当研究肺癌的医生患上肺癌，他给世界留下一封“信”
When This Professor Got Cancer, He Didn’t Quit. He Taught a Class About It.

Dr. Bryant Lin stood before his class at Stanford University in September, likely one of the last he would ever teach.
去年9月，布赖恩特·林博士站在斯坦福大学的讲台上，这可能是他最后的几次授课之一。

Just 50 years old and a nonsmoker, he had been diagnosed with Stage 4 lung cancer four months earlier. The illness is terminal, and Lin estimated that he had roughly two years left before the drug he was taking stopped working. Instead of pulling back from work, he chose to spend the fall quarter teaching a course about his own illness.
四个月前，年仅50岁且从不吸烟的他被诊断出四期肺癌。病情已经到了晚期，林估计，在他服用的药物失效之前，他大概还有两年时间。他没有辞掉工作，而是选择在秋季学期教授一门关于他自己所患疾病的课程。

Registration for the class had filled up almost immediately. Now the room was overflowing, with some students forced to sit on the floor and others turned away entirely.
这门课几乎立刻就报满了。现在，教室里挤满了人，一些学生只得坐在地板上，还有一些学生被拒之门外。

“It’s quite an honor for me, honestly,” Lin said, his voice catching. “The fact that you would want to sign up for my class.”
“你们想报名上我的课，老实说，这对我来说是一种荣誉，”林说，他的声音有些哽咽。

He told his students he wanted to begin with a story that explained why he chose to pursue medicine. He picked up a letter he had received years earlier from a patient dying of chronic kidney disease. The man and his family had made the decision to withdraw from dialysis, knowing he would soon die.
他告诉学生们，他想先讲一个故事，解释自己为什么选择从医。他拿起一封信，这是几年前他收到的一封信，来自一位因慢性肾病而濒临死亡的病人。这名男子和家人决定停止透析，因为他们知道，他很快就会死去。

Lin adjusted his glasses and read, choking up again.
林调整了一下眼镜，读着读着，他的声音又哽咽了。

“‘I wanted to thank you so much for taking such good care of me in my old age,’” he read, quoting his patient. “‘You treated me as you would treat your own father.’”
“‘我非常感谢你在我的晚年对我的悉心照顾，’”他读着这位病人的话。“你对待我就像对待自己的父亲一样。”

Lin said this final act of gratitude had left a lasting impact on him. He explained that he had created this 10-week medical school course — “From Diagnosis to Dialogue: A Doctor’s Real-Time Battle With Cancer” — with similar intentions.
林说，这最后的感恩给他留下了深刻的影响。他解释说，他开设这门为期10周的医学院课程——“从诊断到对话：一名医生与癌症的实时战斗”——也是出于类似的目的。

“This class is part of my letter, part of what I’m doing to give back to my community as I go through this,” he said.
他说：“这门课也是我留下的信，是我在经历这一切的过程中回馈给社会的一部分。”

Later, an 18-year-old first-year student in his first week at Stanford caught up on a recording of the class, which was also open to students outside the medical school. The course had filled up before he could enroll, but after emailing Lin, he received permission to follow along online. He had questions that needed answers.
这门课也对医学院以外的学生开放，后来有一名18岁的一年级生在就读斯坦福大学的第一周看到了授课的录像。这门课在他入校前就已经报满了，但在给林发了邮件后，他得到了在线上课的许可。他有很多问题需要解答。

From Doctor to Patient
从医生到病人

Last spring, Lin developed a persistent and increasingly severe cough. A CT scan showed a large mass in his lungs, and a bronchoscopy confirmed the diagnosis: cancer. It had metastasized to his liver, his bones and his brain, which alone had 50 cancerous growths. He is married, with two teenage sons.
去年春天，林的咳嗽持续不断，而且越来越严重。CT扫描显示他的肺部有巨大的团块，支气管镜检查证实了诊断：癌症。癌细胞已经转移到他的肝脏、骨骼和大脑，仅大脑就有50处癌细胞生长。他已婚，有两个十几岁的儿子。

The diagnosis was particularly cruel given his work. Lin, a clinical professor and primary care physician, was a founder of the Stanford Center for Asian Health Research and Education. One of its priorities has been nonsmoker lung cancer, a disease that disproportionately affects Asian populations.
鉴于他的工作，这个诊断结果显得格外残酷。林是一名临床医学教授和基础医疗医生，是斯坦福亚裔健康研究与教育中心的创始人之一。该中心的研究重点之一是非吸烟者的肺癌，这种疾病对亚裔人群的影响尤为严重。

Lin learned that his cancer was advancing rapidly. He felt pain in his spine and ribs, and his weight dropped. His doctor put him on a targeted therapy designed to attack the specific mutation driving his cancer. He also underwent chemotherapy, which caused nausea and sores in his mouth.
林得知他的病情在迅速恶化。他感到脊柱和肋骨疼痛，体重下降。医生让他接受了一种靶向治疗，旨在攻击导致他患癌的特定突变。他还接受了化疗，这引起了恶心和口腔溃疡。

After a few cycles of chemotherapy, his breathing and coughing began to improve, and scans showed drastic reductions in the cancer’s extent. He continued to see patients and teach, and he began to think about what to do with the time he had left.
经过几个周期的化疗后，他的呼吸和咳嗽开始好转，扫描显示癌症的范围急剧缩小。他继续给病人看病，继续授课，他开始考虑如何使用自己剩下的时间。

The dying dialysis patient had written a letter because he wanted Lin to know he was appreciated. Lin had a couple of ambitions for his own message to his students. He liked to think that some of them, having taken his course, might go on to dedicate themselves to some aspect of cancer care. And he wanted them all to understand the humanity at the core of medicine.
那位垂死的透析病人写信是为了向林表示感激。而林想向学生们传达的讯息中包含了一些他的愿景。他希望，这些学生中的一些人在上了他的课程后，能够投身于癌症疗护的某个领域。他希望他们都能理解，医学的核心是人性。

The ‘Primary Care’ Model
“基础医疗”模式

Lin’s class met for about an hour each Wednesday. One week, he led a session on having difficult conversations, where he stressed that doctors should be honest enough to say “I don’t know” when necessary — an answer he had to accept as a patient amid the uncertainties of his own diagnosis.
林这门课在每周三授课约一个小时。有一周，他的主题是如何进行困难的对话，他强调，医生应该在必要的时候诚实地说“我不知道”——作为病人，在诊断还不确定时，他不得不接受这个答案。

In another class, he discussed how spirituality and religion help some patients cope with cancer. Though he isn’t religious, he shared that he found comfort in others’ offering to pray, chant or light a candle on his behalf.
还有一堂课上，他讨论灵修和宗教如何帮助一些病人战胜癌症。虽然他本人不信教，但他说，别人为他祈祷、唱圣歌或点蜡烛，让他感到安慰。

And in a session on the psychological impact of cancer, Lin spoke about the disappointment he felt after a scan showed that some of his tumors had shrunk but hadn’t disappeared — because, deep down, he was still holding out hope for a miracle.
在一堂关于癌症对心理影响的课上，林谈到，扫描显示他的一些肿瘤缩小了，但并没有消失，他对此感到失望——因为，在内心深处，他仍然对奇迹抱有希望。

He taught the sessions using what he described as the “primary care” model. He was the initial point of contact, sharing how his cancer diagnosis had affected him, but he referred his students to specialists — guest speakers — when more exploration was needed.
他用他所称的“基础医疗”模式进行教学。他是最直接的联系人，分享自己的癌症诊断对他的影响，但当需要更多的探索时，他会向学生们介绍专家——客座演讲者。

For a class on caregiving, Lin brought in Christine Chan, whom he introduced as “my wonderful wife.”
在一堂关于看护的课上，林请来了克莉丝汀·陈，他介绍说，她是“我了不起的妻子”。

A Massachusetts Institute of Technology graduate and program manager at Google DeepMind, Chan acknowledged that letting go of her instinct to plan for the future had been difficult.
陈毕业于麻省理工学院，是谷歌DeepMind的项目经理，她承认，放弃规划未来的本能是很困难的。

“We just have to go through it one day at a time,” she said.
“我们只能一天一天地来，”她说。

A Job Not Quite Finished
一项尚未完成的工作

Watching Lin teach, I often wondered what his students were thinking. What was it like for them to become attached to him as a professor, knowing his prognosis was so dire?
看着林讲课，我常常想知道他的学生在想什么。在知道他的预后如此糟糕的情况下，与一位教授建立这样的情感联系，是什么感觉？

When I asked, some used the phrase “once-in-a-lifetime opportunity” to describe the course. Others saw Lin as brave.
当我采访他们时，有些人用“一生只有一次的机会”来形容这门课程。也有人认为林很勇敢。

It was difficult for some students to reconcile his upbeat attitude with the severity of his diagnosis. Gideon Witchel, of Austin, Texas, was one. He was the 18-year-old student who had watched a recording of the first class from his dorm room. A spot had since opened up, and now he was enrolled.
有些学生很难理解，他的病情如此严重，他怎么还能如此乐观。得克萨斯州奥斯汀的吉迪恩·威切尔就是其中之一。他就是前文提到的那个18岁的学生，他在宿舍里观看了第一节课的录像。后来课程又有了一个名额，现在他加入了。

When Witchel was 5 years old and his sister was 3, his mother, Danielle Witchel, was diagnosed with breast cancer, but he had never talked to her about it in depth. He had never been able to say, “Tell me the story of your cancer.” He was taking Lin’s class in hopes that it would help him start that conversation.
威切尔五岁、他妹妹三岁时，他的母亲丹妮尔·威切尔被诊断患有乳腺癌，但他从来没有和她深入谈论过这件事。他从来没能说：“告诉我你患癌的故事。”他正在上林的课，希望这能帮助他开启这种对话。

Lin referred to the class as his letter to his students, but he had crafted an actual letter to his sons for them to read after he was gone.
林说，这门课是他给学生的信，但他给自己的儿子们写了一封真正的信，让他们在自己离开后再读。

“Whether I’m here or not, what I want you to know is that I love you,” he wrote. “Of the many things I’ve done that have given my life meaning, being your daddy is the greatest of all.”
“无论我在不在这里，我想让你们知道的是，我爱你们，”他写道。“在我所做的许多赋予我生命意义的事情中，成为你们的爸爸是最棒的一件事。”

The ‘Luckiest Man’
“最幸运的人”

For the last class, Lin and his students met in a library at Stanford Hospital.
最后一节课，林和学生们在斯坦福医院的图书馆见面。

Near the end of the class, Lin stood at the front of the room, folding and unfolding a piece of paper where he had printed his closing remarks. It was time to finish his letter.
快下课的时候，林站在教室前面，把手里的一张纸折起来又展开，纸上打印着他的结束语。是时候完成他的信了。

He gave what he called his version of Lou Gehrig’s farewell speech, referring to the Hall of Fame baseball player for the New York Yankees who died at 37 from amyotrophic lateral sclerosis, or ALS, an incurable neurological disease.
他发表了他所谓的“卢·格里克告别演说”，格里克是纽约扬基队的名人堂棒球运动员，37岁时死于肌萎缩性侧索硬化症，这是一种无法治愈的神经系统疾病。

“For the past quarter, you’ve been hearing about the bad break I got,” he said, echoing parts of Gehrig’s address at Yankee Stadium. “Yet today, I consider myself the luckiest man on the face of this earth.”
“在过去的一个学季里，你们一直在听我讲述我的不幸遭遇，”他说，这和格里克在洋基体育场演讲的部分内容很相似。“然而今天，我认为自己是世界上最幸运的人。”

With that, he choked up. “Sure, I’m lucky,” he said. He said he was lucky to have his two sons, who brought joy and laughter into his house. His teaching assistants, who made the course possible. The Stanford community, his colleagues and the people at the Asian health center. His students and residents. His patients. His friends. His parents. His wife.
说到这里，他哽咽了。“当然，我很幸运，”他说。他说他很幸运有两个儿子，他们给家里带来了欢乐和笑声。是他的助教们让这门课成为可能。还有斯坦福社区，他的同事和亚裔健康中心的人们。他的学生和住院医生。他的病人。他的朋友。他的父母。他的妻子。

“So I close in saying that I may have had a tough break, but I have an awful lot to live for,” he said. “Thank you. And it’s been an honor.”
“所以我想说的是，我可能经历了一段艰难的时期，但我还有很多值得为之奋斗的东西，”他说。“谢谢。这是我的荣幸。”

It seemed clear that Lin had achieved at least some of his goals. When he asked whether students were thinking of careers in cancer care, about a third raised their hands. The ones planning to be doctors told me they would remember Lin’s story when seeking to understand their patients’ experience of illness.
显然，林至少达到了他的部分目标。当他问学生是否考虑从事癌症疗护工作时，大约三分之一的人举了手。那些打算成为医生的人告诉我，当他们试图了解病人的患病经历时，他们会想起林的故事。

For Witchel, the effect of the quarter was more personal. He had finally talked to his mother about her cancer.
对威切尔来说，这个学季的影响更加个人化。他终于和母亲谈起了她的癌症。

His mother had come to visit him during the fall, and he had told her about Lin’s class and broached the subject with her.
他的母亲在秋天来看望他，他和她说起林的那门课，并和她谈论了这个话题。

He learned that she had something in common with Lin: letters.
他了解到，她和林有共同之处：他们都写了信。

During her illness, Danielle Witchel had written messages to family members and friends. Some wrestled with her uncertainty about whether she would survive, as well as the effect her diagnosis might have on her children.
在生病期间，丹妮尔·威切尔给家人和朋友写信。她在一些信中挣扎于自己是否能够活下来，以及她的诊断结果可能对孩子产生的影响。

After she went into remission, she compiled the writings along with medical records, photographs and other documents into a book. When Gideon Witchel returned home for Thanksgiving break, he sat down at the kitchen table with the book and his parents.
病情缓解后，她将这些文字连同医疗记录、照片和其他文件汇编成一本书。当吉迪恩·威切尔回家过感恩节假期时，他拿着这本书和父母一起坐在厨房的餐桌旁。

Together, they alternated between reading from the book and talking. They laughed and cried. For the first time, Gideon Witchel felt he was interacting with his mother as an adult.
他们一起时而看书，时而谈话。他们又笑又哭。吉迪恩·威切尔第一次感受到，自己是在以成年人的身份面对母亲。