雙語·當呼吸化為空氣 如果死亡的沉重感不會減輕一分一毫

如果死亡的沉重感不會減輕一分一毫，那么至少，能不能變得更習以為常一些？
If the weight of mortality does not grow lighter, does it at least get more familiar?

被診斷出絕癥之后，我開始擁有兩個角度的世界觀，分別用醫(yī)生和病人的身份去看待死亡。作為醫(yī)生，我知道不要去宣稱什么“抗癌是一場戰(zhàn)斗，我會贏”，也不要問“為什么是我”。（答案是：為什么不是我？）我很了解相關(guān)的醫(yī)療服務、并發(fā)癥和治療方法。我很快從腫瘤專家和自己的研究中得出結(jié)論——肺癌第四期，在今天的醫(yī)療界，算是有變數(shù)的絕癥，就像二十世紀八十年代末的艾滋?。核劳雎室廊缓芨撸灿泻芏嘞嚓P(guān)方面的專家紛紛涌現(xiàn)，出現(xiàn)了長期存活下去的病例。
Once I had been diagnosed with a terminal illness, I began to view the world through two perspectives; I was starting to see death as both doctor and patient. As a doctor, I knew not to declare “Cancer is a battle I’m going to win!” or ask “Why me?” (Answer: Why not me?) I knew a lot about medical care, complications, and treatment algorithms. I quickly learned from my oncologist and my own study that stage IV lung cancer today was a disease whose story might be changing, like AIDS in the late 1980s: still a rapidly fatal illness but with emerging therapies that were, for the first time, providing years of life.

借助醫(yī)療和科研方面所受的訓練，我得以分析各種數(shù)據(jù)。而根據(jù)數(shù)據(jù)來分析我的預后，顯然是不夠的，這種局限我也能接受。然而，這并不能幫我做好一個病人。那些訓練無法給露西和我一個確切的答案，到底要不要往前一步，生個孩子；也無法告訴我們，當我的生命正在消逝時，去培養(yǎng)一個新生命，到底意味著什么。我也不得而知，在不能保證充足時間的情況下，還要不要去為我的事業(yè)抗爭，重新去實現(xiàn)我多年來一心一意立下的雄心壯志。
While being trained as a physician and scientist had helped me process the data and accept the limits of what that data could reveal about my prognosis, it didn’t help me as a patient. It didn’t tell Lucy and me whether we should go ahead and have a child, or what it meant to nurture a new life while mine faded. Nor did it tell me whether to fight for my career, to reclaim the ambitions I had singlemindedly pursued for so long, but without the surety of the time to complete them.

和我過去的病人一樣，我也必須面對自己即將死亡這個事實，努力去弄清楚是什么讓我這輩子值得一活。我需要艾瑪?shù)膸椭?。醫(yī)生和病人的雙重身份讓我有種撕裂的感覺，我一邊鉆研醫(yī)學，一邊又轉(zhuǎn)向文學作品尋找答案。面對自己的死亡，我在掙扎，是重建舊生活，還是去尋找新生活？
Like my own patients, I had to face my mortality and try to understand what made my life worth living—and I needed Emma’s help to do so. Torn between being a doctor and being a patient, delving into medical science and turning back to literature for answers, I struggled, while facing my own death, to rebuild my old life—or perhaps find a new one.

不過我每周的主要時間并非在進行認知療法，而是接受物理治療。每個我經(jīng)手的病人，幾乎都被送去接受過物理治療。結(jié)果現(xiàn)在我才震驚地發(fā)現(xiàn)，原來過程是這么艱難。作為醫(yī)生，你當然了解生病是怎么回事，但如果不親身經(jīng)歷，你就不算真正了解。跟墜入愛河或者生孩子是一樣的。堆積如山的病歷表格需要填寫，還有其他煩瑣的小事，都會讓你心煩意亂。比如，輸液的時候，液體進入血管時，嘴里真的會涌起一股咸味。他們告訴我，人人都是這樣，但從醫(yī)十一年的我卻是頭一回切身體會。
The bulk of my week was spent not in cognitive therapy but in physical therapy. I had sent nearly every one of my patients to physical therapy. And now I found myself shocked at how difficult it was. As a doctor, you have a sense of what it’s like to be sick, but until you’ve gone through it yourself, you don’t really know. It’s like falling in love or having a kid. You don’t appreciate the mounds of paperwork that come along with it, or the little things. When you get an IV placed, for example, you can actually taste the salt when they start infusing it. They tell me that this happens to everybody, but even after eleven years in medicine, I had never known.

在物理療法上，我還沒進展到舉重物的那一步，只是抬抬腿什么的。這就已經(jīng)累得我筋疲力盡了，真是丟臉。我的腦子還在，但根本找不回以前的自己了。我身體很虛弱，不堪一擊，那個經(jīng)常去跑半程馬拉松的人，似乎已成為遙遠的過去。這也成為你的特性之一。難以忍受的背痛可以塑造你的特性，疲乏與惡心的感覺也可以。負責我物理治療的教練凱倫問我有什么目標，我說了兩個：可以騎自行車，可以出去跑個步。身體虛弱了，決心就變得很重要。我每天都堅持鍛煉，力量每增加一點，我的世界就更寬廣一點，我自身的可能性也就更多一點。我開始增加鍛煉的次數(shù)、抬舉的重量和練習的時間，逼著自己一直練到想吐為止。兩個星期后，我可以連坐三十分鐘不覺得累，也能跟朋友出去吃個晚飯了。
In physical therapy, I was not even lifting weights yet, just lifting my legs. This was exhausting and humiliating. My brain was fine, but I did not feel like myself. My body was frail and weak—the person who could run half marathons was a distant memory—and that, too, shapes your identity. Racking back pain can mold an identity; fatigue and nausea can, as well. Karen, my PT, asked me what my goals were. I picked two: riding my bike and going for a run. In the face of weakness, determination set in. Day after day I kept at it, and every tiny increase in strength broadened the possible worlds, the possible versions of me. I started adding reps, weights, and minutes to my workouts, pushing myself to the point of vomiting. After two months, I could sit for thirty minutes without tiring. I could start going to dinner with friends again.

一天下午，露西和我開車到了幽谷路——騎單車的好地方，也是我們的最愛。（出于個人的驕傲，我得說一句，一般來說，我們都是騎車去那里的，但我這弱不禁風的身子骨，騎車怕是爬不上那些小山坡了。）我左搖右晃地騎了十公里左右。去年夏天，我可是輕輕松松就騎了將近五十公里啊，現(xiàn)在和那時比起來真是天壤之別。但至少我還是在兩個輪子上坐穩(wěn)了。
One afternoon, Lucy and I drove down to Ca. ada Road, our favorite biking spot. (Usually we would bike there, pride forces me to add, but the hills were still too formidable for my lightweight frame.) I managed six wobbly miles. It was a far cry from the breezy, thirtymile rides of the previous summer, but at least I could balance on two wheels.