译文及生词短语整理:朗读者小组
Translation
How Long Have I Got Left?
我还有多长时间可活?
By Paul Kalanithi
As soon as the CT scan was done, I began reviewing the images. The diagnosis was immediate: Masses matting the lungs and deforming the spine. Cancer. In my neurosurgical training, I had reviewed hundreds of scans for fellow doctors to see if surgery offered any hope. I’dscribblein the chart “Widely metastatic disease— no role for surgery,” and move on. But this scan was different: It was my own.
CT扫描刚做完,我就开始分析这些CT影像,诊断结论立即就出来了:肿瘤已经布满了肺脏,并且导致脊柱弯曲,癌症!在神经外科的从业训练中,我已经为同事分析过数百个CT扫描影像,以判断手术是否会有效。我通常会在诊断表上潦草地写上:“癌症细胞已经大范围转移,没有必要进行手术了”,然后继续下一个影像分析。但是这次扫描影像不同:因为扫描的是我自己。
I have sat with countless patients and families to discuss grim prognoses: It’s one of the most important jobs physicians have. It’s easier when the patient is 94, in the last stages of dementia and has a severe brain bleed. For young people like me — I am 36 — given a diagnosis of cancer, there aren’t many words. My standard pieces include “it’s a marathon, not a sprint, so get your daily rest” and “illness can drive a family apart or bring it together — be aware of each other’s needs and find extra support.”
我已经和无数的病人和家庭讨论过严酷的死亡预告:这是内科医生最重要的工作之一。如果病人已经94岁了,病情处于痴呆症晚期、并且有严重的脑出血,那么这种对话会比较容易。但是对于一个像我一样的年轻人——我现在36岁——如果诊断结果是癌症,那么我就不知道该说些什么了。在这种情况下,我的标准用语包括:“治疗癌症是一场马拉松,因此请照常休息”、“疾病可以让一个家庭破碎也可以让一个家庭更团结紧密——你们要了解彼此的需要,并且寻求额外的支持。”
I learned a few basic rules. Be honest about the prognosis but always leave some room for hope. Be vague but accurate: “days to a few weeks,” “weeks to a few months,” “months to a few years,” “a few years to a decade or more.” We never cite detailed statistics, and usually advise against Googling survival numbers, assuming the average patient doesn’t possess a nuanced understanding of statistics.
在此过程中我学到了一些基本原则:把病情预告坦诚地告知病人,但是要给病人留一些希望;说话模糊而又准确,比如几天到几周、几周到几个月、几个月到几年、几年到十几年或者更多。我们从来不会对病人说详细的统计结果,并且通常建议病人也不要谷歌查询存活率,因为一般的病人对统计结果并不能理解透彻。
People react differently to hearing “Procedure X has a 70 percent chance of survival” and “Procedure Y has a 30 percent chance of death.” Phrased that way, people flock to Procedure X, even though the numbers are the same. When a close friend developed pancreatic cancer, I became the medical maven to a group of people who were sophisticated statisticians. I still dissuaded them from looking up the statistics, saying five-year survival curves are at least five years out of date. Somehow I felt that the numbers alone were too dry, or that a physician’s daily experience with illness was needed for context. Mostly, I felt that impulse: Keep a measure of hope.
比如说,对于以下两种说法病人会有不同的反应:“疗法X有70%的存活率”、“疗法Y有30%的死亡率”。如果这么说的话,病人通常会选择疗法X,但是实际上这两种说法是完全等价的(70%的存活率就相当于说有30%的死亡率,反之亦然)。当我的一个关系很近的朋友得了胰腺癌的时候,我成了一群资深统计专家中的医学专家,但是我仍然劝阻他们不要查阅统计数字,并且说道如果是一个5年存活曲线,那么它已经至少晚了5年了。因为我感觉数字本身太枯燥而无意义,并且认为需要一个内科医生的日常从医经验来帮助理解。通常情况下我都有一种冲动:保留一些希望。
New words
1.diagnosis英 [,daɪəg'nəʊsɪs] 美 [,daɪəɡ'nosɪs]
n. 诊断
e.g.The doctor was out in his diagnosis.
医生诊断错了。
2.deform英 [dɪ'fɔːm] 美 [dɪ'fɔrm]
vt. 使变形;使成畸形 vi. 变形;变畸形 adj. 畸形的;丑陋的
e.g.Shoes take up more space. Slip into each shoe a plastic bag that contains rolled socks orunderwear. This will fill the gap and prevent the shoe from deforming.
鞋子会占更多的位子。你可以每只鞋子各塞进一个卷着袜子或内衣的塑料袋。这招不但可以填满空间,还能防止鞋子变形。
3.neurosurgical[,njʊərəʊ'sɜːdʒɪkəl]
adj.神经外科的
e.g.Among them is the Helios Clinic in the town of Hattingen, which specializes in neurosurgical andneurological rehabilitation.
其中,哈廷根的赫利俄斯诊所专门研究神经外科学和神经病学的康复。
4.scribble英 ['skrɪb(ə)l] 美 ['skrɪbl]
n. 潦草写成的东西;潦草的写法;vt. 乱写;滥写;潦草地书写 vi. 乱写;乱涂
e.g.Don't scribble [scrawl] on the wall.
别在墙上乱涂。
5.grim英 [grɪm] 美 [ɡrɪm]
adj. 冷酷的;糟糕的;残忍的
e.g.Not all of their conclusions were that grim.
其实并非所有结论都是那么的严峻。
6.prognose英 [prɔɡ'nəus, -'nəuz] 美 [prɔɡ'nəus, -'nəuz]
vt. 预测 vi. 预测
e.g.They have their skinny little acts together. They expound, prognose, probe, and prick.
他们充分调动其瘦人的行为,去阐述、预测、探索和寻觅。
7.dementia英[dɪ'menʃə] 美 [dɪ'mɛnʃə]
n. [内科] 痴呆
e.g.More than half the inmates have some form of dementia.
(这里)超过一半的犯人都患有某种痴呆症。
8.vague英 [veɪg] 美 [veɡ]
adj. 模糊的;含糊的;不明确的;暧昧的
e.g.One must not be vague on matters of principle.
在原则问题上不能含糊。
9.nuanced英 ['njuːɑːnst] 美 ['nju:ɑ:nst, nju:'ɑ:nst]
adj. 微妙的;具有细微差别的
e.g.So I’m trying very hard to credit the committee with thinking this nuanced.
所以考虑到这些细小但微妙的因素,我很难信服评选委员会的决定。
10.sophisticated英 [sə'fɪstɪkeɪtɪd] 美 [sə'fɪstɪketɪd]
adj. 复杂的;精致的;久经世故的;富有经验的
e.g.So there are more sophisticated approaches, some of them are mechanical.
那么这里还有更复杂的方法,有的人是无意识的。
Phrases
1.metastatic disease (肿瘤)转移性疾病
2.flock to 聚集到 涌到 成群结队地走向
3.pancreatic cancer 胰腺癌;胰脏癌
4.a measure of 一定程度的
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