尖叫當然停不下來,很快血和其他不明液體也隨著尖叫一起噴薄而出。清晰整齊的醫(yī)學圖表完全無法表現(xiàn)自然的天性,不僅尖牙利爪會見血,生命的誕生也是一樣。(這可不是安妮·哥蒂斯的照片。)我已經清楚地意識到,在病房里真刀真槍地學做醫(yī)生,和在教室里做醫(yī)學生,受到的是完全不同的教育。讀書和做選擇題,完全不像身負重任采取行動。你也許很明白,自己要頭腦清醒,往外拉孩子的頭,好讓肩膀一起出來,但真正干起來又是另一回事了。萬一我拉得太狠了呢?(我腦子里響起一聲咆哮:那會造成無可挽回的神經損傷!)產婦每使勁一次,寶寶的頭就出現(xiàn)一點,但歇口氣的間隙,又縮回去了。每次往外三步,縮回兩步。我等待著。人類的大腦承擔了這個生物體最基礎的任務,而生育實在是一件危險的事。就是這樣的大腦,想出了陣痛和分娩部門、子宮分娩和心率監(jiān)測、硬脊膜外麻醉和緊急剖腹產這樣的主意;同時,也是因為這樣的大腦,以上這些都有必要進行。
The screaming didn’t stop, and was soon accompanied by a gush of blood and other fluids. The neatness of medical diagrams did nothing to represent Nature, red not only in tooth and claw but in birth as well. (An Anne Geddes photo this was not.) It was becoming clear that learning to be a doctor in practice was going to be a very different education from being a medical student in the classroom. Reading books and answering multiple-choice questions bore little resemblance to taking action, with its concomitant responsibility. Knowing you need to be judicious when pulling on the head to facilitate delivery of the shoulder is not the same as doing it. What if I pulled too hard? (Irreversible nerve injury, my brain shouted.) The head appeared with each push and then retracted with each break, three steps forward, two steps back. I waited. The human brain has rendered the organism’s most basic task, reproduction, a treacherous affair. That same brain made things like labor and delivery units, cardiotocometers, epidurals, and emergent C-sections both possible and necessary.
我一動不動地站著,不確定該干些什么。主治醫(yī)生口頭指導我,伸手抓住露出的頭,接著產婦再次使勁時,我輕輕扶住寶寶慢慢鉆出來的肩膀。是個個頭挺大的女孩,胖乎乎的,渾身濕透了,至少是昨天晚上那兩個小鳥一樣的寶寶的三倍大。梅麗莎夾住臍帶,我伸手剪斷。寶寶睜開眼睛,張嘴哇哇大哭。我又抱了她一會兒,感覺到她實實在在的存在,接著把她抱給護士。護士把她抱到媽媽身邊。
I stood still, unsure when to act or what to do. The attending’s voice guided my hands to the emerging head, and on the next push, I gently guided the baby’s shoulders as she came out. She was large, plump, and wet, easily three times the size of the birdlike creatures from the previous night. Melissa clamped the cord, and I cut it. The child’s eyes opened and she began to cry. I held the baby a moment longer, feeling her weight and substance, then passed her to the nurse, who brought her to the mother.