英文版其实很难懂,但是整理思绪和重新看看读书笔记,又有新的想法

西西莉亚
2020-11-06 看过

人类的伟大在于,一直失败但是一直斗争。本书词汇量要求巨大,各种病的单词不认识,导致阅读体验下降,但是作者的叙述水平,揭露癌症,实例分析又不舍得放弃这本书。

癌症之所以这么难攻克,原因是每个癌细胞都有可能变异,和他们的祖宗有些许不同,因此能够治疗癌细胞祖宗的药物并不一定适合他们的孙子和曾孙子。经过各种大胆勇敢的尝试,其中包括在当时青霉素和麻醉药还未发现,治疗癌症的方法就是切除被癌症感染的组织和器官,结果医生越来越激进,一个患乳腺癌的病人,医生可以把病人整个胸部连同锁骨部位切除,最后病人还是死了。当时医生并没有认识到,癌细胞会扩散。而这一切的手术,病人都是在强忍着巨大疼痛中进行的,去做手术的医生也要极为冷静,一般是在地下进行,对于手术台下,大叫的病人,依然要能下得去刀。当然一般能够接受这样无麻醉手术的病人也是做好了充足心里准备,有些在整个过程中,一句话也没说。

后来随着青霉素和麻醉药的发现,上面那种类似于变态的治疗法得到了改进。接下来居里夫人发现了镭,于是镭被广泛使用,还有传言一些商家打广告,镭可以提高性能力,各种男性背锅,购买含镭的内裤。直到居里夫人因为肌肤大面积裸露在镭下,辐射而死,人们才意识到,x-ray只适用于检测,但是要想靠着镭把癌细胞辐射死,也是杀敌一千,自损八百。科学研究继续向前发展,就像科学家偶然通过发霉的面包,发现了青霉素,在一个平平无奇的大夜晚,Ehrlish终于发现了chemotherapy —化疗,可以有效对抗癌症。这种治疗方法避免了大面积切除身体器官,尤其是对于得了阴囊癌和睾丸癌的,切除,就是和尚尼姑生活了,是个好消息。但是就像上面说的,癌症的每一代和下一代都有不同,这就是使得无法根本对症下药。因为癌细胞增长速度非常快,用杀死白细胞的方法,能够快速把那些变异的攻克我们正常器官和人体机能的癌细胞,降到正常值。但是同时,我们正常的白细胞也被杀死,因此我们会变得非常虚弱。

1918年,才刚经历完一战的世界人民,马上一场大的流行病席卷美国,(历史果然惊人的相似,看看今年),大量人员死亡,这让Lasker 意识到我们人类需要专门的医疗队对付专门的疾病。她努力说服和号召政府组织,建立研究队伍,共同研究抵抗疾病,提倡不应该大学毕业生全部直接与工厂挂钩,科学家还应该被分类: space scientists, industrialists, administrationors, planners and cancer research specilists。最开始没人理会,美国总统尼克松认为科学家是对于未知真相调查做虚妄努力的人,只会大量骗取经费。他还嘲笑科学家 “scientists didn’t know a goddamn thing about the management of science. Nor was he particularly symathetic to open-ended scientific funding. 科学家经常被其他部门称为nuts和bastards, 但是最后一系列的政治局势变化,尤其是美国阿波罗11登月成功,让大家看到了科学的魅力,她的声音终于被听到。她之后也成为了the fairy godmother. 阿波罗登月成功也别叫做a “moon shot” for cancer. 二战的爆发也到为癌症研究治疗做出了贡献,它促进了血浆冷冻,血液保存,急救等(抱歉一大堆词汇不认识) 的发展。

里面有对病人的描述,开始作者总是看到形影不离的两人,忽然一天其中一个没来了,问了问,结果被告诉,在这个特殊时期,因为自己情绪不稳定,和朋友吵架,她也走了。作者作为医生的无力感和愧疚感顿时上来了。也描述了病人的心理遭遇:第一轮化疗下来,头发没了,接下来几轮,自己也终身不孕不育。在一轮轮药物化疗下,白细胞聚减,身体也非常虚弱,但是即使好了,将来也一直要面临复发的威胁中。“it’s going to be a long haul. A marathon,” I stammered apologetically, groping for an analogy. “But we’ll get to the end’” He nodded again silently, as if he already knew.

病人有描述到:当你被告知患了癌症后,你的整个世界都陷入了黑暗,生活中就是各种检查治疗,出了医院后,每天像疯了一样,不断在网上搜集信息,想知道自己活下去的几率有多大。”she lost sleep, her hair, and her appetite and then something more important and ineffable— her animus, her drive, her will. She walked around the hospital like a zombie, shuffling in small steps from the blue vinyl couch in the infusion room to the water dispenser in the central corridor”对于患者周围的人又怎么不是折磨,看着身边的亲人朋友遭受折磨,但是自己无能为力,看着他们沦陷,想要阻止,可是我们都不是上帝,我们没有super power,我们只能看着至亲痛苦的走向终点。“she needed to be needed, and i just couldn’t fulfill thay demand.” “ his wife suggested that they sit outside to enjoy the afternoon. Cleland realised, to his utter shame, that he was too weak to stand up. He was carried to his bed like a baby, weeping with embarrassment 这里和being mortal里说的情况一样,很多病人在面对疾病,连最基本的自尊都要丢掉。失去的尊严和因为总是麻烦周围人的愧疚心理,加剧了一系列心理问题的爆发。医生绞尽脑汁 想法子治疗病人,周围家人忙上忙下,怎么会注意到病人的情感崩溃点,大家都太忙于与这个突然而来的怪物斗争了 “when doctors say that the side effects are tolerable or acceptable, they are talking about life- threatening things.” she wrote. “ but if you just vomit so hard that you break the blood vessels in you eyes ... they don’t consider that even mentionable. And they certainly don’t care if you’re bald” 癌症不是集中营,但是它却有着和集中营相似的点,他们都摧毁人的生存意志,毒害人心。“it shares the quality of annihilation: it negates the possibility of life outside and beyond itself; it subsumes all living. The daily life of a patient becomes so intensely preoccupied with his or her illness that the world fades away.”

病人自己用尽全部精力与病魔作斗争,怎么还会有精力去观察自己情绪是否健康, 对待他人怎么样,他们面对从此人生被改写,每天接受药物治疗,住在一个充满了消毒剂的房子里,看着亲人因为自己憔悴,看着周围人为自己做出巨大努力,愧疚的心理如何找到一个宣泄口。“but Carla had barely any emptional energy for he own recuperation— and certainly none to spare for the needs of others”. “ we went on constantly —but no effective sympathy.”所以医生不仅要和疾病作斗争,还要和病人奄奄一息的斗志作斗争,“it is because death has first possessed his imagination.” Death possessed the imagination of my patients that month, and my task was to repossess imagination from death.

每个人身体里都有癌细胞,他们就像恶魔一样等待一个时机,一个唤醒它们的时机,一旦被请入,就如同打开潘多拉的魔盒,肆无忌惮的开始在身体里蔓延,攻击我们的内部组织,攻击我们的器官。“Cancer was intrinsically ‘loaded’ in our genome, awaiting activation. We were destined to carry this fatal burden in our genes —our own genetic “oncos”

在1950年 Doll Hill 和 Wynder Graham发现了吸烟加速肺癌的爆发,但是当时为了利润 美国政府默认了 烟草公司的解释 “new filter tils on cigarrettes — to supposedly filter away carcinogens and make cigarettes ‘safe’” 后来经过不断努力,终于 “cogarrete makers would need to acknowledge this risk directly in advertising for their products. The most effective method to alert consumers about this risk, the commission felt, was to imprint the message onto the product itself: Caution Cigarrete Smoming is dangerous to health. it may cause death from cancer and other diseases.后来他们发现很多人还是没能意识到,抽烟对于身体的危害,又开始提倡反对烟草公司打出任何关于烟草的广告,“the advertisement in question clearly promote the use of a particular cigarette as attractive and enjoyable. 但是“multinational cigarrete companies act as a vector that spreads disease and death throughout the world. This is largely because the tobacco industry uses its wealth to influence politicians to create a favourable environment to promote smoking.作者说不能说吸烟一定导致癌症,但是他见过太多吸烟患者进入癌症病房,已经被癌症折磨痛苦不堪,任然像个zoombie 一样苦苦哀求护士给他吸一口烟,这个对于人的精神腐蚀太大。 “it remains an astonishing, disturding fact that in America — a nation where nearly every new drug is subjected to rigorous scrutiny as a potential carcinogen, and even the bare hint od a substance’s link to cancer ignites a firestorm of public hysteria and media anxiety — one of the most potent and common carcinogens known to humans can be freely bought and sold at every corner store for a few dollars.

随着科学家的不断努力 “i’ve made a long voyage and been to a strange country, and i’ve seen the dark man very close. I had not made the journey muself, and i had only seen the darkness reflect in the eyes of others.”

书中也说了 大量乱用农药也是导致我们现在得癌症几率越来越高,之前有谣言说使用手机接电话,会提高我们患癌风险,这里作者用实验数据告诉我们这个推论是没有科学依据的的

最后部分,作者又重新讲回了被记载下来的第一个患癌的病人Atossa, 他假设Atossa带着她的癌症,从公元五百年一步步走到现在,她会接受哪些治疗,在这2000多年的时间里,我们人类在攻克癌症上取得了哪些进步:从最初的惶恐,疑惑到慢慢开始认识这个恶魔,到将来能否攻克这个似乎永远打不死的疾病,我们还有很多问号。科学努力进步是为了更好的了解自然,技术帮助人们了解自然,然后希望通过药物掌控自然,但是人类真的能掌控自然吗?从我们祖先亚当夏娃背叛上帝开始,所有人被逐出伊甸园,体验这个被撒旦控制的世界,我们生老病死,我们遭受苦难,饥饿,贫穷,孤独。人生来就是来体验的苦难的。但是就像作者说的“death in old age is inevitable, but death before old age is not.”我们应该努力的方向是攻克基因弊端,延长我们的寿命,而不是消除死亡,这样我们才有可能在和癌症的这一场仗中,有赢的机会。最初希腊人把癌症 cancer 叫做 onkos, 它的意思是:大量, 压力,癌症确实是在我们的身体里无限复制。 然而在印欧语族中 onkos 的意思是 负重携带,把包袱从一个地方移到另一个地方,在扛着这个包袱我们注定要学会忍受,学会如何生存,这个就像是Atossa 抗癌旅行一样。作者最后用了Germaine的故事作为结尾,癌症带来的病痛和一些身体机能丧失,一次一次羞辱她,但是她如同斗士一般,抗击回去,Germanine就是我们千千万万人类缩影,可以被打倒,但是我们绝不放弃前进。”Her illness had tried to humiliate her. It had made her anonymous and seemingly humorless; it had sentenced her to die an unsightly death in a freezing hospital room thousands of miles away from home. She had responded with vengeance, moving to be always one step ahead, trying to outwit it.... everytime her disease moved, imposing yet another terrifying constraint on her, she made an equally assertive move in return.

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