双语·当呼吸化为空气 第二天一早我就要出院了

夕阳西下。第二天一早我就要出院了。我和肿瘤医生约在那周晚些时候见面，但护士告诉我，我的肿瘤医生晚上下班去接孩子之前，会来看看我。她叫艾玛·海沃德，想在正式治疗开始之前先打个招呼。我和艾玛算是认识，之前接过她的一些病人。但除了偶尔因为工作上的事情接洽一下之外，没有过其他接触。我的父母兄弟们也在病房里，各自待着，没说什么。而露西一直坐在床边，握着我的手。门开了，艾玛走了进来，她那身白大褂一看就知道穿了一整天，而且是很漫长的一天。但她的笑容很精神、很明朗。跟在她后面的是她的同事和一位高级专科住院实习医生。艾玛只比我年长几岁，深色的长发，不过有点灰白的迹象。反正和死神打交道的人，几乎都有过早白头的状况。她拉了把椅子坐下。
The sun was setting. I would be discharged the next morning. An oncology appointment was set for later in the week, but the nurse told me my oncologist was going to drop by that night, before leaving to pick up her kids. Her name was Emma Hayward, and she wanted to say hello before the initial office visit. I knew Emma a little—I had treated some of her patients before—but we had never spoken beyond passing professional courtesies. My parents and brothers were scattered about the room, not saying much, while Lucy sat by the bed, holding my hand. The door opened and in she walked, her white coat showing the wear of a long day but her smile fresh. Trailing behind her were her fellow and a resident. Emma was only a few years older than I, her hair long and dark, but as is common to all those who spend time with death, streaked with gray. She pulled up a chair.

“你好，我叫艾玛，”她说，“今天只能待一会儿，很抱歉。但我还是想过来，做个自我介绍。”
“Hi, my name is Emma,” she said. “I’m sorry to have to be so brief today, but I wanted to come by and introduce myself.”

我们握手。我的胳膊和输液管纠缠在一起。
We shook hands, my arm entangled in the IV line.

“谢谢你过来，”我说，“我知道你要去接孩子。这些是我的家人。”她向露西点头致意，接着又向我爸妈和兄弟们问好。
“Thanks for stopping by,” I said. “I know you have kids to pick up. This is my family.” She nodded hello at Lucy, at my brothers and parents.

“很遗憾，你遇到这种事情，”她说，“很遗憾你们遇到这种事情。过几天我们再长谈。我已经让那边开始检测你的肿瘤切片了，这样治疗也好有个方向。可能用化疗，也可能不用，要看检测结果了。”
“I’m sorry this is happening to you,” she said. “To all of you. There will be a lot of time to talk in a couple days. I went ahead and had the lab start running some tests on your tumor sample, which will help guide therapy. Treatment may be chemotherapy or not, depending on the tests.”

十八个月前，我因为阑尾炎住院。那时候大家都不把我当病人看，我还是他们的同事，甚至是我自己的医疗顾问。我觉得现在也应该一样。“我知道现在不是时候，”我开口了，“但过几天想跟你谈谈卡普兰-迈耶生存曲线。”
Eighteen months earlier, I’d been in the hospital with appendicitis. Then I’d been treated not as a patient but as a colleague, almost like a consultant on my own case. I expected the same here. “I know now’s not the time,” I proceeded, “but I will want to talk about the Kaplan-Meier survival curves.”

“不行，”她说，“绝对不行。”
“No,” she said. “Absolutely not.”

短暂的沉默。她怎么敢这么说话？我心想。在我这样的医生眼里，这种预测是很有必要的，我有权利知道啊。
A brief silence. How dare she? I thought. This is how doctors—doctors like me—understand prognostication. I have a right to know.

“我们后面再谈治疗方案，”她说，“还可以讨论一下你回来工作的可能性，如果你愿意的话。传统的化疗方法是用顺铂、培美曲塞，可能还要加阿瓦斯丁，但是引起周围神经病变的概率很高。所以我们可能会把顺铂换成卡铂，可以更好地保护你的神经，因为你是个外科医生。”
“We can talk about therapies later,” she said. “We can talk about your going back to work, too, if that’s what you’d like to do. The traditional chemotherapy combination—cisplatin, pemetrexed, possibly with Avastin, too—has a high rate of peripheral neuropathy, so we’d probably switch the cisplatin for carboplatin, which will protect your nerves better, since you’re a surgeon.”

回来工作？她在扯些什么啊？她是出现幻觉了，还是说我对自己的诊断大错特错了？还有，要是不对我的生存周期做个实际的估计，这些都怎么谈啊？过去几天那种天旋地转的眩晕感又席卷而来。
Go back to work? What is she talking about? Is she delusional? Or am I dead wrong about my prognosis? And how can we talk about any of this without a realistic estimate of survival? The ground, having already buckled and roiled over the past few days, did so again.

“细节我们后面再说吧，”她继续道，“我知道，眼前这些就够你消化的了。我现在来主要是想在周四之前先见见你们大家。那么今天，除了生存曲线之外，还有什么需要我帮忙的吗？还有什么问题吗？”
“We can do details later,” she continued, “as I know this is a lot to absorb. Mostly, I just wanted to meet you all before our appointment Thursday. Is there anything I can do, or answer—besides survival curves—today?”

“没有了。”我还晕着呢，“谢谢你过来。真的很感谢。”
“No,” I said, my mind reeling. “Thanks so much for stopping by. I really appreciate it.”

“这是我的名片，”她说，“还有诊室的电话。我们下次见面之前这两天，要是遇到什么事，尽管打电话好了。”
“Here’s my card,” she said, “and there’s the clinic number. Feel free to call if anything comes up before we see you in two days.”

我的亲朋好友很快寻遍了各自在医疗行业的人脉，看谁是美国最好的肺癌医生。休斯敦和纽约有比较大的肿瘤中心，我是不是应该去那样的地方接受治疗？至于怎么搬过去，或者暂时转院之类的具体操作问题，就到时候再说了。结果大家很快得到答案：艾玛是全国顶尖、世界知名的肿瘤医生，在一个国家级的癌症咨询委员会做肺癌方面的专家；不仅如此，她还是个很会理解病人的好医生，知道何时进，何时退。我略略想了想冥冥中的一系列事件：我满世界飘游，然后电脑随机地进行一通匹配，我就到这里做了住院医生，最后被诊断出绝症，又被分配到一个最好的医生手里。
My family and friends quickly wired through our network of medical colleagues to find out who the best lung cancer oncologists in the country were. Houston and New York had major cancer centers; was that where I should be treated? The logistics of moving or temporarily relocating or what have you—that could be sorted out later. The replies came back quickly, and more or less unanimously: Emma not only was one of the best— a world-renowned oncologist who served as the lung cancer expert on one of the major national cancer advisory boards—but she was also known to be compassionate, someone who knew when to push and when to hold back. I briefly wondered at the string of events that had sent me looping through the world, my residency determined by a computerized match process, only to end up assigned here, with a freak diagnosis, in the hands of one of the finest doctors to treat it.