523: Death and Taxes - This American Life
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00:00 00:00 Transcript Share This American Life Life Partners How to Listen Episodes Recommended About Overview Staff Announcements Fellowships Jobs Music Make Radio On The Road FAQ Submissions Merch Contact Us Our Other Shows Merch Follow Us Life Partners Subscribe to our newsletter Full episode Toggle Audio and Transcript Sync Transcript | Episode #523 | March 25, 2022 523: Death and Taxes Note: This American Life is produced for the ear and designed to be heard.
00:00 00:00 文字记录 分享此 美国生活 生活伙伴 如何收听 剧集 推荐 关于 概述 员工公告 奖学金 工作 音乐 在路上制作电台 常见问题解答 提交 商品 联系我们 我们的其他节目 商品 关注我们 生活伙伴 订阅我们的时事通讯 整集 切换音频和文字记录同步 文字记录 | 内容第 523 集 | 2022 年 3 月 25 日 523：死亡和税收 注：《美国生活》是为耳朵而制作的，旨在让人们听到。
If you are able, we strongly encourage you to listen to the audio, which includes emotion and emphasis that's not on the page.
如果可以的话，我们强烈建议您收听音频，其中包括页面上没有的情感和重点。
Transcripts are generated using a combination of speech recognition software and human transcribers, and may contain errors.
文字记录是使用语音识别软件和人工转录员结合生成的，可能包含错误。
Please check the corresponding audio before quoting in print.
请在印刷版引用前检查相应的音频。
Prologue Ira Glass In Janah Boccio's Health and Human Relations class, they're studying puberty now.
序言 Ira Glass 在 Janah Boccio 的健康与人际关系课上，他们现在正在研究青春期。
And for the entire period, the sixth-grade boys are a squirming, moving, fidgeting, chatty mess.
在整个时期，六年级的男孩们都在蠕动、移动、坐立不安、喋喋不休。
[STUDENTS LAUGHING] And can I say, as they get deeper into the material, they do not seem to see much of an upside to puberty at all, anywhere.
[学生笑]我可以说，当他们更深入地了解这些材料时，他们似乎根本没有看到青春期在任何地方都有什么好处。
When they notice that one of the books uses the word "enjoyable" to describe sex, one boy declares...
当他们注意到其中一本书使用“令人愉快”这个词来描述性时，一个男孩宣称……
Why are you saying that?
你为什么这么说？
Student Because it's disgusting.
学生 因为这很恶心。
And when Miss Boccio asked the boys if they're looking forward to any part of puberty--
当博西奥小姐问男孩们是否期待青春期的任何阶段时——
OK.
好的。
Student A lot of things are growing.
学生 很多东西都在成长。
So is there anything that you're not looking forward to?
那么还有什么是你不期待的吗？
Yeah-- Student I'm not looking forward to pubic hair.
是的——学生，我不期待阴毛。
What else are you not looking forward to?
还有什么是你不期待的呢？
Sweating more, a lot more.
出汗更多，更多。
Student Chest hair.
学生胸毛。
Chest hair.
胸毛。
Chest hair.
胸毛。
Student Sweating like a moose.
学生像驼鹿一样出汗。
You're going to smell more bad.
你的气味会更难闻。
You're going to sweat.
你会出汗的。
Your shirt is going to get all sweaty.
你的衬衫会被汗湿透的。
It's going to get worse.
情况会变得更糟。
Yeah, because when I was younger, it didn't smell like this.
是的，因为我年轻的时候，没有这个味道。
I know, it smelled nice.
我知道，味道很好闻。
You smelled better.
你闻起来更好了。
Now, you smell bad.
现在，你闻起来很难闻。
They said that shaving seems like it's going to be a drag, which, by the way, good call, kids.
他们说刮胡子似乎会很麻烦，顺便说一句，孩子们，这是个好主意。
Several boys squealed that the illustration of pubic hair in the book looked like burnt macaroni and cheese.
几个男孩尖叫着书中阴毛的插图看起来像烧焦的通心粉和奶酪。
Near the end of class, one of the kids, Jack, told me that part of what's so freaky is that you just don't know when puberty is going to strike you.
Near the end of class, one of the kids, Jack, told me that part of what's so freaky is that you just don't know when puberty is going to strike you.
It's scary because it's not like a set date and time.
这很可怕，因为它不像一个固定的日期和时间。
It can happen when you're 8 or happen when you're 16.
它可能发生在你 8 岁时，也可能发生在你 16 岁时。
So you're not 100% prepared.
所以你还没有100%准备好。
It's like a mysterious monster.
它就像一个神秘的怪物。
You know it's going to get you.
你知道它会抓住你。
So it's like, you know that there's this thing that's coming to get you.
所以这就像是，你知道有这个东西会来抓你。
You don't know when it's going to be, and you're going to be totally different on the other side of it.
你不知道什么时候会发生，而到了另一边你就会完全不同。
On the opposite end of the country, in Northern California, 10-year-old Paris was at a similar class, a class about puberty for moms and girls.
在美国的另一端，也就是加利福尼亚州北部，10 岁的帕丽斯也在参加一个类似的课程，这是一门为妈妈和女孩开设的关于青春期的课程。
And she described the approaching monster in different terms that got across pretty much the same idea.
她用不同的术语描述了正在逼近的怪物，但表达了几乎相同的想法。
It's a little scary, almost.
差不多了，有点吓人。
I guess it's a little like on the edge of a cliff.
我想这有点像在悬崖边缘。
Like, there's a really good movie coming out, and you're just about to see it.
就像，有一部非常好的电影要上映了，你正要去看它。
But people say that it can be either bad or good, and you're not really sure which.
但人们说这可能是坏事，也可能是好事，但你并不确定是哪一个。
Paris told the reporter that she talked to, Marianne McCune, that she was one of the first ones in her class to hit puberty, which of course is not fun.
Paris told the reporter that she talked to, Marianne McCune, that she was one of the first ones in her class to hit puberty, which of course is not fun.
Like most kids, I think, she did not like looking different from everybody else.
我想，像大多数孩子一样，她不喜欢看起来与其他人不同。
It's like, you don't want it to happen.
就像，你不希望它发生。
You want your body to stay the same.
你希望你的身体保持不变。
You don't want your body to look gross.
你不想让你的身体看起来很糟糕。
And so it's kind of gross being different.
所以与众不同是有点恶心的。
Yeah, I really didn't want to.
是的，我真的不想。
No, I didn't think there was going to be a way out.
不，我不认为会有出路。
I was hoping that there would be some type of medicine or something that I could take, and it would go away.
我希望有某种药物或某种我可以服用的东西，这样它就会消失。
But no, it didn't really work that way.
但不，事实并非如此。
A lot of kids feel this way.
很多孩子都有这样的感觉。
In these classes, they ask the teachers, why does this have to happen, and is there any way I can stay a kid?
在这些课堂上，他们问老师，为什么会发生这种事，有什么办法可以让我继续做个孩子吗？
It's crazy to be told you can't do anything about this.
被告知你对此无能为力，这太疯狂了。
It's coming.
它来了。
And when it happens, everything will be different.
当它发生时，一切都会不同。
How many things in our lives are like that?
我们的生活中有多少事情是这样的？
Well, today, on our show, we have stories of people dealing with the inevitable, trying to do their best, trying to stay themselves through these things that can be so confusing and potentially soul-crushing.
Well, today, on our show, we have stories of people dealing with the inevitable, trying to do their best, trying to stay themselves through these things that can be so confusing and potentially soul-crushing.
And we're not going to mess around today with little inevitable things in life, with traffic and relatives you don't like and what happens if you never brush your teeth.
And we're not going to mess around today with little inevitable things in life, with traffic and relatives you don't like and what happens if you never brush your teeth.
No, no, no. We're going to go with the big ones.
不，不，不。我们将与大公司一起去。
We're going to go with two inescapable things that are absolutely certain.
我们将面对两件绝对确定、不可避免的事情。
Act 1 of our show is about death.
我们节目的第一幕是关于死亡的。
Act 2 is about taxes.
第二幕是关于税收的。
These are two things that are unavoidable, that actually I think most of us don't know that much about.
这是不可避免的两件事，实际上我认为我们大多数人都不太了解。
And today we turn to people who know more than us.
今天，我们求助于那些比我们了解更多的人。
Prepare to be surprised at what they say.
准备好对他们所说的话感到惊讶吧。
From WBEZ Chicago, it's This American Life.
来自芝加哥 WBEZ 的《This American Life》。
I'm Ira Glass.
我是艾拉·格拉斯。
Stay with us.
留在我们身边。
Act 1, Death.
第一幕，死亡。
So we can only guess at what happens to us after we die, but we do not have to guess at what happens right before.
所以我们只能猜测我们死后会发生什么，但我们不必猜测死前会发生什么。
Though most of us remain ignorant until we arrive at that moment ourselves, Nancy Updike found a spot where she could understand all this better.
Though most of us remain ignorant until we arrive at that moment ourselves, Nancy Updike found a spot where she could understand all this better.
Here's Nancy.
这是南希。
Before I tell you where I went, let me tell you why I wanted to go.
在告诉你我去了哪里之前，让我先告诉你我为什么想去。
Four years ago, my mother's husband, Asa, was dying.
四年前，我母亲的丈夫亚撒快要死了。
She was taking care of him at home with help from a hospice.
她在临终关怀医院的帮助下在家照顾他。
And I went to be with her and him for the last 10 days of his life.
我去陪伴她和他度过了他生命的最后十天。
He was this tall, very funny man with beautiful manners who adored my mother.
他是一个身材高大、非常风趣、举止优美的人，非常崇拜我的母亲。
I felt clumsy and helpless all the time in those last days-- with Asa, with my mom.
在最后的日子里，我一直感到笨拙和无助——和阿萨在一起，和我妈妈一起。
I didn't know what to say to someone who's dying.
我不知道该对一个即将死去的人说什么。
I didn't know how to be.
我不知道该怎么办。
I'm sure that's true for lots of people.
我相信对很多人来说都是如此。
I remember checking in on Asa one afternoon and asking him if he needed anything.
我记得有一天下午去看望了阿萨，问他是否需要什么。
He looked at me and said, I need everything.
他看着我说，我需要一切。
We both laughed.
我们都笑了。
That was the closest I ever got to talking with him about what was happening.
那是我与他最接近地谈论所发生的事情。
There were people around who did know what to do, though-- the nurses.
不过，周围有人确实知道该怎么做——护士。
I watched them from my stupor of awkwardness.
我从尴尬的呆滞中看着他们。
They never brought any false cheer into the room with Asa, which is hard not to do with a dying person.
他们从来没有给亚撒的房间带来任何虚假的欢乐，这对于一个垂死的人来说很难不这样做。
They were direct.
他们很直接。
When Jackie, the weekend day nurse, left the Sunday before Asa died, she said to him, is it OK if I kiss your hand?
当周末日间护士杰基在阿萨去世前的那个周日离开时，她对他说，我可以吻你的手吗？
And then she said, God willing, I'll see you next week.
然后她说，上帝保佑，我们下周见。
The nurses knew how to deal with us, the rest of the family, too.
护士们也知道如何与我们以及家庭其他成员打交道。
One of the nurses, Jenny, got me cleaning out the fridge one morning.
一天早上，其中一位护士珍妮让我清理冰箱。
We did it together for an hour and a half, just talking, passing the time.
我们一起做了一个半小时，只是聊天，打发时间。
It wasn't until later that I realized, oh, she did that for me, to give me something to do.
直到后来我才意识到，噢，她这么做是为了我，给我一些事情做。
It was a strange feeling to know I was that transparent to her.
知道我对她来说是那么透明，这种感觉很奇怪。
For the last hour of Asa's life, the people in the room were my mother, one of Asa's sons, Jenny, and me.
在阿萨生命的最后一个小时，房间里的人是我的母亲、阿萨的儿子珍妮和我。
We held Asa's hands.
我们握着阿萨的手。
Jenny was standing, and she sometimes touched Asa's head gently.
珍妮站着，时不时地轻轻抚摸阿萨的头。
She told him, it's all right.
她告诉他，没关系。
It's OK.
没关系。
Your family is OK.
你的家人都还好。
Everyone is all right.
大家都没事。
Asa's eyes were open.
阿萨的眼睛睁开了。
They'd been that way all day.
他们一整天都是这样。
He was staring up and to the right, over our heads.
他的目光在我们头顶上方向右上方凝视。
He didn't see us.
他没有看到我们。
He moaned every once in a while, and we spoke to him when he moaned.
他每隔一段时间就会呻吟一次，当他呻吟时我们就跟他说话。
The four of us watched his breathing slow down and get shallower until he was taking just sips of air.
我们四个人看着他的呼吸减慢、变浅，直到他只吸了一口空气。
When he was very close to the end, Jenny brought over a glass of water and a little dropper that we'd been using to moisten Asa's mouth.
当他快要结束时，珍妮端来了一杯水和一个小滴管，我们一直用它来润湿阿萨的嘴。
And she told us each to take the dropper and give him some water and say our names close to his ear so that he would know who was giving him each bit of water.
And she told us each to take the dropper and give him some water and say our names close to his ear so that he would know who was giving him each bit of water.
As a ritual, it felt comforting and sad and vaguely religious.
作为一种仪式，它给人一种安慰、悲伤和隐约的宗教色彩。
And Asa's son and I were both crying.
我和亚撒的儿子都哭了。
I had no idea how badly we'd needed a ritual at that moment until Jenny gave us one.
我不知道我们当时多么需要一个仪式，直到珍妮给了我们一个仪式。
I had never seen the kind of expertise these nurses had.
我从未见过这些护士拥有如此专业的知识。
They knew death.
他们知道死亡。
They seemed to understand it, whereas I-- even though I had just watched someone fade away and die right in front of me, all I could think was, what just happened?
They seemed to understand it, whereas I-- even though I had just watched someone fade away and die right in front of me, all I could think was, what just happened?
But I didn't realize how much of a hold all of this had on me still until I heard a stranger talking a few months ago about how his mother is a nurse who works in a hospice facility, seeing people die almost every day.
But I didn't realize how much of a hold all of this had on me still until I heard a stranger talking a few months ago about how his mother is a nurse who works in a hospice facility, seeing people die almost every day.
And then he went on to say that after his mother had worked there for a few months, she forgot the president's name.
然后他接着说，他母亲在那里工作了几个月后，她忘记了总统的名字。
And when she mentioned that to her boss, her boss said, yeah, that happens.
当她向老板提到这一点时，她的老板说，是的，确实会发生这种情况。
That's normal here.
这在这里很正常。
Your brain is blocking out a lot of what you're seeing, and some other stuff is getting blocked, too.
你的大脑挡住了你所看到的很多东西，其他一些东西也被挡住了。
My first thought was, my god, of course.
我的第一个想法是，天哪，当然。
They're experts, not robots.
他们是专家，而不是机器人。
My second thought was, I need to go to this place and talk to these people.
我的第二个想法是，我需要去这个地方和这些人交谈。
Oop, this guy wants to pass me.
哎呀，这家伙想超越我。
Usually, nobody ever passes me.
通常，没有人会超过我。
I'm on my best behavior with you in the car.
我在车里对你表现得最好。
[LAUGHS]
[笑]
So this is Pattie Burnham.
这是帕蒂·伯纳姆。
She's the one who forgot the president's name.
她就是忘记总统名字的人。
That was five years ago, though.
不过那是五年前的事了。
She's on top of it now.
她现在正处于巅峰。
It's Barack Obama, by the way.
顺便说一下，这是巴拉克·奥巴马。
Pattie is a registered nurse, and the place she works is an inpatient hospice about 30 minutes north of Boston called the Kaplan Family Hospice House.
帕蒂是一名注册护士，她工作的地方是一家住院临终关怀医院，位于波士顿以北约 30 分钟路程处，名为卡普兰家庭临终关怀之家。
We're driving there now.
我们现在正开车去那里。
Pattie's got a double shift today.
帕蒂今天有两班倒。
I told her my whole backstory so she knows why I'm here.
我告诉了她我的整个背景故事，这样她就知道我为什么在这里。
Pattie is 5'8", blonde, full of energy, even though it's 6:00 AM.
Pattie 身高 5 英尺 8 英寸，金发碧眼，尽管现在是早上 6:00，但仍充满活力。
She's lived in this part of Massachusetts her whole life, worked at a hospital, then as a nurse at her kids' school.
她一生都住在马萨诸塞州的这个地区，在一家医院工作，然后在孩子的学校担任护士。
And then when they graduated, she was looking for another job, and she went to the Kaplan House.
当他们毕业时，她正在寻找另一份工作，她去了卡普兰之家。
I pulled into the parking lot and thought, wow, this place is beautiful.
我把车开进停车场，心想，哇，这个地方真漂亮。
And then I noticed, off to the left, there's sort of a back entrance, a garage entrance.
然后我注意到，在左边，有一个后门，一个车库入口。
And there were two funeral-home cars pulled up there waiting.
两辆殡仪馆的车停在那里等候。
And I just sat in the parking lot, staring at the house and staring at the cars and wondering what could possibly be going on in that building.
我只是坐在停车场，盯着房子，盯着汽车，想知道那栋楼里可能发生了什么。
Hospice can mean a building, like Kaplan, or home care, like Asa had.
临终关怀可以指一座建筑，比如卡普兰，也可以指家庭护理，比如阿萨。
They both mean the same thing.
它们的意思是一样的。
The patient is not looking to be cured.
病人并不希望被治愈。
It's palliative care for people at the end of their life.
这是对生命尽头的人们的姑息治疗。
The Kaplan House actually is beautiful.
卡普兰之家实际上很漂亮。
All the rooms have big windows.
所有的房间都有大窗户。
The lobby and main common area have vaulted ceilings and skylights.
大堂和主要公共区域设有拱形天花板和天窗。
Nothing is covered in plastic.
没有任何东西被塑料覆盖。
I overheard one family member of a patient say, the thing I like about this place is, there isn't a phony plant in here.
我无意中听到一位病人的家属说，我喜欢这个地方的一点是，这里没有假植物。
All the flowers are real.
所有的花都是真的。
There's a big kitchen for any patients who can still eat.
有一个大厨房供任何还能吃饭的病人使用。
Pattie speed-walks by.
帕蒂快步走过。
I need a fruit cup for room 4, please and thank you.
我需要 4 号房间的水果杯，谢谢。
This is not just a place for rich people with private insurance.
这不仅仅是拥有私人保险的富人的地方。
Lots of patients are on Medicare or Medicaid.
许多患者正在享受医疗保险或医疗补助。
Kaplan House is run by a nonprofit called Care Dimensions, and the bulk of what they do is home care.
Kaplan House 由一家名为 Care Dimensions 的非营利组织运营，他们所做的大部分工作是家庭护理。
Kaplan House has rooms for just 20 patients.
Kaplan House 的房间仅可容纳 20 名患者。
And it's not full today, but Pattie is busy.
今天还没有满员，但帕蒂很忙。
She rushes between rooms and then slows down as soon as she steps inside one.
她在房间之间奔跑，一踏进其中就放慢了速度。
Yes.
是的。
Nancy Updike Pattie is talking to Crystal, the daughter of a 51-year-old woman named Lori who came to Kaplan House a few hours ago.
南希·厄普代克·帕蒂 (Nancy Updike Pattie) 正在与克里斯托 (Crystal) 交谈，克里斯托是一位名叫洛丽 (Lori) 的 51 岁妇女的女儿，她几个小时前来到了卡普兰之家 (Kaplan House)。
She has lung cancer.
她患有肺癌。
It's metastasized to her brain.
它已转移到她的大脑。
Lori is delirious, making sounds but not speaking much anymore.
洛瑞神志不清，发出声音，但不再说话。
Her family has been taking care of her at home.
她的家人一直在家照顾她。
They tell Pattie that Lori always liked to look good.
他们告诉帕蒂，洛瑞总是喜欢看起来漂亮。
She has a perfect red manicure and pedicure.
她有完美的红色美甲和足疗。
Yeah, you've been taking beautiful care of her.
是的，你一直把她照顾得很好。
She looks beautiful.
她看起来很漂亮。
[SNIFFLES] Pattie Burnham If you want to chat about anything, if you have any questions about the medications or what's going on--
[抽鼻子] Pattie Burnham 如果您想聊任何事情，如果您对药物或正在发生的事情有任何疑问 -
Yeah.
是的。
Pattie Burnham --we can step outside.
帕蒂·伯纳姆——我们可以出去了。
And you might not have any questions now, but they might come up.
您现在可能没有任何问题，但它们可能会出现。
The questions do come up.
问题确实出现了。
Crystal comes and finds Pattie, and she does something I remember doing.
克里斯托来找到帕蒂，她做了我记得做过的事。
Crystal starts out asking about one small, specific thing to try and get a handle on what's happening.
克里斯托首先询问一件小而具体的事情，试图了解正在发生的事情。
She wants to know, what is the tube that's on her mother's face right under her nose?
她想知道，她妈妈脸上鼻子下面的管子是什么？
She asks so quietly it's hard to hear.
她问得那么小声，很难听清。
But she says, what's that thing on her nose?
但她说，她鼻子上的东西是什么？
She smells like bleach.
她闻起来像漂白剂。
What's that thing on her nose?
她鼻子上那个东西是什么？
She smells like bleach.
她闻起来像漂白剂。
This question-- basically, what is that thing on my mother's face that is making her look and smell like she's not my mother?
这个问题——基本上，我母亲脸上的那个东西让她看起来和闻起来都不像我母亲？
That's just the first in a giant, unsorted pile of questions about what's happening and why, and what am I supposed to be doing and feeling?
这只是一大堆未分类的问题中的第一个，这些问题涉及正在发生的事情和原因，以及我应该做什么和感受什么？
Crystal says some of the family and friends in the room have been saying that no one should touch Lori.
克里斯托说，房间里的一些家人和朋友一直在说，任何人都不应该碰洛瑞。
You can touch her.
你可以触摸她。
Nancy Updike From there, she tells Pattie, in one long, crying sentence, that people in the room have been telling her mother that it's OK to let go.
南希·厄普代克（Nancy Updike）从那里开始，她用一个长长的、哭泣的句子告诉帕蒂，房间里的人一直在告诉她的母亲，放手是可以的。
And one of the times someone said it, her mother all of a sudden said, no. And what does that mean, since she's delirious?
有一次有人这么说，她妈妈突然说，不。既然她神志不清，这意味着什么？
And should I be saying it's OK for her to let go?
我应该说她可以放手吗？
In some ways, I wish she would let go so she wouldn't suffer anymore, but I feel weird even thinking that.
在某些方面，我希望她能放手，这样她就不会再受苦了，但即使这样想我也觉得很奇怪。
And my mom has gotten close to the end like this a few times before, and then she's come back.
我妈妈以前也有过几次这样接近结局，然后她又回来了。
And maybe that's what's happening.
也许这就是正在发生的事情。
And some people in the room are saying you guys are drugging her so that she'll die faster.
房间里的一些人说你们给她下了药，这样她就会死得更快。
And I don't know about any of this.
我对这些一无所知。
I don't know.
我不知道。
Pattie listens to the whole thing and then jumps in.
帕蒂听完了整个事情，然后插了进来。
So a lot of people, Crystal, ask these questions.
所以很多人，水晶，问这些问题。
We are not drugging her to put her to sleep.
我们不会给她下药让她入睡。
I wouldn't do this job if that was the case.
如果是这样的话我就不会做这份工作。
Your mom, I'm sorry to say, is dying.
我很遗憾地说，你妈妈快要死了。
She has started her dying process.
她已经开始了她的死亡过程。
This is what-- everything you're seeing is part of the dying process.
这就是——你所看到的一切都是死亡过程的一部分。
Because I know they keep saying, she's going to die.
因为我知道他们一直在说，她就要死了。
And she's done this, like, three or four times and got through it.
她已经这样做过三四次了，并且都成功了。
And I'm just wondering what--
我只是想知道什么——
So the things I'm seeing that makes me think that it's this time-- this is the time-- is her heart is beating really, really fast and just fluttering.
所以我所看到的事情让我觉得这一次——这一次——她的心脏跳动得非常非常快，而且扑通扑通。
You can't feel a good, strong pulse out here.
你在这里感觉不到良好、强劲的脉搏。
Her legs and her hands are cold.
她的腿和手都很冷。
Her feet-- it's showing a telltale sign that we see called mottling, where the feet and the knees get dappled, like little purplish marks.
她的脚上出现了一个明显的迹象，我们称之为斑点，脚和膝盖上有斑点，就像紫色的小痕迹。
And it just means her body is conserving all her blood to be around here.
这只是意味着她的身体正在保存所有的血液留在这里。
I would bet my nursing license that your mother is not going to turn around from this.
我敢用我的护士执照打赌，你妈妈不会因此而改变主意。
But if her body is meant to turn around, I'm not giving her anything that won't allow her to turn around.
但如果她的身体注定要回转，我不会给她任何不允许她回转的东西。
Does that make sense to you?
这对你来说有意义吗？
Yeah.
是的。
Nancy Updike I remember standing with my mother and one of Asa's nurses in the kitchen and having this conversation, the this-is-it conversation.
南希·厄普代克 我记得我和我的母亲以及阿萨的一位护士站在厨房里进行了这样的对话，就是这样的对话。
There are so many stages to a long decline-- dips and resurgences and good days.
长期衰退有很多阶段——低谷、复苏和好日子。
And you know-- you know it's all the same thing.
你知道——你知道这都是同一件事。
It's all dying.
一切都快要死了。
But there's a huge difference between dying and the very last part of dying, what Pattie and the other nurses call actively dying, a process that can take hours or even days.
但死亡和死亡的最后阶段之间存在巨大差异，帕蒂和其他护士称之为主动死亡，这个过程可能需要几个小时甚至几天。
But it's different from what comes before.
但与之前的情况不同。
And being familiar with one doesn't mean you'll recognize the other.
熟悉一个并不意味着你会认出另一个。
I talked to Pattie later, and I asked her how she knows when someone is actively dying.
后来我和帕蒂谈过，我问她怎么知道有人正在濒临死亡。
How does she know it so well that she would say, I'd bet my nursing license that this is what's happening?
她怎么知道得这么清楚，以至于她会说，我敢用我的护士执照打赌，这就是发生的事情？
I don't always feel that way.
我并不总是有这样的感觉。
Yeah.
是的。
It's a weird thing, because when I came to work at the Kaplan House-- and I was a registered nurse and had worked as a nurse for a while-- I followed another nurse, Jeannette, for a month.
这是一件奇怪的事情，因为当我来到卡普兰之家工作时——我是一名注册护士，并且已经当过一段时间的护士——我跟随另一位护士珍妮特一个月。
And I was floored by the whole dying process, because it was nothing that I had learned.
整个死亡过程让我感到震惊，因为我没有学到任何东西。
And I saw Jeanette say to a family-- she woke them up and said, he's dying.
我看到珍妮特对一个家庭说——她叫醒他们说，他快死了。
He's dying right now.
他现在快死了。
And the man had been there-- the patient had been there for a week.
那个人已经在那里——病人已经在那里呆了一个星期了。
And I didn't know what was different.
我不知道有什么不同。
I didn't know what she saw that was different.
我不知道她看到了什么不同。
And when I asked her to explain it to me and to teach it to me, she said, you'll know.
当我请她向我解释并教我时，她说，你就会知道。
You just need about a month here, and you'll know.
你只需要在这里呆一个月，你就会知道。
I talked to a palliative-care doctor who told me that the most important thing she got better at with experience was looking for openings that allow you to be helpful-- little windows, little moments.
我和一位姑息治疗医生交谈过，她告诉我，随着经验的积累，她最擅长的事情就是寻找可以提供帮助的机会——小窗口，小时刻。
With hospice, part of that is trying to help people take in, bit by bit, the realness of what's happening.
对于临终关怀来说，其中一部分就是试图帮助人们一点一点地了解正在发生的事情的真实性。
Some dying people, no surprise, are not at all OK with the fact that they're dying.
毫不奇怪，一些垂死的人对自己即将死去的事实感到非常不安。
And they don't often get a chance to just say so.
而且他们通常没有机会直接这么说。
I saw a home-care nurse talking to a man, a former math teacher in his 60s.
我看到一名家庭护理护士正在与一名 60 多岁的男子交谈，他曾是一名数学老师。
She was talking about antidepressants, asking him whether he was depressed.
她正在谈论抗抑郁药，问他是否患有抑郁症。
He thought about it, and he said, well, I'm not "jump out the window" depressed, more like, what the fuck happened?
他想了想，然后说，好吧，我并不是郁闷地“跳出窗外”，而是，他妈的到底发生了什么？
Asa was a courtly man.
亚撒是一位彬彬有礼的人。
I never heard him swear or even speak harshly in my life.
我一生中从未听过他发誓，甚至从未听过他说过粗话。
But I could tell how frustrated he was sometimes by the sheer logistics of being a dying person, the imposition of it.
但我能看出他有时对作为一个垂死之人的纯粹后勤工作感到多么沮丧，强加它。
Sometimes just the question, do you want this, seemed overwhelming.
有时，“你想要这个吗”这个问题似乎让人难以承受。
Dying is a constant series of judgment calls and decisions based on options that are very far from what anyone would want.
死亡是一系列持续不断的判断和决定，这些判断和决定基于与任何人想要的相去甚远的选择。
And one thing the nurses are experienced at is trying to make the best of those narrow options.
护士们所擅长的一件事就是努力充分利用这些狭窄的选择。
Joanne, it is no bother, first of all.
乔安妮，首先，这不麻烦。
And Christiana and I were going to do it together.
克里斯蒂安娜和我打算一起做这件事。
I would love to give you a shower before you head home.
我很乐意在你回家之前给你洗个澡。
Pattie is crouching next to a woman named Joanne, who's going home later today.
帕蒂蹲在一位名叫乔安妮的女士旁边，她今天晚些时候要回家。
She has lung cancer, and she's been getting hospice care at home.
她患有肺癌，一直在家接受临终关怀。
But her pain got worse, so she came to the Kaplan House for a few days of round-the-clock supervision while the doctors adjusted her pain medications.
但她的疼痛越来越严重，所以她来到卡普兰之家进行了几天的全天候监护，同时医生调整了她的止痛药物。
People sometimes come in and out of Kaplan House like this.
人们有时会像这样进出卡普兰之家。
They're dying, but they still have time left in their lives.
他们快要死了，但他们的生命还剩下时间。
And the staff tries to get their symptoms under control-- pain or vomiting or whatever it is-- so that they can do more with that time than just be sick.
工作人员试图控制他们的症状——疼痛或呕吐或其他什么——这样他们就可以利用这段时间做更多的事情，而不仅仅是生病。
This room smells bad.
这个房间气味难闻。
It's strong.
它很强。
Joanne hasn't been able to shower in a little while.
乔安妮已经有一段时间没能洗澡了。
She said she has a hard time doing it at home.
她说她在家里很难做到这一点。
She's tiny in the bed, barely looking up, talking almost inaudibly.
她在床上显得很小，几乎没有抬头，说话的声音几乎听不见。
But her strength of will is intact.
但她的意志力完好无损。
She knows the ambulance can't pick her up and take her home until later, but she wants to be home now, already.
她知道救护车要等一会儿才能接她回家，但她现在就想回家了。
And anything that isn't going home is something she doesn't want to do, even though, a couple of hours ago, she was glad when Pattie suggested a shower, because it's much easier to do here when two people can get on either side of her and steady her.
任何不回家的事情她都不想做，尽管几个小时前，当帕蒂建议洗澡时，她很高兴，因为在这里，当两个人可以站在她的两侧并稳定她时，这样做会容易得多。
I just feel like this is such a great opportunity, because it's so hard to do at home, and there's two of us here.
我只是觉得这是一个很好的机会，因为在家里很难做到这一点，而且这里有我们两个人。
Why can't I take a shower in my own shower?
为什么我不能在自己的淋浴间洗澡？
Do you do that regularly at home?
你在家经常这样做吗？
Or is it hard because you need two people?
或者因为需要两个人而很难？
Because you were telling me you don't feel that safe with the left side.
因为你告诉我你觉得左侧不太安全。
Yeah, but I do have-- what do you call it?
是的，但我确实有——你怎么称呼它？
I have that--
我有那个——
The bar that you hold onto and stuff, yeah.
你抓住的酒吧和东西，是的。
Want a back rub or--
想要按摩背部或者——
Yeah, maybe a neck rub.
是的，也许是擦脖子。
Pattie Burnham OK, OK.
帕蒂·伯纳姆 好吧，好吧。
Yeah, it helps with your pain.
是的，它有助于缓解你的疼痛。
We could put some lotion.
我们可以涂一些乳液。
Can we wash your back?
我们可以给你洗背吗？
Yeah.
是的。
Pattie Burnham Want to head into the bathroom?
帕蒂·伯纳姆 (Pattie Burnham) 想要去洗手间吗？
And you can sit on this in the bathroom.
您可以坐在浴室里。
OK, let's do that.
好吧，我们就这么做吧。
Maybe you can tell where Pattie is going with this.
也许你能看出帕蒂的去向。
I'd seen her taking care of Joanne and others all day, people clearly in the midst of some of the worst days of their lives-- afraid, in pain, sick of being sick.
我看到她整天照顾乔安妮和其他人，他们显然正处于一生中最糟糕的日子——害怕、痛苦、厌倦生病。
And it takes serious skills to be able to nudge somebody in that situation toward a thing that they don't think they want but are very glad when they get it.
在这种情况下，能够推动某人去做他们认为自己不想要的事情，但当他们得到它时却非常高兴，这需要严肃的技巧。
Can we take your pants down so she can get your backside?
我们可以把你的裤子脱下来，这样她就可以摸你的屁股了吗？
All right, is that a comfortable position for you?
好吧，这对你来说舒服吗？
Joanne, you do know we're getting pretty close to a shower.
乔安妮，你知道我们马上就要下阵雨了。
Yeah.
是的。
Pattie Burnham You sure you don't-- look at how--
帕蒂·伯纳姆（Pattie Burnham）你确定你不——看看如何——
Go ahead.
继续吧。
Pattie Burnham Go ahead.
帕蒂·伯纳姆 继续吧。
Whoo-hoo!
呼呼！
Whoo-hoo!
呼呼！
Joanne's husband, Larry, had been sitting quietly in the room this whole time.
乔安妮的丈夫拉里一直安静地坐在房间里。
He had agreed that a shower was a good idea, but he didn't want to push Joanne on it.
他同意洗澡是个好主意，但他不想强迫乔安妮这么做。
And then he seemed happy when she decided to do it.
当她决定这样做时，他似乎很高兴。
Once she was in, both he and Joanne relaxed a bit.
她进来后，他和乔安安都放松了一些。
Joanne joked around with Pattie in the shower, and Larry got up to leave and go home to get the house ready for when Joanne got back.
乔安妮在淋浴时和帕蒂开玩笑，拉里起身离开并回家准备乔安妮回来时的房子。
They've been married 27 years.
他们结婚已经27年了。
Do you want to give him a grocery list or anything, Joanne?
乔安妮，你想给他一份购物清单什么的吗？
[CHUCKLING] Little honey-do list before you get there?
[咯咯笑]在你到达那里之前，有一些亲爱的要做的事情清单吗？
Love you, hon.
爱你，亲爱的。
Larry I love you, too.
拉里，我也爱你。
See you soon.
再见。
Your tailbone is sore?
你的尾骨酸痛吗？
All right, we'll make sure to get that.
好吧，我们一定会得到的。
There's a note on the Medicare website about hospice, saying, hospice isn't just for cancer.
医疗保险网站上有一条关于临终关怀的说明，称临终关怀不仅仅针对癌症。
I saw people at Kaplan House with other conditions-- end-stage dementia, congestive heart failure.
我在卡普兰之家看到患有其他疾病的人——末期痴呆、充血性心力衰竭。
But mostly I saw cancer.
但大多数时候我看到的是癌症。
Asa had cancer.
亚撒得了癌症。
At the Kaplan House, I realized I had questions about the physical part of what had happened with him.
在卡普兰之家，我意识到我对他身上发生的事情的身体部分有疑问。
I saw other people who had that extreme cancer thinness I learned the medical term-- cachectic.
我看到其他人患有癌症般的极度瘦弱，我学到了医学术语——恶病质。
It's from Greek words that mean bad condition.
它来自希腊语，意思是状况不佳。
In a few rooms, I saw the same swabs, these little green sponges on the end of a stick, that we used to keep Asa's mouth clean and moist.
在几个房间里，我看到了同样的棉签，这些位于棍子末端的绿色小海绵，我们用它们来保持阿萨的口腔清洁和湿润。
The swabs stayed with me because I remember being grateful that they gave us a way-- a small way-- we could care for Asa even after he'd stopped being able to tell us what he wanted.
棉签一直留在我身边，因为我记得我很感激它们给了我们一种方式——一种小方式——我们可以照顾阿萨，即使他不再能够告诉我们他想要什么。
That was the hardest time-- for me, at least-- to hear him groaning and not know what to do or not do.
那是最艰难的时刻——至少对我来说——听到他的呻吟声，却不知道该做什么或不该做什么。
We grilled the nurses about what they thought was going on and what we should do.
我们盘问护士们他们认为发生了什么以及我们应该做什么。
And at the Kaplan House, I saw that a significant part of the nurses' jobs is trying to figure out what a person might need when they can't communicate anymore.
在卡普兰之家，我看到护士工作的一个重要部分是试图弄清楚当一个人无法再沟通时可能需要什么。
Are you having pain?
你痛吗？
Does something hurt?
有什么东西疼吗？
[MUMBLING] Nancy Updike Pattie is back in Lori's room, Crystal's mother.
[咕哝]南希·厄普代克·帕蒂回到了克里斯托尔的母亲洛丽的房间。
It's nighttime.
现在是晚上。
We're into the double part of Pattie's double shift.
我们进入了帕蒂双班制的双班部分。
And Lori is moving around a lot in the bed.
洛瑞在床上动来动去。
It sounds terrible to say, but I felt comforted to see it and to see others at Kaplan House do it, too, because I'd seen it with Asa.
这听起来很糟糕，但看到它以及看到 Kaplan House 的其他人也这样做，我感到很欣慰，因为我和 Asa 一起看过它。
[MUMBLING] Nancy Updike Apparently, it's common toward the end.
[咕哝]南希·厄普代克 显然，这在最后很常见。
It's called terminal agitation.
这就是所谓的末端搅动。
Lori's family hasn't slept in 24 hours because Lori was up all night last night, delirious, moving, sometimes trying to get out of bed, even though she's too weak to stand and could easily break a bone if she falls.
洛瑞的家人已经24小时没有睡觉了，因为洛瑞昨晚整夜没睡，精神错乱，动来动去，有时还想从床上爬起来，尽管她太虚弱了，无法站立，如果摔倒很容易骨折。
It's exhausting to deal with and hard to watch.
处理起来很累，观看起来也很困难。
The problem with agitation, as a palliative-care doctor told me, is that it isn't a diagnosis.
正如一位姑息治疗医生告诉我的那样，躁动的问题在于它不是一种诊断。
It's something you see, but the person can be doing it for lots of reasons, each of which calls for a different approach.
这是你看到的事情，但这个人这样做的原因可能有很多，每个原因都需要不同的方法。
They could be constipated, anxious, in pain, some combination.
他们可能会便秘、焦虑、疼痛，或者是以上几种情况的结合。
A dying person is like a baby that way, except we know even less about a dying person's brain than we do about a baby's.
在这方面，一个垂死的人就像一个婴儿，只不过我们对一个垂死的人的大脑的了解甚至比对婴儿的大脑的了解还要少。
Some of the guesses we make are based on what we know from coma patients.
我们做出的一些猜测是基于我们从昏迷患者那里了解到的情况。
But a dying brain is not a comatose brain.
但垂死的大脑并不是昏迷的大脑。
It's different.
这是不同的。
And in terms of what a dying person perceives, someone who's non-responsive, the science of it-- we know almost nothing.
对于一个垂死的人、一个没有反应的人的感知，以及其中的科学原理——我们几乎一无所知。
The nurses told me they assume that people can hear us right to the end, but no one knows for sure.
护士告诉我，他们认为人们可以听到我们的声音直到最后，但没有人确切知道。
[MUMBLING] Nancy Updike Lori's eyes are open, but it's that distant stare like Asa had.
[咕哝]南希·厄普代克·洛瑞的眼睛睁着，但眼神却像阿萨那样遥远。
She's not seeing what's in front of her.
她没有看到眼前的东西。
Her mouth is open, and she's squirming in the bed.
她的嘴张开，在床上蠕动。
She was a sign-language interpreter, and sometimes she seems to be signing.
她是一名手语翻译，有时她看起来像是在用手语。
But no one in the room knows what she's saying, if anything.
但房间里没有人知道她在说什么（如果有的话）。
Pattie is right up close, talking to Lori, watching her face.
帕蒂就在很近的地方，和洛瑞说话，看着她的脸。
It's something I saw the nurses do with Asa, too-- get right up close and talk to him and watch his face, even after he seemed to have stopped responding, because sometimes, suddenly, he would respond, especially to direct questions like--
我看到护士们也对阿萨做这件事——靠近他说话，观察他的脸，即使他似乎已经停止回应，因为有时，他会突然回应，特别是对于直接的问题，比如——
Are you having pain?
你痛吗？
Nancy Updike --are you in pain?
南希·厄普代克——你痛苦吗？
Lori gives a small shake of her head and says, no.
洛瑞轻轻摇摇头说，不。
No. Pattie Burnham Oh, good.
不，帕蒂·伯纳姆哦，很好。
Oh, I'm glad to hear that.
哦，我很高兴听到这个。
Yeah.
是的。
Do you have to pee?
你需要小便吗？
[MUMBLING] Pattie Burnham I'm thinking of putting a catheter in to help you pee.
[咕哝] Pattie Burnham 我正在考虑插入导尿管来帮助你小便。
[MUMBLING] Pattie Burnham Yeah, I think it's probably bothering her.
[咕哝] Pattie Burnham 是的，我想这可能让她感到困扰。
She hasn't peed.
她还没尿过
And yeah, I'm going to do that, OK?
是的，我会这么做，好吗？
Pattie and Christiana, one of the hospice aides, put in a catheter, and the bag immediately starts filling up.
帕蒂和临终关怀中心的一名助手克里斯蒂安娜插入一根导管，袋子立即开始充满。
Lori relaxes.
洛瑞放松下来。
The whole family relaxes.
全家人都放松下来。
Or at least, they're able to give in to their exhaustion.
或者至少，他们能够屈服于疲惫。
Lori's girlfriend, Karen, finds Pattie in the hall.
洛瑞的女朋友凯伦在大厅里找到了帕蒂。
The cancer doctor said that she might-- chances are, she might fall asleep and die in her sleep, because--
癌症医生说她可能——很有可能，她可能会睡着并在睡梦中死去，因为——
That's what I think.
我就是这么认为的。
Karen --the cancer doctor knew her well, too-- knew she was a toughie.
凯伦——癌症医生也很了解她——知道她是个硬汉。
I think the catheter is really helping her to settle down.
我认为导管确实帮助她安定下来。
Yeah, I think I'm going to go home, take a shower--
是的，我想我要回家，洗个澡——
Good.
很好。
Karen --relax as much as I can.
凯伦——尽可能放松。
And then--
然后——
Good, good.
好，好。
If I see a major change, I will call you.
如果我发现重大变化，我会打电话给你。
OK.
好的。
Pattie Burnham But as I said, sometimes they just sneak away.
帕蒂·伯纳姆（Pattie Burnham）但正如我所说，有时他们只是偷偷溜走。
You feel useless.
你感觉自己没用。
Nancy Updike This is the sister of another patient.
南希·厄普代克（Nancy Updike） 这是另一位患者的妹妹。
She came straight from work to be with him and has been here day and night for two days.
她下班后直接赶来陪他，这两天没日没夜地待在这里。
I've been talking to her a lot.
我和她聊了很多。
I know the strain of this waiting, where nothing is happening, and your brain keeps flitting between the giant, existential thing that's going on and the tedious nuts and bolts of just getting through every hour.
我知道这种等待的压力，什么也没有发生，你的大脑不断地在正在发生的巨大的、存在的事情和每小时都要经历的乏味的具体细节之间来回切换。
Every moment seems full of meaning and yet not meaningful at all.
每一刻似乎都充满意义，却又毫无意义。
It's surreal, and it is crazy-making.
这是超现实的，也是疯狂的。
How are you doing?
你好吗？
Visitor I'm exhausted.
访客我累了。
Yeah, I'm exhausted.
是的，我累坏了。
It's like, what am I doing?
就像，我在做什么？
I'm just watching him.
我只是看着他。
Like, last night, all's he does is-- I'll tell you what he does.
就像，昨晚，他所做的就是——我会告诉你他做了什么。
He makes this noise.
他发出这种声音。
It's like, [GROANS], but non-stop.
就像，[呻吟]，但不间断。
So I try to do it with him.
所以我尝试和他一起做。
Not as loud, just-- I cannot hold it as long as he can.
声音没那么大，只是——我不能像他那样坚持那么久。
I'm like, this kid is not even going to stop to take a breath.
我想，这孩子甚至不会停下来喘口气。
Me?
我？
I'm like, [PANTS].
我就像，[裤子]。
It's exhausting, and he can do it.
这很累，但他可以做到。
You must really think I'm nuts.
你一定认为我疯了。
There's nothing else to do, is all.
没有什么可做的，就是这样。
I don't know what I want to do.
我不知道我想做什么。
It's not like he can--
他不可能——
I'm so sorry.
我很抱歉。
Visitor Oh, no, don't be sorry.
访客哦，不，别抱歉。
You know what?
你知道吗？
I'm just sitting here for like-- just sitting.
我只是坐在这里——只是坐着。
You can't do anything.
你什么也做不了。
I'm tired of praying to God.
我厌倦了向上帝祈祷。
Really, I'm tired.
真的，我累了。
But I told him I'd stay with him.
但我告诉他我会留在他身边。
And I don't want to-- even if he doesn't know I'm here or not, I know I'm here.
我不想——即使他不知道我是否在这里，我知道我在这里。
I never knew what anyone was going to say at the Kaplan House.
我从来不知道卡普兰之家的人会说什么。
Listening to family members in rooms and in the halls, I got the feeling that their brains were full to the brim with what was happening, and asking them any question tipped all their thoughts out in a rush.
听着房间里和大厅里的家人的讲述，我感觉他们的脑子里都充满了正在发生的事情，问他们任何问题都会让他们的想法匆匆流露出来。
Some people told me the whole story of their family member's diagnosis and treatment up to five minutes ago.
有的人直到五分钟前才向我讲述了他们家人的诊断和治疗的整个过程。
I heard one of the doctors say to an 84-year-old woman who was sitting with her dying husband, you know him better than we do.
我听到一位医生对一位与她垂死的丈夫坐在一起的 84 岁妇女说，你比我们更了解他。
Does he look comfortable to you?
他让你看起来舒服吗？
The woman responded by telling the entire story of their relationship, starting with, we met when I was 13.
这位女士回应道，讲述了他们关系的整个故事，从我 13 岁时我们相识开始。
The staff has a name for that kind of answer.
工作人员对这种答案有一个名字。
It's called life review.
这就是所谓的人生回顾。
They say it happens a lot.
他们说这种事经常发生。
And I heard life reviews that were a lot darker than that one.
我听到的生活评论比那篇要黑暗得多。
Not every death is the end of a well-lived life.
并非每一次死亡都是美好生活的结束。
But all the stories seem to be trying to tackle the same huge question.
但所有的故事似乎都在试图解决同一个巨大的问题。
How did we get here?
我们是怎么到这里的？
Grief is one thing, but watching somebody die is a whole 'nother thing.
悲伤是一回事，但看着某人死去又是另一回事。
Pattie again.
又是帕蒂。
Pattie Burnham You know, not everybody can sit beside a dying person and hold their hand.
帕蒂·伯纳姆（Pattie Burnham）你知道，不是每个人都能坐在垂死的人旁边并握住他们的手。
And I think sometimes it's too much.
我认为有时这太多了。
Nobody wants their loved ones to be alone.
没有人希望自己的亲人孤独一人。
I get that.
我明白了。
But you could wait here for days and days, and when you go to take that one shower is when the person might die.
但你可以在这里等上好几天，当你去洗个澡的时候，这个人可能就会死。
And sometimes people I've talked to say it's common that the person will die--
有时与我交谈过的人说，这个人会死是很常见的——
Alone.
独自一人。
Nancy Updike Well, it's almost like they're waiting for everyone to go away.
南希·厄普代克：嗯，这几乎就像他们在等待每个人都离开一样。
Right, right.
对，对。
Nancy Updike Is that what you've found?
南希·厄普代克 这是你发现的吗？
We see that over and over and over again.
我们一遍又一遍地看到这一点。
When I first started working there, I'm like, this is a bit of mumbo-jumbo.
当我第一次开始在那里工作时，我想，这有点胡言乱语。
[LAUGHS] And it just seemed like, come on.
[笑] 看起来就像是，来吧。
Now I'm repeating the same stuff that I heard people say when I first got there, because I've seen it.
现在我正在重复我第一次到达那里时听到人们说的同样的话，因为我已经看到了。
You mean that people die when either everyone leaves the room, or their spouse or their child or whoever has been there for a long time-- they die after that person leaves the room.
你的意思是，当每个人都离开房间，或者他们的配偶、孩子或任何在那里待了很长时间的人时，人们就会死亡——他们在那个人离开房间后就会死亡。
Yeah, or they're comatose, and the loved ones keep saying, he's waiting for his brother to get here on Saturday.
是的，或者他们昏迷了，而亲人一直说，他正在等他的兄弟周六来这里。
They're coming from Florida on Saturday.
他们周六从佛罗里达州过来。
And I'm, inside, rolling my eyes, thinking, it's Tuesday.
我在心里翻白眼，心想，今天是星期二。
He's going to die on Wednesday or Thursday.
他将于周三或周四去世。
He's not going to be here on Saturday for when his brother arrives from Florida.
周六他的兄弟从佛罗里达来时他不会来这里。
And then the brother arrives at Logan, shows up at the Kaplan House at 12:30, and the patient dies at 1:00.
然后，兄弟到达洛根，于 12:30 出现在卡普兰之家，患者于 1:00 死亡。
And they say to me, I told you.
他们对我说，我告诉过你了。
He just needed Billy to come from Florida.
他只需要比利从佛罗里达来。
And it's like, what?
就像，什么？
Talking to people about whoever they were visiting at the Kaplan House always brought up other, earlier losses.
与人们谈论他们在卡普兰之家拜访的人时，总是会提到其他早期的损失。
Always.
总是。
One woman who was sitting with her mother told me about how her husband had died suddenly eight years earlier, making her a widow at age 51.
一位和她母亲坐在一起的女士告诉我，她的丈夫八年前突然去世，导致她 51 岁成为寡妇。
A woman whose younger sister was dying said she lost both parents before age 13.
一名妹妹即将去世的妇女表示，她在 13 岁之前就失去了双亲。
A woman visiting her brother told me about how his daughter had died years ago at only two years old.
一位拜访她兄弟的妇女告诉我，他的女儿多年前就去世了，当时她才两岁。
The woman said her brother was so angry about his daughter's death that he said to her, his sister, why couldn't it have been one of your effing daughters?
这位女士说，她的兄弟对女儿的死非常愤怒，他对她说，他的妹妹，为什么这不是你该死的女儿之一呢？
You've got two.
你有两个。
It was like a map.
它就像一张地图。
This death related to that death over there, linked to this living person here, a hidden geography shaping all of our lives.
这个死亡与那边的死亡有关，与这里的这个活着的人有关，一个隐藏的地理塑造了我们所有人的生活。
After I'd been at the Kaplan House for several days, I ran into Larry, the husband of Joanne, the woman Pattie coaxed into getting a shower before going home.
我在卡普兰之家待了几天后，遇到了拉里，乔安妮的丈夫，乔安妮是帕蒂在回家前哄着洗个澡的女人。
Larry was sitting alone in the main common area.
拉里独自坐在主要的公共区域。
I knew it couldn't be good that Joanne was back so soon.
我知道乔安妮这么快回来肯定不好。
Well, the doctor was in earlier.
还好医生来得比较早。
Were you there when the doctor said she thought she had like a week or so left?
当医生说她认为自己只剩下一周左右的时间时，你在场吗？
I wasn't there.
我当时不在场。
Larry Yeah.
拉里 是的。
And I figured she was closing in on it, because of the way I've watched her deteriorate.
我认为她已经接近了，因为我看到她的情况每况愈下。
But when you hear somebody who's used to dealing with this for a living tell you that they think that's what's left, it hits home.
但是，当你听到那些习惯于处理这些问题为生的人告诉你，他们认为这就是剩下的东西时，你就明白了。
I'm so sorry, Larry.
我很抱歉，拉里。
Larry [SIGHS] It's a bitter pill to swallow, but that's life.
拉里（叹气）这是一颗难以吞咽的苦果，但这就是生活。
It goes on no matter what.
无论如何，它都会继续下去。
[SIGHS]
[叹气]
Nancy Updike One of the many ways I've been a smug idiot in my life was by disparaging the use of euphemisms for death and dying.
南希·厄普代克（Nancy Updike）：我一生中自以为是的白痴有很多，其中之一就是贬低对死亡和垂死的委婉说法的使用。
I thought it was weak.
我以为它很弱。
Who would do that?
谁会这么做？
By the time Asa was at the end, I had barely been able to utter the words "death" or "dying" for several months.
当阿萨结束时，我已经好几个月几乎无法说出“死亡”或“垂死”这个词了。
I felt like the thing itself was only manageable if I didn't invoke it.
我觉得如果我不调用它，事情本身就可以管理。
Pattie told me that one of her strategies for protecting herself at work is never to imagine herself in the place of the dying person or their family members.
帕蒂告诉我，她在工作中保护自己的策略之一就是永远不要想象自己处于临终者或其家人的位置。
She tries not to picture her husband or her kids.
她尽量不去想象她的丈夫或孩子。
I remember trying and failing at that.
我记得我曾尝试过但失败了。
I think part of my clumsiness around Asa and my mother was my barely-suppressed terror at the thought of my own husband dying.
我认为我在阿萨和母亲面前表现得笨拙的部分原因是我一想到自己丈夫的死就难以抑制的恐惧。
I pictured myself in my mother's place all the time.
我一直想象自己处于母亲的位置。
Every morning before going to her apartment, I pulled out a piece of paper, and I had to read the words on it out loud in order to make it out the door.
每天早上去她的公寓之前，我都会拿出一张纸，必须大声读出上面的字才能走出门。
"Your husband isn't dying.
“你的丈夫没有死。
This is not about you.
这与你无关。
Your mother needs you.
你妈妈需要你。
Go to her apartment now." It was my own little serenity prayer.
现在就去她的公寓吧。”这是我自己小小的平静祈祷。
God grant me the wisdom to know the difference between my fear and her reality.
上帝赐予我智慧，让我能够区分我的恐惧和她的现实。
When I heard a woman at the Kaplan House say to her husband, who was dying of colon cancer, something like, we had a really good run until the last few months, didn't we, baby?
当我听到卡普兰之家的一位女士对她因结肠癌濒临死亡的丈夫说时，类似这样的话，我们在过去几个月之前都过得很好，不是吗，宝贝？
I had to turn away to go look at a lamp in the corner.
我不得不转身去看角落里的一盏灯。
But I think death makes narcissists of us all at one point or another, even the pros.
但我认为死亡在某一时刻会让我们所有人变得自恋，甚至是职业选手。
I was walking with a nurse named Kim.
我和一位名叫金的护士一起散步。
She worked in critical care for two-plus decades before changing over to hospice.
在转到临终关怀医院之前，她在重症监护室工作了二十多年。
We had just left one woman's room and were heading down the hall when Kim said, shaking her head--
我们刚刚离开一位女士的房间，正朝大厅走去，这时金摇着头说道——
She's 51.
她51岁了。
I'm 52.
我52岁了。
Nancy Updike Kim, and everyone else, said these are the cases that can be hardest to defend against-- the ones where you can't not picture yourself when you look at them.
南希·厄普代克·金（Nancy Updike Kim）和其他人都表示，这些是最难防范的案例——当你看到这些案例时，你无法不想象自己的样子。
She had another just last week.
上周她又生了一次。
There was one woman I had my age.
有一个和我同龄的女人。
And she had two boys that were my age--
她有两个和我同龄的男孩——
Your sons' ages.
你儿子的年龄。
Kim My sons' ages.
金 我儿子的年龄。
And the boys were very attentive.
而且男孩们非常专心。
They stayed with her and just laid beside her.
他们陪着她，就躺在她身边。
And it was just really-- it hit me on the way home.
这真的是在回家的路上让我震惊的。
You think, oh my gosh, this could be me.
你想，天哪，这可能就是我。
This is Juliet, one of the CNAs, Certified Nursing Assistants.
我是朱丽叶，CNA 认证护士助理之一。
She's studying to be a nurse, and she remembered the first time she had a patient her own age.
她正在学习成为一名护士，她记得第一次接待同龄病人的情景。
At that time, I had just turned 39.
那时，我刚满39岁。
And I'm like, oh my god.
我想，天啊。
I actually said, oh my god.
我实际上说，天哪。
That's my age.
这就是我的年龄。
Oh my god.
我的天啊。
That's me.
这就是我。
That's me.
这就是我。
That's me.
这就是我。
Sometimes they see patients their children's ages.
有时他们会看到与孩子年龄相仿的病人。
This is Jackie, another nurse.
这是杰基，另一位护士。
We had a nine-year-old boy that was here.
我们这里有一个九岁的男孩。
And my daughter, Sarah, was nine years old at the time.
我的女儿莎拉当时九岁。
And I remember climbing in her bed when I went home, and I just fell asleep in her bed.
我记得当我回家时爬到她的床上，然后我就在她的床上睡着了。
And she was so mad at me, [LAUGHS] because I'm breathing on her and stealing her covers.
她对我很生气，[笑]因为我在她身上呼吸，偷了她的被子。
And she was so mad.
她非常生气。
And I remember just waking up and thinking that was the funniest thing in the world-- that she was mad.
我记得我刚醒来就觉得这是世界上最有趣的事情——她生气了。
But I needed to do that when I came home that night.
但那天晚上我回家后我需要这样做。
I needed to know, my nine-year-old is OK.
我需要知道，我九岁的孩子还好吗。
Jackie also told me, while I was following her around, throwing out questions--
当我跟踪她并提出问题时，杰基还告诉我——
Last year, I had my kidney removed because I had a big tumor in it.
去年，我的肾脏被切除了，因为里面有一个很大的肿瘤。
So--
所以——
Oh my god.
天哪。
Jackie --all I could think of was, oh, shit, I'm going to end up at work.
杰基——我所能想到的就是，哦，该死，我要结束工作了。
[LAUGHS] But if I'm to be anywhere, that's where I wanted to be.
[笑]但如果我要去任何地方，那就是我想去的地方。
And when one of our docs-- Dr. Warren came to see me in the hospital.
当我们的一位医生沃伦医生来医院看我时。
And I thought, this is it.
我想，就是这样了。
I'm dying.
我要死了。
The hospice doc just walked in the door.
临终关怀医生刚刚走进门。
And it does happen.
它确实发生了。
A nurse named Rosemary, who's been there for a long time, told me about one of the other longtime nurses, Kathleen.
一位名叫罗斯玛丽的护士在那里工作了很长时间，她向我讲述了另一位长期护士凯瑟琳的故事。
Went out on medical leave to have her bunions fixed and was diagnosed with ovarian cancer, and just had a very rough go of it.
她休病假去修复拇囊炎，并被诊断出患有卵巢癌，并且经历了一段非常艰难的时期。
Nothing worked.
什么都没起作用。
Every treatment, she had reactions to.
每次治疗，她都会有反应。
And finally, it was time for Kathleen to come to the Kaplan House.
最后，凯瑟琳来到了卡普兰之家。
And she was determined that she was not going to come in on a stretcher like the other patients, because she was a nurse.
她决定不会像其他病人一样用担架进来，因为她是一名护士。
So she walked down the hall and greeted everybody on her way down.
于是她沿着大厅走去，一路上向每个人打招呼。
But it was really hard for us to take care of one of our own, because I think we think, well, we're hospice nurses, so we don't get sick.
但照顾自己的一个人对我们来说真的很难，因为我认为我们认为，我们是临终关怀护士，所以我们不会生病。
And the first night, she came in, and I had her as a patient.
第一天晚上，她进来了，我把她当作病人。
And I came out to my med cart, and there was a note.
我走到我的医疗车前，看到一张纸条。
"Dear Rosemary, could I please have a milligram of Dilaudid for 8 out of 10 pain?
“亲爱的罗斯玛丽，我可以服用一毫克二劳迪来治疗十分之八的疼痛吗？
I know you're going to think I should have 2 milligrams, but I only want 1 milligram.
我知道你会认为我应该有 2 毫克，但我只想要 1 毫克。
No hurry.
不着急。
Take care of the patients first.
首先照顾病人。
And one face cloth and one towel when you get a chance." And that was just Kathleen.
如果有机会的话，还会提供一块面巾和一条毛巾。”那只是凯瑟琳。
Death and illness, who's here and who's not, how we live with this hanging over us-- these are the conversations I'd been waiting years to have.
死亡和疾病，谁在这里，谁不在这里，我们如何生活在这笼罩在我们头上的事情上——这些都是我多年来一直等待的对话。
Before I left, I got to ask Pattie what it's like to talk with her patients so directly the way that I was never able to do with Asa.
在我离开之前，我必须问帕蒂，与她的病人如此直接地交谈是什么感觉，而我从来没有像阿萨那样直接地交谈过。
Patients all the time ask you, is this it?
病人总是问你，是这个吗？
Am I dying?
我快死了吗？
And the first thing I usually do is say, well, you might know better than me.
我通常做的第一件事就是说，好吧，你可能比我更了解。
Do you think you're dying?
你觉得你快死了吗？
And usually, if it's a dying person, they say yes.
通常，如果是一个垂死的人，他们会说“是”。
And I'll say, are you nervous?
我会说，你紧张吗？
Are you anxious?
你焦虑吗？
What are you afraid of?
你怕什么？
And if they say, I'm afraid I'm going to have pain, we'll just talk about it and say, well, I've got this, this, and this to give you if you have pain.
如果他们说，我担心我会感到疼痛，我们就会谈论它并说，好吧，如果您感到疼痛，我可以给您这个，这个，这个。
So if you feel a little bit of pain, I want you to tell me.
所以如果你感到一点痛苦，我希望你告诉我。
And we'll head off a little problem rather than a big problem.
我们会阻止一个小问题而不是一个大问题。
And they'll say, well, I'm afraid I'll feel like I won't be able to breathe.
他们会说，好吧，我担心我会感觉无法呼吸。
Then we talk about that, about the medications I'll give them.
然后我们讨论这个问题，讨论我要给他们开的药物。
And all they have to do is tell me they're short of breath, and they get the medicine.
他们所要做的就是告诉我他们呼吸急促，然后他们就去拿药。
They're afraid they'll be alone.
他们害怕自己会孤单。
And I'll say, well, let's talk to your family about that, or I'll be here.
我会说，好吧，让我们和你的家人谈谈这件事，否则我会在这里。
I'll be checking on you.
我会检查你的情况。
I asked Pattie if anyone at the end of that list says, well, I'm just afraid of dying.
我问帕蒂，名单最后是否有人说，好吧，我只是害怕死。
I fear death.
我害怕死亡。
She said yes.
她说是的。
And she listens if they want to talk about it, offers to bring in the chaplain or the social worker.
如果他们想谈论这件事，她会倾听，并主动提出请牧师或社会工作者进来。
What else is there?
还有什么？
That might be the biggest thing that she and the other nurses know that we don't.
这可能是她和其他护士知道而我们不知道的最重要的事情。
They know the limits of what they can do.
他们知道自己能做的事情的局限性。
Nancy Updike is one of the producers of our show.
南希·厄普代克是我们节目的制片人之一。
Coming up, since the federal government can no longer count on cartoon characters to bring in our tax dollars as they once did, what is left for them?
接下来，既然联邦政府不能再像以前那样指望卡通人物为我们带来税收，那么他们还剩下什么？
My answer is in a minute, from Chicago Public Radio, when our program continues.
当我们的节目继续进行时，我会立即从芝加哥公共广播电台得到答复。
It's This American Life.
这就是美国生活。
I'm Ira Glass.
我是艾拉·格拉斯。
Each week on our program, of course, we choose a theme.
当然，每周我们的节目都会选择一个主题。
Today's program-- death and taxes, stories about the inevitable, stories where people who know about these things share their inside knowledge with us.
今天的节目——死亡和税收，关于不可避免的事情的故事，了解这些事情的人与我们分享他们的内部知识的故事。
In Act 1, we heard all about death.
在第一幕中，我们听到了有关死亡的一切。
We have now arrived at Act 2, which is about taxes.
现在我们已经到了第二幕，这是关于税收的。
I think most of us think of taxes as inevitable like death.
我想我们大多数人都认为税收就像死亡一样不可避免。
But in fact, while we all die, we do not all pay our taxes.
但事实上，虽然我们都会死，但我们并不都缴税。
According to the most recent statistics, the IRS only successfully collects 85% of the money that all of us owe, which is a lot of money.
根据最新的统计，国税局只成功收回了我们所有人所欠钱的85%，这是很多钱。
They miss $385 billion out of $2.6 trillion they should be collecting.
他们应该筹集到的 2.6 万亿美元中，却漏掉了 3850 亿美元。
Though when you think about it, what is amazing is how many of us actually do pay.
但仔细想想，令人惊奇的是我们中有多少人确实付了钱。
There are entire countries where it seems like most people are cheating.
在某些国家，似乎大多数人都在作弊。
Greece, I'm looking at you.
希腊，我在看着你。
Here, we pay up, most of us, because of some combination of, A, we think we don't have a choice-- though if you'd bother to look into it, you would learn that the IRS does not have that many people checking on us-- and B, we think it's the right thing to do.
在这里，我们大多数人都付了钱，因为以下因素的结合：A，我们认为我们别无选择——尽管如果你费心去调查，你会发现国税局没有那么多人检查我们——B，我们认为这是正确的做法。
NPR's David Kestenbaum has this story about how we got here and about one former IRS special agent trying, even in retirement, to help Uncle Sam in this quest.
NPR 的大卫·凯斯滕鲍姆 (David Kestenbaum) 讲述了我们如何走到这一步的故事，以及一位前美国国税局 (IRS) 特工即使在退休后仍试图帮助山姆大叔完成这一任务的故事。
The first year the government tried to collect an income tax from broad swaths of Americans was during World War II.
政府尝试向广大美国人征收所得税的第一年是在第二次世界大战期间。
And really, it was unclear how well it was going to work.
事实上，目前还不清楚它的效果如何。
One poll showed that one third to one half of people weren't sure what they were supposed to do.
一项民意调查显示，三分之一到一半的人不确定他们应该做什么。
And the government faced this choice.
而政府也面临这样的选择。
There were basically two options.
基本上有两种选择。
The government could play tough, say this is the law.
政府可以表现得很强硬，说这是法律。
You have to pay.
你必须付钱。
It could scare people.
它可能会吓到人们。
Or it could try to inspire people to pay their taxes.
或者它可以尝试激励人们纳税。
We went with inspire.
我们带着灵感去了。
We chose a spokesperson who could sell the income tax, someone with credibility, someone who was instantly recognizable and easy to understand.
我们选择了一位可以推销所得税的代言人，一个有信誉的人，一个一眼就能认出、容易理解的人。
That is not right!
那是不对的！
David Kestenbaum We went with Donald Duck.
大卫·凯斯滕鲍姆 我们和唐老鸭一起去了。
This is a short film by Disney from 1942, commissioned by the government.
这是迪士尼 1942 年受政府委托制作的短片。
In it, Donald Duck is marching around his house patriotically, listening to the radio, and talking back to it.
影片中，唐老鸭爱国地绕着他的房子走来走去，一边听着广播，一边与之顶嘴。
Donald Duck runs and gets a gun and a sword and an axe and boxing gloves.
唐老鸭跑过去，得到一把枪、一把剑、一把斧头和拳击手套。
Yes, sir!
是的，先生！
Announcer --eager to do your part?
播音员——渴望尽自己的一份力量吗？
Yes, sir!
是的，先生！
Announcer Then there's something important you can do.
播音员 那么您可以做一些重要的事情。
Oh, that's all right.
哦，没关系。
Announcer It may mean a sacrifice on your part.
播音员 这可能意味着你要做出牺牲。
I'll do it anyway.
无论如何我都会这么做。
Announcer But it will be a vital help to your country in this hour of need.
播音员但这将在你们的国家需要帮助的时刻提供至关重要的帮助。
I'll do anything!
我什么都会做！
Anything!
任何事物！
Announcer Shall I tell you what it is?
播音员要我告诉你这是什么吗？
Yes!
是的！
What is it?
它是什么？
Tell me!
告诉我！
Announcer Shall I?
播音员可以吗？
Tell me what it is!
告诉我那是什么！
Announcer Your income tax.
播音员 你的所得税。
Yes, your income tax.
是的，你的所得税。
Donald Duck Doggone income tax.
唐老鸭所得税。
They walk him through filing his whole tax return.
他们引导他填写完整的纳税申报表。
Yes, sir!
是的，先生！
Announcer Well, then you can use the new simplified form.
播音员 好吧，那么您可以使用新的简化形式。
Donald Duck writes in occupation-- actor.
唐老鸭的职业是——演员。
Income-- $2,501.
收入——2,501 美元。
He lists his dependents, three-- Huey, Dewey, and Louie.
他列出了他的三个家属：休伊、杜威和路易。
Huey, Dewey, and Louie.
休伊、杜威和路易。
David Kestenbaum They have him look up how much he owes in the tax tables.
大卫·凯斯滕鲍姆 他们让他在税表中查一下自己欠了多少钱。
Oh, I owe just about-- David Kestenbaum This film was nominated for an Academy Award.
哦，我欠——大卫·凯斯滕鲍姆这部电影获得了奥斯卡金像奖提名。
And remarkably, this approach worked.
值得注意的是，这种方法奏效了。
Millions of Americans became responsible income taxpayers for the first time.
数百万美国人首次成为负责任的收入纳税人。
Of course, when you're fighting the Nazis and you've got Donald Duck making the pitch, it's an easy sell.
当然，当你与纳粹作战并且有唐老鸭在场时，这是很容易推销的。
During the war, almost 90% of Americans polled said their taxes were fair.
战争期间，近 90% 的受访美国人表示他们的税收是公平的。
After the war, that plunged to around 60%.
战后，这一比例骤降至 60% 左右。
These days, some of us aren't so convinced of our duty.
如今，我们中的一些人不太确信自己的责任。
A recent survey by the IRS showed something like 1 in 10 people felt it was OK to cheat a little here and there or as much as possible on their taxes.
美国国税局最近的一项调查显示，大约十分之一的人认为可以在这里或那里稍微作弊或尽可能多地偷税漏税。
This is the taxpaying world that Al Drucker discovered when he started working for the IRS in 1981.
这就是阿尔·德鲁克 (Al Drucker) 1981 年开始为美国国税局 (IRS) 工作时发现的纳税世界。
He'd just graduated from John Jay College of Criminal Justice, and he was hoping to land a job at the FBI, or maybe the DEA, chasing drug traffickers.
他刚刚从约翰·杰伊刑事司法学院毕业，他希望能在联邦调查局（FBI）或者缉毒局（DEA）找到一份追捕毒贩的工作。
But the way things worked is, you just took this general aptitude test, and you waited to see who called.
但事情的运作方式是，你刚刚参加了一般能力倾向测试，然后就等着看谁打来电话。
And the call he got was from the IRS.
他接到的电话是国税局打来的。
Was it my peak choice?
这是我的巅峰选择吗？
No. If I was in that recruiting forum and there were 20 booths, and one was DEA, and one was IRS, I'd probably go to the IRS last.
不。如果我在那个招聘论坛上，那里有 20 个摊位，其中一个是 DEA，一个是 IRS，我可能会最后去 IRS。
Al didn't really even know the IRS hired law-enforcement people.
艾尔甚至不知道国税局雇佣了执法人员。
But he took the job.
但他接受了这份工作。
They trained him to shoot a gun.
他们训练他射击。
They taught him special driving pursuit skills.
他们教给他特殊的驾驶追逐技巧。
And they gave him an impressive-looking badge that said Special Agent Number 4158, with the seal of the US Treasury on it.
他们还给了他一枚令人印象深刻的徽章，上面写着特工编号 4158，上面盖有美国财政部的印章。
And he got to work.
他开始工作了。
One of Al's first cases came from a tip.
艾尔的第一个案件来自举报。
It was a tip about a guy who ran a pharmacy in New Jersey.
这是关于一个在新泽西州经营一家药店的人的消息。
Someone had told the IRS, hey, you should check this guy out.
有人告诉国税局，嘿，你应该检查一下这个人。
I'm pretty sure he's cheating on his taxes.
我很确定他在偷税漏税。
So Al, with a colleague, went to the pharmacy.
于是艾尔和一位同事一起去了药房。
And it was an old-fashioned-type pharmacy, a regular prescription-bearing pharmacy that would sell newspapers and gum and any of the stationery and cards, greeting cards and things of this nature.
这是一家老式药房，一家正规的处方药房，出售报纸、口香糖以及任何文具、卡片、贺卡和类似的东西。
Even in retirement, Al still speaks like a cop-- things of this nature, the suspect, the informant.
即使退休了，阿尔说话的方式仍然像个警察——这种性质的事情，嫌疑人，线人。
Anyway, Al and his partner walk into the pharmacy, and the pharmacist is there.
不管怎样，阿尔和他的搭档走进药房，药剂师就在那里。
And they get the strangest reception.
他们受到了最奇怪的接待。
Believe it or not, he looked at my partner and myself.
不管你信不信，他看着我的搭档和我自己。
And he looked at us, and he said, you guys are with the IRS, aren't you?
他看着我们，说，你们是国税局的，不是吗？
As if he was expecting a visit.
仿佛他正在等待着来访。
Which, of course, he might have been.
当然，他可能就是这样。
Someone, after all, had ratted him out.
毕竟有人出卖了他。
That was why Al was looking into this guy.
这就是阿尔调查这个人的原因。
And it was probably someone the pharmacist knew pretty well.
而且很可能是药剂师很熟悉的人。
It may be an employee.
可能是一名员工。
Sometimes an employee will brag about, when they're fired, turning the boss in, et cetera, et cetera.
有时，员工会吹嘘，当他们被解雇时，告发老板等等。
The insider tip.
内幕消息。
It was a powerful thing.
这是一件很强大的事情。
Al looked into the pharmacist's bank records and pretty quickly found something fishy.
艾尔查看了药剂师的银行记录，很快就发现了一些可疑之处。
The guy didn't seem to be depositing any cash.
那家伙似乎没有存任何现金。
All the money came from checks and credit cards.
所有的钱都来自支票和信用卡。
And clearly, people had been buying gum and newspapers and greeting cards with cash.
显然，人们一直在用现金购买口香糖、报纸和贺卡。
Where was all the cash going?
所有现金都去哪儿了？
We were able to establish that there was another secret bank account where the cash was going.
我们能够确定现金的去向还有另一个秘密银行账户。
Just a different bank than he typically used.
只是与他通常使用的银行不同。
Oh, it wasn't-- Al Drucker No, it wasn't offshore.
哦，不是——艾尔·德鲁克 不，不是离岸。
It wasn't-- no, it--
这不是——不，是——
It was around the corner.
就在拐角处。
Al Drucker It was a neighboring town, and it was a different bank than he typically would use.
艾尔·德鲁克 那是一个邻近的城镇，而且这家银行与他通常使用的银行不同。
Was it in his real name?
这是他的真名吗？
Al Drucker It was in his real name.
阿尔·德鲁克 这是他的真名。
[LAUGHS] It's just amazing how simple it is.
[笑] 令人惊奇的是它是如此简单。
Basically, his secret bank account was a bank account in his name, one town over.
基本上，他的秘密银行账户是以他的名字在一个城镇之外的银行账户。
And when he got paid in cash at the pharmacy, he just deposited it there and never declared it.
当他在药房拿到现金时，他只是存在那里，从未申报。
There's no question.
毫无疑问。
I think a lot of times, it's not nearly as complex as you might think.
我想很多时候，它并不像你想象的那么复杂。
A lot of cases are like that, he says.
他说，很多案例都是这样。
The fraud is right there once you start looking.
一旦你开始寻找，欺诈就在那里。
But you need a reason to start looking.
但你需要一个开始寻找的理由。
In this case, it was the tip that gave him that reason.
在这种情况下，正是这个提示给了他这个理由。
Tip, of course, is a nice word for it.
当然，“提示”是一个很好的词。
Ratting out is another.
出局是另一回事。
But this notion that good ideas could come from people telling on each other-- it stuck with Al.
但阿尔坚持认为好的想法可以来自于人们互相交流。
So a couple years ago, when he retired from the IRS, he set up a business built around this idea, that people could help the government do its job collecting taxes by volunteering information.
因此，几年前，当他从国税局退休时，他围绕这个想法创办了一家企业，即人们可以通过自愿提供信息来帮助政府完成征税工作。
And here, for once, he did not give it a cop-speak name.
在这里，他第一次没有给它起一个警察用语的名字。
TaxSqueal.com.
TaxSqueal.com。
David Kestenbaum It's not subtle.
David Kestenbaum 这并不微妙。
You went straight to squeal.
你直接尖叫起来。
Those are the two words that best connote what I was trying to say, which is taxes and squealing.
这两个词最能表达我想说的话，那就是税收和尖叫。
It could have been tax rat.
它可能是税率。
And, well, we experimented plenty with the tax rat, believe me.
而且，相信我，我们对税率进行了大量实验。
I suppose tax rat, you could have had a rat on the site.
我想税鼠，你可能在网站上有一只老鼠。
Tax squeal, you could have a pig.
税收尖叫声，你可以养一头猪。
Well, if I could be honest, the name was taken.
好吧，老实说，这个名字已经被占用了。
The IRS does have a way you can rat or squeal on other people.
美国国税局确实有办法可以向其他人举报或抱怨。
But like all things IRS, it's a pain.
但就像国税局的所有事情一样，这很痛苦。
Welcome to the Internal Revenue Service Tax Fraud Referral Hotline.
欢迎使用国税局税务欺诈转介热线。
There's a hotline.
有热线电话。
But if you call, you get this.
但如果你打电话，你就会得到这个。
You can report tax fraud and abuse by completing Form 3949-A or by sending us a letter.
您可以通过填写 3949-A 表格或写信给我们来举报税务欺诈和滥用行为。
Of course there's a form.
当然有一个表格。
You have to print it out, fill it out, and actually put it in an envelope and mail it to the IRS in Fresno.
您必须将其打印出来，填写完毕，然后将其放入信封中，然后邮寄给弗雷斯诺的国税局。
TaxSqueal.com, Al says, removes the hassle and provides an extra layer of anonymity.
艾尔说，TaxSqueal.com 消除了麻烦，并提供了额外的匿名层。
You just go to the website, type in some answers-- basically, who are you squealing on, where does the person live, what did they do?
你只需访问网站，输入一些答案——基本上，你在向谁抱怨，这个人住在哪里，他们做了什么？
And that's it.
就是这样。
Al will file the form for you for free.
Al 将免费为您填写表格。
Al works out of the back of a store his wife runs in a New Jersey strip mall.
艾尔在他妻子在新泽西州一家购物中心经营的商店后面工作。
The store is a little hard to describe.
这家店有点难以描述。
One side, literally one side of it, is devoted to sports memorabilia-- jerseys, photos, baseball cards.
一侧，实际上是一侧，专门展示体育纪念品——球衣、照片、棒球卡。
The other side is window treatments--
另一边是窗帘——
You have a blind that goes up, a blind that goes down, and certainly a blind that tilts.
你有一个上升的百叶窗，一个下降的百叶窗，当然还有一个倾斜的百叶窗。
--making this, I think, the only store in America where you can buy baseball cards and window shades and squeal on your neighbor.
——我想，这将成为美国唯一一家可以买到棒球卡和窗帘并可以对邻居大喊大叫的商店。
Al works at a desk in back with his old badge, now preserved in a Lucite block, and some squeals he's printed out.
艾尔在后面的一张桌子上工作，手里拿着他的旧徽章，现在保存在有机玻璃块中，还有他打印出来的一些尖叫声。
When enough of them pile up, he mails them to the IRS.
当足够多的东西堆积起来时，他将它们邮寄给国税局。
Al says the IRS-- despite what you might think, it's not all powerful.
艾尔说，美国国税局——不管你怎么想，它并不是万能的。
When he worked there, the IRS had only around 3,000 field agents doing criminal investigations.
当他在那里工作时，国税局只有大约 3,000 名现场特工进行刑事调查。
They are massively outmatched.
他们远远落后于对手。
So the IRS faces this fundamental problem.
因此，美国国税局面临着这个根本问题。
How do you find the cheaters?
如何找到作弊者？
Al's answer, rat them out-- it may sound unpleasant.
艾尔的回答是，出卖他们——这听起来可能令人不快。
But it turns out this is one of the oldest tricks we've got.
但事实证明这是我们拥有的最古老的技巧之一。
During the Civil War, we had an income tax on the rich for a while.
内战期间，我们曾一度对富人征收所得税。
And the government made it so that you could see exactly how much everyone was paying.
政府这样做是为了让你可以准确地看到每个人支付了多少钱。
The idea was that neighbors could rat out the guy next door if he lived on a big estate and didn't seem to be paying much.
这个想法是，如果隔壁的人住在一个大庄园里，而且似乎没有付太多钱，邻居们就可以出卖他。
Squealing was the original form of tax enforcement.
尖叫是税收执法的最初形式。
The IRS today has a whistleblower program where they reward people for turning in big fish.
美国国税局如今有一个举报人计划，奖励那些举报大鱼的人。
Last year, the program paid out $53 million in awards.
去年，该计划支付了 5300 万美元的奖金。
For smaller squeals, you can print out that form, fill it out, and mail it in.
对于较小的尖叫声，您可以打印该表格，填写后邮寄。
Or there's TaxSqueal.com.
或者有 TaxSqueal.com。
This goes.
这样就可以了。
Let's see what's come in recently.
让我们看看最近有什么。
Al reads through some of the stuff he's gotten through his website.
艾尔仔细阅读了他通过网站获得的一些内容。
There's someone squealing on jai alai gamblers in Florida.
有人在佛罗里达州对回力球赌徒大喊大叫。
There's a retired sheriff ratting out a hair salon.
有一位退休警长正在出租一家发廊。
There's one angry one in all caps, and a woman saying her ex-husband is claiming the kids as dependents when she's supposed to be.
其中一个全大写的愤怒的，一位女士说她的前夫在她应该是的时候却声称孩子们是受抚养人。
Actually, Al says there are a lot of exes-- ex-wives, ex-friends, ex-employees.
事实上，艾尔说有很多前任——前妻、前朋友、前雇员。
Dr. So-and-so had a dental office installed in the farm in Ohio and would routinely work on Amish and Mennonite patients on the weekends and off days.
某某医生在俄亥俄州的农场设立了一家牙科诊所，通常会在周末和休息日为阿米什人和门诺派患者服务。
And those patients paid fully in cash.
这些病人全部用现金支付。
He would then not include those transactions as part of the regular business income.
然后，他不会将这些交易纳入正常业务收入的一部分。
He would also trade and barter for services and not share those with his staff, who was paid on commission.
他还通过贸易和易货贸易来换取服务，而不是与他的员工分享这些服务，而他的员工是按佣金支付的。
Al doesn't check the validity of these allegations.
艾尔没有检查这些指控的有效性。
He doesn't look into them at all.
他根本不看他们。
He just prints them out and mails them in.
他只是把它们打印出来然后邮寄出去。
But if you want to pay just $2, Al does offer one extra service.
但如果您只想支付 2 美元，Al 确实提供一项额外服务。
For $2, Al will mail a little postcard to the person you've squealed on.
Al 会花 2 美元给你抱怨的人寄一张小明信片。
Postcard is yellow with big black letters that read, you've been squealed on, exclamation point.
明信片是黄色的，上面写着大黑字，你被尖叫了，感叹号。
On the back is a legal disclaimer saying, Tax Squeal is not a government entity, and explaining the Tax Squeal mission.
背面是法律免责声明，声明“Tax Squeal”不是政府实体，并解释了“Tax Squeal”的使命。
He shows one to me and producer Chana Joffe-Walt.
他向我和制片人查娜·乔菲-沃尔特展示了一张。
We have these nifty little postcards that say, you've been squealed on.
我们有这些漂亮的小明信片，上面写着“你被尖叫了”。
And this will get mailed out.
这将被邮寄出去。
[SIGH] Yes, it is.
[叹气] 是的，确实如此。
But it gives people another opportunity to get this information forward.
但这为人们提供了另一个传播此信息的机会。
And it's a way to really scare somebody who's not paying their taxes.
这是一种真正吓唬那些不缴税的人的方法。
If they haven't, that's exactly right.
如果他们没有，那是完全正确的。
If you have, then it's not an issue.
如果你有，那么这不是问题。
No, I think that would scare me even if I had paid my taxes.
不，我认为即使我已经缴纳了税款，这也会吓到我。
Maybe.
或许。
Maybe-- Chana Joffe-Walt You don't think so?
也许——Chana Joffe-Walt 你不这么认为吗？
You don't think people-- anybody who gets that is freaked out by it, even if they're completely compliant?
你不认为人们——任何得到这个的人都会被它吓坏吗，即使他们完全顺从？
Yeah, I guess you would be frightened.
是的，我猜你会害怕。
I guess you would be frightened.
我猜你会害怕。
I don't look at it that way.
我不这么看。
But yeah, the average person would probably be frightened.
但是，是的，普通人可能会感到害怕。
I think if you've done what you should do, you don't worry about it.
我想，如果你已经做了你应该做的事情，你就不用担心了。
If you haven't, well, you have the possibility of cleaning up your act before somebody comes knocking on your door.
如果你还没有，那么，你可以在有人来敲你的门之前改正自己的行为。
Honestly, I was conflicted about all this.
老实说，我对这一切都很矛盾。
It felt kind of wrong, but I can't say why.
感觉有点不对劲，但又说不出为什么。
Maybe it's that if you turn someone in, you worry that bad things are going to happen to them.
也许如果你举报某人，你会担心他们会遇到不好的事情。
One time I was in this little corner grocery store, and I saw this woman shoplifting.
有一次我在街角的一家小杂货店里，看到一个女人在商店行窃。
And I went back and forth about whether I should say something.
我反复考虑是否应该说些什么。
In the end, I did.
最后，我做到了。
But my heart was pounding.
但我的心却在狂跳。
And as I left I heard the store owner confronting her, and I just felt awful.
当我离开时，我听到店主与她对峙，我感觉很糟糕。
Squealing-- it doesn't feel like something to be proud of.
尖叫——感觉不是什么值得骄傲的事情。
An Al-- even Al-- he's got complicated feelings about it.
作为一个阿尔——甚至是阿尔——他对此有着复杂的感受。
If you feel strongly enough about a certain situation, I think you should report it.
如果你对某种情况有足够强烈的感觉，我认为你应该报告它。
It's as simple as that.
就这么简单。
My own personal belief-- would I do it?
我个人的信念——我会这么做吗？
No.
不。
I would be-- no, I wouldn't do it.
我会——不，我不会这么做。
I just wouldn't do it, because I don't think-- I just wouldn't do it.
我只是不会这样做，因为我不认为——我只是不会这样做。
Why?
为什么？
Al Drucker It's just not my nature to do those kind of thing.
艾尔·德鲁克：做这种事不是我的本性。
Because it feels wrong to you to turn them in?
因为你觉得交出它们是不对的？
No, it's just not something I would do.
不，这不是我会做的事情。
It's not wrong or right.
这没有对错。
No, it's got to be right.
不，它必须是正确的。
It's got to be right to turn them in if they're doing something wrong.
如果他们做错了事，举报他们一定是正确的。
It really depends.
这确实取决于。
It depends on the situation.
这取决于具体情况。
I would have to be directly affected before I would do something like that.
在我做这样的事情之前，我必须受到直接影响。
I wouldn't do it.
我不会这么做。
I'd sooner approach the person before I did this.
在我这样做之前，我最好先接近这个人。
The anonymous feature makes it very suspect.
匿名的特性让人非常怀疑。
You're allowing people to do this thing that you yourself wouldn't do.
你允许人们做你自己不会做的事情。
I'm giving the ability to do it.
我正在赋予这样做的能力。
Doesn't mean I choose to do it, right?
并不意味着我选择这样做，对吗？
Al's Tax Squeal business is not going as well as he'd hoped.
艾尔的税务尖叫生意进展并不如他所希望的那样。
The tax attorneys he thought would pay to advertise on the website?
他认为税务律师会花钱在网站上做广告？
They didn't really materialize.
他们并没有真正实现。
And that $2 "you've been squealed on" postcard service?
还有那个 2 美元的“你被尖叫了”明信片服务吗？
Most people don't do it.
大多数人不这样做。
Most people, it turns out, are like Al.
事实证明，大多数人都像阿尔一样。
They don't want to squeal.
他们不想尖叫。
Sure, there are lots of vindictive ex-employees and ex-spouses out there eager to squeal, just maybe not enough to support a business.
当然，有很多怀恨在心的前雇员和前配偶渴望尖叫，只是可能不足以支持企业。
Al says the postage alone is killing him.
艾尔说光是邮费就让他丧命了。
David Kestenbaum.
大卫·凯斯滕鲍姆。
Normally you can hear him on NPR's Planet Money.
通常你可以在 NPR 的 Planet Money 节目中听到他的声音。
Their absolutely free, deeply informative and entertaining podcast is at npr.org/money.
他们的播客完全免费，内容丰富且有趣，位于 npr.org/money。
Our show was produced today by Chana Joffe-Walt with Alex Blumberg, Ben Calhoun, Sean Cole, Stephanie Foo, Sarah Koenig, Miki Meek, Jonathan Menjivar, Brian Reed, Robyn Semien, Alissa Shipp, and Nancy Updike.
今天我们的节目由 Chana Joffe-Walt 与 Alex Blumberg、Ben Calhoun、Sean Cole、Stephanie Foo、Sarah Koenig、Miki Meek、Jonathan Menjivar、Brian Reed、Robyn Semien、Alissa Shipp 和 Nancy Updike 共同制作。
Our senior producer is Julie Snyder.
我们的高级制片人是朱莉·斯奈德。
Production help from Alison Davis.
艾莉森·戴维斯提供制作帮助。
Seth Lind is our operations director.
塞思·林德 (Seth Lind) 是我们的运营总监。
Emily Condon is our production manager.
艾米丽·康登 (Emily Condon) 是我们的生产经理。
Elise Bergerson is our administrative assistant.
埃莉斯·伯格森是我们的行政助理。
Adrianne Mathiowetz runs our website.
阿德琳娜·马修韦茨 (Adrianne Mathiowetz) 负责运营我们的网站。
Research help from Michelle Harris and Julie Beer.
米歇尔·哈里斯和朱莉·比尔的研究帮助。
Music help from Damien Graef.
达米安·格雷夫 (Damien Graef) 的音乐帮助。
Special thanks to doctors Jane DeLima Thomas, Charles DeCarli, Jimo Borjigin, and Lisa Sanders.
特别感谢 Jane DeLima Thomas、Charles DeCarli、Jimo Borjigin 和 Lisa Sanders 医生。
Thanks also to Bo Burnham.
还要感谢博·伯纳姆。
And thanks especially to the staff of the Kaplan House and Care Dimensions, to the patients and family members who spoke with us.
特别感谢 Kaplan House 和 Care Dimensions 的工作人员，感谢与我们交谈的患者和家属。
Thanks to the Churchill School in New York and the Lucile Packard Children's Hospital in Palo Alto, where we interviewed kids about puberty.
感谢纽约的丘吉尔学校和帕洛阿尔托的露西尔·帕卡德儿童医院，我们在那里采访了孩子们有关青春期的问题。
Our website, ThisAmericanLife.org.
我们的网站 ThisAmericanLife.org。
This American Life is distributed by Public Radio International.
《美国生活》由国际公共广播电台发行。
Thanks, as always, to our program's co-founder, Mr. Torey Malatia.
一如既往地感谢我们项目的联合创始人 Torey Malatia 先生。
He just joined a new health club, and they have a sauna.
他刚刚加入了一个新的健身俱乐部，他们有桑拿浴室。
And he cannot shut up about how great it's going to be when I join.
他无法掩饰我加入后将会有多么美好。
You're going to smell more bad.
你的气味会更难闻。
You're going to sweat.
你会出汗的。
Sweating more, a lot more.
出汗更多，更多。
Chest hair.
胸毛。
Chest hair.
胸毛。
Janah Boccio OK.
贾纳·博西奥 好的。
Getting really smelly.
真的越来越臭了
Janah Boccio Chest hair.
Janah Boccio 胸毛。
Sweating like a moose.
像驼鹿一样出汗。
Ira Glass I'm Ira Glass.
艾拉·格拉斯 我是艾拉·格拉斯。
Back next week with more stories of This American Life.
下周我们将带来更多《美国生活》的故事。
This American Life is produced in collaboration with WBEZ Chicago and delivered to stations by PRX The Public Radio Exchange.
《This American Life》与 WBEZ Chicago 合作制作，并由 PRX 公共广播电台传送到各电台。