下面两个真实的故事，也许会帮助你了解什么是“痛”。

…the story of the two nails.

……两个钉子的故事。

…2007 “Journal of Psychosomatic Medicine” reported on two gentlemen. They were both construction workers, because apparently that’s the most dangerous job anyone can ever have. So one was a 29-year-old construction worker, and he was on a job site, and he jumped off a platform straight onto a seven-inch nail.

雷切尔佐夫内斯：2007年《心身医学杂志》报道了两位男士。 他们都是建筑工人，因为显然这是最危险的工作。 其中一位是 29 岁的建筑工人，他在一个工作现场，从平台上跳下，直接撞到了一个七英寸的钉子上。

And that nail went straight through his boot, clear through to the other side. And he was in terrible, excruciating pain. And his colleagues were all horrified, and they rushed him to the emergency room. And he was screaming with pain and they gave him an I.V. of intravenous fentanyl, which is a very powerful opioid, as we all know.

那颗钉子直接穿过他的靴子，直达另一边。 他处于可怕的、难以忍受的痛苦之中。 而他的同事们都吓坏了，赶紧把他送到了急诊室。 他痛得尖叫，他们给了他静脉注射。众所周知， 静脉注射芬太尼，这是一种非常强大的阿片类药物。

And the good doctors removed his boot, and they discovered that a miracle had occurred. The nail had passed between the space between his toes. There was no blood. There was no wound. There was no tissue damage, but his pain was real. How is that possible?

医生把他的靴子脱掉，他们发现奇迹发生了。 钉子从他的脚趾间穿过了。 没有血。 没有伤口。 没有组织损伤，但他的疼痛是真实的。 这怎么可能？

His brain, a.k.a. his danger detector, used all available information — memories of past pain experiences, knowledge of the dangerous work environment, the panic that he saw on his friends faces, this visual, of course his five senses, this visual of a nail sticking out of his boot. I also would freak out, and because —

他的大脑，也就是他的危险探测器，使用了所有可用的信息——对过去痛苦经历的记忆，对危险工作环境的了解，他在朋友脸上看到的恐慌，这种视觉，当然是他的五种感官，这种钉子的视觉 从他的靴子里伸出来。 我也会吓坏的，因为——

Ezra Klein

I feel pain just hearing this story.

埃兹拉·克莱恩：

听到这个故事，我感到很痛苦。

Rachel Zoffness

Yeah, and because his brain decided that his body was in danger, it made to protect him. So second tail of nails, and by the way, of course I like stories that rhyme. I call it a tale of two nails. The second story, another construction worker was on a job site. He was somewhere in Colorado. And he was using a nail gun.

雷切尔佐夫内斯：

是的，因为他的大脑决定他的身体处于危险之中，所以大脑保护了他。顺便说一句，我当然喜欢押韵的故事。 我称之为两个钉子的故事（a tale of two nails）。第二个故事，另一个建筑工人在工地上。 他在科罗拉多的某个地方。 他用的是射钉枪。

And the nail gun accidentally discharged, and ricocheted backwards, and it clocked him in the jaw. And he had a mild headache and a mild toothache, but he continued on with work and life for about six days. And at the end of six days, he turned to his wife and said, you know, I’m going to get this toothache checked out.

射钉枪意外射出，向后弹回，正中他的下巴。 他有轻微的头痛和轻微的牙痛，但他继续工作和生活了大约六天。 六天后，他转身对妻子说，你知道，我得去看看为什么会有牙痛。

And he went to a dentist, and the dentist did a scan of his patient’s jaw. And much to both men’s surprise, they discovered a four-inch nail embedded in his face. Right, and what had happened was, when the nail gun discharged, he saw a nail shoot across the room and bury in the wall across from him.

他去看牙医，牙医扫描了他病人的下巴。 令两人大吃一惊的是，他们在他的脸上发现了一颗四英寸长的钉子。 是的，实际情况是，当钉枪发射时，他看到一根钉子射过房间，埋在他对面的墙上。

So again, his brain, our danger detector, used all available information to determine whether or not to make pain and how much. So it used this visual of this nail shooting across the room, and information also of this experience of having this nail gun clock him in the jaw, and decided that not much pain was needed because his body ultimately was safe.

因此，他的大脑，即我们的危险探测器，再次使用所有可用信息来确定是否要制造疼痛以及疼痛程度。 所以它使用了这个钉子穿过房间的视觉效果，以及用这把钉枪打在他下巴上的经历的信息（非常不可能），并决定不需要太多的痛苦，因为他的身体最终是安全的。

And I read this, like I went down this rabbit hole with these stories so far you have no idea. I have a collection of every interview, everything. And one of the doctors who finally did the surgery to remove the nail said something like, he’s the luckiest man I’ve ever met. Ezra’s shuttering, everybody.

我读了这篇文章，就像我带着这些故事走进了这个兔子洞，到目前为止你还不知道。 我收集了每一次采访，一切内容。 一位最终做了拔钉子手术的医生说，他是我见过的最幸运的人。 大家注意，埃兹拉惊呆了。

So again, to me what I really love about these stories is that they illustrate the point, pun intended, that I’m trying to make, which is your brain is always using all information, not just some information. Pain and tissue damage are not the same thing.

再说一次，对我来说，我真正喜欢这些故事的地方在于，它们说明了我试图表达的观点，即你的大脑总是在使用所有信息，而不仅仅是一些信息。 疼痛和组织损伤不是一回事。

The conclusion of the tale of two nails is, you can have damage to your body and not a lot of pain, like a four-inch nail embedded in your face. And you can have no tissue damage and have a lot of pain, like our friend who had the nail in his boot.

两个钉子的故事的结论是，你的身体可能会受到伤害而不是很痛，就像一个四英寸的钉子嵌入你的脸。 你可以没有组织损伤，但会感到很痛，就像我们的朋友靴子里进了钉子一样。

And we all know that this is true. If you’ve ever gotten into the shower and you’re like, whoa, I have a black and blue mark. How did that get there? That’s evidence of damage to your body without accompanying pain. Or if you’re someone who’s an athlete — I am not. I am a bookworm.

我们都知道这是真的。 如果你曾经洗过澡，你会想，哇，我身上有一块黑色和蓝色的。 那是怎么回事？ 这是你身体受损但没有伴随疼痛的证据。 或者，如果你是运动员——我不是。 我是一个书呆子。

But if you’re someone who grew up playing sports, and you ever had a great soccer game or a great football game, and at the end of the game, you discover that you were covered in blood and you had no idea what happened, and it was only then that the pain started, you also have had that experience. All factors matter when it comes to pain production and pain reduction.

但如果你是一个从小就喜欢运动的人，你曾经有过一场精彩的足球比赛或一场精彩的足球比赛，而在比赛结束时，你发现自己浑身是血而且你不知道发生了什么， 直到那时才开始疼痛，你也有过那种经历。 当谈到疼痛的产生和减轻时，所有因素都很重要。

来源于：

This Book Changed My Relationship to Pain

The pain psychologist Rachel Zoffness explains how pain is a “biopsychosocial phenomenon” — and how we can better treat it as such.

Tuesday, February 21st, 2023