孤獨這種流行病吞噬着我們的生命
My patient and I both knew he was dying.
我和我的病人當時都知道他將不久於人世。
Not the long kind of dying that stretches on for months or years.
不是那種會拖上幾個月甚至幾年的瀕死狀態。
He would die today.
他可能會在當天死去。
Maybe tomorrow.
也可能是明天。
And if not tomorrow, the next day.
如果不是明天，那就是後天。
Was there someone I should call? Someone he wanted to see?
我應該電話通知某個人，某個他想見到的人嗎？
Not a one, he told me.
這樣一個人不存在，他告訴我。
No immediate family.
沒有直系親屬。
No close friends.
也沒有親密的朋友。
He had a niece down South, maybe, but they hadn’t spoken in years.
他或許在南部有一個侄女，但他們好多年都沒交談過了。
For me, the sadness of his death was surpassed only by the sadness of his solitude.
在我看來，唯有他的孤獨所帶來的傷感，能壓過他的死亡所帶來的傷感。
Every day I see variations at both the beginning and end of life: a young man abandoned by friends as he struggles with opioid addiction; an older woman getting by on tea and toast, no longer able to clean her cluttered apartment.
每一天，我都會在生命的起點和終點看到這類情況的種種版本：一個年輕的男人在竭力對抗毒癮之際遭到友人的拋棄；一個上了年紀的女人靠茶和烤麪包片度日，再也不能清理她那雜亂的公寓。
In these moments, it seems the only thing worse than suffering a serious illness is suffering it alone.
在這些時刻，唯一一件比承受嚴重病痛更糟糕的事情，似乎就是獨自承受嚴重的病痛。
Social isolation is a growing epidemic — one that’s increasingly recognized as having dire physical, mental and emotional consequences.
社交孤立是一種不斷升級的流行病——人們日益認爲它會對身體、精神和情感造成可怕的影響。
Since the 1980s, the percentage of American adults who say they’re lonely has doubled from 20 percent to 40 percent.
自從上世紀80年代以來，說自己感到孤獨的美國成人的比例已經從20%上升到40%，整整多了一倍。
About one-third of Americans older than 65 live alone; half of those over 85 do.
65歲以上的美國老人約有三分之一獨自居住，85歲以上者則有一半是如此。
People in poor health — especially those with mood disorders like anxiety and depression — are likelier to feel lonely.
健康狀況差的人——尤其是有焦慮、抑鬱等情緒病的人——更有可能感到孤獨。
Those without a college education are the least likely to have someone they can talk to about important personal matters.
想要談論重要的個人事務時，沒接受過大學教育的人最不可能找到傾吐對象。
A wave of new research suggests social separation is bad for us.
一系列新研究表明，社會隔離對我們有害無益。
People with less social connection have disrupted sleep patterns, altered immune systems, more inflammation and higher levels of stress hormones.
社會交往較少的人睡眠模式會紊亂，免疫系統會發生變化，更容易出現炎症反應，體內壓力荷爾蒙的水平也更高。
One recent study found that isolation increases the risk of heart disease by 29 percent and stroke by 32 percent.
最近的一項研究發現，孤獨會讓罹患心臟病和發生中風的風險分別增加29%和32%。
Another analysis that pooled data from 70 studies and 3.4 million people found that socially isolated individuals had a 30 percent higher risk of dying in the next seven years, an effect largest in middle age.
對來自70項研究和340萬人的數據進行了彙總的一項分析發現，處於社交孤立狀態的個人在接下來的7年內死亡的風險比普通人高30%，這種效應在中年人身上最爲突出。
Loneliness can accelerate cognitive decline in older adults, and isolated individuals are twice as likely to die prematurely as those with more robust social interactions.
孤獨可能會讓老年人認知能力下降的速度有所加快，孤立的人過早死亡的風險比交際廣泛者多出一倍。
These effects start early: Socially isolated children have significantly poorer health 20 years later, even after controlling for other factors.
這些影響的種子可以在很早的時候種下：即使調整了其他因素，處於社交孤立狀態的孩子在20年後的健康狀況也非常差。
All told, loneliness is as important a risk factor for early death as obesity and smoking.
所有這些都表明，與肥胖、吸菸一樣，孤獨是導致早亡的重要風險因素。
The evidence on social isolation is clear.
關於社交孤立的事實證據頗爲清晰。
What to do about it is less so.
但人們對於該如何應對社交孤立還不甚瞭然。
Loneliness is especially tricky because accepting and declaring our loneliness carries profound stigma.
孤獨是一個尤爲棘手的問題，因爲承認並宣示我們的孤獨會讓我們深深地感到羞恥。
Admitting we’re lonely can feel as if we’re admitting we’ve failed in life’s most fundamental domains: belonging, love, attachment.
承認我們是孤獨的，就好像是承認我們在生活的某些最基本的方面遭遇了失敗：歸屬感，愛，依戀。
It attacks our basic instincts to save face, and makes it hard to ask for help.
它會觸及我們想要保全臉面的本能，從而讓求助變得更加困難。
I see this most acutely during the holidays when I care for hospitalized patients,
在假期照顧住院治療的患者時，我對這一點看得尤爲清楚。
some connected to IV poles in rooms devoid of family or friends — their aloneness amplified by cheerful Christmas movies playing on wall-mounted televisions.
有些患者待在一個親友也沒有的房間裏打着點滴——壁掛式電視上放映的歡快的聖誕電影，尤爲突顯了他們的孤獨。
And hospitalized or not, many people report feeling lonelier, more depressed and less satisfied with life during the holiday season.
此外，不論住院與否，很多人都表示，他們在假期會感到更孤獨、更沮喪、更不滿。
New research suggests that loneliness is not necessarily the result of poor social skills or lack of social support, but can be caused in part by unusual sensitivity to social cues.
新研究顯示，孤獨不一定是社交技巧糟糕、社會支持缺失的結果，但在某種程度上可以由對社交提示不同尋常的敏感引發。
Lonely people are more likely to perceive ambiguous social cues negatively, and enter a self-preservation mindset — worsening the problem.
孤獨的人更有可能對模糊的社交提示做出負面解讀，並進入一種自我保護的思維模式——從而讓問題變得更糟。
In this way, loneliness can be contagious: When one person becomes lonely, he withdraws from his social circle and causes others to do the same.
這樣，孤獨就具有了傳染性：當一個人變得孤獨的時候，會退出自己的社交圈，導致其他人也如此行事。
Dr John Cacioppo, a psychology professor at the University of Chicago, has tested various approaches to treat loneliness.
芝加哥大學(University of Chicago)心理學教授約翰•卡奇奧波(John Cacioppo)博士對各種應對孤獨的方法進行了測試。
His work has found that the most effective interventions focus on addressing maladaptive social cognition — that is, helping people re-examine how they interact with others and perceive social cues.
他經研究發現，最有效的干預以應對非適應性社會認知爲重點——意即幫助人們重新審視他們與人互動和感知社交線索的方式。
He is collaborating with the US military to explore how social cognition training can help soldiers feel less isolated while deployed and after returning home.
他正與美國軍方合作，研究社會認知培訓如何能夠有助於減少士兵在服役期間和退役後的孤立感。
The loneliness of older adults has different roots — often resulting from family members moving away and close friends passing away.
老年人的孤獨有着不同的根源——常常是由家庭成員從家裏搬走或者親密的朋友過世引起。
Ideally, experts say, neighborhoods and communities would keep an eye out for such older people and take steps to reduce social isolation.
專家稱，理想狀態下，鄰居和社區會密切關注這樣的老年人，並採取措施減少他們的社交孤立感。
Ensuring they have easy access to transportation, through discounted bus passes or special transport services, can help maintain social connections.
通過提供公交車票折扣或者特殊交通服務，確保他們有便捷的出行方式，可以幫助他們維繫社會交往。
Religious older people should be encouraged to continue regular attendance at services.
應該鼓勵信教的老年人繼續定期參加宗教儀式。
Those capable of caring for an animal might enjoy the companionship of a pet.
有能力照顧小動物的人或許會享受寵物的陪伴。
And loved ones living far away from a parent or grandparent could ask a neighbor to check in periodically.
住在離父母或者祖父母輩很遠的地方的人，可以拜託鄰居定期查看其狀況。
But more structured programs are arising, too.
但更加有組織的項目也在涌現。
For example, Dr Paul Tang of the Palo Alto Medical Foundation started a program called linkAges, a cross-generational service exchange inspired by the idea that everyone has something to offer.
例如，帕洛•奧爾圖醫療基金會(Palo Alto Medical Foundation)的保羅•唐(Paul Tang)博士受人人都能有所貢獻這一理念啓發，創建了一個跨越代際的服務交換項目，名爲linkAges。
The program works by allowing members to post online something they want help with: guitar lessons, a Scrabble partner, a ride to the doctor’s office.
項目成員可以把自己想要求得幫助的事項發到網上：學吉他，找猜字遊戲玩伴，搭車去看醫生。
Others can then volunteer their time and skills to fill these needs and bank hours for when they need something themselves.
然後其他人可以志願貢獻自己的時間和技能來滿足這些需求，再把相應的小時數存進銀行，等到他們自己需要幫助的時候便可以提現。
In America, you almost need an excuse for knocking on a neighbor’s door, Tang told me.
在美國，幾乎連敲響鄰居的房門都需要一個好理由，唐告訴我。
We want to break down those barriers.
我們想打破這些藩籬。
The program now has hundreds of members in California and plans to expand to other areas of the country with a recent grant from the Robert Wood Johnson Foundation.
該項目目前在加利福尼亞州有數百名成員，最近收到了來自羅伯特•伍德•約翰遜基金會(Robert Wood Johnson Foundation)的一筆資助，打算向美國其他地區拓展。
We in the medical community have to ask ourselves: Are we controlling blood pressure or improving health and well-being? Tang said.
我們這些醫學界的人必須自問：我們是在控制血壓，還是在提升人們的健康狀況和幸福感？唐說。
I think you have to do the latter to do the former.
我認爲只有做到後者才能做到前者。
Increasingly, research confirms our deepest intuition: Human connection lies at the heart of human well-being.
一系列研究日益表明，我們內心最深處的直覺是正確的：人與人的交往在人類的幸福感中居於核心位置。
It’s up to all of us to maintain bonds where they’re fading, and create ones where they haven’t existed.
當關系變淡的時候，要靠我們所有人去維繫；當關系尚未建立的時候，要靠我們所有人去建立。
