加護病房週
【作者:著/楊腓力 譯/徐成德】楊腓力(Philip Yancey) 2010.02.14
「坐下來吃晚飯，你所熟悉的人生就此結束了，」瓊‧蒂蒂安在回憶錄中記述丈夫死於心臟病如此寫道。經歷過驟變的人都能了解這種下沉的感受。
我哥哥的生命並沒有結束於這個夏天 (譯按：此文寫於2009年9月)，但經過一週不斷惡化的中風，他的大腦終止了大部分的身體功能。有個星期五，他的視力出現問題，所以隔週禮拜一自己開車去看醫生，醫生立刻叫救護車把他送到當地醫院。禮拜二，他間或口齒清晰，間或語焉不詳。禮拜三還可以走路，但是右手已經失去控制。到了禮拜四，站也站不起來，連個簡單的指令都無法照作。核磁共振的片子顯出他的腦部受損不輕。
我隔天抵達，他眼睛都難以睜開，身體右半部也已經不能動彈。我講話的時候，他會適時捏捏我的手，也常常哭，所以我知道他還是有些理解能力。等他腦部狀態穩定，醫生在他的頭骨開口，花了六個小時，將頭皮的一道動脈重新導入內腦。
我整個星期都在醫院的候診室，在探視時段之間與其他的家屬閒聊。在這種情境，陌生人成了親密朋友。一位母親說她的燥鬱症女兒肺被切除。我們都看到她狂燥的狀態，掛著點滴在廳內不住走動。我們也看到她憂鬱的狀態，護士要觀察她的自殺跡象。
有名年輕女子服用止痛藥過量，男友總是一個人手不離書，在病床邊日夜守候了三個禮拜。不遠處，一名印度男子為他的妻子翻譯。她腦部受傷以後，完全失去講英語的能力，回頭重拾母語。一個焦急萬分的家庭在電梯貼海報──「懇請請幫忙救尼克的命」──呼籲有心亞裔人士捐贈骨髓。
有些病人沒有訪客，令人難過。在醫院，支配財富與地位的規則不同：交換媒介不是現金，而是訪客與愛心。
慈悲的擴音器
年紀大了會變成小孩子一樣，腦部受傷讓我們看見驚心的前兆。他們會用些很簡單的字眼，或是大聲講話。一些基本動作像是吃飯或上廁所，都需要幫忙。我哥哥手術之後，可以數到五，而且用嘴型說出「生日快樂」，已經讓我興奮至極。才前兩個禮拜，他還是個主修哲學與鋼琴的人，很可能在討論尼采或是舒伯特。
我們這些病患家屬像張嘴待哺的幼鳥，極其想要從醫護人員得到些許盼望。如今在我的英雄榜上多了些人物：護士與治療師。來自菲律賓的珍妮、金髮紋身的克麗斯婷，還有一手就可以幫我哥哥翻身的「大護士」瑪莉。因著她們的開朗與鼓勵，使得我哥哥能繼續撐下去。他也總是像小孩子一樣，急著想要讓語言與動作的治療師高興。
觀看這些專業人士，發現我們極不重視院牧與牧師探訪的角色。他們也能提供盼望與安慰的寶藏，特別是在無助與恐懼的時刻可以幫助到家屬。有多少教會的執委會獎勵牧師花在醫院的時間？
魯益師說，痛苦是上帝的擴音器。有些人覺得這個意象不妥，好像是上帝導致痛苦，藉此要傳達什麼。或許把痛苦比作喇叭狀助聽器更恰當。這是小型助聽器尚未發明前的圓椎型擴大聲音的用具。在候診室，在加護病房，甚至那些未知論者也會吐出簡單的禱詞：「救命」，並且豎起耳朵等候回音。
我太太在安寧病房工作的時候曾提及，訪客離開前說「祝你好運」，或是真心說「我為你禱告」，兩者確實有差別。我哥哥接觸過基督教，但是認為對他沒用。有時他甚至覺得自己被上帝咒詛，永遠得不到赦免。但是在加護病房，每當我在他耳邊禱告，他都會緊捏我的手，淚水也常常從他沒有動靜的臉上滑落。
這種時候，上帝確實可以對我們說話。我想到，自己兩年前車禍頸椎受傷，對我這個控制狂來說，正視自己的脆弱與倚賴是多麼重要。我可說是在「恩典的霧藹」中離開醫院，對生命滿懷著希望永不會消失的感激之情。
《公禱書》的入殮禮拜禱詞，有一句很肅穆的真理：「在生命當中，我們是在死亡裡。」要實質體會生命的脆弱與珍貴，在加護病房一週是再理想不過了！
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 楊腓力(Philip Yancey)《今日基督教》(Christianity Today)雜誌的特約編輯；其著作豐富，多本著作榮獲美國ECPA書藉金牌獎。