雙語(yǔ)·當(dāng)呼吸化為空氣 序言

序言
FOREWORD

亞伯拉罕·維基斯
Abraham Verghese

寫(xiě)下這些文字時(shí)，我突然想到，這本書(shū)的序言，其實(shí)最好作為后記來(lái)讀，因?yàn)樯婕氨Ａ_·卡拉尼什的一切，時(shí)間都是倒著來(lái)的。比如說(shuō)，我是在保羅死后，才真正認(rèn)識(shí)他的。（請(qǐng)寬恕我吧。）當(dāng)他已經(jīng)不在人世，才成了我親密的朋友。
It occurs to me, as I write this, that the foreword to this book might be better thought of as an afterword. Because when it comes to Paul Kalanithi, all sense of time is turned on its head. To begin with—or, maybe, to end with—I got to know Paul only after his death. (Bear with me.) I came to know him most intimately when he’d ceased to be.

2014年2月初，一個(gè)難忘的下午，我在斯坦福見(jiàn)到了他。他剛剛在《紐約時(shí)報(bào)》發(fā)表了一篇特稿——《我還能活多久》，這篇文章引起了強(qiáng)烈反響，眾多讀者紛紛回應(yīng)。發(fā)表之后的幾天內(nèi)，傳播速度極其迅猛。（我專(zhuān)攻傳染病，所以原諒我沒(méi)有用“病毒”來(lái)形容。）余波未了，他便與我聯(lián)系，說(shuō)要來(lái)聊聊，問(wèn)問(wèn)著作權(quán)代理、編輯和圖書(shū)出版之類(lèi)的問(wèn)題。他想寫(xiě)一本書(shū)，就是這一本，這本你正在捧讀的書(shū)。我還記得陽(yáng)光透過(guò)我辦公室窗外的玉蘭樹(shù)，照亮眼前的一幕：保羅和我面對(duì)面坐著，好看的雙手穩(wěn)穩(wěn)地放在面前；臉上留著先知一樣的絡(luò)腮胡；深色的眼睛上下打量著我。在我的記憶中，這一幕有點(diǎn)像維米爾的畫(huà)，像針孔照相機(jī)呈現(xiàn)的作品。還記得當(dāng)時(shí)我心想，你得記住這一幕。因?yàn)橛吃谖乙暰W(wǎng)膜上的一切都太珍貴了。還因?yàn)?，由于保羅已經(jīng)被診斷出了癌癥，我想到他將死的命運(yùn)，更意識(shí)到自己也是個(gè)必死的凡人。那天下午，我們聊了很多。他當(dāng)時(shí)是神經(jīng)外科的住院總醫(yī)師。我們的工作曾經(jīng)也許有過(guò)交集，但也沒(méi)能想起有過(guò)哪位共同的病人。他告訴我，他在斯坦福本科學(xué)的是英語(yǔ)和生物學(xué)，之后又繼續(xù)留在本校，攻讀了英語(yǔ)文學(xué)的碩士學(xué)位。
I met him one memorable afternoon at Stanford in early February 2014. He’d just published an op-ed titled “How Long Have I Got Left?” in The New York Times, an essay that would elicit an overwhelming response, an outpouring from readers. In the ensuing days, it spread logarithmically. (I’m an infectious diseases specialist, so please forgive me for not using the word viral as a metaphor.) In the aftermath of that, he’d asked to come see me, to chat, to get advice about literary agents, editors, the publishing process—he had a desire to write a book, this book, the one you are now holding in your hands. I recall the sun filtering through the magnolia tree out-side my office and lighting this scene: Paul seated before me, his beautiful hands exceedingly still, his prophet’s beard full, those dark eyes taking the measure of me. In my memory, the picture has a Vermeer-like quality, a camera obscura sharpness. I remember thinking, You must remember this, because what was falling on my retina was precious. And because, in the context of Paul’s diag-nosis, I became aware of not just his mortality but my own. We talked about a lot of things that afternoon. He was a neurosurgical chief resident. We had probably crossed paths at some point, but we hadn’t shared a patient that we could recall. He told me he had been an English and biology major as an undergraduate at Stanford, and then stayed on for a master’s in English literature.

我們聊了他對(duì)寫(xiě)作和閱讀與生俱來(lái)的熱愛(ài)。我有點(diǎn)吃驚，他本來(lái)輕輕松松就可以成為一名英文教授，而且，曾經(jīng)也好像要走這條路。然而，就像和他同名的保羅前往大馬士革途中時(shí)一樣，他也感覺(jué)到了冥冥中的召喚，成了一名醫(yī)師。但他一直希望以某種形式實(shí)現(xiàn)自己的文學(xué)夢(mèng)。也許有一天，寫(xiě)本書(shū)什么的。他本以為自己時(shí)間還多。本來(lái)就是嘛！然而，現(xiàn)在，時(shí)間，成為他最稀缺的東西。
We talked about his lifelong love of writing and reading. I was struck by how easily he could have been an English professor—and, indeed, he had seemed to be headed down that path at one point in his life. But then, just like his namesake on the road to Damascus, he felt the calling. He became a physician instead, but one who always dreamed of coming back to literature in some form. A book, perhaps. One day. He thought he had time, and why not? And yet now time was the very thing he had so little of.

我還記得他溫柔又帶點(diǎn)嘲弄意味的笑容，盡管已經(jīng)枯瘦憔悴，臉上還是帶著一絲頑皮。他已經(jīng)和癌癥過(guò)招許久，身心俱疲，但最近一次生物療法起到了良好的效果，讓他有時(shí)間考慮接下來(lái)的事情。他說(shuō)，學(xué)醫(yī)的時(shí)候，一直覺(jué)得自己會(huì)成為精神科醫(yī)生，沒(méi)想到愛(ài)上了神經(jīng)外科。他愛(ài)的不僅僅是大腦的錯(cuò)綜復(fù)雜和經(jīng)過(guò)訓(xùn)練可以做驚人手術(shù)的滿(mǎn)足感，還有對(duì)那些飽受痛苦的人深切的愛(ài)與同情。他們的遭遇，和他能夠?qū)崿F(xiàn)的可能，是他入行的主要原因。他給我講的時(shí)候輕描淡寫(xiě)，相比之下，我有些曾經(jīng)做過(guò)他助手的學(xué)生跟我談得比較多，他們總是說(shuō)起保羅這可貴的品質(zhì)——他堅(jiān)定地相信自己的工作有道德上的意義和價(jià)值。接著，我們又談了他面臨死亡的現(xiàn)實(shí)。
I remember his wry, gentle smile, a hint of mischief there, even though his face was gaunt and haggard. He’d been through the wringer with this cancer but a new biological therapy had produced a good response, allowing him to look ahead a bit. He said during medical school he’d assumed that he would become a psychiatrist, only to fall in love with neurosurgery. It was much more than a falling in love with the intricacies of the brain, much more than the satisfaction of training his hands to accomplish amazing feats—it was a love and empathy for those who suffered, for what they endured and what he might bring to bear. I don’t think he told me this as much as I had heard about this quality of his from students of mine who were his acolytes: his fierce belief in the moral dimension of his job. And then we talked about his dying.

那次之后，我們通過(guò)電子郵件保持聯(lián)系，但再也沒(méi)見(jiàn)過(guò)面了。不僅是因?yàn)槲冶桓鞣N各樣的工作淹沒(méi)了，還因?yàn)槲矣蟹N強(qiáng)烈的感覺(jué)，一定要尊重他的時(shí)間。見(jiàn)不見(jiàn)我，要讓保羅來(lái)定。我覺(jué)得他現(xiàn)在最不需要的，就是來(lái)維持一段新的友誼。不過(guò)，我倒是常常想起他，也想起他的妻子。我想問(wèn)他有沒(méi)有在寫(xiě)東西，找到時(shí)間來(lái)寫(xiě)了嗎。多年來(lái)，作為一個(gè)忙碌的醫(yī)師，我很難找到時(shí)間寫(xiě)作。我想告訴他，一位著名作家曾經(jīng)用同情的語(yǔ)氣和我談起這個(gè)永恒的難題：“如果我是個(gè)神經(jīng)外科醫(yī)生，說(shuō)我必須撇下家里的客人，去做緊急開(kāi)顱手術(shù)，沒(méi)人會(huì)說(shuō)什么。但如果我說(shuō)，我得把客人撇在客廳，到樓上去寫(xiě)作……”我想知道，保羅會(huì)不會(huì)覺(jué)得這話(huà)很滑稽。畢竟，他還真的可以說(shuō)自己要去做開(kāi)顱手術(shù)！反正很合理！然后他就可以離開(kāi)去寫(xiě)東西了。
After that meeting, we kept in touch by email, but never saw each other again. It was not just that I disappeared into my own world of deadlines and responsibilities but also my strong sense that the burden was on me to be respectful of his time. It was up to Paul if he wanted to see me. I felt that the last thing he needed was the obligation to service a new friendship. I thought about him a lot, though, and about his wife. I wanted to ask him if he was writing. Was he finding the time? For years, as a busy physician, I’d struggled to find the time to write. I wanted to tell him that a famous writer, commiserating about this eternal problem, once said to me, “If I were a neurosurgeon and I announced that I had to leave my guests to go in for an emergency craniotomy, no one would say a word. But if I said I needed to leave the guests in the living room to go upstairs to write. . . ” I wondered if Paul would have found this funny? After all, he could actually say he was going to do a craniotomy! It was plausible! And then he could go write instead.

寫(xiě)作這本書(shū)的同時(shí)，保羅在《斯坦福醫(yī)學(xué)》上發(fā)表了一篇很出色的短文，主要探討時(shí)間的問(wèn)題。我也有篇相同主題的文章，就和他的并排在一起。不過(guò)，等雜志拿到手，我才看到保羅的文章。讀著他的字字句句，我又產(chǎn)生了讀《紐約時(shí)報(bào)》那篇文章時(shí)的感受：保羅寫(xiě)的東西，真是令人叫絕。他隨便寫(xiě)點(diǎn)什么，都會(huì)充滿(mǎn)沖擊力。但他的選材可不是隨隨便便的，他專(zhuān)注于寫(xiě)時(shí)間，寫(xiě)生病之后時(shí)間對(duì)于他的意義。這樣的主題，讓他的文章變得那樣尖銳深刻，令人沉痛。
While Paul was writing this book, he published a short, remarkable essay in Stanford Medicine, in an issue that was devoted to the idea of time. I had an essay in the same issue, my piece juxtaposed to his, though I learned of his contribution only when the magazine was in my hands. In reading his words, I had a second, deeper glimpse of something of which there had been a hint in the New York Times essay: Paul’s writing was simply stunning. He could have been writing about anything, and it would have been just as powerful. But he wasn’t writing about anything—he was writing about time and what it meant to him now, in the context of his illness. Which made it all so incredibly poignant.

不過(guò)，除了主題，我必須要說(shuō)的是，他的文筆也令人難忘。他的筆尖仿佛有“點(diǎn)石成金”的魔力。
But here’s the thing I must come back to: the prose was unforgettable. Out of his pen he was spinning gold.

我一再捧讀保羅這篇文章，努力去理解他想表達(dá)的東西。他的文章如同美妙的音樂(lè)，有點(diǎn)加爾威·金耐爾的感覺(jué)，幾乎可以稱(chēng)之為散文詩(shī)了。（“如果有一天／你與愛(ài)人／在米拉波橋頭／咖啡館里／鋅吧臺(tái)上／向上的敞開(kāi)的酒杯里盛著美酒……”這是金耐爾的一首詩(shī)，我曾在愛(ài)荷華的一家書(shū)店聽(tīng)他現(xiàn)場(chǎng)背誦過(guò)，全程沒(méi)有低頭看稿。）但保羅的文字中還有別的東西，來(lái)自一片古老的土地，來(lái)自鋅吧臺(tái)的年代之前。幾天后，我再次捧讀他的文章，終于想明白了：保羅的文字，頗得托馬斯·布朗的神韻，1642年，布朗寫(xiě)了《一個(gè)醫(yī)生的信仰》，用的都是古英語(yǔ)的拼寫(xiě)和語(yǔ)法。還是個(gè)年輕醫(yī)生時(shí)，我對(duì)那本書(shū)頗為著迷，總是一讀再讀，就像一個(gè)農(nóng)民立志要抽干一個(gè)泥塘，以完成父輩未竟之事。盡管難于登天，我還是迫切地想探究書(shū)中的奧妙，有時(shí)沮喪地放到一邊，接著又拿起來(lái)。我不知道自己能否從書(shū)中汲取到什么，但有時(shí)我會(huì)一字一句地讀出聲來(lái)，感覺(jué)里面的確有寫(xiě)給我的東西。我覺(jué)得自己似乎缺乏了什么關(guān)鍵的感官，讓那些字母無(wú)法盡情歌唱，展露它們的意義。無(wú)論我多努力，仍然看不透書(shū)中的奧義。
I reread Paul’s piece again and again, trying to understand what he had brought about. First, it was musical. It had echoes of Galway Kinnell, almost a prose poem. (“If one day it happens / you find yourself with someone you love / in a café at one end /of the Pont Mirabeau, at the zinc bar / where wine stands in upward opening glasses. . . ” to quote a Kinnell line, from a poem I once heard him recite in a bookstore in Iowa City, never looking down at the paper.) But it also had a taste of something else, something from an antique land, from a time before zinc bars. It finally came to me a few days later when I picked up his essay yet again: Paul’s writing was reminiscent of Thomas Browne’s. Browne had written Religio Medici in the prose of 1642, with all its archaic spellings and speech. As a young physician, I was obsessed with that book, kept at it like a farmer trying to drain a bog that his father before had failed to drain. It was a futile task, and yet I was desperate to learn its secrets, tossing it aside in frustration, then picking it up again, unsure that it had anything for me but, in sounding the words, sensing that it did. I felt that I lacked some critical receptor for the letters to sing, to impart their meaning. It remained opaque, no matter how hard I tried.

那你一定會(huì)問(wèn)了——為什么？為什么我這么不屈不撓？誰(shuí)在乎《一個(gè)醫(yī)生的信仰》？
Why, you ask? Why did I persevere? Who cares about Religio Medici ?

嗯，我的偶像威廉·奧斯勒就在乎。奧斯勒是現(xiàn)代醫(yī)學(xué)之父，于1919年逝世。他很鐘愛(ài)這本書(shū)，總是放在床頭柜上，還要求用這本書(shū)來(lái)陪葬。那時(shí)候，我沒(méi)能從書(shū)中悟出奧斯勒悟出的東西。經(jīng)過(guò)多次努力，經(jīng)過(guò)幾十年的歲月，這本書(shū)的真意終于展現(xiàn)在我眼前。（一個(gè)比較新的版本用了現(xiàn)代英語(yǔ)的行文方式，也有助于理解。）我發(fā)現(xiàn)，關(guān)鍵是要把內(nèi)容大聲讀出來(lái)，那種抑揚(yáng)頓挫的韻律也是至關(guān)重要的：我們身負(fù)奇跡而行，卻在自身之外尋找奇跡：作為人類(lèi)搖籃的非洲和她的奇觀，都蘊(yùn)含在我們身體里；我們是自然大膽冒險(xiǎn)的造物，研究自然者，如若睿智，則提綱挈領(lǐng)，研究人類(lèi)足矣，其他人則孜孜以求，埋首于分裂的碎片與浩繁的卷帙。等你讀到保羅這本書(shū)的最后一段，大聲讀出來(lái)吧，也會(huì)感受到同樣的韻律節(jié)奏，可能讓你情不自禁地跺起腳來(lái)打起拍子……但就像讀布朗的作品一樣，沖動(dòng)之后，你會(huì)掩卷深思。在我看來(lái)，保羅，就是布朗的化身。（或者，按照我時(shí)間倒轉(zhuǎn)的說(shuō)法，布朗是保羅·卡拉尼什的化身。是啊，真是讓人暈頭轉(zhuǎn)向。）
Well, my hero William Osler cared, that’s who. Osler was the father of modern medicine, a man who died in 1919. He had loved the book. He kept it on his night-stand. He’d asked to be buried with a copy of Religio Medici. For the life of me, I didn’t get what Osler saw in it. After many tries—and after some decades—the book finally revealed itself to me. (It helped that a newer edition had modern spellings.) The trick, I discovered, was to read it aloud, which made the cadence inescapable: “We carry with us the wonders, we seek without us: There is all Africa, and her prodigies in us; we are that bold and adventurous piece of nature, which he that studies, wisely learns in a compendium, what others labour at in a divided piece and endless volume.” When you come to the last paragraph of Paul’s book, read it aloud and you will hear that same long line, the cadence you think you can tap your feet to. . . but as with Browne, you will be just off. Paul, it occurred to me, was Browne redux. (Or given that forward time is our illusion, perhaps it’s that Browne was Kalanithi redux. Yes, it’s head-spinning stuff.)

然后，保羅去世了。我去斯坦福的教堂參加了他的追悼會(huì)。那是個(gè)很華麗的地方，我經(jīng)常在沒(méi)人時(shí)跑去坐著，欣賞教堂里的光影，享受靜謐的一刻，出來(lái)的時(shí)候總會(huì)覺(jué)得煥然一新。追悼會(huì)那天，教堂里人頭攢動(dòng)。我坐在一邊，聽(tīng)保羅最親密的朋友、他的牧師和他的弟弟講述一個(gè)個(gè)關(guān)于他的故事，都很動(dòng)人，也有一些很苦楚。是的，保羅已經(jīng)去世了，但我有種奇怪的感覺(jué)，自己正在慢慢地了解他，這種了解超越了那次在我辦公室的會(huì)面，超越了他寫(xiě)的那幾篇文章。在斯坦福紀(jì)念教堂里，他活在這些故事中。高聳的圓頂很適合用來(lái)紀(jì)念這個(gè)男人，他的身體已經(jīng)化歸塵土，然而形象依然如此親切鮮活。他活在美麗的妻子和可愛(ài)的小女兒身體里，活在悲痛的雙親與手足心中，活在這教堂里眾多好友、同事和過(guò)去的病人的表情中。后來(lái)戶(hù)外的招待會(huì)上，大家共聚一堂，他也在場(chǎng)。我看到人們臉上帶著平靜的微笑，仿佛剛剛在教堂中見(jiàn)證了極其優(yōu)美而深遠(yuǎn)的事物。也許我臉上也帶著同樣的表情：在一場(chǎng)追悼?jī)x式上，在一片頌揚(yáng)稱(chēng)贊之聲中，在一起流下的眼淚里，我們找到了生命的意義。而在招待會(huì)上，我們喝水解渴，進(jìn)食果腹，和素未謀面的陌生人交談，因?yàn)楸Ａ_，我們有了親密的聯(lián)系。這其中，也有著更為深遠(yuǎn)的意義。
And then Paul died. I attended his memorial in the Stanford church, a gorgeous space where I often go when it is empty to sit and admire the light, the silence, and where I always find renewal. It was packed for the service. I sat off to one side, listening to a series of moving and sometimes raucous stories from his closest friends, his pastor, and his brother. Yes, Paul was gone, but strangely, I felt I was coming to know him, beyond that visit in my office, beyond the few essays he’d written. He was taking form in those tales being told in the Stanford Memorial Church, its soaring cathedral dome a fitting space in which to remember this man whose body was now in the earth but who nevertheless was so palpably alive. He took form in the shape of his lovely wife and baby daughter, his grieving parents and siblings, in the faces of the legions of friends, colleagues, and former patients who filled that space; he was there at the reception later, outdoors in a setting where so many came together. I saw faces looking calm, smiling, as if they had witnessed something profoundly beautiful in the church. Perhaps my face was like that, too: we had found meaning in the ritual of a service, in the ritual of eulogizing, in the shared tears. There was further meaning residing in this reception where we slaked our thirst, fed our bodies, and talked with complete strangers to whom we were intimately connected through Paul.

然而，一直等到保羅去世兩個(gè)月后，我終于拿到你現(xiàn)在捧讀的這本書(shū)時(shí)，才感覺(jué)自己終于進(jìn)一步了解了他。能和他做朋友，真是我的福氣。讀完你即將開(kāi)始讀的這本書(shū)后，我坦白，自己實(shí)在甘拜下風(fēng)：他的文字中，有種誠(chéng)懇正直，讓我驚羨不已。
But it was only when I received the pages that you now hold in your hands, two months after Paul died, that I felt I had finally come to know him, to know him better than if I had been blessed to call him a friend. After reading the book you are about to read, I confess I felt inadequate: there was an honesty, a truth in the writing that took my breath away.

做好準(zhǔn)備，找個(gè)地方坐下，見(jiàn)證勇氣的模樣?？匆豢葱枰嗝从赂?，才能如此剖析和袒露自己。但最重要的是，你會(huì)見(jiàn)證雖死猶生的奇跡，死去之后，仍然能用你的文字對(duì)他人的生命產(chǎn)生深遠(yuǎn)的影響。當(dāng)今世界，信息爆炸，我們常常淹沒(méi)在屏幕中，眼睛牢牢盯著手上那塊嗡嗡響的長(zhǎng)方形發(fā)光體，時(shí)時(shí)刻刻都在注意著那些碎片化的東西?，F(xiàn)在，請(qǐng)你停一停，與我英年早逝的同事進(jìn)行一次心靈的對(duì)話(huà)。他雖死去，卻永遠(yuǎn)年輕，永遠(yuǎn)存在于回憶之中。傾聽(tīng)保羅吧。在他字里行間的沉默中，傾聽(tīng)你自己的回應(yīng)。他要傳遞的信息就在書(shū)中。我已然明了。我希望你也一樣去感受。這是一份禮物。我已經(jīng)無(wú)須在保羅和你之間傳話(huà)了。
Be ready. Be seated. See what courage sounds like. See how brave it is to reveal yourself in this way. But above all, see what it is to still live, to profoundly influence the lives of others after you are gone, by your words. In a world of asynchronous communication, where we are so often buried in our screens, our gaze rooted to the rectangular objects buzzing in our hand, our attention consumed by ephemera, stop and experience this dialogue with my young departed colleague, now ageless and extant in memory. Listen to Paul. In the silences between his words, listen to what you have to say back. Therein lies his message. I got it. I hope you experience it, too. It is a gift. Let me not stand between you and Paul.

本書(shū)涉及的事件全部基于卡拉尼什醫(yī)生回憶的真實(shí)經(jīng)歷。不過(guò)，書(shū)中出現(xiàn)的病人均為化名。除此之外，所有醫(yī)學(xué)案例中的細(xì)節(jié)，比如病人的年齡、性別、種族、職業(yè)、家屬、住址、病史和診斷，全部進(jìn)行了修改?？ɡ崾册t(yī)生的同事、朋友和治療他的醫(yī)師也全部為化名，只有一人除外。若因化名和細(xì)節(jié)修改引起的任何雷同，純屬巧合，無(wú)意冒犯。
EVENTS DESCRIBED ARE BASED on Dr. Kalanithi’s memory of real-world situations. However, the names of all patients discussed in this book—if given at all—have been changed. In addition, in each of the medical cases described, identifying details—such as patients’ages, genders, ethnicities, professions, familial relationships, places of residence, medical histories, and/or diagnoses— have been changed. With one exception, the names of Dr. Kalanithi’s colleagues, friends, and treating physicians have also been changed. Any resemblance to persons living or dead resulting from changes to names or identifying details is entirely coincidental and unintentional.