双语·当呼吸化为空气 原来如此

原来如此。
And there it was.

如果他要完成对我的义务，就需要在“待办事项”上加上一条：给上司打电话，难为情地暴露自己的错误。他又在值夜班。住院医生培训的规定迫使很多培训项目都设置了轮班工作制。轮来轮去地，有些人也就变成了“滑轮”，巧妙地利用制度去推卸责任。如果他再拖延几小时，我就是别人的问题了。
Meeting his obligation to me meant adding one more thing to his todo list: an embarrassing phone call with his boss, revealing his error. He was working the night shift. Residency education regulations had forced most programs to adopt shift work. And along with shift work comes a kind of shiftiness, a subtle undercutting of responsibility. If he could just push it off for a few more hours, I would become somebody else’s problem.

“这药我一般是凌晨五点吃的，”我说，“我们俩应该都明白，‘等到早上再说’的意思是等到早上查房完再说，也就是说基本上要到下午了，对吧？”
“I usually take it at five a. m.,” I said. “And you know as well as I do that ‘waiting till morning’ means letting someone deal with it after morning rounds, which will be more like the afternoon. Right?”

“好吧，好吧。”他说着走出了病房。
“Okay, fine,” he said, and left the room.

到了早上，我发现他还是没开药。
When morning arrived, I discovered that he had not ordered the medication.

艾玛打了个电话来问好，说她会解决特罗凯的问题。她祝我早日康复，很抱歉整个星期都不在。仅仅一天的时间，我的病情就开始恶化，腹泻迅速加重。我一直在输液防止脱水，但补水速度跟不上脱水速度。我的肾功能开始衰竭。接下来做检查时，我的血清钠浓度已经快达到致命的地步。我被转移到重症监护室，因为脱水，我的软腭和咽头都有部分坏死，从我嘴里脱落出来。我身体剧痛，意识飘忽不定，一会儿清醒，一会儿糊涂，来了一大堆专家抢救我：重症护理人员、肾病专科医生、肠胃病专科医生、内分泌医生、传染病专家、神经外科医生、一般肿瘤科医生、胸腔肿瘤科医生、耳鼻喉科专家。怀孕三十八周的露西每天都守在我身边，还偷偷搬进了我原来的值班室，离重症监护室就几步路的距离，这样她晚上好随时来看看我。她和我爸爸也对病情发表了一些看法。
Emma dropped in to say hello and told me she would sort out the Tarceva order. She wished me a speedy recovery and apologized for the fact that she was heading out of town for a week. Over the course of the day I began to deteriorate, my diarrhea rapidly worsening. I was being rehydrated, but not quickly enough. My kidneys began to fail. My mouth became so dry I could not speak or swallow. At the next lab check, my serum sodium had reached a near-fatal level. I was transferred to the ICU. Part of my soft palate and pharynx died from dehydration and peeled out of my mouth. I was in pain, floating through varying levels of consciousness, while a pantheon of specialists was brought together to help: medical intensivists, nephrologists, gastroenterologists, endocrinologists, infectious disease specialists, neurosurgeons, general oncologists, thoracic oncologists, otolaryngologists. Lucy, thirty-eight weeks pregnant, stayed with me by day and secretly moved into my old call room, steps from the ICU, so she could check on me at night. She and my father also lent their voices.

清醒的时候，我能很清楚地听到大家嘈杂的声音，众说纷纭的意见。这在医学上被称为“WICOS”（Who Is the Captain of the Ship，谁是船长）问题：到底谁掌舵，谁说了算？肾病专家不同意重症医生的意见，重症医生和内分泌专家起争执，内分泌专家和肿瘤医生意见相左，肿瘤医生和肠胃病学家争论不休。我感觉到自己也应该负起责任，所以在偶尔清醒的时候，会把目前病情的一些细节打出来，并且在露西的帮助下，努力引导所有的医生，不要偏离事实，进行准确的解读。后来，半睡半醒之间，我依稀听到父亲和露西跟每个医生团队讨论我的病情。我们觉得目前还是应该以静脉点滴为主，一直到化疗的影响消失。但每个团队的专家必须去挖掘属于他们专业的可能性，多做一些检查，主张自己赞成的疗法。不过有的看上去真的没有必要，而且很欠考虑。各种采样检查都做了，约了很多扫描照片，开了很多药。我开始搞不清治疗的进展，时间概念也模糊起来。我要求他们向我解释这些治疗计划，但听着听着对方的声音就渐渐变得沉闷飘散，常常是医生说着说着，我就眼前一黑，几乎都听不全。我万分盼望艾玛在场掌控着一切。
During lucid moments, I was acutely aware that with this many voices, cacophony results. In medicine, this is known as the WICOS problem: Who Is the Captain Of the Ship? The nephrologists disagreed with the ICU doctors, who disagreed with the endocrinologists, who disagreed with the oncologists, who disagreed with the gastroenterologists. I felt the responsibility of my care: during bouts of consciousness, I typed out the sequential details of my current illness and, with Lucy’s help, tried to corral all the doctors to keep the facts and interpretations straight. Later, while half asleep, I could dimly hear my father and Lucy discussing my condition with each team of doctors. We suspected that the main plan should just be to treat me with fluids until the effects of the chemotherapy wore off. But each group of specialists had to allow for more esoteric possibilities and advocate tests and treatments for them, some of which seemed unnecessary and ill-advised. Samples were taken, scans were ordered, medications were given; I began losing track of events and time. I requested that these plans be explained to me, but sentences would become slippery, voices would dampen and muffle, and darkness would descend in the midst of doctors’ speeches as I wobbled in and out of coherence. I desperately wished Emma were there, in charge.