我看到了。看來亟待訓練的不僅是我的頭腦,還有雙眼。
I did. Not only would my mind have to be trained, my eyes would, too.
“剪刀!”梅麗莎剪開我笨手笨腳打的結,重新縫合了傷口,貼上帶有傷口敷料的膠貼。病人被帶去了康復病房。
“Scissors!” Melissa cut out my amateur knots, resutured the wound, applied the dressing, and the patient was taken to recovery.
梅麗莎之前跟我講過,在子宮內存活到二十四周,是培養(yǎng)胎兒生存能力的關鍵。雙胞胎堅持了二十三周零六天。他們的器官已經(jīng)形成,但也許還不足以負擔起維持生命的責任。他們本應該再在子宮的保護下安穩(wěn)地發(fā)育將近四個月,接受臍帶運送來的含氧血和營養(yǎng)素?,F(xiàn)在,他們必須靠脆弱的肺部吸入氧氣,而小小的肺還無法進行復雜的擴張和氣體轉移,也就是呼吸。我到新生兒重癥監(jiān)護室去看他們,兩個雙胞胎各自待在一個透明的塑料保溫箱中,周圍巨大的機器嘟嘟響著,顯得他們那么小,幾乎淹沒在纏繞糾結的線和管子里。保溫箱邊上開了個小小的窗口,父母可以伸手進去輕輕摸摸他們的腿或者胳膊。對于小寶貝們來說,這種來自真人的觸碰,是生死攸關的。
As Melissa had told me earlier, twenty-four weeks in utero was considered the edge of viability. The twins had lasted twenty-three weeks and six days. Their organs were present, but perhaps not yet ready for the responsibility of sustaining life. They were owed nearly four more months of protected development in the womb, where oxygenated blood and nutrients came to them through the umbilical cord. Now oxygen would have to come through the lungs, and the lungs were not capable of the complex expansion and gas transfer that was respiration. I went to see them in the NICU, each twin encased in a clear plastic incubator, dwarfed by large, beeping machines, barely visible amid the tangle of wires and tubes. The incubator had small side ports through which the parents could strain to reach and gently stroke a leg or arm, providing vital human contact.
太陽升起,我的輪班結束了。我可以回家了,但雙胞胎被從子宮中取出的畫面讓我難以成眠。我感覺自己也有點像一個未發(fā)育完全的肺臟,還沒做好維系生命的準備。那天晚上我去上班,被派給一個新的準媽媽。大家都覺得這個孕婦沒什么問題。一切都按常規(guī)來,而且今天剛好就是她確定的預產(chǎn)期。我和護士一起跟進這個媽媽四平八穩(wěn)的生產(chǎn)過程,宮縮頻率穩(wěn)定上升。護士不時報告子宮頸張開的狀況,從三厘米到五厘米再到十厘米。
The sun was up, my shift over. I was sent home, the image of the twins being extracted from the uterus interrupting my sleep. Like a premature lung, I felt unready for the responsibility of sustaining life. When I returned to work that night, I was assigned to a new mother. No one anticipated problems with this pregnancy. Things were as routine as possible; today was even her actual due date. Along with the nurse, I followed the mother’s steady progress, contractions racking her body with increasing regularity. The nurse reported the dilation of the cervix, from three centimeters to five to ten.
“好,現(xiàn)在可以開始了?!弊o士轉身看著我,“別擔心,快生了我們呼你。”
“Okay, it’s time to push now,” the nurse said.Turning to me, she said, “Don’t worry—we’ll page you when the delivery is close.”
我在醫(yī)生休息室找到梅麗莎,過了一會兒,婦產(chǎn)團隊被召集到產(chǎn)房:要生了。梅麗莎在門外遞給我一件長大褂、一雙手套和一雙很長的靴套。
I found Melissa in the doctors’ lounge. After some time, the OB team was called into the room: delivery was near. Outside the door, Melissa handed me a gown, gloves, and a pair of long boot covers.
“很臟的?!彼f。
“It gets messy,” she said.
我們走進產(chǎn)房,我一直有點尷尬地站在旁邊,直到梅麗莎把我推到產(chǎn)婦的兩腿之間,主治醫(yī)生的前面。
We entered the room. I stood awkwardly off to the side until Melissa pushed me to the front, between the patient’s legs, just in front of the attending.
“使勁!”護士鼓勵產(chǎn)婦,“再來一遍,就像剛才那樣,不過不要尖叫了。”
“Push!” the nurse encouraged. “Now again: just like that, only without the screaming.”