多年前我就发现，达尔文和尼采有一个观点是一致的：生物体最重要的特征就是奋斗求生。没有奋斗的人生，就像一幅画里身上没有条纹的老虎。多年来与死亡并肩而行的经历，让我更深刻地懂得，最轻易的死亡有时候并非最好的结局。我们就此事进行了长谈。家人也表示支持，并给予祝福。我们决定要孩子。我们要继续活着，而不是等死。
Years ago, it had occurred to me that Darwin and Nietzsche agreed on one thing: the defining characteristic of the organism is striving. Describing life otherwise was like painting a tiger without stripes. After so many years of living with death, I’d come to understand that the easiest death wasn’t necessarily the best. We talked it over. Our families gave their blessing. We decided to have a child. We would carry on living, instead of dying.
由于我在吃药，借助外力来怀孕看来是唯一的选择。我们去找了帕洛阿尔托一家生殖内分泌诊所的专家。她雷厉风行，非常专业，但显然，她之前接触的大都是不孕不育的病人，对于我这种时日无多的绝症患者，还很缺乏经验。她给我们说了一连串相关的东西，眼睛一直盯着笔记本：
Because of the medications I was on, assisted reproduction appeared to be the only route forward. So we visited a specialist at a reproductive endocrinology clinic in Palo Alto. She was efficient and professional, but her lack of experience dealing with terminally ill, as opposed to infertile, patients was obvious. She plowed through her spiel, eyes on her clipboard:
“你俩试了多久了？”
“How long have you been trying?”
“这个嘛，我们还没试呢。”
“Well, we haven’t yet.”
“哦，对。当然。”
“Oh, right. Of course.”
最后她问道：“根据你的……呃……情况，我猜你们应该想快点怀孕吧？”
Finally she asked, “Given your, uh, situation, I assume you want to get pregnant fast?”
“是的，”露西说，“我们想马上开始。”
“Yes,” Lucy said. “We’d like to start right away.”
“那我建议你们先尝试一下试管婴儿。”她说。
“I’d suggest you begin with IVF, then,” she said.
我说，我们想尽量减少培养和破坏的胚胎数量。专家看上去满脸疑惑。大多数来这儿的人都是怎么方便怎么来。但我下定决心，一定不能在我死后让露西面对好多胚胎，不知如何是好。那是我俩共享的基因组，也是我留存在世界上最后的遗物，封存在某个地方的冰柜里，要毁灭掉太痛苦，又不能把它们变成真正的人——毕竟现在的技术有限。然而，几轮人工授精之后，很显然我们需要借助更高深的技术：我们至少需要培养几个试管胚胎，然后移植最健康的那个。其他胚胎只能自生自灭。就连一个新生命诞生的过程，死亡也占有一席之地。
When I mentioned that we’d rather minimize how many embryos were created and destroyed, she looked slightly confused. Most people who came here prized expedience above all. But I was determined to avoid the situation where, after I died, Lucy had responsibility for a half dozen embryos—the last remnants of our shared genomes, my last presence on this earth—stuck in a freezer somewhere, too painful to destroy, impossible to bring to full humanity: technological artifacts that no one knew how to relate to. But after several trials of intrauterine insemination, it was clear we needed a higher level of technology: we would need to create at least a few embryos in vitro and implant the healthiest. The others would die. Even in having children in this new life, death played its part.
治疗开始后六个星期，我去做了一次CT，看看特罗凯的疗效。等我从CT机上下来，工作人员看着我说：“医生，这本来是不合规矩的，但你如果想看看就去看吧，电脑在那边。”我把指示器上的图像上传到电脑，把自己的名字打了进去。
Six weeks after starting treatment, I was due for my first CT scan to measure the efficacy of the Tarceva. As I hopped out of the scanner, the CT tech looked at me. “Well, Doc,” he offered, “I’m not supposed to say this, but there’s a computer back there if you want to take a look.” I loaded up the images on the viewer, typing in my own name.
长痤疮是令人安心的好现象。我的肢体力量也有所恢复，尽管背痛依然剧烈，疲乏感还是不断袭来。我坐在那儿，回想艾玛说的话，不管肿瘤生长情况如何，只要是比较小规模的生长，都算是治疗有效果。（当然，我父亲之前预言说，一切癌细胞都会消失。“你的片子上肯定什么也没有，保比！”他喊着家人对我的昵称，郑重其事地宣布。）我不断对自己重复，就算是小规模的生长，也是有疗效的，然后深呼吸一下，在屏幕上点开图像。我的肺部，之前散布着数不清的肿瘤，现在却非常清晰，只有右肺上叶有一个一厘米左右的小瘤子。看得出来，我的脊椎也开始康复。很显然，肿瘤大大减少了，实在令人始料未及。
The acne was a reassuring sign. My strength had also improved, though I was still limited by back pain and fatigue. Sitting there, I reminded myself of what Emma had said: even a small amount of tumor growth, so long as it was small, would be considered a success.(My father, of course, had predicted that all the cancer would be gone. “Your scan will be clear, Pubby!” he’d declared, using my family nickname.) I repeated to myself that even small growth was good news, took a breath, and clicked. The images materialized on the screen. My lungs, speckled with innumerable tumors before, were clear except for a one-centimeter nodule in the right upper lobe. I could make out my spine beginning to heal. There had been a clear, dramatic reduction in tumor burden.
我大大松了一口气。
Relief washed over me.
