抉擇（小旺）

Ｂｏｂ?。模澹簦颍幔睿铩。停摹。校瑁?/p>

My young son had just died of hunger.

I could not suppress a wail of my own

When the whole land was sobbing.

What troubles me is in being a father

My not getting food caused this infants death.

I could not have known that before the harvest

Such calamity would come to our poverty.

……幼子餓已卒!

吾寧舍一哀,里巷亦嗚咽。

所愧為人父,無食致夭折。

豈知秋禾登,貧窶有倉卒。

??——節(jié)選自杜甫《自京赴奉先縣詠懷五百字》

Poet Du Fu (about 755 AD) after learning that his son was a victim of the famine in his village in western China.

詩人杜甫(約公元755年)獲知兒子在位于西部的家鄉(xiāng)死于饑荒后寫下的。

Pediatrician Richard Lu called me from the Bless China Christian Clinic in Western Kunming on Monday afternoon. I nervously guessed that it was another case of pediatric congenital heart disease. Trained as an adult cardiologist and having spent 90% of my 30 year medical career researching coronary heart disease, I felt under-qualified to evaluate and recommend treatment for children. When I had established my twice a month home clinic in Kunming, I had expected to see angina, congestive heart failure, rheumatic heart disease and maybe a rare adult congenital case.Instead, most of my patients were little kids; some blue, some short of breath, some passing out, and some with fingers deformed by chronic hypoxemia.

周一下午,兒科醫(yī)生理查德?陸從昆明西部的一家名為Bless China Christian的診所給我打來電話。我不安地猜測可能又是一例兒童先天性心臟病。作為一名訓(xùn)練有素的成人心臟病專家,30年醫(yī)學(xué)生涯中我90%的時(shí)間都用來研究冠心病,但每當(dāng)遇到要給小孩做體檢和治療建議的時(shí)候我總覺得自己不能勝任。當(dāng)我確定每月兩次回昆明坐診時(shí),更希望碰上的是患咽峽炎、充血性心力衰竭、風(fēng)濕性心臟病或者罕見的成人先天性疾病的患者,但是,我大部分的病人都是小孩子。他們有的(由于先天心損害)皮膚發(fā)紫,有的呼吸困難,有的已經(jīng)失去知覺,還有些則因?yàn)殚L期血氧不足造成了手指畸形。

Richard Lu had been providing free care for impoverished rural children from the Yunnan hills for five years. He resorted to me because I was the only cardiologist in Kunming who performed free consultations. There was another reason he sought me. I had contacts in Los Angeles who were congenital heart experts. Richard knew that, unless I was sure, I would always check with them before making a recommendation.

五年以來,理查德?陸都在無償照料云南山區(qū)貧困的農(nóng)村孩子們。他求助于我是因?yàn)槲沂抢ッ魑ㄒ灰粋€(gè)提供免費(fèi)咨詢的心臟病專家。另一個(gè)原因則是:我認(rèn)識(shí)一些洛杉磯的先天性心臟病專家。理查德知道,除非我已經(jīng)胸有成竹,我通常會(huì)在給出醫(yī)療建議之前跟那些專家們商量。

'I have a three year old boy who has frequent colds and loses his breath when he runs with other kids in his village. He has had a loud murmur since birth and I can't figure out what it is. His name is Xiao Wang. Can you take a look at him?'

“我這兒有一個(gè)三歲的小男孩,他經(jīng)常感冒,和村里的小伙伴們賽跑的時(shí)候就喘不過氣來。打從出生開始他的體內(nèi)就有種明顯的連續(xù)低沉的聲音,我不知道是怎么回事。他叫做小旺,你能給他看一下嗎?”

After agreeing to see the child on Thursday and asking that Richard first send him for an echo - cardiogram at Yan An hospital, I hung up and hoped that this would be another ventricular septal defect; a hole between the right and left pumping chambers that usually closes spontaneously during childhood. There would be no hard decisions about surgical procedures for that.

我答應(yīng)周四去看這個(gè)孩子,并讓理查德先把他送到延安醫(yī)院做回聲心電圖。掛掉電話之后,我希望這又是一例室間隔缺損的病例:在兒童時(shí)期,心房左右兩瓣之間的一個(gè)小孔常常會(huì)自動(dòng)關(guān)閉。在這種情況下確定手術(shù)實(shí)施步驟并不是什么難事。

Thursday at 2 PM, my cell phone rang. The caller spoke a Miao (the local minority people) dialect I could not understand. I passed the phone to my assistant, Xin Hua. Xin Hua learned that Xiao Wang's Ye Ye (grandfather) had arrived at the building and could not find the staircase to climb to my apartment on the 11th floor. Impatiently, she told him to use the elevator. Ten minutes later, Ye Ye arrived at the apartment, panting and puffing with the toddler on his back. Ye Ye had never used an elevator and would rather climb eleven flights than admit ignorance and ask for instructions.

周四下午兩點(diǎn)鐘,我的手機(jī)響了。來電者說著一口我聽不懂的苗語。我把電話遞給了我的助手新華。新華得知小旺的爺爺已經(jīng)到樓下了,可就是找不著可以通往我居住的第11層公寓的樓梯。她不耐煩地讓他搭電梯上來。10分鐘以后,爺爺背著小孩上氣不接下氣地來到了我的公寓。爺爺從來沒有搭過電梯,他寧愿爬11層的樓梯也不愿意承認(rèn)自己的無知,向別人請教。

While Ye Ye was catching his breath, I examined the child. Xiao Wang's heart rate was fast, over 150 beats per minute and he, like his grand father was short of breath though he had traveled the 11 flights on Ye Ye's back. Xiao Wang's was not the murmur of ventricular septal defect but rather a long, loud, rough murmur that penetrated from his breast bone through to his spine. Patent ductus arteriosus is the abnormal retention of a short arterial connection between the main artery of the body, the aorta, and the main artery of the lungs. Usually this short artery closes spontaneously at birth, but when it does not, it can cause breathing difficulties and eventually death in childhood. The Yan An hospital echo cardiogram confirmed that this was a rather large patent ductus arteriosus and that the pressure inside the pulmonary artery was only mildly elevated. The ductus needed to be closed pretty soon to give this child a decent chance to live a normal life. Of course, before sending the child for a procedure, I would consult a congenital expert, but first I had to get a good history from Ye Ye.

在爺爺歇息的時(shí)候,我給小孩做了檢查。小旺的心率非常快,每分鐘心跳超過150下。雖然他是爺爺背上來的,卻和爺爺一樣喘不過氣來。小旺體內(nèi)的聲音不是由于室間隔缺損而發(fā)出的,而是一種從胸骨一直滲透到脊椎的既長又響亮的刺耳的聲音。軀干大動(dòng)脈、主動(dòng)脈和肺部主要?jiǎng)用}由一小節(jié)動(dòng)脈連接,而動(dòng)脈導(dǎo)管未閉是指這一小節(jié)動(dòng)脈的不正常固位。通常情況下,這個(gè)短動(dòng)脈會(huì)在人出生的時(shí)候自動(dòng)閉合,如果沒有閉合,則可能引起呼吸困難甚至導(dǎo)致夭折。延安醫(yī)院的回聲心電圖將其確診為嚴(yán)重的動(dòng)脈導(dǎo)管未閉,肺動(dòng)脈的壓強(qiáng)只能輕度上升。要使這個(gè)孩子有機(jī)會(huì)能夠過上正常的生活,必須馬上閉合導(dǎo)管。當(dāng)然,在送這個(gè)孩子去手術(shù)之前,我會(huì)向先天性疾病的專家咨詢一下。不過首先我必須先從爺爺那了解一下過去的事情。

Ye Ye had recovered from his 11 floor climb. He told Xiao Wang's story. They lived in a Miao village in western Yunnan where incomes were less than $120 per year. Ye Ye was not really Xiao Wang's grandfather but had adopted the child at infancy when Xiao Wang's real parents had left him in a field because he would not be able to work the potato and corn fields. Farming families in that region can legally have a second child only if the first is a girl. Xiao Wang was worse than a girl. His body was deformed. Ye Ye had lost his wife and one of his own children and had a little money that his daughter was earning at her waitressing job in Kunming. Ye Ye cared for the boy and hoped. When Xiao Wang had starting coughing and having trouble running, Ye Ye discovered Richard Lu's clinic in Kunming.

爺爺已經(jīng)從爬11層樓梯的疲勞中恢復(fù)過來了。他講了小旺的故事。他們住在云南西部的一個(gè)苗族村落里,那里的年收入還不到120美元。爺爺其實(shí)并不是小旺的親爺爺。小旺還是個(gè)嬰兒時(shí),被父母拋棄在田里,是爺爺收養(yǎng)了他。小旺之所以被遺棄,是因?yàn)樗L大以后不能在馬鈴薯或者玉米地里干活。在那個(gè)地方,農(nóng)村家庭只能在第一胎是女孩的情況下才能生第二胎。因?yàn)樗兄鴼埣驳纳眢w,小旺甚至還不如一個(gè)女孩。爺爺?shù)睦习楹鸵粋€(gè)孩子已經(jīng)過世,靠女兒在昆明當(dāng)服務(wù)員賺回來的一點(diǎn)錢過活。爺爺照顧著這個(gè)小男孩并且對他充滿希望。當(dāng)小旺開始咳嗽并且跑步有困難的時(shí)候,爺爺找到了理查德在昆明的診所。

Xiao Wang had fallen asleep on the examining couch. As I lifted him, he woke up, coughed twice and his little hand clutched my shirt. His eyes stared gratefully at his grandfather. The love that brought Xiao Wang and Ye Ye together, and then to Richard Lu and myself will soon bring Xiao Wang to others who would remove a tiny plug from into his inside and save his life. That love is the engine that transcends family and blood, nation and race and will soften and give courage to the hearts of those so desperate and lost that they abandon their children.

小旺在檢查臺(tái)上睡著了。當(dāng)我抱起他的時(shí)候,他醒了,咳嗽了兩下,小手緊緊地抓住我的襯衣。他充滿感激地看著爺爺。愛把小旺和爺爺連在了一起,又把他帶到了我和理查德身邊,不久還會(huì)將小旺交給其他醫(yī)生,他們能夠把他體內(nèi)的小塞子取出,從而挽救他的生命。愛正如一個(gè)引擎,能夠超越家族和血緣,國家和種族,能夠軟化和鼓勵(lì)那些棄子之人絕望茫然的心靈。

After checking out my recommendation with my overseas expert friends and negotiating ways to pay for the curative procedure, I sent Ye Ye and Xiao Wang to a local Kunming hospital for placement of an expensive closure device. That worked fine. Xiao Wang does not cough any more and he runs just fine. He will grow up not quite understanding why parents would leave a healthy baby in a field.

我和海外專家朋友們檢查過我的醫(yī)治方案,并商討了醫(yī)療手續(xù)的付費(fèi)方法,之后,我把爺爺和小旺送到昆明當(dāng)?shù)匾患裔t(yī)院,給他安上了昂貴的閉合儀器。一切都很順利,小旺停止了咳嗽,還能跑步了。長大之后,他可能會(huì)不明白,為什么父母要把這樣一個(gè)健康的孩子遺棄在田地里。

Notes

1. pass out

意為“分發(fā), 昏倒”。

例句:The boxer passed out during a game.

拳擊手在一場比賽中昏倒過去了。

2. resort to

意為“求助于”。

例句:He resorts to me because I will never turn him down.

他求助于我是因?yàn)橹牢矣肋h(yuǎn)不會(huì)拒絕他。

You must never resort to violence.

你們決不能訴諸武力

3. figure out

意為“解決, 斷定, 領(lǐng)會(huì)到”。

例句:Sooner or later we can figure it out.

很快我們就會(huì)弄清楚了。

4. catch ones breath

意為“屏息;喘氣,氣喘;歇口氣”。

例句:He runs all the way, without stopping to catch his breath.

他一直在跑,沒有停下來喘口氣。

The song is so beautiful that it make me catch my breath.

這首歌太好了,我禁不住屏息而聽。