[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:15.75,0:00:19.45,Default,,0000,0000,0000,,The host (from TEDxTaipei) invited me to speak about “Positive Destruction.”
Dialogue: 0,0:00:19.45,0:00:24.95,Default,,0000,0000,0000,,After giving it some thought, I thought I might as well share my own story.
Dialogue: 0,0:00:24.95,0:00:26.93,Default,,0000,0000,0000,,Among all the physicians in Taiwan,
Dialogue: 0,0:00:26.93,0:00:30.45,Default,,0000,0000,0000,,I am probably the one ER doctor who has seen the most cadavers.
Dialogue: 0,0:00:30.45,0:00:32.90,Default,,0000,0000,0000,,I've seen many cases of life and death.
Dialogue: 0,0:00:32.90,0:00:36.95,Default,,0000,0000,0000,,Perhaps that's why I'm suited to share such stories on this stage.\N
Dialogue: 0,0:00:36.95,0:00:39.31,Default,,0000,0000,0000,,There's a joke about\N
Dialogue: 0,0:00:39.31,0:00:40.87,Default,,0000,0000,0000,,the most famous physician -- Dr. Yeh
Dialogue: 0,0:00:40.87,0:00:42.74,Default,,0000,0000,0000,,here in Taiwan.
Dialogue: 0,0:00:42.74,0:00:44.53,Default,,0000,0000,0000,,After Shao Xiao Ling's (Taichung First Lady) car accident,
Dialogue: 0,0:00:44.53,0:00:46.61,Default,,0000,0000,0000,,a patient went to Chi-Mei Hospital in Liu-Ying city\N
Dialogue: 0,0:00:46.61,0:00:48.70,Default,,0000,0000,0000,,to seek a doctor named Yeh.\N
Dialogue: 0,0:00:48.70,0:00:49.54,Default,,0000,0000,0000,,The staff in the hospital said
Dialogue: 0,0:00:49.54,0:00:51.99,Default,,0000,0000,0000,,that there's no Dr. Yeh.\N
Dialogue: 0,0:00:51.99,0:00:53.21,Default,,0000,0000,0000,,"There is, " said the patient.
Dialogue: 0,0:00:53.21,0:00:56.42,Default,,0000,0000,0000,,"I was told that his name is 'Yeh Ker-Mo' (ECMO: Extra-Corporeal Membrane Oxygenation).
Dialogue: 0,0:00:56.42,0:01:00.02,Default,,0000,0000,0000,,This Dr. Yeh was the one who saved Shao Xiao Ling's life!"
Dialogue: 0,0:01:00.04,0:01:01.34,Default,,0000,0000,0000,,Speaking of ECMO, its concept is quite easy to understand.
Dialogue: 0,0:01:01.34,0:01:02.61,Default,,0000,0000,0000,,You divert the blood flow from the femoral vein
Dialogue: 0,0:01:03.88,0:01:05.15,Default,,0000,0000,0000,,and pass it through a pump,
Dialogue: 0,0:01:05.15,0:01:06.01,Default,,0000,0000,0000,,which serves as an artificial heart.
Dialogue: 0,0:01:06.01,0:01:07.29,Default,,0000,0000,0000,,The blood then passes through a membrane oxygenator,
Dialogue: 0,0:01:07.41,0:01:08.56,Default,,0000,0000,0000,,which acts as a pair of artificial lungs.\N
Dialogue: 0,0:01:08.56,0:01:10.48,Default,,0000,0000,0000,,Afterwards, the blood re-enters the body.
Dialogue: 0,0:01:10.48,0:01:12.94,Default,,0000,0000,0000,,So, ECMO is a temporary substitute of a human's cardiovascular system.
Dialogue: 0,0:01:12.94,0:01:14.97,Default,,0000,0000,0000,,This is how an ECMO machine looks like.
Dialogue: 0,0:01:14.97,0:01:17.49,Default,,0000,0000,0000,,You now have a machine acting as an artificial heart
Dialogue: 0,0:01:17.49,0:01:20.07,Default,,0000,0000,0000,,that pumps blood to the oxygenator and back to the body.\N
Dialogue: 0,0:01:20.07,0:01:22.70,Default,,0000,0000,0000,,As a matter of fact, ECMO technique
Dialogue: 0,0:01:22.70,0:01:24.29,Default,,0000,0000,0000,,was already available and widely used
Dialogue: 0,0:01:24.29,0:01:27.50,Default,,0000,0000,0000,,at the National Taiwan University (NTU) Hospital\N
Dialogue: 0,0:01:27.50,0:01:30.05,Default,,0000,0000,0000,,since 1994 prior to the first lady's car accident.
Dialogue: 0,0:01:30.05,0:01:31.93,Default,,0000,0000,0000,,It was only since her incident that folks in Taiwan are aware of the ECMO technique.
Dialogue: 0,0:01:31.93,0:01:33.38,Default,,0000,0000,0000,,It’s similar to the saying: "One can spend decades painting in relative obscurity,"\N
Dialogue: 0,0:01:33.38,0:01:36.24,Default,,0000,0000,0000,,"but the world only sees the artist's finished masterpiece."
Dialogue: 0,0:01:36.24,0:01:37.60,Default,,0000,0000,0000,,That's just my personal opinion.
Dialogue: 0,0:01:37.60,0:01:41.04,Default,,0000,0000,0000,,ECMO became a household term due to its overexposure from Taiwan's media press.\N
Dialogue: 0,0:01:41.04,0:01:43.73,Default,,0000,0000,0000,,here's no doubt that ECMO technique has its relatively successful cases.\N
Dialogue: 0,0:01:43.73,0:01:45.41,Default,,0000,0000,0000,,One prominent example is the case of singer Jay Chou's backup dancer.
Dialogue: 0,0:01:45.41,0:01:47.83,Default,,0000,0000,0000,,
Dialogue: 0,0:01:47.08,0:01:48.76,Default,,0000,0000,0000,,One day, this patient was admitted with fulminant myocarditis,
Dialogue: 0,0:01:48.76,0:01:50.95,Default,,0000,0000,0000,,and was undergoing cardiac arrest.
Dialogue: 0,0:01:50.95,0:01:52.100,Default,,0000,0000,0000,,I would like to show you a photo of him at the time,
Dialogue: 0,0:01:52.100,0:01:56.65,Default,,0000,0000,0000,,with the patient lying on his hospital bed.
Dialogue: 0,0:01:56.65,0:01:57.92,Default,,0000,0000,0000,,The eyes of this patient were wide open,
Dialogue: 0,0:01:57.92,0:01:59.41,Default,,0000,0000,0000,,and were staring straight,\N
Dialogue: 0,0:01:59.41,0:02:01.74,Default,,0000,0000,0000,,reading the flat lines showing on the ECG screen.
Dialogue: 0,0:02:01.74,0:02:03.32,Default,,0000,0000,0000,,As a result of fulminant myocarditis,\N
Dialogue: 0,0:02:03.32,0:02:05.47,Default,,0000,0000,0000,,the patient's heart stopped beating.
Dialogue: 0,0:02:05.47,0:02:07.82,Default,,0000,0000,0000,,He suffered a cardiac arrest.\N
Dialogue: 0,0:02:07.82,0:02:10.64,Default,,0000,0000,0000,,This is a biopsy of his cardiac muscle
Dialogue: 0,0:02:10.64,0:02:12.40,Default,,0000,0000,0000,,magnified 100 times under the microscope.\N
Dialogue: 0,0:02:12.40,0:02:13.73,Default,,0000,0000,0000,,Even under this type of magnifying power, \N
Dialogue: 0,0:02:13.73,0:02:16.31,Default,,0000,0000,0000,,it's still quite hard to see.
Dialogue: 0,0:02:16.31,0:02:18.83,Default,,0000,0000,0000,,However, magnified 400 times will be much clearer.
Dialogue: 0,0:02:18.83,0:02:22.14,Default,,0000,0000,0000,,Those blue spots are lymphocytes.\N
Dialogue: 0,0:02:22.14,0:02:26.09,Default,,0000,0000,0000,,From here, we can see a serious case of fulminant myocarditis.
Dialogue: 0,0:02:26.09,0:02:29.44,Default,,0000,0000,0000,,Lymphocytes infiltrated his entire heart,
Dialogue: 0,0:02:29.44,0:02:33.82,Default,,0000,0000,0000,,which caused sudden cardiac arrest.\N
Dialogue: 0,0:02:33.82,0:02:37.06,Default,,0000,0000,0000,,The patient stared at the screen,\N
Dialogue: 0,0:02:37.06,0:02:40.42,Default,,0000,0000,0000,,as it displayed no signs of a working heart.\N
Dialogue: 0,0:02:40.42,0:02:42.88,Default,,0000,0000,0000,,After the ninth day,
Dialogue: 0,0:02:42.88,0:02:44.56,Default,,0000,0000,0000,,after a heart and a kidney transplant,
Dialogue: 0,0:02:44.56,0:02:46.81,Default,,0000,0000,0000,,She returned to dance in less than one month's recovery.
Dialogue: 0,0:02:46.81,0:02:49.33,Default,,0000,0000,0000,,It was a great miracle in modern medicine.\N
Dialogue: 0,0:02:49.33,0:02:52.41,Default,,0000,0000,0000,,In modern medical records,
Dialogue: 0,0:02:52.41,0:02:55.15,Default,,0000,0000,0000,,this patient holds the longest record for CPR survival:
Dialogue: 0,0:02:55.15,0:02:57.29,Default,,0000,0000,0000,,4 hours.
Dialogue: 0,0:02:57.29,0:03:00.77,Default,,0000,0000,0000,,CPR was performed on him from Cathay General Hospital to NTU Hospital.
Dialogue: 0,0:03:00.77,0:03:02.81,Default,,0000,0000,0000,,When physicians tried ECMO technique at the NTU hospital,\N
Dialogue: 0,0:03:02.81,0:03:05.02,Default,,0000,0000,0000,,they found that over 100 doses
Dialogue: 0,0:03:05.02,0:03:06.68,Default,,0000,0000,0000,,of cardiotonic drugs\N
Dialogue: 0,0:03:06.68,0:03:08.75,Default,,0000,0000,0000,,were already given to him.\N
Dialogue: 0,0:03:08.75,0:03:10.30,Default,,0000,0000,0000,,When an incision was made
Dialogue: 0,0:03:10.30,0:03:10.95,Default,,0000,0000,0000,,to insert an ECMO tube,
Dialogue: 0,0:03:10.95,0:03:12.41,Default,,0000,0000,0000,,the patient's veins and arteries were too narrow.
Dialogue: 0,0:03:12.41,0:03:13.64,Default,,0000,0000,0000,,Therefore, CPR had to be conducted again\N
Dialogue: 0,0:03:13.64,0:03:14.88,Default,,0000,0000,0000,,until he was in the operating room.
Dialogue: 0,0:03:14.88,0:03:15.81,Default,,0000,0000,0000,,Surgeons had to saw open the patient's chest
Dialogue: 0,0:03:15.81,0:03:18.19,Default,,0000,0000,0000,,to insert ECMO tubes from the top.
Dialogue: 0,0:03:18.19,0:03:22.45,Default,,0000,0000,0000,,The entire procedure sounds surreal right now.\N
Dialogue: 0,0:03:22.45,0:03:27.16,Default,,0000,0000,0000,,Every time I recall this case, I always say it's a modern medical miracle.
Dialogue: 0,0:03:27.16,0:03:30.33,Default,,0000,0000,0000,,The fact that a man‘s heart had stopped for 9 days.
Dialogue: 0,0:03:30.33,0:03:34.10,Default,,0000,0000,0000,,And after enduring heart and kidney transplants,\N
Dialogue: 0,0:03:34.10,0:03:36.73,Default,,0000,0000,0000,,a 4 hour CPR,\N
Dialogue: 0,0:03:36.73,0:03:39.17,Default,,0000,0000,0000,,he could still survive.\N
Dialogue: 0,0:03:39.17,0:03:40.87,Default,,0000,0000,0000,,Here is anthother patient case.
Dialogue: 0,0:03:40.87,0:03:42.52,Default,,0000,0000,0000,,The headline reads ”World's First:
Dialogue: 0,0:03:42.52,0:03:43.94,Default,,0000,0000,0000,,Miracle of Taiwan".\N
Dialogue: 0,0:03:43.94,0:03:46.42,Default,,0000,0000,0000,,Man without heart for 16 days.\N
Dialogue: 0,0:03:46.42,0:03:49.75,Default,,0000,0000,0000,,In this case, the patient is a 56-year-old man.
Dialogue: 0,0:03:49.75,0:03:51.35,Default,,0000,0000,0000,,He had a tooth decay.
Dialogue: 0,0:03:51.35,0:03:53.40,Default,,0000,0000,0000,,Bacteria from the cavity went into the blood,
Dialogue: 0,0:03:53.40,0:03:54.30,Default,,0000,0000,0000,,and spread to the portions of the heart.
Dialogue: 0,0:03:54.30,0:03:55.88,Default,,0000,0000,0000,,It caused a pus buildup.
Dialogue: 0,0:03:55.88,0:03:57.82,Default,,0000,0000,0000,,The patient went to a different hospital\N
Dialogue: 0,0:03:57.82,0:03:59.76,Default,,0000,0000,0000,,where the surgical team opened up his chest,
Dialogue: 0,0:03:59.76,0:04:00.56,Default,,0000,0000,0000,,and began to eliminate\N
Dialogue: 0,0:04:00.56,0:04:01.94,Default,,0000,0000,0000,,infected tissues of the heart.\N
Dialogue: 0,0:04:01.94,0:04:02.80,Default,,0000,0000,0000,,The team continued to remove \N
Dialogue: 0,0:04:02.80,0:04:03.85,Default,,0000,0000,0000,,more affected tissues
Dialogue: 0,0:04:03.85,0:04:06.87,Default,,0000,0000,0000,,until not much of the muscular organ was left.
Dialogue: 0,0:04:06.87,0:04:07.86,Default,,0000,0000,0000,,So what can the team do now?\N
Dialogue: 0,0:04:07.86,0:04:13.27,Default,,0000,0000,0000,,Transfer this patient to NTU hospital.\N
Dialogue: 0,0:04:13.31,0:04:17.13,Default,,0000,0000,0000,,It seems that NTU hospital is the last line of medical defense in Taiwan.
Dialogue: 0,0:04:17.13,0:04:18.99,Default,,0000,0000,0000,,NTU hospital has to take patients in.
Dialogue: 0,0:04:18.99,0:04:21.83,Default,,0000,0000,0000,,\NIn the first case, the case was cardiac arrest.\N
Dialogue: 0,0:04:21.83,0:04:22.54,Default,,0000,0000,0000,,This case is more extreme.
Dialogue: 0,0:04:22.54,0:04:23.78,Default,,0000,0000,0000,,This is a man with not much of a heart left.
Dialogue: 0,0:04:23.78,0:04:25.48,Default,,0000,0000,0000,,It was almost all surgically removed.
Dialogue: 0,0:04:25.48,0:04:26.71,Default,,0000,0000,0000,,When the patient was transferred to NTU hospital,
Dialogue: 0,0:04:26.71,0:04:28.53,Default,,0000,0000,0000,,\Nbecause of the state he was in,\N
Dialogue: 0,0:04:28.53,0:04:30.25,Default,,0000,0000,0000,,our medical team had to use two ECMOs.
Dialogue: 0,0:04:30.25,0:04:31.24,Default,,0000,0000,0000,,Look at this slide.\N\N
Dialogue: 0,0:04:31.24,0:04:32.73,Default,,0000,0000,0000,,There are two ECMO devices.\N
Dialogue: 0,0:04:32.73,0:04:34.38,Default,,0000,0000,0000,,This one is even more unbelievable.\N
Dialogue: 0,0:04:34.38,0:04:35.51,Default,,0000,0000,0000,,Since he didn't have a heart left,
Dialogue: 0,0:04:35.51,0:04:37.75,Default,,0000,0000,0000,,so the ECG displayed a completely flat line.\N
Dialogue: 0,0:04:37.75,0:04:40.88,Default,,0000,0000,0000,,There's not much to explain here.\N
Dialogue: 0,0:04:40.88,0:04:42.43,Default,,0000,0000,0000,,This is his CT scan result.\N
Dialogue: 0,0:04:42.43,0:04:43.28,Default,,0000,0000,0000,,Theoretically,
Dialogue: 0,0:04:43.28,0:04:45.92,Default,,0000,0000,0000,,there should have been a heart in his thorax.
Dialogue: 0,0:04:45.92,0:04:47.03,Default,,0000,0000,0000,,However, the heart is missing here.\N
Dialogue: 0,0:04:47.03,0:04:49.39,Default,,0000,0000,0000,,There are only tubes.\N
Dialogue: 0,0:04:49.39,0:04:51.28,Default,,0000,0000,0000,,After 16 days,
Dialogue: 0,0:04:51.28,0:04:53.48,Default,,0000,0000,0000,,our surgical team performed a heart transplant surgery on this patient.\N
Dialogue: 0,0:04:53.48,0:04:56.41,Default,,0000,0000,0000,,Cardiologist surgeon Dr. Wan showed me this.
Dialogue: 0,0:04:56.41,0:04:58.47,Default,,0000,0000,0000,,Dr. Wan said during the surgery,\N
Dialogue: 0,0:04:58.47,0:04:59.49,Default,,0000,0000,0000,,he opened the patient's chest
Dialogue: 0,0:04:59.49,0:05:01.94,Default,,0000,0000,0000,,and had expected a heart in the thorax.
Dialogue: 0,0:05:01.94,0:05:03.83,Default,,0000,0000,0000,,However, there were only plastic tubes
Dialogue: 0,0:05:03.83,0:05:06.63,Default,,0000,0000,0000,,connecting to the ECMO.\N
Dialogue: 0,0:05:06.63,0:05:09.18,Default,,0000,0000,0000,,The patient had no heart at all.\N
Dialogue: 0,0:05:09.18,0:05:12.20,Default,,0000,0000,0000,,And after 16 days, the heart transplant surgery was completed.\N
Dialogue: 0,0:05:12.20,0:05:15.32,Default,,0000,0000,0000,,The patient was discharged later.\N
Dialogue: 0,0:05:15.32,0:05:18.83,Default,,0000,0000,0000,,Here is the Straits Times of Singapore.\N
Dialogue: 0,0:05:18.83,0:05:22.16,Default,,0000,0000,0000,,A vendor I know sent me an e-mail from Singapore.
Dialogue: 0,0:05:22.16,0:05:24.59,Default,,0000,0000,0000,,He told me that we were featured in the Straits Times.
Dialogue: 0,0:05:24.59,0:05:26.33,Default,,0000,0000,0000,,16 days without heart
Dialogue: 0,0:05:26.33,0:05:27.99,Default,,0000,0000,0000,,A person had lived for 16 days without a heart.
Dialogue: 0,0:05:27.99,0:05:29.22,Default,,0000,0000,0000,,But after receiving heart transplant,\N
Dialogue: 0,0:05:29.22,0:05:33.34,Default,,0000,0000,0000,,he still went home in good shape.
Dialogue: 0,0:05:33.34,0:05:35.10,Default,,0000,0000,0000,,This is a third case.\N
Dialogue: 0,0:05:35.10,0:05:39.21,Default,,0000,0000,0000,,He’s a 26-year-old aboriginal Taiwanese.
Dialogue: 0,0:05:39.21,0:05:41.37,Default,,0000,0000,0000,,He went swimming even when he was seriously drunk.
Dialogue: 0,0:05:41.37,0:05:45.08,Default,,0000,0000,0000,,Jokingly, he probably thought he was Li Bai the poet.\N
Dialogue: 0,0:05:45.08,0:05:47.18,Default,,0000,0000,0000,,The pond he swam in was really unsanitary.
Dialogue: 0,0:05:47.18,0:05:48.22,Default,,0000,0000,0000,,He choked on water.\N
Dialogue: 0,0:05:48.22,0:05:49.62,Default,,0000,0000,0000,,As a result,
Dialogue: 0,0:05:49.62,0:05:51.41,Default,,0000,0000,0000,,he caught a severe case of pneumonia.
Dialogue: 0,0:05:51.41,0:05:53.39,Default,,0000,0000,0000,,He’d relied on ECMO for 117 days.\N
Dialogue: 0,0:05:53.39,0:05:55.19,Default,,0000,0000,0000,,Look at his lungs.\N
Dialogue: 0,0:05:55.19,0:05:55.98,Default,,0000,0000,0000,,After he ingested unclean water,
Dialogue: 0,0:05:55.98,0:05:57.38,Default,,0000,0000,0000,,his condition worsened to a severe case of pneumonia.\N
Dialogue: 0,0:05:57.38,0:05:59.82,Default,,0000,0000,0000,,This is called acute respiratory distress syndrome.\N
Dialogue: 0,0:05:59.82,0:06:01.95,Default,,0000,0000,0000,,The lungs became abnormally white.
Dialogue: 0,0:06:01.95,0:06:05.09,Default,,0000,0000,0000,,He lived on ECMO for 117 days.
Dialogue: 0,0:06:05.09,0:06:09.52,Default,,0000,0000,0000,,We can see clearly from this slide.\N
Dialogue: 0,0:06:09.52,0:06:11.86,Default,,0000,0000,0000,,For one entire month,
Dialogue: 0,0:06:11.86,0:06:13.49,Default,,0000,0000,0000,,the patient's ventilation volume
Dialogue: 0,0:06:13.49,0:06:15.16,Default,,0000,0000,0000,,did not exceed 100 c.c.\N
Dialogue: 0,0:06:15.16,0:06:18.02,Default,,0000,0000,0000,,But the patient still recovered.
Dialogue: 0,0:06:18.02,0:06:19.46,Default,,0000,0000,0000,,In short,
Dialogue: 0,0:06:19.46,0:06:21.23,Default,,0000,0000,0000,,in the these three medical cases,
Dialogue: 0,0:06:21.23,0:06:22.96,Default,,0000,0000,0000,,in the these three medical cases,
Dialogue: 0,0:06:22.96,0:06:24.61,Default,,0000,0000,0000,,the patient undergoing cardiac arrest,
Dialogue: 0,0:06:24.61,0:06:27.11,Default,,0000,0000,0000,,or the patient with lung failure,
Dialogue: 0,0:06:27.11,0:06:29.31,Default,,0000,0000,0000,,with the help of ECMO,
Dialogue: 0,0:06:29.31,0:06:32.59,Default,,0000,0000,0000,,no matter whether 9 days later
Dialogue: 0,0:06:32.59,0:06:34.60,Default,,0000,0000,0000,,or even 100 days afterwards,\N
Dialogue: 0,0:06:34.60,0:06:36.37,Default,,0000,0000,0000,,after a heart transplant
Dialogue: 0,0:06:36.37,0:06:37.83,Default,,0000,0000,0000,,or lung transplant,\N
Dialogue: 0,0:06:37.83,0:06:39.52,Default,,0000,0000,0000,,their lives were saved.\N
Dialogue: 0,0:06:39.52,0:06:41.63,Default,,0000,0000,0000,,It is really incredible.
Dialogue: 0,0:06:41.63,0:06:42.82,Default,,0000,0000,0000,,To be honest...\N
Dialogue: 0,0:06:42.82,0:06:44.58,Default,,0000,0000,0000,,In recent history, ECMO has retained
Dialogue: 0,0:06:44.58,0:06:45.73,Default,,0000,0000,0000,,a high level of awareness \N
Dialogue: 0,0:06:45.73,0:06:47.66,Default,,0000,0000,0000,,thanks to the media presses in Taiwan.
Dialogue: 0,0:06:47.66,0:06:48.70,Default,,0000,0000,0000,,The reason why folks know about ECMO,\N
Dialogue: 0,0:06:48.70,0:06:50.57,Default,,0000,0000,0000,,is because of past success cases,
Dialogue: 0,0:06:50.57,0:06:52.26,Default,,0000,0000,0000,,and also because of the first lady in Taichung,\N
Dialogue: 0,0:06:52.26,0:06:53.76,Default,,0000,0000,0000,,and famed astrologer Nick Yen.\N
Dialogue: 0,0:06:53.76,0:06:55.33,Default,,0000,0000,0000,,However,\N
Dialogue: 0,0:06:55.33,0:06:56.40,Default,,0000,0000,0000,,the media usually\N
Dialogue: 0,0:06:56.40,0:06:58.21,Default,,0000,0000,0000,,only reports on the successful stories.
Dialogue: 0,0:06:58.21,0:06:59.41,Default,,0000,0000,0000,,Reporters don’t write failed cases.
Dialogue: 0,0:06:59.41,0:07:00.94,Default,,0000,0000,0000,,Hidden from the public eye.\N
Dialogue: 0,0:07:00.94,0:07:04.12,Default,,0000,0000,0000,,As a critical care physician,
Dialogue: 0,0:07:04.12,0:07:06.32,Default,,0000,0000,0000,,I am certainly glad to encounter successful patient cases.
Dialogue: 0,0:07:06.32,0:07:08.19,Default,,0000,0000,0000,,However, there are cases that are not as successful.\N
Dialogue: 0,0:07:08.19,0:07:12.95,Default,,0000,0000,0000,,This baby was one and half months old.\N
Dialogue: 0,0:07:12.95,0:07:14.77,Default,,0000,0000,0000,,He suffered from a congenital heart disease.
Dialogue: 0,0:07:14.77,0:07:16.32,Default,,0000,0000,0000,,After undergoing a heart surgery,
Dialogue: 0,0:07:16.32,0:07:17.89,Default,,0000,0000,0000,,the baby still could not live without a heart-lung machine.
Dialogue: 0,0:07:17.89,0:07:19.64,Default,,0000,0000,0000,,So, we hooked the baby up to an ECMO.\N
Dialogue: 0,0:07:19.64,0:07:20.67,Default,,0000,0000,0000,,The ECMO was inserted in the baby's heart.\N
Dialogue: 0,0:07:20.67,0:07:21.96,Default,,0000,0000,0000,,After the procedure, \N
Dialogue: 0,0:07:21.96,0:07:22.99,Default,,0000,0000,0000,,in three days,\N
Dialogue: 0,0:07:22.99,0:07:24.21,Default,,0000,0000,0000,,the baby's feet turned black.\N
Dialogue: 0,0:07:24.21,0:07:25.38,Default,,0000,0000,0000,,Let’s zoom in.
Dialogue: 0,0:07:25.38,0:07:27.03,Default,,0000,0000,0000,,Look at his tiny, blackened feet.\N
Dialogue: 0,0:07:27.03,0:07:28.49,Default,,0000,0000,0000,,So now, as a physician,\N
Dialogue: 0,0:07:28.49,0:07:29.99,Default,,0000,0000,0000,,you have to make a decision.\N
Dialogue: 0,0:07:29.99,0:07:31.51,Default,,0000,0000,0000,,Should you amputate his tiny feet
Dialogue: 0,0:07:31.51,0:07:32.62,Default,,0000,0000,0000,,to try to save his life?
Dialogue: 0,0:07:32.62,0:07:33.58,Default,,0000,0000,0000,,Or should you just give up
Dialogue: 0,0:07:33.58,0:07:34.84,Default,,0000,0000,0000,,and let him go?\N
Dialogue: 0,0:07:34.84,0:07:37.70,Default,,0000,0000,0000,,These types of decisions are incredibly stressful to make.
Dialogue: 0,0:07:37.70,0:07:40.09,Default,,0000,0000,0000,,But if you can’t make the call,
Dialogue: 0,0:07:40.09,0:07:42.11,Default,,0000,0000,0000,,then the next case is more difficult to gauge.\N
Dialogue: 0,0:07:42.11,0:07:44.83,Default,,0000,0000,0000,,Here is a 7-year-old boy
Dialogue: 0,0:07:44.83,0:07:46.15,Default,,0000,0000,0000,,suffering from streptococcus pneumonia.\N
Dialogue: 0,0:07:46.15,0:07:48.96,Default,,0000,0000,0000,,His condition worsened to acute respiratory distress syndrome.
Dialogue: 0,0:07:48.96,0:07:51.54,Default,,0000,0000,0000,,So the medical team decided to employ ECMO technique.
Dialogue: 0,0:07:51.54,0:07:53.83,Default,,0000,0000,0000,,After using ECMO, however,\N
Dialogue: 0,0:07:53.83,0:07:55.04,Default,,0000,0000,0000,,there were complications.\N
Dialogue: 0,0:07:55.04,0:07:56.89,Default,,0000,0000,0000,,His limbs all turned black.
Dialogue: 0,0:07:56.89,0:07:58.49,Default,,0000,0000,0000,,His adorable eyes would look at you,
Dialogue: 0,0:07:58.49,0:07:59.32,Default,,0000,0000,0000,,his conscious in a clear state.
Dialogue: 0,0:07:59.32,0:08:00.71,Default,,0000,0000,0000,,He could even ask for water when he was thirsty.
Dialogue: 0,0:08:00.71,0:08:02.64,Default,,0000,0000,0000,,But as a doctor,\N
Dialogue: 0,0:08:02.64,0:08:04.54,Default,,0000,0000,0000,,you have to make incredibly hard decisions.\N
Dialogue: 0,0:08:04.54,0:08:05.96,Default,,0000,0000,0000,,If you want to save him,
Dialogue: 0,0:08:05.96,0:08:07.54,Default,,0000,0000,0000,,you have to cut off his limbs first,
Dialogue: 0,0:08:07.54,0:08:08.98,Default,,0000,0000,0000,,and continue with further medical treatment.\N
Dialogue: 0,0:08:08.98,0:08:10.87,Default,,0000,0000,0000,,And if you give up,\N
Dialogue: 0,0:08:10.87,0:08:12.33,Default,,0000,0000,0000,,you have to turn off the ECMO.\N
Dialogue: 0,0:08:12.33,0:08:14.08,Default,,0000,0000,0000,,Now think of this:\N
Dialogue: 0,0:08:14.08,0:08:16.30,Default,,0000,0000,0000,,Between life and death,
Dialogue: 0,0:08:16.30,0:08:17.80,Default,,0000,0000,0000,,when the patient is in a conscious state,\N
Dialogue: 0,0:08:17.80,0:08:21.89,Default,,0000,0000,0000,,of course, the doctor's mind is clear, too.
Dialogue: 0,0:08:21.89,0:08:23.79,Default,,0000,0000,0000,,How would you ask the boy?
Dialogue: 0,0:08:23.79,0:08:24.88,Default,,0000,0000,0000,,"Hi dear"
Dialogue: 0,0:08:24.88,0:08:26.59,Default,,0000,0000,0000,,"If you want to live"\N
Dialogue: 0,0:08:26.59,0:08:28.49,Default,,0000,0000,0000,,"I will need to amputate your limbs."
Dialogue: 0,0:08:28.49,0:08:30.40,Default,,0000,0000,0000,,"Or you'd rather give up,"
Dialogue: 0,0:08:30.40,0:08:32.40,Default,,0000,0000,0000,,"and rest in peace?"
Dialogue: 0,0:08:32.40,0:08:34.42,Default,,0000,0000,0000,,\NHow do you communicate this type of life and death decision\N
Dialogue: 0,0:08:34.42,0:08:37.57,Default,,0000,0000,0000,,with a 7-year-old?\N
Dialogue: 0,0:08:37.57,0:08:39.65,Default,,0000,0000,0000,,This is the line of work I have to deal with
Dialogue: 0,0:08:39.65,0:08:41.72,Default,,0000,0000,0000,,as a critical care physician.
Dialogue: 0,0:08:41.72,0:08:43.80,Default,,0000,0000,0000,,In the beginning, I made decisions rather logically.
Dialogue: 0,0:08:43.80,0:08:47.37,Default,,0000,0000,0000,,I identified everything by patients.
Dialogue: 0,0:08:47.37,0:08:48.65,Default,,0000,0000,0000,,Gradually,
Dialogue: 0,0:08:48.65,0:08:49.84,Default,,0000,0000,0000,,I targeted diseases, not patients.
Dialogue: 0,0:08:49.84,0:08:51.26,Default,,0000,0000,0000,,A diseased heart, for example.\N
Dialogue: 0,0:08:51.26,0:08:53.12,Default,,0000,0000,0000,,Fortunately, when I turned fifty,\N
Dialogue: 0,0:08:53.12,0:08:56.58,Default,,0000,0000,0000,,I gradually realized that I should treat patient as a whole again.
Dialogue: 0,0:08:56.58,0:08:58.08,Default,,0000,0000,0000,,To be quite honest,
Dialogue: 0,0:08:58.08,0:09:00.50,Default,,0000,0000,0000,,I consider myself academically inclined.
Dialogue: 0,0:09:00.50,0:09:02.09,Default,,0000,0000,0000,,When I reached my 30s,
Dialogue: 0,0:09:02.09,0:09:03.06,Default,,0000,0000,0000,,heart transplants,
Dialogue: 0,0:09:03.06,0:09:04.07,Default,,0000,0000,0000,,lung transplants,\N
Dialogue: 0,0:09:04.07,0:09:05.14,Default,,0000,0000,0000,,ECMO technique,\N
Dialogue: 0,0:09:05.14,0:09:07.89,Default,,0000,0000,0000,,youngest chief physician in NTU hospital,
Dialogue: 0,0:09:07.89,0:09:09.52,Default,,0000,0000,0000,,chief physician of the Surgical Intensive Care Unit,
Dialogue: 0,0:09:09.52,0:09:11.92,Default,,0000,0000,0000,,Initiated the Organ Registry and Sharing Center project,\N
Dialogue: 0,0:09:11.92,0:09:13.14,Default,,0000,0000,0000,,Chief physician of the Trauma Unit.\N
Dialogue: 0,0:09:13.14,0:09:15.74,Default,,0000,0000,0000,,All these were accomplished by my 30s.
Dialogue: 0,0:09:15.74,0:09:17.21,Default,,0000,0000,0000,,During this journey, \N
Dialogue: 0,0:09:17.21,0:09:20.14,Default,,0000,0000,0000,,I believed that medical knowledge was incredibly powerful.
Dialogue: 0,0:09:20.14,0:09:21.68,Default,,0000,0000,0000,,Medical knowledge can cure everything.\N
Dialogue: 0,0:09:21.68,0:09:23.98,Default,,0000,0000,0000,,But in my 40s,\N
Dialogue: 0,0:09:23.98,0:09:25.41,Default,,0000,0000,0000,,there were many unsuccessful cases
Dialogue: 0,0:09:25.41,0:09:27.12,Default,,0000,0000,0000,,with the use of ECMO.\N
Dialogue: 0,0:09:27.12,0:09:28.05,Default,,0000,0000,0000,,Sometimes the families of the patients asked me,\N
Dialogue: 0,0:09:28.05,0:09:29.24,Default,,0000,0000,0000,,“How come the First Lady of Taichung survived,
Dialogue: 0,0:09:29.24,0:09:31.93,Default,,0000,0000,0000,,but my family member didn't make it?”
Dialogue: 0,0:09:31.93,0:09:33.22,Default,,0000,0000,0000,,I don’t know how to answer such questions.
Dialogue: 0,0:09:33.22,0:09:36.50,Default,,0000,0000,0000,,I couldn’t say because he or she was not the First Lady, could I?
Dialogue: 0,0:09:36.50,0:09:37.39,Default,,0000,0000,0000,,Others ask me,\N
Dialogue: 0,0:09:37.39,0:09:39.23,Default,,0000,0000,0000,,“why do his limbs turned black?”\N
Dialogue: 0,0:09:39.23,0:09:40.13,Default,,0000,0000,0000,,If I'd known the answer,
Dialogue: 0,0:09:40.13,0:09:41.05,Default,,0000,0000,0000,,I would have definitely prevented it from happening.
Dialogue: 0,0:09:41.05,0:09:42.35,Default,,0000,0000,0000,,I have to admit that I don't know.
Dialogue: 0,0:09:42.35,0:09:44.44,Default,,0000,0000,0000,,So when I was in my 40s,
Dialogue: 0,0:09:44.44,0:09:46.49,Default,,0000,0000,0000,,I thought that
Dialogue: 0,0:09:46.49,0:09:49.55,Default,,0000,0000,0000,,why couldn't this patient be saved?\N
Dialogue: 0,0:09:49.55,0:09:51.56,Default,,0000,0000,0000,,Finally, when I was reached my 50s,
Dialogue: 0,0:09:51.56,0:09:54.06,Default,,0000,0000,0000,,the concept dawned on me.\N
Dialogue: 0,0:09:54.06,0:09:56.66,Default,,0000,0000,0000,,There's a Chinese poetry that says: "I've searched high and low for her."
Dialogue: 0,0:09:56.66,0:09:57.53,Default,,0000,0000,0000,,"It's only when I turned around,"\N
Dialogue: 0,0:09:57.53,0:09:59.65,Default,,0000,0000,0000,,"The woman I seek is just standing behind me near a lantern."
Dialogue: 0,0:09:59.65,0:10:00.44,Default,,0000,0000,0000,,That day,
Dialogue: 0,0:10:00.44,0:10:01.88,Default,,0000,0000,0000,,it dawned on me that
Dialogue: 0,0:10:01.88,0:10:04.14,Default,,0000,0000,0000,,doctors are people, not God.\N
Dialogue: 0,0:10:04.14,0:10:05.26,Default,,0000,0000,0000,,Doctors can only try our best.
Dialogue: 0,0:10:05.26,0:10:08.06,Default,,0000,0000,0000,,That’s it.
Dialogue: 0,0:10:08.06,0:10:10.28,Default,,0000,0000,0000,,I began to reason this philosophy out.
Dialogue: 0,0:10:10.28,0:10:11.14,Default,,0000,0000,0000,,Let's look at seasons. \N
Dialogue: 0,0:10:11.14,0:10:13.20,Default,,0000,0000,0000,,There's spring, summer, autumn, and winter.
Dialogue: 0,0:10:13.20,0:10:15.45,Default,,0000,0000,0000,,Medicine has its limit.\N
Dialogue: 0,0:10:15.45,0:10:18.01,Default,,0000,0000,0000,,No matter how advanced science is,
Dialogue: 0,0:10:18.01,0:10:19.24,Default,,0000,0000,0000,,with today’s technology,
Dialogue: 0,0:10:19.24,0:10:19.92,Default,,0000,0000,0000,,a person without a heart,
Dialogue: 0,0:10:19.92,0:10:20.50,Default,,0000,0000,0000,,or lungs,
Dialogue: 0,0:10:20.50,0:10:21.53,Default,,0000,0000,0000,,or liver,
Dialogue: 0,0:10:21.53,0:10:21.89,Default,,0000,0000,0000,,or kidney,
Dialogue: 0,0:10:21.89,0:10:23.17,Default,,0000,0000,0000,,can still live.
Dialogue: 0,0:10:23.17,0:10:26.16,Default,,0000,0000,0000,,But can we replace our organs with devices or gadgets\N
Dialogue: 0,0:10:26.16,0:10:27.98,Default,,0000,0000,0000,,forever?
Dialogue: 0,0:10:27.98,0:10:30.49,Default,,0000,0000,0000,,Medicine still has its limits.
Dialogue: 0,0:10:30.49,0:10:32.70,Default,,0000,0000,0000,,So I came to a conclusion.
Dialogue: 0,0:10:32.70,0:10:35.60,Default,,0000,0000,0000,,Can gardeners change the seasons?
Dialogue: 0,0:10:35.60,0:10:37.17,Default,,0000,0000,0000,,Of course not.\N
Dialogue: 0,0:10:37.17,0:10:39.07,Default,,0000,0000,0000,,Gardeners can only make flowers
Dialogue: 0,0:10:39.07,0:10:42.22,Default,,0000,0000,0000,,grow prettier in the four seasons.
Dialogue: 0,0:10:42.22,0:10:43.49,Default,,0000,0000,0000,,As a doctor,
Dialogue: 0,0:10:43.49,0:10:45.81,Default,,0000,0000,0000,,am I capable of changing nature's rules to birth, aging, sickness or death?
Dialogue: 0,0:10:45.81,0:10:46.73,Default,,0000,0000,0000,,Well,\N
Dialogue: 0,0:10:46.73,0:10:47.99,Default,,0000,0000,0000,,it's very difficult.
Dialogue: 0,0:10:47.99,0:10:49.46,Default,,0000,0000,0000,,As a doctor,\N
Dialogue: 0,0:10:49.46,0:10:52.36,Default,,0000,0000,0000,,all we can do is to enable people
Dialogue: 0,0:10:52.36,0:10:53.69,Default,,0000,0000,0000,,to go through life a little easier when they’re alive.
Dialogue: 0,0:10:53.69,0:10:54.56,Default,,0000,0000,0000,,That’s all.
Dialogue: 0,0:10:54.56,0:10:55.36,Default,,0000,0000,0000,,So gradually,\N
Dialogue: 0,0:10:55.36,0:10:57.11,Default,,0000,0000,0000,,I came to realize that
Dialogue: 0,0:10:57.11,0:11:01.23,Default,,0000,0000,0000,,doctors are just the gardeners in the life's garden.
Dialogue: 0,0:11:01.23,0:11:05.38,Default,,0000,0000,0000,,As a gardener,
Dialogue: 0,0:11:05.38,0:11:07.31,Default,,0000,0000,0000,,when faced with the withered plants,\N
Dialogue: 0,0:11:07.31,0:11:09.07,Default,,0000,0000,0000,,how to treat them is a great question.\N
Dialogue: 0,0:11:09.07,0:11:11.56,Default,,0000,0000,0000,,As an expert in critical care,
Dialogue: 0,0:11:11.56,0:11:14.93,Default,,0000,0000,0000,,how do I face death?
Dialogue: 0,0:11:14.93,0:11:16.88,Default,,0000,0000,0000,,From a scientific aspect,
Dialogue: 0,0:11:16.88,0:11:19.29,Default,,0000,0000,0000,,or more precisely, from molecular science,
Dialogue: 0,0:11:19.29,0:11:20.62,Default,,0000,0000,0000,,a system undergoing physical reaction
Dialogue: 0,0:11:20.62,0:11:21.55,Default,,0000,0000,0000,,on a molecular level\N
Dialogue: 0,0:11:21.55,0:11:22.40,Default,,0000,0000,0000,,will tend to minimize energy
Dialogue: 0,0:11:22.40,0:11:23.42,Default,,0000,0000,0000,,and maximize entropy.
Dialogue: 0,0:11:23.42,0:11:26.61,Default,,0000,0000,0000,,So delta S (entropy) should be greater or equal to zero.\N
Dialogue: 0,0:11:26.61,0:11:29.52,Default,,0000,0000,0000,,Some may ask how delta s is greater than zero.
Dialogue: 0,0:11:29.52,0:11:31.32,Default,,0000,0000,0000,,Some believe it's from the Big Bang theory,
Dialogue: 0,0:11:31.32,0:11:33.75,Default,,0000,0000,0000,,as it describes the state of ever-expanding universe.
Dialogue: 0,0:11:33.75,0:11:35.83,Default,,0000,0000,0000,,So that's how delta S is greater than zero.
Dialogue: 0,0:11:35.83,0:11:36.70,Default,,0000,0000,0000,,Or you may ask,
Dialogue: 0,0:11:36.70,0:11:38.78,Default,,0000,0000,0000,,is anything constant in the laws of this universe?
Dialogue: 0,0:11:38.78,0:11:39.35,Default,,0000,0000,0000,,Honestly,
Dialogue: 0,0:11:39.35,0:11:40.24,Default,,0000,0000,0000,,I don’t have an answer to this.
Dialogue: 0,0:11:40.24,0:11:41.72,Default,,0000,0000,0000,,There’s an old saying\N
Dialogue: 0,0:11:41.72,0:11:46.17,Default,,0000,0000,0000,,"A blind man is no judge of colors."
Dialogue: 0,0:11:46.17,0:11:47.33,Default,,0000,0000,0000,,Visually impared folks
Dialogue: 0,0:11:47.33,0:11:48.64,Default,,0000,0000,0000,,can’t distinguish colors
Dialogue: 0,0:11:48.64,0:11:50.44,Default,,0000,0000,0000,,so it's pointless to ask them to judge.
Dialogue: 0,0:11:50.44,0:11:52.26,Default,,0000,0000,0000,,Does constant apply
Dialogue: 0,0:11:52.26,0:11:53.45,Default,,0000,0000,0000,,to the laws in this universe?
Dialogue: 0,0:11:53.45,0:11:55.30,Default,,0000,0000,0000,,Does eternity exist\N
Dialogue: 0,0:11:55.30,0:11:55.99,Default,,0000,0000,0000,,in space and time?
Dialogue: 0,0:11:55.99,0:11:56.48,Default,,0000,0000,0000,,Frankly,
Dialogue: 0,0:11:56.48,0:11:57.54,Default,,0000,0000,0000,,I don’t know these answers.
Dialogue: 0,0:11:57.54,0:11:58.56,Default,,0000,0000,0000,,But at least,
Dialogue: 0,0:11:58.56,0:12:00.60,Default,,0000,0000,0000,,within the realm of our discussion\N
Dialogue: 0,0:12:00.60,0:12:02.62,Default,,0000,0000,0000,,delta S is still positive.\N
Dialogue: 0,0:12:02.62,0:12:04.49,Default,,0000,0000,0000,,\NWhat does it mean when we say delta S is positive?\N
Dialogue: 0,0:12:04.49,0:12:05.30,Default,,0000,0000,0000,,In theory,
Dialogue: 0,0:12:05.30,0:12:07.16,Default,,0000,0000,0000,,objects tends to be in minimum energy and maximum entropy,
Dialogue: 0,0:12:07.16,0:12:08.18,Default,,0000,0000,0000,,creating greater disorder.\N
Dialogue: 0,0:12:08.18,0:12:10.14,Default,,0000,0000,0000,,My existence
Dialogue: 0,0:12:10.14,0:12:11.36,Default,,0000,0000,0000,,would mean a delta S less than zero,
Dialogue: 0,0:12:11.36,0:12:14.96,Default,,0000,0000,0000,,which defies molecular science.\N
Dialogue: 0,0:12:14.96,0:12:17.20,Default,,0000,0000,0000,,Then how should we view life and death?\N
Dialogue: 0,0:12:17.20,0:12:18.61,Default,,0000,0000,0000,,Actually,\N
Dialogue: 0,0:12:18.61,0:12:20.68,Default,,0000,0000,0000,,\Nwe often see ourselves only.\N
Dialogue: 0,0:12:20.68,0:12:22.60,Default,,0000,0000,0000,,\NWe don’t realize that we are in the universe.
Dialogue: 0,0:12:22.60,0:12:24.92,Default,,0000,0000,0000,,The universe is the combination of us and the environment.
Dialogue: 0,0:12:24.92,0:12:26.35,Default,,0000,0000,0000,,So total delta S\N
Dialogue: 0,0:12:26.35,0:12:29.45,Default,,0000,0000,0000,,equals to delta S system and delta S surrounding.\N
Dialogue: 0,0:12:29.45,0:12:30.44,Default,,0000,0000,0000,,So
Dialogue: 0,0:12:30.44,0:12:32.63,Default,,0000,0000,0000,,this is an important concept.
Dialogue: 0,0:12:32.63,0:12:35.20,Default,,0000,0000,0000,,Any organized group\N
Dialogue: 0,0:12:35.20,0:12:37.24,Default,,0000,0000,0000,,is always in an unstable state.\N
Dialogue: 0,0:12:37.24,0:12:39.43,Default,,0000,0000,0000,,The group disrupts its surrounding.\N
Dialogue: 0,0:12:39.43,0:12:41.18,Default,,0000,0000,0000,,So even if delta S for the group is negative,
Dialogue: 0,0:12:41.18,0:12:43.28,Default,,0000,0000,0000,,because the group disrupts its surrounding,\N
Dialogue: 0,0:12:43.28,0:12:44.56,Default,,0000,0000,0000,,delta S total is greater than zero
Dialogue: 0,0:12:44.56,0:12:46.36,Default,,0000,0000,0000,,to make the equation positive.
Dialogue: 0,0:12:46.36,0:12:47.19,Default,,0000,0000,0000,,So my existence
Dialogue: 0,0:12:47.19,0:12:49.33,Default,,0000,0000,0000,,is to disrupt my surroundings
Dialogue: 0,0:12:49.33,0:12:50.30,Default,,0000,0000,0000,,until one day\N
Dialogue: 0,0:12:50.30,0:12:52.06,Default,,0000,0000,0000,,when I can no longer do so,
Dialogue: 0,0:12:52.06,0:12:53.66,Default,,0000,0000,0000,,that's when I disrupt myself\N
Dialogue: 0,0:12:53.66,0:12:56.40,Default,,0000,0000,0000,,so Delta S total can remain positive.
Dialogue: 0,0:12:56.40,0:12:58.21,Default,,0000,0000,0000,,In essence, our existence is to disrupt.
Dialogue: 0,0:12:58.21,0:12:59.27,Default,,0000,0000,0000,,When you’re unable to disrupt the surrounding,\N
Dialogue: 0,0:12:59.27,0:13:00.31,Default,,0000,0000,0000,,you end up disrupting yourself.
Dialogue: 0,0:13:00.31,0:13:01.64,Default,,0000,0000,0000,,That is the meaning of death.\N
Dialogue: 0,0:13:01.64,0:13:04.92,Default,,0000,0000,0000,,It's death from a molecular science aspect.\N
Dialogue: 0,0:13:04.92,0:13:07.54,Default,,0000,0000,0000,,However,\N
Dialogue: 0,0:13:07.54,0:13:08.80,Default,,0000,0000,0000,,as a doctor,
Dialogue: 0,0:13:08.80,0:13:10.88,Default,,0000,0000,0000,,I understand molecular science.
Dialogue: 0,0:13:10.88,0:13:13.16,Default,,0000,0000,0000,,But what about the meaning of life?
Dialogue: 0,0:13:13.16,0:13:14.76,Default,,0000,0000,0000,,One day, when I was in ICU
Dialogue: 0,0:13:14.76,0:13:15.62,Default,,0000,0000,0000,,making my rounds\N
Dialogue: 0,0:13:15.62,0:13:16.91,Default,,0000,0000,0000,,I came to realize
Dialogue: 0,0:13:16.91,0:13:18.62,Default,,0000,0000,0000,,that humans only have two types of ending.\N
Dialogue: 0,0:13:18.62,0:13:19.29,Default,,0000,0000,0000,,One is with inserted tubes.\N
Dialogue: 0,0:13:19.29,0:13:21.53,Default,,0000,0000,0000,,The other is without.
Dialogue: 0,0:13:21.53,0:13:24.34,Default,,0000,0000,0000,,Both represent death.\N
Dialogue: 0,0:13:24.34,0:13:26.86,Default,,0000,0000,0000,,Death is every person's final journey.
Dialogue: 0,0:13:26.86,0:13:27.80,Default,,0000,0000,0000,,So\N
Dialogue: 0,0:13:27.80,0:13:30.78,Default,,0000,0000,0000,,what does death mean to us?\N
Dialogue: 0,0:13:30.78,0:13:33.69,Default,,0000,0000,0000,,I'd like to share a contrasting viewpoint on this.
Dialogue: 0,0:13:33.69,0:13:35.84,Default,,0000,0000,0000,,If you ask me what death is,
Dialogue: 0,0:13:35.84,0:13:37.49,Default,,0000,0000,0000,,I will ask you:
Dialogue: 0,0:13:37.49,0:13:40.50,Default,,0000,0000,0000,,what does it mean to be alive?
Dialogue: 0,0:13:40.50,0:13:41.45,Default,,0000,0000,0000,,Everyone here in this audience
Dialogue: 0,0:13:41.45,0:13:43.15,Default,,0000,0000,0000,,came to hear a lecture.\N
Dialogue: 0,0:13:43.15,0:13:45.16,Default,,0000,0000,0000,,I hope you can do one thing when you leave.
Dialogue: 0,0:13:45.16,0:13:46.57,Default,,0000,0000,0000,,Before falling asleep tonight,
Dialogue: 0,0:13:46.57,0:13:47.43,Default,,0000,0000,0000,,when you’re lying on your bed,
Dialogue: 0,0:13:47.43,0:13:49.02,Default,,0000,0000,0000,,ask yourself this question:
Dialogue: 0,0:13:49.02,0:13:58.42,Default,,0000,0000,0000,,"What does it mean to be alive?"\N
Dialogue: 0,0:13:58.42,0:13:59.21,Default,,0000,0000,0000,,Because\N
Dialogue: 0,0:13:59.21,0:14:00.62,Default,,0000,0000,0000,,this question\N
Dialogue: 0,0:14:00.62,0:14:02.55,Default,,0000,0000,0000,,leads us to contemplate \N
Dialogue: 0,0:14:02.55,0:14:03.83,Default,,0000,0000,0000,,on the meaning of life.\N
Dialogue: 0,0:14:03.83,0:14:05.91,Default,,0000,0000,0000,,My answer to the question is this:
Dialogue: 0,0:14:05.91,0:14:07.17,Default,,0000,0000,0000,,"When you’re searching for the answer to the question,
Dialogue: 0,0:14:07.17,0:14:10.51,Default,,0000,0000,0000,,it is the answer to the question."
Dialogue: 0,0:14:10.51,0:14:12.33,Default,,0000,0000,0000,,Everyone dies eventually.\N
Dialogue: 0,0:14:12.33,0:14:14.20,Default,,0000,0000,0000,,No one will set death\N
Dialogue: 0,0:14:14.20,0:14:15.40,Default,,0000,0000,0000,,as his or her goal in life.
Dialogue: 0,0:14:15.40,0:14:17.30,Default,,0000,0000,0000,,Therefore, life is just a process.
Dialogue: 0,0:14:17.30,0:14:20.08,Default,,0000,0000,0000,,In this process \N
Dialogue: 0,0:14:20.08,0:14:21.37,Default,,0000,0000,0000,,during one's entire lifespan\N
Dialogue: 0,0:14:21.37,0:14:23.53,Default,,0000,0000,0000,,we keep searching for the answer
Dialogue: 0,0:14:23.53,0:14:25.13,Default,,0000,0000,0000,,to the meaning of existence.
Dialogue: 0,0:14:25.13,0:14:27.40,Default,,0000,0000,0000,,So when you’re searching for the answer to existence
Dialogue: 0,0:14:27.40,0:14:29.04,Default,,0000,0000,0000,,that is the very answer to the question.\N
Dialogue: 0,0:14:29.04,0:14:31.25,Default,,0000,0000,0000,,Death is not the goal of life.\N
Dialogue: 0,0:14:31.25,0:14:33.49,Default,,0000,0000,0000,,Life is just a process.
Dialogue: 0,0:14:33.49,0:14:37.56,Default,,0000,0000,0000,,Recently, I've been sharing the story of feces.
Dialogue: 0,0:14:37.56,0:14:39.11,Default,,0000,0000,0000,,At one time, my advisor was going to retire.
Dialogue: 0,0:14:39.11,0:14:39.67,Default,,0000,0000,0000,,So he said,
Dialogue: 0,0:14:39.67,0:14:40.56,Default,,0000,0000,0000,,"I am going to retire,
Dialogue: 0,0:14:40.56,0:14:41.38,Default,,0000,0000,0000,,treat me to somewhere fancy."
Dialogue: 0,0:14:41.38,0:14:42.48,Default,,0000,0000,0000,,I said, "Of course."
Dialogue: 0,0:14:42.48,0:14:44.39,Default,,0000,0000,0000,,So my advisor, another schoolmate, and I
Dialogue: 0,0:14:44.39,0:14:46.50,Default,,0000,0000,0000,,went to the 2nd floor of the Sheraton Hotel
Dialogue: 0,0:14:46.50,0:14:48.96,Default,,0000,0000,0000,,to celebrate in a French restaurant.
Dialogue: 0,0:14:48.96,0:14:51.65,Default,,0000,0000,0000,,The three of us spent TWD$ 26,000.
Dialogue: 0,0:14:51.65,0:14:54.40,Default,,0000,0000,0000,,I was astonished when I got the bill.\N
Dialogue: 0,0:14:54.40,0:14:56.01,Default,,0000,0000,0000,,How could I eat something so expensive?\N
Dialogue: 0,0:14:56.01,0:14:57.91,Default,,0000,0000,0000,,I’d never been to that kind of restaurant before,
Dialogue: 0,0:14:57.91,0:14:58.60,Default,,0000,0000,0000,,so we ordered
Dialogue: 0,0:14:58.60,0:14:59.99,Default,,0000,0000,0000,,some random and unknown dishes.
Dialogue: 0,0:14:59.99,0:15:01.37,Default,,0000,0000,0000,,When I saw the bill,
Dialogue: 0,0:15:01.37,0:15:03.17,Default,,0000,0000,0000,,TWD$ 26,000, I was too shocked to speak.
Dialogue: 0,0:15:03.17,0:15:04.93,Default,,0000,0000,0000,,The next morning, in the toilet,\N
Dialogue: 0,0:15:04.93,0:15:09.08,Default,,0000,0000,0000,,I examined my feces carefully.
Dialogue: 0,0:15:09.08,0:15:10.61,Default,,0000,0000,0000,,I thought in my mind,\N
Dialogue: 0,0:15:10.61,0:15:15.39,Default,,0000,0000,0000,,"I’d spent TWD$ 9,000 dollars producing this."
Dialogue: 0,0:15:15.39,0:15:15.91,Default,,0000,0000,0000,,After careful examination, I concluded that\N
Dialogue: 0,0:15:15.91,0:15:18.39,Default,,0000,0000,0000,,this "poo" looks no different from the feces I produced after dining in the NTU hospital cafeteria.
Dialogue: 0,0:15:18.39,0:15:19.80,Default,,0000,0000,0000,,The buffet there costs TWD$ 70 only.
Dialogue: 0,0:15:19.80,0:15:23.55,Default,,0000,0000,0000,,I couldn't tell the difference.
Dialogue: 0,0:15:23.55,0:15:26.66,Default,,0000,0000,0000,,On the toilet, I came to realize that
Dialogue: 0,0:15:26.66,0:15:28.61,Default,,0000,0000,0000,,all the wealth one desires
Dialogue: 0,0:15:28.61,0:15:35.67,Default,,0000,0000,0000,,turns out to be crap.
Dialogue: 0,0:15:40.07,0:15:43.06,Default,,0000,0000,0000,,Confucianism is the most important philosophical system in the Chinese culture.
Dialogue: 0,0:15:43.08,0:15:45.61,Default,,0000,0000,0000,,The advantages of Confucianism are that
Dialogue: 0,0:15:45.61,0:15:48.05,Default,,0000,0000,0000,,its philosophy is about human virtues.\N
Dialogue: 0,0:15:48.05,0:15:50.25,Default,,0000,0000,0000,,Let's look at a few passages
Dialogue: 0,0:15:50.25,0:15:51.10,Default,,0000,0000,0000,,in the Analects of Confucius.
Dialogue: 0,0:15:51.10,0:15:52.46,Default,,0000,0000,0000,,"“If you don't understand what life is, how will you understand death?"
Dialogue: 0,0:15:52.46,0:15:53.06,Default,,0000,0000,0000,,"If you can't yet serve men,"
Dialogue: 0,0:15:53.06,0:15:54.47,Default,,0000,0000,0000,,"how can you serve the spirits?”
Dialogue: 0,0:15:54.47,0:15:55.22,Default,,0000,0000,0000,,“When your parents are alive,"
Dialogue: 0,0:15:55.22,0:15:55.62,Default,,0000,0000,0000,,"serve them with propriety;"
Dialogue: 0,0:15:55.62,0:15:56.02,Default,,0000,0000,0000,,"when they die,"
Dialogue: 0,0:15:56.02,0:15:56.92,Default,,0000,0000,0000,,"bury them with propriety,"
Dialogue: 0,0:15:56.92,0:15:58.32,Default,,0000,0000,0000,,"and then worship them with propriety."
Dialogue: 0,0:15:58.32,0:15:59.98,Default,,0000,0000,0000,,\NConfucianism refused to talk about life and death.\N
Dialogue: 0,0:15:59.98,0:16:00.96,Default,,0000,0000,0000,,Instead, Confucius gave answers to
Dialogue: 0,0:16:00.96,0:16:02.62,Default,,0000,0000,0000,,sacrificing life for justice
Dialogue: 0,0:16:02.62,0:16:04.29,Default,,0000,0000,0000,,and how man holds no regret
Dialogue: 0,0:16:04.29,0:16:06.65,Default,,0000,0000,0000,,once he understands "the way".
Dialogue: 0,0:16:06.65,0:16:09.51,Default,,0000,0000,0000,,To a follower of Confucianism, the question of life and death
Dialogue: 0,0:16:09.51,0:16:11.07,Default,,0000,0000,0000,,is a topic to be avoided.
Dialogue: 0,0:16:11.07,0:16:12.28,Default,,0000,0000,0000,,He offered no direct answers.
Dialogue: 0,0:16:12.28,0:16:14.44,Default,,0000,0000,0000,,So...
Dialogue: 0,0:16:14.44,0:16:15.29,Default,,0000,0000,0000,,on the positive side,
Dialogue: 0,0:16:15.29,0:16:15.99,Default,,0000,0000,0000,,he focuses on the time when he is alive.
Dialogue: 0,0:16:15.99,0:16:17.81,Default,,0000,0000,0000,,Just avoid these big questions
Dialogue: 0,0:16:17.81,0:16:19.56,Default,,0000,0000,0000,,and focus on the things you have at hand.
Dialogue: 0,0:16:19.56,0:16:20.55,Default,,0000,0000,0000,,But there is one problem.
Dialogue: 0,0:16:20.55,0:16:23.68,Default,,0000,0000,0000,,He totally sidesteps the question of life and death.
Dialogue: 0,0:16:23.68,0:16:26.10,Default,,0000,0000,0000,,The following is what I think.
Dialogue: 0,0:16:26.10,0:16:27.75,Default,,0000,0000,0000,,In Chinese culture,\N
Dialogue: 0,0:16:27.75,0:16:29.72,Default,,0000,0000,0000,,Confucianism is the most crucial philosophy.
Dialogue: 0,0:16:29.72,0:16:31.51,Default,,0000,0000,0000,,Back then, our forefathers didn't want to discuss life and death.
Dialogue: 0,0:16:31.51,0:16:33.37,Default,,0000,0000,0000,,They tried to avoid the question.
Dialogue: 0,0:16:33.37,0:16:36.35,Default,,0000,0000,0000,,There’s a saying from Sun Tzu's Art of War:
Dialogue: 0,0:16:36.35,0:16:38.20,Default,,0000,0000,0000,,"Force soldiers to see the face of death; they will fight to stay alive."
Dialogue: 0,0:16:38.20,0:16:40.22,Default,,0000,0000,0000,,Only when we can face death
Dialogue: 0,0:16:40.22,0:16:42.74,Default,,0000,0000,0000,,or even face death straight up
Dialogue: 0,0:16:42.74,0:16:45.72,Default,,0000,0000,0000,,can we begin to reflect on
Dialogue: 0,0:16:45.72,0:16:47.23,Default,,0000,0000,0000,,what life is.
Dialogue: 0,0:16:47.23,0:16:49.55,Default,,0000,0000,0000,,We will all die one day.
Dialogue: 0,0:16:49.55,0:16:51.76,Default,,0000,0000,0000,,Life is just a process,
Dialogue: 0,0:16:51.76,0:16:55.43,Default,,0000,0000,0000,,a process of searching for the meaning of existence.
Dialogue: 0,0:16:55.43,0:16:57.35,Default,,0000,0000,0000,,That's just my humble opinion.
Dialogue: 0,0:16:57.35,0:16:58.84,Default,,0000,0000,0000,,I think I can be considered an astute person.
Dialogue: 0,0:16:58.84,0:17:00.57,Default,,0000,0000,0000,,My stamina is good, too.
Dialogue: 0,0:17:00.57,0:17:03.36,Default,,0000,0000,0000,,I've biked around the entire Taiwan island on my first biking tour.
Dialogue: 0,0:17:03.36,0:17:05.46,Default,,0000,0000,0000,,Just because I'm asute
Dialogue: 0,0:17:05.46,0:17:07.23,Default,,0000,0000,0000,,and also in good physical shape,
Dialogue: 0,0:17:07.23,0:17:09.22,Default,,0000,0000,0000,,can I use these blessings
Dialogue: 0,0:17:09.22,0:17:10.15,Default,,0000,0000,0000,,to bully \N
Dialogue: 0,0:17:10.15,0:17:11.32,Default,,0000,0000,0000,,or to take advantage of others?
Dialogue: 0,0:17:11.32,0:17:12.13,Default,,0000,0000,0000,,Definitely not.
Dialogue: 0,0:17:12.13,0:17:12.82,Default,,0000,0000,0000,,So
Dialogue: 0,0:17:12.82,0:17:14.87,Default,,0000,0000,0000,,those who are blessed
Dialogue: 0,0:17:14.87,0:17:16.53,Default,,0000,0000,0000,,should be grateful.\N
Dialogue: 0,0:17:16.53,0:17:18.48,Default,,0000,0000,0000,,If we are very capable,
Dialogue: 0,0:17:18.48,0:17:20.09,Default,,0000,0000,0000,,shouldn't we actively help others
Dialogue: 0,0:17:20.09,0:17:22.72,Default,,0000,0000,0000,,and make our lives more meaningful?
Dialogue: 0,0:17:22.72,0:17:23.86,Default,,0000,0000,0000,,Life is about "knowing gratitude" and "repaying gratitude."
Dialogue: 0,0:17:23.86,0:17:25.83,Default,,0000,0000,0000,,When I visited Dharma Drum Mountain Monastery,
Dialogue: 0,0:17:25.83,0:17:27.72,Default,,0000,0000,0000,,the abbot there, Veneralble Guo-Dong, shared with me
Dialogue: 0,0:17:27.72,0:17:28.71,Default,,0000,0000,0000,,the idea of "knowing and repaying gratitude,"
Dialogue: 0,0:17:28.71,0:17:29.57,Default,,0000,0000,0000,,as well as "being grateful, not resentful."
Dialogue: 0,0:17:29.57,0:17:31.24,Default,,0000,0000,0000,,He said,
Dialogue: 0,0:17:31.24,0:17:32.53,Default,,0000,0000,0000,,“I know you've been wronged,”
Dialogue: 0,0:17:32.53,0:17:34.50,Default,,0000,0000,0000,,“but you can’t complain."
Dialogue: 0,0:17:34.50,0:17:38.67,Default,,0000,0000,0000,,"Instead, you should make greater vows to help others in need.”
Dialogue: 0,0:17:38.67,0:17:40.66,Default,,0000,0000,0000,,Lastly, let me share a concept
Dialogue: 0,0:17:40.66,0:17:42.43,Default,,0000,0000,0000,,called “a to the power of n.”\N
Dialogue: 0,0:17:42.43,0:17:44.08,Default,,0000,0000,0000,,If "a" is greater than 1,
Dialogue: 0,0:17:44.08,0:17:45.44,Default,,0000,0000,0000,,"a" to the power of "n" is infinity.
Dialogue: 0,0:17:45.44,0:17:46.68,Default,,0000,0000,0000,,If "a" is less than 1,
Dialogue: 0,0:17:46.68,0:17:48.28,Default,,0000,0000,0000,,"a" to the power of "n" will approach zero rapidly.
Dialogue: 0,0:17:48.28,0:17:49.76,Default,,0000,0000,0000,,What does that mean?
Dialogue: 0,0:17:49.76,0:17:52.54,Default,,0000,0000,0000,,If what I give to the society
Dialogue: 0,0:17:52.54,0:17:54.06,Default,,0000,0000,0000,,is greater than what I take from the society,
Dialogue: 0,0:17:54.06,0:17:55.28,Default,,0000,0000,0000,,my "a" is greater than one.
Dialogue: 0,0:17:55.28,0:17:57.26,Default,,0000,0000,0000,,This society will become better and better accordingly.
Dialogue: 0,0:17:57.26,0:17:58.80,Default,,0000,0000,0000,,If what I take from the society
Dialogue: 0,0:17:58.80,0:18:00.49,Default,,0000,0000,0000,,is greater than what I give to the society,\N
Dialogue: 0,0:18:00.49,0:18:01.64,Default,,0000,0000,0000,,my "a" will be less than 1.
Dialogue: 0,0:18:01.64,0:18:03.43,Default,,0000,0000,0000,,Consequently, this society will increasingly collapse.
Dialogue: 0,0:18:03.43,0:18:05.42,Default,,0000,0000,0000,,I will end my speech
Dialogue: 0,0:18:05.42,0:18:07.30,Default,,0000,0000,0000,,with these words.
Dialogue: 0,0:18:07.30,0:18:09.42,Default,,0000,0000,0000,,"Facing hardships is not the most difficult thing."
Dialogue: 0,0:18:09.42,0:18:11.17,Default,,0000,0000,0000,,"The most difficult thing is..."
Dialogue: 0,0:18:11.17,0:18:12.78,Default,,0000,0000,0000,,"to facing the hardships"
Dialogue: 0,0:18:12.78,0:18:14.24,Default,,0000,0000,0000,,"without loosing your passion for mankind."
Dialogue: 0,0:18:14.24,0:18:16.18,Default,,0000,0000,0000,,Thank you, everyone!