医学人文翻译：粉色沙丽

A Pink Salwar

粉色沙丽

I wake before the alarm goes off to a glorious dawn chorus in London. Usually drowned out by the cacophony of humans, cars, and sirens, now a symphony of birdsong bursts through the window. My morning coffee has no smell or taste, the heat from the mug providing the only stimulus. I walk to the station through the park, where cherry trees are in bud, teasing that they will soon erupt in pink blossoms. A rusty flash in my peripheral vision leads to a stare-off with a fox, each of us surprised to see the other. Scenes from films of a postapocalyptic world come to mind as my footsteps echo through the deserted station. The gentle hum of the escalator transports me underground, and in the eeriness of an empty Tube carriage at rush hour, there is comfort in the familiar voice of the station announcements.

拂晓，伦敦，群雀齐鸣，震彻寰宇，闹铃方将我唤醒。平素车水马龙、人声鼎沸，百鸟竞歌湮灭其中，而今一反常道，奔窗直泻而入。今晨的咖啡索然无味，只有杯子的温暖给我一丝慰藉。喝完咖啡穿过公园，我走向地铁站，公园里的樱桃树正吐蕾，似乎预示它们很快就会绽放出粉红色的花朵。突然一道深红色从余光中一闪而过，诧异之际却与一只狐狸四目相对。当脚步声开始在空旷的地铁站回荡时，脑海中不禁浮现出电影中世界末日后世界的场景。伴随着电梯轻柔的嗡嗡声我来到地下候车厅，高峰时段空荡荡的地铁车厢阴森恐怖，但车站熟悉的播报声让我感到些许安慰。

Through the main entrance of the hospital, the usual bustle of visitors and patients attending appointments is absent. I can hear none of the accustomed small talk between porters and patients being transported to scans. On the ward, I struggle to squeeze my hair under a surgical cap. Donning personal protective equipment (PPE) is like learning dance steps — gown, mask, face shield, gloves, more gloves. I feel like an astronaut as I step through the doors of the respiratory highdependency unit, each step weighed down by the PPE and the anticipation of the day.

走进医院的大门，门可罗雀，不复往常熙熙攘攘的来访者和就诊现象，也未听见护工和前往检查的患者惯常的闲聊。在病房里，我艰难地将头发塞进手术帽，穿戴个人防护装备（PPE——防护服、口罩、面屏、一层又一层的手套），这个过程就像练跳舞。当我走进呼吸ICU的门时，感觉自己就像一名宇航员，每走一步都要被PPE和对这天的期待所压垮。

The resident presents the histories as we round. “The first patient is a 45-year-old man, no previous medical history. Lives with wife and three children. Fevers, dry cough, shortness of breath. Day 10 of Covid-19 symptoms.” Blood results show lymphopenia, chest radiograph shows bilateral infiltrates. He has been continuing his work as a taxi driver despite the lockdown. “No work, no money,” he explains through gasps. The patient is Somali and 6 feet 5 inches tall. His long legs stretch out, almost comically uncontained by the length of the bed. He clasps his mobile phone and I catch a glimpse of the home screen, a photograph of his young children smiling broadly. Respiratory rate, 60 breaths per minute. The alarm from the pulse oximeter bleeps continuously, signaling his extreme hypoxemia. As the anesthetic team rushes to intubate him, there is no breath left for him to ask the difficult questions to which we have no answers. “When will I wake up?” “Will I wake up?”

查房时，住院医汇报病史，“第1例患者为45岁男性，无任何既往病史，与妻子和三个孩子一起生活。COVID-19感染后第10天，现发热、干咳、呼吸短促。”血液检查显示淋巴细胞减少，胸片显示双肺浸润。尽管已封城，他还在开出租载客，“不工作，就没钱喽，”他上气不接下气地解释道。这位患者为索马里人，身高6英尺5英寸，这使得他的长腿滑稽地从床沿边伸了出来。他攥着手机，我瞥了一眼主屏幕，上面是他年幼孩子们灿烂的笑容。呼吸已每分钟60次了，脉搏血氧仪的警报持续响个不停，提示他极度低氧。当麻醉医师团队冲过去给他气管插管时，他已经没有了呼吸，不能再问那些我们也无法回答的难题：“我什么时候能醒来？”“我会醒来吗？”

“The next patient is 68 years old, female, type 2 diabetes, on metformin. Lives with son, daughter-in-law, and grandchildren. Independent in activities of daily living and does the household cooking. Fevers, dry cough, shortness of breath. Day 8 of Covid-19 illness.” The patient has not changed into a hospital gown and wears a pink salwar kameez, the traditional long tunic and loose trouser suit of South Asia. The warm tones of the peach detailing of the salwar catch the light of the gold bangles that adorn her delicate wrists. She smiles despite her fever of 40°C and the tight face mask strapped to her head. We make adjustments to the pressures of the CPAP machine and the oxygen.

“下一位患者是68岁女性，2型糖尿病，正服用二甲双胍。与儿子、儿媳和孙辈同住，生活自理，还能家庭烹饪。现发热、干咳、呼吸短促，这是她与Covid-19抗争的第八天。”患者并未更换医院病号服，而是着一袭粉色的沙丽克米兹，这是南亚传统的长袍与宽松裤装，沙丽暖色的桃花装饰映照着她纤细手腕上的金手镯，熠熠生辉。尽管发烧40℃、脸部还紧扣面罩，她还是微笑面对。我们调整了CPAP的压力和吸入氧浓度。

“52-year-old female, hypertension on ramipril. Works as a nurse in the dialysis unit. Day 11 of Covid-19 symptoms.” The chest x-ray is the worst I have seen, both lungs almost completely obliterated by infiltrates. I am surprised to see the patient sitting with calm composure in a chair and to hear a polite, muffled inquiry, “How are you, doc?” through her face mask. I place the probe on her finger, and 74% starkly appears. She puts her family on speakerphone, and I inform them that she is being transferred to intensive care. She speaks in Tagalog to her family, trying to reassure them, and inter- spersed I hear her teenage daughter speaking in English through tears, “I love you, Mama.” Her sister begs me, “Please doctor, please, please save her. Please promise me, doctor.”

“52岁，女护士，在透析部门工作，有高血压，雷米普利治疗。11天前出现Covid-19症状”。这是我见过的最严重的胸部X线片，两侧肺部几乎全被浸润。然而，令我惊讶的是，患者坐在椅子上，从容而镇静，口罩里传来她礼貌而低沉的问候：“医生，你好！”我把脉氧探头放在她手指上，赫然出现惊愕的数值，只有74%。她打开免提，让我与她家人通话，我告诉他们她正转往重症监护病房。她用塔加拉族语与家人对话，试图安慰他们。电话那头，我听到她十几岁的女儿用英语哽咽说，“妈妈，我爱你！” 她的姐姐则恳求我：“医生，请一定救救她！请答应我，医生！”

“78-year-old man. History of myocardial infarction in 2012 and chronic kidney disease. Walks with a stick. Day 14 of Covid illness. Day 4 of CPAP. Worsening.” The patient’s turban is neatly tied. He has a long, white flowing beard and wears a kara — an iron bracelet, a symbol representing his faith. He is exhausted. His thin facial skin is bruised from the tight-fitting mask, and a pressure ulcer is slowly forming on his cheek, despite the regular adjustments made diligently by his nurse. After discussion with him and his family, we remove the CPAP mask and switch to a simple face mask. He asks for milky tea with two teaspoons of sugar. Later that afternoon, he closes his eyes and dies. A life filled with family and friendships, and at the end he is alone. The empty tea-stained polystyrene cup sits on the bedside table, its solace drained.

“78岁的男性，有慢性肾病，2012年曾有心肌梗死，需持拐行动，14天前确诊Covid-19，4天前使用CPAP治疗，但病情持续恶化。”他头戴整齐的穆斯林头巾，长须飘然，手腕上戴着象征信仰的卡拉铁手镯。他看起来疲惫不堪，尽管护士们勤勉地调整着面罩，但面罩勒紧脸部的肌肤还是擦出了淤青，脸颊上依旧悄然生出了压疮。在跟他以及他的家人商讨后，我们卸下了CPAP面罩，改用普通面罩。他点了一杯加两茶匙糖的奶茶，当天下午晚些时候，他安详地闭上了眼睛。他一生充满了亲情和友谊，但走时孑然一身。床头柜上，静静摆放着茶渍斑斑的空塑料杯，曾带给患者的慰藉已耗尽。

“55-year-old female. Diet-controlled type 2 diabetes. Works as a nurse in acute medicine. Day 8 of anosmia, fevers, and cough.” She looks so youthful, her eyes bright, her walnutcolored skin smooth. Her son lives in Ghana, her daughter is in the United States. “I am alone here,” she says, and tears overflow from her eyes. We try to fill the air with kind words, but they hang heavily, a meager attempt at consolation for the absence of family.

“55岁女性，急诊科护士，患2型糖尿病，饮食控制中。8天前嗅觉丧失、发热和咳嗽”。她看上去很年轻，眼睛明亮，光滑的核桃色皮肤。她的儿子远在加纳，女儿则在大洋彼岸的美国。“在这里，我孤身一人”，说完，眼泪不禁夺眶而出。我们试图用亲切的话语打破沉重的氛围，但微薄的安慰，无法弥补家人的缺席，常无语凝噎。

“47-year-old man with type 2 diabetes. Day 5 of cough and fevers. Admitted this morning. Oxygen saturations 95% on 4 liters of oxygen, and respiratory rate is 24.” The observations on the chart are the best I have seen today. My relief is displaced by the panic in his eyes. He has not been able to move his right arm for the past 30 minutes. His words tumble out like he is drunk. Imaging reveals the filling defect in the left internal carotid artery and the resulting infarct, the virus making his blood sticky and his endothelium inflamed. This virus is wicked and keeps taking.

“47岁男性，2型糖尿病，5天前咳嗽、发热，今早入院。吸入4升/分的氧气后氧饱和度为95%，呼吸频率为24次/分”。今日所有的病历中，他的数据是最好的。我刚松了一口气，瞬间就被他眼中的恐惧激醒。30分钟前，他的右臂已无法动弹，言语含糊，仿佛醉酒一般。影像检查显示左侧颈内动脉充盈缺损，以及由此导致的脑梗死。这种邪恶的、不断肆虐的病毒使得患者血液粘滞、引起了他的血管内皮细胞发炎。

The ward fills with gold warmth as the sun starts to set. The cardiac arrest alarm blares. The nurse has started chest compressions, and we go through the orchestrated ballet of resuscitation. Scissors quickly cut through the pink salwar, and the paddles are applied. Pulseless electrical activity due to hypoxemia. After we stop, the team stands dazed, stifled by PPE, stifled by not being able to console each other by a squeeze of the hand or a pat on the shoulder, stifled by watching this virus choke the breath from our patients.

太阳开始西下，病房里洒满了温暖的金色余晖。突然，心脏骤停警报声划破宁静，护士第一时间开始了胸外按压，随后我们开始了有序的复苏。锋利的剪刀迅速划破粉色的沙丽，电击板紧随其后，因为低氧血症，心脏出现无脉电活动。抢救失败后，我们茫然地站着，头晕目眩，也许是因为长时间防护服的束缚，也许是因为无法通过握手或拍肩来安慰彼此，也许是眼睁睁看着病毒夺走了她的呼吸，每个人都感到窒息。

I doff my PPE carefully and wash my hands. My face hurts, the tight mask that protects me marking my cheeks. The granddaughter is listed as the next of kin. I slowly dial the number and wait for an answer. I hear the background noise of family life, the volume on a television hastily turned down, the clang of a pot as dinner is prepared. I explain who I am and that I’m calling from the hospital. “Why are you calling? What’s happened? She’s OK, right?” I give the granddaughter the news and wait as this family’s world crumbles. The sounds of raw grief come through the receiver — crying, howling, guttural sobs. I am silent.

我轻轻地卸下个人防护装备，仔细洗净双手。面颊，因防护面罩紧扣的勒痕，而生疼。患者登记的近亲是孙女，我小心翼翼地拨了号码，心中忐忑，等待接听。耳边传来了家庭生活的背景噪音,有急忙调低的电视机声音、准备晚餐时锅碗瓢盆的叮当声。我自我介绍，告知他们我是从医院打来的。“你为什么打电话来？”“出什么事了？”“她还好吧？”我把患者不幸去世的沉重消息告诉了她，电话那头的空气仿佛凝固，这个家庭的世界在这一刻崩塌。哭泣、哀嚎、撕心裂肺的呜咽，从听筒那端传来悲痛的声音。我沉默了。

Morning news bulletins scream and shout the fears of the second wave. I inhale the steam from the cup and take a sip of tea, savoring the intricacy of cardamom and ginger. Autumn has erupted, and the leaves are changing to feuille morte and turmeric colors. A dark winter brings a tsunami of patients, countless individual desperate experiences accumulating in our collective grief. I dream of scissors cutting through the pink salwar.

晨间新闻声嘶力竭地响彻着病毒二次来袭的警报，带来了新的恐惧。我吸了一口杯中升腾的热汽，抿了一口茶，品味着豆蔻和姜细腻的口感。秋天来得猝不及防，树叶变幻成棕黄和姜黄色。在这个黑暗的冬天，Covid病患潮大量涌现，无数个绝望的经历让我们集体陷入了更深切的哀悼中。睡梦中，我又用剪刀剪开了那件粉色的沙丽。

I walk to the station through the park. Yellow heralds a hopeful reawakening with the drama of forsythia and daffodils trumpeting the arrival of spring. There has been a light rain in the early hours, and the earthy aroma of petrichor lies teasingly just below the surface. I can’t breathe deeply enough to fill my lungs with the scent.

穿过公园，我缓步走向地铁站，园中一片黄艳艳的景象，那是盛开的连翘和水仙，那是春归的前奏，那是心灵的觉醒，那是希望的重燃。清晨细雨过后，泥土芳香淡淡散发，似乎就在地表下诱人而至。然而，我却发现，无论如何深呼吸，也无法将这沁人心脾的香气完全充满我的肺腑。