Tom Scocca: Unraveling My Medical Mystery
Let’s begin with an action scene: I was in midair, tumbling sideways, heading for the floor of the Columbus Circle subway station.
让我们从一个动作场景开始：我在半空中，侧身翻滚，前往哥伦布圆环地铁站的地板。
Not a place I wanted to be.
这不是我想去的地方。
Where I wanted to be was on the downtown 1, five or ten yards away, doors standing open.
我想去的地方是市中心 1 号，五码或十码外，门敞开着。
I’d made this connection more than a thousand times, though usually getting off the 1, not on it.
我已经建立了这种连接一千多次，尽管通常都是从一号线下车，而不是上车。
This time, I was out of practice and I got it wrong.
这次我练习不够，结果就错了。
After stepping off the downtown B or C, I took the wrong stairway and had to double back to get over to the right side of the 1.
从市中心 B 区或 C 区出来后，我走错了楼梯，不得不原路折返才能到达 1 号线的右侧。
When I climbed up the correct stairs, the stairs I used to fly down every morning, straight from the optimal train door on my precisely plotted commute, I saw the 1 arriving.
当我爬上正确的楼梯时，我每天早上都会飞下楼梯，直接从我精确规划的通勤中的最佳火车门处飞下来，我看到一趟车到了。
And then — well, if I knew exactly what happened, it wouldn’t have happened, would it?
然后——好吧，如果我确切地知道发生了什么，那就不会发生了，不是吗？
What I registered went like this: I sped up, or I meant to speed up.
我注册的内容是这样的：我加速了，或者我打算加速。
Someone cut across my path.
有人挡住了我的路。
I tried to steer around them and my legs …
我试图绕过他们和我的腿……
my legs did something else.
我的腿做了别的事。
Or did nothing.
或者什么也没做。
The extra walking and climbing had taken too much effort, and my intentions lost contact with my legs.
额外的步行和攀爬花费了太多的力气，我的意图与双腿失去了联系。
I reached out and tried to brace myself on someone’s shoulder; they were wearing a black-on-white shirt; I was so undone I was trying to make physical contact with a total stranger on the subway platform .
我伸出手，试图靠在某人的肩膀上；但我还是没能成功。他们穿着一件白底黑字的衬衫；我非常沮丧，以至于试图在地铁站台上与一个完全陌生的人进行身体接触。
I missed.
我错过了。
All that was left was to hit the station floor, so I did.
剩下的就是去车站地板，所以我做到了。
I rolled to my knees and discovered that was as far as I could make it.
我跪倒在地，发现已经是我能做到的极限了。
My legs couldn’t get me upright again.
我的双腿再也无法直立起来。
One guy streaming by broke stride, asked if I was okay, and hauled me to my feet.
一个人大步流星地走过来，问我还好吗，然后把我拉了起来。
I checked myself: no torn clothes, no blood.
我检查了自己：衣服没有撕裂，没有血迹。
Another 1 was pulling in, one minute behind the train I’d missed.
另一趟车正在进站，比我错过的火车晚一分钟。
I got on and went where I’d been going.
我上了车，去了我要去的地方。
I had just had a fall.
我刚刚摔倒了。
Old people have falls.
老年人有跌倒的情况。
I had only just turned 52 one week before the September evening I collapsed.
九月的那个晚上，我崩溃之前一周，我才刚满 52 岁。
But the year from 51 to 52 had been a remarkably bad one.
但从 51 岁到 52 岁这一年是非常糟糕的一年。
I gambled on a job I wanted, as the editor-in-chief of a small magazine, and it ran out of funding.
我赌了一份我想要的工作，担任一家小杂志的主编，但资金耗尽了。
I sent applications to other publications and got thoughtful rejections.
我向其他出版物发送了申请，但遭到了深思熟虑的拒绝。
I sent more applications, and they went unanswered.
我发送了更多申请，但没有得到答复。
I made an appeal for paid subscriptions at a newsletter I’d been writing.
我在我一直在写的一份时事通讯中呼吁付费订阅。
Its revenue flattened out at about 20 percent of my share of our living expenses.
它的收入稳定在我生活开支的 20% 左右。
The household finances began to drain.
家庭财务开始枯竭。
I picked up an adjunct gig, teaching a writing class on Zoom, three straight hours a shot, and the anxiety of filling the time — of giving the students what they were paying for — gathered into a lump in my upper torso until I couldn’t stand the taste of the herbal tea that was supposed to relax me and give me something to do with my hands on-camera.
我找了一份兼职，在 Zoom 上教写作课，每次连续三个小时，而为了打发时间（给学生们他们所付的钱）的焦虑在我的上半身聚集成一团，直到我无法忍受花草茶的味道，花草茶本应该让我放松，让我在镜头前有事可做。
My shoulder locked up.
我的肩膀锁住了。
I got pins and needles in my arm.
我的手臂如针刺般刺痛。
What was happening to me?
我到底怎么了？
I don’t go looking for medical-mystery articles in the newspaper, but when I see one, I read it end to end.
我不会在报纸上寻找医学神秘文章，但当我看到一篇文章时，我会从头到尾地阅读它。
The strangest things happen to other people’s bodies!
最奇怪的事情发生在别人的身体上！
Someone, if I remember right, fought a lingering cough for years because they accidentally inhaled a pea and forgot about it.
如果我没记错的话，有人因不小心吸入豌豆而忘记了这一点，多年来一直与持续的咳嗽作斗争。
The medical-mystery column has a beginning and a conclusion.
医学之谜专栏有一个开头和一个结论。
In between is a fumble for clues, moving toward a flash of insight.
其间是摸索线索，走向顿悟。
Some doctor finally runs the right test, recollects the right journal article.
一些医生终于进行了正确的测试，回忆起了正确的期刊文章。
The shapeless misery takes shape.
无形的痛苦成形了。
I went to see a shoulder specialist.
我去看了肩部专家。
He knew exactly what was wrong.
他清楚地知道出了什么问题。
I had trigger points, little knots in the muscle under the shoulder blade.
我有触发点，肩胛骨下的肌肉里有小结。
He gave me some exercises — pin a tennis ball between the shoulder and the wall, lean back, and roll around on it — and a prescription for an anti-inflammatory.
他给了我一些练习——在肩膀和墙壁之间钉一个网球，向后倾斜，然后在上面打滚——并给了我一些抗炎药的处方。
A few days later, I noticed my shoes were laced too tight when I tried to put them on.
几天后，当我试图穿上鞋子时，我发现鞋带太紧了。
Another day and I made the connection: No, my feet were too big for my shoes.
有一天，我发现了这一点：不，我的脚太大了，穿不下鞋子。
Google said that anti-inflammatories can cause swelling in the extremities, so I stopped taking the pills.
谷歌说消炎药会导致四肢肿胀，所以我停药了。
My feet kept swelling, day by day, until my pink ankles looked like deli hams and I started using a butter knife as a shoehorn.
我的脚日复一日地肿胀，直到我粉红色的脚踝看起来像熟食火腿，我开始使用黄油刀作为鞋拔子。
I’d reluctantly spent some money to order a new pair of canvas sneakers, off-white, for the spring and summer, and I left them in the box, unable to face the thought of jamming my distended feet into them.
我不情愿地花了一些钱订购了一双新的春夏季帆布运动鞋，灰白色，我把它们留在盒子里，无法面对要把我肿胀的脚塞进去的想法。
The pins and needles spread to both arms, like I’d slept on them funny, except the sensation lasted all day.
针刺般的感觉蔓延到双臂，就像我睡在上面一样，很有趣，只是这种感觉持续了一整天。
I could still type through the numbness, though, publishing what I could for what money I could get.
不过，我仍然可以在麻木的状态下打字，用我能得到的钱发表我能发表的内容。
I stopped buying myself things that seemed discretionary — the good oolong tea leaves, crushproof imported pocket notebooks, a new pair of jeans — but some spending had its own momentum.
我不再给自己买一些看似随意的东西——上好的乌龙茶叶、防碎的进口袖珍笔记本、一条新牛仔裤——但有些支出有其自身的动力。
My wife’s family had booked an Airbnb in Italy for April.
我妻子的家人在意大利的 Airbnb 上预订了四月份的房间。
It would be our first vacation since before the pandemic, our middle-schooler’s first trip abroad since he was in an infant seat.
这将是我们自大流行之前以来的第一次假期，也是我们中学生自从坐在婴儿座椅上以来第一次出国旅行。
It would have been absurd to cancel just because I was between jobs.
仅仅因为我在工作间隙就取消是很荒谬的。
My ankle ached on the clutch pedal of the rented Fiat.
我的脚踝踩在租来的菲亚特的离合器踏板上感到疼痛。
I brought along a folder of unfinished tax paperwork.
我带来了一文件夹未完成的税务文件。
The amount I owed the IRS would match, almost exactly, a big freelance check I was waiting on.
我欠国税局的金额几乎与我正在等待的一大笔自由支票相符。
The deposit went into and out of my account on the same day.
存款在同一天存入和取出我的帐户。
I went to my regular doctor, whom I’d bypassed on the shoulder thing.
我去看了我的常规医生，但我因为肩膀问题而绕过了他。
He was baffled at the symptoms and frank about his bafflement.
他对这些症状感到困惑，并坦率地讲述了自己的困惑。
Swollen feet can mean congestive heart failure, so he referred me to a cardiologist.
脚肿可能意味着充血性心力衰竭，所以他推荐我去看心脏病专家。
She instructed me to walk and then run on an inclined treadmill, hopping on and off for ultrasound imaging of my heart.
她指导我走路，然后在倾斜的跑步机上跑步，跳上跳下对我的心脏进行超声成像。
I have — had — always been extremely healthy without being physically fit, so while I didn’t enjoy the test, I still passed handily.
我一直非常健康，但身体并不健康，所以虽然我不喜欢考试，但我仍然轻松通过了。
My heart was strong and well.
我的心坚强而健康。
Sometimes this kind of swelling just happens and then goes away, the cardiologist said.
心脏病专家说，有时这种肿胀会发生，然后就会消失。
Whatever it is, you won’t die of it.
不管是什么，你都不会因此而死。
I’ve told the story over and over, to various doctors, till it almost sounds like a coherent narrative.
我向不同的医生一遍又一遍地讲述这个故事，直到它听起来几乎是一个连贯的叙述。
When I drafted this passage, in the dark, by thumb, on a phone plugged into the USB socket of a hospital bed, I’d been telling it to several people a day: general practitioners, neurologists, rheumatologists, radiologists, nurses, physical therapists, medical aides, a dietitian, a surgeon.
当我在黑暗中用拇指用插入医院病床 USB 插座的手机起草这段文字时，我每天都会向几个人讲述它：全科医生、神经科医生、风湿科医生、放射科医生、护士、物理治疗师、医疗助手、营养师、外科医生。
The story, I told them, happened in two parts.
我告诉他们，这个故事分为两部分。
In the spring and summer, part one, I chased the swelling and numbness and other symptoms — stiff fingers, shortness of breath, tightness in the chest — in slow motion from doctor to doctor.
在春季和夏季的第一部分中，我以慢动作从一个医生到另一个医生追踪肿胀、麻木和其他症状——手指僵硬、呼吸短促、胸闷。
Mostly, this was shepherded by the cardiologist, who seemed to feel as if, by ruling the problem not to be her business, she had made it her duty to discover whose business it might in fact be.
大多数情况下，这是由心脏病专家引导的，她似乎觉得，通过裁定这个问题不关她的事，她有责任去发现这实际上可能是谁的事。
I saw a neurologist, who talked me into spending $700 from our high-deductible health plan on getting my muscles zapped with a little Taser and told me the results said I had carpal tunnel.
我去看了一位神经科医生，他说服我从我们的高免赔额健康计划中花 700 美元用泰瑟枪电击我的肌肉，并告诉我结果显示我患有腕管综合症。
I did have carpal tunnel, but not really, not because my terrible ergonomic habits had caught up with me.
我确实有腕管，但不是真的，不是因为我糟糕的人体工程学习惯影响了我。
The swelling had simply gotten into my carpal tunnels for a while.
肿胀已经进入我的腕管一段时间了。
I ignored his suggestions for exercises and supplements, and months later, in the hospital, I got an email telling me his practice was going out of business.
我忽略了他关于锻炼和补充的建议，几个月后，在医院里，我收到一封电子邮件，告诉我他的诊所即将停业。
I saw a rheumatologist.
我看了一位风湿病专家。
He ordered a bunch of blood tests and suggested I take prednisone and something else.
他要求我进行一系列血液检查，并建议我服用泼尼松和其他药物。
When I opened the paper bag from the pharmacy, I realized the something else was hydroxychloroquine , the malaria drug that had a moment in the news as a spurious COVID treatment.
当我打开药房的纸袋时，我意识到还有一种东西是羟氯喹，这种疟疾药物曾作为一种虚假的新冠治疗药物而在新闻中出现过。
I took only the prednisone.
我只服用了泼尼松。
My ankles stayed puffy.
我的脚踝一直浮肿。
You could jab a finger into one and leave a dent that lingered.
你可以用一根手指戳进其中，留下一个挥之不去的凹痕。
Before this, my hands had been loose-skinned and a bit wrinkly, the one part of me going more visibly on ahead through middle age than the rest.
在此之前，我的双手皮肤松弛，有点皱纹，我的这一部分在人到中年时比其他部分更加明显。
My hands looked like my mom’s hands, and I would catch myself gazing at them sometimes and congratulate myself on my resignation to the realities of aging, the mortality of all flesh.
我的手看起来就像我妈妈的手，有时我会发现自己凝视着它们，并庆幸自己已经接受了衰老和所有肉体都会死亡的现实。
Now my fingers resembled Italian sausage links, tight and shiny, with no reassuring philosophical overtones at all.
现在我的手指就像意大利香肠，紧绷而闪亮，完全没有令人放心的哲学暗示。
One symptom would fade and a new one would assert itself.
一种症状会消失，新的症状就会出现。
My ankles deflated and I started wearing the new sneakers, but my breathing and stamina steadily worsened.
我的脚踝瘪了，我开始穿新运动鞋，但我的呼吸和耐力逐渐恶化。
A wheeze or cough would interrupt my talking.
喘息或咳嗽会打断我的谈话。
On the mile-long walk back from school with my younger son, the route we’d been taking for two years, I lagged behind, guiltily asking him to slow down.
和小儿子从学校走一英里路回来时，我们已经走了两年的路，我落在后面，内疚地要求他放慢速度。
I started buying five-pound bags of rice from H Mart instead of ten-pound ones.
我开始从 H Mart 购买五磅袋大米，而不是十磅袋。
Then I just started getting rice delivered.
然后我就开始送米饭了。
Nobody cracked the puzzle.
没有人破解这个谜题。
The folder of referrals and results I carried to appointments got thicker.
我去预约时携带的推荐和结果文件夹变得更厚了。
My blood tested positive for signs of general inflammation and negative for the constellations of markers that would point to any particular inflammatory condition.
我的血液检测结果显示，一般炎症迹象呈阳性，而指示任何特定炎症状况的一系列标记物呈阴性。
I had not been bitten by any ticks; I had never gotten the Lyme rash or any other diagnostically meaningful rash.
我没有被蜱虫咬过；我从未患过莱姆皮疹或任何其他具有诊断意义的皮疹。
My fingers did not exhibit a telltale sign of turning stark white when they got cold.
当我的手指变冷时，并没有出现明显变白的迹象。
My chest X-ray and CT scan were clean.
我的胸部 X 光检查和 CT 扫描结果均正常。
The closest thing to a breakthrough was basically an accident: During a routine vitals check, a nurse asked if I was holding my breath.
最接近突破的事情基本上是一次事故：在例行的生命体征检查中，一名护士问我是否屏住了呼吸。
I was sitting still, and my pulse-oximeter reading was refusing to go over 95 percent.
我静静地坐着，我的脉搏血氧计读数拒绝超过 95%。
Normal is 95 and above.
正常值是95以上。
Below 90 is an emergency.
低于90是紧急情况。
I self-tested at home with a device on my finger.
我在家中用手指上的设备进行了自我测试。
Light activity, like bustling around the kitchen, would knock my level down to 91.
轻微的活动，比如在厨房里忙碌，会让我的水平下降到 91。
Walking a bag of groceries home and up the stairs dropped me to 87.
拎着一袋杂货回家，然后上楼，我的体重降到了 87。
At a medical center, I did breathing exercises with a mouthpiece in a sealed booth.
在一家医疗中心，我在一个密封的隔间里用咬嘴进行呼吸练习。
I passed that test.
我通过了那个测试。
I went to a pulmonologist and passed every test there, too.
我去看了肺科医生，也通过了那里的每项测试。
If you ignored the pulse-ox readings, my lungs and heart were, officially, fine.
如果你忽略脉搏氧读数，我的肺和心脏，正式来说，都很好。
There was zero explanation; there was, maybe, the absolutely obvious explanation: that I was stressing myself into this over money.
零解释；也许有一个绝对明显的解释：我是因为金钱而给自己施加压力。
We’d been absorbing plenty of strain in the household before I lost my job — some normal midlife stuff, some normal parent stuff, some abnormal and menacing stuff that I truly can’t even get into.
在我失业之前，我们已经承受了家庭中的大量压力——一些正常的中年压力，一些正常的父母压力，一些我真的无法承受的异常和威胁性的压力。
Our black cat gnawed our potted prosperity bamboo to shreds.
我们的黑猫把我们盆栽的富贵竹啃成了碎片。
Trying to save it, we overwatered it until it rotted from the inside out.
为了拯救它，我们给它浇了太多水，直到它从里到外腐烂。
It had not been the wisest time to choose an unstable job in a beyond-unstable field.
在一个极其不稳定的领域选择一份不稳定的工作并不是最明智的时机。
If my time as an editor-in-chief had even been a job: I applied for unemployment, got rejected, and after months of appeal, the State of New York ruled that my past two full-time situations had been contract gigs, uncovered.
如果我担任主编的时间是一份工作的话：我申请失业，被拒绝，经过几个月的上诉，纽约州裁定我过去的两次全职工作都是合同工作，没有被揭露。
I considered whether my illness could be a conversion disorder flowing from my misguided career choices.
我考虑过我的病是否可能是由于我错误的职业选择而导致的转换障碍。
On some level, I believed the swelling would go down and the oxygen would go up as soon as I collected a few consecutive pay stubs from a normal, salaried job.
在某种程度上，我相信一旦我从正常的带薪工作中连续收到几张工资单，肿胀就会消退，氧气就会上升。
Back in the winter, I’d met up with a friendly fellow writer who happened to have just secured, through a different line of work, an amount of money that meant financial security forever.
早在冬天，我遇到了一位友好的作家同事，他碰巧通过不同的工作刚刚获得了一笔钱，这意味着永远的财务保障。
In theory, we were talking about ways to fund the job of mine that was about to run out of money, but we both knew that wouldn’t happen.
理论上，我们正在讨论如何为我即将耗尽资金的工作提供资金，但我们都知道这不会发生。
“You’ve got a good reputation,” he said.
“你的名声很好，”他说。
“Someone will want you to work for them.”
“有人会希望你为他们工作。”
This had been true enough before.
这在以前就已经足够真实了。
I’d made myself a useful editor and a reasonably well-known writer over the years.
多年来，我使自己成为一名有用的编辑和相当知名的作家。
I moved between jobs without much trouble, tending to get hired the way murderers in movies get hired: a message or phone call from someone who needed something done and who thought I could do it.
我在不同的工作岗位之间换来换去，没有遇到太多麻烦，倾向于像电影中的杀人犯一样被雇用：来自需要完成某件事并且认为我能做到的人的消息或电话。
Abruptly, all that my connections could offer were gigs.
突然之间，我的关系所能提供的只是演出。
Someone needed a manuscript edited before they gave it to their book editor.
有人在将手稿交给图书编辑之前需要对其进行编辑。
A magazine wanted a book review.
一本杂志想要一篇书评。
Work, but no jobs.
有工作，但没有工作。
I kept applying for something stable.
我一直在申请一些稳定的东西。
A notoriously lavish start-up loved my proposal for a mini-section within its soon-to-be-launched vertical until the sponsorship for the vertical failed to come through.
一家臭名昭著的奢侈初创公司很喜欢我在其即将推出的垂直领域内设立一个小型版块的提议，直到对该垂直领域的赞助未能通过。
A major media company advertised for a position that exactly fit my history, then withdrew the listing in the middle of an executive meltdown.
一家大型媒体公司招聘了一个与我的经历完全相符的职位，然后在高管崩溃期间撤回了招聘信息。
A friend of a friend let me know that another major media company was ignoring my application because it wanted someone less opinionated.
朋友的朋友告诉我，另一家大型媒体公司忽略了我的申请，因为它想要一个不那么固执己见的人。
I started calling in favors, nagging people with whom my friendships had previously been non-transactional.
我开始寻求帮助，对那些以前与我没有交易关系的人进行唠叨。
It broke up the dead silence, at least.
至少，它打破了死一般的寂静。
My wife and I considered disaster scenarios in which the “disaster” was simply that things kept going the way they were going.
我和我的妻子考虑了灾难情景，其中“灾难”只是事情继续按照原来的方式发展。
We did the math on vacating our condo, finding tenants, and living in a cheaper rental.
我们计算了搬出公寓、寻找租户以及住在更便宜的租金中的情况。
Maybe it was time to leave New York.
也许是时候离开纽约了。
But it wasn’t clear if we had enough savings to cover such a move.
但尚不清楚我们是否有足够的积蓄来支付这一举措。
It wasn’t even clear if I had the physical energy to pack boxes.
甚至不清楚我是否有体力去收拾箱子。
On the online job forms, there was usually a question about whether I, the applicant, identified as disabled.
在网上的求职表格上，通常会出现一个问题，即我（申请人）是否被认定为残疾人。
I paused longer and longer each time.
我每次停顿的时间越来越长。
Disabled?
残疾人？
I was …
我当时……
less able.
能力较差。
To do things.
做事。
Than I’d been.
比我以前。
For now?
目前？
I clicked “no,” uncertainly.
我不确定地点击了“否”。
Part two of the story is I got COVID.
故事的第二部分是我感染了新冠病毒。
I’d avoided it for three years, but everyone is going to contract the virus sooner or later.
我已经躲避了三年，但每个人迟早都会感染病毒。
It’s not worth the trouble, officially, to even politely suggest people should wear masks or to keep the public up to date on the rate of new cases.
从官方角度来看，即使是礼貌地建议人们应该戴口罩或让公众了解新病例的最新情况也是不值得的。
The pandemic is over, people keep on saying.
人们一直在说，疫情已经过去了。
You are free to make your own decisions about what risks to take individually without any useful information about the overall risk picture.
您可以自由地自行决定要单独承担哪些风险，而无需任何有关总体风险情况的有用信息。
I’d been furious about this already on other people’s behalf.
我已经代表其他人对此感到愤怒了。
Most Americans, the Biden administration said, would be fine if they were vaccinated.
拜登政府表示，大多数美国人如果接种疫苗就会没事。
This elided the people who wouldn’t be: the immunocompromised, for example, and those with certain respiratory conditions.
这排除了那些不会的人：例如，免疫功能低下的人和患有某些呼吸系统疾病的人。
The political and journalistic consensus had set the value of these people’s safety at zero, not even granting them the benefit of mask advisories or ventilation standards.
政治和新闻界的共识将这些人的安全价值定为零，甚至没有给予他们口罩建议或通风标准的好处。
When I started hearing about the late-summer COVID wave, it occurred to me that now I was one of those people myself.
当我开始听说夏末的新冠疫情浪潮时，我突然意识到我自己也是其中之一。
This is what disability advocates have said all along, not that it usually sinks in: The able and the disabled aren’t two different kinds of people but the same people at different times.
这是残疾人倡导者一直在说的，但人们通常不这么认为：有能力的人和残疾人不是两种不同的人，而是不同时期的同一个人。
Last year, I was healthy; this year, I had a breathing ailment, even if nobody could say exactly what that ailment was.
去年，我身体健康；今年，我患有呼吸系统疾病，尽管没有人能确切地说出这种疾病是什么。
I got Paxlovid delivered and sank into fever.
我送了帕克斯洛维德，然后开始发烧。
The back of my throat was so raw I would wake up snorting for air.
我的喉咙后部很痛，我会因呼吸空气而醒来。
Rolling around in my bed, I felt, for the first time, that this body of mine truly was going to die someday.
我在床上滚来滚去，第一次感觉到，我的这副身体真的有一天会死去。
Not the abstract knowledge that death awaits all of us but the shocking awareness that eventually this system of veins and nerves and organs would lose its familiar stubborn equilibrium, cease functioning, and fail.
不是死亡等待着我们所有人的抽象知识，而是令人震惊的认识，即这个由静脉、神经和器官组成的系统最终将失去其熟悉的顽固平衡，停止运作并失效。
I fixated on whales.
我专注于鲸鱼。
They’re right out in New York Harbor.
他们就在纽约港。
What if I used up my allotted time on the planet without ever laying eyes on a whale?
如果我在地球上度过了分配的时间而没有看到鲸鱼怎么办？
I booked a whale-watching cruise for the family.
我为家人预订了观鲸游船。
Later, when the day came, it got canceled by a hurricane.
后来，当这一天到来时，它被飓风取消了。
In August, when the acute COVID infection ran its course, I got out of bed and back on my feet.
八月，当急性新冠病毒感染逐渐消退时，我下床重新站起来。
But after a week or two on the upswing, a whole new set of malfunctions took over.
但在一两周的上升期之后，一系列全新的故障出现了。
Routine movements burned as if I were doing deep stretching.
日常动作就像在做深度伸展运动一样燃烧。
I couldn’t get through a meal without a coughing fit from a lump of food getting stuck or a drink of water splashing the wrong way.
我吃完一顿饭就会因为食物卡住或水溅到错误的方向而咳嗽。
Saliva accumulated in my mouth till I had to go to the sink and spit.
口水在我嘴里积聚，直到我不得不去水槽吐口水。
I ate more slowly and stopped getting seconds, feeling like I was in one of those testimonials about the new anti-obesity drugs, in which people tell how their motivation to keep eating has disappeared.
我吃得更慢，不再吃秒，感觉就像是在那些关于新型抗肥胖药物的推荐中，人们在其中讲述他们继续吃东西的动力如何消失了。
I was far past needing or wanting any weight loss.
我已经不再需要或想要任何减肥了。
My sedentary midlife flab had long since ebbed away, and now I was losing something else, down ten pounds in a month.
我久坐的中年松弛早已消失，现在我正在减掉一些东西，一个月内减掉了十磅。
Maybe, the cardiologist said, eyeing my scrawny limbs and loose clothes, I should consider checking into a hospital.
心脏病专家看着我骨瘦如柴的四肢和宽松的衣服说，也许我应该考虑去医院检查。
Just so I could get all my testing coordinated in one place.
这样我就可以将所有测试协调到一个地方。
It was only a thought, one that dissipated as I sought out second opinions.
这只是一个想法，当我寻求第二意见时，这个想法就消失了。
The medical-mystery column doesn’t usually dwell on how slowly the inquiry goes in our fractured health-care system.
医学之谜专栏通常不会详细讨论我们支离破碎的医疗保健系统中的调查进展有多慢。
How the highly recommended pulmonologist doesn’t return the first phone call and only has an opening five months away, and how the major-medical center does have an appointment but isn’t in network with the major-medical insurer.
备受推荐的肺科医生如何不回第一个电话，并且只有五个月后才有空缺，以及大型医疗中心如何进行预约，但未与大型医疗保险公司建立网络。
How the chest X-ray is over by the East River and the breathing booth is in the West 160s and the phlebotomist is by Columbia, and how each one has its own online portal for billing and results.
胸部 X 光检查如何在东河进行，呼吸室如何在西 160 度，抽血医生如何在哥伦比亚进行，以及每个人如何拥有自己的计费和结果在线门户。
Every day, my legs were harder to move.
每一天，我的腿都变得更加难以移动。
Climbing in the door of an SUV, I couldn’t lift my rear foot over the threshold until I reached down with my hands and pulled it in.
爬进一辆SUV的车门，我的后脚抬不上门槛，直到我把手伸进去把它拉进去。
Then the grab-and-lift maneuver became necessary to step into my pants.
然后，必须进行抓举动作才能进入我的裤子。
I had to ask the kids to pull pots and cutting boards out of the bottom kitchen cabinets for me.
我不得不让孩子们帮我从厨房底部的柜子里拿出锅子和切菜板。
I gave up bedtime-story duty, crawling into bed each night before anyone else, half-hearing my wife’s voice reading in the next room, feeling myself fading out of my own life.
我放弃了睡前故事的责任，每天晚上都先于其他人爬上床，隐隐约约地听到妻子在隔壁房间朗读的声音，感觉自己正在从自己的生活中消失。
I imagined living in a world and a class where a person could retreat to a sanatorium and shut everything down until the problem was figured out.
我想象生活在一个世界和一个阶级中，一个人可以退回疗养院并关闭一切，直到问题得到解决。
I stopped leaving the apartment.
我不再离开公寓。
The project of washing left me needing to lie down.
清洗工作让我需要躺下。
One morning, or possibly afternoon, it took me four or five tries to shrug my way into my bathrobe, nearly overcome by the weight and friction.
一天早上，或者可能是下午，我花了四五次尝试才穿上浴袍，几乎被重量和摩擦力压垮了。
I gave up on shaving, and the rattiest stubble of my life took over my chin.
我放弃了刮胡子，我一生中最乱七八糟的胡茬占据了我的下巴。
The kids were put in charge of the cat box because I couldn’t reach that corner of the bathroom anymore, but one night I got down on the floor to help and when we were done I couldn’t stand up.
孩子们被安排负责猫箱，因为我再也够不到浴室的那个角落了，但有一天晚上，我趴在地板上帮忙，当我们完成后，我无法站起来。
I didn’t even know how to start to try.
我什至不知道如何开始尝试。
Eventually, my wife grabbed me under the armpits from behind and hauled me most of the way upright while I gabbled warnings about my legs giving way.
最终，我的妻子从后面抓住我的腋下，将我大部分拉直，而我则喋喋不休地警告我的双腿要垮掉。
Two different realities or images stood superimposed in my mind.
两种不同的现实或图像叠加在我的脑海中。
There was the body I’d occupied two months ago — my body , as I understood it — walking over to Broadway for pizza, taking the younger boy to the basketball courts, ducking into Central Park to climb the Great Hill.
那是我两个月前占据的身体——我所理解的我的身体——走到百老汇吃披萨，带小男孩去篮球场，躲进中央公园爬上大山。
And then there was Andrew Wyeth’s Christina’s World , a gaunt figure dragging her useless legs along the ground.
然后是安德鲁·怀斯的《克里斯蒂娜的世界》，一个憔悴的身影拖着无用的双腿沿着地面行走。
If this was histrionic or self-pitying, it seemed less so on the days when I couldn’t raise my hips up off the floor.
如果说这是做作或自怜的话，那么在我无法将臀部抬离地板的日子里，这就显得不那么重要了。
The only thing that still felt more or less normal was sitting at a desk, doing the work I was trying to get someone to pay me to do.
唯一感觉或多或少正常的事情就是坐在办公桌前，做我试图让别人付钱给我做的工作。
Meanwhile, in the span of time that it took a newspaper to move one step down its hiring checklist from a Zoom interview to an edit test, a law school in a small southern town progressed from sending my wife a preliminary inquiry to making her a tenured job offer with a part-time teaching slot for me thrown in.
与此同时，在一家报纸将其招聘清单从 Zoom 面试改为编辑测试的时间内，南方小镇的一所法学院从向我妻子发送初步询问，发展到向她提供终身工作机会，并为我提供了一个兼职教学职位。
We booked a visit for the family to see if we could really live there.
我们为家人预订了一次参观，看看我们是否真的可以住在那里。
As the trip came closer, we realized there was simply no way I could walk through an airport.
随着行程越来越近，我们意识到我根本无法步行穿过机场。
The rest of the family would have to scout out our possible future while I stayed home.
当我待在家里时，家里的其他人必须寻找我们可能的未来。
As they prepared to go, my GP called with the results of my latest bloodwork.
当他们准备出发时，我的家庭医生打电话来告诉我最新的血液检查结果。
A normal range for creatine kinase, a marker of muscle breakdown, might be between 30 and 200 units per liter.
肌酸激酶（肌肉分解的标志物）的正常范围可能在每升 30 到 200 单位之间。
A new test said my level was 8,000.
一项新测试显示我的等级为 8,000。
The reason my muscles felt so weak was that they were actively dissolving into my bloodstream.
我的肌肉感觉如此虚弱的原因是它们正在积极地溶解到我的血液中。
I wrapped up a job-recruiting call, threw my glasses and contact-lens case into a shoulder bag, and booked an Uber to the emergency room.
我接完一个招聘电话，把眼镜和隐形眼镜盒扔进肩包，然后叫了一辆 Uber 去急诊室。
My wife took my sons to see about the job.
我的妻子带着我的儿子们去看了这份工作。
It was unclear which of us was going to the place that would offer a solution.
目前还不清楚我们中谁会去那个能提供解决方案的地方。
In the hospital, the medical mystery falls into an awkward, indeterminate zone.
在医院里，医学之谜陷入了尴尬、不确定的境地。
Between the fall and the choking and the creatine kinase, my story qualified me as a definite emergency when I shuffled up to the admission desk.
在跌倒、窒息和肌酸激酶之间，当我拖着脚步走向入院柜台时，我的故事使我成为一个明确的紧急情况。
But it was a conundrum to be solved, not as straightforward and urgent as a stroke or broken hip.
但这是一个需要解决的难题，不像中风或髋部骨折那么简单和紧迫。
The staff put me in a wheelchair and parked me in a walkway lined with other people in wheelchairs.
工作人员把我放在轮椅上，然后把我停在一条人行道上，人行道上还有其他坐轮椅的人。
The hospital was beyond full.
医院已经满员了。
There were genuinely not any open beds, not only as an administrative category but as literal objects to lie down on.
确实没有任何开放的床，不仅作为行政类别，而且作为真正可以躺下的物体。
I spent my first night on a gurney in the ER observation section, fully dressed and still in my shoes.
我的第一个晚上是在急诊室观察区的轮床上度过的，穿着整齐，仍然穿着鞋子。
To avoid catching anything else, I kept a mask on, the elastic digging into my ears.
为了避免感染其他东西，我一直戴着口罩，松紧带扎进耳朵里。
On the second day, I got a bed and changed into two layers of hospital gowns.
第二天，我得到了床位，换了两层病号服。
My clothes and my new sneakers went into a pair of plastic patient-possession bags.
我的衣服和新运动鞋被装进一对塑料病人专用袋中。
Doctors came by, individually and in teams, with blue gloves on, to test my muscles.
戴着蓝色手套的医生单独或成组地过来测试我的肌肉。
Squeeze my fingers.
捏紧我的手指。
Push up against my hand with your knee.
用你的膝盖顶住我的手。
Stick out your elbows and don’t let me push them down.
伸出你的手肘，别让我把它们推下去。
The closer the blue gloves came to the middle of my body, the worse I did.
蓝色手套越靠近我的身体中部，我的表现就越糟糕。
The doctors had questions.
医生们有疑问。
Had I been hiking at all back in the spring, when my troubles started?
当我的麻烦开始的时候，我在春天徒步旅行过吗？
No?
不？
Was I sure?
我确定吗？
Not even in Central Park?
中央公园也不行吗？
This was about Lyme disease again, of course.
当然，这又是关于莱姆病的。
I knew about Lyme, and the ever-growing literature of people’s struggles with Lyme, and the whole elusive post-Lyme complex.
我了解莱姆病，了解人们与莱姆病斗争的不断增长的文献，以及整个难以捉摸的后莱姆情结。
But I also still knew, as solidly as I could know any fact about my health, that I had not been bitten by any ticks.
但我仍然知道，正如我对自己健康状况的了解一样，我没有被蜱虫叮咬。
One doctor after another asked me to blink my eyes, harder, over and over, watching for the lids to droop from fatigue, which might mean myasthenia gravis.
一位又一位医生要求我一遍又一遍地用力眨眼，观察眼睑是否因疲劳而下垂，这可能意味着重症肌无力。
My lids did not droop.
我的眼皮没有下垂。
ER time took over, with “day” and “night” merely more or less busy spells in an unbroken atmosphere of fluorescent lights and beeping.
急诊室时间接管了，“白天”和“夜晚”只是在荧光灯和蜂鸣声不间断的气氛中或多或少忙碌的时间。
A 24-hour flight in coach, a 48-hour flight in coach, a 72-hour flight in coach.
24 小时经济舱航班、48 小时经济舱航班、72 小时经济舱航班。
The patient behind the curtain to my right kept his TV blaring all night, cycling episodes of the same forensic true-crime show: some ghastly rape or murder, the bafflement of investigators, the infallibility of scientific evidence coming to the rescue.
我右边窗帘后面的病人整晚都开着电视，循环播放同一部法医真实犯罪节目：一些可怕的强奸或谋杀，调查人员的困惑，可靠的科学证据来拯救。
The Kars-4-Kids jingle playing in between.
其间播放着 Kars-4-Kids 的歌曲。
My obvious risks — choking, falling — had standard countermeasures: puréed meals and caution-yellow nonslip socks with a matching wristband that read FALL RISK.
我面临的明显风险——窒息、跌倒——都有标准的应对措施：食物泥、黄色防滑袜子以及配套的腕带，上面写着“跌倒风险”。
For treatment, there was nothing but big bags of IV fluids to flush out the creatine kinase while keeping my underlying symptoms untouched, the better for accurate testing and observation.
在治疗方面，除了大袋静脉输液来冲洗肌酸激酶，同时保持我的潜在症状不受影响，这样更有利于准确的测试和观察。
The creatine kinase went down to 5,000, back up to 6,000, down again.
肌酸激酶下降到 5,000，又回到 6,000，再次下降。
The staff rolled me away to a chest X-ray, a thyroid ultrasound, a contrast CT scan, an MRI.
工作人员把我推到一边去做胸部 X 光检查、甲状腺超声检查、对比 CT 扫描、核磁共振检查。
Wheeling down the hall toward an echocardiogram, I passed the neurology team going the other way, misconnecting on a planned meeting.
我沿着大厅走向超声心动图检查处，经过神经病学团队的另一条路，误入了计划中的会议。
I never talked to them again.
我再也没有和他们说过话。
A real hospital room, outside the ER, opened up in the late afternoon on the fourth day, a Saturday.
第四天，星期六，下午晚些时候，急诊室外的一间真正的病房开放了。
It was on the tenth floor with a window looking uptown over the top of Central Park.
它位于十楼，有一扇窗户可以俯瞰中央公园顶部的住宅区。
I could see the boathouse by the Harlem Meer, but not the water itself, because the trees were so thick and green.
我可以看到哈莱姆湖边的船库，但看不到水本身，因为树木又茂密又绿。
I wondered, tempting fate, what it might look like when the colors turned.
我试探着命运，想知道当颜色转变时会是什么样子。
My new roommate, a friendly, stooped figure, was in agony for non-mysterious reasons — a manageable condition that had gone unmanaged because the treatments cost too much money.
我的新室友是一个友好的、弯腰驼背的人，他因为一些不神秘的原因而感到痛苦——原本可以控制的病情，但由于治疗花费太多而无法控制。
The problem-solving sessions on his side of our shared curtain, with the doctors and social workers, were about which programs or policies might help him if he and his family could sort them out.
在我们共同的幕布下，他一边与医生和社会工作者一起进行问题解决会议，讨论如果他和他的家人能够解决问题，哪些计划或政策可能会帮助他。
For me, evidence and theories kept trickling in.
对我来说，证据和理论不断涌现。
Doctors would come by and mention some finding, or my phone would give an automated notice that a new lab result had arrived and I would Google as best I could.
医生会过来提及一些发现，或者我的手机会自动发出通知，表明新的实验室结果已经到达，我会尽力谷歌。
Open tabs accumulated on my phone: RNP antibodies, rheumatoid arthritis, polymyositis, mixed connective tissue disease .
打开手机上积累的标签：RNP抗体、类风湿关节炎、多发性肌炎、混合结缔组织病。
(“The overall ten-year survival rate is about 80 percent.”) I was negative for hepatitises B and C, negative for Sjögren’s-syndrome antibodies, negative for syphilis, negative for Lyme ( told you ) — negative for most things, as I’d been all along.
（“总体十年生存率约为 80%。”）我的乙型肝炎和丙型肝炎呈阴性，干燥综合征抗体呈阴性，梅毒呈阴性，莱姆病呈阴性（告诉过你）——对大多数事情呈阴性，就像我一直以来的情况一样。
The speed with which my muscles were falling apart seemed to be, in some sense, good news, meaning that I probably wasn’t going through one of the more gradual neurological degenerations like ALS.
从某种意义上说，我的肌肉崩溃的速度似乎是个好消息，这意味着我可能不会经历像肌萎缩侧索硬化症（ALS）这样更为渐进的神经退行性疾病。
Down in radiology, I took a swallowing test, a three-course flight of barium snacks: a thick barium drink, spoonfuls of barium marshmallow fluff, then bites of the barium fluff on a graham cracker, consumed one after another on live X-ray video.
在放射科，我做了一次吞咽测试，吃了三道菜的钡餐：一杯浓稠的钡饮料，几勺钡棉花糖绒毛，然后咬一口全麦饼干上的钡绒毛，在现场 X 射线视频中一个接一个地吃掉。
There was my jaw, my tongue, my hyoid bone, and there were clots of barium-tinged food getting visibly hung up short of the esophagus, behind the tongue, in little pockets of underperforming pharyngeal muscle.
我的下巴、我的舌头、我的舌骨，还有一些带有钡味的食物凝块，明显挂在食道附近、舌头后面、咽部肌肉功能不佳的小口袋里。
None of the food, however, was obstructing my windpipe.
然而，没有食物阻塞我的气管。
It meant I was eligible to trade in puréed green beans for individual green beans, French-toast paste for ordinary French toast.
这意味着我有资格用青豆泥换单颗青豆，用法式吐司酱换普通法式吐司。
A provisional unifying idea took shape.
一个临时统一的想法已经形成。
More and more, the conversations circled back to one form or another of myositis: an autoimmune attack on my proximal muscles.
谈话越来越多地回到一种或另一种肌炎：对我的近端肌肉的自身免疫攻击。
If the muscles were the essence of the problem, then my oxygen troubles could have been a muscle problem all along too, a creeping weakness in the diaphragm.
如果问题的本质是肌肉，那么我的缺氧问题也可能一直是肌肉问题，是横膈膜逐渐无力的问题。
The swallowing trouble would be the muscle problem appearing in the pharynx.
吞咽困难可能是咽部肌肉出现问题。
The swollen ankles and knuckles — well, those weren’t quite muscle problems, but they also were no longer a pressing concern.
肿胀的脚踝和指关节——好吧，这些不完全是肌肉问题，但它们也不再是一个紧迫的问题。
What I needed, urgently, was a muscle biopsy, one that might tell the doctors exactly how that part of me was going wrong.
我迫切需要的是肌肉活检，这样可以准确地告诉医生我的那部分出了什么问题。
It was my bad luck, the attending doctor said at my bedside, to be an interesting case.
主治医生在我床边说，这是一个有趣的病例，这是我的运气不好。
Our meetings had a tone of rueful amusement.
我们的会议充满了悲伤和有趣的语气。
Yes, I was in pain and reeking from infrequent showering, but we could talk about the unresolved mystery and its submysteries with a certain detachment.
是的，我很痛苦，而且由于很少洗澡而浑身臭气，但我们可以以某种超然的态度谈论这个未解之谜及其子谜团。
My oxygen levels were behaving themselves.
我的氧气水平正常。
No one knew where that problem had gone, nor why my voice had suddenly gone faint and reedy.
没有人知道问题出在哪里，也不知道为什么我的声音突然变得微弱而刺耳。
My wife was back from the job-scouting trip, but she’d picked up a foot infection and was stuck in the apartment, taking antibiotics.
我的妻子刚刚结束求职旅行，但她的脚部感染了，被困在公寓里服用抗生素。
The boys trooped across the park to bring me my laptop.
男孩们成群结队穿过公园给我拿笔记本电脑。
They were visibly alarmed by how gaunt and shaky I was.
他们显然对我的憔悴和颤抖感到震惊。
I took them on a shuffling tour to a long back hallway lined with sleek, derelict equipment, with a window facing out on a black monolith of a building, to show them how much it looked like Andor .
我带着他们拖着脚步来到了一条长长的后走廊，走廊里摆满了时尚的废弃设备，有一扇窗户朝外，正对着一座黑色巨石建筑，向他们展示它有多像安道尔。
We shared the crunchy, startlingly good French fries on my dinner tray.
我们在我的晚餐托盘上分享了松脆可口的炸薯条。
I couldn’t have swallowed that many on my own.
我一个人不可能吞下那么多。
Now that I had the computer, I rummaged through test results and image scans on the hospital information portal.
现在我有了电脑，我在医院信息门户上翻阅了检查结果和图像扫描。
I could navigate this way and that through the inside of my own body on the CT or MRI files, moving the cutaway to watch the stark white rib cage flow into the spine.
我可以在 CT 或 MRI 文件上这样或那样地穿过自己身体的内部，移动剖面图以观察纯白色的胸腔流入脊柱。
My thoracic aorta was “normal in caliber and course.” My right iliac bone had a “tiny sclerotic focus” that was probably a “bone island.” My muscles were all fucked up:
我的胸主动脉“口径和走向均正常”。我的右侧髂骨有一个“微小的硬化灶”，可能是一个“骨岛”。我的肌肉都被搞砸了：
Diffuse STIR hyperintense signal throughout the visualized musculature of the pelvis and thighs as well as partially visualized portions of the paraspinal muscles of the lower back, including the quadriceps muscle (vastus lateralis, medialis, intermedius), hamstrings, iliacus, psoas major, gluteus medius and minimus, pubococcygeal muscles, adductor muscles, highly suggestive of systemic myositis in the appropriate clinical setting.
弥漫性 STIR 高信号遍布骨盆和大腿的可视化肌肉组织以及下背部椎旁肌肉的部分可视化部分，包括股四头肌（股外侧肌、内侧肌、中间肌）、腘绳肌、髂肌、腰大肌、臀中肌和臀小肌、耻骨尾骨肌、内收肌，在适当的临床环境下高度提示系统性肌炎。
I knew this, implicitly.
我暗自知道这一点。
It was apparent every time a nurse or technician asked me to scoot a little in my bed and my psoas major or adductor or the rest simply wouldn’t do the scooting.
很明显，每次护士或技术人员要求我在床上移动一点时，我的腰大肌或内收肌或其他部位根本无法移动。
The most minimal movements were the most impossible.
最微小的动作也是最不可能的。
It was easier to clamber out of bed, take a six-inch step, and clamber back in at the new spot than to shift my body.
从床上爬起来，迈出六英寸的台阶，然后爬回到新的位置，比移动身体要容易得多。
If my pillow slipped down to the small of my back, there was no retrieving it.
如果我的枕头滑落到我的后背，就无法恢复。
A perverse rule of medical technology is the more you scan, the more you discover, whether those discoveries matter or not.
医疗技术的一个不正当规则是你扫描的越多，你发现的就越多，无论这些发现是否重要。
The imaging reports noted a “small hiatal hernia”: Google said a weakened diaphragm could cause that.
影像报告指出了“小型食管裂孔疝”：谷歌表示，膈肌变弱可能会导致这种情况。
I had an “underdistended stomach,” as would anyone who was expected to eat French-toast paste.
我有一个“胃部膨胀不足”的情况，就像任何要吃法式吐司酱的人一样。
My liver was “prominent in size,” which qualified as “hepatomegaly.” My lower lungs had “minimal mild reticular opacities.”
我的肝脏“尺寸突出”，符合“肝肿大”的标准。我的下肺有“极轻微的轻度网状混浊”。
One discovery was notable, or might have been.
一项发现是值得注意的，或者可能是值得注意的。
A night-shift doctor brought it up offhandedly, as if someone else must have already mentioned it: The ultrasound had picked up a nodule on my thyroid.
一位夜班医生随口提起，好像肯定有人已经提到过：超声波检查发现我的甲状腺上有一个结节。
Could it be squeezing my trachea?
会不会挤压我的气管？
Could it be cancer?
会不会是癌症？
Could it be nothing?
难道就没什么吗？
Sure.
当然。
A little more inspection and the nodule became nodules, plural, the largest being a nearly inch-long sausage on the thyroid isthmus, salient and crying out for analysis.
再检查一下，结节变成了多个结节，最大的是甲状腺峡部的一个近英寸长的香肠，很突出，急需分析。
The thyroid-biopsy team swooped in during lunchtime, chatty and armed with portable gear for working at my bedside.
午餐时间，甲状腺活检团队突然出现，他们很健谈，并携带便携式设备在我的床边工作。
One person tracked down the sausage with an ultrasound wand against my neck while another jackhammered away at it with a tiny needle.
一个人用超声波棒抵着我的脖子追踪香肠，而另一个人用一根小针敲击它。
They prepared the samples in little vessels of brightly colored liquids laid out in the sun on the windowsill.
他们在窗台上阳光下放置的小容器中准备了颜色鲜艳的液体样品。
The technicians eyeballed the cells on a microscope set up in the hallway and declared that nothing looked obviously malignant.
技术人员在走廊里设置的显微镜上观察细胞，并宣称没有任何东西看起来明显是恶性的。
My thyroid itself, they said, showed “lymphocytic thyroiditis.” Also known as Hashimoto’s disease, although who could say, here, whether it was a disease unto itself or a manifestation of some greater disease.
他们说，我的甲状腺本身出现了“淋巴细胞性甲状腺炎”。也称为桥本氏病，尽管谁能说清楚它本身是一种疾病还是某种更大疾病的表现。
The question was bigger than the thyroid.
这个问题比甲状腺更重要。
Now there was almost nothing left to do but the muscle biopsy.
现在除了肌肉活检之外几乎没有什么可做的了。
Ten stories up turned out to be cruising altitude for hawks, wheeling by the window in the sunlight, borne along on the fresh autumn breezes.
十层楼高原来是鹰的巡航高度，它们在阳光下在窗边盘旋，乘着新鲜的秋风。
I gave my daily samples of blood.
我每天都采集血液样本。
I sent some follow-up emails about jobs.
我发送了一些有关工作的后续电子邮件。
The procedure was scheduled for Thursday, my ninth day in the hospital, in the last slot of the afternoon.
手术安排在星期四，即我住院的第九天，下午的最后一个时段。
As the time came closer, I began to apprehend an uncomfortable truth.
随着时间的临近，我开始理解一个令人不安的事实。
The actual medical mystery wasn’t about anything inside me.
真正的医学之谜与我内心的任何事物无关。
It was whether the tests were going to point to some far side of this where I got my life back.
问题是这些测试是否会指向我恢复生活的另一边。
Was there a future where I could walk out the door on Sunday morning in decent shoes and make it to church?
未来我是否可以在周日早上穿着体面的鞋子走出家门并到达教堂？
Where I could pick up heavy groceries to put a three-course meal on the family dinner table?
我可以在哪里买一些沉重的杂货，把一顿三道菜的饭菜放在家庭餐桌上？
Where we could rent a rowboat?
哪里可以租划艇？
Where I was a helpful and economically viable member of the household?
我在哪里是一个乐于助人且经济上可行的家庭成员？
The operating team drew a mark on my right thigh and put me under sedation.
手术组在我的右大腿上画了一个记号，并给我注射了镇静剂。
When I came around, I was still in the operating room.
当我醒来时，我还在手术室里。
My wound was neatly sewn up but the team was on the phone with the pathologists, who wanted to discuss whether they’d taken a big enough chunk of my leg.
我的伤口被整齐地缝合，但团队正在与病理学家通电话，他们想讨论他们是否截取了我腿上足够大的一块。
Pleasantly high and feeling fantastic, I assured everyone it was fine if they wanted to go back and get more.
我很高兴，感觉棒极了，我向每个人保证，如果他们想回去获得更多，那就没问题了。
You know — While we’re here, happy to oblige.
你知道的——当我们在这里时，我们很乐意效劳。
They decided against it, and off I went to recovery.
他们决定不这样做，然后我就开始康复了。
It was the nicest feeling I’d had in weeks.
这是我几周以来最美妙的感觉。
I looked at my hands and I could believe the old familiar wrinkles were coming back.
我看着我的手，我相信那些熟悉的皱纹又回来了。
Later on, it felt as if someone had sliced open my thigh, since they had — an additional stabbing pain tucked inside the usual burning pain when I used my quadriceps.
后来，感觉好像有人切开了我的大腿，因为当我使用股四头肌时，通常的灼痛中隐藏着额外的刺痛。
But that was tolerable.
但这是可以忍受的。
I was finished with being a test subject.
我已经不再是一个测试对象了。
All the possible diagnoses pointed to the same treatment, anyway, so the next morning, I got a syringe of steroids pushed into my IV, chased with a cold squirt of saline to make sure every drop went through.
无论如何，所有可能的诊断都指向相同的治疗，所以第二天早上，我将一针类固醇注射器推入我的静脉注射，并用冷的盐水喷射以确保每一滴都通过。
I was a patient, trying to get well.
我是一名病人，正在努力康复。
Within hours, maybe, my thigh muscles seemed a little less dead than before.
也许几个小时之内，我的大腿肌肉似乎比以前不再那么死气沉沉了。
That afternoon, I limped off to the bathroom, pulled the shower chair out of the shower, and sat down to make a job interview call, away from any beeping machines or doctor visits.
那天下午，我一瘸一拐地走进浴室，把淋浴椅从淋浴间拉出来，坐下来打电话去面试，远离任何蜂鸣声的机器或医生的就诊。
At least it wasn’t a Zoom.
至少它不是 Zoom。
Out the window, I could see magenta and gold in the tree canopy of Central Park.
窗外，我可以看到中央公园树冠上的洋红色和金色。
It was deep enough into October for that now.
现在已经是十月了。
My creatine kinase dropped from 6,200 to 4,500 overnight, then headed for the 3,000s, a level a person could go home with.
我的肌酸激酶一夜之间从 6,200 下降到 4,500，然后又跌至 3,000，这是一个人可以回家的水平。
Whatever had made my immune system start tearing up my muscles, the steroids seemed to be making it slow down.
无论是什么让我的免疫系统开始撕裂我的肌肉，类固醇似乎都让它减慢了速度。
That’s what they were: immunosuppressive drugs, to be followed over time by other, different immunosuppressives.
这就是它们的本质：免疫抑制药物，随着时间的推移，其他不同的免疫抑制剂也会随之而来。
If all went well, I would trade being an actively sick person for being an immunocompromised one.
如果一切顺利，我会放弃成为一名活跃的病人，而成为一名免疫功能低下的人。
The blue-gloved muscle checks resumed.
蓝色手套的肌肉检查继续进行。
Oh, yes: Much stronger in the legs.
哦，是的：腿部更加强壮。
I took a lap around the ward.
我绕着病房转了一圈。
I spent less time in bed and more in a chair.
我在床上的时间减少了，在椅子上的时间增加了。
I booked another job call with maybe some steroids-laced overconfidence.
我又预约了一次工作电话，也许是因为类固醇的过度自信。
My wife, with a counteroffer from her current employer in hand, turned down the southern school.
我的妻子拿着现任雇主的还价，拒绝了南方学校。
Normal life, or whatever would stand in for normal, was calling.
正常的生活，或者任何可以代替正常的东西，正在召唤着我。
On my 15th day, with the pathology report on my leg sample still a work in progress, the last sparkling dregs of a fat bottle of immunoglobulin filtered into my veins.
在我的第 15 天，我的腿部样本的病理报告仍在进行中，一大瓶免疫球蛋白的最后闪闪发光的残渣渗入了我的静脉。
The two-day infusion was the final piece of treatment that had required hospital care.
为期两天的输液是需要住院治疗的最后一项治疗。
I was free to go.
我可以自由地走了。
When the IV came out of my arm, I dug out my things from the closet and got dressed.
当静脉注射从我的手臂中拔出来时，我从壁橱里翻出我的东西并穿好衣服。
Clean pants and a clean T-shirt over my poorly cleaned body.
干净的裤子和干净的T恤罩在我干净得不太干净的身体上。
My eyes in the mirror were sunken, my neck withered.
镜子里的我眼睛凹陷，脖子枯萎。
Nonstop mask wearing had scraped the bridge of my nose raw, and my ratty stubble was now a full ratty Vandyke, the chin shot through with gray.
不停地戴口罩把我的鼻梁刮破了，我那破烂的胡茬现在变成了一个完整的破烂的范戴克，下巴变成了灰色。
I peeled off my last pair of grimy yellow nonslip socks and wrestled my way into my own regular socks.
我脱下最后一双脏兮兮的黄色防滑袜，穿上自己的普通袜子。
Now the shoes.
现在是鞋子。
I’d been imagining how this would feel for days.
几天来我一直在想象这会是什么感觉。
I reached into the hospital bag for my canvas sneakers and pulled them out.
我把手伸进医院的袋子里，拿出我的帆布运动鞋，然后把它们拉了出来。
They were mashed out of shape and …
它们被捣碎变形了……
damp to the touch?
摸起来潮湿吗？
Damp to the touch.
摸起来潮湿。
Had something spilled into the bag, somehow, or was it just residual sweat?
是不是有什么东西掉进包里了，或者只是残留的汗水？
Either way, they had been sealed in plastic with it for two weeks.
不管怎样，它们已经用塑料密封了两周。
Flecks of mold had sprung up on the otherwise new-looking insoles.
本来看起来很新的鞋垫上已经长满了霉菌。
There was nothing to do but wear them.
除了穿上它们，别无他法。
I would be taking myself home.
我会带自己回家。
The hospital had sent my prescriptions to the nearest pharmacy for me to pick up on my way out.
医院已将我的处方发送到最近的药房，以便我在出门时领取。
A string of robocalls and human calls then informed me that the branch did not, in fact, have all the meds I needed, specifically the steroids.
然后一连串的自动呼叫和人工呼叫告诉我，该分行实际上没有我需要的所有药物，特别是类固醇。
My wife headed across town to another location, where the computer indicated there were enough steroid pills to last me three days.
我的妻子穿过城镇去了另一个地方，电脑显示那里有足够我三天用的类固醇药。
The nurse who’d unplugged me reappeared with a sheaf of papers: I was discharged.
拔掉我电源的护士再次出现，手里拿着一叠文件：我已经出院了。
No final consultation with any of the doctors.
没有与任何医生进行最终咨询。
The nurse asked if I wanted a wheelchair.
护士问我是否需要轮椅。
I figured I might as well start walking.
我想我不妨开始步行。
By the time I reached the ground floor of the hospital with my bags, I understood that had been a mistake.
当我带着行李到达医院一楼时，我意识到这是一个错误。
My room had been on the west side of the building; the pharmacy was on the east, an entire avenue over.
我的房间位于大楼的西侧；药店在东边，隔了一整条大街。
I walked a few yards down the vast hallway, paused for a stricken moment, then walked a few more.
我沿着宽阔的走廊走了几码，停顿了一下，然后又走了几步。
I couldn’t wipe out again.
我无法再次抹去。
Stopping and going, I made it to the east side of the building, down a short flight of steps, and out.
我走走停停，走到了大楼的东侧，下了一小段台阶，然后出去了。
Numbly, I trudged up the sidewalk in the quickly fading twilight, clutching my papers.
在迅速消逝的暮色中，我手抓着证件，麻木地走在人行道上。
It dawned on me that I still didn’t have a diagnosis.
我突然意识到我还没有得到诊断。
I despise those stories where a writer tells you all about some mystery for thousands of words and then fails to deliver the solution.
我鄙视那些作家用数千字向你讲述一些谜团却无法提供解决方案的故事。
Usually with some metaphysical vamping about the unknowability of all things.
通常带有一些关于所有事物的不可知性的形而上学的迷惑。
What are you even telling anyone about it for?
你为什么要告诉别人这件事？
But I didn’t have an answer, and I still don’t.
但我没有答案，现在仍然没有。
It would be more than another week before the pathology report came back.
又过了一个多星期，病理报告才回来。
My muscles, it said, showed “myopathy with scattered necrotic myofibers in the absence of significant lymphocytic inflammatory infiltrates.” I couldn’t raise a doctor on the phone to talk about it.
报告称，我的肌肉表现出“肌病，伴有散在的坏死肌纤维，但没有明显的淋巴细胞炎症浸润。”我无法通过电话与医生谈论此事。
Whoever wrote the report had floated a whole new possibility, “antisynthetase syndrome,” to go with the other possibilities still bobbing around.
无论谁写了这份报告，都提出了一种全新的可能性，即“抗合成酶综合症”，与其他仍然存在的可能性相伴。
The hospital rheumatologists, weeks later, would stick with polymyositis; a different myositis expert would propose “immune-mediated necrotizing myopathy.” A neurologist would suggest “lupus-myositis overlap syndrome.”
几周后，医院的风湿病专家坚持认为是多发性肌炎。另一位肌炎专家会提出“免疫介导的坏死性肌病”。神经科医生会建议“狼疮肌炎重叠综合征”。
Medicine hasn’t really solved for the body attacking itself.
医学还没有真正解决身体攻击自身的问题。
Since the inflammation first brought me to the rheumatologist months before, I’d been quietly bracing for an answer that wouldn’t feel like an answer.
自从几个月前炎症第一次让我去看风湿病专家以来，我一直在默默地等待一个感觉不像答案的答案。
An authoritative-sounding name like scleroderma would come up, and Googling would fill in non-detail details like “no cure” and “symptoms vary” and “don’t know exactly what causes this process to begin.” The thing that had taken me apart was something rare and diffuse, its effects almost certainly melded with those of the coronavirus.
一个听起来很权威的名字，比如硬皮病，就会出现，谷歌搜索会填写一些非细节的细节，比如“无法治愈”、“症状各不相同”和“不知道到底是什么导致这个过程开始”。让我崩溃的是一种罕见且分散的东西，它的影响几乎肯定与冠状病毒的影响融合在一起。
I was on my own with it.
我只能靠自己了。
I was three weeks behind on a freelance editing gig, and November’s bills were cycling into view.
我的自由编辑工作落后了三周，十一月的账单又开始出现在我的视野中。
In January, an endocrinologist had an opening to see about my thyroid.
一月份，一位内分泌科医生有空来检查我的甲状腺。
The pharmacy window was, as pharmacy windows are, all the way at the back of the store.
药房橱窗和药房橱窗一样，一直位于商店的后面。
An incredible distance.
令人难以置信的距离。
A terrifying distance, alone on my shaky legs.
可怕的距离，我独自一人颤抖着双腿。
I put out a hand to steady myself against the shelves along the way, and waiting in line I just grabbed on.
一路上我伸出一只手靠在架子上稳定自己，在排队等候时我只是抓住了它。
I said my name to the pharmacist as clearly as my cracked voice could muster, got the pills, and retraced the long path to the door.
我用嘶哑的声音尽可能清楚地向药剂师喊出了我的名字，拿到了药片，然后沿着漫长的路回到了门口。
It was fully night now.
现在已经是晚上了。
As I stepped outside the pharmacy vestibule, I saw an empty taxi coming up the block, preparing to turn the corner.
当我走出药房门厅时，我看到一辆空出租车从街区驶来，准备拐过街角。
Memory and instinct said it was mine: Two or three long, quick strides to the curb and a sharply upthrust hand would catch the driver’s eye.
记忆和直觉告诉我，那是我的：两三步快速地大步走到路边，一只猛烈向上的手就会引起司机的注意。
My body knew otherwise.
我的身体知道情况并非如此。
I ventured a short step, not even to the middle of the sidewalk, and the taxi went on by my half-raised arm.
我冒险迈出了一小步，甚至没有走到人行道的中间，出租车就在我半举起的手臂上继续前行。