双语·当呼吸化为空气 第一次解剖尸体

你也许会觉得，第一次解剖尸体，大概会有点滑稽。然而，奇怪的是，我觉得一切都特别正常和自然。明晃晃的手术灯，不锈钢的解剖台和戴着领结的教授们都带着一种庄严的礼节。即便如此，从颈背一直割到腰背的第一刀，也是永生难忘的。手术刀很锋利，感觉不是割开皮肤，只是拉开一个顺滑的拉链，皮囊包裹之下本无从得见的筋骨展露在眼前。就算之前做了很多准备，你仍然会有种出其不意的感觉，羞愧与兴奋并存。尸体解剖是医学生的重大仪式，但也侵犯了圣洁的神明，令人刹那间百感交集：嫌恶、愉悦、恶心、沮丧与敬畏。然而时日长久之后，这只不过是枯燥沉闷的课堂练习。一切都仿佛在跷跷板上忽高忽低，有时悲痛感伤到无以复加，有时又想些琐碎平常的小事。你看看你，违反着最基本的社会禁忌，但手术室里的甲醛能让人胃口大开，所以又特别想吃个玉米卷饼。最终，当你解剖了正中神经，把骨盆锯成两半，割开心脏，完成任务之后，心里想的就完全是那些小事了：侵犯圣洁的神明又如何？这就是医学院课堂的常态啊。班上也有书呆子，有开心果，有和常人别无二致的同学。很多人认为，正是尸体解剖，将有着正常人悲欢情绪与恭敬礼貌的学生，转变成冷酷无情、傲慢自大的医生。
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.

医学这种“罪大恶极”的道德使命，让我这个满怀崇高理想的医学院新生经历了一个急速下坠的过程。尸体解剖之前，第一天是心肺复苏训练，也是我的第二次训练。第一次是在本科的时候，当时场面很滑稽，很不严肃，大家都嬉皮笑脸的。教学视频粗制滥造，用来练习的塑料模特连手脚都没有，真是假得不能再假了。然而，现在，这些东西我们某一天可能真的用得上，气氛完全变了，人人都跃跃欲试。我不断用手掌按压着一个塑料小孩的胸，耳边是同学们有一搭没一搭的笑话，但仿佛还是听到这个孩子的肋骨被我一个不小心弄断了。
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.

尸体解剖则恰恰相反。心肺复苏用的假模特，你假装那是真的，而尸体解剖用的真尸体，你却要假装那是假的。但第一天的时候，你完全做不到。我面对的属于自己的那具尸体，有点发青，有点肿胀，但他曾经是个活生生的人，已经死亡，这样的事实无可否认。一想到接下来的四个月，我将用一把钢锯给这男人的脑袋做个对角线平分，我就觉得良心受到深深的谴责。
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.

这就轮到解剖学教授出场了。他们建议我们，好好看一眼尸体的脸，然后用布盖上，这样更容易下手。我们不断深呼吸，眼神里带着认真与热切，准备割开尸体的头。恰好一个外科医生过来聊天，他斜着身子，手肘就撑在尸体的脸上。他指着光溜溜的尸体躯干上好几处瘢痕和伤疤，为我们构建了尸体的病史。这条伤疤，来自腹股沟疝气手术；这条来自颈动脉内膜切除手术；这些瘢痕，是他不断抓挠留下的；病人生前可能有黄疸，胆红素很高；他可能是得了胰腺癌去世的，不过没有相关手术的伤疤，也许还没来得及动手术就死了。他滔滔不绝地讲着，我的眼睛却离不开他的手肘。每说一条新的医学假设，教一点新的医学词汇，他的手肘就在尸体被遮住的脸上挪来挪去。我在心里默念：脸盲症，一种神经障碍疾病，患者对人脸会失去辨别能力。很快我也会得这种病，手里拿着钢锯，心里轻松无比。
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.