雙語(yǔ)·當(dāng)呼吸化為空氣 我第一次見(jiàn)證出生 也是第一次見(jiàn)證死亡

我第一次見(jiàn)證出生，也是第一次見(jiàn)證死亡。當(dāng)時(shí)我剛剛通過(guò)醫(yī)師認(rèn)證的第一階段考試，整整兩年，高強(qiáng)度的學(xué)習(xí)，埋在書(shū)山之中，在圖書(shū)館獨(dú)坐到深夜，在咖啡館聚精會(huì)神地看課堂筆記，躺在床上也不忘看自制的學(xué)習(xí)卡。而接下來(lái)的兩年，我將奔波在醫(yī)院和診所，終于可以把那些理論知識(shí)付諸實(shí)踐，去緩解真正的病痛。我的首要關(guān)注對(duì)象，終于要變成病人，而不是那些抽象的知識(shí)了。我的實(shí)習(xí)從婦產(chǎn)科開(kāi)始，會(huì)經(jīng)常上大夜班，在病房目睹產(chǎn)婦分娩、孩子出生。
I had recently taken Step 1 of my medical boards, wrapping up two years of intensive study buried in books, deep in libraries, poring over lecture notes in coffee shops, reviewing hand-made flash cards while lying in bed. The next two years, then, I would spend in the hospital and clinic, finally putting that theoretical knowledge to use to relieve concrete suffering, with patients, not abstractions, as my primary focus. I started in obgyn, working the graveyard shift in the labor and delivery ward.

日落時(shí)分，我走進(jìn)醫(yī)院大樓，努力回憶分娩的各個(gè)階段和相應(yīng)的子宮頸擴(kuò)張程度，孩子在往外鉆時(shí)各個(gè)位置的名字，反正只要關(guān)鍵時(shí)刻能派上用場(chǎng)的，我都要想個(gè)遍。我這個(gè)醫(yī)學(xué)生的任務(wù)就是觀察學(xué)習(xí)，不要礙手礙腳。我的老師們，主要是那些已經(jīng)讀完醫(yī)學(xué)院，并且選好專業(yè)、完成培訓(xùn)的住院醫(yī)生，以及有著多年臨床經(jīng)驗(yàn)的護(hù)士。但我心中仍有恐懼如影隨形，如同不安分的小鳥(niǎo)撲閃著翅膀。我害怕萬(wàn)一有什么意外情況，或者誰(shuí)滿懷期待地讓我自己去接生，然后我失敗了。
Walking into the building as the sun descended, I tried to recall the stages of labor, the corresponding dilation of the cervix, the names of the “stations” that indicated the baby’s descent—anything that might prove helpful when the time came. As a medical student, my task was to learn by observation and avoid getting in the way. Residents, who had finished medical school and were now completing training in a chosen specialty, and nurses, with their years of clinical experience, would serve as my primary instructors. But the fear still lurked—I could feel its fluttering—that through accident or expectation, I’d be called on to deliver a child by myself, and fail.

我來(lái)到醫(yī)生休息室，見(jiàn)指導(dǎo)我的住院醫(yī)生。走進(jìn)去后，看到一個(gè)深色頭發(fā)的年輕女人，躺在沙發(fā)上，大嚼著一塊三明治，同時(shí)一邊看電視，一邊讀著期刊上的文章。我做了個(gè)自我介紹。
I made my way to the doctors’ lounge where I was to meet the resident. I walked in and saw a dark-haired young woman lying on a couch, chomping furiously at a sandwich while watching TV and reading a journal article. I introduced myself.

“哦，好，”她說(shuō)，“我是梅麗莎。需要我的話，到這兒或者值班室來(lái)找我。嗯，你最好注意一下那個(gè)叫加西亞的病人，二十二歲，早產(chǎn)宮縮，懷的還是雙胞胎。其他人都還挺正常的?！?br>“Oh, hi,” she said. “I’m Melissa. I’ll be in here or in the call room if you need me. Probably the best thing for you to do is keep an eye on patient Garcia. She’s twenty-two-year-old, here with preterm labor and twins. Everyone else is pretty standard.”

梅麗莎一邊大口咬著三明治，一邊向我簡(jiǎn)要介紹了一下情況，信息真是很密集：雙胞胎還只有二十三周半大；希望能盡量幫她保胎，不管能保多久，以便讓胎兒發(fā)育得更成熟一些；至少要超過(guò)二十四周，這是培養(yǎng)胎兒生存能力的關(guān)鍵時(shí)期，之后的每一天都會(huì)好很多；病人在吃很多控制宮縮的藥物。這時(shí)，梅麗莎的呼機(jī)響了。
Between bites, Melissa briefed me, a barrage of facts and information: The twins were only twenty-three and a half weeks old; the hope was to keep the pregnancy going until they were more developed, however long that might be; twenty-four weeks was considered the cusp of viability, and every extra day made a difference; the patient was getting various drugs to control her contractions. Melissa’s pager went off.

“好，”她雙腿晃蕩著從沙發(fā)上落了地，“我要走了。你要是愿意，就在這兒待會(huì)兒。能收到很多不錯(cuò)的有線電視頻道。要么你就跟我來(lái)?！?br>“Okay,” she said, swinging her legs off the couch. “I gotta go. You can hang out here, if you like. We have good cable channels. Or you can come with me.”

我跟著梅麗莎來(lái)到護(hù)士站。一面墻上全是顯示器，顯示著密密麻麻的遙測(cè)曲線。
I followed Melissa to the nurses’ station. One wall was lined with monitors, displaying wavy telemetry lines.

“那是什么？”我問(wèn)。
“What’s that?” I asked.

“子宮分娩力計(jì)輸出的圖像和胎兒的心率。我?guī)闳タ纯床∪?。她?tīng)不懂英語(yǔ)。你會(huì)說(shuō)西班牙語(yǔ)嗎？”
“That’s the output of the tocometers and the fetal heart rates. Let me show you the patient. She doesn’t speak English. Do you speak Spanish?”

我搖搖頭。梅麗莎把我?guī)У讲》?，很昏暗。?zhǔn)媽媽躺在床上休息，很安靜，肚子上纏著各種各樣的監(jiān)控帶，檢測(cè)她的宮縮情況和雙胞胎的心率，將信號(hào)傳輸?shù)轿覄偛旁谧o(hù)士站看到的屏幕上。準(zhǔn)爸爸站在窗邊，握著妻子的手，憂慮地緊皺著眉頭。梅麗莎用西班牙語(yǔ)朝他們小聲說(shuō)了幾句話，然后拉著我出去了。
I shook my head. Melissa brought me to the room. It was dark. The mother lay in a bed, resting, quiet, monitor bands wrapped around her belly, tracking her contractions and the twins’ heart rates and sending the signal to the screens I’d seen at the nurses’ station. The father stood at the bedside holding his wife’s hand, worry etched on his brow. Melissa whispered something to them in Spanish, then escorted me out.