双语·当呼吸化为空气 是一本未完成的书

从某种意义上说，《当呼吸化为空气》是一本未完成的书，主要是因为保罗的病情急剧恶化了。但这种未完成，恰恰也是本书真意的一部分，反映了保罗面临的现实状况。生命的最后一年，保罗笔耕不辍，完成此书成为他活着的目的，所剩无多的时日也催促他抓紧时间。他还在担任神经外科住院总医生时就开始写了，常常午夜时分文思如泉涌，就在床上我的身边打开笔记本电脑，轻轻敲击键盘；后来，他利用躺椅上的午后时光写作；在肿瘤医生的候诊室里也不忘写个几段；化疗输液时就接编辑的电话，无论去哪里，都带着他那个银色的笔记本电脑。后来，因为化疗，他的指尖出现了龟裂现象，很痛，我们就找了镶着银边的无缝手套，好让他继续使用触摸板和键盘。癌症的恶化带来令人痛苦万分的疲惫感，但他还是采取了一些策略，保持头脑清醒，继续写作。这也是他缓和医疗的重点。他决心坚定，一直坚持。
When Breath Becomes Air is, in a sense, unfinished, derailed by Paul’s rapid decline, but that is an essential component of its truth, of the reality Paul faced. During the last year of his life, Paul wrote relentlessly, fueled by purpose, motivated by a ticking clock. He started with midnight bursts when he was still a neurosurgery chief resident, softly tapping away on his laptop as he lay next to me in bed; later he spent afternoons in his recliner, drafted paragraphs in his oncologist’s waiting room, took phone calls from his editor while chemotherapy dripped into his veins, carried his silver laptop everywhere he went. When his fingertips developed painful fissures because of his chemotherapy, we found seamless, silver-lined gloves that allowed use of a trackpad and keyboard. Strategies for retaining the mental focus needed to write, despite the punishing fatigue of progressive cancer, were the focus of his palliative-care appointments. He was determined to keep writing.

这本书言辞恳切，本来写的时候就在和时间赛跑，表达的也全是保罗认为重要的心声。无论是作为医生，还是病人，他一直都与死神面对面：检验、对抗和接受。他想帮助人们理解死亡，并直面自己必死的命运。现在，三十几岁就去世的人算是少见，但死亡并不少见。“肺癌并不是什么天外来客，”保罗在写给最好的朋友罗宾的一封电子邮件中说，“得了肺癌，的确悲惨，但也可以想象。可以让自己身临其境，感受一下，说：‘原来是这样一种感觉……迟早我可能也会亲自走到这一步。’这可能就是我的目的。不去哗众取宠地用死亡煽情，也不老生常谈地劝大家‘花开堪折直须折’，而是告诉大家这一路上到底会面对什么。”当然，他所做的远不止为大家描述一路的状况，还以自己的血肉之躯，勇敢地在这险境中跋山涉水。
This book carries the urgency of racing against time, of having important things to say. Paul confronted death—examined it, wrestled with it, accepted it—as a physician and a patient. He wanted to help people understand death and face their mortality. Dying in one’s fourth decade is unusual now, but dying is not. “The thing about lung cancer is that it’s not exotic,” Paul wrote in an email to his best friend, Robin. “It’s just tragic enough and just imaginable enough. [The reader] can get into these shoes, walk a bit, and say,‘So that’s what it looks like from here. . . sooner or later I’ll be back here in my own shoes.’ That’s what I’m aiming for, I think. Not the sensationalism of dying, and not exhortations to gather rosebuds, but: Here’s what lies up ahead on the road.” Of course, he did more than just describe the terrain. He traversed it bravely.

我们身处对死亡避而不谈的文化，而保罗决定毫不避讳地直面死亡，这种刚毅和勇气正是我们所倡导和敬佩的。他的力量中有抱负和努力，但也有柔韧，有着与苦涩截然相反的味道。他的大半生都在反复思考如何度过充满意义的一生，而这本书也对这个核心领域进行了探索。“预言者总是发言者，”爱默生写道，“他的梦总会以某种方法公之于众，他总会用肃穆的喜悦将其昭告天下。”写这本书，就是保罗这个勇敢的预言者成为发言者的一个机会，教会我们坦诚地直面死亡。
Paul’s decision not to avert his eyes from death epitomizes a fortitude we don’t celebrate enough in our death-avoidant culture. His strength was defined by ambition and effort, but also by softness, the opposite of bitterness. He spent much of his life wrestling with the question of how to live a meaningful life, and his book explores that essential territory. “Always the seer is a sayer,” Emerson wrote. “Somehow his dream is told; somehow he publishes it with solemn joy.” Writing this book was a chance for this courageous seer to be a sayer, to teach us to face death with integrity.

在这本书出版之前，我们的家人和朋友应该大都对保罗住院医生生涯后期我俩之间的婚姻问题毫不知情，但我很高兴保罗在书中写到了这件事。这是我们生活真相的一部分，也是对保罗与我生命的重新定义，这其中有挣扎，有救赎，也充满意义。他被诊断出癌症，就像一把胡桃夹子夹破了我们婚姻中坚硬的隔阂，让我们重新回到那充满营养的柔软内核之中。我们彼此支撑依赖，只求他的身体安好，两人的精神不倒，我们以完全坦诚的爱相濡以沫。我们各自都对很亲密的朋友开过同样的玩笑，说挽救婚姻关系的秘诀，就是其中一人患上绝症。相反地，我们其实是明白了，直面绝症的方法之一，就是深爱——袒露自己的脆弱，满怀善良、慷慨与感恩。他被确诊后的几个月，我们并排站在教堂的一排座位前，一起唱着赞美诗《仆从之歌》。对于共同面对未来的不确定与痛苦的我们来说，歌词充满了振聋发聩的意义：“我将分享你的喜乐与伤悲／直到这一路携手共度。”
Most of our family and friends will have been unaware, until the publication of this book, of the marital trouble Paul and I weathered toward the end of his residency. But I am glad Paul wrote about it. It’s part of our truth, another redefinition, a piece of the struggle and redemption and meaning of Paul’s life and mine. His cancer diagnosis was like a nutcracker, getting us back into the soft, nourishing meat of our marriage. We hung on to each other for his physical survival and our emotional survival, our love stripped bare. We each joked to close friends that the secret to saving a relationship is for one person to become terminally ill. Conversely, we knew that one trick to managing a terminal illness is to be deeply in love—to be vulnerable, kind, generous, grateful. A few months after his diagnosis, we sang the hymn “The Servant Song” while standing side by side in a church pew, and the words vibrated with meaning as we faced uncertainty and pain together: “I will share your joy and sorrow / Till we’ve seen this journey through.”

确诊之后，保罗立刻对我说，在他过世之后一定要再婚。而他在整个与病魔抗争的过程中，种种行动也充分体现了这句话背后的目的。他努力努力再努力，就是要保障我的未来，不遗余力地确保我能继续好好生活，不用担心财务问题，安心工作奔事业，并享受一个母亲的天伦之乐。与此同时，我也努力努力再努力，确保他此时此刻和剩下的时日能过得尽可能地好。我追踪和监管他所有的症状和医疗护理，面面俱到，无微不至。这大概是我医生生涯中最重要的工作。我还支持他的抱负和梦想，在灯光昏暗、安全感满满的卧室里与他拥抱，听他低声倾诉自己的恐惧，见证他的努力，肯定他的勇气，接受眼前的现实，抚慰他的情绪。我们恢复了医学生时代的形影不离，那时候我们连听课都手拉着手。现在，做完化疗走出医院大门的时候，我们也在他的大衣口袋里手拉着手。即使天气转暖，保罗仍然穿着厚厚的冬大衣，戴着帽子。他知道自己永远不会孤零零一个人，永远不会承受不必要的痛苦。他去世前的几个星期，我们待在家里，躺在床上。我问他：“我像这样把头靠在你胸上，你呼吸没问题吧？”他回答：“只有这样，我才知道怎么呼吸。”保罗和我在彼此的生命中都有着深刻的意义，这是我一生最大的福佑之一。
When Paul told me, immediately after his diagnosis, to remarry after he died, it exemplified the way he would, throughout his illness, work hard to secure my future. He was fiercely committed to ensuring the best for me, in our finances, my career, what motherhood would mean. At the same time, I worked hard to secure his present, to make his remaining time the best it could be, tracking and managing every symptom and aspect of his medical care—the most important doctoring role of my life—while supporting his ambitions, listening to his whispered fears as we embraced in the safety of our darkened bedroom, witnessing, acknowledging, accepting, comforting. We were as inseparable as we had been as medical students, when we would hold hands during lectures. Now we held hands in his coat pocket during walks outside after chemotherapy, Paul in a winter coat and hat even when the weather turned warm. He knew he would never be alone, never suffer unnecessarily. At home in bed a few weeks before he died, I asked him, “Can you breathe okay with my head on your chest like this?” His answer was “It’s the only way I know how to breathe.” That Paul and I formed part of the deep meaning of each other’s lives is one of the greatest blessings that has ever come to me.

我们俩也都从保罗的家人那里汲取了力量。他们在保罗患病期间一直支持着我们，并帮助我们产下自己的孩子，让她也成为这个家的一员。得知儿子罹患绝症，保罗的父母当然震惊而痛苦，但仍然给予了我们坚定的抚慰和安全感。他们在我们家附近租了间公寓，经常来探望。保罗的爸爸帮他揉脚，妈妈常常做美味的印度薄饼，蘸酸辣椰酱吃。保罗、吉旺和苏曼常常懒洋洋地躺在我们家的沙发上。保罗的腿支起来好减轻背部的疼痛。他们三兄弟闲扯着橄榄球赛的排兵布阵。吉旺的妻子艾米丽和我就在一边哈哈大笑。而卡迪则和她的堂姐伊芙、堂哥詹姆斯一同安睡。那些美好的午后，我们家的客厅就像个安宁的小村庄。后来，也是在同一个房间，保罗坐在写字椅上，抱着卡迪，大声朗读罗伯特·弗罗斯特、艾略特和维特根斯坦等人的著作，我则忙着拍照。这些简单轻松的时刻洋溢着美好与福佑，甚至可以说是我们每个人的好运，如果这个世界上存在运气这种东西的话。我们发自内心地感到幸运，充满感恩，为我们的家人，为朋友的陪伴，为一生的机遇，为我们的女儿，为我们在关键时刻都能给予对方绝对的信任和接受。虽然过去这几年我们过得很艰难，有时甚至产生走不下去的感觉，但这同时也是我一生中最美妙、意义最深远的岁月——每天都在生与死之间采取着行动，喜乐与痛苦平衡并存，进一步深入探索感恩与爱。
Both of us drew strength from Paul’s family, who bolstered us as we weathered his illness and supported us in bringing our own child into the family. Despite stunning grief over their son’s illness, his parents remained an unwavering source of comfort and security. Renting an apartment nearby, they visited often, Paul’s father rubbing his feet, his mother making him Indian dosa with coconut chutney. Paul, Jeevan, and Suman lounged on our sofas, Paul’s legs propped up to alleviate his back pain, discussing the “syntax” of football plays. Jeevan’s wife, Emily, and I laughed nearby while Cady and her cousins, Eve and James, napped. On those afternoons, our living room felt like a small, safe village. Later in that same room, Paul would hold Cady in his writing chair, reading aloud works by Robert Frost, T.S. Eliot, Wittgenstein, as I snapped photos. Such simple moments swelled with grace and beauty, and even luck, if such a concept can be said to exist at all. And yet we did feel lucky, grateful—for family, for community, for opportunity, for our daughter, for having risen to meet each other at a time when absolute trust and acceptance were required. Although these last few years have been wrenching and difficult—sometimes almost impossible—they have also been the most beautiful and profound of my life, requiring the daily act of holding life and death, joy and pain in balance and exploring new depths of gratitude and love.

依靠自己的力量以及亲朋好友们的支持，保罗以优雅的姿态面对病痛的每一个阶段——他没有故作勇敢，也没有怀着虚妄的信念，认为可以“克服”或者“战胜”癌症。他坦然真诚，自己本来规划好的未来变得无望，他表示悲痛，但同时又创造了一个新的未来。确诊那天，他哭了。看着浴室镜子上我们画的画，写的字——“我余生每一天都想和你一起待在这里”，他哭了。在手术室的最后一天，他哭了。他允许自己敞开心扉，展露脆弱，接受别人的安慰。就算身患绝症，保罗也活得非常充实。就算身体已然垮掉，他还是精力充沛，开朗大方，充满希望，当然不是奢望能病愈，而是希望充实地度过目标明确、意义深远的每一天。
Relying on his own strength and the support of his family and community, Paul faced each stage of his illness with grace—not with bravado or a misguided faith that he would “overcome” or “beat”cancer but with an authenticity that allowed him to grieve the loss of the future he had planned and forge a new one. He cried on the day he was diagnosed. He cried while looking at a drawing we kept on the bathroom mirror that said, “I want to spend all the rest of my days here with you.” He cried on his last day in the operating room. He let himself be open and vulnerable, let himself be comforted. Even while terminally ill, Paul was fully alive; despite physical collapse, he remained vigorous, open, full of hope not for an unlikely cure but for days that were full of purpose and meaning.