雙語·當呼吸化為空氣 第一次解剖尸體

你也許會覺得，第一次解剖尸體，大概會有點滑稽。然而，奇怪的是，我覺得一切都特別正常和自然。明晃晃的手術燈，不銹鋼的解剖臺和戴著領結的教授們都帶著一種莊嚴的禮節(jié)。即便如此，從頸背一直割到腰背的第一刀，也是永生難忘的。手術刀很鋒利，感覺不是割開皮膚，只是拉開一個順滑的拉鏈，皮囊包裹之下本無從得見的筋骨展露在眼前。就算之前做了很多準備，你仍然會有種出其不意的感覺，羞愧與興奮并存。尸體解剖是醫(yī)學生的重大儀式，但也侵犯了圣潔的神明，令人剎那間百感交集：嫌惡、愉悅、惡心、沮喪與敬畏。然而時日長久之后，這只不過是枯燥沉悶的課堂練習。一切都仿佛在蹺蹺板上忽高忽低，有時悲痛感傷到無以復加，有時又想些瑣碎平常的小事。你看看你，違反著最基本的社會禁忌，但手術室里的甲醛能讓人胃口大開，所以又特別想吃個玉米卷餅。最終，當你解剖了正中神經(jīng)，把骨盆鋸成兩半，割開心臟，完成任務之后，心里想的就完全是那些小事了：侵犯圣潔的神明又如何？這就是醫(yī)學院課堂的常態(tài)啊。班上也有書呆子，有開心果，有和常人別無二致的同學。很多人認為，正是尸體解剖，將有著正常人悲歡情緒與恭敬禮貌的學生，轉(zhuǎn)變成冷酷無情、傲慢自大的醫(yī)生。
You would think that the first time you cut up a dead person, you’d feel a bit funny about it. Strangely, though, everything feels normal. The bright lights, stainless steel tables, and bow-tied professors lend an air of propriety. Even so, that first cut, running from the nape of the neck down to the small of the back, is unforgettable. The scalpel is so sharp it doesn’t so much cut the skin as unzip it, revealing the hidden and forbidden sinew beneath, and despite your preparation, you are caught unawares, ashamed and excited. Cadaver dissection is a medical rite of passage and a trespass on the sacrosanct, engendering a legion of feelings: from revulsion, exhilaration, nausea, frustration, and awe to, as time passes, the mere tedium of academic exercise. Everything teeters between pathos and bathos: here you are, violating society’s most fundamental taboos, and yet formaldehyde is a powerful appetite stimulant, so you also crave a burrito. Eventually, as you complete your assignments by dissecting the median nerve, sawing the pelvis in half, and slicing open the heart, the bathos supersedes: the sacred violation takes on the character of your average college class, replete with pedants, class clowns, and the rest. Cadaver dissection epitomizes, for many, the transformation of the somber, respectful student into the callous, arrogant doctor.

醫(yī)學這種“罪大惡極”的道德使命，讓我這個滿懷崇高理想的醫(yī)學院新生經(jīng)歷了一個急速下墜的過程。尸體解剖之前，第一天是心肺復蘇訓練，也是我的第二次訓練。第一次是在本科的時候，當時場面很滑稽，很不嚴肅，大家都嬉皮笑臉的。教學視頻粗制濫造，用來練習的塑料模特連手腳都沒有，真是假得不能再假了。然而，現(xiàn)在，這些東西我們某一天可能真的用得上，氣氛完全變了，人人都躍躍欲試。我不斷用手掌按壓著一個塑料小孩的胸，耳邊是同學們有一搭沒一搭的笑話，但仿佛還是聽到這個孩子的肋骨被我一個不小心弄斷了。
The enormity of the moral mission of medicine lent my early days of med school a severe gravity. The first day, before we got to the cadavers, was CPR training, my second time doing it. The first time, back in college, had been farcical, unserious, everyone laughing: the terribly acted videos and limbless plastic mannequins couldn’t have been more artificial. But now the lurking possibility that we would have to employ these skills someday animated everything. As I repeatedly slammed my palm into the chest of a tiny plastic child, I couldn’t help but hear, along with my fellow students’ jokes, real ribs cracking.

尸體解剖則恰恰相反。心肺復蘇用的假模特，你假裝那是真的，而尸體解剖用的真尸體，你卻要假裝那是假的。但第一天的時候，你完全做不到。我面對的屬于自己的那具尸體，有點發(fā)青，有點腫脹，但他曾經(jīng)是個活生生的人，已經(jīng)死亡，這樣的事實無可否認。一想到接下來的四個月，我將用一把鋼鋸給這男人的腦袋做個對角線平分，我就覺得良心受到深深的譴責。
Cadavers reverse the polarity. The mannequins you pretend are real; the cadavers you pretend are fake. But that first day, you just can’t. When I faced my cadaver, slightly blue and bloated, his total deadness and total humanness were undeniable. The knowledge that in four months I would be bisecting this man’s head with a hacksaw seemed unconscionable.

這就輪到解剖學教授出場了。他們建議我們，好好看一眼尸體的臉，然后用布蓋上，這樣更容易下手。我們不斷深呼吸，眼神里帶著認真與熱切，準備割開尸體的頭。恰好一個外科醫(yī)生過來聊天，他斜著身子，手肘就撐在尸體的臉上。他指著光溜溜的尸體軀干上好幾處瘢痕和傷疤，為我們構建了尸體的病史。這條傷疤，來自腹股溝疝氣手術；這條來自頸動脈內(nèi)膜切除手術；這些瘢痕，是他不斷抓撓留下的；病人生前可能有黃疸，膽紅素很高；他可能是得了胰腺癌去世的，不過沒有相關手術的傷疤，也許還沒來得及動手術就死了。他滔滔不絕地講著，我的眼睛卻離不開他的手肘。每說一條新的醫(yī)學假設，教一點新的醫(yī)學詞匯，他的手肘就在尸體被遮住的臉上挪來挪去。我在心里默念：臉盲癥，一種神經(jīng)障礙疾病，患者對人臉會失去辨別能力。很快我也會得這種病，手里拿著鋼鋸，心里輕松無比。
Yet there are anatomy professors. And the advice they gave us was to take one good look at our cadaver’s face and then leave it covered; it makes the work easier. Just as we prepared, with deep breaths and earnest looks, to unwrap our cadaver’s head, a surgeon stopped by to chat, leaning with his elbows on the corpse’s face. Pointing out various marks and scars on the naked torso, he reconstructed the patient’s history. This scar is from an inguinal hernia operation, this one a carotid endarterectomy; these marks here indicate scratching, possibly jaundice, high bilirubin; he probably died of pancreatic cancer, though no scar for that—killed him too quick. Meanwhile, I could not help but stare at the shifting elbows that, with each medical hypothesis and vocabulary lesson, rolled over this covered head. I thought: Prosopagnosia is a neurological disorder wherein one loses the ability to see faces. Pretty soon I would have it, hacksaw in hand.