見途徑。但著名的神經外科醫生、免疫學家和發明家凱文·特雷西 （Kevin Tracey） 在他照顧的一名年輕女子因敗血症去世后做出了一個重要發現：迷走神經似乎是一種“炎症反射”，它與慢性炎症相反，可以抵消或逆轉其有害影響。¹當迷走神經被啟動時，迷走神經會感知到體內的炎症，並將這些信息傳遞給大腦和中樞神經系統，然後反射性地增強免疫系統，抑制炎症並防止器官損傷。正在進行研究，以探索刺激迷走神經在多大程度上可以預防或逆轉許多炎症性疾病，包括關節炎、結腸炎、癲癇、充血性心力衰竭、敗血症、克羅恩病、頭痛、耳鳴、抑鬱症、糖尿病和可能的其他自身免疫性疾病。但問題就變成了：你如何啟動或刺激你的迷走神經？

The vagus is a nerve, but in one important way, it’s more like a muscle—the more you use it, the stronger it becomes. Using the vagus—stimulating it through everything from deep breathing to connecting with a friend or partner—is like flexing your biceps as you lift weights; it increases its strength, flexibility, and elasticity. And just like with physical exercise, the more you use it, the better you get at using it, and the more health benefits you reap.

迷走神經是一種神經，但在一個重要方面，它更像是一塊肌肉——你使用它的次數越多，它就會變得越強壯。使用迷走神經——通過從深呼吸到與朋友或伴侶聯繫的所有方式來刺激它——就像在舉重時彎曲你的二頭肌;它增加了它的強度、柔韌性和彈性。就像體育鍛煉一樣，你使用它的次數越多，你使用它的效果就越好，你獲得的健康益處就越多。

Remember when I said that you don’t have to go falling in love with every person you meet to reap the health benefits of micro-connections? Well, an expert in the burgeoning field of “positive psychology” and its biological impact on the body disagrees—sort of.

還記得我說過，你不必愛上你遇到的每一個人才能獲得微連接對健康的好處嗎？嗯，“積極心理學”這一新興領域的專家及其對身體的生物學影響不同意——有點。

Barbara Fredrickson, a lead researcher at the University of North Carolina–Chapel Hill, has immersed herself in research on this topic for over two decades. She’s run study after study² showing that what truly tones the vagus nerve is small moments of connection—a sort of “falling in love,” if you will—with the people who surround you on a day-to-day basis, everyone from your husband or wife, to children, to the barista you’re getting to know at your corner coffee shop. It could even be a total stranger you meet on the street.

芭芭拉·弗雷德里克森 （Barbara Fredrickson） 是北卡羅來納大學教堂山分校 （University of North Carolina–Chapel Hill） 的首席研究員，二十多年來一直致力於這一主題的研究。她進行了一項又一項的研究² 表明，真正調和迷走神經的是與每天圍繞在你周圍的人建立聯繫的時刻——如果你願意的話，這是一種“墜入愛河”，從你的丈夫或妻子到孩子，再到你在街角咖啡店認識的咖啡師。它甚至可能是你在街上遇到的完全陌生的人。

Fredrickson’s research was fresh in my mind one morning as I was walking to a meeting along the streets of Cambridge. I zoomed by person after person who didn’t meet my gaze as we passed on the redbrick sidewalk. They were lost in thought or wrapped up in the music I could hear coming from their headphones, faint and tinny. But as I crossed over the Charles River on a busy bridge, I fell in step next to an older woman pushing a baby in a stroller. I smiled at the baby, who turned out to be her grandson, and she smiled at me; when she broke the ice by asking where a particular building was on campus (the baby’s mother, a student, was waiting there to breastfeed him), we fell into an animated discussion of children, families, and life with babies. I found myself remembering the years when my kids were infants and the difficulties and joys of that time. We ended up laughing together over the baby’s unselfconscious facial expressions.

一天早上，當我沿著劍橋的街道走去參加一個會議時，弗雷德里克森的研究在我腦海中記憶猶新。我飛快地經過一個又一個的人，當我們經過紅磚人行道時，他們沒有與我的目光相遇。他們沉浸在思考中，或者沉浸在我能聽到的從他們的耳機裡傳出的音樂中，微弱而微小。但是，當我在一座繁忙的橋上穿過查理斯河時，我一步一步地挨著一位推著嬰兒車裡嬰兒的老婦人。我對嬰兒微笑，原來是她的孫子，她也對我微笑;當她打破僵局，詢問校園裡某棟建築的位置時（嬰兒的母親是一名學生，正在那裡等著給他餵奶），我們陷入了一場關於兒童、家庭和嬰兒生活的熱烈討論。我發現自己想起了我的孩子還是嬰兒的歲月，以及那段時間的困難和快樂。我們最終一起為嬰兒不自覺的面部表情而大笑。

Fredrickson believes that culturally, we underestimate these fleeting moments of connection. They’re more important than we realize. While I was talking with this grandmother, whose name I never even caught, I was wrapped up in our conversation, laughing, making eye contact, and when we arrived at the building, it seemed like the long cold walk had flown by. I held the door for her as she struggled inside with the stroller; she waved goodbye and disappeared down a hallway. I realized that in that fleeting conversation, I’d experienced a real moment of connection with someone, and “exercised” my vagus nerve in the same way I work out my leg and heart muscles when I go for a run.

Fredrickson 認為，從文化上講，我們低估了這些轉瞬即逝的聯繫時刻。他們比我們意識到的更重要。當我和這位祖母交談時，我甚至從未聽過她的名字，我全神貫注於我們的談話中，大笑，進行眼神交流，當我們到達大樓時，似乎漫長而寒冷的步行已經飛逝而過。我為她扶著門，她推著嬰兒車掙扎著進去;她揮手告別，消失在走廊上。我意識到，在那次轉瞬即逝的對話中，我體驗到了與某人的真正聯繫，並像跑步時鍛煉腿部和心肌一樣“鍛煉”了我的迷走神經。

And just as exercise tones muscles, stimulating the vagus tones it in the same way. Vagal tone refers to your ability to rapidly activate the parasympathetic. The higher vagal tone you have, the more rapidly you can recover from stress and relax into healing mode. Whereas doing reps with a hand weight will tone your biceps, positive emotions like love actually tone your vagus.

就像運動可以調理肌肉一樣，刺激迷走神經也會以同樣的方式調理肌肉。迷走神經張力是指您快速啟動副交感神經的能力。您的迷走神經張力越高，您就越能更快地從壓力中恢復並放鬆到癒合模式。雖然用手重做重複動作會鍛煉你的二頭肌，但像愛這樣的積極情緒實際上會鍛煉你的迷走神經。

What is love? In very important ways, it may not be what we think it is. It’s not a continuous, never-ending state that we exist in when we’re “in love” with a romantic partner. Or at least, it’s not that exclusively. According to Fredrickson, love is a series of “micro moments of positivity resonance”³ that we experience, over and over again, as we go through life. We may have just one of these micro-moments with a stranger at a bus stop; or a million of them over the course of a lifetime with the person we marry. We think of the love we share with a spouse as being the most “important” love out there, and in certain aspects—socially, culturally—it is. What we don’t realize is that when it comes to our health and biological systems, each moment of micro-connection—whether it’s with your spouse, with a friend, or with an Uber driver you just met—is equally as important as the next and carries the same weight.

什麼是愛？在非常重要的方面，它可能不是我們認為的那樣。這不是我們 「愛 」一個浪漫的伴侶時所處的持續、永無止境的狀態。或者至少，它不是那麼排他性。根據Fredrickson的說法，愛是我們在生活中一遍又一遍地經歷的一系列“積極共鳴的微時刻”³。我們可能只有一個在公共汽車站與陌生人之間的微時刻;或者與我們結婚的人在一生中擁有一百萬個。我們認為我們與配偶分享的愛是世界上最“重要”的愛，在某些方面——社會、文化——確實如此。我們沒有意識到的是，當涉及到我們的健康和生物系統時，微聯繫的每一刻——無論是與你的配偶、朋友還是你剛認識的Uber司機——都與下一刻一樣重要，並且具有相同的重量。

Think of each of these moments of connection over the course of your typical day as stars, appearing in the sky as the sun goes down. Each one is its own individual, bright moment, and as the stars emerge, they begin to fill the sky with points of light. There might be a hundred stars that represent micro-moments with your partner or child, forming constellations that represent those important relationships, and one solitary star representing the laugh you shared with a coworker on a thirty-second elevator ride. But each one did essential work, quietly, inside your body—it lit up your vagus nerve.

將您平常一天中的每一個聯繫時刻都想像成星星，隨著太陽下山而出現在天空中。每一個都是自己獨立的明亮時刻，當星星出現時，它們開始用光點填滿天空。可能有 100 顆星星代表與您的伴侶或孩子的微時刻，形成代表那些重要關係的星座，還有一顆孤獨的星星代表您在乘坐 30 秒電梯時與同事分享的笑聲。但每一個都在你的身體里悄悄地做了重要的工作——它點燃了你的迷走神經。

Our narrow concept of love could be making us sick. In her book on the topic, Love 2.0: Finding Happiness and Health in Moments of Connection, Fredrickson makes the bold claim that our fixation on the idea of love as something that can only be shared in long-term, intimate romantic relationships shows “a worldwide collapse of imagination.” She writes: “Thinking of love purely as romance or commitment that you share with one special person—as it appears most on earth do—surely limits the health and happiness you derive from micro-moments of positivity resonance. Put differently, your beliefs about what love is become self-fulfilling prophecies.”

我們狹隘的愛概念可能會讓我們生病。在她關於這個主題的書中， 愛 2.0：在聯繫的時刻尋找幸福和健康，弗雷德里克森大膽地聲稱，我們執著於愛的概念，即只能在長期、親密的浪漫關係中分享的東西，這表明 “全球想像力的崩潰”。她寫道：「純粹將愛情視為你與一個特別的人分享的浪漫或承諾——就像地球上大多數人一樣——肯定會限制你從積極共鳴的微時刻獲得的健康和幸福。換句話說，你對愛是什麼的信念變成了自我實現的預言。

Essentially, Fredrickson is telling us that to feel better, we need to expand our definition of love. We need to see all moments of micro-connection as meaningful—because when we do, we are more open to connection and more open to feeling the positive emotions of love, compassion, and empathy. In this way, our vagus nerve gets stimulated again and again and again, and the positive effects begin to build on one another, growing stronger. This leads to what Fredrickson calls an “upward spiral of the heart.” It turns out that vagal tone, and the ability to experience moments of love, compassion, and connection, increase in relationship to each other, exponentially. That means that the higher your vagal tone, the abler you are to easily engage and connect with people, and the more you engage and connect with people, the higher your vagal tone.

從本質上講，弗雷德里克森告訴我們，要想感覺更好，我們需要擴大我們對愛的定義。我們需要將所有微聯繫的時刻都視為有意義——因為當我們這樣做時，我們會更開放地接受聯繫，更開放地感受愛、同情心和同理心等積極情緒。通過這種方式，我們的迷走神經一次又一次地受到刺激，積極影響開始相互疊加，變得更加強大。這導致了Fredrickson所說的 「心臟的螺旋式上升」。事實證明，迷走神經的語氣，以及體驗愛、同情和聯繫時刻的能力，彼此之間的關係呈指數級增長。這意味著你的迷走神經張力越高，你就越能輕鬆地與人互動和聯繫，而你與人接觸和聯繫的次數越多，你的迷走神經張力就越高。

That might sound like a catch-22 where, if you’re not very good at forging social connections, you’re screwed. Luckily, that’s not the case! It is a self-perpetuating cycle, where the better you get at it, the more health benefits you reap, and the easier it gets. Fredrickson calls it a “use it or lose it” situation. If you’re rusty, you have to get back on the bike and teach yourself to ride again. It’ll feel awkward and hard at first, but it doesn’t take very long until it becomes second nature and you gain momentum.

這聽起來像是第 22 條軍規，如果你不太擅長建立社交關係，那你就完蛋了。幸運的是，事實並非如此！這是一個自我延續的迴圈，你做得越好，你獲得的健康益處就越多，而且它就越容易。Fredrickson 稱之為 「要麼使用它，要麼失去它」 的情況。如果你生疏了，你必須重新騎上自行車並自學再次騎行。一開始會感到尷尬和困難，但沒過多久它就會成為第二天性，你就會獲得動力。

To test the idea of the reciprocal loop, Fredrickson ran a study⁴ where participants signed up to practice a certain type of meditation called loving-kindness meditation, or LKM. People were randomly selected from a pool of volunteers to take a six-week course in LKM, which focuses on training participants to cultivate feelings of love, compassion, and goodwill toward themselves and others. The study wasn’t especially demanding in terms of immersion; participants were simply asked to practice the meditation tactics they’d learned at home, whenever they wanted, for however long they wanted. It was up to them. They gave the researchers daily reports on both their meditative activity and their social interactions on that day.

為了測試互惠迴圈的想法，Fredrickson 進行了一項研究⁴，參與者報名練習某種類型的冥想，稱為慈愛冥想，或 LKM。人們是從志願者中隨機選擇的，參加為期六周的 LKM 課程，該課程的重點是培訓參與者培養對自己和他人的愛、同情和善意。這項研究在沉浸感方面並不是特別苛刻;參與者被簡單地要求練習他們在家裡學到的冥想策略，無論他們想練習多久，只要他們想練習多久。這取決於他們。他們向研究人員提供當天的冥想活動和社交互動的每日報告。

Fredrickson and her research partner, Bethany Kok of the Max Planck Institute for Human Cognitive and Brain Sciences, tested their subjects’ vagal tone (we’ll get into how that’s measured a bit later) before the study and then after. They found that as study participants’ positive emotions increased through LKM, so did their social interactions, and as the number of social interactions went up, so did vagal tone. And the higher your vagal tone was when you started, the more it increased over the course of the study. There it was: the upward spiral.

弗雷德里克森和她的研究夥伴，馬克斯-普朗克人類認知和腦科學研究所的貝瑟尼-科克，在研究前和研究后測試了他們受試者的迷走神經張力（我們稍後會討論如何測量）。他們發現，隨著研究參與者的積極情緒通過 LKM 增加，他們的社交互動也會增加，而隨著社交互動次數的增加，迷走神經張力也會增加。開始時你的迷走神經張力越高，它在研究過程中增加的就越多。就在那裡：向上的螺旋。

The good news is that there’s no certain level that you need to achieve on this spiral before you can begin accessing the parasympathetic for longer stretches. It’s not like Chutes and Ladders, where you have to land exactly on the right square to climb the ladder toward healing and health. Fredrickson emphasizes that there are “multiple points of entry” to the spiral. And the higher you get, the faster you progress. Love is a spiral that lifts you higher and faster the more you allow yourself to feel it.

好消息是，在您可以開始更長時間地訪問副交感神經之前，您不需要在這個螺旋上達到一定的水準。它不像 Chutes and Ladders，您必須準確地降落在正確的方塊上才能爬上梯子以獲得治療和健康。Fredrickson 強調，螺旋存在“多個切入點”。而且你升得越高，進步就越快。愛是一個螺旋，你越是讓自己感受到它，它就會讓你更高、更快。

To return to the idea of the guitar, the more you practice, the better at it you’ll get, and the more beautiful the music you make. Strumming the strings of your vagus nerve works the same way. Make sure you’re playing music, and keeping that instrument warmed up and in use. But just as with Benson’s relaxation response, a little bit goes a long way. And this begs the question: What could be achieved, health- and healing-wise, if you devoted yourself even more deeply to these practices?

回到吉他的想法，你練習得越多，你就會越擅長，你製作的音樂就越美。彈奏迷走神經的琴弦也是這樣。確保您正在播放音樂，並保持該樂器的預熱和使用狀態。但就像 Benson 的放鬆反應一樣，一點點就會大有説明。這就引出了一個問題：如果你更深入地投入到這些實踐中，在健康和療癒方面可以取得什麼成就？

We talked in the previous chapter about how our bodies are, from an evolutionary perspective, preprogrammed to drop into fight or flight at the slightest provocation. Indeed, it’s the reason we’re here—those of us who are alive today exist because our ancestors had a very highly developed, sharply honed fight-or-flight response that allowed them to live long enough to reproduce. We discussed the idea of learning how to override this programming now that we live in the modern world, where our fight-or-flight response is turned on too much of the time. But the deeper, more complicated truth is that we also have ancient programming that runs concurrent to that—programming that actually wants us to be in the parasympathetic. In fact, we are descended from the early humans who not only were adept at dropping into the sympathetic but adept at shifting back out of it, too.

我們在上一章中談到了，從進化的角度來看，我們的身體是如何被預先程式設計為在最輕微的挑釁下進入戰鬥或逃跑的。事實上，這就是我們來到這裡的原因——我們這些今天活著的人之所以存在，是因為我們的祖先有一種非常發達、磨練得非常激烈的戰鬥或逃跑反應，使他們能夠活得足夠長，可以繁殖。我們討論了學習如何覆蓋這個程式設計的想法，因為我們生活在現代世界中，我們的戰鬥或逃跑反應在很多時候都處於開啟狀態。但更深層次、更複雜的事實是，我們也有與此並行運行的古老程式設計——實際上希望我們處於副交感神經狀態的程式設計。事實上，我們是早期人類的後代，他們不僅善於陷入同情心，而且也善於從中移出。

SURVIVAL OF THE FITTEST, OR SURVIVAL OF THE KINDEST?

適者生存，還是最善良的生存？

When you’re running from a tiger, social connection is not the first thing on your mind. But as soon as the threat is out of the picture, it had better be—and fast. Your life could depend on it.

當你逃離老虎時，社交關係並不是你首先想到的事情。但是，一旦威脅消失，它最好是——而且要快。你的生活可能取決於它。

In fight or flight, you’re ready to hit, punch, run, or hide—you’re not ready to connect. Your ability to do so is literally shut down by your body’s physiological and hormonal response, for your own protection. But once you can turn off fight or flight and shift into rest and digest, your body allows you to have these moments of connection, to feel compassion, to bond with others and experience love. As we’ve seen when looking at the vagus nerve, this can have long-term benefits for your physical health. But there are other reasons why we developed this biological response and why that programming is there—just as strong as our fight-or-flight instinct, and just as necessary for survival.

在戰鬥或逃跑中，您已準備好攻擊、拳打腳踢、逃跑或躲藏 - 您還沒有準備好連接。為了保護自己，您這樣做的能力實際上被您身體的生理和荷爾蒙反應關閉了。但是，一旦你可以停止戰鬥或逃跑，轉入休息和消化，你的身體就會讓你擁有這些聯繫的時刻，感受到同情心，與他人建立聯繫並體驗愛。正如我們在觀察迷走神經時所看到的那樣，這對您的身體健康有長期的好處。但是，我們發展出這種生物反應以及這種程式設計存在還有其他原因——與我們的戰鬥或逃跑本能一樣強烈，也同樣是生存所必需的。

Let’s zoom out and look at all this from a biological perspective. For your ancestor on the savanna, shifting into the parasympathetic was a very evolved defense mechanism. If you can connect emotionally with someone who’s a potential threat, you can perhaps defuse the situation before it escalates. Basically, love and connection can be understood in part as a highly evolved, proactive defense mechanism.

讓我們縮小範圍，從生物學的角度來看這一切。對於你在稀樹草原上的祖先來說，轉變為副交感神經是一種非常進化的防禦機制。如果你能與潛在威脅的人建立情感聯繫，你也許可以在事態升級之前化解。基本上，愛和聯繫可以部分地理解為一種高度進化的主動防禦機制。

When the parasympathetic is engaged, the vagus activates a face-heart connection. At a metaphorical level, it opens your heart to others, and on a literal level, it both relaxes and constricts different facial muscles that help you to smile, focus, and express warmth and interest so that you can connect with the person you’re speaking with. When you’re in chronic fight-or-flight mode, you have—without even realizing it—a flatter or forced affect. Fight or flight stiffens your body, inhibits the warmth of your gaze, limits the genuineness of your smile, and overall inhibits your ability to make connections, letting those opportunities for micro-moments of love slip by. Others can sense—if only subconsciously—if your vagus is activated or not; they can feel your genuine positive emotion and connection with them, or the lack of it. A person in fight or flight will have more difficulty, therefore, in connecting with others.

當副交感神經參與時，迷走神經會啟動面部-心臟連接。在隱喻層面上，它向他人敞開心扉，在字面上，它既放鬆又收縮不同的面部肌肉，説明您微笑、集中注意力並表達溫暖和興趣，以便您可以與正在交談的人建立聯繫。當你處於長期的戰鬥或逃跑模式時，你甚至沒有意識到——一種更扁平或被迫的影響。戰鬥或逃跑會讓你的身體僵硬，抑制你目光的溫暖，限制你笑容的真實性，總體上抑制你建立聯繫的能力，讓那些短暫的愛情機會溜走。其他人可以感覺到——如果只是潛意識地——你的迷走神經是否被啟動;他們可以感受到你真正的積極情緒和與他們之間的聯繫，或者缺乏它。因此，一個處於戰鬥或逃跑中的人在與他人建立聯繫時將更加困難。

Neuroception is the brain process in which you determine whether a person or situation is safe or dangerous. It’s the reason, for example, why a baby will smile at a familiar face and cry at an unfamiliar one. Stephen Porges, a psychologist at Indiana University and UNC–Chapel Hill and an expert on vagal function, has researched what happens when people go into a neurocepid state and lose the capacity to make social connections. Trauma victims, for example, will have a nervous system that is extremely focused on detecting a predator but totally compromised at being social. Trauma, anxiety, chronic stress—all of this can put us into the “freeze” mode of fight-flight-freeze, shutting down our ability to experience micro-connections of positivity with the people we encounter throughout our days and even with those we love over the long term. And we’re seeing more and more how the long-term effects of this disrupt healing and usher us more quickly into, as Elizabeth Blackburn puts it, the “disease span.”

神經感覺是大腦過程，您可以在其中確定一個人或情況是安全還是危險。例如，這就是為什麼嬰兒會對熟悉的面孔微笑而對陌生的面孔哭泣的原因。印第安那大學和北卡羅來納大學教堂山分校的心理學家、迷走神經功能專家斯蒂芬·波爾赫斯 （Stephen Porges） 研究了當人們進入神經頭狀狀態並失去建立社會聯繫的能力時會發生什麼。例如，創傷受害者的神經系統將非常專注於檢測捕食者，但在社交方面完全妥協。創傷、焦慮、慢性壓力——所有這些都會讓我們進入戰鬥-逃跑-凍結的“凍結”模式，關閉我們與日常生活中遇到的人，甚至與我們長期所愛的人體驗積極微聯繫的能力。我們越來越多地看到這種病的長期影響如何破壞癒合，並讓我們更快地進入伊莉莎白·布萊克本 （Elizabeth Blackburn） 所說的“疾病跨度”。

A recent review of twenty-eight studies, involving over 180,000 adult subjects, showed in stark relief how deadly it can be if you’re cut off from social connection. After examining the data, the review panel found that loneliness, social isolation, or both are associated with a 29 percent increased risk of heart attack and a 32 percent greater risk of stroke⁵—a huge increase. People who reported fewer social connections also showed disrupted sleep patterns, altered immune systems, higher inflammation, and greatly increased levels of stress hormones. And consider the sociological landscape here—in the United States, one-third of those over age sixty-five live alone, as do more than half of the 1.6 million people who live in Manhattan. In the UK, sociologists saw a marked increase in the number of people living alone over the course of a decade; between 2001 and 2011, it went up by 600,000 people, a 10 percent rise.

最近對 28 項研究（涉及超過 180,000 名成人受試者）的回顧清楚地表明，如果你與社會聯繫隔絕，那將是多麼致命。在檢查了數據后，審查小組發現，孤獨、社交孤立或兩者兼而有之，心臟病發作的風險增加 29%，中風風險增加 32%⁵——這是一個巨大的增加。報告社交聯繫較少的人還表現出睡眠模式紊亂、免疫系統改變、炎症升高和壓力荷爾蒙水準大幅增加。想想這裡的社會學景觀——在美國，65 歲以上的人中有三分之一獨居，曼哈頓 160 萬人口中有一半以上獨居。在英國，社會學家發現，在過去十年中，獨居人數顯著增加;2001 年至 2011 年間，它增加了 600,000 人，增長了 10%。

Now, there are important distinctions to make between living alone, feeling lonely, or being socially isolated, but similar numbers repeat across other developed countries, leading sociologists and researchers to describe this, in multiple studies and reports, as “an epidemic of loneliness.” Loneliness, if you look at the numbers,⁶ is as important a risk factor for your health as poor nutrition, lack of exercise, obesity, or even smoking⁷—but we don’t see a lot of bus stop posters warning us about this fact. You might have seen this with a loved one in your own life—that when they experience the death of a spouse and are suddenly alone, their health can decline dramatically.

現在，獨居、感到孤獨或被社會孤立之間存在重要區別，但類似的數位在其他發達國家重複出現，導致社會學家和研究人員在多項研究和報告中將其描述為 “孤獨的流行病”。如果你看一下數位，⁶ 與營養不良、缺乏運動、肥胖甚至吸煙一樣，孤獨是你健康的重要風險因素⁷——但我們沒有看到很多公交車站的海報警告我們這個事實。您可能在自己的生活中看到過這一點——當他們經歷配偶的去世並突然孤獨時，他們的健康情況會急劇下降。

Fredrickson found that moments of micro-connection—those little power boosts that fuel the love engine—have to happen in person. While positive feelings like happiness and contentment can certainly slow down the flow of those stress hormones and tip you over into parasympathetic mode, it turns out that in-person interactions are the most potent fuel for the vagus—the higher octane that really makes your parasympathetic hum. This means that calling your mother to talk on the phone is good, but even though she’s emotionally closer to you, she’s going to get the best health boost from chatting with her mailman as he drops off a package or from sitting down with her neighbor for coffee.

Fredrickson 發現，微聯繫的時刻——那些為愛情引擎提供動力的小小動力提升——必須親自發生。雖然快樂和滿足等積極的感覺肯定會減慢這些壓力荷爾蒙的流動，並使您進入副交感神經模式，但事實證明，面對面的互動是迷走神經最有效的燃料——真正讓您的副交感神經嗡嗡作響的高辛烷值。這意味著打電話給媽打電話是件好事，但即使她在情感上與你更親近，她也會通過在郵遞員投遞包裹時與他聊天或與鄰居坐下來喝咖啡來獲得最好的健康提升。

When a person feels alone or is without social connection most of the time, and the vagus begins to go dark, inflammation can flare up, the immune system is suppressed, and pathways for disease that were previously closed begin to open up. We are now beginning to understand the science behind this: how lack of warm social interaction boots us out of that upward spiral that we need to be in to thrive. In fact, feeling lonely long term, or becoming socially isolated, can suck you into a downward spiral, where feelings of loneliness lead to more intense feelings of loneliness as time goes on—compounding exponentially just like Fredrickson’s upward spiral. John Cacioppo, a social psychologist working out of the University of Chicago, researched the effects of loneliness on health and found that lonely or isolated individuals had an increased risk not only of heart disease and stroke but cancer. The reason for this comes down—no surprise—to the immune system.

當一個人大部分時間感到孤獨或沒有社交聯繫，迷走神經開始變黑時，炎症會突然發作，免疫系統受到抑制，以前關閉的疾病途徑開始打開。我們現在開始理解這背後的科學原理：缺乏溫暖的社交互動如何使我們擺脫茁壯成長所需的上升螺旋。事實上，長期感到孤獨，或在社會上被孤立，會讓你陷入一個惡性循環，隨著時間的推移，孤獨感會導致更強烈的孤獨感——就像弗雷德里克森的螺旋上升一樣呈指數級增長。芝加哥大學（University of Chicago）的社會心理學家約翰·卡奇奧波（John Cacioppo）研究了孤獨對健康的影響，發現孤獨或孤立的人不僅患心臟病和中風的風險增加，而且患癌症的風險也增加。這並不奇怪，原因歸結為免疫系統。

Cacioppo and his research partner, Steve Cole of UCLA, found that in lonely individuals, their immune system cells were altered—right down to their gene expression. In other words, there was a notable change in the way the cells of the immune system behaved in lonely individuals versus those who had more opportunity for genuine social connection. In lonely individuals who tended to view the world more as a threat (remember the differences between threat stress versus challenge stress), the cells of the immune system became more inflammatory; that means more cells were constantly cycling through the body looking for something to fight like an army unit always on patrol with no break. Because of this, they tended to fixate on the body’s own tissues, as happens in many of the autoimmune illnesses we’ve seen in this book.

Cacioppo 和他的研究夥伴、加州大學洛杉磯分校的史蒂夫·科爾 （Steve Cole） 發現，在孤獨的個體中，他們的免疫系統細胞發生了變化——甚至到他們的基因表達。換句話說，與那些有更多機會建立真正社會聯繫的人相比，孤獨個體的免疫系統細胞行為方式發生了顯著變化。在傾向於將世界更多地視為威脅的孤獨個體中（記住威脅壓力與挑戰壓力之間的區別），免疫系統的細胞變得更加具有炎症性;這意味著更多的細胞不斷在體內迴圈，尋找可以戰鬥的東西，就像一個陸軍單位總是不間斷地巡邏一樣。正因為如此，他們傾向於關注身體自身的組織，就像我們在本書中看到的許多自身免疫性疾病一樣。

The immune system has a fixed fighting capacity. When too many of the battalions are directed toward constant inflammation, it doesn’t have the bandwidth to take care of other problems like viruses, infections, and even mutating cells. In the earlier chapter “Natural-Born Killers,” we talked about how important it is to keep the immune system healthy and honed so that it can efficiently find, tag, and remove mutating cells before they become full-blown cancer. Well, it turns out that one of the best ways to do that is to genuinely fall in love—over and over again, every day, with your spouse, your kids, your friends, your neighbors, your coworkers. And if you don’t have those people in your life, then find a way to socially engage in a manner that feels enjoyable and life-giving to you, whether it’s a book club or an exercise class at the local YMCA. It could save your life as surely as picking up a lifesaving medication at the pharmacy.

免疫系統具有固定的戰鬥能力。當太多的營被引導到持續的炎症上時，它就沒有足夠的頻寬來處理其他問題，如病毒、感染，甚至突變的細胞。在前面的章節「天生殺手」中，我們談到了保持免疫系統健康和磨練的重要性，這樣它才能在突變細胞變成全面的癌症之前有效地發現、標記和去除突變細胞。嗯，事實證明，做到這一點的最好方法之一就是真正地墜入愛河——每天一遍又一遍，與你的配偶、你的孩子、你的朋友、你的鄰居、你的同事。如果你的生活中沒有這些人，那麼就想辦法以一種讓你感到愉快和賦予生命的方式進行社交活動，無論是讀書俱樂部還是當地基督教青年會的健身課。它可以像在藥房買救命葯一樣肯定地挽救您的生命。

Cacioppo laid out his research in an interview⁸ with The Guardian: loneliness is contagious (it can spread from another lonely person you interact with as they cease to make eye contact and interact) and heritable (the changes in gene expression can be passed down to your offspring), and it affects one in four people—an epidemic indeed. It increases your risk of an early death by 20 percent. As Cacioppo puts it, if we were to build a zoo for the human animal, we would include the instructions “Do not house in isolation.”

Cacioppo 在接受《衛報》採訪⁸ 時闡述了他的研究：孤獨是會傳染的（它可以從你與之互動的另一個孤獨的人那裡傳播，因為他們停止了眼神交流和互動）和可遺傳的（基因表達的變化可以遺傳給你的後代），它影響了四分之一的人——確實是一種流行病。它會使您過早死亡的風險增加 20%。正如 Cacioppo 所說，如果我們要為人類動物建造一個動物園，我們會包括“不要孤立地居住”的說明。

Social connections turn out to be an essential nutrient like any other; you can’t heal without micro-connections to light up your vagus just as you can’t heal without nutrient-rich food to fuel your body. Love and connection are clearly among the most potent medicines. We should be writing prescriptions for people to spend restorative time—those micro-moments of positivity—with friends, family, and new acquaintances, just as we write prescriptions for pharmaceutical medications. We should be asking, How is the emotional nutrition in your life?

社會關係被證明是一種必需的營養素，就像任何其他營養素一樣;如果沒有微連接來照亮你的迷走神經，你就無法治癒，就像沒有營養豐富的食物為你的身體提供能量就無法癒合一樣。愛和聯繫顯然是最有效的藥物之一。我們應該為人們開處方，讓人們與朋友、家人和新認識的人一起度過恢復性的時間——那些積極的微時刻，就像我們開藥物處方一樣。我們應該問，你生活中的情緒營養如何？

When you think about it, social connection is a more evolved coping strategy than fight or flight. Fight or flight, after all, came first—the amygdala, buried deep in the brain, was one of the first areas of the brain to develop after we crawled out of the proverbial soup, which is why it’s often referred to as the lizard brain. It’s been there for thousands of years. But the parasympathetic response originates from more evolved parts of the brain. As we evolved, it was only when these more advanced, complex strategies for survival—forging connections, friendships, and alliances—failed that our ancestors fell back on more primitive modes of survival. It holds true today; when we lose the ability to connect, our lizard brains kick in, and we regress to more primitive forms of coping.

仔細想想，社交關係是一種比戰鬥或逃跑更進化的應對策略。畢竟，戰鬥或逃跑是第一位的——深埋在大腦中的杏仁核是我們從眾所周知的湯中爬出來后大腦最先發育的區域之一，這就是為什麼它通常被稱為蜥蜴腦。它已經存在了數千年。但副交感神經反應起源於大腦中更進化的部分。隨著我們的進化，只有當這些更先進、更複雜的生存策略——建立聯繫、友誼和聯盟——失敗時，我們的祖先才會回到更原始的生存模式。今天仍然適用;當我們失去連接能力時，我們的蜥蜴大腦就會啟動，我們就會倒退到更原始的應對形式。

The fight-or-flight response is strong and acute, and for that reason, it can seem like an insurmountable instinctual curse—we can’t overcome it, because it’s coded into our genes. But love and connection—the spark and fire of the parasympathetic—is coded in there, too. We are biologically built for positive love and connection; it’s the leading edge of how we are evolving, and as a species, we now seem to be working on how to take this to the next level and drop the chronic fight or flight from being our most frequent go-to strategy.

戰鬥或逃跑的反應是強烈而尖銳的，因此，它似乎是一個無法克服的本能詛咒——我們無法克服它，因為它已經編碼到我們的基因中。但愛和聯繫——副交感神經的火花和火焰——也編碼在那裡。我們在生物學上是為積極的愛和聯繫而生的;這是我們進化的前沿，作為一個物種，我們現在似乎正在努力將其提升到一個新的水準，並放棄長期的戰鬥或逃跑成為我們最常見的策略。

Think of the human baby. Holding my first child, looking down at his sweet, sleeping face, his tiny body wrapped in one of those blue-and-pink-striped blankets, I was temporarily flattened by how helpless he was, how dependent on me. Growing up on a farm, I saw newborn calves clamber to their feet and wobble along next to their mothers within minutes of being born. But long ago, when we evolved from primates and began walking upright, our hips narrowed, and our brains became more complex. To give birth to a baby that would be able to function at the level of other mammals, the human mother would have to gestate her baby for up to two years—which is too taxing for the female body. In order to evolve into the upright, highly intelligent animals we are today, we needed to give birth before our babies were really ready.

想想人類嬰兒。抱著我的第一個孩子，低頭看著他甜美、熟睡的臉龐，他小小的身體裹在一條藍色和粉紅色條紋的毯子裡，我暫時被他是多麼的無助，多麼依賴我而感到沮喪。我在農場長大，我看到新生的小牛在出生後幾分鐘內就爬起來爬起來，在媽媽旁邊搖搖晃晃。但是很久以前，當我們從靈長類動物進化而來並開始直立行走時，我們的臀部變窄了，我們的大腦變得更加複雜。為了生下能夠與其他哺乳動物水準相媲美的嬰兒，人類母親必須讓嬰兒懷孕長達兩年——這對女性身體來說太費力了。為了進化成我們今天正直、高度聰明的動物，我們需要在嬰兒真正準備好之前分娩。

So evolution, ever ingenious, worked in such a way that the benefit for another (a baby) is interlocked with ours. Love for our young, the helpless little creatures in our arms, rapidly became the most important survival tactic. The compassion, connection, and caregiving we practice with our young stimulates the vagus and improves our health, as well as sustaining theirs. It’s a symbiotic relationship, a win-win. It might not feel that way to exhausted new parents, but even over the most sleepless nights, a breastfeeding mother’s body is awash in oxytocin, and her vagus nerve is humming.

因此，進化論永遠是巧妙的，其運作方式使另一個（嬰兒）的利益與我們的利益環環相扣。愛我們的幼崽，懷裡無助的小生物，迅速成為最重要的生存策略。我們與年輕人一起練習的同情心、聯繫和照顧可以刺激迷走神經並改善我們的健康，並維持他們的健康。這是一種共生關係，雙贏。對於疲憊不堪的新父母來說，這可能不是這樣，但即使在最不眠之夜，母乳餵養的母親的身體也會被催產素淹沒，她的迷走神經在嗡嗡作響。

Dacher Keltner, a professor of psychology at the University of California–Berkeley, has devoted his career to investigating and understanding the link between human compassion, survival, and health. Our capacity for compassion, he says, is what helped us survive and evolve as a species, and it could be the “medicine” we need today for making radical progress in health and healing. “We became the super caregiving species, to the point where acts of care improve our physical health and lengthen our lives,” he writes. “We are born to be good to each other.”

加州大學伯克利分校 （University of California–Berkeley） 的心理學教授達赫爾·凱爾特納 （Dacher Keltner） 的職業生涯致力於研究和理解人類同情心、生存和健康之間的聯繫。他說，我們的同情心是幫助我們作為一個物種生存和進化的原因，它可能成為我們今天在健康和康復方面取得根本性進步所需的“良藥”。“我們成為超級護理物種，以至於護理行為可以改善我們的身體健康並延長我們的壽命，”他寫道。“我們生來就是為了善待彼此。”

Charles Darwin is famous for his “survival of the fittest” theory of natural selection. I always assumed it was the gospel truth—I’d heard it repeated so many times, even in medical school. And then it was pointed out to me that in Darwin’s seminal text, On the Origin of Species, the “survival of the fittest” was a flattening of his more complex ideas about who survived to evolve and why. Scholars looking with a fresh eye at Darwin’s groundbreaking work are now telling us that his message was more along the lines of “survival of the kindest.”

查理斯·達爾文 （Charles Darwin） 以其“適者生存”的自然選擇理論而聞名。我一直認為這是福音真理——我聽過它重複很多次，甚至在醫學院也是如此。然後有人向我指出，在達爾文的開創性著作《物種起源》中，“適者生存”是他關於誰倖存下來進化以及為什麼倖存下來的更複雜的想法的扁平化。以新的眼光看待達爾文的開創性工作的學者現在告訴我們，他的資訊更接近於「最善良的生存」。。

On the Origin of Species is Darwin’s most famous work, where he lays out the foundations of evolutionary biology in animal populations. But his lesser-known follow-up, The Descent of Man, focused all its eight-hundred-plus pages on human evolution. In these pages, he looks at the edge we gained as a species from taking care of each other and connecting in friendship instead of fighting. In The Descent of Man, he spoke only twice of “survival of the fittest.” Love, however, is mentioned ninety-five times.

《物種起源》是達爾文最著名的著作，他在其中奠定了動物種群進化生物學的基礎。但他鮮為人知的後續著作《人類的起源》（The Descent of Man）用了八百多頁的篇幅，把重點放在了人類的進化論上。在這些頁面中，他著眼於我們作為一個物種從相互照顧和友誼聯繫而不是爭吵中獲得的優勢。在《人類的起源》中，他只提到了兩次 「適者生存」。。然而，愛被提到了95次。

New research is coming together to show how love, compassion, and connection are even more than a survival tactic as Darwin perceived it. These same actions that lift us up as a species or society—caring for one another, helping, having empathy, and so on—are also causing an internal shift inside our bodies. They’re letting us climb into that upward spiral toward health and vitality.

新的研究彙集在一起，表明愛、同情心和聯繫如何超越達爾文所認為的生存策略。這些提升我們作為一個物種或社會的行動——互相關心、説明、同理心等等——也正在引起我們身體內部的轉變。他們讓我們爬進通往健康和活力的螺旋。

What we know: stimulating the vagus nerve reduces inflammation and boosts the immune system. Recovery from injury or illness is faster in those with higher vagal tone, and Fredrickson’s work tells us that vagal tone is an incredibly accurate indicator of overall health. So if that’s all true, how can we tell if our vagal tone is good? We can’t just look in the mirror and flex it like rolling up a sleeve to check out our biceps.

我們所知道的：刺激迷走神經可以減少炎症並增強免疫系統。迷走神經張力較高的人從受傷或疾病中恢復得更快，Fredrickson 的工作告訴我們，迷走神經張力是整體健康情況的一個非常準確的指標。那麼，如果這一切都是真的，我們如何判斷我們的迷走神經張力是否良好呢？我們不能只是照鏡子並彎曲它，就像捲起袖子檢查我們的二頭肌一樣。

Turns out, there is a fast and simple way to check vagal tone, and by extension, your capacity for health and healing—and just like love, it has to do with your heart.

事實證明，有一種快速簡單的方法可以檢查迷走神經張力，進而檢查你的健康和癒合能力——就像愛一樣，它與你的心臟有關。

THE WISDOM OF THE HEART

心靈的智慧

There is a window into vagal function, and it’s a biometric called heart rate variability. Heart rate variability, or HRV, is different from blood pressure or simple heart rate, which only looks at the number of beats per minute. HRV refers to the changing time interval between your heartbeats and captures a snapshot of the heart’s ability to flexibly respond to situations or stimuli. Your heart is not meant to beat at the same speed at all times; it needs to be able to change depending on your level of activity, emotions, and environment. High heart rate variability is good; it means your body can adapt your heart rate to your circumstances. It usually indicates a high level of ability to deal with and recover from stress. Low heart rate variability is concerning; it means there’s rigidity in the system, that it has become less responsive, perhaps due to chronic overdoses of stress hormones, hardening of the cardiovascular arteries due to inflammation, or other causes. Low HRV has been associated not only with anxiety and depression but also with an increased risk of cardiovascular disease and early death.

有一個瞭解迷走神經功能的視窗，它是一種稱為心率變異性的生物識別技術。心率變異性 （HRV） 不同於血壓或簡單心率，後者僅關注每分鐘的心跳次數。HRV 是指心跳之間不斷變化的時間間隔，並捕捉到心臟靈活應對情況或刺激的能力的快照。你的心臟不應該一直以相同的速度跳動;它需要能夠根據您的活動水平、情緒和環境而變化。高心率變異性是好的;這意味著您的身體可以根據您的情況調整您的心率。它通常表明處理壓力和從壓力中恢復的能力很高。低心率變異性令人擔憂;這意味著系統僵化，反應遲鈍，可能是由於長期過量的壓力荷爾蒙、炎症導致心血管動脈硬化或其他原因。低 HRV 不僅與焦慮和抑鬱有關，還與心血管疾病和早逝風險增加有關。

And most important, HRV is an excellent indicator of vagal tone. The higher your HRV, the more engaged the vagus nerve, and the more the parasympathetic is active in your system. What this boils down to is that HRV is a major, underutilized index of general health, and of vagal health specifically.

最重要的是，HRV 是迷走神經張力的極好指標。您的 HRV 越高，迷走神經的參與程度就越高，副交感神經在您的系統中就越活躍。歸根結底，HRV 是一般健康，特別是迷走神經健康的主要、未充分利用的指標。

Can we use HRV in our everyday lives to help us understand our bodies better? Until recently, finding out your HRV wasn’t the easiest thing to do. You’d have to go to a doctor, have them hook you up to a heart monitor, and then study the readout from the software that analyzed the electrocardiogram. But lately, there’s been a proliferation of ever-more affordable devices combined with free downloadable apps that can give you a snapshot of your HRV. The technology is still developing, and some may be more effective than others, but at the rate things are going, it seems that it will only get easier to figure out your HRV and use it as a tool to navigate toward health and healing. And in the meantime, if heart rate monitors and apps aren’t for you, just be aware that any of the tactics we’ve discussed here for getting in touch with your body, bringing down inflammation, and shifting into the parasympathetic will also positively affect HRV. Practicing the relaxation response or meditation, getting to know your stress triggers, and learning about your body’s responses to stress and connection so you can more flexibly move into healing mode—all of these can only help improve HRV, and with it, vagal tone.

我們可以在日常生活中使用 HRV 來幫助我們更好地了解我們的身體嗎？直到最近，找出您的 HRV 並不是一件容易的事情。你必須去看醫生，讓他們把你連接到心臟監測器上，然後研究分析心電圖的軟體的讀數。但最近，越來越實惠的設備與可免費下載的應用程式相結合，可以為您提供 HRV 的快照。這項技術仍在發展中，有些可能比其他技術更有效，但按照事情的發展速度，似乎只會更容易弄清楚您的 HRV 並將其用作通往健康和康復的工具。與此同時，如果心率監測器和應用程式不適合您，請注意，我們在這裡討論的任何與您的身體取得聯繫、降低炎症和轉變為副交感神經的策略也會對 HRV 產生積極影響。練習放鬆反應或冥想，瞭解你的壓力觸發因素，瞭解你的身體對壓力和聯繫的反應，這樣你就可以更靈活地進入康復模式——所有這些都只能説明改善 HRV，隨之而來的是迷走神經張力。

The heart is an important messenger, and there’s a reason that it has become such a powerful metaphor in our culture—the physiological changes that happen in the body in response to emotions and stress can make it seem as if those feelings are originating from the heart. No wonder the poets have long focused on the heart as the symbol for love and loss. In medicine, however, the heart is simply a pump; its job is to keep us alive by circulating blood and oxygen. But what if the whole truth somehow includes both poles—both the literal muscle and the metaphorical symbol?

心臟是一個重要的信使，在我們的文化中，它成為如此強大的隱喻是有原因的——身體因情緒和壓力而發生的生理變化會讓人覺得這些感覺好像是發自內心的。難怪詩人長期以來一直將心作為愛與失去的象徵。然而，在醫學中，心臟只是一個泵;它的工作是通過迴圈血液和氧氣來維持我們的生命。但是，如果整個真理以某種方式包括兩極——包括字面上的肌肉和隱喻的象徵呢？

Heartbreak is something we talk about metaphorically; we don’t actually believe our hearts can break like a dropped vase. But there is a rare, deadly heart complication called takotsubo cardiomyopathy, or more colloquially, stress cardiomyopathy. Doctors call it broken heart syndrome because it’s essentially a situation where acute emotional pain causes potentially fatal heart complications. Until very recently, there was a lot of debate over whether broken heart syndrome was real, with doctors and surgeons choosing sides. Then, in 2016, a woman was airlifted to a Houston hospital with a clear-cut case of broken heart syndrome that was impossible to deny.

心碎是我們用比喻來談論的東西;我們實際上並不相信我們的心會像掉落的花瓶一樣破碎。但有一種罕見的致命心臟併發症稱為章魚壺心肌病，或者更通俗地說，壓力性心肌病。醫生稱其為心碎綜合征，因為它本質上是一種急性情緒痛苦導致可能致命的心臟併發症的情況。直到最近，關於心碎綜合症是否真實存在很多爭論，醫生和外科醫生都在選邊站。然後，在2016年，一名婦女被空運到休斯頓的一家醫院，她患有無法否認的心碎綜合症。

Joanie Simpson arrived by helicopter at Memorial Hermann with intense chest pain, exhibiting the classic signs of a heart attack. Doctors immediately threaded a catheter into her heart, expecting to find blocked arteries that they would have to prop open with stents. Instead, they were startled to discover that her arteries were “crystal clear.”⁹

喬安妮·辛普森 （Joanie Simpson） 乘坐直升機抵達赫爾曼紀念醫院 （Memorial Hermann），胸痛劇烈，表現出心臟病發作的典型跡象。醫生立即將一根導管插入她的心臟，希望能找到阻塞的動脈，他們必須用支架撐開這些動脈。相反，他們驚訝地發現她的動脈是「晶瑩剔透的」。。⁹

A study published a decade before in The New England Journal of Medicine (NEJM), a journal that’s a standard-bearer in medicine, had confirmed that in some cases, an intense flood of stress hormones could essentially stun the heart and produce, essentially, a heart attack. Switching gears, doctors quizzed Simpson about whether she’d had any unusual stress in her life recently—and she had. She cited a number of recent family and financial stressors and then came to the most devastating: the day before, she’d watched her dog, a pet that she’d loved and treated like a child, die a painful death. She took it hard. So hard, in fact, that it interfered with the function of her heart muscle and could have damaged her heart or even killed her.

十年前發表在醫學標杆雜誌《新英格蘭醫學雜誌》（NEJM） 上的一項研究證實，在某些情況下，強烈的壓力荷爾蒙洪流基本上會使心臟昏迷，並導致心臟病發作。換個話題，醫生問辛普森她最近生活中是否有任何不尋常的壓力——她確實有。她列舉了最近的一些家庭和財務壓力，然後得出了最具破壞性的：前一天，她看著她的狗——一隻她像孩子一樣愛護和對待的寵物——痛苦地死去。她接受了它。事實上，它如此堅硬，以至於干擾了她的心肌功能，可能會損害她的心臟，甚至殺死她。

Simpson’s case was written up for The NEJM,¹⁰ settling the debate over whether or not broken heart syndrome was real. In an interview with The Washington Post, who followed up on the remarkable case, Joanie was quoted as saying that she “takes things more to heart” than other people. We think of phrases like this as being simply metaphors, a playful use of language, but they can be much more. In this case, Joanie Simpson used the well-worn phrase to offer a window into both her emotional and physical truth: she literally “takes things to heart.”

辛普森的案子被寫給了《新英格蘭醫學雜誌》（The NEJM），¹⁰，解決了關於心碎綜合症是否真實的爭論。在跟進這起非凡案件的《華盛頓郵報》採訪中，喬安妮被引述說，她比其他人“更把事情放在心上”。我們認為這樣的短語只是簡單的隱喻，一種對語言的俏皮使用，但它們可以遠不止於此。在這種情況下，喬安妮·辛普森 （Joanie Simpson） 使用了一句老生常談的短語，為她的情感和身體真相提供了一個視窗：她真的“把事情放在心上”。

Consider the difference between Joanie and Eileen, the woman who arrived in the ER with AFib after her husband left her. In the case of Joanie Simpson, the link between emotional upheaval and the biology of the body was quickly homed in on and explored, instead of ignored or dismissed. The vagus runs right through the heart—the nerve endings from both are intricately interwoven and constantly exchanging information. And the heart has over forty thousand neurons, more than any other location in the body after the brain and the gut. This means that the heart is another little brain—the heart brain—its own locus of emotion, sensation, and knowledge. And it provides a unique window into our mind-body connection and how that is helping us heal—or stopping us from doing so.

想想 Joanie 和 Eileen 之間的區別，Eileen 是在丈夫離開她後帶著 AFib 來到急診室的。在喬安妮·辛普森 （Joanie Simpson） 的案例中，情緒動蕩與身體生物學之間的聯繫很快就被關注和探索，而不是被忽視或忽視。迷走神經直接穿過心臟——兩者的神經末梢錯綜複雜地交織在一起，不斷交換資訊。心臟有超過 40,000 個神經元，比大腦和腸道之後身體的任何其他位置都多。這意味著心臟是另一個小大腦——心腦——它自己的情感、感覺和知識的聚集地。它提供了一個獨特的視窗，讓我們瞭解我們的身心聯繫，以及它如何幫助我們治癒或阻止我們治癒。

If there’s one thing I’ve learned from caring for thousands of patients, it’s that the heart is more than a pump. It is not just an organ that distributes blood throughout our bodies; it is also representative of our deepest longings, greatest joys, and most profound sorrows. Sometimes the heart reflects—like a metaphor—something going on in another, deeper part of us, something missing that we don’t easily acknowledge or know how to put into words. If we listen, we might be able to find our way toward the life we truly want and deserve—a life of authenticity and fulfillment—and perhaps also toward healing.

如果我從照顧數千名患者中學到了什麼，那就是心臟不僅僅是一個泵。它不僅僅是一個將血液分配到我們全身的器官;它也代表了我們最深的渴望、最大的喜悅和最深的悲傷。有時，心會像一個隱喻一樣反映出我們另一個更深處發生的事情，一些我們不輕易承認或不知道如何用語言表達的缺失。如果我們傾聽，我們也許能夠找到通往我們真正想要和應得的生活的道路——一種真實和充實的生活——也許也能走向治癒。

LIVING IN HEALING MODE

以治癒模式生活

A lot of us have been locked out of healing mode for a long time. Our vagus nerves haven’t been lit up consistently and may need some electrical repairs. Perhaps, like Jan before she visited Brazil, stress, anxiety, or trauma have worsened our health. Perhaps constant and elevated doses of cortisol have washed away too much of our telomerase, and we have invisible telomere shortening in our cells, those all-important building blocks of life. Or it may seem that we are simply fated to become ill—that something was coded into our DNA like a computer virus, just waiting to start running its malware programming.

我們中的許多人已經被鎖在治癒模式之外很長一段時間了。我們的迷走神經沒有一直亮起來，可能需要一些電氣維修。也許，就像 Jan 訪問巴西之前一樣，壓力、焦慮或創傷使我們的健康情況惡化。也許恆定和高劑量的皮質醇已經洗走了我們太多的端粒酶，我們的細胞中有看不見的端粒縮短，而這些是生命最重要的組成部分。或者，我們似乎只是註定要生病——某些東西像計算機病毒一樣被編碼到我們的DNA中，等待開始運行其惡意軟體程式設計。

When you have a serious illness, it can start to seem hopeless—like your health future is already written. But it’s never too late to shift gears. That Goldilocks planet, with conditions just right for health and healing, is open to all. Researchers have found that a childhood full of adversity or a life with constant stress shortens your telomeres and your health span, but they have also found that those effects could be dramatically mitigated and even rolled back. When we look back at Jan’s case, we see a perfect storm of overlapping conditions that came together to allow her to heal. She completely changed her life, leaving a toxic marriage and finding a loving, supportive one. She let go of the overwhelming responsibility she felt for her children’s lives. She started living a more authentic life where she understood her value.

當您患上嚴重疾病時，它可能開始顯得毫無希望——就像您的健康未來已經寫好了一樣。但換檔永遠不會太晚。那個金髮姑娘星球，擁有適合健康和康復的條件，向所有人開放。研究人員發現，充滿逆境的童年或持續壓力的生活會縮短您的端粒和健康壽命，但他們也發現這些影響可以顯著減輕甚至減少。當我們回顧 Jan 的案例時，我們看到一場重疊條件的完美風暴，這些條件結合在一起，讓她得以治癒。她徹底改變了自己的生活，離開了一段有毒的婚姻，找到了一個充滿愛、支援的婚姻。她放下了她對孩子們生活的壓倒性責任。她開始過上更真實的生活，在那裡她明白了自己的價值。

We know now that the vagus nerve is activated by compassion for others, compassion for the self, and positive feelings in general. We know that what really lights up that circuit is not only the relaxation response but also love—micro-moments of positive connection with those you are intimate with and even those you barely know. Fight or flight, with its hair-trigger rush of stress chemicals, is powerful. But if you can rearrange your life to allow yourself to more frequently experience those higher states of love and other positive emotions, you can “inoculate” yourself against chronic fight-or-flight response as surely as you can get vaccinated against tuberculosis or the flu.

我們現在知道，迷走神經是由對他人的同情心、對自我的同情心和一般的積極情緒啟動的。我們知道，真正點亮這個迴路的不僅是放鬆反應，還有愛——與你親密的人，甚至是你幾乎不認識的人建立積極聯繫的微時刻。Fight or Flight，憑藉其令人毛骨悚然的壓力化學物質，是強大的。但是，如果你能重新安排你的生活，讓自己更頻繁地體驗那些更高的愛的狀態和其他積極的情緒，你就可以像接種結核病或流感疫苗一樣，讓自己“接種”慢性戰鬥或逃跑反應。

The precise lineup of conditions that make the parasympathetic possible in today’s world might seem as rare as an eclipse. But unlike an eclipse, which is the product of celestial bodies drifting through space and far beyond our reach, setting the conditions for radical healing is within our control. From what you eat, to how you think about stress, to how you interact with others, you can change the biology of your body right down to those telomeres inside your cells.

在當今世界，使副交感神經成為可能的確切條件陣容似乎就像日食一樣罕見。但與日食不同，日食是天體在太空中漂移且遙不可及的產物，為徹底治愈創造條件在我們的控制範圍內。從你吃什麼，到你如何看待壓力，再到你如何與他人互動，你可以改變你身體的生物學特性，一直到你細胞內的端粒。

Back when Benson was running his first studies over thirty years ago, the idea that our emotions or mental state might have any impact on blood pressure or the rhythms of the heart was considered ludicrous—so much so that it deterred researchers from investigating that area of rich potential. Today, the same biases continue to hold us back from taking the next step in finding pathways to healing. There’s been a modicum of progress—a grudging acceptance that, yes, the mind can impact the body, and vice versa. But while this understanding has trickled into the popular culture, it has yet to be integrated in any real way into mainstream medicine; it’s grabbing hold in popular culture more than in the day-to-day practice of medicine.

早在 30 多年前，當 Benson 進行他的第一批研究時，我們的情緒或精神狀態可能對血壓或心臟節律產生任何影響的想法被認為是荒謬的——以至於它阻止了研究人員研究這個具有豐富潛力的領域。今天，同樣的偏見繼續阻礙我們邁出下一步尋找治愈的途徑。已經取得了一點進展——勉強接受了，是的，思想可以影響身體，反之亦然。但是，儘管這種理解已經滲透到流行文化中，但它還沒有真正融入主流醫學;它在流行文化中的地位比在日常醫學實踐中的地位更大。

Fundamentally, in medicine and psychiatry, we are still operating with an understanding of the mind and body developed by the philosopher and mathematician René Descartes back in the seventeenth century: that the mind and body are separate entities, existing in completely different realms. Descartes conceived of two separate “worlds,” one which contained the body, or matter, while the other contained the mind, or consciousness. The belief was that events in the physical world had no impact on the mental world and vice versa.

從根本上說，在醫學和精神病學中，我們仍然按照哲學家和數學家勒內·笛卡爾 （René Descartes） 在 17 世紀提出的對身心的理解來運作：心靈和身體是獨立的實體，存在於完全不同的領域中。笛卡爾設想了兩個獨立的“世界”，一個包含身體或物質，而另一個包含思想或意識。人們相信物理世界中的事件對精神世界沒有影響，反之亦然。

Where did this idea come from? Well, in many ways, Descartes developed the concept of mind-body dualism as a backlash against the prevailing ideas of his own time, which, back then, were effectively holding medicine back from necessary progress. In the seventeenth century, religion and medicine were braided tightly together. Humans were seen as spiritual beings—the body and soul were one entity. Very little distinction was made between mind, body, soul, or consciousness, to the point that when a person died, their body had to be preserved perfectly intact to preserve the soul. Medical dissections were not allowed; if the body was taken apart, the soul would be similarly dismembered and would never be able to ascend to heaven. And illness and disease were often blamed on wrongdoing, either by the individual or by the community as a whole, or as a judgment from God.¹¹ If a woman fell ill with mysterious symptoms—a growing lump in her abdomen, rapidly losing weight, sallow skin, vomiting and unable to eat—it might have been suspected that she had committed a sin. Her soul was being punished, and therefore, her body as well. If an illness swept through the town, killing children and babies with dehydration and diarrhea, the community would take the blame upon themselves. They had not been pious enough; they hadn’t worked as hard as they should; there were disbelievers in their midst.

這個想法從何而來？嗯，在許多方面，笛卡爾發展了身心二元論的概念，作為對他那個時代流行思想的強烈反對，這些思想在當時有效地阻礙了醫學的必要進步。在17世紀，宗教和醫學緊緊地交織在一起。人類被視為靈性生物——身體和靈魂是一個實體。思想、身體、靈魂或意識之間幾乎沒有區別，以至於當一個人死去時，他們的身體必須完好無損地保存下來，以保存靈魂。不允許進行醫學解剖;如果身體被拆開，靈魂也會被肢解，永遠無法升天。疾病和疾病經常被歸咎於錯誤的行為，要麼是個人的，要麼是整個社區的，要麼是上帝的審判。¹¹如果一個女人生病時出現神秘的癥狀——腹部腫塊越來越大、體重迅速下降、皮膚蠟黃、嘔吐和無法進食——人們可能會懷疑她犯了罪。她的靈魂受到了懲罰，因此她的身體也受到了懲罰。如果一種疾病席捲了整個小鎮，導致兒童和嬰兒脫水和腹瀉而死亡，社區就會把責任推到自己身上。他們不夠虔誠;他們沒有盡其所能地努力工作;他們中間有不通道的人。

“Treatment” in these cases would be prayer, confession, a purging of the soul. The woman’s body would never be dissected to reveal the cancerous tumor that was the real cause of her death. Attention would never be turned to the town’s wells, contaminated with a dangerous strain of bacteria. The origins of health and illness were shrouded in superstition and fear and a firm belief that maladies of the body were punishments handed down by an omniscient god.

在這些情況下，「治療」 是祈禱、懺悔、淨化靈魂。這名婦女的屍體永遠不會被解剖以揭示癌性腫瘤，而這正是她死亡的真正原因。人們永遠不會注意到鎮上的水井，那裡被一種危險的細菌菌株污染了。健康和疾病的根源籠罩在迷信和恐懼中，並堅信身體的疾病是無所不知的神所賜予的懲罰。

When Descartes peeled apart the mind and body, he assigned the “soul” to the realm of the mind, freeing up the body to be examined, dissected, experimented upon. While it might seem like only a philosophical shift, it had the groundbreaking effect of making the human body available to science. Suddenly, the anatomy of the body was allowed to be revealed. Doctors and scientists were finally free to explore the biological mechanisms of the human body, and with that, the mechanisms of disease.

當笛卡爾將思想和身體分開時，他將「靈魂」分配給思想領域，釋放身體以供檢查、剖析和實驗。雖然這看起來只是一個哲學上的轉變，但它具有開創性的效果，使人體可用於科學。突然間，屍體的解剖結構被允許展示出來。醫生和科學家終於可以自由地探索人體的生物學機制，以及隨之而來的疾病機制。

The major medical advancements of the last three hundred years have essentially toppled from the separation of the mind and body like a line of dominos. But we’ve reached the end of that line of dominos. The last one has fallen; we are now in a lull. I believe that we’ve made as much progress as we could within the constraints of mind-body dualism and that we need to reach back, to reclaim what was actually right about that old idea that the body and soul were one.

過去 300 年的重大醫學進步基本上已經像一排多米諾骨牌一樣從身心分離中推倒。但我們已經到達了那條多米諾骨牌線的盡頭。最後一個已經倒下了;我們現在處於平靜期。我相信，在身心二元論的約束下，我們已經取得了盡可能多的進步，我們需要回過頭來，重新找回身體和靈魂是一體的舊觀念的真正正確之處。

Perhaps progress is more of an upward spiral than a line: we keep circling back to old ideas, but with new knowledge and technology, so that as we arrive back at the old point, we do so on a new plane, full of new possibilities. That begs the question: What will we now do with the burgeoning understanding that the mind and body are in fact deeply interconnected and that healing the soul, in many cases, can heal the body?

也許進步更像是一個向上的螺旋，而不是一條線：我們不斷回到舊的想法，但有了新的知識和技術，因此當我們回到舊點時，我們會在一個新的平面上這樣做，充滿新的可能性。這就引出了一個問題：我們現在將如何看待這樣一種日益增長的理解，即思想和身體實際上是緊密相連的，在許多情況下，治癒靈魂可以治癒身體？

I’d come so far in my research after Brazil, where I’d had access to a pool of promising cases to evaluate and pull from. Though not all of them had panned out under rigorous inspection, Brazil had certainly represented a hot spot of spontaneous remissions, one that had been illuminating for my research. Looking at those cases as a group, I had to wonder: Was spontaneous healing really so “spontaneous”? While some cases of remission did seem very sudden—a tumor that was present one day disappearing the next, for example—the accumulating evidence suggested that many recoveries were weeks, months, even years in the making. A reversal of disease that may seem spontaneous to doctors, who are only seeing a small slice of a patient’s life, or even to the patient themselves, might in fact be the result of something that’s been developing for a while—like seeds planted long ago that “suddenly” burst out of the soil and bloom.

在巴西之後，我的研究取得了如此大的進步，在那裡我獲得了大量有前途的案例可供評估和提取。雖然並非所有國家都在嚴格的檢查下取得成功，但巴西無疑代表了自發緩解的熱點，對我的研究具有啟發性。作為一個群體來看這些案例，我不得不想：自發的癒合真的那麼「自發」嗎？雖然一些緩解病例看起來確實非常突然——例如，腫瘤前一天還存在，第二天就消失了——但越來越多的證據表明，許多康復是數周、數月甚至數年的醞釀。對於只看到患者生活一小部分的醫生來說，甚至對患者自己來說，疾病的逆轉似乎是自發的，但實際上可能是已經發展了一段時間的結果——就像很久以前種下的種子“突然”從土壤中迸發出來並開花。

I felt close to gaining the big picture on spontaneous healing, but it reminded me of scaling a mountain peak on the wilderness trips I’d led in college—knowing you were close to the peak, even though it was obscured by clouds—only to crest the hill to see the peak still farther ahead. I needed another Brazil.

我覺得自己快要瞭解自發療治的大局了，但這讓我想起了我在大學時帶領的荒野旅行中攀登一座山峰——知道你已經接近山峰，即使它被雲層遮住了——只是為了爬上山頂，看到山峰更遠。我需要另一個巴西。