真是太夢(mèng)幻了。也就是那個(gè)時(shí)候,我恍然大悟:這只是夢(mèng)幻而已。我們不可能搬來威斯康星。萬(wàn)一我這兩年癌癥嚴(yán)重復(fù)發(fā)呢?露西得孤孤單單在這里,遠(yuǎn)離朋友和家人,僅憑一己之力照顧病入膏肓的丈夫和新生的孩子。我近乎暴怒地抵擋著想接受這份工作的欲望,也意識(shí)到,癌癥已經(jīng)徹底顛覆了我對(duì)人生的規(guī)劃打算。過去幾個(gè)月來,我一直全力以赴,想讓生活恢復(fù)到癌癥之前的軌跡,否認(rèn)癌癥對(duì)我的生活造成了任何影響。然而,現(xiàn)在的我,不管多么希望感覺到勝利的喜悅,還是感到癌癥如同螃蟹的大鉗子,緊緊夾住我,阻止我前進(jìn)。癌癥的詛咒是奇怪而緊張的存在,也是對(duì)我的極大挑戰(zhàn),對(duì)于死神的步步逼近,我既不能無(wú)視,也不能任其擺布。就算現(xiàn)在死神蟄伏起來,他的陰影也時(shí)刻籠罩著我。
It was like a fantasy. And in that moment, it hit me: it was a fantasy. We could never move to Wisconsin. What if I had a serious relapse in two years? Lucy would be isolated, stripped of her friends and family, alone, caring for a dying husband and new child. As furiously as I had tried to resist it, I realized that cancer had changed the calculus. For the last several months, I had striven with every ounce to restore my life to its precancer trajectory, trying to deny cancer any purchase on my life. As desperately as I now wanted to feel triumphant, instead I felt the claws of the crab holding me back. The curse of cancer created a strange and strained existence, challenging me to be neither blind to, nor bound by, death’s approach. Even when the cancer was in retreat, it cast long shadows.
一開始丟掉斯坦福那個(gè)教授職位的時(shí)候,我安慰自己,要管理一個(gè)實(shí)驗(yàn)室,至少需要有二十年的計(jì)劃?,F(xiàn)在,我覺得這安慰其實(shí)是不折不扣的真理。弗洛伊德一開始就是個(gè)成功的神經(jīng)科學(xué)家,后來他認(rèn)識(shí)到,神經(jīng)科學(xué)還需要至少一個(gè)世紀(jì)的時(shí)間,才能滿足他在了解心靈和思想方面真正的抱負(fù),于是丟開顯微鏡,另起爐灶。我的感覺跟他可能有點(diǎn)像。通過研究來創(chuàng)造神經(jīng)外科的變革就像一個(gè)長(zhǎng)期的賭局,因?yàn)槲业牟?,這個(gè)賭局幾乎沒有了勝算。我所剩的籌碼不多,不想押在實(shí)驗(yàn)室里了。我耳邊又響起艾瑪?shù)脑挘耗惚仨毰靼?,自己最看重的是什么?br>When I’d first lost the professorship at Stanford, I’d consoled myself with the idea that running a lab made sense only on a twenty-year time scale. Now I saw that this was, in fact, true. Freud started his career as a successful neuroscientist. When he realized neuroscience would need at least a century to catch up with his true ambition of understanding the mind, he set aside his microscope. I think I felt something similar. Transforming neurosurgery through my research was a gamble whose odds had been made too long by my diagnosis; the lab wasn’t the place I wanted to plunk the remainder of my chips. I could hear Emma’s voice again: You have to figure out what’s most important to you.
如果我已經(jīng)不想再問鼎神經(jīng)外科與神經(jīng)系統(tǒng)科學(xué)這兩座高峰了,那我想干什么呢?
If I no longer sought to fly on the highest trajectory of neurosurgeon and neuroscientist, what did I want?
當(dāng)個(gè)爸爸?
To be a father?
做個(gè)神經(jīng)外科醫(yī)生?
To be a neurosurgeon?
教書?
To teach?
我也不知道。不過,就算我不知道自己要什么,也還是有收獲,這收獲并非來自希波克拉底、邁蒙尼德或者奧斯勒,而是我獨(dú)有的頓悟:醫(yī)者的職責(zé),不是延緩死亡或讓病人重回過去的生活,而是在病人和家屬的生活分崩離析時(shí),給他們庇護(hù)與看顧,直到他們可以重新站起來,面對(duì)挑戰(zhàn),并想清楚今后何去何從。
I didn’t know. But if I did not know what I wanted, I had learned something, something not found in Hippocrates, Maimonides, or Osler: the physician’s duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence.
現(xiàn)在,我那些屬于外科醫(yī)生的驕傲自負(fù)實(shí)在毫無(wú)用處。我的確是本著對(duì)病人盡職盡責(zé)的態(tài)度,全心全意地救死扶傷,但說穿了這就是暫時(shí)的責(zé)任,是轉(zhuǎn)瞬即逝的全心全意。解決了嚴(yán)重的健康危機(jī),病人醒來了,身上的管子拔掉了,然后出院了,病人和家屬繼續(xù)生活,但事情永遠(yuǎn)不會(huì)和以前一樣了。醫(yī)生的話能安撫人心,就像神經(jīng)外科醫(yī)生的手術(shù)刀能減緩大腦的疾病。然而,這其中的不確定性與后續(xù)的發(fā)病率,還是需要繼續(xù)去克服、去纏斗。
My own hubris as a surgeon stood naked to me now: as much as I focused on my responsibility and power over patients’ lives, it was at best a temporary responsibility, a fleeting power. Once an acute crisis has been resolved, the patient awakened, extubated, and then discharged, the patient and family go on living—and things are never quite the same. A physician’s words can ease the mind, just as the neurosurgeon’s scalpel can ease a disease of the brain. Yet their uncertainties and morbidities, whether emotional or physical, remain to be grappled with.
艾瑪沒有讓我恢復(fù)原來的個(gè)人特性,而是保護(hù)了我創(chuàng)造新特性的能力。終于,我明白,必須去創(chuàng)造新的自我了。
Emma hadn’t given me back my old identity. She’d protected my ability to forge a new one. And, finally, I knew I would have to.
大齋節(jié)的第三個(gè)星期日,明澈通透的春日清晨,我們夫妻倆和我的父母一起去了教堂。他們倆從亞利桑那飛來過周末。我們一起坐在長(zhǎng)長(zhǎng)的木凳子上,媽媽和坐在旁邊的一家人攀談起來,先是對(duì)那位母親說,她小女兒的眼睛真好看,接著迅速聊起格局更大的話題。她充分展示了一個(gè)傾聽者、好閨密和聯(lián)結(jié)者的高超能力。牧師讀《圣經(jīng)》的時(shí)候,我突然情不自禁地偷笑起來。這段《圣經(jīng)》文字中,沮喪的耶穌說了一些隱喻,而使徒們非要去做一些字面的解釋:
On a crystalline spring morning on the third Sunday of Lent, Lucy and I went to church with my parents, who had flown in from Arizona for a weekend visit. We sat together in a long wooden pew, and my mother struck up a conversation with the family sitting next to us, first complimenting the mother on her baby daughter’s eyes, then quickly moving on to matters of greater substance, her skills as a listener, confidante, and connector fully evident. During the pastor’s Scripture reading, I suddenly found myself chuckling. It featured a frustrated Jesus whose metaphorical language receives literal interpretation from his followers:
耶穌回答說:“凡喝這水的,還要再渴;人若喝我所賜的水就永遠(yuǎn)不渴;我所賜的水,要在他里頭成為泉源,直涌到永生?!眿D人說:“先生,請(qǐng)把這水賜給我,叫我不渴,也不用來這么遠(yuǎn)打水?!?br>Jesus answered and said to her, “Everyone who drinks this water will be thirsty again; but whoever drinks the water I shall give will never thirst; the water I shall give will become in him a spring of water welling up to eternal life.” The woman said to him, “Sir, give me this water, so that I may not be thirsty or have to keep coming here to draw water.”
……這其間,門徒對(duì)耶穌說:“拉比,請(qǐng)吃?!币d說:“我有食物吃,是你們不知道的。”門徒就彼此對(duì)問說:“莫非有人拿什么給他吃嗎?”
. . . Meanwhile, the disciples urged him, “Rabbi, eat.” But he said to them, “I have food to eat of which you do not know.” So the disciples said to one another, “Could someone have brought him something to eat?”
正是這樣的文字,很明顯地諷刺了對(duì)《圣經(jīng)》進(jìn)行拘于字面意義來理解的行為,也讓我在對(duì)基督教長(zhǎng)期的疏離之后得以回歸。大學(xué)以后,我對(duì)上帝和耶穌的概念逐漸變得貧乏(這個(gè)詞算是用得比較委婉了)。當(dāng)時(shí)我一頭扎進(jìn)堅(jiān)不可摧的無(wú)神論。對(duì)抗基督教思想的主要武器,就是基督教義在實(shí)際運(yùn)用中的失敗。啟蒙的理性當(dāng)然更說得通,更能解釋身邊的種種;“奧卡姆剃刀理論”當(dāng)然也將信眾們從盲目的信仰中解放出來。沒有證據(jù)能證明上帝的存在,所以,信仰上帝并不合理。
It was passages like these, where there is a clear mocking of literalist readings of Scripture, that had brought me back around to Christianity after a long stretch, following college, when my notion of God and Jesus had grown, to put it gently, tenuous. During my sojourn in ironclad atheism, the primary arsenal leveled against Christianity had been its failure on empirical grounds. Surely enlightened reason offered a more coherent cosmos. Surely Occam’s razor cut the faithful free from blind faith. There is no proof of God; therefore, it is unreasonable to believe in God.