《杨腓力(Philip Yancey)》

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加护病房周

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「坐下来吃晚饭,你所熟悉的人生就此结束了,」琼・蒂蒂安在回忆录中记述丈夫死于心脏病如此写道。经历过骤变的人都能了解这种下沉的感受。

我哥哥的生命并没有结束于这个夏天 (译按:此文写于2009年9月),但经过一周不断恶化的中风,他的大脑终止了大部分的身体功能。有个星期五,他的视力出现问题,所以隔周礼拜一自己开车去看医生,医生立刻叫救护车把他送到当地医院。礼拜二,他间或口齿清晰,间或语焉不详。礼拜三还可以走路,但是右手已经失去控制。到了礼拜四,站也站不起来,连个简单的指令都无法照作。核磁共振的片子显出他的脑部受损不轻。

我隔天抵达,他眼睛都难以睁开,身体右半部也已经不能动弹。我讲话的时候,他会适时捏捏我的手,也常常哭,所以我知道他还是有些理解能力。等他脑部状态稳定,医生在他的头骨开口,花了六个小时,将头皮的一道动脉重新导入内脑。

我整个星期都在医院的候诊室,在探视时段之间与其他的家属闲聊。在这种情境,陌生人成了亲密朋友。一位母亲说她的燥郁症女儿肺被切除。我们都看到她狂燥的状态,挂着点滴在厅内不住走动。我们也看到她忧郁的状态,护士要观察她的自杀迹象。

有名年轻女子服用止痛药过量,男友总是一个人手不离书,在病床边日夜守候了三个礼拜。不远处,一名印度男子为他的妻子翻译。她脑部受伤以后,完全失去讲英语的能力,回头重拾母语。一个焦急万分的家庭在电梯贴海报――「恳请请帮忙救尼克的命」――呼吁有心亚裔人士捐赠骨髓。

有些病人没有访客,令人难过。在医院,支配财富与地位的规则不同:交换媒介不是现金,而是访客与爱心。

慈悲的扩音器

年纪大了会变成小孩子一样,脑部受伤让我们看见惊心的前兆。他们会用些很简单的字眼,或是大声讲话。一些基本动作像是吃饭或上厕所,都需要帮忙。我哥哥手术之后,可以数到五,而且用嘴型说出「生日快乐」,已经让我兴奋至极。才前两个礼拜,他还是个主修哲学与钢琴的人,很可能在讨论尼采或是舒伯特。

我们这些病患家属像张嘴待哺的幼鸟,极其想要从医护人员得到些许盼望。如今在我的英雄榜上多了些人物:护士与治疗师。来自菲律宾的珍妮、金发纹身的克丽斯婷,还有一手就可以帮我哥哥翻身的「大护士」玛莉。因着她们的开朗与鼓励,使得我哥哥能继续撑下去。他也总是像小孩子一样,急着想要让语言与动作的治疗师高兴。

观看这些专业人士,发现我们极不重视院牧与牧师探访的角色。他们也能提供盼望与安慰的宝藏,特别是在无助与恐惧的时刻可以帮助到家属。有多少教会的执委会奖励牧师花在医院的时间?

鲁益师说,痛苦是上帝的扩音器。有些人觉得这个意象不妥,好像是上帝导致痛苦,藉此要传达什么。或许把痛苦比作喇叭状助听器更恰当。这是小型助听器尚未发明前的圆椎型扩大声音的用具。在候诊室,在加护病房,甚至那些未知论者也会吐出简单的祷词:「救命」,并且竖起耳朵等候回音。

我太太在安宁病房工作的时候曾提及,访客离开前说「祝你好运」,或是真心说「我为你祷告」,两者确实有差别。我哥哥接触过基督教,但是认为对他没用。有时他甚至觉得自己被上帝咒诅,永远得不到赦免。但是在加护病房,每当我在他耳边祷告,他都会紧捏我的手,泪水也常常从他没有动静的脸上滑落。

这种时候,上帝确实可以对我们说话。我想到,自己两年前车祸颈椎受伤,对我这个控制狂来说,正视自己的脆弱与倚赖是多么重要。我可说是在「恩典的雾蔼」中离开医院,对生命满怀着希望永不会消失的感激之情。

《公祷书》的入殓礼拜祷词,有一句很肃穆的真理:「在生命当中,我们是在死亡里。」要实质体会生命的脆弱与珍贵,在加护病房一周是再理想不过了!

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You sit down to dinner and life as you know it ends," Joan Didion writes in a memoir of her husband's death from a heart attack. Everyone who has suffered sudden loss knows that freefall feeling.

My brother's life did not end this summer, but in one terrifying week of progressive strokes, his brain shut down much of his body. On a Friday, he began experiencing vision problems. The following Monday, he drove himself to the doctor, who sent him in an ambulance to a local hospital.

On Tuesday he spoke sometimes clearly and sometimes in gibberish. Wednesday he could walk but lost control over his right hand and arm. By Thursday he could not stand and failed to follow simple commands. An MRI showed significant brain damage.

When I arrived the following day, my brother could barely open his eyes and had lost movement on his right side. Sometimes he squeezed my hand appropriately when I talked and he cried often, so I knew he had some understanding. After the brain had stabilized, a surgeon cut a window through his skull and in a six-hour procedure redirected an artery from the scalp to the inner brain.

I spent all that week in a hospital waiting room, hanging out with other families between visiting hours. In such a setting, strangers become intimate friends. A mother told stories of her bipolar daughter whose lung had been removed. We saw her in the manic phase, pacing the halls with a medicine-dispensing pack; in her depressive phase, nurses watched her for suicidal signs.

Alone, always with a book in hand, the boyfriend of a young woman who had overdosed on Vicodin kept vigil by her bed for three weeks. Nearby, an Indian man translated for his wife: after a brain injury, she had lost facility in English and reverted to her mother tongue. A desperate family put up posters in the elevators—Help Save Nick's Life—asking for Asian Americans to consider a bone marrow donation.

Sadly, some patients had no visitors. Different rules govern wealth and status in a hospital: the currency is not cash, but visitors and love.

The Merciful Megaphone

Old age reprises childhood and brain injuries give a haunting preview. People use simple words around you, and talk too loudly. You need help with basic tasks such as eating and going to the bathroom. After the surgery, I was ecstatic over my brother's ability to count to five and mouth the words to "Happy Birthday." Two weeks before, he, a philosophy and piano major, might have been conversing about Nietzsche or Schubert.

Like helpless baby birds with open beaks, we his family craved morsels of hope from the medical staff. I came away with a new set of heroes: nurses and therapists. Jenny from the Philippines, Cristin the tattooed blonde, even "Big Nurse" Mary who could flip my brother on his side with one hand—their cheerfulness and encouragement kept him going. With childlike eagerness he tried to please the therapists who worked on speech and movement.

It occurred to me while watching these professionals that we severely undervalue the role of chaplains and visiting pastors. They, too, offer the treasures of hope and comfort, touching families in a unique moment of vulnerability and fear. How many church boards reward pastors for their time in hospitals?

Pain is God's megaphone, said C. S. Lewis, an image that some find troubling if it implies that God causes the pain through which he speaks. Perhaps the image of pain as an ear trumpet—the conical device that amplified sound before the invention of hearing aids—is more accurate. In waiting rooms, in ICU wards, even the agnostic may breathe the one-word prayer, "Help!" and strain for some response.

While working in hospice, my wife commented on the difference between visitors who would say "Good luck" as they left and those who would say "I'm praying for you"—and truly mean it. My brother tried Christianity and decided it didn't work for him. At some level he believed himself cursed by God, unpardonably. In the ICU, though, he squeezed my hand tightly each time I prayed in his ear, and often tears ran down his immobile face.

God can speak at such a time. I remember how important it was for me, a control freak, to confront my own vulnerability and dependence after breaking my neck in an auto accident two years ago. I left the hospital in a "daze of grace," with an overwhelming gratitude for life that I hope will never fade away.

For graveside services the Book of Common Prayer includes the somber truth, "In the midst of life we are in death." Nothing demonstrates both the fragility and the preciousness of life better than a week in the ICU.

about 杨腓力(Philip Yancey)《今日基督教》(Christianity Today)杂志的特约编辑;其着作丰富,多本着作荣获美国ECPA书藉金牌奖。