Neuro-surgeon,腦神經外科醫師

Admissions: A Life in Brain Surgery. By Henry Marsh. Weidenfeld & Nicolson; 271 pages; £16.99. To be published in America by Thomas Dunne in October; $26.99.

入场券：献于脑外科手术的一生。亨利·马什著。韦登菲尔德-尼克森出版社；271页；£16.99。十月将由托马斯·邓恩出版社于美国出版。$26.99。

ILLNESS, wrote Susan Sontag, is “the night-side of life”. In his bestselling 2014 memoir, “Do No Harm”, Henry Marsh, a neurosurgeon, gave an elegant account of his role as a gatekeeper of this night-side, an “underworld of suffering”. In “Admissions” he returns to the same territory, but also covers his life before and after the heart of his career.

苏珊·桑塔格写道，“疾病是生活的阴暗面”。在神经外科医生亨利·马什2014年的畅销回忆录《不做伤害》一书中，他优雅地讲述了他作为这个阴暗面看门人的角色，他说这是“痛苦的地狱”。在《入门课》中，他重提这个领域，也涉及到了他从业的前前后后。

• Bestselling：adj.畅销作     

• Neurosurgeon：n.神经外科医生

• Territory：n.领域，范围

The book starts at the ignominious end of Mr Marsh’s time in Britain’s National Health Service (NHS).Ground down, as he tells it, by bureaucrats and needless regulations, Mr Marsh sends his resignation letter. His final operation is tricky, but a success. The next day he finds his patient has had an unnecessary nasogastric tube inserted. He asks the nurse to remove it but, without the paperwork, the nurse refuses. Mr Marsh snaps. Hetweaks the nurse’s nose, shouts “I hate your guts!”, and storms off. He later, sheepishly, returns to apologise. The telling episode shows both Mr Marsh’s disarmingly frank storytelling and his querulous, warty sort of heroism. He is, in spite of himself, hugely likeable.（读者试译）

这本书是从马什先生在英国国民保健署（NHS）不光彩地结束工作开始说起。据他说，当他深受官僚主义以及一些不必要的规定的打击时，他提交了辞职信。他的最后一个手术很复杂，但做得很成功。第二天，他发现这个病人被插入了不必要的鼻饲导管，他让护士把导管取出，但是由于没有文书报告，护士拒绝了他的要求。马什先生情绪失控了，他拧着她的鼻子，大喊道“我恨你”，然后愤然离开。过了一会儿，他腼腆地向护士道了歉。

• Ignominious：耻辱的，不光彩的     

• Ground down：使某人受打击

• Needless：不必要的    

• Tricky：复杂的    

• Nasogastric：鼻饲的

• Snap：（精神）突然崩溃    

• Tweaks：拧    

• storm off：愤然离开

• sheepishly：羞怯腼腆的    

• disarmingly：消除敌意的

• querulous：易怒的，爱抱怨的    

• warty：疣的   

• likeable：可爱的

After 40 years in the NHS, Mr Marsh fearsfalling idle and useless. So he keeps busy, and he writes. In Nepal and Ukraine he helps former colleagues in their clinics. Every day people appear with tumours bigger than any he had ever seen in Britain. The suffering is overwhelming, the surgery almost pointless. Here his reflections on death and dying equal those in Atul Gawande’s excellent “Being Mortal”. And every few chapters he returns to Oxford, where he has begun renovating a lock-keeper’s cottage near his childhood home. This brings him back to his youth, from swimming lessons to first loves, his time at Oxford University, and a brief stay as a patient in a psychiatric hospital. The effect is of a rather wayward Bildungsroman of his path to becoming a neurosurgeon.

在NHS工作了40年后，马什害怕自己会赋闲在家老而无用，于是他坚持让自己忙碌，坚持写作。在尼泊尔和乌克兰他在原来同事的诊所中帮忙。每天都会有长着大肿瘤的病人出现，而这些肿瘤比他在英国所见到过的都大。病人承受着巨大的痛苦，手术几乎毫无意义。而今他对待死亡和濒死的态度与Atul Gawande所著的《身为凡人》中的描述不谋而合。每隔几章他都会讲到牛津，那是他现在着手修复运河水闸管理员的小屋的地方，那小屋靠近他童年时期的家。这总会让他回想起他的青春时期，从游泳课到他的初恋，到他在牛津大学的时光，以及作为一名病人在精神病院的短暂逗留。因此写成这部讲述他走上神经外科医生这条路的相当任性的成长小说。

• Falling idle变得无所事事；懈怠的；懒惰的；闲置的；没有工作的

• Overwhelming：巨大的；压倒性的；无法抗拒的

• lock-keeper：运河水闸管理员      

• Psychiatric：精神病的

• Bildungsroman：成长小说；教育小说；成长教育小说

• Wayward：难以控制的；任性的；倔强的

It was the privileged insights into neurosurgery which made “Do No Harm” such a remarkable book. “Admissions”, to some extent, offers more of the same. Mr Marsh describes neurosurgeons as a tribe, isolated by the terrible responsibility of their job. There is the decision of whether to operate, which involves great uncertainty. And there is the risk of neurosurgery itself, where the smallest mistake can blind, paralyse or kill someone. But Mr Marsh describes it as a sort of addiction, where the huge responsibility is part of the thrill. “Like all surgeons all I want to do is operate.” As soon as he makes the first incision, he finds a “fierce and happy concentration”. His writing is at its vivid best in the “muted drama of the theatre”, with “the bleeping of the anaesthetic monitors, the sighing of the ventilator” and “the sucker slurping obscenely” as he removes a tumour from someone’s brain.

正是作者对神经外科深刻的理解使得《不做伤害》成为一本了不起的著作。《入场券》在一定程度上也是如此。马什把神经外科医生描述为一个部落，部落因职责重大而孤立于世。他们的职责包括决定是否进行手术，这涉及到很大的不确定性。并且神经外科手术本身就存在风险：一个微小的失误可能使人失明、瘫痪、或丧命。但是马什把这描述为一种瘾，巨大的责任就是兴奋的一部分。“像所有外科医生一样，手术是我唯一想做的事。”只要他开了第一刀，“就狂热且愉悦地全神贯注”。他最为生动的描写就是这“剧院里的哑剧”，伴随着“麻醉监视器的哔哔声与排风扇的叹息”，当他把一个瘤块从病人大脑中移除时，“吸管下流地咕噜作响”。

• to some extent：在一定程度上    

• incision：切口    

• bleeping：哔哔声

• slurping：出声地吃或喝    

• tumour：瘤块

There are, though, fewer such moments in Mr Marsh’s new book. Those expecting a second “Do No Harm” will be surprised, but not disappointed. “Admissions” is more about the man than the surgeon, but it is excellent in its own right.

但是这样的片段在马什先生的新书里少之又少。那些期望重览《不做伤害》的人会感到意外，但并不会失望。《入场券》讲的更多的是关于这个人而不是他作为外科医生的故事，但它本身就是一部杰作。