今天分享的书是《当呼吸化为空气》，后台回复「空气」就可以获取双语版本。
感觉应该是最长的一篇推文了。
When Breath Becomes Air 英语名字来自一首诗：
You that seek what life is in death,
Now find it air that once was breath.
New names unknown, old names gone:
Till time end bodies, but souls none.
Reader! then make time, while you be,
But steps to your eternity.
—Baron Brooke Fulke Greville, “Caelica 83”
翻译成中文是：
你在死亡中探究生命的意义，
你见证生前的呼吸化作死后的空气。
新人尚不可知，故旧早已逝。
躯体有尽时，灵魂无绝期。
读者啊，趁生之欢愉，快与时间同行，
共赴永恒生命！
生命转瞬即逝，你生前无时无刻的呼吸死后也只是成为空气。不要消极，这会让我们更应抓住现有的时间创造更多的价值，而不仅仅只留下空气。
I FLIPPED THROUGH THE CT scan images, the diagnosis obvious: the lungs were matted with innumerable tumors, the spine deformed, a full lobe of the liver obliterated. Cancer, widely disseminated. I was a neurosurgical resident entering my final year of training. Over the last six years, I’d examined scores of such scans, on the off chance that some procedure might benefit the patient. But this scan was different: it was my own.
📖
be matted with
matted hair or fur is twisted or stuck together in a thick mass
Her hair was matted with blood.
她的头发沾着血，粘在了一起。
innumerable = countless
不可胜数的
She's served on innumerable committees.
她担任过无数委员会的委员。
deformed
something that is deformed has the wrong shape, especially because it has grown or developed wrongly〔尤因指发育、生长不良而〕畸形的
obliterate
to remove all signs of sth, either by destroying or covering it completely 毁掉；覆盖；清除
disseminate
to spread information, knowledge, etc. so that it reaches many people 散布，传播（信息、知识等）
neurosurgical
神经外科的
on the off chance (that)
because of the possibility of sth happening, although it is unlikely
抱（一线）希望；碰碰运气
I wasn’t in the radiology suite, wearing my scrubs and white coat. I was dressed in a patient’s gown, tethered to an IV pole, using the computer the nurse had left in my hospital room, with my wife, Lucy, an internist, at my side. I went through each sequence again: the lung window, the bone window, the liver window, scrolling from top to bottom, then left to right, then front to back, just as I had been trained to do, as if I might find something that would change the diagnosis.
✏️
📖
radiology
the study and use of different types of radiation in medicine, for example to treat diseases
放射学；放射医疗
scrub
手术服（英语：Scrubs）是一种医疗人员穿着的服装，最初被使用于外科手术房内，但因为其便于更换清洗、不妨碍护理行为的特点，让越来越多的医院采用手术服为标准医疗人员服装（包括取代护士服）。
甚至连医院外的医疗相关产业人员（兽医、助产士等）也开始使用手术服。 手术服的特点是设计极为简单，尽量降低藏污纳垢的可能性，几乎没有任何金属配件（拉链、钮扣）以避免拉扯，易于清洗且造价便宜，可于受到严重污染时直接丢弃替换。在英国，手术服也被戏称为手术室蓝（Theatre Blues）。
我记得scrub是看外刊写下架赵薇作品，因为scrub的动词本意是擦除嘛，等于抹去某人的印记。
tether
1、~ sth (to sth) to tie an animal to a post so that it cannot move very far 拴（牲畜）to use a smartphone to connect a computer to the Internet 共享网络（利用智能手机的数据连线供电脑等接入互联网）
We lay together on the hospital bed.
Lucy, quietly, as if reading from a script: “Do you think there’s any possibility that it’s something else?”
“No,” I said.
We held each other tightly, like young lovers. In the past year we’d both suspected, but refused to believe, or even discuss, that a cancer was growing inside me.
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1、像是在念台词 as if reading from a script
你看，为什么要加from。script意思有电影剧本 （ the written form of a speech, play, film etc）
Lucy只说了一句话，当然不是整个剧本啦。
2、怀疑得了癌症 a cancer was growing inside me 这里比 diagnosed with更直接了。
About six months before, I had started losing weight and having ferocious back pain. When I dressed in the morning, my belt cinched one, then two notches tighter. I went to see my primary care doctor, an old classmate from Stanford. Her sister had died suddenly as a neurosurgery intern, after contracting a virulent infection, and so she’d taken a maternal watch on my health. When I arrived, however, I found a different doctor in her office—my classmate was on maternity leave.
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lose weight 体重减轻；瘦了
ferocious 凶猛的，可怕的；猛烈的; 使人不舒服的；感情强烈的
cinch 给…系
notch （表面或边缘的）V 形刻痕，圆形切口
She tightened her belt an extra notch.
她将腰带又束紧了一格。
primary care doctor 主治医师
neurosurgery 神经外科（学）
contract 感染，患病
virulent（ 毒物）剧毒的;〔疾病〕恶性的，致命的；充满仇恨的，刻毒的，恶毒的〔含贬义〕
maternal 母性的; 慈母似的;母亲一方的;母系的
take a maternal watch on 格外关注，像我妈一样（自己造句的时候可以把maternal换成其他形容词哦）
on maternity leave 休产假
Dressed in a thin blue gown on a cold examining table, I described the symptoms to her. “Of course,” I said, “if this were a boards exam question —thirty-five-year-old with unexplained weight loss and new-onset back pain—the obvious answer would be (C) cancer. But maybe it’s just that I’m working too hard. I don’t know. I’d like to get an MRI to be sure.”
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thin blue gown （thin瘦瘦的，用来形容衣服？就是薄薄的
She's only wearing a thin summer jacket (=a jacket made of light material) .
她只穿了一件薄薄的夏季短上衣。
boards exam question 医生资格考试
new-onset 初发性的
MRI magnetic resonance imaging 磁共振成像
“I think we should get X-rays first,” she said. MRIs for back pain are expensive, and unnecessary imaging had lately become a major national point of cost-saving emphasis. But the value of a scan also depends on what you are looking for: X-rays are largely useless for cancer. Still, for many docs, ordering an MRI at this early stage is apostasy. She continued: “X- rays aren’t perfectly sensitive, but it makes sense to start there.
句型：
…… unnecessary imaging had lately become a major national point of cost-saving emphasis.
全国上下都在强调，为了节省医疗成本，不要做这种不必要的检查。
◻️ 造句
写作文的时候可以用到诶！我自己造句，介绍为什么政府限制未成年上网游戏时间。
A stringent social intervention has lately become a major national point of mental health-protecting emphasis.
全国上下都在强调，为了保护未成年人心理健康，应当采取严格的社会干预措施。
“How about we get flexion-extension X-rays, then—maybe the more realistic diagnosis here is isthmic spondylolisthesis?”
From the reflection in the wall mirror, I could see her googling it.
“It’s a pars fracture affecting up to five percent of people and a frequent cause of back pain in the young.”
“Okay, I’ll order them, then.”
“Thanks,” I said.
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reflection 〔反射出来的〕影像; 倒影
pars fracture 稱椎弓骨折
affecting up to 受影响人数
VOA
But the ice is melting. Scientists say if that continues at current levels, two-thirds of the plateau's glaciers will likely be gone by 2050, affecting up to 2 billion people in China, India, Pakistan, Bangladesh and Bhutan.
但这里正在融化。科学家认为如果这样的情况继续发展，到2050年，三分之二的高原冰川将有可能融化，受影响人数将达到20亿人，面积涵盖中国、印度、孟加拉以及不丹。
Why was I so authoritative in a surgeon’s coat but so meek in a patient's gown? The truth was, I knew more about back pain than she did— half of my training as a neurosurgeon had involved disorders of the spine. But maybe a spondy was more likely. It did affect a significant percent of young adults—and cancer in the spine in your thirties? The odds of that couldn’t be more than one in ten thousand. Even if it were one hundred times more common than that, it’d still be less common than a spondy. Maybe I was just freaking myself out.
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authoritative 权威性的，可信的，可靠的；威严的
surgeon 外科医生
meek 温顺的，驯服的
spondy 脊柱炎
✏️
学一个表达「自己吓自己」 freak oneself out
freak out 看美剧的小伙伴最熟悉的短语了，吓坏了，激动啦，抓狂啦，都可以用到它。
Oh, Boy, Sheldon's going to freak out.
哦，老天，谢尔顿会兴奋死的。
The X-rays looked fine. We chalked the symptoms up to hard work and an aging body, scheduled a follow-up appointment, and I went back to finish my last case of the day. The weight loss slowed, and the back pain became tolerable. A healthy dose of ibuprofen got me through the day, and after all, there weren’t that many of these grueling, fourteen-hour days left. My journey from medical student to professor of neurosurgery was almost complete: after ten years of relentless training, I was determined to persevere for the next fifteen months, until residency ended. I had earned the respect of my seniors, won prestigious national awards, and was fielding job offers from several major universities. My program director at Stanford had recently sat me down and said, “Paul, I think you’ll be the number one candidate for any job you apply for. Just as an FYI: we’ll be starting a faculty search for someone like you here. No promises, of course, but it’s something you should consider.”
✏️ 学一个表达「chalk sth up to」，我本来不知道这个是什么意思，但你看后面跟的是辛苦工作和变老的身体，可以得出指的是生病的原因。那「chalk sth up to」就可以翻译成 「归咎于」。
牛津给出的解释是「 to consider that sth is caused by sth」 把某事归因于。
We can chalk that win up to a lot of luck.
我们可以把那次胜利归因于好运十足。
你看，读不懂的时候不一定非要查字典！
✏️……until residency ended residency 特指 a period of time when a doctor receives special training in a particular type of medicine, especially at a hospital 专科住院医生实习期
✏️ sit me down 这里如果翻译成让我坐下，我的天也太中式英语了，让作者坐下是为了和他谈话呀，就可以翻译成他找我谈了一次。
At age thirty-six, I had reached the mountaintop; I could see the Promised Land, from Gilead to Jericho to the Mediterranean Sea. I could see a nice catamaran on that sea that Lucy, our hypothetical children, and I would take out on weekends. I could see the tension in my back unwinding as my work schedule eased and life became more manageable. I could see myself finally becoming the husband I’d promised to be.
✏️
两个词 mountaintop 和 the Promised Land
不用查字典就会知道mountaintop是山顶，可翻译的时候能说是山顶吗？这里指的是人生巅峰。
the Promised Land 是特指哦！
a place or situation where you expect to be happy, safe, etc. 福地；乐土；安乐境界
（《圣经》中上帝赐给亚伯拉罕及其族人的土地）
figurative America was the Promised Land for many immigrant families.
对许多移民家庭来说，美国是希望之乡。
Then, a few weeks later, I began having bouts of severe chest pain. Had I bumped into something at work? Cracked a rib somehow? Some nights, I’d wake up on soaked sheets, dripping sweat. My weight began dropping again, more rapidly now, from 175 to 145 pounds. I developed a persistent cough. Little doubt remained. One Saturday afternoon, Lucy and I were lying in the sun in Dolores Park in San Francisco, waiting to meet her sister. She glimpsed my phone screen, which displayed medical database search results: “frequency of cancers in thirty- to forty-year-olds.”
✏️
having bouts of severe chest pain
bouts 一阵一阵的疾病发作就是它了：
He suffered occasional bouts of depression.
他有时会犯抑郁症
但不一定是病发作，突然想狂喝酒也可以：
a drinking bout
狂饮一通
另外，从实体到抽象，它还形容▼
~ of sth/of doing sth
the latest bout of inflation
最近一波通货膨胀
Little doubt remained.
没啥疑问了。
哎，这句话好难受啊，这样的癌症基本上就等于被判死刑。
“What?” she said. “I didn’t realize you were actually worried about this.”
I didn’t respond. I didn’t know what to say.
“Do you want to tell me about it?” she asked.
She was upset because she had been worried about it, too. She was upset because I wasn’t talking to her about it. She was upset because I’d promised her one life, and given her another.
“Can you please tell me why you aren’t confiding in me?” she asked.
I turned off my phone. “Let’s get some ice cream,” I said.
✏️
许诺的是一件事，给她的，又是一回事。
I'd promised her one life, and given her another.
confide 的意思是袒露隐私，那注意和谁吐露隐私，这里搭配的介词是in哦
confide in sb
I've never felt able to confide in my sister.
我从来都觉得无法对姐姐吐露心中的秘密。
We were scheduled for a vacation the following week to visit some old college friends in New York. Maybe a good night’s sleep and a few cocktails would help us reconnect a bit and decompress the pressure cooker of our marriage.
✏️ help us reconnect a bit // reconnect 本意是「重新接通;重新提供」，人与人之间呢！就是指恢复感情吧。
✏️ decompress the pressure cooker of our marriage // decompress 使减压，减少…的气压 // pressure cooker ① 压力锅，高压锅 ② 压力大的局面（地方）: the pressure cooker of soccer management 足球经营管理的巨大压力
所以，又学到一个表示巨大压力的短语：pressure cooker
那这里是直译成给婚姻的“高压锅”降压，还是给婚姻的巨大压力降压呀！还是第一个好，虽然直译，但很生动！不过我应该发翻译成「给高压的婚姻降降压」
But Lucy had another plan. “I’m not coming to New York with you,” she announced a few days before the trip. She was going to move out for a week; she wanted time to consider the state of our marriage. She spoke in even tones, which only heightened the vertigo I felt.
✏️ in even tones // even 心平气和的;平静的（多用在文学类）
My voice surprised me; it was even and emotionless. 我的声音听起来心平气和、不露一丝感情，这让我自己颇感惊讶。
✏️ vertigo （从高处俯视时感到的）眩晕，头晕目眩
“What?” I said. “No.”
“I love you so much, which is why this is so confusing,” she said. “But I’m worried we want different things from our relationship. I feel like we’re connected halfway. I don’t want to learn about your worries by accident. When I talk to you about feeling isolated, you don't seem to think it’s a problem. I need to do something different.”
“Things are going to be okay,” I said. “It’s just residency.”
✏️ 表示渐行渐远，心意不再相通「I feel like we’re connected halfway.」很多人啊，走着走着就散了。
halfway 时间到一半;事情进行到中途 既然遇到了就学一个halfway的各种实用例子：
① adj. 〔空间或时间的〕中间（的），半途（的）;
They've just reached the halfway stage of the project.
他们刚刚完成这个项目的一半。
② 短语 be halfway there 成功了一半
Establish the right relationships at work and you're halfway there.
在工作中建立恰当的人际关系，你就成功了一半
③ be / come / go halfway to doing sth 完成某事的一半（⚠️ 这里的to 是介词，后面搭配动名词）
We're still only halfway to finishing the job.
我们离完成工作还有一半的进程呢。
④ halfway decent / normal / successful etc 可以用 reasonably替换 // 还没成功才到一半，就只能是「还好」吧。
reasonably good, normal, successful etc
还算体面/正常/成功等:
the only halfway decent hotel here
这里唯一一家还算体面的旅馆
拓展：渐行渐远的英语表达
push further apart、 drift apart、 far apart
① I know, that just pushes them further and further apart. 我知道，这样只会使他们渐行渐远。 《我们这一天 第一季》
② I've noticed our diner family is drifting apart. 餐厅小家庭成员最近渐行渐远。《破产姐妹》
③ Negotiations continue, but the two sides seemed far apart. 谈判仍在进行中，但双方似乎渐行渐远。
Were things really so bad? Neurosurgical training, among the most rigorous and demanding of all medical specialties, had surely put a strain on our marriage. There were so many nights when I came home late from work, after Lucy had gone to bed, and collapsed on the living room floor, exhausted, and so many mornings when I left for work in the early dark, before she’d awoken. But our careers were peaking now—most universities wanted both of us: me in neurosurgery, Lucy in internal medicine. We’d survived the most difficult part of our journey. Hadn’t we discussed this a dozen times? Didn’t she realize this was the worst possible time for her to blow things up? Didn’t she see that I had only one year left in residency, that I loved her, that we were so close to the life together we’d always wanted?
✏️
demanding 要求高的; 需要技能的; 费力的: （搭配不同的副词 就有不同的生动表达 比如 physically demanding 就是 要求体能）
put a strain on 给……造成压力 （翻译成让婚礼亮起红灯比较地道）奇奇怪怪的是，我在搜例句的说话，发现很多给出的例句都是让婚姻紧张，看吧，婚姻❌ 来个其他的🌰
They probably put a little extra strain on women in the workplace.
人们可能给职场妈妈压力大了点。
collapse 倒下了，崩溃了，〔尤指因精疲力竭或想放松而〕瘫坐:
I was so exhausted when I got home, I just collapsed on the sofa.
我到家时已经筋疲力尽，一屁股瘫坐在沙发上。
blow things up 本意是爆炸，也形容搞砸事情。
Yes, well, she does have a way of blowing things up.
她确实总有办法把事情搞砸。
我大概整理了这些搞砸的英语表达，看美剧常看到：
screw up
mess up
fuck up （最好不用！）
“If it were just residency, I could make it,” she said. “We’ve made it this far. But the problem is, what if it’s not just residency? Do you really think things will be better when you’re an academic neurosurgery attending?”
I offered to skip the trip, to be more open, to see the couples therapist Lucy had suggested a few months ago, but she insisted that she needed time —alone. At that point, the fuzziness of the confusion dissipated, leaving only a hard edge. Fine, I said. If she decided to leave, then I would assume the relationship was over. If it turned out that I had cancer, I wouldn’t tell her—she’d be free to live whatever life she chose.
At that point, the fuzziness of the confusion dissipated, leaving only a hard edge.
你有没有感受过突然有个瞬间，大脑一片空白！估计就是这种感觉吧！
dissipate
to gradually become or make sth become weaker until it disappears （使）消散，消失；驱散
Eventually, his anger dissipated.
他的愤怒终于平息了。
Her laughter soon dissipated the tension in the air.
她的笑声很快消除了紧张气氛。
[T] ~ sth to waste sth, such as time or money, especially by not planning the best way of using it 挥霍，浪费，消磨（时间、金钱等） SYN squander （squander sth on sth）
Before leaving for New York, I snuck in a few medical appointments to rule out some common cancers in the young. (Testicular? No. Melanoma? No. Leukemia? No.) The neurosurgical service was busy, as always. Thursday night slipped into Friday morning as I was caught in the operating room for thirty-six hours straight, in a series of deeply complex cases: giant aneurysms, intracerebral arterial bypasses, arteriovenous malformations. I breathed a silent thanks when the attending came in, allowing me a few minutes to ease my back against a wall. The only time to get a chest X-ray was as I was leaving the hospital, on the way home before heading to the airport. I figured either I had cancer, in which case this might be the last time I would see my friends, or I didn’t, in which case there was no reason to cancel the trip.
✏️
snuck in a few medical appointments
snuck是sneak 的过去式和过去分词 ⚠️sneak 过去式通常为 sneaked，但在美式英语非正式的口语中，现在普遍用 snuck，在英式英语中也有人用 snuck。不过，许多人认为这不正确，不应在正式书面语中使用。
生动的表达「偷偷看医生」
① sneak不仅仅形容偷偷溜走，还形容偷偷看一眼：
If the gate is open, you can sneak a peek at the gardens.
如果大门开着，你可以偷瞥一眼花园。
② 对了！还形容告发！！记住！介词是 on！！sneak on sb
〔向家长、老师等〕告发，打…的小报告:
A little brat named Oliver sneaked on me.
一个叫奥利弗的小家伙告了我的状。
③ 怎么说呢，sneak真是个鬼鬼祟祟的词啊！
[+ on / behind etc ]
I wish you wouldn't sneak up on me like that!
你不要这样偷偷摸摸地走过来好不好！
I rushed home to grab my bags. Lucy drove me to the airport and told me she had scheduled us into couples therapy.
From the gate, I sent her a text message: “I wish you were here.”
A few minutes later, the response came back: “I love you. I will be here when you get back.”
✏️ grab my bags 把bag 翻译成回去拿包就好笑了哈！
行李袋子多，一般就是这个就是表示拿行李：
I just have to go back to your place and grab my bags.
我得到你家去收拾行李。
My back stiffened terribly during the flight, and by the time I made it to Grand Central to catch a train to my friends’ place upstate, my body was rippling with pain. Over the past few months, I’d had back spasms of varying ferocity, from simple ignorable pain, to pain that made me forsake speech to grind my teeth, to pain so severe I curled up on the floor, screaming. This pain was toward the more severe end of the spectrum. I lay down on a hard bench in the waiting area, feeling my back muscles contort, breathing to control the pain—the ibuprofen wasn’t touching this—and naming each muscle as it spasmed to stave off tears: erector spinae, rhomboid, latissimus, piriformis...
✏️
看到描述都感觉痛。
stiffen 〔身体〕变僵直，绷紧; OPP relax
He touched her, and she stiffened.
他碰了她一下，她身体绷得紧紧的。
my body was rippling with pain
ripple [I] + adv./prep.(of a feeling, etc. 感觉等) to spread through a person or a group of people like a wave 扩散；涌起A gasp rippled through the crowd. 人群中传出一片惊诧之声。
生死之外无大事。
A security guard approached. “Sir, you can’t lie down here.”
“I’m sorry,” I said, gasping out the words. “Bad...back...spasms.”
“You still can’t lie down here.”I’m sorry, but I’m dying from cancer.
security guard 保安人员
gasping out 气喘吁吁地说
The words lingered on my tongue—but what if I wasn’t? Maybe this was just what people with back pain live with. I knew a lot about back pain —its anatomy, its physiology, the different words patients used to describe different kinds of pain—but I didn’t know what it felt like. Maybe that’s all this was. Maybe. Or maybe I didn’t want the jinx. Maybe I just didn’t want to say the word cancer out loud.
The words lingered on my tongue…… 话到了嘴边
Meanwhile, the dispute over gays lingers on.
同时，关于同性恋问题的争议一直不断。
His eyes lingered on his picture.
他的目光仍然滞留在自己的画上。
I pulled myself up and hobbled to the platform.
pull myself up 形容慢慢的把自己拉起来
I gradually pulled myself up and got to the side of the road.
我慢慢把自己挪到路边。
hobble
①
[I] (+ adv./prep.) to walk with difficulty, especially because your feet or legs hurt 蹒跚；跛行
The old man hobbled across the road.
老人一瘸一拐地穿过马路。
②
[T] ~ sth to tie together two legs of a horse or other animal in order to stop it from running away 捆绑（马等的）两腿（以防其走失）
③
[T] ~ sth to make it more difficult for sb to do sth or for sth to happen 阻止；妨碍
走得慢，别人当然会嫌弃你「妨碍」到他了！
It was late afternoon when I reached the house in Cold Spring, fifty miles north of Manhattan on the Hudson River, and was greeted by a dozen of my closest friends from years past, their cheers of welcome mixed with the cacophony of young, happy children. Hugs ensued, and an ice-cold dark and stormy made its way to my hand.
cacophony
刺耳嘈杂的声音:
▪ [+ of ]
a cacophony of car horns
汽车喇叭嘈杂的嘟嘟声
Hugs ensued, and an ice-cold dark and stormy made its way to my hand.
ensue
继而发生; 因而发生:
▪ [+ from ]
problems that ensue from food and medical shortages
因食品和药品短缺而引起的问题
真的，永远永远不要往后看往下看。
往前看，往上看，哪怕黑暗，也有希望。
活着，就是希望。
