散文佳作108篇 第60期:A Nation of Hypochondriacs 一個疑病癥患者的國度

A Nation of Hypochondriacs

一個疑病癥患者的國度

Norman Cousins

諾曼·克森斯

The main impression growing out of twelve years on the faculty of a medical school is that theNo.1 health problem in the U.S. today, even more than AIDS or cancer, is that Americans don'tknow how to think about health and illness. Our reactions are formed on the terror level. Wefear the worst, expect the worst, thus invite the worst. The result is that we are becoming anation of weaklings and hypochondriacs, a self-medicating society incapabel of distinguishingbetween casual, everyday symptoms and those that require professional attention.

在一所醫(yī)學(xué)院校任教十二年來,我獲得的主要印象是:當(dāng)今美國頭號的健康問題,甚至比愛滋病或癌癥都更為嚴(yán)重的問題,就是美國人不知道如何去認(rèn)識健康與疾病。我們的反應(yīng)是建立在恐懼這個尺度之上的。我們怕最壞的事,期待著最壞的事,而恰恰就招來了最壞的事。結(jié)果,我們變成了一個一個虛弱的、自疑有病的國度,一個分不清哪些 是日常偶發(fā)癥狀、哪些又是需要醫(yī)生醫(yī)治的癥狀,而自己擅自用藥的社會。

Somewhere in our early educatioin we become addicted to the notion that pain means sickness.We fail to learn that pain is the body's way of informing the mind that we are doing somethingwrong, not necessarily that something is wrong. We don't understand that pain may be tellingus that we are eating too much or the wrong things; or that we are smoking too much ordrinking too much; or that there is too much emotional congestion in our lives; or that we arebeing worn down by having to cope daily with overcrowded streets and highways, theprounding noise of garbage grinders, or the cosmic distance between the entrance to theairport and the departure gate. We get the message of pain all wrong. Instead of addressingourselves to the cause, we become pushovers for pills, driving the pain underground andinviting it to return with increased authority.

在我們早期教育的某個階段,我們變 得對疼痛即疾病這一概念深信不疑。我們不知道,人體只是用疼痛這種方式通知大腦,我們的行為出了差錯,而并—定是健康有間題。我們不明白,疼痛可能是在告威我們,或吃得太飽,或吃得不當(dāng),或吸煙太多,或飲酒過度,或生 活中感愔煎熬太苦,或因每天都得面對擁擠的大街和公路、忍受垃圾粉碎機的撞擊聲和奔波于從機場入口到登機 □之間的長距離而被搞得過分疲勞。我們把疼痛傳達(dá)的信息全搞錯了。我們不去探査其緣由,卻大服其藥,把疼痛 壓下去,從而招致它以更大的威力再次發(fā)作。

Early in life, too, we become seized with the bizarre idea that we are constantly assaulted byinvisible monsters called germs, and that we have to be on constant alert to protectourselves against their fury. Equal emphasis, however, is not given to the presiding fact thatour bodies are forestalling an attack is to maintain a sensible life-style.

我們在少年時代就種下了一種奇怪的觀念:一種肉眼看不見的叫做 細(xì)菌的小妖怪在不斷向我們進(jìn)玟,我們必須常備不懈地保護(hù)自己不受其傷害。然而，我們對另一個重要事實卻未能給予同樣的重視，那就是，我們的身體裝備精良，足以對付這些小妖怪，而且防止妖怪進(jìn)攻的最佳途徑就是保持合理的生活方式。

The most signficant single statement about health to appear in the medical journals during thepast decade is by Dr. Franz Ingelfinger, the late and former editor of the New England Journalof Medicine. Ingelfinger noted that almost all illnesses are self-limiting. That is, the human bodyis capable of handling them without outside intervention. The thrust of the article was thatwe need not feel we are helpless if disease tries to tear away at our bodies, and that we canhave greater confidence in the reality of a healing system that is beautifully designed to meetof its problems. And even when ourside help is required, our own resources have something ofvalue to offer in a combined strategy of treatment.

《新英格蘭醫(yī)學(xué)雜志》前主編(已故)弗朗茲·英杰芬格博士的文章,是過去十年中醫(yī)學(xué)刊物上發(fā)表的有關(guān)健康的最重要論述,他指出，幾乎所有的疾病本身都有一定的極限。也就是說，人體可在沒有外來干預(yù)的情況下對付這些疾患。這篇文章雄辯地指出，受到疾病攻擊時，我們無需感到無助，而且對下述事實應(yīng)抱有更充分的信心：人體的康復(fù)機制十分精妙，足以應(yīng)付大部分疾病。即使在需要外援的情況下,我們的肌體本身也能對治療進(jìn)行有力的合作。

No one gets out of this world alive, and few people come through life without at least oneserious illness. If we are give a serious diagnosis, it is useful to try to remain free of panic anddepression. Panic can constrict the blood vessels and impose an additional burden on theheart. Depression, as medical researchers all the way back to Galen have observed, can set thestage for other illnesses or intensify existing ones. Is is no surprise that so many patients wholearn that they have cancer or heart disease---or any other catastrophic disease---becomeworse at the time of diagnosis. the moment they have a label to attach to their symptoms, theillness deepens. All the terrible things they have heard about disease produce the kind ofdespair that in turn complicates the underlying condition. It is not unnatural to severelyapprehensive about a serious diagnosis, but a reasonable confidence is justified. Cancertoday, for example, is largely a treatable disease. A heavily damaged heart can bereconditioned. Even a positive HIV diagnosis does not necessarily mean that the illness will moveinto the active stage.

沒有一個人能活著離開這個世界，極少有人一生—世沒生過一次重病。如果醫(yī)生診斷說你得了重病，力戒恐慌和沮喪是大有益處的?？只艜寡苁湛s，增加心臟負(fù)擔(dān)。而沮喪，正如自占希臘名醫(yī)蓋倫以來的醫(yī)學(xué)專家們所指出的.可誘發(fā)其他疾病或家中目前的疾病，難怪許多患者一聽說自己得了癌癥或心臟病—或其他什么災(zāi)難性疾病，病癥立即就會惡化。一旦給自己的各種癥狀貼上某種標(biāo)簽，病情便隨他們想起聽到過的有關(guān)疾病的種種可怕的事情，感到絕望，而這反過來又使病情愈發(fā)嚴(yán)重。診斷得了重病，憂心忡忡，本屬合情合理，但也應(yīng)保持一定的信心。例如，癌癥現(xiàn)在已基本上是一種可治之 癥。嚴(yán)重受損的心臟也可以重新修復(fù)。即使診斷出HIV呈陽性。也不一定就意味著疾病會進(jìn)入活躍期。

One of the interesting things researchers at the UCLA medical center have discovered is thatthe enviroment of medical treatment can actually be enhanced if seriously ill patients can be keptfree of depression. In a project involving 75 malignantmelanoma patients, it was learned that adirect the connection exists between the mental state of the patient and the ability of theimmuse system to do its job. In a condition of emotional devastation, immune function isimpaired. Conversely, liberation from depression and panic is frequently accompanied by a anincrease in the body's interleukins, vital substances in the immune system that help activatecancer-killing immune cells. The wise physician, therefore, is conscious of both the physicaland emotional needs of the patient.

加利福尼亞大學(xué)洛杉磯分校醫(yī)學(xué)中心的研究人員有一個有趣的發(fā) 那就：讓重病患者擺脫沮喪心情，實際上就能使醫(yī)療環(huán)境得以改善。一項包括75名惡性黑瘤患者的研究顯示，病人的心理狀態(tài)和免疫功能之間存在直接聯(lián)系。在心情十分惡劣的情況下，免疫系統(tǒng)也會受損。相反，擺脫了沮喪和恐慌，常常會使得體內(nèi)白細(xì)胞間素增多，而這種物質(zhì)在免疫系統(tǒng)中至關(guān)重要，它有助于激活克癌免疫細(xì)胞。因此明智的醫(yī)生對病人的身體和心理需求都會加以重視。

People who have heart attacks are especially prone to despair. After they come through theemergency phase of the episode, they begin to reflect on all the things they think they will beunable to do. They wonder whether they will be able to continue at their jobs, whether they willbe able to perform satisfactorily at sex, whether they can play tennis or golf again. In short,they contemplate an existence drained of usefulness and joy. The spark goes out of theirsouls. It may help for these people to know that in addition to miracles that modern medicinecan perform, the heart can make its own bypass around the occluded arterirs and thatcollateral circulation can provide a rich supply of oxygen. A heart attack need not bereggarded as consignment to a mincing life-style. Under circumstances of good nutrition, areasonable amount of exercise and a decrease in the wear and tear of stressful events, lifeexpectancy need not be curtailed.

心臟病患者尤其容易心情沮喪。闖過急救階段以后，他們便開始思考所有那些他們認(rèn)為自己再也不能做的事情。他們擔(dān)心是否還能繼續(xù)工怍，是否還能正常發(fā)揮性功能，是否還能打網(wǎng)球或高爾夫球?？傊麄円芟氤鲆环N沒有一點奉獻(xiàn)和換了的生活。他們靈魂中的火花熄滅了。 讓這些人了解下事實將是有益的：一方面現(xiàn)代醫(yī)學(xué)能創(chuàng)造奇跡，另一方面，心臟本身也可以使血液繞過阻塞的動脈，而這種旁側(cè)循環(huán)同樣可提供足夠的氧氣。無須認(rèn)為患上心臟病就意味著要戰(zhàn)戰(zhàn)兢兢地生活，只要營養(yǎng)良好，適當(dāng)運動，減少重大事件對自己的壓力，壽命就未必會縮短。

Plainly, the American people need to be re-educated about their health. They need to know thatthey are the possessors of a remarkably robust mechanism. They need to be de-intimidatedabout disease. They need to understand the concept of a patient-physician partnership inwhich the best that medical science has to offer is combined with the magnificent resources ofmind and body.

顯然，美過人需要接受一次健康問題的再教育。他們應(yīng)該知道，自己擁有十分強健的肌體，不必為疾病所嚇倒。他們需要理解這樣一個概念：患者和醫(yī)生要建立一種伙伴關(guān)系。這樣，醫(yī)學(xué)可提供的最佳治療就能與患者身體和心理的奇妙功能結(jié)合起來。

We need not wait, of course, for a catastrophic illness before we develop confidence in ourability to rise to a serious challenge. Confidence is useful on the everyday level. We arestronger than we think. Much stronger.

當(dāng)然，我們不必等到了災(zāi)難性疾病才對自己奮起對抗嚴(yán)重挑戰(zhàn)的能力樹立其信心。信心每時每刻都是重要的。我們比自己想象中的要更強健。強健得多。