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在我成為一位傑出的世界級神經心理學家過程中,一件有趣的事發生了:我懷孕了。並不是說我真的成了一位傑出的世界級神經心理學家,TED,抱歉,但我確實成了一位相當敏銳,可說是世界級的杞人憂天者。我研究所的一位女性朋友Marie說,「Kim,我瞭解了,你並不是比其他人更神經質,只是你更誠實地看待自己的神經質。」
所以在這個被全面瞭解的勇氣鼓舞下,我帶來一些照片與大家分享。喔,我只能說,這是七月。(笑聲)(模仿拉鏈聲)為了安全。浮板,一英吋的水,然後,最後是,全副武裝,為了到Copper山的90分鐘車程。所以你們大略能從中感受到我的神經質,所以我的孩子,Vander,現在8歲了,跟缺乏運動能力的我不同,他踢足球、對美式足球感興趣、還想學騎獨輪車。
所以,我為什麼要擔憂呢?因為這正是我從事和教導的東西,也是我研究和要解決的問題。我知道每年都有兒童遭受腦震盪,事實上,每年有超過四百萬人遭受腦震盪,這只是14歲以下兒童到急診室就診的數據。所以當兒童遭受腦震盪時,我們叮嚀他們,或要他們注意,但我們說的究竟是指什麼呢?現在來看看吧!
沒錯,簡直是《警界雙雄》的場景,是的,這是一場車禍,以每小時40英哩速度撞上固定圍欄,撞擊力是35G。一位重量級拳擊手重重地打在你臉上,撞擊力是58G。如果你看漏了,我們再看一遍,請看螢幕右方,你認為力道多大?多少G?接近了,72G,如果我說出答案,你會很震驚吧!103G。一般造成腦震盪的撞擊力是95G,當右邊的孩子沒站起來時,我們就知道他們腦震盪了。
但左邊的孩子或離場的運動員呢?我們怎麼知道他或她是否也腦震盪了呢?我們怎麼知道要求他們停止比賽,直到恢復後才能返回比賽中的規定適用於他們?腦震盪的定義事實上並不需要失去意識,只要意識發生變化就算,可能是以下幾種症狀,包括感覺模糊、眩暈、耳裡有響聲、比平常更衝動或具有敵意。
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以下為系統擷取之英文原文
So, a funny thing happened on my way to becoming a brilliant, world-class neuropsychologist: I had a baby. And that's not to say I ever went on to become a brilliant, world-class neuropsychologist. Sorry TED. But I did go on to be a reasonably astute, arguably world-class worrier. One of my girlfriends in graduate school, Marie, said, "Kim, I figured it out. It's not that you're more neurotic than everyone else, it's just that you're more honest about how neurotic you are."
So in the spirit of full disclosure, I brought some pictures to share. Awwww. I'll just say, July. (Laughter) Zzzzzzip for safety. Water wings -- an inch of water. And then, finally, all suited up for the 90-minute drive to Copper Mountain. So you can get kind of a feel for this. So my baby, Vander, is eight years old now. And, despite being cursed with my athletic inability, he plays soccer. He's interested in playing football. He wants to learn how to ride a unicycle.
So why would I worry? Because this is what I do. This is what I teach. It's what I study. It's what I treat. And I know that kids get concussed every year. In fact, more than four million people sustain a concussion every year, and these data are just among kids under 14 who were seen in emergency rooms. And so when kids sustain a concussion, we talk about them getting dinged or getting their bell rung, but what is it that we're really talking about? Let's take a look.
All right. "Starsky and Hutch" arguably. Yes. So a car accident. 40 miles an hour into a fixed barrier -- 35 G's. A heavy weight boxer punches you straight in the face -- 58 G's. In case you missed it, we'll look again. So look to the right-hand side of the screen. What would you say? How many G's? Close. 72. Would it be crazy to know, 103 G's. The average concussive impact is 95 G's. Now, when the kid on the right doesn't get up, we know they've had a concussion.
But how about the kid on the left, or the athlete that leaves the field of play? How do we know if he or she has sustained a concussion? How do we know that legislation that would require that they be pulled from play, cleared for return to play, applies to them? The definition of concussion doesn't actually require a loss of consciousness. It requires only a change in consciousness, and that can be any one or a number of symptoms, including feeling foggy, feeling dizzy, hearing a ringing in your ear, being more impulsive or hostile than usual.
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所以考慮這些,以及我是多麼神經質,我怎能睡得著呢?因為我知道我們的大腦有恢復能力,它們被設計成可自行從損傷狀態復原,如果,但願不會,我們當中有人今晚離開這裡並遭受腦震盪,我們當中大多數人在幾個小時到幾個星期內可以完全康復。但兒童更易遭受腦部傷害,事實上,高中運動員可能遭受嚴重傷害的機率是大學生的三倍,而且他們需要更長的時間來復原。在第一次受傷之後,他們第二次受傷的風險成指數增加,以此看來,他們第三次受傷的風險更大,以此類推。這確實是值得警惕的部份。
我們完全不知道多次受傷的長期影響。你們可能知道這個由NFL(美國職業美式足球聯盟)進行的研究,簡言之,這個研究顯示,在退役的NFL運動員中,遭受過三次以上腦震盪職業傷害的人,發生早發型失智症的機率比一般人大得多。所以你們都看過這個,紐約時報,你們看過的,你們可能不知道的是,這個研究是由NFL隊員的妻子們提議的,她們說,「我46歲的丈夫總是找不到鑰匙,不是很奇怪嗎?」「我47歲的丈夫老是找不到他的車,不是很奇怪嗎?」「這不是很奇怪嗎?我48歲的丈夫開著車時,總是記不得從車道通往家門的路。」我可能忘了提,我兒子是獨子,所以將來他能開車載我這件事是相當重要的。
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So given all of that and given how darn neurotic I am, how do I get any sleep at all? Because I know our brains are resilient. They're designed to recover from an injury. If, God forbid, any of us left here tonight and sustained a concussion, most of us would go on to fully recover inside of a couple hours to a couple of weeks. But kids are more vulnerable to brain injury. In fact, high school athletes are three times more likely to sustain catastrophic injuries relative even to their college-age peers, and it takes them longer to return to a symptom-free baseline. After that first injury, their risk for second injury is exponentially greater. From there, their risk for a third injury, greater still and so on.
And here's the really alarming part: we don't fully understand the long-term impact of multiple injuries. You guys may be familiar with this research that's coming out of the NFL. In a nutshell, this research suggests that among retired NFL players with three or more career concussions, the incidents of early-onset dementing disease is much greater than it is for the general population. So you've all seen that -- New York Times, you've seen it. What you may not be familiar with is that this research was spearheaded by NFL wives who said, "Isn't it weird that my 46 year-old husband is forever losing his keys? Isn't it weird that my 47 year-old husband is forever losing the car? Isn't it weird that my 48 year-old husband is forever losing his way home in the car, from the driveway?" So I may have forgotten to mention that my son is an only child. So it's going to be really important that he be able to drive me around some day.
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那麼,我們該如何保證我們孩子的安全?我們如何能百分之百保證我們孩子的安全?讓我告訴你們我想出的方法。(笑聲)但願如此。我孩子在這裡,像是在說,「她不是開玩笑的,她真的不是在開玩笑。」所以,說正經的,我孩子該玩美式足球嗎?你們的孩子該玩美式足球嗎?我不知道,但我知道有三件事你們能做。第一,學習,你們必須瞭解我們今天討論的東西,這裡有一些很好的資源。
CDC(美國疾病控制與預防中心)有個計畫,叫做「預防腦震盪警告」,就在CDC.gov.網站上,「預防腦震盪警告」專門針對兒童的腦震盪。第二個資源讓我相當自豪,我們在過去幾個月完成了這個,協助兒童預防腦損傷,這對學生運動員、老師、家長、專家職業運動員和教練來說,都是很好的資源,如果你有問題的話,這是一個可以提供幫助的地方。第二件事是說出來。就在兩周前,一個由Kefalas議員提出的法案,要求18歲以下的運動員及兒童在騎自行車時戴上頭盔,這法案在委員會中被否決了,主要是因為缺乏選民支持,缺乏投票者支持。我現在不是要告訴你們應該或不應該支持什麼樣的立法,但我要告訴你們,如果這跟你們有關,你們的立法者應該知道這些。
也應該向教練組成員開口詢問,詢問有什麼樣的保護設施,保護設施的預算是多少?使用時間多久了?也許提議成立資金籌集會來買新設備,讓我們能著好裝備,戴上頭盔。阻止壞結果發生的唯一途徑是防止第一次傷害的發生。最近,我的一位研究生Tom說,「Kim,我決定在上課途中戴上自行車頭盔。」Tom知道,自行車頭盔中的小塊海綿能使撞擊產生的G力減少一半,現在,我認為這是因為我強力倡導戴頭盔運動。沒錯,Tom已有所領悟,以Tom的情形來說,20元美金的頭盔就能保護他繼續值10萬美金的研究生教育,這確實是個好方法。
(笑聲)
所以,Vander該玩美式足球嗎?我無法說不,但我能確保每次離開家時,這孩子都會戴上頭盔,像是乘坐汽車,或到學校去的時候。所以不論是運動員、學者、受到過度保護的孩子、神經質的母親或是其它人,這是我的孩子Vander,提醒你們,要關心你們所在意的人。
謝謝。
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So how do we guarantee the safety of our kids? How can we 100 percent guarantee the safety of our kids? Let me tell you what I've come up with. (Laughter) If only. My little boy's right there, and he's like, "She's not kidding. She's totally not kidding." So in all seriousness, should my kid play football? Should your kid play football? I don't know. But I do know there are three things you can do. The first, study up. You have to be familiar with the issues we're talking about today. There are some great resources out there.
The CDC has a program, Heads Up. It's at CDC.gov. Heads Up is specific to concussion in kids. The second is a resource I'm personally really proud of. We've just rolled this out in the last couple months -- CO Kids With Brain Injury. This is a great resource for student athletes, teachers, parents, professionals, athletic and coaching staff. It's a great place to start if you have questions. The second thing is speak up. Just two weeks ago, a bill introduced by Senator Kefalas that would have required athletes, kids, under 18 to wear a helmet when they're riding their bike died in committee. It died in large part because it lacked constituent buy-in, it lacked stakeholder traction. Now I'm not here to tell you what kind of legislation you should, or shouldn't, support, but I am going to tell you that, if it matters to you, your legislators need to know that.
Speak up also with coaching staff. Ask what kind of protective equipment is available. What's the budget for protective equipment? How old it is? Maybe offer to spearhead a fundraiser to buy new gear. Which brings us to suit up; wear a helmet. The only way to prevent a bad outcome is to prevent that first injury from happening. Recently, one of my graduate students, Tom, Tom said, "Kim, I've decided to wear a bike helmet on my way to class." And Tom knows that that little bit of foam in a bike helmet can reduce the G-force of impact by half. Now I thought that it was because I have this totally compelling helmet crusade, right, this epiphany of Tom's. As it turns out, it occurred to Tom that a 20-dollar helmet is a good way to protect 100,000-dollar graduate education.
(Laughter)
So, should Vander play football? I can't say no, but I can guarantee that every time he leaves the house that kid's wearing a helmet -- like to the car, or at school. So whether athlete, scholar, over-protected kid, neurotic mom, or otherwise, here's my baby, Vander, reminding you to mind your matter.
Thank you.