多年前我就發(fā)現(xiàn),達(dá)爾文和尼采有一個觀點(diǎn)是一致的:生物體最重要的特征就是奮斗求生。沒有奮斗的人生,就像一幅畫里身上沒有條紋的老虎。多年來與死亡并肩而行的經(jīng)歷,讓我更深刻地懂得,最輕易的死亡有時候并非最好的結(jié)局。我們就此事進(jìn)行了長談。家人也表示支持,并給予祝福。我們決定要孩子。我們要繼續(xù)活著,而不是等死。
Years ago, it had occurred to me that Darwin and Nietzsche agreed on one thing: the defining characteristic of the organism is striving. Describing life otherwise was like painting a tiger without stripes. After so many years of living with death, I’d come to understand that the easiest death wasn’t necessarily the best. We talked it over. Our families gave their blessing. We decided to have a child. We would carry on living, instead of dying.
由于我在吃藥,借助外力來懷孕看來是唯一的選擇。我們?nèi)フ伊伺谅灏柾幸患疑硟?nèi)分泌診所的專家。她雷厲風(fēng)行,非常專業(yè),但顯然,她之前接觸的大都是不孕不育的病人,對于我這種時日無多的絕癥患者,還很缺乏經(jīng)驗。她給我們說了一連串相關(guān)的東西,眼睛一直盯著筆記本:
Because of the medications I was on, assisted reproduction appeared to be the only route forward. So we visited a specialist at a reproductive endocrinology clinic in Palo Alto. She was efficient and professional, but her lack of experience dealing with terminally ill, as opposed to infertile, patients was obvious. She plowed through her spiel, eyes on her clipboard:
“你倆試了多久了?”
“How long have you been trying?”
“這個嘛,我們還沒試呢。”
“Well, we haven’t yet.”
“哦,對。當(dāng)然?!?br>“Oh, right. Of course.”
最后她問道:“根據(jù)你的……呃……情況,我猜你們應(yīng)該想快點(diǎn)懷孕吧?”
Finally she asked, “Given your, uh, situation, I assume you want to get pregnant fast?”
“是的,”露西說,“我們想馬上開始。”
“Yes,” Lucy said. “We’d like to start right away.”
“那我建議你們先嘗試一下試管嬰兒?!彼f。
“I’d suggest you begin with IVF, then,” she said.
我說,我們想盡量減少培養(yǎng)和破壞的胚胎數(shù)量。專家看上去滿臉疑惑。大多數(shù)來這兒的人都是怎么方便怎么來。但我下定決心,一定不能在我死后讓露西面對好多胚胎,不知如何是好。那是我倆共享的基因組,也是我留存在世界上最后的遺物,封存在某個地方的冰柜里,要?dú)绲籼纯?,又不能把它們變成真正的人——畢竟現(xiàn)在的技術(shù)有限。然而,幾輪人工授精之后,很顯然我們需要借助更高深的技術(shù):我們至少需要培養(yǎng)幾個試管胚胎,然后移植最健康的那個。其他胚胎只能自生自滅。就連一個新生命誕生的過程,死亡也占有一席之地。
When I mentioned that we’d rather minimize how many embryos were created and destroyed, she looked slightly confused. Most people who came here prized expedience above all. But I was determined to avoid the situation where, after I died, Lucy had responsibility for a half dozen embryos—the last remnants of our shared genomes, my last presence on this earth—stuck in a freezer somewhere, too painful to destroy, impossible to bring to full humanity: technological artifacts that no one knew how to relate to. But after several trials of intrauterine insemination, it was clear we needed a higher level of technology: we would need to create at least a few embryos in vitro and implant the healthiest. The others would die. Even in having children in this new life, death played its part.
治療開始后六個星期,我去做了一次CT,看看特羅凱的療效。等我從CT機(jī)上下來,工作人員看著我說:“醫(yī)生,這本來是不合規(guī)矩的,但你如果想看看就去看吧,電腦在那邊。”我把指示器上的圖像上傳到電腦,把自己的名字打了進(jìn)去。
Six weeks after starting treatment, I was due for my first CT scan to measure the efficacy of the Tarceva. As I hopped out of the scanner, the CT tech looked at me. “Well, Doc,” he offered, “I’m not supposed to say this, but there’s a computer back there if you want to take a look.” I loaded up the images on the viewer, typing in my own name.
長痤瘡是令人安心的好現(xiàn)象。我的肢體力量也有所恢復(fù),盡管背痛依然劇烈,疲乏感還是不斷襲來。我坐在那兒,回想艾瑪說的話,不管腫瘤生長情況如何,只要是比較小規(guī)模的生長,都算是治療有效果。(當(dāng)然,我父親之前預(yù)言說,一切癌細(xì)胞都會消失?!澳愕钠由峡隙ㄊ裁匆矝]有,保比!”他喊著家人對我的昵稱,鄭重其事地宣布。)我不斷對自己重復(fù),就算是小規(guī)模的生長,也是有療效的,然后深呼吸一下,在屏幕上點(diǎn)開圖像。我的肺部,之前散布著數(shù)不清的腫瘤,現(xiàn)在卻非常清晰,只有右肺上葉有一個一厘米左右的小瘤子。看得出來,我的脊椎也開始康復(fù)。很顯然,腫瘤大大減少了,實在令人始料未及。
The acne was a reassuring sign. My strength had also improved, though I was still limited by back pain and fatigue. Sitting there, I reminded myself of what Emma had said: even a small amount of tumor growth, so long as it was small, would be considered a success.(My father, of course, had predicted that all the cancer would be gone. “Your scan will be clear, Pubby!” he’d declared, using my family nickname.) I repeated to myself that even small growth was good news, took a breath, and clicked. The images materialized on the screen. My lungs, speckled with innumerable tumors before, were clear except for a one-centimeter nodule in the right upper lobe. I could make out my spine beginning to heal. There had been a clear, dramatic reduction in tumor burden.
我大大松了一口氣。
Relief washed over me.