墙角的花-熟识

graceful a. 1.优美的，优雅的 2.得体的
chart n. 图，图表
vt. 制图表
preceding a. 在前的，在先的，前面的
decay n. 变坏，腐烂，衰败
vi. 1.腐烂，变坏 2.衰退，衰落，衰败
vinegar n. 醋
pit n. 1.坑 2.矿井，煤矿
▲skeleton n. 1.骨骼，骨架 2.梗概，提要
loose a. 1.宽松的，不紧的 2.自由的，散漫的
loosely ad. 松地，大致地
secure vt. 1.关紧，固定 2.使安全，保护 3.得到，获得
a. 1.安全的 2.牢固的 3.无忧的，安心的
fluid n. 液体，流体
drip v. 滴
n. 1.(连续落下的)液滴 2.一滴
faint a. 1.微弱的 2.虚弱
pulse n. 脉搏
vi. 搏动，跳动
straw n. 1.吸管，麦管 2.稻草，麦杆
moisture n. 潮湿，湿气
slide v. 1.（使）滑动 2.（使）悄悄地移动
n. 1.滑，滑行 2.幻灯片
thirst n. 1.渴，口渴 2.渴望
liquid n. 液体
naked a. 1.赤身的，裸露的 2.赤裸裸的，无遮蔽的
▲gown n. 女长服；罩衣
famine n. 饥荒
lid n. 盖，盖子
jar n. 罐子，坛子
palm n. 1.手掌，掌心 2.棕榈树
injure vt. 伤害，损伤
outline n. 1.轮廓，外形 2.要点，大纲
vt. 概述
pillow n. 枕头
rainbow n. 虹，彩虹
butterfly n. 蝴蝶
hint n. 1.细微的迹象 2.暗示，提示
v. 暗示
reader n. 1.读者 2.读物，读本
ounce n. (重量单位)盎司
being n. 1.生物，人 2.存在
interval n. 1.间隔，间距 2.幕间休息，中场休息
blank a. 1.茫然的，无表情的 2.空白的，无字的，空着的
n. 空白
shallow a. 1.(呼吸)浅的，弱的 2.浅的 3.肤浅的，浅薄的
n. 浅水处，浅滩
emotion n. 情感，感情，激情
privilege n. 特权，优惠
episode n. 1.一个事件，一组事件 2.(尤指电视或无线电广播的)一集，一出，一部分
association n. 1.协会，社团，组织 2.联合，结交，结合



Phrases and Expressions

the pit of the stomach 胸口，心窝
hang around sth. (使)在……上挂着， （使）围在……上
so that 为的是，以便
reach for 伸出手以触到或拿到
feel for （用手、足、棍等）摸索，寻找
turn towards 转向
bend to 俯向
make an attempt to do sth. 尝试，企图
go about doing sth. 着手处理，开始做
provide for sth. 为可能发生的事做安排
pick sb. up 举起，抱起
pull up 把... ...拉过来，把... ...拉向前
stroke n. 1.中风 2.击，打，敲
vt. 抚摸
worthless a. 无价值的，没有用处的
dependent a. 1.依赖的，依靠的 2.取决于... ...的
x-ray n. 1. [C] X光照片 2. [C] X射线; X光
■infection n. 1.传染病 2.传染，感染
germ n. 1.微生物，病菌，细菌 2.萌芽，起源
al chart and the report I received from the preceding shift that tonight she will die.

The only light in her room is coming from a piece of medical equipment, which is flashing its red light as if in warning. As I stand there, the smell hits my nose, and I close my eyes as I remember the smell of decay from past experience. In my mouth I have a sour, vinegar taste coming from the pit of my stomach. I reach for the light switch, and as it silently lights the scene, I return to the bed to observe the patient with an unemotional, medical eye.

Mrs. Clark is dying. She lies motionless: the head seems unusually large on a skeleton body; the skin is dark yellow and hangs loosely around exaggerated bones that not even a blanket can hide; the right arm lies straight out at the side, taped cruelly to a board to secure a needle so that fluid may drip in; the left arm is across the sunken chest, which rises and falls with the uneven breaths.

I reach for the long, thin fingers that are lying on the chest. They are ice cold, and I quickly move to the wrist and feel for the faint pulse. Mrs. Clark's eyes open somewhat as her head turns toward me slightly. I bend close to her and scarcely hear as she whispers, "Water." Taking a glass of water from the table, I put my finger over the end of the straw and allow a few drops of the cool moisture to slide into her mouth and ease her thirst. She makes no attempt to swallow; there is just not enough strength. "More," the dry voice says, and we repeat the procedure. This time she does manage to swallow some liquid and weakly says, "Thank, you."

She is too weak for conversation, so without asking, I go about providing for her needs. Picking her up in my arms like a child, I turn her on her side. Naked, except for a light hospital gown, she is so very small and light that she seems like a victim of some terrible famine. I remove the lid from a jar of skin cream and put some on the palm of my hand. Carefully, to avoid injuring her, I rub cream into the yellow skin, which rolls freely over the bones, feeling perfectly the outline of each bone in the back. Placing a pillow between her legs, I notice that these too are ice cold, and not until I run my hand up over her knees do I feel any of the life-giving warmth of blood.

When I am finished, I pull a chair up beside the bed to face her and, taking her free hand between mine, again notice the long, thin fingers. Graceful. I wonder briefly if she has any family, and then I see that there are neither flowers, nor pictures of rainbows and butterflies drawn by children, nor cards. There is no hint in the room anywhere that this is a person who is loved. As though she is a mind reader, Mrs. Clark answers my thoughts and quietly tells me, "I sent ... my family ... home ... tonight ... didn't want ... them ... to see ..." Having spent her last ounce of strength she cannot go on, but I have understood what she has done. Not knowing what to say,
I say nothing. Again she seems to sense my thoughts, "You …stay …"

Time seems to stand still. In the total silence, I feel my own pulse quicken and hear my breathing as it begins to match hers, breath for uneven breath. Our eyes meet and somehow, together, we become aware that this is a special moment between two human beings ... Her long fingers curl easily around my hand and I nod my head slowly, smiling. Without words, through yellowed eyes, I receive my thank you and her eyes slowly close.

Some unknown interval of time passes before her eyes open again, only this time there is no response in them, just a blank stare. Without warning, her shallow breathing stops, and within a few moments, the faint pulse is also gone. One single tear flows from her left eye, across the cheek and down onto the pillow. I begin to cry quietly. There is a swell of emotion within me for this stranger who so quickly came into and went from my life. Her suffering is done, yet so is the life. Slowly, still holding her hand, I become aware that I do not mind this emotional battle, that in fact, it was a privilege she has allowed me, and I would do it again, gladly. Mrs. Clark spared her family an episode that perhaps they were not equipped to handle and instead shared it with me. She had not wanted to have her family see her die, yet she did not want to die alone. No one should die alone, and I am glad I was there for her.

Two days later, I read about Mrs. Clark in the newspaper. She was the mother of seven, grandmother of eighteen, an active member of her church, a leader of volunteer associations in her community, a concert piano player, and a piano teacher for over thirty years.

Yes, they were long and graceful fingers.







Decisions of the Heart

Assume for a moment that your 90-year-old mother has recently suffered a stroke. She is right-handed, and now she is unable to move her right arm and leg — they are worthless to her. She can make sounds, but she can't make herself understood.

The condition has lasted two months and since there has been no sign of improvement, the doctor tells you she will never get significantly better. Until this time your mother has always been an active, independent person who lived on her own. Now she is completely dependent on others.

Next, x-rays show your mother has a lung infection — a frequent problem with stroke patients. The doctor then calls you, her only surviving relative.

"We can treat the infection with drugs and she'll probably get better in a week," he says. "When I say better, I mean she'll go on as she has — until some other germ comes along. Or I can deny her the medicine, in which case she'll probably die in three or four days. We can make those days comfortable by giving her painkillers and sleeping pills. Which course do you want me to follow?"

Tough question, isn't it? On the one hand, you cannot bear to see your once vigo
rous mother living the painful, limited life to which the stroke has condemned her. On the other hand, you hate to be the one to decide to let nature take its course.

I'll tell you which choice I would make in this theoretical situation. I'd say, "Don't give her anything to fight the infection. Keep her comfortable and let's see what happens; maybe she'll fight off the infection on her own and if she doesn't, she'll die a peaceful death. I don't want to be responsible for condemning my mother to a living hell."

I can make this decision because I've gone down this road with patients many times. Recently I operated in vain on an eighty -year-old woman with cancer of the liver ... There was nothing I could do to relieve the problems the cancer had caused. She was an intelligent woman, without any close relatives, and a couple of days after the operation I sat down with her and explained the situation.

"I can give you some anti-cancer drugs," I said, "but they will make you sick and cannot cure you. Similarly, I can give you fluids through a needle in your arm, which will keep you fed as your appetite slips away; the fluids might add a week or two to your life. Or I can withdraw all other treatment and just give you a vitamin pill, and we can see what happens. Personally, my recommendation would be the last choice. I'll keep you comfortable, and we'll see what happens."

The patient elected to follow my advice and died peacefully, pain free, a fortnight later.

Sometimes such a transparent decision is more difficult to come by. Recently I had a patient who suffered a severe stroke. He was completely unable to move and couldn't swallow anything. We gave him fluids for the first two weeks and then fed him through a tube which passed through his nose into his stomach.

After three weeks he was still completely unconscious, and the tube caused him to have a constant, painful sore throat ... I talked to his four grown children and told them I thought we should insert a tube directly into his stomach through a small hole so he could be fed without so much pain. I also told them, "I can remove the tube and just let him swallow whatever he can. Chances are he won't live long, but he won't be in pain." No one wanted to take the responsibility for permitting an operation, yet no one would give permission to stop feeding the patient entirely.

As a result, the poor man continued on for nearly three more months with a painful throat and frequent bleeding caused by sores in the mouth. He died of a major infection - a sad way to die.

So what should responsible persons do when confronted with the necessity of such an enormous decision?

What it all comes down to is common sense. For the 30 years I have been a doctor, and for hundreds of years before that, doctors and families have been quietly cooperating to decide what is best for a patient in the final phase of an illness.

In 95 percent o
f the cases a sympathetic, reasonable decision can be made after appropriate discussion. In 5 percent of cases where such a judgment cannot immediately be reached, the proper decision will become apparent after a few days or weeks of basic treatment, observing the patient's progress.

Let me sound one note of warning. Neither families nor doctors like to make life-death decisions. But there is no question that if either party insists on bringing in a so-called "neutral"; third party (usually some representative of the state or legal profession), not only will the process take longer, in many instances it will be more arbitrary and less sympathetic.

What we are trying to avoid is neutrality; the only people with any qualification to decide are those who know the patient intimately and can put his or her interests first. If there's one place from which the interference of lawyers and government officials should be barred, it's from the rooms of critically ill patients.







Generations

My mother called last week to tell me that my grandmother is dying. She has refused an operation that would delay, but not prevent, her death from cancer. She can't eat, she has been bleeding, and her skin is a deep yellow color. "I always prided myself on being different," she told my mother. "Now I am different. I'm yellow."

My grandmother was born in Russia to a large and prosperous Jewish (犹太人的) family. But the prosperity didn't last. She tells stories of attacks by other Russians when she was twelve. Soon after that, her family moved to Canada, where she met my grandfather.

Their children were the center of their life. Though they never had much money, my grandmother saw to it that her daughter had speaking lessons and piano lessons, and assured her that she would go to college.

But while she was at college, my mother met my father, who was blue-eyed and yellow-haired and not Jewish. When my father sent love letters to my mother, my grandmother would open and then hide them.

After my grandfather died, my grandmother lived, more than ever, through her children. When she came to visit, I would hide my diary. She couldn't understand that some things were private. She couldn't bear it if my mother left the house without her.

This desire to possess and control others made my mother very angry (and then guilty that she felt that way, when of course she owed so much to her mother). So I felt the anger that my mother — the good daughter — would not allow herself. I — who had always performed especially well for my grandmother, danced and sung for her, presented her with kisses and good report cards — stopped writing to her, ceased to visit.

But when I heard that she was dying, I realized I wanted to go to see her one more time. Mostly to make my mother happy, I told myself (certain patterns being hard to break). But also, I was presenting to her one more particularly fine a
chievement: my own dark-eyed, dark-skinned, dark-haired daughter, whom my grandmother had never met.

I put on my daughter's best dress for our visit, the way the best dresses were always put on me, and I filled my pockets with small cookies, in case my daughter started to cry. I washed her face without mercy. Going up to Grandma's hospital room, I realized how much I was sweating.

Grandma was lying flat with her eyes shut, but she opened them when I leaned over to kiss her. "It's Dorothy's daughter, Kathleen," I shouted, because she doesn't hear well anymore, but I could see that no explanation was necessary. "You came," she said. "You brought the baby."

Laurie is just one year old, but she has seen enough of the world to know that people in beds are not meant to be so still and yellow, and she looked frightened. I had never wanted, more, for her to smile.

Then Grandma waved at her — the same kind of slow wave a baby makes — and Laurie waved back. I spread her toys out on my grandmother's bed and sat her down. There she stayed, most of the afternoon, playing and singing and drinking from her bottle, sleeping at one point, leaning against my grandmother's leg. When I played some music, Laurie stood up on the bed and danced. Grandma wouldn't talk much anymore, though every once in a while she would say how sorry she was that she wasn't having a better day. "I'm not always like this," she said. Mostly she just watched Laurie.

We were flying back to the US that night and I had hated telling her, remembering how she had always cried when I left. But in the end, I was the one who cried. She had said she was ready to die. But as I leaned over to stroke her forehead, what she said was, "I wish I had your hair" and "I wish I was well."

On the plane flying home, with Laurie in my arms, I thought about mothers and daughters, and the four generations of the family that I know most intimately. Every one of those mothers loves and needs her daughter more than her daughter will ever love or need her mother. We mothers are, each of us, the only person on earth who has quite such an all-consuming interest in our child.

Sometimes I kiss and hold Laurie so much she starts crying — which is, in effect, what my grandmother was doing to my mother, all her life. And what makes my mother sad right now, I think, is not simply that her mother will die in a day or two, but that, once her mother dies, there will never again be someone to love her in quite such a complete, unrestrained way. She will only be a mother, then, not a daughter anymore.

Laurie and I have stopped over for a night to be with my mother. Tomorrow my mother will fly back to be with my grandmother. But tonight she is feeding me, as she always does when I come, and I am eating more than I do anywhere else. I admire the wedding dishes (once my grandmother's) that my mother has set on the table. She says (the way Grandma used to say to he
r), "Some day they will be yours."

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