治癒AIDS 的方法和成功例子—“The Berlin Patient.”

治癒AIDS 的方法和成功例子—“The Berlin Patient.”

作者: 法德

汀滿希1995年當在柏林讀書時, 就被診斷出得了愛滋病. 所有的人都認為他大概只有幾年可活. 但他活過大家的預估而且愛滋病也被治癒.1996 年之後, 因為對抗HIV 病毒的研究及雞尾酒治療法 (何大一博士的貢獻), 所以很多愛滋病患得以存活. 汀滿希也是其中之一 , 汀滿希以為他會在每天吃一堆抗HIV 病毒藥物的輪迴中苟延殘喘過一生. 直到11 年後(2006年) 他被診斷出急性白血病, 化療未完, 他得了肺炎並暴發敗血症, 差點死亡, 但他竟然存活下來.

他的主治–優特醫師提出一個治療建議:接受特殊人種的骨髓移植.

我在此粗淺解釋: 因為愛滋病毒會攻擊侵犯CD4 T 細胞( 白血球的一種), 利用此種細胞來繁殖後代, 所以 損害病人免疫能力. 病毒會去找CD4 T 細胞上的接受器CD4 Receptor +Co receptor (CCR5 receptor) 然後通過此門路登堂入室. 但有些人有些人不會得 AIDS 因為他們擁有兩條( 一對) 突變CCR5基因( 叫CCR5-delta32), 因為這種不正常突變, 導致於在細部外膜找不到CCR5 這個蛋白質來幫助HIV 進入CD4 T cell 中. 擁有 一對突變CCR5-delta32基因的人非常稀少, 只有1% 的白人 , 但有20%的白人擁有一條CCR5-delta32基因, 這種只有半套保全系統的人, 得了愛滋病 症狀較輕微 容易控制.

所以優特醫師建議是: 移植基因突變沒有CCR5 receptor 的捐贈者 (非常稀少, 在北歐只有1% 的人) 的幹細胞進入汀滿希體內, 來一舉雙得, 既治療白血病; 又可能可以治療愛滋病.  結果他們成功了,  汀滿希現在不需要服用任何對抗HIV 病毒的藥物, 活得有滋有味. 血液中無法檢驗出任何愛滋病毒.

問題是 :

這種有CCR5 delta32 gene的人太少了, 無法滿足廣大愛滋病患的需求. 況且幹細胞移植有很大風險, 有沒有可行的代替方案?

答案是:

有! 有家藥廠發明改寫病人CCR5 co-receptor 基因的方法, 讓它們基因突變, 讓HIV 病毒無後代 來治療愛滋病,

Sangamo BioSciences 的ZFN‐based technology SB-728 通過控制zinc finger DNA-binding proteins (ZFPs)來控制愛滋病 ,甚至治癒愛滋病( 理想狀況).

Sangamo BioSciences 擁有很多ZFN‐based technology 模型專利. 其中的一個SB-728 就是破壞CCR5 基因, 讓它無法幫助 CD4 接受器, 進而使HIV 病毒 找不到入口, 好侵犯CD4 T cell.

現在進行臨床實驗第2 階段.

附註-

1. ZFPs 是很小的蛋白質結構, 可以去找它們看上的一段基因, 然後改寫病人的未來生病日誌, 進而根本治療疾病.

2. 擁有 一對突變CCR5-delta32基因的人, 也有死於愛滋病的記錄 咦, 為什麼?

因為他們認為他們是天之驕子, 決不會被愛滋病傳染, 只要我喜歡隨便找性伴侶. 理論上是這樣, 因為他們沒有門可以給HIV 進入CD4 T cell. 但他們忘了, 這有生命的世界有開小門的習慣. HIV 也會突變. 因為很多控制愛滋病的藥物是阻礙病毒去跟CCR5見面. 久了新品種的病毒就不需要CCR5, 而是轉為依賴CXCR4 co-receptor進入CD4 T cell. 所以賓果, 通常變種的病毒, 發病猛烈, 所以病人很快就預約好跟閻羅王喝咖啡.

3. 只有白種人有突變CCR5-delta32基因的遺傳 ( 可能跟歷史上歐洲 黑死病或天花疫情有關)東方人, 黑人都沒有這種突變基因 所以要更小心.

References:

1. http://www.sangamo.com/technology/index.html

2. https://www.23andme.com/health/Resistance-to-HIV-AIDS/

3. Jeffr y D . Sander. Iowa State. UniversityCharacterization and design of C2H2 zinc finger proteins as custom DNA binding domains

4. “The Berlin Patient.” http://timothyrbrown.com/

偷偷地告訴各位,我為什麼會注意Sangamo. 當然主因是因為我對臨床實驗的工作有興趣, 但我也買它們的股票.

向教育偉人–日常法師致敬

作者: Inder Peng

想成為一粒小小, 屈成一點的細沙, 是我長久的希望. 不是那種一望無際在海灘上的沙子; 更不是那種不小心會被吹入人們眼瞼中的風飛沙. 是停在一個特別的地方, 在衣服上, 在觀音菩薩衣角的任何地點. 從此我可以不再畏懼疾風厲雨, 從此我無憂無慮. 我只是顆量極輕微的細沙, 安靜本份, 應該不會為觀音菩薩帶來任何困擾. 菩薩自行菩薩道, 我隨喜讚嘆, 過我自在被保護的細沙歲月.

 直到遇見日常法師, 我的春秋細沙美夢, 被日常法師跟他推銷的菩薩道次第廣論給打亂了.我怎麼從來沒想過: 世上眾生多過恆河沙, 有多少人跟我一樣, 要得不多, 只是細沙沾在菩薩衣衫上.  細如微沙, 微不足道, 但積沙成塔 , 聚沙成山. 要觀音菩薩如何邁步向前? 因為菩薩道次第廣論, 微乎其微細沙宏觀的我, 願意如此思量: 為什麼我不是觀音菩薩體內的一粒細胞? 做不來, 那就甚至更小. 是一個蛋白質? 是一段氨基酸的一分子? 無能搬運氧氣,養份; 那在腸內搬移廢棄物也比細沙有貢獻吧?

長久以來 我對自己的評語是: “ 雖不是大善人, 但心腸很好, 決不敢作奸犯科害人”

早就知道人間有地獄. 在兵荒馬亂, 顛沛流離的國度裡, 人命如薄紙, 輕輕一撕, 血肉橫飛, 肝膽俱裂. 但我不知, 有座地獄所派遣使者與我同床共寢, 同桌而食, 就存在我的俯仰之中. 直到, 直到遇見日常法師, 讀了菩薩道次第廣論的幾年後, 我偶然會在轉角處 ,在寂靜無聲時, 與使者不期而遇. 我跟使者同時有被雷電鞭撻的驚駭, 對使者而言: 我怎麼知道他的存在? 對我而言:真不敢相信我竟然這麼邪惡. 為了一點小利小錢, 會產生 “ 一掌擊死那人” 的念頭. 會有違背倫常傷天害理的思緒. 怎會在睡夢中, 沉沉浮浮,顛顛覆覆隨著無法駕馭的思維奔馳千萬里呢?

如果, 如果, 因為遇見日常法師, 而思量,思量. 有勇氣想成為觀音菩薩體內一個微如細沙小分子的我, 最後斂羽而歸. 我會再成為菩薩衣袖上的細沙. 但不同的是: 因為日常法師 “我是常敗將軍” 的教誨, 當細沙, 我, 養息足夠 . 一轉身. 細沙會再化成體內活潑有貢獻的小分子.

假設, 假設, 因為遇見日常法師 , 我的目光能穿越時空,  逼視那地獄之城. 看透那純淨白雪覆蓋下的城堡中, 隱藏著汙泥 ,臭水, 噁心蠕動的老鼠爬蟲,  我還會沾沾自喜的恭維自己“ 雖不是大善人,  但心腸很好” 嗎? 我會心甘情願跟那地獄使者, 手拉手高高興興唱合唱曲, 共生下去嗎? 至少我會反抗吧.

燦燦笑容

下午一點過後, 餐館裡比較少客人. 所以我沒預期會遇見他們, 先遇見他太太帶著9 歲活潑快捷的寶貝. 很難想像幾個月前寶貝的肝臟全面壞死,幸好即時肝臟移植才能康復. 儘管可能一輩子都須要吃抗排斥的藥物. 但慶幸啊!

連同我那兩個青少年孩子我們同桌吃飯. 後來他來了,帶著燦燦笑容跟我們打招呼,並親了寶貝的臉頰一下.我看他形銷骨立, 走路還一拐一拐. 幾次到口想要問他有關他自己癌病情的話都忍住包裹夾雜隨食物吞嚥進胃腸中, 成為難以消化的食塊. 他說他剛去史丹佛大學附屬醫院幫女兒拿藥, 我鬆一口氣, 還好不是他須要看醫師. 食物的菜根香這時才淡淡顯露出.

但吃到一半太太突然問他那檢查報告怎麼說? 他說不想給小朋友擔心, 回家再講. 太太是不肯等的, 而我也不知所措. 等寶貝跑去倒水時, 他才說今天是他檢驗報告出來的日子, 他順便也幫寶貝拿抗排斥藥. 他的檢查報告很不好, 癌細胞擴散到他右側大腿骨.太太接著說: 看他晚上都痛得徹夜難眠, 我好難過喔. 我看著他用溫厚的眼神注視太太, 彷彿有許多無言歉意. 而坐在我右側身旁的我的孩子, 照著往例, 不是沉沒在閱讀書中的世界中; 就是兩人自顧自的嘻嘻哈哈, 完全把成年人的複雜拋擲腦後. 而我呢? 除了雙眼自主外, 我像工畫師筆下的靜態人物一樣—–安靜異常. 我不是伶牙俐齒嘛? 怎麼說不出, 找不到任何合適安慰的話語啊?
觀察到我的沉默, 於是他頭轉向坐在旁邊的我接著說: “今天內科醫師不在, 是外科醫師讀的片子, 因為外科醫師不是專家中的專家, 很有可能誤判, 不用太擔心.” 走路一拐一拐, 晚上痛得徹夜難眠會有多少機會誤判? 會這樣說只是想安撫我這朋友於事無補的傷痛. 我是否該告訴他們, 早在幾個月前, 我在附近超市購物時, 突然有人喊我的名字. 我回頭一看, 原來是行動自如燦燦笑容的他. 就在剎那間, 我彷彿看見他的背後站著另外一個身影—死神的影子. 我照著慣例, 難過整晚, 哭紅雙眼, 好脾氣的先生陪我受罪.

或許他早知道了自己的情況, 不用我說. 所以不知如何開口的我只能沉默.

接著他滿面笑容的拿起飽滿的素菜漢堡, 大口咀嚼, 並伴隨著他對主治醫師經過醫美手術後 前後判若兩人的評議. 說著說著, 空氣也流動起來. 他吃完了所有的食物 一點也不剩.

我們都是佛學班的同學, 為什麼他對自己生死如此淡然, 笑逐顏開的吃這頓飯. 而我像坐雲霄飛車一樣, 心情起伏動盪, 弧度之大, 吃進的食物衝鋒陷陣撞擊在喉頭和五臟六腑之間, 我此時想做是嚎啕大哭.

發病!

關於愛情, 他發誓遇見愛情, 就像是被江湖追補令通緝一樣. 惶惶不可終日, 逃都來不及,怎會有任何任何留連忘返的念頭. 愛情是挫敗疲憊的過程.
關於他的愛情, 我認為每次他遇見愛情, 就像癲癇發作. 你實在無法苛責一個發病的癲癇病人. 他無法控制什麼時候; 什麼地點. 是否合宜或優雅? 是否淡定? 是否皆大歡喜? 他甚至根本也無法控制發作時間的長短. 在一陣驚濤駭浪的不正常放電後, 他就會用虛弱,無助, 恍惚的眼光顯露對紅塵人世的無知及不解. 用疲軟的語調絮絮抱怨被追殺的極大苦處, 希望永生能免疫, 不再發病.
關於他的牽手, 他是這樣形容的 “極端尖酸刻薄, 冷淡無情.” 然後他再加強語氣掺雜著酸溜溜鄙夷的神情, “ 吃齋唸佛人!” 每次當他想要在家清淨清淨, 一望見他的牽手寒冬大海的褐色瞳孔 ,冷烈氣流立即團圍著他轉, 這時他又會覺得應該待在豔陽下取暖才對. 他的牽手會這樣, 其實是一種動物為生存下去所做的蛻變. 她的心再也禁不起任何煨刀炙火了, 她的情緒不容許她再體會任何痛心疾首的激動. 於是她將自己安置在沉默黯色的世界中. 像一灘被遺忘的死水.
當他的牽手離世時, 他每天淚流滿面, 哀慟不已. 他告訴所有來參加喪禮的訪客, “她是我畢生的唯一至愛!” 所有的訪客表面客氣, 無聲的質疑: “ 沒良心的東西, 外遇記錄像接力賽一樣, 一樁接一樁, 從沒停過. 演孝子哭墓戲是要唬誰?”
我,唯有我,相信他是真誠的, 相信他的煎熬和苦不堪言, 像阿里山脈一樣長. 握著他青筋暴露, 滿是老年斑的顫抖雙手, 我品嚐著他弔詭的不堪心態. 只有痛過才知道有多痛, 是誰賦予眾人正義警員的勳章, 用來苛責一個癲癇病患發病時的違反教條? 我,唯有我, 瞭解當他被病魔舔嗜時的極大苦處! 因為我跟他是患了同種病的同船人.

重逢:

我見到他從迷霧中穿越枯竭的草原, 向我邁進. 應該是第幾世的再重逢啊? 經過生生世世的一再練習 , 屢次的串習, 故事卻一再發生 .同樣的悸動 ; 同樣的手足無措; 同樣難以抉擇的疑遲; 同樣的無解. 我努力專注, 不敢輕易眨眼, 深怕他的身影會與荒野重疊 ,然後搓揉消失.
無法也無能掩飾自己盎然的情緒的我, 想用顫抖的指尖 ,試探他髮稍的熱度, 可是距離還太遠.
長久以來我深信著, 這是兩人專屬的時空旋律, 在這柔美月光下翩翩起舞, 直到永恆.
幽幽低低的音符總有盡頭, 於是燈光燦燦, 在一片錯愕中, 對著鏡子輕聲低吟的是我自己; 溫柔輕撫著我左手的是我的右手. 而他在這場重逢的迴光返照中, 只剩下古老黯淡摺痕加印的小照片, 嵌在牆上眾多框框中很不起眼的一個.
當短暫一柱香後的重逢, 不堪負荷的餘燼 ,撐不住跌落桌面. 是該曲終人散, 下次重逢, 是否也如此?
讀Sandra Brown’s “Rainwater” 後感.

Ed Boyden:為腦神經元安裝發光的配備

Ed Boyden: A light switch for neurons
Ed Boyden:為腦神經元安裝發光的配備

Ed Boyden shows how, by inserting genes for light-sensitive proteins into brain cells, he can selectively activate or de-activate specific neurons with fiber-optic implants. With this unprecedented level of control, he’s managed to cure mice of analogs of PTSD and certain forms of blindness. On the horizon: neural prosthetics. Session host Juan Enriquez leads a brief post-talk Q&A.

Ed Boyden 告訴我們通過轉錄光敏感蛋白基因進入腦細胞，然後利用植入光纖,他可以選擇性地活化或去活化特定神經元。由於這前所未有的大腦控制技巧水平，他成功地治愈老鼠類似創傷後精神緊張症的症狀和某些形式的失明現象。而不久的未來將會有:神經修復術(神經性義肢)。會議的主持人Juan Enriquez在演講結束後主持簡短的”問題和解答”談話單元。

Think about your day for a second. You woke up, felt fresh air on your face as you walked out the door, encountered new colleagues and had great discussions, and felt at awe when you found something new. But I bet there’s something you didn’t think about today — something so close to home that you probably don’t think about it very often at all. And that’s that all the sensations, feelings, decisions and actions are mediated by the computer in your head called the brain.

花一點時間想想你的一天.早上你醒來,走出家門口,感覺清新空氣輕拂過你的臉龐.巧遇你的一些新同事並和他們相談勝歡,而且哇!當你發現了新的事務時你目瞪口呆.但我敢打賭，有一些東西你今天決對沒想到-有些東西是如此貼近您,以至於很多時候你根本忽略它的存在.那就是你所有的一切喜怒哀樂,一切感覺,所有的決定和行動都是被你的頭裡的電腦所控制.就是你的大腦.

Now the brain may not look like much from the outside — a couple pounds of pinkish-gray flesh, amorphous — but the last hundred years of neuroscience have allowed us to zoom in on the brain, and to see the intricacy of what lies within. And they’ve told us that this brain is an incredibly complicated circuit made out of hundreds of billions of cells called neurons. Now unlike a human-designed computer, where there’s a fairly small number of different parts — we know how they work, because we humans designed them — the brain is made out of thousands of different kinds of cells, maybe tens of thousands. They come in different shapes; they’re made out of different molecules; and they project and connect to different brain regions. And they also change different ways in different disease states.

大腦看起來和它的外表大不同–幾英磅粉紅偏灰色的肉，無一定形狀–但近百年來神經科學的研究.
使我們能夠更無障礙的觀測大腦，看到大腦內的複雜構造.經由這樣告訴我們,大腦由數千億的神經元細胞組造成一個令人難以置信的複雜電路.不同於人為設計的電腦,由相當少數目的不同各單位組成–我們知道它們是如何工作的,因為我們人類設計它們-大腦是由數千種不同種類的細胞架構的，或許有數萬種吧。它們各有不同的形狀,是由不同的分子組成，不同的功能且連繫到不同的大腦區域。隨著不同疾病狀態而呈現不同的改變.

Let’s make it concrete. There’s a class of cells, a fairly small cell, an inhibitory cell, that quiets its neighbors. It’s one of the cells that seems to be atrophied in orders like schizophrenia. It’s called the basket cell. And this cell is one of the thousands of kinds of cell that we are learning about. New ones are being discovered everyday. As just a second example: these pyramidal cells, large cells, they can span a significant fraction of the brain. They’re excitatory. And these are some of the cells that might be overactive in disorders such as epilepsy. Every one of these cells is an incredible electrical device. They receive input from thousands of upstream partners and compute their own electrical outputs, which then, if they pass a certain threshold, will go to thousands of downstream partners. And this process, which takes just a millisecond or so, happens thousands of times a minute in every one of your 100 billion cells, as long as you live and think and feel.

讓我更進一步解釋.這類細胞,一個相當小的細胞，具抑制作用的細胞,專門控制它的鄰居,要它們安靜下來守紀律.是精神分裂症患者腦部萎縮的細胞種類之一.就是所謂的籃狀細胞。這種細胞是我們正在學習瞭解中的
數千種細胞其中之一.而今我們每天發現許多新種類的細胞。這是第二個例子：這些是錐體細胞,很大的細胞，
它們能覆蓋大腦的一個部分.它們具有興奮性.當癲癇患者發病時,這些細胞可能都會有些過度活躍.每一種腦細胞都是一種巧奪天工的電氣設備。它們接收上千個上游腦神經細胞同事的訊息後,規劃整理出自己的電子訊號,然後等到,訊號夠強度超過臨界點,它們就會把訊號傳送給成千上萬的下游細胞同事.而這個過程,只需一毫秒左右，而且每分鐘發生幾千次,1千億個腦細胞同部進行.不斷進行只要你還活著,有思想,有感覺.

So how are we going to figure out what this circuit does? Ideally, we could go through the circuit and turn these different kinds of cell on and off and see whether we could figure out which ones contribute to certain functions and which ones go wrong in certain pathologies. If we could activate cells, we could see what powers they can unleash, what they can initiate and sustain. If we could turn them off, then we could try and figure out what they’re necessary for. And that’s a story I’m going to tell you about today. And honestly, where we’ve gone through over the last 11 years, through an attempt to find ways of turning circuits and cells and parts and pathways of the brain on and off, both to understand the science, and also to confront some of the issues that face us all as humans.

那麼我們如何能確認這些電路各扮演什麼角色呢? 理想的情況下,我們可以通過電路,把這些不同類型的細胞開和關閉.看看我們能否找出它們各自特殊的功能,或是當它們表現不正常,會產生那些疾病.如果我們可以起動細胞,我們就知道它們可以發揮什麼能力,什麼功能是它們可以啟動或維持的.如果我們可以將它們關閉，我們就可以試著弄清處他們對我們的必要性是什麼。這就是今天我要告訴你的故事.真的,超過11年的研究歷經中,我們企圖尋找方法去開和關腦中電路,細胞,任何小部份和它們傳導的途徑.不僅是為了滿足對科學的好奇心也為了正視解決人類現在所面臨的一些問題.

Now before I tell you about the technology, the bad news is that a significant fraction of us in this room, if we live long enough, will encounter, perhaps, a brain disorder. Already, a billion people have had some kind of brain disorder that incapacitates them. And the numbers don’t do it justice though. These disorders — schizophrenia, Alzheimer’s, depression, addiction — they not only steal our time to live, they change who we are; they take our identity and change our emotions — and change who we are as people. Now in the 20th century, there was some hope that was generated through the development of pharmaceuticals for treating brain disorders. And while many drugs have been developed that can alleviate symptoms of brain disorders, practically none of them can be considered to be cured. And part of that’s because, we’re bathing the brain in the chemical. This elaborate circuit made out of thousands of different kinds of cell is being bathed in a substance. That’s also why, perhaps most of the drugs, and not all, on the market can present some kind of serious side effect too.

現在，在我告訴你有關的技術前,我要告訴您一個壞消息,在這房間裡的不少人如果活的夠久,他們的大腦就會有機會紊亂,不聽指揮.目前,約有十億人已有了大腦病變，癱瘓殘障他們。而數字無法真切代表出疾病的嚴重性.這些疾病-精神分裂症，老年癡呆症，抑鬱症，成癮症-他們不僅偷走我們的生命,他們改變了我們的人格剽竊走我們的自我認知和改變我們的情緒–讓我們變成另一個人。20世紀的今天,由於新的治療腦部疾病藥品,不斷被研發出來,讓我們還有一些希望。縱使有許多藥物已能緩解腦部疾病的的症狀，大概幾乎沒有任何一種被認為可以完成治愈腦病變。部分的原因是我們浸泡我們的大腦在化學藥劑中(藥物到腦中血液中).這精心設計的電路是由數千種不同的細胞組成,但都被浸泡在同一種物質溶液中.這也是為什麼,或在市場上的許多藥物，即使不是所有的，會產生一些嚴重的副作用。

Now some people have gotten some solace from electrical stimulators that are implanted in the brain. And for Parkinson’s disease, Cochlear implants, these have indeed been able to bring some kind of remedy to people with certain kinds of disorder. But electricity also will go in all directions — the path of least resistance, which is where that phrase, in part, comes from. And it also will affect normal circuits as well as the abnormal ones that you want to fix. So again, we’re sent back to the idea of ultra-precise control. Could we dial in information precisely where we want it to go?

現在有些人把電極植入大腦中刺激腦細胞來改某些疾病的症狀.的確對於像帕金森氏症病患，從耳蝸植入電極確實能夠帶來某種程度的緩解,降低病人的殘礙程度.但是電流波會向各個方向傳導-所謂”專撿軟柿子捏”(傳向阻礙力最小的通路).想來這也是這句名言的起源之一.就是電流將影響到正常的電路,不是只在我們想修復的不正常處.所以問題回到極精密度的控制上.我們可不可能只傳送訊息到標靶區呢?

So when I started in neuroscience 11 years ago, I had trained as an electrical engineer and a physicist, and the first thing I thought about was, if these neurons are electrical devices, all we need to do is to find some way of driving those electrical changes at a distance. If we could turn on the electricity in one cell, but not its neighbors, that would give us the tool we need to activate and shut down these different cells, figure out what they do and how they contribute to the networks in which they’re embedded. And also it would allow us to have the ultra-precise control we need in order to fix the circuit computations that have gone awry. Now how are we going to do that? Well there are many molecules that exist in nature, which are able to convert light into electricity. You can think of them as little proteins that are like solar cells. If we can install these molecules in neurons somehow, then these neurons would become electrically drivable with light. And their neighbors, which don’t have the molecule, would not. There’s one other magic trick you need to make this all happen, and that’s the ability to get light into the brain. And to do that — the brain doesn’t feel pain — you can put — taking advantage of all the effort that’s gone into the Internet and communications and so on — optical fibers connected to lasers that you can use to activate, in animal models for example, in pre-clinical studies, these neurons and to see what they do.

所以11年前,當我開始投入神經科學研究時，我已受過電氣工程師和物理學家的訓練.所以首先我想到是，如果這些神經元都是電氣設備的話，我們須要做的只是找到某種方式,在一定距離中傳送電流到目的地.如果我們能使某一個細胞的電路被打開,而不要干擾到它的鄰居們.這將讓我們有能力去活化或催眠不同的各種細胞,瞭解到它們的功能和它們對整體腦神經系統的貢獻.同時也讓我們有能力去執行極精密度的控制,所以可以修改出了錯的腦細胞電路計算.那我們該怎麼做呢？存在於自然界中,有很多小分子，能夠將光能轉化成電能.你可以把它們想像成像太陽能電池的微小蛋白質。如果我們可以安裝這些分子在神經元內那麼這些神經元將會因為光而電源暢通.而他們的鄰居因為不具有這些分子不會發光被活化.但須要一件神奇的技術配合才能成功.那就是怎麼把光裝設入腦中啊!並且要做到這-把光置入大腦而不感到疼痛–運用腦中本有的互聯網和其溝通能力等等功能-然後光纖連接到雷射光使我們能夠利用它們來起動開闢.例如,在初步臨床前動物研究，就可以知道這些神經元是扮演什麼角色.那麼,如何才能做到這一點？

So how do we do this? Around 2004, in collaboration with Gerhard Nagel and Karl Deisseroth, this vision came to fruition. There’s a certain alga that swims in the wild, and it needs to navigate towards light in order to photosynthesize optimally. And it senses light with a little eye-spot, which works not unlike how our eye works. In its membrane, or its boundary, it contains little proteins that indeed can convert light into electricity. So these molecules are called channelrhodospins. And each of these proteins acts just like that solar cell that I told you about. When blue light hits it, it opens up a little hole and allows charged particles to enter the eye-spot. And that allows this eye-spot to have an electrical signal just like a solar cell charging up a battery.

大約在2004年,當吉爾 納格(Gerhard Nagel),和卡爾 得許窪多(Karl Deisseroth) 和我合作時我們終於發現這可能可以成功.有一種野生的藻類,它們會自我導航向光游去,達到光合作用的最佳狀態。它的感光系統是一個光感眼點,跟我們的眼睛運作方法不同.在眼點的外膜,或者其邊界，含有小蛋白質可以將光能轉化成電能。這些分子被稱為:視紫質管道(channelrhodospins).這些蛋白質就像我之前說的跟太陽能電池功能一樣。當用藍光照射它,它會開了一個小洞，讓帶電粒子進入眼點。然後眼點就會有電子信號，就像太陽能電池充電一樣。

Elliot Krane: 解碼慢性疼痛

Elliot Krane: The mystery of chronic pain
Elliot Krane: 解碼慢性疼痛

譯者:法德

We think of pain as a symptom, but there are cases where the nervous system develops feedback loops and pain becomes a terrifying disease in itself. Starting with the story of a girl whose sprained wrist turned into a nightmare, Elliot Krane talks about the complex mystery of chronic pain, and reviews the facts we’re just learning about how it works and how to treat it.

大家都認為疼痛是一種症狀，但有些情況下神經系統自己發展成為一個一個的反饋迴路引起疼痛,所以這疼痛本身就成為一種可怕的疾病.由一個女孩扭傷手腕變成了一場噩夢的故事作開場白.Elliot Krane 揭開複雜的慢性疼痛之謎.並坦承評估對於剛被瞭解的慢性疼痛,現在所能應用的護理和控制方法.

I’m a pediatrician and an anesthesiologist, so I put children to sleep for a living. (Laughter) And I’m an academic, so I put audiences to sleep for free. (Laughter) But what I actually mostly do is a manage the pain management service at the Packard Children’s Hospital up at Stanford in Palo Alto. And it’s from the experience from about 20 or 25 years of doing that that I want to bring to you the message this morning, that pain is a disease.

我是一名小兒麻醉科醫生，所以我靠把孩子們弄睡來賺錢生活。 （眾笑）我也是個專業學者，所以我也會催眠聽眾睡覺–這免費。（眾笑）但實際上我大部份的時間是在 Palo Alto市的斯坦福帕( Stanford)大學附屬兒童醫院( the Packard Children’s Hospital )裡幫助病童控制護理他們的疼痛。我已經擁有大約20年或25年的經驗，所以今天上午我想給你們傳遞一個消息: 疼痛是一種疾病。

Now most of the time, you think of pain as a symptom of a disease. And that’s true most of the time. It’s the symptom of a tumor or an infection or an inflammation or an operation. But about 10 percent of the time, after the patient has recovered from one of those events, pain persists. It persists for months and oftentimes for years. And when that happens, it is its own disease. And before I tell you about how it is that we think that happens and what we can do about it, I want to show you how it feels for my patients. So imagine, if you will, that I’m stroking your arm with this feather, as I’m stroking my arm right now. Now, I want you to imagine that I’m stroking it with this. Please keep your seat. (Laughter) A very different feeling. Now what does it have to do with chronic pain? Imagine, if you will, these two ideas together. Imagine what your life would be like if I were to stroke it with this feather, but your brain was telling you that this is what you are feeling — and that is the experience of my patients with chronic pain. In fact, imagine something even worse. Imagine I were to stroke your child’s arm with this feather, and their brain [was] telling them that they were feeling this hot torch.

大多數的時候，我們都覺得疼痛是疾病所引起的一種症狀。通常這是對的。的確疼痛是腫瘤,感染,發炎或手術後的症狀.但是，大約有百分之十的機會，當病人已經完成痊癒後，疼痛仍然存在。有時疼痛會持續幾個月，甚至於常常疼痛多年。當發生這種情況時，疼痛本身就是一種疾病.在我還沒告訴你們,我們(醫師們)對持續不正常疼痛為何發生的推理,及我們可能治療它的方法之前,我想讓你們瞭解我的病人疼痛的感覺.如果你願意，想像一下，我正用這個羽毛輕撫你的手臂,就像我現在輕輕用羽毛劃過手臂一樣。現在，我要您們想像,我是用噴火槍的火焰來”撫摸”你的手臂.請大家坐好,不要跑掉.（眾笑）一個非常不同的感覺吧。咦,這跟慢性疼痛有什麼關係啊? 如果你願意再想像一下，把這兩個例子擺在一起.想像一下你的生活會是什麼行情?如果我是用羽毛碰觸你,但你的大腦卻一再告訴你-你正在被火紋身-痛不欲生.這就是我的病人對慢性疼痛的經驗.事實上，更可怕的是,如果我是用羽毛碰觸你的孩子的手臂,他們的大腦卻告訴自己，他們正被非常炙熱的火炬煎烤著.

That was the experience of my patient, Chandler, whom you see in the photograph. As you can see, she’s a beautiful, young woman. She was 16 years old last year when I met her, and she aspired to be a professional dancer. And during the course of one of her dance rehearsals, she fell on her out stretched arm and sprained her wrist. Now you would probably imagine, as she did, that a wrist sprain is a trivial event in a person’s life. Wrap it in an ACE bandage, take some ibuprofen for a week or two, and that’s the end of the story. But in Chandler’s case, that was the beginning of the story. This is what her arm looked like when she came to my clinic about three months after her sprain. You can see that the arm is discolored, purplish in color. It was cadaverically cold to the touch. The muscles were frozen, paralyzed — dystonic is how we refer to that. The pain had spread from her wrist to her hands, to her fingertips, from her wrist up to her elbow, almost all the way to her shoulder.

這就是我的病人，璇得拉,的經驗.這是她的照片。正如你所看到的，她是一個美麗年輕的女孩。去年我見到她時她16歲，她渴望成為一名專業舞蹈演員。然而有一次舞蹈排練過程中,她跌落壓在在她自己伸展的一隻手臂上,並扭傷手腕.你可能會以為，在一個人的日常生活中,手腕扭傷是一個很小的事件.只要用一個ACE繃帶纏繞手腕,再吃一至兩個星期的布洛芬止痛劑,就可以了.但是對璇得拉(Chandler)而言,她的血淚史才剛開始.這是她來到我的診所時手臂的樣子,大概是發生意外扭傷三個月後，你可以看到那手臂已變色，帶點紫色。摸起來有屍體一樣的冰冷感覺.肌肉已經凍結癱瘓–所謂肌肉張力不足異常.疼痛已經從她的手腕擴散到她的手掌,到她的指尖，疼痛也從手腕漫延到胳膊肘，幾乎到達她的肩膀。

But the worst part was, not the spontaneous pain that was there 24 hours a day. The worst part was that she had allodynia, the medical term for the phenomenon that I just illustrated with the feather and with the torch. The lightest touch of her arm — the touch of a hand, the touch even of a sleeve, of a garment, as she put it on — caused excruciating, burning pain.

但是，最糟糕的是，並非那持續每一天24小時自發性的疼痛,最糟糕的是她有”痛敏感症”. 痛敏感症 是醫學上的術語.所產生的症狀是跟羽毛與火炬的故事一樣.最輕微的觸摸她的手臂-觸摸她的手,甚至於當她穿衣時被衣袖觸到,被衣服磨到–都會造成難以忍受的燒灼痛。

How can the nervous system get this so wrong? How can the nervous system misinterpret an innocent sensation like the touch of a hand and turn it into the malevolent sensation of the touch of the flame. Well you probably imagine that the nervous system in the body is hardwired like your house. In your house, wires run in the wall, from the light switch to a junction box in the ceiling and from the junction box to the light bulb. And when you turn the switch on, the light goes on. And when you turn the switch off, the light goes off. So people imagine the nervous system is just like that. If you hit your thumb with a hammer, these wires in your arm — that, of course, we call nerves — transmit the information into the junction box in the spinal cord where new wires, new nerves, take the information up to the brain where you become consciously aware that your thumb is now hurt.

神經系統為什麼會錯得那麼離譜?為什麼神經系統會曲解一個無害的感覺,比如被手摸到,轉達成被火焰灼傷的惡意感覺?你可能會想像人身體內的神經系統就像我們房子內的電線系統.房子裡,電線有系統的被嵌在牆壁裡,從電燈開關到天花板的轉接箱,在從轉接箱到燈泡。當你打開開關，燈會亮起。而當你關閉開關，燈就熄滅。因此，大家想神經系統就是像這樣子.如果你的拇指被錘子打著,你的手臂內的電線–當然，我們稱之為神經-發送信息去脊髓的轉接箱,在那兒新線，新神經傳遞信息到大腦，然後你會意識到你的拇指受傷了。

But the situation, of course, in the human body is far more complicated than that. Instead of it being the case that that junction box in the spinal cord is just simple where one nerve connects with the next nerve by releasing these little brown packets of chemical information called neurotransmitters in a
linear one-on-one fashion, in fact, what happens is the neurotransmitters spill out in three dimensions — laterally, vertically, up and down in the spinal cord — and they start interacting with other adjacent cells. These cells, called glial cells, were once thought to be unimportant structural elements of the spinal cord that did nothing more than hold all the important things together, like the nerves. But it turns out the glial cells have a vital role in the modulation, amplification and, in the case of pain, the distortion of sensory experiences. These glial cells become activated. Their DNA starts to synthesize new proteins, which spill out and interact with adjacent nerves. And they start releasing their neurotransmitters. And those neurotransmitters spill out and activate adjacent glial cells, and so on and so forth, until what we have is a positive feedback loop.

當然，在人體內的情況更為複雜得多。並不是單純的像是在脊髓內的轉接箱,在那裡一個神經結連絡另一個神經結是通過釋放包含化學信息的小包(神經傳導素)來線性一對一傳導訊息.事實上，神經傳導素的釋放是三方向的–在脊髓中橫向，縱向，上下-然後他們開始與其他相鄰的細胞相互影響.這些細胞被稱為神經膠質細胞，以前被認為是不重要的脊髓結構元素,除了幫助所有重要的物質(像神經細胞)聚集一起外,一無用處.但事實證明，膠質細胞，不僅調配,放大,對疼痛的感覺,在扭曲的感官經驗中扮演至關重要的角色.這些膠質細胞就活化起來。他們的DNA開始合成新的蛋白質，然後釋放出來與相鄰神經互動,然後神經細胞被活化,釋出神經傳導素.這些神經傳導素被釋放,活化鄰近的神經膠質細胞.然後相同故事一再重演.直到一個正向回饋循環系統產生.

It’s almost as if somebody came into your home and rewired your walls, so that the next time you turned on the light switch, the toilet flushed three doors down, or your dishwasher went on, or your computer monitor turned off. That’s crazy, but that’s, in fact, what happens with chronic pain. And that’s why pain becomes its own disease. The nervous system has plasticity. It changes, and it morphs in response to stimuli.

這幾乎好像有人走進你的家裡,重新佈署牆中的電線系統.所以當下次你開燈時,廁所馬桶自動乒乒乓乓大聲沖洗.或者洗碗機會自動起動,或電腦顯視窗自動關閉.這簡直是瘋了,但事實就是這樣.這就是慢性疼痛的行情.這就是為什麼疼痛本身變成了疾病的原因.神經系統具有對環境改變的可塑適應性.它會改變 或者說變種來反應不同的刺激.

Well, what do we do about that? What can we do in a case like Chandler’s? We treat these patients in a rather crude fashion at this point in time. We treat them with symptom-modifying drugs — pain-killers — which are, frankly, not very effective for this kind of pain. We take nerves that are noisy and active that should be quiet, and we put them to sleep with local anesthetics. And most importantly, what we do is we use a rigorous, and often uncomfortable, process of physical therapy and occupational therapy to retrain the nerves in the nervous system to respond normally to the activities and sensory experiences that are part of everyday life. And we support all of that with an intensive psychotherapy program to address the despondency, despair and depression that always accompanies severe, chronic pain.

那麼，我們該怎麼辦呢？有什麼我們可以幫助璇得拉的呢?目前我們對這些病人的治療方法,還停留在一個相當不成熟,粗糙的階段.我們隨他們症狀改變調整藥物–止痛藥-坦率地說，對這種痛苦,藥物不是很有效.對於原本是安靜但現在嘈雜過動的神經,我們使用局部麻醉劑使它們睡覺.但最重要的方法是,我們採用很嚴格的，而且通常非常不舒服的物理治療及職業治療的過程來再教育神經系統裡的神經反應正常,尤其是那些日常生活的一切正常活動與感官經驗. 我們利用密集心理治療課程來支持所有這一切因嚴重慢性疼痛所伴隨引起的 沮喪,絕望和憂鬱症。

It’s successful, as you can see from this video of Chandler, who, two months after we first met her, is now doings a back flip. And I had lunch with her yesterday, because she’s a college student studying dance at Long Beach here. And she’s doing absolutely fantastic.

璇得拉的例子是成功了，你可以看到這個視頻中的璇得拉,距離她第一次踏入我們的診療室後兩個月的現在,她已經可以表演後翻轉。昨天我和她一起吃午飯，因為她在Long Beach的一間大學學習舞蹈專業,她現在康復非常好,在校表現很棒.

But the future is actually even brighter. The future holds the promise that new drugs will be developed that are not symptom -modifying drugs that simply mask the problem, as we have now, but that will be disease-modifying drugs that will actually go right to the root of the problem and attack those glial cells, or those pernicious proteins that the glial cells elaborate, that spill over and cause this central nervous system wind-up, or plasticity, that so is capable of distorting and amplifying the sensory experience that we call pain. So I have hope that in the future, the prophetic words of George Carlin will be realized, who said, “My philosophy: No pain, no pain.”

Thank you very much.

(Applause)

實際上未來的藍圖將更美好.曙光已出現,新的有效藥品已經快要問世.未來新發展的藥品不再是只是症狀控制的藥物，不再是如我們現在所用的藥物,只是掩蓋了疼痛症狀而已.新的藥品將是為疾病本身作必要的修改(對症下藥)，新的藥品會確切的尋覓到疼痛根本的問題,攻擊神經膠質細胞,或那些神經膠質細胞所產生的有害的蛋白質,這些蛋白質釋出後會導致這個中心神經系統罷工或變異.這麼就可以對抗扭曲和放大的感官經驗，也就是我們所指的疼痛。所以我希望在不久的將來，喬治卡林的聞名真言可成真:“我的哲學是：沒有痛苦，沒有痛苦。“

謝謝!

http://www.ted.com/talks/elliot_krane_the_mystery_of_chronic_pain.html

Tom Honey on God and the tsunami Tom Honey：上帝和海嘯

Producer: TEDTalks
Tom Honey on God and the tsunami
Tom Honey：上帝和海嘯
譯者: Inder

In the days following the tragic South Asian tsunami of 2004, the Rev. Tom Honey pondered the question, “How could a loving God have done this?” Here is his answer.

在2004年南亞海嘯悲劇後的日子裡，Tom Honey牧師一再思考一個問題，“一位慈愛的上帝怎麼能製造這樣的海嘯悲劇呢？“下面是他的答案。

I am a vicar in the Church of England. I’ve been a priest in the Church for 20 years. For most of that time, I’ve been struggling and grappling with questions about the nature of God. Who is God? And I’m very aware that when you say the word God, many people will turn off immediately. And most people, both within and outside the organized church, still have a picture of a celestial controller, a rule maker, a policeman in the sky who orders everything, and causes everything to happen. He will protect his own people, and answer the prayers of the faithful.

我是一個英格蘭教會的牧師,我在教會當牧師已經20年了.大多數的時間我一直在絞盡腦汁努力回答有關於上帝本質的問題，誰是上帝？我很清楚知道,當一開口談上帝時，很多人會立即腳底抹油跑走.而大多數人，無論是教徒或非教徒,都會有這種印像:上帝是天國的控制者;規則裁定者;住在天上的警察,主宰一切,命令一切事發生,他將保護他自己的子民，並順應酬答虔誠禱告的信徒。

And in the worship of my church, the most frequently-used adjective about God is “almighty.” But I have a problem with that. I have become more and more uncomfortable with this perception of God over the years. Do we really believe that God is the kind of male boss that we’ve been presenting in our worship and in our liturgies over all these years?

而在我的教會禮拜中，最常用關於上帝的形容詞是“萬能“。但我卻不這樣認為.這些年來,我越來越無法自在用這種角度去衡量上帝.難道我們真的相信那個我們這些年來崇拜和禮敬的神是一個男性上司的形象嗎?

Of course, there have been thinkers who have suggested
different ways of looking at God. Exploring the feminine, nurturing side of divinity. Suggesting that God expresses himself or herself through powerlessness, rather than power. Acknowledging that God is unknown and unknowable by definition. Finding deep resonances with other religions and philosophies and ways of looking at life as part of what is a universal and global search for meaning. These ideas are well-known in liberal academic circles, but clergy like
myself have been reluctant to air them, for fear of creating tension and division in our church communities; for fear of upsetting the simple faith of more traditional believers. I have chosen not to rock the boat.

當然，有思想家提出不同的方式來看待上帝。試圖提出上帝具有女性面及培育面的神性。提出上帝會借由他(她)無能為力的一面來示現世人,而不是只有強權的一面。承認上帝的定義是未知和不可知。尋找與其他宗教和哲學更深切的共鳴以及是在宇宙間世界中如何看待追尋生命意義的方法.這些想法在自由派學術界中早就眾所周知,但作為神職人員的我一直不願意公開這種思想，因為怕製造緊張和分裂我們的教會團體，生怕打破了信徒們傳統單純的信念。所以我選擇視而不見,不要惹麻煩.

Then, on December 26th last year, just two months ago,that underwater earthquake triggered the tsunami. And two weeks later, Sunday morning, ninth January, I found myself standing in front of my congregation — intelligent, well meaning, mostly thoughtful Christian people — and I needed to express, on their behalf, our feelings and our questions. I had my own personal responses, but I also have a public role, and something needed to be said. And this is what I said.

然後，在去年12月26日，距離現在僅僅兩個月前，海底地震引發海嘯。兩個星期後，星期日上午，1月9號.我發現自己站在教徒們的前面: 一群聰明，心善，有思想的基督徒的前面- 我必須要發表演說,我必須代表他們，來抒發我們的感情和提出我們的疑問。我有我個人的反應，但我也扮演著公共的角色，我必需說一些話的。下面這就是我說的。

Shortly after the tsunami I read a newspaper article written by the Archbishop of Canterbury — fine title — about the tragedy in Southern Asia. The essence of what he said was this: the people most affected by the devastation and loss of life do not want intellectual theories about how God let this happen. He wrote, “If some religious genius did come up with an explanation of exactly why all these deaths made sense, would we feel happier, or safer, or more confident in God?”

海嘯發生後不久，我看了報紙上坎特伯雷大主教寫的文章-很棒的文章-關於南亞的悲劇。文中要義是:那些被海嘯摧毀所有及失去至親好友生命的難民,並不想聽到思想學給他們一個合理的解釋關於上帝為什麼讓這種事情發生。他寫道：“如果某些宗教天才能想出了一個好理由:究竟為什麼這些死亡是有道理的,我們就會感到更快樂嗎，或者更安全，更信上帝嗎？“

If the man in the photograph that appeared in the newspapers, holding the hand of his dead child was standing in front of us now, there are no words that we could say to him. A verbal response would not be appropriate. The only appropriate response would be a compassionate silence and some kind of practical help. It isn’t a time for explanation, or preaching, or theology; it’s a time for tears.

如果在報紙中出現的男人,在照片中那個手掌緊緊的貼握著他死去小孩的手的人.現在站在我們面前，我們有什麼話可以對他說? 任何言語都不恰當.唯一適當的回應是充滿同情心的沉默和某種實值上的幫助。這不是解釋的時機或說教，或佈道的時候,這是一個憂傷含淚的時候.

This is true. And yet here we are, my church in Oxford, semi-detached from events that happened a long way away, but with our faith bruised. And we want an explanation from God. We demand an explanation from God. Some have concluded that we can only believe in a God who shares our pain. In some way, God must feel the anguish, and grief, and physical pain that we feel. In some way the eternal God must be able to enter into the souls of human beings and experience the torment within. And if this is true, it must also be that God knows the joy and exaltation of the human spirit, as well. We want a God who can weep with those who weep, and rejoice with those who rejoice.

沒錯,我的教會在牛津，因為相隔十萬八千里,受海嘯災區影響微弱.但是我們的信仰卻受內傷我們希望上帝給我們一個解釋.我們要求上帝作出解釋。有些人最後的結論是相信上帝在分擔我們的痛苦。一定是這樣,上帝一定會感受到我們所受的痛苦，憂傷，和身體上的疼痛.毫無疑問的,永恆的上帝一定會探觸到人類的靈魂共同來承受痛苦折磨。如果這是真的，那麼上帝一定知道喜悅和激勵人們的兩個精神領域.我們希望的上帝是必須能夠當我們傷心時陪伴著我們哭泣,當我們歡樂時分享著我們高興.

This seems to me both a deeply moving and a convincing re-statement of Christian belief about God. For hundreds of years, the prevailing orthodoxy, the accepted truth, was that God the Father, the Creator, is unchanging and therefore by definition cannot feel pain or sadness. Now the unchanging God feels a bit cold and indifferent to me. And the devastating events of the 20th century have forced people to question the cold, unfeeling God. The slaughter of millions in the trenches and in the death camps have caused people to ask, where is God in all this? Who is God in all this?

對我來說,這重新撰釋基督教信仰的上帝的宣言深深的令人感動和令人信服.數百年來，正統的，可被接受的真理是上帝是天父,造物主，是不變的，因此被定義成沒有疼痛或悲傷的情緒反映。現在這不變上帝令我感覺到有點冷漠，令人不解.而20世紀的許多災難性事件，促使人們質疑為什麼上帝那麼冷漠無情呢。千百萬被屠殺在戰壕裡的死屍和千百萬在死亡集中營受刑的無辜百姓,人們不禁要問:上帝您在那裡啊?在這一切的痛苦中您扮演什麼角色?

And the answer was, “God is in this with us, or God doesn’t deserve our allegiance anymore.” If God is a bystander, observing but not involved, then God may well exist, but we don’t want to know about him. Many Jews and Christians now feel like this, I know. And I am among them.

無疑的,答案是，“上帝時時與我們同在,否則上帝不值得我們效忠.” 如果上帝只是一個旁觀者，只是觀察，但不參與，那麼，上帝可能存在，但我們不想了解他。許多猶太人和基督徒現在都有相同感受, 我知道。因為我也是其中之一。

So we have a suffering God. A God who is intimately connected with this world, and with every living soul. I very much relate to this idea of God. But it isn’t enough. I need to ask some more questions, and I hope they are questions that you will want to ask, as well, some of you.

因此，我們有一個飽受折磨的神.緊密連接這個世界,慈眼視眾生,關念每個人的靈魂。我很贊同這樣的想法.但這還不夠。我需要探討更多的問題，我希望這些問題您也想知道,至少在坐的一些人想知道.

Over the last few weeks I have been struck by the number of times that words in our worship have felt a bit inappropriate, a bit dodgy. We have a pram service on Tuesday mornings for mums and their pre-school children. And last week we sang with the children one of their favorite songs, “The Wise Man Built His House Upon the Rock.” Perhaps some of you know it. Some of the words go like this: “The foolish man built his house upon the sand/ And the floods came up/And the house on the sand went crash.” Then in the same week, at a funeral, we sang the familiar hymn “We Plow the Fields and
Scatter,” a very English hymn. In the second verse comes the line, “The wind and waves obey him.” Do they? I don’t feel we can sing that song again in church, after what’s happened.

過去的幾禮拜裡，我已經好幾次在我們的崇拜儀式中感受到有點不適當,和有點騙人的感覺.每個星期二早我們為媽媽和他們的學前兒童舉行一個親子教室.上週我們與孩子們唱一首他們都喜愛的歌曲,”聰明的人把房子建在磐石上。” 也許在坐的有些人知道這首歌.有些歌詞是這樣的：”愚蠢的人把房子建在沙上/海水來了/沙灘上的房子崩潰了。” 然後在同一周，在一個葬禮上，我們唱起了熟悉的讚美詩”我們犁田和播種,” 典型英國的讚美詩歌.在第二章句有一行是,”風和海都必須服從他(上帝)。” 真的嗎？海嘯發生後,我不覺得我們能在教堂再唱這首歌.

So the first big question is about control. Does God have a plan for each of us? Is God in control? Does God order each moment? Does the wind and the waves obey him? From time to time, one hears Christians telling the story of how God organized things for them, so that everything worked out all right. Some difficulty overcome, some illness cured, some trouble averted, a parking space found at a crucial time. I can remember someone saying this to me, with her eyes shining with enthusiasm at this wonderful confirmation of her faith and the goodness of God.

因此，第一個問題是關於統制駕馭。上帝決定每個人的命運嗎？上帝在獨攬管制世人嗎? 每件事件的發生都是上帝的旨意嗎? 上帝可以呼風喚雨? 一次又一次,我們聽到基督徒強調上帝是如何為他們安排人生,所以一切均有完美結局.克服一些難解的困難，治好有些醫師束手無策的疾病，避免有些麻煩，甚至在一個關鍵時刻找到一個停車位。我記得有人對我說這些奇蹟時,她的眼睛閃閃發光,熱情的見證她對上帝的信心和上帝的真善美.

But if God can or will do these things — intervene to change the flow of events — then surely he could have stopped the tsunami. Do we have a local God who can do little things like parking spaces, but not big things like 500 mile-per-hour waves? That’s just not acceptable to intelligent Christians, and we must acknowledge it. Either God is responsible for the tsunami, or God is not in control.

但是，如果上帝能夠或會做這些事情 -介入改變事件發生的結果- 那麼他一定能夠阻止海嘯。我們是否有一個在某區的上帝，他可以做一些小事:像是找車位，但卻不去阻止每小時500英里的海浪？這是有智慧的基督徒不能接受的，我們必須承認這一點。上帝要不是必須為此災難負責(創造海嘯),就是根本不法控制海嘯.

After the tragedy, survival stories began to emerge. You probably heard some of them. The man who surfed the wave. The teenage girl who recognized the danger because she had just been learning about tsunamis at school. Then there was the congregation who had left their usual church building on the shore to hold a service in the hills. The preacher delivered an extra long sermon, so that they were still out of harm’s way when the wave struck. Afterward someone said that God must have been looking after them.

悲劇發生後，許多倖存者的故事開始流傳.你可能聽說過一些。一名男子隨浪潮衝浪竟存活.十幾歲的女孩瞭解到海嘯危險,因為她剛在校學習過.然後有一群教徒當天離開了他們在一貫使用的岸邊教堂,改在山上禮拜.那天牧師花在講道時間異常的長.所以，他們當海嘯襲擊時他們沒被傷害.後來有人說，上帝一定在照顧保護他們。

So the next question is about partiality. Can we earn God’s favor by worshipping him or believing in him? Does God demand loyalty, like any medieval tyrant? A God who looks after his own, so that Christians are OK, while everyone else perishes? A cosmic us and them, and a God who is guilty of the worst kind of favoritism? That would be appalling, and that would be the point at which I would hand in my membership. Such a God would be morally inferior to the highest ideals of humanity.

因此，接下來的問題是關於偏袒。是不是必須要相信他,崇拜他才能贏得上帝的青睞呢？是不是上帝要求忠誠像中世紀暴君一樣？上帝只照顧自己的子民.所以，基督徒可以平安,而其他人就任其滅亡? 在同一個宇宙,有我,有您和一個有最惡劣的偏袒罪行的上帝?這將是駭人聽聞的,如果這樣子,我將放棄我的會員資格.這樣的上帝在道德上不如人類中的聖人.(具人性最高理念)

So who is God, if not the great puppet-master or the tribal protector? Perhaps God allows or permits terrible things to happen, so that heroism and compassion can be shown. Perhaps God is testing us: testing our charity, or our faith. Perhaps there is a great, cosmic plan that allows for horrible suffering so that everything will work out OK in the end. Perhaps, but these ideas are all just variations on God controlling everything. The supreme commander toying with expendable units in a great campaign. We are still left with a God who can do the tsunami and allow Auschwitz.

那麼，誰是上帝，如果他不是木偶戲大師或部落的保護者？也許上帝允許可怕事情發生，讓英雄主義和同情心可以被激發。也許上帝是考驗我們：考驗我們的慈善，或者我們的信仰。也許另一個偉大的宇宙計劃將實現，所以會有可怕的天災人禍,因為要從新洗牌,為美麗遠景而受苦.或許吧，但這些想法都只是對上帝是主宰者的不同聯想.最高統帥在巨大的活動中,玩弄著可被消耗的單位.我們的上帝還是那個製造海嘯,同意Auschwitz 死亡集中營的神.

In his great novel, “The Brothers Karamazov,” Dostoevsky gives these words to Ivan, addressed to his naive and devout younger brother, Alyosha: “If the sufferings of children go to make up the sum of sufferings which is necessary for the purchase of truth, then I say beforehand that the entire truth is not worth such a price. We cannot afford to pay so much for admission. It is not God that I do
not accept. I merely, most respectfully, return Him the ticket.”

Dostoevsky在他的偉大小說“卡拉馬佐夫兄弟＂中寫到艾本(Ivan)告訴自己天真,虔誠的弟弟，阿憂沙(Alyosha)：”如果須要累積總合無數次孩子們的痛苦才有足夠的能力購買真理,那我想先說，這個真理不值得購買。我們付不起這麼多的入場費。不是說我不接受上帝(而是這過程,我不能承受)，我只好用最虔誠的態度,把進入(天國)的門票還給上帝.

Or perhaps God set the whole universe going at the beginning and then relinquished control forever, so that natural processes could occur, and evolution run its course. This seems more acceptable, but it still leaves God with the ultimate moral responsibility. Is God a cold, unfeeling spectator? Or a powerless lover, watching with infinite compassion things God is unable to control or change? Is God intimately involved in our suffering, so that He feels it in His own being?

或者當上帝創造整個宇宙時,就決定永遠放棄控制.所以該在自然過程會發生的就發生,而演化過程也扮演其該有的角色.這解釋似乎比較容易接受，但上帝還是背負終極的道德責任.難道上帝是冷漠無情的觀眾？或是一個無能為力的愛人，眼睜睜看著無數次的悲哀卻無法控制或改變?還是上帝密切參與我們的痛苦，所以他也深切的體會那份苦?

If we believe something like this, we must let go of the puppet-master completely, take our leave of the almighty controller, abandon traditional models. We must think again about God. Maybe God doesn’t do things at all. Maybe God isn’t an agent like all of us are agents. Early religious thought conceived God as a sort of superhuman person, doing things all over the place. Beating up the Egyptians, drowning them in the Red Sea, wasting cities, getting angry. The people knew their God by His mighty acts.

如果我們相信這樣的推理，我們必須完全放棄木偶大師的上帝形象，拋開全能控制者上帝的理念，拋棄傳統的模式。我們一定要從新定位上帝.也許上帝根本什麼也沒做(沒有創造所有的災難).也許人類才是所有災禍的媒介,不是上帝.早期的宗教思想,設想上帝是超人.在每個不同角落,做每件事 。毆打埃及人，把他們淹死在紅海裡，摧毀整個城市，(因為埃及人惹)上帝生氣.人們瞭解的上帝是透過他的偉大神跡.

But what if God doesn’t act? What if God doesn’t do things at all? What if God is in things? The loving soul of the universe. An in-dwelling compassionate presence, underpinning and sustaining all things. What if God is in things? In the infinitely complex network of relationships and connections that make up life. In the natural cycle of life and death, the creation and destruction that must happen continuously. In the process of evolution. In the incredible intricacy and magnificence of the natural world. In the collective nconscious, the soul of the human race. In you, in me; mind and body and spirit. In the tsunami, in the victims. In the depth of things. In presence and in absence. In simplicity and complexity. In change and development and growth.

但是，如果上帝根本沒有採取任何行動？如果上帝根本沒有做任何事？又如果上帝是與任何事件共同存在？是存在宇宙間充滿愛心的靈魂.是支撐和維持一切事物的一種內在的仁慈善心.可不可能上帝是與任何事件共同存在呢？在無限複雜的關係網和連接中形成生命.所以必須遵循自然法則-有生有死,創造和破壞，一定會不斷發生.上帝是在自然的進化的過程中.是在令人難以置信的錯綜複雜中和壯麗的自然世界中.在潛意識中,與人類的靈魂同在.與您,與我,與我們的記憶,我們的身體和靈魂同在.上帝在海嘯中, 上帝與世界受難者同在.深刻的滲入事件的內函.　與存在和失落同在,在簡單中也在繁雜中,在變異.　發展和茁壯中存在.

How does this in-ness, this innerness, this interiority of God work? It’s hard to conceive, and begs more questions. Is God just another name for the universe, with no independent existence at all? I don’t know To what extent can we ascribe personality to God? I don’t know. In the end, we have to say, “I don’t know.” If we knew, God would not be God.

如何解釋上帝這種＂同在性＂　＂內心性＂＂內在性＂的特質呢？這想法很難被接受,因此引出更多的疑問.是不是上帝只是宇宙的另一個名稱，根本沒有獨立存在過呢？我不知道在何種程度上,我們可以賦予上帝多少人格特質？我不知道。最終，我們不得不說，“我不知道。＂　如果我們知道，上帝就不是上帝了。

To have faith in this God would be more like trusting an essential benevolence in the universe, and less like believing a system of doctrinal statements. Isn’t it ironic that Christians who claim to believe in an infinite, unknowable being, then tie God down in closed systems and rigid doctrines?

對上帝的信心應該跟相信世界裡有一個根本的善念一樣,而不是只是相信刻板理論教條的上帝.對基督徒的我們而言這不是很諷刺嗎？我們宣稱我們相信無限和不可知,然而卻用封閉系統和僵化教條來困鎖我們的上帝.

How could one practice such a faith? By seeking the God within. By cultivating my own inwardness. In silence, in meditation, in my inner space, in the me that remains when I gently put aside my passing emotions and ideas and preoccupations. In awareness of the inner conversation.

那麼如何能實踐這種對上帝的信念呢？在內心深處尋求上帝,通過培養自己的內在.　在寂靜，在打坐中,在我的內在世界中,在我們淡定自在的剝棄自己的情緒,想法和偏見時所萃取出那個＂純真的我們＂中,和在我們自我檢視的過程中.

And how would we live such a faith? How would I live such a faith? By seeking intimate connection with your inwardness. The kind of relationships when deep speaks to deep. If God is in all people, then there is a meeting place where my relationship with you becomes a three-way encounter. There is an Indian greeting, which I’m sure some of you know: “Namaste,” accompanied by a respectful bow, which roughly translated means “That which is of God in me greets that which of God is in you.” Namaste.

那麼我們如何能活出這樣的信念呢？　我又將如何能在生活中實踐這樣的信仰呢？經由尋求與您的內在密切聯繫.是那種乳水交融的關係.如果上帝存在所有的人中.那麼就有一個地方，在那兒我跟您的關係是三方面的接觸,是相通的.印度有句問候語,我敢肯定，你們有些人知道：”Namaste,”（“合十禮“）伴隨著恭敬的一鞠躬，大致翻譯的意思是＂我心中的神跟您心中的神打招呼＂Namaste.

And how would one deepen such a faith? By seeking the inwardness which is in all things. In music and poetry, in the natural world of beauty and in the small ordinary things of life, there is a deep, indwelling presence that makes them extraordinary. It needs a profound attentiveness and a patient waiting. A contemplative attitude, and a generosity and openness to those whose experience is different from my own.

那我們如何加強這種信念呢？通過追索所有的事物的內在層面.在悠揚樂章中在動人詩歌中,在欣賞美麗的自然世界中和處理日常生活中的瑣碎小事中.因為這些事務中都包含一個深奧的道德,所以不平凡.(一花一世界）　是須要深刻徹底的關注和耐心才能完成, 是須要深思熟慮的態度和慷慨開放的胸襟來接受與我們不同的背景的他人.

When I stood up to speak to my people about God and the tsunami, I had no answers to offer them. No neat packages of faith, with Bible references to prove them. Only doubts and questioning and uncertainty. I had some suggestions to make — possible new ways of thinking about God. Ways that might allow us to go on, down a new and uncharted road. But in the end, the only thing I could say for sure was, “I don’t know,” and that just might be the most profoundly religious statement of all.

Thank you.

當我站在我的教友前,對他們講有關上帝和海嘯時，我沒有任何的答案可給他們。聖經中沒有完善的標準答案.我無法找到可參考証明的任何有關資料.所以只剩下懷疑，疑問和不確定.我想提出一些建議，使-是否能用新的思維方式來定位上帝.一條新的和未經探測的思考方式讓我們可能繼續下去.但最後,我唯一能說的還是，“我不知道“，而這或許也是我最深切的宗教聲明。

謝謝。

臭蟲外傳

以色列西蒙 斯坦伯格(Shimon Steinberg)不但是生物科學界首席研究員之一，也是世界最大規模且獨特的生物系統農場培育中心的領導.他的農場生產世界上最好的,最自然的植物病蟲害控制劑:昆蟲.在農場,大規模生產有益的昆蟲和蟎類作為農業用途.他們使農夫能歡快的迎接成群小蜜蜂來作媒傳花粉;他們並幫助地中海果蠅做不育手術,使農夫的蔬果,更大更鮮美.大片農作物，水果,樹木，觀賞植物等,因為這些昆蟲的保護而蓬勃.也因此而能生產無農藥食品,進而避免成千上萬的廣闊大眾危險暴露在化學農業製劑下.

當我與世界週刊韓傑先生討論西蒙 斯坦伯格這個賣蜘蛛高手時,韓先生天外飛一筆的提出:有沒有關於以蟲治臭蟲(Bedbug)的消息? 於是我鑽進臭蟲資訊世界,想要發現科學家的任何最新有關於臭蟲的消息:然後我有一些嘆為觀止的心得.

一.主角簡介:

臭蟲早在公元前400年的古希臘就存在.臭蟲是一種小的寄生蟲( 4-5毫米長，寬1.5-3毫米),為什麼說它們是寄生蟲呢?因為它們須要宿主供應熱血來存活,生命中的每個里程碑均須要宿主的血祭才能完成.而宿主包括任何溫血動物:人,六畜,老鼠,蝙蝠等等.其中人類的血是它們最頂級的佳餚.當它們覓食時,主要是透過找尋宿主排出的二氧化碳，或熱量來尋求，被咬後會紅腫奇癢,甚至會過敏.雖然臭蟲至少帶有32種對人類有害的病原體,但目前為止沒有研究數據可証明臭蟲造成任何瘟疫過.臭蟲有六個生命階段（五個不成熟期和最後階段的成蟲期）每一次的蛻變都須吸食宿主血液.一般來說，在寒冷的天氣，臭蟲可存活一年左右，在溫度更有利於活動和覓食的環境，反而只有大約5個月壽命。母臭蟲一生可產卵200至400顆，平均每天下三到五個蟲卵在不同的隱密地區,然後蟲卵約十四天孵化,四個月成熟.以此推斷一年之內,一定可以三代同堂.它們具有很強的繁殖能力.住房的床架,桌椅等家具,用具的縫隙是臭蟲的主要棲息場所,所以一旦被臭蟲侵入家宅中任何縫隙均能成為它們的溫室.

二.特殊進食及交配方式:

找到宿主通常不會馬上大塊朵頤,而是到處觀察爬來爬去,找到最適合的一點.然後,伸出口器刺穿皮膚,口器像兩個空心管 一條吐含有抗凝血劑和止痛麻醉成份的口水到宿主體內;另一條空心管快速抽取新鮮溫血入自己的肚子.所有的進食在10分鐘內完成,等到麻醉成份消失宿主覺醒時,臭蟲早已遠離犯罪現場.
當成蟲吸足血液後就會交配,但公臭蟲非常沒耐心沒有羅曼蒂克的素養,很快上演情人看刀的戲碼.公臭蟲把母臭蟲翻倒,然後雖然母臭蟲有雌性器官來排卵,但公臭蟲嫌麻煩,直接用其皮下生殖器刺入母臭蟲下腹,造成母臭蟲腹部撕裂流血(大多是宿主的),再由(人)血液帶著公臭蟲的精液流向母蟲的卵去受精.這種惡狠狠的愛情故事也會發生在公臭蟲對另一隻公臭蟲身上,如果”被誤會大了”的弱公臭蟲沒有來得及分泌警報信息素(一種賀爾蒙)來溝通溝通,那它可能會受傷慘重.

三.它們是地球上的超強生物:

漫畫電影中超人可以忍受的酷刑,對臭蟲而言也是小菜一碟不足掛齒.
.速度飛快每分鐘可跑126 公分.
.處在-10℃（14.0 °F）下,臭蟲可以存活至少五天;暴露(無任何保護)在-32℃（-26°F）低溫下可存活15分鐘.
.可以使身體縮小成三分之一對抗極度乾燥的天候.
.雖然無法生存在高濃度的二氧化碳的環境下很長,但對几乎只有氮氣的密封空間中即使72小時後還安然自得,換句話說無氧氣也行.
.45℃（113 °F）是其熱死點,但要消滅所有蟲卵及各種成虫,幼虫須要46℃（115°F) 連續加熱7分鐘.
.雖說每五至十天吸血一次,但不進食也可存活一年而無恙.

由此可知小小臭蟲神通廣大,唯一殺死臭蟲的方法可能是連續7分鐘加熱超過46℃.所以如果把衣物放進烘乾機高溫烘轉超過7分鐘效果應該很好.而民間傳言用熱水澆燙家具或太陽曝曬衣物,因為難以維持溫度持續超過7分鐘.可能安慰人心多於其效果.

四.窮鄉僻壤,環境條件不好的國家或地區才會臭蟲猖獗?

錯了! 1940年代臭蟲由於吸塵器和DDT的發明且大量使用而几乎消聲匿跡.但自從1995年起先是在丹麥,挪威發現它們重出江湖的足跡,到最近紐約的臭蟲大恐慌,甚至於五星級的旅館都有臭蟲受害者.由此可知並非落後貧窮才會招惹臭蟲.會有這現象主要的原因有兩個: 這是個國際旅遊快捷的時代,所以臭蟲常搭免費飛機和其他交通工具移民國外; 第二,由於殺蟲劑的濫觴,所以臭蟲進化成抗藥性很強的品種.2008年發行的醫學昆蟲學期刊中明確的指出在紐約市的臭蟲抗藥性是比其他地區高達264倍以上.用殺蟲劑唯一的小貢獻是這種抗藥性很強的品種比較不耐餓,只可忍受二個月的饑餓就會死亡.總而言之現在能毒死臭蟲的農藥也會對我們的健康產生極端傷害.

五.怎麼知道有沒有臭蟲在身旁呢?

專業的臭蟲探測犬其準確率達到 97.5％,但2009年的數據顯示:全美只有100 多隻口碑名副其實的臭蟲探測犬,而最出名的那隻狗叫做瓢蟲(Ladybug).由於稀少,所以普通人家可能只能在電視上看到它們.至於那些除蟲公司帶來的探測犬,到底比鄰居家的妮娜高明多少就不得而知.市面上還有賣類似蟑螂屋原理一樣的”臭蟲屋” 爬進去就被黏住,價格不是很大眾化而且只對大隻吃得飽飽的臭蟲有效,至於扁平幼小的臭蟲就會被網開一面.所以可能花了錢還不能消災.幸運的是2010年12月16日在美國昆蟲學會年度會議中,羅格斯大學的一位中國蔡姓研究員(Wan-Tien Tsai)發表了一個新的低成本，自製臭蟲探測器的籃圖.經濟又有效!震驚臭蟲研究界,方法如下:

1.在運動器材店或超市買一個可以絕緣保溫約三分之一加侖大的水瓶
2.放入2.5磅的乾冰顆粒,蓋上蓋子,但不要完全關閉,留細縫允許二氧化碳洩出.
3.取一個貓食盤中間倒入滑石粉,食盤周圍貼紙張,造成斜坡方便臭蟲爬入
4.把水瓶放在貓食盤中間,效果可以維持11小時.

原理:臭蟲主要是透過找尋宿主排出的二氧化碳來尋覓宿主,持續緩慢洩出二氧化碳是為了引誘臭蟲來覓食.斜坡方便臭蟲爬入但滑石粉太滑使它們爬不出來.
當蔡博士接受記者訪問的時候,她很高興的說:”所有的部分，包括乾冰，成本是15元，並且不需要任何特殊技能,每個人都能做，”

六.驅蟲劑有效嘛?

根據很多歷史小說,野史記載及民間老祖母殷切吩咐.應該是有效的.但很多科學家認為,當臭蟲饑餓時任何刀山劍海也擋不住它們,何況只是氣味撲鼻的驅蟲劑.但是如果臭蟲不餓時,或有別的更好人選時,全身佈滿驅蟲劑應該會打消它們想搭便車的念頭.有此可知,當坐地鐵,公車,或待在電影院內遇到氣味強烈刺鼻的犀利哥或異味妹時不用懷疑,勇敢的跟他們坐在一起比跟乾淨筆挺拖著小型旅行箱的紳士淑女更安全.

七.能不能以蟲治臭蟲?

終於回到韓先生的問題,有沒有天敵可以殺死臭蟲? 答案是很多!但是先別高興太早,因為如果戰事是發生在後院或廣大農場,隔著玻璃門或站在陽台往下瞭望–宜情宜性.但是如果戰場搬到自己的屋內,甚至試想臭蟲跟它們的天敵在每晚睡覺的大床上華山論劍,比劃比劃,可能再也優雅不起來.更何況請神容易送神難.許多天敵並不太受人類歡迎.舉例說明:最有效的天敵是蒙面殺手(masked hunter),性格怪異稍有不順即把主人叮得滿頭皰.還有螞蟻,蟑螂,跳蚤,蝨子跟蜘蛛等等.. 有文獻甚至指出雖然臭蟲體內有致病菌,目前為止並無任何證據顯示它們會傳播病毒細菌給人類,但吃了臭蟲的跳蚤,蝨子會把臭蟲體內病菌傳給人類.如果要以蟲制蟲,套用現今當紅議員邱毅的話:”請它們幫忙,是請鬼抓藥.” 行不通!

八.總結:

最好的防制方法是所謂IPM program,也就是探測(Inspection),防範(Prevention)和監督(Monitoring) 三管齊下.利用蔡博士的發明來探測和監督,利用吸塵器和高溫設備如煮沸衣物或高溫烘乾機來防範殺死臭蟲或用塑膠罩把床墊罩起來防止臭蟲做窩在床舖上.至於殺菌劑只能暫時解決問題,但未來會製造更艱鉅的問題.值得我們三思而後行.也由於臭蟲是靠賀爾蒙交談,如果賀爾蒙被干擾,那公臭蟲會找錯對象交配,最後徒勞無功.所以最後希望科學家能發現干擾賀爾蒙的元素,使臭蟲得到控制.

References:
1.
The man who sells spiders for strawberries
http://www.israel21c.org/201009018279/people/the-man-who-sells-spiders-for-strawberries

2.bedbug
http://en.wikipedia.org/wiki/Bedbug#cite_note-52

3.
Bedbug

Click to access bedbug_Wik_.pdf

4.
Bed bugs bounce back

Click to access MarApril2007.pdf

5.
Posts Tagged ‘Bed Bug Life Cycle’
http://blog.bugbustersusa.com/index.php/tag/bed-bug-life-cycle/

6.
Bed Bugs Resist Pesticides
By Robin Lloyd, LiveScience Senior Editor
“The New York bugs have acquired mutations in their nerve cells, which blunt the neurotoxic effect of the pyrethroid toxins used against them…”
http://www.livescience.com/animals/090112-bed-bug-resistance.html

7.
Do-It-Yourself Bed Bug Detector: Insulated Jug and Dry Ice
http://redhumpy.com/blog/2010/10/do-it-yourself-bed-bug-detector-insulated-jug-and-dry-ice/

8.Do-it-yourself Bed-bug Detector
Tsai said December 16 at the annual meeting of the Entomological Society of America.
http://blog.makezine.com/archive/2009/12/do-it-yourself_bed-bug_detector.html

9.
WanTien Tsai (MS ’05, PhD ’08) Designs a DIY Bed Bug Detector
http://www.ag.purdue.edu/entm/Lists/News/DispFormNoSummary.aspx?List=8a0d6fbd-206c-4231-9f9a-83f1da3610f6&ID=69

談判高手

以前小時候,當媽媽到台灣傳統市場採購時, 如果缺人手,會不得不帶著我去幫忙,或提菜或站在一角看顧她的戰利品.我不是一個好幫手,常不知不覺花很多功夫去注意那些路邊董事長們跟他們的顧客的討價還價,一來一往的對話.他們臉上的表情,嘴角上揚及下垂的曲度;眼中兩粒黑豆仁忽大忽小;忽明忽暗,隨著是否佔到便宜或失了戰鬥碉堡而色彩豐富.跟莫内的畫風很像–很印象派,純粹以生活中的平凡事物做為描繪對象,且著重於對時間光影改變的印象，我常太專注於他們討價還價的藝術中.看顧的商品就會不翼而飛,當然回家也少不了一頓好打.

當我小時候被媽媽處罰時,我常很不服氣:是我比較寶貴?還是被順手牽羊的菜比較重要?當然現在我瞭解我當時的表現其實是嚴重的傷害她為人師表的身份地位.”看人家小販的對話竟然也可以嘴巴開開,目瞪口呆,十足白痴樣!”再加一句”我真不敢相信你是我生的.”而今我還是對那些足智多謀的談判者興趣盎然.這些偉大高超的談判者,無論是研究員,思想家,宗教學家或政治學家等等.為地球人類所做的談判溝通,所簽署的和平條約,所尋找的圓滿渠道.再再都像是菩薩或上帝慈悲的眼光,緩慢慎重的滲入我們頑固的內心深處,改變我們的生命.所有一切使我訝異且不自主的目瞪口呆.