For the past 24 years, I have been a firefighter in Huntington, West Virginia.
过去二十四年，我一直都是西弗吉尼亚州亨廷顿市的消防员。
As firefighters, my team and I are tasked with saving lives and property from such disasters as car wrecks,
身为消防员，我和我的队员的工作任务就是要拯救性命和地产，不受到灾难的威胁，如车祸、
house fires and also life-threatening medical emergencies.
房子失火以及会危及性命的医疗紧急事件。
I am a woman leading a department in a male-dominated profession.
在男性主宰的行业中，我是领导一个局的女性主管。
And 10 years ago, I decided to increase my medical knowledge and I received a nursing degree.
十年前，我决定要增加我的医疗知识，我取得了一个护理学位。
That was because it became clear that the next big threat facing not only my city,
那是因为，现在大家都清楚，不只是我的城市，
but other cities around the country, was not the one-and-done disaster,
还有全国其他城市，要面临的下一个大威胁并不是发生了就会过去了的灾难，
where you can ride in like the cavalry, as a firefighter, put out the fire and leave,
对那些灾难，你可以用救兵、消防员的身份抵达，把火灭掉后离开，
feeling like you have made a difference and everything is OK.
觉得你造就了不同且一切都没事了。
The next big disaster in my city was and is the long, debilitating and lethal disaster known as opioid addiction.
我城市里的下一个大灾难是很漫长、让人衰弱且致命的灾难，就是大家所知的鸦片类药物成瘾。
We now call this a health epidemic, and we have replaced the name "addiction" with "substance use disorder."
我们现在称之为健康流行病，并且我们把“成瘾”这个字换成了“物质使用障碍症”。
To give you some perspective of how significant this epidemic has become,
我给大家一点关于这种流行病变得多重大的概念，
in 2017, in my county of 95,000 people, we saw 1,831 overdoses 183 deaths from overdose.
2017年，我的郡人口是九万五千人，我们发现了1831个服药过量的案例，以及183个因为服药过量致死的案例。
This is the job of my firefighters, as well as other agencies, to respond to that.
我们消防员以及其他机构的工作都包括要对那些状况做应变。
Excuse me. So, watching this epidemic unfold for several years, I developed some insight.
对不起。数年来，看着这种流行病渐渐出现，我也发展出了一些洞见。
For this disaster, we need to redefine our job as a first responder.
对这种灾难，我们需要重新定义我们身为第一线应变人员的工作。
We need to be more than just the cavalry. We need to do more than just save a life.
我们不能只当救兵。我们要做的不只是拯救性命。
We need to find ways to rebuild that life.
我们得要找出方法来重塑那些生命。
And it's going to take a lot of people to do that.
这需要很多人才能够做到。
And that is exactly what we are trying to do in Huntington, West Virginia.
而这正是我们在西弗吉尼亚州亨廷顿市试图去做的事。
Now, let me give you some insight as to what we do.
让我说明一下，我们做的是什么事。
First, this is what happens when somebody overdoses.
首先，当有人用药过量时，状况会是这样的。
Imagine you are somebody who is suffering from the brain disorder of addiction.
想象你受到成瘾的脑部功能失调所苦。
You are fragile. You're embarrassed, you're ashamed. And you overdose.
你很脆弱。你很尴尬，你很羞耻。并且你用药过量。
Maybe a friend or a family member calls 911.
也许你的朋友或家人打了求救电话。
And then all of a sudden, you are awakened by five or six total strangers in uniform.
接着，突然间，你醒来就看到五六个穿着制服的陌生人。
And they're rubbing your sternum, and they're saying, "Wake up, wake up! You overdosed, you could've died."
他们在磨擦你的胸骨，他们说：“醒醒，醒醒！你用药过量了，你本来可能丧命的。”
Now, would you not be defensive and angry? Because I know I would be.
你不会有防御心或感到生气吗？因为我知道我就会。
And on top of that, those strangers gave you a dose of naloxone,
此外，那些陌生人还给了你一剂钠洛酮，
which has sent you into withdrawals, or what is better known as "dope sickness."
让你进入戒断，更为人所知的说法是“毒品戒断不适”。
Dope sickness makes you feel absolutely horrible.
毒品戒断不适会让你感觉非常糟糕。
Some say it's like the flu, times ten. Nausea, vomiting, diarrhea, body aches.
有人说就像是流感再乘以十倍。恶心、呕吐、腹泻、身体疼痛。
So not only did we, as strangers, wake you up, but we also made you feel really sick.
所以，我们这些陌生人不仅是把你唤醒，我们还让你感觉非常不舒服。
So in turn, you, the patient, are not going to be very kind to us.
所以，相对的，身为病人，你对我们不会太仁慈。
And you're going to refuse further medical treatment.
你将会拒绝接受进一步的医疗治疗。
OK, well, then that's going to frustrate the heck out of us, and we're going to be mad,
那会让我们非常有受挫感，我们会被惹毛，
because you're ungrateful that we just saved your life. This is not a good dynamic here.
因为你不知感激，我们刚救了你一命呢。这并不是很好的互动关系。
What we are dealing with is a brain disorder that changes your thinking.
我们在处理的是大脑功能失调，会改变你的思想。
It convinces you that you don't have a problem.
它会说服你说你没有问题。
So, this might have been not only the first time you've overdosed,
所以，这可能不是你头一次用药过量，
it might have been the third, fourth or fifth time that we, personally, have revived you. This is not a good situation.
可能是我们第三次、第四次或第五次，亲手把你救回来。这并不是很好的状况。
Second, first responders do not receive much education on what substance use disorder is.
再者，第一线应变人员并没有受过很多关于物质使用失调的相关教育。
Neither does the medical community. We're not trained how to deal with those suffering from substance use disorder.
连医疗界也是一样。我们没有受过如何处理物质使用失调患者的训练。
I am trained to put out many different types of fires.
我受过扑灭各种火灾的训练。
I am trained to save a life in the moment.
我受过当下拯救人命的训练。
But I am not trained to deal with the intricate interaction between first responders,
但我受过的所有训练都没有教我处理第一线应变人员、
the health care community, social services and the wider community that is necessary to save a life long-term.
健康照护圈、社工服务和更广大的群体之间复杂的互动，但要长期拯救生命这是必需学会的。
Thirdly, and this hits home. As a first responder, I consider myself the cavalry.
第三， 这点正中要害。身为第一线应变人员，我认为我自己是救兵。
We're knights in shining armor. We want to swoop in,
我们是穿着闪亮盔甲的骑士。我们想要冲到现场，
do our job and leave feeling satisfied that we've made a difference in somebody's life.
做我们的工作，带着满足感离开，认为我们为别人的生命带来了不同。
But that just doesn't happen when we're dealing with somebody with substance use disorder.
但当我们在处理物质使用失调患者时，就不是这样的状况。
We leave feeling frustrated and useless. We deal with the same people over and over again, with no positive outcome.
我们带着挫折感和无用感离开。我们不断处理同样的人，没有任何正面的结果。
And you know what? At some point, I realized that it is up to us as first responders and as a community
你们知道吗？在某个时点，我了解到，我们要以第一线应变人员以及一个团体的身份，
to solve this problem, to find better ways to deal with those that are suffering.
来解决这个问题，来找到更好的方式，处理那些受苦的人。
So what I did is I started observing more on overdoses.
所以，我便开始对用药过量做更多的观察。
I started talking and listening to my patients.
我开始和我的病人交谈，倾听他们。
I wanted to know what led them to where they are.
我想要知道是什么原因导致他们变成现在这样。
What exactly are they experiencing? What makes their situation worse?
他们到底经历了什么？什么会让他们的状况更糟？
What makes their situation better?
什么会让他们的状况变好？
I began experimenting with my words and paying attention to my own actions and how it affected those of my patients.
我开始用我的话语来做实验，并对我自己的行为多加留心，看我的行为会如何影响我的病人。

The education that I have received and continue to receive on a street level in Huntington
我在亨廷顿市街头曾经受到/持续受到的教育，
has been both eye-opening and life-changing for me.
对我来说，既让我开了眼界，也改变了我的人生。
So, in Huntington, West Virginia, we have come together as a community,
在西弗吉尼亚的亨廷顿市，我们结合成了一个群体，
and we are changing the way that we treat those that suffer from this horrible disease.
对于那些受到这种可怕疾病所苦的人，我们正在改变对待他们的方式。
We have started many programs, and it's making a difference. I'll tell you about just a few of those.
我们开始了许多方案，创造了很多不同。我会告诉各位其中几项。
Last year, we started a Quick Response Team, QRT for short.
去年，我们成立了快速反应小队，缩写是QRT。
The team consists of a paramedic, a police officer,
小队成员有一位医务人员、一位警官、
somebody in the recovery community and somebody in the faith community.
一名来自康复界的人及一名来自宗教信仰界的人。
As a team, they go out and visit people who have overdosed within 72 hours of that resuscitation.
在一个人用药过量被救回来之后的七十二小时内，整个小队会一起去造访他。
They talk. They listen. They build a rapport with that patient, and they offer them treatment options.
他们会交谈。他们会倾听。他们会和那名病人建立友好关系，并且他们会提供病人一些治疗选择。
Right now, about 30 percent or up to 30 percent of those that the Quick Response Team have reached out to have accepted some form of help.
目前，在快速应变小队接触过的人当中，大约有30%或高达30%都接受了某种形式的协助。
And the wonderful thing about this is the first responders who are involved in this team,
很棒的一点是，参与这种小队的第一线应变人员，
they actually feel like they can make a difference.
他们真的有感觉到他们能够创造不同。
Positive change where there wasn't any. This year...
这些正面改变是以前无法做到的。今年...
This year, we opened a free-standing specialty clinic, called PROACT, for those suffering from substance use disorder.
今年，我们成立了一家自立专科诊所，简称PROACT，服务对象是受物质使用失调之苦的人。
It's a one-stop shop, if you will.
可以说它是一站购齐式的商店。
A patient comes in, they're immediately assessed by somebody who's an addiction specialist.
病人进来之后，马上有成瘾的专家为他做评估。
They work with them to provide treatment options based on their own needs, individual needs.
他们会根据病人自己个别的需求，来提供相关的治疗选择。
This does several things for us.
这对我们也会有些影响。
It gives first responders a place to either take or refer our patients
第一线应变人员就可以接受或转介
who are no longer in a life-threatening situation, that have refused to go to the hospital.
已经没有生命危险且已经拒绝去医院的病人到这里来。
And it also clears up the overwhelmed emergency rooms in hospitals that we have.
它也能帮已经爆满的医院急诊室分担一些病人。
The third thing that I want to tell you about is very dear to me and very important to my team.
我想要谈的第三点，我个人非常有感，并且对我的团队也非常重要。
We recently started a first responders self-care program.
最近，我们开始了一项第一线应变人员的自我照顾方案。
More and more ... first responders are experiencing compassion fatigue and PTSD.
越来越多的...第一线应变人员经历到同情心疲劳和创伤后压力症候群。
It is not uncommon for the average firefighter in Huntington to deal with or see up to five young deaths per month.
对亨廷顿市的一般消防员来说，每个月要处理或看见五个年轻人死亡是家常便饭。
These are their friends, these are their classmates.
这些人是他们的朋友、他们的同学。
So this much-needed program will not only recognize their hard work, it's going to give them a voice.
所以这个很被需要的方案，不仅是肯定他们的辛苦努力，也会让他们的可以发声。
It's going to provide them with training that will help deal with the stress that they are under.
这个计划会提供他们训练，协助他们处理他们所受的压力。
And it will give them more mental-health options that they desperately need.
这个计划也会给予他们更多心理健康的选择，这些是他们迫切需要的。
We now have yoga classes in fire stations. We've also provided on-duty massages, which is fabulous.
现在在消防局里还有瑜伽课。我们还在执勤时段提供按摩，这真的很棒。
And we have some off-duty programs that we've started,
我们也开始有一些不当班时的方案，
like cooking classes for first responders and their significant other and pottery classes.
比如烹饪课，对象是第一线应变人员以及他们的重要另一半，还有陶艺课。
So a couple of months ago, I walked out on the apparatus floor, where I had some firefighters.
几个月前，我走到消防车车库，在那里有些消防员。
And half of them had had a massage, and the other half were getting ready to have a massage.
当中有一半的人都做过按摩，另一半的人也准备好要做按摩了。
And I saw 10 firefighters who were bantering in a very positive, relaxed manner.
我看到十名消防员以非常正面、放松的方式在开玩笑。
And I hadn't seen that in years. And that relaxed state is trickling down to the community, to the citizens.
我好多年没看到这种景象了。而那种放松的状态会向下渗到小区、到市民。
So a couple of weeks ago, I had a neighbor overdose. Twenty-two years old.
几个星期前，我有一位邻居用药过量。二十二岁。
So of course, I hurried down to help my firefighters and my neighbor.
当然，我赶快去协助我的消防员和那位邻居。
And what I witnessed was my firefighters being supportive. Talking in a non-judgmental way.
我看到的是，这些消防员的表现充满支持。他们说话的方式不带有评断。
I watched as one of my firefighters showed the father and another family member
我看着我的其中一位消防员教导这位邻居的爸爸和另一位家人，
how to provide rescue breaths, should this happen again.
如果再发生这样的事，要如何做人工呼吸。
And left him with a bag valve mask. Positive change. Positive change.
并留给他一个袋瓣呼吸面罩。正面的改变。正面的改变。
Did I happen to mention the two things that firefighters dislike the most? The way things are and change.
我刚有没有提到消防员最不喜欢的两样东西？事物的现状和改变。
You know, I recognize that there have been drug epidemics before.
我知道以前也有毒品流行。
And I've seen what crack can do to a community.
我曾经见过古柯碱对小区的影响。
A lot of our critics think that this new compassionate response that we're doing in Huntington is because of race.
很多评论家认为我们在亨廷顿市做这种新的同情式应变是因为种族。
That because the overdoses are happening so much to the white community.
因为在白人小区发生这么多用药过量。
And I understand that criticism, because we as a country messed up.
我能了解这种批评，因为我们这个国家搞砸了。
And we treated black people poorly during the crack epidemic.
在古柯碱流行的时候，我们对待黑人的方式很糟糕。
We can't forget that. And we must do better.
我们无法忘怀这件事。我们必须要做得更好。
But right now, what I know is people are dying.
但现在，我所知道的是有人在步向死亡。
And we in Huntington deal with people suffering from substance use disorder of every color and every background, on the streets, every day.
在亨廷顿市，我们每天在街头要处理的物质使用失调患者是什么肤色都有、什么背景都有。
The job of a first responder: prevent unnecessary deaths. Period. So ...
第一线应变人员的工作：预防不必要的死亡。就这样。所以...
Obviously, I'm a stubborn firefighter and nurse.
很显然，我是位很固执的消防员和护士。
And I refuse to believe that there isn't a way around every barrier.
我拒绝相信我们找不到路可以绕过障碍。
One of the barriers that we have dealing with the opioid epidemic is stigma.
我们在处理鸦片类药物所遇到的障碍之一就是视之为羞耻。
So ... We in Huntington, West Virginia, are showing the rest of the country that change can happen.
所以...在西弗吉尼亚的亨廷顿市，我们要让全国其他地方看到，改变是有可能发生的。
That there is hope dealing with this epidemic.
仍然有希望可以处理这种流行。
Our current overdoses are down 40 percent.
我们目前用药过量的状况已经下降四成。
Currently, our overdose deaths are down 50 percent.
目前，我们因为用药过量造成的死亡下降了五成。
This epidemic is far from over. But each and every one of us has a part to play in this epidemic.
这种流行病离结束还很远。但在这场流行病当中，我们每一个人都有角色要扮演。
Just by listening and being kind to somebody, you have the ability to make a difference in their lives.
只要能够倾听他人、对他人仁慈，你就有能力可以在他们的生命中创造改变。
Thank you and God bless.
谢谢大家，愿上帝保佑。