0:00:15.750,0:00:19.447 They asked me to talk about “positive destruction.” 0:00:19.447,0:00:24.946 So I thought why not just talk about myself? 0:00:24.946,0:00:26.926 I am probably the one 0:00:26.926,0:00:30.448 that has seen the most deaths 0:00:30.448,0:00:32.901 among the doctors in Taiwan. 0:00:32.901,0:00:36.947 So I think I can share something about life and death. 0:00:36.947,0:00:39.314 There's a joke: 0:00:39.314,0:00:40.871 the most famous doctors in Taiwan is Dr.(?). 0:00:40.871,0:00:42.744 You might know this joke 0:00:42.744,0:00:44.530 After Shao Hsiao-Ling accident happened, 0:00:44.530,0:00:46.613 a person went to Chi-Mei Hospital in Liu-Ying 0:00:46.613,0:00:48.697 to see a doctor named Mo 0:00:48.697,0:00:49.536 The staff in the hospital said 0:00:49.536,0:00:51.988 that there's no Dr. Mo. 0:00:51.988,0:00:53.206 "There is , " said the person. 0:00:53.206,0:00:56.421 "His name is EcMo! 0:00:56.421,0:01:00.023 He saved Shao's life! 0:01:00.038,0:01:01.341 It’s easy to understand ECMO actually. 0:01:01.341,0:01:03.650 Venous blood 0:01:04.134,0:01:05.149 passes through a pump, 0:01:05.149,0:01:06.012 which is an artificial heart, 0:01:06.012,0:01:07.293 and then passes through an oxygenator, 0:01:07.409,0:01:08.558 which is an artificial lungs, 0:01:08.558,0:01:10.480 and in the end, goes back to the body. 0:01:10.480,0:01:12.939 It is a temporary replacement of Cardiovascular Function. 0:01:12.939,0:01:14.973 it’s look like this. 0:01:14.973,0:01:17.486 It’s a machine 0:01:17.486,0:01:20.066 operating as an artificial heart 0:01:20.066,0:01:22.695 As a matter of fact, 0:01:22.695,0:01:24.292 ECMO has been used for a long time. 0:01:24.292,0:01:27.504 National Taiwan University Hospital 0:01:27.504,0:01:30.054 has used ECMO since 1994. 0:01:30.054,0:01:31.933 Now everyone in Taiwan knows it because of Shao ’car accident. 0:01:31.933,0:01:33.384 It’s similar to the old saying” One can study for ten years in obscurity, 0:01:33.384,0:01:36.239 but as soon as one passes the examination the whole world pays attention “ 0:01:36.239,0:01:37.595 It became famous 0:01:37.595,0:01:41.035 due to the media. 0:01:41.035,0:01:43.731 There are successful cases with ECMO of course. 0:01:43.731,0:01:46.645 his man is a backup dancer for Jay Chou. 0:01:46.645,0:01:48.761 He suffered an Acute myocarditis one day. 0:01:48.761,0:01:50.947 so his heart stopped. 0:01:50.947,0:01:52.999 Why did I put the slide, 0:01:52.999,0:01:56.646 and why did I take a picture of him? 0:01:56.646,0:01:57.922 His eyes opened wide, 0:01:57.922,0:01:59.414 staring at the screen. 0:01:59.414,0:02:01.739 The lines on the screen were all flat 0:02:01.739,0:02:03.317 His heart stopped, 0:02:03.317,0:02:05.474 because of Acute myocarditis. 0:02:05.474,0:02:07.819 The heart stopped beating. 0:02:07.819,0:02:10.636 This is his biopsy of cardiac muscle, 0:02:10.636,0:02:12.395 ranging 100 under the microscope. 0:02:12.395,0:02:13.727 It’s not clear enough 0:02:13.727,0:02:16.312 when it ranges in 100. 0:02:16.312,0:02:18.831 And it’s crystal clear ranging 400. 0:02:18.831,0:02:22.140 Those blue spots are lymphocytes. 0:02:22.140,0:02:26.092 Obviously, it’s a serious Acute myocarditis. 0:02:26.092,0:02:29.439 The heart was soaked in lymphocytes 0:02:29.439,0:02:33.818 and it stopped. 0:02:33.818,0:02:37.062 He stared at the screen 0:02:37.062,0:02:40.421 He stared at the screen. 0:02:40.421,0:02:42.880 His heart ‘d stopped for nine days, 0:02:42.880,0:02:44.558 however, with heart and kidney transplant, 0:02:44.558,0:02:46.807 he could dance again in a month. 0:02:46.807,0:02:49.329 It's a miracle in modern medicine 0:02:49.329,0:02:52.406 In modern medicine records, 0:02:52.406,0:02:55.150 he’s the one that is still alive after the longest CPR treatment. 0:02:55.150,0:02:57.291 4 hours. 0:02:57.291,0:03:00.766 He’d been done CPR on his way from Kuo-Tei Hospital to NTU Hospital. 0:03:00.766,0:03:02.808 When they installed ECMO at NTU hospital, 0:03:02.808,0:03:05.015 they found out he’d been injected 100 cardiotonics. 0:03:05.015,0:03:06.683 So his iliac artery and vein 0:03:06.683,0:03:08.746 were narrower than pencils 0:03:08.746,0:03:10.303 So when they opened the wound 0:03:10.303,0:03:10.947 trying to put ECMO in 0:03:10.947,0:03:12.408 ,they were unable to put the tube in. 0:03:12.408,0:03:13.636 They had to do the CPR again, 0:03:13.636,0:03:14.879 until he was sent to the OR. 0:03:14.879,0:03:15.807 They had to saw the chest 0:03:15.807,0:03:18.192 to put ECMO. 0:03:18.192,0:03:22.448 It’s just like magic. 0:03:22.448,0:03:27.160 It is a miracle in modern medicine without saying. 0:03:27.160,0:03:30.330 A man ‘s heart had stopped for 9 days. 0:03:30.330,0:03:34.100 And he was still alive, 0:03:34.100,0:03:36.728 after 4 hours CPR, 0:03:36.728,0:03:39.169 heart ,and kidney transplant. 0:03:39.169,0:03:40.871 This is another case. 0:03:40.871,0:03:42.516 It reads that ”first in the world, 0:03:42.516,0:03:43.943 miracle in Taiwan, 0:03:43.943,0:03:46.421 a man lived without heat for 16 days. 0:03:46.421,0:03:49.746 This is a 56-year-old man. 0:03:49.746,0:03:51.346 He had decayed teeth. 0:03:51.346,0:03:53.396 The bacteria went into the blood, 0:03:53.396,0:03:54.297 arriving at the heart. 0:03:54.297,0:03:55.885 The heart then festered. 0:03:55.885,0:03:57.824 The operation team in the hospital 0:03:57.824,0:03:59.761 opened his chest, 0:03:59.761,0:04:00.561 and was like 0:04:00.561,0:04:01.945 “Well, it looks not well here. Cut it off. 0:04:01.945,0:04:02.796 And it looks not fine here, either. Cut it off too.” 0:04:02.796,0:04:03.849 In the end, 0:04:03.849,0:04:06.866 the whole heart was cut off. 0:04:06.866,0:04:07.861 What should we do? 0:04:07.861,0:04:13.267 “Well, transfer to NTU hospital” 0:04:13.308,0:04:17.128 I always say that NTU hospital is the line of defense in Taiwan. 0:04:17.128,0:04:18.990 Well, we still had to do it. 0:04:18.990,0:04:21.831 In the previous case, the man’s heart cannot beat. 0:04:21.831,0:04:22.543 And here, 0:04:22.543,0:04:23.779 we got a man even without a heart. 0:04:23.779,0:04:25.475 It was cut off, after all. 0:04:25.475,0:04:26.706 When he was transfer to NTU hospital, 0:04:26.706,0:04:28.527 they had to use two ECMOs 0:04:28.527,0:04:30.254 because he had no heart. 0:04:30.254,0:04:31.241 Look at the screen, 0:04:31.241,0:04:32.733 two ECMOs. 0:04:32.733,0:04:34.376 It’s really incredible I have to say. 0:04:34.376,0:04:35.511 He had no heart, 0:04:35.511,0:04:37.747 so ECG showed flat lines. 0:04:37.747,0:04:40.880 There is no heart after all. 0:04:40.880,0:04:42.432 This is his CT result. 0:04:42.432,0:04:43.285 There should have been a heart 0:04:43.285,0:04:45.915 in his thorax. 0:04:45.915,0:04:47.030 However, there was no heart. 0:04:47.030,0:04:49.390 There were only tubes. 0:04:49.390,0:04:51.285 After 16 days, 0:04:51.285,0:04:53.485 they did the heart transplant surgery. 0:04:53.485,0:04:56.408 Cardiologist surgeon Dr.Wan showed me this. 0:04:56.408,0:04:58.472 He said that when he was doing the surgery, 0:04:58.472,0:04:59.494 he should have seen a heart in the thorax 0:04:59.494,0:05:01.938 after opening his chest. 0:05:01.938,0:05:03.830 But there were only tubes 0:05:03.830,0:05:06.634 connecting to the ECMO. 0:05:06.634,0:05:09.179 The patient had no heart at all. 0:05:09.179,0:05:12.196 And after the surgery, 0:05:12.196,0:05:15.317 he was discharged. 0:05:15.317,0:05:18.834 This is The Straits Times in Singapore. 0:05:18.834,0:05:22.161 A friend of mine sent me the e-mail from Singapore. 0:05:22.161,0:05:24.590 He told me that we were in the newspapers. 0:05:24.590,0:05:26.329 16 days without heart
. 0:05:26.329,0:05:27.989 A person had lived for 16 days without heart. 0:05:27.989,0:05:29.219 But after receiving heart transplant, 0:05:29.219,0:05:33.337 he still went home healthily. 0:05:33.337,0:05:35.103 This is the other case. 0:05:35.103,0:05:39.209 He’s a 26-year-old aboriginal. 0:05:39.209,0:05:41.370 He went swimming when he was seriously drunk. 0:05:41.370,0:05:45.080 He thought he was Li Bai I guess. 0:05:45.080,0:05:47.175 But the pond was really dirty. 0:05:47.175,0:05:48.217 He choked on water. 0:05:48.217,0:05:49.618 As a result, he suffered from serious pneumonia. 0:05:49.618,0:05:51.410 It was terrible. 0:05:51.410,0:05:53.393 He’d relied on ECMO for 117 days. 0:05:53.393,0:05:55.187 Look at his lungs. 0:05:55.187,0:05:55.976 This is a serious pneumonia, 0:05:55.976,0:05:57.380 due to choke on water. 0:05:57.380,0:05:59.818 This is called cute respiratory distress syndrome. 0:05:59.818,0:06:01.948 The lungs became white. 0:06:01.948,0:06:05.090 He had used ECMO for 117 days. 0:06:05.090,0:06:09.524 We can see clearly from this picture. 0:06:09.524,0:06:11.860 His respiratory minute volume 0:06:11.860,0:06:13.486 had not exceed 100 c.c 0:06:13.486,0:06:15.155 for almost one month. 0:06:15.155,0:06:18.018 But he still recovered. 0:06:18.018,0:06:19.459 So 0:06:19.459,0:06:21.226 in the previous cases, 0:06:21.226,0:06:22.961 the man lived without heart, 0:06:22.961,0:06:24.606 the man with heart that couldn’t beat, 0:06:24.606,0:06:27.110 or the one’s lungs did not work, 0:06:27.110,0:06:29.308 they all rode out with the use of ECMO. 0:06:29.308,0:06:32.590 Even though they’d waited for 9 days 0:06:32.590,0:06:34.605 or even 100 days. 0:06:34.605,0:06:36.373 They are still alive 0:06:36.373,0:06:37.832 after heart 0:06:37.832,0:06:39.519 and lungs transplant. 0:06:39.519,0:06:41.629 It is really incredible. 0:06:41.629,0:06:42.823 To be honest, 0:06:42.823,0:06:44.578 with the media 0:06:44.578,0:06:45.728 and those successful cases, 0:06:45.728,0:06:47.664 ECMO seems to be really famous 0:06:47.664,0:06:48.695 around the island. 0:06:48.695,0:06:50.572 Of course there are successful cases, 0:06:50.572,0:06:52.259 such as the cases I’ve mentioned 0:06:52.259,0:06:53.761 and Shao. 0:06:53.761,0:06:55.333 However, 0:06:55.333,0:06:56.403 The media usually 0:06:56.403,0:06:58.211 only writes the successful ones. 0:06:58.211,0:06:59.408 They don’t write failure ones. 0:06:59.408,0:07:00.942 So we usually can’t see them. 0:07:00.942,0:07:04.117 As a Critical care medicine doctor, 0:07:04.117,0:07:06.322 I am absolutely to see the successful cases. 0:07:06.322,0:07:08.187 Nevertheless, there are unsuccessful ones. 0:07:08.187,0:07:12.953 This baby was one and half months old. 0:07:12.953,0:07:14.767 He suffered from Congenital Heart Disease. 0:07:14.767,0:07:16.324 After heart transplant, 0:07:16.324,0:07:17.886 he still could not live without a heart-lung machine. 0:07:17.886,0:07:19.643 So 0:07:19.643,0:07:20.668 they used ECMO 0:07:20.668,0:07:21.965 connected to his heart. 0:07:21.965,0:07:22.989 But not in three days, 0:07:22.989,0:07:24.209 his feet turned black. 0:07:24.209,0:07:25.379 Let’s zoom in. 0:07:25.379,0:07:27.028 Look at his feet. 0:07:27.028,0:07:28.488 So now, as a doctor. 0:07:28.488,0:07:29.993 You had to make the call. 0:07:29.993,0:07:31.510 Are you going to save his life, 0:07:31.510,0:07:32.615 by having his feet amputated. 0:07:32.615,0:07:33.580 Or will you just give up 0:07:33.580,0:07:34.835 let him go? 0:07:34.835,0:07:37.695 No matter what you do, you will suffer from pressure. 0:07:37.695,0:07:40.091 But if you can’t make the call, 0:07:40.091,0:07:42.114 This one is definitely much more difficult. 0:07:42.114,0:07:44.830 This is a 7-year-old boy 0:07:44.830,0:07:46.151 suffering from pneumoniae septicemia 0:07:46.151,0:07:48.962 It resulted in cute respiratory distress syndrome. 0:07:48.962,0:07:51.538 So they used ECMO. 0:07:51.538,0:07:53.829 After using ECMO, 0:07:53.829,0:07:55.044 there was complication. 0:07:55.044,0:07:56.889 His limbs all became black. 0:07:56.889,0:07:58.493 He stared at you with his eyes open wide 0:07:58.493,0:07:59.316 consciously. 0:07:59.316,0:08:00.711 He could even ask for water when he was thirsty. 0:08:00.711,0:08:02.645 But as a doctor, 0:08:02.645,0:08:04.540 you have to make a decision. 0:08:04.540,0:08:05.963 If you’re going to save him, 0:08:05.963,0:08:07.541 you have to cut off his limbs 0:08:07.541,0:08:08.983 all his limbs. 0:08:08.983,0:08:10.868 And if you give up, 0:08:10.868,0:08:12.332 you have to turn off the ECMO. 0:08:12.332,0:08:14.080 Now think of this: 0:08:14.080,0:08:16.298 two roads diverged in the yellow woods. 0:08:16.298,0:08:17.801 The patient is conscious. 0:08:17.801,0:08:21.887 Well, the doctor is conscious, too. 0:08:21.887,0:08:23.788 But how do you ask the boy, 0:08:23.788,0:08:24.883 " hey if you want to go on, 0:08:24.883,0:08:26.589 I have to have your limbs amputated, 0:08:26.589,0:08:28.493 all your limbs. 0:08:28.493,0:08:30.400 Or if you do not want to go on, 0:08:30.400,0:08:32.397 I will turn off the machine." 0:08:32.397,0:08:34.421 How do you talk about life and death 0:08:34.421,0:08:37.569 with a 7-year-old. 0:08:37.569,0:08:41.508 As a critical care medicine doctor, 0:08:41.508,0:08:43.800 let me tell you my experiences in the past years. 0:08:43.800,0:08:45.048 In the beginning, 0:08:45.048,0:08:47.812 I saw a patient. 0:08:47.812,0:08:48.652 Gradually, 0:08:48.652,0:08:49.843 I saw only a disease. 0:08:49.843,0:08:51.260 I saw a heart only. 0:08:51.260,0:08:53.123 Fortunately, when I turned fifty 0:08:53.123,0:08:56.585 I gradually saw a patient again. 0:08:56.585,0:08:58.079 To be frank, 0:08:58.079,0:09:00.505 I am good at studying. 0:09:00.505,0:09:02.089 I had done heart transplant, 0:09:02.089,0:09:03.057 lungs transplant, 0:09:03.057,0:09:04.067 ECMO 0:09:04.067,0:09:05.138 when I was about 30. 0:09:05.138,0:09:07.888 I was the youngest chief doctor in NTU hospital. 0:09:07.888,0:09:09.517 Chief of surgical intensive care unit. 0:09:09.517,0:09:11.919 I was in Taiwan Organ Registry and Sharing Center. 0:09:11.919,0:09:13.136 And I was the vice chief of Trauma Unit. 0:09:13.136,0:09:15.740 In my thirties, 0:09:15.740,0:09:17.207 I thought 0:09:17.207,0:09:20.140 medicine was such an awesome thing. 0:09:20.140,0:09:21.678 It solved everything. 0:09:21.678,0:09:23.982 But in my forties, 0:09:23.982,0:09:25.414 There are so many unsuccessful cases 0:09:25.414,0:09:27.116 with the use of ECMO. 0:09:27.116,0:09:28.052 Sometimes the families of the patients asked me, 0:09:28.052,0:09:29.239 “why was Shao saved, 0:09:29.239,0:09:31.926 while my family members weren’t ?” 0:09:31.926,0:09:33.220 I don’t know how to answer the questions. 0:09:33.220,0:09:36.495 I couldn’t say because he or she was not Shao, could I? 0:09:36.495,0:09:37.390 Or they asked me, 0:09:37.390,0:09:39.234 “why does his limbs turned black?” 0:09:39.234,0:09:40.131 If I had known, 0:09:40.131,0:09:41.048 I would definitely avoid it. 0:09:41.048,0:09:42.354 I did not know. 0:09:42.354,0:09:44.440 When I was in my forties, 0:09:44.440,0:09:46.487 I thought that 0:09:46.487,0:09:49.553 why could not some patients be saved? 0:09:49.553,0:09:51.557 Finally, when I was about 50 0:09:51.557,0:09:54.057 the principle dawned on me. 0:09:54.057,0:09:56.661 It’s like a poetry said, "for, everywhere, no trace of her can be seen. 0:09:56.661,0:09:57.533 When, all of a sudden, I turned about. 0:09:57.533,0:09:59.652 It’s her. Where lanterns are few and far between." 0:09:59.652,0:10:00.439 One day, 0:10:00.439,0:10:01.880 it dawned on me that 0:10:01.880,0:10:04.143 doctors are people, not God. 0:10:04.143,0:10:05.262 All we can do is try our best. 0:10:05.262,0:10:08.058 That’s it. 0:10:08.058,0:10:10.284 It’s just like seasons. 0:10:10.284,0:10:11.144 There are spring, summer 0:10:11.144,0:10:13.199 autumn, and winter. 0:10:13.199,0:10:15.449 Medicine has its limit, 0:10:15.449,0:10:18.010 no matter how well developed is the science. 0:10:18.010,0:10:19.243 With today’s technology, 0:10:19.243,0:10:19.921 we can still be live 0:10:19.921,0:10:20.497 without heart 0:10:20.497,0:10:21.530 without lungs 0:10:21.530,0:10:21.894 without kidney 0:10:21.894,0:10:23.168 or without liver. 0:10:23.168,0:10:26.162 But we can’t rely on machines 0:10:26.162,0:10:27.981 for our whole lives. 0:10:27.981,0:10:30.493 Medicines has its limit. 0:10:30.493,0:10:32.696 It’s just like 0:10:32.696,0:10:35.604 the gardeners 0:10:35.604,0:10:37.168 can’t change seasons at all. 0:10:37.168,0:10:39.070 All the gardeners can do 0:10:39.070,0:10:42.221 is to make the flowers prettier in seasons. 0:10:42.221,0:10:43.490 As a doctors, 0:10:43.490,0:10:45.806 can we change birth, aging, sickness or death? 0:10:45.806,0:10:46.731 Well, 0:10:46.731,0:10:47.990 of course not. 0:10:47.990,0:10:49.455 As a doctor, 0:10:49.455,0:10:52.358 All we can do, is to make people 0:10:52.358,0:10:53.692 live a little better when they’re alive. 0:10:53.692,0:10:54.557 That’s all. 0:10:54.557,0:10:55.356 So 0:10:55.356,0:10:57.114 I came to realize that 0:10:57.114,0:11:01.231 doctors are just the gardeners in the life of garden. 0:11:01.231,0:11:05.380 As a gardener, 0:11:05.380,0:11:07.308 how to face the withered plants 0:11:07.308,0:11:09.070 is a question. 0:11:09.070,0:11:11.563 As an expert of critical care medicine, 0:11:11.563,0:11:14.931 how do I face death? 0:11:14.931,0:11:16.884 From scientific aspect of death, 0:11:16.884,0:11:19.289 or precisely, from physical and chemical aspects of death. 0:11:19.289,0:11:20.615 Every physical reaction , 0:11:20.615,0:11:21.548 or chemical reaction, 0:11:21.548,0:11:22.398 tends to achieve minimum energy 0:11:22.398,0:11:23.418 and maximum entropy. 0:11:23.418,0:11:26.607 Delta S is always positive. 0:11:26.607,0:11:29.524 Some will ask where does the relation come from? 0:11:29.524,0:11:31.317 Some people believe it came from the Big Bang Theory. 0:11:31.317,0:11:33.748 The universe is expanding due to the Big Bang Theory, 0:11:33.748,0:11:35.827 delta S is always positive. 0:11:35.827,0:11:36.697 Or 0:11:36.697,0:11:38.784 is there universality in the laws of universe ? 0:11:38.784,0:11:39.353 Honestly, 0:11:39.353,0:11:40.244 I don’t know either. 0:11:40.244,0:11:41.720 There’s an old saying 0:11:41.720,0:11:46.173 Blind men can judge no colours 0:11:46.173,0:11:47.329 Blind people 0:11:47.329,0:11:48.644 can’t talk about colours 0:11:48.644,0:11:50.435 because they can see nothing. 0:11:50.435,0:11:52.263 is there universality 0:11:52.263,0:11:53.449 in the laws of universe ? 0:11:53.449,0:11:55.297 Is there university 0:11:55.297,0:11:55.993 in the unlimited space and time . 0:11:55.993,0:11:56.483 Frankly, 0:11:56.483,0:11:57.535 I don’t know. 0:11:57.535,0:11:58.562 But at least, 0:11:58.562,0:12:00.605 among the scope we’re in 0:12:00.605,0:12:02.618 delta S is still positive. 0:12:02.618,0:12:04.490 What does it mean when we say delta S is positive? 0:12:04.490,0:12:05.295 In theory, 0:12:05.295,0:12:07.157 it should be minimum energy and maximum entropy. 0:12:07.157,0:12:08.176 So it all becomes more chaotic. 0:12:08.176,0:12:10.140 My existence 0:12:10.140,0:12:11.361 would mean a negative delta S 0:12:11.361,0:12:14.958 and this disobey the theory. 0:12:14.958,0:12:17.202 Then how should we view life and death? 0:12:17.202,0:12:18.611 Actually, 0:12:18.611,0:12:20.682 we often see ourselves only. 0:12:20.682,0:12:22.601 We don’t realize that we are in the universe. 0:12:22.601,0:12:24.923 The universe is the combination of we and the environment. 0:12:24.923,0:12:26.347 So total delta S 0:12:26.347,0:12:29.446 equals to delta S system and delta S surrounding. 0:12:29.446,0:12:30.437 So 0:12:30.437,0:12:32.631 this is an important concept. 0:12:32.631,0:12:35.202 Any organized group 0:12:35.202,0:12:37.240 are unstable. 0:12:37.240,0:12:39.428 It has to destroy the environment. 0:12:39.428,0:12:41.178 Delta S is negative, 0:12:41.178,0:12:43.284 however, it should be positive. 0:12:43.284,0:12:44.561 As a result, it will destroy the environment 0:12:44.561,0:12:46.361 to make the equation positive. 0:12:46.361,0:12:47.188 So my existence 0:12:47.188,0:12:49.326 is to destroy the environment. 0:12:49.326,0:12:50.298 Until one day, 0:12:50.298,0:12:52.062 when I can no longer destroy the environment, 0:12:52.062,0:12:53.659 can I destroy myself only. 0:12:53.659,0:12:56.399 Delta S should maintain positive, 0:12:56.399,0:12:58.207 so to exist is to destroy. 0:12:58.207,0:12:59.268 When you’re unable to destroy, 0:12:59.268,0:13:00.311 you can only destroy yourself. 0:13:00.311,0:13:01.635 This is death. 0:13:01.635,0:13:04.917 This is death from physical and chemical aspects. 0:13:04.917,0:13:07.544 However, 0:13:07.544,0:13:08.797 as a doctor, 0:13:08.797,0:13:10.885 I understand physics and chemistry. 0:13:10.885,0:13:13.159 How do I think of life? 0:13:13.159,0:13:14.758 One day, 0:13:14.758,0:13:15.620 when I took round in the intensive care units. 0:13:15.620,0:13:16.907 I came to realize 0:13:16.907,0:13:18.623 that there are only two kind of outcomes in lives. 0:13:18.623,0:13:19.286 One is with tubes insertion, 0:13:19.286,0:13:21.529 while the other is not. 0:13:21.529,0:13:24.340 But they’re all called death. 0:13:24.340,0:13:26.855 Death is an immutable law. 0:13:26.855,0:13:27.804 So 0:13:27.804,0:13:30.780 how do we think of death? 0:13:30.780,0:13:33.692 I have a flip point of view. 0:13:33.692,0:13:35.840 If you ask me what death is. 0:13:35.840,0:13:37.486 I will ask you: 0:13:37.486,0:13:40.495 what is life? 0:13:40.495,0:13:41.452 You guys came here 0:13:41.452,0:13:43.149 to attend a lecture. 0:13:43.149,0:13:45.157 I hope you can do one thing when you leave. 0:13:45.157,0:13:46.567 Tonight, when you are going to sleep, 0:13:46.567,0:13:47.433 when you’re lying on your bed, 0:13:47.433,0:13:49.017 ask yourself a question: 0:13:49.017,0:13:58.424 what is being alive? 0:13:58.424,0:13:59.208 Because 0:13:59.208,0:14:00.621 when you think of the question 0:14:00.621,0:14:02.552 we have to think of a question: 0:14:02.552,0:14:03.831 what is life ? 0:14:03.831,0:14:05.909 My answer to the question is this: 0:14:05.909,0:14:07.168 when you’re searching for the answer to the question, 0:14:07.168,0:14:10.508 it is the answer to the question. 0:14:10.508,0:14:12.331 Everyone dies eventually. 0:14:12.331,0:14:14.200 No when will set death 0:14:14.200,0:14:15.404 as the goal of life. 0:14:15.404,0:14:17.299 Life is a process. 0:14:17.299,0:14:20.082 We keep searching 0:14:20.082,0:14:21.371 for the answer 0:14:21.371,0:14:23.530 to what being alive is 0:14:23.530,0:14:25.133 in our life. 0:14:25.133,0:14:27.403 So when you’re searching, 0:14:27.403,0:14:29.042 that is the very answer to the question. 0:14:29.042,0:14:31.249 Death is not the goal of life. 0:14:31.249,0:14:33.491 Life is a process. 0:14:33.491,0:14:37.558 Recently, I always share the story of feces. 0:14:37.558,0:14:39.110 My teacher was going to retire, 0:14:39.110,0:14:39.673 he said, 0:14:39.673,0:14:40.556 "
 I am going to retire, 0:14:40.556,0:14:41.375 let’s go to somewhere fancy." 0:14:41.375,0:14:42.480 So 0:14:42.480,0:14:44.389 My teacher, my schoolmate and I 0:14:44.389,0:14:46.503 went to a French restaurant at Sheraton. 0:14:46.503,0:14:48.959 And it’s on me. 0:14:48.959,0:14:51.654 We spent 26,000 NT dollars. 0:14:51.654,0:14:54.397 I was too astonished to speak. 0:14:54.397,0:14:56.010 How could I eat something so expensive? 0:14:56.010,0:14:57.909 I’d never been to that kind of restaurant. 0:14:57.909,0:14:58.596 I had no idea 0:14:58.596,0:14:59.993 about what I’d ordered. 0:14:59.993,0:15:01.369 When I saw the bill, 0:15:01.369,0:15:03.168 I almost collapsed. 0:15:03.168,0:15:04.927 The next morning, in the restroom, 0:15:04.927,0:15:09.081 I examined my feces carefully. 0:15:09.081,0:15:10.606 I’d spent 9,000 NT dollars 0:15:10.606,0:15:15.390 producing it. 0:15:15.390,0:15:15.909 But I could not tell the difference 0:15:15.909,0:15:18.394 with the meals in the cafeteria, which cost 70 NT dollars, 0:15:18.394,0:15:19.800 at the NTU hospital. 0:15:19.800,0:15:23.550 I just could not tell the difference. 0:15:23.550,0:15:26.659 Then, in the restroom, I came to realize 0:15:26.659,0:15:28.606 that all the wealth you can get 0:15:28.606,0:15:35.666 is just feces. 0:15:40.074,0:15:43.061 Confucianism is the most crucial ism in Chinese culture. 0:15:43.077,0:15:45.613 Confucianism has its virtues. 0:15:45.613,0:15:48.047 It talks about human. 0:15:48.047,0:15:50.254 You can see the sayings in Confucian Analects as followed. 0:15:50.254,0:15:51.104 While you do not know life, 0:15:51.104,0:15:52.455 how can you know about death? 0:15:52.455,0:15:53.059 While you are not able to serve men, 0:15:53.059,0:15:54.474 how can you serve their spirits? 0:15:54.474,0:15:55.223 When alive, 0:15:55.223,0:15:55.624 be served according to propriety; 0:15:55.624,0:15:56.015 that, when dead, 0:15:56.015,0:15:56.921 they should be buried according to propriety; 0:15:56.921,0:15:58.320 and that they should be sacrificed to according to propriety. 0:15:58.320,0:15:59.975 Confucianism refuses to talk about death. 0:15:59.975,0:16:00.955 If you keep asking, 0:16:00.955,0:16:02.620 he would answer something about laying downing one's life for justice, 0:16:02.620,0:16:04.293 or if a man in the morning hear the right way, he may die in the evening without regret, 0:16:04.293,0:16:06.653 or sacrificing their lives to preserve their virtue complete. 0:16:06.653,0:16:09.508 Confucianism avoids 0:16:09.508,0:16:11.074 talking about death. 0:16:11.074,0:16:12.281 It doesn’t want to discuss about it 0:16:12.281,0:16:14.439 So 0:16:14.439,0:16:15.292 it is enthusiastic 0:16:15.292,0:16:15.986 about human, 0:16:15.986,0:16:17.812 and it leaves others behind. 0:16:17.812,0:16:19.564 It cares about the things you can see now. 0:16:19.564,0:16:20.551 However, 0:16:20.551,0:16:23.685 it doesn’t talk about death at all. 0:16:23.685,0:16:26.098 The following is what I think. 0:16:26.098,0:16:27.749 In Chinese culture, 0:16:27.749,0:16:29.722 Confucianism is the most crucial thought. 0:16:29.722,0:16:31.506 But we didn’t want to think of death in the past. 0:16:31.506,0:16:33.372 We avoided talking about it. 0:16:33.372,0:16:36.354 There’s a common saying based onSunzi's Art of War: 0:16:36.354,0:16:38.198 Placing somebidy on field of death and he will fight to live. 0:16:38.198,0:16:40.219 Only when we face the death, 0:16:40.219,0:16:43.720 seriously, 0:16:43.720,0:16:47.743 can we ask what life is. 0:16:47.743,0:16:49.930 We will all die in the end. 0:16:49.930,0:16:51.371 Life is just a process, 0:16:51.371,0:16:54.333 of searching for the meaning of being alive. 0:16:54.333,0:16:56.782 This is my point of view. 0:16:56.782,0:16:58.619 Actually, I am a smart person, 0:16:58.619,0:16:59.931 and strong enough. 0:16:59.931,0:17:03.440 I can travel around the island by bike. 0:17:03.440,0:17:05.553 But can I 0:17:05.553,0:17:07.810 bully others 0:17:07.810,0:17:09.780 just because I am a little smarter, 0:17:09.780,0:17:10.063 or a little stronger? 0:17:10.063,0:17:11.273 Well, 0:17:11.273,0:17:12.315 definitely not. 0:17:12.315,0:17:13.420 So 0:17:13.420,0:17:15.092 those who benefit from the society 0:17:15.092,0:17:16.692 should be grateful. 0:17:16.692,0:17:18.300 You should help others 0:17:18.300,0:17:20.044 if you’re able to. 0:17:20.044,0:17:21.922 That makes your life much more meaningful. 0:17:21.922,0:17:23.567 It’s about gratitude. 0:17:23.567,0:17:25.228 When I went to Dharma Drum Mountain, 0:17:25.228,0:17:27.322 the master talked with me 0:17:27.322,0:17:28.234 about gratitude. 0:17:28.234,0:17:29.263 Being grateful. 0:17:29.263,0:17:30.516 Being kind instead of being revengeful. 0:17:30.516,0:17:33.153 “I know you are misunderstood,” he said, 0:17:33.153,0:17:37.158 “but you can’t complain. 0:17:37.158,0:17:40.166 You should help others instead.” 0:17:40.166,0:17:41.633 At the end of my speech, let me share a concept with you. 0:17:41.633,0:17:43.170 It is “a to the power of n.” 0:17:43.170,0:17:44.351 If a is greater than 1, 0:17:44.351,0:17:45.927 a to the power of n is infinity. 0:17:45.927,0:17:47.080 If a is less than 1, 0:17:47.080,0:17:50.039 a to the power will approach zero rapidly. 0:17:50.039,0:17:51.827 What does that mean? 0:17:51.827,0:17:53.185 If what I give to the society 0:17:53.185,0:17:54.537 is greater than what I get from the society, 0:17:54.537,0:17:55.810 a is greater than one. 0:17:55.810,0:17:57.265 Our society will become better and better. 0:17:57.265,0:17:58.610 If what I get from the society 0:17:58.610,0:18:00.045 is greater than what I give to the society, 0:18:00.045,0:18:00.993 a is less than 1 0:18:00.993,0:18:02.578 Our society will become worse. 0:18:02.578,0:18:04.490 And I end the my speech, 0:18:04.490,0:18:07.205 with these words. 0:18:07.205,0:18:09.389 Facing difficulties is not the hardest thing. 0:18:09.389,0:18:10.376 The hardest thing is 0:18:10.376,0:18:12.117 facing the difficulties 0:18:12.117,0:18:12.117 without losing passion for your life and world. 0:18:12.117,0:18:16.302 Thank you very much.