接下來的幾個星期,我的力量繼續(xù)回升,操作手術的流暢性與技巧也漸漸重回巔峰。我的雙手重新熟練起來,能夠操縱和調(diào)整那些只有幾微米細的血管,又不造成任何傷害。我的手指又找回曾經(jīng)的靈活。一個月后,我?guī)缀跏侨摵傻卦谧鍪中g了。
Over the next couple of weeks, my strength continued to improve, as did my fluency and technique. My hands relearned how to manipulate submillimeter blood vessels without injury, my fingers conjuring up the old tricks they’d once known. After a month, I was operating a nearly full load.
不過我還是有意識地限制自己。只做手術。相關的行政文件、病人看護,以及晚上和周末的病例,都交給維多利亞和其他資深高級住院醫(yī)生。反正,那些技巧我已經(jīng)爛熟于心了,只需要做一些更復雜精確的手術就算圓滿了。每一天工作結束的時候,我都感到極度疲乏,身體肌肉火辣辣的,就像要燃燒起來,它們在慢慢恢復力量。但事實上,我卻絲毫不覺得快樂。曾經(jīng)在手術中獲得的那種發(fā)自內(nèi)心的愉悅感不知所終了,取而代之的是一種冷冰冰的專注,要去克服不斷襲來的惡心、疼痛與疲乏。每天晚上回到家,我會趕緊吞下一把止痛片,然后上床,在露西身邊躺下。她也恢復了全職工作,而且已經(jīng)懷孕了,還沒滿三個月,寶寶的預產(chǎn)期是六月,剛好我也將在那時結束住院醫(yī)生生涯。移植之前,我們給孩子的囊胚照了張相片。(“她的細胞膜長得像你?!蔽覍β段髡f。)此時此刻的我,仍然想讓自己的生活重回原來的軌道。
I kept myself limited to operating, leaving the administration, patient care, and night and weekend calls to Victoria and the other senior residents. I had already mastered those skills, anyway, and needed to learn only the nuances of complex operations to feel complete. I ended my days exhausted beyond measure, muscles on fire, slowly improving. But the truth was, it was joyless. The visceral pleasure I’d once found in operating was gone, replaced by an iron focus on overcoming the nausea, the pain, the fatigue. Coming home each night, I would scarf down a handful of pain pills, then crawl into bed next to Lucy, who had returned to a full work sched-ule as well. She was now in the first trimester of pregnancy, with the baby due in June, when I would complete residency. We had a photo of our child as a blastocyst, taken just before implantation. (“She has your cell membrane,” I remarked to Lucy.) Still, I was determined to restore my life to its prior trajectory.
診斷出癌癥后的六個月,再次照片子,病情穩(wěn)定。我又開始找工作了。既然癌癥沒有再擴散,我也許還能活好幾年。那么,我為之辛勤奮斗多年的事業(yè),經(jīng)歷了病痛的阻礙之后,似乎又重回到咫尺之遙的地方。我?guī)缀醵寄苈牭洁诹恋膭倮柦橇恕?br>Another stable scan six months after diagnosis passed, and I reopened my job search. With my cancer under control, I might have several years left. It seemed the career I had worked for years to attain, which had disappeared amid disease, was now back in reach. I could almost hear trumpets sounding a victory fanfare.
接著,我去見艾瑪,談論宏觀意義上的生命,以及我自己的生命走向。我說起亨利·亞當斯,他曾比較過內(nèi)燃機帶來的科學力量和圣母瑪利亞的存在帶來的力量?,F(xiàn)在,關于我的科學問題算是暫時塵埃落定,關于我的存在問題就成了頭等大事。不過,這兩種問題都是醫(yī)生所關心的。最近我聽說斯坦福那個外科兼科研的職位,就是那個我?guī)缀跻呀?jīng)被內(nèi)定為“法定繼承人”的職位,在我病假期間已經(jīng)找到人了。我很崩潰,也跟艾瑪傾訴了。
During my next visit with Emma, we talked about life and where it was taking me. I recalled Henry Adams trying to compare the scientific force of the combustion engine and the existential force of the Virgin Mary. The scientific questions were settled for now, allowing the existential ones full play, yet both were in the doctor’s purview. I had recently learned that the surgeon-scientist position at Stanford—the job for which I had been heir apparent—had been filled while I was out sick. I was crushed, and told her so.
“嗯,”她說,“這件事情還真是挺折磨人的。你肯定已經(jīng)深切體會到個中滋味了。我很遺憾?!?br>“Well,” she said, “this doctor-professor thing can be a real grind. But you know that already. I’m sorry.”
“嗯,我覺得科研給我的興奮點是,能花個十幾二十年去做項目。現(xiàn)在那么長的時間我是不敢想了,所以也就不那么迫切想當科學家了?!蔽蚁氚参孔约?,“短短幾年,也做不成什么?!?br>“Yeah, I guess the science that excited me was about twenty-year projects. Without that kind of time frame, I’m not sure I’m all that interested in being a scientist.” I tried to console myself. “You can’t get much done in a couple of years.”
“說得對。只要記住,你做得很好。你又開始工作了。你就要有孩子了。你在尋找自己的價值。這可不容易?!?br>“Right. And just remember, you’re doing great. You’re working again. You’ve got a baby on the way. You’re finding your values, and that’s not easy.”
那天晚些時候,一個比較年輕的教授——過去也是住院醫(yī)生,我的好朋友——在走廊里叫住我。
Later that day one of the younger professors, a former resident and close friend, stopped me in the hallway.
“嘿,”她說,“系里開會,都在討論拿你怎么辦?!?br>“Hey,” she said. “There’s been a lot of discussion in faculty meetings about what to do with you.”
“拿我怎么辦,為什么?”
“What to do with me, how?”
“我覺得有些教授很擔心你畢業(yè)的問題。”
“I think some professors are concerned about you graduating.”
住院醫(yī)生畢業(yè)有兩個條件:一是達到一系列國家級和地方級的要求,這我已經(jīng)做到了;二就是系里的批準。
Graduation from residency required two things: meeting a set of national and local requirements, which I’d already done, and the blessing of the faculty.
“怎么了?”我說,“不是我驕傲,我也算很好的外科醫(yī)生了,比得上——”
“What?” I said. “I don’t mean to sound cocky, but I’m a good surgeon, just as good as—”
“我知道。我覺得他們只是想看到你完全承擔起住院總醫(yī)生的責任。那是因為他們很喜歡你。說句真心話?!?br>“I know. I think they probably just want to see you performing the full load of a chief. It’s because they like you. Seriously.”
我意識到她這話的確真心:過去幾個月里,我的表現(xiàn)僅僅稱得上是一個“外科技師”。我拿癌癥當借口,沒有履行對病人的全部職責。話說回來,癌癥也真是個好借口啊,媽的。但現(xiàn)在我已經(jīng)漸漸早出晚歸,又開始看顧病人,每天工作十二小時之外,還加班四個小時。我再次時時刻刻以病人為中心了。頭兩天我以為自己快不行了,無時無刻不在忍著波濤洶涌的惡心、疼痛與疲乏,撐不住的時候找張沒人的病床就睡了。但是,到了第三天,盡管身體還是不行,我卻又開始享受工作了。與病人重新親密接觸,讓我又找回了這份工作的意義。手術與看顧的間隙和查房之前,我會記得吃止吐藥和非類固醇的抗炎藥。的確很痛苦,但我又完全回歸了。我不再去找沒人的病床,而是在初級住院醫(yī)生的沙發(fā)上休息,指導他們看顧我的病人;一邊忍受背部痙攣,一邊給他們講課。身體上的折磨越多,完成工作的樂趣就越大。第一周結束后,我整整睡了四十個小時。
I realized it was true: For the past few months, I had been acting merely as a surgical technician. I had been using cancer as an excuse not to take full responsibility for my patients. On the other hand, it was a good excuse, damn it. But now I started coming in earlier, staying later, fully caring for the patients again, adding another four hours to a twelve-hour day. It put the patients back in the center of my mind at all times. The first two days I thought I would have to quit, battling waves of nausea, pain, and fatigue, retreating to an unused bed in down moments to sleep. But by the third day, I had begun to enjoy it again, despite the wreck of my body. Reconnecting with patients brought back the meaning of this work. I took antiemetics and nonsteroidal anti-inflammatory drugs (NSAIDs)between cases and just before rounds. I was suffering, but I was fully back. Instead of finding an unused bed, I started resting on the junior residents’ couch, supervising them on the care of my patients, lecturing as I rode a wave of back spasms. The more tortured my body became, the more I relished having done the work. At the end of the first week, I slept for forty hours straight.