雙語(yǔ)·當(dāng)呼吸化為空氣 第一次解剖尸體

你也許會(huì)覺(jué)得，第一次解剖尸體，大概會(huì)有點(diǎn)滑稽。然而，奇怪的是，我覺(jué)得一切都特別正常和自然。明晃晃的手術(shù)燈，不銹鋼的解剖臺(tái)和戴著領(lǐng)結(jié)的教授們都帶著一種莊嚴(yán)的禮節(jié)。即便如此，從頸背一直割到腰背的第一刀，也是永生難忘的。手術(shù)刀很鋒利，感覺(jué)不是割開(kāi)皮膚，只是拉開(kāi)一個(gè)順滑的拉鏈，皮囊包裹之下本無(wú)從得見(jiàn)的筋骨展露在眼前。就算之前做了很多準(zhǔn)備，你仍然會(huì)有種出其不意的感覺(jué)，羞愧與興奮并存。尸體解剖是醫(yī)學(xué)生的重大儀式，但也侵犯了圣潔的神明，令人剎那間百感交集：嫌惡、愉悅、惡心、沮喪與敬畏。然而時(shí)日長(zhǎng)久之后，這只不過(guò)是枯燥沉悶的課堂練習(xí)。一切都仿佛在蹺蹺板上忽高忽低，有時(shí)悲痛感傷到無(wú)以復(fù)加，有時(shí)又想些瑣碎平常的小事。你看看你，違反著最基本的社會(huì)禁忌，但手術(shù)室里的甲醛能讓人胃口大開(kāi)，所以又特別想吃個(gè)玉米卷餅。最終，當(dāng)你解剖了正中神經(jīng)，把骨盆鋸成兩半，割開(kāi)心臟，完成任務(wù)之后，心里想的就完全是那些小事了：侵犯圣潔的神明又如何？這就是醫(yī)學(xué)院課堂的常態(tài)啊。班上也有書(shū)呆子，有開(kāi)心果，有和常人別無(wú)二致的同學(xué)。很多人認(rèn)為，正是尸體解剖，將有著正常人悲歡情緒與恭敬禮貌的學(xué)生，轉(zhuǎn)變成冷酷無(wú)情、傲慢自大的醫(yī)生。
You would think that the first time you cut up a dead person, you’d feel a bit funny about it. Strangely, though, everything feels normal. The bright lights, stainless steel tables, and bow-tied professors lend an air of propriety. Even so, that first cut, running from the nape of the neck down to the small of the back, is unforgettable. The scalpel is so sharp it doesn’t so much cut the skin as unzip it, revealing the hidden and forbidden sinew beneath, and despite your preparation, you are caught unawares, ashamed and excited. Cadaver dissection is a medical rite of passage and a trespass on the sacrosanct, engendering a legion of feelings: from revulsion, exhilaration, nausea, frustration, and awe to, as time passes, the mere tedium of academic exercise. Everything teeters between pathos and bathos: here you are, violating society’s most fundamental taboos, and yet formaldehyde is a powerful appetite stimulant, so you also crave a burrito. Eventually, as you complete your assignments by dissecting the median nerve, sawing the pelvis in half, and slicing open the heart, the bathos supersedes: the sacred violation takes on the character of your average college class, replete with pedants, class clowns, and the rest. Cadaver dissection epitomizes, for many, the transformation of the somber, respectful student into the callous, arrogant doctor.

醫(yī)學(xué)這種“罪大惡極”的道德使命，讓我這個(gè)滿懷崇高理想的醫(yī)學(xué)院新生經(jīng)歷了一個(gè)急速下墜的過(guò)程。尸體解剖之前，第一天是心肺復(fù)蘇訓(xùn)練，也是我的第二次訓(xùn)練。第一次是在本科的時(shí)候，當(dāng)時(shí)場(chǎng)面很滑稽，很不嚴(yán)肅，大家都嬉皮笑臉的。教學(xué)視頻粗制濫造，用來(lái)練習(xí)的塑料模特連手腳都沒(méi)有，真是假得不能再假了。然而，現(xiàn)在，這些東西我們某一天可能真的用得上，氣氛完全變了，人人都躍躍欲試。我不斷用手掌按壓著一個(gè)塑料小孩的胸，耳邊是同學(xué)們有一搭沒(méi)一搭的笑話，但仿佛還是聽(tīng)到這個(gè)孩子的肋骨被我一個(gè)不小心弄斷了。
The enormity of the moral mission of medicine lent my early days of med school a severe gravity. The first day, before we got to the cadavers, was CPR training, my second time doing it. The first time, back in college, had been farcical, unserious, everyone laughing: the terribly acted videos and limbless plastic mannequins couldn’t have been more artificial. But now the lurking possibility that we would have to employ these skills someday animated everything. As I repeatedly slammed my palm into the chest of a tiny plastic child, I couldn’t help but hear, along with my fellow students’ jokes, real ribs cracking.

尸體解剖則恰恰相反。心肺復(fù)蘇用的假模特，你假裝那是真的，而尸體解剖用的真尸體，你卻要假裝那是假的。但第一天的時(shí)候，你完全做不到。我面對(duì)的屬于自己的那具尸體，有點(diǎn)發(fā)青，有點(diǎn)腫脹，但他曾經(jīng)是個(gè)活生生的人，已經(jīng)死亡，這樣的事實(shí)無(wú)可否認(rèn)。一想到接下來(lái)的四個(gè)月，我將用一把鋼鋸給這男人的腦袋做個(gè)對(duì)角線平分，我就覺(jué)得良心受到深深的譴責(zé)。
Cadavers reverse the polarity. The mannequins you pretend are real; the cadavers you pretend are fake. But that first day, you just can’t. When I faced my cadaver, slightly blue and bloated, his total deadness and total humanness were undeniable. The knowledge that in four months I would be bisecting this man’s head with a hacksaw seemed unconscionable.

這就輪到解剖學(xué)教授出場(chǎng)了。他們建議我們，好好看一眼尸體的臉，然后用布蓋上，這樣更容易下手。我們不斷深呼吸，眼神里帶著認(rèn)真與熱切，準(zhǔn)備割開(kāi)尸體的頭。恰好一個(gè)外科醫(yī)生過(guò)來(lái)聊天，他斜著身子，手肘就撐在尸體的臉上。他指著光溜溜的尸體軀干上好幾處瘢痕和傷疤，為我們構(gòu)建了尸體的病史。這條傷疤，來(lái)自腹股溝疝氣手術(shù)；這條來(lái)自頸動(dòng)脈內(nèi)膜切除手術(shù)；這些瘢痕，是他不斷抓撓留下的；病人生前可能有黃疸，膽紅素很高；他可能是得了胰腺癌去世的，不過(guò)沒(méi)有相關(guān)手術(shù)的傷疤，也許還沒(méi)來(lái)得及動(dòng)手術(shù)就死了。他滔滔不絕地講著，我的眼睛卻離不開(kāi)他的手肘。每說(shuō)一條新的醫(yī)學(xué)假設(shè)，教一點(diǎn)新的醫(yī)學(xué)詞匯，他的手肘就在尸體被遮住的臉上挪來(lái)挪去。我在心里默念：臉盲癥，一種神經(jīng)障礙疾病，患者對(duì)人臉會(huì)失去辨別能力。很快我也會(huì)得這種病，手里拿著鋼鋸，心里輕松無(wú)比。
Yet there are anatomy professors. And the advice they gave us was to take one good look at our cadaver’s face and then leave it covered; it makes the work easier. Just as we prepared, with deep breaths and earnest looks, to unwrap our cadaver’s head, a surgeon stopped by to chat, leaning with his elbows on the corpse’s face. Pointing out various marks and scars on the naked torso, he reconstructed the patient’s history. This scar is from an inguinal hernia operation, this one a carotid endarterectomy; these marks here indicate scratching, possibly jaundice, high bilirubin; he probably died of pancreatic cancer, though no scar for that—killed him too quick. Meanwhile, I could not help but stare at the shifting elbows that, with each medical hypothesis and vocabulary lesson, rolled over this covered head. I thought: Prosopagnosia is a neurological disorder wherein one loses the ability to see faces. Pretty soon I would have it, hacksaw in hand.