很好,這樣很好。
Good. One good thing.
我們掀開病人身上的無菌布,一個以前沒合作過的手術(shù)助理護(hù)士問我:“這周末你值班嗎,醫(yī)生?”
As we uncovered the patient, the scrub nurse, one with whom I hadn’t worked before, said, “You on call this weekend, Doc?”
“不。”也許永遠(yuǎn)都不值班了。
“Nope.” And possibly never again.
“今天還有手術(shù)嗎?”
“Got any more cases today?”
“沒有了?!币苍S永遠(yuǎn)都沒有了。
“Nope.” And possibly never again.
“啊,那好。那就是大團(tuán)圓結(jié)局了!工作做完啦。我喜歡大團(tuán)圓的結(jié)局,你也是吧,醫(yī)生?”
“Shit, well, I guess that means this is a happy ending! Work’s done. I like happy endings, don’t you, Doc?”
“是啊,是啊,我也喜歡大團(tuán)圓?!?br>“Yeah. Yeah, I like happy endings.”
我坐在電腦旁邊輸入一些術(shù)后指令,護(hù)士們進(jìn)行著清理工作,麻醉師開始喚醒病人。我一直半開玩笑地威脅說,如果是我主刀的手術(shù),就不許聽那種人人都喜歡的“打雞血”的流行音樂,只能聽巴薩諾瓦舞曲。我播放了巴薩諾瓦風(fēng)格的經(jīng)典專輯《不老的傳說》,薩克斯柔和而又鏗鏘的演奏響徹整個手術(shù)室。
I sat down by the computer to enter orders as the nurses cleaned and the anesthesiologists began to wake the patient. I had always jokingly threatened that when I was in charge, instead of the high-energy pop music everyone liked to play in the OR, we’d listen exclusively to bossa nova. I put Getz/Gilberto on the radio, and the soft, sonorous sounds of a saxophone filled the room.
過了一會兒,我出了手術(shù)室,收拾好七年來用的所有東西——一些為通宵工作準(zhǔn)備的備用衣服、牙刷、幾塊肥皂、手機(jī)充電器、零食、我的頭骨模型和一系列神經(jīng)外科的書,諸如此類。我轉(zhuǎn)念一想,又把書留下了。它們在這兒,應(yīng)該更能發(fā)揮作用吧。
I left the OR shortly after, then gathered my things, which had accumulated over seven years of work—extra sets of clothes for the nights you don’t leave, tooth-brushes, bars of soap, phone chargers, snacks, my skull model and collection of neurosurgery books, and so on. On second thought, I left my books behind. They’d be of more use here.
走向停車場的路上,一個同事走過來想問我什么事,但他的呼機(jī)響了。他看了一眼,揮揮手,轉(zhuǎn)身往醫(yī)院里面跑?!巴睃c(diǎn)再找你!”他回頭朝我喊了一聲。我坐在車?yán)铮瑹釡I盈眶,轉(zhuǎn)動鑰匙,慢慢開到路上。回到家,我走進(jìn)家門,掛好我的白大褂,摘下我的名牌,接著取出呼機(jī)的電池,脫下手術(shù)衣,痛痛快快地洗了個澡。
On my way out to the parking lot, a fellow approached to ask me something, but his pager went off. He looked at it, waved, turned, and ran back in to the hospital—“I’ll catch you later!” he called over his shoulder. Tears welled up as I sat in the car, turned the key, and slowly pulled out into the street. I drove home, walked through the front door, hung up my white coat, and took off my ID badge. I pulled the battery out of my pager. I peeled off my scrubs and took a long shower.
再晚點(diǎn)的時(shí)候,我給維多利亞打電話,告訴她周一我沒法去上班了,可能永遠(yuǎn)都不能去了,所以就做不了手術(shù)室的安排了。
Later that night, I called Victoria and told her I wouldn’t be in on Monday, or possibly ever again, and wouldn’t be setting the OR schedule.
“嗯,我一直做噩夢,夢見這一天來了?!彼f,“真不知道你是怎么堅(jiān)持這么久的?!?br>“You know, I’ve been having this recurring nightmare that this day was coming,” she said. “I don’t know how you did this for so long.”
星期一,露西和我一起去見了艾瑪。她肯定了我們列出的計(jì)劃:支氣管鏡活檢,針對性地尋找突變,實(shí)在不行,只有化療。但我去見她的真正原因,是希望得到一些引領(lǐng)和指導(dǎo)。我告訴她,我已經(jīng)在神經(jīng)外科那邊請假了。
Lucy and I met with Emma on Monday. She confirmed the plan we’d envisioned: bronchoscopic biopsy, look for targetable mutations, otherwise chemo. The real reason I was there, though, was for her guidance. I told her I was taking leave from neurosurgery.
“好,”她說,“沒事。嗯,要是你想集中精力做更重要的事情,那就別回神經(jīng)外科了。但別單純因?yàn)槟悴×司筒桓闪?。和一個星期前相比,你的病情并沒有加重。這一路上的確有些顛簸,但你還是可以維持現(xiàn)有生活軌道的。對你來說,神經(jīng)外科的工作很重要?!?br>“Okay,” she said. “That’s fine. You can stop neurosurgery if, say, you want to focus on something that matters more to you. But not because you are sick. You aren’t any sicker than you were a week ago. This is a bump in the road, but you can keep your current trajectory. Neurosurgery was important to you.”
我再一次走上了從醫(yī)生到病人的軌道,從行動者變成被動者,從主語變成了直接賓語。生病之前,我的生活可以說是心想事成,按照既定的軌道一帆風(fēng)順地前進(jìn)著。大多數(shù)現(xiàn)代文學(xué)作品中,人物的命運(yùn)都是由自身和旁人的人為行動決定的?!独顮柾酢分械母鹆_斯特伯爵埋怨過,說人類的命運(yùn)之于神明,正如“蒼蠅之于頑童”。然而那部作品主要的戲劇沖突,還是來源于李爾王的虛榮與專制。從啟蒙運(yùn)動開始,占據(jù)舞臺中心位置的,就是個人。但現(xiàn)在,我所在的世界已然不同,這是個更古老的世界,人類的行動在超人類的力量面前顯得蒼白無力。這個世界比起莎士比亞的作品更具有希臘悲劇的色彩。不管付出多少努力,俄狄浦斯和他的父母都逃脫不出命運(yùn)的股掌;他們只能通過神諭與預(yù)言,通過那些既定的占卜,才能接觸到掌控他們命運(yùn)的力量。我來找艾瑪,不是想要治療方案。我讀的資料已經(jīng)夠多了,未來會采取什么樣的醫(yī)學(xué)手段我已經(jīng)了然于心。我想要的,是眼前這個“神諭家”充滿智慧的安慰。
Once again, I had traversed the line from doctor to patient, from actor to acted upon, from subject to direct object. My life up until my illness could be understood as the linear sum of my choices. Like most modern narratives, a character’s fate depended on human actions, his and others. King Lear’s Gloucester may complain about human fate as “flies to wanton boys,” but it’s Lear’s vanity that sets in motion the dramatic arc of the play. From the Enlightenment onward, the individual occupied center stage. But now I lived in a different world, a more ancient one, where human action paled against superhuman forces, a world that was more Greek tragedy than Shakespeare. No amount of effort can help Oedipus and his parents escape their fates; their only access to the forces controlling their lives is through the oracles and seers, those given divine vision. What I had come for was not a treatment plan—I had read enough to know the medical ways forward—but the comfort of oracular wisdom.
“這不是結(jié)束?!彼f。這種說辭她恐怕已經(jīng)用過成千上萬遍了。想想我自己,難道就沒有跟病人說過類似的話嗎?反正面對那些想尋找不可能的答案的人,她肯定都這么說?!吧踔炼疾荒苷f是結(jié)束的開始。這僅僅是開始的結(jié)束?!?br>“This is not the end,” she said, a line she must have used a thousand times—after all, did I not use similar speeches to my own patients?—to those seeking impossible answers. “Or even the beginning of the end. This is just the end of the beginning.”