【正文】 ems, but replicating those successes with ACEs and toxic stress is going to take determination and mitment, and when I look at what our nationamp。39。s response has been so far, I wonder, why havenamp。39。t we taken this more seriously?
　　當(dāng)你理解了這門(mén)科學(xué)時(shí), 你會(huì)想要把它廣而告之, 因?yàn)檫@不僅僅是 灣景區(qū)(Bayview)孩子的問(wèn)題。 我本來(lái)以為 其他人一旦了解到這一點(diǎn), 就會(huì)著手例行檢查、 組建多學(xué)科治療團(tuán)隊(duì), 甚至大家爭(zhēng)先恐后 想找到最有效的治療方案。 可這些都沒(méi)有發(fā)生。 這可是給了我一個(gè)很大的教訓(xùn)。 我原以為簡(jiǎn)單的找到 最好的臨床手段來(lái)治療就行了, 現(xiàn)在我明白了,這是一場(chǎng)運(yùn)動(dòng)。 正如Robert Block博士, 這位前美國(guó)兒科學(xué)會(huì)會(huì)長(zhǎng)所言, amp。quot。童年不良經(jīng)歷(ACE)是 今天我們國(guó)家所面臨的,唯一,最大的, 未能解決的公共健康威脅.amp。quot。 對(duì)于很多人來(lái)說(shuō), 這個(gè)前景可不容樂(lè)觀。 這個(gè)問(wèn)題的范圍之廣,規(guī)模之大 使我們不得不考慮應(yīng)對(duì)之策。 但在我看來(lái),危機(jī)即是轉(zhuǎn)機(jī)， 當(dāng)我們確立正確框架時(shí), 當(dāng)我們意識(shí)到 這是公共健康危機(jī)時(shí), 我們才能開(kāi)始使用 正確的方法來(lái)求得解決方案。 從煙草到鉛中毒,再到艾滋病, 在解決公共健康問(wèn)題方面, 美國(guó)實(shí)際上保持著良好記錄, 但要,在ACE和毒性應(yīng)激方面 取得同樣成功, 則需要下定決心、履行承諾, 當(dāng)我看到,我們國(guó)家 對(duì)這一問(wèn)題至今的反應(yīng)時(shí), 我想知道, 為什么我們沒(méi)有更認(rèn)真的對(duì)待這個(gè)問(wèn)題?
　　You know, at first I thought that we marginalized the issue because it doesnamp。39。t apply to us. Thatamp。39。s an issue for those kids in those neighborhoods. Which is weird, because the data doesnamp。39。t bear that out. The original ACEs study was done in a population that was 70 percent Caucasian, 70 percent collegeeducated. But then, the more I talked to folks, Iamp。39。m beginning to think that maybe I had it pletely backwards. If I were to ask how many people in this room grew up with a family member who suffered from mental illness, I bet a few hands would go up. And then if I were to ask how many folks had a parent who maybe drank too much, or who really believed that if you spare the rod, you spoil the child, I bet a few more hands would go up. Even in this room, this is an issue that touches many of us, and I am beginning to believe that we marginalize the issue because it does apply to us. Maybe itamp。39。s easier to see in other zip codes because we donamp。39。t want to look at it. Weamp。39。d rather be sick.
　　要知道,一開(kāi)始我還想, 這是因?yàn)槲覀兡暳诉@個(gè)問(wèn)題, 以為它跟我們無(wú)關(guān)。 以為只有別的小孩, 鄰居家的小孩才有這問(wèn)題。 但很奇怪,數(shù)據(jù)可不是這么說(shuō)的。 初始ACE的研究樣本群體為： 白人占70%, 大學(xué)畢業(yè)占70%。 后來(lái),我和大家談得多了, 我便開(kāi)始想,也許 我把這個(gè)問(wèn)題完全本末倒置了。 如果我問(wèn)現(xiàn)場(chǎng)這個(gè)房間內(nèi)有多少人 在成長(zhǎng)過(guò)程中 有家庭成員患有精神疾病, 我相信,會(huì)有幾個(gè)人舉手。 如果我再問(wèn),有多少人 父親或母親酗酒, 或者是堅(jiān)信： 孩子要打,慣不得。 我敢打賭會(huì)有更多的人舉手。 即使只是在我們的會(huì)場(chǎng), 這也是一個(gè)影響到了很多人的問(wèn)題。 我開(kāi)始相信 我們漠視這個(gè)問(wèn)題 是因?yàn)?它與我們息息相關(guān)。 也許把它說(shuō)成別的地區(qū)的事, 我們才能更容易的看清楚, 因?yàn)槲覀冏约呵樵干? 也不愿意正視這個(gè)問(wèn)題。
　　Fortunately, scientific advances and, frankly, economic realities make that option less viable every day. The science is clear: Early adversity dramatically affects health across a lifetime. Today, we are beginning to understand how to interrupt the progression from early adversity to disease and early death, and 30 years from now, the child who has a high ACE score and whose behavioral symptoms go unrecognized, whose asthma management is not connected, and who goes on to develop high blood pressure and early heart disease or cancer will be just as anomalous as a sixmonth mortality from HIV/AIDS. People will look at that situation and say, amp。quot。What the heck happened there?amp。quot。 This is treatable. This is beatable. The single most important thing that we need today is the courage to look this problem in the face and say, this is real and this is all of us. I believe that we are the movement. Thank you.
　　幸運(yùn)的是,科學(xué)進(jìn)步, 坦率地說(shuō),還有經(jīng)濟(jì)現(xiàn)實(shí) 逐漸使我們無(wú)法再繼續(xù)漠視下去了。 科學(xué)研究清楚顯示： 早期不良經(jīng)歷對(duì)人的一生 的健康影響巨大。 今天,我們開(kāi)始了解如何中斷 從早期不良經(jīng)歷發(fā)展至 疾病和過(guò)早死亡這一進(jìn)程, 從現(xiàn)在算起,30年后, 高ACE分?jǐn)?shù)的兒童, 如果其行為癥狀未被識(shí)別, 哮喘診療未與ACE相關(guān)聯(lián), 持續(xù)發(fā)展為高血壓, 并患上早期心臟病或癌癥, 那么這就象6個(gè)月的嬰兒患艾滋病一樣, 都是異常的。 人們看到這種情況都會(huì)說(shuō)： amp。quot。這究竟發(fā)生的是什么鬼事?amp。quot。 這種病癥是可以治療的, 也是可以戰(zhàn)勝的。 我們今天最需要的是 直面這個(gè)問(wèn)題的勇氣, 并且承認(rèn),這個(gè)問(wèn)題確實(shí)存在, 與我們息息相關(guān)。 我相信我們將實(shí)現(xiàn)這一變革運(yùn)動(dòng)。謝謝大家。